Purpose:To determine the effect of aspirin on hepatocellular carcinoma (HCC) recurrence and survival after thermal ablation. Methods:A retrospective analysis was performed to evaluate the efficacy and safety of aspirin in combination with thermal ablation. The clinical data were collected for the enrolled patients. Progression-free survival (PFS), overall survival (OS), and adverse events were analyzed. Results:A total of 174 patients with HCC were enrolled. The median PFS was 11.1 (95% confidence interval [CI]: 8.1-14.0) months for patients who took aspirin and 8.6 (95% CI: 5.5-11.8) months for patients who did not take aspirin. The median OS of patients in the aspirin group was 76.7 (95% CI: 58.1-95.3) months and that in the non-aspirin group was 53.5 (95% CI: 42.7-64.3) months. In patients with non-viral HCC, OS was significantly better for the aspirin group (P = 0.03) after ablation. The PFS of patients who underwent ablation alone in the aspirin group was obviously superior to that of patients in the non-aspirin group (P = 0.002). Stratified Cox regression analysis demonstrated that aspirin use after ablation might be a protective factor in specific HCC patient subgroups. The incidence of major adverse events did not significantly differ between the two groups. Conclusion:Low-dose aspirin use was associated with better OS in patients with non-viral HCC after thermal ablation. In patients who received thermal ablation alone, the administration of low-dose aspirin could improve PFS. Aspirin use might be a protective factor in some patients after ablation.

Purpose:Tumor capsule is an independent prognostic factor for patients with hepatocellular carcinoma (HCC) and used increasingly to guide clinical decision-making. Considering the genetic complexity for capsule formation and its potential association with hypoxia, the significance of the polymorphisms of hypoxia-related genes in capsule formation and HCC prognosis remains to be elucidated.Patients and Methods:Peripheral blood samples from HCC patients were collected in this study. Single nucleotide polymorphism (SNP) genotyping was conducted by the iPLEX chemistry on a matrix-assisted laser desorption/ionization time-of-flight mass spectrometer (Sequenom, Inc.). The demographic and clinical data for the patients were obtained through medical chart review and/or consultation with the treating physicians. SPSS 25.0, R 4.1.1, and PLINK toolset were used to perform statistical analysis.Results:A total of 183 patients were enrolled, including 88 patients assigned to the capsule group and 95 to the non-capsule group. SLC2A1 rs841858 T allele, SLC2A1 rs2297977 T allele, STAT1 rs1547550 C allele, and STAT1 rs34997637 G allele were associated with significantly increased risk of capsule formation. The genotypes of SLC2A1 rs841858, SLC2A1 rs2297977, STAT1 rs34997637, and STAT1 rs1914408 were significantly associated with the formation of HCC capsule. The polymorphisms of STAT1 rs2066802, STAT1 rs12693591, and HIF1A rs2057482 showed close relationship with the prognosis of HCC patients in the capsule group, while the genotype distributions of CTNNB1 rs4135385, IFNG rs1861494, and SERPINE1 rs2227631 were closely related to the survival of patients in the non-capsule group. Further haplotype analysis suggested that SLC2A1 block 1 and STAT1 block 2 were related to the susceptibility of HCC capsule.Conclusion:The polymorphisms of the hypoxia-related genes (HIF1A, SERPINE1, IFNG, STAT1, CTNNB1, and SLC2A1) were correlated with the formation of HCC capsule. Several SNPs in these genes also showed association with HCC prognosis except SLC2A1. Further functional studies are warranted to explore the underlying mechanisms.

