布拉酵母菌辅助治疗腹泻型肠易激综合征疗效的Meta分析

目的系统评价布拉酵母菌辅助治疗腹泻型肠易激综合征(IBS-D)的有效性。方法计算机检索The Cochrane Library、PubMed、EMbase、中国生物医学文献数据库、中国知网、维普中文期刊数据库和万方数据库,时限为建库至2020年2月。由2位研究人员按纳入、排除标准筛选文献,提取数据,评价纳入文献的方法学质量。研究主要结果为总症状改善人数,次要结果为症状总积分及腹痛、腹胀、腹泻情况。采用RevMan 5.3统计学软件进行Meta分析。结果共纳入13篇RCT文献(n=1 320),Meta分析结果显示,使用布拉酵母菌辅助治疗IBS-D可提高患者治疗效果[RR=1.24,95%CI(1.18,1.31),P0.01],降低总症状积分[SMD=-0.98,95%CI(-1.21,-0.74),P0.01],改善患者腹痛[SMD=-0.79,95%CI(-1.02,-0.57),P0.01]、腹泻[SMD=-0.80,95%CI(-1.02,-0.58),P0.01]和腹胀[SMD=-0.97,95%CI(-1.02,-0.57),P0.01]状况。结论布拉酵母菌可以辅助治疗IBS-D,改善患者症状,但仍需更多高质量研究验证。     

益生菌制剂对脑卒中患者肠道菌群及肠道功能影响的Meta分析

目的探讨益生菌制剂对脑卒中患者肠道菌群及肠道功能的影响。方法通过检索PubMed、EMbase、Cochrane Library、CNKI、维普和万方数据库,收集各数据库从建库至2020年3月发表的所有关于脑卒中患者应用益生菌制剂的随机对照试验,由2名研究者独立筛选文献,按照系统评价的要求对文献质量进行评估,使用RevMan 5.3和Stata 14.0统计软件进行Meta分析。结果共纳入19篇文献(1 528例患者),Meta分析结果显示,2组患者肠道中肠球菌的数量差异没有统计学意义[SMD=-0.74,95%CI(-1.64,0.17),P=0.110],而益生菌组患者肠道中大肠埃希菌的数量低于对照组[SMD=-1.27,95%CI(-1.81,-0.73),P0.001];益生菌组患者肠道中乳杆菌和双歧杆菌数量高于对照组[SMD=1.50,95%CI(0.96,2.03),P0.001;SMD=1.66,95%CI(1.16,2.15),P0.001]。益生菌组患者血清中二胺氧化酶(DAO)和D-乳酸水平低于对照组[SMD=-1.76,95%CI(-2.39,-1.13),P0.001;SMD=-2.21,95%CI(-2.92,-1.51),P0.001];益生菌组患者粪便中分泌型免疫球蛋白A(sIgA)的量高于对照组[SMD=1.76,95%CI(0.84,2.68),P0.001]。结论在肠内营养的基础上添加益生菌制剂对脑卒中患者进行营养治疗,能够有效调节患者肠道菌群,改善患者的肠道功能。     

