Acupuncture is widely used worldwide, and systematic reviews on acupuncture are increasingly being published. Although acupuncture systematic reviews share several essential elements with other systematic reviews, some essential information for the application of acupuncture is not covered by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Considering this, we aimed to develop an extension of the PRISMA statement for acupuncture systematic reviews. We used the PRISMA statement as a starting point, and conducted this study referring to the development strategy recommended by the EQUATOR network. The initial items were collected through a wide survey among evidence users and a review of relevant studies. We conducted a three-round Delphi survey and one-day face-to-face meeting to select items and formulate the checklist. After the consensus meeting, we drafted the manuscript (including the checklist) and sent it to our advisory experts for comments, following which the checklist was refined and circulated to a group of acupuncture systematic review authors for pilot test. We also selected a sample of acupuncture systematic reviews published in 2017 to test the checklist. A checklist of five new sub-items (including sub items) and six modified items was formulated, involving content related to title, rationale, eligibility criteria, literature search, data extraction, and study characteristics. We clarified the rationales of the items and provided examples for each item for additional guidance. The PRISMA for Acupuncture checklist is developed for improving the reporting of systematic reviews of acupuncture interventions. We have registered the study on the EQUATOR network ( http://www.equator-network.org/library/reporting-guidelines-under-development/#91 ).

Objective: This study aims to report the trends and cross-national disparities in the burden of osteoarthritis (OA) by region, age, gender, and time from 1990 to 2021, and to further project changes through 2035. Methods: In this systematic analysis based on the Global Burden of Disease (GBD) study, population survey data on osteoarthritis from 21 countries/regions and U.S. insurance claims data were used to estimate the prevalence and incidence of OA in 204 countries and regions from 1990 to 2021. The reference case definition for OA was symptomatic and radiographically confirmed osteoarthritis. Studies using definitions other than the reference, such as self-reported OA, were adjusted through a regression model to align with the reference case. The distribution of OA severity was derived from a pooled meta-analysis using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Final prevalence estimates were multiplied by disability weights to calculate years lived with disability (YLD). An Autoregressive Integrated Moving Average (ARIMA) model was used to forecast the prevalence and incidence of OA through 2035. Results: In 2021, approximately 607 million (95%UI 538–671) people worldwide were affected by osteoarthritis, accounting for 7.7% of the global population. Compared to 2020, the age-standardized prevalence of OA among males is projected to increase from 5,763 per 100,000–5,922 per 100,000 by 2036, while the age-standardized prevalence among females is expected to decline slightly from 8,034 per 100,000–7,925 per 100,000. In 2021, the global age-standardized YLD rate for osteoarthritis was 244.5 (95%UI 117.06–493.11), the global age-standardized prevalence rate was 6,967.29 (95%UI 6,180.7–7,686.06), and the global age-standardized incidence rate was 535 (95%UI 472.38–591.97). In 2021, the age-standardized prevalence rate exceeded 5.5% across all regions, ranging from 5,675.8 per 100,000 (95%UI 5,001.76–6,320.8) in Southeast Asia to 8,608.63 per 100,000 (95%UI 7,674.07–9,485.19) in high-income Asia Pacific regions. The knee was the most commonly affected joint. High BMI and metabolic risks are the only two GBD risk factors for osteoarthritis. From 1990 to 2021, the age-standardized prevalence, incidence, and YLD attributable to osteoarthritis have been on the rise, with substantial international variations across indicators. Countries with high socio-demographic index (SDI) bear a disproportionately high burden of OA, and inequalities in the burden of disease due to differences in SDI between countries have been increasing over time. Conclusions: As a major public health problem, the overall global burden of OA has shown an upward trend from 1990 to 2019, including an increase in the number of cases and inequalities in distribution across the globe, which has resulted in significant health losses and economic burdens. In addition, SDI-related inequalities between countries are increasing. In this regard, national public health authorities and the World Health Organization (WHO) should work together to improve diagnosis and early treatment rates by strengthening disease awareness and education, as well as strengthening international cooperation, providing necessary medical assistance to less developed regions, and actively exploring new strategies for the prevention and treatment of OA.

