Objective:To investigate the level and clinical significance of inflammatory factors in recurrence after microwave ablation(MWA)in patients with hepatitis B virus(HBV)-hepatocellular carcinoma(HCC).Methods:92 patients with HBV-HCC who were treated with MWA from December 2016 to December 2019 in the department of Infection, Dezhou People′s Hospital.There were 49 males and 43 females, aged(60.25±3.51)years old, and ranging from 52 to 73 years old.According to whether relapse after MWA treatment, patients were divided into the recurrence group( n=28)and non-recurrence group( n=64). Univariate and logistic multivariate analysis was used to investigate the correlation between clinical parameters and inflammatory factors and relapse after MWA treatment. Results:Age, gender, number of lesions, BCLC stage, interleukin-2 level, interleukin-6 level, interleukin-8 level, interleukin-10 level, interleukin-23 level, and tumor necrosis factor-level were not significantly different between the recurrence group and the non-recurrence group( P>0.05). The percentage of patients with tumor diameter >10 cm in the recurrence group was higher than that in the non-recurrence group [60.7%(17/28), P<0.05]. The level of interleukin-17(IL-17)in the recurrence group [(1.25±0.42)pg/ml]was significantly higher than [(0.46±0.15)pg/ml]in the non-recurrence group, ( P<0.05). Logistic analysis showed that IL-17 level and tumor diameter >10 cm were significant risk factors for recurrence of HCC after MWA therapy( P<0.05). Conclusion:IL-17 level and tumor maximum diameter of >10 cm can be used as high risk factors for recurrence of HBV-HCC after MWA treatment, which should be paid enough attention in clinical treatment.

Objective:To investigate the efficacy and influencing factors of transarterial chemoembolization (TACE) combined with microwave ablation on early liver cancer.Methods:Fifty-eight patients with early liver cancer admitted to Dezhou People’s Hospital from January 2018 to January 2019 were selected, and they were divided into conventional therapy group and combined therapy group by random number table method, with 29 cases in each group. Patients in the conventional therapy group were treated by microwave ablation, while patients in the combined therapy group were treated by TACE combined with microwave ablation. The clinical efficacy, recurrence and complications of the two groups were compared, and the risk factors of early recurrence were analyzed.Results:The clinical effect of the combined therapy group (93.10%, 27/29) was better than that of the conventional therapy group (72.41%, 21/29), P<0.05. The recurrence rate of the combined therapy group (3.45%, 1/29) was lower than that of the conventional therapy group (17.24%, 5/29), P<0.05. The complication rate of the combined therapy group (34.48%, 10/29) was higher than that of the conventional therapy group (31.03%, 9/29), but the difference was not statistically significant ( P>0.05). Recurrence after TACE combined with microwave ablation for early liver cancer was correlated with alpha-fetoprotein (AFP)≥ 100 μg/L, number of virus ≥10 3 copies/ml, and irregular tumor margins ( P<0.05), and was not correlated with child-pugh grade, number of tumors, and major diameter of tumor ( P>0.05). AFP≥100 μg/L, number of virus ≥10 3 copies/ml and irregular tumor margins were risk factors of recurrence after TACE combined with microwave ablation for early liver cancer ( P<0.05). Conclusions:TACE combined with microwave ablation in the treatment of early liver cancer can significantly improve its therapeutic effect and reduce recurrence, while the preoperative control of recurrence risk factors is of great clinical value.

<正>自发性细菌性腹膜炎(SBP)是肝硬化患者常见并发症[1],死亡率20%。SBP病原菌多为单株细菌,常见病原菌以革兰阴性肠杆菌为主,如大肠杆菌、肺炎克雷伯杆菌;革兰阳性菌很少,如肺炎链球菌、肠球菌、葡萄球菌。感染途径包括:血行感染;肠道细菌直接外移渗入腹水;淋巴途径感染。起病有急有缓,症状轻重不一,可有发热、腹痛、腹水、腹膜炎等表现。起病隐匿者

目的观察炎琥宁联合病毒唑治疗儿童流行性腮腺炎临床疗效。方法将68例流行性腮腺炎患儿随机分为治疗组与对照组各34例,对照组仅给予病毒唑静脉滴注;治疗组在观察组的基础上,联合炎琥宁静脉滴注,观察并比较两组的临床疗效。结果治疗组总有效率为100%,对照组总有效率为79.41%,治疗组疗效明显优于对照组,差异有统计学意义(P<0.05)。结论炎琥宁联合病毒唑治疗儿童流行性腮腺炎疗效显著,值得临床推广应用。