BACKGROUND:D-dimer exhibits a certain prognostic value in hepatocellular carcinoma (HCC) patients who underwent hepatectomy and microwave ablation, while its value in estimating the clinical benefit of drug-eluting beads transarterial chemoembolization (DEB-TACE) remains unclear. Hence, this study aimed to investigate the correlation of D-dimer with tumor features, response and survival to DEB-TACE in HCC patients. METHODS:Fifty-one HCC patients treated with DEB-TACE were recruited. Their serum samples at baseline and after DEB-TACE were collected and proposed for D-dimer detection by the immunoturbidimetry method. RESULTS:Elevated D-dimer levels were related to a higher Child‒Pugh stage (P = 0.013), tumor nodule number (P = 0.031), largest tumor size (P = 0.004), and portal vein invasion (P = 0.050) in HCC patients. Then, patients were classified by the median value of D-dimer, and it was observed that patients with D-dimer >0.7 mg/L achieved a lower complete response rate (12.0% vs. 46.2%, P = 0.007) but a similar objective response rate (84.0% vs. 84.6%, P = 1.000) compared to those with D-dimer ≤0.7 mg/L. The Kaplan‒Meier curve showed that D-dimer >0.7 mg/L (vs. ≤0.7 mg/L) was related to shorter overall survival (OS) (P = 0.013). Further univariate Cox regression analyses showed that D-dimer >0.7 mg/L (vs. ≤0.7 mg/L) was related to unfavorable OS [hazard ratio (HR): 5.524, 95% confidence interval (CI): 1.209-25.229, P = 0.027], but it failed to independently estimate OS (HR: 10.303, 95%CI: 0.640-165.831, P = 0.100) in multivariate Cox regression analyses. Moreover, D-dimer was elevated during DEB-TACE therapy (P<0.001). CONCLUSION:D-dimer may be helpful for monitoring prognosis to DEB-TACE therapy in HCC, while further large-scale-study validation is warranted.

This study aimed to compare the treatment efficacy and tolerance between drug-eluting beads transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (cTACE) in hepatocellular carcinoma (HCC) patients with arterioportal fistula (APF). A total of 44 HCC patients with APF scheduled for DEB-TACE (N = 24, as DEB-TACE group) or cTACE (N = 20, as cTACE group) were recruited. Treatment response, hepatic function, and adverse events were assessed or recorded. Besides, progression-free survival (PFS) and overall survival (OS) were calculated. Total treatment response was better in the DEB-TACE group compared with the cTACE group (P = .012). Meanwhile, the objective response rate (87.5% versus 60.0%) was higher (P = .013), while the disease control rate (95.8% versus 85.0%) was similar in the DEB-TACE group compared to the cTACE group (P = .213). Besides, PFS (mean value: 12.2 (95%CI: 9.9-14.6) months versus 7.8 (95%CI: 5.6-10.0) months) (P = .037), but not OS (mean value: 20.0 (95%CI: 18.1-21.9) months versus. 18.6 (95%CI: 15.4-21.8) months) (P = .341) was prolonged in DEB-TACE group compared with cTACE group. Regarding the safety, Child-Pugh stage, albumin level, and bilirubin level after treatment were all similar between the DEB-TACE group and cTACE group (all P > .05); moreover, no difference was found in the occurrence of adverse events during or after treatment between the two groups (all P > .05). Moreover, subsequent analyses found that embolic materials for APF (microspheres) in the DEB-TACE group did not affect the treatment efficacy (all P > .05). DEB-TACE promotes treatment response and PFS compared with cTACE and shows good safety in HCC patients with APF.

Background: We prospectively evaluated the security and efficiency of percutaneous microwave ablation (MWA) using combined computed tomography (CT) and ultrasound (US)-guided imaging in patients with BCLC-A1-3 hepatocellular carcinoma (HCC) given that they have shortcomings when used alone.Methods: We included 88 consecutive patients with single HCC who were treated with transcatheter hepatic arterial chemoembolization (TACE). The patients were divided into 3 groups at random by using draw lots 1 week after TACE. The combination group (34 patients) received MWA under the guidance of CT and US, while the single group (CT group, 30 patients; US group, 24 patients) received MWA under the guidance of CT or US alone. Contrast-enhanced MRI or CT scans were performed in all patients 1, 3, 6 and 12 months after the procedure. The study endpoints included the treatment time, puncture time, local recurrence rate, and adverse events.Results: The median diameter of the lesions was 3.1 (1.5-4.2) cm. The median treatment time was 38.6 (30-45) min and 36.7 (30-47) min in the combination group and US group, respectively. The median puncture number was 1.2 (1-2) times and 1.1 (1-2) times, respectively. Both were significantly less than in the CT group (45.8 min and 4.2 times). The local recurrence rate was 5.9% in the combination group, which was significantly inferior to that in the US group (16.7%). The grade C complication rate in the combination group was 5.9%, while it was 13.3% and 8.3% in the CT group and US group, respectively. There was a statistically significant difference between the combination group and CT group.Conclusions: Using CT- and US-guided microwave ablation in patients with BCLC-A1-3 hepatocellular carcinoma appeared to be much better in terms of security and efficiency than the use of microwave ablation under the guidance of CT or US alone.

