Molecular-targeted therapy is a new method and tendency in the treatment of hepatocellular carcinoma (HCC). To date, sorafinib, a multi-targeted gent, is the only one proved to be effective in improving the survival of patients with advanced HCC. Sorafinib is also the first line systemic agent for advanced HCC. Other multi-targeted agents, such as sunitinib, are also proved to be effective. Erlotinib, gefitinib and eetuximab, which target epidermal growth factor receptor, show effectiveness but still need further investigation. Bevacizumab, which targets vascular endothelial growth factor and vascular endothelial growth factor receptor, shows excellent results and deserves more clinical trials. The effects of bortezomib, sirolimus and imatinib, which target other pathways, are still under investigation. The future studies of molecular-targeted therapy for HCC should be focused on the combination of different targeted medicine, and combination of molecular-targeted therapy and chemotherapy, as well as individualized therapy.

Objective:To explore the risk factors and event characteristics of unplanned removal of peripherally inserted central catheters (PICCs) in patients with chest tumors.Methods:The convenience sampling method was used to select chest cancer patients treated in a hospital in Shanghai between March 2018 and December 2021. Logistic regression analysis was used to identify the risk factors of unplanned removal in these patients.Results:A total of 242 patients were included in this study, of whom 42 (17.3%) experienced unplanned removal. The most common causes of unplanned removal in descending order were catheter related dermatitis, catheter slippage, catheter occlusion, catheter related thrombosis, and local or catheter related infections. Logistic multivariate regression analysis showed that a history of radiation therapy ( OR=0.295, 95% CI: 0.108 to 0.806, P=0.017) and a history of surgery ( OR=0.247, 95% CI: 0.076 to 0.799, P=0.020) were protective factors for preventing unplanned removal. Catheterization during spring or autumn ( OR=8.771, 95% CI: 2.828 to 27.204, P<0.001), catheter-related dermatitis ( OR=12.404, 95% CI: 4.176 to 36.845, P<0.001), catheter slippage ( OR=25.105, 95% CI: 7.040 to 89.523, P<0.001), occlusion ( OR=6.155, 95% CI: 1.713 to 22.111, P=0.005), and catheter related thrombosis ( OR=17.817, 95% CI: 2.848 to 111.479, P=0.002) were independent risk factors of unplanned removal. Unplanned removal may occur anytime when the patient had the catheter inserted, but is less likely to happen in the early stage and more likely in the first month after catheterization. Besides, catheter related complications demonstrated seasonality, with catheter related thrombosis and occlusion more frequent in autumn and winter, compared with dermatitis and catheter slippage showing no difference in incidence around the year. Conclusions:The incidence of unplanned removal is high in chest tumor patients with PICC. Nursing staff should familiarize themselves with the risk factors, event characteristics, and the seasonality of catheter related complications, and improve the evaluation and early intervention of complications, to reduce the incidence of unplanned removal and improve the patient's experience of living with catheters.

Currently, the definition, classification and Chinese nomenclature of intra-hepatic cholangiocarcinoma (ICC) are controversial. Whether ICC belongs to liver cancer or carcinoma of bile duct is debatable, and the two terms"intrahepatic cholangiocarcinoma"and"cholangiocellular carcinoma"are simultaneously used without distinction, bringing great confusions to clinical practice. Based on authoritative literatures at home and abroad, the authors give suggestions on the definition, classification and Chinese nomenclature of ICC, as well as the classification of carcinoma of bile duct, which recommend that the Chinese translation of "cholangiocarcinoma" should be "epithelial carcinoma of bile duct (cholangiocellular carcinoma)", the mass-forming type ICC should be classified as primary liver cancer, naming as"intrahepatic cholangiocarcinoma"and the periductal-infiltrating type and intraductal-growing type ICCs still be classified as carcinoma of bile duct, naming as"perihilar cholangiocarcinoma". The authors recommend to classify carcinoma of bile duct into: perihilar cholangiocarcinoma, hilar cholangiocarcinoma, and distal cholangiocarcinoma.

Hepatocellular carcinoma (HCC) accounts for approximately 75%-85% of primary liver cancer cases and is one of the most frequently diagnosed malignancies worldwide. Immunotherapy is currently considered to be the most promising treatment to prevent the progression and postoperative recurrence of HCC. At present, the treatment strategies of immunotherapy for HCC are classified as active immunotherapy and passive immunotherapy, including tumor vaccine therapy, immune checkpoint inhibitors, and adoptive cell therapy. Here we review the current clinical progression and discuss the future perspective on immune therapy for HCC.