Background: The purpose of this paper is to evaluate the effectiveness and safety of electroacupuncture in the treatment of spasticity after stroke. Methods: We will electronically search PubMed, Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-Fang Database from the date of creation to November 2020. In addition, we will manually retrieve other resources including the reference lists of identified publications, conference articles, and gray literature. The clinical randomized controlled trials or quasi-randomized controlled trials related to electroacupuncture in the treatment of spasticity after stroke will be included in the study. The language is limited to Chinese and English. Research selection, data extraction, and research quality assessment will be independently completed by 2 researchers. Data were synthesized by using a fixed effect model or random effect model depend on the heterogeneity test. The modified Ashworth scale was the primary outcomes. Simplified Fugl–Meyer assessment scale (FMA), Stroke specific quality of life scale (SS-QOL) and adverse events will also be assessed as secondary outcomes. RevMan V.5.3 statistical software will be used for meta-analysis. If it is not appropriate for a meta- analysis, then a descriptive analysis will be conducted. Data synthesis will use the risk ratio and the standardized or weighted average difference of continuous data to represent the results. Results: This study will provide a high-quality synthesis to assess the effectiveness and safety of electroacupuncture in the treatment of spasticity after stroke. Conclusion: This systematic review will provide evidence to judge whether electroacupuncture is an effective and safety intervention for patients with spasticity after stroke. Ethics and dissemination: The protocol of the systematic review does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and presented at relevant conferences. Systematic review registration: CRD42021220300.

Cerebral infarction (CI), a common cerebrovascular disease worldwide, is caused by unknown factors common to many diseases, including hypokalemia, respiratory diseases, and lower extremity venous thrombosis. Tianma Gouteng (TMGT), a traditional Chinese Medicine (TCM) prescription, has been used for the clinical treatment of CI. In this study, high-performance liquid chromatography (HPLC) fingerprint analysis was used to detect and identify major chemical constituents of TMGT. TCMSP and BATMAN-TCM databases were used to screen for active TMGT constituent compounds, while the GeneCards database was used to screen for protein targets associated with CI. Next, GO and KEGG enrichment analysis of these core nodes were performed to determine the identities of key associated biological processes and signal pathways. Meanwhile, a total of six possible gene targets of TMGT, including NFKBIA, PPARG, IL6, IL1B, CXCL8, and HIF1A, were selected for further study using two cellular models of CI. For one model, PC12 cells were treated under oxygen and glucose deprivation (OGD) conditions to generate an OGD cellular model of CI, while for the other model, BV2 cells were stimulated with lipopolysaccharide (LPS) to generate a cellular model of CI-associated inflammation. Ultimately TMGT treatment increased PPARγ expression and downregulated the expression of p-P65, p-IκBα, and HIF-1α in both OGD-induced and LPS-induced cell models of CI. In addition, molecular docking analysis showed that one TMGT chemical constituent, quercetin, may be a bioactive TMGT compound with activity that may be associated with the alleviation of neuronal damage and neuroinflammation triggered by CI. Moreover, additional data obtained in this work revealed that TMGT could inhibit neuroinflammation and protect brain cells from OGD-induced and LPS-induced damage by altering HIF-1α/PPARγ/NF-κB pathway functions. Thus, targeting this pathway through TMGT administration to CI patients may be a strategy for alleviating nerve injury and neuroinflammation triggered by CI.

Background:Limb spasms are a common complication of stroke. It not only affects the quality of life of stroke survivors, but also brings an economic burden. Tuina combined with physical therapy is widely used in the rehabilitation of poststroke spasticity. However, there is no supporting evidence for its efficacy and safety. This study aimed to evaluate the effectiveness and safety of Tuinas combined with physical therapy in the treatment of spasticity after stroke.Methods:Literature will be collected from the following databases: China Biology Medicine (CBM), Wanfang Database, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), PubMed, Embase, Cochrane Library, and Web of Science; We will include randomized controlled trials of Tuina combined with physical therapy for poststroke spasticity range from the establishment to May 1, 2021. There were no limitations to the publication time, and the language was limited to Chinese and English. The primary outcome was evaluated using the Modified Ashworth scale, and the secondary outcomes were the simplified Fugl-Meyer Assessment scale, Modified Barthel Index, Functional Independence Measurement (FIM), and Visual Analog Scale. RevMan V.5.4.1 software was used for the meta-analysis. The Cochrane Intervention System Evaluation Manual analyzes the risk of bias, and the recommended grading assessment, development and evaluation are used to assess the quality of evidence.Ethics and dissemination:This study will be based on published systematic review studies, no ethical approval is required and the results of the study will be published in a peer-reviewed scientific journal.Systematic review registration:INPLASY2021110064.

Background: Post-stroke depression (PSD) is the most common mental health issue, affecting approximately 33% of stroke survivors. Tuina and acupuncture treatments are often combined to treat PSD; however, there has been no meta-analysis on their synergistic effect. Therefore, we aimed to perform a systematic review and meta-analysis to estimate the effectiveness of Tuina and acupuncture in PSD treatment. Methods: The following electronic databases will be searched: PubMed, the Cochrane Library, Embase, Web of Science, Medline, CNKI, Chinese Biomedical Literature Database, VIP, and Wan Fang databases. We will consider articles published between database initiation and April 2021. Clinical randomized controlled trials related to Tuina combined with acupuncture for post-stroke depression will be included in the study. Language is limited to Chinese and English. Research selection, data extraction, and research quality assessment were independently completed by 2 researchers. Data were synthesized using a fixed effect model or random effect model, depending on the heterogeneity test. The Hamilton depression rating scale (HDRS) and effective rate were the primary outcomes. The post-stroke depression rating scale (PSDRS), patient health questionnaire-9 (PHQ-9), and the incidence of adverse events will also be assessed as secondary outcomes. RevMan V.5.4 statistical software will be used for meta-analysis. If it is not appropriate for a meta-analysis, a descriptive analysis will be conducted. Data synthesis uses the risk ratio and the standardized or weighted average difference of continuous data to represent the results. Results: This study provides a high-quality synthesis to assess the effectiveness and safety of Tuina for post-stroke depression. Conclusion: This systematic review will provide evidence to determine whether Tuina plus acupuncture is an effective and safe intervention for patients with post-stroke depression. Ethics and dissemination: The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences. Systematic review registration: INPLASY202140098

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