ObjectiveAntiviral treatments could benefit chronic hepatitis B (CHB) patients with the regression or improvement of liver fibrosis. However, the degree of dynamic change of liver fibrosis for patients who had not received antiviral treatment remained to be studied. The current study aimed to observe the long-term variation of liver stiffness measurement (LSM), virological and biochemical response on patients without standard antiviral therapy.MethodsA total of 220 patients who were diagnosed with chronic HBV infection, who had not reached the standard of antiviral therapy, and completed a follow-up date of over 2 years in the First Affiliated Hospital of Xi’an Jiaotong University from 2012 to 2018 were retrospectively enrolled. According to the changes of LSM in baseline and follow-up period, the patients were divided into regression group, non-progressive group, and progressive group. The virological and biochemical characteristics of each group were analyzed.ResultsAmong the 220 patients, 153 patients (69.5%) had no progress in LSM degree. Alanine aminotransferase (ALT), HBV DNA, and HBsAg in a few patients increased or slightly decreased, while the vast majority remained in a relatively stable state. 89.5% (137/153) of the non-progressive patients were in grade F0. In addition, 58 patients showed spontaneous improvement with a decreasing rate of 0.460 kPa per year. Patients with ALT of 1-2 ULN had a statistically significant decrease in LSM improvement compared to patients with normal ALT. 82.8% of the LSM-improving patients showed baseline LSM of F1-F3. Only 9 patients showed LSM deterioration, however, which could not be explained by virus replication or necroinflammatory activity. ConclusionsFor patients unsatisfying standard antiviral therapy, most patients with baseline LSM of F0 grade fail to progress, and patients with baseline LSM of F1-F3 show a decrease during follow-up, LSM progression occurs in 4.1% of patients.
Objective To investigate the efficacy and safety of abdominal indwelling catheterization for the patients with large-volume ascites. Methods A total of 84 patients with liver cirrhosis complicated with large-volume ascites admitted in the first affiliated hospital of Xi’an Jiaotong University from January 2015 to December 2015 were retrospectively analyzed. Patients were divided into two groups, one was the puncture group and another was the catheterization group. The efficacy and safety were evaluated. Results Forty-four patients were enrolled in catheterization group, whereas forty patients were enrolled in puncture group. Symptoms associated with ascites had been eased and patients’ qualities of life had been improved in 2 weeks in each group. The tube fell out rate was 27.3% for patients in catheterization group. There was no operation related complications such as death, bleeding and intestinal perforation occurred. Either Child B stage or Child C stage, the dynamic changes of liver function and renal function in catheterization group were comparable to those in puncture group. No adverse event such as catheterization-related or puncture-related infection was observed. Conclusion Abdominal catheterization is effective and safe in management of large amount of ascites complicated with cirrhosis, however, the high rate of tube-fell-out should be paid more attention.