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 investigate the safety and efficacy of hepatic arterial infusion chemotherapy(HAIC)combined with anti-PD-1 monoclonal antibody(anti-PD-1 mAb)in treating advanced hepatocellular carcinoma(HCC)with microvascular invasion(MVI).Methods The clinical data of 156 patients with advanced HCC,who received HAIC-mFOLFOX6 combined with anti-PD-1 mAb(HAIC-PD-1 group,n=61)or received simple HAIC-mFOLFOX6(simple HAIC group,n=95)at the Union Shenzhen Hospital,Huazhong University of Science and Technology of China From January 2018 to December 2021,were retrospectively collected.After propensity score matching(PSM)for 156 patients,the overall cohort and the matched cohort(PSM cohort)were obtained.The differences in overall survival(OS)and progression-free survival(PFS)were compared between the two cohorts.Based on the modified Response Evaluation Criteria in Solid Tumors(mRECIST)the tumor response to treatment was evaluated.The objective response rate(ORR)and disease control rate(DCR)were compared between the overall cohort and the PSM cohort.Univariate analysis and multivariate analysis were used to identify the independent predictive factors affecting OS and PFS.Results In both the overall cohort and the PSM cohort,the OS and PFS in the HAIC-PD-1 group were better than those in the simple HAIC group(both P＜0.01),while no statistically significant differences in ORR and DCR existed between the HAIC-PD-1 group and the simple HAIC group(both P＞0.05).Multivariate analysis showed that ALBI grade and therapeutic method were the independent predictive factors for OS,while extrahepatic metastases and therapeutic method were the independent predictive factors for PFS.Conclusion In treating patients with advanced HCC complicated by MVI,H AIC-mFOLFOX6 combined with anti-PD-1 mAb carries more significant survival benefits when compared with simple HAIC-mFOLFOX6.In aspect of controlling the tumor progression,HAIC-mFOLFOX6 combined with anti-PD-1 mAb and simple HAIC-mFOLFOX6 have similar efficacy.

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 explore the network structure characteristics and core items of meaning in life and coping styles among college students, and provide a basis for understanding their relationships and related interventions. 【Methods:】 A survey was conducted among college students using the Simplified Coping Style Questionnaire and Meaning in Life Questionnaire . The network analysis method was used to construct a network of college students’ meaning in life and coping styles, and R software was used for statistical analysis and visualization. 【Results:】 In the network of college students’ meaning in life and coping styles, "believing that time will change the status quo, and the only thing to do is to wait" and "trying to forget the whole thing" had the closest connection. "Learning from others to handle similar difficult situations" had the highest expected impact. "Seeking the meaning in life" and "pursuing hobbies and actively participating in cultural and sports activities" had the highest bridge expected influence. The average predictability value of all nodes was 0.775. 【Conclusions:】 Interventions aimed at "learning from others to handle similar difficult situations", "changing one’s own ideas and rediscovering what is important in life" and "changing some of the original practices or problems" may maximize the coping effect of college students. "Seeking the meaning in life" can furthest influence the coping styles, and "pursuing hobbies and actively participating in cultural and sports activities" can maximize the improvement of meaning in life.

Objective To investigate the value of a clinical-CT radiomics model in predicting cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods A total of 262 cases with PTC confirmed by pathology after surgery were selected.On CT arterial phase images,the PTC was outlined layer by layer via software 3D-slicer to extract CT radiomics features.The least absolute shrinkage and selection operator(LASSO)algorithm was used for dimensionality reduction and feature screening in relation to CLNM.The Mann-Whitney U test or Chi square test was performed to identify clinical parameters significantly associated with CLNM.The statistically significant CT radiomics features and clinical parameters were all selected for the multivariate logistic regression analysis to construct the clinical-CT radiomics model.The predictive efficiency of model was evaluated via the receiver operating characteristic(ROC)curve.Results The clinical-CT radiomics model demonstrated favorable predictive performance in both the training group[area under the curve(AUC)0.804,sensitivity 68.7％,specificity 82.4％]and the validation group(AUC 0.782,sensitivity 84.4％,specificity 61.8％).Conclusion The clinical-CT radiomics model demonstrates significant value in predicting CLNM of PTC,thereby,aiding in the development of personalized clinical plans for cervical lymph node(CLN)dissection.

