Objective To formulate an evidence-based treatment plan for a patient with hepatitis C after kidney transplantation with combination of interferon-α and ribavirin. Methods Based on an adequate assessment of the patient’ s condition and using the principle of PICO, we searched The Cochrane Library (Issue 1, 2009), PubMed (1995 to March 2009), and CHKD (1995 to 2008.12). Results Eighteen studies were identified including 17 in English (5 case reports, 11 cohort studies, and 1 meta–analysis) and 1 in Chinese. According to the current evidence as well as the patient’ s clinical condition and preference, PEG-IFNα-2b 50 µg /week plus ribavirin 600 mg/day was given to the patient for 6 months. Conclusion Evidence-based approaches help us to prepare the anti-viral therapy plan and will improve the assessment of the efficacy and safety in kidney transplantation.
ObjectiveTo investigate the influence of immunoglobulin (Ig)on celluar immune function of postoperative infants with cyanotic congenital heart disease (CCHD). MethodsForty infants who underwent surgical repair of CCHD in Department of Cardiac Surgery, Children's Hospital of Hebei Province from March to December 2012 were enrolled in this study. All the patients were randomly divided into 2 groups. Patients in Ig group received intravenous Ig treatment at the dosage of 1g/ (kg·day)for 2 days postoperatively in addition to routine therapy. Patients in the control group only received routine therapy without Ig treatment. Five ml venous blood samples of all the patients were taken preoperatively, 0.5 hour and 2 days postoperatively to examine serum levels of interferon gamma (IFN-γ)and interleukin-4 (IL-4)with double-antibody sandwich enzyme-linked immunosorbent assay (ELISA), which were compared between the 2 groups. ResultsThere was no statistical difference in serum levels of IL-4 or IFN-γ preoperatively and at 0.5 hour postoperatively between the 2 groups (P > 0.05). Serum levels of IL-4 and IFN-γ at 0.5 hour postoperatively were significantly higher than preoperative levels in the 2 groups respectively (P=0.000). Serum IL-4 level of Ig group 2 days postoperatively was not statistically different from preoperative level (P=0.362), while serum IL-4 level of the control group 2 days postoperatively was significantly higher than preoperative level (P=0.006). Two days after the operation, serum levels of IL-4 and IFN-γ of Ig group were significantly lower than those of the control group respectively (P=0.039 and 0.007 respectively). Compared with serum levels at 0.5 hour postoperatively in the control group, serum IL-4 level at 2 days postoperatively decreased by 20.08% (P=0.001), and serum IFN-γ increased by 17.80% (P=0.001). Compared with serum levels at 0.5 hour postoperatively in Ig group, serum IL-4 level at 2 days postoperatively decreased by 35.38% (P=0.000), and serum IFN-γ only increased by 7.60% (P=0.143). ConclusionCellular immune function disorder caused by the operation and cardiopulmonary bypass can be effectively improved by postoperative intravenous Ig administration, which may help to reduce postoperative complications.
Objective To examine the levels of interferon-gamma; (INF-gamma;), tumor necrosis factor-alpha; (TNF-alpha;) and interleukin-6(IL-6) in serum of patients with acute uveitis before and after treatment, and to explore the possible roles of those cytokines in the initiation and progression of the uveitis. Methods A series of 75 patients with acute uveitis,and 30 healthy persons from our hospital were investigated. The levels of INF-gamma;, TNF-alpha; and IL-6 in acute phase and convalescent phase were measured by the enzymelinked immunosorbent assay. Result The serum levels of INF-gamma;, TNF-alpha; and IL-6 in acute phase were significantly higher than that of the convalescent phase and the healthy controls (F=65.805/50.418/155.381, P=0.000). A significant negative correlation was found between the serum levels of INF-gamma;, TNF-alpha; and IL-6 in acute phase with their initial visual acuity(r=-0.656, -0.592 and -0.653, Plt;0.01). There was also a positive correlation among the serum levels of INF-gamma;, TNF-alpha; and IL-6(r=0.340, 0.467 and 0.338, Plt;0.05). Conclusions There are high serum levels of INF-gamma;, TNF-alpha; and IL-6 in patients with acute uveitis, and the cytokines levels were decreased after the treatment. The results suggested that the INF-gamma;, TNF-alpha; and IL-6 involved in initiation and progression of uveitis.
