Clinical effect of drug-eluting beads and conventional transcatheter arterial chemoembolization in treatment of unresectable liver cancer: A meta-analysis / 临床肝胆病杂志

ObjectiveTo systematically review the clinical effect of transcatheter arterial chemoembolization with drug-eluting beads (DEB-TACE) versus conventional transcatheter arterial chemoembolization (cTACE) in the treatment of unresectable liver cancer. MethodsPubMed, Embase, Cochrane, and CNKI were searched for articles on clinical control trials of DEB-TACE versus cTACE in the treatment of unresectable liver cancer. The articles were screened according to inclusion and exclusion criteria, and after valid data were extracted, Revman 5.3 software was used for meta-analysis. The two groups were compared in terms of the number of patients with complete remission (CR), partial remission (PR), or stable disease (SD) and 6- and 12-month survival rates. ResultsA total of 12 articles were included, with 1177 patients in total, among whom 519 patients underwent DEB-TACE and 658 underwent cTACE. Compared with the cTACE group, the DEB-TACE group had a significantly higher number of patients with CR (risk ratio ［RR］=1.42, 95% confidence interval ［CI］: 1.18-1.72, P=0.0002), and had a significantly higher 12-month survival rate (RR=1.09, 95% CI: 1.01-1.17, P=0.03). There were no significant differences between the two groups in the number of patients with PR (RR=1.13, 95% CI: 0.97-130, P=0.12), the number of patients with SD (RR=0.82, 95% CI: 0.64-1.05, P=0.12), 6-month survival rate (RR=1.05, 95% CI: 1.00-1.10, P=0.07). ConclusionDEB-TACE has a better therapeutic effect than cTACE with iodinated oil.

Comparison of different scoring systems evaluating short-term prognosis of patients with hepatitis B associated acute hepatic failure / 实用医学杂志

Objective To assessment short-term prognosis in patients with acute on chronic liver failure , several scoring systems were compared. Methods Two hundred and sixteen patients with acute on chronic liver failure were divided into survival group and death group according to the results of 90 days after admission.CTP , MELD,APACHEⅡ, SOFA and SMSVH score were calculated.After ROC curves were performed ,the areas under the curves of these scoring systems were compared. Results The areas under the ROC curves of MELD, APACHEⅡ, SOFA, CTP and SMSVH were 0.88, 0.76, 0.89,0.79and 0.69,respectively. The areas under the curves of SOFA and MELD were larger than the APACHEⅡ, CTP and SMSVH (P0.05). The area under the curve of CTP was larger than the APACHEⅡ, but there was no statistically significant difference (P > 0.05). The area under the curve of SMSVH were less than 0.7. Conclusions The SOFA, MELD,CTP and APACHEⅡcan predict the short-term prognosis of acute on chronic liver failure. The SOFA and MELD are the best scoring systems.CTP,APACHEⅡ are better than SMSVH. SMSVH fail to predict the prognosis of acute on chronic liver failure.