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| 1 | TACE治疗不同年龄组原发性肝癌367例显示文摘目的:探讨经导管动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)对不同年龄组原发性肝癌(primary hepatocellular carcinoma,PHC)患者疗效是否存在差别.方法:对2006-01/2011-07收治的PHC患者367例行肝动脉化疗栓塞,并进行回顾性分析,其中青年组≤44岁(n=46),中年组45-59岁(n=172),老年组≥60岁(n=149),对不同年龄组生存率进行Kaplan-Meier模型分析和Log-rank检验.结果:367例原发性肝癌患者6mo,1-,2-,3-年的生存率分别是88.8%、65.6%、35.1%、15.8%,中位生存时间为18mo.不同年龄组原发性肝癌患者6mo,1-,2-,3-年生存率的差异有统计学意义(P<0.05).虽然肿瘤大小在3组之间没有明显的差别(P=0.076),但老年患者在原发性肝癌的早期接受肝动脉化疗栓塞治疗比例明显高于青年组(20.1%vs8.7%).结论:老年组的生存期优于中年组及青年组,而青年组最差. | 王胜强 梁茂全 毛景松 邢榕 苏洪英 | 2012 | 世界华人消化杂志2012，20，24： | 5 |
| 2 | Hepatitis C genotype 6:A concise review and response-guided therapy proposal显示文摘Hepatitis C genotype 6 is endemic in Southeast Asia[prevalence varies between 10%-60% among all hepatitis C virus(HCV) infection], as well as also sporadically reported outside the area among immigrations.The diagnosis of HCV genotype can be inaccurate with earlier methods of genotyping due to identical 5'-UTR between genotype 6 and 1b, hence the newer genotyping methods with core sequencing are preferred.Risk factors and clinical course of HCV genotype 6 do not differ considerably from other genotypes. Treatment outcome of HCV genotype 6 with a combination of pegylated interferon and ribavirin is superior to genotype 1, and nearly comparable to genotype 3, with expected sustained virological response(SVR) rates of 60%-90%. Emerging data suggests that a shorter course 24-wk treatment is equally effective as a standard 48-wk treatment, particularly for those patients who attained undetectable HCV RNA at week 4(RVR).In addition, baseline and on-treatment predictors of response used for other HCV genotypes appear effective with genotype 6. Although some pan-genotypic directacting antivirals have completed phase Ⅱ/Ⅲ studies(sofosbuvir and simeprevir) with clinical benefit demonstrated in small number of patients with genotype6, broad availability of these agents in Southeast Asia may not be expected in the near future. While awaiting the newer therapy, response-guided therapy seems appropriate for patients with HCV genotype 6. Patients with RVR(representing>70% of patients) are suitable for 24-wk treatment with expected SVR rates>80%. Patients without RVR and/or those with poor response predictors may benefit from 48 wk of therapy,and a detectable HCV RNA at week 12(with no early virological response) serves as a stopping rule. This treatment scheme is likely to have a major economic impact on HCV therapy, particularly in Southeast Asia,wherein treatment can be truncated securely in the majority of patients with HCV genotype 6. | Chalermrat Bunchorntavakul Disaya Chavalitdhamrong Tawesak Tanwandee | 2013 | World Journal of Hepatology2013，5，9： | 2 |
| 3 | HCV-1b型基因变异与干扰素/利巴韦林疗效的相关性研究显示文摘目的探讨HCV-1b型ISDR区、PKR-BD区、NS5A-V3功能区及2-PePHD功能区的基因序列突变程度与干扰素屏0巴韦林联合治疗慢性丙型肝炎疗效的相关性。方法收集拟进行干扰素和利巴韦林联合治疗的慢性丙型肝炎患者的血清标本以及实验室数据和随后的临床治疗资料。提取血清标本RNA,RT-PCR鉴定HCV基因型。选取H弹1b型阳性的标本,利用R11-PCR分别扩增ISDR区、PKR-BD区、NS5A-V3功能区及E2-PePHD功能区的基因片段,对Pat产物进行基因测序,与标准株的基因序列比对,确定各区的氨基酸突变位点和数量。回顾性分析各基因区氨基酸突变数量与干扰素/利巴韦林疗效的相关性。结果169例慢性丙型肝炎患者中HCV-1b型患者124例,占74.4%;在干扰素/利巴韦林联合治疗满12个月并随访满6个月的HCV-1b型感染者中,治疗前NS5A区的ISDR突变程度与持续病毒反应(SVR)的发生率之间呈显著相关性(P〈0.05)。突变型(突变氨基酸数≥4)患者群的SVR发生率为85.7%,中间型(突变氨基酸数为1~3)患者群的s、R发生率为55%,而野生型患者群的SVR发生率最低,仅为30%;而PKR-BD区、NS5A-V3、功能区以及E2-PePHD功能区的氨基酸突变数量与SVR发生率无显著相关性(P〉0.05)。结论HCV-1b型感染者治疗前NS5A区的ISDR突变程度对于干扰素/利巴韦林联合治疗的疗效具有很大的预测价值。 | 毛源 苗盛巍 王伟 邱洁 沈传来 沈玲 胡朝晖 谢维 | 2013 | 中华实验和临床感染病杂志(电子版)2013，7，3： | 2 |
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