Effectiveness and safety of acupuncture for postoperative ileus following gastrointestinal surgery: A systematic review and meta-analysis.

BACKGROUND: Postoperative ileus (POI) is an important complication of gastrointestinal (GI) surgery. Acupuncture has been increasingly used in treating POI. This study aimed to assess the effectiveness and safety of acupuncture for POI following GI surgery. METHODS: Seven databases (PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Wan fang Data, VIP Database for Chinese Technical Periodicals, and Chinese Biomedical Literature Database) and related resources were searched from inception to May 30, 2021. Randomized controlled trials (RCTs) reporting the acupuncture for POI in GI were included. The quality of RCTs was assessed by the Cochrane Collaboration Risk of Bias tool, and the certainty of the evidence was evaluated by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. A meta-analysis was performed by using RevMan 5.4 software. RESULTS: Eighteen RCTs involving 1413 participants were included. The meta-analysis showed that acupuncture could reduce the time to first flatus (TFF) (standardized mean difference [SMD] = -1.14, 95% confidence interval [CI]: -1.54 to -0.73, P < 0.00001), time to first defecation (TFD) (SMD = -1.31, 95% CI: -1.88 to -0.74, P < 0.00001), time to bowel sounds recovery (TBSR) (SMD = -1.57, 95% CI: -2.14 to -1.01, P < 0.00001), and length of hospital stay (LOS) (mean difference [MD] = -1.68, 95% CI: -2.55 to -0.80, P = 0.0002) compared with usual care. A subgroup analysis found that acupuncture at distal acupoints once daily after surgery had superior effects on reducing TFF and TFD. A sensitivity analysis supported the validity of the finding. Acupuncture also manifested an effect of reducing TFF, TFD and TBSR compared with sham acupuncture but the result was not stable. Relatively few trials have reported whether adverse events have occurred. CONCLUSIONS: Acupuncture showed a certain effect in reducing POI following GI surgery with very low-to-moderate quality of evidence. The overall safety of acupuncture should be further validated. More high-quality, large-scale, and multicenter original trials are needed in the future.

Surface unsaturated WOx activating PtNi alloy nanowires for oxygen reduction reaction.

PtNi alloy nanoparticles display promising catalytic activity for oxygen reduction reaction (ORR), while the Ostwald ripening of particles and the dissolution/migration of surface atoms greatly affect its stability thus restricting the application. Herein, the WOx-surface modified PtNi alloy nanowires (WOx-PtNi NWs) exhibiting enhanced ORR catalytic property is reported, which has high aspect ratio with the diameter of only 2 âˆ¼ 3 nm. It is found that the WOx-PtNi NWs shows a volcano relationship between the ORR activity and the content of WOx. The WOx-(0.25)-PtNi NWs has the best performance among all the synthesized catalysts. Its mass activity (0.85 A mg-1Pt) is reduced by only 23.89% after 30k cycles durability test, which is much more stable than that of PtNi NWs (0.33 A mg-1Pt, 45.94%) and Pt/C (0.14 A mg-1Pt, 57.79%). Hence this work achieves an effective regulation of the ORR activity for PtNi alloy NWs by the synergistic effect of WOx on Pt.