[Abstract] Objective: To develop a new type of CD7 chimeric antigen receptor modified T cell (CD7-CAR-T) for the treatment of CD7 positive acute myeloid leukemia (AML), and to observe its killing effect on CD7 positive AML cells. Methods: The CD7-CAR lentiviral vector was constructed based on the CD7 Nanobody sequence and costimulatory domain sequence of CD28 and 4-1BB. The lentiviral particles were packaged and used to co-transfect human T cells with protein expression blocker (PEBL), so as to prepare CD7- CAR-T cells. Real time cellular analysis (RTCA) was used to monitor the cytotoxicity of CD7-CAR-T cells on CD7 overexpressed 293T cells. Flow cytometry assay was used to detect the effect of CD7-CAR-T cells on proliferation and cytokine secretion of AML cells with high, medium and low CD7 expressions (KG-1, HEL and Kasumi-1 cells, respectively). Results: CD7-CAR-T cell was successfully constructed and its surface expression of CD7 was successfully blocked. Compared with T cells, CD7-CAR-T cells could significantly inhibit the proliferation of CD7-293T cells and promote the release of TNF, Granzyme B and INF-γ; in addition, CD7-CAR-T cells also significantly promoted the apoptosis (t=147.1, P<0.01; t=23.57, P<0.01) and cytokine release (P<0.05 or P<0.01) in CD7 positive KG-1 and HEL cells, but had little effect on Kasumi-1 cells that only expressed minimal CD7 antigen (t=0.7058, P>0.05). Conclusion: CD7-CAR-T cells can specifically kill CD7-positive AML cells in vitro.

Objective To assess the characteristics of brain glucose metabolism in patients with early Parkinson's disease (PD) accompanied by visuospatial working memory impairment using 18F-fluorodeoxyglucose (FDG) PET imaging.Methods Between January 2015 and March 2017,early PD patients with visuospatial working memory impairment (14 males,6 females,age:(55.7±6.7) years),early PD patients without visuospatial working memory impairment (13 males,7 females,age:(55.7±8.5) years) and healthy controls (14 males,6 females,age:(54.6±6.4) years) were included.Resting-state 18F-FDG PET was performed to obtain the brain glucose metabolism,Subsequently,statistical parametric mapping (SPM) was used to compare the brain glucose metabolic changes among different groups.Results Compared with the control group,hypermetabolism was observed in putamen,globus pallidus,thalamus,pons,cerebellum and primary motor cortex and hypometabolism was found in part of the occipital and temporal lobe in the groups ofearly PD (Zmax values:3.19-6.86,t values:2.11-9.96,all P＜0.001).The PD group with visuospatial working memory impairment had hypometabolism regions in bilateral lateral prefrontal cortex and posterior parietal cortex compared with the group without visuospatial working memory impairment.Conclusion Abnormal metabolism of glucose in visual processing channels of brain in early PD patients may be one of the causes of visuospatial working memory impairment.

Objective To evaluate the role of P2X7 receptor in the ventrolateral periaqueductal gray (vlPAG) in tramadol-induced reduction of neuropathic pain (NP) in rats.Methods Fifty-four male clean-grade healthy Sprague-Dawley rats,aged 7 days,weighing 190-230 g,were studied.NP was induced by chronic constrictive injury (CCI) to sciatic nerve.Experiment Ⅰ Thirty-six rats were divided into 3 groups (n =12 each) using a random number table method:sham operation group (group S),group NP1 and NP plus tramadol group (group NP1 +T).Tramadol 15 mg/kg was intraperitoneally injected once a day from day 7 to day 14 after CCI in group NP1+T.The mechanical and thermal pain thresholds of the nerve-injured hindlimb were measured before CCI and on 1,5,7,10,12 and 14 days after CCI.Rats were sacrificed after measurement of pain threshold on day 14 after CCI,and the expression of P2X7 receptor in vlPAG was detected by immunohistochemistry and Western blot assay.Experiment Ⅱ Eighteen rats were divided into 3 groups (n =6 each) using a random number table method:group NP2,NP plus tramadol group (group NP2+T) and NP plus tramadol plus a specific P2X7 receptor antagonist A-438079 group (group NP2+T+A).In NP2+T+A group,a catheter was implanted in vlPAG,and the NP model was established on 5th day after successful catheterization.Tramadol 15 mg/kg was intraperitoneally injected once a day from day 7 to day 14 after CCI in group NP2+T.In group NP2+T+A,tramadol 15 mg/kg was intraperitoneally injected once a day from day 7 to day 14 after CCI,followed by a microinjection of A-438079 100 pmol (0.3 μl) via vlPAG before giving tramadol on day 14.The mechanical and thermal pain thresholds were measured at the end of the last tramadol administration and within 1 h after the end of the last tramadol administration.Results Experiment Ⅰ Compared with group S,the mechanical and thermal pain thresholds were significantly decreased at each time point after CCI,the number of P2X7 receptor positive cells was increased,and the expression of P2X7 receptor was up-regulated in the other two groups (P＜0.01).Compared with group NP1,the mechanical and thermal pain thresholds were significantly increased at days 7-14 after CCI,the number of P2X7 receptor positive cells was increased,and the expression of P2X7 receptor was up-regulated in group NP1 +T (P＜0.01).Experiment Ⅱ Compared with group NP2,the mechanical and thermal pain threshold were significantly increased at each time point after CCI in NP2+T and NP2 +T+A groups (P＜0.01).Compared with group NP2 +T,the mechanical and thermal pain thresholds were significantly decreased at each time point after CCI in group NP2+T+A (P＜ 0.01).Conclusion The mechanism by which tramadol mitigates NP is partially related to enhanced function of P2X7 receptors in vlPAG of rats.

