Pegylated interferon plus ribavirin is still the standard treatment for hepatitis C,but the efficacy is often restricted by adverse events.HCV genotypes,viral dynamics during early treatment and gene polymorphism may be useful in predicting the efficacy of antiviral treatment.Several strategies have emerged to improve outcomes including low accelerating dose regimen (LADR) and prevention of complications.Direct antiviral drugs have been already used for HCV genotype 1 patients,and demonstrated improved efficacy.Besides,inhibitors and vitamin D may also be applied in antiviral therapy to improve the efficacy.This article reviews efficacy predictors,standard therapy,strategies and research on new medicaments in antiviral treatment of hepatitis C.

Artificial liver support system (ALSS),as a means of bridging patients with liver failure to transplantation,has been widely used at home and abroad.However,clinical trails show that different ALSS may have different therapeutic effects.This review briefly introduces the widely-used non-biological liver support technologies and extensively-studied biological liver support technologies,and tries to give an overview on their impact on biochemical markers and survival.

Objective To observe the efficacy and adverse effects of conventionally fractionated (CF) versus hypofractionated (HF) three-dimensional conformal radiotherapy (3DCRT) for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis.Methods A retrospective analysis was performed on the clinical data of 65 patients with HCC suitable for 3DCRT from 2008 to 2012.These patients were randomly divided into HF group (n =32) and CF group (n =32).The HF group received 3DCRT at a total dose of 45-55 Gy (3-4 Gy/fraction,3-5 fractions/week),while the CF group at a total dose of 40-56 Gy (2 Gy/fraction,5 fractions/week).Results The follow-up rate was 100％.For the HF group and CF group,the short-term response rates were 72％ vs.55％ (P =0.034),the 1-year local control rates were 72％ vs.55％ (P=0.034),the 1-year overall survival rates were 59％ vs.45％ (P=0.042),and the numbers of individuals with grade 1-2 acute gastrointestinal reactions,deterioration of liver function,and radiation hepatitis were 14 vs.11,8 vs.8,and 1 vs.0,respectively (P =0.237).Conclusions HF 3DCRT is superior to CF 3DCRT in the treatment of HCC.

Objective To establish a method for the determination of geniposide in Bazheng Dispersible Tablet by HPI,C. Methods The HPLC was performed on a Hypersil ODS column(250 mm?4 mm,5?m).The mobile phase was acetoni- tril-water(11:89).The detection wavelength was at 238 nm and flow rate was 1.0 mL/min.Results Geniposide showed a good linearity in the range of 0.046～0.46?g,and r=0.999 9.The average recovery was 99.54%,and RSD was 1.42%。Conclusion This method is accurate and can be used for the quality control of Bazheng Dispersible Tablet.

Objective To investigate the efficacy of intracoronary tirofiban during percutaneous coronary intervention(PCI)for patients with acute myocardial infarction(AMI).Methods Seventy-six consecutive AMI patients,treated with primary coronary angioplasty in 12 hours were enrolled.They were randomly divided into two groups:tirofiban group(39 cases)and control group(37 cases).Tirofiban group was treated with intracoronary timfiban during PCI and after the operation for 48 hours.Both of them were given heparin in PCI and aspirin,clopidogrel before PCI.At the end of PCI procedure,angiographic features such as TIMI flow grade and TIMI myocardial perfusion grade(TMPG)were analyzed.The difference of two groups in complication and major adverse cardiac events(MACE) was investigated.Results The myocardial reperfusion of tirofiban group was better than that of control group[TIMI grade 3 flow 94.9%(37/39) vs 78.4%(29/37),P<0.05;TMPG 3 grade 89.7%(35/39)vs 67.6%(25/37),P<0.05].There was no significant difference between two groups in bleeding complication.The occurrence of MACE in tirofiban group was less than that in control group[7.7%(3/39)vs 18.9%(7/37),P<0.05].Conclusion Intracoronary tirofiban dunng primary PCI in patients with AMI can improve coronary flow and myocardial perfusion,and has no more bleeding and less MACE occurrence.

Objective To observe the therapeutic effect of balloon dilation in acute thrombus disease. Methods After coronary angiography, 137 patients with acute thrombus disease who were performed percutaneous coronary artery interventional therapy (PCI) from August 2010 to August 2012 were enrolled. In them, 53 patients (control group) didn′t undergo balloon dilation after PCI, and 84 patients(observation group)underwent balloon dilation after PCI. The intraoperative complications and the major adverse cardiac events (MACE) rate were observed. Results The rate of residue stenosis in observation group was lower than that in control group:(6.7 ± 1.3)% vs. (17.1 ± 1.8)%, and there was significant difference (P<0.05). The operation time in observation group was higher than that in control group:(57 ± 26) min vs.(48 ± 32) min, and there was significant difference (P<0.05). The no-reflow or slow flow after PCI in observation group was 3.8%(2/53), in control group was 3.6%(3/84), and there was no significant difference (P>0.05). The follow-up time was (0.9 ± 0.2) years. In control group, myocardial infarction occurred in 2 patients, 7 patients reviewed coronary angiography, and 2 patients underwent revascularization. In observation group, there was no MACE. Five patients reviewed coronary angiography, and no patient underwent revascularization. Conclusions The method of balloon dilation after PCI in acute thrombus disease is safe and feasible. It can reduce the incidence of MACE, and did not increase the rate of no-reflow or slow flow.

