rGO/ZIF-8 Aerogel for Effective Removal of Malachite Green from Wastewater.

In this study, dopamine-modified graphene aerogel (DGA) is synthesized through a one-step hydrothermal method using graphene oxide as the precursor and dopamine as the reducing agent. Subsequently, in situ immersion synthesis is conducted to obtain ZIF-8 loaded on a dopamine-modified graphene aerogel skeleton (ZDGA), featuring a regular honeycomb interconnected mesoporosity and a high specific surface area of 532.8 m2/g. The synthesized ZDGA exhibited exceptional adsorption performance for the cationic dye malachite green. At room temperature, ZDGA achieved an impressive equilibrium adsorption capacity of 6578.34 mg/g. The adsorption process followed pseudo-secondary kinetics and adhered to the Langmuir model, indicating chemically dominated adsorption on a monomolecular layer. Intraparticle diffusion was the primary rate determinant, with π-π stacking, electrostatic adsorption, hydrogen bonding, and Lewis acid-base interactions serving as the key driving forces. It has an ideal specific surface area and good cycling performance, which highlights its potential application in dye wastewater treatment.

Graphene oxide nanosheets immobilised on honeycomb pore structure of pomelo peel for enhanced removal of methylene blue.

Herein, for the first time, a simple, green, direct immersion immobilisation method is reported for graphene oxide (GO) nanosheets using pomelo peel (PL) as a substrate. A GO/PL porous sponge was successfully prepared and used to remove methylene blue (MB) from dye wastewater. Considering the porosity, hydrophilicity and elasticity of the PL, the PL was placed in a GO aqueous suspension through direct immersion immobilisation. The carboxyl and hydroxyl groups in the peel could effectively capture and immobilise the GO nanosheets. GO was adsorbed into the PL pores and dispersed throughout the PL. Finally, the prepared super-hydrophilic and elastic GO/PL exhibited excellent adsorption performance towards MB in dye wastewater. The adsorption results revealed that the adsorption behaviour was consistent with the Langmuir isotherm and quasi-secondary kinetic models. The maximum equilibrium adsorption capacity of GO/PL towards MB was 124.2 mg/g, exceeding the values obtained for most of the previously reported adsorbents. Moreover, after five consecutive adsorption-desorption cycles, GO/PL retained 75% of its initial adsorption capacity. Mechanistic analysis revealed that pore filling, electrostatic attraction, ion exchange and hydrogen bonding interactions are the primary driving forces facilitating MB adsorption.

[Review of Leachable Substances in Hemodialyzer].

With the rapid development of my country's hemodialysis industry, the application of hemodialysis machines has become more and more extensive, but at the same time, the quality control technology of hemodialysis machines is not perfect. Especially for a wide range of leachable substances in dialyzers, there are few studies and detection methods. This study first briefly describes the development of hemodialyzers, and then expounds the common types of leachables, extraction methods, and chromatography and mass spectrometry conditions. It is summarized that the research plan of leachable substances is to determine the type first, then formulate the extraction plan, and then establish the detection method. Finally, we look forward to the research prospects of hemodialyzer leachables, and point out that with the deepening and extensive development of research, it can further promote the healthy development of the hemodialyzer industry.

3D nitrogen-doped graphene created by the secondary intercalation of ethanol with enhanced specific capacity.

Here, we report an improved synthesis strategy for 3D nitrogen-doped graphene to increase the specific capacity of supercapacitors. Ethanol replaces the strong oxidant hydrogen peroxide in the improved Hummers method, and the loose porous structure is conducive to charge transfer. N-doped porous 3D graphene was synthesized from RGO-C prepared by ethanol secondary intercalation modification of functional groups. Ammonia was selected as the dopant; the microstructure and electrochemical performance of samples synthesized at different temperatures were examined. The results demonstrate that the 3D nitrogen-doped graphene (N-RGO-5) had a layered tuple shape with a sheet thickness of 0.612 nm.The specific surface area of the 3D N-RGO-5, which was prepared at 190°C, was 258.371 m2g-1, which was higher than that (5.877 m2g-1) of the original graphite. The 3D N-RGO-5 exhibited a specific capacitance of 236 F g-1and an energy density of 32.78 Wh kg-1at a current density of 1 A g-1, which is 27% higher than the specific capacitance of RGO. The 3D N-RGO-5 demonstrated an excellent capacity retention rate of 93.6% after 5000 cycles at a current density of 1 A g-1. This study demonstrates that the unique 3D structure and N-doping of N-RGO considerably improved the overall energy storage performance of graphene-based nanomaterials.

