Background: In recent years, platelet-rich plasma (PRP) injections for osteoarthritis (OA) have been widely promoted in clinical practice, but their effectiveness is controversial. Therefore, we conducted a meta-analysis of relevant randomized controlled trials (RCTs) to determine the efficacy and safety of PRP injections for the treatment of OA.Methods: We searched databases including Embase, Web of Science, Medline, PubMed, and the Cochrane Library for relevant studies. Two researchers (YQX and CG) performed literature screening, baseline data extraction, literature quality assessment, and heterogeneity analysis of RCTs from the retrieved studies. Based on the magnitude of heterogeneity I², random-effects or fixed-effects models were selected for the meta-analysis.Results: We included 24 RCTs comprising 1344 patients with OA who met the inclusion criteria, with the main types of morbidity being knee osteoarthritis (KOA), hip osteoarthritis (HOA), ankle osteoarthritis (AOA), and temporomandibular joint osteoarthritis (TMJOA). Our results indicate that PRP injections were effective in improving Visual Analog Scale (VAS) pain scores in patients with KOA, HOA, and AOA compared to controls (AOA, MD = −1.15, CI = 95% [−1.74, −0.56], I² = 40%, P < 0.05; KOA, MD = −1.03, CI = 95% [−1.16, −0.9], I² = 87%, P < 0.05; TMJOA, MD = −1.35, CI = 95% [−1.74, −0.97], I² = 92%, P < 0.05) but showed no significant efficacy in patients with HOA (MD = −0.27, CI = 95% [−0.8, 0.26], I² = 56%, P>0.05). Compared to controls, PRP injections were effective in improving Knee Injury and Osteoarthritis Outcome Score (KOOS), including the patient's pain symptoms, activities of daily living (ADL), and adhesion symptomatology, but not for that of sports function (KOOS-pain, MD = 2.77, CI = 95% [0, 5.53], I² = 0%, P < 0.05; KOOS-symptoms, MD = 3.73, CI = 95% [0.76, 6.71], I² = 0%, P < 0.05; KOOS-ADL, MD = 3.61, CI = 95% [0.79, 6.43], I² = 0%, P < 0.05; KOOS-QOL, MD = 4.66, CI = 95% [0.98, 8.35], I² = 29%, P < 0.05, KOOS-sport, MD = 0.48, CI = 95% [−3.02, 3.98], I² = 0%, P > 0.05). PRP injections were effective in improving Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, including pain, stiffness, and functional joint motion, in patients with OA compared with the control group (WOMAC-pain, MD = −1.08, CI = 95% [−1.62, −0.53], I² = 87%, P < 0.05; WOMAC-stiffness, MD = −1.17, CI = 88% [−1.72, −0.63], I² = 87%, P < 0.05; WOMAC-function, MD = −1.12, CI = 95% [−1.65, −0.58], I² = 87%, P < 0.05). In addition, subgroup analysis showed that leukocyte-poor (LP) PRP injections were more effective than leukocyte-rich (LR) PRP injections in improving pain symptoms in patients with OA (VAS, LR-PRP, MD = −0.81, CI = 95% [−1.65, −0.03], I² = 83%, P = 0.06 > 0.05; LP-PRP, MD = −1.62, CI = 95% [−2.36, −0.88], I² = 92%, P < 0.05). A subgroup analysis based on injection sites showed that no statistical difference in efficacy between intra-articular (IA) combined with intra-osseous (IO) simultaneous PRP injections. IA PRP injections only improved VAS pain scores in patients with OA (IA+IO PRP injections, MD = −0.74, CI =95% [−1.29, −0.18], I² = 61%, P < 0.05; IA PRP injections, MD = −1.43, CI = 95% [−2.18, −0.68], I² = 87%, P < 0.05, test for subgroup differences, P > 0.05, I² = 52.7%).Conclusion: PRP injection therapy can safely and effectively improve functional activity in patients with OA and produce positive analgesic effects in patients with KOA, TMJOA, and AOA. However, PRP injection therapy did not significantly reduce pain symptoms in patients with HOA. In addition, the analgesic effect of LP-PRP was greater than that of LR-PRP.Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022362066.

Objective: This study synthesized the highest level of evidence to analyse the effectiveness and safety of using extracorporeal shock wave therapy (ESWT) to treat upper limb tendonitis, which was unknown.Design: We conducted a systematic review and meta-analysis of 18 randomized controlled trials (RCTs) in PubMed, Embase, Web of Science, Medline, and the Cochrane Library.Methods: Two researchers performed the screening, data extraction, literature quality assessment, and heterogeneity analysis of the searched RCTs.Results: The main types of morbidity included rotator cuff tendonitis, lateral epicondylitis, finger tendonitis, and long bicipital tendonitis. The results of the meta-analysis showed that ESWT was effective in relieving pain in all four types of tendonitis. In addition, ESWT was more effective in relieving pain in patients with upper limb tendonitis than placebo at the 3- and 6-month follow-ups, especially with radial ESWT (RESWT). Data analysis of the forest plot showed that the experimental group with ESWT as an intervention had a significant improvement in function in patients with rotator cuff tendonitis at the 3-month follow-up. However, subgroup analysis showed that low-energy ESWT was effective in improving function in patients with calcified and non-calcified rotator cuff tendonitis, whereas it was not effective in relieving pain.Conclusion: ESWT can effectively improve the functional activity in patients with rotator cuff tendonitis and may produce positive analgesic effects in patients with upper limb tendonitis. The incidence of adverse effects is low.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023403594, identifier: PROSPERO, CRD42023403594.