目的 探讨阿德福韦酯治疗慢性乙型肝炎的临床疗效.方法 选择60例慢性乙型肝炎患者,随机分为观察组和对照组各30例,观察组给予拉米夫定治疗,对照组给予阿德福韦酯胶囊治疗,3个月后检查患者的丙氨酸氨基转移酶(ALT)、乙肝病毒-脱氧核糖核酸(HBV-DNA)以及肝功能,并观察药物不良反应.结果 阿德福韦酯治疗乙肝e抗原(HBeAg)阳性患3个月后,ALT、血清HBV-DNA水平均明显低于拉米夫定治疗HBeAg阳性患者,两组比较差异有统计学意义(P＜0.05),肝功能没有明显变化,两组比较差异无统计学意义(P＞0.05),治疗过程中均未见明显不良反应.结论 阿德福韦酯治疗慢性乙型肝炎均能取得较好的临床疗效,并且安全性高,可作为首选的一线抗病毒药物,值得临床推广应用.

目的 观察中西医结合治疗小儿麻疹合并支气管肺炎的疗效.方法 采用随机对照的方法选择60例麻疹合并支气管肺炎患儿,分为对照组和治疗组各30例,对照组采用抗感染、抗病毒及对症处理,治疗组在对照组治疗的基础上加用痰热清注射液静脉滴注,比较两组患儿的临床疗效.结果 对照组与治疗组的总有效率分别为83.33％、100％,治疗组明显优于对照组,两组比较,差异有统计学意义(P＜ 0.05).结论 联合痰热清治疗小儿麻疹合并支气管肺炎在改善部分临床症状、缩短疗程方面有显著优势,是一种安全有效的治疗方法,值得临床推广应用.

目的:评价阿德福韦酯联合肝苏治疗慢性乙型肝炎24周后,在肝组织学及血清HBV DNA、ALT方面的疗效。方法:治疗组24例口服阿德福韦酯10 mg,每日1次,肝苏每日3次,每次5片;对照组19例口服阿德福韦酯10 mg,每日1次。观察24周(24周后两组患者继续服用阿德福韦酯)。两组治疗前、后均接受肝穿刺活检,按照Kondell组织学活动指数评价肝组织学改变,并观察肝功能、HBV DNA的变化。结果:治疗24周后,治疗组58.3%、对照组36.8%的患者肝组织学改善(治疗后Knodell坏死炎症评分降低≥2分,且不伴有Knodell纤维化评分恶化),治疗组优于对照组(P<0.05)。治疗后ALT复常率治疗组为83.3%、对照组为52.6%,治疗组优于对照组(P<0.05)。治疗后治疗组HBV DNA下降了3.11 log10拷贝/ml、对照两组下降了3.27 log10拷贝/ml,两组比较,差异无统计学意义(P>0.05)。结论:在阿德福韦酯治疗慢性乙型肝炎基础上加用肝苏,患者肝功能及肝组织学获得明显改善。

目的观察水飞蓟宾胶囊治疗单纯性脂肪肝的临床治疗效果。方法将40例单纯性脂肪肝患者随机分成四组,每组10人,投入到四种治疗方案中,分别于第8w、12w、24w检测ALT、AST、γ-GT、ALP、BUN、Cr、TG、GLU、B超、HDL-C、LDH-C并观察不良反应。结果水飞蓟宾胶囊治疗30例单纯性脂肪肝患者肝功能变化12w时疗效与对照组比较P<0.05,具有显著性差异,24w时与对照组比较P<0.05,有统计学意义;水飞蓟宾胶囊70mg组治疗12w与24w的疗效观察x2=15,P<0.005,有可比性;70mg组与140mg组治疗12w疗效观察x2=7.37,P<0.05,具有统计学意义。1例出现临床轻度不良反应,占3.3%。结论该药具有一定的抗炎症反应,促进受损细胞的修复及再生。无明显毒副作用,价格低廉,患者依从性高。大剂量、足疗程是有效治疗的保证。