Fanrong Liang’s research while affiliated with Chengdu University of Traditional Chinese Medicine and other places

Acupuncture is used worldwide to treat migraine, but its scientific mechanism remains unclear. Here, we report a ¹ H NMR metabolomics study involving 40 migraine patients and 10 healthy individuals randomly receiving acupuncture or sham acupuncture, followed by machine learning techniques and functional analysis. We found that acupuncture at acupoints particularly enhanced anaerobic glycolysis and modified mitochondrial function by adjusting the levels of plasma pyruvic acid ( p = 0.012), lactic acid ( p = 0.031) and citrate ( p = 0.00079) at a Bonferroni-corrected level of significance compared to the pre-treatment level of these three metabolites in migraine patients. Therefore, acupuncture supplies energy to migraine patients and relieves migraine attacks. In contrast, we observed that sham acupuncture may partially supply energy to migraine patients through lipid metabolism by changing the levels of plasma lipid ( p = 0.0012), glycerine ( p = 0.021), and pyruvic acid ( p = 0.047) at a Bonferroni-corrected level of significance. The functional network analysis further indicates this different way of supplying energy contributes to the different effects of acupuncture and sham acupuncture. Our findings reveal novel metabolic evidence for the specific effect of acupuncture in relation to sham acupuncture. This metabolic evidence could enlighten a brand new direction into acupuncture analgesia mechanism, which in turn would pose fresh challenges for future acupuncture research.

Background Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease. The occurrence of COPD is associated with gut microbiota, meticulous metabolism and inflammation. Acupuncture may be effective as an adjunctive therapy for COPD, but the available evidence is limited. This study aims to confirm whether acupuncture therapy has an adjunctive therapeutic effect on COPD and to investigate the relationship between the efficacy and the gut microbiota, metabolomics and inflammation. Methods This study is a multicenter randomized controlled trial. A total of 72 patients with stable COPD eligible will be randomized in a 1:1 ratio to receive either manual acupuncture (MA) or sham acupuncture (SA) without puncturing the skin. There will be no changes to the essential medicines used for all patients. The intervention will be 12 weeks, 3 times per week and follow-up will be 52 weeks. The primary outcome will be the change in COPD Assessment Test (CAT) score before and after treatment. Secondary outcomes will include modified Medical Research Council (mMRC), St. George’s Respiratory Questionnaire (SGRQ), 6-min walk test (6MWT), and the number of moderate or severe acute exacerbations during follow-up. A total of 36 healthy volunteers will also be recruited as normal control. In addition, feces and blood will be collected from each participant to characterize the gut microbiota, metabolomics, immune cells and inflammatory cytokines. Differences between COPD patients and healthy participants will be observed, as well as changes before and after treatment in MA and SA groups. Ultimately, the correlation among gut microbiota, metabolomics, immune cells, inflammatory cytokines and clinical efficacy in COPD patients will be analyzed. Discussion This study will evaluate the efficacy and provide preliminary possible mechanisms of acupuncture as an adjunctive therapy in treating COPD. In addition, it will identify biomarkers of the gut microbiota, metabolites, immune cells, and inflammatory cytokines associated with therapeutic efficacy. The results of this study will be published in a peer-reviewed journal.

BACKGROUND: Medication overuse headache (MOH) is a secondary headache disorder associated with the chronic use of pain-relieving medications, leading to significant alterations in brain structure and function. Previous studies have shown inconsistent findings in gray matter (GM) changes in MOH patients, making it necessary to conduct a comprehensive meta-analysis to synthesize these results. OBJECTIVES: The objective is to conduct a thorough review and meta-analysis of the consistency among voxel-based morphometry (VBM) neuroimaging studies that focus on MOH. STUDY DESIGN: Systematic review and meta-analysis. SETTING: This meta-analysis examined all VBM studies that involved the whole-brain alterations of MOH. METHODS: A comprehensive search of neuroimaging studies was conducted across 6 databases, including EMBASE, PubMed, Web of Science, Wan-Fang Database, China National Knowledge Infrastructure (CNKI), and Chongqing VIP, covering publications from the inception thereof to December 1, 2023. Two independent researchers performed quality assessment, data extraction, and study selection. Researchers performed a thorough examination of GM data in MOH, utilizing both activation likelihood estimation (ALE) and Anisotropic effect size-signed differential mapping (AES-SDM). Additionally, the research included clinical variables correlation analysis and subgroup analysis. RESULTS: A total of 8 studies were selected for analysis based on stringent screening criteria, resulting in the inclusion of 378 patients (comprising 191 patients with MOH and 187 healthy patients). The 2 different neuroimaging meta-analysis methods both revealed that MOH patients had increased amounts of GM in their cerebellar vermis, left red nuclei, and right medial dorsal nuclei. Additionally, MOH patients showed reductions in the GM of their left superior frontal gyri, left inferior frontal gyri, right precunei, and bilateral middle frontal gyri. Correlation analysis findings indicated that numerous cerebral areas were linked to clinical variables of MOH, including the duration of the condition, frequency of headaches, and patient age. MOH patients using different medications exhibited partially inconsistent GM alterations. LIMITATIONS: The limited number of neuroimaging studies and the variability in methodologies across studies might have affected the robustness of the findings. Future research should address these gaps by exploring both structural and functional neuroimaging in diverse MOH subtypes. CONCLUSION: Significant alterations in GM across various brain regions associated with pain processing, modulation, and reward have been observed in association with MOH. These observations contribute to a better understanding of the neural mechanisms underlying MOH and may potentially guide the development of specific therapeutic strategies. Additional studies are required to investigate whether GM changes can serve as potential biomarkers for diagnosing and treating MOH. KEY WORDS: Medication overuse headache, MRI, neuroimaging, gray matter, voxel-based morphometry, neuroimagers meta-analysis

