OBJECTIVE:To observe clinical effect and safety of temozolomide (TMZ) combined with radiotherapy in the treatment of malignant glioma. METHODS:58 patients with malignant glioma were randomly divided into TMZ-RT group(32 cas-es)and RT group(26 cases). RT group were given the therapy of 3D-CRT 1.8-3 Gy/d,and some patients received the hyperfrac-tion radiotherapy with total dose of 60-75 Gy. TMZ-RT group were given TMZ chemotherapy 75 mg/(m2·d)combined with radio-therapy for 6 weeks and TMZ sequential therapy 150-200 mg/(m2·d)for 4 weeks. Therapeutic efficacy and ADR were observed in 2 groups. RESULTS:After treatment,in TMZ-RT group,9 cases had complete remission,11 cases had partial remission,10 cas-es were stable and 2 cases were progressive;in RT group,6 cases had complete remission,8 cases had partial remission,8 cases were stable and 4 cases were progressive. There was no statistical significance in short-term efficacy between 2 groups(P>0.05). The 1,2,3-year survival rates of TMZ-RT group were 81.3%(26/32),78.1%(25/32) and 62.5%(20/32),while those of RT group were 84.6%(22/26),34.6%(9/26)and 15.4%(4/26). There were statistical significance in 2,3-year survival rates between 2 groups (P<0.05). Median recurrent time of TMZ-RT group was (23.2 ± 8.6) months,while that of RT group was (15.6 ± 8.7) months,with statistical significance(P<0.05). According to the KPS,TMZ-RT group was(89.6±9.6)and RT group(65.1±10.1), with statistical significance (P<0.01). The side effect of 2 groups were slight. CONCLUSIONS:Radiotherapy combined with TMZ can significantly improve the survival rates of 2 and 3-year and delay the tumor recurrent time,and lighter adverse reaction. It can be used as new therapy method for malignant glioma. But it needs further study for treating the malignant glioma patients with osteomyelitis or low immune function.

OBJECTIVE:To observe the clinical efficacy of pegylated interferon α-2a(Peg-INFα-2a)combined with adefovir (ADV)in the treatment of HBeAg-positive chronic hepatitis B (CHB). METHODS:An open randomized controlled clinical trial was performed. According to random number table,70 patients with HBeAg-positive chronic hepatitis B were divided into observa-tion group and control group,with 35 cases in each group. Observation group received Peg-INF α-2a combined with ADV,and control group was treated with Peg-INF α-2a only. Therapeutic efficacy and safety evaluation were evaluated after 24 and 48 weeks of treatment. RESULTS:After 24 weeks of treatment,ALT normalization rate of observation group and control group were 51.43%and 25.71%,and HBV-DNA negative rate of 2 groups were 68.57% and 37.14% respectively,with statistical significance (P<0.05). There was no statistical significance between HBsAg negative rate and HBeAg negative rate (P>0.05). After 48 weeks of treatment,ALT normalization rate of observation group and control group were 77.14% and 54.29%,and HBeAg negative rate 54.29% and 31.43%,and HBV-DNA negative rate 82.86% and 42.86% respectively,with statistical significance(P<0.05).There was no statistical significance in HBsAg negative rate and ADR (P>0.05). CONCLUSIONS:Peg-INFα-2a combined with ADV have good clinical efficacy in the treatment of HBeAg-positive CHB,and it is better than Peg-INFα-2a monotherapy and has less ADR.

Objective:To explore the correlation of neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio (PLR) with lower extremity arterial disease (LEAD) in type 2 diabetes mellitus (T2DM).Methods:A total of 314 T2DM patients hospitalized in Tengzhou Central People′s Hospital from January 2018 to December 2019 were collected and divided into LEAD group (168 cases) and control group (146 cases) according to the results of color Doppler ultrasound of lower extremity arteries. General clinical data were collected. Fasting venous blood samples were collected to detect blood routine and biochemical indicators. NLR and PLR values were calculated. Patients were divided into 4 groups according to the NLR and PLR quartiles. The differences of data in each group were analyzed; Spearman correlation was used to analyze the correlation between NLR, PLR and each index; The risk factors of LEAD in T2DM patients were analyzed by logistic regression. The receiver operating characteristic (ROC) curve was used to determine the efficiency of the model predicting LEAD in T2DM patients.Results:The age, white blood cells count (WBC), neutrophil count, NLR, PLR and C-reactive protein (CRP) in LEAD group were significantly higher than those in control group (all P<0.05). With the increase of NLR and PLR quartiles, the age, body mass index, WBC, neutrophils and platelets increased gradually ( P<0.05), and the lymphocytes decreased gradually ( P<0.05). Spearman correlation analysis showed that NLR and PLR were positively correlated with age, neutrophils and platelets (all P<0.01), but negatively correlated with lymphocytes (all P<0.01). Logistic regression analysis showed that age, NLR, PLR, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and CRP were the risk factors of LEAD in T2DM patients (all P<0.01). The area under the curve (AUC) of NLR, PLR, CRP and age were 0.813, 0.683, 0.668 and 0.630, respectively; The sensitivity was 82.49%, 84.37%, 72.58% and 62.87%, respectively. Conclusions:NLR and PLR are closely related to LEAD in T2DM patients. NLR is superior to PLR and CRP in the diagnosis of LEAD.

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