Objective: To explore the clinical safety and efficacy of a single-position robot-assisted radical nephroureterectomy (RRUN) in the treatment of upper tract urothelial carcinoma (UTUC). Methods: A retrospective study was conducted on 136 UTUC patients who underwent RRUN (n=35) and laparoscopic radical nephroureterectomy (LRUN，n=101) in our hospital during Dec.2020 and Aug.2023.The perioperative and safety indicators of the two groups were compared.The intravesical recurrence-free survival (IVRFS)，recurrence-free survival (RFS)，and overall survival (OS) of the two groups were compared using Kaplan-Meier method. Results: There were no significant differences in the baseline data between the two groups (P>0.05).All surgeries were successfully completed without conversion to open surgery.RRUN demonstrated superior perioperative outcomes compared to LRUN in overall postoperative complication rate [37.1%(13/35) vs. 56.4%(57/101)]，postoperative hospital stay [6(5,7) days vs. 7(6,8) days]，and catheter indwelling time [3(2，4) days vs. 4(3，5) days]，with statistically significant differences (P<0.05).Safety indicators of both surgical approaches were similar (P>0.05).Survival analysis showed no significant difference in oncological outcomes between the two groups [IVRFS (1 year：92.1%，2 years：85.2%)，RFS (1 year:82.4%，2 years:74.9%)，OS (1 year:90.6%，2 years:84.2%)] (P>0.05). Conclusion: Compared with retroperitoneal LRUN，single-position RRUN for UTUC demonstrates comparable safety and oncological efficacy，while offering significant advantages in perioperative outcomes such as reducing postoperative complication rate and shortening hospital stay.

Radical prostatectomy (RP) is the main therapeutic method for early localized prostate cancer.With the advancement of technology，robot-assisted radical prostatectomy (RARP) is widely applied，which can enable better achievement of the “five wins”, including long-term tumor control，recovery of urinary control，negative surgical margins，preservation of erectile function，and reduced postoperative complications，thereby improving the treatment efficacy.This paper reviews the various surgical approaches (transabdominal，transperitoneal，transvesical，transperineal，single-hole)，current status of optional surgical equipment (da Vinci surgical robot，domestic robot)，and advantages and limitations of RARP，so as to provide reference for clinicians in choosing the optimal surgical method for prostate cancer.

Objective To investigate the differences in human epidermal factor receptor 2(HER-2)expression between urothelial bladder carcinoma(UBC)and upper tract urothelial carcinoma(UTUC)and the relationship between HER-2 expression and disease recurrence and progression.Methods Clinical data of 184 patients with urothelial carcinoma admitted in our hospital during Nov.2015 and Jun.2022 were retrospectively analyzed.The patients were divided into UBC group and UTUC group.The positive expression rate of HER-2,recurrence-free survival(RFS)and progression-free survival(PFS)of the two groups were compared,and the survival curve was drawn.The effects of HER-2 expression on the recurrence and progression of disease were analyzed with Cox proportional hazards model.Results The positive expression of HER-2 was significantly higher in UBC patients than in UTUC patients(49.6％vs.32.2％,P=0.027).Among UTUC patients,there was no statistically significant difference in the positive expression of HER-2 in those with renal pelvis cancer and ureteral cancer(30.6％vs.34.8％,P＞0.05).Cox analysis showed that HER-2 positive expression affected UBC recurrence(P＜0.001),but had no effects on the recurrence and progression of UTUC;HER-2 positive expression(P＜0.001),tumor diameter ≥3 cm(P＜0.001),stage ≥T2(P=0.003)and multiple tumor foci(P=0.033)affected the progression of UBC.Conclusion The positive expression of HER-2 is significantly higher in UBC than in UTUC,which can increase the risk of recurrence and progression of UBC,but has no significant effects on the recurrence and progression of UTUC.HER-2 expression is not recommended to independently predict the risk of recurrence and progression of UTUC.

