ObjectiveTo systematically summarize recent research advances in immunotherapy for hepatocellular carcinoma (HCC) and analyze key challenges in this field. MethodsThrough a systematic review of literature, this study concludes researches on the application of immune checkpoint inhibitors in HCC treatment, combination therapy strategies, and mechanisms of drug resistance. ResultsImmune therapies, particularly immune checkpoint inhibitors, have significantly transformed the treatment landscape of hepatocellular carcinoma. Dual immune combination therapies and immunotherapies combined with anti-angiogenic agents have become new treatment strategies. However, high heterogeneity of HCC, complex tumor microenvironment and the resulting acquired drug resistance remain major which affect the efficacy of immunotherapy. ConclusionAlthough immunotherapy bring new hope in HCC patients, further in-depth investigation on resistance mechanisms and develop novel combination treatment strategies are needed to break through the bottleneck of current immunotherapy.
Objective To investigate the effectiveness of Ilizarov technique in treatment of rigid congenital clubfoot in older children. Methods A clinical data of 55 patients (69 feet) with rigid congenital clubfoot (Diméglio grade Ⅳ) between September 2005 and September 2015 were retrospectively analyzed. There were 33 boys and 22 girls with an average age of 11 years (range, 6-14 years). There were 41 cases of unilateral clubfoot and 14 cases of bilateral clubfeet. The degree of foot deformity was rated as fair in 24 feet and as poor in 45 feet according to International Clubfoot Study Group (ICFSG) score before operation. Sixty-nine feet were treated by Ilizarov external fixator combined with limited soft tissue release, and 21 feet were combined with individualized V-shaped osteotomies. Results All patients were followed up 2-10 years ( mean, 4.2 years). The incisions healed well after operation. Five cases of needle tract infection occurred and were cured by local dressing change. The effectiveness was excellent in 39 feet, good in 21 feet, and fair in 9 feet according to ICFSG score, with the excellent and good rate of 87.0%. During the follow-up, X-ray films showed that no blood supply disorder or necrosis of talus, scaphoid, cuneiform, metatarsal, calcaneus, and cuboid occurred. No osteomyelitis occurred. Conclusion Ilizarov technique combined with limited soft tissue release or V-shaped osteotomy for the older children with rigid congenital clubfeet is safe and can obtain significant orthopedic effectiveness.