Objective To investigate the association between serum lipid levels and antiviral treatment outcome in chronic hepatitis C ( CHC) patients. Methods A total of 171 treatment-naive CHC patients were included in the present retrospective study and received a standard therapy of pegylated interferon ( PEG- IFN) plus ribavirin. Serum levels of total cholesterol ( TC) , triglycerides ( TG) , low- density lipoprotein cholesterol ( LDL- C) , high- density lipoprotein cholesterol ( HDL- C) , apolipoprotein A ( apoA) , apolipoprotein B ( apoB) , and other vital indicators in laboratory were determined, and their relationships with treatment responses, hepatitis C virus ( HCV) genotypes, and therapy time points ( for non- 1b type, 0, 12, and 24 weeks; for 1b type, 0, 24, and 48 weeks) were analyzed. For normally distributed measurement data, values were expressed as mean ± SD, and statistical analysis was performed by t test and ANOVA; for non- normally distributed data, values were expressed as median and interquartile range, and statistical analysis was performed by rank sum test; for categorical variables, values were expressed as frequency ( constituent ratio) , and statistical analysis was performed by chi- square test. Univariate and multivariate logistic regression analyses were performed to determine prognostic factors. Results Among the 171 CHC patients receiving PEG- IFN plus ribavirin, 81. 87% achieved a sustained virological response ( SVR) , and 18. 13% did not; SVR patients showed significantly lower TG and apoB levels than non- SVR patients ( P < 0. 05) . Compared with patients infected with HCV- 1b and HCV- 6a, those with HCV- 3 infection had lower serum levels of TC, LDL- C, apoA, and apoB ( P < 0. 05) , while the opposite results were observed in terms of the levels of alanine aminotransferase and aspartate aminotransferase ( P < 0. 05) . In the SVR group, significant increases in TG and apoB were observed at the end of treatment process, while a significant decrease in HDL- C was also noted ( P <0. 05) . However, no significant changes in serum lipids were observed in non- SVR patients. The univariate logistic regression analysis revealed that SVR was closely related to the following factors: age ≤50 years, HCV genotype non- 1b, TG ≤3. 11 mmol /L, and apoB≤0. 63 g/L ( P <0.05) . The multivariate logistic regression analysis indicated that patients with CHC were more likely to achieve a SVR if they were ≤50 years old with a serum apoB level of ≤0. 63 g /L. Conclusion Serum lipid levels and age are closely related to the clinical outcome of CHC. Age ( ≤50 years) and serum apoB level ( ≤0. 63 g /L) are two independent predictors for SVR in CHC patients.

Objective To investigate the risk factors for early rebleeding from esophageal and gastric varices ( EGV) in patients with liver cirrhosis. Methods A total of 432 patients with liver cirrhosis who were admitted to Ningxia Medical University from January 2006 to December 2009 were included in the study. These patients were divided into control group ( n = 325) , who stopped bleeding after initial treatment, and study group ( n = 107) , who had rebleeding after initial treatment. The clinical and test data of the two groups were analyzed.Comparison of measurement data between the two groups was made by t test, while comparison of enumeration data was made by chi- square test; multiple comparison of constituent ratios was made. The univariate unconditional logistic regression model was used for analyzing the risk factors for rebleeding. Results There were significant differences in sex, smoking, hemoglobin ( Hb) level, white blood cell ( WBC) count, alanine aminotransferase level, aspartate aminotransferase level, and spleen thickness between the two groups ( P < 0. 05) . The univariate unconditional logistic regression analysis showed that percentage of neutrophils ( OR = 0. 976, P = 0. 034) , WBC count ( OR =1. 173, P = 0. 007) , portal vein width ( OR = 7. 530, P = 0. 001) , and Hb level ( OR = 1. 415, P = 0. 013) were positively correlated with rebleeding. Conclusion WBC count, percentage of neutrophils, Hb level, and portal vein width are positively correlated with rebleeding from EGV, and they are the risk factors for early rebleeding from EGV in patients with liver cirrhosis if their values are high.

Objective To compare the perioperative outcomes of laparoscopic hepatectomy ( LH) versus open hepatectomy ( OH) for liver cancer patients with cirrhosis. Methods From September 2010 to June 2012, 78 liver cancer patients with cirrhosis hospitalized in Renmin Hospital affiliated to Wuhan University were considered for liver resection; among them, 32 patients were treated with LH, and 46 patients with OH. Intraoperative and postoperative conditions and tumor recurrence were compared between the two groups. Group t- test and paired t- test were used for measurement data, while chi- square test for enumeration data. Results The comparison of two groups indicated that the following indicators were significantly lower in the LH group than in the OH group: intraoperative blood loss ( t = 0. 057, P = 0. 040) , incidence of postoperative complications ( electrolyte imbalance, bile leakage, and ascites: t = 3. 001, 3. 241, and 4. 255, respectively, P< 0. 05 for all) , liver function on the first day after operation ( AST and ALT: t = 3. 427 and 3. 201, P = 0. 001 and 0. 002) , postoperative time to oral intake ( t = 3. 012, P = 0. 001) , length of hospital stay ( t = 2. 157, P = 0. 003) , and tumor recurrence ( t = 2. 751, P =0. 006) ; whereas, the operative time in LH group was significantly longer than that in OH group ( t = 3. 101, P = 0. 003) . Conclusion Compared with OH, LH has various advantages in liver cancer patients with cirrhosis, such as smaller abdominal incision, less intraoperative blood loss, lower incidence of postoperative ascites, decreased postoperative complications, shorter hospital stay, and lower incidence of tumor recurrence.

