Objective:To investigate the safety and efficacy of FOLFOX (5-fluorouracil + calcium folinate + oxaliplatin) hepatic arterial infusion chemotherapy (FOLFOX-HAIC) combined with immune and targeted therapy as triple combination therapy for patients with single China Liver Cancer Staging (CNLC) Ⅰb hepatocellular carcinoma.Methods:A total of 20 patients with single CNLC Ⅰb hepatocellular carcinoma who received FOLFOX-HAIC combined with immune and targeted therapy as triple combination therapy in the First Affiliated Hospital of Guangxi Medical University from October 2021 to August 2022 were included. The clinical data of all patients was retrospectively analyzed. There were 18 males and 2 females, with the age of (55.1±9.9) years. Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and Modified Response Evaluation Criteria in Solid Tumors (mRECIST) were used to evaluate the efficacy of FOLFOX-HAIC combined with immune and targeted therapy, and the clinical safety of triple combination therapy was evaluated by common terminology criteria for adverse events 4.0.Results:According to RECIST 1.1, objective response rate of 20 patients was 70.0% (14/20) and disease control rate was 100.0% (20/20) after 2 cycles of treatment (one cycle of FOLFOX-HAIC plus programmed death-1 antibody). According to mRECIST, objective response rate was 90.0% (18/20) and the disease control rate was 100.0% (20/20) after 2 cycles of treatment. Following the treatment, 12 patients (60.0%) received liver tumor resection, and all of them achieved R 0 resection, 2 patients (10.0%) received radiotherapy, 3 patients (15.0%) stopped drug treatment for surgery, 2 patients (10.0%) refused surgery, and 1 patient (5.0%) died of multiple organ failure caused by immune hepatitis. According to pathological results, 3 patients (25.0%, 3/12) achieved pathological complete response, and 4 patients (33.3%, 4/12) achieved major pathological response. In the safety evaluation, the overall incidence of adverse events was 100.0% (20/20). Seven patients (35.0%) had grade 3 adverse events and 1 patient (5.0%) died of multiple organ failure due to immune hepatitis (grade 5). Grade 1-3 adverse events could be relieved after symptomatic treatment. Conclusion:The triple combination therapy of FOLFOX-HAIC combined with immune and targeted therapy is safe and has high objective response rate and disease control rate, which could be a new strategy for the neoadjuvant treatment of hepatocellular carcinoma.

Objective:To explore an applicative value of a 5-type precise diagnostic technique in integrated precise repair and reconstruction of digit-tip injuries.Methods:From March 2012 to June 2022, 45 digit-tip injuries (38 patients, with an average age of 33 years old) were classified under microscope on the basis of effectiveness of blood vessels remained in the severed tissue. Among the injured digits, there were 15 thumbs, 9 index fingers, 16 middle fingers, 4 ring fingers and 1 little finger. The diagnosis was categorised into 5 types according to involvement of blood vessels: Type I, injury of proper palmar digital artery (10 digits) ; Type II, injury of small artery (5 digits) ; Type Ⅲ, injury of whole vein (4 digits) ; Type IV, injury of superficial palmar arch (4 digits) ; and Type V, vessels missing (22 digits). The timing and therapeutic method of surgery were selected based on the precise classification of 5 types of diagnosis: (1) For type Ⅰ-Ⅳ injuries, 16 patients (23 digits) received in situ tissue replantation after emergency classification. Of which, type Ⅰ-Ⅱ injuries received conventional replantation, type Ⅲ injuries had replantation with arterialised vein, and type IV injuries received replantation with artery-vein shunt. (2) For the type V injuries, 22 patients (22 digits), staged and categorised flap reconstruction with toe flaps were performed. Of which, 7 were performed in emergency surgery, 12 in subemergency surgery and 3 in elective surgery. Based on the severity of defects, small tissue flaps of toe were used in reconstruction of type V injuries and following toe flaps were employed: 9 hallux nail flaps, 3 hallux nail flaps (for reconstruction of distal phalanx), 5 hallux fibular flaps, 3 hallux abdominal flaps and 2 compound tissue flaps with nail bed of the second toe. The sizes of the 45 replanted/transferred tissues flaps were 1.0 cm×0.6 cm×0.4 cm-2.2 cm×1.5 cm×0.8 cm. Donor sites directly sutured. Medical APP was applied in the rehabilitation exercises. Functions of digits were assessed by scheduled follow-ups at outpatient clinic and via remote medical APP to evaluate the clinical efficacy.Results:All small tissue blocks and (or) tissue flaps survived after replantation and (or) flap reconstruction of 45 injured digits. Postoperative follow-up lasted for 6 months to 7 years, with 36 months in average. The appearances of the reconstructed digit-tips were close to normal digits, with TPD at 3-7 mm. According to the Michigan Hand Outcomes Questionnaire (MHQ), 32 patients (37 digits) were in excellent, 5 patients (7 digits) in good, and 1 patient (1 digit) in poor, with 97.78% of excellent and good rate.Conclusion:Five-type precise diagnostic technique is the key to the integrated and precise reconstruction of digit-tip injuries. This method has been clinically validated and achieved realistic recovery from the injured digits.

