Spontaneous regression of hepatic inflammatory pseudotumor with primary biliary cirrhosis:Case report and literature review

肝的煽动性的假肿瘤(IPT ) 是煽动性的房间渗入的增殖的纤维组织描绘的稀罕良性的非肿瘤的损害。IPT 的准确病原学仍然保持不清楚。尽管有全身的煽动性的混乱的 IPT 的协会很好被建立了，有胆管炎的一种特殊关系是显然稀罕的。我们与主要胆汁性肝硬变(PBC ) 报导肝的 IPT 的自发的回归的一个案例。迄今为止，仅仅有 PBC 的 IPT 的二个案例被报导了。在我们的情况中，然而， IPT 在有效治疗导致的 PBC 的胆管炎的改进的功课期间发展了，不同于二个以前报导的案例。我们的案例显示 IPT 的发展也不联系到胆管炎或亢奋的 gamma-globulinemia 的活动，自从我们的案例被证实当胆汁的酶和免疫球蛋白比承认上的相应价值高得多时，没有 IPT 的放射线学的联盟者。我们有二个以前报导的案例的案例的比较建议与 PBC 发生的 IPT 不代表一样的疾病实体或是为 PBC 的一个旁观者。

Efficacy of balloon-occluded retrograde transvenous obliteration, percutaneous transhepatic obliteration and combined techniques for the management of gastric fundal varices

瞄准：评估为胃的静脉曲张的处理包含 transvenous 涂去的三个 interventional 处理的效果，并且比较功效和这些方法的不利效果。方法：从 1995 ～ 2004，有胃的底的静脉曲张的 93 个病人经历了 interventional 在我们的医院的放射线学的 embolotherapy。93 个病人， 75 被对待与堵塞汽球后退 transvenous 涂去(BRTO ) 过程；8 与经皮的 transhepatic 涂去(PTO ) 是过程；并且 10 与联合 BRTO 和 PTO 治疗。后续评估检验了幸存的率，复发并且胃的静脉曲张重新流血，在每个组食道的静脉曲张和复杂并发症变得更坏。结果：BRTO， PTO，和联合治疗在 81% 是技术上成功的(75/93 ) ， 44%(8/18 ) ，并且 100%(10/10 ) 病人分别地。胃的静脉曲张的复发在 PTO 组在 BRTO 组并且在 3 个病人在 3 个病人被发现。重新流血在 PTO 组在 BRTO 组并且在 1 个病人在 1 个病人被观察。没有肝细胞癌(HCC ) ， 1 年、 3 年的幸存率在在 PTO 组的 BRTO 组， 100% 和 100% 在病人是 98% 和 87% ，并且 90% 和 75% 分别地在联合治疗组织。结论：尽管有我们的学习的限制，联合 BRTO 和 PTO 治疗可以与与 BRTO 或 PTO 仍然是甚至术后疗法的控制不了的胃的底的静脉曲张救盒子，包括在在 BRTO， PTO 和联合治疗组之间的样品尺寸的回顾的自然和差异。

