Hepatitis B virus (HBV)-related liver failure has an extremely high mortality rate and a complex pathogenesis,and since related mechanisms are not fully understood,it has been very difficult to diagnose and treat this disease in clinical practice.Apart from liver transplantation,there is still a lack of specific and effective drugs and therapies for the medical treatment of HBV-related liver failure.This article summarizes our experience and research achievements in the diagnosis and treatment of HBV-related liver failure,explores the association between host's genetic background and development and aggravation of chronic hepatitis B,and elaborates on the phenomenon of three attacks and the concept of four time phases.In the aspect of treatment,this article focuses on the clinical application of antiviral therapy,anti-infective therapy,glucocorticoids,and stem cell transplantation;for the evaluation of patients' condition,this article establishes a suitable system for evaluating the prognosis of HBV-related liver failure.

0.05).Conclusions The expression of galetin-3 was obviously increased in liver metastasis from colon cancer,and MCP can effectively inhibit the development of liver metastasis of colon cancer.

Objective To investigate the effect of cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma. Methods 124 cases with primary liver carcinoma were randomly divided into two groups:60 cases were treated by TACE and cryotherapy; the other 64 cases were simply done by TACE as control. In general, TACE was undertaken once a month and altogether three times for a course. Cryotherapy was undergone 1-3 times for a course. Results The total effective rates (CR+PR) were 45.3% for the control group and 68.3% for the combined therapy group, with an obvious difference between the two groups, 0.5,1,1.5 years survival rate were 81.3%,62.5%,43.8% respectively in the control group;93.3%,83.3%,63.3% respectively for the combined group. There was an obvious difference between the two groups of 1,1.5 years of survival rates. Conclusions Cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma is feasible with raising the effective rate and prolonging survival time.

1.0 ?10 7 copies/ml than those with lower HBV DNA levels both in combination group and lamivudine group (52.0% vs 25.8%, P= 0.04; 63.2% vs 28.6%, P= 0.03). Necro-inflammatory activity, fibrosis and the expression of HBV DNA showed no correlation with response rate in combination group. Among those who had higher levels of HBV DNA expression, seroconversion rate in combination group is higher than that in lamivudine group (46.2% vs 9.5%, P= 0.03). Conclusions The efficacy of combination therapy appeared to be better in patients with at least moderately elevated baseline ALT, high level of HBV DNA as well as HBV DNA expression in hepatocytes. Combination therapy may delay or diminish the development of YMDD mutation-related resistance to lamivudine.

Liver failure caused by hepatitis B virus (HBV) infection is common in China, among which acute-on-chronic liver failure (ACLF) is the main type.Because the pathogenesis is complex and the diagnosis and treatment is difficult,HBV related ACLF has high mortality.In recent years, some progress has achieved in diagnosis and therapy of ACLF.This article reviews the new strategies and advances about HBV related ACLF on basis of researches at home and abroad,including the definition, mechanisms, management and prognosis assessment of ACLF.

ObjectiveTo investigate the neural mechanism of prospective memory(PM) using functional magnetic resonance imaging (fMRI).MethodsFifteen healthy volunteers were enrolled,and all subjects were scanned with fMRI while performing the event-based PM tasks (double-task paradigm,including the ongoing task and PM task).And the image data were preprocessed and analyzed by using SPM8 software.Results ( 1 ) Compared to the control task,bilateral rostral prefrontal cortex ( x,y,z =6/- 2,54/42,- 8/- 12,t =3.71 ),right somatosensory association area ( x,y,z =14,- 62,64,t =4.64 ),superior temporal gyrus ( x,y,z =42,- 46,16,t =3.95 ) and right paracentral lobule (x,y,z =10,-22,76,t =4.01 ) were activated significantly by the ongoing task (P ＜ 0.001 ).(2) Bilateral rostral prefrontal cortex ( x,y,z =- 2/6,42/54,- 12/- 12,t =3.28) and paracentral lobule (x,y,z =- 30/10,- 22/- 22,72/76,t =4.25 ),left postcentral gyrus ( x,y,z =- 38,- 46,64,t=3.13) and middle occipital gyrus ( x,y,z =- 30,- 70,0,t =3.97 ) were activated significantly by the PM task (P ＜ 0.001 ).ConclusionRostral prefrontal cortex (BA 10 area) is the major area of prospective memory,and medial BA10 area may be involved in the monitoring of external cues.The present study supports the gateway hypotheses of prospective memory.