Objective To evaluate the efficacy and safety of direct stenting technique in emergent percutaneous coronary intervention(PCI)for pa?tients with acute myocardial infarction(AMI). Methods Totally 460 consecutive patients with acute myocardial infarction who underwent emergent PCI during August 2010 to July 2013 were involved,among whom 346 patients were assigned to the control group(traditional balloon dilation and stenting),114 patients were assigned to the experiment group(direct stenting). The safety and efficacy of direct stenting technique was observed. Results In the control group,7 cases had no reflow during operation,2 cases had reflow after the pre?expansion and 5 cases after stent implanta?tion,no similar cases in the experiment group(P=0.125 9). The follow?ups showed the control group had 2 cases of major adverse cardiac events including 1 case of acute stent thrombosis who required urgent revascularization,and 1 case of cardiac death at four days after operation;the experi?ment group had 1 case of stent thrombosis,there was no statistically significant difference(P=0.730 7). Conclusion Direct stenting technique may be performed selectively for certain coronary diseases when performing emergent PCI for AMI.

Objective:To explore the relationship among plasma level of lipoprotein‐associated phospholipase A2 (Lp‐PLA2) ,ankle brachial index (ABI) ,brachial‐ankle pulse wave velocity (baPWV) and coronary heart disease (CHD) .Methods :According to results of coronary angiography ,a total of 120 patients with suspected or diagnosed CHD were divided into CHD group (n=90) and non‐CHD group (n=30) .CHD group was further divided into sin‐gle vessel coronary disease group (single vessel group ,n=30) ,double‐vessel coronary disease group (double‐vessel group ,n=30) and multi‐vessel coronary disease group (multi‐vessel group ,n= 30) .Plasma Lp‐PLA2 level ,ABI and baPWV were measured and compared among all groups .Results:Compared with non‐CHD group ,there were significant rise in plasma Lp‐PLA2 level [ (23.60 ± 13.33)μg/L vs .(36.65 ± 17.24)μg/L] and baPWV [ (1244.27 ± 127.85) cm/s vs .(1753.08 ± 284.32) cm/s] in CHD group ,P<0.01 both .In CHD group ,compared with single vessel group ,plasma Lp‐PLA2 level significantly rose [ (25.81 ± 8.97)μg/L vs .(35.03 ± 9.80)μg/L vs .(49.13 ± 21.22)μg/L] in double‐vessel group and multi‐vessel group ,and that of multi‐vessel group was significantly higher than that of double‐vessel group ( P<0.05 or <0.01 );baPWV significantly rose [ (1579.77 ± 178.05 ) cm/s vs . (1808.07 ± 272.11) cm/s ,(1871.40 ± 306.03) cm/s] in double‐vessel group and multi‐vessel group , P<0.01 both . ABI of single vessel group and double‐vessel group were significantly higher than that of multi‐vessle group [ (1.19 ± 0.08) ,(1.17 ± 0.07) vs .(1.11 ± 0.15)] ,P<0.01 or <0.05 .Conclusion:Plasma Lp‐PLA2 level ,ABI and baP‐WV are related to CHD and its lesion degree ,combined measurement of these three indexes can predict CHD and its severity more accurately ,then preventing and treating CHD should be more effective .

Inflammation plays an important role in occurrence and progression of atherosclerosis.Among numerous studies on inflammatory markers, the relationship between high sensitive C-reactive protein (hsCRP) and coronary heart disease (CHD) has been widely studied.The present article made a review about the relationship between hsCRP and CHD.

Objective To establish a method for the determination of patchouli alcohol in Huoxiang Qingwei Tablets by gas chromatography (GC).Methods HP- 5 column( 30 m? 0.32 mm? 0.25 ? m) was used and 5 % crosslinked phenyl polydimethyl siloxane was used as the mobile phase. The increase of column temperature was controlled by programming: the initial temperature was 150 ℃ and maintained for 23 min, and then rose at 8 ℃ /min up to 230 ℃ for 2 min. The injector temperature and the detector temperature both were 280 ℃ .The flow rate was 0.9 mL/min and the injection volume was 1 ? L, split ratio was 5∶ 1.Result A good linearity was obtained in the range of 0.057～ 1.140 mg/mL,r=0.9994. The average recovery was 99.38 % with a RSD of 1.82 % (n=5). Conclusion The method is simple and accurate and can be used for the quality control of Huoxiang Qingwei Tablets.