目的:系统评价奥马珠单抗在儿童中重度过敏性哮喘治疗中的有效性和安全性。方法:计算机检索中国知网、万方数据库、PubMed、Cochrane Controlled Register of Trials(CENTRAL)及Embase数据库,检索时间均为建库至2021年3月,纳入奥马珠单抗治疗儿童中重度过敏性哮喘的随机对照试验(研究组患儿使用奥马珠单抗治疗;对照组患儿使用其他治疗过敏性哮喘的药物或安慰剂),由2名评价员按纳入与排除标准筛选文献、提取资料,采用Rev Man 5.3软件进行荟萃分析(Meta分析)。结果:最终纳入8篇文献,包括1756例患儿。Meta分析结果显示,有效性方面,研究组患儿的哮喘恶化发生率(以恶化风险人日数表示恶化发生率:RR=0.68,95%CI=0.55~0.85,P=0.0007;以发生恶化患儿所占百分比表示恶化发生率:RR=0.54,95%CI=0.45~0.66,P<0.00001)显著低于对照组,哮喘全球疗效评估(GETE)优良率(RR=1.39,95%CI=1.23~1.58,P<0.00001)、儿童控制哮喘测试(C-ACT)评分(MD=0.76,95%CI=0.31~1.21,P=0.001)显著高于对照组,上述差异均有统计学意义;但两组患儿的第1秒用力呼气容积占预计值百分比(FEV_(1)%)(MD=0.62,95%CI=-0.89~2.13,P=0.42)、第1秒用力呼气容积占用力肺活量百分比(FEV_(1)/FVC)(MD=-0.10,95%CI=-0.98~0.79,P=0.83)比较,差异均无统计学意义。安全性方面,研究组患儿的严重不良事件发生率显著低于对照组(RR=0.54,95%CI=0.39~0.76,P=0.0004),缺课时间(MD=-0.30,95%CI=-0.57~-0.02,P=0.04)显著少于对照组,差异均有统计学意义。结论:奥马珠单抗可有效改善儿童中重度过敏性哮喘患者的临床指标,显著降低严重不良事件发生率,改善患儿的生活质量。
Objective To screen and identify differentially expressed genes in the dorsal root ganglion （DRG） in early experimental diabetic rats. Methods Diabetic model rats were induced by single intraperitoneal injection of streptozotocin （STZ）. At the second week after STZ injection, the sensory nerve conduction velocities （SNCV） of sciatic nerve were measured as an indicator of neuropathy. The technique of silver-staining mRNA differential display polymerase chain reaction （DD-PCR） was used to detect the levels of differentially expressed genes in rat DRG. The cDNA fragments that displayed differentially were identified by reverse-hybridization, cloned and sequenced subsequently, and then confirmed by Northern blot. Results The SNCV in the diabetic model group [n = 9, （45.25±10.38） m/s] reduced obviously compared with the control group [n = 8, （60.10± 11.92） m/s] （P 〈 0.05）. Seven distinct cDNA clones, one was up-regulated gene and the others were downregulated ones, were isolated by silver-staining mRNA differential display method and confirmed by Northern blot. According to the results of sequence alignment with GenBank data, majority of the clones had no significant sequence similarity to previously reported genes except only one that showed high homology to 6-pyruvoyl-tetrahydropterin synthase mRNA （accession No., BC059140）, which had not been reported to relate to diabetic neuropathy. Conclusion These differentially expressed genes in the diabetic DRG may contribute to the pathogenesis of diabetic peripheral neuropathy.