Objective To analyze the changes in platelet parameters and their influential factors in cirrhotic patients with hepatocellular carcinoma ( HCC) . Methods The clinical data of 602 cirrhotic patients with HCC who were admitted to the First Hospital of Jilin University from January 2011 to December 2012, as well as 200 cirrhotic patients hospitalized during the same period, were collected. Statistical analysis was performed using SPSS 19. 0. Normally distributed continuous data were expressed as mean ± standard deviation; comparison between two groups was made by t test, and comparison between multiple groups was made by analysis of variance. Non- normally distributed data were expressed as median and interquartile range ( P25- P75) ; comparison between groups was made by rank sum test. Results Compared with the cirrhotic group, the HCC group had significantly higher platelet count ( PLT) and plateletcrit ( PCT) ( t = 5. 019, P = 0. 000;t = 5. 017, P = 0. 000) and a significantly lower mean platelet volume ( MPV) /PLT ( t = 5. 877, P = 0. 000) ; there were no significant differences in MPV and platelet distribution width between the two groups ( t =- 0. 942, P = 0. 347; t =- 1. 040, P = 0. 298) . The receiver operating characteristic ( ROC) analysis showed that the area under the ROC curve was 0. 636 for PLT, 0. 633 for PCT, and 0. 639 for MPV /PLT in the diagnosis of HCC in cirrhotic patients. Decreases in PLT and PCT were closely related to hepatitis C virus ( HCV) infection. Patients with Child- Pugh class A cirrhosis had significantly higher PLT and PCT than those with Child- Pugh class B and C cirrhosis ( P <0.01) ; patients with a maximum tumor diameter of ≥5 cm had significantly higher PLT and PCT than those with maximum tumor diameters of 2- 5 cm and ≤2 cm ( P < 0. 01) . Patients with Child- Pugh class A cirrhosis had a significantly lower MPV /PLT than those with Child- Pugh class B and C cirrhosis ( P < 0. 01) ; patients with a maximum tumor diameter of ≥5 cm had a significantly lower MPV /PLT than those with maximum tumor diameters of 2- 5 cm and ≤2 cm ( P < 0. 01) . Conclusion PLT, PCT, and MPV /PLT can be used in the auxiliary diagnosis of HCC in cirrhotic patients, which are related to HCV, Child- Pugh classification, and tumor size.

Objective To investigate the pathogenesis, diagnostic keys, and treatment of hepatogenous diarrhea. Methods Sixty- two patients with hepatogenous diarrhea were assigned to three levels of treatment. Patients given level- one treatment received live combined Clostridium butyricum and Bifidobacterium powder for regulating intestinal flora; patients given level- two treatment received montmorillonite powder for constriction, adsorption, and stopping diarrhea and compound diphenoxylate for inhibiting intestinal peristalsis; patients given level- three treatment received somatostatin for reducing portal pressure. Total bilirubin, albumin, total bile acid, prothrombin time, platelet count, spleen thickness, spleen length, splenic vein width, and portal vein width, as well as routine stool test and stool culture, were measured before treatment, and the times of diarrhea and time of onset were determined before and after treatment. Measurement data were expressed as M ( P25- P75) , and statistical analysis was performed using the Spearman rank correlation coefficient. Results Hepatogenous diarrhea was mostly seen in patients with decompensated liver cirrhosis. The higher the Child- Pugh score, the severer the diarrhea and the higher the susceptibility to diarrhea. Hepatogenous diarrhea had no specific clinical manifestations. Mild or moderate diarrhea was treated mainly by improving liver function, regulating intestinal flora, and inhibiting intestinal peristalsis, while severe diarrhea mainly by reducing portal pressure. Conclusion The pathogenesis of hepatogenous diarrhea is complex, without specificity for the diagnosis. The key to therapy is to treat the primary liver disease, regulate intestinal flora, reduce portal pressure, and somatostatin shows good efficacy for severe diarrhea.

Objective To evaluate the clinical efficacy and safety of magnesium isoglycyrrhizinate in the treatment of liver injury among patients with obstructive jaundice after percutaneous transhepatic cholangiodrainage ( PTCD) . Methods Sixty- two obstructive jaundice patients with liver injury after PTCD were randomly divided into treatment group ( n = 32) and control group ( n = 30) . All patients were given vitamin B6, vitamin C, and coenzyme complex by intravenous drip. At the same time, the treatment group was given magnesium isoglycyrrhizinate ( 100 mg) after PTCD for 7 days, while the control group was given reduced glutathione ( 1200 mg) for 7 days. After treatment, the improvements in serum alanine transaminase ( ALT) , aspartate aminotransferase ( AST) , albumin ( Alb) , γ- glutamyl transpeptidase ( GGT) , alkaline phosphatase ( ALP) , total bilirubin ( TBil) , direct bilirubin ( DBil) , tumor necrosis factor- α ( TNFα) , and nuclear factor- kappa B ( NF- κB) were evaluated. The adverse reactions associated with magnesium isoglycyrrhizinate were observed. Results After treatment, both groups showed significant decreases in serum TBil, DBil, ALT, AST, ALP, TNFα, and NF- κB ( P < 0. 05) , and the treatment group had significantly higher decreases in these indices ( P < 0. 05) . However, there were no significant improvements in Alb and GGT in either group after treatment, and the two indices showed no significant differences between the two groups ( P > 0. 05) . Conclusion Treated with magnesium isoglycyrrhizinate, obstructive jaundice patients with liver injury after PTCD can regain the liver function and recover from jaundice rapidly, and magnesium isoglycyrrhizinate has good efficacy and safety.