To investigate the quantitative evaluation and subjective analysis of multiplexed sensitivity-encoding diffusion weighted imaging (MUSE-DWI) versus single-shot echo-planar diffusion weighted imaging (SS-DWI) in prostate cancer (PCa).

MUSE-DWI and SS-DWI images of 146 pathologically confirmed PCa patients in the Third Affiliated Hospital of Sun Yat-sen University was performed to quantify the signal to noise ratio (SNR), contrast signal to noise ratio (CNR), apparent diffusion coefficient (ADC) and subjective evaluation of the two sequences were quantitatively analyzed retrospectively.

The SNR and CNR of MUSE-DWI were significantly higher than those of SS-DWI (38±13) vs (18±7), (43±24) vs (18±7), the differences were statistically significant (P<0.001); the ADC values of MUSE-DWI and SS-DWI were (0.75 ±0.14) vs (0.74±0.13), respectively, P=0.020. The subjective scores were in high agreement between the two physicians, with kappa values of 0.764 (MUSE-DWI) and 0.691 (SS-DWI), respectively. Total MUSE-DWI image scores (229.0±5.7) were higher than SS-DWI (127.0±5.2); MUSE-DWI image scores were higher than SS-DWI [(3.7±3.4) vs (2.1±1.0), P<0.05].

Compared with SS-DWI, MUSE-DWI has clearer images, higher SNR and CNR for detecting PCa, and higher subjective physician scores, which are valuable to assist clinical diagnosis and treatment of PCa.

To investigate the feasibility and effectiveness of the mpMRI-TRUS-guided cognitive fusion targeted prostate biopsies combined with systematic biopsies in the diagnosis of prostate carcinoma.

A prospective and randomized study of 111 patients who underwent prostate biopsy for the first time in Yangjiang People's Hospital from March 2020 to March 2022 randomly assigned into two groups, with 56 cases in observation group and 55 cases in control group. The observation group adopted mpMRI-TRUS-guided cognitive fusion targeted prostate biopsies combined with systematic biopsies, whereas the control group performed 12-needle systematic biopsies. The differences of overall puncture positive rate, the detection rate of clinically significant prostate cancer, the rate of missed diagnosis, the positive rate of single core, the tumor tissue length of specimen, the tumor proportion of specimen, postoperative complications and the cases of pathological upgrading after secondary puncture, transurethral enucleation or radical resection were compared between the two groups.

There were no significant differences in age, the positive rate of digital rectal examination,prostate volume, prostate-specific antigen (PSA), the cores of biopsies, PI-RADS scores and postoperative complications between the two groups. However, in the observation group, the overall puncture positive rate (50.0% vs 27.3%, P=0.014), the detection rate of clinically significant prostate cancer (50.0% vs 25.5%, P=0.008) and the positive rate of single core (26.8% vs 16.0%, P<0.001) was significantly higher than the control group. Moreover, the observation group showed longer tumor tissue length of specimen [(8±4) mm vs (4±3) mm, P=0.001], higher tumor proportion of specimen [(64.5±20.7)% vs (40.0±23.8)%, P=0.002], lower missed diagnosis rate (0% vs 25.0%, P=0.021), and less pathological upgrading cases after secondary puncture, transurethral enucleation or radical resection (0 vs 8, P=0.009).

The mpMRI-TRUS-guided cognitive fusion targeted prostate biopsies combined with systematic biopsies can significantly improve the overall puncture positive rate and the detection rate of clinically significant prostate cancer, reduce the rate of missed diagnosis and the cases of pathological upgrading after secondary puncture, enucleation or radical resection, while the operation is simple, convenient, safe and suitable for clinical promotion.

To investigate the feasibility of thulium laser bladder tumor resection using cystoscopy under local anesthesia (urethral mucosal anesthesia) or no anesthesia in elderly patients with high risk of anesthesia, and to find an appropriate and effective treatment method for these special patients.

