Acute liver failure:A systematic review and network meta-analysis of optimal type of stem cells in animal models

BACKGROUND The therapeutic effects of various stem cells in acute liver failure(ALF)have been demonstrated in preclinical studies.However,the specific type of stem cells with the highest therapeutic potential has not been determined.AIM To validate the efficacy of stem cells in ALF model and to identify the most promising stem cells.METHODS A search was conducted on the PubMed,Web of Science,Embase,Scopus,and Cochrane databases from inception to May 3,2022,and updated on November 16,2022 to identify relevant studies.Two independent reviewers performed the literature search,identification,screening,quality assessment,and data extraction.RESULTS A total of 89 animal studies were included in the analysis.The results of traditional meta-analysis showed that stem cell therapy could significantly reduce the serum levels of alanine aminotransferase[weighted mean difference(WMD)=-181.05(-191.71,-170.39)],aspartate aminotransferase[WMD=-309.04(-328.45,-289.63)],tumor necrosis factor-alpha[WMD=-8.75(-9.93,-7.56)],and interleukin-6[WMD=-10.43(-12.11,-8.76)]in animal models of ALF.Further subgroup analysis and network meta-analysis showed that although mesenchymal stem cells are the current research hotspot,the effect of liver stem cells(LSCs)on improving liver function is significantly better than that of the other five types of stem cells.In addition,the ranking results showed that the possibility of LSCs improving liver function ranked first.This fully proves the great therapeutic potential of LSCs,which needs to be paid more attention in the future.CONCLUSION LSCs may have a higher therapeutic potential.Further high-quality animal experiments are needed to explore the most effective stem cells for ALF.

Protective effect and possible mechanisms of Salvia miltiorrhiza Bge. for the treatment of diabetic nephropathy: A systematic review and meta-analysis of animal studies

Objective:To explore the protective effect and potential mechanisms of danshen root(Salvia miltiorrhiza Bge.,S.miltiorrhiza) and its extracts for the treatment of diabetic nephropathy(DN).Methods:Preclinical studies of S.miltiorrhiza and its extracts on DN were systematically searched in nine databases.The primary outcomes were blood glucose,kidney function,proteinuria,and renal histopathology.The secondary outcomes included the related mechanisms.The methodological quality of animal studies was assessed based on the risk of bias tool of the Systematic Review Centre for Laboratory Animal Experimentation(SYRCLE) for animal studies.Meta-analysis was performed using R software(version 4.1.2).Results:Twenty-nine animal experimental studies that met the eligibility criteria were included in this study.Compared to the control group,S.miltiorrhiza reduced the serum creatinine,blood urea nitrogen,24-h urine protein,24-h urine albumin,blood glucose,and kidney index(kidney weight/body weight),and alleviated renal pathological damage.In terms of the mechanism of action,compared to the control group,S.miltiorrhiza reduced the levels of transforming growth factor β1,collagen Ⅳ,malondialdehyde,tumor necrosis factor α,interleukin-6,and monocyte/macrophage(ED-1),and increased the levels of superoxide dismutase,glutathione peroxidase,nuclear factor E2-related factor 2,and heme oxygenase-1.Conclusion:The existing evidence shows that S.miltiorrhiza has beneficial effects on the animal model of DN,and its mechanism is mainly related to improving kidney fibrosis,oxidative stress,and inflammatory response.

Curcumin in The Treatment of in Animals Myocardial ischemia reperfusion:A Systematic review and Meta-analysis

