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Dan Liu, Li Zhang, Mengna Shou, Hong Yu, Yanqing Yang, Hong Cheng Shaoxing Maternity and Child Health Care Hospital, Shaoxing University, Shaoxing, Zhejiang, People’s Republic of ChinaCorrespondence: Dan Liu, Email marcia1981@126.comBackground: The presence of abnormal vision during early childhood has been shown to have a substantial impact on the development of visual, motor, and cognitive functions, potentially resulting in long-term adverse psychosocial outcomes. The objective of this study was to examine the prevalence and associated risk factors of abnormal vision among preschool children aged 4– 6 years in Shaoxing, China.Methods: A cross-sectional study was conducted from March to May 2023 in Shaoxing, involving a sample of 9913 children within the specified age range. Parents were interviewed using a structured questionnaire that gathered information on sociodemographic characteristics and other relevant factors.Results: The study revealed that 14.4% of participants had abnormal vision. Logistic regression analysis indicated that individuals who watched TV for more than 3 hours daily had a 2.206 times higher likelihood of developing abnormal vision (P< 0.05). Additional risk factors for abnormal vision included watching TV at a distance of less than 3 meters, misalignment of eyes and screen while watching TV, early exposure to electronic devices before the age of 2, parents are unaware of the impact of chewing on eye development, and lack of promotion of good eye habits in children (P < 0.05). An association was found between parent’s and children’s refractive error (P < 0.05), with good family lighting and a balanced dietary structure being identified as protective factors against abnormal vision.Conclusion: The study concluded that exposure to electronic products was a significant factor in the development of abnormal vision among children aged 4– 6. Furthermore, family environment and genetic predisposition were also found to influence vision. Regular ocular screenings and early interventions may be effective in preventing abnormal vision.Keywords: risk factors, abnormal vision, preschool children, China

Abstract Background Combination therapy is required for the treatment of moderate acne vulgaris. However, patient compliance in applying multiple topical formulations is poor. Objective To assess the efficacy and safety of a fixed-dose combination gel with adapalene 0.1% and clindamycin 1% (adapalene-clindamycin) relative to adapalene 0.1% monotherapy and clindamycin 1% monotherapy in patients with moderate facial acne vulgaris. Methods This was a randomized, controlled, assessor-blind, phase III study conducted in patients with moderate facial acne vulgaris. Results A total of 1617 patients were enrolled. At week 12, patients in the adapalene–clindamycin gel treatment group showed a significant reduction in the percentage change from baseline in total lesion count (− 66.85%), compared with adapalene alone (− 50.82%) or clindamycin gel alone (− 57.61%). The difference in the least square means of the adapalene–clindamycin gel group and adapalene group, or clindamycin gel group was − 16.08% (95% CI − 19.95% to − 12.21%) and − 9.38% (95% CI − 13.25% to − 5.51%;), respectively. At week 12, 19.28% of participants who received adapalene–clindamycin gel achieved at least 2-grade improvement in IGA, versus 7.74% with adapalene gel (OR 3.05, 95% CI 1.93, 4.80) and 14.77% with clindamycin gel (OR 1.42, 95% CI 0.97, 2.07). The study also achieved all its secondary endpoints. Adverse event rates were mostly mild to moderate and comparable across the three treatment groups. Conclusion Adapalene 0.1%–clindamycin 1% combination gel is well tolerated and demonstrated superior efficacy over 0.1% adapalene gel monotherapy and 1% clindamycin gel monotherapy for the treatment of moderate acne vulgaris. Trial Registration ClinicalTrials.gov identifier NCT03615768.

Abstract As an unconventional oil and gas resource, coalbed methane has become a key area of unconventional oil and gas exploration worldwide, and hydraulic fracturing is the critical technology for the efficient stimulation of coalbed methane. However, due to the strong heterogeneity of deep coal seam reservoirs and the development of natural cleat fractures, the fracture propagation path is quite complex and difficult to capture. In this study, we propose a hydraulic fracture propagation simulation method using the ABAQUS Software for natural cleat fracture networks and a fluid–solid fully coupled two‐dimensional finite element model with the global embedded cohesive zone model (CZM). CZM is established to simulate the propagation of hydraulic fractures in the heterogeneous combination of coal rock and mudstone. The accuracy of this model is verified by using Blanton's experiment criterion. Finally, the model is used to simulate the influence of cleat angle, cleat density, length ratio of coal rock and mudstone combination, and construction displacement on the propagation behavior of hydraulic fractures. This study aims to deepen the understanding of the mechanism of hydraulic fracture propagation in deep coal seams and provides guidance for deep coal seam fracturing and hydraulic fracturing design.

