呼吸道过敏性疾病与社会心理因素双向关系的Meta分析

目的：系统评价呼吸道过敏性疾病和社会心理因素的关系。方法：计算机检索Cochrance图书馆、Medline、EMbase、Pubmed、CBM、CNKI等数据库,查找包括心理社会因素对呼吸道过敏性疾病的影响或者呼吸道过敏性疾病对精神健康影响的临床研究。根据纳入和排除标准选择文献,对符合纳入标准的文献进行Meta分析,计算其合并OR值及95％CI。结果：共纳入20个病例研究（13篇文献）,其中13个研究评估心理社会因素对呼吸道过敏性疾病的影响,7个研究评估效果呼吸道过敏性疾病对心理健康的影响。在这些研究中呼吸道过敏性疾病是评估哮喘和过敏性鼻炎。Meta分析结果显示社会心理因素和呼吸道疾病的发生发展有关[OR=1．77,95％CI（1．42,2．22）],呼吸道过敏性疾病与未来不健康的心理发生发展有关[OR=1．73,95％CI（1．47,2．03）]。结论：当前的研究发现呼吸道过敏性疾病和社会心理因素有很大的关系。这支持在呼吸道过敏性疾病治疗除了传统的生理和药理干预外,心理干预呼吸道对过敏性疾病的预防和管理也发挥作用。     

生命早期益生菌干预预防儿童过敏性疾病的Meta分析CSCD

目的 系统评价生命早期益生菌干预预防儿童过敏性疾病的疗效。方法 采用计算机检索万方、中国知网、CBM、PubMed、Cochrane library、Embase和Web of science数据库有关生命早期益生菌干预对儿童过敏性疾病预防作用的随机对照试验研究,检索时间为建库至2020年9月,应用Stata 11.0软件对纳入研究进行Meta分析。结果 最终纳入36篇随机对照试验文献。Meta分析结果显示,生命早期益生菌干预对预防湿疹(RR=0.84,95%CI:0.73~0.98,P=0.022)和食物过敏(RR=0.82,95%CI:0.68~0.98,P=0.028)作用显著,但对预防哮喘(RR=0.92,95%CI:0.80~1.06,P=0.231)、喘息(RR=0.98,95%CI:0.89~1.07,P=0.635)、过敏性鼻炎(RR=0.99,95%CI:0.78~1.26,P=0.945)和过敏性鼻结膜炎(RR=1.13,95%CI:0.86~1.49,P=0.376)无显著作用。结论 生命早期益生菌干预对儿童湿疹、食物过敏具有预防作用,但对哮喘、喘息、过敏性鼻炎和过敏性鼻结膜炎无预防作用,对于其机制仍需进一步研究。     

集落刺激因子治疗重型再生障碍性贫血疗效和安全性的Meta 分析

目的:通过Meta分析评价粒系或粒单系集落刺激因子(G-CSF或GM-CSF)对接受免疫抑制治疗(IST)的重型再生障碍性贫血(SAA)患者的疗效和安全性。方法:使用相关检索词检索MEDLINE、Cochrane Library、EMBASE、CNKI及CBM数据库,检索时间1990年1月～2011年12月。纳入G-CSF或GM-CSF治疗SAA的随机对照研究。用Review Manager4.2统计软件对数据进行Meta分析。结果:共纳入4篇文献,共466例SAA患者。Meta分析结果显示:①IST疗效:G-CSF/GM-CSF组与对照组的SAA患者对比,近远期疗效与生存率均无显著差异:总体生存率[OR=1.15,95%C(I0.73,1.82),P=0.54]、完全缓解率[OR=1.20,95%CI(0.71,2.02),P=0.50]、早期总体有效率[OR=1.61,95%CI(0.85,3.03),P=0.14]、远期总体有效率[OR=1.17,95%CI(0.78,1.74),P=0.45];②IST相关感染:IST治疗早期感染发生率、严重感染发生率、感染相关死亡率方面均未优于对照组;③G-CSF/GM-CSF组的复发率低于对照组,差异显著[OR=0.57,95%C(I0.35,0.93),P=0.02];④G-CSF/GM-CSF组远期随访发生克隆性病变的发生率与对照组无统计学差异,恶性肿瘤(MDS/AML)发生率[OR=0.90,95%CI(0.41,1.99),P=0.79]、PNH发生率[OR=1.48,95%CI(0.65,3.33),P=0.35]。结论:G-CSF/GM-CSF应用于接受IST治疗的SAA患者,尚不能证明具有提高总体生存率、完全缓解率、总体有效率、减少感染和感染相关死亡率等优势。虽然有可能降低复发率,也不增加远期克隆性病变发生率,但还需要更严格设计的大样本双盲随机对照试验,并进行更为长期的随访研究。     