Analysis of colonoscopic perforations at a local clinic and a tertiary hospital

AIM:To define the clinical characteristics,and to assess the management of colonoscopic complications at a local clinic.METHODS:A retrospective review of the medical records was performed for the patients with iatrogenic colon perforations after endoscopy at a local clinic between April 2006 and December 2010.Data obtained from a tertiary hospital in the same region were also analyzed.The underlying conditions,clinical presentations,perforation locations,treatment types(operative or conservative) and outcome data for patients at the local clinic and the tertiary hospital were compared.RESULTS:A total of 10 826 colonoscopies,and 2625 therapeutic procedures were performed at a local clinic and 32 148 colonoscopies,and 7787 therapeutic procedures were performed at the tertiary hospital.The clinic had no perforations during diagnostic colonoscopy and 8(0.3%) perforations were determined to be related to therapeutic procedures.The perforation rates in each therapeutic procedure were 0.06%(1/1609) in polypectomy,0.2%(2/885) in endoscopic mucosal resection(EMR),and 3.8%(5/131) in endoscopic submucosal dissection(ESD).Perforation rates for ESD were significantly higher than those for polypectomy or EMR(P < 0.01).All of these patients were treated conservatively.On the other hand,three(0.01%) perforation cases were observed among the 24 361 diagnostic procedures performed,and these cases were treated with surgery in a tertiary hospital.Six perforations occurred with therapeutic endoscopy(perforation rate,0.08%;1 per 1298 procedures).Perforation rates for specific procedure types were 0.02%(1 per 5500) for polypectomy,0.17%(1 per 561) for EMR,2.3%(1 per 43) for ESD in the tertiary hospital.There were no differences in the perforation rates for each therapeutic procedure between the clinic and the tertiary hospital.The incidence of iatrogenic perforation requiring surgical treatment was quite low in both the clinic and the tertiary hospital.No procedure-related mortalities occurred.Performing closure with endoscopic clipping reduced the C-reactive protein(CRP) titers.The mean maximum CRP titer was 2.9 ± 1.6 mg/dL with clipping and 9.7 ± 6.2 mg/dL without clipping,respectively(P < 0.05).An operation is indicated in the presence of a large perforation,and in the setting of generalized peritonitis or ongoing sepsis.Although we did not experience such case in the clinic,patients with large perforations should be immediately transferred to a tertiary hospital.Good relationships between local clinics and nearby tertiary hospitals should therefore be maintained.CONCLUSION:It was therefore found to be possible to perform endoscopic treatment at a local clinic when sufficient back up was available at a nearby tertiary hospital.

Hepatocellular carcinoma in extremely elderly patients:An analysis of clinical characteristics,prognosis and patient survival

瞄准：80 年或更多与肝细胞癌(HCC ) 识别病人的临床、预示的特征。方法：有 HCC 的 1310 个病人的一个总数在这研究被包括。80 年或更多的 91 个病人在 HCC 的诊断的时候被定义为极其老的组。】 或 = 的 234 个病人 50 年但是不到 60 年被认为是非老的组。结果：两性比率(到女性的男性) 比在非老的组在极其老的组(0.90:1 ) 是显著地更低的(3.9:1， P 【 0.001 ) 。为 HBsAg 的积极的率在极其老的组和为显然在极其老的组增加的 HBsAg 和 HCVAb 否定的病人的比例是显著地更低的(P 【 0.001 ) 。在下列参数没有有效差量：肿瘤，分级的孩子呸，肿瘤阶段，门静脉血栓形成或腹水的存在，和为 HCVAb 的积极的率的直径和数字。极其老的病人经常没收到外科疗法(P 【 0.001 ) 并且他们是更可能的收到保守疗法(P 【 0.01 ) 。基于与在二个组之间的全面病人比较的 Kaplan-Meier 方法在幸存曲线没有有效差量。然而，幸存曲线在有阶段 I/II 的极其老的病人是显著地更坏的，上演 I/II，孩子呸分级与非老的组比较的肝硬化。死亡的原因没在病人之中不同，并且大多数盒子甚至在极其老的病人死于肝相关的疾病。结论：在有好肝功能和好表演地位的病人，为 HCC 的好攻击的治疗可能改进幸存率，甚至在极其老的病人。

Probable case of drug reaction with eosinophilia and systemic symptom syndrome due to combination therapy with daclatasvir and asunaprevir