The measurement of cellular forces, which reflect crucial biological attributes, has the potential to replace conventional cell assessment methods, such as morphology, proliferation, and molecular expression analysis, in medical cell diagnosis and cell culture studies. In medical cell evaluations, force inference techniques have gained prominence due to their non-invasiveness and lack of requirement for specialized equipment. Among those techniques, the method proposed by Ishihara et al., which estimates forces in densely packed cells based only on cell geometry, is a promising method. However, its applicability range of this method has not been fully established. In this study, we employed a two-dimensional vertex model to numerically assess the applicability of this method on homogeneous and heterogeneous cells. Our comparisons between the true values from numerical simulations and the estimated values from the inference method revealed a significant correlation between estimation accuracy and cell roundness in systems of homogeneous cell. Moreover, the method demonstrated efficient force estimations in heterogeneous-cell systems. These findings may be useful when the force inference method is employed to evaluate medical cells.

Under complex conditions, the vertical, lateral and longitudinal dynamics of vehicles have obvious coupling and interaction. This paper aims to provide a suitable driver cab and a vehicle model for the study of vehicle coupling dynamic performance. In modeling the cab and body kinetic equation, two shock absorbers are considered in the front axle suspension system. In addition, the vertical, roll and pitch motion of the diver cab, vehicle body, the vertical and roll behavior of three wheel axles, the pitch angles of the left and right balancing pole on rear suspension, and roll angle the of each tire are considered. Finally, based on the above coupled motion characteristics, a diver cab and a vehicle model for three-axles heavy-duty vehicle with 26 degrees of freedom (DOF) are proposed.

Understanding the mechanical properties of rock is of great significance for the development of unconventional reservoirs. However, a large number of bedding makes the mechanical laws of rock unclear. To investigate the effect of bedding properties on the uniaxial mechanical properties of rock, the coal model containing bedding is developed based on the continuous–discontinuous method, and the effect of bedding angle, bedding strength, bedding number, and loading rate on the uniaxial mechanical properties of rock is investigated. The failure morphology, stress–strain evolution, peak stress, and fracture degrees are analyzed and discussed in detail. The reliability of the numerical model in this paper has been verified by comparison with the indoor experiments. The results show that when the bedding angle is 0°, the peak stress of the rock is maximum, 8.16 MPa, and when the bedding angle is 90°, the fracture degree of the rock is maximum, 3.74%. For the different bedding strengths, the peak stress first decreases linearly with the decrease of the bedding strength. The peak stress barely varies when the bedding strength is less than 0.5 MPa. The fracture degree of the rock shows a nonlinear increase with the increase in bedding strength. For different bedding numbers, the activation of the bedding is not related to the bedding number. The loading speed also has a great influence on the mechanical properties of rock. With the increase in loading rate, the difficulty of bedding activation gradually increases, and the complexity of fractures gradually increases. This study aims to further improve the understanding of the effect of bedding properties on the uniaxial mechanical properties of rock.

Tanshinones, isolated from Salvia miltiorrhiza, is efficient to treat cardiovascular and cerebrovascular diseases. Abscisic acid (ABA) treatment is found to promote tanshinone biosynthesis; however, the underlying mechanism has not been fully elucidated. A protein kinase namely SmAPK1 was identified as an important positive regulator of ABA-induced tanshinone accumulation in S. miltiorrhiza. Using SmAPK1 as bait, a basic region leucine zipper (bZIP) family transcription factor SmbZIP4 was screened from the cDNA library. Functional identification reveals that SmbZIP4 negatively regulates tanshinone biosynthesis in hairy roots and transgenic plants through directly targeting SmGGPPS and SmCYP76AK1. SmAPK1 phosphorylates the Ser97 and Thr99 site of SmbZIP4, leading to its degradation via the 26S proteasome pathway, which is promoted by ABA-induced enhancement of SmAPK1 kinase activity. Degradation of SmbZIP4 upregulates the expression levels of SmGGPPS and SmCYP76AK1, resulting in increased tanshinone content. Taken together, our results reveal new molecular mechanism by which SmAPK1-SmbZIP4 module plays a crucial role in ABA-induced tanshinone accumulation. This study sheds new insights in the biosynthesis of bioactive compounds in medicinal plants., (© 2024 The Author(s). New Phytologist © 2024 New Phytologist Foundation.)

