Objective To observe the change of serum associated factors concentrations in the patients with idiopathic choroidal neovascularization (CNV).Methods The clinical data of 21 patients (21 eyes) with idiopathic CNV (CNV group) and 20 normal individuals (control group) were retrospective analyzed. Serous concentrations of vascular endothelial growth factor (VEGF), tumor necrosis factor alpha;(TNFalpha;), interleukin 1-beta; (IL1-beta;), IgG, IgA, IgM, IgE, CH50, C3, C4 and Creactive protein (CRP) were assayed by enzymelinked immunosorbent assay (ELISA) and immunonephelometry. Results The level of VEGF in CNV group was significantly higher than that in control group(t=2.340，P=0.025). The level of IgE in CNV group was significantly lower than that in control group(Z=-2.765，P=0.006). The other factors were not significantly different between the two groups（Pgt;0.05）.Conclusion VEGF and IgE may play an important role in the formation of idiopathic CNV.
ObjectiveTo learn the serum immunoglobulin G4 (IgG4) level in patients with pemphigus vulgaris (PV) in the active phase by detecting the IgG4 concentration in the patients with PV. MethodsWe collected the serum samples from patients with active-phase PV (including acute-onset and chronic active phases) between April and December 2014. The serum IgG4 level was detected by immuno-scatter turbidmetry, and the difference of serum IgG4 level between PV patients and normal subjects was assessed by Student's t-test. ResultsThirty-two patients with pemphigus vulgaris in the active phase were enrolled for this study, among whom 22 (including 8 males and 14 females) had normal serum IgG4 level, 8 (including 3 males and 5 females) higher and 2 (including 1 male and 1 female) lower. Compared with normal subjects, the average level of serum IgG4 in PV patients was not significantly different (P>0.05). The serum IgG4 level of acute-onset and chronic active PV patients was (1.015±0.825) g/L and (1.058±1.133) g/L, respectively, with no significant difference (P>0.05). ConclusionThe serum IgG4 level of patients with pemphigus vulgaris in the active phase can be normal, higher or lower. And there is no obvious difference in the serum IgG4 level between acute-onset and chronic active PV patients.
Immunoglobulin G4-related disease (IgG4-RD) is a new disease entity recognized at the start of this century noted to be involving many organ systems including endocrine system and thyroid in particular. It represents an immune mediated fibro inflammatory condition with characteristic histopathological appearance affecting single or multiple organs. In general, immunoglobulin G4-related thyroid disease (IgG4-RTD) is rarely considered and it may be isolated or with other organ involvement. Four subcategories of IgG4-RTD have been identified so far: Riedel thyroiditis, fibrosing variant of Hashimoto thyroiditis, immunoglobulin G4-related Hashimoto thyroiditis, and Graves disease with elevated immunoglobulin G4 levels. The diagnostic approach is complex and the work up relies on the coexistence of clinical features, histological features and serological evidence. Demonstration of the classic histopathological features is vital to diagnose IgG4-RD in most cases, and biopsy proof is preferred strongly by most disease experts before the initiation of treatment. The treatments for IgG4-RTD include medical and surgical options. Steroids are first line treatment though it may need further evaluation. Tamoxifen and rituximab are second line treatment for steroid resistant patients. Surgical excision of thyroid gland in presence of compression symptoms is the surgical option. Inspite of pathophysiology of the disease being poorly understood till now, early and prompt diagnosis and an early treatment initiation can improve the outcomes.
