Electroacupuncture (EA) may reduce the duration of postoperative ileus (POI) after laparoscopic gastrectomy for gastric cancer, although evidence is limited. We investigated the efficacy of EA in reducing POI duration and enhancing gastrointestinal (GI) recovery in patients undergoing laparoscopic surgery for gastric cancer. This multicenter randomized trial was conducted at 7 hospitals in China, enrolling 585 participants who underwent laparoscopic resection for gastric cancer from October 27, 2021, to December 21, 2023. Participants received perioperative standard care and were randomized to 4 sessions of EA, 4 sessions of sham EA (SA), or standard care only. The primary outcome was the time to first flatus. Secondary outcomes included time to first defecation, dietary recovery, quality of life, postoperative mobilization, and duration of hospital stay. A total of 578 participants were in the full analysis set. EA exhibited a shorter time to first flatus compared with both SA and standard care, with differences of -12.96 hours (95% confidence interval (CI), -19.17 to -6.75; P < .001) and -24.46 hours (95% CI, -30.61 to -18.30; P < .001), respectively. Similarly, EA significantly reduced the time to first defecation: -15.41 hours (95% CI, -27.73 to -3.09; P = .007) vs SA; -24.66 hours (95% CI, -36.76 to -12.55; P < .001) vs standard care. Incidence of prolonged POI was significantly lower in the EA group than in the SA and standard care groups, with group differences of -0.41 (95% CI, -0.66 to -0.16; P < .001) and -0.56 (95% CI, -0.82 to -0.31; P < .001), respectively. No severe adverse events were reported. EA was superior to SA and standard care only for reducing POI duration and the risk of prolonged POI in patients undergoing laparoscopic gastrectomy for gastric cancer (Chinese Clinical Trials Register identifier: ChiCTR2100050660).

Integrated traditional Chinese medicine (TCM) and Western medicine (WM) is a new medical science grounded in the knowledge bases of both TCM and WM, which then forms a unique modern medical system in China. Integrated TCM and WM has a long history in China, and has made important achievements in the process of clinical diagnosis and treatment. However, the methodological defects in currently published clinical practice guidelines limit its development. The organic integration of TCM and WM is a deeper integration of TCM and WM. To realize the progression of "integration" to "organic integration", a targeted and standardized guideline development methodology is needed. Therefore, the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.

The gastrointestinal (GI) tract is an organ actively involved in mechanical processes, where it detects forces via a mechanosensation mechanism. Mechanosensation relies on specialized cells termed mechanoreceptors, which convert mechanical forces into electrochemical signals via mechanosensors. The mechanosensitive Piezo1 and Piezo2 are widely expressed in various mechanosensitive cells that respond to GI mechanical forces by altering transmembrane ionic currents, such as epithelial cells, enterochromaffin cells, and intrinsic and extrinsic enteric neurons. This review highlights recent research advances on mechanosensitive Piezo channels in GI physiology and pathology. Specifically, the latest insights on the role of Piezo channels in the intestinal barrier, GI motility, and intestinal mechanosensation are summarized. Additionally, an overview of Piezo channels in the pathogenesis of GI disorders, including irritable bowel syndrome, inflammatory bowel disease, and GI cancers, is provided. Overall, the presence of mechanosensitive Piezo channels offers a promising new perspective for the treatment of various GI disorders.

Background and Aims: Parkinson’s disease (PD) patients frequently experience constipation and non-motor symptoms, significantly affecting their quality of life. Although constipation is common, its causal relationship with mental health issues, such as anxiety and depression, remains underexplored. This study aims to investigate the association between constipation severity, non-motor symptoms, and mental health outcomes in PD patients. Methods: A total of 97 PD patients from three hospitals in Changshu City were included in this study. Clinical data were collected using assessment tools, including the Non-Motor Symptoms Scale, Patient Assessment of Constipation Quality of Life questionnaire, Hamilton Depression Rating Scale , and Hamilton Anxiety Rating Scale. Mendelian randomization analysis was applied to examine the causal relationships between constipation severity, non-motor symptoms, and mental health outcomes. Results: A moderate correlation was found between constipation severity and non-motor symptoms, especially in elderly and female patients. However, no significant causal association was identified between constipation and mental health issues such as anxiety, depression, or sleep disorders. Conclusions: The study underscores the importance of managing constipation in PD patients to improve their non-motor symptoms and quality of life. Despite the observed correlation with non-motor symptoms, further studies are needed to clarify the role of constipation in mental health issues in PD.

Purpose: Research on the effects of acupuncture on autonomic function has been conducted for several decades, and a few notable studies have emerged in recent years. This study used bibliometric analysis to assess 100 top-cited articles to characterize the current status and research trends over the last three decades.Methods: The 100 top-cited publications were identified from the Web of Science Core Collection database. The bibliometrix package in R was used for quantitative and qualitative analyses of the publication patterns and the country/region, institution, and author contributions. VOSviewer was used to construct networks based on co-citation analysis of the journals and the keyword co-occurrence.Results: The 100 top-cited articles were identified with a total of 8,123 citations (range: 37–345). The majority of the articles came from the USA (n = 42), followed by Japan (n = 14) and mainland China (n = 13). Articles from the USA exhibited the largest number of citations (3,582 citations), followed by articles from Japan (1,189 citations), then articles from mainland China (755 citations). Neurosciences/Neurology was the most studied research area (n = 41). The Autonomic Neuroscience: Basic and Clinical published the largest number of papers (n = 14), while Brain Research received the largest number of citations (205 citations). Longhurst JC was the most productive author (10 publications), and Sato A was first among the cited authors (87 citations). The most frequently cited articles that focused on gastrointestinal, cardiovascular, or gynecologic responses to acupuncture regulation of the autonomic nervous system first appeared in the 1990s, peaked in the 2000s, then decreased after 2010. Publication of articles focused on the anti-inflammatory effects of acupuncture associated with autonomic function demonstrated an increasing trend over the last three decades.Conclusion: From the initial studies focusing on the autonomic mechanism of visceral responses to acupuncture, researchers concentrated on exploring the autonomic mechanism of acupuncture in the control of systemic inflammation. Non-invasive electrical methods that activate somato-autonomic reflexes are current translational directions in clinical practice. Additional investigation of the underlying neuroanatomical basis of somato-autonomic reflexes also is needed.

Functional dyspepsia (FD) is known to be influenced by gut microbiota (GM) and circulating inflammatory proteins (CIPs), however, the causal relationship between GM, CIPs and FD haven’t been investigated. This study employed two-sample Mendelian Randomization (TSMR) to investigate their associations using data from Genome-Wide Association Studies (GWAS). In this study, Inverse-variance weighted (IVW) method was employed as the primary analysis, with supplementary approaches including weighted median, weighted mode, simple mode, and MR-Egger. Heterogeneity and pleiotropy were assessed using the Cochrane Q test, MR-Egger intercept test, and MR-PRESSO global test. Totally, 196 GM traits and 91 CIPs were analyzed, and the results uncovered the causal impact of 12 GM taxa and 5 proteins on functional dyspepsia (FD). 9 GM genera were linked to a reduced risk of FD, while 3 GM genera were associated with an increased risk of FD.Additionally, reverse analysis revealed no FD-GM causation. Furthermore, IL-12, IL-10, CXCL10, CXCL9 and VEGFA were significantly correlated with FD, with CXCL9 and VEGFA acting as mediators in the association between GM traits and FD. Taken together, our findings established a link between specific GM and CIPs in the pathogenesis of FD, offering novel insights for its diagnosis and treatment.