Purpose: This systematic review and meta-analysis of randomized controlled trials (RCTs) is aimed at assessing the clinical efficacy and safety of stellate ganglion block (SGB) for angina pectoris (AP). Methods: PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang databases were comprehensively searched for RCTs investigating SGB treatment for AP. The retrieval time was from the establishment date of each database to October 10, 2024. The Cochrane risk of bias assessment tool was used to determine the methodological quality. Review Manager 5.4 software was employed for data analysis, and GRADEpro GDT software was utilized to evaluate the quality of evidence. Results: Ultimately, six RCTs were included, encompassing 373 patients with angina. The overall methodological quality of the included studies was moderate, with the evaluation of evidence quality showing 12 low-quality and five extremely low-quality studies. The meta-analysis results demonstrated that compared with the control group, the experimental group had lower frequency and duration of AP, visual analog scale score, heart rate, detection rate of S-T segment elevation ≥ 0.1 mV on electrocardiogram (ECG) after 24 h of treatment, detection rate of abnormal T waves on ECG after 24 h of treatment, and S-T segment displacement on ECG after treatment. Furthermore, the experimental group exhibited lower serum Cardiac Troponin I levels, a decreased incidence of acute myocardial infarction (AMI) and rehospitalization, and improved clinical efficacy. However, none of the included studies reported SGB-related adverse events. Conclusion: SGB is effective in alleviating myocardial injury and reducing the incidence of AMI and rehospitalization in patients with AP. Nevertheless, the limited number and relatively low quality of included studies emphasize the requirement for more high-quality research to verify these conclusions.

Background Chemotherapy-induced peripheral neuropathy (CIPN) is one of the commonly reported symptoms impacting cancer survivors. This study evaluated and compared the effectiveness of acupuncture treatments for CIPN. Methods We searched six databases from their inception to August 2024 to identify eligible randomized controlled trials (RCTs). Primary outcome were pain scores. Secondary outcomes were quality of life including FACT/GOG-Ntx and EORTC QLQ-C30. The robust error meta-regression (REMR) method was used to evaluate the dose-response relationship across treatment parameters, including number of sessions, frequency, and duration. Results In total, 11 RCTs featuring 740 participants were included. The meta-analysis demonstrated that the primary analysis achieved a significant reduction in pain scores, with a standardized mean difference of [SMD= -1.23, 95% CI = (-2.22, -0.24); P < 0.01; I² = 95%], improvement quality of life including FACT/GOG-Ntx [SMD = 0.95, 95% CI = (0.02, 1.88); P < 0.01; I² = 93%] and EORTC QLQ-C30 [SMD = 0.36, 95% CI = (0.03, 0.68); P = 0.14; I² = 46%]. The nonlinear dose-response analysis suggests that pain improvement achieves the MCID at 16 treatment sessions, over 8 weeks, with a frequency of twice per week. Furthermore, analysis of the treatment duration chart shows that acupuncture maintains therapeutic effects during the follow-up period. Sensitivity analysis confirmed the robustness of these findings. Conclusion Acupuncture demonstrates significant potential in managing CIPN, particularly through individualized treatment regimens. The identified time-dose-response relationship suggests that tailoring acupuncture frequency and duration can to optimize pain relief in CIPN patients. Future high-quality studies and large-scale multicenter clinical trials are needed to validate these findings.

