Second liver: Opportunity + decision-making + cure

In June 2007 8-9 day, sponsor by company of China contagion magazine, Sino-US Shanghai Shi Guibao company assist the liver of second of the 2nd focusing that do forum is held in Shanghai. Professor Weng Xinhua and Professor Zhuang Hui hold the position of chairman of the first day of forum, professor Chen Chengwei is held the position of the following day conference chairman. Professor Chen Chengwei thinks, this forum relatively content of the first forum is richer, the person that attend the meeting participates in degree taller, the person that tell reachs 19 people. Forum of focusing second liver rolled out afterwards successfully last year after two controversies, this second forum the following day those who argued to attract numerous physician likewise take an active part in. Ill doctor of our country liver is in make a diagnosis and give treatment is many on the foundation of case of illness, combine international to study new positive result, to second liver cure formed original view, the following day the case of illness afternoon discussed to reflect their active thinking again. This period B8-B9 continues wonderful to forum content has a story. Center of medicine of American Stanford university Professor Keeffe was 2006 liver of American chronic second treats a standard (abbreviation standard) main write person, he combines new research data nearly two years, and through unscrambling the make a diagnosis and give treatment 2006 the standard is mixed liver of AASLD chronic second treated a guideline 2007 (abbreviation guideline) , the remedial opportunity that discussed chronic second liver with the person that attend the meeting and cure are politic. When to begin to treat 　 　 standard and the remedial target that raised in the guideline 2007 all duplicated to restrain HBV DNA continuously 2006, prevent or defer liver disease to make progress. Announced 2006 be as long as 13 years along with visit research -- REVEAL research confirmed dependency of base line HBV DNA and liver ill evolutional further, putting forward 104 Copies/ml of ≥ of serum HBV DNA may be development of patient of chronic second liver the independence of the sclerosis that it is liver and liver cell cancer forecasts an element. About beginning to treat an opportunity, 2006 standards all lift with HBV DNA and ALT with 2007 guidelines regard cure as start, but 2006 normative views should be treated more actively. 2006 standards are recommended, ALT treats start to be Gt;ULN, among them male ULN is 30 U/L, the female is 19 U/L; and 2007 guidelines continue to be gone to along in order to the cure of the HBV DNA of standard;HBeAg electronegative patient of ALTgt;2 × ULN is critical value, 2007 guidelines are 105 Copies/ml surely, 2006 standards are 104 Copies/ml surely, emphasize nucleotide analogue should applying for a long time. At present the curative content of first selection includes favour the Wei that replace card, A Defu Wei, get together glycol interferon α - 2a and for decide than the husband (if begin 24 weeks of HBV DNA after cure,achieve detect be less than horizontal) . Sclerotic to the liver of acting countervail sex of HBV DNAgt;104 Copies/ml patient, two guidelines all are recommended should treat for a long time, first selection favour replaces Ka Wei or rummy husband combines Adefuwei surely. When to stop medical 　 about pausing medical opportune moment, professor Keeffe points out, to HBeAg electropositive patient, should treat disappear to HBeAg ± serum changeover, restrain HBV DNA to come continuously low-level or detect be less than a level, the 6-12 after occurrence HBeAg serum is changed the abiding and respondent rate that the month stops drug can be amounted to 80% . To HBeAg electronegative patient, answer to be treated for a long time. When to change remedial program 　 to should appear respondent inadequate or produce virus to be able to bear or endure when medicine, need adjusts remedial plan. Undertaking monitoring in treating a process is to decide inchoate virus learns respondent case. When treating 12 weeks, detect HBV DNA purpose is except initiative without respondent (drop from base line extent Lt;1 Log) . 24 Zhou Shi detects the purpose is certain pharmaceuticals whether enough restrains virus. Put forward inchoate virus to learn recently respondent it is good to can serve as prognosis and reduce be able to bear or endure of medical happening calculate index, cure 24 weeks of virus learn respondent cent to be completely respondent [HBV DNA is electronegative (Lt;300 Copies/ml)] , part is respondent (HBV DNAlt;104 Copies/ml) and respondent inadequate (104 Copies/ml) of HBV DNA ≥ . Should appear completely respondent when, continue to treat and monitor interval to relax if; is a part respondent, tenability is treated at present and monitor closely if; is respondent inadequate, should change medicine or add drug, increase the frequency that monitor. Be able to bear or endure medical virus individual plant is the choice that refusing virus medicaments be come out by the choice below pressure, be restrained to be in continuously when virus extremely low-level when won't happen be able to bear or endure medicine, namely No Replication = No Resistance. Because this is initiative remedial choice is strong, be able to bear or endure the medicaments with medical happening low risk but utmost ground avoids to be able to bear or endure medical happening. In already was approved to treat the nucleotide analogue of chronic second liver at present, favour the disease-resistant poisonous action that replaces Ka Wei is the strongest, initiative cure is able to bear or endure lowest of medical occurence rate (graph 1) , advocate first choice favour to serve as initiative cure to be able to bear or endure in order to prevent for Ka Wei medical happening. Be able to bear or endure in virus medical happening in time order, genotype is able to bear or endure medicine (be able to bear or endure medical virus level is low) learn a breakthrough at virus first (virus level is elevatory) , final occurrence biochemistry learns a breakthrough (virus level is top) , because this tackles an opportunity,had jumped over earlier. Be approved by FDA at present to be able to bear or endure the processing program of medical virus is: High mountain  chases after buccal? of ┗ of Fu  ostrich to convert favour replace Ka Wei or add treat; to be able to bear or endure to A Defu Wei with Adefuwei medical patient, add be decided with rummy husband or replace decide than the husband, if be gone to already,be able to bear or endure surely without rummy husband medicine, convert or add with favour be opposite for Ka Wei; favour for Kaweinai medical patient, convert or add; of the De Fuwei that use A to be able to bear or endure surely than the husband to replacing medical patient, add the Defuwei that use A. Liver has ailmenting hunger to cause! Liver protects to come after third liver sends the 3 old dangerous wine of cancer of the liver bowl hot noodles in soup walks out of error recognize small 3 this world encounter Oriental liver when western liver " liver " ask: Is the road in He Fang? Chinese traditional medicine hurts liver word you know! 18 action prevent hepatic grow stout! What natural food can protect liver? Second liver cure wants to understand more liverish in 　 of ceaseless progress 　 relevant knowledge, click Nbsp; of Gt;gt;gt;gt; liver ill channel please (the exercitation edits: Plum apricot)