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12885-021-08923-0

Objective To summarize and analyze the imaging features and outcomes of patients with ruptured hepatocellular carcinoma (HCC) following transcatheter arterial chemoembolization (TACE). Methods We investigated all consecutive patients with HCC who received standardized TACE based on our hospital database. Ruptured HCCs were divided into three types according to their relationship with the liver capsule, determined by computed tomography or magnetic resonance imaging scans: Type I, portion of tumor cambered outwards ≤30%; Type II, portion of tumor cambered outwards >30% and <50%; and Type III, portion of tumor cambered outwards ≥50%. Results There were 54, 40, and 26 patients with Type I, II, and III HCCs, respectively. Among these, eight patients developed ruptured tumors within 2 weeks after TACE, including one, two, and five patients with type I, II, and III ruptured HCCs, respectively. Patients with type III HCCs had a shorter median survival time than patients with type I–II HCCs. Conclusions Patients with type III HCCs might have a higher re-rupture rate and benefit less from emergency arterial embolization procedures than patients with type I–II HCCs.

Aim: To preliminarily evaluate the effect of microwave ablation (MWA) alone on platelet (PLT) and coagulation function in patients with BCLC-A hepatocellular carcinoma (B-A-HCC) using a retrospective method. Materials and Methods: A total of 36 patients with 48 B-A-HCCs were radically treated with MWA alone under the guidance of ultrasound between April and October 2018. PLT coagulation indexes were measured before and after MWA at 1 day, 3 days, 1 week, and 2 weeks, and blood samples (after morning fasting) were collected from cubital veins. Coagulation indexes included prothrombin time (PT), prothrombin activity (PTA), thrombin time (TT), Activated Partial Thromboplastin Time (APTT), international standardized ratio (INR), plasma fibrinogen (FIB), plasma antithrombin III (AT-III), and D dimer (DD). Overall survival (OS), recurrence-free survival (RFS), local tumor progression (LTP), and adverse reactions were also recorded. Results: All patients were radically treated with MWA alone. The median size of the lesion was 2.6 (1.5–7.0) cm3. On the first day after MWA, the level of PLT decreased significantly compared with the values before MWA and gradually returned to preoperative levels one week after MWA. One day after MWA, the levels of PT, INR, and AT-III increased markedly and the level of PTA decreased significantly, all of them gradually returned to baseline after 3 days to a week of time. 1, 3, and 7 days after MWA, the levels of FIB, and DD increased significantly, and the level of TT decreased significantly; all of them gradually returned to baseline at 2 weeks. At 6 months posttreatment, the OS and RFS rates were 100% and 91.7%, the LTP rates was 5.6%, no significant adverse reactions. Conclusion: PLT and coagulation indexes were abnormal in patients with B-A-HCC who were radically treated with MWA alone after treatment; without specific treatment, they all gradually returned to baseline within a week or two.

Background Abundant evidence has manifested that long noncoding RNAs (lncRNAs) are closely implicated in human cancers, including hepatocellular carcinoma (HCC). Remarkably, lncRNA FAM83H antisense RNA 1 (FAM83H-AS1) has been reported to be a tumor-propeller in multiple cancers. However, its effect on HCC progression remains unknown. Methods FAM83H-AS1 expression was analyzed by RT-qPCR. Colony formation, EdU, and flow cytometry as well as transwell assays were implemented to analyze the biological functions of FAM83H-AS1 on HCC progression. Luciferase reporter, RIP and RNA pull-down assays were implemented to detect the interaction among FAM83H-AS1, microRNA-485-5p (miR-485-5p), and myocyte enhancer factor 2D (MEF2D) in HCC cells. Results FAM83H-AS1 expression in HCC cells was markedly elevated. FAM83H-AS1 accelerated cell proliferation, migration and invasion whereas inhibiting cell apoptosis in HCC. Besides, we confirmed that FAM83H-AS1 acts as a miR-485-5p sponge in HCC cells. Additionally, MEF2D was verified to be a direct target of miR-485-5p. FAM83H-AS1 could upregulate MEF2D expression via sponging miR-485-5p. Further, rescue experiments testified that MEF2D upregulation or miR-485-5p downregulation offset the repressive effect of FAM83H-AS1 depletion on HCC cell progression. Conclusions FAM83H-AS1 facilitates HCC malignant progression via targeting miR-485-5p/MEF2D axis, suggesting that FAM83H-AS1 may be a promising biomarker for HCC treatment in the future.