Background/objectives: Animal studies have demonstrated the ability of stem cell therapy (SCT) to treat diabetic kidney disease (DKD). However, the efficacy of SCT in patients with DKD remain unclear. This systematic review and meta-analysis aimed to investigate the efficacy of SCT in patients with DKD.Methods: A comprehensive and systematic literature search was conducted using PubMed, EMBASE, Cochrane Library, and Web of Science to identify articles on SCT for DKD published up to March 2024. RevMan V.5.4 software was used for statistical analysis.Results: We identified four studies that included 90 participants, 53 (58%) of whom underwent SCT. SCT improved estimated glomerular filtration rate (eGFR) [mean difference (MD) = 0.41, 95% confidence interval (CI): 0.08–0.74; p = 0.02], serum creatinine (SCr) reduction (standardized MD = −0.65, 95% CI: −1.19 to −0.1, p = 0.02), and microalbuminuria (MAU) (MD = −32.10, 95% CI: −55.26–8.94; p = 0.007) compared to the control group, but did not improve urine microalbumin/creatinine ratio (UACR) (MD = −63.36, 95% CI: −194.52–67.79, p = 0.56) or blood sugar (MD = 0.49, 95% CI: 4.16–2.01, p = 0.49). Adverse events (AEs) were common (67 events in 60 SCT subjects vs. 35 in 28 controls), with urinary system AEs occurring exclusively in the SCT group and nervous system AEs markedly higher.Conclusion: SCT can effectively improve eGFR and SCr levels by lowering the MAU but cannot improve UACR and blood sugar levels.

Background/Objectives: Animal studies have demonstrated the ability of stem cell therapy (SCT) to treat diabetic kidney disease (DKD). However, the safety and efficacy of SCT in patients with DKD remain unclear. This systematic review and meta-analysis aimed to investigate the safety and efficacy of SCT in patients with DKD. Methods: A comprehensive and systematic literature search was conducted using PubMed, EMBASE, Cochrane Library, and Web of Science to identify articles on SCT for DKD published up to March 2024. RevMan V.5.4 software was used for statistical analysis. Results: We identified four studies that included 90 participants, 53 (58%) of whom underwent SCT. SCT improved estimated glomerular filtration rate (eGFR) (mean difference [MD] = 0.41, 95% confidence interval [CI]: 0.08–0.74; p < 0.05), serum creatinine (SCr) reduction (standardized MD = -0.65, 95%CI: -1.19 to -0.1, p < 0.05), and microalbuminuria (MAU) (MD = -32.10, 95% CI: -55.26–8.94; p < 0.05) compared to the control group, but did not improve urine microalbumin/creatinine ratio (UACR) (MD = -63.36, 95% CI: 194.52–67.79, p = 0.56) or blood sugar (MD = 0.49, 95% CI: 4.16–2.01, p = 0.49). In addition, the incidence of adverse events was significantly high in both groups (risk ratio = 0.93; 95% CI: 0.74–1.17; p = 0.54); there was no significant difference regarding I ₂ = 0%). Conclusions: SCT can safely and effectively improve eGFR and SCr levels by lowering the MAU but cannot improve UACR and blood sugar levels.

Background: Chronic obstructive pulmonary disease (COPD) remains the leading cause of illness and death. Traditional Chinese mind-body exercises (TCMBEs), such as Tai Chi, Baduanjin, Liuzijue, and Yijin Jing, have emerged as additional treatment options for pulmonary rehabilitation (PR). This meta-analysis sought to find out the extent to which TCMBEs affect lung function, exercise capacity, and health-related quality of life (HRQoL) in patients with COPD. Methods: Five international databases (PubMed, Embase, Web of Science, Cochrane Library, and Scopus) were examined until October 2025. Twenty-two randomized controlled trials (RCTs) with 1,871 individuals fulfilled the qualifying criteria. Outcomes included forced expiratory volume in 1 s (FEV ₁ ), forced vital capacity (FVC), the FEV ₁ /FVC ratio, percent predicted FEV ₁ (FEV ₁ % predicted), six-min walk distance (6MWD), and patient-reported measures such as the St. George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), and the modified Medical Research Council (mMRC) dyspnea scale. Data were synthesized using a random-effects model, with subgroup analyses conducted according to exercise type. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Results: Compared with usual care or conventional PR, TCMBEs significantly improved FEV ₁ ( MD = 0.20 L; 95% CI 0.09–0.30), FVC ( MD = 0.22 L; 95% CI 0.06–0.38), FEV ₁ /FVC (MD = 3.42 %; 95% CI 2.54–4.29), FEV ₁ % predicted ( MD = 4.98 %; 95% CI 2.53–7.42), and 6MWD ( MD = 42.05 m; 95% CI 29.06–55.05; p < 0.01). Quality-of-life scores improved significantly, as reflected by reductions in SGRQ (−13.76 points), CAT (−2.62 points), and mMRC (−0.50 points). Subgroup analyses revealed that Liuzijue and Yijinjing produced the greatest gains in pulmonary function, while Tai Chi yielded the most pronounced improvement in functional endurance. No serious adverse events were reported across the included studies. Conclusions: TCMBEs are effective and safe adjuncts for COPD rehabilitation. By focusing on controlled breathing, gentle movement, and mindful awareness, these practices can enhance lung function, improve exercise capacity, and support psychological well being. Incorporating approaches such as Liuzijue, Tai Chi, and Yijinjing into structured PR programs may provide a sustainable and cost-effective way to promote functional recovery and improve overall quality of life in people with COPD.