Yongji Wang

Objective: This study aimed to conduct an umbrella review comparing intravenous versus nebulized magnesium sulfate for acute asthma exacerbations, providing evidence to guide route selection and clinical decision-making. Methods: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, WANFANG, and CBM from inception to August 2025, for systematic reviews/meta analyses comparing intravenous versus nebulized magnesium sulfate for acute asthma exacerbations. Overlap among primary studies was assessed using a citation matrix and corrected covered area. Quality assessment was performed using ROBIS, AMSTAR-2, PRISMA 2020, and GRADE. Quantitative and qualitative analyses of primary outcomes were performed. Results: A total of 18 systematic reviews/meta analyses were included. The corrected covered area was 5.168%, indicating some overlap in primary studies. ROBIS judged all studies at low risk of bias. AMSTAR-2 rated 6 studies as high quality, 2 as moderate, and 10 as low. PRISMA 2020 scores ranged from 25.5 to 41, with 10 studies of high and 8 of moderate reporting quality. GRADE yielded 13 high-quality, 38 moderate-quality, 27 low-quality, and 26 extremely low-quality outcomes. Conclusion: This overview clarifies the role of intravenous magnesium sulfate in acute asthma: not for routine use but as secondary adjunctive therapy for severe cases refractory to first-line treatment. The role of nebulized magnesium sulfate is more complex—neither universally applicable nor a replacement for first-line medications. Current evidence does not support routine use, warranting only a weak recommendation for patients who fail standard therapy. Future research should focus on its synergistic effects with other therapies and further elucidate its mechanisms. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , PROSPERO: CRD420251122150.

Objective: This study aimed to systematically assess the association between fermented dairy consumption and the risk of asthma and wheeze in children. Methods: Following a protocol registered with PROSPERO (CRD420251269745), a systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library up to January 2026 to identify observational studies reporting relevant effect estimates. A random-effects model was used to pool odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup analyses were performed based on study design, outcome phenotype, product type, and timing of exposure. Sensitivity analyses, including Hartung–Knapp adjustment, were conducted to assess robustness. Results: A total of 11 studies (119,372 participants) were included. In the primary DerSimonian–Laird random-effects analysis, fermented dairy consumption was associated with a reduced risk of the composite outcome of asthma/wheeze in children (OR = 0.72, 95% CI: 0.55–0.95), with substantial heterogeneity ( I ² = 77.0%). However, this association was not retained after Hartung–Knapp adjustment (OR = 0.72, 95% CI: 0.52–1.01; p = 0.054). Subgroup analyses indicated that this association was largely influenced by cross-sectional studies (OR = 0.51, 95% CI: 0.33–0.78), whereas no statistically significant association was found in cohort studies (OR = 0.91, 95% CI: 0.72–1.16). Additional subgroup analyses showed stratum-specific differences, but tests for subgroup differences were not statistically significant. Egger’s test did not indicate statistically significant publication bias. The overall certainty of evidence was very low. Conclusion: The current evidence does not support a robust association between fermented dairy consumption and the risk of asthma or wheeze in children. The observed potential association may be influenced by methodological factors, particularly study design. Well-designed, large-scale prospective studies are warranted to further clarify this association. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251269745 , identifier: CRD420251269745.

Introduction: Omalizumab, an anti-IgE monoclonal antibody, is an established biologic for asthma. This overview synthesized evidence from systematic reviews on its efficacy and safety. Methods: We systematically searched multiple electronic databases from inception to July 19, 2025. The methodological quality, risk of bias, reporting quality, and certainty of evidence of the included systematic reviews were assessed using the AMSTAR-2, ROBIS, PRISMA 2020, and GRADE tools, respectively. The degree of overlap among primary studies across reviews was measured using the Corrected Covered Area (CCA). Results: Nineteen studies were included. The CCA calculation indicated a moderate level of overlap (CCA ≈ 0.1421). Most demonstrated low risk of bias, high methodological/reporting quality, and provided moderate-to-high certainty evidence. Omalizumab significantly reduced asthma exacerbation rates and improved overall treatment effectiveness, asthma control, and quality of life. It also facilitated a reduction in daily corticosteroid use, with a confirmed favorable safety profile. Conclusion: This overview confirms that omalizumab is an effective and safe add-on therapy for asthma. Its mechanism of neutralizing free IgE translates into significant clinical benefits, including reduced exacerbations and improved patient outcomes, establishing it as a valuable therapeutic option. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , CRD420251107860.

