[Effect of hemoperfusion combined with continuous veno-venous hemofiltration on acute paraquat poisoning: a Meta-analysis].

OBJECTIVE: To comprehensively evaluate the clinical efficacy of hemoperfusion (HP) combined with continuous veno-venous hemofiltration (CVVH) on acute paraquat poisoning (APP). METHODS: Literatures of Chinese and English randomized controlled trials (RCTs), case control and cohort study on HP combined with CVVH in the treatment of APP from the PubMed, Embase, Wanfang, and CNKI up to November 2017 were enrolled (the subjects were > 16 years old). The obtained literatures were strictly screened and evaluated in quality, and data such as mortality, the life time of dead patients, inefficiency rate, incidence of multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) were extracted. Meta-analysis was performed by RevMan 5.3. RESULTS: Twenty-one studies were included with 2 222 subjects, among whom 976 subjects were in HP combined with CVVH group (experimental group) and 1 246 subjects in HP group (control group). Compared with control group, the mortality in experimental group were significantly decreased [43.77% (362/827) vs. 55.26% (604/1 093), odds ratio (OR) = 0.68, 95% confidential interval (95%CI) = 0.56-0.82, P = 0.000 1], the life time of death patients was significantly prolonged [mean difference (MD) = 4.63, 95%CI = 2.60-6.66, P < 0.000 01], incidence of MODS [25.93% (70/270) vs. 55.36% (155/280), OR = 0.26, 95%CI = 0.14-0.49, P < 0.000 1], and incidence of ARDS [30.37% (82/270) vs. 51.07% (143/280), OR = 0.42, 95%CI = 0.30-0.61, P < 0.000 01], and inefficiency rate [8.72% (13/149) vs. 34.64% (53/153), OR = 0.17, 95%CI = 0.09-0.34, P < 0.000 01] were significantly reduced. Funnel chart showed that except the publication bias of mortality rate, there were less publication bias about other indicators among studies. CONCLUSIONS: HP combined with CVVH can significantly reduce the mortality of patients with APP compared with HP alone on the whole, prolong the life time and reduce the occurrence of MODS and ARDS, thus improving the treatment efficiency.

[Early screening of developmental dysplasia of the hip among hospitalized children].

OBJECTIVE: To summarize retrospectively developmental dysplasia of the hip (DDH) screening of children within 36 months. METHODS: Newborn infants underwent initial DDH screening at First Affiliated Hospital, Zhengzhou University from September 2011 to May 2013. The examinations included double hip function, abduction test and Ortolani/Barlow test. After initial DDH screening, suspected and abnormal infants were transferred to our department for re-screening. And clinical physical examinations, type B ultrasound or radiological imaging were performed for confirmation or elimination. RESULTS: A total of 10 428 children were DDH screened. And 1 260 children were examined with ultrasound and 346 suspected and abnormal children (445 hips) were transferred for further assessments. Among them, 33 children (49 hips) were positive with Ortolani or Barlow test, 61 children (88 hips) had dysplasia of hip and 48 children (14 boys, 34 girls) (69 hips) received a final diagnosis of DDH. Left (n = 52) and right hip (n = 17) were involved with a disease incidence of DDH at 0.46%. CONCLUSIONS: Ultrasonic examination is both simple and cost-effective for DDH screening of children within 6 months. And meticulous medical examinations and imaging studies are effective DDH screening for children from 6 to 36 months.

[Expression and promoter methylation of SIX2 gene in peripheral blood of pediatric patients with nephroblastoma].

OBJECTIVE: To explore the transcriptional expression and promoter methylation status of SIX2 gene in peripheral blood of pediatric children with nephroblastoma and discuss their clinicopathological correlations. METHODS: Approved by the hospital ethics committee, peripheral blood samples were collected from 45 children with Wilms' tumor(case group) at the Department of Pediatric Surgery, First Affiliated Hospital, Zhengzhou University from October 2008 to January 2012. And another 15 pediatric cases gender-and-age matched, were selected as the control group (excluding cancer and other malignant diseases). The real-time quantitative (qRT)-PCR and methylation-specific PCR (MSP) were used to detect the mRNA expression level and methylation status of SIX2 gene.t or χ(2) test were used. Then analyzed their clinicopathological correlations in the case group and how SIX2 gene methylation affected its transcription. RESULTS: Relative quantity(RQ) of SIX2 mRNA in the case group was higher than that of the control group (1.93 ± 1.10 vs 0.57 ± 0.39, t = 5.354, P = 0.000). There were 8 SIX2 gene methylation-positive cases in the case group versus 12 cases in the control group. And the methylation positive ratio was extremely lower in the case group (χ(2) = 19.600, P = 0.000). RQ values in the case group was associated with tumor size, clinical stage, pathological type, lymph node metastasis, treatment and outcome (all P < 0.05). RQ values in the methylated group was lower than that of the unmethylated group both in case and control group (1.35 ± 0.44 vs 1.95 ± 1.15, 0.43 ± 0.29 vs 1.13 ± 0.20, t = 2.459 and 3.896, P = 0.020 and 0.002) . RQ values of case group was higher than that of the control group in methylated group (t = 5.624, P = 0.000) . No statistical significance existed in RQ values between the case and control groups of unmethylated group (t = 1.222, P = 0.229) . CONCLUSIONS: A close correlation between SIX2 low methylation and high mRNA expression in blood suggests that aberrant promoter methylation is possibly one of gene expression regulations, and may be correlated with the occurrence and development of Wilms' tumor. And SIX2 gene in methylated Wilms' tumor may play the role of oncogenes. A negative correlation exists between the overexpression in transcriptional level and its methylation status.