Uncoordinated chemistry enables highly conductive and stable electrolyte/filler interfaces for solid-state lithium-sulfur batteries.

Composite-polymer-electrolytes (CPEs) embedded with advanced filler materials offer great promise for fast and preferential Li+ conduction. The filler surface chemistry determines the interaction with electrolyte molecules and thus critically regulates the Li+ behaviors at the interfaces. Herein, we probe into the role of electrolyte/filler interfaces (EFI) in CPEs and promote Li+ conduction by introducing an unsaturated coordination Prussian blue analog (UCPBA) filler. Combining scanning transmission X-ray microscope stack imaging studies and first-principle calculations, fast Li+ conduction is revealed only achievable at a chemically stable EFI, which can be established by the unsaturated Co-O coordination in UCPBA to circumvent the side reactions. Moreover, the as-exposed Lewis-acid metal centers in UCPBA efficiently attract the Lewis-base anions of Li salts, which facilitates the Li+ disassociation and enhances its transference number (tLi+). Attributed to these superiorities, the obtained CPEs realize high room-temperature ionic conductivity up to 0.36 mS cm-1 and tLi+ of 0.6, enabling an excellent cyclability of lithium metal electrodes over 4,000 h as well as remarkable capacity retention of 97.6% over 180 cycles at 0.5 C for solid-state lithium-sulfur batteries. This work highlights the crucial role of EFI chemistry in developing highly conductive CPEs and high-performance solid-state batteries.

The role of surgical factors eliciting oculocardiac reflex of patients undergoing orbital tumor surgery: a retrospective study.

PURPOSE: Orbital tumors are an interdisciplinary disease, and surgery is one of the main treatment methods. The oculocardiac reflex (OCR) is a condition of surgery for orbital tumors. The aim of this study was to investigate whether there is an association between many surgical factors and the incidence of OCR in orbital tumor surgery. METHODS: Comparisons were made between patients with and without OCR using the Mann-Whitney test, Fisher's exact test, and Chi-square test. When comparing multiple groups (groups > 2), to explain which two groups had differences, post hoc testing was used for analysis, and the differences between groups were judged according to the adjusted standardized residuals. RESULTS: The results showed that the incidence of intraoperative OCR was different based on the different exposed operative field locations (p = 0.021). The OCR incidence in those with lesions involving the orbital apex and lesions adhering to extraocular muscles was higher than that of others (p < 0.001 and p = 0.003). In addition, multivariate logistic regression analysis revealed that orbital apex involvement and extraocular muscle adhesion were highly associated with a higher incidence of OCR (p < 0.001 and p = 0.013), while the operative field located in the lateral-superior orbit was highly associated with a lower incidence of OCR (p = 0.029). CONCLUSION: In orbital tumor surgery under general anesthesia, lesions involving the orbital apex and lesion adhesion to the extraocular muscles were independent risk factors for OCR, and an operative field located in the lateral-superior orbit was a protective factor for OCR.

A New Method in Dealing With Children's Condylar Fracture by Botulinum Toxin A Injection in Lateral Pterygoid Muscle.

Condylar is one of the most vulnerable sites to be traumatized in pediatric mandible fracture, while temporomandibular joint ankylosis might be the most severe complication of condylar fracture in children. There exists a long-time controversy on the treatment of condylar fractures in children. Considering the risk of facial nerve injury and a certain probability of absorption or even ankylosis after open reduction and internal fixation (ORIF) of condylar fractures, a series of nonsurgical approaches are preferred in cases without severe malocclusion or shortening of the ramus. Our treatment plan was carried out through combining procedures of Botulinum toxin A injection in lateral pterygoid muscle with ORIF of para symphyseal fracture; subsequently, a conservative way of the occlusal splint with elastic traction was performed. Three patients of bilateral or unilateral condylar fractures, aged between 2 y and 6 y, were involved in this treatment. After more than 1 year's follow-up, the occlusion was satisfactory in all patients. Condylar remodeling was approximately complete in 3 months, and no unwanted complications were observed. We may expect this method to offer a new idea when dealing with children's condylar fracture.

ScRNA-seq links dental fibroblasts heterogeneity with mechanoresponsiveness.

