Objective To evaluate the efficacy and influence factors of peginterferon combined with ribavirin for the treatment of elderly patients with chronic hepatitis C (CHC).Methods 34 CHC patients aged over 60 years were enrolled in this retrospective study.Virological responses,relapse rate and discontinuation rate were evaluated,and the predictive factors associated with these outcomes were analyzed.Results The proportions of rapid virological response (RVR),early virological response (EVR),end of treatment virological response(ETR),sustained virologic response (SVR) were 26.5％,41.2％,52.9％ and 35.3％,respectively in patients after peginterferon plus ribavirin theraphy,and the relapse rate was 33.3％.The relapse rate was higher in patients with the interferon treatment history than in patients with initial interferon treatment (P＜0.05).The rates of ETR and SVR were lower in CHC patients with diabetes than without diabetes (P＜0.05 or 0.01).The ratio of dose adjustment of peginterferon and ribavirin alone and in combination were 26.5％ (9/ 34),61.8％ (21/34) and 8.8％ (3/34),respectively.The discontinuation rate was 20.6％ (7/34).Multivariate Logistic regression analysis showed that SVR rate was lower in CHC patients with diabetes than in those without diabetes (P＜ 0.05).Conclusions Peginterferon plus ribavirin therapy has a better virological response,but a poor tolerance in CHC patients.Diabetes may be an important risk factor for sustained virologic response in CHC patients.

AIM: To establish a HPLC method for determining notoginsenoside R_1, ginsenoside Rg_1, Rb_1 and Rd in Suxiong Pill (Radix et Rhizoma Notoginseng, Flos Carthami, Rhizoma Chuanxiong). METHODS: A Kromasil C_ 18 column was used. The mobile phase was acetonitrile-water in linear gradient elution. The detection wavelength was 203 nm. RESULTS: The linear range was at 1.20-6.02 ?g(r= 0.999 6 ) for notoginsenoside R_1, 5.60-27.99 ?g(r= 0.999 9 ) for ginsenoside Rg_1, 2.84-14.20 ?g(r= 0.999 9 )for ginsenoside Rb_1, 0.51-2.55 ?g(r= 0.999 7 ) for ginsenoside Rd. The average recoveries (n=6) were 96.4% (RSD= 1.9% ) , 103.7% (RSD= 0.8% ), 106.6% (RSD= 1.3% ), 98.5% (RSD= 1.1% ), respectively. CONCLUSION: The method is simple, reliable, accurate and can be applied to the quality control of the preparation.

Objective:To investigate the clinical efficacy and safety of gabapentin or topiramate combined with venlafaxine in the treatment of chronic migraine patients with generalized anxiety disorder.Methods:From June 2018 to February 2020, 127 patients with chronic migraine complicated with generalized anxiety disorder in the Second Affiliated Hospital of Guangxi Medical University were selected. The patients were divided into gabapentin combined with venlafaxine group (observation group, 64 cases) and topiramate combined with venlafaxine group (control group, 63 cases) according to the random number table method, and all patients were treated for 6 months. The headache attack days per month, headache visual analogue scale (VAS), migraine specific quality of life questionnaire V2.1 (MSQ V2.1), headache impact measurement-6 (HIT-6) score, Pittsburgh sleep quality index (PSQI) score were recorded before treatment and 3 and 6 months after treatment.Results:In observation group, 57 cases completed 3 months of treatment, and 53 cases completed 6 months of treatment. In the control group, 56 cases completed 3 months of treatment, and 50 cases completed 6 months of treatment. The headache attack days per month, headache VAS, HIT-6 and PSQI 3 and 6 months after treatment in 2 groups were significantly lower than those before treatment, observation group: (16.31 ± 5.02) and (15.69 ± 6.31) d vs. (22.62 ± 3.27) d, (3.67 ± 1.60) and (1.91±1.05) scores vs. (5.09 ± 1.43) scores, (49.34 ± 11.01) and (47.34 ± 9.05) scores vs. (60.25 ± 11.61) scores, (10.09 ± 2.81) and (9.68 ± 2.74) scores vs. (13.50 ± 2.81) scores; control group: (14.58 ± 7.37) and (9.92 ± 5.07) d vs. (23.05 ± 5.24) d, (4.74 ± 1.15) and (3.16 ± 1.60) scores vs. (5.90 ± 2.06) scores, (42.77 ± 8.02) and (40.09 ± 9.72) scores vs. (59.37 ± 9.08) scores, (9.66 ± 2.71) and (8.62 ± 2.07) scores vs. (14.61 ± 2.79) scores, and there were statistical differences ( P<0.05). The headache VAS 3 and 6 months after treatment in observation group was significantly lower than that in control group, and there was statistical difference ( P<0.05). The functional limitations, function loss, emotional function scores and total score of MSQ V2.1 3 and 6 months after treatment in 2 groups were significantly lower than those before treatment, observation group: (17.62 ± 9.81) and (16.01 ± 5.73) scores vs. (36.96 ± 9.55) scores, (12.17 ± 5.60) and (11.09 ± 3.27) scores vs. (17.06 ± 6.08) scores, (8.42 ± 2.17) and (8.94 ± 1.90) scores vs. (11.40 ± 4.09) scores, (33.24 ± 9.61) and (28.62 ± 5.04) scores vs. (62.75 ± 14.02) scores; control group: (17.08 ± 8.73) and (16.79 ± 5.19) scores vs. (36.82 ± 9.68) scores, (9.04 ± 4.48) and (8.90 ± 3.46) scores vs. (17.26 ±6.01) scores, (6.92 ± 2.61) and (5.15 ± 1.74) scores vs. (11.30 ± 5.47) scores, (31.65 ± 9.17) and (30.66 ± 6.04) scores vs. (62.91 ± 11.18) scores, and there were statistical differences ( P<0.05). There was no significant difference in the effective rate and the incidence of adverse drug reactions 3 and 6 months after treatment between 2 groups ( P>0.05). Conclusions:Gabapentin or topiramate combined with venlafaxine can reduce the degree of headache in chronic migraine patients with generalized anxiety disorder, reduce the number of headache days per month, improve sleep and improve the quality of life. However, the adverse reactions of gabapentin still need to be paid more attention.

