Objective:To analyze the applied effect of artificial intelligence(AI)rehabilitation system combined with telemedicine platform in individualized rehabilitation treatment for patients with long-term coma,so as to realize individual management for them.Methods:An AI rehabilitation system that aimed to patients with long-term coma was designed by integrating data of multimodal sensors included inertial sensor,image sensor and bioelectric sensor.A telemedicine platform,which included seven modules(patient management,consultation management,video communication,data transmission,electronic medical records,cost management and system maintenance),was designed by using a browser/server(B/S)architecture.The changes of patients'condition were followed up,and the full process of the management for rehabilitation treatment and the individualization of treatment plan were realized.A total of 60 inpatients whose coma duration exceeded 28 days were selected from the Coma Awakening Center of Dongguan Shipai Hospital between October 1,2021 and September 30,2022.They were randomly divided into control group(n=30)and observation group(n=30)by random number table.The control group received physical therapy and rehabilitation training based on evaluation results of rehabilitation,while the observation group adopted AI rehabilitation system combined with the telemedicine platform to conduct intervention.The consciousness levels,quality of life,hospital stay duration and treatment costs of two group were compared after intervention.Results:The Glasgow Coma Scale(GCS)scores,Coma Recovery Scale-Revised(CRS-R)scores,and Persistent Vegetative State(PVS)scores of two groups after intervention were significantly higher than those before intervention,and these indicators of observation group were significantly higher than them of control group after intervention,and the differences were significant(t=7.187,15.586,9.293,P<0.05),respectively.There were not significant differences in Glasgow Outcome Scale(GOS)scores and Activities of Daily Living(ADL)scores between two groups before intervention(P>0.05),and these scores of two groups were significantly increased after intervention,and these scores of observation group were significantly higher than them of control group after intervention,and the differences were significant(t=7.584,6.755,P<0.05).Additionally,the hospital stay duration and treatment costs of observation group were significantly less than those of control group,and the differences were significant(t=20.965,9.503,P<0.05).Conclusion:The intervention of AI rehabilitation system combines with a telemedicine platform on patients with long-term coma can enhance GCS,CRS-R,PVS,GOS and ADL scores,and reduce hospital stay duration and treatment cost.

Objective To compare the clinical efficacy of different urinary diversions,specifically exploring whether the flap embedding technique can improve bladder cancer patients'quality of life and reduce the incidence of related complications.Methods 63 bladder cancer patients undergoing radical cystectomy with urinary diver-sion,between December 2022 and December 2023,were divided into three groups:Ileal conduit group(n=21),flap embedding technique group(n=21),and traditional cutaneous ureterostomy group(n=21).General clini-cal data,surgical data,preoperative and postoperative renal function indicators,incidence of complications within 6 months postoperatively,and quality of life scores were compared among the groups.Results The operative time in the ileal conduit group was longer than that in the other two groups(P<0.05).The quality of life scores in the flap embedding technique group were superior to those in the traditional cutaneous ureterostomy group(P<0.05),but no significant difference was found compared to the ileal conduit group(P>0.05).In terms of postoperative complications,the incidence of intestinal obstruction in the flap embedding technique group was lower than that in the ileal conduit group(P<0.05),and the rate of reinsertion of a single-J stent for hydronephrosis in the flap embedding technique group was lower than that in the traditional cutaneous ureterostomy group(P<0.05).Postop-erative serum creatinine levels in the traditional cutaneous ureterostomy group were significantly higher than preop-erative levels(P<0.05),while no significant differences in renal function indicators were observed in the other two groups(P>0.05).Conclusion The flap embedding technique significantly improves patients'quality of life and reduces the incidence of postoperative complications.It is worthy of further promotion in clinical practice.

Objective To compare the clinical efficacy of different urinary diversions,specifically exploring whether the flap embedding technique can improve bladder cancer patients'quality of life and reduce the incidence of related complications.Methods 63 bladder cancer patients undergoing radical cystectomy with urinary diver-sion,between December 2022 and December 2023,were divided into three groups:Ileal conduit group(n=21),flap embedding technique group(n=21),and traditional cutaneous ureterostomy group(n=21).General clini-cal data,surgical data,preoperative and postoperative renal function indicators,incidence of complications within 6 months postoperatively,and quality of life scores were compared among the groups.Results The operative time in the ileal conduit group was longer than that in the other two groups(P<0.05).The quality of life scores in the flap embedding technique group were superior to those in the traditional cutaneous ureterostomy group(P<0.05),but no significant difference was found compared to the ileal conduit group(P>0.05).In terms of postoperative complications,the incidence of intestinal obstruction in the flap embedding technique group was lower than that in the ileal conduit group(P<0.05),and the rate of reinsertion of a single-J stent for hydronephrosis in the flap embedding technique group was lower than that in the traditional cutaneous ureterostomy group(P<0.05).Postop-erative serum creatinine levels in the traditional cutaneous ureterostomy group were significantly higher than preop-erative levels(P<0.05),while no significant differences in renal function indicators were observed in the other two groups(P>0.05).Conclusion The flap embedding technique significantly improves patients'quality of life and reduces the incidence of postoperative complications.It is worthy of further promotion in clinical practice.

