Objective To investigate the safety and efficacy of hepatic arterial infusion chemotherapy(HAIC)using lenvatinib plus immune checkpoint inhibitors(ICI)in the treatment of progressive advanced hepatocellular carcinoma(HCC).Methods The clinical data of 67 patients with HCC of BCLC stage C,who received HAIC treatment at the Guangdong Provincial Hospital of Traditional Chinese Medicine of China from May 2018 to March 2022 and were assessed as in disease progression(PD)status after HAIC treatment,then had to further receive second-line treatment with lenvatinib plus ICI regimen.According to modified Response Evaluation Criteria in Solid Tumors(mRECIST),the tumor responses,including overall survival(OS),progression free survival(PFS),objective response rate(ORR),and disease control rate(DCR),were evaluated.Univariate analysis and multivariate analysis based on the COX proportional hazards regression model were used to determine the prognosis-related risk factors.According to the Common Terminology Criteria for Adverse Events version 5.0(CTCAE 5.0),the treatment-related adverse effects were recorded and evaluated.Results The median OS and median PFS in the 67 patients with HCC of BCLC stage C receiving second-line treatment with lenvatinib plus ICI regimen,who were evaluated as in PD status after first-line HAIC treatment,were 18.4 months and 7.2 months respectively.The ORR and DCR were 22.4％(15/67)and 67.4％(45/67)respectively.Univariate analysis and multivariate analysis showed that Eastern Cooperative oncology Group(ECOG)score and hepatitis B virus(HBV)infection were the independent risk factors affecting OS,while AFP level was an independent risk factor affecting PFS.The main treatment-related adverse reactions included elevation of transaminase level,hypertension,and hyperbilirubinemia.No death occurred during the therapeutic course.Conclusion For patients with HCC of BCLC stage C,who become in PD status after first-line HAIC treatment,second-line treatment with lenvatinib plus ICI regimen carries satisfactory efficacy and its adverse reaction is tolerable.

Objective To discuss the safety and efficacy of hepatic arterial infusion chemotherapy(HAIC)combined with apatinib and carizolizumab in the treatment of hepatocellular carcinoma(HCC)with major portal vein tumor thrombosis(Vp4).Methods The clinical data of patients with HCC complicated by Vp4 from three certain Grade Ⅲ medical centers,who received HAIC combined with apatinib and carizolizumab(triple treatment group)or received HAIC alone(simple HAIC group)from July 2018 to December 2023,were retrospectively collected.Propensity score matching(PSM)was used to balance the general differences between groups,and the pre-PSM and post-PSM overall survival time(OS),progression-free survival time(PFS),and tumor response rate were compared between the two groups.Based on COX proportional hazards regression model the survival-related risk factors were identified.The clinical safety was evaluated by comparing the incidence of adverse reactions between different therapeutic regimens.Results In the overall cohort,the median OS and median PFS in the triple treatment group were 16.4 months and 9.1 months respectively,which in the simple HAIC group were 6.9 months and 4.2 months respectively(both P＜0.001).In the triple treatment group and the simple HAIC group,the objective response rate(ORR)was 41.2％and 15.2％respectively(P＜0.001),and the disease control rate(DCR)was 77.9％and 68.5％respectively(P=0.185).In the PSM cohort,the median OS and median PFS in the triple treatment group were 16.4 months and 9.1 months respectively,which were significantly longer than 7.4 months and 3.7 months respectively in the simple HAIC group.In the triple treatment group and the simple HAIC group,the ORR was 39.5％and 11.6％respectively(P=0.003),and the DCR was 81.4％and 62.8％respectively(P=0.054).Univariate and multivariate analyses showed that HAIC combined with apatinib and carizolizumab treatment was an independent factor influencing both OS and PFS.No statistically significant difference in the incidence of adverse reactions of all levels existed between the two groups,although the incidence of some adverse reactions in triple therapy group was higher than that in the simple HAIC group.Conclusion Compared with pure HAIC therapy,HAIC combined with apatinib and carizolizumab has better survival benefits and tumor response rate,it is clinically safe and effective,besides,the patients can well tolerate this treatment.Therefore,HAIC combined with apatinib and carizolizumab is a promising treatment option for patients with HCC complicated by Vp4.

