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Abstract Objective: Salivary pepsin has emerged as a biomarker for Laryngopharyngeal Reflux (LPR), which, however, has been questioned for its efficacy due to a lack of supporting medical data. Therefore, this study analyzed the diagnostic value of salivary pepsin for LPR and assessed a better cutoff value. Methods: Studies were searched in PubMed, Embase, and Cochrane Library from their receptions to October 1, 2021. Then, RevMan 5.3 and Stata 14.0 were utilized to summarize the diagnostic indexes for further meta-analysis. Data were separately extracted by two reviewers according to the trial data extraction form of the Cochrane Handbook. The risk of bias in Randomized Control Trials (RCTs) was evaluated with the Cochrane Risk of Bias Tool. Results: A total of 16 studies matched the criteria and were subjected to meta-analysis. The results revealed a pooled sensitivity of 61% (95% CI 50%-71%), a pooled specificity of 67% (95% CI 48%-81%), a positive likelihood ratio of 2 (95% CI 1.2-2.8), a negative likelihood ratio of 0.58 (95% CI 0.47-0.72), and the area under the receiver operating characteristic curve of 0.67 (95% CI 0.63-0.71). Subgroup analyses indicated that the cutoff value of pepsin at 50 ng/mL had a higher degree of diagnostic accuracy than that of pepsin at 16 ng/mL in cohort studies. Conclusion: The review demonstrated low diagnostic performance of salivary pepsin for LPR and that the cutoff value of 50 ng/mL pepsin had superior diagnostic accuracy. Nevertheless, the diagnostic value may vary dependent on the utilized diagnostic criteria. Therefore, additional research is needed on the improved way of identifying salivary pepsin in the diagnosis of LPR, and also longer-term and more rigorous RCTs are warranted to further assess the effectiveness of salivary pepsin.
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Objective@#To analyze the association between the concentration of metalloestrogens ( MEs ) in seminal plasma and sperm quality in infertile patients, so as to provide the basis for the study of MEs on human sperm quality.@*Methods@#The spermatozoa concentration, progressive rate ( PR ), normal morphology rate ( NMR ) and DNA fragmentation index ( DFI ) were determined in the infertile male patients from Zhejiang Provincial People's Hospital from March to April, 2020. The contents of As, Cd, Co, Cr, Cu, Hg and Ni in seminal plasma were determined by inductively coupled plasma mass spectrometry ( ICP-MS ). The distribution of MEs in seminal plasma and the sperm quality in different concentration of MEs ( grouped by quartiles ) were analyzed.@*Results@#Among 105 cases recruited, 28 cases were normal in sperm parameters and 77 cases were abnormal, including 22 cases of oligospermia, 47 cases of asthenospermia, 54 cases of dysspermia and 30 cases of abnormal DFI. As, Cr, Cu, Hg and Ni were detected in all samples, the detection rates of Cd and Co were 78.57%-90.91%. Compared with the normal group, the concentration of As in oligospermia group was higher [( 18.96±12.56 ) µg/L vs. (13.67±4.19) µg/L, P<0.05],the concentration of Cr was higher in asthenospermia, dysspermia and abnormal DFI in Q3 and Q4 groups groups [( 386.62±81.92 ), ( 378.02±81.46 ), ( 393.88±77.03 ) µg/L vs. ( 343.12±55.08 ) µg/L,P<0.05]. The PRs in Q3 and Q4 groups of Cr were lower than that in Q2 group [( 32.95±18.22 )%, ( 27.74±22.77 )% vs. ( 54.18±24.64 )%, P<0.05], the DFI in Q3 and Q4 groups was higher than that in Q2 group [( 26.91±14.77 )%, ( 29.91±16.93 )% vs. ( 9.87±10.93 )%, P<0.05], and the NMR in Q4 group was lower than that in Q2 group [( 1.62±1.72 )% vs. ( 3.36±1.97 )%, P<0.05]. The concentration of sperm in Q3 group of Cu was higher than that in Q2 group [( 115.87±88.22 )×106/mL vs. (61.91±66.16)×106/mL, P<0.05]. @*Conclusion@#As and Cu in seminal plasma are associated with abnormal sperm concentration, and Cr is associated with NMR, PR and DFI.