Objective:To analyze the applied effect of artificial intelligence(AI)rehabilitation system combined with telemedicine platform in individualized rehabilitation treatment for patients with long-term coma,so as to realize individual management for them.Methods:An AI rehabilitation system that aimed to patients with long-term coma was designed by integrating data of multimodal sensors included inertial sensor,image sensor and bioelectric sensor.A telemedicine platform,which included seven modules(patient management,consultation management,video communication,data transmission,electronic medical records,cost management and system maintenance),was designed by using a browser/server(B/S)architecture.The changes of patients'condition were followed up,and the full process of the management for rehabilitation treatment and the individualization of treatment plan were realized.A total of 60 inpatients whose coma duration exceeded 28 days were selected from the Coma Awakening Center of Dongguan Shipai Hospital between October 1,2021 and September 30,2022.They were randomly divided into control group(n=30)and observation group(n=30)by random number table.The control group received physical therapy and rehabilitation training based on evaluation results of rehabilitation,while the observation group adopted AI rehabilitation system combined with the telemedicine platform to conduct intervention.The consciousness levels,quality of life,hospital stay duration and treatment costs of two group were compared after intervention.Results:The Glasgow Coma Scale(GCS)scores,Coma Recovery Scale-Revised(CRS-R)scores,and Persistent Vegetative State(PVS)scores of two groups after intervention were significantly higher than those before intervention,and these indicators of observation group were significantly higher than them of control group after intervention,and the differences were significant(t=7.187,15.586,9.293,P<0.05),respectively.There were not significant differences in Glasgow Outcome Scale(GOS)scores and Activities of Daily Living(ADL)scores between two groups before intervention(P>0.05),and these scores of two groups were significantly increased after intervention,and these scores of observation group were significantly higher than them of control group after intervention,and the differences were significant(t=7.584,6.755,P<0.05).Additionally,the hospital stay duration and treatment costs of observation group were significantly less than those of control group,and the differences were significant(t=20.965,9.503,P<0.05).Conclusion:The intervention of AI rehabilitation system combines with a telemedicine platform on patients with long-term coma can enhance GCS,CRS-R,PVS,GOS and ADL scores,and reduce hospital stay duration and treatment cost.

[Objective] To explore the clinical application of cutaneous ureterostomy-flap embedding in radical cystectomy plus urinary diversion. [Methods] The clinical data of 10 patients with bladder cancer treated with this method in our hospital during Feb.and May 2023 were involved.Cutaneous ureterostomy-flap embedding was used in urinary diversion.The stoma-free rate and stenosis rate of stomas within 1 year postoperatively, differences in renal function indicators 1 day before operation and 1 year after operation, urinary diversion-related complications within 6 months postoperatively, including hydronephrosis, urinary tract infections, renal stones were analyzed. [Results] All surgeries were successfully completed.At 1 year postoperatively, renal function indicators showed no significant difference compared to preoperative levels (P>0.05). At 6 months postoperatively, 1 patient developed renal stones, successfully treated with surgery; 2 had urinary tract infection, recovered after antibiotic treatment; 2 had mild unilateral hydronephrosis, alleviated with conservative management.At 1 year postoperatively, the catheter-free rate was 80%(8/10), with no worsening of hydronephrosis or occurrence of ureteral obstruction, and the stent placement duration ranged from 97 to 211 days, average (151.63±42.47) days.The ureteral stent was not removed in 2 patients within 1 year, so the stoma stenosis rate was 20%(2/10). [Conclusion] The application of flap embedding in urinary diversion following radical cystectomy is a simple and safe procedure, with few postoperative complications, high success rate of stent removal, and overall favorable outcomes.

Organoids are novel in vitro models that can effectively simulate the complexities of tumor microenvironments.Compared to tra-ditional preclinical models,organoids retain most of the histological and molecular properties of the primary tumor;therefore,they are more useful for studying tumor heterogeneity,underlying functional pathways,and immune microenvironments as well as for research on biomarker discovery,drug screening,and individual chemotherapy.Furthermore,current limitations,challenges such as low modeling suc-cess rates,high costs,and lack of standardization are expected to be overcome by continued innovations in bioengineering technologies and interdisciplinary integration.This article reviews the advantages,establishment processes,and prospects and challenges associated with the clinical application of organoids in bladder cancer.

Objective To explore the efficacy and technical points of complete preservation of female reproductive organ in radical cystectomy.Methods In 2020 and 2021,two female patients with bladder cancer undergoing radical cystectomy in The First Affiliated Hospital of Naval Medical University were selected.The clinical conditions of the patients were evaluated before surgery,and the reproductive organs were completely preserved according to the patients'wishes during the operation.The patients were regularly followed up after surgery.The efficacy and prognosis of patients were evaluated.Results The operation was successful and the two patients recovered well without surgery-related complications.The follow-up time for two patients were 22 months and 36 months.During the follow-up period,no tumor recurrence was found,and the scores of sexual function and quality of life were good.One patient was successfully pregnant at 17 months after surgery,and routine prenatal examination and non-invasive fetal DNA testing showed no abnormalities.Conclusions Under the premise of strictly grasping the surgical indications,the complete preservation of female reproductive organs in radical cystectomy can improve patients'quality of life after surgery,especially protect the reproductive function of women of childbearing age.