BACKGROUND AND OBJECTIVE: Periodontal ligament (PDL) and dental pulp (DP) share a common origin but have distinct biological and mechanical functions. To what extent the mechanoresponsive property of PDL can be attributed to its unique transcriptional profiles of cellular heterogeneity is unclear. This study aims to decipher cellular heterogeneity and distinct mechanoresponsive characteristics of odontogenic soft tissues and their underlying molecular mechanisms. MATERIALS AND METHODS: A single-cell comparison of digested human periodontal ligament (PDL) and dental pulp (DP) was performed using scRNA-seq. An in vitro loading model was constructed to measure mechanoresponsive ability. Dual-luciferase assay, overexpression, and shRNA knockdown were used to investigate the molecular mechanism. RESULTS: Our results demonstrate striking fibroblast heterogeneity across and within human PDL and DP. We demonstrated that a tissue-specific subset of fibroblasts existed in PDL exhibiting high expression of mechanoresponsive extracellular matrix (ECM) genes, which was verified by an in vitro loading model. ScRNA-seq analysis indicated a particularly enriched regulator in PDL-specific fibroblast subtype, Jun Dimerization Protein 2 (JDP2). Overexpression and knockdown of JDP2 extensively regulated the downstream mechanoresponsive ECM genes in human PDL cells. The force loading model demonstrated that JDP2 responded to tension and that knockdown of JDP2 effectively inhibited the mechanical force-induced ECM remodeling. CONCLUSIONS: Our study constructed the PDL and DP ScRNA-seq atlas to demonstrate PDL and DP fibroblast cellular heterogeneity and identify a PDL-specific mechanoresponsive fibroblast subtype and its underlying mechanism.

Influence of nuclear power plant interface complexity on user decision-making: an ERP study.

ABSTRACUser decision-making concerning critical operations is very important to nuclear power plant (NPP) safety. The NPP interface is the main information source that guides decision-making; thus, a good interface design is essential. Among the interface design factors such as interface complexity, layout and colour, interface complexity (the amount of information in the interface) has the greatest impact on NPP operator decision-making. This paper used the event-related potential (ERP) to evaluate the impact of interface complexity on user decision-making and found interface complexity has a specific range suitable for decision-making. Based on this important finding, a fast and economical method of evaluating NPP interfaces in all design phases was proposed. This method compensates for the shortcomings of traditional methods, such as heuristic evaluation and experimental evaluation, which are inconvenient for evaluating interfaces in initial design phase; it can also be applied to interfaces with similar features in other industrial fields. Practitioner summary: Evaluation of the impact of NPP interface complexity on user decision-making through an ERP experiment revealed a specific range of interface complexity that facilitates user decision-making. Based on this finding, a new, fast and inexpensive interface evaluation method was proposed. Abbreviations: NPP: nuclear power plant, it is a thermal power station in which the heat source is a nuclear reactor; ERP: event-related potential, it is the measured brain response that is the direct result of a specific cognitive, or motor event.

Room-Temperature Spin Transport in Metal Nanocluster-Based Spin Valves.

As a new type of inorganic-organic hybrid semiconductor, quantum-confined atomically precise metal nanoclusters (MNCs) have been widely applied in the fields of chemical sensing, optical imaging, biomedicine and catalysis. Herein, we successfully design and fabricate the first example of MNC-based spin valves (SVs) that exhibit remarkable magnetoresistance (MR) value up to 1.6 % even at room temperature (300 K). The concomitant photoresponse of MNC-based SVs unambiguously confirms that the spin-polarized electron transmission takes place across the MNC interlayer. Furthermore, the spin-dependent transport property of MNC-based SVs is largely varied by changing the atomic structure of MNCs. Both experimental proofs and quantum chemistry calculations reveal that the atomic structure-discriminative spin transport behavior is attributed to the distinct spin-orbit coupling (SOC) effect of MNCs.

Elevating Photooxidation of Methane to Formaldehyde via TiO2 Crystal Phase Engineering.

Photocatalytic conversion of methane to value-added products under mild conditions, which represents a long sought-after goal for industrial sustainable production, remains extremely challenging to afford high production and selectivity using cheap catalysts. Herein, we present the crystal phase engineering of commercially available anatase TiO2 via simple thermal annealing to optimize the structure-property correlation. A biphase catalyst with anatase (90%) and rutile (10%) TiO2 with the optimal phase interface concentration exhibits exceptional performance in the oxidation of methane to formaldehyde under the reaction conditions of water solvent, oxygen atmosphere, and full-spectrum light irradiation. An unprecedented production of 24.27 mmol gcat-1 with an excellent selectivity of 97.4% toward formaldehyde is acquired at room temperature after a 3 h reaction. Both experimental results and theoretical calculations disclose that the crystal phase engineering of TiO2 lengthens the lifetime of photogenerated carriers and favors the formation of intermediate methanol species, thus maximizing the efficiency and selectivity in the aerobic oxidation of methane to formaldehyde. More importantly, the feasibility of the scale-up production of formaldehyde is demonstrated by inventing a "pause-flow" reactor. This work opens the avenue toward industrial methane transformation in a sustainable and economical way.