Introduction: Despite the increasing use of immunotherapy in treating various cancer types, there is still limited understanding of its impact on surgical complications. We used a national database to examine the difference in surgical outcomes for rectal cancer patients who received standard neoadjuvant chemoradiation plus neoadjuvant immunotherapy and patients who received neoadjuvant chemoradiation only., Methods: This retrospective cohort study used the National Cancer Database (NCDB). We selected patients aged 18-90 with T1-3, N1-2, and M0 rectal cancer who underwent curative-intent surgery between 2010 and 2020. We performed a 1:1 propensity match to control for patient age, sex, Charlson-Deyo comorbidity index, surgical approach, and tumor site. Our primary outcome was difference in surgical outcomes (hospital length of stay, unplanned 30-day readmission, 30-day mortality) between the two groups. Secondary outcomes included days from diagnosis to surgery and pathologic outcomes., Results: Our study included 26 229 patients, of which 126 received immunotherapy in addition to chemoradiation and 26 103 received only chemoradiation. In our matched population of 125 pairs of patients, patients who received immunotherapy and chemoradiation underwent surgery later compared to patients who only received chemoradiation (median 245 vs. 144 days, p < 0.001). There were no significant differences in median length of stay (5 vs. 5 days, p = 0.202), unplanned 30-day readmission (7 vs. 9, p = 0.617), and 30-day mortality (0 vs. 1, p = 1.000) between the two groups., Conclusion: Neoadjuvant immunotherapy for rectal cancer is not associated with adverse surgical outcomes. This work can help clinicians optimize treatment protocols and move closer toward strategies tailored to specific patient profiles., (© 2024 Wiley Periodicals LLC.)

Phenolic acids are one of the major secondary metabolites accumulated in Salvia miltiorrhiza with various pharmacological activities. Moderate drought stress can promote the accumulation of phenolic acids in S. miltiorrhiza , while the mechanism remains unclear. Therefore, we performed transcriptome sequencing of S. miltiorrhiza under drought treatment. A total of 47,169 unigenes were successfully annotated in at least one of the six major databases. Key enzyme genes involved in the phenolic acid biosynthetic pathway, including SmPAL , SmC4H , Sm4CL , SmTAT , SmHPPR , SmRAS and SmCYP98A14 , were induced. Unigenes annotated as laccase correlated with SmRA S and SmCYP98A14 were analyzed, and seven candidates that may be involved in the key step of SalB biosynthesis by RA were obtained. A total of 15 transcription factors significantly up-regulated at 2 h and 4 h potentially regulating phenolic acid biosynthesis were screened out. TRINITY&#95;DN14213&#95;c0&#95;g1 (AP2/ERF) significantly transactivated the expression of SmC4H and SmRAS , suggesting its role in the regulation of phenolic acid biosynthesis. GO and KEGG enrichment analysis of differential expression genes showed that phenylpropanoid biosynthesis and plant hormone signal transduction were significantly higher. The ABA-dependent pathway is essential for resistance to drought and phenolic acid accumulation. Expression patterns in drought and ABA databases showed that four PYLs respond to both drought and ABA, and three potential SnRK2 family members were annotated and analyzed. The present study presented a comprehensive transcriptome analysis of S. miltiorrhiza affected by drought, which provides a rich source for understanding the molecular mechanism facing abiotic stress in S. miltiorrhiza .

Skin is the most important defense shield which touched external environment directly. Effectively clearing microbes in infected wound via non-antibiotic therapy is crucial for the promotion of recovery in complex biological environments, and the wound healing is a crucial process after sterilization to avoid superinfection. Herein, a kind of Prussian blue-based photothermal responsive gel, Bletilla striata polysaccharide-mingled, isatin-functionalized Prussian blue gel (PB-ISA/BSP gel) was reported for effective treatment of bacterial infection and wound healing. The introduction of effective components of traditional Chinese medicine (TCM), isatin (ISA), enhanced the efficiency of sterilization synergistically. Furthermore, the process of wound healing was promoted by Bletilla striata polysaccharides (BSP). PB-ISA@BSP had a considerable antibacterial rate with 98.5 % under an 808 nm laser for 10 min in vitro. Besides, PB-ISA/BSP gel showed an effective antibacterial efficacy in vivo and a fast wound healing rate as well. The as-prepared functional particles can invade and destroy bacteria membrane to kill microbes. This work highlights that PB-ISA/BSP gel is a promising antibacterial agent based on synergistically enhanced photothermal effect and wound healing promotion ability and provides inspiration for future therapy based on the synergy between photothermal agent and active components in TCM., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

