Objectives: Several clinical trials have evaluated the efficacy and safety of baricitinib in COVID-19 patients. Recently, there have been reports on critical patients, which are different from previous research results. The meta-analysis was performed to investigate the effects of baricitinib in COVID-19, by pooling data from all clinically randomized controlled trials (RCTs) available to increase power to testify. Methods: Studies were searched in PubMed, Embase, and Cochrane Library databases on January 31, 2023. We performed a meta-analysis to estimate the efficacy and safety of baricitinib for the treatment of hospitalized adults with COVID-19. This study is registered with INPLASY, number 202310086. Results: A total of 3010 patients were included in our analyses. All included studies were randomized controlled trials or prospective study. There was no difference in 14-day mortality between the two groups [OR 0.23 (95% CI 0.03–1.84), I² = 72%, P = 0.17]. In subgroup analyses we found that baricitinib did not seem to improve significantly in 24-day mortality critically ill patients [OR 0.60 (95% CI 0.35–1.02), I² = 0%, P = 0.06]. Fortunately, baricitinib have led to faster recovery and shorter hospital stays for COVID-19 patients. There were no difference in infections and infestations, major adverse cardiovascular events, deep vein thrombosis and pulmonary embolism. Conclusions: Baricitinib did not increase the incidence of adverse reactions. At the same time, we can find that it reduces the mortality of COVID-19 patients, not including the critically ill.

Low molecular weight heparin (LMWH) is often used to prevent perioperative venous thrombosis after surgery, but aspirin is also recommended by academics. Studies were searched in electronic databases until February 24, 2023. We performed a meta-analysis to evaluate the safety and efficacy of aspirin and LMWH for venous thromboembolism (VTE) prophylaxis in patients after orthopedic surgery. The outcomes were death from any causes, deep vein thrombosis (DVT), pulmonary embolism (PE), etc. This study was registered with INPLASY, number 202320117. Six randomized controlled trials enrolled 13,851 patients with postoperative joint surgery. The risk of DVT was comparable between the two groups when aspirin was combined with mechanical devices (RR 0.61 [95% CI 0.27–1.39],I² = 62%,P= 0.24). No significant differences in all cause death, PE, wound infection, and wound complication were found between the aspirin and LMWH groups. In this meta-analysis, the mortality rate was comparable between the aspirin and LMWH groups. However, aspirin alone had a higher risk of DVT than LMWH. Based on the results of this meta-analysis, we suggest aspirin combined with mechanical devices for VTE prophylaxis in patients after orthopedic surgery.

Throughout the COVID‐19 pandemic, rhinovirus (RV) remained notable persistence, maintaining its presence while other seasonal respiratory viruses were largely suppressed by pandemic restrictions during national lockdowns. This research explores the epidemiological dynamics of RV infections among pediatric populations on Hainan Island, China, specifically focusing on the impact before and after the zero‐COVID policy was lifted. From January 2021 to December 2023, 19 680 samples were collected from pediatric patients hospitalized with acute lower respiratory tract infections (ARTIs) at the Hainan Maternal and Child Health Hospital. The infection of RV was detected by tNGS. RV species and subtypes were identified in 32 RV‐positive samples representing diverse time points by analyzing the VP4/VP2 partial regions. Among the 19 680 pediatric inpatients with ARTIs analyzed, 21.55% were found to be positive for RV infection, with notable peaks observed in April 2021 and November 2022. A gradual annual decline in RV infections was observed, alongside a seasonal pattern of higher prevalence during the colder months. The highest proportion of RV infections was observed in the 0–1‐year age group. Phylogenetic analysis on 32 samples indicated a trend from RV‐A to RV‐C in 2022. This observation suggests potential evolving dynamics within the RV species although further studies are needed due to the limited sample size. The research emphasizes the necessity for ongoing surveillance and targeted management, particularly for populations highly susceptible to severe illnesses caused by RV infections.