Objective:The protective effects of curcumin on myocardial ischemia-reperfusion were systematically evaluated by analyzing the related literatures of curcumin and myocardial ischemia-reperfusion.Methods:The computer was searched for Wanfang,VIP,China National Knowledge Infrastructure(CNKI),SinoMed,and Pubmed database to find animal experiments on curcumin treatment of myocardial ischemia-reperfusion.The retrieval time is from the establishment of the database to November 2018.Two researchers independently screened the literature based on inclusion and exclusion criteria,extracted the data,and assessed the risk of bias in the included studies.Meta analysis was performed using RevMan 5.3 software.Results:Finally,9 studies were included for analysis.Meta-analysis showed that the curcumin group can reduce LDH and MDA levels compared with the ischemiarreperfusion group(LDH:SMD=-4.75,95%CI[-6.56,-2.94],P<0.01,MDA:SMD=-2.27,95%CI[-3.07,-1.47],P<0.01),the difference was statistically significant(P<0.01).In the subgroup analysis of different doses of curcumin,different doses of curcumin(0.8,10,12.5,20,25,30,50 mg)were able to reduce LDH content compared with the ischemia-reperfusion group,and the differences were statistically significant.Different doses of curcumin(5,10,20,30,40mg)can reduce MDA content,and the difference is statistically significant;curcumin(0.8mg)group has no statistically significant effect on MDA content(SMD=-0.54,95%CI[-1.35,0.28],P=0.20).The relationship between the content of MDA and the dose of curcumin showed that compared with the curcumin(20 mg)group,the curcumin(40 mg)group could better reduce the MDA content,and the difference was statistically significant(P=0.03).Conclusion:Curcumin can reduce the content of LDH and MDA in myocardial ischemia-reperfusion,and has a protective effect on myocardium.Moreover,the ability to reduce the damage is related to the dose of curcumin.However,the sample of the included studies is limited,and this conclusion requires more high-quality experiments to verify.

The potential of gene therapies for spinal cord injury repair:a systematic review and meta-analysis of pre-clinical studies

Currently,there is no cure for traumatic spinal co rd injury but one therapeutic approach showing promise is gene therapy.In this systematic review and meta-analysis,we aim to assess the efficacy of gene therapies in pre-clinical models of spinal cord injury and the risk of bias.In this metaanalysis,registe red at PROSPERO(Registration ID:CRD42020185008),we identified relevant controlled in vivo studies published in English by searching the PubMed,Web of Science,and Embase databases.No restrictions of the year of publication were applied and the last literature search was conducted on August 3,2020.We then conducted a random-effects meta-analysis using the restricted maximum likelihood estimator.A total of 71 studies met our inclusion crite ria and were included in the systematic review.Our results showed that overall,gene therapies were associated with improvements in locomotor score(standardized mean difference[SMD]:2.07,95%confidence interval[CI]:1.68-2.47,Tau^(2)=2.13,I^(2)=83.6%)and axonal regrowth(SMD:2.78,95%CI:1.92-3.65,Tau^(2)=4.13,I^(2)=85.5%).There was significant asymmetry in the funnel plots of both outcome measures indicating the presence of publication bias.We used a modified CAMARADES(Collaborative Approach to M eta-Analysis and Review of Animal Data in Experimental Studies)checklist to assess the risk of bias,finding that the median score was 4(IQR:3-5).In particula r,reports of allocation concealment and sample size calculations were lacking.In conclusion,gene therapies are showing promise as therapies for spinal co rd injury repair,but there is no consensus on which gene or genes should be targeted.

Retrieval,reporting and methodological characteristics for systematic reviews/meta-analyses of animal models:a meta-epidemiological study

The study aimed to analyze the reporting and methodological quality of systematic reviews(SRs)/meta-analyses(MAs)of animal models to provide references for later studies and avoid the waste of medical resources.EMBASE and MEDLINE databases were searched from inception to November 2017,with no language restriction.Two reviewers selected inclusion dependently and extracted the basic characteristics.Review Manager 5.3,stata 12.0,and SPSS 21 software were used to conduct analyses.A total of 46 SRs/MAs were included.The results showed that the English databases with high retrieval frequency are PubMed/MEDLINE,EMBASE,and Web of Science.67.31%(31/46)of the articles reported the search strategy in the full text or the appendix.65.22%(30/46)reported the literature screening flow diagram,and only 19.57%(9/46)reported the number of works of literature retrieved in each database.60.87%(28/46)illustrated supplement retrieval.Through 2 subgroup analyses,it was found that there were no significant differences in the quality of reports of PRISMA items.But referring to the methodological quality or reporting of PRESS items,SCI was better than that of non-SCI,while there seemed a source of funding to have no significant impact on the methodological quality or the items of PRESS.The results of PRESS,AMSTAR 2,and PRISMA were correlated,and the correlation between PRISMA and AMSTAR 2 was strong.These results demonstrated that search strategies of animal model SRs/MAs are still not enough comprehensive,report specification and methodological quality still need to be ameliorated.To show users the scientificity and rigor of the study,future research should focus on these various guidelines like PRESS,PRISMA,and AMSTAR 2 checklists that have been issued,it can help to increase the value of research and improve the utilization of medical resources.