Objective To investigate the effects of transformin growth factor-beta (TGF-beta;) and interferon-gamma(IFN-gamma;)on collagen synthesis in human retinal pigment epithelial cells(RPE)． Methods TGF-beta;(0.01～10 ng/ml),recombinant IFN-gamma;(100～10000 Ｕ/ml)or a combination of two were added to cultures of RPE and collagen synthesis of the cells were measured by3 H-proline incorporation assay,indirect immunofluorescence staining and dot-blot hybridization. Results TGF-beta; at 10 ng/ml increased cell uptake of 3 H-proline to 130．87% of controls．It intensified Type IV,I and Ⅲ collagen fluorescent staining as well as mRNA expression．IFN-gamma; at 10000 Ｕ/ml caused 54．72% inhibition of 3 H-proline uptake by RPE,and decreased TypeⅣ collagen fluorescent staining as well as mRNA expression of Type Ⅳ,I and Ⅲ collagens. Conclusion TGF-beta; and IFN-gamma; stimulated and inhibited collagen synthesis of human RPE,respectively．The combination of two had antagonistic effects．IFN-gamma; can be used for inhibition of collagen synthesis of RPE. (Chin J Ocul Fundus Dis, 1999, 15: 245-248)
Objectives To evaluate the efficacy of interferon (IFN) maintenance therapy in patients with small cell lung cancer (SCLC). Methods We searched MEDLINE (1966-Jan.2006), EMbase (1984-Jan.2006), The Cochrane Library(Issue 1, 2006)and the Chinese Biomedical Database (1980-Jan.2006). We checked the references in the reports of related studies and handsearched the education books of ASCO and ESMO meetings. The quality of the included trials was evaluated. Data were extracted by two reviewers independently into a specially designed extraction form. The Cochrane Collaboration’s RevMan 4.2.7 software was used for data analysis. Results Five randomized controlled trials involving 587 patients were included. The pooled result of the 5 studies showed that IFN plus chemotherapy induction treatment did not have a significant effect on 1-year (RR 1.19, 95%CI 0.88-1.6) or 2-year survival rate (RR 1.44, 95% CI 0.99-2.10). However, IFN maintenance therapy significantly increased 2-year (RR 2.08, 95%CI 1.16-3.72) and 1-year survival (RR 2.99, 95%CI 1.13-7.93). Conclusion IFN maintenance therapy may increase 2-year and 1-year survival rates after patients have achieved complete or partial response to chemotherapy. Further randomized, double-blind multi-center trials are needed to investigate this further.
【Abstract】Objective To investigate the prevention and treatment for recurrence of hepatitis B after liver transplantation on HBV-related diseases. Methods Making a literature summarization based on published papers review.Results Acute and chronic HBV-related diseases are the main indications of liver transplantation.Recurrence rate of hepatitis B is from 80% to 100% in the untreated patients after liver transplantation,and it affects the survivals of patients seriously.It has become a focus to prevent and treat the recurrence of hepatitis B.After a series of explotation and application,there have been a lot of drugs of preventing and treating HBV reinfection, including hepatitis B immunoglobulin,interferon and nucleotide analog antivirus drugs(lamivudine, famcyclovir, adefovir),etc.The therapeutic characteristics of them are different. Their utilizations of dividing or alliance are developing rapidly.Conclusion Liver transplatation is an effective therapy for HBV-related disease. Anti-HBV treatments perioperation play an important role in the improvement of succeed of liver transplantation.
ObjectiveTo observe the effects of Th9 cell relative factors, including PU.1, interferon regulatory factor 4 (IRF4) and interleukin 4 (IL-4), in rats with pulmonary fibrosis. MethodsNinety SD rats were randomly divided into 3 groups, ie. a normal group, a pulmonary fibrosis group, and a dexamethasone treatment group, with 30 rats in each group. Ten rats in each group were sacrificed respectively on 7th, 14th, 28th days. Model rats were induced by injecting bleomycin into trachea. Real-time PCR was applied to detect mRNA expression of PU.1 and IRF4 in bronchoalveolar lavage fluid. IL-4 in the peripheral blood was measured by ELISA. ResultsIn the normal group, the lung tissue was normal without inflammatory reaction and fibrosis at any time points. In the pulmonary fibrosis group, at the early stage the lung tissue showed alveolar inflammation with a large number of macrophages and other inflammatory cells infiltratation in the pulmonary interstitial and alveolar cavity; on 14th day, part of the alveolar structure disappeared, inflammatory cells infiltrated slightly, while the alveolar septum was mildly widened and fibroblasts proliferated; on 28th day, alveolar structure was destructed, partial alveolar walls were collapsed, alveolar septuml was significantly widened, extracellular matrix was hyperplastic, a wide range of fibrosis occured. In the dexamethasone treatment group, the alveolar structure exsisted completely, and the inflammatory cell infiltration, widened alveolar septum and fibrosis were significantly lighter than those in the pulmonary fibrosis group. PU.1 mRNA was significantly lower in the pulmonary fibrosis group compared with the normal group. Compared with the pulmonary fibrosis group, PU.1 mRNA were lower on 14th day and 28th day in the dexamethasone treatment group (P < 0.05). PU.1 mRNA increased from 7th day, reached peak on 14th day, and declined on 28th day. IRF4 mRNA was significantly lower in the pulmonary fibrosis group compared with the normal group. Compared with the pulmonary fibrosis group, IRF4 mRNA was lower on 28th day in the dexamethasone treatment group (P < 0.05). There was a positive correlation between the content of IRF4 mRNA and IL-4 on 14th day in the pulmonary fibrosis group (r=0.044, P < 0.05). ConclusionPU.1 and IRF4 play a role in inflammation leading to pulmonary interstitial fibrosis, and IL-4 may regulate Th9 cells through activating IRF4.
