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.

When the elderly patients with hip fracture receive surgical treatment,they often face a high risk of unfavorable prognosis due to the influence of multiple complications,which reduces their quality of life and also brings certain economic burden to the society.Therefore,minimally invasive treatment techniques for elderly hip fracture have been developing to improve the prognosis of elderly hip fracture patients.Based on the epidemiology of elderly hip fracture and the results of domestic and foreign literature review and expert investigation,this consensus summarizes the classification,surgical path and rehabilitation measures of elderly hip fracture,to provide a reasonable and standard treatment plan for minimally invasive surgical treatment of elderly hip fracture.

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 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.

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.

Objective To explore the technique and clinical application of Fustar combined with disposable biopsy forceps in the recovery of inferior vena cava filter. Methods A retrospective analysis of 117 cases of the inferior vena cava filter recovered from December 2017 to December 2020 in Wangjing Hospital of the Chinese Academy of Chinese Medical Sciences.The Fustar combined with disposable biopsy forceps were used during the operation.The filter was successfully recovered and performed after the operation.Follow-up observation. Results In this study,117 cases of vena cava filters,including 103 cases of Aegisy filter,9 cases of Optease filter,and 5 cases of Günther Tulip filter,were successfully recovered using the Fustar combined with disposable biopsy forceps,and the recovery success rate was 100%.The operation time of grasping the filter under fluoroscopy It was 45 seconds to 12 minutes and 57 seconds,with an average of 2 minutes and 38 seconds.The angiography showed that the inferior vena cava blood flowed smoothly,and there was no extravasation of contrast agent.Observation and removal of the filter was normal,without deformation or damage.The patients were followed up for 1 to 36 months,with an average of 6 months,and there were no complications such as inferior vena cava stenosis or secondary thrombosis. Conclusion The Fustar combined with disposable biopsy forceps in the recovery of the inferior vena cava filter has the characteristics of simple operation,small trauma,accurate positioning,high recovery rate,and short operation time.It can be promoted as the preferred solution for recovery of vena cava filter.

The development of the popularity of chest CT has led to an increasing number of lung cancer patients being detected at an early stage.Early lung cancer is often presented in the form of small lung nodules on chest CT,and small lung nodules are often clinically wedge-shaped or pulmonary segment resection.Because small lung nodules are small in diameter and low in density,surgeons cannot determine whether the resection range is sufficient.With the development of science and technology,the technology of localization of small lung nodules has also been greatly developed,but the specific role of each method in lung cancer surgery is not clear.We review the clinically relevant studies such as computed tomography-guided percutaneous puncture localization technique,bronchoscopic assisted positioning technology,computed tomography virtual 3D assisted positioning technology and intraoperative anatomical localization technique and summary the application progress of various localization techniques in lung cancer surgery.

Objective To explore the clinical application and effect of an improved method of drainage tube fixation and incision suture after thoracoscopic surgery. Methods Between February 2020 and October 2020,202 patients who underwent video-assisted thoracic surgery in Department of Lung Cancer,Tianjin Medical University Cancer Institute and Hospital were enrolled in this study.All patients used an improved drainage tube fixation and incision suture method. Results All 202 patients have no obvious leakage.To a certain extent,this improved method can well improve the problem of easy leakage of thoracoscopic drainage nozzle after surgery,promote rapid wound healing,significantly reduce postoperative scar hyperplasia,and thus improve the incision aesthetics. Conclusion The improved method of drainage tube fixation and incision suture after thoracoscopic surgery has achieved satisfactory results in clinical practice.

晚期胃癌治疗选择有限，易发生化疗耐药。目前，包括免疫检查点抑制剂、过继细胞疗法、肿瘤疫苗、非特异免疫增强剂及细胞因子疗法在内的免疫疗法对胃癌显示出了良好的疗效。载体药物及3D打印技术也在临床前实验中取得了疗效。临床试验采用免疫肿瘤学单一疗法或联合免疫化学疗法来提高胃癌病人的总体生存时间和客观反应率。根据初步证据，我们相信免疫治疗可以积极影响自然病史，改善胃癌病人的预后。

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.

Glioma is the most common intracranial malignant tumor,among which glioblastoma is the most malignant and still incurable.The main reasons for its recurrence include high heterogeneity of tumor,invasive growth,resistance to existing treatments,etc.Many genetic changes promote the occurrence and malignant progression of glioma.At present,great progress has been made in the molecular research of glioma.Individualized and precise treatment for genetic changes may be the hope of curing glioma in the future,but the results of many basic trials and clinical studies are still not ideal.In this article,based on relevant literature,we reviewed the progress of molecular research and targeted therapy of glioma.

Objective To review the experience approaching middle mediastinal mass by surgery.Method  Clinical data of 9 patients with middle mediastinal mass who were treated in between 2018 to 2022 in Tongji hospital were retrospectively analyzed.8 cases underwent radical resection and 1 case underwent mediastinal tumor biopsy.5 mediastinal tumors were operated by video-assisted thoracoscopic surgery(VATS),and 4 cases required conversion thoracotomy. Result Histologic diagnosis was mediastinal cysts in 2 cases,Castleman disease in 1 case,metastatic lymphadenopathy in 1 case,neurogenic tumors in 3 cases(Schwannoma in 1 case,Neurofibroma in 1 case,and Paraganglioma in 1 case),angiolipoma in 1 case and undifferentiated malignant tumors in 1 case.All recovered and were discharged from hospital.Conclusion Surgical resection is an important treatment for mediastinal tumors. Surgical treatment should not only pursue the thoroughness of excision, but also pay attention to organ protection.

The onset of cholangiocarcinoma is insidious and the degree of malignancy is extremely high.Most of the patients are already in the advanced stage when they are first diagnosed and have lost the opportunity of radical surgery.The prognosis of patients is poor and the quality of life is low.Currently,the common treatment methods for unresectable cholangiocarcinoma include biliary stent,radiotherapy and chemotherapy,radiofrequency ablation,targeted therapy and immunotherapy,etc.However,due to the poor degree of malignancy of biliary duct tumor,radiotherapy and chemotherapy are not sensitive and prone to drug resistance,the existing treatment methods are limited in improving the survival time and quality of life of patients.Therefore,clinicians urgently need to explore new treatment strategies to overcome the current dilemma.Photodynamic therapy (PDT),as a new treatment for cholangiocarcinoma,has attracted attention due to its excellent local anti-tumor effect.In this paper,the research and development of photosensitizers,the molecular mechanism,and the clinical application of PDT in recent years are summarized.Combined with the corresponding clinical work carried out by the author's team,the spots and potential of PDT research are described,so as to provide references for clinical and scientific research.