Should we perform sigmoidoscopy for colorectal cancer screening in people under 45 years?

BACKGROUND: The strategy for preventing colorectal cancer is screening by colonoscopy, which offers a direct way for detection and removal of adenomatous polyps (APs). American College of Gastroenterology guidelines recommend that people aged ≥ 45 years should undergo colonoscopy; however, how to deal with people aged ≤ 45 years is still unknown. AIM: To compare the prevalence of APs and high-grade neoplasia between the left and right colon in patients ≤ 45 years. METHODS: A retrospective observational study was conducted at a single tertiary III hospital in China. This study included patients aged 18-45 years with undergoing initial colonoscopy dissection and pathological diagnosis AP or high-grade neoplasia between February 2014 and January 2021. The number of APs in the entire colon while screening and post-polypectomy surveillance in following 1-3 years were evaluated. RESULTS: A total of 3053 cases were included. The prevalence of APs in the left and right colon was 55.0% and 41.6%, respectively (OR 1.7, 95%CI 1.6-2.4; P < 0.05). For APs with high-grade neoplasia, the prevalence was 2.7% and 0.9%, respectively (OR 3.0, 95%CI 2.0-4.6; P < 0.05). Therefore, the prevalence of APs and high-grade neoplasia in the left colon was significantly higher than in the right colon in patients aged ≤ 45 years. There were 327 patients who voluntarily participated in post-polypectomy surveillance in following 1-3 years, and APs were found in 216 cases (66.1%); 170 cases had 1-3 polyps (52.0%) and 46 cases had > 3 polyps (14.1%; OR 0.3, 95%CI 0.1-0.6; P < 0.05). CONCLUSION: This study suggests that flexible sigmoidoscopy would be an optimal approach for initial screening in people aged ≤ 45 years and would be a more cost-effective and safe strategy.

Exploring the impact of autumn color and bare tree landscapes in virtual environments on human well-being and therapeutic effects across different sensory modalities.

In recent years, there has been a growing awareness of the potential health benefits of the natural environment for human well-being. Given the fast-paced nature of contemporary lifestyles, research into the use of virtual environments as a means to provide various seasonal landscapes has gained increasing importance. OBJECTIVE: The aim of this study is to investigate the impact of different sensory modes on the preferences and therapeutic effects of virtual autumn landscapes on university campuses. METHODS: In this study, 320 participants, with an average age of 21.11 years (±1.21 years), were exposed to virtual environments featuring autumn color landscapes and bare tree landscapes using visual, auditory, and combined conditions. A control group was included for comparison. Differences in participants' physiological indicators (EEG, heart rate) and psychological measures (POMS, PANAS, SVS, ROS) were analyzed, with the use of the Holm correction (P < 0.05). RESULTS: (1) Autumn virtual landscapes with color had a superior therapeutic effect. (2) There were significant differences in the therapeutic effects of different sensory modes within the same season's landscape categories, suggesting that incorporating additional sensory dimensions may enhance therapeutic outcomes. CONCLUSION: Based on the study's findings, we recommend that when designing therapeutic environments, attention should be given to seasonal variations and the integration of various sensory modes to optimize therapeutic results.

Ruthenium-Catalyzed Difunctionalization of Vinyl Cyclopropanes for Double m-C(sp2)-H/C-5(sp3)-H Functionalization.

With in-depth research on 1,2-difunctionalization, remote difunctionalization has garnered widespread attention for achieving multifunctionality. Herein, we report a strategy for achieving remote difunctionalization under mild conditions. This strategy exhibited good substrate suitability and functional group tolerance. In addition, the significance of this method is further evidenced by its successful application in scaling up and conducting additional transformations of target compounds. Mechanistic studies showed that a radical might be involved in this process.

Characterization of a novel high-efficiency cracking Burkholderia gladiolus phage vB_BglM_WTB and its application in black fungus.

