Long-term antifibrotic action of interferon-γ treatment in patients with chronic hepatitis B virus infection

BACKGROUND:The first priority in treating fibrosis is to eliminate the causes that result in liver injury,e.g.,hepatitis B and C virus.However,in many liver diseases the cause is either unknown or untreatable.The present study was designed to investigate the long-term antifibrotic effect of interferon-gamma(IFN-γ)treatment in patients chronically infected with hepatitis B virus. METHODS:A total of 42 patients,30 treated with IFN-γand 12 controls,were enrolled from an original clinical trial(Clin Gastroenterol Hepatol 2005;3:819.).Three serial liver biopsies that were obtained at the initiation and end of IFN-γtreatment as well as 4 to 6 years after treatment discontinuation were assessed according to the modified Chevallier scoring system. RESULTS:Twenty-five out of 30 IFN-γ-treated patients were followed up until 4 to 6 years after the treatment was stopped. However,all controls were excluded from follow-up due to death,loss and elevated virus level within 2 years.Twenty-five IFN-γ-treated patients had stable serum liver function and liver fibrosis indices without any further antiviral or anti-fibrotic treatment.Improved inflammatory and fibrotic scores were found after nine months of IFN-γtreatment according to the modified Chevallier scoring system(inflammation:11.8±6.5 at the beginning of IFN-γtreatment vs.9.2±4.1 after 9 months, P<0.05;fibrosis:15.0±7.3 at baseline vs.12.6±6.8 after 9 months, P<0.05).Among them,14 patients accepted a third serial liver biopsy 4 to 6 years after treatment discontinuation,and the fibrotic score was increased(14.2±8.3 vs.11.9±7.6 after 9 months, P<0.05). CONCLUSIONS:Nine-month IFN-γtreatment significantly improves the fibrosis score in patients with chronic HBV infection.The majority of patients demonstrate stable serum biochemical indices and quality of life.However,they do not show a long-term benefit according to histological criteria. Given the limited sample size,long-term IFN-γtreatment regimens should be assessed in further clinical trials.

Extravascular use of drug-eluting beads: A promising approach in compartment-based tumor therapy

Intraperitoneal carcinomatosis(PC)may occur with several tumor entities.The prognosis of patients suffering from PC is usually poor.Present treatment depends on the cancer entity and includes systemic chemotherapy,radiation therapy,hormonal therapy and surgical resection.Only few patients may also benefit from hyperthermic intraperitoneal chemotherapy with a complete tumor remission.These therapies are often accompanied by severe systemic side-effects.One approach to reduce side effects is to target chemotherapeutic agents to the tumor with carrier devices.Promising experimental results have been achieved using drug-eluting beads(DEBs).A series of in vitro and in vitro experiments has been conducted to determine the suitability of their extravascular use.These encapsulation devices were able to harbor CYP2B1producing cells and to shield them from the hosts immune system when injected intratumorally.In this way ifosfamide-which is transformed into its active metabolites by CYP2B1-could be successfully targeted into pancreatic tumor growths.Furthermore DEBs can be used to target chemotherapeutics into the abdominal cavity for treatment of PC.If CYP2B1 producing cells are proven to be save for usage in man and if local toxic effects of chemotherapeutics can be controlled,DEBs will become promising tools in compartmentbased anticancer treatment.

Age related differences and outcome of patients with Takotsubo syndrome

BackgroundTakotsubo 症候群(TS ) 是影响主要绝经后的女人的重要心脏病。这研究被进行在 TS patients.Methods 与 ResultsThe 数据的短期、长期的结果上决定年龄的影响从一有 1591 的吝啬的后续的 114 个 TS

AB026. Referrals from optometry-a comparative study (the R.O.C.S study)

Background:To characterize emergency optometrist referrals triaged at a tertiary ophthalmology care center by pathology,physical exam findings,and provisional diagnosis accuracy.Methods:Variables extracted from the patients’charts included date of referral,age,sex,eye(s)under examination,visual acuity(VA)at the time of referral,intraocular pressure(IOP)at the time of the referral,the referring optometrist’s provisional diagnosis,VA at the time of the ophthalmologist consultation,IOP at the time of the ophthalmologist consultation,number of days between referral and ophthalmic consultation,and the ophthalmologist’s diagnosis.Results:After categorizing disease by anatomical location,absolute agreement between optometrist provisional diagnosis and ophthalmologist diagnosis was 60%.A strong correlation was found between optometrist and ophthalmologist VA measurements.IOP measurements were checked less frequently by optometrists.In cases where referral IOP was documented,no significant difference was observed between optometrist and ophthalmologist IOP measures.Conclusions:VA and IOP measurements by optometrists are reliable,but IOP is less frequently checked in the optometry setting.While optometrist referrals correctly localized eye pathology in 60%of cases,posterior pathology was missed in two cases of retinal tear and retinal detachment.

干扰素γ与肝纤维化治疗

干扰素γ（IFNγ）具有很强的抗肝纤维化作用，近年来IFNγ治疗肝纤维化的临床和基础研究已有很大进展，现就此作一综述。