A 66-year-old, interferon-ineligible, treatment-naive man who was diagnosed with chronic hepatitis C due to hepatitis C virus genotype 1b began combination therapy with daclatasvir and asunaprevir. On day 14 of treatment, hepatic reserve and renal function deterioration was observed, while his transaminase levels were normal. Both daclatasvir and asunaprevir were discontinued on day 18 of treatment, because the patient complained of dark urine and a rash on his trunk and four limbs. After discontinuing antiviral therapy, the abnormal laboratory finding and clinical manifestations gradually improved, without recurrence. Our case fulfilled the diagnostic criteria of probable drug reaction with eosinophilia and systemic symptom(DRESS) syndrome. Despite the 18-d treatment, sustained virological response 12 was achieved. Based on the clinical course, we concluded that there was a clear cause-and-effect relationship between the treatment and adverse events. To our knowledge, this patient represents the first case of probable DRESS syndrome that includes concomitant deterioration of hepatic reserve and renal function due to combination therapy with daclatasvir and asunaprevir, regardless of normalization of transaminase levels. Our case suggests that we should pay attention not only to the transaminase levels but also to allergic symptoms associated with organ involvement during combination therapy with daclatasvir and asunaprevir.

Fulminant hepatic failure resulting from small-cell lung cancer and dramatic response of chemotherapy

在联系肿瘤的脑病的迅速的治疗可以延长幸存。我们描述与暴发性的肝的失败被介绍的一个 69 岁的男病人，对有很快进行的脑病的小房间的肺癌第二等。两症状汇寄后面的化疗，建议在暴发性的肝的失败和脑病的治疗有效的化疗的快速的诊断和管理。

Triple therapy of interferon and ribavirin with zinc supplementation for patients with chronic hepatitis C:A randomized controlled clinical trial

瞄准：为了与锌学习干扰素(IFN ) 和 ribavirin 的治疗学的效果，与长期的丙肝在病人上补充病毒(HCV ) 感染。方法：组织学地证实与遗传型 1b 和 HCV 的超过 100 KIU/mL 有长期的 HCV 感染的 102 个病人的一个总数随机被分到学习的每只手臂，各个收到了为 4 wk 的干扰素( IFN-alpha-2b )日报每隔一天由一样的剂量跟随了为的 pegylated 的1000万个单位加 ribavirin ( 600 或 800 mg/d 取决于体重)的 20 wk ，与或没有 polaprezinc ( 150 mg/d )口头上地为 24 wk 。主要端点是在浆液定义为否定 HCV-RNA 的持续 virological 反应(SVR ) 6 瞬间术后疗法。结果：比在另外的组(P【0.05 ) 除了在双治疗组的更多的女性在在二个组之间的临床的背景没有差别。SVR 在 33.3% 三倍的治疗组和 33.3% 双治疗组被观察。副作用是几乎，在两个的一样除了胃肠的症状组织，它是在三倍的治疗组(P=0.019 ) 的更少。结论：一起考虑了，加为有遗传型 1b 和高病毒的负担的 HCV 感染病人的 IFN 和 ribavirin 的锌的三倍的治疗不除了胃肠的副作用的更低的发生比双治疗好。

Randomized controlled trial of consensus interferon with or without zinc for chronic hepatitis C patients with genotype 2

瞄准：为长期的丙肝的治疗在高病毒的负担的肝炎病毒遗传型 1b 被表明了的干扰素的功效上的锌补充的有益的效果。这研究与遗传型 2 集中于病人，它比遗传型 1b 对干扰素更敏感，并且使用了一致干扰素(CIFN ) 与或没有锌。方法：我们使随机化有到在 18 MIU 的 CIFN 的长期的丙肝的 83 个病人为 4 wk 的六 times/wk，在 18 MIU 由 CIFN 列在后面为另一 20 wk 的六 times/wk，在有 polaprezinc 的联合 300 mg (政体 A， n=41 ) 或同样单音的治疗(政体 B， n=42 ) 。在政体 A 的 31 个病人和在政体 B 的 33 个病人完成了临床的试用；因为副作用或转移，留下的病人撤退了到另一所医院。结果：支撑了生物化学的反应，作为正常定义 aminotransferase 在 6 瞬间的结束铺平处理以后的观察，是 68% 和 69% ，并且支撑了 virological 反应，在 6 瞬间的结束定义为无法发现的 HCV-RNA 处理以后的观察，分别地为政体 A 和 B 是 54% 和 67% 。结论：与锌相结合的 CIFN 治疗没提高出现由的 CIFN 的效果生物化学， virological 标准。与 polaprezinc 有关的副作用都没被注意。