Burkholderia gladiolus (B. gladiolus) is foodborne pathogenic bacteria producing bongkrekic acid (BA), which causes food poisoning and has a mortality rate of up to 40 % or more. However, no drugs have been reported in the literature for the prevention and treatment of this infection. In this study, a phage was identified to control B. gladiolus. The novel phage vB_BglM_WTB (WTB), which lyse B. gladiolus with high efficiency, was isolated from sewage of Huaihe Road Throttle Well Sewage Treatment Plant in Hefei. Transmission electron microscopy showed that WTB had an icosahedral head (69 ± 2 nm) and a long retractable tail (108 ± 2 nm). Its optimal temperature and pH ranges to control B. gladiolus were 25 °C -65 °C and 3-11 respectively. The phage WTB was identified as a linear double-stranded DNA phage of 68, 541 bp with 60.04 % G + C content, with a long latent period of 60 min. Phylogenetic analysis and comparative genetic analysis indicated that phage WTB has low identity (<50 %) with other phages, with the highest similarity to Burkholderia phage Maja (25.7 %), which showed that it does not belong to any previous genera recognized by the International Committee on Taxonomy of Viruses (ICTV) and was a candidate for a new genus within the Caudoviricetes. We have submitted a new proposal to ICTV to create a new genus, Bglawtbvirus. No transfer RNA (tRNA), virulence associated and antibiotic resistance genes were detected in phage WTB. Experimental results indicated that WTB at 4 °C and 25 °C had excellent inhibition activity against B. gladiolus in the black fungus, with an inhibition efficiency of over 99 %. The amount of B. gladiolus in the black fungus was reduced to a minimum of 89 CFU/mL when treated by WTB at 25 °C for 2 h. The inhibition rate remained at 99.97 % even after 12 h. The findings showed that the phage WTB could be applied as a food-cleaning agent for enhancing food safety and contributed to our understanding of phage biology and diversity.

Development and comprehensive SBSE-GC/Q-TOF-MS analysis optimization, comparison, and evaluation of different mulberry varieties volatile flavor.

Optimization of seven parameters of stir bar sorptive extraction (SBSE) on mulberry volatile components for the first time. A total of 347 volatile components were identified and quantified in 14 mulberry varieties, predominantly encompassing esters, aldehydes, terpenoids, hydrocarbons, ketones, alcohols, heterocyclics, acids, and phenols. Hexanal and (E)-2-hexenal were the dominant volatiles. Furthermore, 79 volatile compounds characterized by odor activity values (OAVs) > 1 were identified, making a significant contribution to the distinctive mulberry flavor. "Green" notes were the most intense, followed by "fatty" and "fruity". Utilizing odor ring charts, the volatile flavor characteristics of the 14 mulberry varieties could be intuitively distinguished. This study not only established a viable methodology for differentiating mulberry varieties but also laid a theoretical foundation for the quality evaluation and variety breeding of mulberry flavor.

Correlation of academic emotion and hardiness personality of undergraduate nursing students.

BACKGROUND: Academic emotion is a fundamental emotional concept closely linked to academic achievement. Understanding the connection between academic emotion and the personality trait of hardiness is pivotal in maintaining a stable career orientation throughout one's educational career. Therefore, in pursuit of fostering the robust growth of nursing careers, it is imperative to delve into the academic emotions experienced by undergraduate nursing students. This study endeavors to mitigate the impact of gender differences among nursing students while investigating the intricate relationship between academic emotions and the trait of hardiness in their personalities. METHODS: This study employed a cross-sectional research design. We gathered data from a convenient sample of 292 nursing students enrolled at Shanxi University of Chinese Medicine. Each student provided demographic information and responded to a general academic mood questionnaire, as well as a Hardiness Personality Rating Scale. Subsequently, we used canonical correlation analysis to evaluate the correlation between academic emotion and tenacity personality in 292 undergraduate nursing students. RESULTS: We discovered that academic emotions among nursing students are predominantly characterized by feelings of disappointment and boredom. Furthermore, personality hardiness is primarily influenced by the dimensions of engagement and control. It is important to note that a heightened level of negative, low-arousal academic emotions can diminish the level of engagement. The first typical correlation coefficient corresponding to academic emotion and hardiness were 0.660. The linear combination of standardized variables of the first typical variable corresponding to academic emotion (X1) = -0.444*negative hyperarousal -0.443 * positive hyperarousal + 0.694 * negative hypoarousal -0.260 * positive hypoarousal. The standardized variable equation of the first typical variable corresponding to hardiness personality (η1) = 0.235* hardiness -0.433* control -0.530* investment -0.303* challenge. CONCLUSIONS: Nursing students generally believe that their input is out of proportion to the return, and this unbalanced emotional experience will seriously affect their academic emotions in China. It is suggested that paying attention to cultivating their tenacious personality traits in the teaching process may help to enhance their academic emotions and enhance the sense of belonging and identity of nursing students engaged in the nursing profession.