OBJECTIVE:To evaluate the use of transarterial chemoembolisation (TACE) combined with microwave ablation (MWA) to treat patients with hepatocellular carcinoma (HCC) and type Ⅱ-Ⅲ portal vein tumour thrombosis (PVTT) intolerant to targeted drug (TG) therapy.METHODS:A total of 18 patients with HCC and type Ⅱ-Ⅲ PVTT intolerant to TG were enrolled between June 2015 and December 2019, who were treated with TACE + MWA (MWA group). 24 patients were treated with TACE + TG (TG group; control cohort). Time to progression and overall survival (OS) were analysed along with the incidence of adverse events.RESULTS:The median follow-up time was 19.0 months (9.0-32.0 months). The median OS was 17.0 months (8.3-29.3 months; MWA group) and 13.5 months (5.5-22.5 months; TG group) and was not significantly different. The 1- and 2 year OS was also comparable (MWA group: 66.7%, 44.4% vs Target group: 41.7%, 29.2%). Time to progression showed no distinct differences (MWA group: 11.5 months; TG group: 9.0 months) between the two groups. Moreover, the incidence of major Grade 3-4 adverse events in the MWA group (5.6%) was similar to those in the TG group (8.3%).CONCLUSION:TACE + MWA and TACE + TG were comparable in their safety and efficacy in patients with HCC, type Ⅱ-Ⅲ PVTT, and intolerance to TG.ADVANCES IN KNOWLEDGE:TACE + MWA can be used as a palliative treatment alternative for TACE + TG in patients with HCC, type Ⅱ-Ⅲ PVTT, and intolerance to TG.

The present study aimed to compare the efficacy and safety of drug-eluting beads-transarterial chemoembolization (DEB-TACE) plus microwave ablation (MWA) versus (vs.) surgery in treating patients with hepatocellular carcinoma (HCC) adjacent to gallbladder. Totally 54 patients with HCC adjacent to gallbladder were included and divided into two groups: DEB-TACE plus MWA group (n = 24) and surgery group (n = 30). Treatment response, relapse-free survival (RFS), progression-free survival (PFS), overall survival (OS) and adverse events were assessed and documented. For DEB-TACE plus MWA group, complete response rate, objective response rate and disease control rate were 79.2%, 95.8% and 100.0% after one-month post treatment, respectively. In terms of survival profiles, DEB-TACE plus MWA group presented similar RFS (28.2 (95% CI: 12.5-43.9) months vs. 26.6 (95% CI: 19.2-34.1) months) (P = 0.930), PFS (21.2 (95% CI: 1.6-40.8) months vs. 26.6 (95% CI: 19.2-34.1) months) (P = 0.541), and OS (41.4 (95% CI: 35.0-47.9) months vs. 59.7 (95% CI: 51.7-67.7) months) (P = 0.138) compared with surgery group, and further multivariate Cox's regression analysis validated that, after adjustment of confounding factors, DEB-TACE plus MWA group exhibited no difference of RPS, PFS or OS compared with surgery group. Regarding safety, the intraoperative adverse event incidence was higher in DEB-TACE plus MWA group compared with surgery group (P = 0.008), while two groups exhibited no difference of postoperative adverse event incidence (P = 0.618). In conclusion, DEB-TACE plus MWA presents to be an optional treatment strategy in patients with HCC adjacent to gallbladder.

