Huangan Wu

Introduction: Polytrauma is a leading cause of morbidity and mortality worldwide, often complicated by multiple organ dysfunction syndrome (MODS). Early identification of risk factors for prolonged intensive care unit (ICU) stay is crucial. This study assessed organ dysfunction in polytrauma patients and identified predictors of prolonged ICU stays. Methods: A retrospective observational study was conducted on 101 polytrauma patients admitted to the ICU between March 2023 and April 2025. Clinical data, including laboratory markers for liver, kidney, cardiac, and coagulation functions, were analyzed. Patients were stratified by ICU length of stay (P P = 0.02), and longer Prothrombin Time (14.6 ± 3.0 vs. 13.4 ± 1.6, P = 0.02), indicating greater coagulation dysfunction. Conversely, the ICU ≥7 days group had higher fibrinogen, degradation products levels (90.8 ± 95.1 vs. 46.6 ± 86.9, P = 0.04) and white blood cell counts (16.0 ± 7.1 vs. 12.1 ± 4.9, P <0.05), suggesting increased risks of infection or thrombotic complications. Conclusion: Coagulation disturbances and leukocytosis are key predictors of extended ICU stays in polytrauma patients, highlighting their prognostic value. Early monitoring and intervention targeting these factors may improve outcomes.

Background and Aims: How Crohn's disease alters large‐scale brain network organization and interacts with affective symptoms remains poorly understood. We aimed to characterize disease‐related disruptions in functional topology, rich‐club organization, and hierarchical gradients, and to determine their associations with disease activity and anxiety. Methods: Ninety‐seven Crohn's disease patients and 64 healthy controls underwent resting‐state fMRI. Graph‐theoretical metrics, rich‐club analysis, functional gradients, and spectral dynamic causal modeling were applied to assess network properties, hierarchical architecture, and effective connectivity. Associations with the Crohn's Disease Activity Index and anxiety were examined via linear regression. Results: Crohn's disease patients showed widespread network disruptions modestly linked to disease activity, including reduced global and local efficiency, impaired rich‐club connectivity, and compressed sensorimotor gradients. Decreased degree centrality in the insula, thalamus, and postcentral gyrus was accompanied by altered hierarchical organization and effective connectivity. Spectral dynamic causal modeling revealed anxiety‐related modulation of insular excitation and thalamo‐putaminal pathways. Conclusions: Crohn's disease involves widespread functional network disruption and reorganization, particularly in interoceptive regions supporting sensory and emotional processing. Anxiety modulates core limbic circuitry, highlighting the interplay between disease activity and affective symptoms in shaping brain network.

Gastric cancer is one of the most prevalent gastrointestinal malignancies worldwide, with Helicobacter pylori infection, host genetic susceptibility and environmental exposure serving as major driving risk factors. Accumulating studies have demonstrated that host genetics, the microbiome and epigenetic modifications collectively govern gastric cancer initiation and progression. These three components form a bidirectional regulatory axis: host genetic profiles and epigenetic remodeling shape the composition of endogenous microbial communities, while the microbiome and its metabolites trigger epigenetic reprogramming to modulate transcription of oncogenes and tumor suppressors. Deciphering this intricate tripartite regulatory network holds great potential to facilitate the development of precise therapeutic interventions for gastric cancer. This review delineates the respective roles of host genetics, the microbiome and epigenetic modifications throughout gastric cancer evolution and summarizes corresponding prospective intervention strategies. We elaborate on the reciprocal interplay between the microbiome and host genetic/epigenetic factors, and highlight the vital clinical significance of this crosstalk for gastric cancer prevention and treatment.

