Objective To evaluate the clinical efficacy and safety of a new spiral thermo-expandable prostate stent(Memokath 028,Pnn Medical) in the treatment of patients with benign prostatic hyperplasia with moderate to severe lower urinary tract symptoms.Methods Retrospective analysis was peformed on 50 patients with benign prostatic hyperplasia who underwent implantation of prostatic stent from October 2020 to June 2021 in the Shanghai Fourth People’s Hospital of Tongji University.The urodynamic parameters of patients before operation and 1,3,6 and 12 months after operation were collected,including International Prostate Symptom Score(IPSS),Quality of Life(QOL),and maximum urinary flow rate(Qmax),residual urine parameter values,and records such as perioperative and postoperative complications.Results The average operation time was 19.8 minutes,and the average VAS score at 10 minutes after surgery was 1.8±0.6 points.Spontaneous urination was restored after the operation,and all patients were discharged on the first day after the operation.In terms of postoperative complications,there were 7(14%) cases of postoperative hematuria,6(12%) cases of urination urgency,and 4(8%) cases of painful urination.Acute urinary tract infection(UTI) occurred in 5 patients(10%).The first follow-up was conducted at 1 months after the operation.The average IPSS,QOL score and PVR were 13.9±3.2 points,2.4±0.5 points,and （52.7±22.5）ml，respectively,which were significantly lower than those before the operation(P＜0.05).Qmax was （11.9±1.6）ml/s,which was significantly higher than that before surgery(P＜0.05).As time went on,the above indicators remain stable.Conclusion The new spiral thermo-expandable prostate stent is easy to operate.It is safe and feasible for the treatment of urinary tract obstruction in the prostate.The short-term clinical efficacy is definite,and the early complications are few.

Osteoporotic vertebral compression fractures is a common type of osteoporotic fractures,often occurring with minimal external force or even without obvious trauma.They manifest as pain,deformity,and functional impairment,significantly impacting patients’ quality of life.Following reduction of vertebral compression fractures,bone defects often occur and typically require bone grafting for repair.Surgical treatments primarily include percutaneous vertebral augmentation and open surgery.Cement augmentation,appropriate bone implantation,and anti-pullout internal fixation are crucial components of bone repair therapy.Different types of cement materials and novel vertebral augmentation techniques offer more options for vertebral fracture repair.This consensus incorporates epidemiological characteristics of osteoporotic vertebral compression fractures,referencing literature search results and expert survey opinions,to address common controversies regarding commonly used vertebral bone repair materials,strategies,and postoperative considerations in clinical practice.It is hoped that this consensus will improve treatment outcomes,enhance patient prognosis,and promote standardized clinical management of osteoporotic vertebral compression fracture repair.

Objective To observe the influencing factors of cerebrospinal fluid leakage after endoscopic transsphenoidal pituitary adenoma resection,and promote the early identification of high-risk patients with this complication. Methods Retrospective analysis was made on the clinical data of 176 patients with pituitary adenoma who underwent endoscopic transsphenoidal pituitary adenoma resection in Department of Neurosurgery,Second Affiliated Hospital of Nanjing Medical University from May 2019 to October 2022,and the cerebrospinal fluid leakage after operation was counted.Single factor analysis was used to screen the possible influencing factors of postoperative cerebrospinal fluid leakage,and logistic regression analysis was used to determine the independent risk factors. Results 12 of 176 patients with pituitary adenoma had cerebrospinal fluid leakage after operation,the incidence was 6.82% (12/176).Univariate analysis showed that tumor diameter,reoperation,intraoperative cerebrospinal fluid leakage,and intraoperative cerebrospinal fluid leakage classification were related to postoperative cerebrospinal fluid leakage (P＜0.05).Logistic regression analysis showed that tumor diameter (OR=3.843,95%CI=1.652～8.940),reoperation (OR=2.407,95%CI=1.094～5.298),intraoperative cerebrospinal fluid leakage (OR=4.552,95%CI=1.483～13.972),and intraoperative cerebrospinal fluid leakage classification (OR=3.516,95%CI=1.204～10.269) were independent risk factors for postoperative cerebrospinal fluid leakage (P＜0.05). Conclusion Tumor diameter,reoperation,intraoperative cerebrospinal fluid leakage,and intraoperative cerebrospinal fluid leakage classification are closely related to cerebrospinal fluid leakage after endoscopic transsphenoidal pituitary adenoma resection,we should pay close attention to the strategies of sellar floor reconstruction in the above patients,and strengthen the observation of the signs of cerebrospinal fluid leakage after surgery.