ObjectiveTo investigate the influence of immunoglobulin (Ig)on celluar immune function of postoperative infants with cyanotic congenital heart disease (CCHD). MethodsForty infants who underwent surgical repair of CCHD in Department of Cardiac Surgery, Children's Hospital of Hebei Province from March to December 2012 were enrolled in this study. All the patients were randomly divided into 2 groups. Patients in Ig group received intravenous Ig treatment at the dosage of 1g/ (kg·day)for 2 days postoperatively in addition to routine therapy. Patients in the control group only received routine therapy without Ig treatment. Five ml venous blood samples of all the patients were taken preoperatively, 0.5 hour and 2 days postoperatively to examine serum levels of interferon gamma (IFN-γ)and interleukin-4 (IL-4)with double-antibody sandwich enzyme-linked immunosorbent assay (ELISA), which were compared between the 2 groups. ResultsThere was no statistical difference in serum levels of IL-4 or IFN-γ preoperatively and at 0.5 hour postoperatively between the 2 groups (P > 0.05). Serum levels of IL-4 and IFN-γ at 0.5 hour postoperatively were significantly higher than preoperative levels in the 2 groups respectively (P=0.000). Serum IL-4 level of Ig group 2 days postoperatively was not statistically different from preoperative level (P=0.362), while serum IL-4 level of the control group 2 days postoperatively was significantly higher than preoperative level (P=0.006). Two days after the operation, serum levels of IL-4 and IFN-γ of Ig group were significantly lower than those of the control group respectively (P=0.039 and 0.007 respectively). Compared with serum levels at 0.5 hour postoperatively in the control group, serum IL-4 level at 2 days postoperatively decreased by 20.08% (P=0.001), and serum IFN-γ increased by 17.80% (P=0.001). Compared with serum levels at 0.5 hour postoperatively in Ig group, serum IL-4 level at 2 days postoperatively decreased by 35.38% (P=0.000), and serum IFN-γ only increased by 7.60% (P=0.143). ConclusionCellular immune function disorder caused by the operation and cardiopulmonary bypass can be effectively improved by postoperative intravenous Ig administration, which may help to reduce postoperative complications.
The change of Ig-forming cells in the gallbladder mucoderm were studied in the rabbit models.One hundred rabbits were randomly divided into the control group(Con,n=10),simple biliary obstruction group(BO,n=45)and biliary obstruction and infection group(BOI,n=45).The results showed that only a few Ig-forming cells presented in the gallbladder mucoderm of normal rabbit.At the 3rd,7th and 14th day,the quantities of IgG and IgA-forming cells in the mucoderm in BO group remained unchange,but increased much higher in BOI group(Plt;0.001),especially in IgG formation.This study suggests that the gallbladder of rabbit may be the important place of Ig-formation.The quantities of Ig-forming cells in bilitary tract may have a close relationship with the gallstone formation.
【Abstract】Objective To investigate the prevention and treatment for recurrence of hepatitis B after liver transplantation on HBV-related diseases. Methods Making a literature summarization based on published papers review.Results Acute and chronic HBV-related diseases are the main indications of liver transplantation.Recurrence rate of hepatitis B is from 80% to 100% in the untreated patients after liver transplantation,and it affects the survivals of patients seriously.It has become a focus to prevent and treat the recurrence of hepatitis B.After a series of explotation and application,there have been a lot of drugs of preventing and treating HBV reinfection, including hepatitis B immunoglobulin,interferon and nucleotide analog antivirus drugs(lamivudine, famcyclovir, adefovir),etc.The therapeutic characteristics of them are different. Their utilizations of dividing or alliance are developing rapidly.Conclusion Liver transplatation is an effective therapy for HBV-related disease. Anti-HBV treatments perioperation play an important role in the improvement of succeed of liver transplantation.