Background: Targeting the neuro-immune microenvironment to suppress triple-negative breast cancer (TNBC) represents a critical strategy in tumor immunotherapy. Methods: A syngeneic 4T1 orthotopic TNBC model in Balb/c mice was employed. EA was applied at ST36 (Zusanli) using systematically optimized parameters (2/15 Hz, 3 mA, 30 min, every other day). Multi-dimensional immunophenotyping by flow cytometry, immunofluorescence, and Western blot was performed across tumor, blood, and splenic compartments. Transcriptome sequencing coupled with KEGG/GSEA pathway analysis was used to identify downstream signaling networks. The NGF/Hippo/YAP axis and adrenergic receptor subtype specificity were validated through pharmacological intervention in vitro, while EA synergy with αPD-L1 was assessed in a CD8 ⁺ T cell-depletion model. Results: ST36 stimulation at 3 mA preferentially suppressed TNBC tumor growth and augmented intratumoral immune infiltration, characterized by elevated CD8 ⁺ T cells, NK cells, and M1-polarized macrophages. EA significantly enhanced CD8 ⁺ T cell effector capacity, upregulating perforin, granzyme B, CD69, and ZAP70 phosphorylation, and synergized with αPD-L1 in a CD8 ⁺ T cell-dependent manner. Mechanistically, EA activated c-Fos ⁺ /ChAT ⁺ cholinergic neurons in the dorsal motor nucleus of the vagus (DMV) and reduced norepinephrine (NE) output in both circulation and tumors. Transcriptomic profiling identified NGF downregulation and Hippo pathway activation as central events. EA upregulated AMOT, driving YAP phosphorylation at Ser127, cytoplasmic sequestration of YAP, and suppression of downstream IL-6 secretion. In vitro, exogenous NGF suppressed YAP phosphorylation and promoted TNBC malignant behavior, effects fully reversed by the YAP inhibitor verteporfin. α2-adrenergic receptor (α2-AR) antagonism with yohimbine abrogated NE-induced NGF upregulation, pinpointing α2-AR as the receptor subtype linking sympathetic signaling to the NGF/Hippo axis. Conclusion: EA at ST36 recalibrates neuro-sympathetic tone in TNBC by activating vagal cholinergic outflow, reducing NE-driven α2-AR/NGF/Hippo signaling, and thereby relieving immunosuppression while amplifying CD8 ⁺ T cell-mediated cytotoxicity. These findings establish a neuro-immune mechanistic framework for EA-based adjuvant immunotherapy in TNBC.

Background: The current method for managing opioid tolerance is opioid rotation, but its effectiveness is limited. Transcutaneous electrical acupoint stimulation (TEAS) combined therapy has been shown to effectively relieve moderate-to-severe pain in patients with hepatocellular carcinoma (HCC), but there is insufficient evidence regarding its role in modulating opioid tolerance. Additionally, exosomal proteomics can aid in exploring the potential mechanisms of action of TEAS. Methods: This single-center, patient-blinded, randomized controlled clinical trial will enroll 72 participants with moderate-to-severe cancer pain secondary to HCC. Participants will be randomly assigned to the observation group or the control group in a 1:1 ratio. On the basis of conventional Western medical analgesia, the observation group will receive TEAS treatment, while the control group will receive sham TEAS treatment. The treatment course will last for 2 weeks, followed by a 4-week follow-up period. The primary outcome is the opioid tolerance index after the treatment concludes in week 2. It quantitatively reflects the degree of opioid tolerance by measuring changes in opioid consumption over time. Secondary outcomes include the Numerical Rating Scale score, numbers of breakthrough pain, frequency of gastrointestinal side effects, quality of life evaluation, and protein biomarkers. Conclusion: The expected results will clarify the efficacy of TEAS in alleviating opioid tolerance in patients with moderate-to-severe HCC-related pain. Exosome proteomics can provide exploratory insights into potential mechanisms underlying the efficacy of TEAS. Ethics and Trial Registration: The Research Ethics Committee of the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine has approved the study protocol (No. 2025– 045). The trial has been registered with the International Traditional Medicine Clinical Trial Registry (http://itmctr.ccebtcm.org.cn/). Registration number: ITMCTR2025002162. Registered on June 9, 2025.

Background: Chronic insomnia (CI) is associated with dysregulation of brain network dynamics, and patient response to electroacupuncture (EA) treatment varies. This study aimed to investigate the characteristics of electroencephalographic (EEG) microstates in patients with CI, analyze changes in microstate parameters before and after EA treatment, and explore the potential application of machine learning (ML) models based on baseline microstate features for predicting treatment response. Methods: We enrolled 41 CI patients and 19 healthy controls (HC). Baseline resting-state EEG was recorded, and microstate parameters (classes A–D) were analyzed. CI patients underwent 4-week EA treatment. Six clinical scales—including the Pittsburgh Sleep Quality Index (PSQI) and Hamilton Depression Scale, and microstate dynamics were compared pre- and post-treatment. Treatment response was defined as ≥50% PSQI reduction. Multi-stage feature selection and eight ML algorithms were used to build the prediction model. Results: At baseline, CI patients showed differences in some temporal metrics of microstates B, A, and C compared to HC. After EA, all clinical scores improved significantly ( p < 0.001). Coverage_B and Duration_B, as well as Occurrence_C, increased, and multiple transition probabilities were regulated—particularly, microstate B temporal indicators normalized to HC levels. In the exploratory ML modeling, RF performed best (AUC = 0.849). “Duration_A,” “OrgTM_D → B,” and “OrgTM_C → B” were the top positive predictors, while “Occurrence_C” and “Duration_B” were negative predictors. Conclusion: This study found that EA treatment was associated with improved clinical scores and alterations in some EEG microstate parameters in patients with CI. In this exploratory analysis with a limited sample size, baseline microstate features showed preliminary potential for predicting treatment response, though further validation in larger cohorts is needed. These findings may provide a reference for future research on neurophysiological predictors and the development of individualized treatment strategies.

