Enhancing THz fingerprint detection by the stretchable substrate with a dielectric metagrating.

The terahertz (THz) wave contains abundant spectrum resources and is still in the early stages of development. It has great application potential in biomedical engineering and public security. However, in these areas there are difficulties to overcome like measuring the wide band absorption of a trace mount sample. In this paper, a THz absorption enhancing method is suggested by a multiplexing strategy. By gradually expanding the stretchable substrate of the dielectric metagrating with an oblique THz wave incidence, the resonance peak frequencies can cover the frequency range of 0.48-0.58 THz. Also, the corresponding envelope built by the peaks of the metagrating absorption spectrum with the 0.2 µm α-lactose film can demonstrate 71.55 times boosting compared to the original absorption amplitude of the film. The investigation witnesses possibilities for the detection of biomacromolecular materials.

Electrocatalytic NiCo2O4 Nanofiber Arrays on Carbon Cloth for Flexible and High-Loading Lithium-Sulfur Batteries.

Lithium-sulfur batteries have ultrahigh theoretical energy densities, which makes them one of the most promising next-generation energy storage systems. However, it is still difficult to achieve large-scale commercialization because of the severe lithium polysulfide (LiPS) shuttle effect and low sulfur loading. Here, we report a flexible lithium-sulfur battery of a high sulfur loading with the assistance of NiCo2O4 nanofiber array grown carbon cloth. The NiCo2O4 nanofibers are ideal electrocatalysts for accelerating LiPS conversion kinetics through strong chemical interactions. Therefore, the composite cathode delivers a high specific capacity of 1280 mAh g-1 at 0.2 C with a sulfur loading of 3.5 mg cm-2, and it can maintain a high specific capacity of 660 mAh g-1 after 200 cycles, showing a good cycle stability. The "layer-by-layer" stacking strategy enables the Li-S battery with a high S loading of ∼9.0 mg cm-2 to deliver a high areal capacity of 8.9 mAh cm-2.

Cation/Anion Codoped and Cobalt-Free Li-Rich Layered Cathode for High-Performance Li-Ion Batteries.

Lithium-rich layered oxides have received great attention due to their high energy density as cathode material. However, the progressive structural transformation from layered to spinel phase triggered by transition-metal migration and the irreversible release of lattice oxygen leads to voltage fade and capacity decay. Here, we report a Fe, Cl codoped and Co-free Li-rich layered cathode with significantly improved structural stability. It is revealed that the Fe and Cl codoping can facilitate the Li-ion diffusion and improve the rate performance of the materials. Moreover, the calculations show that the structural stability is enhanced by Fe and Cl codoping. As a result, the Fe and Cl codopant reduces the irreversible release of lattice oxygen, mitigates voltage fade, and improves the first-cycle Coulombic efficiency. This work provides a low-cost, environmentally friendly, practical strategy for high-performance cathode materials.

Comparing mortality between positive and negative blood culture results: an inverse probability of treatment weighting analysis of a multicenter cohort.

BACKGROUND: The association between blood culture status and mortality among sepsis patients remains controversial hence we conducted a tri-center retrospective cohort study to compare the early and late mortality of culture-negative versus culture-positive sepsis using the inverse probability of treatment weighting (IPTW) method. METHODS: Adult patients with suspected sepsis who completed the blood culture and procalcitonin tests in the emergency department or hospital floor were eligible for inclusion. Early mortality was defined as 30-day mortality, and late mortality was defined as 30- to 90-day mortality. IPTW was calculated from propensity score and was employed to create two equal-sized hypothetical cohorts with similar covariates for outcome comparison. RESULTS: A total of 1405 patients met the inclusion criteria, of which 216 (15.4%) yielded positive culture results and 46 (21.3%) died before hospital discharge. The propensity score model showed that diabetes mellitus, urinary tract infection, and hepatobiliary infection were independently associated with positive blood culture results. There was no significant difference in early mortality between patients with positive or negative blood culture results. However, culture-positive patients had increased late mortality as compared with culture-negative patients in the full cohort (IPTW-OR, 1.95, 95%CI: 1.14-3.32) and in patients with severe sepsis or septic shock (IPTW-OR, 1.92, 95%CI: 1.10-3.33). After excluding Staphylococcal bacteremia patients, late mortality difference became nonsignificant (IPTW-OR, 1.78, 95%CI: 0.87-3.62). CONCLUSIONS: Culture-positive sepsis patients had comparable early mortality but worse late mortality than culture-negative sepsis patients in this cohort. Persistent Staphylococcal bacteremia may have contributed to the increased late mortality.

