Objective To evaluate the short-term efficacy of recombinant human endostatin (rhES) combined with transcatheter arterial chemoembolization (TACE) versus TACE alone for intermediate and advanced primary hepatic carcinoma.Methods The relevant controlled trials about rhES plus TACE versus TACE alone in the treatment of intermediate and advanced primary hepatic carcinoma were retrieved from the databases of PubMed,Elsevier,Cochrane Library,China National Knowledge Infrastructure (CNKI),Chinese Biomedical Literature Database (CBM),Wan Fang Database.The retrieval time limited was from the database construction to January 2018,and the Meta-analysis was performed by using RevMan5.3 software.Results 18 controlled trials were included in this Meta-analysis.There were 948 cases,of which 522 cases in rhES plus TACE group and 426 cases in TACE alone group.According to the usage of rhES,the trials were further divided into intrahepatic arterial embolization group,intrahepatic arterial pump group,and intravenous infusion group.rhES plus TACE had an overall advantage over TACE alone in terms of objective response rate (ORR),and the difference was statistically significant (RR =1.59,95％CI:1.41～1.79,P＜0.05).And the ORR of rhES plus TACE in intrahepatic arterial embolization group,intrahepatic arterial pump group,intravenous infusion group was better than that of TACE alone (Intrahepatic arterial embolization group RR=1.63,95％CI:1.36～ 1.95;Intrahepatic arterial pump group RR=1.49,95％CI:1.24～1.79;Intravenous infusion group RR=1.69,95％CI:1.22～2.34),and the difference was statistically significant (P＜0.05).The subgroups analysis of anthracycline and platinum also showed that ORR in rhES plus TACE patients was better than that in TACE patients alone.Conclusion The short-term efficacy of rhES plus TACE in the treatment of intermediate and advanced primary hepatic carcinoma was better than that of TACE alone,and the same results were obtained by subgroup analysis.

Objective:To explore the efficacy and safety of TiRobot combined with three-dimensional imaging in the minimally invasive surgery for pelvic fractures.Methods:A retrospective analysis was conducted of the 40 patients with pelvic fracture who had been treated by fixation with S1 and S2 sacroiliac screws at Department of Orthopaedics and Traumatology, Yangjiang People's Hospital from January 2019 to May 2021. They were divided into 2 groups according to their treatment methods. In the TiRobot group of 20 cases subjected to percutaneous sacroiliac screw fixation assisted by TiRobot combined with three-dimensional imaging, there were 13 males and 7 females with an age of (38.2 ± 8.8) years. In the manual group of 20 cases subjected to fixation with manual placement of sacroiliac screws under conventional C-arm fluoroscopy, there were 11 males and 9 females with an age of (37.3 ± 9.2) years. The 2 groups were compared in terms of fluoroscopy time for screw placement, guide needle adjustment, operation time, intraoperative blood loss, visual analogue scale (VAS) 72 hours after operation, postoperative hospital stay, time to ambulation, excellent to good rate of screw placement, complication rate, fracture union time, Majeed score at 6 months after operation, and excellent to good rate of functional evaluation.Results:There was no significant difference between the 2 groups in their preoperative general data, showing they were comparable ( P > 0.05). In the TiRobot group, fluoroscopy time for screw placement [(8.2 ± 2.9) s], guide needle adjustment [(0.4 ± 0.2) times], operation time [(67.4 ± 5.5) min], and intraoperative blood loss [(36.5 ± 8.0) mL] were significantly less than those in the manual group [(40.4 ± 4.5) s, (8.6 ± 0.7) times, (78.4 ± 7.2) min, and (41.6 ± 7.8) mL], postoperative VAS [3.0 (4.0, 5.0) points] was significantly lower than that in the manual group [4.0 (5.0, 6.0) points], the excellent to good rate of screw placement (100%, 40/40) was significantly higher than that in the manual group (85.0%, 34/40), and the complication rate (5.0%,1/20) was significantly lower than that in the manual group (35.0%, 7/20) (all P < 0.05). There was no significant difference between the 2 groups in postoperative hospital stay, time to ambulation, fracture union time, Majeed score, or excellent to good rate of functional evaluation ( P > 0.05). Conclusion:In the minimally invasive surgery for pelvic fractures, TiRobot combined with three-dimensional imaging leads to positive outcomes, because it can reduce operation time and radiation exposure, improve accuracy of screw placement, and increase safety.

Since sorafenib has been first-line molecular-targeted drug for advanced hepatocellular carcinoma (HCC), clinical studies in the last 10 years failed to confirm that a new molecular-targeted drug or immune checkpoint inhibitor was superior or non-inferior to sorafenib, or approved second-line treatment for patients with the failure of sorafenib. However, many clinical studies published in 2017 have changed people′s previous understanding. REFLECT trial showed that as the first-line treatment of advanced HCC, lenvatinib was non-inferior than sorafenib. In addition, RESORCE trial and CheckMate-040 trial confirmed respectively that regorafenib and PD-1 inhibitor nivolumab were options of second-line treatment for patients with advanced HCC after sorafenib treatment. The development of these drugs will bring a new prospect for advanced HCC patients.