Xuqiang Wei

Background: Perioperative neurocognitive disorder (PND) is a prevalent complication among older patients undergoing general anesthesia, imposing significant burdens on individuals, health care systems, and society. While electroacupuncture shows promise for PND prevention, current evidence remains inconclusive. Objective: This study aims to critically evaluate the effectiveness and safety of perioperative electroacupuncture for PND prevention in older patients undergoing surgery under general anesthesia. Methods: A comprehensive literature search will be conducted in 8 electronic databases (PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP Chinese Science and Technology Periodical Database, Wan Fang Database, and China Biomedical Literature Database) and 3 clinical trial registries from inception to March 16, 2025. The search strategy aims to identify all relevant randomized controlled trials evaluating perioperative electroacupuncture for PND prevention in older patients (aged ≥60 years) undergoing general anesthesia. The primary outcome will be the incidence of PND. Secondary outcomes will include (1) neuropsychological assessment scores (Mini-Mental State Examination and Montreal Cognitive Assessment), (2) serum inflammatory biomarker levels (interleukin-1β, interleukin-6, and tumor necrosis factor-α), (3) serum neurological damage marker levels (neuron-specific enolase and S100 calcium-binding protein β), and (4) safety outcomes (incidence of adverse events). Two independent reviewers will perform study selection, data extraction, and methodological quality assessment using the revised Cochrane risk of bias tool for randomized trials. All statistical analyses will be conducted in RevMan 5.4 using suitable meta-analysis models based on heterogeneity testing. The certainty of evidence will be evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: The study selection process will be presented through a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram, detailing the number of records identified, screened, and included. Characteristics of eligible studies will be summarized in evidence tables, including study designs and populations, intervention protocols, and outcome measures. The results will be visualized through a risk of bias graph, forest plots displaying pooled effect estimates with 95% CIs, and funnel plots for publication bias evaluation (when ≥10 studies are available). This protocol is currently in the active phase. The literature search has been completed as of April 2025, with an updated search planned until December 31, 2025. Data extraction is scheduled to commence on January 15, 2026, followed by data analysis starting February 1, 2026. Results are expected to be submitted for publication in March 2026. Conclusions: The effectiveness and safety of perioperative electroacupuncture for PND prevention in older patients undergoing general anesthesia remain uncertain. This systematic review will provide an evidence-based evaluation of perioperative electroacupuncture’s effectiveness in preventing PND, offer practical recommendations for optimizing surgical care for older adults, and identify knowledge gaps to inform future research.

Introduction Limited by the specific location of atopic facial dermatitis, treatment options for atopic dermatitis are limited. Our previous research confirms that BiShengZhiYan cream (BSZY cream) can reconstruct the damaged skin barrier and strengthen the repair ability of skin. However, little evidence of its efficacy and safety for the treatment of atopic facial dermatitis is available. Methods and analysis A protocol for a randomised, double-blind, controlled trial of BSZY cream is designed for patients with mild-to-moderate atopic facial dermatitis. We will recruit 130 patients with mild-to-moderate atopic facial dermatitis from the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine. The participants will be assigned to the BSZY cream group (treatment group) or the emulsion matrix group (control group) randomly. The intervention period will be 4 weeks, once daily in the morning and once in the evening. The primary outcome is the Scoring Atopic Dermatitis Scale. The Clinical Dermatologist Evaluation Form, Patient Self-Assessment Questionnaire and Safety Indicators will be evaluated as secondary outcomes. The follow-up will be conducted at week 8±3 days. The skin condition is assessed by a clinical dermatologist at week 0±3 days, week 2±3 days and week 4±3 days. Ethics and dissemination The protocol has been approved by Shanghai University of Traditional Chinese Medicine’s Yueyang Hospital ethics committee (No. 2023-024). All participants will be asked to sign an informed consent in compliance with the Declaration of Helsinki. On completion of the trial, we plan to disseminate the results through peer-reviewed publications and present the findings at relevant scientific conferences. Data will be provided on reasonable request under participant confidentiality and data privacy regulations. Trial registration number NCT05792826.

Introduction The incidence of postoperative gastrointestinal dysfunction (POGD) is notably high among patients following colorectal cancer surgery, highlighting the urgency for the prompt development of efficacious preventive and therapeutic approaches. Electroacupuncture (EA) represents an intervention modality that holds promise for the management of POGD. However, the existing empirical evidence substantiating its efficacy remains scarce. The aim of this study is to evaluate the efficacy and safety of EA as a treatment for POGD in patients undergoing colorectal cancer surgery. Methods This study is a multicenter, parallel-group, randomized controlled trial, named as CORRECT. CORRECT trial will recruit 300 participants diagnosed with colorectal cancer and about to undergo radical surgery across four sub-centers. The participants will be randomly assigned to one of three groups: the EA group, sham-electroacupuncture group, or control group, with a randomization ratio of 2:2:1. All groups will follow a standardized Enhanced Recovery After Surgery (ERAS) protocol. The EA group will receive EA at acupoints LI4, SJ6, ST36, and ST37, while the SA group will undergo sham-electroacupuncture. The treatments will be administered twice daily from the day of surgery until the fourth day after the operation. The primary endpoint is the time to first flatus, while secondary endpoints encompass time to first defecation, bowel sound emergence, initial water intake, duration of postoperative hospitalization, nausea and vomiting, pain levels, and blinded evaluations. Additional outcomes include medication usage and complication rates, et al. Discussion The CORRECT trial aims to provide high-quality evidence for the role of EA in the treatment of POGD following colorectal cancer surgery. It will contribute data towards the integration of acupuncture into ERAS protocols. Insights from the trial could help in tailoring treatment plans based on individual patient responses to EA, optimizing care on a case-by-case basis. Trial registration Clinical Trial Registry registration was approved by the ClinicalTrials.gov committee on November 2023 with the ClinicalTrials.gov Identifier: NCT06128785. URL: https://clinicaltrials.gov/study/NCT06128785?tab=history&a=1#study-details-card.