Objective To study the transduction efficiency of expressing human neprilysin by using a lentiviral vector (Lenti-NEP) in mouse embryonic neural stem cells (NSC) in vitro.Methods Primary NSC were harvested from C57BL/6J pregnant mouse at embryonic day 11.5 and transducted with LentiNEP.Immunofluorescent stainingand Western blot were performed to detect NEP protein expression in NSC.Degradation of amyloid beta 1-40 (Aβ1-40) by NEP protein transduced with Lenti-NEP in NSC was analyzed using ELISA and HPLC.Results Over 90％ NSC were successfully transduced with Lenti-NEP via observation of fused protein green fluorescent protein under the microscopy.Expressions of NEP transduced with Lenti-NEP in NSC and of the markers of NSC (nestin) and neuron (MAP2).The enzyme activity of 2.5 μg (21.00 ± 2.51) and 1.0 μg (15.00 ± 0.54) NEP on degrading Aβ1-40 was shown to improve significantly compared to 0.5 μg NEP(8.00 ±0.81,t =40.4 and 12.7,respectively,both P ＜0.01).The activity of NEP was inhibited in the presence of 50 μmol/L phosphoramidon (0.5 pg:0.08 ±0.01 ;1.0 μg:0.04 ±0.01 ;2.5 μg:0.05 ±0.01,t =17.2,51.3 and 14.1,respectively,all P ＜0.01).The hydrolytic cleavage on degrading Aβ1-40 by NEP was 11.4％,28.4％ and 93.7％ with incubation for 1 h,4 h and 12 h,respectively.Conclusions Lentiviral vector successfully delivers NEP gene to NSC in vitro.Targeting on NEP and NSC may provide potential therapeutic tool for Alzheimer' s disease.

Objective: To analyze the therapeutic effect of repeated hepatectomy on recurrent hepatocellu-lar carcinoma and prognostic factors. Methods: We retrospectively analyzed the clinicopathologic data of 48 patients who underwent repeated hepatectomy for recurrent hepatocellular carcinoma between July 1995 and July 2003. Overall survival rate and disease-free survival (DFS) rate were calculated by Kaplan-Meier meth-od. Prognostic factors were analyzed by univariate and multivariate analysis. Results: The median survival of 48 patients was 36.4 months. The overall 1-, 3-, and 5-year survival rates were 81.3%, 45.8%, and 27.1%, re-spectively. The disease-free 1-, 3-, and 5-year survival rates were 70.8%, 25.0%, and 16.7%, respectively. Univariate analysis showed that TNM stage of primary tumor, TNM stage of the recurrent tumor, vascular in-vasion, recurrent tumor size (>5cm) and recurrence-free interval were prognostic risk factors for overall surviv-al. While TNM stage of primary tumor, recurrent tumor size (>5cm), TNM stage of recurrent tumor, vascular in-vasion, pathological grading of recurrent tumor, preoperative AFP and recurrence-free interval were prognos-tic risk factors for DFS. Multivariate analysis showed that recurrence-free interval and TNM stage of recurrent tumor were independent prognostic risk factors for overall survival. While recurrence-frae interval and recur-rent tumor size (>5cm) were independent prognostic risk factors for DFS. Conclusion: Short recurrence-free in-terval (≤24 months), recurrent tumor size (>5cm) and TNM stage of recurrent tumor indicate poor prognosis of patients who received repeated hepatectomy for recurrent hepatocellular carcinoma.

