聚乙二醇干扰素α-2a联合乙肝疫苗治疗慢性乙型肝炎疗效观察

目的探讨聚乙二醇干扰素α-2a(PEG-IFNα-2a)联合乙肝疫苗治疗慢性乙型肝炎(CHB)的临床疗效及安全性。方法随机将172例CHB患者分为观察组和对照组,每组86例。对照组应用PEG-IFNα-2a治疗,观察组应用PEG-IFNα-2a联合乙肝疫苗治疗。比较两组在治疗6 m、12 m和随访6 m时HBV DNA阴转率、HBeAg阴转率和ALT复常率。结果在治疗12 m和随访6 m时,观察组HBV DNA阴转率、HBeAg阴转率和ALT复常率分别为81.4%、53.5%和82.6%,和93.0%、64.0%和95.3%,均显著高于对照组水平(67.4%、38.7%和68.6%,和75.6%、46.5%和77.9%,P<0.05);在治疗6 m、12 m和随访6 m时,观察组ALT和AST水平分别为(93.5±43.1)U/L和(86.0±50.6)U/L、(40.8±25.1)U/L和(50.7±28.6)U/L、(36.5±11.3)U/L和(43.2±15.7)U/L,均显著低于对照组(116.4±58.6)U/L和(105.3±52.8)U/L、(50.6±26.2)U/L和(59.5±25.4)U/L、(46.0±24.4)U/L和(52.6±23.9)U/L,P<0.05。结论 PEG-IFNα-2a联合乙肝疫苗治疗CHB可有效地提高干扰素的临床疗效。

聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎的疗效观察

目的:探讨聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎的临床疗效及安全性。方法:选取2014年1月—2017年1月嘉应学院医学院附属医院收治的慢性丙型肝炎患者100例,以计算机随机数字分组法分为对照组和观察组,每组50例。对照组采用普通干扰素α-1b联合利巴韦林治疗,观察组采用聚乙二醇干扰素α-2a联合利巴韦林治疗,比较两组患者的临床疗效、病毒学应答率、肝功能及不良反应发生情况。结果:观察组患者的总有效率为84%(42/50),明显高于对照组的62%(31/50);观察组患者的快速病毒学应答率、早期病毒学应答率和治疗终点病毒学应答率明显高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者的丙氨酸氨基转移酶、天门冬氨酸氨基转移酶和碱性磷酸酶等肝功能指标水平均明显低于本组治疗前,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05);两组患者不良反应发生率的差异无统计学意义(P>0.05)。结论:聚乙二醇干扰素α-2a联合利巴韦林治疗慢性丙型肝炎,疗效显著,安全可靠。

长效与短效α-干扰素治疗慢性丙型肝炎疗效观察

目的：对比长效干扰素联合利巴韦林与普通干扰素联合利巴韦林治疗慢性丙型肝炎的临床疗效及安全性。方法回顾性分析60例慢性丙型肝炎患者的临床资料，其中长效干扰素组采用聚乙二醇干扰素α-2a （PEG-INFα-2a）联合利巴韦林进行抗病毒治疗（n=30例），普通干扰素组采用普通IFNα-2a联合利巴韦林治疗（n=30例），均分别于治疗4、12、24、48w及治疗结束后24w评价疗效，并观察药物的不良反应。结果长效干扰素组持续病毒学应答率（SVR）为90.0%，显著高于普通干扰素组的56.7%（P〈0.01）；两组药物不良反应均有发热、肌肉酸痛、脱发及中性粒细胞、血小板下降等，但长效干扰素组发生发热和肌肉酸痛比率分别为36.7%和33.3%，显著低于普通干扰素组（90.0%和93.3%，P〈0.01）；长效干扰素组中性粒细胞下降明显高于普通干扰素组，在4～24w尤其明显。结论长效干扰素联合利巴韦林治疗方案疗效显著优于普通干扰素联合利巴韦林，且未增加不良反应。

Fabrication and Excellent Properties of Polyvinylidene fluoride/Graphene Composite Films as Thermal Interface Materials

The growing concern about thermal conductivityand electromagnetic shielding inelectronic equipment has promoted the development of interfacial film materials.In this work,polyvinylidene fluoride(PVDF)/graphene composite films with different graphene contents were fabricated by high-energy ball milling,cold isostatic pressing,scraping and coating,successively.High-energy ball milling is beneficial to the dispersion of graphene powder,while cold isostatic pressing can greatly enhance thermal conductivity and mechanical strength by reducing the voids in the film and increasing the contact area of graphene sheets.The thermal conductivity,tensile strength and electromagnetic shielding properties of the films were carefully investigated and compared.It was demonstrated that the thermal conductivity increased from 0.19 Wm-1.K-1 for pure PVDF to 103.9 W-m-1.K-1 for the composite film with PVDF:graphene=1:3.Meanwhile the electromagnetic shielding efficiency can reach 36.55 dB.The prepared PVDF/graphene composite films exhibit outstanding overall performance and have the potential for practical applications.

