高通量血液透析对维持性血透患者预后的meta分析

目的 采用meta分析评价高通量血液透析（HFHD）对维持性血透（MHD）患者临床预后的影响。方法 检索国内外发表的关于HFHD对比低通量血液透析（LFHD）随机对照试验（RCT）和临床对照试验（CCT）研究,并经过严格的方法学质量评价,meta综合后,系统评价HFHD对MHD患者的生存率、心脑血管死因病死率等指标对预后的影响。结果 共纳入8篇相关研究,其中3篇为高质量RCT,5篇为CCT。经meta综合,共计5 015例患者入选。结果显示：HFHD组相对于LFHD组病死率差异无统计学意义（RR=0.85, 95%CI：0.71~1.01,P=0.06）。3项RCT经meta分析后显示HFHD可以降低心血管疾病病死率（RR=0.83, 95%CI：0.71~0.98,P=0.03）。2项RCT使用相同单位描述β2微球蛋白（β2-MG）清除情况,经meta分析后显示HDHF具有更好的β2-MG清除率（MD=-10.89, 95%CI：-14.89~6.97,P〈0.000 1）。结论 HFHD虽然能提高β2-MG的清除率及降低心血管死亡率,但是并不能降低MHD患者的病死率。HFHD对血清白蛋白较低的患者以及糖尿病肾病患者可能有较好的远期效果。     

芪参益气滴丸治疗慢性肺源性心脏病的系统评价

目的:采用Meta分析的方法评价芪参益气滴丸治疗肺源性心脏病的临床疗效.方法:计算机检索数据库,搜集在西药常规治疗的基础上加用芪参益气滴丸治疗肺源性心脏病的RCT,检索时限均从建库至2016年9月30日.由2位评价员按照纳入与排除标准独立筛选文献、提取资料和评价纳入研究的方法后,采用RevMan 5.3软件进行Meta分析.共纳入6个RCTs,共490例慢性肺源性心脏病患者.结果:经分析显示,芪参益气滴丸+常规治疗组(治疗组)与常规治疗组(对照组)相比:可提高临床治疗有效率;改善心功能.结论:在常规西药治疗的基础上加用芪参益气滴丸可有效改善慢性肺源性心脏病患者的心功能,提高临床总有效率,且不良反应少,耐受性好.虽然本研究所纳入文献数量较少,研究样本量有限,更需大量研究证据支持,但目前的结果已经可以显示芪参益气滴丸在肺源性心脏病方面的疗效与裨益,值得进一步深入研究与临床推广.     

阿奇霉素治疗支气管哮喘疗效及安全性的系统评价

目的系统评价阿奇霉素治疗支气管哮喘（以下简称哮喘）的疗效及安全性。方法计算机检索中国知网、万方数据库、
PubMed、Medline 电子数据库,检索时间从建库至2013 年12 月,查找公开发表的关于阿奇霉素治疗哮喘的随机对照试验
（randomized controlled trial, RCT）;对符合条件的RCT,由两位评价员独立进行资料提取及质量评价,并交叉核对;采用
Revman5.1软件对纳入文献行进Meta分析。结果共纳入8项RCTs,分析结果显示,与对照组相比,阿奇霉素组呼气峰值流速
（peak expiratory flow, PEF）［加权均数差（weighted mean difference, WMD）=0.15, 95% CI=0.06—0.24,P=0.001］、哮喘控制测试
（asthma control test, ACT）评分［WMD=1.59, 95% CI=0.95—2.23, P<0.00001］、第1 秒用力呼气容积（forced expiratory volume
in one second, FEV1）占预计值百分比（FEV1%）水平改善［WMD=1.44,95% CI=0.40—2.49, P=0.007］,但后者的改善作用仅见
于中文研究［WMD=1.48,95% CI=0.40—2.57, P=0.007］;哮喘控制问卷（asthma control questionnaire, ACQ）评分［WMD=0.07,
95% CI=-0.11—0.25, P=0.45］及哮喘生活质量问卷调查（asthma quality of life questionnaire, AQLQ）评分［WMD=-0.06, 95%
CI=-0.42—0.31, P=0.77］无统计学差异（P>0.05）;无明显不良反应。结论阿奇霉素可改善哮喘患者PEF、ACT,以及中国人种
的FEV1%水平,但对于生活质量无明显作用,长期服用耐受性良好,有可能成为哮喘治疗的辅助用药。
     

中国人群GSTM1基因多态性与非吸烟肺癌发病风险的Meta分析

目的 利用Meta 分析方法评价谷胱甘肽S- 转移酶M1(glutathione S-transferase M1,GSTM1) 基因多态性与中国人群非吸烟肺癌发病的相关性.方法 检索中国期刊全文数据库(1979-2011)、维普中文科技期刊数据库(1989-2011)、中国生物医学文献数据库(1979-2011)、万方数据库(1998-2011)、EMbase(1900-2011) 和PubMed (1966-2011) 数据库,收集有关中国人群GSTM1 基因多态性与非吸烟肺癌关系的研究.结果 共纳入16 篇文献对照研究,包括非吸烟肺癌患者818 例,对照组921 例.Meta 分析结果显示:GSTM1 缺失基因型的中国人群患非吸烟肺癌的风险明显增高(OR=1.65,95%CI=1.34,2.04).亚组分析发现,具有GSTM1 缺失基因型的中国南方和北方人群罹患非吸烟肺癌的风险分别为对照组的1.48 倍(95%CI=1.14,1.91) 和2.03 倍(95%CI=1.42,2.90).结论 GSTM1 缺失基因型使中国人群非吸烟肺癌的发病风险显著增加.     

