Brain metastasis (BM), a devastating complication of advanced malignancy, has a high incidence in non-small cell lung cancer (NSCLC). As novel systemic treatment drugs and improved, more sensitive imaging investigations are performed, more patients will be diagnosed with BM. However, the main treatment methods face a high risk of complications at present. Therefore, based on immunotherapy of tumor immune microenvironment has been proposed. The development of NSCLC and its BM is closely related to the tumor microenvironment, the surrounding microenvironment where tumor cells live. In the event of BM, the metastatic tumor microenvironment in BM is composed of extracellular matrix, tissue-resident cells that change with tumor colonization and blood-derived immune cells. Immune-related cells and chemicals in the NSCLC brain metastasis microenvironment are targeted by BM immunotherapy, with immune checkpoint inhibition therapy being the most important. Blocking cancer immunosuppression by targeting immune checkpoints provides a suitable strategy for immunotherapy in patients with advanced cancers. In the past few years, several therapeutic advances in immunotherapy have changed the outlook for the treatment of BM from NSCLC. According to emerging evidence, immunotherapy plays an essential role in treating BM, with a more significant safety profile than others. This article discusses recent advances in the biology of BM from NSCLC, reviews novel mechanisms in diverse tumor metastatic stages, and emphasizes the role of the tumor immune microenvironment in metastasis. In addition, clinical advances in immunotherapy for this disease are mentioned.

Objectives: Surgical treatment is the preferred treatment for pediatric hydrocephalus. The analysis of the outcome of pediatric hydrocephalus surgery and its complications is limited by the lack of available data. Our goal was to better understand the effectiveness of surgery and to explore better surgical treatment methods and management of complications.Methods: 163 patients with pediatric hydrocephalus were included. A retrospective chart review was performed on all patients. Data collected included surgical techniques, number of surgical treatments, complications, and basic demographics.Results: There were 163 patients in this group including 103 males and 60 females. Among the patients, 106 (106/163, 65.0%) patients received ventricular peritoneal shunt (VP), 7 (7/163, 4.3%) patients received ventricle-right atrium shunt (VA) and 50 (50/163, 30.7%) patients received endoscopic third ventriculostomy (ETV). Among the patients who received VP, 74 (74/163, 45.4%) patients were cured and 32 (32/163, 19.6%) patients underwent surgery again. Among the patients who received VA, 38 (38/163, 23.3%) patients were cured and 12 (12/163, 7.4%) patients underwent surgery again. Among the patients who received ETV, 3 (3/163, 1.8%) patients were cured and 4 (4/163, 2.5%) patients underwent surgery again. The most common complication is shunt-related peritonitis or abdominal abscess, abdominal end obstruction (17/163，10.4%).Conclusion: A single surgery can cure most patients, and sometimes more than one surgery is required. For pediatric hydrocephalus, ETV is more efficient and has fewer surgical complications. However, the management of unrelieved symptoms and related complications after ETV surgery and bypass surgery should still be taken seriously.