As an advanced sensing technology, dual-mode flexible sensing, integrating both tactile and touchless perception, propels numerous intelligent devices toward a more practical and efficient direction. The ability to incorporate multiple sensing modes and accurately distinguish them in real time has become crucial for technological advancements. Here, we proposed a dual-mode sensing system (B-MIGS) consisting of a dual-layer sensing device with a magnetically induced grid structure and a testing device. The system was capable of utilizing mechanical pressure to perceive tactile stimulation and magnetic sensing to simultaneously transduce touchless stimulation simultaneously. By leveraging the triboelectric effect, the decoupling of tactile and touchless signals in the presence of unknown signal sources was achieved. Additionally, the sensing characteristics of the B-MIGS were optimized by varying the curing magnetic induction intensity and magnetic particle concentration. The influence of the temperature and humidity on the sensing signals was also discussed. Finally, the practical value of the B-MIGS as a dual-mode monitoring system was demonstrated on soft petals and sensor arrays, along with exploration of its potential application in underwater environments.

Memristors are recognized as crucial devices for future nonvolatile memory and artificial intelligence. Due to their typical neuron-synapse-like metal-insulator-metal(MIM) sandwich structure, they are widely used to simulate biological synapses and have great potential in advancing biological synapse simulation. However, the high switch voltage and inferior stability of the memristor restrict the broader application to the emulation of the biological synapse. In this study, we report a vertically structured memristor based on few-layer MoS2. The device shows a lower switching voltage below 0.6 V, with a high ON/OFF current ratio of 104, good stability of more than 180 cycles, and a long retention time exceeding 3 × 103 s. In addition, the device has successfully simulated various biological synaptic functions, including potential/depression propagation, paired-pulse facilitation (PPF), and long-term potentiation/long-term depression (LTP/LTD) modulation. These results have significant implications for the design of a two-dimensional transition-metal dichalcogenides composite material memristor that aim to mimic biological synapses, representing promising avenues for the development of advanced neuromorphic computing systems.

Epigenetic therapies that cause genome-wide epigenetic alterations, could trigger local interplay between different histone marks, leading to a switch of transcriptional outcome and therapeutic responses of epigenetic treatment. However, in human cancers with diverse oncogenic activation, how oncogenic pathways cooperate with epigenetic modifiers to regulate the histone mark interplay is poorly understood. We herein discover that the hedgehog (Hh) pathway reprograms the histone methylation landscape in breast cancer, especially in triple-negative breast cancer (TNBC). This facilitates the histone acetylation caused by histone deacetylase (HDAC) inhibitors and gives rise to new therapeutic vulnerability of combination therapies. Specifically, overexpression of zinc finger protein of the cerebellum 1 (ZIC1) in breast cancer promotes Hh activation, facilitating the switch of H3K27 methylation (H3K27me) to acetylation (H3K27ac). The mutually exclusive relationship of H3K27me and H3K27ac allows their functional interplay at oncogenic gene locus and switches therapeutic outcomes. Using multiple in vivo breast cancer models including patient-derived TNBC xenograft, we show that Hh signaling-orchestrated H3K27me and H3K27ac interplay tailors combination epigenetic drugs in treating breast cancer. Together, this study reveals the new role of Hh signaling-regulated histone modifications interplay in responding to HDAC inhibitors and suggests new epigenetically-targeted therapeutic solutions for treating TNBC., (© 2023 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences. Production and hosting by Elsevier B.V.)

In this study, we successfully prepared core-shell heterostructured nanocomposites (Fe NWs@SiO 2 ), with ferromagnetic nanowires (Fe NWs) as the core and silica (SiO 2 ) as the shell. The composites exhibited enhanced electromagnetic wave absorption and oxidation resistance and were synthesized using a simple liquid-phase hydrolysis reaction. We tested and analyzed the microwave absorption properties of Fe NWs@SiO 2 composites with varied filling rates (mass fractions of 10 wt%, 30 wt%, and 50 wt% after mixing with paraffin). The results showed that the sample filled with 50 wt% had the best comprehensive performance. At the matching thickness of 7.25 mm, the minimum reflection loss ( RL min ) could reach -54.88 dB at 13.52 GHz and the effective absorption bandwidth (EAB, RL < -10 dB) could reach 2.88 GHz in the range of 8.96-17.12 GHz. Enhanced microwave absorption performance of the core-shell structured Fe NWs@SiO 2 composites could be attributed to the magnetic loss of the composite, the core-shell heterogeneous interface polarization effect, and the small-scale effect induced by the one-dimensional structure. Theoretically, this research provided Fe NWs@SiO 2 composites with highly absorbent and antioxidant core-shell structures for future practical applications.

