Objective To investigate manifestations of connective tissue nevi (CTN) by dermoscopy and reflectance confocal miscroscopy (RCM),and to analyze its pathological features.Methods According to the course of the disease,skin lesions of a patient with CTN were classified into 2 categories:skin lesions of less than 1-year duration and those of more than 1-year duration,which were observed by dermoscopy and RCM,and analyzed by the combination with histopathological examination.Results Dermoscopy imaging of the CTN lesions of more than 1-year duration showed grey-white maculae with clear boundaries in the center of lesions.There were white network structures,brown globules,red spots and punctiform or comma-shaped blood vessels in the gray-white macula area,and vellus hairs and dermal papillary rings could be seen sometimes.The white macula was evenly surrounded by brown to black pigments,and the boundary was clear.For the lesions of less than 1-year duration,gray-white maculae with clear boundaries were also found in the center of the lesions.Besides,there were a few scattered brown to black pigments,vellus hairs and dermal papillary rings in the gray-white macula area.RCM imaging of the lesions of less than 1-year duration or early skin lesions showed dermal papillae of different sizes and shapes crowded with each other and formed a honeycomb or cobblestone-like structure.The density and brightness of the dermal papilla ring obviously increased,and the refraction of the dermal collagen fiber bundles was also enhanced.Some of the dermal collagen fiber bundles were attached to the dermal papilla or intertwined and arranged in a whirlpool pattern.For the lesions of more than 1-year duration,the refraction of the tissue structure was weakened when the depth in Z-axis direction reached 2 to 3 millimetres due to the thickened epidermis,while the dermal collagen fiber bundles were not obvious and only a few lymphocytes could be seen.Conclusions CTN has particular characteristics in dermoscopy,and there is a definite correspondence among dermoscopy features,histopathological findings and RCM features.RCM is helpful for the diagnosis of lesions of less than 1-year duration.

Objective:To explore the application and research progress of lasers in the treatment of kidney neoplasms through an integrated bibliometric and Meta-analysis study.Methods:On June 7th, 2024, an online search of the Web of Science Core Collection (WoSCC) and China National Knowledge Infrastructure (CNKI) databases for all relevant literature on lasers in kidney neoplasms was conducted. The retrieved results were subjected to a comprehensive bibliometric analysis. The high-quality studies were then screened to further describe the clinical characteristics of patients who underwent laser-assisted laparoscopic partial nephrectomy (LLPN). Subsequently, a Meta-analysis was performed using RevMan 5.4.1 software on further selected high-quality studies to compare the changes in renal function before and after LLPN treatment, and the differences in efficacy between LLPN and traditional laparoscopic partial nephrectomy (LPN).Results:Our study obtained a total of 549 publications on lasers in kidney neoplasms, including 513 in English and 36 in Chinese. Bibliometric analysis revealed an overall upward trend in the annual publications and citations in this field. China was found to be a leading contributor ranking second in total publications ( n=100, 18.2%). The primary application of laser treatment was in nephron-sparing surgery for kidney neoplasms, especially in LPN. We further screened 11 high-quality studies comprising 284 patients who underwent LLPN for kidney neoplasms. Comprehensive descriptive statistical analysis was performed on clinical characteristics of the 284 patients. All patients had T 1a stage tumors with a mean tumor length of 2.6 cm (range: 0.8-4.0 cm), all being local, solitary, and exophytic tumors. Further Meta-analysis indicated that there were no significant differences in renal function indicators including both serum creatinine levels ( MD=4.52, 95% CI-9.73-0.69, P = 0.09) and estimated glomerular filtration rate ( MD=3.05, 95% CI-1.03-7.13, P= 0.14) before and after LLPN. Additionally, compared to traditional LPN, LLPN showed significantly reduced operative time ( MD=-10.58, 95% CI= -13.11-8.06, P<0.001), but no significant differences in estimated blood loss ( MD= -27.09, 95% CI-67.38-13.21, P=0.19) and hospital stay ( MD=-1.59, 95% CI-3.42-0.25, P=0.09). Conclusions:The application of lasers in managing of kidney neoplasms is arousing increasing attention among urologists. LLPN offers several advantages, including precise cutting and effective hemostasis. This technique demonstrates considerable clinical value for patients with exophytic T 1a kidney neoplasms undergoing "zero-ischemia" nephron-sparing surgery.