In vivo biological safety evaluation of an iron-based bioresorbable drug-eluting stent.

Bioresorbable stents (BRS) are investigated and designed to revascularize occluded arteries. The iron-based bioresorbable stent is a promising device in interventional therapies, although it's corrosion and bioresorption rate remain challenging. In this work, we introduced a novel nitrided iron coronary stent (IBS) with enhanced degradation rate compared with pure iron stent. To evaluate the biosafety of this device, a sub-chronic systemic toxicity study was conducted and a stainless steel stent (Supporter™) served as a control. Here, the bioresorbable stent was first evaluated in rat abdominal aortic implantation model. When subjected to exaggerated exposure dose, no clinical signs of toxicity or mortality were observed in either, the IBS group or the control group. Histopathological examinations showed the corrosion particles of iron were encapsulated by fibrocytes and engulfed by macrophages, indicating that the degradation of iron was in the early stage. Our results demonstrated that the nitrided iron stent did not induce systemic toxicity under the experimental conditions.

Design of the influenza virus inhibitors targeting the PA endonuclease using 3D-QSAR modeling, side-chain hopping, and docking.

With the emergence of drug resistance and the structural determination of the PA N-terminal domain (PAN), influenza endonucleases have become an attractive target for antiviral therapies for influenza infection. Here, we combined 3D-QSAR with side-chain hopping and molecular docking to produce novel structures as endonuclease inhibitors. First, a new molecular library was generated with side-chain hopping on an existing template molecule, L-742001, using an in-house fragment library that targets bivalent-cation-binding proteins. Then, the best 3D-QSAR model (AAAHR.500), with q(2)=0.76 and r(2)=0.97 from phase modeling, was constructed from 23 endonuclease inhibitors and validated with 17 test compounds. The AAAHR.500 model was then used to select effective candidates from the new molecular library. Combining 3D-QSAR with docking using Glide and Autodock, 13 compounds were considered the most likely candidate inhibitors. Docking studies showed that the binding modes of these compounds were consistent with the crystal structures of known inhibitors. These compounds could serve as potential endonuclease inhibitors for further biological activity tests.

Graphene/Heterojunction Composite Prepared by Carbon Thermal Reduction as a Sulfur Host for Lithium-Sulfur Batteries.

An interlayer nanocomposite (CC@rGO) consisting of a graphene heterojunction with CoO and Co9S8 was prepared using a simple and low-cost hydrothermal calcination method, which was tested as a cathode sulfur carrier for lithium-sulfur batteries. The CC@rGO composite comprises a spherical heterostructure uniformly distributed between graphene sheet layers, preventing stacking the graphene sheet layer. After the introduction of cobalt heterojunction on a graphene substrate, the Co element content increases the reactive sites of the composite and improves its electrochemical properties to some extent. The composite exhibited good cycling performance with an initial discharge capacity of 847.51 mAh/g at 0.5 C and a capacity decay rate of 0.0448% after 500 cycles, which also kept 452.91 mAh/g at 1 C and in the rate test from 3 C back to 0.1 C maintained 993.27 mAh/g. This article provides insight into the design of cathode materials for lithium-sulfur batteries.

Patient-Reported Outcomes Measurement Information System -29 Domains Interaction in Chronic Musculoskeletal Pain During Acupuncture: A Pilot Study.

Objective: This pilot study explored interactions of domains of physical, psychologic, and social factors in the Patient-Reported Outcomes Measurement Information System® (PROMIS®)-29 system and their dynamic changes during acupuncture treatment of chronic musculoskeletal pain. Materials and Methods: PROMIS-29 profile, version 2.1 was applied among participants with chronic musculoskeletal pain, who received acupuncture treatment for 5 weeks. Data from function-oriented and symptom-oriented domains as well as changes in pain intensity were evaluated at weeks 0, 3, and 5, in 9 patients who completed full sessions. Scores of the domains were analyzed by hierarchical cluster analysis at each timepoint to identify the patterns of interactions of PROMIS domains. Results: Hierarchical cluster analysis revealed the existence of 2 main clusters: one consisting of pain, fatigue, and emotional domains; the other comprising physical function and social domains. The general pattern was stable but interactions were found throughout the treatment. The score for sleep disturbance did not improve but was correlated with different domains at varying stages of treatment. Conclusions: Interaction between 2 clusters of pain with fatigue and emotional domains; and physical function with social domains showed that acupuncture produces holistic reductions in chronic musculoskeletal pain. However, the limitation of sample size and bias in this pilot study requires future research on the need to adopt an interdisciplinary and holistic approach to the recovery of patients with chronic musculoskeletal pain, who have dynamic needs.

