Treatment with interferon and thymosin alpha-1 versus interferon monotherapy for HBeAg positive chronic hepatitis B: a meta-analysis / 中华肝脏病杂志

To compare the efficacy of interferon and thymosin alpha-1 combination therapy with interferon monotherapy for HBeAg positive chronic hepatitis B. The relevant randomized controlled trials were searched throughout PubMed, EBSCO, Cochrane Library, CBMdisc, VIP, WanFang since Janurary 1990. Studies were included if patients were followed up for at least 6 months after cessation of treatment. Meta-analysis was carried out with RevMan5.0 software. Subgroup analyses were used at different time of observation. Seven randomized controlled trials were included(535 patients in total). According to the results of meta-analysis, the combination therapy was remarkably more effective than monotherapy both at the end of the treatment and the follow-up in terms of HBV-DNA negative rate (54.9% vs 36.3%, OR=2.39, 95% CI=1.64-3.49, P value is less than 0.01; 58.6% vs 30.7%, OR=3.68, 95% CI=2.51-5.41, P value is less than 0.01, respectively), ALT normalization rate (74.5% vs 60.9%, OR=1.94, 95% CI=1.26-3.00, P value is less than 0.01; 74.0% vs 55.6%, OR=2.36, 95% CI=1.54-3.62, P value is less than 0.01, respectively), HBeAg loss rate (56.9% vs 36.7%, OR=2.38, 95% CI=1.61-3.51, P value is less than 0.01; 62.2% vs 33.2%, OR=3.42, 95% CI=2.31-5.06, P value is less than 0.01, respectively) , and HBeAg seroconversion rate (40.1% vs 29.0%, OR=1.65, 95% CI=1.10-2.47, P value is less than 0.05; 47.0% vs 29.5%, OR=2.13, 95% CI=1.43-3.16, P value is less than 0.01, respectively); the HBsAg loss rate of the combination therapy group was significantly higher than that of the monotherapy group only at the end of the follow-up (9.8% vs 3.7%, OR=2.92, 95% CI=1.09-7.76, P value is less than 0.05). Interferon and thymosin alpha-1 combination therapy achieves superior effect with no increase in the adverse effects as compared to interferon monotherapy for HBeAg positive chronic hepatitis B.

Levels of serum interleukin-15 and the expression of T-helper lymphocyte subsets in peripheral blood of children with juvenile rheumatoid arthritis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the changes of serum interleukin-15 (IL-15) levels and the expression of CD4(+)T (T-helper lymphocyte) subsets CD4(+)CD45RA(+) and CD4(+)CD45RO(+) in peripheral blood of children with juvenile rheumatoid arthritis (JRA).</p><p><b>METHODS</b>The serum concentration of IL-15 was detected using ELISA in 39 children with JRA. The expressions of CD4(+)CD45RA(+)T and CD4(+)CD45RO(+)T in peripheral blood were detected by flow cytometry in 24 out of the 39 patients with JRA. Twenty-six age and sex-matched healthy children were used as the Control group.</p><p><b>RESULTS</b>The mean serum IL-15 level in JRA patients was significantly higher than that in controls (1.37 +/- 0.98 pg/mL vs 0.96 +/- 0.41 pg/mL, P <0.05). Among the 39 JRA patients, the serum IL-15 level in 17 patients with systemic JRA increased remarkably (P < 0.01), but not in patients with the other two types of JRA, the oligoarthritis and polyarthritis (n=13, n=9, respectively), compared with that in controls. The mean serum IL-15 level of the JRA patients was significantly reduced after conventional treatment (P < 0.01). The serum IL-15 level in JRA patients positively correlated with white blood cell count (r=0.347, P <0.05) and C reactive protein (r=0.452, P < 0.01) but not with the erythrocyte sedimentation rate. The patients with high serum IL-15 levels (> or = medium level 1.73 pg/mL) had higher expression of CD4(+)CD45RO(+)T than those with low serum IL-15 levels (< medium level) (16.29 +/- 5.46% vs 11.75 +/- 3.15 %, P < 0.05).</p><p><b>CONCLUSIONS</b>The serum IL-15 levels in JRA patients increased significantly. An increased IL-15 level can transform CD45RA into CD45RO in peripheral blood of patients with JRA, and then result in T lymphocyte activation and mediate the immunopathological impairment. IL-15 may be used a marker for the evaluation of severity of JRA.</p>

Thirty-Nine Children with Refractory Systemic Juvenile Idiopathic Arthritis Treated by Glucocorticoid / 实用儿科临床杂志

Objective To investigate clinical characteristics of refractory systemic juvenile idiopathic arthritis(JIA)and the efficiency of glucocorticoid in therapy on this kind of disease.Methods Thirty-nine children with systemic JIA were divided into low dose group 0.5-1.0 mg/(kg?d)and high dose group 1.0-1.5 mg/(kg?d).And the efficiency was observed by change of active index after 10 and 20 days.Results The effective power was 58.8% and 72.7% after 10 days,respectively.After 20 days,the power was 76.5% and 90.9%,respectively.The power in high dose group was significantly higher than that in low dose group.It had no difference in statistical analysis for efficiency of 2 kind of glucocorticoid dosage to control fever,but it had obvious difference to control arthralgia,arthrocele,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP).Conclusion Glucocorticoid therapy is very effective to control the activity of disease in patients with systemic JIA.