Objectives To evaluate the effects of hepatitis B immunoglobulin (HBIG) intrauterine injection before delivery on interrupting mother-to-child transmission of hepatitis B virus (HBV). Methods The randomized controlled trials (RCTs) on HBIG intrauterine injection on interrupting mother-to-child transmission of HBV published between January 1992 and May 2012 were searched in The Cochrane Library, PubMed, CBM, CNKI, VIP, WanFang Data, etc. The studies were screened according to inclusive and exclusive criteria, the data were extracted, the quality was assessed by two reviewers independently, and meta-analysis, publication bias and sensitivity analysis was conducted using Stata software. Results The total 42 studies involving 7 212 infants were included. The randomized methods were asserted in all studies, three of which reported the details of randomization, one study mentioned blinded method, two studies mentioned incomplete outcome data, 13 studies had other potential threats to validity, no allocation concealment and selective outcome reporting was mentioned. Results of meta-analysis indicated that the infant HBV infection rates in the HBIG group and the control group were 8.971% and 25.470% (RR=0.359, 95%CI 0.303 to 0.425) at birth, 5.385% and 13.919% (RR=0.391, 95%CI 0.278 to 0.550) after half a year, 5.318% and 12.457% (RR=0.429, 95%CI 0.335 to 0.551) after one year; the infant anti-HBs rates in the HBIG group and the control group were 61.964% and 14.523% (RR=6.712, 95%CI 1.920 to 23.467) at birth, 77.754% and 66.311% (RR=1.209, 95%CI 0.989 to 1.478) after half a year. Funnel graphs showed that there was publication bias. Sensitivity analysis showed that the results except the infant anti-HBs protection after half-a-year follow-up were stable and consistent with the original results. Conclusion Injection of HBIG during pregnancy for HBV-carrying mothers can effectively reduce the occurrence of HBV whenever at birth, after half a year or after one year, and increase the infant anti-HBs protection rate at birth, but it is ineffective to improve anti-HBV protection rate after half a year. Owing to the low quality of the included studies and existence of biases, this conclusion should be cautiously put into clinical practice.
Immunogammopathy maculopathy is a newly discovered retinopathy associated with macroglobulinemia in recent years. The main manifestations were retinal vein convulsion and dilation caused by high blood viscosity, retinal interlaminar effusion and macular serous detachment. With the prolongation of the course of disease, the photoreceptor layer and RPE layer in the detachment area showed atrophic changes. The pathogenesis of ophthalmopathy is still unknown. Understanding the clinical features, diagnosis, differential diagnosis and treatment of ophthalmopathy is of great significance for understanding this kind of disease and improving the level of diagnosis and treatment of ophthalmopathy.
IgG4-related disease (IgG4-RD) is a chronic, immune-mediated inflammatory and fibrotic condition that can affect virtually any organ system. While some patients experience involvement of only a single organ, isolated IgG4-RD of the mediastinum is even rarer. This article reports a case of a 48-year-old male patient with isolated IgG4-RD of the middle mediastinum. After a biopsy failed to establish a definitive diagnosis, the patient underwent a right thoracotomy-assisted mediastinal tumor resection via video-assisted thoracoscopic surgery. The tumor was completely resected during the procedure, which lasted 130 minutes, with an estimated blood loss of approximately 50 mL. The patient had a favorable postoperative course and satisfactory clinical outcome. No glucocorticoid or other medical treatment was administered postoperatively, and there was no recurrence during a 6-month follow-up period.
ObjectTo systematically review the efficacy and safety of intravenous immunoglobulin (IVIG) for children with severe hand, foot and mouth disease in China. MethodDatabases including CNKI, CBM, WanFang Data, PubMed and The Cochrane Library (Issue 2, 2015) were searched to collect randomized controlled trials (RCTs) about IVIG combined with conventional therapy versus conventional therapy alone for severe hand, foot and mouth disease from inception to March 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 and Stata 9.0 software. ResultA total of 23 RCTs involving 2271 patients were included. The results of meta-analysis showed that, compared with the conventional therapy group, the IVIG group had higher total effective rate (RR=1.18, 95%CI 1.11 to 1.26, P<0.00001), shorter fever relieving time (MD=-1.47, 95%CI -1.80 to -1.15, P<0.00001), shorter rash regression time (MD=-1.61, 95%CI -2.51 to -0.71, P=0.0005), shorter remission time of nervous symptoms (MD=-2.14, 95%CI -3.02 to -1.25, P<0.00001), shorter mouth ulcer regression time (MD=-1.36, 95%CI -2.27 to -0.4, P=0.004), and shorter average length of hospital stay (MD=-2.46, 95%CI-3.29 to -1.63, P<0.00001). ConclusionCompared with conventional therapy alone, IVIG combined with conventional therapy can improve the effect for severe hand, foot and mouth disease. Due to the limited quality of the include studies, more high quality studies are needed to verify the above conclusion.