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Bifidobacterium and Lactobacillus for preventing necrotizing enterocolitis in very-low-birth-weight preterm infants: a systematic review and meta-analysis.
Jiao, X, Fu, MD, Wang, YY, Xue, J, Zhang, Y
World journal of pediatrics : WJP. 2020;(2):135-142
Abstract
BACKGROUND The therapeutic effect of Bifidobacterium and Lactobacillus on necrotizing enterocolitis (NEC) in very-low-birth-weight preterm infants was controversial, and we aimed to explore the exact impact of the two probiotics. METHODS The PubMed, EMBASE, Web of Science and Cochrane Library were systematically searched for studies published from January 1, 2010 to February 28, 2019. Results were combined with fixed-effect model or random-effect model with specific conditions. Sensitivity analysis was conducted by the trim-and-fill method, and the Begger's and Egger's test were used to measure publication bias. RESULTS The meta-analysis included 16 original articles with 4632 very-low-birth-weight preterm infants. With respect to the intervention of Bifidobacterium, we estimated non-significant decrease in the morbidity of NEC with a risk ratio (RR) of 0.75 [95% confidence internal (CI) 0.56-1.01, P = 0.06]. Regarding the effect of Lactobacillus, there was no evidence of significant lower risk in the incidence of NEC (RR = 0.67, 95% CI 0.39-1.17, P = 0.16). The use of mixture of probiotics (Bifidobacterium and Lactobacillus) reduced the risk of NEC in the probiotics group (RR = 0.45, 95% CI 0.25-0.80, P = 0.007). CONCLUSION The mixture of Bifidobacterium and Lactobacillus could prevent the morbidity of NEC in very-low-birth-weight preterm infants. But Bifidobacterium or Lactobacillus alone did not show this effect.
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Safety and efficacy of Lactobacillus for preventing necrotizing enterocolitis in preterm infants.
Liu, D, Shao, L, Zhang, Y, Kang, W
International journal of surgery (London, England). 2020;:79-87
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Abstract
AIM: To evaluate the safety and efficacy of Lactobacillus for preventing necrotizing enterocolitis (NEC) in preterm infants. METHODS We searched the Cochrane Library, PubMed, EMBASE, and Web of Science databases from inception to September 2019. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated to compare outcomes. We also performed a subgroup analysis of the incidence of NEC. Moreover, a sensitivity analysis was performed to examine the stability of the results. A Begg funnel plot was generated to detect publication bias. Two reviewers assessed trial quality and extracted data independently. This work has been reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and the Assessing the Methodological Quality of Systematic Reviews guidelines. Statistical analysis was performed using standard procedures in Review Manager 5.2 software. RESULTS Twenty-three randomized, placebo-controlled studies (N = 4686 participants) were included in this analysis. Comparing the Lactobacillus and control groups, a significant reduction was found in the incidence of NEC (RR 0.34, 95% CI 0.25-0.46; P < 0.00001) and death (RR 0.48, 95% CI 0.36-0.64; P < 0.00001). No significant difference in the incidence of sepsis was found between the Lactobacillus and placebo groups (RR 0.90, 95% CI 0.72-1.12; P = 0.34). CONCLUSIONS Lactobacillus is safe and can prevent necrotizing enterocolitis in preterm infants.
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Efficacy of Probiotics and Synbiotics in Patients with Nonalcoholic Fatty Liver Disease: A Meta-Analysis.
Liu, L, Li, P, Liu, Y, Zhang, Y
Digestive diseases and sciences. 2019;(12):3402-3412
Abstract
BACKGROUND AND AIM Extensive epidemiological evidence suggests that nonalcoholic fatty liver disease (NAFLD) is the primary chronic liver disease worldwide. However, some studies have showed conflicting results on the effects of probiotics and synbiotics supplementation. Therefore, we conducted a systematic review and meta-analysis to investigate the effectiveness of the supplementation in subjects with NAFLD. METHODS We searched systematically PubMed, Cochrane, and Embase databases up to April 2018 and checked manually the bibliography of the original articles. The quality of the studies was evaluated using the Cochrane Risk of Bias Tool. RESULTS This study analyzed 15 randomized, controlled trials involving 782 patients with NAFLD. Probiotics and synbiotics supplementation could significantly improve liver steatosis, alanine aminotransferase, aspartate aminotransferase, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, homeostasis model assessment-insulin resistance, liver stiffness and tumor necrosis factor-alpha (all P < 0.05). But the supplementation could not ameliorate body mass index (mean difference [MD] = -0.00; 95% confidence interval [CI]: -0.22 to 0.22, P = 0.99), waist circumference (MD = -0.01; 95% CI -0.03 to 0.02, P = 0.57) and fasting blood sugar (standard mean difference [SMD] = -0.10; 95% CI -0.32 to 0.12, P = 0.39). CONCLUSION We present clear evidence for the benefit of probiotics and synbiotics supplementation for liver steatosis, liver enzymes, lipid profiles and liver stiffness in patients with NAFLD.
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Probiotics supplementation in children with asthma: A systematic review and meta-analysis.
