OBJECTIVE: To compare the efficacy and safety of different antiviral and antifibrotic regimens in patients with chronic hepatitis B (CHB) and hepatic fibrosis and the incidence of hepatocellular carcinoma (HCC) associated with these therapies. METHODS: A total of 840 patients with CHB and concurrent hepatic fibrosis, who received antiviral therapy in Nanfang Hospital between June, 2010 and June, 2018, were enrolled in this follow-up cohort study. The patients were assigned to 3 cohorts matched for gender, age (difference≤5 years), HBeAg status and liver stiffness measurement (LSM) for treatment with one of the 3 antiviral drugs, namely entecavir, tenofovir dipivoxil and adefovir dipivoxil; each cohort was divided into 2 groups, with one of the groups having a combined treatment with Fufang Biejiaruangan tablet. The cumulative negative conversion rate of HBV DNA, normalization rate of ALT, hepatic fibrosis regression and the incidence of HCC were compared among the 3 cohorts and across the 6 groups at 144 weeks. RESULTS: A total of 749 patients were available to follow-up at 144 weeks. Compared with the baseline data, the cumulative negative conversion rate of HBV DNA increased gradually and the abnormal rate of ALT decreased significantly over time during the treatment in all the 6 groups (all < 0.001). Compared with the any of the antiviral drugs used alone, the combined treatments all resulted in significantly better antifibrotic effects (χ=11.345, χ=10.160, χ=6.358; all < 0.05). At 144 weeks, the incidence of HCC were 2.2%, 1.7%, 1.7% and 3.3% in enecavir group, enecavir with Biejiaruangan tablet group, adefovir group, and adefovir with Biejiaruangan tablet group, respectively, showing no significant difference between the two cohorts (4 groups; χ=6.813, =0.138). None of the patients in the 2 groups with tenofovir treatment had HCC by the end of the observation. CONCLUSIONS Antiviral therapy combined with antifibrotic therapy can effectively reverse hepatic fibrosis and reduce the incidence of HCC in patients with CHB; among the 3 antiviral drugs, tenofovir dipivoxil can be a better option for reducing the incidence of HCC in these patients.
Antiviral Agents ; Carcinoma, Hepatocellular ; etiology ; DNA, Viral ; Follow-Up Studies ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; complications ; Humans ; Liver Cirrhosis ; complications ; Liver Neoplasms ; etiology ; Prospective Studies

Objective To explore the solution for regional population health information platform based on the involvement of internet plus and big data.MethodsThe objective and contents of the platform were discussed,and its logic structure and deployment architecture were designed.The functions of a platform-based application system and two information integration platforms were described.The key technical links of the system were demonstrated.Results The solution for regional population health information platform based on internet plus completed population health information service system,and laid a foundation for the application of medical big data.Conclusion The solution contributes to the inter-connection and communication between medical fields in some region,promotes healthcare informatizatoin platform and is thus worthy applying practically.

Objective Microdialysis technique is a technology which can continuous monitoring of a substance′s metabolism level in specific tissues or organs,it can provide a series of substances monitoring of the liver transplantation,especially monitoring of glucose,lactate,glycerol,pyruvate and some amino acids. By the range of these substances, we can anticipate complications and ischemia?reperfusion injury after liver transplantation. In this paper we reviewed the principle, characteristics of the microdialysis technique and its applications of monitoring the ischemia?reperfusion and complications after liver transplantation,then pointed out the main problems and trends of the technology to provide a reference for further research in the field.

Information security is the key in construction of digital hospitals and determines the successful diagno-sis and treatment of diseases in hospitals with information as a tool.The major problems in our hospital were imper-fect information security system , weak technique support , and insufficient implementation of regulations .The infor-mation security can be assured by constructing the security systems-for computer room, networks, data and their management , respectively .

Objective To investigate surgical treatments for hepatolithiasis complicated with biliary cirrhosis and portal hypertension. Methods Clinical data of 31 patients with hepatolithiasis complicated with biliary cirrhosis and portal hypertension receiving surgical treatments in Nanfang Hospital, Southern Medical University from June 2004 to June 2013 were analyzed retrospectively. There were 21 males and 8 females with the mean age of (49±8) years old. The informed consents of all patients were obtained and local ethical committee approval had been received. The surgical treatments included one-stage cholangiolithotomy (n=26), two-stage cholangiolithotomy (n=5). The perioperative situation and the treatment efifcacy were observed. Results The median intraoperative blood loss was 537 (300-1 800) ml for the 26 cases undergoing one-stage cholangiolithotomy. Postoperative bleeding was observed in 2 cases. Pericardial fundus devascularization and transjugular intrahepatic portosystem shunt (TIPS) were performed emergently in the patients respectively and then the bleeding was ceased. The intraoperative blood loss was 350 (300-450) ml for the left 5 cases undergoing two-stage cholangiolithotomy. The liver function of the patients recovered well and no liver failure, hepatic encephalopathy were observed. The postoperative choledochoscope residual rate of calculus was 16%(5/31) and the ultrasound residual rate of calculus was 26% (8/31). Good efficacy was observed in 14 cases and fine in 17 cases. Conclusions The surgical operation for hepatolithiasis complicated with biliary cirrhosis and portal hypertension is with high dififculty and risk. It is necessary to design personalized surgical plan and to perform multiple surgical procedures.

