BACKGROUND: Hepatitis B virus (HBV) recurrence following liver transplantation has been difficultly treated, and antiviral therapy following HBV recurrence has been less reported yet.OBJECTIVE: To investigate the antiviral therapy using Adefovir + Lamivudine + anti-hepatis B immunoglobulin on liver functional improvement following liver transplantation.METHODS: A total of 208 cases with hepatitis B-related end-stage liver disease following liver transplantation were selected from Liver Transplantation Center of Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from January 2005 to October 2008. All patients were treated with Lamivudine + anti-hepatis B immunoglobulin so as to prevent from HBV recurrence. At 6-43 months after following up, HBV recurrence was found in 19 cases, including 13 with positive HBeAg and 8 with YMDD mutation. The 19 patients were treated with Adefovir based on the application of Lamivudine + anti-hepatis B immunoglobulin.RESULTS AND CONCLUSION: At 12, 24, and 48 weeks after treatment, DNA and glutamic-pyruvic transaminase of 19 cases were significantly decreased (P < 0.01). After 48-week treatment, recovery rate of glutamic-pyruvic transaminase, negativity rate of HBeAg, and negativity rate of HBV DNA were 84.1 %, 76.92%, and 78.9%, respectively. The results demonstrated that the application of Adefovir + Lamivudine + anti-hepatis B immunoglobulin effectively inhibited viral replication and prevented HBV recurrence following liver transplantation.

Objective:To investigate the efficacy of laparoscopic treatment of gangrenous appendicitis at the base using barbed wire for closure of the residual appendiceal stump.Methods:A case-control study was conducted among 58 patients with acute gangrenous appendicitis at the base who were admitted to the Department of General Surgery at Fujian Tingzhou Hospital from January 2018 to December 2022. Based on the type of suture used for burying the residual appendiceal stump during the procedure, the patients were divided into two groups: the control group ( n = 28, intermittent full-thickness suture embedding of the appendiceal stump using absorbable sutures) and the observation group ( n = 30, continuous full-thickness suture embedding of the appendiceal stump using barbed sutures). Intraoperative and postoperative related indicators, as well as the incidence of postoperative complications, were compared between the two groups. Results:In the observation group, the time for closure of the residual stump was (4.17 ± 0.66) minutes, which was significantly shorter than that in the control group ( t = 10.98, P < 0.001). The rate of conversion rate to open surgery in the observation group was significantly lower than that in the control group [3.33% (1/30) vs. 21.42% (6/28), χ 2 = 15.13, P < 0.001]. The recovery time of gastrointestinal function and the length of hospital stay in the observation group were (39.40 ± 8.10) hours and (4.33 ± 0.80) days, respectively, which were significantly shorter than those in the control group [(65.70 ± 11.30) hours, (6.11 ± 1.13) days, t = 10.26, 6.92, both P < 0.001]. Conclusion:The use of barbed wire sutures for burying the appendiceal stump in laparoscopic surgery for gangrenous/perforated appendicitis at the base effectively shortens the closure time of the stump, reduces the conversion rate to open surgery, minimizes postoperative complications, and shortens the length of hospital stay, making it a valuable technique for promotion in primary care hospitals.