In Vitro Carcinogenicity Test of a Copper-Containing Intrauterine Device.

The aim is to study the cellular carcinogenicity of a copper-containing intrauterine device (IUD). So we analyzed the chemical elements of copper-containing IUDs. After that, we used Bhas42 cells in initiation and promotion assays to evaluate the leaching solution that extracted from the copper-containing IUDs at serial dilutions. In the cell carcinogenic experiment, the number of cell foci with malignant transformation was calculated. Although we uncovered no significant differences between the leaching solution at different concentrations and the negative control in the initiation assay, the sample at four concentrations showed significant differences relative to the negative control in the promotion assay (chi-squared test, p < 0.01). Therefore, we preliminarily evaluated that copper-containing IUDs are nongenotoxic carcinogen. Impact statement For the first time, we executed two-stage transformation assays with Bhas42 cells to assess the potential carcinogenicity of a copper-containing intrauterine device (IUD). In this study, we demonstrated that the copper-containing IUD manifested nongenotoxic carcinogenicity, making this the first-ever published report regarding this type of IUD's nongenotoxic carcinogenicity and revealing that its use carries a cancer risk.

The diagnostic value of combined detection of microRNA-155, TNF-α and IL-37 for active pulmonary tuberculosis in the elderly.

OBJECTIVE: To identify a panel of potential biomarkers consisting of microRNA-155 (miR-155), tumor necrosis factor-alpha (TNF-α), interleukin-37 (IL-37) for the diagnosis of active pulmonary tuberculosis (PTB) infection in elderly patients. METHODS: The serum expression of miR-155 and TNF-α in patients was measured by RT-qPCR, and the serum IL-37 level was determined by ELISA. The correlation between their expression and the features of active PTB patients was also analyzed. The AUCs of miR-155, TNF-α and IL-37 in diagnosing active PTB was calculated according to the ROC curves. The sensitivity, specificity and Youden's index of the three biomarkers alone or in combination for the active PTB diagnosis in the elderly were assessed. RESULTS: miR-155, TNF-α, and IL-37 were overexpressed in the sera of elderly patients with active PTB. miR-155, TNF-α and IL-37 serum levels were enhanced in the elderly patients with pulmonary and extrapulmonary TB relative to those with PTB only, and in patients with active TB infection in both lungs compared to those with unilateral lung infection. The AUCs of miR-155, TNF-α and IL-37 for the diagnosis of active PTB were 0.7920, 0.8734 and 0.7398, respectively. The combination of these three improved the sensitivity of the diagnosis (84.78%). CONCLUSION: miR-155, TNF-α and IL-37 were overexpressed in elderly patients with active PTB. The combined detection of serum miR-155/TNF-α/IL-37 expression has potential to serve as a diagnostic tool for active PTB in the elderly.

Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial.

BACKGROUND: Chronic Sciatica is a disabling condition causing considerable medical, social and financial implications. Currently, there is no recognised long-term effective treatment to alleviate sciatica. Acupuncture has been widely used for treating chronic pains with persistent analgesic effects. We aim to evaluate the efficacy and safety of acupuncture for chronic sciatica with follow-up in 52 weeks. METHODS AND ANALYSIS: This is a multicenter randomised sham-controlled trial. A total of 216 patients with chronic sciatica will be enrolled and randomly assigned to the acupuncture or sham acupuncture group. There will be 10 treatment sessions applied in 4 weeks with frequency decreased over time. Patients will complete follow-ups during 52 weeks. The primary outcomes are changes in leg pain intensity and disability from baseline to week 4. Secondary outcomes include back pain intensity, frequency and bothersomeness, quality of life, and global perceived effect. Adverse events will be recorded in detail. ETHICS AND DISSEMINATION: Ethical approval of this trial was granted from the ethics committee of Beijing University of Chinese Medicine and all study centres (No. 2020BZYLL0803). Written informed consent will be obtained from enrolled patients. Trial results will be disseminated in peer-reviewed publications. TRIAL REGISTRATION NUMBER: ChiCTR2100044585 (Chinese Clinical Trial Registry, http://www.chictr.org.cn, registered on 24 March 2021); preresults.