含谷氨酰胺的肠外营养对急性胰腺炎患者预后影响的Meta分析

目的：探讨含谷氨酰胺制剂的肠外营养对急性胰腺炎患者死亡率、感染并发症发生率和住院时间的影响。方法：在检索Medline、Embase和Cochrane图书馆等数据库后,两位研究者独立对截止2012年发表的文献的纳入和质量做出评估。资料的Meta分析采用RevMan5.0软件。结果：4篇文献被纳入我们的研究。结果显示谷氨酰胺制剂可以有效降低急性胰腺炎患者的死亡率（OR=0.26,95%CI=[0.09,0.76]）,感染并发症的发生率（OR=0.26,95%CI=[0.11,0.60]）和住院天数（OR=2.58,95%CI=[-4.78,-0.45]。结论：含谷氨酰胺制剂的场外营养可以改善急性胰腺炎患者的预后,但仍需大规模高质量的临床研究进一步明确。     

不同疗程全身糖皮质激素对AECOPD患者的疗效与安全性Meta分析

目的通过系统评价比较不同疗程全身糖皮质激素治疗对AECOPD患者的有效性与安全性。方法计算机检索PubMed,EMBASE数据库,Cochrane图书馆中关于对AECOPD患者全身使用糖皮质激素的所有文献(使用随机对照实验)。检索时间从建库至2016年1月,并由2名评价者独立筛选文献、提取资料并评估纳入研究偏倚风险后,采用RevMan 5.0软件进行Meta分析。激素组按照疗程分为短期组(≤3天)和长期组(3天),分别在两组中按照起始剂量80mg泼尼松为界限分为高剂量组(≥80mg/d)和低剂量组(80mg/d)两个亚组,并进行分析。结果纳入文献11篇,涉及1142例患者。其中10篇文献涉及肺功能FEV1,在短期组中使用SCS后病人FEV1明显提高,Meta分析结果显示[MD=0.13,95%CI(0.08,019)],在短期组的中高剂量组为[MD=0.09,95%CI(0.03,0.16)],低剂量组为[MD=0.23,95%CI(0.12,0.33)],差异均有统计学意义。长期组与对照组比较,FEV1差异无统计学意义[MD=0.06,95%CI(-0.01,012)];在长期组的中低剂量组与对照组比较,差异有统计学意义[MD=0.14,95%CI(0.05,0.22)],高剂量组无统计学意义[MD=-0.06,95%CI(-0.16,0.04)]。激素组与对照组不良反应患者中,发生高血糖的Meta分析结果显示[OR=3.94,95%CI(2.15,7.24)],高剂量组[OR=3.50,95%CI(1.73,7.05)],低剂量组[OR=5.48,95%CI(1.58,18.96)],高低剂量激素组发生糖尿病的风险均较对照组增加,差异均有统计学意义。激素组与对照组及不同剂量亚组中二重感染、高血压、胃肠道出血等不良反应比较,差异无统计学意义。结论AECOPD患者行全身糖皮质激素治疗以低剂量短期疗法的效果较好,安全性更高。     

双歧杆菌三联活菌胶囊/散治疗儿童功能性便秘临床疗效的Meta分析

目的采用Meta分析评价双歧杆菌三联活菌胶囊/散治疗儿童功能性便秘的临床疗效。方法检索中国知网、万方、维普、Pubmed、Embase、Web of Science数据库,检索时限均从建库至2015年12月,收集国内外应用双歧杆菌三联活菌胶囊/散治疗儿童功能性便秘的所有随机对照试验(randomized controlled trial,RCT)和前瞻性非随机对照试验(non-randomized controlled trial,non-RCT),纳入文献时间从2005年1月至2013年12月。按照纳入与排除标准选择文献,进一步提取纳入研究的资料并评价其方法学质量后,采用Cochrane协作网提供的RevMan 5.2软件进行Meta分析。结果检索文献无RCT研究,纳入9个前瞻性non-RCT研究,合计673例患者,其中治疗组(对照组常规治疗+双歧杆菌三联活菌胶囊/散)345例,对照组328例。Meta分析结果显示:治疗组的治疗有效率优于对照组[OR=4.81,95%CI=(2.32,9.97),P0.0001];治疗组儿童功能性便秘复发率低于对照组[OR=0.19,95%CI(0.05,0.68),P=0.01]。结论双歧杆菌三联活菌胶囊/散与常规治疗药物联用可以提高儿童功能性便秘的总体疗效,同时可以有效降低儿童功能性便秘的复发率。     