Objective:To investigate the relationship between three-dimensional choroidal vascularity index (3D CVI) and the severity of diabetic retinopathy (DR) using swept-source optical coherence tomography angiography (SS-OCTA).Methods:A cross-sectional study was conducted.A total of 139 eyes of 139 subjects, including 115 eyes with diabetes mellitus and 24 control eyes without diabetes, were enrolled in the Second People's Hospital of Hefei from March to December 2022.DR was graded according to the standard seven-field ETDRS color fundus photographs.Eyes with diabetes mellitus were divided into non-DR (NDR) group (34 eyes), non-proliferative DR (NPDR) group (42 eyes), NPDR with diabetic macular edema (DME) group (21 eyes) and PDR group (18 eyes).3D CVI in central fovea 1 mm (C1) and parafoveal 3 mm (C3), choroidal vascular volume (CVV), and choroidal thickness were measured by SS-OCTA in the area of 3 mm×3 mm centered on the fovea using the built-in automated quantification software.Parafoveal region was divided into superior, inferior, temporal and nasal quadrants, and 3D CVI of the different quadrants was detected.3D CVI was defined as the ratio of CVV to total choroidal volume.The monocular data were analyzed to compare 3D CVI among the five groups, and multiple linear regression analysis was used to evaluate the influencing factors.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University (No.2022064).All subjects were aware of the study purpose and agreed to participate the study.Results:There were significant differences in 3D CVI-C1 and 3D CVI-C3 among all groups ( F=3.103, 3.036, both at P<0.05).In PDR group, 3D CVI-C1 was lower than in non-DR group, and 3D CVI-C3 was lower than in control group and non-DR group, with statistically significant differences (all at P<0.05).There were significant differences in 3D CVI in the inferior and nasal quadrants among all groups ( F=2.714, 4.020, both at P<0.05).In PDR group, 3D CVI in the inferior quadrant was lower than that in non-DR group, and 3D CVI in nasal quadrant in PDR group was lower than that in control group, non-DR group, NPDR group and NPDR with DME group, with statistically significant differences (all at P<0.05).Multiple linear regression showed that after controlling for age, course of disease and glycosylated hemoglobin, the severity of DR was the influencing factor of 3D CVI in fovea and parafovea.PDR eyes had the greatest impact on 3D CVI in fovea and parafovea.Compared with non-DR eyes, there was a -0.019(95% CI: -0.031--0.007, P=0.003) decrease in central foveal 3D CVI and a -0.019(95% CI: -0.030--0.008, P=0.001) decrease in parafoveal 3D CVI in PDR eyes, followed by a 0.014(95% CI: -0.027-0.000, P=0.044) decrease in central foveal 3D CVI in NPDR with DME eyes. Conclusions:Macular foveal 3D CVI correlates with DR severity, and a decrease in 3D CVI of large vessels in the macular choroid may be a sensitive indicator of DR exacerbation.

Objective:To provide scientific basis for the prevention and control of pneumoconiosis and the formulation of relevant policies, this paper discusses the loss of health life and economic loss caused by coal worker's pneumoconiosis in a mining group.Methods:From March to October 2017, 1262 cases of coal worker's pneumoconiosis were diagnosed in a mining group from 1972 to 2013. The direct and indirect economic losses are calculated by the step-by-step model method. Direct economic losses include medical expenses, one-time disability allowance, disability allowance, funeral allowance, one-time work death allowance, living and nursing expenses, food allowance, pension for supporting relatives and transportation expenses, etc. Indirect economic losses includes loss of social productivity, additional training fee for new employees, transportation fee for accompanying family members, loss of social productivity of accompanying family members, loss of production suspension and production reduction, etc. Life table method was used to calculate the loss of social productivity caused by coal worker's pneumoconiosis.Results:All 1262 coal worker's pneumoconiosis patients were male. In the stage of pneumoconiosis, 95.40% (1204/1262) of the first stage of pneumoconiosis and 42.62% (538/1262) of the seventh stage of disability. The age of diagnosis (22.02-71.33) was 47.38 years on average. 1262 coal worker's pneumoconiosis patients caused a total of 9068.54 years of health life loss, of which YLD accounted for 93.56% (8484.69/9068.54) . The loss of YLD (0.06-33.30) years in 1262 coal worker's pneumoconiosis patients was 6.70 years per capita. The total economic loss of 1262 coal workers with pneumoconiosis was 2842185447.70 yuan, with a per capita of 2252127.93 yuan. The direct economic loss accounted for 81.59% (2318990168.46/2842185447.70) , which was 4.42 times of the indirect economic loss. Among the direct economic loss per capita, medical expenses accounted for a large proportion of 50.04% (919510.84/1837551.64) . The per capita indirect economic loss is 414576.29 yuan. The loss of social productivity accounted for 56.18% (232908.95/414576.29) .Conclusion:Coal worker's pneumoconiosis causes heavy economic burden and serious loss of social productivity.