Objective To explore the public attitude towards kidney xenotransplantation in China by constructing and validating the prediction model based on xenotransplantation questionnaire. Methods A convenient sampling survey was conducted among the public in China with the platform of Wenjuanxing to analyze public acceptance of kidney xenotransplantation and influencing factors. Using random distribution method, all included questionnaires (n=2 280) were divided into the training and validation sets according to a ratio of 7:3. A prediction model was constructed and validated. Results A total of 2 280 questionnaires were included. The public acceptance rate of xenotransplantation was 71.3%. Multivariate analysis showed that gender, marital status, resident area, medical insurance coverage, religious belief, vegetarianism, awareness of kidney xenotransplantation and whether on the waiting list for kidney transplantation were the independent influencing factors for public acceptance of kidney xenotransplantation (all P<0.05). The area under the curve (AUC) of receiver operating characteristic (ROC) of the prediction model in the training set was 0.773, and 0.785 in the validation set. The calibration curves in the training and validation sets indicated that the prediction models yielded good prediction value. Decision curve analysis (DCA) suggested that the prediction efficiency of the model was high. Conclusions In China, public acceptance of kidney xenotransplantation is relatively high, whereas it remains to be significantly enhanced. The prediction model based on questionnaire survey has favorable prediction efficiency, which provides reference for subsequent research.

Objective To analyze the research progress and development trend of xenotransplantation in China.Methods Literatures related to xenotransplantation in Chinese and English were searched from CNKI and Web of Science Core Collection databases from January 1,2014 to December 31,2023.Visualization analysis of the research progress,hot topics and research frontiers in this field was performed by CiteSpace software and R language from the aspects of number of publications,keywords,distribution of journal origin,core author cooperation network,main research institutions,and citation of key literatures,etc.Results Chinese scholars published 684 articles in Chinese and 624 articles in English,ranking 2nd worldwide.The top 3 Chinese journals regarding the number of publications were Organ Transplantation,Practical Journal of Organ Transplantation(Electronic Version)and Acta Laboratorium Animalis Scientia Sinica.The top 3 English journals were Xenotransplantation,Frontiers in Immunology and Scientific Reports.The top 5 authors regarding the number of publications in Chinese were Pan Dengke,Cai Zhiming,Mou Lisha,Li Xiao and Dou Kefeng.The top 5 authors regarding the number of publications in English were Mou Lisha,Cai Zhiming,Dai Yifan,Wang Yi and Pan Dengke.High-frequency Chinese keywords included xenotransplantation,immune rejection,transplantation,xenogenic,animal model,xenogeneic bone,liver transplantation,gene editing,kidney transplantation,burn and bone transplantation.High-frequency English keywords were expression,xenotransplantation,cells,transplantation and survival.Conclusions In recent years,certain research achievement and global influence have been obtained in the field of xenotransplantation in China,involving a variety of disciplines and a wide range of research contents.However,cooperation among different institutions is still lacking.In the future,cross-regional and interdisciplinary communication and cooperation should be prompted.Resource sharing and integration should be strengthened to maintain rapid and steady advancement in this field.

Objective To investigate the establishment of a six-gene-edited pig-to-non-human primate kidney xenotransplantation model. Methods The kidney of humanized genetically-edited pig (GTKO/β4GalNT2KO/CMAHKO/hCD55/hCD46/hTBM) was transplanted into a cynomolgus monkey. The survival of the recipient and kidney condition after blood perfusion were observed. The parenchymal echo, blood flow changes, and size of the kidney were monitored on a regular basis. Routine blood test, kidney function test and electrolyte assessment were carried out. Dynamic changes of urine, feces and body mass were monitored. At the end of life, the transplant kidney, heart, liver, spleen, lung, and cecum were collected for pathological examination. Results The recipient died at postoperative 7 d. After blood flow was restored, the kidney was properly perfused, the organ was soft and the color was normal. At the end of the recipient's life, a slight amount of purulent secretion was attached to the ventral side of the kidney, with evident congestion and swelling, showing the appearance of "red kidney". Postoperatively, the echo of renal parenchyma was increased, blood flow was decreased, the cortex was gradually thickened, and a slight amount of effusion surrounded the kidney and abdominal cavity over time. In the recipient, the amount of peripheral red blood cells, hemoglobin, albumin, and platelets was progressively decreased, and serum creatinine level was increased to 308 μmol/L at postoperative 7 d, whereas the K⁺ concentration did not significantly change. Light yellow urine was discharged immediately after surgery, diet and drinking water were resumed within postoperative 3 h, and light yellow and normal-shape stool was discharged. The reddish urine was gradually restored to normal color within postoperative 1 d, which were consistent with the results of the routine urine test. A large amount of brown bloody stool was discharged twice in the morning of 2 d after surgery. Omeprazole was given for acid suppression, and the stool returned to normal at postoperative 4 d. The β₂-microglobulin level was increased to 0.75 mg/L at postoperative 7 d. The body mass was increased by 1.7 kg. Autopsy pathological examination showed interstitial edema and bleeding of the transplant kidney, a large amount of infiltration of lymphocytes and macrophages, infiltration of lymphocytes in the arteriole wall and arterial cavity, accompanied by arteritis changes, lymphocyte infiltration in the cecal stroma and congestion in the spleen tissues. No significant abnormal changes were observed in other organs. Conclusions The humanized genetically-edited pig-to-non-human primate kidney xenotransplantation model is successfully established, and postoperative survival of the recipient is 1 week.

