Objective To investigate the efficacy and safety of cryoablation combined with Camrelizumab monoclonal antibody in the treatment of hepatocellular carcinoma(HCC).Methods A total of 103 HCC patients who were admitted to our hospital from June 2020 to June 2023 were enrolled and randomly divided into combined treatment group with 53 patients and control group with 50 patients.The patients in the control group received percutaneous argon-helium cryoablation,and those in the combined treatment group received percutaneous argon-helium cryoablation combined with Camrelizumab monoclonal antibody.The two groups were compared in terms of short-term response,changes in T lymphocyte subsets after treatment,changes in liver function and alpha-fetoprotein(AFP)after treatment,and progression-free survival and overall survival during follow-up.The t-test was used for comparison of normally distributed continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to plot survival curves,and the log-rank test was used for comparison of survival time between the two groups.Results The combined treatment group had significantly higher overall response rate and disease control rate than the control group(χ2=4.156 and 4.348,P=0.042 and 0.037).After treatment,the combined treatment group had significant increases in the percentages of CD3+and CD4+T lymphocytes and CD4+/CD8+ratio(P＜0.05)and a significant reduction in the percentage of CD8+T lymphocytes(P＜0.05),while the control group had no significant changes in T lymphocyte subsets after treatment(P＞0.05),and compared with the control group after treatment,the combined treatment group had significantly higher percentages of CD3+and CD4+T lymphocytes and CD4+/CD8+ratio(all P＜0.05)and a significantly lower percentage of CD8+T lymphocytes(P＜0.05).After treatment,both groups had significant reductions in the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and AFP(all P＜0.05)and a significant increase in the level of albumin(Alb)(P＞0.05),and compared with the control group after treatment,the combined treatment group had significantly lower levels of ALT,AST,and AFP(all P＜0.05)and a significantly higher level of Alb(P＜0.05).There were no significant differences in the incidence rates of grade Ⅲ—Ⅳ(moderate to severe)adverse reactions between the two groups(P＞0.05).Compared with the control group,the combined treatment group had significantly better median progression-free survival(21.32 months vs 15.31 months,χ2=4.689,P=0.030)and median overall survival(28.36 months vs 20.75 months,χ2=5.030,P=0.025).Conclusion Argon-helium cryoablation combined with Camrelizumab monoclonal antibody can effectively improve short-term response,enhance immune function,and prolong survival time,with a favorable safety profile.

Objective To investigate the influence of different end shapes of esophageal stents on the mechanical behavior of the stent-esophagus system. Methods Through finite element simulation, the mechanical behavior of the coupling system between braided esophageal stents with different end shapes (straight-tube-shaped, cup-spherical-shaped, double-trumpet-shaped) and the esophageal cavity was analyzed. The influences of bare stents and covered stents with three different end shapes on stress distributions in the inner wall of the esophagus and on dilatation of the esophageal stenosis zone were compared. Results The reduction in stenosis rate caused by the bare stent was larger than that of the covered stent. Moreover, the equivalent stress and the contact stress caused by the bare stent were much larger than those of the covered stent. Different end shapes had a significant influence on the stress occurring in the healthy esophageal zone. Stress concentration occurred in the zones where the esophagus contacted the central part of the cup-shaped end and the edge of the double-trumpet-shaped end. The braided esophageal stents with three different end shapes all had good apposition.Conclusions Different end shapes of stents cause different stress states in the esophagus. A larger stress involves a higher probability of occurrence of esophageal tissue hyperplasia, but a smaller possibility of stent migration. Therefore, understanding the effect of the end shapes on stent performance can provide important theoretical references for optimization design of the braided stent and its clinical selection.