糖尿病患者肠道菌群特征及其相关性的系统评价

目的对糖尿病患者肠道菌群特征及其相关性进行系统评价。方法检索知网、维普、万方、PubMed、Cochrane library、Embase等数据库关于糖尿病患者肠道菌群特征及其相关性的文献,同时追踪纳入文献的参考文献,时限为2009年3月至2019年3月,采用统一提取表,由两名研究者独立按照规定的纳入排除标准进行文献提取和方法学质量评估。最后采用RevMan 5.3软件进行Meta合并,Stata 12.0软件进行亚组分析与发表性偏倚识别。结果共纳入25篇研究,合计2 209例患者。Meta分析显示:(1)糖尿病患者菌群总量(SMD=-0.30,P=0.53)、乳杆菌数量(SMD=-0.79,P=0.20)下降,拟杆菌数量(SMD=1.43,P=0.12)、梭菌数量(SMD=0.28,P=0.40)增加,差异均无统计学意义,双歧杆菌数量(SMD=-1.82,P=0.02)下降,差异有统计学意义。(2)糖尿病患者菌群Shannon指数I~2=91%,r=-0.21[-0.32,0.09],P0.05;Chao1指数I~2=0%,r=-28.17[-40.85,-15.48],P0.05;均下降。(3)拟杆菌、双歧杆菌、梭菌与空腹血糖的相关性分别为:I~2=0%,r=-0.15[-0.27,-0.03];I~2=0%,r=-1.16[-1.42,0.91];I~2=0%,r=-0.28[-0.42,-0.14],均P0.05。而乳杆菌的相关性差异无统计学意义:I~2=47%,r=-0.00[-0.30,0.29],P=0.98。(4)乳杆菌和拟杆菌与炎症因子(TNF-α、IL-6)呈负相关,乳杆菌(r=-0.43;r=-0.60),P0.05;拟杆菌(r=-0.58;r=-0.58),P0.05,差异有统计学意义。结论糖尿病患者肠道菌群总量无明显变化,但有益菌含量和多样性下降,拟杆菌、双歧杆菌和梭菌含量与血糖水平呈负相关,而乳杆菌无相关,其结果还需要大样本、高质量的研究加以论证。     

布拉酵母菌补充三联疗法根除儿童幽门螺杆菌的疗效: 随机对照试验的Meta分析

目的探讨补充布拉酵母菌的三联疗法对儿童幽门螺杆菌根除率和治疗相关副作用的疗效。方法电子检索数据库,包括CNKI、VIP、WanFang、Embase、The Cochrane Library和PubMed。搜集布拉酵母菌补充三联疗法治疗儿童幽门螺杆菌感染的随机对照试验(RCT)。检索时间从建库到2019年8月。两名研究者独自完成文献筛选、提取资料和质量评价。采用RevMan 5.3软件进行Meta分析。结果共纳入6项研究,计1 114例患儿。Meta分析结果显示,布拉酵母菌组与对照组相比,可提高幽门螺杆菌根除率[OR=2.02,95%CI(1.48,2.76),P0.001]。补充布拉酵母菌显著降低了腹泻[OR=0.42,95%CI(0.29,0.60),P0.001]、便秘[OR=0.35,95%CI(0.23,0.52),P0.001]、口腔炎[OR=0.24,95%CI(0.13,0.43),P0.001]等的发生率。两组研究资料在恶心、呕吐、腹痛发生率方面差异均无统计学意义。结论现有证据表明,布拉酵母菌作为三联疗法的辅助手段,可以提高幽门螺杆菌的根除率,并减少儿童治疗相关腹泻、便秘、口腔炎的发生率。但受纳入样本量和质量限制,需进一步开展大规模高质量随机对照试验加以验证。     

核黄素磷酸钠联合布拉氏酵母菌治疗小儿轮状病毒肠炎的临床疗效

目的观察核黄素磷酸钠注射液联合布拉氏酵母菌散剂治疗小儿轮状病毒肠炎(RVE)的临床疗效。方法将78例RVE患儿随机分为对照组和治疗组各39例。两组均行抗病毒等常规治疗。对照组患儿口服布拉氏酵母菌散剂,1岁0.125g/次、2次/d,1~3岁0.25g/次、2次/d。治疗组在对照组基础上联合核黄素磷酸钠注射液5mg/(次·d),加入5%~10%葡萄糖注射液50~100mL中静脉滴注,3d为1个疗程。结果治疗后,治疗组显效率为51.28%(20/39),对照组为28.21%(11/39),两组比较差异有统计学意义(χ2=4.33,P0.05);治疗组总有效率为94.87%(37/39),对照组为74.36%(29/39)。两组比较差异有统计学意义(χ2=6.30,P0.05)。治疗后热退时间、呕吐与腹泻停止时间观察组明显短于对照组(t=14.51、5.81、16.45,P0.01)。且两组未见明显不良反应。结论核黄素磷酸钠注射液联合布拉氏酵母菌散剂治疗小儿轮状病毒肠炎疗效显著。     