Effect of traditional Chinese medicine on anthracycline-induced cardiotoxicity in animal models:A systematic review and metaanalysis

Objective:To evaluate the effect of traditional Chinese medicine(TCM)on anthracycline-induced cardiotoxicity(AIC)in animal models.Methods:Separate systematic searches for preclinical studies were performed in the PubMed,EMBASE,Web of Science,Chinese National Knowledge Infrastructure,Chinese Biomedical Database,Chinese Scientific Journal Database,and Wanfang Data from inception to August 2019.The primary outcomes were echocardiography,serum assays for myocardial enzymograms,histological assessments,and electrocardiograms.The secondary outcomes mainly included body weight and safety evaluations.The protocol is registered on PROSPERO(CRD42019145819).RevMan(V.5.3)was used for meta-analysis.Results:We identified 10 studies from 9 international scientific publications describing the efficacy of TCM on AIC animal models.All the included studies reported that,compared with animal model without any intervention,TCM significantly improved ventricular function,cardiac biomarkers,electrocardiograph results,and cardiac fibrosis.Improved survival rates and body mass indices were also observed with TCM.We further pooled the available data from four studies(63 animals)for the meta-analysis and the results showed that,compared with models without any intervention,TCM significantly increased the ejection fraction by 14.13%(95%CI,9.96e18.29)and fraction shortening by 8.66%(95%CI,6.05 e11.26).Creatine kinase-MB(SMD=2.49,95%CI:-3.12 to-1.85)and lactate dehydrogenase(SMD=-2.78,95%CI:-3.45 to-2.12)were also significantly decreased by TCM.Conclusions:TCM is effective in improving AIC in animal models and has tremendous potential to be translated to treat AIC in clinical practice.Additionally,the systematic review and meta-analysis of animal experiments may be valuable in enhancing and guiding animal experiments and promoting the transformation of the results.

Biodegradable metals for bone defect repair:A systematic review and meta-analysis based on animal studies

Biodegradable metals are promising candidates for bone defect repair.With an evidence-based approach,this study investigated and analyzed the performance and degradation properties of biodegradable metals in animal models for bone defect repair to explore their potential clinical translation.Animal studies on bone defect repair with biodegradable metals in comparison with other traditional biomaterials were reviewed.Data was carefully collected after identification of population,intervention,comparison,outcome,and study design(PICOS),and following the inclusion criteria of biodegradable metals in animal studies.30 publications on pure Mg,Mg alloys,pure Zn and Zn alloys were finally included after extraction from a collected database of 2543 publications.A qualitative systematic review and a quantitative meta-analysis were performed.Given the heterogeneity in animal model,anatomical site and critical size defect(CSD),biodegradable metals exhibited mixed effects on bone defect repair and degradation in animal studies in comparison with traditional non-degradable metals,biodegradable polymers,bioceramics,and autogenous bone grafts.The results indicated that there were limitations in the experimental design of the included studies,and quality of the evidence presented by the studies was very low.To enhance clinical translation of biodegradable metals,evidence-based research with data validity is needed.Future studies should adopt standardized experimental protocols in investigating the effects of biodegradable metals on bone defect repair with animal models.

Evaluation of patches for rotator cuff repair:A systematic review and meta-analysis based on animal studies

Based on the published animal studies,we systematically evaluated the outcomes of various materials for rotator cuff repair in animal models and the potentials of their clinical translation.74 animal studies were finally included,of which naturally derived biomaterials were applied the most widely(50.0%),rats were the most commonly used animal model(47.0%),and autologous tissue demonstrated the best outcomes in all animal models.The biomechanical properties of naturally derived biomaterials(maximum failure load:WMD 18.68[95%CI 7.71-29.66];P=0.001,and stiffness:WMD 1.30[95%CI 0.01-2.60];P=0.048)was statistically significant in the rabbit model.The rabbit model showed better outcomes even though the injury was severer compared with the rat model.

