The degradation of TYR variants derived from Chinese OCA families is mediated by the ERAD and ERLAD pathway.

Oculocutaneous albinism (OCA) is a genetically heterogeneous group of autosomal recessive disorders, which presents with decreased or absent pigmentation in the hair, skin, and eyes. OCA1, as a subtype of OCA, is caused by mutations in the tyrosinase gene (TYR). In this study, we performed in vitro functional analysis of eight TYR variants (one frameshift variant: c.929dupC (p.Arg311Lysfs*7); seven missense variants: c.896G>A (p.Arg299His), c.1234C>A (p.Pro412Thr), c.1169A>G (p.His390Arg), c.937C>A (p.Pro313Thr), c.636A>T (p.Arg212Ser), c.623 T>G (p.Leu208Arg), c.1325C>A (p.Ser442Tyr)) identified in Chinese OCA families. TYR plasmids were transfected into HEK 293 T cells to explore the effects of TYR variants on their processing, protein expression, activity, and degradation. The results showed that all eight variants caused TYR to be retained in the endoplasmic reticulum (ER), processing was blocked, and TYR activity almost disappeared; the frameshift variant caused the size of the TYR protein to be reduced by about 30KD, and the protein expression of the remaining seven missense variants was reduced; the ER-associated degradation (ERAD) pathway mediates the degradation of TYR variants that occur on the Tyrosinase copper-binding domain, while the degradation of TYR variants that are not located on that domain may be mediated by a new degradation pathway--ER-to-lysosome-associated degradation (ERLAD). In summary, TYR variants affected their protein processing and activity, and may also induce ER stress and trigger degradation through the ERLAD pathway in addition to the ERAD degradation pathway, providing new insights into the potential pathogenic mechanism for OCA1 caused by TYR variants.

Site-selective construction of N-linked glycopeptides through photoredox catalysis.

The glycosylation of peptides and proteins can significantly impact their intrinsic properties, such as conformation, stability, antigenicity, and immunogenicity. Current methods for preparing N-linked glycopeptides typically rely on amide bond formation, which can be limited by the presence of reactive functional groups like acids and amines. Late-stage functionalization of peptides offers a promising approach to obtaining N-linked glycopeptides. In this study, we demonstrate the preparation of N-linked glycopeptides through a photoredox-catalyzed site-selective Giese addition between N-glycosyl oxamic acid and peptides containing dehydroalanine (Dha) under visible light conditions. Unlike traditional methods that rely on the coupling of aspartic acid and glycosylamine, this approach utilizes the conjugation of N-glycosylated carbamoyl radicals with Dha, facilitating the straightforward modification of complex peptides.

Evaluation and driving force analysis of ecological environment in low mountain and hilly regions based on optimized ecological index.

In low mountain and hilly regions, vegetation cover is higher and plant growth has an accumulative effect, sequestering carbon more strongly. The traditional remote sensing based ecological index (RSEI) lacks the consideration of vegetation productivity, and using it to evaluate ecological environment in low mountain and hilly regions will be biased. In this study, the vegetation productivity was introduced to construct a natural remote sensing based ecological index (NRSEI) that responds to the low mountain and hilly regions, as an example of Gaizhou City, China. Additionally, this study explored the spatiotemporal evolution of ecological environment quality from 2014 to 2020 and quantified the influences of factors. The results show that the first principal component (PC1) increased from 56 to 67% to 65-87% and considered the accumulation process in the ecosystem. NRSEI was more valid. From 2014 to 2020, the quality of the ecological environment generally declined and then increased. The area with "Excellent" increased from 23 to 38%. The quality of ecosystems in the west, northwest, and south deteriorated significantly, a distribution pattern of "high in the center, low in the north and south". Landuse and topographic conditions dominate the impacts on the ecosystem in the context of social, economic and policy influences. The interactions of the factors were two-factor enhancement that together affect the ecological environment. The results contribute to the development of urban conservation policies in low mountain and hilly regions.

Prevalence and correlations of schistosomiasis mansoni and schistosomiasis haematobium among humans and intermediate snail hosts: a systematic review and meta-analysis.