Objective To investigate the status and the influencing factors of thyroid volume of children aged 8-10 years in Hefei City.Methods In 2016,according to the requirements of "National Iodine Deficiency Disorders Surveillance Plan (the 2016 Edition)",the method of multistage stratified sampling was used in 9 counties (cities,districts) of Hefei.Five primary schools were randomly selected from each county (city,district),with one in each direction (the east,west,south,north and center),then 40 children aged 8-10 years (male ∶ female =1 ∶ 1,with similar age distribution) were randomly chosen in each primary school.The thyroid volume,height and weight were measured.In addition,a questionnaire with the items including personality,learning pressure,dietary habits,related disease history and contact history was designed and used to collect the data of the subjects.Results Totally 1 800 children aged 8-10 years were selected from 45 primary schools in 9 counties (cities,districts).The mean thyroid volume was (3.009 ± 1.197) ml.Totally 71 people were found with thyroid enlargement and the goiter rate was 3.9％,which was in the range described in the elimination iodine deficiency disorders (IDD) standard (＜ 5％).Univariate analysis showed that for children in different age groups,seafood consumption frequency,radiological examination,height,and body mass,the thyroid volumes were significantly different (P＜ 0.05);Multivariate linear regression showed that body weight and height were main factors affecting the thyroid volume of children aged 8-10 years in Hefei City,the standard partial regression coefficient are 0.288 and 0.140,respectively.Conclusions The thyroid volume of the 8-10 years old children is generally in the normal range in Hefei.Goiter rate is lower than the standard for elimination of iodine deficiency The findings have showed that not only age,but also height,body mass and other factors should be considered while evaluating the influencing factors of the thyroid volume of school-aged children.

Purpose To assess the feasibility of measuring maximal density of a region of interest (ROI) with contrast-enhanced CT in quantifying degrees of intestinal ischemia in patients with intestinal obstruction.Materials and Methods Abdominal CT images and reports of 160 patients with intestinal obstruction were retrospectively studied.All the data were reviewed by CT visual evaluation method and measuring maximal density of ROI respectively.The CT visual evaluation took the way of accumulated points,and divided the degrees of intestinal ischemia into five categories.The measuring maximal density of ROI quantified the degrees of bowel enhancement with a bar histogram on CT workstation.The results were compared with the pathological examination.The sensitivity,specificity,positive and negative predictive values and accuracy of the two methods were calculated respectively,and compared.Results The sensitivity,specificity,positive and negative predictive values and accuracy of CT visual evaluation method were 96.7％,72.9％,82.1％,94.4％ and 86.2％,respectively.The sensitivity,specificity,positive and negative predictive values and accuracy of the measuring maximal density of ROI were 68.8％,100.0％,100.0％,71.4％,82.5％,respectively.By measuring the area under the ROC curve,the ROI method (0.995) was more accurate than CT visual evaluation method (0.908) in the diagnosis of bowel ischemia.Conclusion Measuring the maximal density of ROI can quantize bowel wall enhancement.It is a reliable and useful method in the diagnosis of intestinal ischemia,and in accordance with pathological results.