阅读文本必须抓住“文眼”

阅读文本抓住“文眼”．能够提高阅读的质量和效益。本文从三个方面来论述抓住“文眼”：阅读的重要性以及什么是“文眼”；“文眼”的位置不同，作用不同；怎样抓住“文眼”，解读文本。

Impact of liver steatosis on response to pegylated interferon therapy in patients with chronic hepatitis B

AIM： To evaluate the impact of liver steatosis upon response to given therapy in chronic hepatitis B （CriB） patients.METHODS： 84 consecutive Crib patients treated with 48-wk PEGylated interferon （PEG-IFN） therapy were enrolled. Baseline characteristics and sustained viral re- sponse （SVR） to PEG-IFN therapy were evaluated.RESULTS： Mean body mass index （BMI） was 27.36 ±4.4 kg/m2. Six （7.1%） had hypertension and three （3.5%） had diabetes mellitus. Steatosis was present in 22.6% （19/84） of liver biopsy samples. Age, BMI, and triglyceride levels of the patients with hepatic steatosis were significantly higher than those without hepatic steatosis （P 〈 0.05）. SVR to PEG-IFN therapy was 21.4% （18/84）. Sixteen of these 18 CriB patients with SVR （88.9%） did not have any histopathologically determined steatosis. On the other hand, only two of the 19 CriB patients with hepatic steatosis had SVR （10.5%）. Although the SVR rate observed in patients without steatosis （16/65, 24.6%） was higher compared to those with steatosis （2/19, 10.5%）, the difference was not statistically significant （P 〉 0.05）.CONCLUSION： Occurrence of hepatic steatosis is significantly high in CHB patients and this association leads to a trend of decreased, but statistically insignificant, SVR rates to PEG-IFN treatment,

Unperturbed dimensions of atactic poly(dibenzyl itaconate)s

The unperturbed dimension and temperature character of poly(dibenzyl itaconate)s (PDBzI) are studied by a revised rotational isomeric state (RIS) method. The improved formulas of the mean-square radius of gyration, deduced by the pseudo-stereochemical equilibrium approach, may be used to investigate the configurational-conformational properties of atactic polymers with large side groups [poly(itaconates) for instance]. The calculated results showed that poly(itaconates) have larger dimension of the molecule than other vinyl polymers. Comparison of the dimension between considering and without considering side groups showed that the effect of large side groups on the unperturbed dimension for short-chain polymers is more obvious than that of long-chain polymers and, if the dimension of side groups increases, the effect also increases. The dimension differences of PDBzI between short-chain and long-chain polymers are investigated by the relation of characteristic ratios and temperature coefficients with temperature. Moreover, the dependence between the temperature coefficients and the tacticity of chains shows that the temperature characters of the isotactic, syndiotactic and atactic PDBzI chains have remarkable difference.

聚乙二醇干扰素α-2a治疗慢性丙型肝炎的不良反应观察

目的观察聚乙二醇干扰素α-2a治疗慢性丙型肝炎的不良反应,探讨有效的处理措施。方法回顾性分析我院2011年1月～2012年1月收治的38例慢性丙型肝炎患者的临床资料,所有患者均给予聚乙二醇干扰素α-2a治疗,观察患者治疗期间的不良反应。结果本组38例患者治疗期间流感样症状发生率最高,为68.4%,患者主要表现为发热、鼻塞、关节肌肉痛,其次脱发的发生率为47.4%。肝功能损害、骨髓抑制反应、神经系统症状、皮疹的发生率分别为39.5%、28.9%、15.8%、7.9%。结论聚乙二醇干扰素α-2a治疗慢性丙型肝炎的不良反应较多,应引起临床医师的足够重视,一旦发生不良反应应迅速给予有效的对症处理,保证用药安全。

New therapeutic vaccination strategies for the treatment of chronic hepatitis B

Chronic hepatitis B virus(CHB) is currently treated with either interferon-based or nucleot(s)idebased antiviral therapies.However,treatment with pegylated interferon alpha results in a durable antiviral response in only about 30%patients and is associated with side effects.Most patients receiving nucleot(s)ide analogue treatment do not establish long-term,durable control of Infection and have rebounding viremia after cessation of therapy.Thus,novel therapy strategies are necessary to achieve the induction of potent and durable antiviral immune responses of the patients which can maintain long-term control of viral replication.Therapeutic vaccination of HBV carriers is a promising strategy for the control of hepatitis B.Here the authors review new therapeutic vaccination strategies to treat chronic hepatitis B which may be introduced for patient treatment in the future.