Acupoint catgut embedding for simple obesity in animal studies:a systematic review and Meta-analysis

OBJECTIVE:To assess the efficacy of acupoint catgut embedding(ACE)for simple obesity in preclinical animal experiments.METHODS:We searched the following 14 electronic databases:PubM ed,Cochrane Library,EMBASE,Oriental Medicine Advanced Searching Integrated System,KoreaMed,Korean Studies Information Service System,Science-on,Research Information Sharing Service,Korea Citation Index,Korea Traditional Knowledge Portal,China Network Knowledge Infrastructure Database,Wanfang Database,Chinese Science and Technology Journal Database,and Chinese Biology Medicine Database,from inception to November 2021 without language limitation.The assessment was performed according to the guidelines of Animal Research:Reporting of in vivo experiments;and Metaanalysis was performed using Reviewer Manager 5.4.1 software.RESULTS:Twenty-four studies involving 813 animals were selected.Meta-analysis showed that ACE was beneficial for weight control[n=40,MD=-50.63,95%CI(-57.59,-43.67),P<0.00001,I 2=0%]and reduced the Lee index[n=40,MD=-18.79,95%CI(-20.01,-17.57),P<0.00001,I 2=0%].However,when efficacy of ACE was compared with that of manual acupuncture,electroacupuncture,or oilistat therapy,statistical difference was not observed between the two groups.CONCLUSIONS:This systematic review suggests that ACE may be efficacious in treating obesity.Moreover,the analyses highlighted the necessity to perform welldesigned,higher-quality experiments.

Systematic review and Meta-analysis of brain plasticity associated with electroacupuncture in experimental ischemic stroke

OBJECTIVE:To systematically evaluate the role of electroacupuncture in maintaining brain plasticity in ischemic stroke mediated brain damage.METHODS:We searched for all relevant trials published through Oct 7,2022 from seven databases.Methodological quality was assessed using the CAMARADES Risk of Bias Tool.A Meta-analysis of comparative effects was performed using Review Manager v.5.3 software.RESULTS:A total of 101 studies involving 2148 animals were included.For most studies,primary outcomes results of the Meta-analysis indicate that EA significantly improved ischemic stroke rat's postsynaptic density thickness[Standardized Mean Difference(SMD)=1.41,95%confidence interval(CI)(0.59,2.23),P=0.0008],numerical density of synapses[SMD=1.55,95%CI(0.48,2.63),P=0.005]compared with non-EA-treated.Similarly,EA could improve parts of biomarkers of synapses,neurogenesis,angiogenesis and neurotrophin activity than the control group(P<0.05).CONCLUSION:The existing evidence suggests EA regulating ischemic stroke may be through brain plasticity.More rigorous and high quality studies should be conducted in the future.

基于动物实验系统评价大黄素治疗糖尿病肾病的可行性

目的:系统评价大黄素对糖尿病肾病动物肾脏的保护作用。方法:计算机检索中国知网、维普、万方、中国生物医学文献及PubMed等数据库,检索从建库至2023年2月25日关于大黄素治疗糖尿病肾病的动物实验。采用RevMan 5.4.1软件进行分析。结果:共纳入14个研究,结果显示,相比于对照组,大黄素组更能降低糖尿病动物血糖[SMD=-2.51,95%CI(-3.77,-1.24),I^(2)=89%]、肌酐[SMD=-3.05,95%CI(-4.75,-1.34),I^(2)=91%]、尿素氮[SMD=-2.69,95%CI(-3.88,-1.50),I^(2)=82%]、24 h尿蛋白定量[SMD=-3.35,95%CI(-4.85,-1.85),I^(2)=87%]、相对肾重[SMD=-7.72,95%CI(-12.55,-2.88),I^(2)=90%]、三酰甘油[SMD=-1.24,95%CI-1.94,-0.54),I^(2)=0%]等指标。而大黄素与对照组在胆固醇[SMD=-1.19,95%CI(-2.29,-0.55),I^(2)=77%]等方面的差异无统计学意义。同时Meta分析提示大黄素保护肾脏与nephrin的表达、相关信号通路等有关。此类研究相关的严重不良反应鲜有报道。结论:大黄素对糖尿病肾病动物肾脏有保护作用,但有待于更高质量、严谨规范的大样本临床试验进一步证实。

