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.

ObjectiveTo study the application of retinal tomography in primary open angle glaucoma diagnosis.MethodsThe differences between POAG, high myopia with suspected glaucoma and normal volunteers on the rim area, rim volume and the thickness of retinal nerve fiber layer (RNFL) thickness in quadrants under Heideberg retinal tomography-Ⅱ(HRT-Ⅱ) were analyzed.ResultsIn the cases of POAG and high myopia with suspected glaucoma, the values of rim area, rim volume and RNFL thickness were significantly lower than that in normal group.ConclusionRetinal tomography can be used in the diagnosis of POAG.

Objective To investigate the correlation between the expression of peripheral blood CD8 + T lymphocytes and the severity degree of hand,foot and mouth disease( HFMD)in children infected by enterovirus( EV)71 at different ages,and further to predict the role of the expression of CD8+ T lympho-cytes played in the occurrence of neurological complications infected by EV71. Methods A total of 138 pe-ripheral blood samples derived from the confirmed HFMD cases were collected in the department of infectious disease at Kunming Children′s Hospital between March and September in 2014,including 33 mild cases,45 severe cases,and 60 critical cases. Patient ages were 9 months to 5 years old. Flow cytometry was used to detect the expression of peripheral blood CD8 + T lymphocytes in all of above patients. Results Compared to the reference value of CD8 + T lymphocytes in normal healthy children at different age groups,the percentage of peripheral blood CD8 + T lymphocytes elevated or increased slightly in patients of all ages,except the obvi-ously increasing expression in the age group of ~2 years and decreasing expression in critical cases of the age group of ~5 years. The expression of peripheral blood CD8+ T lymphocytes significantly increased in mild and severe patients but slightly increased in critical patients of the age group of 9 to 15 months,gradually de-creased in the age group of ~2 years and slightly increased in mild and severe cases but decreased in critical patients of the age group of ~5 years. There were significant differences between the patients in mild condi-tion and in severe condition or critical condition respectively within the age group of ~2 years( P﹤0. 05 ), and there were no significant differences in other age groups between different severity of disease. Conclusion
There are correlations between the expression of CD8+ T cells and the severity of HFMD in patients at different ages. Especially,the patient′s condition developing into severe degree is associated with the rapid decreasing of CD8 + T cells in HFMD patients of the age group of ~2 years. CD8+T cells play an important role in antiviral immune response in HFMD patients of ~2 years old.

Objective To determine the correlation between aquaporin-4 antibody (AQP4-Ab) and optic neuropathy in patients with neuromyelitis optica spectrum disorder (NMOSD).Methods The clinical and biochemical data of 53 patients with NMOSD diagnosis based on AQP4-Ab level in Changhai Hospital between January 2010 and October 2015 were retrospectively analyzed.According to optic neuropathy occurrence,the NMOSD patients were divided into optic neuropathy and non-optic neuropathy groups.Clinical and biochemical characteristics were compared between the two groups.According to the serum AQP4-Ab levels,the NMOSD patients were divided into AQP4-Ab seropositive and seronegative groups.The incidence of optic neuropathy was compared between the two groups.The correlation between optic neuropathy and AQP4-Ab levels was analyzed.Results Between the optic neuropathy and non-optic neuropathy groups,no significant differences in sex,age at onset,disease course,serum alanine aminotransferase levels,protein levels in cerebral spinal fluid,IgG index,and oligoclonal band were observed (P ＞ 0.05).However,statistically significant differences were found in frequency,superficial sensory impairment,serum creatinine level,and serum AQP4-Ab level (P ＜ 0.05).Between the AQP4-Ab sempositive and semnegative groups,a statistically significant difference in the incidence of optic neuropathy was observed (F =4.93,P ＜ 0.05).The incidence of optic neuropathy positively correlated with AQP4-Ab levels (r =0.297,P ＜ 0.05).Conclusion NMOSD patients with AQP4-Ab seropositivity could be prone to optic neuropathy,and the correlation may be beneficial to early diagnosis,therapy,and monitoring of NMOSD.

