Objective To screen the key genes in childhood therapy-resistant asthma by bioinformatic method, and to verify its expression and diagnostic value in peripheral blood of children with therapy-resistant asthma. Methods The transcriptome dataset GSE27011 of peripheral blood mononuclear cells from healthy children (healthy control group), mild asthma (MA) children (MA group) and severe asthma (SA) children (SA group) was downloaded from the Gene Expression Omnibus of the National Center for Biotechnology Information of the United States. Key genes were obtained by using R software for gene differential expression analysis, weighted gene co-expression network analysis (WGCNA) and clinical phenotypic correlation analysis. The differential expression levels of key genes were verified in children with asthma and immune cell transcriptome datasets. Seventy-eight children with asthma and 30 healthy children who were diagnosed in the Department of Pediatrics of Tangshan People’s Hospital between September 2020 and September 2021 were selected and divided into control group, MA group and SA group. Peripheral blood samples from children with asthma and healthy children who underwent physical examination were collected to detect the expression levels of key genes and inflammatory factors interleukin (IL)-4 and IL-17 in peripheral blood of children. Receiver operating characteristic curve was used to evaluate the sensitivity, specificity and accuracy of key genes in predicting childhood therapy-resistant asthma. Results The key gene GNA15 was obtained by bioinformatic analysis. Analysis of asthma validation dataset showed that GNA15 was up-regulated in asthma groups, and was specifically expressed in eosinophils. Clinical results showed that the expression levels of IL-4, IL-17 and GNA15 among the three groups were significantly different (P<0.05). The expression levels of IL-4 and IL-17 in the MA group and the SA group were higher than those in the control group (P<0.05). Compared with the control group and the MA group, the expression level of GNA15 in the SA group was up-regulated (P<0.05). Neither the difference in the expression level of IL-4 or IL-17 between the MA group and the SA group, nor the difference in the expression level of GNA15 between the control group and the MA group was statistically significant (P>0.05). The specificity, sensitivity and accuracy of GNA15 in predicting SA were 92.90%, 80.00% and 86.10%, respectively. Conclusion GNA15 has a significant clinical value in predicting the childhood therapy-resistant asthma, and may become a potential diagnostic marker for predicting the severity of asthma in children.
Objective To overview the systematic reviews/meta-analysis (SR/MA) for the effectiveness of yoga on patients with type 2 diabetes mellitus. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Cochrane Library, Embase, Web of Science, JBI and CINAHL databases were electronically searched to collect SR/MA on the intervention of yoga in diabetes mellitus from inception to November 6th, 2023. Two researchers independently screened the literature and extracted data. AMSTAR was used to evaluate the quality of methodology, and GRADE was used to evaluate the certainty of evidence, and the outcome indicators were statistically analyzed. Results A total of 14 SR/MA were included. The evaluation results of AMSTAR showed that 7 articles were of high quality and 7 articles were of moderate quality. The result of GRADE showed that there were 2 items of high-level evidence, 26 items of intermediate evidence, and the remaining 31 items were low-level or very low-level evidence. The results showed that yoga could significantly reduce fasting blood glucose (FBG) (moderate confidence), glycosylated hemoglobin (HA1C) (moderate confidence) and postprandial blood glucose (PPBG) levels (moderate confidence), and was also superior to other interventions in high-density cholesterol (HDL) (moderate confidence), low-density cholesterol (LDL) (moderate confidence), triglyceride (TG) (moderate confidence), total cholesterol (TC) (moderate confidence), systolic blood pressure (SBP) and diastolic blood pressure (DBP) (moderate confidence), muscle strength (high confidence), cardiorespiratory fitness (moderate confidence) and weight (moderate confidence). Conclusion The existing evidence shows that yoga has a good effect on blood glucose control (moderate confidence) and also has a certain effect on lipid parameters (moderate confidence) and anthropometric indicators (moderate confidence), but the quality and confidence of the current research evidence are low. Future researchers should standardize the research design to provide more high-quality evidence for the prognosis and treatment of type 2 diabetes mellitus.
ObjectiveTo systematically review the recommendations for antiretroviral therapy in the AIDS guidelines, and summarize the sources of evidence supporting the recommendations, the quality of the evidence and the strength of the recommendations, and the consistency of the recommendations. MethodsWe systematically searched for articles published before Dec 2024 in PubMed, Web of Science, Embase, CNKI, WanFang Data, VIP, CBM, and 9 guideline databases, websites, integrating recommendations. Quality and reporting practices were evaluated using AGREE Ⅱ and RIGHT tools respectively. ResultsThe average score of AGREE Ⅱ was 62 points, the overall reporting rate was 69.68%, and the quality of methodology and reporting specifications were low. Analysis of the recommendation results showed that a total of 57 recommendations for ART therapy were extracted from 18 guidelines, mainly recommending 2 NRTIs combined with third-category drugs. NRTI drugs are mainly based on TDF+FTC (3TC), TAF+FTC, and ABC+3TC. The third category of drugs recommended by various guidelines with relatively high frequency includes INSTI (DTG, BIC, RAL), NNRTI (EFV) and PIs (DRV/r). The third category of drugs recommended with relatively high frequency in alternative therapies includes INSTI (DTG, RAL), NNRTI (EFV, RPV) and PIs (DRV/c). ConclusionThe methodological quality and reporting specifications of the HIV clinical practice guidelines need to be improved. The evidence grading of the guidelines is not standardized, there are differences in the combination of drugs recommended by each guideline, the strength of recommendations and the quality of the evidence are inconsistent, and there are obvious differences in the sources of evidence to support the opinions. In the future, it is necessary to combine high-quality clinical trials or randomized controlled trials, adopt systematic and rigorous evidence level and recommendation grading standards when necessary, and provide high-quality evidence sources to formulate complete guidelines. Specific conditions such as the patient's biological indicators should also be fully considered to clarify which virological and biological indicators ART therapy is suitable for, so as to provide precise treatment.
