Acupoint Selection Standards of Auricular Therapy in the Treatment of Maintenance Hemodialysis Insomnia Based on Data Mining

Background:Insomnia is a high-incidence complication in patients undergoing maintenance hemodialysis(MHD).Auricular therapy can effectively improve sleep with few adverse effects.Acupoint selection affects the impact of auricular therapy.However,there is currently a lack of analysis on the standards of acupoint selection.Our study used data mining technology to investigate the acupoint selection principles and characteristics of auricular therapy for the treatment of MHD-related insomnia.Objective:The objective of the study is to explore the standards of acupoint selection in auricular therapy for the treatment of MHD-related insomnia through data mining technology.Materials and Methods:We searched three English(PubMed,WOS,and Embase)and four Chinese(CNKI,VIP,Wangfang,and CBM)databases for studies on auricular therapy for MHD-related insomnia from self-establishment to November 14,2022.Results:Eighty-one publications were involved,which included 33 acupoints.The most common auricular points in patients with MHD-related insomnia were the Shenmen,heart,and kidney points.More applications involved the visceral,nervous system,and specific acupoints.Five effective clusters and two clusters were obtained through cluster analysis,including specific auricular points for insomnia,such as the multi-dream area,neurasthenia area,deep sleep point,and anterior ear lobe.Complex network analysis showed that the core auricular acupoint combinations for the intervention of MHD-related insomnia were Shenmen with kidney,Shenmen with heart,heart with kidney,heart with Shenmen,and heart and Shenmen with subcortex.Conclusions:The selection of auricular points for the treatment of MHD-related insomnia was guided by the heart theory of traditional Chinese medicine.Clinical treatment attaches importance to the use of the multi-dream area,neurasthenia area,and other acupoints.

Highly efficient enantioselective synthesis of bispiro[benzofuran-oxindole/benzofuran-chromanone]s through organocatalytic inter-/intramolecular Michael cycloaddition

A quinine-derived thiourea-catalyzed inter-/intramolecular Michael cycloaddition of chromoneoxindole/benzofuranone synthons with 3-substituted methylenebenzofuranones has been established,which constructed enantiomerically pure bispiro[benzofuran-oxindole/benzofuran-chromanone]s bearing five consecutive stereocenters including two spiro quaternary carton centers in good yields(up to 93%) with high diastereoselectivities(up to>20:1 dr) and good enantioselectivities(up to>99% ee).Moreover,this is the first example of bifunctional chromone-benzofuranone synthon directed organocatalytic tandem reaction,and also the first example of the bispiro[benzofuran-oxindole] and bispirobenzofuranone,potentially useful in medicinal chemistry.