Objective: This study aims to provide an overview of systematic reviews and meta-analyses on probiotic adjuvant therapy for allergic rhinitis, with the goal of offering evidence-based support for clinical practice and decision-making. Methods: A comprehensive search was performed in PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, WANFANG, and CBM databases from their inception to 5 July 2025, to identify systematic reviews and meta-analyses on probiotic adjuvant therapy for allergic rhinitis. Constructing a literature overlap matrix and calculating the adjusted overlap area for assessing duplication rates in source literature. ROBIS, AMSTAR-2, PRISMA 2020, and GRADE were used to assess bias risk, methodological/reporting quality, and evidence certainty. Quantitative and qualitative analyses of primary outcomes provided comprehensive insights. Results: Fifteen systematic reviews and meta-analyses were included; the adjusted overlap area, calculated from the literature overlap matrix, was 16.939%, all demonstrating low bias risk. Methodological quality assessment identified 9 high-, 5 low-, and 1 critically low-quality study. The evaluation of reporting quality showed 7 high-, 7 moderate-, and 1 low-quality study. Evidence certainty grading yielded 11 high-, 37 moderate-, 35 low-, and 17 critically low-quality outcomes. Quantitative analysis confirmed that probiotic adjunct therapy significantly reduced eosinophil counts in patients with allergic rhinitis. Qualitative synthesis indicated probiotics alleviated symptoms, improved quality of life, and exhibited favorable safety as adjuvant treatment. Conclusion: Probiotics show significant adjuvant value in allergic rhinitis, effectively alleviating symptoms and improving quality of life. Their immunomodulatory effects restore Th1/Th2 balance, while demonstrating excellent safety and tolerability for clinical application. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier: CRD420251087317.

Objective: Conduct an overview of systematic reviews and meta-analyses on intralymphatic immunotherapy for allergic rhinitis, providing systematic evidence to optimize clinical practice and evidence-based decision-making. Methods: A computer-based retrieval system was used to comprehensively search databases such as PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, WANFANG, and CBM. The retrieval time limit was set from the inception date of each database to August 14, 2025, aiming to obtain systematic review/Meta-analysis literatures on lymph node intralymphatic immunotherapy for the treatment of allergic rhinitis. Use evaluation tools such as ROBIS, AMSTAR-2, PRISMA 2020, and GRADE to perform quality re-evaluations on the systematic reviews/Meta-analyses of included studies from the aspects of bias risk, methodology, reporting, and evidence level, and conduct comprehensive re-evaluations on the outcome indicators of the included studies. Results: A total of seven systematic reviews/meta-analyses were included. Risk of bias assessment indicated all studies had low risk. Methodological quality evaluation revealed six studies were of low quality and one was of very low quality. In terms of reporting quality, all included studies demonstrated high quality, with PRISMA scores ranging from 33 to 40. For outcome measures, evidence quality assessment identified 6 high-quality, 13 moderate-quality, 18 low-quality, and 27 very low-quality results. Quantitative analysis showed that intralymphatic immunotherapy not only improved subjective symptom scores in allergic rhinitis patients but also effectively induced immune tolerance. Qualitative analysis further confirmed that this targeted approach significantly enhanced allergen tolerance and reduced nasal symptom severity. The therapy demonstrated a favorable safety profile, primarily characterized by mild local adverse events, with substantially fewer systemic reactions compared to conventional subcutaneous immunotherapy. Conclusion: Intralymphatic immunotherapy demonstrates efficacy in improving symptoms and objective indicators of allergic rhinitis, particularly for grass pollen and mixed allergens, with acceptable short-to-medium term outcomes despite limited long-term effectiveness. The treatment exhibits a favorable safety profile dominated by mild local reactions. However, these findings are constrained by low evidence quality. Future studies should adhere to established guidelines to produce higher-quality evidence through systematic reviews and meta-analyses. Systematic review registration: The systematic review was registered on PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ ) with the registration number CRD420251126501.