Nano-hydroxyapatite coated TiO2 nanotubes on Ti-19Zr-10Nb-1Fe alloy promotes osteogenesis in vitro.

Titanium and titanium alloys have broad applications in orthopedic implants due to their excellent mechanical properties and biocompatibility. The biological activity of the metallic implants can be improved by implementing a nano-hydroxyapatite (nano-HA) coating, while it is still challenging to synthesize uniform and stable nano-HA on the metallic materials. The characterization results confirmed that the nanotube array with a diameter of 87 ± 21 nm and a length of 8.1 ± 1.3 µm is achieved by using double anodic oxidation, and then microsphere-like nano-HA crystals are formed on the TiO2 nanotube arrays. Through X-ray diffraction (XRD) and Fourier Transform Infrared Spectrometer (FT-IR) analysis, it is determined that the chemical composition of the coating is hydroxyapatite. in vitro cell experiments, compared to the TZNF metal surface, the TZNF-NTs/HA is beneficial to the proliferation and adhesion of osteoblasts, and the activity of ALP was 6.93 ± 0.47 DEA unit and the content of OCN was 7.04 ± 0.51 ng/L. In terms of the expression of osteogenic gene information as osterix, osteopontin, and osteonectin, the mRNA levels of TZNF-NTs/HA were 2.6-fold, 1.6-fold, and 4.3-fold higher than that of TZNF samples, respectively, at 14 days. The results suggested that the introduction of nano-HA improves osteoblast differentiation and local factor production, as well as indicates the potential for improved implant osseointegration.

Efficacy of acupuncture for sciatica: study protocol for a randomized controlled pilot trial.

BACKGROUND: Acupuncture is widely used for pain diseases while evidence of its efficacy for sciatica is insufficient. We aim to explore the feasibility and efficacy of acupuncture with different acupoint selecting strategies for sciatica induced by lumbar disc herniation. METHODS: This is a multicenter, three-arm, patient-assessor-blinded randomized controlled pilot trial. Ninety patients will be assigned randomly into 3 groups including disease-affected meridians (DAM) group, non-affected meridians (NAM) group, and sham acupuncture (SA) group in a 1:1:1 ratio. The trial involves a 4-week treatment along with follow-up for 22 weeks. The primary outcome is the change of leg pain intensity measured by the visual analogue scale (VAS) from baseline to week 4 after randomization. Secondary outcomes include functional status, back pain intensity, and quality of life. Adverse events will also be recorded. DISCUSSION: The results will inspire the optimal acupuncture strategy for sciatica and help establish a better design as well as power calculation for a full-scale study. TRIAL REGISTRATION: ChiCTR2000030680 (Chinese Clinical Trial Registry, http://www.chictr.org.cn , registered on 9 March 2020).

Antineutrophil cytoplasmic antibody-positive infective endocarditis complicated by acute kidney injury: a case report and literature review.

Patients with infective endocarditis (IE) may present with multisystem disturbances resembling autoimmune diseases, such as antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The kidneys are susceptible to damage in IE and AAV, which is a source of diagnostic ambiguity. Therefore, distinguishing infection from an inflammatory process is pivotal for guiding appropriate therapy. We report a 22-year-old man with IE characterized by ANCA positivity and complicated by acute kidney injury. A renal biopsy showed crescentic nephritis with tubulointerstitial lesions. However, transthoracic echocardiography and blood culture provided evidence of IE, and AAV was ruled out. Surgical intervention and antibiotic treatments were successful. We summarized previously reported cases of ANCA-positive IE that had renal biopsy data. We found that ANCA-positive IE can involve multiple organs. The representative renal pathology was crescentic nephritis, focal segmental glomerulonephritis, mesangial cell proliferation, tubular injury, and interstitial oedema. Immunofluorescence showed predominate C3 deposits. Electron microscopy showed electron-dense deposits in the subendothelial or mesangial areas. Eight patients received immunosuppressive therapy with excellent results. Repeated testing for bacterial pathogens and multiple renal biopsies may be useful for diagnosing ANCA-positive IE. With ANCA-positive IE, immunosuppressive therapy along with antibiotic treatments may be beneficial for recovery of renal function.