Between June 2020 and January 2022, 12 elderly patients in the Second Hospital of Tianjin Medical University with bladder cancer accompanied with severe comorbidity underwent thulium laser transurethral resection of bladder tumor using a flexible cystoscope under local anaesthesia. Preoperative assessment of intraoperative and post-operative risk using anesthesia classification standard, Essen stroke risk scale, exercise tolerance, revised cardiac risk index and cardiac complication rate, and crude prediction of post-operative recovery and surgical value using Karnofsky performance functional status scale, age-adjusted charlson comorbidity index score and the frailty screening scale, the status of patients were assessed immediately after surgery. Patients were assessed for tolerance by the numerical rating scale immediately intraoperatively, while the data of the duration of urinary catheter retention, postoperative hospital stay and complications were collected postoperatively. The patients were followed to January 2023 or disease recurrence.

All patients had no intraoperative obturator nerve reflexes or bladder perforationm, no persistent bladder bleeding or bladder tamponade postoperatively. Immediate pain scores ranged from 0-7 with a mdian of 2. All patients tolerated the procedure with less pain, the median duration of postoperative urethral catheterization was 2 days. The median postoperative hospital stay was 2 days. Twelve patients were followed up regularly with a follow-up period of 3-19 months; one patient was lost, one patient recurred 5 months after surgery and one patient recurred 13 months after surgery.

It's a relatively safe and effective way of treating high-risk patients with bladder cancer who are at high risk of anaesthesia by ThuLRBT under local anaesthetic using a flexible cystoscope, with few complications, good patient tolerance and satisfactory recent outcomes.

To explore the application value of 3D reconstruction imaging based on CT images in laparoscopic adrenalectomy for large adrenal tumors.

A retrospective analysis was performed on 12 patients with large adrenal tumor from June 2019 to August 2021 in Inner Mongolia Autonomous Region People's Hospital. The mean age of patients was (46±14) years old, and the median tumor diameter was 7.40(6.72, 8.27) cm. All patients underwent post-analysis and 3D reconstruction according to enhanced CT medical 3D image data processing software. After preoperative preparation, laparoscopic retroperitoneal resection was performed in 9 cases and laparoscopic transperitoneal resection in 3 cases.

12 cases of tumors were found to be located in retroperitoneum during operation, including 3 cases on the left side and 9 cases on the right side. The spiral CT 3D imaging was consistent with the intraoperative situation. All 12 patients underwent operation, the mean operative time was (168±19) min, the median intraoperative blood loss was 105(80, 167) ml, no accessory injury of important organs or large vessels, and no conversion to open surgery.

For large retroperitoneal tumors, spiral CT 3D imaging can make surgeons fully understand the relationship between tumors and surrounding organs and blood vessels, reduce intraoperative bleeding and accessory injury, improve the success rate of laparoscopic resection and the safety of surgery.

To compare the safety and effect of breaststroke position and traditional prone position of percutaneous nephrolithotomy (PCNL) in the treatment of upper urinary tract calculi.

The clinical data of 147 patients with renal calculi or upper ureteral calculi who underwent PCNL surgery in the Fifth Affiliated Hospital of Sun Yat-sen University from June 2019 to June 2020 were analyzed retrospectively. According to the different surgical positions during the operation, the patients were divided into the breaststroke position group and the traditional prone position group. The distance from the lower edge of the left twelfth rib to the lowest edge of the kidney, the distance from the back of the waist to the posterior edge of the kidney, the time to establish the channel, the operation time, the rate of multi-channel, the incidence of complications and the stone removal rate were compared between the two groups.

Compared with the traditional position group, in the breaststroke position group, the distance from the lower edge of the 12th rib to the lowest edge of the kidney was longer (P=0.006), the distance from the body surface of the back of the waist to the plane of the posterior edge of the kidney was shorter (P=0.020), the time to establish the channel was shorter (P<0.001), the operation time was shorter (P=0.031), and the rate of multi-channel was lower (P=0.027). There were no significant differences in stone clearance rate (P=0.751), complication rate (P=0.109), and total length of hospital stay (P=0.188) between the two groups.

In the treatment of upper urinary tract calculi, the breaststroke position can improve the efficiency of PCNL.

To investigate the safety, practicability and effectiveness of CT and B-ultrasound pre-positioning "three-step" percutaneous nephrolithotomy (PCNL) for the treatment of upper urinary tract calculi.

From March 2018 to March 2022, the data of 210 renal calculi and 138 upper ureteral calculi diagnosed in Loudi Central Hospital were retrospectively analyzed. Among them, 164 sides of the study group were operated with "three-step" PCNL with prone position CT and B ultrasonic pre-positioning. In the control group, 184 sides were operated with traditional PCNL in prone position only by manual black and white ultrasound (convex array probe 3.5 MHz) guiding the position.