Haloperidol is the most frequently prescribed medication for managing delirium in the intensive care unit (ICU). However, there is limited and inconclusive evidence regarding its efficacy. A meta-analysis was conducted by pooling data from recent clinical randomized controlled trials to assess the effectiveness of haloperidol in adult ICU patients with delirium. Studies were searched in PubMed, Embase and Cochrane Library databases on August 10, 2024. We performed a meta-analysis to estimate the efficacy of haloperidol for the treatment of ICU adult patients with delirium. This study is registered with INPLASY, number 202480104. The estimates are expressed as odds ratio (OR) or mean difference (MD) with a 95% confidence interval (CI). A total of 2863 patients were included in the analyses. All the included studies were randomized controlled trials. The frequency of patients diagnosed with delirium used both confusion assessment method of intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) was 34% (n = 2863), and used CAM-ICU only was 66% (n = 2863). There was no difference in short-term (28–30 days) mortality between the two groups [OR = 0.89, 95% CI 0.60–1.32, P = 0.56] and long-term (90 days to 1 year) mortality [OR = 0.87, 95% CI 0.70–1.07, P = 0.19]. Furthermore, the haloperidol group demonstrated an advantage in reducing the length of ICU stay [MD = -1.13, 95% CI − 1.93–− 0.32, P < 0.05] compared to the placebo group, with no statistically significant difference in length of hospital stay [MD = − 0.24, 95% CI -1.71–1.24, P = 0.75]. Haloperidol showed a significant trend in reducing the length of ICU stay. However, there was no statistical difference between the two groups in terms of delirium reduction.

We conducted a meta-analysis to investigate the effect of dexmedetomidine on postoperative delirium in elderly orthopedic surgery patients. A meta-analysis was conducted to identify randomized controlled trials of dexmedetomidine in elderly patients undergoing orthopedic surgery. The data was published on October 25, 2024. PubMed, Embase, and Cochrane Library databases were searched. Outcome measures included incidence of delirium, length of hospital stay, visual analogue scale, and postoperative complications. Estimates are expressed as relative risk (RR) or mean difference (MD) with a 95% confidence interval (CI). The publications were reviewed according to the guidelines of the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This study was registered with INPLASY (number INPLASY2024110004). A total of 3159 patients were included in 9 randomized controlled trials. The results showed that dexmedetomidine exhibited a preventive effect on delirium compared with the control group in elderly patients after orthopedic surgery (RR: 0.55, 95% CI: 0.45–0.66, P < 0.01, I2 = 0%). Subgroup analysis suggested that dexmedetomidine was significantly different from saline(RR: 0.56; 95% CI: 0.44–0.73, P<0.01, I²=31%) and propofol(RR: 0.52; 95% CI: 0.39–0.70, P 0.05). Certainty of evidence for postoperative delirium was moderate. Dexmedetomidine has been shown to have a protective effect on postoperative delirium in elderly patients following orthopedic surgery.

There is some controversy regarding drug therapy to prevent in-stent restenosis (ISR) after carotid artery stenting. In recent years, cilostazol has received increasing research attention. We performed a meta-analysis to evaluate the effects of cilostazol on the outcome of ISR after carotid stenting. A meta-analysis was carried out to identify the clinical trials that had been published up to 22 December 2024. The databases PubMed, Embase, Cochrane Library, CNKI and Wanfang have all been queried. The study population was composed of patients with stent carotid heart disease who were receiving cilostazol. Results included in-stent-restenosis, ischemic stroke and all-cause mortality. Publications were reviewed according to the Cochrane Handbook and the guidelines set out in the Preferred Reporting Project for Systematic Review and Meta-Analysis (PRISMA 2020). The methodological quality of the studies was assessed using the Revised Cochrane Risk of Bias tool for randomized trials (RoB 2.0) and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I). This study was registered with INPLASY (number INPLASY202510004). A total of 1975 patients were included in 4 randomized controlled trials (RCTs) and 5 non-RCTs. A statistically significant reduction in ISR was observed for antiplatelet regimens including cilostazol compared to the control group (OR = 0.27, 95%CI: 0.13 ~ 0.54, P<0.01, I2 = 30%). Subgroup analysis revealed this finding was primarily driven by non-randomized controlled trials (non-RCTs), demonstrating a consistent effect (OR = 0.17, 95%CI: 0.08 ~ 0.39, P<0.01, I2 = 0%). For other primary end events, no significant differences were noted in the incidence of ischemic stroke (OR = 0.83, 95%CI: 0.50 ~ 1.39, P = 0.49, I2 = 0%) or all cause death (OR = 0.53, 95%CI: 0.26 ~ 1.05, P = 0.07, I2 = 0%). The certainty of evidence for the ISR outcome was rated as low. Cilostazol was associated with less postoperative carotid stent restenosis, with no statistically significant difference in ischemic stroke and all-cause mortality.