The SIRT3 and SIRT6 Promote Prostate Cancer Progression by Inhibiting Necroptosis-Mediated Innate Immune Response.

The sirtuins (SIRTs), including seven family members, belong to class III histone deacetylase (HDAC) enzymes, which have been intensively investigated in cancers. Although the function of SIRTs in the cancer immunology is explored, SIRT-specific mechanisms regulating necroptosis-related innate immune response are not clear. In our present study, we found that both the mRNA and protein expression levels of SIRT3 and SIRT6 are significantly increased in the PCa tissues (HR, CI P = 3.30E - 03; HR, CI P = 2.35E - 08; and HR, CI P = 9.20E - 08) and were associated with patients' Gleason score and nodal metastasis. Furthermore, multivariate analysis showed that the PCa patients with higher expression levels of SIRT3 and SIRT6 had shorter overall survival (OS). Mechanistically, we found that SIRT3 and SIRT6 promote prostate cancer progress by inhibiting RIPK3-mediated necroptosis and innate immune response. Knockdown of both SIRT3 and SIRT6 not only activates TNF-induced necroptosis but also refreshes the corresponding recruitment of macrophages and neutrophils. Overall, our study identified that SIRT3 and SIRT6 are key regulators of necroptosis during prostate cancer progression.

Increased Risk of Toxoplasma gondii Infection in Patients with Colorectal Cancer in Eastern China: Seroprevalence, Risk Factors, and a Case-Control Study.

The aim of this study was to explore the epidemiology of Toxoplasma gondii infection in patients with colorectal cancer (CRC) in eastern China. Therefore, 287 primary CRC patients and 287 age-matched healthy control subjects were recruited to estimate the seroprevalence of T. gondii and identify the risk factors of infection. Enzyme-linked immunoassays were used to test for anti-T. gondii immunoglobulin G (IgG) and IgM antibodies. Forty-six (16%) samples were positive for anti-T. gondii IgG antibodies in patients with CRC, compared with 26 (9.1%) in the healthy controls, a significant difference (P = 0.007). By contrast, eight (2.8%) patients tested positive for T. gondii IgM antibodies, compared with three (1.1%) in the controls, a difference that was not significant (P = 0.13). Multivariable backward stepwise logistic regression analysis revealed that a rural residence (OR 2.83; 95% CI 1.15-7.01; P = 0.024) and treatment with chemotherapy (OR 2.16; 95% CI 1.02-4.57; P = 0.045) were risk factors for T. gondii infection in patients with CRC. Thus, T. gondii infection is serious in patients with CRC, and a rural residence and treatment with chemotherapy are independent risk factors for infection by this parasite. Therefore, medical professionals should be aware of this pathogen in patients with CRC, and the causes of T. gondii infection in these patients need to be explored further.

Bazedoxifene enhances paclitaxel efficacy to suppress glioblastoma via altering Hippo/YAP pathway.

Glioblastoma multiform (GBM) is an aggressive type of brain tumor originated from astrocytes. Owing to the limited therapeutic options, intensive efforts are still being made to find novel treatments for GBM. In this study, we first identified that bazedoxifene bore the ability to reduce cell survival and cell invasion of glioblastoma cells. Furthermore, our results also revealed that bazedoxifene combining with paclitaxel had better efficacy to suppress glioblastoma progression by promoting apoptosis and reducing EMT. Combination of bazedoxifene and paclitaxel also accelerated YAP phosphorylation and inactivation. Importantly, preclinical animal model also verified our in vitro findings. Together, our data not only define the underlying mechanism responsible for action of bazedoxifene on glioblastoma cells but also build strong rational to develop bazedoxifene for the treatment of GBM patients.

Covalent immobilization of biomolecules on stent materials through mussel adhesive protein coating to form biofunctional films.