BACKGROUND: The control of schistosomiasis is particularly difficult in sub-Saharan Africa, which currently harbours 95% of this disease. The target population for preventive chemotherapy (PC) is expanded to all age group at risk of infection, thus increasing the demands of praziquantel (PZQ) tablets according to the new released guideline by World Health Organization. Due to the gap between available PZQ for PC and requirements, alternative approaches to assess endemicity of schistosomiasis in a community, are urgently needed for more quick and precise methods. We aimed to find out to which degree the infection status of snails can be used to guide chemotherapy against schistosomiasis. METHODS: We searched literature published from January 1991 to December 2022, that reported on the prevalence rates of Schistosoma mansoni, S. haematobium in the intermediate snails Biomphalaria spp. and Bulinus spp., respectively, and in humans. A random effect model for meta-analyses was used to calculate the pooled prevalence estimate (PPE), with heterogeneity assessed using I-squared statistic (I2), with correlation and regression analysis for the exploration of the relationship between human S. mansoni and S. haematobium infections and that in their specific intermediate hosts. RESULTS: Forty-seven publications comprising 59 field investigations were included. The pooled PPE of schistosomiasis, schistosomiasis mansoni and schistosomiasis haematobium in humans were 27.5% [95% confidence interval (CI): 24.0-31.1%], 25.6% (95% CI: 19.9-31.3%), and 28.8% (95% CI: 23.4-34.3%), respectively. The snails showed an overall infection rate of 8.6% (95% CI: 7.7-9.4%), with 12.1% (95% CI: 9.9-14.2%) in the Biomphalaria spp. snails and 6.9% (95% CI: 5.7-8.1%) in the Bulinus spp. snails. The correlation coefficient was 0.3 (95% CI: 0.01-0.5%, P < 0.05) indicating that the two variables, i.e. all intermediate host snails on the one hand and the human host on the other, were positively correlated. CONCLUSIONS: The prevalence rate of S. mansoni and S. haematobium is still high in endemic areas. Given the significant, positive correlation between the prevalence of schistosomes in humans and the intermediate snail hosts, more attention should be paid to programme integration of snail surveillance in future.

The reporting quality of meta-epidemiological studies needs substantial improvement: a research on research study.

BACKGROUND: Meta-epidemiological research plays a vital role in providing empirical evidence needed to develop methodological manuals and tools, but the reporting quality has not been comprehensively assessed, and the influence of reporting guidelines remains unclear. The current study aims to evaluate the reporting quality of meta-epidemiological studies, assess the impact of reporting guidelines, and identify factors influencing reporting quality. METHODS: We searched PubMed and Embase for meta-epidemiological studies. The reporting quality of these studies was assessed for adherence to established reporting guidelines. Two researchers independently screened the studies and assessed the quality of the included studies. Time-series segmented linear regression was used to evaluate changes in reporting quality over time, while beta-regression analysis was performed to identify factors significantly associated with reporting quality. RESULTS: We initially identified 1720 articles, of which 125 meta-epidemiological studies met the inclusion criteria. Of these, 65 (52%) had low reporting quality, 60 (48%) had moderate quality, and none achieved high quality. Of the 24 items derived from established reporting guidelines, 4 had poor adherence, 13 had moderate adherence, and 7 had high adherences. High journal impact factor (≥ 10) (OR = 1.42, 95% CI: 1.13, 1.80; P = 0.003) and protocol registration (OR = 1.70, 95% CI: 1.30, 2.22; P < 0.001) were significantly associated with better reporting quality. The publication of the reporting guideline did not significantly increase the mean reporting quality score (- 0.53, 95% CI: - 3.37, 2.31; P = 0.67) or the trend (- 0.38, 95% CI: - 1.02, 0.26; P = 0.20). CONCLUSIONS: Our analysis showed suboptimal reporting quality in meta-epidemiological studies, with no improvement post-2017 guidelines. This potential shortcoming could hinder stakeholders' ability to draw reliable conclusions from these studies. While preregistration could reduce reporting bias, its adoption remains low. Registration platforms could consider creating tailored types for meta-epidemiological research, and journals need to adopt more proactive measures to enforce reporting standards.

Improving Hybrid Tin Halide Films of Lead-Free Perovskite Solar Cells with a Volatile Additive of Dipropyl Sulfide.