Objectives Neuroimaging investigations into chronic low back pain (CLBP) have detected functional abnormalities across a spectrum of brain regions, yet the findings have often been inconsistent. In this meta-analysis, we integrated the existing data, delineating a pattern of coherent results from the encompassed studies. Methods A systematic search of neuroimaging studies investigating the brain activity differences between CLBP and Healthy controls (HCs) was conducted in seven databases up to December 22, 2024. An anisotropic effect-size signed differential mapping (AES-SDM)-based meta-analysis was carried out to report the results and perform a multimodal analysis. Results A total of 20 publications reporting on 24 experiments in this meta-analysis. The ReHo meta-analysis showed abnormal spontaneous activity of left inferior temporal gyrus (ITG), left superior frontal gyrus (SFG), right middle frontal gyrus (MFG), right precuneus, right fusiform gyrus and bilateral postcentral gyrus (PoCG) in CLBP patients. The ALFF meta-analysis demonstrated functional alterations in the right rolandic operculum (extending to the right insula and right IFG), left ITG, left middle occipital gyrus (MOG), left paracentral lobule, left PoCG and bilateral cuneus cortex in CLBP patients. The results of the functional group meta-analysis revealed that patients with CLBP displayed new decreased functional activity in the right thalamus, right precentral gyrus (PreCG) and right lingual gyrus. Conclusion Patients with CLBP exhibit extensive multimodal functional neuroimaging abnormalities, involving brain regions related to pain perception, emotional processing, cognitive functions, and both the visual and motor cortices. These meta-analysis findings might provide a valuable reference for the identification of potential therapeutic targets for CLBP in the brain.

Infertility has emerged as a significant global health concern. Assisted reproductive technology (ART) assists numerous infertile couples in conceiving, yet some experience repeated, unsuccessful cycles. This study aims to identify the pivotal clinical factors influencing the success of fresh embryo transfer of in vitro fertilization (IVF). We introduce a novel Non-negative Matrix Factorization (NMF)-based Ensemble algorithm (NMFE). By combining feature matrices from NMF, accelerated multiplicative updates for non-negative matrix factorization (AMU-NMF), and the generalized deep learning clustering (GDLC) algorithm. NMFE exhibits superior accuracy and reliability in analyzing the in vitro fertilization and embryo transfer (IVF-ET) dataset. The dataset comprises 2238 cycles and 85 independent clinical features, categorized into 13 categories based on feature correlation. Subsequently, the NMFE model was trained and reached convergence. Then the features of 13 categories were sequentially masked to analyze their individual effects on IVF-ET live births. The NMFE analysis highlights the significant influence of therapeutic interventions, Embryo transfer outcomes, and ovarian response assessment on live births of IVF-ET. Therapeutic interventions, including ovarian stimulation protocols, ovulation stimulation drugs, and pre-and intra-stimulation cycle acupuncture play prominent roles. However, their impacts on the IVF-ET model are reduced, suggesting a potential synergistic effect when combined. Conversely, factors like basic information, diagnosis, and obstetric history have a lesser influence. The NMFE algorithm demonstrates promising potential in assessing the influence of clinical features on live births in IVF fresh embryo transfer.

Background: Traditional Chinese Medicine (TCM) therapies have shown great improvement in chronic obstructive pulmonary disease (COPD) patients, yet no bibliometric analysis on TCM therapies for COPD exists. Summary: A comprehensive literature search was conducted on TCM therapies for COPD within the past decade, utilizing the Web of Science (WOS) Core Collection and China National Knowledge Infrastructure (CNKI) databases. To analyze collaborative patterns among countries/regions, institutions, and authors, as well as identify influential references and emerging research trends, CiteSpace and VOSviewer software were employed. The dataset comprised 625 articles from WOS and 5,641 from CNKI, revealing a consistent growth in COPD-related TCM research over the past 10 years. China emerged as the leading contributor, with a predominant focus on TCM Universities. The American Journal of Respiratory and Critical Care Medicine was the most cited journal, while Medicine published the highest number of articles. Li JS was the most prolific author, and Barnes PJ was the most frequently cited researcher. Key studies by Leung RWM [Eur Respir J. 2013;41(5):1051-7], Li SY [BMC Complement Altern Med. 2012;12:197], and Polkey MI [Chest. 2018;153(5):1116-24] garnered significant attention. Keyword analysis highlighted the prominence of Tai Chi, Chinese herbal medicine, acupoint sticking, acupuncture, lung function, quality of life, and inflammation as core research themes. Key messages: Research on TCM therapies for COPD has gained growing attention over the past decade. Among the most commonly studied TCM interventions are Tai Chi, Chinese herbal medicine, acupoint sticking, and acupuncture. Lung function, quality of life, and inflammation have emerged as key areas of investigation and are likely to remain focal points for future research endeavors.