Regulatory T cells percentage in peripheral blood before and after eradication of <i>Helicobacter pylori</i>

Helicobacter pylori (H. pylori) induces gastroduodenal diseases and vigorous humural and cellular immune abnormalities. In order to clarify the immunological changes before and after eradication of H. pylori, the percentages and ratios of the following cells in the peripheral blood of 32 H. pylori-infected patients and 25 control subjects were analyzed: CD4+ T cells, CD8+ T cells, T helper 1 cells (Th1), T helper 2 cells (Th2), CD4+CD25+ T cells, Foxp3+ regulatory T cells (Treg), CD4/CD8 ratio, and Th1/Th2 ratio. CD4/CD8 ratio was significantly higher in H. pylori-infected patients before (mean ± SD, 2.9 ± 1.9) and after (mean ± SD, 2.8 ± 1.6) eradication of H. pylori than in control subjects (mean ± SD, 2.1 ± 0.9). The percentage of Th2 cells was significantly higher in H. pylori-infected patients (mean ± SD, 2.6 ± 1.1) than in control subjects (mean ± SD, 1.9 ± 1.1;p < 0.02). The percentage of Th2 cells after eradication of H. pylori (mean ± SD, 2.3 ± 1.4) was lower than that before eradication. There was no significant difference between control subjects (mean ± SD, 4.1% ± 1.5%) and patients before H. pylori eradication (mean ± SD, 4.5% ± 2.4%) in the percentage of Tregs, but the percentage was significantly higher in patients after H. pylori eradication (mean ± SD, 5.2% ±2.6%) than in control subjects. The function of peripheral induced Tregs was reported to suppress the excessive immune reaction in chronic inflammation. These data suggest that Tregs may proliferate and be activated to suppress the activation of humoral immunity in H. pylori-infected patients, and these changes continue after 3 months or later of successful eradication of H. pylori.

Topical application of glycyrrhizin preparation ameliorates experimentally induced colitis in rats

AIM:To examine the efficacy of glycyrrhizin preparation(GL-p) in the treatment of a rat model of ulcerative colitis(UC).METHODS:Experimental colitis was induced by oral administration of dextran sodium sulfate.Rats with colitis were intrarectally administered GL-p or saline.The extent of colitis was evaluated based on body weight gain,colon wet weight,and macroscopic damage score.The expression levels of pro-inflammatory cytokines and chemokines in the inflamed mucosa were measured by cytokine antibody array analysis.The effect of GL-p on myeloperoxidase(MPO) activity in the inflamed mucosa and purified enzyme was assayed.RESULTS:GL-p treatment significantly ameliorated the extent of colitis compared to sham treatment with saline.Cytokine antibody array analysis showed that GL-p treatment significantly decreased the expression levels of pro-inflammatory cytokines and chemokines,including interleukin(IL)-1β,IL-6,tumor necrosis factor-α,cytokine-induced neutrophil chemoattractant-2,and monocyte chemoattractant protein-1 in the inflamed mucosa.Furthermore,GL-p inhibited the oxidative activity of mucosal and purified MPO.CONCLUSION:GL-p enema has a therapeutic effect on experimental colitis in rats and may be useful in the treatment of UC.