OBJECTIVE：To study the protection ef fects of mulberry anthocyanin- 3-glucoside on epilepsy model mice and the effect of hippocampal brain derived neurotrophic factor （BDNF）/tyrosine kinase B （TrkB）pathway. METHODS ：Totally 120 C57BL/6 mice were randomly divided into normal group ，model group ，single medication group （mulberry anthocyanin- 3- glucoside），agonist combination group（mulberry anthocyanin- 3-glucoside+TrkB agonist LM 22B-10），with 30 mice in each group. single medication group and agonist combination group were given mulberry anthocyanin- 3-glucoside 600 μg/kg intragastrically once a day ，for consecutive 6 weeks. The agonist combination group was given LM22B-10（5 mg/kg）via the lateral ventricle once a day at 6th week. Normal group and model group were given constant volume of normal saline intragastrically. After last medication，except for normal group ，other groups were given lithium chloride-pilocarpine to establish epilepsy model. After modeling，10 mice in each group were taken to record the latency ，frequency and duration of spontaneous recurrent epilepsy ， observed for 6 hours a day for 4 weeks；EEG was recorded on the 14th，28th and 36th day after modeling ，and the abnormal frequency of EEG in 1 h was counted . On the 6th day of modeling ，other 10 mice in each group were taken to detect the serum calcium level ，and the remaining 10 mice in each group were taken to detect the expressions of BDNF mRNA and protein in the hippocampus. RESULTS ：Compared with normal group ，latency，frequency and duration of spontaneous recurrent epilepsy and the times of abnormal brain wave on the 14th，28th and 36th day after modeling were increased significantly in model group （P＜ 0.05）. The serum calcium level ， mRNA and proteinexpression of BDNF in hippocampus were increased E-mail：wangfang7699@126.com significantly （P＜0.05）. Compared with model group ，the latency，frequency，duration of spontaneous recurrent epilepsy and the times of abnormal brain wave on the 28th and 36th day after modeling were decreased significantly in single medication group（P＜0.05），while serum calcium level ，mRNA and protein expression of BDNF in hippocampus were decreased significantly （P＜0.05）. Compared with single medication group ，the latency，frequency and duration of spontaneous recurrent epilepsy and the times of abnormal brain wave on the 28th and 36th day after modeling were increased significantly in agonist combination group （P＜0.05），while serum calcium level ，mRNA and protein expressions of BDNF in hippocampus were increased significantly （P＜0.05）. CONCLUSIONS ：Mulberry anthocyanin- 3- glucoside has a good protection effect on epilepsy model mice ，the mechanism of which may be associated with inhibiting the activation of hippocampal BDNF/TrkB pathway.

Objective To investigate the therapeutic effects of endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic bile duct exploration lithotomy (LBDEL) in treatment of intra/extra-hepatic duct stones. Methods There were 110 patients whose intrahepatic stones located in Ⅰ , Ⅱ hepatic duct and 378 patients whose stones only located in the common bile duct. These patients respectively underwent LBDE combined with choledochoscope laser lithotripsy or ERCP combined with endoscopic sphincterotomy (EST) and endoscopic nasobiliary drainage (ENBD) to remove the stones. Common bile ducts were performed primary suture or T tube placement in the LBDEL cases. The evaluation was carried out for perioperative complications and postoperative recovery of the surgical methods. Results The residual stone rate was 31.82% in 110 cases. The rate was higher in ERCP group (51.06%) than that in LBDEL group (17.46%) (P < 0.05). Postoperative recovery was better in LBDEL group than that in ERCP group. The residual stone rate was 8.20% in 378 cases. The rate was lower in ERCP group (3.68%) than that in LBDEL group(11.63%) (P < 0.05). Between the two groups, there had no statistical significance in postoperative recovery. The incidences of bile leakage and pulmonary infection were higher in LBDEL group than in ERCP group. The incidences of abdominal cavity infection, acute pancreatitis, digestive tract perforation and gastrointestinal bleeding were higher in ERCP group than that in LBDEL group. 2 of the 378 patients occurred death were happened digestive tract perforation which were induced during ERCP procedure. Conclusion LBDEL and ERCP demonstrated the same therapeutic effects in the treatment of common bile duct stones. However, ERCP has no large advantages in the treatment of hepatolithiasis, and shows higher complication rates. LBDEL has a significant curative effect for intra-and extrahepatic bile duct calculi and can maintain the integrity of Oddi sphincter. This technology is easy to spread to the basic-level hospital to benefit the majority of patients.

