Effectiveness of Acupuncture in the Treatment of Hyperemesis Gravidarum: A Systematic Review and Meta-Analysis.

BACKGROUND: Hyperemesis gravidarum (HG) is a common gastrointestinal disease afflicting gravidas. It usually results in hospital admission in early pregnancy. OBJECTIVE: Through a meta-analysis, this study intended to explore acupuncture's clinical efficacy in treating HG. MATERIALS AND METHODS: A comprehensive search of PubMed, the Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biological Medical (CBM), Wanfang Database, and China Science and Technology Journal (VIP) for published clinical randomized controlled trials (RCTs) of acupuncture for treating HG was conducted from the date of database creation to 20th January 2021. We also searched grey literature in four databases: Chinese Cochrane Center, Chinese Clinical Trial Registry, GreyNet International, and Open Grey from their inception to 20th January 2021. Two authors independently screened the literature, extracted data, and evaluated the quality of the literature with Cochrane Handbook 5.1.0 and Review Manager 5.2 software. Review Manager 5.2 and STATA 12.0 software were applied to analyze data. Heterogeneity analysis was performed by the Cochran Chi-square test and I 2 statistic. Egger's tests together with funnel plots were used to identify publication bias. RESULTS: A total of 16 trials covering 1043 gravidas were included. Compared with the conventional treatment, acupuncture had a significantly higher effective rate (OR: 8.11, 95% CI: 5.29∼12.43; P < 0.00001), a higher conversion rate of urine ketone (RR: 1.36, 95% CI: 1.15∼1.60; P=0.0003), an improvement rate of nausea and vomiting (OR: 26.44, 95% CI: 3.54∼197.31; P=0.001), and a relatively higher improvement rate of food intake (RR: 1.17, 95% CI: 1.01∼1.36; P=0.04). Acupuncture also shortened hospitalization time and manifested with a lower pregnancy termination rate and fewer adverse events. Nevertheless, no statistical variation in the improvement of nausea intensity, vomiting episodes, and lassitude symptom, recurrence rate, and serum potassium was observed. CONCLUSION: Our study suggested that acupuncture was effective in treating HG. However, as the potential inferior quality and underlying publication bias were found in the included studies, there is a need for more superior-quality RCTs to examine their effectiveness and safety. PROSPERO registration number: CRD42021232187.

Stable 1T-phase MoS2 as an effective electron mediator promoting photocatalytic hydrogen production.

Coupling two semiconductors together to construct a Z-scheme type photocatalytic system is an efficient strategy to solve the serious recombination challenge of photogenerated electrons and holes. In this work, we develop a novel composite photocatalyst by sandwiching metallic 1T-phase MoS2 nanosheets between MoO3 and g-C3N4 (MoO3/1T-MoS2/g-C3N4) for the first time. The metallic 1T-phase MoS2 acts as an efficient electron mediator between MoO3 and g-C3N4 to construct an all-solid-state Z-scheme photocatalytic system, resulting in a highly-efficient spatial charge separation and transfer process. Benefiting from this, the newly developed MoO3/1T-MoS2/g-C3N4 exhibits a drastically enhanced photocatalytic H2 evolution rate of 513.0 µmol h-1 g-1 under visible light irradiation (>420 nm), which is nearly 12 times higher than that of the pure g-C3N4 (39.5 µmol h-1 g-1), and 3.5 times higher than that of MoO3/g-C3N4 (145.7 µmol h-1 g-1). More importantly, the originally unstable 1T-phase MoS2 becomes very stable in MoO3/1T-MoS2/g-C3N4 because of the sandwich structure where 1T-phase MoS2 is protected by MoO3 and g-C3N4, which endows the photocatalyst with excellent photostability. It is believed that this study will provide new insights into the design of efficient and stable Z-scheme heterostructures for photocatalytic applications.

Multiple carrier-transfer pathways in a flower-like In2S3/CdIn2S4/In2O3 ternary heterostructure for enhanced photocatalytic hydrogen production.