Two patients in the study group experienced postoperative fever and improved after conservative treatment. In the control group, 6 cases experienced postoperative fever, 1 case established a channel through the spleen, and 11 cases established a channel through the pleura, all of which improved after conservative treatment. There were 26 cases of postoperative bleeding, of which 23 cases improved after conservative treatment such as clamping renal fistulas, 2 cases of massive bleeding were treated with superselective embolization, and 1 case was changed to open nephrectomy for hemostasis. The puncture time for the two groups of surgeries was 3 (3.0, 5.0) min and 8 (7.5, 10.0) min, respectively. The success rates of one-time puncture were 98.2% and 82.1%, and the primary stone clearance rates were 97% and 71.7%, respectively. There were significant differences in puncture time, one-time puncture success rate, primary stone clearance rate, and postoperative complications indicators (P<0.05).

The "three-step" PCNL with CT and B-ultrasound pre-positioning is safer, more practical and more effective than the traditional PCNL in the treatment of upper urinary tract calculi, which can reduce the learning curve, improve the stone clearance rate and reduce the incidence of complications.

To explore the clinical safety and efficacy of 4.8 F visual micro-percutaneous nephrolithotomy for the treatment of renal microlithiasis of aircrew.

From March 2017 to September 2021, 4.8 F visual micro-percutaneous nephrolithotomy were performed to treat renal microlithiasis of 28 cases in Armed Police Forces Hospital of Henan, which underwent flexible ureteroscopy without success, it was difficult to place the guide sheath because of ureteral stricture in 19 cases, or no stones were found in 9 cases. Then, retrograde surgical method was perfromed and patients were placed in lithotomy position, then turned to the prone position to complete the operation.

All 28 cases were operated successfully in one stage. Mean operative time was (18.5±6.5) min. Hemoglobin decreased by 1.2-3.5 g/L, with an average of (2.6±0.5) g/L, 2 hours after operation. One patient had postoperative severe gross hematuria, after expectant treatment the patient got better. Followed up 3 days after operation, there was no serious complication such as pleural effusion, perirenal effusion or peripheral organ injury. All patients discharged average was (3.6±0.7) d after operation. Followed up 1 month after operation, the renal CT showed no residual stones. Followed up 3 and 6 month after operation, color Doppler ultrasonography showed no recurrence of stones.

4.8 F visual micro-percutaneous nephrolithotomy-treatment is safe and effective in the treatment of renal microlithiasis of aircrew, especially when flexible ureterosopic lithotripsy fails, it can be tried.

To contruct a core knowledge system for the training of specialized nurses in Urology and provide a reference for the training of specialized nurses in Urology.

Guided by improving the core competence of Urology specialized nurses, the draft of the core knowledge system for Urology specialized nurses training was drawn up, through literature review, group discussions, combined with development of pecialty, specialized nurses training experiences and other methods. The Delphi method was used to conduct 2 rounds of letter inquiries to 25 experts.

The questionnaire response rates in the 2 rounds of letter inquiries were 100% and 96% respectively. The arithmetic mean of the evaluation results of various indicators was 4.17-5.00. The full score frequency was 32% and 100%. The level sum was 100-125. The authority coefficient was 0.938 and 0.946. Expert opinion harmony coefficients were 0.182 and 0.209 respectively (P<0.001). The ultimately formed core knowledge system for urology specialized nurses training includes 7 first level indicators and 48 second level indicators. And it was applied to the third urology specialized nurses training. After the training, the total score of nurses' core abilities was (95.6±13.4), which was significantly improved compared to before the training (P<0.05)

The core knowledge system of Urology specialized nurses training constructed by Delphi method is scientific, authoritative, practical and effective. It can provide theoretical and practical basis for standardized and homogeneous training of Urology specialized nurses.

To explore the efficacy of photodynamic nanocarriers combined with si-P3H4 in the precise treatment of bladder tumors.