Recent advances and perspectives in solar photothermal conversion and storage systems: A review.

Developing high-efficiency solar photothermal conversion and storage (SPCS) technology is significant in solving the imbalance between the supply and demand of solar energy utilization in time and space. Aiming at the current research status in the field of SPCS, this review thoroughly examines the phase change materials and substrates in SPCS systems. It elucidates the design principles and methods of SPCS integrated composites. Comparatively, it analyzes the parameters of various types of SPCS composites in terms of photothermal conversion, thermal conductivity, energy density, and cycling stability. Additionally, the review discusses the trade-offs between each parameter to achieve the most optimal effect of SPCS. By sorting out the current status of the application of SPCS technology in solar thermal/photovoltaic, aerospace, buildings, textile, and other industries, this analysis clarifies the requirements for various latent heat, phase change temperature, and other properties under different environmental conditions. Through a comprehensive discussion of SPCS technology, this paper accurately captures the development trend of efficiently and comprehensively utilizing solar energy by analyzing existing scientific problems. It identifies bottlenecks in SPCS technology and suggests future development directions that need focused attention. The insights gained from this analysis may provide a theoretical basis for designing strategies, enhancing performance, and promoting the application of SPCS.

Janus membranes derived from multi-shelled hollow spheres coated electrospun PVA membranes as phase change composites for photothermal conversion.

The development and preparation of multifunctional photothermal conversion materials has far-reaching significance for the utilization of solar energy resources in response to the energy crisis. Herein, we propose a Janus membrane for interfacial solar evaporation and phase change energy storage. The membranes were fabricated via combining the PVA film with multi-shelled hollow spheres (MHS). The membranes have asymmetric wettability, that is, one side is hydrophilic and the other side is hydrophobic. The as-resulted membranes obtain outstanding light absorption without further processing. According to these two advantages, the membranes were applied to solar evaporation. The evaporation rate of the membrane is 1.41 kg*m-2h-1 and the evaporation efficiency is 92.4 % under 1sun irradiation. Moreover, the membrane prepared by impregnating 1-Hexadecanamine (HDA) into MHS possesses excellent tensile strength (2.21 MPa) and photothermal conversion ability. The light-to-thermal conversion efficiency can reach 81.9 % under 1sun irradiation. Therefore, the membranes have broad application prospects in the field of photothermal conversion.

Copper-Catalyzed Selective Three-Component 1,2-Phosphonoazidation of 1,3-Dienes.

We report a copper-catalyzed selective 1,2-phosphonoazidation of conjugated dienes. This three-component reaction is achieved by using readily available P(O)-H compounds and bench-stable NaN3. Salient features of this strategy include its mild reaction conditions, broad functional group tolerance, and high chemoselectivity and regioselectivity. Moreover, the compatibility with the late-stage functionalization of drug molecules, the potential for scalable production, and the feasibility of further modifications of the products underscore the practical utility of this protocol in synthetic applications.

"Five birds one stone" tri-modal monitoring driven lab-on-magnetic aptasensor for accurate pathogen detection and enhanced germicidal application.

The effective combination of ultra-precise detection and on-demand sterilization stands out as one of the most valuable antifouling methods to combat pathogenic bacteria source and ensure the environment and food safety. Herein, an innovative "five birds one stone" aptasensor has been reported. It integrates magnetic separation, tri-modal precision detection, and efficient sterilization for monitoring of Staphylococcus aureus. Firstly, as a switch of the aptasensor, aptamer-modified potassium chloride-doped carbon dots (apt/KCl@CDs) could be adsorbed onto the surface of magnetic multi-walled carbon nanotube composites (M-MWCNTs) through π-π stacking, which could be replaced by the specific binding of the target bacteria to the aptamer. The mutual interference between the nanomaterials could be eliminated by this reverse magnetosorption strategy, enhancing the test sensitivity. In addition to the fluorescence properties, the peroxidase activity possessed by apt/KCl@CDs enables the conversion of the (3,3',5,5'-tetramethylbenzidine) TMB-H2O2 colorimetric system to a photothermal modal. Then, the ultra-precision detection in the assay was achieved by the fluorescence-colorimetric-photothermal tri-modal sensing from the formation of S. aureus-apt/KCl@CDs in the supernatant. Besides, the efficient sterilization could be ensured by adsorbing the apt/KCl@CDs on the surface of S. aureus, generating toxic •OH for direct attacking cells. This was the first report that was more beneficial for bacterial eradication. The detection limits of fluorescence, colorimetric and photothermal modals were 4.81 cfu/mL, 3.40 cfu/mL and 6.74 cfu/mL, respectively. The magnetic nanoplatform integrating tri-modal detection-sterilization meets the demand for highly sensitive and precise detection in different scenarios, providing immediate control for pathogens and broad application prospects.

