Protective efficacy of probiotics on the treatment of acute rotavirus diarrhea in children: an updated meta-analysis.

OBJECTIVE: This meta-analysis aims to uncover the therapeutic efficacy of probiotics on acute rotavirus diarrhea (RVD) in children. MATERIALS AND METHODS: Randomized controlled studies reporting therapeutic efficacy of probiotics on acute RVD in children published before 1st June 2019 were searched in PubMed, EMBASE, and Cochrane. The citations in all searched literature were manually examined. Data were extracted from eligible literature for calculating STD Mean Difference (SMD) and its corresponding 95% confidence interval (CI). Subsequently, the association between therapeutic efficacy of probiotics and acute RVD in children was evaluated. Moreover, data were weighted by an inverse variance and analyzed by a fixed or random effect model. Heterogeneity test was applied in the enrolled literature. Sensitivity and publication bias was examined. STATA 12.0 was used for meta-analysis. RESULTS: A total of 19 independent Randomized Controlled Trials (RCTs) involving 1,624 children with acute RVD were enrolled in this study. Three pieces of literature were excluded through sensitivity and publication bias analyses. Data extracted from eligible literature indicated that probiotics could markedly reduce the occurrence of acute RVD in children (SMD=-0.49, 95% CI=-0.74-0.25). Subgroup analysis conducted based on ethnicity uncovered a poor therapeutic efficacy of probiotics on reducing the occurrence of acute RVD in Asian children (SMD=-0.45, 95% CI=-0.94-0.04), which was markedly significant in Caucasian children (SMD=-0.54, 95% CI=-0.78--0.30). In addition, the subgroup analysis based on the probiotic subtypes found a pronounced efficacy of both Lactobacillus acidophilus (SMD=-0.67, 95% CI=-0.92-0.42) and non-Lactobacillus acidophilus probiotic (SMD=-0.45, 95% CI=-0.77-0.14) on the occurrence of acute RVD in children. CONCLUSIONS: Probiotics could reduce the occurrence of acute RVD in children, especially in Caucasian population. Our findings still needed to be further validated in a multi-center institution with larger sample size and more qualified data.

[Clinical and genetic analysis of a family with Joubert syndrome type 10 caused by OFD1 gene mutation].

Objective: To investigate the genetic cause for a family with multiorgan dysplasia and "molar tooth sign" on MRI image. Method: The patient, a 3 months and 21 days old boy, was clinically examined and the medical history of his family was collected. Next generation sequencing was performed to analyze his clinical and genetic causes. Result: Clinical manifestation of the child displayed multiorgan dysplasia, such as six finger deformity, short limbs, coloboma of optic disc and choroid, situs inversus.Cranial MRI showed "molar tooth sign" . The gene sequencing confirmed that the child carried a de novo deletion of c. 2843_2844 delAA in OFD1 gene. Conclusion: The child has typical clinical features of Joubert syndrome, such as MRI "molar syndrome" , developmental abnormalities of ocular tissue and limb, visceral inversion, and so on.The OFD1 gene had a novel deletion mutation through gene detection. Combined clinical features with gene detection, it was clear that the child was a rare case of Joubert syndrome type 10 which was the first case of Joubert syndrome caused by OFD1 gene mutation in China.