Background : To evaluate prospectively security and efficiency of percutaneous microwave ablation (MWA) by combining computer tomography (CT)- with ultrasound (US)-guided of in patients with BCLC-A1-3 hepatocellular carcinoma (HCC ). Methods : We studied 88 consecutive patients with single HCC who were treated with transcather hepatic arterial chemoembolization (TACE), patients were divided into 3 groups at random by using draw lots 1 week after TACE, combination group (34 cases) received MWA under the guidance of CT and US, while single group (CT group 30 cases, US group 24 cases) received MWA under the guidance of CT or US alone.1 month,3 months,6months and12 months after the procedure, contrast-enhanced MRI scan were performed in all cases. Study endpoints included treatment time, puncture time, local recurrence rate and adverse events. Results : A total of 88 lesions were radically treated with MWA after TACE. The median diameter of the lesion was 3.1(1.5-4.2) cm. The mean treatment time, puncture time were 38.6 (30-45) min, 36.7 (30-47) min, and 1.2 (1-2), 1.1 (1-2) in the combination group and US group, which were significantly inferior to CT group (45.8 minutes and 4.2); Local recurrence rate was 5.9% in the combination group, which was significantly inferior to US group (16.7%).Grade C complication rates occurred in the combination group was 5.9%, while it was 13.3% and 8.3% in CT group and US group, there was statistically significant between combination group and CT group ( P <0.05). Conclusions : Using CT- and US-guided microwave ablation in patients with BCLC-A1-3 hepatocellular carcinoma appeared to be much better in security and efficiency than that under the guidance of CT or US alone.

Background. - This study aimed to investigate the potential of drug-eluting bead transarterial chemoembolization (DEB-TACE) as downstaging therapy for subsequent radical treatment in patients with hepatocellular carcinoma (HCC). Methods. - Totally, 32 patients with unresectable HCC were enrolled, then they received DEBTACE for down-staging therapy followed by radical treatments (surgery, radiofrequency ablation or microwave ablation). The rate of successful down-staging, treatment response (after DEBTACE and radical therapy), alpha-fetoprotein (AFP), progression-free survival (PFS) and overall survival (OS) were assessed. Results. - After down-staging therapy with DEB-TACE, successful down-staging rate was 59.4%. With the followed radical treatment, the complete response was 81.3%. Subsequent analysis indicated that CNLC stage (IIb vs. IIa) was an independent risk factor for successful down staging. Furthermore, AFP level presented a declined trend throughout the time points (beforeDEB-TACE, after DEB-TACE, and after radical treatment). Additionally, 1-year, 2-year and 3-year accumulating PFS were 68.8%, 40.6% and 31.3%, respectively; 1-year, 2-year and 3-year accumulating OS were 84.4%, 71.9% and 53.1%, respectively. Kaplan-Meier curves exhibited that successful down-staging was correlated with longer PFS and OS, then further Cox's regression analysis verified that successful down-staging was an independent factor for predicting increased OS but not PFS. Besides, child-Pugh stage (B vs. A), CNLC stage (IIb vs. IIa) and AFP abnormal after radical treatment were independent factors for decreased PFS or OS. Conclusions. - DEB-TACE has potential as an additionally effective down-staging therapy for radical treatments, and successful down-staging treatment by DEB-TACE associates with favorable survival profiles in patients with unresectable HCC. (c) 2020 Les Auteurs. Publi & acute;e par Elsevier Masson SAS. Cet article est publi & acute;e en Open Access sous licence CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Objective To evaluate the efficacy of endovascular radiofrequency ablation with Habib TM VesOpen catheter combined with covered-stent placement in biopsy and treating portal vein tumor thrombus (PVTT). Methods 13 patients with PVTT were treated from June 2014 to December 2015. After confirming the location and extent of PVTT , biopsy was performed on 3 patients using 5F biopsy forceps under fluoroscopy. Radiofrequency ablation of the tumor thrombi was then performed using 5F HabibTM VesOpencatheter with the power of 10W for 3 minutes followed by insertion of covered-stent at the location of PVTT. The patients were followed up for 3-18 months by clinical observation, biochemical examination, color Doppler ultrasound, CT, and MRI. Results The procedure was successful in all patients with no complications. Abdominal distension was relieved (9), ascites resolved (2) or was reduced (2),and diarrhearesolved (1). During follow-up, the patients were stable (6)with survival of more than 3 months (12), 6 months (10), 12 months (8), and 18 months (5). The shunt was obstructed in 7 patients. Conclusion Endovascular radiofrequency ablation combined with covered-stent placement may be better than endovascular radiofrequency ablation alone in treating portal vein tumor thrombus. It is safe under the protection of the sheath to biopsy the tumor thrombus with forceps.

