Objective To evaluate on immunogenicity and safety of measles-mumps-rubella-varicella vaccine. Methods The PubMed, BIOSIS Previews, CDSR, The Cochrane Library, CBM, CNKI and VIP were searched between Jan. 1990 and April 2010. Studies were included in the review if they were randomized controlled trials (RCTs) about measles (M) – mumps (M) – rubella (R) and varicella (V) vaccine. Trial screening, data exaction and quality assessment of the included trials were conducted by the method recommended by Cochrane Collaboration. Statistical analyses were conducted by using RevMan 4.2.10 software. Results Five RCTs were included. Among those there were 2 trials of B degree and 3 trials of C degree. Meta-analyses showed that to different inoculation methods, (MMRV or MMR+V) the rate of pain was not significantly different with RR 0.94 and 95%CI 0.83 to 1.05 (P=0.28). The rate of redness was not significantly different with RR 1.08 and 95%CI 0.90 to 1.29 (P=0.40). The rate of hardening was not significantly different with RR 1.16 and 95%CI 0.95 to 1.43 (P=0.14). The rate of fever was significantly different with RR 1.20 and 95%CI 1.12 to 1.29 (Plt;0.000 01). The rate of skin rash was not significantly different with RR 1.18 and 95%CI 1.00 to 1.41 (P=0.05). The serum measles antibody positive rate was not significantly different with RR 1.00 and 95%CI 0.99 to 1.01 (P=0.68). The serum mumps antibody positive rate was not significantly different with RR 0.99 and 95%CI 0.50 to 1.01 (P=0.11). The serum rubella antibody positive rate was not significantly different with RR 1.00 and 95%CI 0.99 to 1.01 (P=0.68). The se-rum varicella antibody positive rate was not significantly different with RR 1.00 and 95%CI 0.99 to 1.01 (P=0.58). Conclusion Compared with MMR+V vaccine, the MMRV vaccine has the same immune effect. In respect of immune safety, in addition to higher rate of fever after vaccination, other local or systemic reaction is good. For the role of reducing vaccination times and good performance on immune effect and safety, the MMRV vaccine can be regarded as candidate vaccine for children. The fever caused by the new component should be strengthened in the following study. Limited to the quality and account for the current original documents, citing evidence of this systematic review would be cautious. Future studies would expand the sample size, fulfill the test design, increase indicators to improve the quality of research and demonstration intensity.
ObjectiveEarly diagnosis of biliary atresia (BA) is crucial for improving patient prognosis. This study aimed to evaluate the accuracy of serum matrix metalloproteinase-7 (MMP-7) and gamma-glutamyl transferase (GGT) in diagnosing BA. MethodsWe conducted a comprehensive search of English-language databases (PubMed, Elsevier, Web of Science) and Chinese-language databases (CNKI, WanFang Data, VIP) for studies published from the inception of these databases up to December 30, 2024. Eligible studies included diagnostic data based on serum MMP-7 and GGT levels from children with BA and non-BA cholestasis. Results Through a systematic review and meta-analysis, a total of 24 publications encompassing 33 studies were included, covering a combined cohort of 6 879 children with cholestasis. The results of the binary diagnostic model analysis revealed that the pooled sensitivity and specificity of serum matrix metalloproteinase-7 (MMP-7) were 93% (95%CI 92 to 94) and 87% (95%CI 85 to 88), respectively. The positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) for MMP-7 were 8.63 (95%CI 5.88 to 12.66), 0.09 (95%CI 0.06 to 0.13), and 115.31 (95%CI 69.08 to 192.48), respectively. The area under the receiver operating characteristic curve (AUC) for MMP-7 was 0.9659, indicating excellent diagnostic performance. In comparison, gamma-glutamyl transferase (GGT) demonstrated a pooled sensitivity of 76% (95%CI 73 to 78) and specificity of 80% (95%CI 78 to 82). The corresponding PLR, NLR, and DOR for GGT were 3.50 (95%CI 2.77 to 4.43), 0.30 (95%CI 0.25 to 0.36), and 12.69 (95%CI 9.18 to 17.55), respectively. The AUC for GGT was calculated to be 0.849 4, reflecting moderate diagnostic accuracy. ConclusionSerum MMP-7 demonstrates higher diagnostic accuracy compared to GGT, which may significantly enhance the diagnostic efficiency for biliary atresia. However, due to its heterogeneity, further multicenter, large-sample, prospective studies that adhere strictly to experimental protocols are necessary to validate its diagnostic accuracy.