Aim To study the analgesic effect of geraniol on neuropathic pain and to explore the possible mechanism.Method A neuropathic pain rat model of Spared Nerve Injury(SNI) was established to measure changes in the threshold of paw withdrawal before and after i.p.administration of geraniol.Patch clamp whole-cell recording was performed to measure activity of sodium channels using ipsilateral L3/L4/L5 dorsal root ganglion(DRG) cells isolated from the SNI rats.In addition, HEK 293 cells expressing hNav1.7 and hTRPA1 channels were used for measuring the changes in channel activities with or without geraniol by whole-cell patch clamp.Results Geraniol had a fast analgesic effect on hypersensitivity of mechanical pain in the SNI model.It significantly inhibited sodium channels on DRGs isolated from SNI rats and hNav1.7 but not hTRPA1 channels expressed by HEK293 cells.However, high concentrations of geraniol facilitated the activation of HTRPA1 channel stimulated by AITC.Conclusion Geraniol may abirritate hypersensitivity of mechanical pain in the SNI model by specifically inhibiting Nav1.7 channel activity on the DRG cells.

Objective This preliminary study aimed to investigate relevant factors of the metacognition of peri?menopausal women. Methods Total 66 perimenopausal women voluntarily participated in this study from October 2012 to July 2013. The Metacognitions Questionnaire 30-item version (MCQ-30) was used to assess metacognition from 5 di?mensions including cognitive confidence (F1), positive beliefs (F2), cognitive self-consciousness (F3), uncontrollability and danger (F4), and need to control thoughts (F5). Eysenck Personality Questionnaire was utilized to measure the person?ality characteristics such as the extraversion/introversion (E), neuroticism/stability (N), psychoticism/socialization (P), and lie (L). Depression and its 4 symptom components including core, cognitive, anxiety, and somatic symptoms were deter?mined by Zung Self-rating Depression Scale (SDS). The linear multiple stepwise regression were performed to analyze the relevant factors of each MCQ dimension. Results The education level (β’=-0.229, P=0.035), N score (β’=0.255, P=0.042), and L score (β’=-0.292, P=0.021) were related to F1. The education level (β’=-0.260, P=0.031) and N score (β’=0.248, P=0.039) were predictors of the dependent variable F2. The core depression symptom (β’=-0.251, P=0.037) and anxiety symptom (β’=-0.248, P=0.039) of SDS were negatively related to F3. Predictors of F4 were the body mass in?dex (β’=0.211, P=0.048) and L score (β’=0.511, P<0.0001). Only P score (β’=0.299, P=0.015) was related to F5. Con?clusion The metacognition level of perimenopausal women is affected by a variety of factors such as personality character?istics and education level, and low self-consciousness and lack of confidence to the cognitive process may be involved in the increased susceptibility to depression.

Objective To explore the effects of amisulpride on the cognitive function in first-episode schizophrenia patients.Methods 64 patients in first-episode schizophrenia were divided into two groups randomly according to the method of tossing a coin,then treated with amisulpride or risperidone respectively for 12 weeks.The efficacy and adverse effect were evaluated with positive and negative scale (PANSS) and treatment emergent side effect scale (TESS) before treatment and after treatment for 2 weeks,4 weeks,8 weeks,12 weeks.Before and after treatment for 12 weeks,cognitive function of all the patients was blindly evaluated with Wechsler Scale-revised China (WMS-RC),Wisconsin Card Sorting Test(WCST) and Trail Making test A and B.Results After 12-week treatment,statistical difference was found in amisulpride(44.7 ± 6.7) and risperidone (45.2 ± 7.4) groups (P ＜ 0.01).But no statistical difference was found between the two groups (P ＞ 0.05).The cognitive function in firstepisode schizophrenia was damaged obviously.In two groups,the scores in recognize,association,comprehend,back a few and MQ of WMS and TAT-A,TAT-B were improved significantly after treatment for 12 weeks (P ＞ 0.05).These items of WCST were improved more remarkably than baseline (amisulpride (20.63 ± 13.06),(28.75 ± 15.72),(43.17 ±22.13),(3.62 ±2.21),P＜0.05; risperidone(20.41 ±13.82),(29.31 ± 16.12),(42.78 ± 21.42),(3.67 ± 2.32),P ＜ 0.05).The improvement in the scores of WCST were statistical difference compared with control group(P ＜ 0.05).But statistical difference was no found between the two groups (P ＞ 0.05).Conclusion The study shows that the cognitive dysfunction in first-episode schizophrenia can be improved by amisulpride,and the efficacy was similar with risperidone.