Objective To investigate the attentional network in patients with temporal lobe epilepsy(TLE) and the disease-related factors. Methods Fity-four patients with TLE and 40 controls were enrolled in our hospital from January 2007 to December 2008.The computerized ANT software was used for evaluating the attentional network efficiency and the clinical date of the patients with TLE were recorded. Logistic regression was used to identify the risk factors of attentional network efficiency. Results The mean reaction time(TLE:688.2±138.1 ms;Control:625.1±100.1 ms, t=2.06, P <0.05)and executive control network efficiency (TLE:155.7±57.0 ms;Control:108.0±33.8 ms, t=4.62, P <0.01) of the TLE group were lower than the healthy control group. The efficiency of alerting network and orienting network between the two groups were no significant difference. Logistic regression analysis showed that the positive epileptiform activity was an independent risk factor of the attentional impairment(95% CI : 1.03～42.33, OR =6.603, P =0.043). Conclusions The ANT demonstrate that patients with TLE may accompany with attentional executive control network efficiency impairment. Epileptiform discharge may cause attentional executive network efficiency impairment.

Objective To investigate the level of caregivers′burden and the coping style among parents of cancer children. Methods Totally, 229 parents of cancer children participated in the investigation by Chinese version of zarit burden interview (ZBI), Chinese version of coping health inventory for parents (CHIP) and self-designed general information questionnaire. The associations between caregivers′burden and coping styles were tested by Spearman correlation analysis. Results The caregiver′s burden on the parents was in the middle level with a total score of (30.50 ± 12.24). The coping style the parents took most frequently was to unite the family and keep a positive attitude and regard it as most effective. The caregiver′s burden was negatively associated with the positive coping style . Conclusion The parents of cancerous children suffer from middle level of burden . Nurses should assess the caregiver′s burden, provide targeted interventions to relieve it, help the to establish effective coping style and change their psychological and mental state and ultimately improve their quality of life.

AIM: Using simvastatin and vitamine E (Vit-E) treatment to coronary artery disease (CAD) patients with low HDL, to investigate the relationship between Ox-LDL, platelet activation and HDL. METHODS: 40 CAD patients with low HDL were divided into two groups (A and B): A group oral simvastatin, B group oral simvastatin and Vit-E. The level of serum Ox-LDL, TXB 2 and GMP-140 were measured before and after treatment. The relationship between Ox-LDL, TXB 2, GMP-140 and HDL were analysed. RESULTS:The level of serum HDL was significantly increased in A and B group after treatment and attained normal level. The level of serum Ox-LDL, TXB 2 and GMP-140 were decreased significantly after simvastatin and Vit-E treatment and neared normal. CONCLUSIONS:This study confirmed that HDL can effectively refrain LDL oxidation. It also revealed that Vit-E and simvastatin treatment were more effectively refrained platelet activation by increasement of HDL and decreasement of Ox-LDL.

Objective:To determine whether the neutrophil-lymphocyte-ratio (NLR) a inflammatory factor can predict tumor response to neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer.Methods:Between 2014 and 2019, 205 locally advanced rectal cancer patients underwent CRT before curative surgery. After propensity score matching, 148 patients (74 matched pairs) were enrolled in this study. The hematological parameters were collected and their relationship with tumor response was investigated.Results:After propensity score matching, NLR before CRT in good response group were significantly lower than that in poor response group(2.2±1.0 vs. 2.4±1.2, Z=-2.465, P<0.05), while there was no significant difference in all hematological characteristics between two groups after CRT. The cutoff values of pre-CRT NLR was 3.88 after receiver operating characteristic analysis(AUC=0.618, 95% CI: 0.528-0.708). Multivariate analysis model indicated that pre-CRT NLR≥3.88 was the predictor of poor tumor response ( OR=5.826, 95% CI: 1.299-26.132, P<0.05). Conclusion:The increased NLR before CRT can be regarded as a hematological factor for poor tumor response in locally advanced rectal cancer.