Introduction: Constipation is one of the most common complications in patients with stroke. Acupuncture has gained increased popularity for the management of constipation. However, there is a lack of supportive evidence on the efficacy of acupuncture for poststroke constipation. This systematic review aims to collect and critically appraise all the available evidence about the efficacy and safety of the acupuncture for constipation in poststroke patients. Methods and analysis: A comprehensive search of Pubmed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, four Chinese databases (National Knowledge Infrastructure (CNKI), Chinese Biomedical Literatures database (CBM), Wanfang Digital Periodicals (WANFANG) and Chinese Science and Technology Periodicals (VIP) database), one Japanese medical database (National Institute of Informatics, CiNii) and one Korean medical database (Oriental Medicine Advanced Searching Integrated System, OASIS) will be conducted to identify randomised controlled trials of acupuncture for constipation in poststroke patients. There is no restriction on language or publication status. The primary outcome measure will be frequency of bowel movement. The risk of bias will be assessed using the approach recommended by Cochrane Handbook for Systematic Reviews of Interventions. We will conduct the meta-analysis to synthesise the evidence for each outcome, if possible. The heterogeneity will be statistically assessed using a χ² test and I² statistic. This protocol is developed following the guideline of Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols 2015. Ethics and dissemination: The ethical approval is not required because no primary data are collected. The findings will be presented at scientific conferences or a peer-reviewed scientific journal. PROSPERO registration number: CRD42017076880.

Intelligent traditional Chinese medicine (ITCM) is an emerging interdisciplinary subject. It aims to efficiently and precisely promote the prevention and treatment of diseases and health management in Chinese medicine clinical practice via the combination of traditional Chinese medicine (TCM) fundamentals and artificial intelligence technologies. Presently, it is experiencing dramatic growth in recent years. On the one hand, a holistic view, as a crucial philosophy in the theory of TCM, will be guiding the development of ITCM. On the other hand, a comprehensive discussion of the benefits of such a holistic view of ITCM is lacking. To this end, we conduct this survey by introducing the named holistic view first. Then, adaptive learning and field theory will be presented and discussed with respect to their application in ITCM. Ethical issues of ITCM will then be taken into account by human-centered TCM and potentials based on affective computing of ITCM. In addition, we give our opinions and insights on the challenges and open issues regarding the future of ITCM. We hope that this survey article can be a good guide for experts in the relevant fields.

Background: Chinese patent medicine Tongxinluo capsule (TXL) is commonly used for cardio-cerebrovascular diseases. Previous research had demonstrated that TXL exhibited great clinical effects on the treatment of acute myocardial infarction (AMI), however there is a lack of systematic review. The purpose of this study was to evaluate the potential effectiveness and safety of TXL for secondary prevention in patients with AMI. Method: We searched 6 databases to identify relevant randomized controlled trials (RCTs) from inceptions to December 30, 2017. Two review authors independently assessed the methodological quality and analyzed data by the RevMan 5.3 software. The publication bias was assessed through funnel plot and Begg's test. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for evaluating the quality of evidence. Results: We included 19 RCTs in this review and performed a meta-analysis based on 16 studies. There were statistical differences of TXL treatment group in reducing primary cardiovascular events (cardiac death [RR = 0.27, 95%CI: 0.08~0.95, I² = 0%], recurrent myocardial reinfarction [RR = 0.38, 95%CI: 0.20~0.74, I² = 0%], arrhythmia [RR = 0.44, 95%CI: 0.30~0.66, I² = 0%], recurrent angina pectoris [RR = 0.34, 95%CI: 0.17~0.69, I² = 0%]). TXL could improve cardiac function (LVEF [MD = 4.10, 95%CI: 3.95~4.25, I² = 0%]), regulate blood lipid TC [MD = −0.66, 95%CI: −0.94 ~ −0.37, I² = 74%], TG [MD = −0.38, 95%CI: −0.62 ~ −0.14, I² = 70%], LDL-C[−0.40, 95%CI: −0.65 ~ −0.16, I² = 88%), decrease the level of hs-CRP (4-week: MD = −0.78, 95%CI: −0.97 ~ −0.60, I² = 20%; Over 4-week: MD = −1.36, 95%CI: −1.55 ~ −1.17, I² = 20%). However, TXL has little effects on revascularization [RR = 0.45, 95%CI: 0.13~1.56, I² = 0%], recurrent heart failure (RR = 0.83, 95%CI: 0.27~2.57, I² = 0%), and HDL-C (MD = 0.14, 95%CI: 0.00 ~0.29, I² = 73%). Furthermore, TXL treatment group was more prone to suffer gastrointestinal discomfort. Conclusion: Chinese patent medicine TXL seemed beneficial for secondary prevention after AMI. This potential benefit needs to be further assessed through more rigorous RCTs. Systematic review registration number in the PROSPERO register: CRD42017068417.