Relationship between Phenotypic Changes of Dendritic Cell Subsets and the Onset of Plateau Phase during Intermittent Interferon Therapy in Patients with CHB

Objective This study aimed to evaluate whether the onset of the plateau phase of slow hepatitis B surface antigen decline in patients with chronic hepatitis B treated with intermittent interferon therapy is related to the frequency of dendritic cell subsets and expression of the costimulatory molecules CD40,CD80,CD83,and CD86.Method This was a cross-sectional study in which patients were divided into a natural history group(namely NH group),a long-term oral nucleoside analogs treatment group(namely NA group),and a plateau-arriving group(namely P group).The percentage of plasmacytoid dendritic cell and myeloid dendritic cell subsets in peripheral blood lymphocytes and monocytes and the mean fluorescence intensity of their surface costimulatory molecules were detected using a flow cytometer.Results In total,143 patients were enrolled(NH group,n=49;NA group,n=47;P group,n=47).The results demonstrated that CD141/CD1c double negative myeloid dendritic cell(DNmDC)/lymphocytes and monocytes(%)in P group(0.041[0.024,0.069])was significantly lower than that in NH group(0.270[0.135,0.407])and NA group(0.273[0.150,0.443]),and CD86 mean fluorescence intensity of DNmDCs in P group(1832.0[1484.0,2793.0])was significantly lower than that in NH group(4316.0[2958.0,5169.0])and NA group(3299.0[2534.0,4371.0]),Adjusted P all<0.001.Conclusion Reduced DNmDCs and impaired maturation may be associated with the onset of the plateau phase during intermittent interferon therapy in patients with chronic hepatitis B.

Improving intermittent androgen deprivation therapy： lessons learned from basic and translational research

Intermittent androgen deprivation therapy （IADT） is an alternative to continuous androgen deprivation therapy （ADT） in prostate cancer patients with nonmetastatic disease. ADT is associated with numerous side effects such as hot flashes, sexual dysfunction, anemia, fatigue, loss of muscle mass, osteoporosis, metabolic syndrome and premature cardiovascular disease. IADT was developed with the intention of improving the quality of life and to delay progression of prostate cancer to castration resistance. The benefits of slightly improved quality of life by IADT compared to ADT were demonstrated in multiple clinical trials. IADT was noted to be noninferior to ADT in patients with biochemical recurrence of prostate cancer but in studies performed in patients with metastatic prostate cancer, the results were inconclusive. Our recent studies suggested that the administration of 5 alpha-reductase inhibitors during the off-cycle of IADT can significantly prolong the survival of mice bearing androgen-sensitive prostate tumors when off-cycle duration was short. This review discusses the survival benefit of 5 alpha-reductase inhibition in IADT in animal models and the potential translation of this finding into clinic.

Intermittent androgen deprivation therapy in patients with prostate cancer: Connecting the dots

Intermittent androgen deprivation therapy(IADT)is now being increasingly opted by the treating physicians and patients with prostate cancer.The most common reason driving this is the availability of an off-treatment period to the patients that provides some relief from treatment-related side-effects,and reduced treatment costs.IADT may also delay the progression to castration-resistant prostate cancer.However,the use of IADT in the setting of prostate cancer has not been strongly substantiated by data from clinical trials.Multiple factors seem to contribute towards this inadequacy of supportive data for the use of IADT in patients with prostate cancer,e.g.,population characteristics(both demographic and clinical),study design,treatment regimen,on-and off-treatment criteria,duration of active treatment,endpoints,and analysis.The present review article focuses on seven clinical trials that evaluated the efficacy of IADT vs.continuous androgen deprivation therapy for the treatment of prostate cancer.The results from these clinical trials have been discussed in light of the factors that may impact the treatment outcomes,especially the disease(tumor)burden.Based on evidence,potential candidate population for IADT has been suggested along with recommendations for the use of IADT in patients with prostate cancer.