RT-qPCR and Western Blot were used to detect the expression of P3H4 mRNA and protein in EJ and T24 cell lines of bladder cancer after siRNA transfection. CCK8, scratch test and Transwell chamber were used to detect the effect of P3H4 knockdown on proliferation, migration and invasion of EJ and T24 bladder cancer cells. The polymer nanocarrier CH3-R9-cRGD was synthesized with amino resin as substrate, and the drug encapsulated si-P3H4 and photosensitizer Ce6 were transfected into bladder cancer cells (HCV29 cells) to detect the drug release in vitro under different pH and laser irradiation conditions. At the same time, the mechanism of targeted binding endocytosis of nano drugs and bladder cancer cells was explored, and the level of intracellular reactive oxygen species (ROS) was detected. Different groups of nanocomposites were transfected into bladder cancer cells, and the cell viability of each group was detected by CCK8 method. In vivo experiments were conducted to further explore of the tumor inhibitory ability of different groups of nanocomposites.

The P3H4mRNA expression levels in the EJ group and T24 group decreased to 68.4% and 57.1% of the control group, respectively, according to RT qPCR. Western blot showed that the expression of P3H4 protein in the EJ and T24 groups decreased to 20.3% and 36.5%, respectively, compared to the negative control group. The absorbance A value of CCK8 experiment was (0.785 ± 0.084) vs (1.358 ± 0.064) in the EJ group compared to the control group at 96 hours, t=12.06, P<0.01; Compared to the control group at 96 hours, the T24 group showed (0.833 ± 0.065) vs (1.346 ± 0.545), t=13.415, P<0.01. The cell healing rate in the scratch experiment was (47.8 ± 4.32)% in the EJ group compared to the control group, (68.60 ± 4.39)%, t=7.545, P<0.01; The T24 group compared to the control group was (50.40 ± 3.64)% vs (70.61 ± 3.85)%, t=8.521, P<0.01. Transwell cell penetration count: The EJ group had [(302.71±7.56) vs (130.42±3.95)] compared to the control group; t=53.40, P<0.01; T24 group [(99.56±4.50) vs (35.22±6.28)], t=24.974, P<0.01. The imaging results showed that the peptide nanocarrier had good permeability and could target si-P3H4 and Ce6 into bladder cancer cells at the same time. The CCK8 method detection results showed that when the concentration of the nanocomposite CH3-R9-cRGD&Ce6 is 50 μ At g/mL, the cell viability of the laser irradiated group was lower than that of the non laser irradiated group, and the cell viability of the nanoprobe+laser+siP3H4 group was the lowest (F=299.57, P<0.05). In vivo experiments had shown that nanocomposites/si-P3H4/laser have the most significant inhibitory effect on tumor cell enhancement.

Nanocarriers can simultaneously target si-P3H4 and Ce6 into bladder cancer cells to inhibit cell proliferation and achieve comprehensive treatment of bladder cancer. Photodynamics and gene therapy have complementary advantages in the field of bladder cancer treatment. The combination of the two can achieve synergistic enhancement of tumor treatment and can be applied to the treatment of bladder urothelial carcinoma.

To evaluate the safety and feasibility of using the EDGE SP1000 single-port surgical robot for laparoscopic partial ureterectomy with end-to-end anastomosis in a live pig model.

The EDGE SP1000 single-port robotic surgical system was used to perform laparoscopic partial ureterectomy with end-to-end anastomosis in pigs. Vital signs of the pigs were monitored during the surgery, and surgical difficulties and complications were recorded. The survival of the pigs was observed for two weeks post-operatively.

All pigs survived for two weeks after the surgery, with no surgical complications or technical difficulties encountered during the procedure. The average time for establishing the surgical access in five pigs was (15.0±1.2) min, while the installation time for the EDGE SP1000 single-port surgical robot system was also (5.6±0.6) min. The time for ureterectomy was (8.8±1.3) min, the time for end-to-end anastomosis of the ureter was (39.2±2.3) min, and the total surgical time was (89±5) min, and intraoperative blood loss was (1.20±0.24) mL. The surgical team highly praised the performance of the surgical system.

This study confirms that the EDGE SP1000 single-port robotic surgical system is safe and feasible for laparoscopic partial ureterectomy with end-to-end anastomosis in pigs. The next step is to evaluate the safety and effectiveness of the EDGE SP1000 system in other surgical procedures, providing more reliable preclinical data support.