麝香保心丸干预动脉粥样硬化模型动物实验的系统评价

目的系统评价麝香保心丸对动脉粥样硬化动物模型的干预作用。方法计算机检索建库至2023年7月18日在PubMed、Web of Science、EMbase、Cochrane Library、中国知网、维普、万方知识服务平台、中国生物医学文献数据库上公开发表的与麝香保心丸干预动脉粥样硬化模型动物实验相关文献。由2名研究者独立对文献进行筛选及资料提取,建立文献信息库,采用SYRCLE动物实验偏倚风险评估工具对纳入文献进行偏倚风险评价,使用RevMan 5.4软件进行Meta分析。结果经过筛选共纳入7篇文献进行Meta分析,与模型空白组相比麝香保心丸组可缩小主动脉斑块与血管腔面积比(SMD=-3.94,95%CI:-6.53~-1.36),降低血清低密度脂蛋白胆固醇水平(SMD=-2.86,95%CI:-4.21~-1.52),降低血清总胆固醇水平(SMD=-2.83,95%CI:-4.18~-1.47),降低血清三酰甘油水平(SMD=-2.80,95%CI:-4.57~-1.03)。麝香保心丸组与模型空白组相比血清高密度脂蛋白胆固醇水平差异无统计学意义(SMD=0.93,95%CI:-0.34~2.19)。结论本研究结果提示麝香保心丸干预动脉粥样硬化动物模型可缩小主动脉斑块面积,降低血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平。其机制可能与抑制炎症反应、促进胆固醇流出调节脂代谢、保护血管内皮、缓解血管内皮凋亡、激活自噬等有关。上述结论仍需要纳入设计更为严谨的高质量文献不断补充验证。

骨碎补总黄酮(强骨胶囊)治疗绝经后骨质疏松症大鼠实验的系统评价

目的评价骨碎补总黄酮(强骨胶囊)治疗绝经后骨质疏松症大鼠实验的有效性及安全性,探索骨碎补总黄酮(强骨胶囊)在绝经后骨质疏松症治疗领域的创新应用与安全使用。方法计算机检索国内外7个常用数据库,筛选骨碎补总黄酮(强骨胶囊)治疗绝经后骨质疏松症大鼠的随机对照试验;采用SYRCLE动物实验偏倚风险评估工具评价纳入文献研究,RevMan5.3软件进行Meta分析。结果经过初筛和严格评价,纳入12个研究,共246例样本,纳入文献质量普遍偏低。Meta分析结果显示,骨碎补总黄酮(强骨胶囊)有助于提高大鼠腰椎(WMD=0.03,95%CI 0.02~0.04,P<0.001)、股骨(WMD=0.03,95%CI 0.02~0.03,P<0.001)骨密度,以及血清骨钙素(osteocalcin,BGP)、碱性磷酸酶(alkaline phosphatase,ALP)、CTX水平,但对大鼠血清钙、血清磷水平的作用及量效关系,仍需更多动物实验加以探索与验证。安全性方面纳入文献中均未报告。结论骨碎补总黄酮(强骨胶囊)可在一定程度上提高绝经后骨质疏松症大鼠骨密度水平及部分骨代谢血液指标。但考虑到纳入研究在方法学质量和报告质量的局限性,本研究所得结论仍需进一步深入研究予以证实和深化。

干细胞治疗慢性颞叶癫痫动物的疗效:基于动物实验的系统评价

背景:干细胞是一种治疗慢性颞叶癫痫的新方法,且已广泛用于治疗各种癫痫动物模型,但各个实验研究中的疗效评价并不一致。目的:系统评价干细胞治疗慢性颞叶癫痫动物模型的有效性,为临床治疗提供实验依据和新思路。方法:计算机检索PubMed、Web of Science、EMBASE、中国期刊全文数据库(CNKI)、中国学术期刊数据库(万方),纳入国内外已发表的干细胞治疗慢性颞叶癫痫的动物实验,检索年限自各数据库建库至2018年5月。由2名研究者独立提取文献资料、进行文献质量评价,并采用CERQual工具对证据质量进行评估。结果与结论:最终纳入8篇动物实验,包括284个慢性颞叶癫痫动物。纳入研究之间存在较大的异质性,则进行定性系统评价。干细胞治疗使慢性颞叶癫痫动物在癫痫发作频率及持续时间方面有一定的改善,能促进大部分癫痫动物的恢复,其他研究指标包括对动物学习记忆功能的影响、干细胞的迁移、分化及融合,但由于纳入研究的实验设计缺乏严谨性、结果特征存在差异、证据质量不足等方面的局限性,尚不能确定干细胞治疗的确切疗效。因此,在临床试验施行之前,有必要进行高质量的临床前研究进一步评估干细胞移植对慢性颞叶癫痫的疗效及其向临床转化的可行性,以降低其结果向临床转化时的风险。