Transposons are the most prevalent elements in human genomes, which plays a vital role in gene expression regulation and evolutionary processes. They also jeopardize genome integrity with the characteristics of jumping and insertions. A delicate balance is maintained between the benefits and deleterious aspects of transposons, mediated by the epigenetic regulatory system. Once the balance is broken, it will give rise to genomic instability, leading to neoplasia. A lot of studies have shown that the transcriptional activation, expression products and methylation of transposons are closely related with urological malignancies, holding tremendous potential as biomarkers for risk and effect prediction, noninvasive diagnosis and targeted therapies of urological malignancies. In this article, the molecular mechanisms of transposons underlying the initiation, promotion and progression of urological malignancies as well as advances in diagnosis and treatment are reviewed.

With the development of new drugs, advances in medical technology and progressions in tumor molecular biology, organ preservation surgery has become the new trend for tumor treatment. Here, we discussed how to select right muscle-invasive bladder cancer patient with strict criteria for multimodality bladder-sparing treatment, and we reviewed the new treatment options, outcomes and trend of development for bladder-sparing treatments.

Objective:To explore the efficacy of different unipolar electrocoagulation power on pathological injury of porcine kidney suffering suture-free partial nephrectomy (SFPN).Methods:From April 2018 to July 2018, nine Guizhou pigs were selected, with an average age of 3 years and an average weight of 48 kg. According to different hemostatic power of unipolar electrocoagulation during open partial nephrectomy, they were divided into three groups(60W group, 80W group, and 100W group), with 3 in each group. The left kidney was exposed with a surgical incision, parallel to the lumbosacral muscle.The left renal artery was clamped and about 2 cm renal tissue was excised at the middle pole of the left kidney. 60W, 80W and 100W were used by unipolar electrocoagulation for hemostasis until no bleeding occurred after the artery clamp was released. The total ischemia time was controlled within 20 min. Temperature was measured by a multi-channel thermometer probe which was inserted into the healthy kidney tissue at a distance of 2 mm, 5 mm, and 10 mm away from the unipolar electrocoagulation hook, and the upper pole of the kidney far away from the operation area. The time of operation, the volume of renal bleeding, the time of hemostasis and the temperature were recorded. On the 7th day after operation, the left kidneys were taken and the pathological changes were observed by toluidine blue staining.Results:All operations were completed safely and successfully. The operation time in 60W group, 80W group, and 100W group was (41.2±5.5)min, (35.1±3.7)min, (31.3±2.2)min , respectively. There was no significant difference of operation time among those group ( P>0.05). The blood loss of renal was (35.3±4.1)ml, (21.4±4.7)ml, (15.3±4.1)ml, respectively. The blood loss in the 100W group and 80W group was less than that in the 60W group ( P<0.05). And the blood loss in the 100W group was less than that in the 80W group ( P<0.05). The hemostasis time was (15.2±1.9)min, (10.1±1.4)min, (6.4±0.8)min. The hemostasis time in the 100W and 80W groups was less than that in the 60W group ( P<0.05). And the hemostasis time in the 100W group was less than that in the 80W group ( P<0.05). At the place of 10 mm away from the electrocoagulation hook, the temperature in the three groups were (33.1±1.1)℃, (34.0±1.0)℃, (34.3±0.6)℃, which was not significantly different from that of the respective upper poles. And there was no significant difference between the three groups( P>0.05). At the place of 5 mm and 2 mm away from the electrocoagulation hook, the temperature in the 100W group (41.7±1.3)℃, (61.4±6.4)℃ and the 80W group (38.6±2.4)℃, (50.3±6.0)℃ was higher than that in the 60W group (36.9±4.1)℃, (42.0±4.7)℃, and the temperature in 100W group is higher than that in 80W group ( P<0.05). When the power was 60W, 80W or 100W, the temperature in the place 10 mm away from the electrocoagulation hook was less than that in the place 5 mm away from the electrocoagulation hook ( P<0.05), and the temperature of the place 5 mm away from the electrocoagulation hook was lower than that of the place 2 mm away from the electrocoagulation hook ( P<0.05). The total pathological injury depth of wounds in 60W, 80W, 100W group was (7 323±50)μm, (8 119±100)μm, (8 896±40)μm, respectively. The depth in 100W group and 80W group was deeper than that in 60W group ( P<0.05), and the depth in 100W group was deeper than that in 80W group ( P<0.05). Conclusions:In SFPN, the hemostatic effect of three different monopolar electrocoagulation output power is satisfactory. With the increase of power, the hemostasis speed is faster. However, the temperature of surrounding healthy renal tissue would be higher, and the total pathological injury depth would be deeper.