Adefovir Dipivoxil plus Chinese Medicine in HBeAg-Positive Chronic Hepatitis B Patients: A Randomized Controlled 48-Week Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the effects of a 48-week course of adefovir dipivoxil (ADV) plus Chinese medicine (CM) therapy, namely Tiaogan Jianpi Hexue () and Tiaogan Jiedu Huashi () fomulae, in hepatitis B e antigen (HBeAg)-positive Chinese patients.@*METHODS@#A total of 605 HBeAg-positive Chinese CHB patients were screened and 590 eligible participants were randomly assigned to 2 groups in 1:1 ratio including experimental group (EG, received ADV plus CM) and control group (CG, received ADV plus CM-placebo) for 48 weeks. The major study outcomes were the rates of HBeAg and HBV-DNA loss on week 12, 24, 36, 48, respectively. Secondary endpoints including liver functions (enzymes and bilirubin readings) were evaluated every 4 weeks at the beginning of week 24, 36, and 48. Routine blood, urine, and stool analyses in addition to electrocardiogram and abdominal B scan were monitored as safety evaluations. Adverse events (AEs) were documented.@*RESULTS@#The combination therapy demonstrated superior HBeAg loss at 48 weeks, without additional AEs. The full analysis population was 560 and 280 in each group. In the EG, population achieved HBeAg loss on week 12, 24, 36, and 48 were 25 (8.90%), 34 (12.14%), 52 (18.57%), and 83 (29.64%), respectively; the equivalent numbers in the CG were 20 (7.14%), 41 (14.64%), 54 (19.29%), and 50 (17.86%), respectively. There was a statistically significant difference between these group values on week 48 (P<0.01). No additional AEs were found in EG. Subgroup analysis suggested different outcomes among treatment patterns.@*CONCLUSION@#Combination of CM and ADV therapy demonstrated superior HBeAg clearance compared with ADV monotherapy. The finding indicates that this combination therapy may provide an improved therapeutic effect and safety profile (ChiCTR-TRC-11001263).

Change of NK Cell Number in Peripheral Blood of Patients with Mantle Cell Lymphoma and Its Clinical Significance / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical significance of peripheral blood NK cell number change in patients with mantle cell lymphoma.</p><p><b>METHODS</b>Eight-four patients with mantle cell lymphoma treated in our hospital from November 2003 to November 2011 were studied, the venous blood was collected from all patients and detected with flow cytometry. The age, sex, pathologic type, B-symptoms, clinical stage, absolute NK count(ANKC), hemoglobin(Hb), lactate dehydrogenase(LDH) and β2-microglobulin(β2-MG) levels, bone marrow involuement(BMI) and the international prognostic index of mantle cell lymphoma(MIPI) were recorded. All patients were followed up.</p><p><b>RESULTS</b>There were no significant differences in ANKC among different age, sex, B symptom, Ann Arbor stages, Hb, LDH and β2-MG levels, BMI and MIPI of patients with MCL(P>0.05). The sensitivity and specificity of ANKC were 76.6% and 73.8%, respectively. The optimal throshold of ANKC was 0.10×10/L and AUC was 0.798(95% CI: 0.689-0.902)(P<0.01). The 3 year-PFS rate in patients with ANKC≥0.10×10/L was higher than that in patients with ANKC<0.10×10/L(68.2% vs 32.10%)(P<0.01). The 3 year-OS rate in patients with ANKC≥0.10×10/L was significantly higher than that in patients with ANKC<0.10×10/L (85.1% vs 43.8%)(P<0.01). Multivariate analysis showed that the independent predictors of PFS and OS in patients with MCL were ANKC and MIPI(P<0.05).</p><p><b>CONCLUSION</b>The ANKC in peripheral blood has an important value for judging the prognosis of patients with MCL and can be used as an important index to judge the disease status of patients with MCL.</p>