【Objective】 To investigate the effects of preoperative ureteroscopy (URS) on the intravesical recurrence (IVR) in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). 【Methods】 The clinical data of 241 UTUC patients treated during May 2012 and Jan.2020 in the Second Hospital of Laozhou University were retrospectively analyzed. The patients were divided into URS before RNU group (URS group) and non-URS before RNU group (non-URS group). The cumulative IVR rate, progression-free survival (PFS) and overall survival (OS) after RNU were compared, and the survival curve was drawn. Cox proportional hazards models were used to assess risk factors affecting IVR. 【Results】 Of the 241 patients, 64 (26.6%) were included in the URS group and 177 (73.4%) in the non-URS group. In the URS group, 49 underwent biopsy and 15 did not. All patients were followed up for a median of 44 (3 to 122) months, with a median time to recurrence of 12 (3 to 56) months. IVR occurred in 18 patients (28.1%) in the URS group and 25 (14.1%) in the non-URS group. Kaplan-Meier survival analysis showed that the cumulative IVR rate was higher in the URS group than in the non-URS group (all P<0.05), regardless of whether patients had a history of bladder cancer (BC) or not, while PFS was lower in the URS group than in the non-URS group (P=0.007). Cox multivariate regression analysis showed that URS (P=0.031) and complicated renal pelvis tumor and ureteral tumor (P=0.004) were independent risk factors for IVR. 【Conclusion】 Preoperative URS increases the incidence of IVR in patients with UTUC, and routine preoperative use of URS is not recommended.

Ureteroscopy plays an important role in the diagnosis and treatment of upper tract urothelial carcinoma (UTUC). Conventional ureteroscopy (URS) can not only identify the location, appearance and size of a tumor, but also assess tumor grade by biopsy. The continued development of electronic flexible ureteroscopy and assistive technologies has led to further advances in the diagnosis of UTUC. Ureteroscopic laser ablation can be used to treat low grade malignancy, renal insufficiency, or isolated kidney. However, the use of URS may have potential risks such as delay of radical treatment, increased surgical difficulty, intraoperative or postoperative complications and intravesical recurrence. This article reviews the advantages and disadvantages of ureteroscopy in the diagnosis and treatment of UTUC.

Familial pheochromocytoma belongs to autosomal dominant inheritance, and has complex and variable clinical manifestations. A child with bilateral PHEO was admitted to our hospital. His grandmother, father and brother were all diagnosed with PHEO, and his aunt was diagnosed with paraganglioma. The child underwent laparoscopic left partial adrenalectomy and open surgery for the contralateral tumor, and was in good postoperative condition. The blood pressure returned to normal and there was no local recurrence and metastasis during the follow-up of 8 months after the second operation.

