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Objective To explore the clinical efficacy and safety of Oxaliplatin combined with transcatheter arterial chemoembolization in the treatment of elderly patients with primary hepatocellular carcinoma.Methods One-hundred and three elderly patients with primary hepatocellular carcinoma who were treated in First Affiliated Hospital of Bengbu Medical College from January 2013 to July 2017 were selected.Based on the treatment methods,all patients were divided into the observation group and the control group by random number table method.Patients in the observation group (n=51) were treated with transcatheter arterial chemoembolization combined with Oxaliplatin,and those in the control group (n =52) treated with traditional hepatic arterial chemoembolization.The clinical efficacy and adverse reactions were compared and analyzed between groups.Results In the observation group,the partial remission rate (70.6％ vs.50％,x2 =4.555,P=0.033) and the total effective rate (72.6％ vs.50％,x2 =5.511,P=0.019) were significantly higher than those in the control group.Additionally,there was no significant difference in the incidence of adverse reactions between the two groups (all P＞0.05).Conclusions Combined with transcatheter arterial chemoembolization,Oxaliplatin could safely and effectively improve the prognosis of elderly patients with primary hepatocellular carcinoma..
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Objective To investigate the association between liver pathological changes and clinical features in patients with chronic HBV infection and alanine aminotransferase (ALT) 1-2 × upper limits of normal (ULN).Methods A total of 80 patients with chronic HBV infection and ALT 1-2 × ULN who were hospitalized in The First Affiliated Hospital of Bengbu Medical College from July 2015 to December 2016 were enrolled.All patients underwent liver biopsy,and according to positive or negative HBeAg,these patients were divided into two groups,and the association of liver pathological changes with age,sex,and HBV DNA load was analyzed.The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.Results The HBeAg-negative group had significantly higher age and serum ALT level than the HBeAg-positive group (t =12.35 and 7.18,both P ＜ 0.01).Compared with the HBeAg-positive group,the HBeAg-negative group had a significantly higher proportion of patients with liver inflammation ≥G2 (54.8％ vs76.3％,x2 =53.68,P＜0.01) or fibrosis degree ≥S2 (57.1％ vs 73.7％,x2 =46.67,P＜0.01).Immunohistochemical staining was performed for 35 patients to measure the expression of HBsAg and HBcAg in the liver,and there were no significant differences in the staining scores of HBsAg and HBcAg between the two groups (both P ＞ 0.05).Conclusion Among patients with chronic HBV infection and slightly elevated ALT,HBeAg-negative patients have significantly worse conditions of liver lesions than HBeAg-positive patients.Liver biopsy is recommended for older patients with a long course of disease,in order to provide guidance for antiviral therapy.
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Objective To investigate the efficacy and safety of lamivudine in the patients of hepatitis B virus-associated glomerulonephritis (HBV-GN) treated by prednisolone with leflunomide. Methods 41 HBV-GN patients treated by prednisolone and leflunomide were enrolled in this study. According to the presence of the indications of antiviral treatment, the patients were divided into the prevention group and the treatment group received lamivudine treatment, and another 15 patients with chronic hepatitis B were treated with lamivudine as the control group. The biochemical, virological and serological responses during the process of the treatment and the serum levels of IFN-γ and IL-4 were determined. Results No significant differences of biochemical, virological and serological responses in the prevention and treatment groups compared with the control group at 48 weeks after treatment. Levels of the IFN-γ and IFN-γ / IL-4 decreased significantly in the prevention group and treatment groups compared with the control group (P < 0.05, respectively). No serious adverse reactions occurred in all patients. Conclusion The antiviral treatment of lamivudine lead to good curative effect and security in HBV-GN patients received hormones combined with leflunomide treatments, but leflunomide with prednisolone inhibited the production of IFN-γ and removal of hepatitis B virus.