乳杆菌治疗幽门螺杆菌感染疗效的Meta分析

目的系统评价乳杆菌治疗幽门螺杆菌(H.pylori)感染的有效性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trials、Clinicatrials.gov、中国临床试验注册中心(http://www.chictr.org.cn/)、中国知网(CNKI)、万方数据库。检索时间从建库至2016年6月30日。此外追索已纳入文献和综述的参考文献。经两位研究者独立筛选文献、提取资料和评价质量,交叉核对后,采用Stata 12.0进行Meta分析。结果最终纳入17个RCT,共1 758例患者。Meta分析结果:乳杆菌联合常规三联疗法能提高H.pylori根除率[OR=2.762,95%CI(2.163,3.526),P0.001],降低不良反应发生率[OR=0.334,95%CI(0.242,0.461),P0.001],但乳杆菌单独应用对H.pylori根除率结果与对照组比较差异无统计学意义。根据乳杆菌给药疗程的亚组分析结果,0~14(含14)d乳杆菌联合给药方案显著提高了H.pylori根除率[OR=2.893,95%CI(2.187,3.827),P0.05],14~28(含28)d给药疗程也显著提高了H.pylori根除率[OR=2.619,95%CI(1.652,4.153),P0.05]。乳杆菌联合三联疗法在欧洲人群及亚洲人群的亚组分析中,均提高了H.pylori根除率。结论乳杆菌联合三联疗法有利于提高H.pylori根除率,并能降低总不良反应的发生,在H.pylori感染相关疾病的治疗中具有一定意义。     

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。     

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。     

阴道用乳酸菌制剂辅助治疗RVVC的Meta分析

目的系统评价阴道用乳酸菌制剂辅助治疗复发性外阴阴道假丝酵母菌病(RVVC)的疗效及安全性。方法计算机检索CNKI、万方、维普、PubMed及Cochrane等数据库(检索时间为各数据库创建时间至2018年1月),纳入关于阴道用乳酸菌制剂辅助治疗RVVC的临床随机对照试验(RCT),采用RevMan 5.3软件对相关研究进行Meta分析。结果共纳入32篇RCT,包括3 635例患者,结果显示:阴道用乳酸菌制剂辅助治疗RVVC的痊愈率优于单纯抗菌药物[P0.001,OR=2.15,95%CI(1.81,2.54)],总有效率高[P0.001,OR=3.26,95%CI (2.5,4.26)],复发率低[P0.001,OR=0.19,95%CI (0.15,0.25)],不良反应发生率低,Begg′s检验表明纳入的RCT研究无发表偏倚(P=0.1020.05)。结论基于现有临床证据,阴道用乳酸菌制剂辅助治疗RVVC疗效优于单纯抗菌药物,可有效改善临床症状,减少疾病发作次数,安全性高,不良反应发生率低,值得临床推广使用。     

Synthesis of 27-oxo, 27-hydroxymilbemycins A3 and A4 and novel 27-alkoxymilbemycins A3 and A4 from milbemycins A3 and A4 and their acaricidal activities

27-Oxomilbemycins A3 and A4 and 27-hydroxymilbemycins A3 and A4 were identified as metabolites in soil metabolism studies of milbemycins A3 and A4. Chemical derivation methods were developed to synthesize 27-oxomilbemycins A3 and A4 and 27-hydroxymilbemycins A3 and A4 from milbemycins A3 and A4. In addition, 27-alkoxymilbemycin derivatives were also synthesized from the same precursors. Some of the synthesized compounds displayed satisfactory acaricidal activity against the organophosphorus-sensitive two-spotted spider mite (Tetranychus urticae), but did not have superior activity to corresponding milbemycins A3 and A4.     

Isolation and Characterization of Gibberellins in Calonyction aculeatum and Structures of Gibberellins A30, A31, A33 and A34

Four novel gibberellins GA₃₀, GA₃₁, GA₃₃, GA₃₄, five known gibberellins GA₈, GA₁₇ (free acid and its monomethyl ester), GA₁₉, GA₂₇, GA₂₉ and the gibberellin-like substances were isolated from immature seeds of evening-glory (Calonyction aculeatum). The structures of GA₃₀, GA₃₁, GA₃₃ and GA₃₄ were elucidated as IX, XVIII, XXII and XXXIV, respectively. The three gibberellin-like substances were partially characterized.     