布拉酵母菌预防我国婴幼儿抗生素相关性腹泻的Meta分析

目的系统评价布拉酵母菌对我国婴幼儿抗生素相关性腹泻(ADD)的预防作用及安全性。方法计算机联机检索Cochrane图书馆、Em Base、Pub Med、CNKI、CBM、Medline、VIP、万方数据库(各数据库检索时间为创建至2014年7月)中关于布拉酵母菌预防ADD的随机对照试验(RCT),用Rev Man 5.3软件对数据进行Meta分析。结果共纳入17篇RCT,包括2 389例患儿。Meta分析结果显示,布拉酵母菌预防婴幼儿ADD效果优于对照组[RR=0.32,95%CI(0.27,0.39),P0.01]。结论基于现有临床证据,布拉酵母菌预防ADD有效,安全性高。但由于纳入研究数量较少,研究质量不统一,本结论尚需要更多大样本、高质量临床RCT予以证实。     

双歧杆菌制剂对肿瘤化疗患者肠道菌群影响的Meta分析

目的 探讨双歧杆菌制剂对肿瘤化疗患者肠道菌群的影响。方法 通过检索PubMed、Embase、The Cochrane Library、Web of Science以及CBM、CNKI、WanFang Data和VIP数据库,收集各数据库从建库至2022年7月发表的所有关于肿瘤化疗患者应用双歧杆菌制剂的随机对照试验,由2名研究者独立筛选文献,按照系统评价的要求对文献质量进行评估,使用Revman 5.4和Stata 17.0统计学软件进行Meta分析。结果 共纳入25篇文献（2 152例患者）,Meta分析结果显示,双歧杆菌制剂组患者肠道中双歧杆菌和乳杆菌的数量高于对照组[SMD=2.89, 95%CI(2.28, 3.49), P<0.001; SMD=2.20, 95%CI(1.57, 2.84),P<0.001],双歧杆菌制剂组患者肠道中大肠埃希菌、肠杆菌和肠球菌的数量低于对照组[SMD=-1.08,95%CI（-1.64,-0.52）, P<0.001; SMD=-0.88, 95%CI（-1.58,-0.17）, P=0.010; SMD=-0.98, 95...     

布拉氏酵母菌散对轮状病毒肠炎患儿肠道微生态的影响

目的观察布拉氏酵母菌散对轮状病毒肠炎患儿肠道微生态的影响。方法采用前瞻性随机对照临床研究方法,将90例轮状病毒肠炎患儿分为观察组和对照组,对照组采用补液及抗病毒等常规治疗,观察组采用常规治疗的基础上加用布拉氏酵母菌散口服,在治疗前、治疗后第8天及治愈后1个月应用实时荧光定量PCR法对粪便标本中双歧杆菌、肠杆菌、乳杆菌的数量进行检测。结果治疗后观察组双歧杆菌、乳杆菌数量高于治疗前(P0.01,P0.05),且观察组两类细菌数量均高于对照组(P0.05)。治疗后两组肠杆菌数量均低于治疗前(P0.01,P0.05),且观察组肠杆菌数量低于对照组(P0.05)。治愈后1个月,三类菌群在两组间比较差异无统计学意义(P0.05)。结论布拉氏酵母菌散可改善轮状病毒肠炎患儿肠道微生态,且无长期不良影响。     