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder that occurs frequently in women of childbearing age and is associated with insulin resistance. Serum visfatin can affect insulin resistance by binding to insulin receptors and further affect the occurrence and development of PCOS. In this study, we investigated the current status of serum visfatin levels in patients with PCOS through a literature search and meta-analysis., Methods: We searched online Pubmed, Embase, Web of Science, the Cochrane Library, CNKI (China National Knowledge Infrastructure), CBMdisc (China Biology Medicine disc) databases and registered websites such as the ICTRP (International Clinical Trial Registration Platform) and clinicaltrials.gov (https://clinicaltrials.gov/) for case-control studies on PCOS and visfatin levels, assessed the quality of the included articles with the Newcastle-Ottawa Scale (NOS scale), and combined the comparison of serum visfatin levels between patients with PCOS and healthy individuals from high-quality studies., Results: 20 research papers were included in the quantitative analysis of this study. The combined analysis showed that obese patients with PCOS had statistically significantly higher visfatin levels than healthy people [MD (mean difference) = 12.94, 95% CI (confidence interval) (6.52-19.37), Z = 3.95, p < 0.0001]. Visfatin levels were higher in non-obese patients with PCOS than in healthy people and are statistically significant [MD = 14.98, 95% CI (5.80-24.16), Z = 3.20, p = 0.001]. Heterogeneity in the combined analysis was not related to study location, the publication year of the literature, source of serum samples, but was influenced by the quality of the literature. After excluding the most influential papers, the combined analysis was conducted again, and the conclusion was consistent with that before the exclusion. The results of Egger's test showed no significant publication bias., Conclusions: High serum visfatin levels are a natural feature of PCOS and are not associated with obesity; Serum visfatin levels may be a potential marker for the diagnosis of PCOS, but their relationship with PCOS and insulin resistance remains worthy of in-depth investigation.

Glucagon has emerged as a key regulator of extracellular amino acid (AA) homeostasis. Insufficient glucagon signaling results in hyperaminoacidemia, which drives adaptive proliferation of glucagon-producing α cells. Aside from mammalian target of rapamycin complex 1 (mTORC1), the role of other AA sensors in α cell proliferation has not been described. Here, using both genders of mouse islets and glucagon receptor (gcgr)-deficient zebrafish (Danio rerio), we show α cell proliferation requires activation of the extracellular signal-regulated protein kinase (ERK1/2) by the AA-sensitive calcium sensing receptor (CaSR). Inactivation of CaSR dampened α cell proliferation, which was rescued by re-expression of CaSR or activation of Gq, but not Gi, signaling in α cells. CaSR was also unexpectedly necessary for mTORC1 activation in α cells. Furthermore, coactivation of Gq and mTORC1 induced α cell proliferation independent of hyperaminoacidemia. These results reveal another AA-sensitive mediator and identify pathways necessary and sufficient for hyperaminoacidemia-induced α cell proliferation., (© 2023. The Author(s).)

The stable operation of climbing robots exposed to high winds is of great significance for the health-monitoring of structures. This study proposes an anole lizard-like climbing robot inspired by its superior wind resistance. First, the stability mechanism of the anole lizard body in adhesion and desorption is investigated by developing adhesion and desorption models, respectively. Then, the hypothesis that the anole lizard improves its adhesion and stability performance through abdominal adjustment and trunk swing is tested by developing a simplified body model and kinematic model. After that, the structures of the toe, limb, and multi-stage flexible torso of the anole lizard-like climbing robot are designed. Subsequently, the aerodynamic behavior of the proposed robot under high-speed airflow are investigated using finite element analysis. The results show that when there is no obstacle, the climbing robot generates the normal force to enhance toepad friction and adhesion by tuning the abdomen's shape to create an air pressure difference between the back and abdomen. When there is an obstacle, a component force is obtained through periodic oscillation of the spine and tail to resist the frontal winds resulting from the vortex paths generated by the airflow behind the obstacle. These results confirm that the proposed hypothesis is correct. Finally, the adhesion and wind resistance performance of the anole lizard-like climbing robot is tested through the developed experimental platform. It is found that the adhesion force is equal to 50 N when the pre-pressure is 20 N. Further, it is shown that the normal pressure of the proposed robot can reach 76.6% of its weight in a high wind of 14 m/s.

