BackgroundThe aim of this study was to assess the efficacy and safety of acupuncture therapy for patients with hypertension.Material/MethodsWe searched PubMed, Embase, the Cochrane Library, the Chinese Biomedical Literature Database, the Chinese National Knowledge Infrastructure, and the Wan-fang Data Database from inception through 29 April 2017. Randomized controlled trials investigating acupuncture therapy for hypertension were included. Review Manager 5.3 software was used for the data analysis.ResultsA total of 30 RCTs involving 2107 patients were included. The overall methodological quality of the included studies was low. Pooled results demonstrate that acupuncture plus anti-hypertensive drugs is better than anti-hypertensive drugs alone at reducing systolic and diastolic blood pressure (SBP and DBP). The same result was observed for pooled data from experiments that compared acupuncture plus medication to sham acupuncture plus medication at reducing SBP and DBP. However, studies reveal that using acupuncture alone or anti-hypertensive drugs alone do not differ in the effect on lowering blood pressure. Similarly, acupuncture alone also did not differ from sham acupuncture alone, and electroacupuncture versus anti-hypertensive drugs was not significantly different at reducing SBP and DBP.ConclusionsOur systematic review indicates there is inadequate high quality evidence that acupuncture therapy is useful in treating hypertension, as the exact effect and safety of acupuncture therapy for hypertension is still unclear. Therefore, research with larger sample sizes and higher-quality RCTs is still needed.

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The self‐calibrating Palmer drought severity index (scPDSI) was computed based on the four atmospheric reanalysis data sets combined with observational data over China during 1980–2015. The discrepancies of scPDSI among the four reanalysis data sets show the necessity of integrating multiple data sets. Drought characteristics, such as drought area, severity, duration, and frequency were examined based on multi‐data set mean scPDSI. The results reveal that significant drying trends are found in Qinghai‐Tibet Plateau, southwest, southeast and entire China. Drought area (drought severity) has increased (decreased) by about 1.16% (0.015%) per decade over entire China. Trends in drought duration, temporally averaged severity and frequency also indicate that droughts become more serious in each region during the past 36 years. The identification of drought events in each month by the clustering algorithm shows that droughts over China are more and more frequent. In addition, 65 separate drought events with the duration longer than 3 months were identified under the area threshold of 150,000 km2. Through severity‐area‐duration analysis, the 2005–2015 drought is found to be the prominent event.

Climate change exerts great influence on streamflow by changing precipitation, temperature, snowpack and potential evapotranspiration (PET), while human activities in a watershed can directly alter the runoff production and indirectly through affecting climatic variables. However, to separate contribution of anthropogenic and natural drivers to observed changes in streamflow is non-trivial. Here we estimated the direct influence of human activities and climate change effect to changes of the mean annual streamflow (MAS) of 96 Canadian watersheds based on the elasticity of streamflow in relation to precipitation, PET and human impacts such as land use and cover change. Elasticities of streamflow for each watershed are analytically derived using the Budyko Framework. We found that climate change generally caused an increase in MAS, while human impacts generally a decrease in MAS and such impact tends to become more severe with time, even though there are exceptions. Higher proportions of human contribution, compared to that of climate change contribution, resulted in generally decreased streamflow of Canada observed in recent decades. Furthermore, if without contributions from retreating glaciers to streamflow, human impact would have resulted in a more severe decrease in Canadian streamflow.