A novel flower-like In2S3/CdIn2S4/In2O3 (ICS) ternary heterostructure (HS) is rationally constructed for the first time by a series of carefully designed procedures. In2O3 nanoflakes are the main constituent units which assemble into a flower-like skeleton structure, and CdIn2S4 nanoparticles are in situ generated on the surface of In2O3 nanoflakes through the transformation of CdS quantum dots (QDs) while In2S3 nanoparticles are in situ produced at the region between CdIn2S4 nanoparticles and In2O3 nanoflakes resulting from a synchronous sulfuration procedure. As expected, the rationally designed ICS ternary HSs display significantly enhanced photocatalytic H2 production, especially ICS5 (sulfurized for 5 h) with the highest H2 evolution rate of 20.04 µmol h-1 (10 mg catalyst is used for photocatalytic reaction), which is 26.7 times and 2.6 times higher than that of pure In2O3 (0.75 µmol h-1) and In2S3/In2O3 binary HS (7.88 µmol h-1), respectively. The enhanced photocatalytic activity can be attributed to the multiple interfaces formed in the ICS HSs, including the CdIn2S4-In2O3 interface, the In2S3-In2O3 interface, and the CdIn2S4-In2O3-In2S3 interface, which construct multiple pathways for the transfer of photogenerated charge carriers, effectively promoting the photocatalytic hydrogen production.

WS2 /Graphitic Carbon Nitride Heterojunction Nanosheets Decorated with CdS Quantum Dots for Photocatalytic Hydrogen Production.

Two-dimensional/two-dimensional (2D/2D) stacking heterostructures are highly desirable in fabricating efficient photocatalysts because face-to-face contact can provide a maximized interfacial region between the two semiconductors; this largely facilitates the migration of charge carriers. Herein, a WS2 /graphitic carbon nitride (CN) 2D/2D nanosheet heterostructure decorated with CdS quantum dots (QDs) has been designed, for the first time. Optimized CdS/WS2 /CN without another cocatalyst exhibits a significantly enhanced photocatalytic H2 evolution rate of 1174.5 µmol h-1 g-1 under visible-light irradiation (λ>420 nm), which is nearly 67 times higher than that of the pure CN nanosheets. The improved photocatalytic activity can be primarily attributed to the highly efficient charge-transfer pathways built among the three components, which effectively accelerate the separation and transfer of photogenerated electrons and holes, and thus, inhibit their recombination. Moreover, the extended light-absorption range also contributes to excellent photocatalytic efficiency. In addition, the CdS/WS2 /CN photocatalyst shows excellent stability and reusability without apparent decay in the photocatalytic H2 evolution within 4 cycles in 20 h. It is believed that this work may shed light on specifically designed 2D/2D nanosheet heterostructures for more efficient visible-light-driven photocatalysts.

Adverse events associated with acupuncture: three multicentre randomized controlled trials of 1968 cases in China.

BACKGROUND: In order to evaluate the safety of acupuncture in China objectively, we investigated the adverse events associated with acupuncture based on three multicentre randomized controlled trials (RCTs) to assess the safety of acupuncture, identifying the common types of acupuncture adverse events, and analysing the related risk factors for their occurrence. METHODS: This observational study included patients who received acupuncture from three multicentre RCTs respectively for migraine, functional dyspepsia and Bell's palsy. The 1968 patients and their acupuncturists documented adverse events associated with acupuncture after treatment. We collected data about adverse events due to acupuncture treatment from their case report forms. We analysed the incidence and details of the adverse effects, and studied the risk factors for acupuncture adverse events with non-conditional logistic regression analysis. RESULTS: Among the 1968 patients, 74 patients (3.76%) suffered at least one adverse event throughout the treatment period. We did not observe the occurrence of serious adverse events. 73 patients with adverse events recovered within 2 weeks through effective treatment such as physiotherapy or self-treatment. A total of 3 patients withdrew because of adverse events. There were 9 types of adverse events related to acupuncture, including subcutaneous haematoma, bleeding, skin bruising and needle site pain. Subcutaneous haematoma and haemorrhage in the needling points were the most common adverse events. Age and gender were related to the occurrence of acupuncture adverse events. The older the patients were, the higher the risk of adverse events was. In addition, male patients had slightly higher risk of an adverse event than female patients. CONCLUSIONS: Acupuncture is a safe therapy with low risk of adverse events in clinical practice. The risk factors for adverse events (AEs) were related to the patients' gender and age and the local anatomical structure of the acupoints. AEs could be reduced and mitigated by improving the medical environment, ensuring a high technical level of the acupuncture practitioners and establishing a good relationship of mutual trust between doctor and patient. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00599586, NCT00599677, NCT00608660.