Objective:To provide scientific basis for the prevention and control of pneumoconiosis and the formulation of relevant policies, this paper discusses the loss of health life and economic loss caused by coal worker's pneumoconiosis in a mining group.Methods:From March to October 2017, 1262 cases of coal worker's pneumoconiosis were diagnosed in a mining group from 1972 to 2013. The direct and indirect economic losses are calculated by the step-by-step model method. Direct economic losses include medical expenses, one-time disability allowance, disability allowance, funeral allowance, one-time work death allowance, living and nursing expenses, food allowance, pension for supporting relatives and transportation expenses, etc. Indirect economic losses includes loss of social productivity, additional training fee for new employees, transportation fee for accompanying family members, loss of social productivity of accompanying family members, loss of production suspension and production reduction, etc. Life table method was used to calculate the loss of social productivity caused by coal worker's pneumoconiosis.Results:All 1262 coal worker's pneumoconiosis patients were male. In the stage of pneumoconiosis, 95.40% (1204/1262) of the first stage of pneumoconiosis and 42.62% (538/1262) of the seventh stage of disability. The age of diagnosis (22.02-71.33) was 47.38 years on average. 1262 coal worker's pneumoconiosis patients caused a total of 9068.54 years of health life loss, of which YLD accounted for 93.56% (8484.69/9068.54) . The loss of YLD (0.06-33.30) years in 1262 coal worker's pneumoconiosis patients was 6.70 years per capita. The total economic loss of 1262 coal workers with pneumoconiosis was 2842185447.70 yuan, with a per capita of 2252127.93 yuan. The direct economic loss accounted for 81.59% (2318990168.46/2842185447.70) , which was 4.42 times of the indirect economic loss. Among the direct economic loss per capita, medical expenses accounted for a large proportion of 50.04% (919510.84/1837551.64) . The per capita indirect economic loss is 414576.29 yuan. The loss of social productivity accounted for 56.18% (232908.95/414576.29) .Conclusion:Coal worker's pneumoconiosis causes heavy economic burden and serious loss of social productivity.

Objective To investigate the effect of neuropeptide Y(NPY) on free calcium concentration in vascular smooth muscle cell(VSMC). Methods The cultured VSMC was loaded with 10 ?mol/L Fluo-3, and were perfused with normal extracelluar fluid, non-calcium extracellular fluid plus 10 -6 mol/L _NPY, 1 ?mol/L nifedipine, 1 ?mol/L nifedipine+10 -6 mol/L _NPY. The intensity of the cells' fluorescence activated by the laser in 525 ?mol/L was detected with confocal microscope and analyzed with the Leica imagine system. Results The concentration of \_i was not changed after cultured with normal extracellular fluid[57.3+3.1 vs 53.7+2.9, fluorescence OD(FOD)]. _NPY increased \_i to maximum of 86.4?2.7 and gradually declined to 58.1?3.0 FOD (P

Insulin pumps go by the name of the second revolution of treatment for diabetes. The result of DCCT publicized in 1993, insulin pumps have been popularized in the world, including China. This article introduces such about insulin pumps as its history, actuality, development trend, advantages and disadvantages.