益生菌对结直肠癌术后 患者炎症因子影响的Meta分析

目的系统评价益生菌对结直肠癌术后患者炎症因子的影响。方法通过计算机检索PubMed、Embase、Cochrane、中国学术期刊全文数据库(CNKI)、万方数据库和维普数据库,评价纳入的临床随机对照研究,应用ReMan 5.3软件进行Meta分析。结果最终纳入8个临床随机对照试验,共597例患者。Meta分析结果显示:与对照组相比,使用益生菌进行术前肠道准备,可以降低结直肠癌术后患者血清IL-6[SMD=-1.67,95%CI(-2.65,-0.68),P0.001]、TNF-α[SMD=-1.39,95%CI(-2.05,-0.73),P0.001]及CRP水平[SMD=-2.12,95%CI(-2.67,-1.56),P0.001]。结论使用益生菌进行术前肠道准备,可减轻结直肠癌术后患者炎症反应,但受纳入研究质量的限制,上述结论有待更多高质量研究验证。     

益生菌联合肠内营养对比单用肠内营养在改善胃癌手术患者预后效果的Meta分析

目的对益生菌联合肠内营养对比单用肠内营养在改善胃癌手术患者预后效果进行Meta分析,以得出综合评价结论。方法利用PubMed、Cochrane、Embase、CNKI、维普和万方数据库进行文献检索,搜集有关益生菌联合肠内营养对比单用肠内营养改善胃癌手术患者预后效果的随机对照试验,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,应用RevMan 5.3分析软件进行Meta分析。结果最终纳入8个临床随机对照试验,共552例患者。Meta分析显示,与仅用肠内营养相比,益生菌联合肠内营养能更有效地降低胃癌患者术后血清内毒素水平[MD=-15.94,95%CI(-27.40,-4.49),P=0.006]、血清TNF-α水平[MD=-9.25,95%CI(-14.51,-3.99),P0.001]、术后腹泻发生率[OR=0.41,95%CI(0.20,0.83),P=0.010];缩短术后住院天数[MD=-1.62,95%CI(-2.78,-0.46),P=0.006];提高淋巴细胞[MD=0.24,95%CI(0.07,0.42),P=0.007],粪便双歧杆菌[MD=1.94,95%CI(0.71,3.17),P=0.002]和乳杆菌[MD=2.21,95%CI(0.69,3.74),P=0.004]计数水平。益生菌还有增加胃癌患者术后血清IgG[MD=2.37,95%CI(-0.32,5.06),P=0.080]和IgM[MD=0.73,95%CI(-0.35,1.82),P=0.190]水平的趋势,但差异无统计学意义。结论当前证据表明,益生菌联合肠内营养治疗胃癌术后临床疗效确切,远优于仅用肠内营养,可以增强胃癌患者术后的机体免疫力、降低感染和腹泻的发生率、减轻全身炎性反应、维持肠道微生态的平衡,促进患者康复。受纳入研究数量和质量限制,上述结论尚待更多高质量研究予以验证。     

布拉酵母菌散联合蒙脱石散对轮状病毒肠炎患儿细胞免疫功能的影响及疗效观察

目的探讨布拉酵母菌散联合蒙脱石散对轮状病毒肠炎患儿细胞免疫功能的影响及疗效。方法76例婴幼儿轮状病毒肠炎随机分为观察组和对照组。两组患儿均予以补液、抗病毒、纠正水电解质及酸碱平衡紊乱等常规治疗。观察组患儿加用布拉酵母菌散剂和蒙脱石散治疗,对照组患儿予以单纯的蒙脱石散治疗。观察两组患儿治疗后临床疗效及不良反应,并比较两组患者治疗后1个月T淋巴细胞亚群的变化。结果治疗72h后,观察组患儿的临床总有效率为94．74％,明显高于对照组的78．95％（χ2=4．15,P〈0．05）,两组患儿治疗中未发现明显药物不良反应。治疗后1个月,观察组患儿CD4＋及CD4＋／CD8＋比值较治疗前明显上升,CD8＋较治疗前明显下降（P〈0．05）。而对照组患儿治疗前后CD4＋、CD8＋、CD4＋／CD8＋比值无明显变化（P〉0．05）。结论布拉酵母菌散联合蒙脱石散治疗婴幼儿轮状病毒肠炎具有较好的疗效,安全性较好,与增强患儿的细胞免疫功能密切相关。     

