Objective To explore the clinical efficacy and adverse reactions of transarterial chemoembolization(TACE)combined with sorafenib for the treatment of liver carcinoma.Methods Forty-eight cases of intermediate-advanced liver carcinoma patients were divided into TACE combined with sorafenib group(test group)and TACE only group(control group)according to the wishes of the patient,with 24 patients in each group.The median Survival Time(mOS),clinical efficacy,quality of life,liver function indexes and adverse reactions were compared in two groups.Results Until the deadline of follow-up time,the mOS in test group(15.9 months)was significantly higher than that in control group(9.3 months).The difference was statistically significant(P<0.05).The ORR,CBR in test group(58.3%,87.5%)were significantly higher than those in control group(33.3%, 54.2%).The difference was statistically significant(P<0.05).The quality of life improvement rate in test group(79.2%)was significantly higher than that in control group(37.5%).The differences were statistically significant (P<0.05 ).The ALB,TBIL increased significantly after treatment than before treatment in both groups.The differences were statistically significant(P<0.05 ).Conclusion TACE combined with sorafenib is more efficiency than TACE only treatment,and it could effectively extend the period of life to guarantee the quality of life.What's more,it has well tolerated adverse reactions,which is worthy of promoting.

Objective To investigate the pathogens and their antibiotic resistance profile of hospital and community-acquired spontaneous bacterial peritonitis ( SBP) in patients with liver cirrhosis. Methods Eighty-four cirrhotic patients with SBP were recruited, in which 61 (72. 6% ) were diagnosed as communityacquired SBP and 23 (27.4% ) were diagnosed as hospital-acquired SBP. Bacterial identification and drug susceptibility tests were performed. SPSS 16. 0 was used for statistical analysis. Results There were 68 (81.0%) Gram-negative strains and 16 (19.0%) Gram-positive strains. Escherichia coli and Klebsiella pneumoniae were the top two prevalent strains. In community-acquired group, there were 21 (21/61, 34. 4% ) strains of Escherichia coli and 15 ( 15/61 , 24. 6% ) strains of Klebsiella pneumoniae; while in hospital-acquired group, it was 12 (12/23, 52.2%) strains and 6 (6/23, 26. 1%) strains, respectively. There were no statistical differences in the infection rates of Escherichia coli and Klebsiella pneumoniae between community and hospital-acquired SBP patients (x2 = 2. 21 and 0. 02, P > 0. 05). Drug susceptibility tests showed that Escherichia coli and Klebsiella pneumoniae were 100% sensitive to impenem, and the sensitivity to Piperacillin/Tazobactam was also high. But these strains were highly resistant to Ampicillin and Ampicillin/Sulbactam. All extended spectrum β-lactamases ( ESBLs) positive strains were resistant to cephalosporins, while ESBLs-negative strains were all sensitive to cephalosporins. Conclusions SBP in patients with liver cirrhosis are mainly caused by Gram-negative strains, especially Escherichia coli and Klebsiella pneumoniae. ESBLs-positive strains are highly resistant to cephalosporins, so proper use of right antibacterial agents is important.

The method of under--water weighing was used to measure the body composition of seventeen rhythmicgymnasts and four ordinary women. The average fat percentage was found to be 19. 0% in the gymoasts and26. 4% in the non--gytnnasts. The fat oercentage in the body composition of an athlete is not directly proportional to her body weight.It is inversely proportional to her training level. Therefore, in evaluating the physical condition of an athlete,her fat percentage must be taken into account. An artistic gymnast who is reducing bodyweight shows a negative energy belance of 50. 5% and insuffi-cient intake of protein and vitamins. Reduction of bodyweight should therefore be carried out under medicalsupervision.

