Objective To investigate the evaluation value of white blood cell count ( WBC ) for the prognosis of patients with acute paraquat ( PQ) poisoning .Methods The clinical data of 661 patients with acute PQ poisoning admitted to the Emergency Department of the First Affiliated Hospital of Zhengzhou University from March 2013 to April 2017 were retrospectively analyzed . The general information of patients and biochemical indicators 24 hours after admission were collected .The in-hospital death were recorded and patients were followed up by telephone .According to the prognosis within 30 days after poisoning , the patients were divided into survival group and death group .Multivariate logistic regression analysis was used to analyze the independent risk factors of PQ poisoning , and the receiver operating characteristic curve ( ROC ) was drawn for prognosis evaluation .Results Among the 661 patients with acute PQ poisoning , 368 cases ( 55.7％) survived and 293 cases ( 44.3％) died. Multivariate logistic regression analysis showed that hospitalization days , dosage , duration of poisoning , urine PQ concentration, WBC, serum potassium and serum creatinine (Scr) were the independent risk factors.The ROC curve showed that the area under the ROC curve (AUC) of urine PQ concentration and WBC predicting the prognosis of patients with acute PQ poisoning were 0.897 [95％CI(0.873, 0.920), P<0.01], and 0.876 [95％CI(0.850, 0.902), P<0.01].WBC≥15.35 ×109/L was used as the critical value for prognosis . The sensitivity and specificity of survival were 72.7％ and 88.59％, respectively .Conclusions White blood cell count may be a powerful and simple predictor for prognosis of PQ.

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.