布拉氏酵母菌散对轮状病毒肠炎患儿血清白介素-6和肿瘤坏死因子-α水平的影响及疗效观察

目的探讨布拉氏酵母菌散对轮状病毒肠炎患儿血清白介素16（IL-6）和肿瘤坏死因子-α（TNF-α）水平的影响及疗效观察。方法选取轮状病毒肠炎患儿84例,随机分为两组（观察组42例和对照组42例）。两组患儿均予以调整饮食、静脉及口服补液、抗病毒及纠正水电解质及酸碱平衡紊乱等常规治疗。观察组患儿加用布拉氏酵母菌散剂治疗,其中〈12个月,0．125g／次,1次／d;≥12个月,0．25g／次,2Oc／a。对照组患儿除不予以布拉氏酵母菌散剂治疗,余治疗药物基本同观察组。治疗3d后,观察两组患儿治疗前后血清细胞因子IL-6和TNF-α水平,并探讨其疗效及不良反应情况。结果治疗3d后,两组患儿血清IL-6和TNF-α水平均比治疗前明显下降（P〈0．05或P〈0．01）,且观察组较对照组下降更明显（P〈0．05）;同时观察组患儿的临床总有效率（95．24％）明显好于对照组（78．57％）（X2=5．13,P〈0．05）,两组患儿治疗期间无明显的药物不良反应发生。结论布拉氏酵母菌散治疗轮状病毒肠炎患儿疗效及安全性均较好,能降低血清细胞因子IL-6和TNF-α表达水平,抑制炎症及免疫反应过程。     

布拉酵母菌治疗小儿轮状病毒肠炎53例临床研究

目的：探讨布拉酵母菌治疗小儿轮状病毒肠炎的疗效。方法：103例患儿随机分为两组,对照组给予静滴病毒唑,口服思密达。治疗组在此基础上口服布拉酵母菌。＜1岁,一日3次,每次1／3袋;＜3岁;一日3次,每次1／2袋。结果：治疗组的总有效率为92．5％,对照组的总有效率为78％,在退热、止泻、总疗程方面治疗组与对照组差异均有 显著性（P＜0．05）。结论：布拉酵母菌对小儿轮状病毒肠炎有良好的疗效。     

The Role of Adiponectin in Breast Cancer: A Meta-Analysis

Published results suggests that high adiponectin level may decrease the risk of breast cancer. However, available evidence on breast cancer is conflicting. Therefore a meta-analysis was performed to assess the association between blood adiponectin and breast cancer risk. PubMed database, Web of Science, Elsevier Science, Springer Link and bibliographies of retrieved articles were searched for epidemiological studies published up to March 2013. Meta-analysis was performed on the combined effect values (OR) as well as standardized mean difference (SMD) including 17 studies. Fixed or random effect pooled measure was selected on the basis of homogeneity test among studies. The publication bias was assessed by the Egger’s regression asymmetry test and Begg’s rank correlation test with Begg’s funnel plot. Subgroup analyses and sensitivity analysis were also performed. A total of 13 studies involving 3578 breast cancer cases and 4363 controls contributed to the OR analysis. The high adiponectin level did not significantly affect breast cancer risk (OR=0.902, 95% CI=0.773–1.053). After excluding articles that were the key contributors to between-study heterogeneity, the OR of high adiponectin level was associated with decreased breast cancer risk (OR=0.838, 95% CI=0.744–0.943). There was a significantly association between high adiponectin level and postmenopausal breast cancer women (OR=0.752, 95%CI=0.604-0.936); and it was not associated with premenopausal breast cancer women (OR=0.895, 95%CI=0.638-1.256). The result of pooled measure on SMD was that the high adiponectin level was associated with decreased breast cancer risk (SMD= -0.348, 95% CI= -0.533--0.614) after excluding articles which were the key contributors to between-study heterogeneity. Our findings indicate that high adiponectin level might decrease the risk of postmenopausal breast cancer. More randomized clinical trials and observational studies are needed to confirm this association with underlying biological mechanisms in the future.     

