Objectives: The aim of this study was to evaluate the potential association between early onset puberty and the risk of different forms of obesity in children.Methods: The databases PubMed, EMBASE, Web of Science and Cochrane Library were systematically searched for relevant studies. The odds ratio (OR) and 95% confidence interval (CI) of obesity in precocious puberty were calculated using Stata software 14.0. A fixed-effects model was used if P > 0.1 and I² ≤ 50%. Otherwise, a random-effects model was used. Publication bias was assessed using funnel plots and Egger's test.Result: The pooling analysis showed that precocious puberty in girls was associated with a higher risk of obesity (OR = 1.98; 95% CI: 1.76–2.24; I² = 0.00%, P < 0.001). Girls with a history of precocious puberty were found to have an increased risk of general obesity (OR = 2.03; 95% CI: 1.62–2.55; I² = 22.2%, P < 0.001), central obesity (OR = 1.96; 95% CI: 1.70–2.26; I²= 0.00%, P < 0.001), and overweight (OR = 2.03; 95% CI: 1.68–2.46; I²= 5.1%, P < 0.001). The pooled analysis showed that precocious puberty in boys was not associated with an increased risk of obesity (OR = 1.14; 95% CI: 0.86–1.51; I²= 50.6%, P = 0.369). In boys, the occurrence of precocious puberty was not associated with an elevated risk of general obesity (OR = 0.96; 95% CI: 0.40–2.27; I² = 79.6%, P = 0.922), central obesity (OR = 1.17; 95% CI: 0.96–1.43; I²= 0.00%, P = 0.125), or overweight (OR = 1.03; 95% CI: 0.56–1.88; I² = 74.4%, P = 0.930).Conclusion: This meta-analysis suggests that the onset of puberty at an early age in girls is associated with an increased risk of obesity, however precocious puberty in boy was not associated with an increased risk of obesity. These findings highlight that precocious puberty should be considered an independent risk factor for obesity in girls.Systematic Review Registration: CRD42023404479.

This study aimed to investigate the relationship between serum lactate levels at admission to the intensive care unit (ICU) and the clinical outcomes of children with sepsis. We used the Pediatric Intensive Care (PIC) database to identify 288 pediatric patients with sepsis. We analyzed the relationship between lactate levels and hospital and ICU mortality in sepsis by establishing a segmented multivariable Cox regression model. We also conducted subgroup analysis as well as analyzed the restricted cubic spline curves. After adjusting for all potential confounding factors, an increase of 1 mmol/L in lactate levels was found to be associated with an 17% rise in the 28-day hospital mortality risk among sepsis patients (HR: 1.17, 95% CI: 1.08–1.27, P = 0.0002). When considering lactate as a categorical variable, the mortality risk of patients with lactate levels ≥ 2.2 mmol/L was significantly increased (HR: 3.61, 95% CI: 1.24–10.54, P = 0.0189). The restricted cubic spline curve analysis revealed a nonlinear correlation between lactate and 28-day mortality, with an inflection point at 2.2 mmol/L. Similar findings were also observed in the assessment of secondary outcomes. Our study demonstrates a non-linear correlation between lactate levels and 28-day mortality in pediatric sepsis, with a critical threshold of 2.2mmol/l for lactate levels in septic patients. Early assessment of lactate levels is recommended for children with sepsis to facilitate prompt intervention and mitigate the risk of fatality.

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.

Omalizumab is a biologic agent used in the management of allergic conditions, including asthma and urticaria. Although the efficacy of omalizumab has been well established, its safety profile is primarily derived from clinical trials with limited sample sizes. To conduct a comprehensive evaluation of its safety in larger populations, this study conducted an extensive analysis of data sourced from the America Food and Drug Administration’s Adverse Event Reporting System (FAERS), with the aim of elucidating adverse drug events associated with omalizumab in real-world settings. We extracted reports of adverse events associated with omalizumab from the FAERS database covering the period from the first quarter of 2004 to the second quarter of 2024. We assessed the significance of the association between omalizumab and adverse events using four distinct methods of disproportionality analysis. Furthermore, we analyzed adverse events across gender and age subgroups. We identified a total of 49,456 adverse event reports linked to omalizumab and pinpointed 357 adverse events related to omalizumab within 27 system organ classes. These adverse events encompassed several commonly reported reactions documented in the product labeling, including anaphylactic reactions (ROR: 17.28, 95%CI:16.62–17.96) and asthma (ROR:19.24, 95%CI:18.74–19.76), alongside unlisted reactions such as asthmatic crisis (ROR: 47.3, 95%CI: 43–52.03), lower respiratory tract congestion (ROR: 35.68, 95%CI: 30.42–41.84). Furthermore, the results of our analysis indicated that omalizumab-related adverse events displayed significant gender and age disparities. The median time to onset for all documented adverse events was approximately 145 days, with a substantial proportion occurring after one year of treatment. This study not only offers a significant reference for optimizing the utilization of omalizumab, enhancing its efficacy while minimizing potential side effects, but also facilitates the safe application and broader implementation of omalizumab in clinical practice.

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.

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.