Objective Comparative analysis of the application effects of straight bipolar coagulation forceps,Focus ultrasonic equipment and high frequency electrosurgical equipment in thyroid cancer surgery. Methods Select 165 patients accept standard radical resection of thyroid cancer from May 2020 to April 2021.Divide randomly into bipolar electrocoagulation group,ultrasonic equipment group and electrosurgical equipment group,with 55 cases in each group.The general patient’s information of the three groups are operation time,intraoperative blood loss,postoperative drainage time,total drainage,preoperative and postoperative parathyroid hormone value,serum calcium ion value,postoperative complication rate and individual costs.This study conducts a comparative analysis of these indicators. Results The three groups of operations were successfully completed;the bipolar electrocoagulation group and the ultrasonic equipment group have significant differences in the postoperative parathyroid hormone value,serum calcium ion value,and postoperative complication rate,and they were statistically significant(P< 0.05),the rest of the indicators were not statistically significant(P>0.05).Among them,the single cost of the bipolar electrocoagulation group is higher than that of the ultrasonic equipment group.The first two groups are compared with the electrosurgical equipment group and find that the operation time,intraoperative blood loss,and postoperative Drainage time,total drainage volume,postoperative parathyroid hormone value,serum calcium ion value,and complication rate are all lower than those in the electrosurgical group,the difference was statistically significant(P<0.05),and the individual cost is higher than that in the electrosurgical group. Conclusion All three groups of energy devices can successfully complete the operation and achieve the treatment goals.In the operation time,intraoperative blood loss,postoperative drainage time,total drainage,postoperative parathyroid hormone value,serum calcium ion value and complications In terms of efficiency,straight bipolar coagulation forceps and Focus ultrasonic scalpel have advantages in higher frequency electrosurgical units.In terms of economy,straight bipolar coagulation forceps are slightly higher than high frequency electrosurgicals,but they have obvious advantages over Focus ultrasonic scalpels.Straight bipolar coagulation forceps has an absolute advantage in fine anatomy.

Objective To explore the independent risk factors of metastatic colorectal cancer(mCRC) combined with digestive tract perforation(DTP),and to construct the prediction model.Methods A total of 171 patients with mCRC treated in the hospital were enrolled between April 2018 and October 2021.According to presence or absence of DTP,they were divided into perforation group and non-perforation group.The data of patients were collected,including gender,age,types of primary tumors,history of smoking and drinking,diabetes mellitus,RAS/RAF status,colonoscopy,intestinal obstruction,anemia,diverticulum and usage of vascular endothelial growth factor(VEGF) inhibitors.The risk factors of mCRC combined with DTP were analyzed.The risk prediction model was constructed,and its predictive efficiency was analyzed. Results In the 171 patients with mCRC,there were 33 cases with DTP and 138 cases without,and the incidence of perforation was 19.30%.Colonoscopy,intestinal obstruction and usage of VEGF inhibitors were independent risk factors of mCRC combined with DTP(P＜0.05).The expression of risk prediction model was as follow:P=1/[1+e(-3.374+1.521×(colonoscopy)+1.418×(intestinal obstruction)+1.872×(usage of VEGF inhibitors)].The results of Hosmer-Lemeshow test were as follows:χ2=2.267,P=0.894.AUC and 95%CI of the model for predicting DTP were 0.734 and 0.724-0.859,showing good fit and predictive efficiency.Conclusion Multivariate Logistic regression model can better predict the occurrence of mCRC combined with DTP.Clinically,close attentions can be given for mCRC patients with aged ≥ 60 years,colonoscopy,intestinal obstruction and usage of VEGF inhibitors.

Objective To explore diagnostic strategies and treatment options for gastrointestinal bleeding after aortic dissection surgery.Methods The clinical data and diagnosis and treatment results of patients with gastrointestinal bleeding after aortic dissection surgery admitted from January 2020 to June 2022 in the Affiliated Nanjing Hospital of Nanjing Medical University were analyzed retrospectively.Results A total of 10 cases of 14 patients with gastrointestinal bleeding after aortic dissection surgery were cured,7 cases were mainly based on basic support and drug therapy,1 case was treated with endoscopic therapy,and 2 cases were treated with surgical operations;In the untreated group,3 cases were basic support and medication,and 1 case died due to poor surgical treatment.Conclusion The diagnosis and treatment strategy of gastrointestinal bleeding after aortic dissection surgery should be comprehensively evaluated according to the amount,location and complications of bleeding,and the individualized treatment of patients should be strengthened.Timely surgical treatment is helpful to improve the prognosis and outcome of patients with gastrointestinal bleeding after aortic dissection surgery.

