The efficacy and adverse effects of nivolumab and lenvatinib in the treatment of advanced hepatocellular carcinoma.

This study intends to investigate nivolumab's efficacy and adverse effects in combination with lenvatinib in treating advanced hepatocellular carcinoma (HCC). For this purpose, ninety-two patients with unresectable advanced HCC admitted were enrolled and were divided into the control group (N=46) and the observation group (N=46) according to the random number table. The control group was treated with lenvatinib while the observation group was treated with nivolumab combined with lenvatinib. The efficacy, adverse effects, liver function, completion rate, interruption and discontinuation of treatment, drug reduction, serum tumor markers, and immune function were compared between the two groups. Also, changes in the expression of some genes that regulate the cell cycle (P53, RB1, Cyclin-D1, c-fos, and N-ras) were investigated in the development of this cancer. According to the results, ORR and DCR  (45.65%, 78.26%) in the observation group were higher than those  (23.91%, 54.35%) in the control group (P<0.05); The incidence of adverse reactions in the observation group was slightly higher than that of the control group, but the difference was not significant (P>0.05); The rate of completion, interruption, discontinuation of treatment and drug reduction did not differ significantly between two groups (P>0.05); After treatment, the serum ALT, AST, TBIL, and GGT levels decreased and were lower in observation group than in control group (P<0.05); The serum tumor markers AFP, ENO1, GPC3, CEA levels decreased in both groups after treatment, and were lower in the observation group than in control group (P<0.05);  CD3, CD4, CD8, and NK levels were improved in the observation group and worsened in the control group, and CD3, CD4, and NK levels were higher in the observation group and lower in the control group after treatment (P<0.05). All in all, nivolumab combined with lenvatinib for advanced hepatocellular carcinoma can improve tumor control, reduce tumor load, and improve liver function and immune function. Common adverse reactions include fatigue, loss of appetite, elevated blood pressure, hand-foot skin reaction, diarrhea, and rash, which should be controlled during treatment.

Association of depressive symptoms with chronic liver disease among middle-aged and older adults in China.

Background: The relationship between depressive symptoms and chronic liver disease (CLD) is still unclear. We aimed to determine whether depressive symptoms are associated with CLD in a large population sample. Methods: The data was from the China Health and Retirement Longitudinal Study (CHARLS), an ongoing nationally representative prospective cohort study. Depressive symptoms were assessed with the catchment-area epidemiology survey-depression (CES-D). CLD was identified by the patient's self-report about a physician's diagnosis at each visit. Multi-adjusted logistic regression and Cox regression models were used. Results: A total of 14,995 participants (53.1% female; mean age: 58.85 ± 9.87 years) and 13,405 participants (53.64% female; mean age: 58.58 ± 9.69 years) were included in the cross-sectional and longitudinal analyses, respectively. In the cross-sectional analysis, the odds ratio of CLD in patients with moderate and severe depressive symptoms were 1.46 [95% confidence interval (CI), 1.16-1.83] and 1.78 (95% CI, 1.23-2.56) than those with none/mild depressive symptoms, respectively. In the longitudinal analysis, compared to participants with none/mild depressive symptoms, the hazard rates of CLD in those with moderate and severe depressive symptoms were 1.65 (95%CI, 1.33-2.03) and 1.80 (95%CI, 1.24-2.60). And the 50th percentile difference of time (years) at the incidence of CLD in participants with moderate and severe depressive symptoms were - 0.83 (95%CI, -1.18, -0.49) and - 0.96 (95%CI, -1.56, -0.35), respectively. Conclusion: Elevated depressive symptoms were associated with an increased risk of CLD among middle-aged and older adults in China.