Objective:To investigate the antiviral efficacy of direct-acting antiviral agents (DAAs) in the treatment of liver transplantation (LT) recipients with hepatitis C virus (HCV) infection.Methods:Twenty-two HCV-infected LT recipients treated with DAAs at Fifth Medical Center of Chinese PLA General Hospital from December 2014 to June 2018 were retrospectively analyzed, Twenty cases of HCV RNA gene type 1b were treated with sofosbuvir (400 mg/d) + ledipasvir (90 mg/d) or sofosbuvir (400 mg/d) + daclatasvir (60 mg/d) for 12 weeks or 24 weeks; 2 cases of gene type 2a were treated with sofosbuvir (400 mg/d) for 12 weeks. The effect of antiviral treatment, adverse reactions during treatment, and laboratory indicators such as HCVRNA quantification, blood routine, liver and kidney function during treatment and follow-up were studied.Results:The LT recipients of HCV infection included 16 males and 6 females, with a median age of 61.5 (36-71) years old, and the median time of antiviral treatment was 48 (2-117) months after transplantation. Among the 22 patients, 16 received a 12-week course of treatment. Except for 2 patients who did not get HCVRNA negative conversion at 4-week, all achieved a negative HCV RNA at 4-week and the end of the treatment. Six LT recipients received a 24-week course of treatment (gene type 1b), and HCVRNA was negative at 4-week and the end of treatment. All patients achieved end of treatment virological response and a sustained virological response (SVR) rate of 100% at 12 weeks and 24 weeks after the end of treatment. The serum levels of alanine aminotransferase (ALT) and creatinine were 71.5 (30, 110) U/L and (89.4±25.7) mmol/L before treatment, respectively. ALT decreased to 22 (17.8, 28.5) U/L after 4 weeks of treatment, and serum creatinine decreased to (77.4±11.5) mmol/L at 24 weeks after the end of treatment. The differences before and after treatment were statistically significant (all P<0.05). No serious adverse events occurred during the treatment. Conclusions:DAAs have a definite antiviral effect in the treatment of LT recipients with HCV infection, and long-term SVR can be obtained.

Objective: To understand the differences in physical indices, physical functions, and physical fitness among primary school students of De’ang and Han nationalities in the De’ang community, and to provide a reference for the healthy development of the physique of children and adolescents. Methods: The cluster sampling method was used to select the test data of height, weight, vital capacity, 50 meter running, seated forward flexion, and 1 minute skipping rope of 2 493 De’ang and Han pupils in five complete primary schools in Mangshi, Dehong Prefecture. Differences in each indices were compared between groups. Results: For physical indicators: height in boys in 8,9 and 11 year old group, girls in 7 and 8 year old group, were significantly higher in Han nationality,weight among Han boys of 9 years old was higher than Deang nationality; For physical function indicators: vital capacity of girls 11 years old group and 12 years old group, boys 9 years old group, 10 years old group, 12 years old group, children of Han nationality were higher than Deang peers. For physical fitness indicators: in 50 m running, Han boys of 8,9,10 and 12 year old,as well as Han girls of 8 year old were higher than age matched peers of De’ang nationality;For seated forward flexion, Han boys of 11 years old and girls of 9 years old, were lower than Deang; in 1 min skipping, Han boys of 9,10,11 and 12 year old,as well as Han girls of 9 and 10 year old, were lower than the De’ang nationality. Conclusion Unbalanced development of physical fitness is observed among primary school students of De’hong and Han nationality, with significant differences in physical, functional and fitness indices.

ObjectiveTo investigate the risk factors for tumor recurrence and death after liver transplantation in patients with hepatocellular carcinoma (HCC) and their survival. MethodsThe patients with HCC who underwent liver transplantation in The Fifth Medical Center of Chinese PLA General Hospital from January 2005 to February 2019 were enrolled, and according to the presence or absence of HCC recurrence after liver transplantation, they were divided into recurrence group and non-recurrence group. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate Cox proportional-hazards regression model analyses were used to determine the risk factors for HCC recurrence and death after liver transplantation. The Kaplan-Meier method was used for survival analysis, and the receiver operating characteristic (ROC) curve was used to investigate the predictive value of death-related risk factors after liver transplantation. ResultsA total of 391 HCC patients who underwent liver transplantation were enrolled, with a median follow-up time of 2 years, among whom 78(19.95%) experienced HCC recurrence. Preoperative alpha-fetoprotein (AFP) level＞200 ng/ml (recurrence: hazard ratio ［HR］=252, 95% confidence interval ［CI］: 1.58-4.03, P＜0.001; death: HR=2.99, 95%CI: 1.59-5.62, P＜0.001］, total tumor diameter (recurrence: HR=1.20, 95%CI: 1.12-1.28, P＜0.001; death: HR=1.10, 95%CI: 1.02-1.17, P=0.002), and vascular invasion (recurrence: HR=1.15, 95%CI: 1.04-1.26, P=0.016; death: HR=1.10, 95%CI: 1.03-1.18, P=0.004) were independent risk factors for tumor recurrence and death after liver transplantation. The 1-, 5-, and 10-year overall survival rates after liver transplantation were 94.8%, 84.2%, and 83.5%, respectively, and the 1-, 5-, and 10-year disease-free survival rates were 840%, 75.1%, and 75.1%, respectively. AFP, involvement of major blood vessels, body mass index, and total tumor diameter had a certain value in predicting the death of HCC patients with recurrence, with an area under the ROC curve of 0.789 (95% CI: 0.719-0858). ConclusionTumor biological features before transplantation are the key factors for tumor recurrence after transplantation.

Objective:To analyze the severity and influencing factors of comorbidities in elderly comorbidity patients and to put forward targeted recommendations to effectively control the development of comorbidities.Methods:A total of 750 elderly comorbidity patients in Xiangyang No.1 People's Hospital Affiliated to Hubei University of Medicine were enrolled using convenience sampling method. General data questionnaire, Modified Cumulative Illness Rating Scale-Geriatric (MCIR-G) , Lubben Social Network Scale 6 (LSNS-6) and Long-Term Care Needs Assessment Questionnaire were collected. Univariate analysis and multiple linear regression analysis were used to explore the influencing factors.Results:The scores of comorbidities, social isolation and long-term care needs of 750 elderly comorbidity patients were (13.85±3.46) , (21.36±4.61) and (140.49±13.69) respectively. Multiple linear regression analysis showed that social isolation and long-term care needs were influencing factors of the severity of comorbidity in elderly patients ( P<0.05) . Conclusions:Medical staff should pay more attention to physical and mental health of elderly comorbidity patients, and develop personalized care programs according to long-term care needs, so as to delay the functional degradation of elderly comorbidity patients and improve their quality of life.