Objective To explore the feasibility of improving the indwelling technique of drainage tube orifice after single-port thoracoscopic lung cancer surgery and analysis of drainage effect.Methods The clinical data of 80 patients who underwent single-port thoracoscopic radical resection of lung cancer who were admitted to Ningbo Huamei Hospital,University of Chinese Academy of Sciences from January to December 2021 were retrospectively analyzed,and they were divided into observation group and control group according to the different drainage tube indwelling techniques.Postoperative drainage tube indwelling time,postoperative hospital stay,postoperative total drainage volume,intraoperative blood loss,operative time,incision infection,postoperative pain score,and drainage port healing.Results The postoperative incision exudation,poor incision healing,incision infection,drainage tube indwelling time,and postoperative hospital stay in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the total drainage volume,intraoperative blood loss,operation time,and secondary suture rate of the incision(P>0.05).Conclusion The single-port thoracoscopic surgery is beneficial to reduce the incidence of postoperative incision infection and incision exudation,shorten the indwelling time of the drainage tube,improve the safety of extubation,and shorten the hospitalization of patients.time.

Pancreatic cancer is a highly malignant tumor of the digestive system with poor prognosis.Due to the lack of effective early screening and diagnosis methods,the majority of patients with pancreatic cancer present with locally advanced or metastatic disease at diagnosis.For advanced pancreatic cancer,the major treatment strategy is still chemotherapy-based comprehensive treatment.The development of immunotherapy and targeted therapy gives us cause for optimism in our pursuit of better treatment.This article reviewed the advances in immunotherapy and targeted therapy of advanced pancreatic cancer.

Objective   To compare the efficacy of three different surgical methods in the treatment of common bile duct stones after cholecystectomy:open common bile duct exploration (OCBDE),endoscopic retrograde cholangiopancreatography and papillary sphincterotomy (ERCP/EST),and laparoscopic common bile duct exploration (LCBDE). Methods   The clinical data of 109 cases of recurrent choledocholithiasis after cholecystectomy treated in our hospital from July 2016 to July 2020 were analyzed retrospectively.Among them,33 cases were ERCP,40 cases were OCBDE group,and 36 cases were LCBDE.The influence of confounding factors among the groups was balanced by the tendentious score matching method (PSM),and the clinical efficacy and complications of the three groups after matching were compared.  Results   28 patients were included in each group by PSM method,and the baseline data of the three groups were not statistically significant(P>0.05).No statistical difference was found in the success rate of operation and stone clearance rate among three groups (P>0.05).The specific amount of bleeding,specific duration of operation,specific duration of anal exhaust and specific duration of hospitalization after operation in ERCP group were lower/shorter than those in OCBSE group and LCBDE group,with obvious difference (P<0.05),while the specific amount of bleeding,specific duration of operation,specific duration of anal exhaust and specific duration of hospitalization after operation in LCBDE group were lower/shorter than those in OCBSE group,with obvious difference (P<0.05).The incidence rate of perioperative complications of ERCP group showed no obvious difference with that of other 2 groups (P>0.05),while the incidence rate of postoperative complications in LCBDE group was lower than that in OCBDE group,with statistical difference (P<0.05).Postoperative follow-up showed that the recurrence rate of common bile duct stones in ERCP group was higher than OCBDE and LCBDE groups,with statistical difference (P<0.05),while the recurrence rate yielded no statistical difference between OCBDE group and LCBDE group (P>0.05). Conclusion   ERCP,OCBDE and LCBDE can effectively remove common bile duct stones after gallbladder surgery.ERCP surgery is less traumatic,but it is prone to severe complications such as acute pancreatitis and hyperamylasemia after surgery,and the residual rate of stones after surgery is high.LCBDE has the advantage of micro-invasive surgery than OCBDE,but it is not suitable for patients with severe abdominal adhesion.It is recommended that the operator select an appropriate surgical method according to the specific situation of the patient.

Hepatocellular carcinoma (HCC) is a common malignant tumor.Patients often lose the opportunity for surgery because of the middle and late stage when they are diagnosed,and the prognosis is extremely poor.In recent years,anti-PD immunotherapy has made a breakthrough in the treatment of advanced liver cancer.Immunotherapy has achieved good results in some patients,but there are still many patients with poor response to immunotherapy.Therefore,there is an urgent need to find clinical or biological indicators that can be used to predict the efficacy of immunotherapy in order to maximize clinical benefits while avoiding adverse effects.This article aims to summarize the relevant indicators and potential predictive mechanisms that can be used to predict the efficacy of liver cancer immunotherapy,so as to provide help for guiding clinical treatment.