Sublethal and transgenerational effects of afidopyropen on biological traits of the green peach aphid Myzus persicae (Sluzer).

The green peach aphid, Myzus persicae (Sulzer), is a cosmopolitan agricultural pest and causes great damages each year. Afidopyropen is a novel insecticide with high efficacy against even the insecticides resistant M. persicae. However, the sublethal and transgenerational effects of afidopyropen on M. persicae is not clear. In the present paper, sublethal and transgenerational effects of afidopyropen on biological traits of M. persicae were determined based on the age-stage, two-sex life table theory. The afidopyropen was more toxic against M. persicae than other widely used insecticides, with LC50 of 0.086 mg/L. The treatment with LC5, LC15 and LC25 concentrations of afidopyropen remarkably reduced the longevity and fecundity of F0M. persicae by 15.9-64.4% and 24.3-76.7%, respectively, compared with those of the control. The life history traits of F1 generation including the pre-adult development time, mean total longevity, pre-adult survival rate, total pre-oviposition period and fecundity were significantly affected after treatment of the F0 with afidopyropen, and the population parameters, including the net reproductive rate (R0), intrinsic rate of increase (r) and finite rate of increase (λ) were also remarkably decreased, while the mean generation time (T) was extended by 6.94%. Among four development and reproduction related genes investigated, JHEH was downregulated by 31.8-38.0% in the afidopyropen treated F0 generation, while the EcR and JHAMT were overexpressed and the Vg was significantly downregulated in F1 generation compared to the control group. All these data indicated that the afidopyropen had significant sublethal and transgenerational effects on M. persicae. These results provide insights into comprehensively understanding of the insecticidal effects of afidopyropen on M. persicae as well as the management of resistant M. persicae.

Metal-organic frameworks as catalytic selectivity regulators for organic transformations.

Selective organic transformations using metal-organic frameworks (MOFs) and MOF-based heterogeneous catalysts have been an intriguing but challenging research topic in both the chemistry and materials communities. Analogous to the reaction specificity achieved in enzyme pockets, MOFs are also powerful platforms for regulating the catalytic selectivity via engineering their catalytic microenvironments, such as metal node alternation, ligand functionalization, pore decoration, topology variation and others. In this review, we provide a comprehensive introduction and discussion about the role of MOFs played in regulating and even boosting the size-, shape-, chemo-, regio- and more appealing stereo-selectivity in organic transformations. We hope that it will be instructive for researchers in this field to rationally design, conveniently prepare and elaborately functionalize MOFs or MOF-based composites for the synthesis of high value-added organic chemicals with significantly improved selectivity.

"Two Ships in a Bottle" Design for Zn-Ag-O Catalyst Enabling Selective and Long-Lasting CO2 Electroreduction.

Electrochemical CO2 reduction (CO2RR) using renewable energy sources represents a sustainable means of producing carbon-neutral fuels. Unfortunately, low energy efficiency, poor product selectivity, and rapid deactivation are among the most intractable challenges of CO2RR electrocatalysts. Here, we strategically propose a "two ships in a bottle" design for ternary Zn-Ag-O catalysts, where ZnO and Ag phases are twinned to constitute an individual ultrafine nanoparticle impregnated inside nanopores of an ultrahigh-surface-area carbon matrix. Bimetallic electron configurations are modulated by constructing a Zn-Ag-O interface, where the electron density reconfiguration arising from electron delocalization enhances the stabilization of the *COOH intermediate favorable for CO production, while promoting CO selectivity and suppressing HCOOH generation by altering the rate-limiting step toward a high thermodynamic barrier for forming HCOO*. Moreover, the pore-constriction mechanism restricts the bimetallic particles to nanosized dimensions with abundant Zn-Ag-O heterointerfaces and exposed active sites, meanwhile prohibiting detachment and agglomeration of nanoparticles during CO2RR for enhanced stability. The designed catalysts realize 60.9% energy efficiency and 94.1 ± 4.0% Faradaic efficiency toward CO, together with a remarkable stability over 6 days. Beyond providing a high-performance CO2RR electrocatalyst, this work presents a promising catalyst-design strategy for efficient energy conversion.