Lead-free perovskite solar cells with hybrid tin halides (Sn-PVKs) as harvesters have attracted attention with respect to eliminating the contamination of conventional hybrid lead halides. However, Sn-PVK films usually have inferior performance due to rapid crystallization and uncontrollable morphology. Moreover, Sn2+ ions suffer from irreversible oxidation that results in self-doping and device instability. Additive engineering is a key strategy for improving the quality of Sn-PVK films, but solid residues of additives could degrade the transport-recombination process. In this work, dipropyl sulfide (DPS) was introduced as a volatile additive into the precursor solution, and no residue exists in the Sn-PVK films after thermal annealing. The coordinating ability of DPS molecules stabilized Sn2+ ions to form the intermediate complex, which retards the crystallization and oxidation of Sn-PVK films. Consequently, the power conversion efficiencies of devices increase from 11.0% to 12.9% with less recombination and a lower leakage current, and the stability of the devices is improved simultaneously.

Integrated Assays of Genome-Wide Association Study, Multi-Omics Co-Localization, and Machine Learning Associated Calcium Signaling Genes with Oilseed Rape Resistance to Sclerotinia sclerotiorum.

Sclerotinia sclerotiorum (Ss) is one of the most devastating fungal pathogens, causing huge yield loss in multiple economically important crops including oilseed rape. Plant resistance to Ss pertains to quantitative disease resistance (QDR) controlled by multiple minor genes. Genome-wide identification of genes involved in QDR to Ss is yet to be conducted. In this study, we integrated several assays including genome-wide association study (GWAS), multi-omics co-localization, and machine learning prediction to identify, on a genome-wide scale, genes involved in the oilseed rape QDR to Ss. Employing GWAS and multi-omics co-localization, we identified seven resistance-associated loci (RALs) associated with oilseed rape resistance to Ss. Furthermore, we developed a machine learning algorithm and named it Integrative Multi-Omics Analysis and Machine Learning for Target Gene Prediction (iMAP), which integrates multi-omics data to rapidly predict disease resistance-related genes within a broad chromosomal region. Through iMAP based on the identified RALs, we revealed multiple calcium signaling genes related to the QDR to Ss. Population-level analysis of selective sweeps and haplotypes of variants confirmed the positive selection of the predicted calcium signaling genes during evolution. Overall, this study has developed an algorithm that integrates multi-omics data and machine learning methods, providing a powerful tool for predicting target genes associated with specific traits. Furthermore, it makes a basis for further understanding the role and mechanisms of calcium signaling genes in the QDR to Ss.

Hypertensive Heart Disease: Mechanisms, Diagnosis and Treatment.

Hypertensive heart disease (HHD) presents a substantial global health burden, spanning a spectrum from subtle cardiac functional alterations to overt heart failure. In this comprehensive review, we delved into the intricate pathophysiological mechanisms governing the onset and progression of HHD. We emphasized the significant role of neurohormonal activation, inflammation, and metabolic remodeling in HHD pathogenesis, offering insights into promising therapeutic avenues. Additionally, this review provided an overview of contemporary imaging diagnostic tools for precise HHD severity assessment. We discussed in detail the current potential treatments for HHD, including pharmacologic, lifestyle, and intervention devices. This review aimed to underscore the global importance of HHD and foster a deeper understanding of its pathophysiology, ultimately contributing to improved public health outcomes.

Preparation and Application of a Sulfur-Doped Fluorescent Carbon Dots with Aggregation-Induced Emission Character.

As a new type of zero-dimensional nanomaterial, carbon dots are widely applied in various fields. However, most of the carbon dots have aggregation fluorescence quenching properties, which limited their practical applications. In this study, a novel sulfur-doped carbon dots (S-CDs) was prepared by solvothermal method. The properties of the S-CDs in ethanol solution and in solid state were investigated respectively. The results showed that the S-CDs have an excited wavelength dependent emission of blue fluorescence in ethanol solution, and have orange fluorescence emission in solid state and composite films, indicating the prepared S-CDs has aggregation-induced emission (AIE) performance. The main reason was that the presence of S-S bonds and the intramolecular rotation of aromatic rings were limited in solid state, resulting in its emission of orange fluorescence. Furthermore, the S-CDs could be applied to identify fingerprints, anti-counterfeiting.

Zwitterionic Thiolate-Protected Ag22(0/I) and Ag20(I) Clusters: Assembly, Structural Characterization, and Antibacterial Activity.