Analysis of ABC (D) stratification for screening patients with gastric cancer

AIM:To evaluate the value of ABC(D) stratification [combination of serum pepsinogen and Helicobacter pylori(H.pylori) antibody]of patients with gastric cancer.METHODS:Ninety-five consecutive patients with gastric cancer were enrolled into the study.The serum pepsinogenⅠ(PGⅠ) /pepsinogenⅡ(PGⅡ) and H.pylori antibody levels were measured.Patients were classified into five groups of ABC(D) stratification according to their serological status.Endoscopic findings of atrophic gastritis and histological differentiation were also analyzed in relation to the ABC(D) stratification.RESULTS:The mean patient age was(67.9±8.9) years.Three patients(3.2%) were classified into group A,7 patients(7.4%) into group A',27 patients(28.4%) into group B,54 patients(56.8%) into group C,and 4patients(4.2%) into group D,respectively.There were only three cases in group A when the patients taking acid proton pump inhibitors and those who had undergone eradication therapy for H.pylori(group A') were excluded.These three cases had mucosal atrophy in the grey zone according to the diagnostic manual of ABC(D) stratification.Histologically,the mean age of the patients with well differentiated adenocarcinoma was significantly higher than that of the patients with poorly differentiated adenocarcinoma(P<0.05) .There were no differences in the pattern of atrophy in the endoscopies between the well differentiated and poorly differentiated groups.CONCLUSION:ABC(D) stratification is a good method for screening patients with gastric cancers.Endoscopy is needed for grey zone cases to check the extent of mucosal atrophy.

Computed tomography-guided transpulmonary radiofrequency ablation for hepatocellular carcinoma located in hepatic dome

瞄准：为了决定，执行计算断层摄影术(CT ) 的可行性为位于肝的屋顶的肝细胞癌(HCC ) 指导了 transpulmonary 射频脱离(RFA ) 。方法：有包括位于肝的屋顶的七个小瘤的 HCC 的七个病人的一个总数从 2004 年 4 月被对待到 2004 年 12 月。指导 CT 的 transpulmonary RFA 基于一个标准化精力协议用一个凉爽尖端的类型电极(电子学公司) 被执行。位于肝的屋顶的所有肿瘤不由平常的超声(美国) 是可检测的方法。损害直径从 15 ～ 27 公里。结果：RFA 在所有病人是技术上可行的。刺过程被执行两次或更少和全部的平均成就时间是 40.6 min。本地肿瘤控制在所有病人被完成。坏死直径从 25 ～ 35 公里。吝啬的后续时期是 9.6 (7-14 瞬间) 瞬间。在后续点没有本地复发。要求肋膜的排水的气胸是主要复杂并发症，它在七个病人(28.6%) 中的二个被观察。然而，它与胸引流管改善了，并且试管能在 2-3 d 以内被移开。没有另外的主要复杂并发症被观察。结论：指导 CT 的刺为位于几乎不由美国可检测的肝的屋顶的肿瘤的治疗是有用的，尽管气胸可以有时作为复杂并发症发生。在有在人工的胸膜渗漏方法不是适当的为胸膜的粘附的情况中，指导 CT 的 RFA 因此被认为是为位于肝的屋顶的 HCC 的其他的治疗。

Reduction of virus burden-induced splenectomy in patients with liver cirrhosis related to hepatitis C virus infection

瞄准：检验丙肝病毒(HCV ) 在在脾切除术以后的肝脏硬化症的病人的层次和免疫学的标记。方法：HCV RNA 乳头 ers 以及细胞、体液的有免疫力的标记与一口未经触动的怒气在脾切除术以后并且在 32 肝脏硬化症的控制在 20 个肝脏硬化症的病人被决定。结果：浆液 HCV RNA 乳头 ers 比在控制在 splenectomized 病人是更低的(186+/-225 x 10 (3 ) copies/mL 对 541+/-417 x 10 (3 ) copies/mL， P【0.01 ) 。HCV RNA 被判定到自发地控制在 4 个 splenectomized 病人，但是在没有被根除了。自然漂亮房间活动比在控制在 splenectomized 病人是更高的(41.2+/-19.3% 对 24.7+/-15.3% ， P【0.01 ) ，并且除了在那些，自然漂亮房间活动否定地与血清型 2-related 感染在 splenectomized 病人被相关到 HCV RNA 乳头 ers。CD4/CD8 比率比在控制在 splenectomized 病人是显著地更低的。结论：调查结果建议那脾切除术可以减少在有 HCV 感染的肝脏硬化症的病人的病毒负担至少部分地，通过自然漂亮房间活动的扩大。