To report the treatment of a peculiar morphology of prostatic hyperplasia nodule-the extra-vesicle median lobe during robot-assisted radical prostatectomy.

Among the 339 cases of RARP performed by a single operator between July 2022 and June 2023, 238 cases with preserved surgical videos were reviewed, focusing on the bladder neck dissection and its subsequent dorsal prostate detachment procedures, and a total of 8 patients with typical extravesical median lobes were screened out for reviewing in combination with the patient's preoperative multiparametric magnetic resonance imaging data. In this article, we would focus on the analysis of one of the cases.

The extra-vesicle median lobe was usually located behind the urethra, and its anatomical location and texture were close to the contralateral vas deferens and seminal vesicles. During robot-assisted radical prostatectomy (RARP), it potentially misled the surgeon into the wrong anatomical plane. Due to the modification of the surgical plane, the operation time would probably be prolonged, which might impact the surgical determination of the surgeon.

How to predict the existence of "the extra-vesicle median lobe" before and during operation and make timely adjustment of surgical strategies is a problem worth exploring by surgeons.

To explore the technical essentials of robot-assisted radical prostatectomy via posterior and completely intrafascial for organ-confined prostate cancer, and to evaluate the oncological and functional outcomes.

Fifteen prostate cancer patients with T_1-2bN₀M₀ were scheduled for robot-assisted radical prostatectomy via posterior and completely intrafascial approach, and their international index of erectile function (IIEF) were performed before operation. All patient was placed in a supine position and the robotic system was established. Firstly, expose the Douglas fossa, free bilateral vas deferens and seminal vesicles, blunt dissection of the Denonvillier fascia, severed lateral ligament and visceral pelvic fascia, then exposed and disconnected urethra, continuous suture bladder neck urethra. Perioperative complications and functional outcome data were recorded. All patients were regularly followed up for tPSA testing, daily urine pads and IIEF-5 scores.

All of the 15 patients were successfully completed the operations. The median (range) operation time was 86(65-116) min, and estimated blood loss was 20 (10-60) ml, and no serious complications occurred. Postoperative pathology was <pT_2c, Gleason score <8, no cases of positive surgical margins, and no biochemical recurrence (BCR) in postoperative follow-up. Catheter were removed after a median (range) time of 7(6-8) d, 13 patients were immediately continent (0 pads/d), and two patients had mild incontinence (2-3 pads/d). All patients were observed as continent within next two weeks. Nine patients achieved a satisfactory erection at 6 months postoperatively, with an IIEF-5 score >18.

Robot-assisted radical prostatectomy via posterior and completely intrafascial approach is technically feasible for patients with low-risk localized prostate cancer and demonstrates promising functional outcomes regarding continence and potency.

To investigate the composition characteristics and risk factors of renal stone in patients with abdominal aortic calcification (AAC).

From January 2021 to February 2022, 90 patients with AAC complicated with kidney stones in the First Hospital of Hebei Medical University were selected as the observation group, randomly selected patients with AAC without nephrolithiasis in the physical examination center during the same period as the control group (88 cases). The characteristics of stone composition in the observation group were analyzed, and the clinical data and biochemical indexes of the two groups were compared. Binary Logistic regression was used to analyze the independent risk factors of renal stone formation in patients with AAC.

The stones in the observation group were mainly composed of calcium oxalate stones in 22 cases (24.44%) and calcium oxalate+carbonated apatite in 30 cases (33.33%). Univariate analysis showed that in the observation group, the proportion of patients with male (P=0.033), hypertension (P<0.001), diabetes (P=0.004), smoking history (P=0.039), TC (P=0.038), LDL-C (P=0.023), blood uric acid (P=0.006) were significantly higher than those in the control group, and HDL-C was significantly lower than that in the control group(P=0.001). Logistic regression analysis showed that hypertension, low HDL-C, high LDL-C and hyperuricemia were independent risk factors for renal stone formation in patients with AAC (OR>1, P<0.05).

The main components of kidney stones in patients with AAC are calcium oxalate stones, calcium oxalate+carbonated apatite. Hypertension, low HDL-C, high LDL-C, and hyperuricemia are independent risk factors for the formation of kidney stones in patients with AAC. Potential risk factors should be screened early in clinical practice and relevant measures should be taken.