微生态制剂在儿童幽门螺杆菌根除治疗中 应用效果的Meta分析

目的系统评价微生态制剂联合标准三联疗法或贯序疗法在儿童幽门螺杆菌(H.pylori)治疗中应用的临床疗效及其对治疗中抗生素相关不良反应发生的改善情况。方法计算机检索CNKI、VIP、Wan Fang Data、Pub Med、Web of science和The Cochrane Library数据库,搜集国内外公开发表的关于微生态制剂在治疗儿童H.pylori感染中应用的随机对照试验(RCT),检索时限均为从建库至2017年10月,同时人工检索相关文献的参考文献,以补充获取研究文献。由2位研究员独立筛选文献、提取数据并对纳入研究进行质量评价,采用RevMan 5.3软件进行Meta分析。结果共纳入17个RCT,共2 033例H.pylori阳性的儿童患者。Meta分析结果显示,微生态制剂+标准三联或贯序疗法vs标准三联或贯序疗法:微生态制剂+标准三联或贯序疗法在儿童H.pylori根除率方面优于对照组[OR=2.66,95%CI(2.09,3.40),P0.00001];总不良反应发生率明显低于对照组[OR=0.28,95%CI(0.21,0.37),P0.00001],差异均有统计学意义。微生态制剂+标准三联或贯序疗法组的恶心呕吐(P0.001)、腹痛(P=0.015)、腹泻(P0.001)、便秘(P=0.023)、纳差(P0.001)、味觉障碍或口腔炎(P0.001)发生率明显低于对照组,差异有统计学意义。结论与标准三联或贯序疗法相比,微生态制剂+标准三联或贯序疗法安全、有效,能提高儿童H.pylori的根除率,降低H.pylori治疗中抗生素相关不良反应的发生。受纳入研究质量的限制,上述结论尚需开展高质量的RCT进一步验证。     

硝苯地平缓释片联合缬沙坦治疗原发性高血压疗效和安全性的Meta分析

目的：系统评价硝苯地平缓释片联合缬沙坦治疗原发性高血压的疗效和安全性。方法：计算机检索PubMed、CochraneLi-brary、CBM、CNKI、V1P等数据库,按照纳入和排除标准纳入依硝苯地平缓释片联合缬沙坦治疗原发性高血压的随机对照试验（RCT）,并补充检索纳入研究的参考文献;按Cochrane系统评价方法由两名评价员独立评价纳入文献质量、提取资料并交叉核对无误后,采用RevMan5．1软件进行统计学分析。结果：共纳入4个RCT,包括共450例患者,其研究质量均为C级。Meta分析结果显示：硝苯地平缓释片联合缬沙坦治疗原发性高血压的显效率[RR=1．29,95％CI（1．08～1．55）,P〈O．011、总有效率[RR=I．19,95％CI（1．10～1．29）,P〈0．01]和无效率[RR=0．38,95％CI（0．24～0．62）,P〈0．01]与单用硝苯地平缓释片比较,两组差异有统计学意义,两组有效率差异无统计学意义[RR=I．02,95％CI（0．97～1．32）,P〉0．01]。结论：现有证据表明：硝苯地平缓释片联合缬沙坦治疗原发性高血压在显效率,总有效率和无效率方面优于硝苯地平缓释片单用,不良反应与苯地平缓释片单用无明显差异,但远期疗效尚不清楚,尚需更多高质量的随机双盲对照试验证实。     