Microdialysis is an automatic biological sampling technique that is directed into the target tissue. Microdialysis is used to monitor the changes of drug and related substances associated with pathological physiology of tumor in the target tissue at the molecular level. Microdialysis is applied to evaluate the pharmaco-kinetics of drugs in the target tissue of tumor,optimize the combination therapy,explore molecular targeted therapy and study the early diagnosis and prognosis of tumor. Microdialysis provides a new idea and method for the prevention and cure research of tumor.

Objective To investigate the association of the SNP in miRNA146A with genetic prediposion and earlier recurrence after resection for hepatocellular carcinoma (HCC).Methods In the casecontrol study including 173 HCC cases,DNA were exacted from cancer tissue embedded with paraffin and were amplificated by PCR,SNP was explored in gene sequence of miRNA146a (385 base pair including extron).The outcome were analyzed with genetic prediposion and clinical features.Result Only hsa-mir-146a rs2910164 was found.The genetype frequence of C/C 、G/G and C/G at rs2910164 gene locus were separately 61 (35.3％),21 (15％) and 86(49.7％) in cases.Compared to G/G genetype,C/C and C/G genetype were danger factor to onset risk of HCC (OR =3.086,95％ CI:1.289-7.390) ; C/G was danger factor to earlier recurrence after resection(OR =8.179,95％ CI:2.248-29.759).Conclusion rs2910164 may be associated with genetic prediposion and earlier recurrence after resection of HCC in Jiangxi hans

OBJECTIVETo detect the expression of Nusap1 of surgical margins in hepatocellular carcinoma (HCC) and investigate its association with early tumor recurrence.

METHODSThe expression of Nusap1 in the surgical margins of HCC, which were histopathologically negative for tumor cells, was examined using immunohistochemistry in 61 HCC cases.

RESULTSFifteen of 21 (71.4%) cases with immunohistochemical positivity for Nusap1 expression in the surgical margins had early recurrence of HCC, a rate significantly higher than that in patients with negative Nusap1 expression (12/40, 30%) (P<0.05).

CONCLUSIONSNusap1 expression in the surgical margins of HCC is closely correlated to early postoperative recurrence and can serve as an indicator for predicting early recurrence of HCC.

Adolescent ; Adult ; Aged ; Carcinoma, Hepatocellular ; metabolism ; pathology ; surgery ; Female ; Humans ; Immunohistochemistry ; Liver Neoplasms ; metabolism ; pathology ; surgery ; Male ; Microtubule-Associated Proteins ; metabolism ; Middle Aged ; Neoplasm Recurrence, Local ; pathology ; Young Adult

Objective To study the influencing factors and clinical characteristic of High Intensity Focused Ultrasound(HIFU) abhtion analgesic in middle-late stage pancreatic carcinoma.Methods Seventyone cases pancreatic cancer patients underwent HIFU treatment were grouped according to the pain efficacy of related influencing factors and the data was analyzed by single factor correlation analysis.The relationship between influencing factors and analgesic effect were analyzed through the pain outcome score.Results Pain score decreased ≥50％ in advanced pancreatic cancer patients occurred in ＜60 years old,Body mass index (BMI) ＜ 22 kg/m2,tumor location in the pancreatic head and neck,tumor size of 2-5 cm,and the average power of HIFU treatment ＞ 400 W,Ductal adenocarcinoma of the tumor histological type were related to the degree of pain rehef,and the difference was statistically significant (P ＜ 0.05).And fewer complications occurred after HIFU ablation.Conclusion Analysis of the relationship between the different factors and the analgesic effect in advanced pancreatic carcinoma can be used to predict the efficacy of HIFU treatment.

Objective To investigate the maneuver of dividing Arantius duct to expose the posterior of left hepatic vein.Methods Based on the anatomy of Arantius duct on 33 cadavers,exposure of posterior of left hepatic vein was carried out in 43 patients by dividing the Arantius ligament.Results The posterior of left hepatic vein was dissected to expose the left hepatic vein in 43 patients.The operations and the recovery of the patients were smooth and uneventful.Conclsion Cutting the Arantius ligament allows safe exposure and extrahepatic division of left hepatic vein.