Background: Gastric cancer pathological biopsy and visual examination have been the gold standard for gastric cancer diagnosis, but their operation is costly, demanding, and risky, so it is especially important to find an effective examination method in clinical practice., Aims: To investigate the correlation between serum pepsinogen I (PGI), pepsinogen II (PGII), pepsinogen I and II ratio (PGR), IL-6, and TNF- α and Helicobacter pylori (Hp) infection in patients with gastric cancer., Materials and Methods: Fifty patients with Hp-infected gastric cancer admitted to the Department of Gastroenterology of our hospital from January 2019 to December 2021 were selected for the study as the observation group, and another 50 patients without Hp-infected gastric cancer were selected as the comparison group to compare the correlation analysis of PGI, PGII, PGR, IL-6, and TNF- α with Hp infection between the two groups after admission and treatment., Results: After measurement, PGI and PGII in the observation group were significantly lower than those in the comparison group, and TNF- α , IL-18, and IL-6 in the observation group were significantly higher than those in the comparison group, and the comparative differences were all statistically significant ( P < 0.05). The results of multivariate logistic regression model analysis of independent risk factors for gastric cancer showed that IL-18, hs-CRP, and tumor necrosis factor- (TNF-) α were risk factors for Hp infection in gastric cancer., Conclusion: The expression of IL-18, hs-CRP, and TNF- α factors in Hp-infected gastric cancer patients is correlated. IL-6, IL-18, and TNF- α are involved in the entire process from the onset to the development of Hp-positive gastric mucosal inflammation in patients, which is of great value in the diagnosis of gastric cancer and helps to assess the degree of progression and prognosis of gastric cancer., Competing Interests: There are no conflicts of interest., (Copyright © 2022 Shunxin Hao et al.)

Foslevodopa (FLD, levodopa 4'-monophosphate, 3 ) and foscarbidopa (FCD, carbidopa 4'-monophosphate, 4 ) were identified as water-soluble prodrugs of levodopa (LD, 1 ) and carbidopa (CD, 2 ), respectively, which are useful for the treatment of Parkinson's disease. Herein, we describe asymmetric syntheses of FLD ( 3 ) and FCD ( 4 ) drug substances and their manufacture at pilot scale. The synthesis of FLD ( 3 ) employs a Horner-Wadsworth-Emmons olefination reaction followed by enantioselective hydrogenation of the double bond as key steps to introduce the α-amino acid moiety with the desired stereochemistry. The synthesis of FCD ( 4 ) features a Mizoroki-Heck reaction followed by enantioselective hydrazination to install the quaternary chiral center bearing a hydrazine moiety.

Background: T long-term effects of cognitive therapy and behavior therapy (CTBT) for menopausal symptoms are unknown, and whether the effects are different between natural menopause and treatment-induced menopause are currently unclear. Therefore, we sought to conduct an accurate estimate of the efficacy of CTBT for menopausal symptoms., Methods: We conducted searches of Cochrane Library, EMBASE, PsycINFO, PubMed, and Web of Science databases for studies from 1 January 1977 to 1 November 2021. Randomized controlled trials (RCTs) comparing intervention groups to control groups for menopausal symptoms were included. Hedge's g was used as the standardized between-group effect size with a random-effects model., Results: We included 14 RCTs comprising 1618 patients with a mean sample size of 116. CTBT significantly outperformed control groups in terms of reducing hot flushes [g = 0.39, 95% confidence interval (CI) 0.23-0.55, I2 = 45], night sweats, depression (g = 0.50, 95% CI 0.34-0.66, I2 = 51), anxiety (g = 0.38, 95% CI 0.23-0.54, I2 = 49), fatigue, and quality of life. Egger's test indicated no publication bias., Conclusions: CTBT is an effective psychological treatment for menopausal symptoms, with predominantly small to moderate effects. The efficacy is sustained long-term, although it declines somewhat over time. The efficacy was stronger for natural menopause symptoms, such as vasomotor symptoms, than for treatment-induced menopause symptoms. These findings provide support for treatment guidelines recommending CTBT as a treatment option for menopausal symptoms.