Objective:To observe the efficacy and safety of PGE1 combined with PHGF in the treatment of patients with moderate or severe chronic hepatitis.Methods:110 patients with chronic hepatitis were randomly divided into two groups:60 in test group and 50 in control group.The patients of test group received the PGE1 combined with the PHGF for 30 days and the control group only received the most in using PGE1 for 30 days.Results:At the end of treatment,the total effective rates were 93.3% in the test group and 80% in control group.No severe side effect was observed in both groups.Conclusion:The PGE1 in conjunction with the PHGF is an effective and safe therapeutic intervention for patients with moderate or severe chronic hepatitis.

Objective:To Study the efficacy and satety of lamivudine in the treatment of CHB and HBV carrier.　Methods:All patients were divided into three groups. 21 patients with CHB were classified CHB test group(namely groupⅠ), 16 HBV carries were classified ASC test group(namely Group Ⅱ), 40 patients with CHB were CHB controlled group(namely controlled group). Both group Ⅰ and group Ⅱ received lamivudine, group Ⅰ was added protecting liver therapy. The controlled group only received protecting liver therapy. The treatment courses of three groups were one year. 　Results:The effective rates of group Ⅰ and group Ⅱ were higher than the controlled group in turning into negative HBeAg and HBV-DNA, both the negative-turning rate of liver functions and hepatic serology target declining fibrosis in group Ⅰ was more significant than the controlled group without severe side effect. 　Conclusion:Lamivudin is efficient and safe medicine in the treatment of CHB and HBV carrier.

Objective:To study the incidence and risk factors of central vein stenosis (CVS) in chronic kidney disease (CKD) patients who received arteriovenous fistula (AVF) creation for the first time, as well as effects of CVS on patency of ipsilateral AVF.Methods:It was a retrospective study. The CKD patients who received AVF creation for the first time in the First Affiliated Hospital of Zhengzhou University from January 2019 to August 2020, with central vein digital subtraction angiography (DSA) results prior to angioplasty were selected as the study subjects. The differences of incidence of CVS in CKD patients with/without a history of cervical catheterization and primary patency rates of AVF between CVS and non-CVS groups were compared. Logistic regression analysis method was applied to analyze the influencing factors of CVS in CKD patients. Kaplan-Meier method was used to analyze the primary patency rate of AVF. Cox regression analysis method was used to analyze the effect of CVS on the primary patency of ipsilateral AVF.Results:A total of 283 CKD patients aged (50.45±14.76) years were enrolled in the study, including 165 males (58.3%). The dialysis age was 0.5 (0, 7.0) months. There were 55 patients (19.4%) diagnosed with CVS before AVF, including 39 patients with stenosis <50% and 16 patients with stenosis ≥50%. The incidence of CVS in patients with history of right internal jugular vein central venous catheter insertion was significantly higher than that in those without this history [60.5% (26/43) vs. 9.9% (15/151), χ2=51.274, P<0.001]. Multivariate logistic regression analysis results showed that hemodialysis catheters indwelling time ≥3 months elevated the risk of CVS ( OR=4.345, 95% CI 1.540-12.263, P=0.006). A subset of 268 patients who had AVF creation ipsilateral to CVS were analyzed to determine the effects of CVS on patency of AVF. The median follow-up time was 34 months. The primary patency rate of AVF in the moderate to severe CVS group was significantly lower than that in the non-CVS group (5/7 vs. 58/228, χ2=7.720, P=0.005). The primary patency rates of AVF in the subclavian vein stenosis group and superior vena cava stenosis group were significantly lower than those in the brachiocephalic vein stenosis group (4/5 vs. 8/27, χ 2=6.974, P=0.008; 6/8 vs. 8/27, χ 2=6.908, P=0.009, respectively). Moderate to severe CVS and combined diabetes were independent influencing factors of primary patency of AVF ( HR=4.362, 95% CI 1.644-11.574, P=0.003; HR=2.682, 95% CI 1.624-4.431, P<0.001, respectively). Conclusions:The incidence of CVS is higher in CKD patients who establish an arteriovenous fistula for the first time. Hemodialysis catheter indwelling time ≥3 months is an independent risk factor of CVS. The moderate to severe CVS is an independent risk factor of primary patency of AVF.