Background: Primary dysmenorrhea (PD) is defined as pain occurring with menses in the absence of pelvic pathology. Traditional Chinese Medicine offers various therapeutic approaches for PD management. Dysmenorrhea Patch, an acupoint application therapy, shows promise for PD management, but its clinical efficacy and safety require further evaluation. This study aimed to assess the efficacy and safety of the Dysmenorrhea Patch in PD. Methods: This multicenter, randomized, double-blind, placebo-controlled trial was conducted at outpatient clinics in Shanghai, China. Recruitment period: May 2021 through October 2024. Women aged 18–40 years with primary dysmenorrhea were randomized 1:1 to receive the Dysmenorrhea Patch (acupoint application patch) or a placebo patch for three consecutive menstrual cycles. Patches were applied to predefined acupoints for 8 hours daily during the non-menstrual phase of each cycle and withheld during menstruation. The primary endpoint was total effective rate (TER) based on the percentage reduction in Numerical Rating Scale (NRS) scores. Secondary endpoints included NRS, Cox Menstrual Symptom Scale (CMSS), Traditional Chinese Medicine (TCM) syndrome score, serum Prostaglandin F2α (PGF2α) and Prostaglandin E2 (PGE2), rescue ibuprofen use, and safety outcomes (local skin reactions and serum alanine aminotransferase [ALT]). Results: Of 110 randomized participants, 102 participants completed the end-of-treatment assessment. After three cycles, TER was significantly higher in the intervention group than the control group (60.00% vs. 34.55%, p = 0.013). Adjusted post-treatment NRS pain intensity was lower in the intervention group (3.08 ± 0.22 vs. 4.55 ± 0.22; p < 0.001). Menstrual pain duration showed a non-significant trend favoring the intervention (1.59 ± 0.07 vs. 1.76 ± 0.07 days; p = 0.087). The intervention group also demonstrated lower TCM syndrome scores (20.73 ± 1.85 vs. 27.98 ± 1.85; p = 0.007) and improved CMSS severity (12.82 ± 1.53 vs. 18.29 ± 1.53; p = 0.013) and duration scores (14.79 ± 1.51 vs. 20.41 ± 1.51; p = 0.010). Serum PGF2α decreased and PGE2 increased in the intervention group, with significant between-group differences for PGF2α ( p = 0.027), PGE2 ( p = 0.041), and PGF2α/PGE2 ratio ( p < 0.001). Rescue ibuprofen use differed significantly between groups ( p = 0.033), favoring the intervention. No adverse events or ALT abnormalities were observed. Conclusion: Dysmenorrhea Patch acupoint application for three menstrual cycles improved clinical response and reduced pain intensity and symptom burden in women with Qi stagnation and blood stasis type PD, with favorable prostaglandin changes and good safety. Larger and longer-term studies with rigorous assessment of blinding and concomitant medication effects are warranted. Clinical Trial Registration: https://www.chictr.org.cn/showprojEN.html?proj=60256 , identifier ChiCTR2000037102.