电针治疗高脂血症动物实验的质量评价

目的:系统评价电针治疗高脂血症动物实验的有效性和安全性。方法:以"针刺""电针""血脂异常"及"高脂血症"等为关键词,计算机检索2017年10月10日以前中国知网(CNKI)、万方、维普中文科技期刊数据库(VIP)、CBM、Pub Med、EMBASE和Cochrane图书馆等数据库,采用软件Revman 5.3对所检索文献进行Meta分析。结果:最终纳入23个研究,质量评价平均分数4.8。Meta分析结果显示,电针可显著性降低低密度脂蛋白(low density lipoprotein cholesterol,LDL-C)含量,差异有统计学意义[SMD-3.09,95%CI(-3.72,-2.45),P<0.000 01]。文献质量分析显示所纳入文献存在一定的发表性偏倚。结论:电针治疗高脂血症动物模型可显著降低LDL-C含量。

如何提高动物实验系统评价质量——基于动物实验系统评价与临床试验系统评价的比较研究

目的全面对比分析动物实验系统评价与临床试验系统评价在研究特点、方法和报告质量等方面的差异,为今后动物实验系统评价的开展和实施提供参考依据。方法计算机检索PubMed数据库,临床试验系统评价与动物实验系统评价检索时间分别限定在2016年10月和2016年1月至12月间的数据,由五名研究者按纳入与排除标准筛选文献、提取资料,对纳入研究的特征进行描述性分析。结果已发表的动物实验系统评价中,低于1/3的研究检索超过3个以上数据库,仅一半研究实施语种限制、无研究实施补充检索,低于20%的研究报告文献筛选流程图、仅一半的研究(51.8%)评估了纳入研究的偏倚风险、仅1/3的研究评估了发表偏倚。虽然大部分(73.2%)研究进行了数据合成(Meta分析),但仅44.6%的研究评估了研究间异质性分析。结论相比较临床系统评价,动物系统评价发表数量少,增长缓慢,且在方法质量上存在明显不足。今后有必要进一步完善动物实验系统评价方法学,并采取恰当的措施,对目前已经形成的如检索策略的制定、偏倚风险的准确评估等规范加大宣传、教育和推广,以促进动物实验系统评价质量的提高。

丹参酮ⅡA治疗心肌纤维化动物实验的系统评价

目的系统评价丹参酮ⅡA对大、小鼠心肌纤维化的影响。方法计算机检索中国知网数据库(CNKI)、万方数据库(WF)、中国生物医学文献数据库(Sino Med)、Pub Med、Embase、The Cochrane Library、Web of science中关于丹参酮ⅡA治疗心肌纤维化的动物实验,检索时限均为建库至2018年1月29日。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,采用Rev Man5.3软件进行Meta分析。结果共纳入8个研究,Meta分析结果显示,与模型组比较,丹参酮ⅡA(20 mg)组可降低转化生长因子-β1(TGF-β1)水平(P=0.000 2);丹参酮ⅡA不同剂量(10,20,35,70 mg)均可降低纤维化心肌左心室质量指数;丹参酮ⅡA不同剂量(10,20,70,100 mg)均可降低纤维化心肌胶原容积分数,差异均有统计学意义(P<0.05)。不同剂量丹参酮ⅡA比较:与丹参酮ⅡA(10 mg)组比较,丹参酮ⅡA(20 mg)可降低TGF-β1水平(P=0.04);与丹参酮ⅡA(35 mg)组比较,丹参酮ⅡA(70 mg)组可更好地降低纤维化心肌左心室质量指数及心肌胶原容积分数,且差异均有统计学意义(P<0.05)。结论丹参酮ⅡA可降低纤维化心肌中TGF-β1、胶原容积分数及左心室质量指数水平,而且有一定的量效关系。受纳入研究数量和质量的影响,上述结论尚待高质量研究予以验证。