ObjectiveTo explore the correlation of resilience and coping style,subjective quality of life of young children of schizophrenia patients.Methods 120 adolescents whose parents were clearly diagnosed with schizophrenia wcrc chosen for the study.They were ranked according their performances by Resilience Scale for Adolescents.32 were classified into the group with high resilience and another 32 were assigned to the group with low resilience by applying the criteria that 27％ of the sample size should be differentiated.Then,children in highscore group and low-score group were administered by Simple Coping Style Questionnaire (SCSQ) and Children 's Subjective Quality of Life Questionnaire(ISLQ).ResultsResilience score of research group were lower than those of normal high school students(P＜ 0.05 or 0.01 ).The score and total score of SCSQ positive coping dimensionality of research group who had high resilience score were higher than those of low resilience score group(P ＜ 0.01 ) ;score of passive coping dimensionality were lower than those of low resilience score group (P ＜ 0.01 ).In addition to dimensionality of living environment,the score of dimensionality of cognitive and affective element and the total score of ISLQ of research group who had high resilience score were higher than those of low resilience score group.The total score of resilience was in significant by positive correlation with the total score of ISLQ,cognitive and affeetive element,the total score of SCSQ,the score of positive coping dimensionality.The total score of resilience was in negative correlation with the score of passive coping dimensionality (P ＜ 0.01 ) ;dimensionality of the target focus of resilience was not correlative with cognitive element of ISLQ,the score of negative coping dimensionality of SCSQ,scores of other dimensionality of resilience were in significant correlation with score of other dimensionality of ISLQ and SCSQ(P ＜ 0.01 or 0.05 ).ConclusionYoung children of schizophrenia have poor resilience; research group who has high resilience score adopts more positive coping and has better subjective quality of life ; resilience is positive correlation with positive coping and subjective quality of life.

ObjectiveTo explore the effect of mental toughness level on positive and negative emotion and mental health in children with epilepsy.MethodsIn accordance with the International League against epilepsy and epilepsy syndrome in 1989 International Classification of young children with epilepsy,160 cases were sampled.Based on the Adolescent Resilience Scale ( HKRA ) score,according to the 27％ principles of delimitation,the patients were divided into high HKRA score group and low HKRA score group,43 cases in each group.Then positive emotions and negative affect scale (PANAS),mental health test (MHT) were applied to two groups.Results,Except family support dimension,the others HKRA dimension and total score were higher in female children with epilepsy than those in male patients,there was significant difference (P＜ 0.01 ).The positive affect score were higher in high HKRA score group than that of low HKRA group ; and negative emotion was significantly lower than that in low HKRA group (P＜ 0.01 ).Except physical symptom dimension,other dimensions and total score of HKRA in high HKRA score group were higher than those in low HKRA group,there was significant difference (P＜ 0.01 ).Children with epilepsy HKRA score was positive correlation with positive emotion score but negative correlation with negative affect scores (P ＜ 0.01 ) ; in addition to physical symptom,HKRA score and MHT score,and all the other dimensions were negatively related (P＜0.01 or 0.015).ConclusionThe mental toughness level are significantly related to children's epilepsy patients with positive and negative emotion and mental health status.A high level of mental toughness can increase positive emotional experience,and reduce the negative emotional experience of children with epilepsy.

ObjectiveTo explore the personality traits of Han Chinese women with recurrent depression.MethodsAssessed by the Big Five Inventory (BFI),a comparison research was conducted between 118 Han Chinese women with recurrent depression and 65 sex,race and culture background matched health controls.Results Han Chinese women with recurrent depression scored lower in extraversion,conscientiousness and openness ( 17.93± 5.43,30.24 ± 5.94,30.03 ± 7.33 ) than matched controls ( 20.72 ± 3.79,31.94 ± 3.84,32.75 ± 5.32 ),while scored higher in neuroticism (21.38 ± 3.91) than the later one ( 27.57 ± 6.19 ).A binary logistic regression model,with group (case vs.control) as dependent variable and extroversion,conscientiousness,openness and neuroticism as independent variables,was built to assess each personality dimension's independent impact on recurrent depression.It came out to be that only extraversion ( OR =0.881,95％ CI =0.083-0.966,P=0.007) and neuroticism ( OR =1.225,95％ CI =1.134-1.323,P ＜ 0.01 ) were statistically significantly associated with recurrent depression ( P＜ 0.05 ).ConclusionIn the big five personality model,extraversion and neuroticism might act as independent personality traits to impact Han Chinese women with recurrent depression in a positive and negative way respectively.