Zwitterionic thiolate ligands have the potential to introduce novel assembly modes and functions for noble metal clusters. However, their utilization in the synthesis of silver clusters remains understudied, particularly for the clusters containing reductive Ag(0) species. In this article, we report the first synthesis of a mixed-valence silver(0/I) cluster protected by zwitterionic Tab as thiolate ligands (Tab = 4-(trimethylammonio)benzenethiolate), denoted as [Ag22(Tab)24](PF6)20·16CH3OH·6Et2O (Ag22·16CH3OH·6Et2O), alongside an Ag(I) cluster [Ag20(Tab)12(PhCOO)10(MeCN)2(H2O)](PF6)10·11MeCN (Ag20·11MeCN). Ag22 has a distinct hierarchical supratetrahedral structure with a central {Ag6} kernel surrounded by four [Ag4(Tab)6]4+ units. High-resolution electrospray ionization mass spectra demonstrate that Ag22 has two free electrons, indicating a superatomic core. Ag20 has a drum-like [Ag12(Tab)6(PhCOO)6(H2O)]6+ inner core capped by two tetrahedral-like [Ag4(Tab)3(PhCOO)2(MeCN)]2+ units. Ag20 can be transformed into Ag22 after its reaction with NaBH4 in solution. Antibacterial measurements reveal that Ag22 has a significantly lower minimum inhibitory concentration than that of the Ag20 cluster. This work not only extends the stabilization of silver(0/I) clusters to neutral thiol ligands but also offers new materials for the development of novel antibacterial materials.

Prediction Model and Nomogram of Early Recurrence of Hepatocellular Carcinoma after Ultrasound-guided Microwave Ablation

BACKGROUND: Ultrasound-guided microwave ablation (MWA) is recommended as a first-line treatment for early liver cancer due to its minimally invasive, efficient, and cost-effective nature. It utilizes microwave radiation to heat and destroy tumor cells as a local thermal therapy and offers the benefits of being minimally invasive, repeatable, and applicable to tumors of various sizes and locations. However, despite the efficacy of MWA, early recurrence after treatment remains a challenge, particularly when it occurs within a year and has a significant impact on the prognosis of the patient. OBJECTIVE: This study aimed to identify the risk factors for early recurrence after MWA in patients with hepatocellular carcinoma (HCC) and establish a predictive model. METHODS: A total of 119 patients with hepatocellular carcinoma (HCC) treated in the Department of Ultrasound at the First Affiliated Hospital of the Air Force Medical University from January, 2020 to April, 2022 were included in this study. Patients were categorized into the early recurrence group and the non-early recurrence group based on whether recurrence occurred within 1 year. We conducted univariate analysis on 29 variables. A predictive model was developed using multiple-factor logistic regression analysis, and a risk column graph was created. RESULTS: A total of 28 patients were included in the early recurrence group, with an early recurrence rate of 23%. Tumor size ≥ 3cm, multiple tumors, AST > 35 U/L, low pathological differentiation, CD34 positive, Ki67 level, quantitative parameters mean transit time (mTT), and rise time (RT) were confirmed as risk factors affecting early recurrence after ablation (P < 0.05). Furthermore, the model constructed based on these 5 predictive factors, including tumor size, tumor number, pathological differentiation, CD34, and quantitative analysis parameter mTT, demonstrated good predictive ability, with an AUC of 0.93 in the training set and 0.86 in the validation set. CONCLUSION: Our research indicates that the risk column graph can be utilized to predict the risk of early postoperative recurrence in patients after MWA. This contributes to guiding personalized clinical treatment decisions and provides important references for improving the prognosis of patients.

Synthesis of Fe-Modified g-C3N4 Nanorod Bunches for the Efficient Photocatalytic Degradation of Oxytetracycline.

Antibiotic residues have been found to have potentially harmful effects on ecological and human health. Carbon nitride-based photocatalysts have widely focused on antibiotic photocatalytic degradation. Herein, we prepared Fe-modified g-C3N4 nanorod bunches (FCNBs) using chemical vapor co-deposition. Specifically, through the process of calcination, a blend of urea and chlorophyllin sodium iron salt underwent an intriguing transformation, resulting in the integration of Fe into the framework of the g-C3N4 nanorod cluster. The resulting photocatalyst exhibited remarkable stability and superior dispersibility. The prepared FCNBs had a unique structure, which was beneficial for increasing light absorption. Furthermore, the Fe species formed a chemical coordination with the g-C3N4 matrix, thereby altering the electronic structure of the matrix. This modification facilitated charge transfer, prolonged the carrier lifetime, and enhanced light absorption, all of which significantly increased the photocatalytic activity. The oxytetracycline degradation efficiency of FCNBs was 82.5%, and they demonstrated outstanding stability in cycle trials. This work introduces a promising photocatalyst for the degradation of antibiotics.