Fe-O Clusters Anchored on Nodes of Metal-Organic Frameworks for Direct Methane Oxidation.

Direct methane oxidation into value-added organic oxygenates with high productivity under mild condition remains a great challenge. We show Fe-O clusters on nodes of metal-organic frameworks (MOFs) with tunable electronic state for direct methane oxidation into C1 organic oxygenates at 50 °C. The Fe-O clusters are grafted onto inorganic Zr6 nodes of UiO-66, while the organic terephthalic acid (H2 BDC) ligands of UiO-66 are partially substituted with monocarboxylic modulators of acetic acid (AA) or trifluoroacetic acid (TFA). Experiments and theoretical calculation disclose that the TFA group coordinated with Zr6 node of UiO-66 enhances the oxidation state of adjacent Fe-O cluster due to its electron-withdrawing ability, promotes the activation of C-H bond of methane, and increases its selective conversion, thus leading to the extraordinarily high C1 oxygenate yield of 4799 µmol gcat -1 h-1 with 97.9 % selectivity, circa 8 times higher than those modulated with AA.

Boosting the Heat Dissipation Performance of Graphene/Polyimide Flexible Carbon Film via Enhanced Through-Plane Conductivity of 3D Hybridized Structure.

The development of materials with efficient heat dissipation capability has become essential for next-generation integrated electronics and flexible smart devices. Here, a 3D hybridized carbon film with graphene nanowrinkles and microhinge structures by a simple solution dip-coating technique using graphene oxide (GO) on polyimide (PI) skeletons, followed by high-temperature annealing, is constructed. Such a design provides this graphitized GO/PI (g-GO/PI) film with superflexibility and ultrahigh thermal conductivity in the through-plane (150 ± 7 W m-1 K-1 ) and in-plane (1428 ± 64 W m-1 K-1 ) directions. Its superior thermal management capability compared with aluminum foil is also revealed by proving its benefit as a thermal interface material. More importantly, by coupling the hypermetallic thermal conductivity in two directions, a novel type of carbon film origami heat sink is proposed and demonstrated, outperforming copper foil in terms of heat extraction and heat transfer for high-power devices. The hypermetallic heat dissipation performance of g-GO/PI carbon film not only shows its promising application as an emerging thermal management material, but also provides a facile and feasible route for the design of next-generation heat dissipation components for high-power flexible smart devices.

A comparison of treatment effectiveness between clear aligner and fixed appliance therapies.

BACKGROUND: Align technology has developed greatly over past few years. Patients tended to prefer clear aligners over conventional brackets because of the superior comfort and esthetics, while the effectiveness of clear aligners was still controversial. The aim of this systematic review was to verify whether the treatment effectiveness of clear aligners was similar to the conventional fixed appliances. METHODS: A comprehensive search of the Pubmed, Web of Science, Embase, Scopus, and Cochrane Central Register of Controlled Clinical Trials Register databases for studies published through to August 20, 2018 was conducted. Comparative clinical studies assessing the effectiveness of clear aligners compared with braces were included. RESULTS: Eight papers were included in this study. Two of the included papers were randomized controlled trials and six were cohort studies. Clear aligners might not be as effective as braces in producing adequate occlusal contacts, controlling teeth torque, increasing transverse width and retention. While no statistically significant difference was found between two groups in Objective Grading System score (WMD = 8.38, 95% CI [- 0.17, 16.93]; P = 0.05). On the other hand, patients treated with clear aligners had a statistically significant shorter treatment duration than with braces (WMD = - 6.31, 95% CI [- 8.37, - 4.24]; P < 0.001). CONCLUSION: Both clear aligners and braces were effective in treating malocclusion. Clear aligners had advantage in segmented movement of teeth and shortened treatment duration, but were not as effective as braces in producing adequate occlusal contacts, controlling teeth torque, and retention.

A high-density genetic map of extra-long staple cotton (Gossypium barbadense) constructed using genotyping-by-sequencing based single nucleotide polymorphic markers and identification of fiber traits-related QTL in a recombinant inbred line population.