Non-linear dose-response relation between urinary levels of nicotine and its metabolites and cognitive impairment among an elderly population in China.

BACKGROUND: Active smoking and exposure to environmental tobacco smoke may be related to cognitive function decline. We assessed the associations of urinary levels of nicotine and its metabolites with cognitive function. METHODS: A total of 553 elder adults at high risk of cognitive impairment and 2212 gender- and age-matched individuals at low risk of cognitive impairment were selected at a ratio of 1: 4 from the remained individuals (n = 6771) who completed the baseline survey of the Shenzhen Ageing-Related Disorder Cohort, after excluding those with either Alzheimer's disease, Parkinson's syndrome or stroke as well as those with missing data on variables (including active and passive smoking status, Mini-Cog score). Urinary levels of nicotine and its metabolites and cognitive function for all individuals were measured by high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) and assessed using the Mini-Cog test, respectively. Associations of urinary levels of nicotine and its metabolites with cognitive function were analyzed by conditional logistic regression models. RESULTS: Individuals in the highest tertile of urinary OHCotGluc (OR: 1.52, 95%CI: 1.19-1.93) or NNO (OR: 1.50, 95%CI: 1.16-1.93) levels as well as in the second tertile of urinary ∑Nic level (OR: 1.43, 95%CI: 1.13-1.82) were at higher risk of cognitive impairment compared with those in the corresponding lowest tertile. Restricted cubic spline models revealed the non-linear dose-response relationships between urinary levels of OHCotGluc, NNO or ∑Nic and the risk of cognitive impairment. CONCLUSIONS: Urinary levels of OHCotGluc, NNO or ∑Nic exhibited a non-linear dose-response relationship with cognitive function in the urban elderly.

Stereolithography Three-Dimensional Printing Solid Polymer Electrolytes for All-Solid-State Lithium Metal Batteries.

Liquid-free all-solid-state lithium metal batteries (ASSLMBs) are promising candidates to meet the requirements of safety and high energy density for energy storages. However, poor interfacial contact is a major obstacle limiting their applications. Herein, we report a solid polymer electrolyte (SPE), originally prepared by stereolithography (SLA) three-dimensional (3D) printing for ASSLMBs. A 3D-Archimedean spiral structured SPE is rationally designed, which can shorten the Li-ion transport pathway from the electrolyte into the electrode, reinforce the interfacial adhesion, and improve the mass loading of active materials. The SLA printed SPE exhibits a high ionic conductivity of 3.7 × 10-4 S cm-1 at 25 °C. Furthermore, Li|3D-SPE|LFP cells achieve reduced interfacial impedance and higher specific capacity of 128 mAh g-1 after 250 cycles than those using structure-free SPE of 32 mAh g-1. This work opens the great promise of SLA 3D printing technology to fabricate high-performance SPEs in ASSLMBs for next-generation energy storages.

Submental Island Flap Combined With Reconstruction Titanium Plate: A New Way to Treat Mandibular Osteoradionecrosis.

Objective. The purpose of this study was to investigate the effect of reconstruction for bone defects in patients with mandibular osteoradionecrosis using submental flap combined with reconstructive titanium plate. Methods. A total of 23 patients with mandibular osteoradionecrosis were included. All patients underwent surgical resection and immediate reconstruction with submental flap combined with reconstructive titanium plate. The postoperative effects and flap success rate were evaluated with a 6- to 18-month follow-up. Results. Twenty-two flaps were successful; 1 flap suffered from partial necrosis in the distal end, but the patient was treated with hyperbaric oxygen therapy and iodoform gauze dressing, and no plate exposure was found after operation in the follow-up period. Conclusion. The use of submental flap combined with reconstructive titanium plate for treating the patients with osteoradionecrosis is a feasible, cost-effective, simple, and safe procedure.

Discovery of 2-phenylthiazole-4-carboxylic acid, a novel and potent scaffold as xanthine oxidase inhibitors.