Objective To investigate HBV genotypes and gene mutations in chrenic hepatitis B (CHB) patients with liver failure after lamivudine withdrawal. Methods Twenty four patients with relapsing CHB after lamivudine withdrawal were divided into liver failure group ( n = 12 ) and chronic hepatitis group ( n = 12 ). HBV DNA from these patients was amplified by PCR. The PCR products were cloned into PGEM-T vector and HBV DNA sequences were analyzed. Results In liver failure group, there were 6 sequences detected, in which 3 were of genotype B and 3 were of genotype C. In chronic hepatitis group, there were 9 sequences detected, in which 2 were of genotype B and 7 were of genotype C. Compared with the wild type HBV sequences, there were multiples mutations in S, P, C, X regions. Gene mutations in high conservative sequences of BCP and P regions were detected in liver failure patients after lamivudine withdrawal. Conclusions In HBV patients with liver failure after lamivudine withdrawal, half of them were of genotype B and the others were of genotype C. Some mutations in high conservative sequences of BCP and P regions may be related to the liver failure in these patients.

Objective To study the surgical treatment of multilevel arterial occlusion of lower extremities. Methods Single or jumping arterial bypass using grafting and percuteneous transluminal angioplasty(PTA)and stenting combined with infrainguinal revascularization were used for the multilevel arterial occlusion in 25 lower extremities. Results 25 cases showed satisfactory results in 6 months to 3 years follow-up. Postoperatively,the ischemia symptoms of limbs were improved or disappeared,4 toes were amputared because of preoperative dry gangrene,the wounds received eurement in a 2 to 4 months,2 graftings became occluded in 6 months postoperation. There were no procedural or postoperative morbidity or mortality.The cumulative patency rate of grafting was 92%(23/25),The rate of curement was 100%.Conclusion According to the individual principle,it is an effective therapy method to choose single or jumping arterial bypass and PTA and stenting combined with infrainguinal revascularization for high risk patients with multilevel arterial occlusion.

Pancreatic adenosquamous carcinoma is a rare exocrine pancreatic cancer,and surgical treatment is the only promising method in survival time extension and life quality enhancement.In July 2013,1 patient with pancreatic adenosquamous carcinoma and sarcomatoid change was admitted to the Shaoxing People's Hospital.A cauda pancreatis cystic nidus was detected by computed tomography 1 year ago,and no any other clinical symptoms were detected.The left upper quadrant of the patient was glutted and unwell,and the levels of CA19-9 and CA125 were 3 630 kU/L and 645 kU/L,respectively.The results of computed tomography and magnetic resonance imaging showed that a huge cystic and solid tumor was located between the cauda pancreatis,the stomach and the spleen;the tumor was mainly cystic and rooted in the tail of the pancreas;the spleen,stomach and surrounding tissues were infiltrated by the tumor.The results of postoperative pathological examination showed that the tumor was pancreatic adenocarcinoma with squamous epithelial differentiation and sarcomatoid change;the invasive squamous carcinoma dominated stomach wall,and the sarcomatoid change dominated spleen and lymph nodes with partial squamous epithelial differentiation and surrounding lymph nodes metastases.Although the surgical resection was complete and the postoperative thymosin injection and traditional Chinese medicine were implemented,tumor recurred at postoperative month 5,and the patient was dead due to cachexia and pernicious anemia at postoperative month 8.The prognosis of patients with pancreatic adenosquamous carcinoma is poor,early detection and surgery are key points for curative effect enhancement.