Objective To observe the effect of telbivudine combined with adefuvir dipivoxil in the treatment of Hepatitis B patients with decompensated cirrhosis.Methods 56 Hepatitis B patients with decompensated cirrhosis were divided into two groups:treatment group (30 cases) and control group (26 cases).During 24 weeks,the control group received adefuvir dipivoxil( 10mg daily),supportive and symptomatic treatments,while the treatment group received telbivudine therapy(600mg daily) combiled with adefuvir dipivoxil ( 10mg daily) based on the regular treatments.After 24 weeks,the effect was observed and compared between the two groups.Results After treatment,the biochemical markers,Child-Pugh score of the treatment group was (33.2 ± 13.8) μmol/L,(44.5 ± 16.4) U/L,(36.1 ±1.5) g/L,(6.1 ± 1.8) points,respectively,and was better than those of the control group[ (71.8 ±18.6) μ mol/L,(89.9 ±44.9) U/L,(29.7 ± 1.3)g/L,(8.1 ±2.2) points] (t=15.32,15.20,23.37,6.09,all P＜0.05) ;HBV-DNA negative rate,HBeAg seroconversion rates of the treatment group was 93.3％ (28/30),43.3％(13/30),and was higher than that of the control group[76.9％ (20/26),7.6％ (2/26) ] (x2 =4.87,9.08,all P＜0.05).Conclusion Telbivudine combined with adefuvir dipivoxil was effective and safe for the treatment of Hepatitis B patients with decompensated cirrhosis.

Objective To investigate the effect of esketamine on perioperative pain and depression in patients with thoracoscopic pulmonary nodule resection. Methods A total of 120 patients with selective thoracoscopic pulmonary nodule resection were randomly divided into low-dose esketamine group (group L), high-dose esketamine group (group H) and saline control group (group C), with 40 cases in each group. Before skin incisionafter anesthetic induction, 0.25 mg/kgesketamine, 0.50 mg/kg esketamine and the equivalent amount of saline were separately administered for patients in the three groups. Visual Analogue Scale (VAS) score for pain and the Self-rating Depression Scale (SDS) score were compared among the three groups at the time points of one day before surgery (T₀), one day after surgery (T₁), three days after surgery (T₂), and the day of discharge (T₃), and postoperative analgesia within 24 h and perioperative adverse reactions were also recorded. Results The VAS scores for rest and coughing at T₁ were significantly lower in group L and group H than group C (P < 0.05); compared with group C, the total press number of analgesic pump with in 24 h and effective press number were significantly decreased in group L and group H, and the dosage of sufentanil was also significantly decreased(P < 0.05). There were no significant differences in depression scores at different time points among the three groups (P>0.05). There were no significant differences in the incidence rates of nausea, vomiting, dizziness, hallucinations, and nightmares among the three groups (P>0.05). Conclusion Esketamine can effectively alleviate pain on the first day after operation and reduce the dosage of opioid analgesics without increasing the incidence of adverse reactions in patients with thoracoscopic pulmonary nodule resection; compared with 0.25 mg/kg esketamine, 0.50 mg/kg esketamine doesn't demonstrate better postoperative analgesia or improvement in perioperative depression.