BACKGROUND: Gossypium barbadense (Sea Island, Egyptian or Pima cotton) cotton has high fiber quality, however, few studies have investigated the genetic basis of its traits using molecular markers. Genome complexity reduction approaches such as genotyping-by-sequencing have been utilized to develop abundant markers for the construction of high-density genetic maps to locate quantitative trait loci (QTLs). RESULTS: The Chinese G. barbadense cultivar 5917 and American Pima S-7 were used to develop a recombinant inbred line (RIL) population with 143 lines. The 143 RILs together with their parents were tested in three replicated field tests for lint yield traits (boll weight and lint percentage) and fiber quality traits (fiber length, fiber elongation, fiber strength, fiber uniformity and micronaire) and then genotyped using GBS to develop single-nucleotide polymorphism (SNP) markers. A high-density genetic map with 26 linkage groups (LGs) was constructed using 3557 GBS SNPs spanning a total genetic distance of 3076.23 cM at an average density of 1.09 cM between adjacent markers. A total of 42 QTLs were identified, including 24 QTLs on 12 LGs for fiber quality and 18 QTLs on 7 LGs for lint yield traits, with LG1 (9 QTLs), LG10 (7 QTLs) and LG14 (6 QTLs) carrying more QTLs. Common QTLs for the same traits and overlapping QTLs for different traits were detected. Each individual QTLs explained 0.97 to 20.7% of the phenotypic variation. CONCLUSIONS: This study represents one of the first genetic mapping studies on the fiber quality and lint yield traits in a RIL population of G. barbadense using GBS-SNPs. The results provide important information for the subsequent fine mapping of QTLs and the prediction of candidate genes towards map-based cloning and marker-assisted selection in cotton.

Ras-ERK1/2 signaling contributes to the development of colorectal cancer via regulating H3K9ac.

BACKGROUNDS/AIMS: Ras is a control switch of ERK1/2 pathway, and hyperactivation of Ras-ERK1/2 signaling appears frequently in human cancers. However, the molecular regulation following by Ras-ERK1/2 activation is still unclear. This work aimed to reveal whether Ras-ERK1/2 promoted the development of colorectal cancer via regulating H3K9ac. METHODS: A vector for expression of K-Ras mutated at G12 V and T35S was transfected into SW48 cells, and the acetylation of H3K9 was measured by Western blot analysis. MTT assay, colony formation assay, transwell assay, chromatin immunoprecipitation and RT-qPCR were performed to detect whether H3K9ac was contributed to K-Ras-mediated cell growth and migration. Furthermore, whether HDAC2 and PCAF involved in modification of H3K9ac following Ras-ERK1/2 activation were studied. RESULTS: K-Ras mutated at G12 V and T35S induced a significant activation of ERK1/2 signaling and a significant down-regulation of H3K9ac. Recovering H3K9 acetylation by using a mimicked H3K9ac expression vector attenuated the promoting effects of Ras-ERK1/2 on tumor cells growth and migration. Besides, H3K9ac can be deacetylated by HDAC2 and MDM2-depedent degradation of PCAF. CONCLUSION: H3K9ac was a specific target for Ras-ERK1/2 signaling pathway. H3K9 acetylation can be modulated by HDAC2 and MDM2-depedent degradation of PCAF. The revealed regulation provides a better understanding of Ras-ERK1/2 signaling in tumorigenesis.

PCA and deep learning based myoelectric grasping control of a prosthetic hand.

BACKGROUND: For the functional control of prosthetic hand, it is insufficient to obtain only the motion pattern information. As far as practicality is concerned, the control of the prosthetic hand force is indispensable. The application value of prosthetic hand will be greatly improved if the stable grip of prosthetic hand can be achieved. To address this problem, in this study, a bio-signal control method for grasping control of a prosthetic hand is proposed to improve patient's sense of using prosthetic hand and the thus improving the quality of life. METHODS: A MYO gesture control armband is used to collect the surface electromyographic (sEMG) signals from the upper limb. The overlapping sliding window scheme are applied for data segmentation and the correlated features are extracted from each segmented data. Principal component analysis (PCA) methods are then deployed for dimension reduction. Deep neural network is used to generate sEMG-force regression model for force prediction at different levels. The predicted force values are input to a fuzzy controller for the grasping control of a prosthetic hand. A vibration feedback device is used to feed grasping force value back to patient's arm to improve patient's sense of using prosthetic hand and realize accurate grasping. To test the effectiveness of the scheme, 15 able-bodied subjects participated in the experiments. RESULTS: The classification results indicated that 8-channel sEMG applying all four time-domain features, with PCA reduction from 32 to 8 dimensions results in the highest classification accuracy. Based on the experimental results from 15 participants, the average recognition rate is over 95%. On the other hand, from the statistical results of standard deviation, the between-subject variations ranges from 3.58 to 1.25%, proving that the robustness and stability of the proposed approach. CONCLUSIONS: The method proposed hereto control grasping power through the patient's own sEMG signal, which achieves a high recognition rate to improve the success rate of grip and increases the sense of operation and also brings the gospel for upper extremity amputation patients.