布拉氏酵母菌散剂联合三联疗法对 儿童幽门螺杆菌感染的治疗

目的观察布拉氏酵母菌散剂联合以质子泵抑制剂(PPI)为基础的标准三联疗法对儿童幽门螺杆菌(H.pylori)感染的疗效,以探索根除率高且不良反应少的H.pylori根除方案。方法采用前瞻性随机对照研究,从确诊为H.pylori感染的患儿中选取120例作为研究对象,再随机分为布拉氏组和标准三联疗法组,每组各60例。标准三联疗法组口服阿莫西林[50mg/(kg·d),饭后分两次服]、克拉霉素[20mg/(kg·d),饭后分两次服]和奥美拉唑[0.7～0.8mg/(kg·d),饭前半小时一次服完]治疗,布拉氏组在标准三联疗法的基础上加服布拉氏酵母菌散剂(250mg/次,2次/d)。两组患者均治疗14d,由患儿家属记录治疗过程中发生不良反应的情况。停药后4周内不再口服任何抗生素,后行14 C呼气试验以评估H.pylori根除情况。比较两组患者根除率及不良反应发生率。结果治疗后三联疗法组H.pylori根除率为76.7%(46/60),布拉氏组为90.0%(54/60),二者差异有统计学意义(P0.05)。治疗过程中布拉氏组患者腹泻发生率低于三联疗法组,差异有统计学意义(P0.05)。结论布拉酵母联合三联疗法能提高H.pylori的根除率,降低治疗过程中的不良反应。     

Association between salivary s-IgA concentration and dental caries: an updated meta-analysis

Objective: To determine the levels of s-IgA in saliva of caries patients and healthy controls, and to evaluate whether there is a correlation between it and caries by meta-analysis. Methods: The PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, Scopus, Chinese National Knowledge Infrastructure, Wanfang Data, Chongqing VIP database for Chinese Technical Periodicals, and China BioMedical Literature Services System databases were searched initially in April 2020 and repeated in August 2020. Two independent evaluators screened the literature and extracted the data according to the inclusion and exclusion criteria. R 4.0.2 software was used for meta-analysis. I² test was commonly reflected the heterogeneity. Subgroup analysis and meta-regression analysis explore the sources of heterogeneity. Sensitivity analysis, funnel diagram, Begg’s rank correlation, and Egger’s linear regression were used to determine the possibility of publication bias. Results: The study was reviewed according to the project guidelines for optimal reporting (PRISMA) based on meta-analysis. A total of 30 case–control studies were included, with a total sample size of 1545 patients, including 918 caries patients and 627 healthy controls. Salivary s-IgA levels in caries patients were significantly lower than those in healthy controls (SMD = −0.49, 95%CI: [−0.94; −0.03], P=0.03). In addition, the results of subgroup analysis showed that the significant decrease of salivary s-IgA level was correlated with children patients, mixed dentition and Asian people (children: SMD = −0.45, 95%CI: [−0.89; −0.01], P=0.04; mixed dentition: SMD = −0.61, 95%CI: [−1.24; 0.03], P=0.06; Asian: SMD = −0.62, 95%CI: [−1.17; −0.08], P=0.02). The funnel diagram included in the study was symmetrically distributed, and the sensitivity analysis confirmed the robustness of the results. Conclusion: Salivary s-IgA levels in caries patients were significantly lower than in healthy controls. It has also been demonstrated that salivary s-IgA may be used as an alternative measure to identify subjects at risk of caries susceptibility, suggesting that salivary s-IgA may be a protective factor for dental caries.     

Efficacy,safety and immunogenicity of hexavalent rotavirus vaccine in Chinese infants