Objective To evaluate the effects of laparoscopic filling with pedicled greater retina for hepatic cysts. Methods Clinical data were reviewed on 36 patients with hepatic cysts undergoing laparoscopic filling with pedicled greater retina from January 2010 to May 2014.The diameters of cysts ranged from 10 to 26 cm, with a diameter smaller than 20 cm in 29 patients and bigger than 20 cm in 7 patients.Laparoscopic fenestration of hepatic cysts was performed to destroy cyst cells with iodine and absolute alcohol. Pedicled greater retina was used for filling the cavity of cysts. Results The procedures were completed smoothly.The operative time was 45-115 min, with an average of (80.4 ±13.1) min.No abdominal cavity infection happened.Primary healing of abdominal incision was achieved in all the patients.The postoperative hospital stay was 5-10 d, with an average of (6.4 ±1.2) d.All the 36 patients were followed up for 6-12 months with a mean of (9.3 ±1.5) months.None of the patients showed recurrence under liver B-ultrasonography or CT scanning. Conclusion Laparoscopic filling with pedicled greater retina for hepatic cysts has advantages of minimal invasion, quick postoperative recovery, short hospital stay, and good results.

Objective To investigate the clinical value of serum apolipoprotein A-1 (Apo A-1) detection in HBV-related liver cancer.Methods Totally 362 cases of patients with chronic HBV infection were enrolled from January 2010 to December 2014 in our hospital,including 88 cases of chronic hepatitis B,94 cases of HBV-related liver cirhosis,18 cases of HBV-related liver cancer (without cirrhosis) and 162 cases of liver cirrhosis merged cancer.At the same time,45 cases of healthy people were selected for normal control.The serum Apo A-1,AFP and other laboratory markers were detected,and the test results were statistically analyzed.Results The difference of Serum Apo A-1 and AFP levels in all groups was statistically significant (F =29.86,x2 =112.53,P =0.000).As the disease progressed,the serum levels of Apo A-1 gradually decreased (P ＜ 0.05).But the difference of Apo A-1 level between normal control and HBV-related liver cancer group (without cirrhosis),chronic hepatitis B and liver cirrhosis merged cancer group,liver cirrhosis and liver cirrhosis merged cancer group was not statistically significant (all P ＞ 0.05).The liver cancer patients with Child-Pugh score A,B,C had different serum Apo A-1 levels (all P ＜ 0.05);The serum Apo A-1 level of liver cancer patients with Child-Pugh score A was significantly higher than that of liver cirrhosis (t =-3.02,P =0.003),but the differences of serum Apo A-1 levels between liver cancer and liver cirrhosis patients with Child-Pugh score B and C were not statistically significant (t =0.52,1.19,P =0.610,0.240).The serum Apo A-1 levels of liver cancer patients with TNM stage Ⅰ and Ⅱ were significantly higher than those with TNM stage Ⅲ and Ⅳ (t =3.85,P ＜ 0.001).Conclusion The serum Apo A-1 levels of HBV-related liver cancer patients are related with cirrhosis,Child-Pugh score and TNM stage,and the liver reserve function,the body's stress response and many other factors may contribute to the expression of serum Apo A-1.

The gastric stump cancer is closely associated with Helicobacter pylori.Helicobacter pylori can promote the proliferation of gastric remnant mucosa epithelial cells,the production of nitroso compounds in gastric juice and abnormal expressions of some genes in human body,and finally to promote the occurrence of gastric stump cancer.The eradication of Helicobacter pylori infection is expected to reduce the incidence of gastric stump cancer.

Objective To explore the effect of hepatitis B virus(HBV) on the expression of apolipoprotein A1 (ApoA1) and its regulatory mechanism.Methods RT-PCR and Western blot were used to measure the expression of ApoA1 in HepG2 and HepG2.2.15 cells,serum ApoA1 and high density lipoprotein cholesterol(HDL-C) levels in patients with HBV infection and in healthy individuals were measured by biochemical analyzer,statistical difference was analyzed by SPSS13.0,HepG2 cells was co-transfected with ApoA1 promoter containing the luciferase gene and HBV infectious clone pHBV1.3,luciferase activity was measured,expression of ApoA1 in HepG2 cells was measured by RT-PCR and Western blot after transfected with pHBV1.3.Results Expression of ApoA1 mRNA and protein was lower in HepG2.2.15 cells than in HepG2 cells,serum ApoA1 and HDL-C levels were much lower in HBV patients as compared to healthy individuals( P＜0.05 ),HBV represses ApoA1 gene promoter activity,ApoA1 mRNA and protein expression in HepG2 cells.Conclusion HBV can inhibit the expression of ApoA1 bothin vivo and in vitro.

