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OBJECTIVE: To observe the efficacy and safety of tocilizumab against refractory systemic onset juvenile idiopathic arthritis(SoJIA). METHODS: A prospective follow-up study of 16 patients with refractory active SoJIA patients with or with tocilizumab after treatment of clinical disease activity indicators and safety. The ANOVA was used for statistical analysis. RESULTS: After 2 weeks,12 weeks and 52 weeks of treatment,the levels of white blood cells,erythrocyte sedimentation rate and hypersensitive C-reactive protein were significantly decreased,and there were statistically significant differences(F=26.25、145.70、517.96,P<0.05). JADAS27 was significantly decreased after 2 weeks,12 weeks and 52 weeks of treatment with tocilizumab(the score being 23.09±3.46,8.19±2.63,4.25±2.86 and 2.63±1.54),the difference being statistically significant(P<0.05). Some children had adverse reactions,2 cases of skin abnormalities,1 case of white pityriasis,1 case of skin infection;3 cases of liver enzyme abnormalities;2 cases of leukopenia. CONCLUSION: Tocilizumab can improve the condition of children with SoJIA in rapid and obvious way,and medium and longterm security and tolerance was good. The duration of tocilizumab therapy should be carefully assessed.
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<p><b>OBJECTIVE</b>To analyze the expression of MicroRNA-15a (miR-15a) in children with primary immune thrombocytopenia (ITP) and its significance.</p><p><b>METHODS</b>The peripheral blood monomuclear cells (PBMNC) were isolated and cultured from ITP patients and healthy volunteers. The expression level of miR-15a was measured by real-time PCR. After miR-15a mimic was transfected into PBMNC, the levels of INF-γ, IL-2, IL-4 and IL-10 were measured by ELISA.</p><p><b>RESULTS</b>The expression of miR-15a was significantly decreased in PBMNC. The production of IFN-γ and IL-2 was dramatically increased, and the level of IL-4, IL-10 was decreased in PBMNC. Moreover, the expression of miR-15a was negatively correlated with IFN-γ and IL-2, and positively with IL-4 and IL-10. Furthermore, the results showed that the overexpression of miR-15a could decrease the production of IFN-γ and IL-2, and increase the production of IL-4 and IL-10.</p><p><b>CONCLUSION</b>miR-15a is significantly down-regulated in PBMNC of children with primary ITP and involved in the regulation of Th1/Th2 imbalance. It is suggested that miR-15a may be a potential therapeutic target for ITP.</p>
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To assess the quality of randomized controlled trials (RCTs) published in Chinese Acupuncture and Moxibustion. Manually retrieve RCT papers published in Chinese Acupuncture and Moxibustion from 2000 to 2006 and use "the extraction form of acupuncture and moxibustion randomized clinical trial report data" to evaluate the quality of RCTs. Six hundred and eighty-six RCTs were enrolled. The methodological quality was lower than the international standard and only one RCT paper described the trial technological process. And there were a less reports about influencing RCT quality, such as acupuncturist's qualification and education background (3.06%), adverse reaction (4.23%), blind method (5.98%) and follow-up (14.43%). RCTs on acupuncture and moxibustion published in Chinese Acupuncture and Moxibustion need to be improved in trial design, conduction and report.
Subject(s)
Humans , Acupuncture Therapy , Moxibustion , Periodicals as Topic , Reference Standards , Randomized Controlled Trials as Topic , Reference Standards , Time FactorsABSTRACT
Objective To explore the clinical characteristics,diagnosis,treatment and misdiagnosis matter of children with idiopathic pulmonary hemosiderosis(IPH).Methods The data of clinical characteristics,laboratory examination,treatment and follow-up of 21 children admitted from Jun.1993 to May 2007 were retrospectively analyzed,included 9 males,12 females,aged 1-14 years old,course of di-sease were 1-6 months.Twenty-one patients were diagnosed as IPH by chest X-ray radiography,CT scan,bone marrow biopsy,hemosiderin-laden macrophages in either sputum or gastric juice or bronchoalveolar lavage fluid.Then,therapy and prognosis of IPH were analyzed.Results All patients had varied degrees of anemia,11(52.38%) children had cough,9 (42.86%) children had fever,6(28.50%) cases had shortage of orexia,4( 19.05%) children had hemoptysis.Chest X-ray radiography and CT scan demonstrated diffuse patchy,nodular,reticulate pattern.Eighteen children received bone marrow biopsy and presented hyperplastic erythropoiesis,4(22.2%) cases were accompanied iron deficiency anemia.Nineteen (90.80%) cases shown the presence of hemosiderin-laden macrophages in either sputum or gastric juice or bronchoalveolar lavage fluid.Twenty-one misdiagnosed patients consisted of bronchopneumonia combined anemia(8 cases),lung tuberculosis combined anemia(5 cases),nulli-iron anemia(4 cases),hemolytic anemia(3 cases),myelodysplastic syndrome(1 case)and received corticosteroid therapy.Four cases of all patients were associatated with large-dose human-?-globulin and 3 cases were associatated with vincristine therapy.The therapeutic effect was significant.Eighteen patients were followed-up,3 patients were of which cured and had stopped treatment for over 2 years,11 patients presented clinically persistent remission,4 patients were recurred and aggravated.Conclusions Early diagnosis and long-term therapy of corticosteroid are very important for controlling acute onset,lessening the frequency of IPH recurrence and improving prognosis of the disease.