G-CSF in Peg-IFN induced neutropenia in liver transplanted patients with HCV recurrence

AIM:To evaluate the efficacy of granulocyte colony stimulating factors(G-CSF)in liver transplanted patients with hepatitis C(HCV)recurrence and Pegylated-IFN α-2b induced neutropenia,and to evaluate the impact of G-CSF administration on virological response. METHODS:Sixty-eight patients undergoing antiviral treatment for post-liver transplantation(OLT)HCV recurrence were enrolled.All patients developing neutropenia received G-CSF. RESULTS:Twenty three(34%)received G-CSF.Mean neutrophil count at the onset of neutropenia was 700/mmc(range 400-750/mmc);after 1 mo of G-CSF it increased to 1210/mmc(range 300-5590/mmc) (P<0.0001).Three patients did not respond to G-CSF. Treatment duration was similar in neutropenic and non-neutropenic patients.No differences in the rate of discontinuation,infections or virological response were observed between the two groups.G-CSF was protective for the onset of de novo autoimmune hepatitis(P<0.003). CONCLUSION:G-CSF administration is effective in the case of Peg-IFN induced neutropenia increasingneutrophil count,prolonging treatment and leading to sustained virological response(SVR)rates comparable to non-neutropenic patients.It prevents the occurrence of de novo autoimmune hepatitis.

PEI-PEG as a siRNA Genetic Vector Demonstrating Interference in the Expression of CD44v6 Protein in Gastric Cancer Cells

OBJECTIVE To investigate the effect of polyethylene imine glycol （PEI-PEG）/siRNA nanocomposites in the in vitro transfection of human gastric cancer SGC7901 cell lines and the down-regulation of gene expression of the adherence factor CD44v6. METHODS PEI-PEG/siRNA nanoparticles, in different N/P ratios, were synthesized and transfected into gastric cancer cells. Lipo2000/siRNA was used in the control group. The transfection efficiencies were observed under fluorescence microscope. The cytotoxicity of the nanoparticles was measured using the MTT assay （mononuclear cell direct cytotoxicity assay）, and the down-regulation effect of siRNA on CD44v6 gene was evaluated by Western blot. Based on the different N/P ratios, PEI-PEG/siRNA composites were synthesized and transfected into gastric cancer cells. Lipo2000/siRNA was used in the controls. The transfection efficiency was observed under fluorescence microscope. The cytotoxicity of the nanoparticles was measured using the MTT assay and the down-regulation effect of siRNA on CD44v6 gene was evaluated by Western blot. RESULTS After transfection, the transfection efficiency of the PEI-PEG/siRNA nanocomposites increased incrementally in N/P ratio value. The transfection efficiency improved with an increase in N/P ratio. When the N/P value was 15, fluorescence became more intense in the PEI-PEG/siRNA group than in the Lipo2000/siRNA group. At the same time, cell viability was （80.4 ± 5.6）% in the MTT reduction assay, which was similar to that in the Lipo2000/siRNA group. The results of Western blot analysis showed that the expression level of CD44v6 protein decreased to （59.7 ± 3.0）% after siRNA-CD44v6 was inhibited. CONCLUSION PEI-PEG could effectively form the nanocomposite in combination with siRNA, be transfected into the SGC7901 gastric cancer cell lines and inhibit CD44v6 protein expression. Moreover, as a genetic carrier, PEI-PEG copolymer has greater advantages, including high transfection e. ciency, less cytotoxicity and an easily alterable vector structure.