A universal mechanism on desiccation tolerance of Cronobacter based on intracellular trehalose accumulation regulated by EnvZ/OmpR.

Cronobacter (seven species) can survive in dry powdered infant formula for a long time, but the thorough molecular mechanism of resistance to desiccation remains elusive. Here we examine the regulation mechanism of Cronobacter's tolerance to desiccation by the typical two-component system (TCS) EnvZ/OmpR. When exposed to desiccation conditions, Cronobacter showed higher survival than other pathogens, as well as significantly up-regulated expression of ompR and otsAB genes with markedly decreased survival of their mutants, suggesting their relationship with desiccation tolerance. OmpR directly binds to the promoter of trehalose biosynthesis operon otsBA, significantly enhancing their expression, and boosting the trehalose levels. The ompR-deletion in other six species further confirmed its positive regulation in desiccation tolerance. Our data present a hypothesis that EnvZ/OmpR increases intracellular trehalose levels against damage to the cells, which prompts Cronobacter to survive in desiccation conditions. This study reveals a universal molecular mechanism for desiccation resistance in Cronobacter species.

Weak correlations among leaf thermal metrics, economic traits and damages under natural heatwaves.

The frequency and intensity of heatwaves are increasing around the world, causing severe damages to plants, but whether leaf thermal metrics is in line with leaf economic spectrum is still controversial. Here, we measured leaf damage ratio, leaf thermal metrics (tolerance and sensitivity) and economic traits of 131 woody species across five cities along the Yangtze River after a two-month natural extreme temperature event. We found that leaf thermal sensitivity but not thermal tolerance was correlated with leaf damage ratio, and the relationships between leaf thermal metrics and economic traits were weak, indicating that leaf thermal adaptation may be independent from leaf carbon construction. This study suggests a potential indicator for predicting plant survival under heatwaves, urging future research to explore more physiological traits to comprehensively understand plant heat responses and adaptations.

P450-Modified Multicyclic Cyclophane-Containing Ribosomally Synthesized and Post-Translationally Modified Peptides.

Cyclic peptides with cyclophane linkers are an attractive compound type owing to the fine-tuned rigid three-dimensional structures and unusual biophysical features. Cytochrome P450 enzymes are capable of catalyzing not only the C-C and C-O oxidative coupling reactions found in vancomycin and other nonribosomal peptides (NRPs), but they also exhibit novel catalytic activities to generate cyclic ribosomally synthesized and post-translationally modified peptides (RiPPs) through cyclophane linkage. To discover more P450-modified multicyclic RiPPs, we set out to find cryptic and unknown P450-modified RiPP biosynthetic gene clusters (BGCs) through genome mining. Synergized bioinformatic analysis reveals that P450-modified RiPP BGCs are broadly distributed in bacteria and can be classified into 11 classes. Focusing on two classes of P450-modified RiPP BGCs where precursor peptides contain multiple conserved aromatic amino acid residues, we characterized 11 novel P450-modified multicyclic RiPPs with different cyclophane linkers through heterologous expression. Further mutation of the key ring-forming residues and combinatorial biosynthesis study revealed the order of bond formation and the specificity of P450s. This study reveals the functional diversity of P450 enzymes involved in the cyclophane-containing RiPPs and indicates that P450 enzymes are promising tools for rapidly obtaining structurally diverse cyclic peptide derivatives.

Vertical porous aerogel based on polypyrrole and bimetallic modified ß-cyclodextrin polymer-chitosan for efficient solar evaporation.

