Biliary tract cancer is one of the digestive system malignances with very poor prognosis.Majority of patients belongs to the advanced stage when diagnosed.Currently,systemic chemotherapy is the standard first-line treatment option for advanced biliary tract cancer.However,the clinical efficacy is not satisfactory.A new era has been coming while the immunotherapy is introduced in the treatment of hepatobiliary cancers.Many clinical studies have been conducted in the treatment of biliary tract cancer with immune checkpoint inhibitor drugs,and the clinical efficacy and safety are acknowledged by the clinicians.Meanwhile,further studies should focus on how to treat biliary tract cancer with immunotherapy drugs more precisely.

Objective To investigate the mechanism of aquaporin 4（AQP4）in the development of breast cancer.Methods The expression of aquaporin 4 in the T47D and MCF-7 cell lines of breast cancer cells was downregulated by siRNA interference，and the effect of this down regulation on the invasion and metastasis of breast cancer cells was detected.Results Decreased expression of AQP4 inhibits invasion and metastasis of breast cancer cells.Conclusion The expression level of AQP4 is correlated with the development of breast cancer，and it can further develop into a new target.

In recent years the precise diagnosis and treatment of thyroid cancer have made great progress and widely applied clinically, which include the judgment of benign and malignant, malignant risk stratification, inheritance and target therapy. It provides new guidelines for the individualized management of thyroid cancer. We try to introduce the applications of molecular diagnosis in thyroid cancer from the above aspects.

Objective:To investigate the clinicopathological characteristics and the meaning of staging evaluation by the prognostic staging system of breast cancer with different molecular types.Methods:Clinicopathologic data of 236 breast cancer cases，which confirmed by surgical treatment.2018.According to the 2017 CACA guidelines of breast cancer diagnosis and treatment distinguished different molecular subtypes，and compared clinicopathological characteristics of different molecular subtypes.The study reappraised the anatomic staging and prognostic staging according to the AJCC staging criteria for breast cancer，and compared the changing characteristics of prognostic staging in different anatomical stages of each molecular subtype.Results:The study found different subtypes show statistical significant differences in histological grading、 Ki67 level、lymph node metastasis、anatomical stage and prognosis stage（P＜0.05），but not in tumor size（P＞0.05）.Compared with anatomical stage，the prognosis stage changed，and there were statistical significant among subtypes（P＜0.05）.The changing characteristics of prognostic staging in different anatomical stages of each molecular subtype is significant（P＜0.05）.Conclusion:There is heterogeneity among different molecular subtypes.Compared with anatomical stage，the changing characteristics of prognostic staging is vary from molecular subtype.Molecular typing combined with prognostic staging maybe provided an important basis for accurated individualized treatment of breast cancer.

Objective:To explore the clinical value of preoperative chest plain scan threedimensional reconstruction technique and enhanced CT threedimensional reconstruction technique in anatomical resection of pulmonary segments.Methods:The clinical data of 40 patients who underwent thoracoscopic anatomical segmentectomy from March 2019 to January 2021 were retrospectively analyzed.Among them,22 patients underwent preoperative plain CT,and 18 patients underwent preoperative enhanced CT.All the patients underwent preoperative threedimensional computed tomography bronchography and angiography(3DCTBA) using the Mimics software to show the anatomy of pulmonary segments,and the safe cutting edge of 2 cm from the pulmonary nodule was constructed.This study was divided into two groups:plain scan reconstruction group and enhanced reconstruction group.The general clinical characteristics,operation complexity,operation time and postoperative recovery of the two groups were compared.Results:There were no significant differences in operation complexity,operation time,intraoperative blood loss,postoperative total drainage volume,postoperative drainage tube indwelling time,postoperative hospital stay and postoperative pathological types(P＞0.05).Conclusion:Preoperative application of 3DCTBA with chest plain CT or enhanced CT can be used to guide anatomic segmentectomy to achieve accurate segmentectomy,which is safe and effective.

Articular cartilage is a major tissue distributed at the joint surface;it plays a role in loadbearing and lubricating.The articular cartilage of the joints in the extremities mainly consists of hyaline cartilage composed of collagen II.Fibrocartilage formation is easily observed when the cartilage is injured or degenerated,which has abundant type I collagen.In this study,a new viewpoint and concept,focusing on the modification of fibrocartilage in situ approach and regeneration of hyaline cartilage,namely “fibrocartilage hyalinization”,was proposed as a practical clinical strategy.We conducted preliminary discussions and prospects on the feasibility and potential mechanisms of fibrocartilage hyalinization.It is hoped that the strategy will be helpful to the development and clinical transformation of cartilage regeneration research.

The complex anatomy of the distal radioulnar joint is the basis for its forearm rotation function and power transmission.It is important to research the anatomical structure and biomechanical mechanism of the distal radioulnar joint to understand the mechanism of the instability of the distal radioulnar joint.The instability of the distal radioulnar joint can be divided into primary instability，post-traumatic or postoperative instability.The combination of medical history，physical examination and imaging findings on the classification of instability of the distal radioulnar joint is helpful for the diagnosis and treatment of the disease.The treatments for the instability of the distal radioulnar joint are conservative treatment and surgical treatment.

Holmium laser is the most commonly used laser for minimally invasive treatment of urinary calculi.To understand the principle of the action of holmium laser and to reasonably set and optimize holmium laser parameters（pulse energy，frequency，pulse width）can improve the efficiency and effect of lithotripsy.We review the present status of laser lithotripsy technology and the recent advances in laser technology，such as Moses technology holmium laser，Laser Lithotripsy System with Automatic RealTime Urinary Stone Recognition and thulium fiber laser.

Objective To compare the therapeutic effect of silver ion antibacterial dressing and povidone iodine gauze on the incision and drainage of the abscess.
Methods From March 2019 to November 2019,62 patients were included in this study,and divided randomly into the observation group and the control group with 31 cases in each group.The patients in the observation group were treated with silver ion antibacterial dressing,while the patients in the control group were treated with povidone iodine gauze.The patients in the two groups were recorded in detail.The infection control time of abscess incision was compared before treatment,the third day and the second week after the first treatment,the number of dressing changes and wound healing time of the two groups,and the clinical effect of the patients was evaluated.
Results .The time of wound control in the observation group was (13.9±1.81)d,shorter than that in the control group (23.4±2.32)d(P<0.05);the BWATBWAT(Bates-Jensen Wound  assessment tool，BWAT) score of the observation group in the second week after the first treatment was (14.98±1.51),lower than that in the control group (19.78±2.46)(P<0.05);the times of drug change and wound healing in the Observation group were significantly shorter than that in the control group(P<0.05).
Conclusion Compared with the traditional povidone iodine gauze,the silver ion antibacterial dressing can control the wound infection and improve the wound healing more quickly,and the dressing change times are less,the wound healing time is obviously shortened.

The incidence and mortality of colorectal cancer in China are on the rise.According to the 2015 China Cancer Statistics，the incidence and mortality of colon cancer are ranked third in malignant tumors worldwide.The clinical manifestations of colon cancer are related to the pathological type and location of the tumor，and the left colon cancer is characterized by intestinal obstruction，diarrhea，constipation and bloody stool.Most patients are already in the advanced or terminal stage when they are diagnosed.Left colon cancer accounts for about 5%6% of all colon cancers.The principle of treatment is comprehensive treatment based on surgical resection.The radical resection of laparoscopic left hemicolectomy includes left transverse colon，descending colon and most sigmoid colon.The current status and related progress of laparoscopic left hemicolectomy were analyzed.