Polymeric membrane potentiometric sensors based on template-removal-free imprinted receptors for determination of antibiotics.

Currently, Nernstian-response-based polymeric membrane potentiometric sensors using molecularly imprinted polymers (MIPs) as receptors have been successfully developed for determination of organic ionic species. However, the preparation of these MIP receptors usually involves tedious and time-consuming template-removal procedures. Herein, a template-removal-free MIP is proposed and used as a receptor for fabrication of a potentiometric sensor. The proposed methodology not only significantly shortens the preparation time of MIP-based potentiometric sensors but also improves the batch-to-batch reproducibility of these sensors. By using antibiotic vancomycin as a model, the new concept offers a linear concentration range of 1.0 × 10-7 to 1.0 × 10-4 mol L-1 with a detection limit of 2.51 × 10-8 mol L-1. It can be expected that the template-removal-free MIP-based sensing strategy could lay the foundation for simple fabrication of electrochemical sensors without the need for template removal such as potentiometric and capacitive sensors and ion-sensitive field-effect transistors.

Improving Hybrid Tin Halide Films by Tin Trifluoromethanesulfonate for Lead-Free Perovskite Solar Cells.

Tin-based perovskite solar cells (Sn-PSCs) without toxic lead ions outperform other types of lead-free PSCs in terms of photovoltaic performance. To avoid the oxidation of Sn2+ cations and the formation of vacancy defects, most reports involve the addition of SnF2 to the perovskite precursor solution, but hybrid tin halide (Sn-PVK) films still suffer from poor crystallinity and stability. In this work, we used an alternative additive of tin trifluoromethanesulfonate (Sn(OTF)2). Compared to SnF2, the solubility of Sn(OTF)2 in the precursor solution is greatly improved, and the crystal nucleation process is delayed, resulting in the enhancement of crystal growth. The coordination ability of the OTF- anions suppresses the oxidation of Sn2+ cations, which promotes the stability of Sn-PVK films. By replacing the conventional additive of SnF2 with Sn(OTF)2, the device achieves an increase in power conversion efficiency from 7.96% to 10.3%, while the stability of the devices is improved simultaneously.

Electrode-Supported Endohedral Metallofullerenes: Insights into the Confined Internal Dynamics.

Endohedral metallofullerenes show great promise as molecular-scale memory units due to their robust architecture and protective capability for encapsulated atoms. However, the flat potential-energy surface within the cage often results in a severe disorder of encapsulated atoms. Here, we focused on prototypical systems involving Li@C60 on metallic surfaces, emphasizing the electrode's confinement effect on caged dynamics. We demonstrated that the varying interfacial stabilities induced by Li motion predominantly depend on the synergetic effect of van der Waals forces and covalent bonds rather than the previously assumed electrostatic interactions. We unveiled that the repulsion effect between encapsulated atom and the metal electrode primarily arises from the antibonding states between the metal states below the Fermi level and the degenerated frontier orbitals from HOMO-4 to HOMO. By manipulating orbital interactions, we observed an ordered arrangement of the encapsulated atom on Rec-Pt(111) at room temperature. Furthermore, our findings underscore the disruptive influence of electric fields on the stability of distinct Li positions, a phenomenon closely tied to the dipole moment induced by Li motion. This research provides a new perspective on the confined internal dynamics of endohedral metallofullerenes by manipulating cage-electrode interactions, contributing to precisely controlled molecular electronics.

Maintenance-free antifouling polymeric membrane potentiometric sensors based on self-polishing coatings.

Polymeric membrane ion-selective electrodes (ISEs) have been widely used in environmental monitoring. However, in complicated marine environments, marine biofouling usually becomes a sticky problem for these electrodes. Herein, for the first time, a novel maintenance-free antifouling potentiometric marine sensor based on a self-polishing coating (SPC) is proposed. The SPC is synthesized by using the seeded emulsion polymerization method based on the triisopropylsilyl methacrylate monomer as the regulator of the self-renewal rate. This coating can be simply modified onto the electrode surface by drop-casting. The silyl acrylate side groups of the obtained SPC on the sensor surface can be hydrolyzed in the marine alkaline medium. The shear movement of seawater driven by sea waves, wind, gravity, or vibration removes the leftover (fouled) brittle polymer backbone and thus the fouling marine microorganisms. As a proof-of-concept experiment, a polymeric membrane Ca2+-ISE is chosen as a model. Compared to the unmodified electrode, the SPC-coated Ca2+-ISE exhibits remarkable improved antifouling properties in terms of superior anti-adhesive abilities towards marine microorganisms, such as bacterial cells and algae and excellent long-term stability even in the presence of high levels of marine microorganisms. Since no additional manual maintenance is required for maintaining the antifouling abilities of the sensor, the proposed self-polishing sensor may lay an important foundation for construction of unattended long-term potentiometric monitoring systems in real marine environments.

