Expression and significance of programmed death-1 and T-cell immunoglobulin- and mucin domain-3-containing molecule 3 in hepatocellular carcinoma / 临床肝胆病杂志

ObjectiveTo investigate the expression and clinical significance of programmed death-1 (PD-1) and T-cell immunoglobulin- and mucin domain-3-containing molecule 3 (TIM-3) in hepatocellular carcinoma (HCC). MethodsThe paraffin blocks of HCC tissue and adjacent tissue (＞1 cm from the tumor margin) were collected from 46 patients with HCC who underwent surgical treatment in No. 900 Hospital of The Joint Service and Security Force of The Chinese People’s Liberation Army from January 2013 to December 2015. Immunohistochemistry was used to measure the expression of PD-1 and TIM-3, and their association with clinicopathological features and prognosis was analyzed. The Wilcoxon test was used for comparison of paired ranked data, and a Spearman correlation analysis was used to investigate the correlation between ranked data; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison of survival rates between groups; the Cox regression model was used to perform a multivariate analysis. ResultsThe expression levels of PD-1 and TIM-3 in HCC tissue were higher than those in adjacent tissue (both P＜0.05). PD-1 was mainly localized in lymphocytes and TIM-3 was mainly localized in tumor-associated macrophages. The expression of PD-1 was positively correlated with that of TIM-3 in HCC tissue (rs=0.397, P=0.006). The expression level of PD-1 in HCC tissue was associated with tumor size (rs=0.480, P=0.001), portal vein tumor thrombus (rs=0.307, P=0.038), and TNM stage (rs=0.534, P＜0.001), and the expression level of TIM-3 was associated with portal vein tumor thrombus (rs=0.301, P=0.042), degree of pathological differentiation (rs=0356, P=0.015), and TNM stage (rs=0.416, P=0.004). For the patients with HCC, the 1-, 3-, and 5-year overall survival rates were 89.1%, 56.5%, and 34.4%, respectively, and the 1-, 3-, and 5-year disease-free survival rates were 52.2%, 21.7%, and 10.9%, respectively. The multivariate analysis showed that degree of pathological differentiation (hazard ratio ［HR］=4.723, 95% confidence interval ［CI］: 1.618-7.684, P=0.001), tumor size (HR=3.234, 95%CI: 1.327-7.883, P=0.010), TNM stage (HR=3.254, 95%CI: 1.076-9.835, P=0.037), and expression level of TIM-3 (HR=0.572, 95%CI: 0.329-0.995, P=0048) were independent prognostic factors for the overall survival of HCC patients, and degree of pathological differentiation (HR=2.945, 95%CI: 1.527-5.682, P=0.001) and TNM stage (HR=2.074, 95%CI: 1.259-9.793, P=0.016) were independent prognostic factors for the disease-free survival of HCC patients. ConclusionHigh expression levels of both PD-1 and TIM-3 are observed in HCC tissue, and PD-1 and TIM-3 may be involved in the progression and poor prognosis of HCC patients.

Impact of WeChat-assisted follow-up on the self-administer medication capability of stroke survivors / 中华行为医学与脑科学杂志

Objective To explore the impact of WeChat-assisted follow-up on self-administer medication capability of stroke survivors.Methods Seventy patients were recruited from a tertiary hospital and randomly divided into intervention group (n=35) and control group (n=35).Patients in intervention group were given WeChat-assisted follow-up including health education program and behavior guidance,and patients in control group received regular discharge care.The effects of WeChat-assisted follow-up and regular care on self-administer medication ability,cognitive and behavior level were assessed.Results After three months' follow-up,the scores of self-administer medication capability (38 (32,42)),experience (25 (20,28) and the integral level (87 (71,92)) in intervention group were significantly higher than those in control group (capability 25(16,38),experience 21 (8.75,27),total score 68 (38,87)) (Z=-2.511,-2.033,-2.209,P＜0.05).The self-administer medication experience,cognitive,capability and total scores increased significantly in intervention group after intervention(Z=-4.525,-4.610,-3.806,-4.718,all P＜ 0.01),while only the cognitive level increased slightly in control group (18 (10,24) vs 13 (11,18),Z =-1.794,P=0.073).Conclusions Follow-up intervention based on WeChat platform can improve the stroke patients' self-administration medication capability,however,the long-term effects on cognitive level and further reform need to be strengthened.