Objective To evaluate HBeAg quantification in predicting the efficacy of pegylated interferon (PegIFN) α treatment for patients with HBeAg-positive chronic hepatitis B (CHB).Methods A total of 216 HBeAg-positive CHB patients admitted in Ningbo No.2 Hospital during March 2009 and December 2011 were enrolled in the study.All patients were given subcutaneous injection of PegIFNα-2a or PegIFNα-2b weekly for 48 weeks and followed up for 24 weeks after discontinuation.Patients were divided into HBeAg seroconversion group and non-seroconversion group at the end of the follow-up.Receiver operating characteristic (ROC) curves were used to evaluate HBeAg levels at baseline and 12,24 weeks of treatment in predicting HBeAg seroconversion.Results HBeAg seroconversion was observed in 31.48％ (68/216) patients at the end of follow-up,and there was no significant difference in seroconversion rate between patients treated with PegIFNα-2a and those with PegIFNα-2b (32.00％ vs.29.27％,P ＞ 0.05).There was significant difference in baseline HBeAg levels between patients with HBeAg seroconversion and those without HBeAg seroconversion (Z =-3.834,P ＜ 0.05).HBeAg seroconversion patients had a tendency of rapidly decreasing HBeAg level,but there was no significant difference in decreasing rate between seroconversion and non-seroconversion patients (F =3.321,P ＞ 0.05).ROC curves showed that HBeAg level at 24-week was the best indicator for predicting HBeAg seroconversion with area under curve of 0.861.Conclusion Serum HBeAg level at 24-week of treatment may be used to predict the HBeAg seroconversion in HBeAg-positive CHB patients treated with PegIFNα.

Objective To investigate the efficacy of polyethylene glycol (PEG)-interferon α (PEG-IFNα) in treating HBeAg-positive chronic hepatitis B (CHB) and explore the relationship between hepatitis B virus (HBV) genotypes and the effect of interferon α (IFNα) therapy.Methods A total of 199 CHB patients with known genotypes were given subcutaneous injection of PEG-IFNα-2a or PEG-IFNαt-2b once a week for 48 weeks,with another 24 weeks follow up.The seroconversion of HBeAg influenced by HBV genotypes were analyzed after discontinuation of treatment.Results In local area,genotype C was the major genotype[64.32％ (128/199)].Except serum ALT and AST level,the differences in gender,age,liver inflammation,degree of liver fibrosis,HBeAg level and HBV DNA level between genotype B and C were not statistically significant(all P ＞0.05).The seroconversion rate of HBeAg in patients with genotype B at early stage of therapy (3 months) was significantly higher than that of patients with genotype C [26.76％ (19/71) vs 10.16％ (13/128),x2 =9.330,P =0.002].While at the end of follow-up,seroconversion rate of HBeAg in patients with genotype B (followed up for 6 months) was higher than that of patients with genotype C [39.44％ (28/71) vs 30.47％ (39/128)],but the difference was not statistically significant(x2 =1.645,P =0.200).By univariate analysis based on log-rank test,the time of HBeAg seroconversion in patients with genotype B was much earlier than that of genotype C [(13.99 ± 0.67) months vs (15.47 ± 0.41)months],but the difference was not statistically significant (P =0.150).Conclusions The seroconversion rate of HBeAg in patients with genotype B treated with PEG-IFNα was significantly higher than that of genotype C in early stage of therapy (3 months),while similar at the end of therapy.

Objective To explore the effect of hepatitis B virus(HBV) on the expression of high sensitive C-reaction protein(hs-CRP) and its clinical implication.Methods mRNA expression of hs-CRP in HepG2 and HepG2.2.15 cells was measured by RT-PCR,serum hs-CRP levels in patients with HBV infection and in healthy individuals were measured by biochemical analyzer Olympus5400,the expression of hs-CRP difference among patients with chronic hepatitis B,liver cirrhosis and hepatocellular carcinoma were analyzed.Results Expression of hs-CRP mRNA was higher in HepG2.2.15 cells than in HepG2 cells,serum hs-CRP levels was much higher in HBV patients as compared to healthy individuals ( P＜0.05 ),hs-CRP was detected at higher levels in patients with liver cirrhosis or hepatocellular carcinoma than those with chronic hepatitis B.Conclusion HBV can upregulated the expression of hs-CRP,which is associated with the disease progression.