Role and mechanism of autophagy in development and progression of hepatocellular carcinoma and regulation of immunotherapy / 临床肝胆病杂志

As a basic physiological phenomenon, autophagy plays an important role in maintaining cellular homeostasis and physiological metabolism and can also induce programmed cell death. At present, many studies have shown that autophagy plays an important role in the development, progression, and metastasis of various tumors, which provide new viewpoints for tumor research and treatment. Hepatocellular carcinoma has an extremely complex pathogenesis, and the effect of immunoregulation on the development, metastasis, and invasion of hepatocellular carcinoma has been generally accepted. Recent studies have found that autophagy is involved in tumor immunity, oxidative stress, and maintenance of cellular homeostasis and thus affect the progression of hepatocellular carcinoma. It may also influence the effect of immunotherapy via multiple pathways. This article reviews the role and mechanism of autophagy in the development and progression of hepatocellular carcinoma and the regulation of immunotherapy, in order to understand the significant influence of autophagy on hepatocellular carcinoma and the potential therapeutic value of autophagy.

Factors affecting quality of life in patients with chronic hepatitis B / 中国感染控制杂志

Objective To analyze factors affecting quality of life (QOL)in patients with chronic hepatitis B (CHB),and provide reference for improving QOL of patients. Methods The MOS 36-item short form health sur-vey (SF-36)was adopted to survey QOL of patients with CHB,Morisky medication adherence scale was used to measure patients'adherence to medication,factors affecting QOL of patients with CHB were analyzed. Results Of 357 CHB patients,271(75.91% )were married,107(29.97% )received college or above education,163(45.66% ) patients'average household monthly income were ￥ 2000-￥ 5000,138(38.66% )patients'family members were also with CHB,198 (55.46% )patients smoked,150 (42.02% )drank. The average score of CHB patients' adherence to medication was (2.15±1.29). Factors affecting QOL in patients with CHB were age,education level, duration of disease,whether or not hospitalized,whether or not drink,as well as adherence to medication. Age, drink,and duration of hepatitis B,and previous hospitalization were negative factors affecting QOL in patients with CHB,education level and adherence to medication were positive factors affecting QOL in patients with CHB. Conclusion Strengthening CHB patients'understanding on disease and improving their medication adherence can help them to improve QOL.

Antiviral treatment and long-term clinical outcome of decompensated cirrhotic patients with hepatitis C virus infection / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of antiviral treatment in patients with hepatitis C virus (HCV) infection and decompensated cirrhosis and determine the effects of virological response on long-term prognosis.</p><p><b>METHODS</b>Sixty-six consecutive,interferon (IFN)-na(i)ve patients with HCV infection and decompensated cirrhosis were enrolled in this prospective study. All patients were given a 48-to 72-week course of IFN plus ribavirin (RBV) combined therapy,with a low accelerating dosage regimen using either:pegylated (PEG)-IFNa-2b at 1.0-1.5 mug/kg/week,PEG-IFNa-2a at 90-180 mug,or standard IFN-a-2b at 3MU,every other day.RBV was given at 800 to 1000 mg/day. All patients were routinely monitored for adverse drug reactions and virological response.Effects of treatments on patient survival were assessed by Kaplan-Meier analysis.</p><p><b>RESULTS</b>At the end of treatment,74.2% of patients were HCV RNA-negative,with 45.5% having achieved sustained virological response and 28.8% having relapsed;the remaining 25.7% of patients showed non-virological response (NVR). Among the patients with HCV genotype 1, 65.9% achieved end-of-treatment virological response (ETVR) and 34.1% achieved SVR;among the patients with HCV genotype 2,90.9% achieved ETVR and 68.2% achieved SVR. The positive and negative predictive values of early virological response (EVR) for ETVR were 95.7% and 75.0% respectively, and for SVR were 65.2% and 100% respectively. Compared with baseline,patients who achieved ETVR had better liver function,as evidenced by changes in levels of total bilirubin,alanine aminotransferase and albumin,as well as prothrombin activity and Child-Pugh score (t =4.564,11.486,2.303,2.699,3.694 respectively, all P less than 0.05).Compared with the NVR patients, the ETVR patients had lower risk of hepatic decompensation and hepatocellular carcinoma, and had improved survival (x2=18.756,6.992,7.580, respectively, all P less than 0.05).Twelve (18.2%) patients experienced serious adverse events,with 10 requiring premature treatment withdrawal and 2 dying.</p><p><b>CONCLUSION</b>Antiviral treatment for patients with HCV infection and decompensated cirrhosis using interferon in a low accelerating dosage regimen in combination with ribavirin is feasible.Patients who achieved ETVR had significantly improved long-term prognosis.</p>

Ethical Consciousness Cultivation of Medical Students in Clinical Teaching of Infectious Diseases / 中国医学伦理学

Because of the specificity of infectious diseases , the the medical ethics education and concepts need to be paid more attention to .During the clinical teaching of infectious diseases , pay attention to teachers′medical ethics accomplishment level of ascension , teaching teachers should play the role of shape model , encourage interac-tion, eliminate the fear and discrimination interns and strengthen medical ethics consciousness and the combination of legal concepts , promote the medical students medical ethics consciousness of the form .

Therapy Effects of Lipid Microspheres Prostaglandin E_1 Injection in Combination with Diammonium Glycyrrhizinate Injection on Patients with Severe Hepatitis / 中国药房

OBJECTIVE:To observe the clinical outcome of lipid microspheres prostaglandin E 1 (Lipo-PGE 1 )injection in combination with diammonium glycyrrhizinate injection plus combined therapy in the treatment of chronic severe hepati-tis.METHODS:68patents with severe hepatitis B were assigned to receive lipid Lipo-PGE 1 injection in combination with di-ammonium glycyrrhizinate injection(treatment group)besides the necessary combined therapy as in the control group for4weeks,the clinical outcome and biochemical indicators were compared between2groups.RESULTS:As compared with the control group,the treatment group had a significantly alleviated clinical symptoms after treatment for2weeks and4weeks(P

Changes of hemodynamics in patients with severe hepatitis treated with molecular adsorbents recirculating system / 西安交通大学学报(医学版)

Objective To evaluate the chang es of hemodynamics and the relationship with the outcome in patients with severe h epatitis treated with molecular adsorbents recirculating system (MARS). Methods A total of 16 patients with severe hepatitis were t reated with MARS for 36 times altogether as the treatment group. Twenty patients with severe hepatitis were treated by comprehensive methods as the control grou p. The age, sex and liver function between the two groups matched. Their prognos is was observed and the levels of serum total bilirubin, the non-conjugated bil irubin and mean arterial pressure (MAP), and heart rate were observed in the pat ients during a single 6 h to 8 h treatment with MARS. The relationship between the change and prognosis was observed. Results There were significant differences in prognosis and complications between the two groups. T he survival rate in treatment and control groups was 62.5% and 37.5%, respective ly (P