Aerobic glycolysis is crucial in the proliferation, metastasis, immunosuppression of hepatocellular carcinoma (HCC). We established mice model with HCC to explore whether electroacupuncture and moxibustion can alleviate HCC mice by inhibiting NSUN2-mediated aerobic glycolysis. HCC mice model was established by intraperitoneal injection of diethylnitrosamine combined with carbon tetrachloride. In the moxibustion and electroacupuncture groups, the acupoints “Ganshu” and “Zusanli” (bilateral) were selected for intervention. Enzyme-linked immunosorbent assay quantified the serum levels. Immunohistochemistry/Western blotting, quantitative real-time PCR assessed protein and mRNA expressions of aerobic glycolysis. MRM-based targeted metabolomics quantified hepatic energy metabolism alterations. After HCC model completion on week 28, macroscopic examination revealed pronounced hepatomegaly with evident morphological distortion. The hepatic surface exhibited a coarse and irregular texture, accompanied by varying degrees of adhesions between adjacent liver lobes. Notably, large, well-defined tumors presenting in either whitish or dark-red appearances were observed scattered across the liver parenchyma. Following a total intervention period of 26 weeks, electroacupuncture and moxibustion significantly decreased the number of liver tumor, tumor load, mean tumor diameter and tumor volume compared to the model group (P < 0.05). Furthermore, the spleen and liver index were also significantly lowered (P < 0.05). A significant decrease was observed in the protein levels of serum AFP and AFP-L3 after treatment (P < 0.05). The protein and mRNA expression levels of NSUN2 and PKM2 were significantly downregulated (P < 0.01). Consistent with the inhibition of glycolytic flux, the protein expression of enzyme hexokinase 2 (HK2) was profoundly reduced (P < 0.001). Meanwhile, moxibustion decreased in the hepatic content of early glycolytic intermediates, glucose-6-phosphate (G6P) and fructose 6 phosphate (F6P) (P < 0.01), and electroacupuncture just decreased G6P (P < 0.001). Conversely, the level of phosphoenolpyruvate, a high-energy intermediate preceding the final step of glycolysis, was significantly elevated and increased (P < 0.001). The study reveals that both electroacupuncture and moxibustion alleviate tumor proliferation in HCC mice by suppressing the NSUN2-PKM2 glycolytic axis, thereby highlighting this pathway as a novel metabolic target for non-pharmacological intervention; moreover, moxibustion uniquely exhibits the potential to induce a more extensive metabolic stress response. The observed reductions in tumor burden and key biomarkers corroborate the therapeutic potential of this approach. Collectively, these preclinical findings suggest that electroacupuncture and moxibustion, as non-pharmacological adjunctive therapies, hold translational potential for modulating tumor metabolism and slowing HCC progression, warranting further clinical investigation.

Background: Hypertension is associated with a high rate of disability and mortality and leads to a substantial socioeconomic burden. Moxibustion is an external treatment in traditional Chinese medicine that has been used to treat mild to moderate hypertension in individuals with phlegm-dampness constitution and has demonstrated acupoint specificity. However, a standard large-scale randomized controlled trial is still needed to verify its effectiveness. This study is proposed to examine the clinical effectiveness and potential cardioprotective benefits of moxibustion performed at home as a treatment for individuals with phlegm-dampness hypertension. Objective: The objective of this trial is to evaluate the cardio-cerebral protective clinical efficacy of moxibustion for phlegm-dampness type hypertension and to explore its acupoint specific effects. Methods: This study is a multicenter, randomized controlled trial. A total of 120 patients with mild to moderate hypertension and phlegm-dampness constitution will be recruited and randomly assigned in a 1:1 ratio to the treatment group (acupoint: Zusanli, ST36) or the control group (acupoint: Xuanzhong, GB39). All patients will receive 12 weeks of treatment and a 12-week follow-up period. The primary outcome measure is the change in morning systolic blood pressure from baseline to week 12. The secondary outcome measures include blood pressure–related indicators (morning diastolic blood pressure, average systolic blood pressure, average diastolic blood pressure, nighttime systolic blood pressure, nighttime diastolic blood pressure, and blood pressure circadian rhythm) and short-term blood pressure variability coefficient, all of which will be measured by 24-hour ambulatory blood pressure monitoring. Additionally, cardiac-related indicators measured by 24-hour Holter monitoring, metabolic disorder-related indicators, liver and kidney function indicators, transformed scores of the traditional Chinese medicine phlegm-dampness constitution scale, and the Montreal Cognitive Assessment will also be evaluated. Results: This study was registered on July 5, 2024, with the Chinese Clinical Trial Registry. Data collection began in June 2023 and ended in February 2025. Currently, data from this trial are in the collection phase, and no data analysis has been performed. As of January 2025, we have collected data from 118 patients. The results of this trial are expected to be submitted for publication in May 2026. Conclusions: This multicenter, randomized, controlled clinical trial will provide evidence on the clinical effectiveness and potential cardioprotective benefits of moxibustion performed at home as a treatment for individuals with phlegm-dampness type of hypertension. Trial Registration: Chinese Clinical Trial Registry ChiCTR2400086582; https://www.chictr.org.cn/showproj.html?proj=211688 International Registered Report Identifier (IRRID): DERR1-10.2196/79158