Long-term outcome of chronic hepatitis C patients with sustained virological response to peginterferon plus ribavirin

AIM: To assess the clinical, biochemical and virological long-term outcome in chronic hepatitis C (CHC) patients with a sustained virological response (SVR) after peginterferon (PEG-IFN) plus ribavirin combination therapy. METHODS: One hundred and fifty three patients with a SVR after treatment with PEG-IFN plus ribavirin were included in a 5-year follow-up study in a single Spanish center, based on standard clinical practice. Clinical anamnesis, biochemical analysis, hepatitis C virus RNA and alpha-fetoprotein measurement, ultrasonography and transient elastography were performed annually. RESULTS: The mean follow-up period of the 153 patients was 76 ± 13 mo after they obtained a SVR. Five patients (3.26%) presented with cirrhosis before treatment and 116 (75.8%) had genotype 1. No patient showed evidence of hepatic decompensation. One patient (0.65%) developed a hepatocellular carcinoma at month 30 after achieving SVR. There were no virological relapses during this follow-up period. Persistently elevated alanine aminotransferase was found in only one patient (0.65%). At the end of the 5-year follow-up, the mean value of transient elastography was 7 ± 4.3 kPa (F1). There were no deaths and no other tumors. CONCLUSION: The long-term outcome of 153 CHC patients with SVR to PEG-IFN plus ribavirin was good. No evidence of a virological relapse was seen. One patient (0.65%) developed a hepatocellular carcinoma.

Two-Stage Resource Allocation Scheme for Three-Tier Ultra-Dense Network

In 5 G Ultra-dense Network(UDN), resource allocation is an efficient method to manage inter-small-cell interference. In this paper, a two-stage resource allocation scheme is proposed to supervise interference and resource allocation while establishing a realistic scenario of three-tier heterogeneous network architecture. The scheme consists of two stages: in stage I, a two-level sub-channel allocation algorithm and a power control method based on the logarithmic function are applied to allocate resource for Macrocell and Picocells, guaranteeing the minimum system capacity by considering the power limitation and interference coordination; in stage II, an interference management approach based on K-means clustering is introduced to divide Femtocells into different clusters. Then, a prior sub-channel allocation algorithm is employed for Femtocells in diverse clusters to mitigate the interference and promote system performance. Simulation results show that the proposed scheme contributes to the enhancement of system throughput and spectrum efficiency while ensuring the system energy efficiency.

CHOP-like Regimen in Combination with Rituximab and Peginterferon Alpha-2b in Newly-diagnosed Diffuse Large B-cell Non-Hodgkin＇s Lymphoma： Experience in a Chinese Center

OBJECTIVE To evaluate the efficacy of rituximab combined with CHOP-like regimen with or without IFN in patients newly diagnosed diffuse large B-cell Non-Hodgkin＇s lymphoma （DLBCL）.METHODS From January 2003 to July 2008, 51 patients received CHOP-like chemotherapy （cyclophosphamide 750 mg/m2, epirubicin 80 mg/m2, vindesine 2.8 mg/m2 on day 1, and prednisolone 100 mg/day on day 1 to day 5）. Thirty-one patients received CHOPR-like treatment （rituximab 375 mg/m2 1 day before CHOP-like chemotherapy）. Twenty patients received CHOP-like regimen in combination with peginterferon （pegIFN） （1μg/kg on day 5） and rituximab （on day 6）.RESULTS -The CR （complete remission） rate in the CHOPR-like （with or without pegIFN） group and in the CHOP-like group was 78.4% and 45.1% （P = 0.005）, respectively. The estimated mean time of overall survival （OS） in the CHOPR-like group and CHOP- like group was 58.7 ± 2.8 and 36.4 ±3.4 months, respectively （P = 0.002）. The rates of CR and OR （overall remission） in CHOPR- like with IFN arm were 85.0% and 95.0%, and the rates of those in CHOPR-like without IFN arm were 74.2% and 87.0% （P 〉 0.05）. The estimated mean time of 4-year-PFS （progression- free survival） in CHOPR-like with IFN arm and in CHOPR-like without IFN arm was 62.9 ±3.0 months and 51.0 ± 4.6 months （P = 0.092）, respectively. In the CHOPR-like with IFN arm, no patient relapsed after achieving CR, while the estimated rate of 4-year- DFS （disease-free survival） in the patients who reached CR in the CHOPR-like without IFN arm was （63.4 ± 19.3）% （P = 0.061）. CONCLUSION Rituximab combined with CHOP-like chemotherapy improved the prognosis of DLBCL patients. The IFN may help to improve the quality and duration of response of DLBCL patients treated with rituximab and CHOP-like regimen.