The xanthine oxidase (XO) plays an important role in producing uric acid, and therefore XO inhibitors are considered as one of the promising therapies for hyperuricemia and gout. We have previously reported a series of XO inhibitors with pyrazole scaffold to extend the chemical space of current XO inhibitors. Herein, we describe further structural optimization to explore the optimal heterocycle by replacing the thiazole ring of Febuxostat with 5 heterocycle scaffolds unexplored in this field. All of these efforts resulted in the identification of compound 8, a potent XO inhibitor (IC50 = 48.6 nM) with novel 2-phenylthiazole-4-carboxylic acid scaffold. Moreover, lead compound 8 exhibited hypouricemic effect in potassium oxonate-hypoxanthine-induced hyperuricemic mice. These results promote the understanding of ligand-receptor interaction and might help to design more promising XO inhibitors.

Sarcopenia in peripheral arterial disease: Establishing and validating a predictive nomogram based on clinical and computed tomography angiography indicators.

Purpose: To establish, validate, and clinically evaluate a nomogram for predicting the risk of sarcopenia in patients with peripheral arterial disease (PAD) based on clinical and lower extremity computed tomography angiography (LE-CTA) imaging characteristics. Methods: Clinical data and CTA imaging features from 281 PAD patients treated between January 1, 2019, and May 1, 2023, at two hospitals were retrospectively analyzed using binary logistic regression to identify the independent risk factors for sarcopenia. These identified risk factors were used to develop a predictive nomogram. The nomogram's effectiveness was assessed through various metrics, including the receiver operating characteristic (ROC) curve, area under the curve (AUC), concordance index (C-index), Hosmer-Lemeshow (HL) test, and calibration curve. Its clinical utility was demonstrated using decision curve analysis (DCA). Results: Several key independent risk factors for sarcopenia in PAD patients were identified, namely age, body mass index (BMI), history of coronary heart disease (CHD), and white blood cell (WBC) count, as well as the severity of luminal stenosis (P < 0.05). The discriminative ability of the nomogram was supported by the C-index and an AUC of 0.810 (95% confidence interval: 0.757-0.862). A robust concordance between predicted and observed outcomes was reflected by the calibration curve. The HL test further affirmed the model's calibration with a P-value of 0.40. The DCA curve validated the nomogram's favorable clinical utility. Lastly, the model underwent internal validation. Conclusions: A simple nomogram based on five independent factors, namely age, BMI, history of CHD, WBC count, and the severity of luminal stenosis, was developed to assist clinicians in estimating sarcopenia risk among PAD patients. This tool boasts impressive predictive capabilities and broad utility, significantly aiding clinicians in identifying high-risk individuals and enhancing the prognosis of PAD patients.

Antimicrobial Resistance and Molecular Characterization of Salmonella Rissen Isolated in China During 2008-2019.

Background: This study aimed to provide epidemiological features of Salmonella enterica serovar Rissen, determine antimicrobial susceptibility, virulence gene profiles, and describe the potential association of S. Rissen from different sources in China. Methods: During 2008-2019, a total of non-repetitive 228 S. Rissen isolates were collected from human, animals and environment in China. The antimicrobial susceptibility test, screening of antimicrobial and virulence genes by PCR, and pulsed-field gel electrophoresis (PFGE) were performed. Results: Among the 154 isolates from human, the majority of the cases (80.5%) occurred in summer, and S. Rissen was mainly detected in people aged 21-40 (37.7%) and 41-60 (28.6%) years old, and 74 non-human source S. Rissen strains were identified, with pork being the most common source. About 93.4% isolates were resistant to at least one of the 12 tested antimicrobial agents, and high frequencies of resistance were observed for tetracyclines (91.2%), trimethoprim-sulfamethoxazole (74.1%) and ampicillin (67.5%). A total of 171 (75%) isolates were resistant to at least three categories of antimicrobials, and the most common resistance profile was Tetracycline(s)-ß-Lactams-Sulfonamides. The resistance rates to chloramphenicol, quinolones and sulfafurazole were significantly higher in strains isolated from human compared to non-human source strains. Among these isolates, the ß-Lactams resistance was mainly associated with gene blaTEM (54.7%), sulfonamide resistance with sul2 (45.7%) and sul3 (54.3%), tetracycline resistance with tetA (81.3%). All the isolates harbored virulence genes hilA, sopB, sciN, stn and ssrB, and most of them harbored ssaQ (98.7%), mgtC (98.7%) and invA (98.2%). The majority (91.7%) of S. Rissen isolates showed high similarity (>80%) with each other in PFGE patterns and came from human, animals and environment. Conclusion: The high frequencies of multidrug resistance and probable clonal dissemination in this serovar call for the necessity of systematic surveillance on S. Rissen in China.

Unraveling the Coupling Effect between Cathode and Anode toward Practical Lithium-Sulfur Batteries.