Structures of Ezomycins A1 and A2

The structures of ezomycins A₁. and A₂, antifungal antibiotics produced by a strain of Streptomyces, were determined as 1 and 2, respectively, by degradative and spectrometric studies.     

Cytotoxicity of polyspermine-ribonuclease A and polyspermine-dimeric ribonuclease A

Polyspermine-ribonuclease A (PS-RNase A) and polyspermine-dimeric ribonuclease A (PS-dimeric RNase A) were prepared by cross-linking ribonuclease A or its covalently linked dimer to polyspermine (PS) using dimethyl suberimidate. The two RNase A derivatives were tested for a possible antitumor action. The in vitro and in vivo cytotoxic activity of PS-RNase A, although strong, is not higher than that known for free polyspermine. PS-dimeric RNase A, which was characterized by mass spectroscopy, titration of free amine groups, and enzymatic assays, proved instead to be a definitely more efficient antitumor agent, both in vitro and in vivo. This result could tentatively be explained in view of the importance of positive charges for ribonuclease activity, considering the higher basicity of PS-dimeric RNase A compared to that of PS-(monomeric)RNase A. It must be also taken into account that the dimeric RNase A moiety of PS-dimeric RNase A could evade the cytoplasmic ribonuclease inhibitor, which instead could trap the monomeric RNase A moiety of the other derivative. The two RNase A derivatives degrade poly(A).poly(U) under conditions where native RNase A is inactive. The results of this work demonstrate once again the importance of positive charges for the functions of mammalian pancreatic type ribonucleases in general, in particular for RNase A derivatives, and the potential therapeutic use of the ribonuclease A derivatives.     

Radioimmunoassay of Gibberellins A5 and A20

Polyclonal anti-GA₅-antiseruin and anti-GA₂₀-antiserum wereprepared by immunizing rabbits with conjugates of N-GA₅-ß-alanylBSA and N-GA₂₀-ß-alanyl BSA. By radioimmunoassay usingthese antisera, GA₅ and GA₂₀ in developing fruits of Pharbitisnil Chois were analyzed after several purification steps andthe results were compared with those obtained by GC-MS to examinethe reliability of the analysis by radioimmunoassay. The analyticalresults by radioimmunoassay did not agree with those by GC-MSuntil two-step purifications by HPLC, indicating that samplesmust be suitably purified prior to radioimmunoassay to obtainreliable results. (Received November 13, 1986; Accepted April 17, 1987)     

Preparation of Radioactive Gibberellins A20, A5 and A8

Many yeasts were isolated from natural sources in the tropics and subtropics by enrichment culture technique, using medium which contained a surfactant. The medium was acidified with citric acid. A strain S–10 belonging to the genus Candida was found to produce itaconic acid. Under suitable conditions in shake culture, a mutant derived from this strain produced the acid at about 35 % yield on the basis of glucose supplied.     

Blood group A and H determinants in polyglycosyl peptides of A1 and A2 erythrocytes

Polyglycosyl peptides were isolated from delipidated erythrocyte membranes of human blood-group A1 and A2 erythrocytes by extensive pronase digestion and gel filtration. As estimated by the amounts of N-acetylgalactosamine and 2-O-substituted galactose residues about 85% of the possible acceptor sites (H determinants) were saturated with A determinants in A1 polyglycosyl peptides whereas only 25% of H sites were filled in A2 glycopeptides. The distribution of A and H determinants in the glycopeptides was studied by affinity chromatography with Sepharose-bound Bandeiraea simplicifolia I-lectin (binds blood-group A and B determinants) and Ulex Europeaus I-lectin (binds blood-group H determinants). About 55% of the polyglycosyl peptides contained A, H, or A and H determinants in both A1 and A2 blood subgroups. 48% of the polyglycosyl peptides of blood group A1 and 10% of A2 bound to Bs I-lectin. 25% of the polyglycosyl peptides in A1 and 53% in A2 carried H determinants. The molecular size, monosaccharide composition and the substitution pattern of the monosaccharides in the Bs-I-bound polyglycosyl peptides were very similar in both A1 and A2 blood groups. The only difference was the amount of N-acetylgalactosamine which was on the average 3.7 mol/mol in A1 and 2.5 mol/mol in A2. The active fraction was found to be heterogeneous with respect to the amount of A determinants, which varied from 1 to 6 per glycopeptide in A1 and A2 polyglycosyl peptides. The findings do not indicate a structural difference between blood-group A1 and A2 polyglycosyl peptides and state chemically that A1 glycopeptides contain more A determinants than A2 glycopeptides.