Objective To evaluate the efficacy and safety of anti-vascular endothelial growth factor (VEGF) agents for advanced renal cell carcinoma. Methods We searched MEDLINE, EMbase, The Cochrane Library, CBMdisc and China Academic Periodical database from the establishment of each database to April 2009. We included randomized controlled trials (RCTs) that evaluated anti-VEGF agents (sunitinib, sorafenib and bevacizumab). The quality of the included trials was evaluated by two reviewers independently. Meta-analyses were conducted by the Cochrane Collaboration’s RevMan 4.2 software. Results Four RCTs involving 2 320 patients were identified. According to the different interventions for advanced renal cell carcinoma, we divided the patients into two groups: anti-VEGF agents monotherapy and anti-VEGF agents plus interferon combination treatment. Our meta-analyses showed: monotherapy was superior to interferon on inhibition of tumor progression [OR=0.38, 95%CI (0.29, 0.51), Plt;0.01] and control of tumor [OR=2.53, 95%CI (1.87, 3.43), Plt;0.01], but was not significantly different from interferon on the overall effective rate [OR=1.97, 95%CI (0.20, 19.57), P=0.56] and serious side effects [OR=1.98, 95%CI (0.90, 4.34), P=0.09]. There were significant differences between anti-VEGF agents plus interferon and interferon alone on inhibition of tumor progression [OR=0.67, 95%CI (0.53, 0.84), P=0.000 5], overall effective rate [OR=2.65, 95%CI (1.94, 3.61), Plt;0.01], control of tumor [OR=2.14, 95%CI (1.65, 2.78), Plt;0.01] and serious side effects [OR=2.63, 95%CI (2.09, 3.31), Plt;0.01]. Conclusion Compared with interferon, anti-VEGF agents could inhibit tumor progression more effectively. Moreover, the combination therapy with interferon could offer a more favorable overall effective rate for advanced renal cell carcinoma, but then followed by more serious side effects. We need to weigh the merits and demerits of drugs before making a clinical decision for advanced renal cell carcinoma.
【Abstract】ObjectiveTo inquire into the regulative effect of interferon (IFN) on human leucocyte antigen-DR(HLADR) expression in human colonic cancer cells. MethodsThe expression of HLA-DR in 4 colonic cancer cell lines HCT-8，lovo，SW-480 and Ls-174-T was detected with immunohistochemical SP and ELISA method before and after being stimulated by different doses of α-IFN or γ-IFN. ResultsAll cell lines except lovo cell were HLA-DR positive before stimulation with α-IFN or γ-IFN. HLA-DR expression was enhanced on all of the 4 cell lines after stimulation, and it was correlated with γ-IFN and the dose of γ-IFN. The effect of γ-IFN was more obvious than that of α-IFN. ConclusionIFN can enhance HLA-DR expression in human colonci cancer cells and clinical therapy of IFN for colon cancer has a certain applying prospect.
Objective To systematically review the effectiveness and safety interferon-α (IFN-α) combined with lamivudine vs. IFN-α alone in treating children with Hepatitis B. Methods Such databases as The Cochrane Library, PubMed, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data were electronically searched for randomized controlled trials (RCTs) on IFN-α combined with lamivudine in treating children with hepatitis B. Two reviewers screened literature, extracted data, and assessed the methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.0 software. Results 8 RCTs were included, with comparable baseline. The results of meta-analysis showed that, compared to the IFN-α alone group, the combined therapy group had higher negative rates of serum HBV-DNA and HBeAg. There was no significant difference in the positive rate of anti-Hbe and the incidence of adverse reaction between the two groups. Conclusion Current evidence shows that IFN-α combined with lamivudine was more effective than IFN-α alone in treating children’s hepatitis B.