The localized reaction heterogeneity of the sulfur cathode and the uneven Li deposition on the Li anode are intractable issues for lithium-sulfur (Li-S) batteries under practical operation. Despite impressive progress in separately optimizing the sulfur cathode or Li anode, a comprehensive understanding of the highly coupled relationship between the cathode and anode is still lacking. In this work, inspired by the Butler-Volmer equation, a binary descriptor (IBD ) assisting the rational structural design of sulfur cathode by simultaneously considering the mass-transport index (Imass ) and the charge-transfer index (Icharge ) is identified, and subsequently the relationship between IBD and the morphological evolution of Li anode is established. Guided by the IBD , a scalable electrode providing interpenetrated flow channels for efficient mass/charge transfer, full utilization of active sulfur, and mechanically elastic support for aggressive electrochemical reactions under practical conditions is reported. These characteristics induce a homogenous distribution of local current densities and reduced reaction heterogeneity on both sides of the cathode and anode. Impressive energy density of 318 Wh kg-1 and 473 Wh L-1 in an Ah-level pouch cell can be achieved by the design concept. This work offers a promising paradigm for unlocking the interaction between cathode and anode and designing high-energy practical Li-S batteries.

A locally solvent-tethered polymer electrolyte for long-life lithium metal batteries.

Solid polymer electrolytes exhibit enhanced Li+ conductivity when plasticized with highly dielectric solvents such as N,N-dimethylformamide (DMF). However, the application of DMF-containing electrolytes in solid-state batteries is hindered by poor cycle life caused by continuous DMF degradation at the anode surface and the resulting unstable solid-electrolyte interphase. Here we report a composite polymer electrolyte with a rationally designed Hofmann-DMF coordination complex to address this issue. DMF is engineered on Hofmann frameworks as tethered ligands to construct a locally DMF-rich interface which promotes Li+ conduction through a ligand-assisted transport mechanism. A high ionic conductivity of 6.5 × 10-4 S cm-1 is achieved at room temperature. We demonstrate that the composite electrolyte effectively reduces the free shuttling and subsequent decomposition of DMF. The locally solvent-tethered electrolyte cycles stably for over 6000 h at 0.1 mA cm-2 in Li | |Li symmetric cell. When paired with sulfurized polyacrylonitrile cathodes, the full cell exhibits a prolonged cycle life of 1000 cycles at 1 C. This work will facilitate the development of practical polymer-based electrolytes with high ionic conductivity and long cycle life.

A Large-Scale Fabrication of Flexible, Ultrathin, and Robust Solid Electrolyte for Solid-State Lithium-Sulfur Batteries.

All-solid-state lithium metal batteries (ASSLMBs) are considered as the most promising candidates for the next-generation high-safety batteries. To achieve high energy density in ASSLMBs, it is essential that the solid-state electrolytes (SSEs) are lightweight, thin, and possess superior electrochemical stability. In this study, a feasible and scalable fabrication approach to construct 3D supporting skeleton using an electro-blown spinning technique is proposed. This skeleton not only enhances the mechanical strength but also hinders the migration of Li-salt anions, improving the lithium-ion transference number of the SSE. This provides a homogeneous distribution of Li-ion flux and local current density, promoting uniform Li deposition. As a result, based on the mechanically robust and thin SSEs, the Li symmetric cells show outstanding Li plating/stripping reversibility. Besides, a stable interface contact between SSE and Li anode has been established with the formation of an F-enriched solid electrolyte interface layer. The solid-state Li|sulfurized polyacrylonitrile (Li|SPAN) cell achieves a capacity retention ratio of 94.0% after 350 cycles at 0.5 C. Also, the high-voltage Li|LCO cell shows a capacity retention of 92.4% at 0.5 C after 500 cycles. This fabrication approach for SSEs is applicable for commercially large-scale production and application in high-energy-density and high-safety ASSLMBs.

Capture of armA by a novel ISCR element, ISCR28.

ISCR28 is a fully functional and active member of the IS91-like family of insertion sequences. ISCR28 is 1,708-bp long and contains a 1,293-bp long putative open reading frame that codes a transposase. Sixty ISCR28-containing sequences from GenBank generated 27 non-repeat genetic contexts, all of which represented naturally occurring biological events that had occurred in a wide range of gram-negative organisms. Insertion of ISCR28 into target DNA preferred the presence of a 5'-GXXT-3' sequence at its terIS (replication terminator) end. Loss of the first 4 bp of its oriIS (origin of replication) likely caused ISCR28 to be trapped in ISApl1-based transposons or similar structures. Loss of terIS and fusion with a mobile element upstream likely promoted co-transfer of ISCR28 and the downstream resistance genes. ArmA and its downstream intact ISCR28 can be excised from recombinant pKD46 plasmids forming circular intermediates, further elucidating its activity as a transposase.