Solar-driven interfacial evaporation (SDIE) stands out as a prospective technology for freshwater production, playing a significant role in mitigating global water scarcity. Herein, a cyclodextrin polymer/chitosan composite aerogel (PPy-La/Al@CDP-CS) with vertically aligned channels was prepared as a solar evaporator for efficient solar steam generation. The vertically aligned pore structure, achieved through directional freezing assisted by liquid nitrogen, not only improves water transport during evaporation but also enhances light absorption through multiple reflections of sunlight within the pores. The polypyrrole particles sprayed on the surface of the aerogel acted as a light-absorbing layer, resulting in an impressive absorbance of 98.15 % under wetting conditions. The aerogel has an evaporation rate of 1.85 kg m-2 h-1 under 1 kW m-2 irradiation. Notably, the vertical pore structure of the aerogel allows it to exhibit excellent evaporation performance and salt resistance even in highly concentrated salt solutions. Furthermore, this aerogel is an excellent solar-driven interfacial evaporator for purifying seawater and fluoride-containing wastewater. This photothermal aerogel has the advantages of excellent performance, low cost, and environmental friendliness, and thus this work provides a new approach to the design and fabrication of solar photothermal materials for water treatment.

P450-Modified Ribosomally Synthesized Peptides with Aromatic Cross-Links.

Cyclization of linear peptides is an effective strategy to convert flexible molecules into rigid compounds, which is of great significance for enhancing the peptide stability and bioactivity. Despite significant advances in the past few decades, Nature and chemists' ability to macrocyclize linear peptides is still quite limited. P450 enzymes have been reported to catalyze macrocyclization of peptides through cross-linkers between aromatic amino acids with only three examples. Herein, we developed an efficient workflow for the identification of P450-modified RiPPs in bacterial genomes, resulting in the discovery of a large number of P450-modified RiPP gene clusters. Combined with subsequent expression and structural characterization of the products, we have identified 11 novel P450-modified RiPPs with different cross-linking patterns from four distinct classes. Our results greatly expand the structural diversity of P450-modified RiPPs and provide new insights and enzymatic tools for the production of cyclic peptides.

Multishell Copper Oxide Hollow Spheres Incorporated with Fatty Amines for High Light-To-Thermal Conversion.

Composite phase change materials (PCMs) are of great importance for the storage and conversion of energy. In this study, a multishell metal oxide hollow microsphere (CuOHS) was prepared by the hydrothermal method, and a new composite PCM (CuOHS@PCMs) for energy storage and conversion purposes was developed by effectively absorbing fatty amines [namely, tetradecylamine (TDA), hexadecylamine (HDA), and octadecylamine (ODA)] PCMs into the CuOHS via the abundant micropores located on the surface of the microsphere. The incorporation of uncontaminated phase alteration substances with CuOHS yields superior light absorption and leak prevention traits. The three CuOHS@PCMs, specifically CuOHS@TDA, CuOHS@HDA, and CuOHS@ODA, possess considerable latent heats of 198.8, 192.6, and 196.0 J·g-1, respectively, and exhibit desirable thermal properties even after completing 50 and 100 thermal cycles. Moreover, under illumination, the photothermal conversion efficiencies of the three variations of CuOHS@PCMs were 84.0, 81.4, and 78.0%. This CuOHS@PCMs, which are based on CuOHS, have considerable potential in the fields of photothermal conversion, solar energy harvesting, and storage.

The mediating role of coping styles between nurses' workplace bullying and professional quality of life.

AIMS: This study aimed to explore the relationship between workplace bullying among nurses and their professional quality of life, as well as the mediating role of coping styles between the two factors. BACKGROUND: In China, the overall status of nurses' professional quality of life is not optimistic, and the problems of low compassion satisfaction and high compassion fatigue persist. Workplace bullying, which is a serious global issue, can negatively impact the mental health and professional quality of nurses. However, it has still not attracted enough attention from managers. METHODS: The study used a cross-sectional research design and surveyed 297 clinical nurses from two tertiary grade A hospitals in Wuhan, China. Data were collected through an online questionnaire survey from March to May 2022. The data were analyzed using descriptive statistical methods, including Pearson correlation analysis and structural equation modeling. RESULTS: The score for nurses' workplace bullying was 38.72 ± 12.30. The scores for the three dimensions of professional quality of life were 27.56 ± 4.79 for compassion satisfaction, 30.51 ± 4.33 for burnout, and 28.47 ± 4.65 for secondary trauma stress. The scores for positive coping style and negative coping style were 34.59 ± 5.72 and 20.34 ± 5.08 points, respectively. Workplace bullying had a direct negative effect on compassion satisfaction, as well as positive direct effects on burnout and secondary traumatic stress. Coping styles played a mediating effect between workplace bullying and the pairwise relationships of compassion satisfaction, burnout, and secondary trauma stress. CONCLUSION: Workplace bullying hurts nurses' professional quality of life while coping styles plays an mediating role between workplace bullying and professional quality of life. Nursing managers can improve nurses' professional quality of life by reducing workplace bullying and enhancing positive coping style. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers can employ management wisdom and techniques to mitigate the presence and detrimental effects of workplace bullying. This, in turn, promotes a positive work environment and enhances the professional quality of life for nurses.