Background: Perioperative neurocognitive disorder (PND) is a critical concern for older patients undergoing cardiac surgery, impacting cognitive function and quality of life. Electroacupuncture and transcutaneous electrical acupoint stimulation (TEAS) hold promise for mitigating PND. This protocol outlines a systematic review and meta-analysis to thoroughly assess the efficacy of electroacupuncture and TEAS in older patients undergoing cardiac surgery with PND, providing up-to-date evidence for PND prevention and treatment. Objective: This study aimed to thoroughly assess the efficacy of electroacupuncture and TEAS in older patients undergoing cardiac surgery with PND, providing up-to-date evidence for PND prevention and treatment. Methods: A comprehensive and systematic approach will be used to identify eligible studies from a diverse range of electronic databases, including 9 major sources such as PubMed (NLM) and Cochrane (Wiley), as well as 2 clinical trial registration websites. These studies will focus on investigating the effects of electroacupuncture and TEAS on PND in older patients undergoing cardiac surgery. The study selection will adhere to the criteria outlined in the patient, intervention, comparison, outcome, and studies (PICOS) format. Data extraction will be carried out by 2 independent researchers (YP and LS), using established tools to evaluate the risk of bias. The primary outcome will be PND incidence, with secondary outcomes including Mini Mental State Examination scores, neuron-specific enolase, S100β, interleukin-1β, interleukin-6, tumor necrosis factor-α, time to first flatus, first defecation, bowel sound recovery, and hospitalization duration to be selectively reported. Adverse events linked to acupuncture, such as bleeding, needle site pain, and local reactions, rather than serious adverse events, will also be considered. Meta-analysis will be performed using appropriate statistical methods to assess the overall effect of electroacupuncture and TEAS on PND prevention, treatment, or other relevant outcomes. The Cochrane Collaboration Risk of Bias tool will be used for assessment, and data synthesis will be executed using the RevMan 5.4 software (Cochrane). Results: We plan to summarize the eligible studies through the use of a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. The findings will be showcased in the form of a summary table of evidence. Figures and forest plots will be used to illustrate the outcomes of the meta-analysis. Conclusions: The impacts of electroacupuncture and TEAS interventions on PND in older patients undergoing cardiac surgery have not yet been established. This protocol addresses a critical gap by thoroughly assessing electroacupuncture and TEAS for PND in older patients undergoing cardiac surgery, enhancing understanding of nonpharmacological interventions, and guiding future research and clinical practices in this field. Its strength lies in rigorous methodology, including comprehensive search strategies, independent review processes, and thorough assessments of the risk of bias. Trial Registration: PROSPERO CRD42023411927; https://tinyurl.com/39xdz6jb International Registered Report Identifier (IRRID): PRR1-10.2196/55996

BACKGROUND Perioperative neurocognitive disorder (PND) is a critical concern for older patients undergoing cardiac surgery, impacting cognitive function and quality of life. Electroacupuncture and transcutaneous electrical acupoint stimulation (TEAS) hold promise for mitigating PND. This protocol outlines a systematic review and meta-analysis to thoroughly assess the efficacy of electroacupuncture and TEAS in older patients undergoing cardiac surgery with PND, providing up-to-date evidence for PND prevention and treatment. OBJECTIVE This study aimed to thoroughly assess the efficacy of electroacupuncture and TEAS in older patients undergoing cardiac surgery with PND, providing up-to-date evidence for PND prevention and treatment. METHODS A comprehensive and systematic approach will be used to identify eligible studies from a diverse range of electronic databases, including 9 major sources such as PubMed (NLM) and Cochrane (Wiley), as well as 2 clinical trial registration websites. These studies will focus on investigating the effects of electroacupuncture and TEAS on PND in older patients undergoing cardiac surgery. The study selection will adhere to the criteria outlined in the patient, intervention, comparison, outcome, and studies (PICOS) format. Data extraction will be carried out by 2 independent researchers (YP and LS), using established tools to evaluate the risk of bias. The primary outcome will be PND incidence, with secondary outcomes including Mini Mental State Examination scores, neuron-specific enolase, S100β, interleukin-1β, interleukin-6, tumor necrosis factor-α, time to first flatus, first defecation, bowel sound recovery, and hospitalization duration to be selectively reported. Adverse events linked to acupuncture, such as bleeding, needle site pain, and local reactions, rather than serious adverse events, will also be considered. Meta-analysis will be performed using appropriate statistical methods to assess the overall effect of electroacupuncture and TEAS on PND prevention, treatment, or other relevant outcomes. The Cochrane Collaboration Risk of Bias tool will be used for assessment, and data synthesis will be executed using the RevMan 5.4 software (Cochrane). RESULTS We plan to summarize the eligible studies through the use of a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. The findings will be showcased in the form of a summary table of evidence. Figures and forest plots will be used to illustrate the outcomes of the meta-analysis. CONCLUSIONS The impacts of electroacupuncture and TEAS interventions on PND in older patients undergoing cardiac surgery have not yet been established. This protocol addresses a critical gap by thoroughly assessing electroacupuncture and TEAS for PND in older patients undergoing cardiac surgery, enhancing understanding of nonpharmacological interventions, and guiding future research and clinical practices in this field. Its strength lies in rigorous methodology, including comprehensive search strategies, independent review processes, and thorough assessments of the risk of bias. CLINICALTRIAL PROSPERO CRD42023411927; https://tinyurl.com/39xdz6jb INTERNATIONAL REGISTERED REPORT PRR1-10.2196/55996