Decoding emotion from high-frequency steady state visual evoked potential (SSVEP).

BACKGROUND: Steady-state visual evoked potential (SSVEP) by flickering sensory stimuli has been widely applied in the brain-machine interface (BMI). Yet, it remains largely unexplored whether affective information could be decoded from the signal of SSVEP, especially from the frequencies higher than the critical flicker frequency (an upper-frequency limit one can see the flicker). NEW METHOD: Participants fixated on visual stimuli presented at 60 Hz above the critical flicker frequency. The stimuli were pictures with different affective valance (positive, neutral, negative) in distinctive semantic categories (human, animal, scene). SSVEP entrainment in the brain evoked by the flickering stimuli at 60 Hz was used to decode the affective and semantic information. RESULTS: During the presentation of stimuli (1 s), the affective valance could be decoded from the SSVEP signals at 60 Hz, while the semantic categories could not. In contrast, neither affective nor semantic information could be decoded from the brain signal one second before the onset of stimuli. COMPARISON WITH EXISTING METHOD(S): Previous studies focused mainly on EEG activity tagged at frequencies lower than the critical flickering frequency and investigated whether the affective valence of stimuli drew participants' attention. The current study was the first to use SSVEP signals from high-frequency (60 Hz) above the critical flickering frequency to decode affective information from stimuli. The high-frequency flickering was invisible and thus substantially reduced the fatigue of participants. CONCLUSIONS: We found that affective information could be decoded from high-frequency SSVEP and the current finding could be added to designing affective BMI in the future.

Effect modification by aging on the associations of nicotine exposure with cognitive impairment among Chinese elderly.

Active and passive exposure to tobacco smoke may increase risk of cognitive decline. However, effects of enhanced the aging process on the association of urinary nicotine metabolites with cognitive impairment remain unclear. In this study, 6657 Chinese older adults completed the physical examinations and cognitive tests. We measured urinary nicotine metabolite levels, mitochondrial DNA copy number (mtDNA-CN), and relative telomere length (RTL) and analyzed effects of urinary nicotine metabolites and their interaction with mtDNA-CN or RTL on cognitive impairment by generalized linear models and qg-computation, respectively. Each 1-unit increase in urinary 3-OHCot, 3-OHCotGluc, CotGluc, or NicGluc levels corresponded to a 1.05-, 1.09-, 1.04-, and 0.90-fold increased risk of cognitive impairment. Each 1-quantile increment in the mixture level of 8 nicotine metabolites corresponded to an increment of 1.40- and 1.34-fold risk of cognitive impairment in individuals with longer RTL or low mtDNA-CN. Urinary 3-OHCotGluc and RTL or mtDNA-CN exhibited an additive effect on cognitive impairment in addition to the mixture of 8 nicotine metabolites and mtDNA-CN. The findings suggested that aging process may increase the risk of tobacco-related cognitive impairment.

Ultrafast Sintering for Ceramic-Based All-Solid-State Lithium-Metal Batteries.

Long processing time and high temperatures are often required in sintering ceramic electrolytes, which lead to volatile element loss and high cost. Here, an ultrafast sintering method of microwave-induced carbothermal shock to fabricate various ceramic electrolytes in seconds is reported. Furthermore, it is also possible to integrate the electrode and electrolyte in one step by simultaneous co-sintering. Based on this ultrafast co-sintering technique, an all-solid-state lithium-metal battery with a high areal capacity is successfully achieved, realizing a promising electrochemical performance at room temperature. This method can extend to other various ceramic multilayer-based solid devices.

Music-based casual video game training alleviates symptoms of subthreshold depression.