Ultrathin Chiral Metal-Organic-Framework Nanosheets for Efficient Enantioselective Separation.

Chiral metal-organic framework (CMOF) nanosheets only a few layers thick remain a virgin land waiting for exploration. Herein, the first examples of ultrathin CMOF nanosheets are prepared by the confinement growth of two-dimensional (2D) chiral layers, which are assembled by helical metal-organic chains within microemulsion. This convenient and easily scaled up inverse microemulsion method gives a series of 2D CMOF nanosheets composed of variable metal nodes or chiral ligands. More significantly, thanks to the exceptionally large number of chiral sites exposed on surfaces, the as-obtained CMOF nanosheets exhibit much higher enantioselectivity in chiral separation compared with their bulk counterparts.

Enantioseparation of Au20 (PP3 )4 Cl4 Clusters with Intrinsically Chiral Cores.

Au20 (PP3 )4 Cl4 (PP3 =tris(2-(diphenylphosphino)ethyl) phosphine), abbreviated as Au20 , is the only Au nanocluster with an intrinsically chiral core without a chiral environment (chiral ligands or Au-thiolate staples), making it a unique object to understand chiral evolution and explore chiral applications. Unfortunately, the synthesized Au20 is racemic, and its enantiomers have not yet been separated. Herein, we report a supramolecular assembly strategy with α-cyclodextrin (α-CD) to afford enantiopure Au20 in bulk, and an enantiomer excess (ee) value of as-separated Au20 of 97 %. As a result of its high purity, the distinctive optical activity of Au20 , which originates from electronic transitions confined in chiral cores, is fully explored. Theoretical studies reveals that the enantioseparation results from the preferential self-assembly of α-CD with organic ligands on the surface of right-handed Au20 .

Boosting Hot Electrons in Hetero-superstructures for Plasmon-Enhanced Catalysis.

Hetero-nanostructures featured with both strong plasmon absorption and high catalytic activity are believed to be ideal platforms to realize efficient light-driven catalysis. However, in reality, it remains a great challenge to acquire high-performance catalysis in such hetero-nanostructures due to poor generation and transfer of plamson-induced hot electrons. In this report, we demonstrate that Au nanorod@Pd superstructures (Au@Pd SSs), where the ordered Pd nanoarrays are precisely grown on Au nanorod surfaces via solution-based seed-mediated approach, would be an excellent solution for this challenge. Both experiment and theory disclose that the ordered arrangement of Pd on Au nanorod surfaces largely promotes hot electron generation and transfer via amplified local electromagnetic field and decreased electron-phonon coupling, respectively. Each effect is separately highlighted in experiments by the significant plasmon-enhanced catalytic activity of Au@Pd SSs in two types of important reactions with a distinct time scale of bond-dissociation event: molecular oxygen activation and carbon-carbon coupling reaction. This work opens the door to design and application of new generation photocatalysts.

High-intensity focused ultrasound (HIFU) treatment for uterine fibroids: a meta-analysis.

PURPOSE: High-intensity focused ultrasound (HIFU) is a non-invasive uterine-preserving treatment alternative to hysterectomy for women with fibroids. METHODS: We performed this meta-analysis to evaluate the efficacy of HIFU in the treatment of women with symptomatic fibroids comparing it to other approaches including medical treatment with mifepristone (Mife), traditional surgery with myomectomy or hysterectomy (MYC/HRM), and radiofrequency ablation (RF). 16 studies with 1725 women were included. RESULTS: The pooled data of HIFU comparing it to other methods in terms of complete or partial response rate (CR/PR) was not significantly better, but in subgroup analysis, the response rate was significantly higher than Mife, significantly lower than RF and comparable to MYC/HRM, respectively. For the endpoints of safety, the superiority of HIFU compared to MYC/HMR or Mife was found to be significant in terms of pain/discomfort, fever, transfusion, genital tract, gastrointestinal tract, and anesthesia-related complications, while no superiority was identified for skin burn, urinary tract, and nervous system complications. CONCLUSION: These results suggest that HIFU treatment of uterine leiomyomas leads to clinical improvement with few significant clinical complications and adverse events.