Objective:To evaluate the efficacy and safety of Tuina(Chinese therapeutic massage)in the treatment of functional dyspepsia(FD)in children and adults. Methods:Related articles in PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,Web of Science,China Biology Medicine Disc(CBM),Wanfang Academic Journal Full-text Database(Wanfang),China National Knowledge Infrastructure(CNKI),and Chongqing VIP Database(CQVIP)were collected.The retrieval time was from each database's start to March 2022.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included studies.A meta-analysis was then performed using the RevMan 5.4 software. Results:A total of 19 clinical trials were included,9 of which encompassed studies on adults while 10 were on children with FD,comprising a total of 1961 patients.The findings of the meta-analysis showed that the effective rate of FD in children and adults treated with Tuina was significantly higher than that in the control group[risk ratio(RR)=1.15,95%confidence interval(CI)(1.09,1.21),P<0.001],[RR=1.13,95%CI(1.06,1.21),P<0.001].In addition,the effective rate of FD in children and adults treated with Tuina combined with other treatments was significantly higher than that in the control group[RR=1.14,95%CI(1.07,1.21),P<0.001],[RR=1.12,95%CI(1.02,1.24),P=0.02].In terms of single symptoms,Tuina improved epigastric burning sensation score in adults[standardized mean difference(SMD)=-0.41;95%CI(-0.79,-0.02);Z=2.08;P=0.04]compared with that of the Western medicine group.Compared with children treated with oral Chinese medications(CM)or Chinese patent medicine(CPM),children with FD demonstrated lower scores of epigastric pain[SMD=-0.38,95%CI(-0.56,-0.19);Z=3.96;P<0.001],postprandial fullness[SMD=-0.30,95%CI(-0.50,-0.10);Z=2.88;P=0.004],and early satiety[SMD=-0.26,95%CI(-0.47,-0.06);Z=2.54;P=0.01]after receiving Tuina combined with CM or CPM treatment.No adverse events were reported in the Tuina treatment group,and the follow-up indicated that the symptom scores in the Tuina group improved. Conclusion:Compared with the control group,both Tuina and Tuina combined with other treatments are shown to have better effective rates,lower incidence of adverse events,and better follow-up outcomes.The study results suggest that Tuina may be a clinically viable complementary therapy.However,due to limitations in the number and quality of the included studies,the above conclusions should be verified by further high-quality studies.

Background: Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder mainly caused by homozygous deletions that include exon 7 of the survival motor neuron 1 (SMN1) gene. A nearby paralog gene, SMN2, obstructs the specific detection of SMN1. We optimized a duplexed real-time PCR approach using locked nucleic acid (LNA)-modified primers to specifically detect SMN1. Methods: An LNA-modified primer pair with 3´ ends targeting SMN1 specific sites c.835-44g and c.840C was designed, and its specificity was examined by real-time PCR and Sanger Sequencing. A duplexed real-time PCR approach for amplifying SMN1 and control gene albumin (ALB) was developed. A randomized double-blind trial with 97 fresh peripheral blood samples and 25 dried blood spots (DBS) was conducted to evaluate the clinical efficacy of the duplexed approach. This new approach was then used to screen 753 newborn DBS. Results: The LNA-modified primers exhibited enhanced specificity and 6.8% increased efficiency for SMN1 amplification, compared with conventional primers. After stabilizing the SMN1 test by optimizing the duplexed real-time PCR approach, a clinical trial validated that the sensitivity and specificity of our new approach for detecting SMA patients and carriers was 100%. Using this new approach, 15 of the screened 753 newborns were identified as carriers via DBS, while the rest were identified as normal individuals. These data reveal a carrier rate of 1.99% in Hunan province, South Central China. Conclusions We have developed a novel, specific SMN1 detection approach utilizing real-time PCR with LNA-modified primers, which could be applied to both prenatal carrier and newborn screening.