It is widely accepted that surface biofunctional modification may be an effective approach to improve biocompatibility and confer new bioactive properties on biomaterials. In this work, mussel adhesive protein (MAP) was applied as a coating on 316 L stainless steel substrates (316 L SS) and stents, and then either immobilized VEGF or CD34 antibody were added to create biofunctional films. The properties of the MAP coating were characterized by scanning electron microscope (SEM), atomic force microscope (AFM) and a water contact angle test. Universal tensile testing showed that the MAP coating has adequate adhesion strength on a 316 L stainless steel material surface. Subsequent cytotoxicity and hemolysis rate tests showed that the MAP coatings have good biocompatibility. Moreover, using N-(3-Dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride and N-hydroxysulfosussinimide (EDC/NHS) chemistry, VEGF and CD34 antibody were immobilized on the MAP coatings. The amount and immobilized yield of VEGF on the MAP coatings were analyzed by enzyme-linked immuno-assays (ELISA). Finally, an endothelial cells culture showed that the VEGF biofunctional film can promote the viability and proliferation of endothelial cells. An in vitro CD34+ cells capturing test also verified the bioactive properties of the CD34 antibody coated stents. These results showed that the MAP coatings allowed effective biomolecule immobilization, providing a promising platform for vascular device modification.

Seroprevalence and risk factors of Toxoplasma gondii infection in children with leukemia in Shandong Province, Eastern China: a case-control prospective study.

Limited information is available concerning the epidemiology of Toxoplasma gondii infection in children with leukemia in Eastern China. Therefore, a case-control study was conducted to estimate the seroprevalence of toxoplasmosis in this patient group and to identify risk factors and possible routes of infection. Serum samples were collected from 339 children with leukemia and 339 age matched health control subjects in Qingdao from September 2014 to March 2018. Enzyme linked immunoassays were used to screen anti- T. gondii IgG and anti- T. gondii IgM antibodies. Forty-eight (14.2%) children with leukemia and 31 (9.1%) control subjects were positive for anti-T. gondii IgG antibodies (P < 0.05), while 13 (3.8%) patients and 14 (4.1%) controls were positive for anti-T. gondii IgM antibodies (P = 0.84). Multivariate analysis showed exposure to soil and a history of blood transfusion were risk factors for T. gondii infection. Compared with IgG, patients with a history of blood transfusion were more likely to present anti- T. gondii IgM (P = 0.003). Moreover, patients with chronic lymphocytic leukemia and acute lymphocytic leukemia had higher T. gondii seroprevalence in comparison to control subjects (P = 0.002 and P = 0.016, respectively). The results indicated that the seroprevalence of T. gondii infection in children with leukemia is higher than that of healthy children in Eastern China. This information may be used to guide future research and clinical management, and further studies are necessary to elucidate the role of T. gondii in children with leukemia.

Effects of acupuncture on the levels of serum estradiol and pituitary estrogen receptor beta in a rat model of induced super ovulation.

AIMS: Acupuncture is frequently recommended as a complementary therapy for infertility. However, whether acupuncture can prevent early ovarian hyperstimulation syndrome has not been examined and its potential mechanisms are not well understood. MAIN METHODS: Forty rats were randomized into four groups: Control, Ovarian Stimulation Model, Acupuncture, and Human Chorionic Gonadotropin (HCG). Serum estradiol, progesterone, testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels were measured by enzyme-linked immunosorbent assay. Pituitary ER mRNA and ERß expression were detected by real-time PCR and western blotting respectively. The pathology of rat ovaries were observed by light microscopy. KEY FINDINGS: We observed significantly lower estradiol levels in the Acupuncture group than in the Model group and increased LH levels in the HCG group than in Model and Acupuncture groups. Testosterone and FSH levels were significantly lower in the Acupuncture group than in the HCG group. Western blotting showed significantly lower pituitary ERß expression in the Model group than in the Control group and higher expression in the Acupuncture group than in the Model group. Real-time PCR showed lower pituitary ER mRNA expression in the Acupuncture group than in the Model group. Hematoxylin and eosin staining showed a lower proportion of atretic follicles in Acupuncture and HCG groups than in Model and Control groups. Instead, Acupuncture and HCG groups showed growing and mature follicles. SIGNIFICANCE: Our results demonstrate a relationship between acupuncture and the hypothalamic-pituitary-gonadal axis, and the potential mechanism underlying the preventative effects of acupuncture on the incidence of early ovarian hyperstimulation syndrome.