Vitamin Supplementation Protects against Nanomaterial-Induced Oxidative Stress and Inflammation Damages: A Meta-Analysis of In Vitro and In Vivo Studies

The extensive applications of nanomaterials have increased their toxicities to human health. As a commonly recommended health care product, vitamins have been reported to exert protective roles against nanomaterial-induced oxidative stress and inflammatory responses. However, there have been some controversial conclusions in regards to this field of research. This meta-analysis aimed to comprehensively evaluate the roles and mechanisms of vitamins for cells and animals exposed to nanomaterials. Nineteen studies (seven in vitro, eleven in vivo and one in both) were enrolled by searching PubMed, EMBASE, and Cochrane Library databases. STATA 15.0 software analysis showed vitamin E treatment could significantly decrease the levels of oxidants [reactive oxygen species (ROS), total oxidant status (TOS), malondialdehyde (MDA)], increase anti-oxidant glutathione peroxidase (GPx), suppress inflammatory mediators (tumor necrosis factor-α, interleukin-6, C-reactive protein, IgE), improve cytotoxicity (manifested by an increase in cell viability and a decrease in pro-apoptotic caspase-3 activity), and genotoxicity (represented by a reduction in the tail length). These results were less changed after subgroup analyses. Pooled analysis of in vitro studies indicated vitamin C increased cell viability and decreased ROS levels, but its anti-oxidant potential was not observed in the meta-analysis of in vivo studies. Vitamin A could decrease MDA, TOS and increase GPx, but its effects on these indicators were weaker than vitamin E. Also, the combination of vitamin A with vitamin E did not provide greater anti-oxidant effects than vitamin E alone. In summary, we suggest vitamin E alone supplementation may be a cost-effective option to prevent nanomaterial-induced injuries.     

The Relationship between Fat Mass Percentage and Glucose Metabolism in Children and Adolescents: A Systematic Review and Meta-Analysis

To assess the relationship between fat mass percentage (FMP) and glucose metabolism in children aged 0–18 years we performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase and Cochrane Library using the PRISMA 2020 guidelines up to 12 October 2021 for observational studies that assessed the relationship of FMP and glucose metabolism. Twenty studies with 18,576 individuals were included in the meta-analysis. The results showed that FMP was significantly associated with fasting plasma glucose (FPG) (r = 0.08, 95% confidence interval (CI): 0.04–0.13, p < 0.001), fasting plasma insulin (INS) (r = 0.48, 95% CI: 0.37–0.57, p < 0.001), and homeostasis model assessment (HOMA)- insulin resistance (IR) (r = 0.44, 95% CI: 0.33–0.53, p < 0.001). The subgroup analysis according to country or overweight and obesity indicated that these associations remained significant between FMP and INS or HOMA-IR. Our results demonstrated that there is a positive relationship between FMP and FPG. Moreover, subgroup analysis according to country or overweight and obesity indicated that FMP is significantly associated with INS and HOMA-IR. This is the first known systematic review and meta-analysis to determine the associations of FMP with glucose metabolism in children and adolescents.     

中国癌症患者癌因性疲乏影响因素的meta分析

目的:探讨中国癌症患者癌因性疲乏(CRF)的影响因素.方法:计算机检索数据库PubMed、Embase、Web of Science及CNKI、CBM、Wan Fang、VIP,搜索建库至2020年3月31日的有关中国癌症患者CRF影响因素的相关文献,使用RevMan 5.3软件进行分析.结果:本研究共纳入21篇文献,...     

Oral Administration of East Asian Herbal Medicine for Inflammatory Skin Lesions in Plaque Psoriasis: A Systematic Review,Meta-Analysis,and Exploration of Core Herbal Materials

Psoriasis is an inflammatory autoimmune skin disease with various clinical manifestations. The aim of this review was to systematically evaluate the efficacy and safety of oral administration of East Asian herbal medicine (EAHM) for inflammatory skin lesions in psoriasis and to explore core herbal materials for drug discovery. A comprehensive search was conducted in 10 electronic databases for randomized controlled trials from their inception until 29 July 2021. Statistical analysis was performed in R version 4.1.2 and R studio. When heterogeneity in studies was detected, the cause was identified through sensitivity analysis, meta-regression, and subgroup analysis. Methodological quality was independently assessed using the revised tool for risk of bias in randomized trials. A total of 56 trials with 4966 psoriasis patients met the selection criteria. Meta-analysis favored EAHM monotherapy on Psoriasis Area Severity Index (PASI) 70 (RR: 1.2845; 95% CI: 1.906 to 1.3858, p < 0.0001), PASI 60 (RR: 1.1923; 95% CI: 1.1134 to 1.2769, p < 0.0001), continuous PASI score (MD: −2.3386, 95% CI: −3.3068 to −1.3704, p < 0.0001), IL-17, IL-23, TNF-α, and Dermatology Life Quality Index. Patients treated with EAHM monotherapy had significantly reduced adverse events incidence rate. In addition, based on additional examination of the herb data included in this meta-analysis, 16 core materials were identified. They are utilized in close proximity to one another, and all have anti-inflammatory properties. The findings in this study support that oral EAHM monotherapy may be beneficial for inflammatory skin lesions in psoriasis. Meanwhile, the identified core materials are expected to be utilized as useful drug candidate hypotheses through follow-up studies on individual pharmacological activities and synergistic effects.