ABSTRACT
<p><b>OBJECTIVE</b>To systematically evaluate the long-term clinical efficacy and safety of mild hypothermia therapy in neonates with hypoxic-ischemic encephalopathy (HIE).</p><p><b>METHODS</b>All randomized controlled trials (RCTs) of mild hypothermia therapy for neonatal HIE from inception to March 2014 were retrieved from databases including Cochrane Library, PubMed, Embase, CBMdisc, and Wanfang Data. Meta analysis was performed using RevMan 5.1 Software.</p><p><b>RESULTS</b>Eight RCTs met the search criteria. The results of Meta analysis showed that, compared with the control group, systemic hypothermia significantly reduced the mortality rate and the incidence of growth delay (RR=0.73, 95% CI: 0.61-0.89; RR=0.70, 95%CI: 0.54-0.93); selective head or systemic hypothermia therapy significantly reduced the incidence of cerebral palsy (RR=0.65, 95%CI: 0.46-0.94; RR=0.67, 95%CI: 0.52-0.86) up to 12-24 months of age. One study reported that hypothermia reduced the mortality rate and the rate of a composite end point of death or severe disability compared with the control group at 6 to 7 years of age. The incidence of adverse events including sinus bradyarrhythmia, thrombocytopenia and hypoglycemia was significantly higher in the hypothermia group than in the control group, whereas the incidence of cardiac arrhythmia, hypotension, thrombosis or bleeding, hypokalemia, sepsis, and liver dysfunction showed no significant differences between the two groups.</p><p><b>CONCLUSIONS</b>Mild hypothermia therapy demonstrates a significant efficacy in children with HIE up to 12-24 months of age, but there is still a need for further research on childhood outcomes after mild hypothermia for neonatal HIE. This therapy has few adverse effects and a high clinical tolerability.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Hypothermia, Induced , Hypoxia-Ischemia, Brain , Mortality , TherapeuticsABSTRACT
<p><b>OBJECTIVE</b>To study the correlation between vitamin D receptor genetic polymorphism Fokand vitamin D deficiency rickets in children between 1 to 3 years old, and to explore the significance of hereditary factors in the development of vitamin D deficiency rickets.</p><p><b>METHODS</b>Sixty-two children with vitamin D deficiency rickets and 60 healthy children as a control group were enrolled. Serum levels of 25-hydroxyvitamin D3 were measured using ELISA. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) genetic analysis method was used. A restriction fragment length polymorphism in the vitamin D receptor genetic polymorphism Fok I was tested. The frequencies of the vitamin D receptor genotype and allele were compared between the two groups.</p><p><b>RESULTS</b>Serum 25-hydroxyvitamin D3 levels in the rickets group were significantly lower than those in the control group ( 9.1+/-4.1 ng/mL vs 16.1+/-6.9 ng/mL; P<0.05 ). FF genotype in the vitamin D receptor genetic polymorphism Fok I was more common in the rickets group than in the control group (53% vs 25%; P<0.05). F allele frequency in the rickets group was significantly higher than that in the control group (73% vs 57%; P<0.05).</p><p><b>CONCLUSIONS</b>There is a correlation between vitamin D receptor genetic polymorphism Fok I and vitamin D deficiency rickets. This suggests that vitamin D receptor genetic polymorphism might play an important role in determining susceptibility to development of vitamin D deficiency rickets.</p>