Overexpression of NK2 inhibits liver regeneration after partial hepatectomy in mice

AIM: To investigate the in vivo effects of NK2 on liver regeneration after partial hepatectomy (PH). METHODS: Survival after PH was observed with 21 NK2 transgenic mice and 23 wild-type (WT) mice over 10 d. Liver regeneration was analyzed using histology and immunohistochemistry. Expressions of genes were analyzed using Northern blot analysis, immunoprecipitation and immunoblotting, and reverse transcriptase polymerase chain reaction assay. KaplanMeier method and the log-rank test were used for ahalyzing the survival after PH. Differences in the resultsof immunohistochemistry and percentage of liver regeneration was determined by the Student's t-test. RESULTS: More than half of NK2 transgenic mice died within 48 h after PH. After PH, increased deposition of small lipid droplets in hepatocytes was evident and hepatic proliferation was inhibited in NK2 transgenic mice. The hepatic expression and kinase activity of HGF receptor, c-Met, were unchanged among WT mice and NK2 transgenic mice after PH. The expression of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in liver tissues were prolonged in NK2 transgenic mice that died after PH.CONCLUSION: Our findings indicate that overexpression of NK2 inhibits liver regeneration after PH.

Non-invasive prediction of non-alcoholic steatohepatitis in Japanese patients with morbid obesity by artificial intelligence using rule extraction technology

AIM To construct a non-invasive prediction algorithm for predicting non-alcoholic steatohepatitis(NASH), we investigated Japanese morbidly obese patients using artificial intelligence with rule extraction technology.METHODS Consecutive patients who required bariatric surgery underwent a liver biopsy during the operation. Standard clinical, anthropometric, biochemical measurements were used as parameters to predict NASH and were analyzed using rule extraction technology. One hundred and two patients, including 79 NASH and 23 non-NASH patients were analyzed in order to create the predictionmodel, another cohort with 77 patients including 65 NASH and 12 non-NASH patients were analyzed to validate the algorithm.RESULTS Alanine aminotransferase, C-reactive protein, homeostasis model assessment insulin resistance, albumin were extracted as predictors of NASH using a recursive-rule extraction algorithm. When we adopted the extracted rules for the validation cohort using a highly accurate rule extraction algorithm, the predictive accuracy was 79.2%. The positive predictive value, negative predictive value,sensitivity and specificity were 88.9%, 35.7%, 86.2% and 41.7%, respectively.CONCLUSION We successfully generated a useful model for predicting NASH in Japanese morbidly obese patients based on their biochemical profile using a rule extraction algorithm.

Concordance of ulcerative colitis in monozygotic twin sisters

The etiology of inflammatory bowel disease is multifacto rial and appears to combine both genetic and environmental factors. We experienced here a rare occurrence of woman monozygotic twins with ulcerative colitis (UC). A 45-year-old woman (the elder monozygotic twin) was admitted to our hospital because of bloody diarrhea occurring over 10 times per day, abdominal pain and fever. She was diagnosed as UC at the age of 22, and repeated the relapse and remission. She was diagnosed as relapse of UC and total colitis type. Her younger monozygotic twin sister also suffered from UC at the age of 22. Human leukocyte antigen was examined serologically with DNA type in both patients. DRB1*1502, which was previously shown to be dominant in Japanese patients with UC, was not observed in this case. Although the concordance in monozygotic twin in UC is reported to be 6.3-18.8%, the concordant case like this is relatively rare. We report this rare case of UC and the previously reported cases are also discussed.