Role of intestinal dysbacteriosis in the pathogenesis of acute-on-chronic hepatitis B liver failure / 临床肝胆病杂志

Acute-on-chronic liver failure is a clinical syndrome with acute exacerbation on the basis of chronic liver disease and can cause severe liver injury and dysfunctions of liver synthesis, detoxification, metabolism, and biotransformation. Intestinal dysbacteriosis is an important factor for the acceleration of liver failure. Therefore, it is important to prevent or delay the progression of liver failure by improving intestinal dysbacteriosis and liver function.

Role of intestinal dysbacteriosis in the pathogenesis of acute-on-chronic hepatitis B liver failure / 临床肝胆病杂志

Acute-on-chronic liver failure is a clinical syndrome with acute exacerbation on the basis of chronic liver disease and can cause severe liver injury and dysfunctions of liver synthesis, detoxification, metabolism, and biotransformation. Intestinal dysbacteriosis is an important factor for the acceleration of liver failure. Therefore, it is important to prevent or delay the progression of liver failure by improving intestinal dysbacteriosis and liver function.

A randomized controlled study of peramivir, oseltamivir and placebo in patients with mild influenza / 中华内科杂志

Objectives To evaluate the effectiveness and safety of peramivir trihydrate in patients with influenza.Methods This was a randomized,double-blind,double-dummy,placebo and positive control,multicenter clinical trial,comparing peramivir trihydrate with oseltamivir and placebo.The inclusive criteria were 15-70 years old,onset within 48 h,positive rapid influenza antigen test,and febrile(＞38℃) accompanied with at least two associated symptoms.The severe cases complicated with chronic pulmonary and cardiac diseases,malignancies,organ transplantation,hemodialysis,uncontrolled diabetes,immunocompromised status,pregnancy and coexistence of bacterium infections were excluded.All patients were randomized 2:2:1 to receive peramivir,oseltamivir and placebo respectively.The primary endpoint was the disease duration,the secondary endpoints included time to normal axillary temperature and normal living activities,viral response,and adverse effects.Results Following informed consent,133 patients were included in this study.Four patients were exclude due to missing medical records,not fitting inclusion or exclusion criteria and poor compliance.A total of 129 patients were finally analyzed,including 49 cases,54 cases and 26 cases in peramivir group,oseltamivir group and placebo group.The median disease duration were 96 (76,120)hours,105(90,124) hours,and 124 (104,172)hours in three groups respectively(P＞0.05).The time to normal axillary temperature,normal living activities and viral response were not significantly different in three groups(P＞0.05).Conclusion The value of antiviral therapy in patients with mild influenza needs to be further determined.

Effect of IL-12 on IFN-gamma and IL-10 produced by peripheral blood mononuclear cells in patients with chronic hepatitis B virus infection during IFN-alpha treatment / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effect of IL-12 on IFN-gamma and IL-10 production of peripheral blood mononuclear cells (PBMC) in chronic hepatitis B virus infection patients during IFN-alpha treatment.</p><p><b>METHODS</b>Before and after IFN-alpha treatment of 3 months and 6 months, PBMC of 20 patients with chronic hepatitis B virus infection were collected and cultured in vitro in the culture fluid containing PHA (100 microg/ml), HBcAg (1 microg/ml), or HBeAg (1 microg/ml) for 48 h under the condition of the presence or absence of IL-12 (10 ng/ml). Then the levels of IFN-gamma and IL-10 were determined by ELISA.</p><p><b>RESULTS</b>There were 12 responders and 8 nonresponders to IFN-alpha treatment. In the responders, the enhancing effect of IL-12 on IFN-gamma production was significantly greater after IFN-alpha treatment than before the treatment. The production of IL-10 was suppressed in the presence of IL-12 after 3 months and 6 months of IFN-alpha treatment. In the same treatment time, the level of IFN-gamma in the presence of IL-12 was significantly higher than that in the absence of IL-12. To the nonresponders, the enhancing effect of IL-12 on IFN-gamma production was also significantly increased after IFN-alpha treatment. Moreover, in the same treatment time, the level of IFN-gamma in the presence of IL-12 was significantly higher than that in the absence of IL-12.</p><p><b>CONCLUSIONS</b>The enhancing effect of IL-12 on IFN-gamma production of PBMC in patients with chronic hepatitis B virus infection is increased during IFN-alpha treatment. IFN-alpha and IL-12 may enhance the efficacy for the treatment of chronic hepatitis B virus infection.</p>