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Objective To evaluate the efficacy and safety of the combined therapy with entecavir (ETV) and adefovir dipivoxil ( ADV) in patients with lamivudine (LAM) - resistant chronic hepatitis B (CHB). Methods A total of 45 patients who were diagnosed with LAM - resistant CHB and admitted to the Kunshan Peoples Hospital from May 2011 to May 2013 were recruited in this study and randomly divided to two groups. The treatment group included 23 CHB patients who received the combined therapy with ETV and ADV. The control group in­ cluded 22 CHB patients who received the combined therapy with LAM and ADV. The changes in levels of HBV DNA , alanine aminotrans­ferase (ALT) , aspartate aminotransferase (AST), total bilirubin (TBil), albumin (Alb), and HBV serum markers before and after 4, 12, 24, and 48 weeks of treatment，as well as the rate of mutations other than that at rtM204I after 48 weeks of treatment，were measured in both groups. Comparison of continuous data between groups was made by t test, and comparison of categorical data by fourfold table chi - square test. Results The levels of ALT and AST in the treatment group were significantly lower than those in the control group after 4 and 12 weeks of treatment (= 3. 124，5. 271，4. 476，5. 125，all P < 0. 01 )，as well as 24 and 48 weeks of treatment ( t = 2. 240，2. 307，2. 886， 2. 998，all P < 0. 05 ). The serum HBV DNA clearance rates in the treatment group after 4，12，24，and 48 weeks of treatment were 73. 9% , 86. 8% , 95. 7% , and 100% , respectively , all of which were significantly higher than those in the control group (χ2 = 11.79， 5.75，10.29 , 5.89 , respectively , all P< 0.05). However, there was no significant difference in the HBeAg seroconversion rate among HBeAg - positive patients between the two groups. No mutations other than that at rtM204I were found in the treatment group, while four new mutations were detected in the control group (X2 =4. 59 , P <0. 05). Conclusion The combined therapy with ETV and ADV has good therapeutic effect in treating LAM - resistant CHB patients , and the clinical application is highly recommended. [ABSTRACT FROM AUTHOR]

Objective To observe the influence of glutathion（GSH）combined entecavir（ETV） on the serum levels of liver fibrosis indexes of patients with chronic hepatitis B（CHB）. Methods We randomly selected 84 cases of patients treated with CHB from February 2012 to March 2014 in our hospital，all the selected patients were randomly divided into 2 groups: the treatment group（GSH combined ETV treatment，n＝43） and the control group （use ETV treatment，n＝41）. The serum liver fibrosis indexes were compared between two groups after treatment. The serum liver fibrosis indexes were compared between pre -and post- treatment in the treatment group．Results（1）After treatment， serum liver fibrosis indexes of the treatment group were significantly lower than those in control group （P < 0.05）， the difference was statistically significant.（2）In the control group， the serum liver fibrosis indexes of post-treatment were significantly lower than those pre-treatment's（P < 0.05）， the difference was statistically significant. Conclusion　The combination therapy of GSH and ETV can effectively reduce the serum levels of liver fibrosis indexes and delay the formation process of liver fibrosis. [ABSTRACT FROM AUTHOR]