Treatment of chronic viral hepatitis with nitazoxanide and second generation thiazolides

Nitazoxanide,the first thiazolide,was originally developed for the treatment of Cryptosporidium parvum.More recently,antiviral activity of nitazoxanide against hepatitis B virus(HBV)and hepatitis C virus was recognized in in vitro systems.These basic studies led to phaseⅡclinical trials that demonstrated the safety and efficacy of nitazoxanide in combination with peginterferon,with or without ribavirin,in the treatment of chronic hepatitis C genotype 4.The sustained virologic response rate was 79%and 80%in two studies,which was higher than the response rate of 50%with the standard of care with peginterferon plus ribavirin.In very preliminary studies of patients with chronic hepatitis B,nitazoxanide suppressed serum HBV DNA and led to loss of hepatitis B e antigen in the majority of patients and hepatitis B surface antigen in approximately a quarter of patients.Randomized controlled studies of naive and nonresponder patients with chronic hepatitis C genotype 1 are underway,new second generation and controlled release thiazolides are being developed,and future studies of patients with chronic hepatitis B are planned.

Suppression of matrix metalloproteinase-2 via RNA interference inhibits pancreatic carcinoma cell invasiveness and adhesion

AIM:To investigate the inhibitory effects of RNA interference (RNAi) on expression of matrix metalloproteinase-2 (MMP-2) gene and invasiveness and adhesion of human pancreatic cancer cell line,BxPC-3.METHODS:RNAi was performed using the vector (pGPU6)-based small interference RNA (siRNA) plasmid gene silence system to specifically knock down MMP-2 expression in pancreatic cancer cell line,BxPC-3. Four groups of different specific target sequence in coding region of MMP-2 and one non-specific sequence were chosen to construct four experimental siRNA plasmids of pGPU6-1,pGPU6-2,pGPU6-3 and pGPU6-4,and one negative control siRNA plasmid of pGPU6 (-). MMP-2 expression was measured by reverse transcription polymerase chain reaction (RT-PCR) and Western blot. Cell proliferation and apoptosis were examined by methyl thiazolyl tetrazolium (MTT) and flow cytometry,respectively. The abilities of adhesion and invasion were detected by cell adhesion assay and cell invasion assay using Transwell chambers.RESULTS:The expression of MMP-2 was inhibited and the inhibitory effects of different sequence varied. pGPU6-1 group had the most efficient inhibitory effect,followed by pGPU6-2 and pGPU6-3 groups.Invasiveness and adhesion were more significantly reduced in pGPU6-1,pGPU6-2 and pGPU6-3 groups as compared with pGPU6 (-) and blank control groups. However,no difference concerning cell proliferation and apoptosis was observed after transfection between experiment groups and control groups.CONCLUSION:RNAi against MMP-2 successfully inhibited the mRNA and protein expression of MMP-2 in the pancreatic cancer cell line,BxPC-3,leading to a potent suppression of tumor cell adhesion and invasion without affecting cell proliferation and apoptosis. These findings suggest that the RNAi approach towards MMP-2 may be an effective therapeutic strategy for the clinical management of pancreatic tumor.

Criteria for intermittent and continuous disturbance transition of ERA interaction with shaped charge jet

There are two interaction mechanisms between shaped charge jet and thin flying plate driven by explosion, that is, the intermittent and continuous disturbance. Determination of the transition criteria for the intermittent and continuous disturbance is of importance for the penetration calculation of the escaping jet and the design of ERA(explosive reactive armour). In this paper a new criteria was presented based on the analysis of interaction process, and the effects of NATO angle and thickness of flying plate on the disturbance frequency were discussed. It is shown that the critical shaped charge jet velocity increases with the plate thickness and NATO angle, especially increases drastically between 45° and 60°.

Underdetermined Blind Source Separation of Adjacent Satellite Interference Based on Sparseness

The problem of underdetermined blind source separation of adjacent satellite interference is proposed in this paper. Density Clustering algorithm(DC-algorithm) presented in this article is different from traditional methods. Sparseness representation has been applied in underdetermined blind signal source separation. However, some difficulties have not been considered, such as the number of sources is unknown or the mixed matrix is ill-conditioned. In order to find out the number of the mixed signals, Short Time Fourier Transform(STFT) is employed to segment received mixtures. Then, we formulate the blind source signal as cluster problem. Furthermore, we construct Cost Function Pair and Decision Coordinate System by using density clustering. At the end of this paper, we discuss the performance of the proposed method and verify the novel method based on several simulations. We verify the proposed method on numerical experiments with real signal transmission, which demonstrates the validity of the proposed method.