Different outcomes of nosocomial infection with hepatitis C virus from the same origin

有丙肝病毒(HCV ) 的感染的结果在个人之中从自我限制的感染实质地变化到长期的肝炎，肝肝硬化，和肝细胞癌。决定清理或 HCV 的坚持还没被澄清了的机制。这里，我们从一样的起源，但是与相当不同的结果与 HCV 经历了医院相关的感染的二个盒子。一个盒子在尖锐肝炎的一个事件以后解决了，当尽管他们感染一样的起源的 HCV，另外的盒子开发了长期的肝炎时。尽管与一样的起源的病毒感染了，临床并且 virological 功课是完全不同的。这建议主人因素在调节起一个主要作用尖锐 HCV 感染的结果。

FDG-PET for predicting efficacy of EGFR-tyrosine kinase inhibitors in lung cancer

Non-small cell lung cancer(NSCLC) is the major cause of cancer-related deaths worldwide. Recent advances in molecular biology have resulted in the clinical use of several molecularly targeted drugs, which usually exhibit cytostatic antitumor activity, to improve the survival of NSCLC patients. The epidermal growth factor receptortyrosine kinase inhibitors(EGFR-TKIs) gefitinib and erlotinib have been approved for the treatment of NSCLC, and several phase Ⅲ trials have demonstrated that sensitizing EGFR mutations are biomarkers for predicting a favorable clinical outcome of NSCLC patients treated with the EGFR-TKIs. The Response Evaluation Criteria in Solid Tumors is generally used to assess the therapeutic response to antitumor drugs based on the morphological changes in tumor size as evaluated by computed tomography or magnetic resonance imaging. However, such assessment may not always reflect the treatment efficacy of cytostatic drugs, such as EGFR-TKIs. In this regard, functional imaging methods, including 18F-fluorodeoxyglucose measured by positron emission tomography(FDG-PET), are potentially beneficial. An increasing body of evidence indicates the usefulness of FDG-PETto predict treatment efficacy for NSCLC patients treated with EGFR-TKIs. In this review, we summarize the current understanding of the potential role of FDG-PET in the clinical use of EGFR-TKIs for NSCLC.

Combination therapy with daclatasvir and asunaprevir for dialysis patients infected with hepatitis C virus

The standard antiviral therapy for dialysis patients infected with hepatitis C virus(HCV) is(pegylated) interferon monotherapy, but its efficacy is insufficient. Oral direct-acting antiviral agents(DAAs) have recently been developed for chronic hepatitis C patients. However, some DAAs have contraindications for chronic renal failure(CRF). Daclatasvir and asunaprevir are metabolized largely in the liver and are not contraindicated in CRF. Combination therapy with daclatasvir and asunaprevir was used for 4 dialysis patients infected with genotype 1b HCV. One patient had viral breakthrough, and the 3 others had sustained virological response 12. One patient was admitted for heart failure and percutaneous coronary intervention due to concomitant ischemic disease. Heart failure was unlikely to be caused by the combination therapy, as it was probably due to water overload. The patient continued to receive the combination therapy after the remission of the heart failure. The combination therapy was well tolerated in the other patients.

Hepatic adenomatosis associated with hormone replacement therapy and hemosiderosis:A case report

我们报导了与荷尔蒙代替治疗(雌激素和孕酮) 联系的肝的腺瘤病的一个案例，血铁质沉着病为长期的 myeloid 的治疗由过多的输血引起了。一个 34 岁的女人被发现在平淡的体格检查上有几个肝的肿瘤。一般条件好。实验室研究显示出铁超载。腹的计算断层摄影术和选择肝的血管造影术在肝(在直径的多达 20 公里) 的正确脑叶显示出几个亢奋的动脉瘤。因为肝细胞癌不能被排除，代替部分肝切除术被执行。外科的标本的组织病理学说的检查与血铁质沉着病显示出肝的腺瘤病。两荷尔蒙代替治疗和铁超载能是肝的腺瘤病的原因。