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.

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 analyze the characteristics of gastrointestinal pancreatic neuroendocrine neoplasm(GEP-NENs) and the risk factors that affect the prognosis of patients. Methods The clinical data and 36 month follow-up data of 108 patients with GEP-NENs who were hospitalized in the First Affiliated Hospital of Air Force Military Medical University from January 2009 to December 2016 were collected.Analyze its clinical characteristics,pathological characteristics and other indicators.Univariate and multivariate Cox regression models were used to study the prognostic factors affecting survival,and Kaplan-Meier method was used for survival analysis. Results The ratio of male to female was 1.16∶1,and the average age was (50.90±12.94) years.The predominant sites were pancreas,rectum,and stomach.The tumor diameter ranged from 0.2cm to 13.2cm,with a mean of (1.90±1.94)cm.Pathological classification:neuroendocrine tumor accounted for 88.9% and neuroendocrine carcinoma 11.1%.Pathological grade:G1 grade accounted for 52.8%,G2 grade accounted for 36.1%,and G3 grade accounted for 11.1%.Among them,95.4% of patients underwent surgical treatment,and 69.9% underwent radical surgical resection.The 3year overall survival rate was 87.1%.Univariate analysis of pathological type,grade,clinical stage,nonfunctional tumor,tumor diameter,Ki67 index,lymph node metastasis and distant metastasis are important factors affecting the prognosis of GEP-NENs patients(P＜0.05).Multivariate analysis showed that tumor size and lymph node metastasis were independent risk factors affecting the prognosis of patients with GEP-NENs.Conclusion The prognosis of patients with GEP-NENs is related to pathological type,grade,clinical stage,non-functional tumor,tumor diameter,Ki-67 index,lymph node metastasis and distant metastasis.Tumor size and lymph node metastasis are independent risk factors that affect the prognosis of patients.

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 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.