A randomized, double-blind, placebo-controlled multicenter trial was conducted in healthy Chinese infants to assess the efficacy and safety of a hexavalent live human-bovine reassortant rotavirus vaccine (HRV) against rotavirus gastroenteritis (RVGE). A total of 6400 participants aged 6–12 weeks were enrolled and randomly assigned to either HRV (n = 3200) or placebo (n = 3200) group. All the subjects received three oral doses of vaccine four weeks apart. The vaccine efficacy (VE) against RVGE caused by rotavirus serotypes contained in HRV was evaluated from 14 days after three doses of administration up until the end of the second rotavirus season. VE against severe RVGE, VE against RVGE hospitalization caused by serotypes contained in HRV, and VE against RVGE, severe RVGE, and RVGE hospitalization caused by natural infection of any serotype of rotavirus were also investigated. All adverse events (AEs) were collected for 30 days after each dose. Serious AEs (SAEs) and intussusception cases were collected during the entire study. Our data showed that VE against RVGE caused by serotypes contained in HRV was 69.21% (95%CI: 53.31–79.69). VE against severe RVGE and RVGE hospitalization caused by serotypes contained in HRV were 91.36% (95%CI: 78.45–96.53) and 89.21% (95%CI: 64.51–96.72) respectively. VE against RVGE, severe RVGE, and RVGE hospitalization caused by natural infection of any serotype of rotavirus were 62.88% (95%CI: 49.11–72.92), 85.51% (95%CI: 72.74–92.30) and 83.68% (95%CI: 61.34–93.11). Incidences of AEs from the first dose to one month post the third dose in HRV and placebo groups were comparable. There was no significant difference in incidences of SAEs in HRV and placebo groups. This study shows that this hexavalent reassortant rotavirus vaccine is an effective, well-tolerated, and safe vaccine for Chinese infants.     

The Effectiveness of Acupuncture in Prevention and Treatment of Postoperative Nausea and Vomiting - A Systematic Review and Meta-Analysis

Background

Acupuncture therapy for preventive and treatment of postoperative nausea and vomiting(PONV), a condition which commonly present after anaesthesia and surgery is a subject of growing interest.

Objective

This paper included a systematic review and meta-analysis on the effect of different type of acupuncture and acupoint selection in PONV prevention and treatment.

Methods

Randomised controlled trials(RCTs) comparing acupuncture with non-acupuncture treatment were identified from databases PubMed, Cochrane, EBSCO, Ovid, CNKI and Wanfangdata. Meta-analysis on eligible studies was performed using fixed-effects model with RevMan 5.2. Results were expressed as RR for dichotomous data, with 95%CI.

Results

Thirty RCTs, 1276 patients (intervention) and 1258 patients (control) were identified. Meta-analysis showed that PC6 acupuncture significantly reduced the number of cases of early vomiting (postoperative 0-6h) (RR=0.36, 95%CI 0.19,0.71; P=0.003) and nausea (postoperative 0-24h) (RR=0.25, 95%CI 0.10,0.61; P=0.002), but not early nausea (postoperative 0-6h) (RR=0.64, 95%CI 0.34,1.19; P=0.150) and vomiting (postoperative 0-24h) (RR=0.82, 95%CI 0.48,1.38; P=0.450). PC6 acupressure significantly reduced the number of cases of nausea (RR=0.71, 95%CI 0.57,0.87; P=0.001) and vomiting (RR=0.62, 95%CI 0.49,0.80; P=0.000) at postoperative 0-24h. PC6 electro-acupoint stimulation significantly reduced the number of cases of nausea (RR=0.49, 95%CI 0.38,0.63; P<0.000) and vomiting (RR=0.50, 95%CI 0.36,0.70; P<0.000) at postoperative 0-24h. Stimulation of PC6 with other acupoint(s) significantly reduced the number of cases of nausea and vomiting (RR=0.29, 95%CI 0.17,0.49; P<0.000) at postoperative 0-24h. Stimulation of other acupoint(s)(non PC6) also significantly reduced the number of cases of nausea and vomiting (RR=0.63, 95%CI 0.49,0.81; P=0.000) at postoperative 0-24h. However, the quality of study was generally low in studies of PC6 combined with other acupoint(s) and other acupoint(s). Details of blinding were not reported in most reports.

Conclusions

Besides PC6, PC6 combined with other acupoint(s) and other alternative acupoint(s) might be beneficial in prevention and treatment of PONV, the evidence justifies future high-quality studies.