ObjectiveTo study the assistant therapic effect of the Botulinum toxin A (BTA) on tiptoe after cerebral palsy(CP).MethodsMulti point injection of BAT into the musculus gastrocnemius combined with the rehabilitate therapy was used on 35 children(39 feet)with tiptoe after CP.The therapeutic effect was evaluated after a month.ResultsThe efficiency rate is 25.6%,the slight efficiency rate is 71.8%,the ineffective rate is 2.6%.There is no toxic or side effect was observed.Conclusions The BTA can relieve spasm of musculature and redress abnormality from convulsing of musculature.

Objective To investigate the diagnostic value of high frequency color Doppler ultrasound combined with gastrointestinal filling in infants with duodenal obstruction . Methods One hundred infants who were suspected with duodenal obstruction underwent both gastrointestinal ultrasound and upper gastrointestinal tract ,put the surgical results as the ?gold standard ,the values of ultrasonic and upper gastrointestinal tract in the diagnosis of pediatric congenital duodenal obstruction were compared . Results The diagnostic accuracy of ultrasound and upper gastrointestinal tract in duodenal obstruction was 100%and 94% respectively ,the difference was statistically significant ( P = 0 .041) . The accuracy rate of obstruction location was 98 .04% and 84 .31% respectively , also was considered to denote statistical significance ( P = 0 .023 ) . The total diagnostic accuracy of congenital disorders caused by duodenal obstruction was 89% and 49% respectively ,and P = 0 .001 implies statistically significant difference . Conclusions There is a high diagnostic accuracy in high frequency ultrasound combined with gastrointestinal filling in children with congenital duodenal obstruction ,and the diagnosis of some diseases is better than that of the upper gastroenterography .

Objective To apply the BestSeqTM new generation pathogenic gene detection technology to perform the genetic detec‐tion in the patients with progressive muscular dystrophy (PMD) validating its sensitivity and specificity .Methods The BestSeqTM new generation pathogenic gene detection technology was used to perform the gene sequencing in 2 cases of limb‐girdle muscular dystrophy(LGMD) and 6 cases of Dunchenne′s muscular dystrophy(DMD) ,and the found point mutations were confirmed by the Sanger sequencing method .Results This study completed the genetic detection in above 8 cases ,2 cases of large fragment deletion and 10 cases of micromutations were detected ,in which 8 micromutations were the new mutation discovered ffor the first time and verified by the Sanger sequencing .Conclusion The BestSeqTM new generation pathogenic gene detection technology greatly increa‐ses the detection efficiency by using the high density imbricate type probe and multiple tag technology ,and has the better clinical ap‐plication prospects .

Objective To explore the clinical value of real-time shear wave elastography (SWE) in liver tissue stiffness of normal children.Methods Totally 243 normal children were examined by SWE.The data of liver stiffness measurement (LSM) were recorded and analyzed.The differences of LSM between different genders and hepatic segments were compared.According to the age,243 normal children were divided into pre-school group,school age group and adolescent group;and the differences of LSM between 3 groups were compared.The consistency was analyzed in different operators.Results The mean value of LSM in normal children was (4.21±0.70)kPa,and the 95％ confidence interval was (4.11,4.31)kPa.The success rate of segment S5 was higher than that of segment S4 (100％ [243/ 243] vs 79.83％ [194/243]),and the mean value of LSM in segment S5 was lower than that in segment S4 (P＜0.05).The mean value of LSM increased with age,and the boys' was a slightly higher than the girls',but there were no statistical differences between them (all P＞ 0.05).LSM had good consistency in different operators,the intraclass correlation coefficient was 0.92.Conclusion SWE could be an objective and quantitative assessment in liver stiffness of children.

@@

Objective To investigate the diagnostic value of high frequency ultrasound combined with esophageal filling in neonates with congenital esophageal atresia.Methods Fifty-eight newborns who were suspected with congenital esophageal atresia underwent ultrasound,the surgical results considered as the gold standard,then the ultrasound features of the congenital esophageal atresia were summarized.ResultsSeven cases were the type Ⅰ of the congenital esophageal atresia,1 case belongs to type Ⅱ,40 cases were considered as type Ⅲ,4 cases were classified type Ⅳ and 6 cases were type Ⅴ,the diagnostic accuracy of ultrasound in congenital esophageal atresia was 96.55% and the classification accuracy was 89.65%.Conclusions High frequency ultrasound combined with esophageal filling has a high accuracy and can be used as a new diagnostic method in diagnosing neonates with congenital esophageal atresia,and it′s worthy of further research and promotion.