Mannan-Binding Lectin Inhibits Candida Albicans-Induced DC Maturation and Cytokine Secretion / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effects of mannan-binding lectin (MBL) on the maturation and cytokine secretion of human dendritic cells (DC) induced by Candida albicans (C. albicans).</p><p><b>METHODS</b>The plastic-adherent mononuclear cells were prepared from the blood of healthy adult volunteers. The human peripheral blood mononuclear cells-derived dendritic cells (MNC-DC) were induced by 5-day-culture in medium supplemented with rhGM-CSF and rhIL-4, and then cultured for 2 days in presence or absence of C. albicans at varying concentration of human MBL ranging from 1 to 20 mg/L. DC's shape and characters were observed under inverted microscopy, the expression of CD83 and CD86 on DC was analyzed by FACS. The levels of TNF-α and IL-6 were detected by ELISA. FACS also was used to investigate the interaction of MBL with immature DC(imDC) and C. albicans. Western blot was used to detect C. albicans-induced IκBα phosphorylation and p65/NF-κB translocation in DC.</p><p><b>RESULTS</b>MBL at higher concentrations (10-20 mg/L) down-regulated the expression of CD83 and CD86 on the monocyte-derived dentritic cells(MoDC) induced by C. albicans, and inhibited the production of TNF-α and IL-6 induced by C. albicans. FACS showed that MBL could not only bind to C. albicans but also bind to imDCs in a Ca2+-dependent manner. Western blot showed that MBL could decrease the phosphorylation of IκBα and the nuclear translocation of p65/ NF-κB.</p><p><b>CONCLUSION</b>MBL may inhibit TNF-α and IL-6 production induced by C. albicans in DC through NF-κB signaling pathways, suggesting that MBL can play some roles in the regulation of C. albicans-induced immune response.</p>

Efficacy of peg interferon alpha-2a in combination with ribavirin in treatment of with hepatitis C cirrhosis patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the clinical efficacy of PEG Interferon alpha-2a combined with ribavirin in treatment of with hepatitis C cirrhosis patients.</p><p><b>METHODS</b>21 patients with chronic hepatitis C cirrhosis (treated group) ,were treated with peg-IFNalpha-2a 135 -180 microg subcutaneously, 1 week,ribavirin tablets 800 -1000 mg/d,48 weeks of treatment and follow-up 24 weeks, 20 patients with Chronic hepatitis C (control group), were treated with peg-IFNalpha-2a 135 -180 microg subcutaneously, 1 week,ribavirin tablets 600 -1000 mg/d, 48 weeks of treatment, follow-up 24 weeks, comparison of rapid virological response (RVR) rates, early virologic response (EVR) rate, sustained virologic response (SVR) rate, adverse reactions was observed.</p><p><b>RESULTS</b>The differences of RVR, EVR, ETVR in two groups is not significant, but SVR in treatment group was lower (P < 0.05), and has a higher incidence bone marrow suppression and anemia (P < 0.05). Flu-like symptoms, hair loss, gastrointestinal reactions and other adverse reactions was no significant difference between the two groups.</p><p><b>CONCLUSION</b>The use of 135 microg peg-IFNalpha-2a and individual in low-dose ribavirin hepatitis C patients with cirrhosis is more security,could get a good early response, but sustained virologic response (SVR) rates is lower than hepatitis C patients. Blood, liver and kidney function should be closely observed during treatment process.</p>

Study on somato-type distribution and its correlations with body mass index, blood lipids and hepato-enzymes in 1 163 patients with non-alcoholic fatty liver disease / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the distribution of somato-types in Chinese medicine and its correlations with body mass index (BMI), blood lipids and hepato-enzymes in patients with non-alcoholic fatty liver disease (NAFLD).</p><p><b>METHODS</b>From January 2008 to December 2008, the somato-types of 1 163 NAFLD patients were categorized, and its correlations with BMI, blood lipids and hepato-enzymes were analyzed.</p><p><b>RESULTS</b>Among the 1 163 patients, 401 were categorized as qi-deficiency type and 371 as phlegm-dampness type, accounting for 66.38%. Levels of BMI, blood lipids (TC, TG, LDL) and hepato-enzymes (ALT, AST, GGT) in patients of phlegm-dampness type were higher than those in patients of other types, the differences were statistically significant (P<0.05).</p><p><b>CONCLUSIONS</b>Qi-deficiency type and phlegm-dampness type are the dominant pathogenetic somsto-types in patients with NAFLD; abnormal BMI, blood lipids and hepato-enzymes may present in those of phlegm-dampness type more frequently.</p>