ObjectiveTo observe feasibility and efifcacy of the modiifed TIPS in treatment of gastro-esophageal bleeding.Methods A total of 56 patients with gastro-esophageal bleeding underwent modified TIPS. Puncture the right internal jugular vein under the guidance of ultrasound, push the Rups-100 to the right hepatic vein along the guide wire, after successful puncture through hepatic vein to portal vein, a stiff wire was exchanged and a balloon (8 mm×40 mm) was sent and inlfated across the liver parenchymal. A bare stent (8 mm×60 mm) was released through the track, and a stent-graft (8 mm×40 mm) was released within the bare stent according to the markers on the balloon. The stent-graft must cover the liver parenchymal track. Gastric coronary veins were emblazed with coils routinely. The portal pressure were measured before and after the shunt established.Results Of all 56 cases were technically successful (100%). The portal pressure fell to (17.36±3.48)mmHg from (31.20±3.98)mmHg. All patients were followed up from 1 to 3 years. The decrease of portal vein pressure pre- and post-TIPS was statistically significant (t=40.062,P<0.001). During the period of 1—3 years follow-up, the shunts patency rate was 89.3%, 75.0%,67.8% and the rate of rebleeding was 7.1%,12.5%,16.1% respectively; the rate of encephalopathy was 12.5%. One case accepted antibiotics treatment because of sepsis; 7 cases underwent re-TIPS due to the shunt occlusion. No other procedure related complications occured. Five cases died of hepatic failure, hepatocellular carcinoma and multiple organ failure.Conclusions The modiifed TIPS with bare stent combined with stent-graft can effectively improve the patency rate of shunt, decrease the rate of rebleeding, and reduce complications related to technique through simplifying the procedure.

病例：患者女62岁。2周前出现尿黄、乏力、纳差，入院后化验转氨酶ALT710u/l总胆红素197.4umol/l，甲型肝炎抗体IgM阴性戊型肝炎抗体IgM阴性抗HCV阴性 HbsAg阴性，自身免疫性抗体包括抗核抗体、抗线粒体抗体、抗线粒体M2型抗体均为阴性，C-反应蛋白阴性。追问病史患者20天前因皮肤病服用藏药，考虑存在药物性肝损害可能。在超声引导下行肝组织活检，取自动活检枪配一次性16G活检针，切取肝组织2cm，行常规石蜡病理检查，结果符合药物性肝损害。肝穿活检后3天，患者出现右上腹阵发性绞痛、呕血及寒战、高热（39。），急查血红蛋白从入院时123g/l降至91.2g/l，立即行腹部CT平扫示左右肝管、胆囊、胆总管内均可见液性高密度阴影，为明确原因行经内镜鼻胆管引流术（ENBD），在X线透视下，经电子内镜至十二指肠降部，见十二指肠乳头正常，肠粘膜水肿，乳头内新鲜血液流出，将引流管经胆总管留置左肝管，造影所见肝内外胆道呈阶段性不规则充盈缺损（血凝块），无胆道扩张。临床诊断为：医源性胆道出血，给予输血、止血、补液及抗感染对症处理，同时经鼻胆管引流管间断性给予冰盐水+去甲肾上腺素冲洗胆道局部止血。经支持治疗后，患者状况无明显好转，血色素仍呈进行性下降，生命体征不稳定，血压70/50mmHg，心率132次/分。立即决定行急诊肝动脉栓塞术，术中患者为仰卧位，右腹股沟区常规消毒铺巾，2%利多卡因局麻后以Seldinger法穿刺股动脉，成功植入5F鞘管并引入肝管至腹腔干造影见：动脉早期肝右动脉S6分支局部血管瘤样扩张，与其伴行门静脉分支提前显示，未见肝内胆道分支显影，延迟透视观察仍未见胆道内造影剂存留，结合病史及肝动脉造影表现考虑肝S6存在动—门静脉瘘，胆道—血管瘘不能除外。将导管超选择至相应靶血管，分别给予明胶海绵颗粒栓塞剂（1400-2000um）一支及金属弹簧圈一枚，再次造影未见门静脉分支显示，栓塞成功，术后血压110/80mmHg<br>　　心率80次/分，生命指征平稳。术后1天经鼻胆管引流出黑褐色胆汁250毫升，无血性液体，患者持续发热高达39。C，白细胞13*109/l中性粒细胞8.5*109/l，经更换抗生素后，患者体温平稳下降，白细胞、中性粒细胞持续降低，患者病情明显好转后出院。