BackgroundThis systematic review aimed at summarizing and evaluating the evidence of randomized controlled trials (RCTs) using acupuncture to improve endometrial receptivity (ER).MethodsWe searched 12 databases electronically through August 2018 without language restrictions. We included RCTs of women of infertility due to low ER, and excluded infertility caused by other reasons or non-RCTs. Two independent reviewers extracted the characteristics of studies and resolved the differences through consensus. Data were pooled and expressed as standard mean difference (SMD) or mean difference (MD) for continuous outcomes and risk ratio (RR) for dichotomous outcomes, with 95% confidence interval (CI).ResultsWe found very low to moderate level of evidence that acupuncture may improve pregnancy rate (RR = 1.23 95%CI[1.13, 1.34] P < 0.00001) and embryo transfer rate (RR = 2.04 95%CI[1.13, 3.70] P = 0.02), increase trilinear endometrium (RR = 1.47 95%CI [1.27, 1.70] P < 0.00001), thicken endometrium (SMD = 0.41 95% CI [0.11, 0.72] P = 0.008), reduce resistive index (RI) (MD = -0.08 95% CI [− 0.15, − 0.02] P = 0.01), pulse index (PI) (SMD = -2.39 95% CI [− 3.85, − 0.93] P = 0.001) and peak systolic velocity/ end-diastolic blood velocity (S/D) (SMD = -0.60 95% CI [− 0.89, − 0.30] P < 0.0001), compared with medication, sham acupuncture or physiotherapy. Acupuncture was statistically significant as a treatment approach.ConclusionThe efficacy and safety of acupuncture on key outcomes in women with low ER is statistically significant, but the level of most evidence was very low or low. More large-scale, long-term RCTs with rigorous methodologies are needed.

Background This systematic review aimed at summarizing and evaluating the evidence from randomized controlled trials (RCTs) which used electroacupuncture (EA) to treat postoperative urinary retention (PUR). Methods We searched thirteen databases electronically through April 2018 without language restrictions. We included RCTs of women with PUR; other types of urinary retention or not-RCTs were excluded. Two independent reviewers extracted studies' characteristics, and disagreements were resolved by consensus. Data were pooled and expressed as standard mean difference (SMD) for continuous outcomes and odds ratio (OR) for dichotomous outcomes, with 95% confidence interval (CI). Results We found very low to moderate level of evidence that effects of less than or equal to a week were statistically significant: therapeutic effect improved (OR=4.21; 95%CI [3.04, 5.83]; P<0.00001), residual urine volume decreased (SMD=-13.24; 95%CI [-15.70, -10.78]; P<0.00001), bladder capacity increased (SMD=0.56; 95%CI [0.30, 0.83]; P<0.0001), and urinary flow rate improved (SMD=0.91; 95%CI [0.64, 1.18]; P<0.00001). Effect over a week was statistically significant as well. Therapeutic effect improved (OR=8.29; 95%CI [2.91, 24.25]; P<0.0001), residual urine volume decreased (SMD=-1.78; 95%CI [-2.66, -0.89]; P<0.0001), bladder capacity (SMD=0.92; 95%CI [0.61, 1.23]; P<0.00001) and urinary flow rate (SMD=1.69; 95%CI [0.59, 2.79]; P=0.003) increased, and first urination after surgery was earlier (SMD=-0.92; 95%CI [-1.37, -0.46]; P<0.0001), compared with physical exercise, medication, or no treatment. Conclusion The efficacy and safety of EA on key outcomes in women with PUR are statistically significant, but the level of most evidence was very low or low. More large-scale, long-term RCTs with rigorous methodological quality are needed.

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Accumulated oxidative damage may lead to irreversible retinal pigmented epithelium (RPE) cell death, which is considered to be the primary cause of dry age-related macular degeneration (AMD), leading to blindness in the elderly. However, an effective therapy for this disease is lacking. Here, we described a robust high-content screening procedure with a library of 814 protective compounds and found that D609 strongly protected RPE cells from sodium iodate (SI)-induced oxidative cell death and prolonged their healthy survival. D609 effectively attenuated excessive reactive oxygen species (ROS) and prevented severe mitochondrial loss due to oxidative stress in the RPE cells. Surprisingly, the potent antioxidative effects of D609 were not achieved through its own reducibility but were primarily dependent on its ability to increase the expression of metallothionein. The injection of this small water-soluble molecule also showed an explicit protective effect of the RPE layer in an SI-induced AMD mouse model. These findings suggested that D609 could serve as a novel antioxidative protector of RPE cells both in vitro and in vivo and unveiled a novel antioxidative mechanism of D609, which may ultimately have clinical applications for the treatment of AMD.Signal Transduction and Targeted Therapy (2020) 5:20; https://doi.