Objectives: In this preregistered study, we investigated the beneficial effects of music-based casual video game training on the depression, anxiety and stress symptoms in a cohort of young individuals with subthreshold depression and the underlying mechanisms. Methods: The study included 56 young individuals (18-26 years of age) with subthreshold or mild depression based on the Beck Depression Inventory-II (BDI-II) scores between 14 and 19. They were randomly assigned into the experimental group (n = 28) or the control group (n = 28). The experimental group underwent music-based casual video game training for 4 weeks. During the same time, the control group participants conducted daily life activities without any intervention. The study participants in the two groups were analyzed using the Depression Anxiety and Stress Scale (DASS-21) during the baseline before the intervention, as well as DASS-21, Positive and negative Affect Scale (PANAS), General Self-efficacy Scale (GSES), and the Emotional Regulation Questionnaire (ERQ) twice a week during the 4 weeks of intervention. Results: The depression, anxiety, and stress symptoms were significantly reduced in the experimental group participants after 4 weeks of music-based video game training compared with the control group. The DAS scores in the experimental group were alleviated in the third and fourth weeks of training compared with the control group. Moreover, analysis using the general linear model demonstrated that the number of training weeks and self-efficacy were associated with significant reduction in depression, anxiety and stress. Furthermore, our results demonstrated that self-efficacy was correlated with positive emotion and emotional regulation. Conclusion: Our study showed that music-based casual video game training significantly decreased depression, anxiety, and stress in the young individuals with subthreshold depression by enhancing self-efficacy.

The advanced lung cancer inflammation index predicts chemotherapy response and infection risk in multiple myeloma patients receiving induction chemotherapy.

Objective: This study aims to determine the clinical significance of the advanced lung cancer inflammation index (ALI) in predicting prognosis, chemotherapy response, and infection risk in newly diagnosed multiple myeloma (MM) patients receiving induction therapy. Methods: A retrospective analysis of the clinical characteristics and laboratory data of 111 newly diagnosed MM patients from the Haematology Department of the Third Xiangya Hospital of Central South University from January 2014 to March 2020 was performed. We first determined the relationship between ALI and overall survival (OS), as well as clinical and laboratory parameters. Second, predictive factors for chemotherapy response were analysed by univariate and multivariate regression analyses. Third, univariate regression analysis of risk factors was performed using infection as the evaluable outcome. Results: Of the 111 evaluable patients, the low ALI group (<32.7) exhibited significantly poorer survival than the high ALI group (51 months versus 77 months). Multivariable analysis showed that advanced age, chemotherapy response and serum calcium level were independent prognostic factors for OS. Better chemotherapy efficacy in the high ALI group (89.3%) than in the low ALI group (42.2%) (p < 0.001) was noted. Multivariate analysis suggested that only ALI [HR: 0.110, 95% CI (0.035-0.350), p = 0.000] is an independent predictive factor in evaluating the efficiency of induction chemotherapy. Forty patients (36.04%) presented with infection after induction chemotherapy. Univariate analysis suggested that low ALI and abnormal renal function increase risk of infection in newly diagnosed MM patients. Conclusion: Our study confirmed that ALI is not only a prognostic biomarker for newly diagnosed patients, but also predicts chemotherapy efficacy in newly diagnosed MM patients receiving induction therapy.

Cognitive Enhancement of Repetitive Transcranial Magnetic Stimulation in Patients With Mild Cognitive Impairment and Early Alzheimer's Disease: A Systematic Review and Meta-Analysis.

Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technique, has been considered as a potentially effective treatment for the cognitive impairment in patients with mild cognitive impairment (MCI) and Alzheimer's Disease (AD). However, the effectiveness of this therapy is still under debate due to the variety of rTMS parameters and individual differences including distinctive stages of AD in the previous studies. The current meta-analysis is aiming to assess the cognitive enhancement of rTMS treatment on patients of MCI and early AD. Three datasets (PubMed, Web of Science and CKNI) were searched with relative terms and finally twelve studies with 438 participants (231 in the rTMS group and 207 in the control group) in thirteen randomized, double-blind and controlled trials were included. Random effects analysis revealed that rTMS stimulation significantly introduced cognitive benefits in patients of MCI and early AD compared with the control group (mean effect size, 1.17; 95% CI, 0.76 - 1.57). Most settings of rTMS parameters (frequency, session number, stimulation site number) significantly enhanced global cognitive function, and the results revealed that protocols with 10 Hz repetition frequency and DLPFC as the stimulation site for 20 sessions can already be able to produce cognitive improvement. The cognitive enhancement of rTMS could last for one month after the end of treatment and patients with MCI were likely to benefit more from the rTMS stimulation. Our meta-analysis added important evidence to the cognitive enhancement of rTMS in patients with MCI and early AD and discussed potential underlying mechanisms about the effect induced by rTMS.