Lin, J, Zhang, Y, He, C, Dai, J
Journal of paediatrics and child health. 2018;(9):953-961
Abstract
AIM: To systematically review the effects of probiotics supplementation in children with asthma. METHODS An electronic search was conducted on PubMed, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure Database, CQ VIP Database and Wanfang Data until November 2017. The reference lists of included studies and pertinent reviews were checked for supplementing our search. Randomised control trials that compared probiotics versus placebo were included. RESULTS Eleven studies with a total of 910 children met eligibility criteria. The pooled data revealed that the proportion of children with fewer episodes of asthma was significantly higher in the probiotics group than in the control group (risk ratio 1.3, 95% confidence interval (CI) 1.06-1.59); the reduction of IL-4 (mean differences -2.34, 95% CI -3.38, -1.29) and the increasing of interferon-γ (mean differences 2.5, 95% CI 1.23-3.76) was also significant after the treatment of probiotics. Nevertheless, no statistical significance was observed in childhood asthma control test, asthmatic symptom in the day and night, the number of symptom-free days, forced expiratory volume in the first second predicted and peak expiratory flow. CONCLUSIONS This systematic review does not confirm or rule out the beneficial effects of probiotics supplementation in children with asthma. More well-designed randomised control trials with larger sample sizes need to be conducted to evaluate the effects of probiotics in children with asthma in the future.
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Efficacy of mesalazine in combination with bifid triple viable capsules on ulcerative colitis and the resultant effect on the inflammatory factors.
Huang, M, Chen, Z, Lang, C, Chen, J, Yang, B, Xue, L, Zhang, Y
Pakistan journal of pharmaceutical sciences. 2018;(6(Special)):2891-2895
Abstract
Present investigation is conducted to investigate the clinical efficacy of mesalazine in combination with the Bifid Triple Viable Capsules on the ulcerative colitis (UC) and the resultant effect on the inflammatory factors (TNF-α, IL-8 and IL-10) of UC patients. A total of 120 UC patients who were admitted to this hospital for treatment between May 2014 and February 2018 were enrolled in this study and divided randomly into the research group and control group, with 60 patients in each group. For patients in the two groups, they underwent medication via mesalazine, while those in the research group additionally received the medication by Bifid Triple Viable Capsules. Following treatment, we evaluated the clinical efficacy, as well as the disease activity index (DAI) of UC, score of clinical symptoms, changes in the inflammatory factors (TNF-α, IL-8 and IL-10) and the adverse reactions to drugs before and after treatment. The total effectiveness rate in the research group was 90.0%, significantly higher than 72.5% in the control group, and the difference had statistical significance (P < 0.05). Before treatment, we assessed the UCDAI and clinical symptoms, and found that there were no statistically significant differences in these indicators between two groups (P>0.05); however, after treatment, both of UCDAI and clinical symptoms scores were decreased evidently in two groups (P<0.05), while the decreases in the research group were more significant (P < 0.05). In addition, following treatment, the levels of TNF-α and IL-8 were all decreased in two groups, with an acute increase in IL-10 (all P<0.01), and the alterations in these indicators in the research group were much more significant than those in the control group (all P <0.05). For adverse reactions, the incidence rate in the research group was 6.67%, significantly lower than 33.33% in the control group (P <0.05). Mesalazine in combination with Bifid Triple Viable Capsules shows a magnificent protective effect on the mucosa of UC patients, and curb the UC-related inflammatory reactions effectively. Thus, it is a safe and reliable method that is worthy of being promoted in clinical practice.
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Efficacy of probiotics on anxiety-A meta-analysis of randomized controlled trials.
Liu, B, He, Y, Wang, M, Liu, J, Ju, Y, Zhang, Y, Liu, T, Li, L, Li, Q
Depression and anxiety. 2018;(10):935-945
Abstract
BACKGROUND The concept "psychobiotics" claims potential beneficial effect of probiotics on anxiety, whereas findings from clinical trials are inconsistent. Thus, a meta-analysis is needed to clarify the effect of probiotics on anxiety. METHODS Randomized controlled trials (RCTs) assessing the effect of probiotics on anxiety were systematically retrieved from online databases and manually screened for references of relevant published literature through September 1, 2017. Standardized mean difference in change from baseline of anxiety rating scales between probiotics groups and placebo groups was selected as the main effect index. Subgroup analyses were conducted with respect to overall health status of the sample, existence of gastrointestinal symptoms, strains of flora, trial duration, and risk of bias assessment. Publication bias was evaluated by funnel plot and Egger's test. The reliability of the result was assessed by leave-one-out sensitivity analysis. RESULTS Twelve studies with 1,551 subjects (871 in probiotics group and 680 in control group) were included. All the studies were rated as low or moderate risk of bias. The meta-analysis and subgroup analyses all showed no significant difference between probiotics and placebo in alleviating anxiety symptoms. The Egger's test revealed no evidence of significant publication bias. Sensitivity analysis showed that leaving out one study would result in marginal significance. CONCLUSIONS The evidence for the efficacy of probiotics in alleviating anxiety, as presented in currently published RCTs, is insufficient. More reliable evidence from clinical trials is needed before a case can be made for promoting the use of probiotics for alleviating anxiety.