The effect of hot intermittent cupping on pain,stiffness and disability of patients with knee osteoarthritis

Objective:The aim of this study was to investigate the effect of hot intermittent cupping on pain,stiffness and inability of patients with knee osteoarthritis(KO).Methods:The present study was a clinical trial,which was performed on 38 patients with KO referring to Gonabad Rheumatology Specialty Clinic.Based on permutation block method,the research units were divided into cupping therapy and control groups.For the cupping therapy group,four sessions of cupping therapy were performed every four days.To collect data,the form of demographic information,Visual Analogue Scale(VAS)and the Western Ontario and McMaster(WOMAC)osteoarthritis scale were used,and the data were analyzed by SPSS software v.16 using descriptive statistics and independent t-test,paired t-test,Chi-square test and Fishers exact test with a significance level of P<0.05.Results:Findings showed that there was no significant difference between the cupping therapy and control groups in terms of demographic characteristics and they were homogeneous.Findings indicated that,based on VAS,the mean pain intensity in the left(P<0.001)and the right knees(P<0.001),as well as based on WOMAC,stiffness(P=0.006),pain intensity(P<0.001)and disability(P<0.001)in the cupping therapy group significantly decreased compared to the control group.Conclusion:Findings showed that hot intermittent cupping therapy reduced the pain intensity,stiffness and disability in patients with KO.

A retrospective study of continuous renal replacement therapy versus intermittent hemodialysis in severe acute renal failure

Objective To investigate the efficacy of continuous renal replacement therapy(CRRT)versus intermittent hemodialysis(IHD)in patients with severe acute renal failure(ARF).Methods One hundred and ninety -three severe ARF patients who received renal support between December 1978 and December 1998 were involved in this study.Of them,101(52.3%)were treated with CRRT(CRRT group),and 92(47.7%)with IHD(IHD group).Results Sixty(59.4%)patients in the CRRT group got through the acute phase of disease and 41 (40.6%)patients did not survive while in the IHD group 59(64.1%)patients survived and 33(35.9%)patients did not.No significant difference in survival rate was found between the two groups.24 of 64 patients(37.5%)in the CRRT group with multiple organ dysfunction syndrome(MODS)survived,while in the IHD group,8 out of 44(27.3%)survived,their survival rate was much lower than that in the CRRT group.Patients in CRRT group were more severely iii,as manifested by lower mean arterial pressure,higher APACHE Ⅱ score,more dysfunctioned organs and requiring mechanical ventilation and vasopressor support as compared with patients in the IHD group,CRRT was found to improve hemodynamic stability with a better fluid balance and control of biochemical status,increased nutritional intake and a shorter duration of acute renal failure(P ＜ 0.05).Conclusion CRRT perhaps may be the best choice in the treatment of severe ARF patients,for it can offer several distinct advantages compared to IHD.These may contribute to improving the survival rate of ARF patients,particularly those that are critically ill patients.

Comparative Analysis of the Effect of Local Citrate Anticoagulation and Non-anticoagulation in Extended Intermittent Renal Replacement Therapy(PIRRT)

Objective:To observe the anticoagulant effect of local citrate anticoagulation and non-anticoagulation in prolonged intermittent renal replacement therapy(PITTR).Methods:From October 2018 to October 2019,30 patients with a high risk of bleeding who received PIRRT treatment in our hospital were selected and divided into RCA group(citrate group)and control group(non-anticoagulant group),15 cases in each group.The anticoagulant efficiency,filter service life,coagulation function,and blood gas indexes were compared between the two groups.Results:(1)the anticoagulant effective rate of the RCA group was higher than that of the control group,and the use time of the filter was longer than that of the control group(P<0.05).(2)There was no significant difference in Pt and APTT between the two groups before and after treatment(P>0.05).(3)There was no significant difference in plasma calcium concentration between the two groups before treatment,4,6 and 8 h after treatment(P>0.05).(4)In the RCA group,the pH value and be valued at 4,6 and 8 h after treatment were higher than those before treatment,but they were in the normal range,and the difference was statistically significant(P<0.05).Conclusion:In the extended intermittent renal replacement therapy,the effect of local citrate anticoagulation is better than that of non-anticoagulant therapy,which can prolong the service life of the filter,and there are no adverse reactions such as prolonged coagulation time,hypocalcemia,and metabolic acid-base imbalance.