Vertical serpentine interconnect-enabled stretchable and curved electronics.

Stretchable and curved electronic devices are a promising technology trend due to their remarkable advantages. Many approaches have been developed to manufacture stretchable and curved electronics. Here, to allow such electronics to better serve practical applications, ranging from wearable devices to soft robotics, we propose a novel vertical serpentine conductor (VSC) with superior electrical stability to interconnect functional devices through a silicon-based microfabrication process. Conformal vacuum transfer printing (CVTP) technology was developed to transfer the networked platform onto complex curved surfaces to demonstrate feasibility. The mechanical and electrical performance were investigated numerically and experimentally. The VSC interconnected network provides a new approach for stretchable and curved electronics with high stretchability and reliability.

Guar Gum-Based Macroporous Hygroscopic Polymer for Efficient Atmospheric Water Harvesting.

Solar-driven atmospheric water harvesting technology has the advantage of not being limited by geography and has great potential in solving the freshwater crisis. Here, we first propose a purely natural and degradable superhydrophilic composite macroporous hygroscopic material by applying guar gum (GG) to atmospheric water harvesting. The material consists of GG-cellulose nanofibers (CNFs) as a porous substrate material, limiting the hygroscopic factor lithium chloride (LiCl) in its three-dimensional (3D) network structure, and carbon nanotubes (CNTs) play a photothermal conversion role. The composite material has a high light absorption rate of more than 95%, and the macroporous structure (20-60 µm) allows for rapid adsorption/desorption kinetics. At 35 °C and 90% relative humidity (RH), the moisture absorption capacity is as high as 1.94 g/g. Under 100 mW/cm2 irradiation, the absorbed water is almost completely desorbed within 3 h, and the water harvesting performance is stable in 10 cycles. Moreover, liquid water was successfully collected in an actual outdoor experiment. This work demonstrates the great potential of biomass materials in the field of atmospheric water collection and provides more opportunities for various energy and sustainable applications in the future.

Acupuncture for in vitro fertilization-embryo transfer: an overview of systematic reviews. / é’ˆç¸è¾ åŠ©ä½“å¤–å—ç²¾èƒšèƒŽç§»æ¤çš„ç³»ç»Ÿè¯„ä»·å†è¯„ä»·.

OBJECTIVES: To evaluate the report quality, methodological quality and evidence quality of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture for in vitro fertilization-embryo transfer (IVF-ET). METHODS: The SRs/MAs of acupuncture for IVF-ET were searched electronically from databases of CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Cochrane Library, from inception of each database to September 27th, 2022. Two reviewers independently screened the literature and extracted the data. Using PRISMA statement, the AMSTAR 2 scale and the GRADE system, the report quality, methodological quality and evidence quality of the included SRs/MAs were assessed. RESULTS: A total of 28 SRs/MAs were included, with PRISMA scores ranging from 8.5 points to 27 points. The problems of report quality focused on protocol and registration, retrieval, risk of bias in studies, additional analysis, limitations and funding. The methodological quality of included studies was generally low, reflecting on items 2, 3, 7, 10, 12 and 16. A total of 85 outcome indexes were included in the GRADE system for evidence grade evaluation. Most of the evidences were low or very low in quality. The reasons for the downgrade were related to study limitations, inconsistency, imprecision and publication bias. CONCLUSIONS: Acupuncture therapy improves the outcomes of IVF-ET, but the methodological quality and evidence quality of related SRs/MAs are low. It is recommended to conduct more high-quality studies in the future to provide more reliable evidences.