Desmoplastic fibroma of the pediatric cranium with CTNNB1 mutation: case report and literature review.

PURPOSE: Desmoplastic fibroma (DF) is an uncommon intermediate bone tumor rarely involving the skull with unidentified pathogenesis. We report the first case of pediatric temporoparietal cranial desmoplastic fibroma (DF) with a CTNNB1 gene mutation and review the previous literature. CASE PRESENTATION: A 3-year-old boy had a firm, painless mass on the right temporoparietal region for 22 months. The cranial CT scan showed isolated osteolytic destruction in the outer plate and diploe of the right temporoparietal bone. Gross total resection of the lesion and cranioplasty were performed. After that, a growing epidural hematoma was observed so another operation was performed to remove the artificial titanium plate. Postoperative pathology indicated a DF diagnosis and molecular pathology suggested a missense mutation in exon 3 of the CTNNB1 gene (c.100G > A,p.Gly34Arg). CONCLUSION: Pediatric cranial DF is rare and easy to be misdiagnosed before operation. For cranial DF, lesion resection can be performed and perioperative management should be strengthened. Mutations in the CTNNB1 gene might be one of the molecular pathologic features of DF.

A Ce-CuZn catalyst with abundant Cu/Zn-OV-Ce active sites for CO2 hydrogenation to methanol.

CO2 hydrogenation to chemicals and fuels is a significant approach for achieving carbon neutrality. It is essential to rationally design the chemical structure and catalytic active sites towards the development of efficient catalysts. Here we show a Ce-CuZn catalyst with enriched Cu/Zn-OV-Ce active sites fabricated through the atomic-level substitution of Cu and Zn into Ce-MOF precursor. The Ce-CuZn catalyst exhibits a high methanol selectivity of 71.1% and a space-time yield of methanol up to 400.3 g·kgcat-1·h-1 with excellent stability for 170 h at 260 °C, comparable to that of the state-of-the-art CuZnAl catalysts. Controlled experiments and DFT calculations confirm that the incorporation of Cu and Zn into CeO2 with abundant oxygen vacancies can facilitate H2 dissociation energetically and thus improve CO2 hydrogenation over the Ce-CuZn catalyst via formate intermediates. This work offers an atomic-level design strategy for constructing efficient multi-metal catalysts for methanol synthesis through precise control of active sites.

The impact of blinding on estimated treatment effects in randomized clinical trials on acupuncture: A meta-epidemiological study.

OBJECTIVE: To evaluate the sole impact of blinding patients and outcome assessors in acupuncture randomized controlled trials (RCTs) on treatment effects while considering the type of outcome measures. METHODS: We searched databases for the meta-analyses on acupuncture with both blinded and non-blinded RCTs. Mixed-effects meta-regression models estimated the average ratio of odds ratios (ROR) and differences in standardized mean differences (dSMD) for non-blinded RCTs versus blinded mixed-effects meta-regression model. RESULTS: The study included 96 meta-analyses (1012 trials). The average ROR for lack of patient blinding was 1.08 (95% confidence intervals 0.79-1.49) in 18 meta-analyses with binary patient-reported outcomes. The average ROR for lack of outcome assessor blinding was 0.98 (0.77-1.24) in 43 meta-analyses with binary subjective outcomes. The average dSMD was -0.38 (-0.96 to 0.20) in 10 meta-analyses with continuous patient-reported outcomes. The average dSMD was -0.13 (-0.45 to 0.18) in 25 meta-analyses with continuous subjective outcomes. The results of the subgroup analysis were consistent with the primary analysis findings. CONCLUSIONS: Blinding of participants and outcome assessors does not significantly influence acupuncture treatment efficacy. It underscores the practical difficulties of blinding in acupuncture RCTs and the necessity to distinguish between trials with and without successful blinding to understand treatment expectations' effects. Enhancing blinding procedures' quality and assessment in future research is crucial for improving RCTs' internal validity and reliability.