Objective. To determine the effectiveness and safety of acupuncture for perimenopausal depression. Methods. We searched the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, CNKI, VIP Citation Databases, Wan Fang, and online trial registries such as ClinicalTrials.gov for randomized controlled trials (RCTs) assessing the efficacy and safety of acupuncture for perimenopausal depression. Literature screening, data extraction, and determination of the risk of bias were performed by two researchers independently. The extracted data were pooled and meta-analyzed using RevMan5.3 software. Results. In total, 16 RCTs covering 1311 patients were enrolled. Overall, the results showed that acupuncture was more effective in the treatment of perimenopausal depression than antidepressants (OR = 2.68, 95% CI (1.84, 3.90), P<0.00001). Furthermore, HAMD scores in the manual acupuncture group and electroacupuncture group were lower than those of antidepressants (manual acupuncture vs. antidepressants (MD = −2.35, 95% CI (−2.93, −1.77), P<0.00001) and electroacupuncture vs. antidepressants (MD = −1.2, 95% CI (−1.92, −0.48), P=0.001)). Data analysis revealed that the treatment effect of acupuncture was more stable than that of antidepressants (MD = −2.4, 95% CI (−3.37, −1.43), P<0.00001). Moreover, acupuncture was safer than antidepressants based on the incidence of adverse events (OR = 0.23, 95% CI (0.1, 0.52), P=0.0004). But acupuncture has no effect on estrogen levels (P≥0.05). Conclusions. Acupuncture for perimenopausal depression is safe and effective. Moreover, it has more stable long-term effects than antidepressants and hormone replacement therapy (HRT). We recommend acupuncture as a clinical treatment of perimenopausal depression.

Background: Breast cancer is the most prevalent cancer among women globally, and surgical procedures are still evaluated as the primary treatment. Faced with the unknown and fear of surgery, previous evidence highlights that over 50% of patients are trapped with preoperative anxiety. However, preoperative anxiety takes responsibility to a variety of diseases and body dysfunction. While drug therapy is widely recognized to tackle with preoperative anxiety, how it is used is still in heated debate, due to its own side effects. Therefore, non-pharmacological therapies to relieve anxiety, including using different methods to conduct preoperative education, gradually emerge and receive increasing attention. WeChat is a synthetical application integrating social media, instant messaging, mobile payment, and e-commerce functions. It is honored as one of the most popular social media platforms worldwide. And WeChat public platform has earned public's recognition as a handy way to transmit information, but whether it is an effective preoperative education tool has not been reported yet. Consequently, this study intends to use WeChat public platform as a tool to conduct preoperative education for persons undergoing breast surgery. Methods: This is a prospective, randomized, and controlled trial. A total of 392 adult women undergoing breast cancer resection will be randomly assigned to the WeChat education group and the regular group. In addition to the regular preoperative visits, the WeChat education group will also watch science videos through a WeChat public platform preoperatively. The regular group only received regular preoperative visits and education by ward nurses. The main observation indicator is the incidence of preoperative anxiety defined as the scores of State Anxiety Inventory (SAI) more than 40 points. The secondary outcome indicators are the incidence of severe anxiety (SAI > 44) the day before surgery, incidence of anxiety 72 hours after surgery, incidence of severe anxiety 72 hours after surgery, NRS scores for pain at rest and during activity 24, 48 and 72 hours after surgery, incidence of nausea and vomiting within 24 hours after surgery, subjective sleep score at 1 week postoperatively, quality of life QoR-15 scores at 1 and 3 months postoperatively, incidence of chronic pain at 3 months postoperatively, bowel function recovery, length of hospital stay and hospitalization expenses. Discussion: This is the first clinical trial attempting to deliver preoperative education on perioperative anxiety through WeChat public platform in breast cancer patients. Our study takes advantage of renowned WeChat public platform to improve the prognosis of patients by providing video education explaining the disease, surgery, and anesthesia preoperatively in a more susceptive way to reduce the incidence of perioperative anxiety. Once our hypothesis is confirmed, this immediate, handy, and flexible non-pharmacological approach may be universally acknowledged as a cost-effective and practical method in clinical care. Its application will also be extended to other fields beyond breast cancer. Trial registration: ClinicalTrials.gov, NCT05291494. Registered on 29 December 2021.