Impacts of acupressure treatment on depression:A systematic review and meta-analysis

BACKGROUND Depression is recognized as a major public health problem with a substantial impact on individuals and society.Complementary therapies such as acupressure may be considered a safe and cost-effective treatment for people with depression.An increasing body of research has been undertaken to assess the effectiveness of acupressure in various populations with depression,but the evidence thus far is inconclusive.AIM To examine the efficacy of acupressure on depression.METHODS A systematic literature search was performed on PubMed,PsycINFO,Scopus,Embase,MEDLINE,and China National Knowledge(CNKI).Randomized clinical trials(RCTs)or single-group trials in which acupressure was compared with control methods or baseline in people with depression were included.Data were synthesized using a random-effects or a fixed-effects model to analyze the impacts of acupressure treatment on depression and anxiety in people with depression.The primary outcome measures were set for depression symptoms.Subgroups were created,and meta-regression analyses were performed to explore which factors are relevant to the greater or lesser effects of treating symptoms.RESULTS A total of 14 RCTs(1439 participants)were identified.Analysis of the betweengroup showed that acupressure was effective in reducing depression[Standardized mean differences(SMDs)=-0.58,95%CI:-0.85 to-0.32,P<0.0001]and anxiety(SMD=-0.67,95%Cl:-0.99 to-0.36,P<0.0001)in participants with mildto-moderate primary and secondary depression.Subgroup analyses suggested that acupressure significantly reduced depressive symptoms compared with different controlled conditions and in participants with different ages,clinical conditions,and duration of intervention.Adverse events,including hypotension,dizziness,palpitation,and headache,were reported in one study.CONCLUSION The evidence of acupressure for mild-to-moderate depressive symptoms was significant.Importantly,the findings should be interpreted with caution due to study limitations.Future research with a well-designed mixed method is required to consolidate the conclusion and provide an in-depth understanding of potential mechanisms underlying the effects.

Unexpected complexity of multidrug resistance in the mcr-1-harbouring Escherichia coli

Dear Editor,The discovery that the mobile colistin resistance gene(mcr-1)is encoded by plasmids and is prevalent in food animals and human beings worldwide(Hasman et al.,2015;Liu et al.,2015)has challenged greatly our traditional idea that polymyxin(consisting of two isoforms:polymyxin B and polymyxin E(colistin))acts as an ultimate line of refuge in the clinical treatment against the severe infections by the multidrug-resistant Gram-negative pathogens(Nation et al.,2015;Paterson and Harris,2015).To make

Diversified variants of the mcr-1-carrying plasmid reservoir in the swine lung microbiota

Dear Editor,Emergence of bacteria with multiple drug resistance is a major problem in global public health.Polymyxin comprising polymyxin E(colistin)and polymyxin B is generally recognized as the last-resort antibiotics with