Reappraisal of Systematic reviews/Meta analyses on Sublingual Immunotherapy for Allergic Rhinitis: Evidence for Clinical Practice and Decision-Making. A comprehensive computerized search was conducted across PubMed, Embase, the Cochrane Library, Web of Science, CNKI, VIP, WANFANG, and CBM databases from their inception to June 8, 2025, to systematically identify Systematic reviews and Meta analyses on Sublingual Immunotherapy for allergic rhinitis. A citation overlap matrix was constructed to calculate the corrected covered area, assessing the degree of primary study overlap. The risk of bias, methodological quality, reporting quality, and certainty of evidence in the included Systematic reviews/Meta analyses were evaluated using ROBIS, AMSTAR-2, PRISMA 2020, and GRADE tools, respectively. Both quantitative and qualitative analyses were performed on the primary outcomes to derive a more comprehensive and in-depth understanding. A total of 20 Systematic reviews/Meta analyses were included in this umbrella review. The corrected covered area of 6.391% derived from the citation matrix analysis indicated a modest degree of primary study overlap among the included literature. Risk of bias assessment demonstrated that all incorporated studies exhibited low bias risk. Methodological quality evaluation revealed 2 high-quality, 3 moderate-quality, 14 low-quality, and 1 extremely low-quality study. Reporting quality assessment yielded scores ranging from 22 to 41.5, with 7 studies classified as high-quality, 11 as moderate-quality, and 2 as low-quality reports. The evidence quality assessment revealed that among all evaluated outcomes, 7 were rated as high quality, 19 as moderate quality, 31 as low quality, and 14 as extremely low quality according to the GRADE framework. Current evidence demonstrates that Sublingual Immunotherapy exhibits favorable efficacy in improving symptom scores and medication use for allergic rhinitis, with generally acceptable safety profiles despite mild adverse reactions in some cases. Future research should focus on large-scale, real-world studies with diverse outcome measures, investigating variations in regional populations, allergen types, dosage regimens, and treatment durations to further optimize clinical application protocols for Sublingual Immunotherapy.

Background: Mycoplasma pneumoniae pneumonia (MPP) is a common respiratory infection in children, current treatments are limited by resistance and side effects. This study aims to evaluate the clinical efficacy and safety of combining Qingke Mixture with azithromycin for treating MPP in children. Methods: This prospective, randomized, double-blind, controlled trial included 92 children diagnosed with MPP. The treatment group received Qingke Mixture and azithromycin, while the control group received azithromycin alone. Outcomes assessed included clinical symptoms, inflammatory markers, immune response, pulmonary function, and adverse events. Results: The treatment group showed significantly higher clinical efficacy (95.65% vs 80.43%, P < 0.05). The treatment group showed faster resolution of pulmonary symptoms, shorter hospital stays, and greater improvements in pulmonary function and TCM symptom scores (P < 0.05). Inflammatory markers (WBC, CRP, IL-6, IL-8) were significantly lower, while immunoglobulin levels (IgA, IgG, IgM) and T lymphocyte subsets (CD3+, CD4+/CD8+ ratio) were higher in the treatment group compared to the control group (P < 0.05). The incidence of adverse events was low in both groups, with no statistically significant difference. Conclusion: Qingke Mixture combined with azithromycin significantly improves clinical outcomes in children with MPP, enhancing efficacy while maintaining safety.