Objective:To investigate the efficacy and safety of black tomato concentrated sauce in the treatment of benign prostatic hyperplasia(BPH) with lower urinary tract symptoms(LUTS).Methods:An open, randomized and controlled trial was conducted, and 150 BPH patients with LUTS were randomly assigned to three groups: experimental group(60 cases), placebo group (45 cases) and positive control group(45 cases) in the Department of Urology, Lanzhou University Second Hospital from December 2018 to September 2020.Inclusion criteria: age≥50 years old; first diagnosis of BPH, or interrupted medical treatment of BPH for more than 1 month; maximum urinary flow rate (Q max) <15ml/s; prostate volume (PV)≥20ml; IPSS≥8, QOL≥2. Exclusion criteria: lower urinary tract obstruction not caused by BPH, post-void residual urine volume(PVR) >250 ml; history of acute urinary retention in the last 3 months; prostate nodules and suspected prostate cancer were revealed by digital rectal examination and transrectal B-ultrasoundor; prostate-specific antigen (PSA)≥10 ng/ml; neurogenic bladder, perivous history of bladder, prostate, or urethra operations; suffering from serious heart, lung, liver, kidney and other diseases. The patients in the experimental group were orally treated with black tomato concentrated sauce(30 g/once, 3 times/day). The patients in the placebo group were orally administrated with placebo. In the positive control group, the patients with PV≤30ml were orally treated with tamsulosin(0.2mg/once, 1 time/day), the patients with PV>30ml were orally administrated with tamsulosin and finasteride(5 mg/once, 1 time/day). All enrolled patients were treated for 3 months. At the end of third month, the IPSS, QOL, PV, PVR, Q max, average urinary flow rate(Q ave), total PSA(tPSA), free PSA (fPSA), testosterone(TST) and the incidence of adverse reaction were assessed. Results:128 of 150 cases, including 52 cases in experimental group, 36 cases in placebo group and 40 cases in positive control group, completed the study, the rest was excluded due to not take medication regularly and fail to follow-up. There were no significant differences in baseline parameters among experimental group, placebo group and positive control group ( P>0.05) in age[(63.21±8.61) vs.(62.36±6.32) vs. (63.94±7.78)years old], body mass index[(23.74±3.17) vs. (23.94±3.09) vs. (24.26±2.91)kg/m 2], IPSS[(17.5±6.6) vs. (15.4±5.8) vs. (17.9±6.8)], QOL[4.0(3.0, 4.0) vs. 4.0(3.0, 4.5) vs. 4.0(3.0, 5.0)], Q max [(8.60±3.04) vs. (9.13±2.92) vs. (9.58±3.26) ml/s], Q ave[(4.39±1.69) vs. (4.66±1.76) vs. (4.88±1.60)ml/s], PV [32.00(25.55, 45.40)vs. 30.00(24.45, 38.35)vs. 34.80(27.65, 56.65)ml], PVR[23.50(8.25, 45.75) vs.5.50(0, 47.75) vs. 29.00(0, 84.00)ml], tPSA [1.53(0.89, 3.00) vs. 1.23(0.69, 1.98) vs. 2.23(0.90, 4.15)ng/ml], fPSA [0.37(0.28, 0.76) vs. 0.37(0.22, 0.52) vs. 0.54(0.30, 0.97) ng/ml] and TST[(443.64±156.32) vs. (493.97±176.16) vs. (450.89±135.08)ng/dl]. After 3 months of treatment, the IPSS in experimental group was(9.9±5.7), QOL score 2.0(2.0, 3.0), Q max(11.78±5.24)ml/s, Q ave(5.86±3.00)ml/s, tPSA 1.64(0.96, 3.32)ng/ml and TST (475.91±177.33)ng/dl, which were significantly different compared with pre-treatment( P<0.05). In positive control group, IPSS was (9.0±6.2), QOL 2.0(2.0, 3.0), Q max(11.73±4.50)ml/s, Q ave(6.11±2.53)ml/s, tPSA 1.57(0.80, 3.09)ng/ml, fPSA 0.37(0.24, 0.63)ng/ml and TST (526.11±126.88)ng/dl, which were statistically different compared with pre-treatment( P<0.01). However, there were no significant differences in all the above indexes in placebo control group compared with the baseline( P>0.05). The numerical changes of IPSS, QOL, Q maxand Q ave between experimental group and placebo group had statistically significant differences ( P<0.05). The changes of IPSS, QOL, Q max, Q ave, PV, tPSA, fPSA and TST between positive control group and placebo group had significant differences ( P<0.05). The changes of PV, tPSA and fPSA between positive control group and experimental group had statistically significant differences ( P<0.05). The incidence of adverse reactions was 5.77% (3/52, including 1 headache and 2 stomach discomfort) in experimental group, 5.56% (2/36, including 1 headache and 1 stomach discomfort) in placebo group, and 10.00%(4/40, including 1 dizzy, 1 nasal obstruction and 2 erectile dysfunction) in positive control group. And there was no statistical difference in the incidence of adverse reactions among three groups ( P>0.05). Conclusions:Black tomato concentrated sauce shows an excellent effect on patients with LUTS/BPH, and improves the quality of life with few adverse events.