中药的动物发育毒性系统评价

目的系统评价中药的体内发育毒性,为妊娠期用药的安全性提供依据。方法在中国期刊全文数据库、中国生物医学文献数据库、万方数据库、维普期刊全文数据库、PubMed、Embase、Toxent数据库中检索自建库至2019年12月31日公开发表的中药对动物发育的毒性研究,系统分析中药对母体妊娠结局和胎仔的致畸性。结果共纳入29篇文献,中药组雌性动物的受孕率与对照组无显著差异[RR=0.98,95%CI(0.92,1.06),P=0.64],而中药组妊娠动物的活胎数显著少于对照组[MD=-0.6,95%CI(-1.00,-0.20),P=0.03];中药组出生胎仔体质量[MD=-0.01,95%CI(-0.08,0.05),P=0.68]、胎仔体长[MD=-0.04,95%CI(-0.24,0.16),P=0.68]与对照组无显著差异,中药组妊娠期母体体质量增加量显著低于对照组[MD=-12.89,95%CI(-21.03,-4.75),P=0.02]。结论目前,中药对动物发育的毒性方面研究缺少高质量文献,需要长期、大规模的临床研究为妊娠期用药指导提供参考。

基于动物实验系统评价干细胞治疗肾脏缺血再灌注损伤的可行性

背景:随着干细胞研究的不断深入和对肾脏缺血再灌注损伤机制的逐渐明晰,干细胞治疗肾脏缺血再灌注损伤已在动物实验中广泛开展并取得了较大进展。因此,有必要开展系统评价以探究干细胞治疗肾脏缺血再灌注损伤的具体疗效。目的:基于动物实验系统评估干细胞对缺血再灌注损伤肾功能、结构和机体免疫功能的影响及其向临床转化的可行性。方法:计算机检索PubMed、Web of science、Embase、CNKI、维普和万方数据库,检索时间截止2019年5月。由2名研究者独立筛选文献、提取资料,采用SYRCLE动物实验偏倚风险评估工具评价纳入研究的方法学质量,并根据CERQual工具对证据质量进行评估。结果与结论:最终纳入17篇动物实验,但各研究间存在较大的临床异质性,故进行定性描述。相比于安慰剂组,干细胞治疗组动物的肾功能(血清肌酐和血尿素氮水平)均有改善,机体的免疫状况及肾脏的组织损伤也有所好转,但6个结局指标的证据质量均为“低”,同时纳入研究存在一定的偏倚风险。由于纳入研究存在实验设计、证据质量等方面的问题,尚不能确定干细胞的确切疗效以及是否能够或有必要开展进一步临床研究。因此,在开展临床试验之前,有必要进行高质量的临床前研究进一步评估干细胞治疗肾脏缺血再灌注损伤的疗效及向临床转化的可行性,以降低其向临床转化时的风险。

电针干预炎症性肠病动物模型的系统评价和Meta分析

目的:系统评价电针干预炎症性肠病(IBD)动物模型疗效及抗炎作用,为相关基础研究提供依据。方法:计算机检索国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、中国生物医学文献数据库(CBM)、PubMed、Embase、Web of Science和The Cochrane library从建库至2022年11月关于电针干预IBD的动物实验研究,由2位研究者独立进行文献筛选、资料提取和偏倚风险评价,采用RevMan 5.3软件进行数据合成和统计分析。结果:最终纳入28项研究。Meta分析结果显示,观察组能降低IBD动物模型疾病活动指数(DAI)(MD=-1.27,95%CI为-1.40~-1.15,P<0.00001)、结肠黏膜损伤评分(SMD=-2.39,95%CI为-2.83~-1.95,P<0.00001)。与对照组比较,观察组IBD动物体内肿瘤坏死因子-α(TNF-α)(SMD=-2.34,95%CI为-2.83~-1.85,P<0.00001)、白细胞介素-1β(IL-1β)(SMD=-2.56,95%CI为-3.78~-1.34,P<0.00001)及白细胞介素-6(IL-6)(SMD=-2.54,95%CI为-3.37~-1.71,P<0.00001)表达下降,差异有统计学意义。结论:电针对IBD动物具有改善疾病程度及抗炎作用,但纳入研究的方法学质量低,仍需要更多高质量的临床研究进一步探讨。