Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

T cell immunoglobulin and immune receptor tyrosine-based inhibitory motif domain (TIGIT) is a co-inhibitory receptor, which is highly expressed in a variety of malignant tumors.It can inhibit T cells and NK cells, and plays a key role in regulating immune response and tumor immune escape.TIGIT is closely related to the growth, metastasis and prognosis of urologic tumors, and its overexpression is associated with tumor progression and poor prognosis.Currently, TIGIT-based urologic tumors treatment strategies include monoclonal antibody therapy and combined immunotherapy, such as combination therapy with PD-1/PD-L1 and other drugs.Experimental and clinical studies on TIGIT are also being carried out and significant progress has been made.Therefore, TIGIT is expected to become a new target for immunotherapy and a biomarker for predicting the prognosis of patients with urologic tumors.This article reviews the research progress of TIGIT in urologic tumors.

【Objective】 To investigate the clinical features, treatment methods and prognosis of advanced renal cell carcinoma (RCC) patients in Xinjiang, especially the Han population. 【Methods】 Clinical data of 233 patients with advanced RCC treated in The First Affiliated Hospital and The Affiliated Cancer Hospital of Xinjiang Medical University were retrospectively analyzed, including 133 Han patients.The median age of patients was 52 years (range: 23 to 87), and the maximum tumor diameter was (7.73±4.04) cm.Survival curves were plotted using the Kaplan-Meier method.Multivariate and univariate Cox regression analysis were conducted for all patients, and further analysis was performed for the Han patients. 【Results】 Among the 233 patients, 131 died during the average follow-up of 27.6 months (range: 1 to 120), and the median survival time was 12 months.In this cohort, 110 patients had lymph node metastasis, and 200 had distant metastasis, among them, 21 (10.5%) patients had brain metastasis and 45 (22.5%) patients had adrenal metastasis.The 1-, 3-, and 5-year survival rate were 48.9%, 18.3% and 6.1%, respectively.Univariate analysis revealed that International mRCC Database Consortium (IMDC) score, pathological type, lymph node metastasis, distant metastasis, number of metastatic foci and treatment methods impacted the prognosis in Xinjian (P<0.05).Multivariate analysis indicated that IMDC score, pathological type and distant metastasis were significant factors influencing the prognosis, which were also the prognostic factors of the Han patients (P<0.05). 【Conclusion】 In Xinjiang, patients with advanced renal cell carcinoma have a 6.1% 5-year survival rate and a median survival time of 12 months.Brain and adrenal metastases are common.Prognostic factors include IMDC score, pathological type, and distant metastasis for all patients, including the Han patients.

Objective To analyze the clinicopathological features and prognostic factors of common subtypes of non-transparent renal cell carcinoma.Methods Retrospective analysis of 115 patients with pathologically confirmed non-transparent renal cell carcinoma from January 2003 to December 2017,including 67 males and 48 females,with a male to female ratio of 1.4∶ 1.The average age is (51.2 ± 13.4)years old.71 cases were asymptomatic renal cancer,44 cases had clinical symptoms,including 10 cases of gross hematuria,28 cases of low back pain,4 cases of hematuria with low back pain,and 2 cases of abdominal mass.There were 49 open surgery and 66 laparoscopic surgery.58 patients underwent radical nephrectomy and 57 underwent partial nephrectomy.Of the 115 patients,17 (14.9％) had abnormal hemoglobin (Hb),22 (19.1％) had abnormal platelet (PLT) count,18 (15.7％) had abnormal alkaline phosphatase,and abnormal lactate dehydrogenase 16 cases (13.9％).The Kaplan-Meier survival analysis method was used to calculate the survival rate of patients,and the Cox proportional regression risk model was used to analyze the prognostic factors.Results The postoperative pathological stage was 57 cases in T1a stage,38 cases in T1b stage,12 cases in T2a stage,8 cases in T2b stage,2 cases of regional lymph node positive,and 113 cases negative;no distant metastasis.Pathological types:42 cases of renal chromophobe cell carcinoma,37 cases of papillary renal cell carcinoma type Ⅰ,36 cases of type Ⅱ.The average follow-up time was 38.6 months,and the rate of loss of follow-up was 3.5％ (4/115).The 1,3,and 5 year overall survival rates of 115 patients with common subtypes of non-transparent renal cell carcinoma were 99.1％,95.8％,and 81.1％,respectively.Multivariate Cox regression analysis found that the pathological type (OR =4.625,P =0.014),four indicators ≥ 3 abnormalities (OR =30.853,P =0.024),lymph node metastasis (OR =35.663,P =0.006) were the group.An independent factor in the survival time of patients with common subtypes of non-transparent renal cell carcinoma.Conclusions Compared with papillary renal cell carcinoma type Ⅰ and renal chromophobe cell carcinoma,papillary renal cell carcinoma type Ⅱ has a higher degree of malignancy and a poor prognosis.The pathological types of the common subtypes of nontransparent renal cell carcinoma,four indicators (Hb,PLT count,alkaline phosphatase,and lactate dehydrogenase) ≥3 abnormalities and lymph node metastasis are independent prognostic factors for overall survival.

Objective To investigate the clinical value of serum metabolomic profile of prostate cancer using nuclear magnetic resonance-based metabolomics.Methods The retrospective case control study was adopted.The clinical data of 31 patients with prostate cancer,28 patients of prostatic hyperplasia and 31 healthy volunteers were enrolled in this study from May 2016 to May 2017 at the first affiliated hospital of Xinjiang medical university.In PCa group,the mean age was 66.3 years old,ranging 53-80 years old.In BPH group,the mean age was 59.3 years old,ranging 46-75 years old.In volunteer group,the mean age was 47.8 years old,ranging 35-62 years old..The serum of the 3 groups was measured by 1H-NMR spectroscopy.Multivariate statistical analysis was used to analyze the serum differential metabolism of the 3 groups,including principal components analysis (PCA),partial least squares discriminant analysis (PLS-DA) and orthogonal partial least squares discriminant analysis (OPLS-DA).Results The multivariate statistical analysis of PCA that the rate of the first principal component 1 (PC1) was 53.24％,the second principal component 2 (PC2) was 25.31％ and the cumulative contribution rate was 78.55 ％.Results of PLS -DA showed that partial data overlap of the three groups,but the separation trend was appeared.The variance of X(R2X) and Y(R2Y) matrixes and predictive value Q2 were 0.67,0.60,and 0.42.The results of OPLS-DA showed that the difference among the PCa group and BPH group,healthy group were obvious.The separation trend were appeared and the differential metabolites could be screened effectively.The R2X、R2Y and Q2 was 0.24,0.57,0.21 and 0.30,0.65,0.36.26 different serum metabolites were detected in the 3 groups,including citric acid,arginine,threonine,citrulline,glutamine,lactic acid,alanine,unsaturated fats,glycoprotein etc.Conclusions Compared with BPH group and healthy group,the serum of prostate cancer patients showed significant differences in metabolism.Nuclear magnetic resonance metabolomics analysis can effectively distinguish these serum metabolic differences.