Objective To explore the clinical efficacy and safety of thulium laser-assisted versus traditional laparoscopic nephron-sparing surgery for the treatment of exophytic renal angiomyolipoma(AML),so as to provide reference for the treatment selection of this disease.Methods The clinical data of 43 AML patients admitted to our hospital during Jan.2022 and Nov.2024 were retrospectively analyzed,including 10 cases in the thulium laser group and 33 cases in the traditional laparoscopic group.In the thulium laser group,renal artery clamping was not performed,while the traditional laparoscopic group underwent conventional renal artery clamping.The general and perioperative data of the two groups were compared.Results All 43 patients successfully underwent surgery,with postoperative pathological confirmation of AML and no severe complications.There were no statistically significant differences between the two groups in terms of operation time,intraoperative blood loss,hemoglobin decline on the first day postoperatively,catheter indwelling time,and postoperative hospital stay.The thulium laser group had shorter warm ischemia time[0 min vs.(21.88±3.84)min,P＜0.01]and less decline in estimated glomerular filtration rate(eGFR)3 months after operation[(0.62±2.42)mL/(min·1.73 m2)vs.(5.74±4.84)mL/(min·1.73 m2),P＜0.01]than the traditional laparoscopic group.During a follow-up of 4-34 months,no tumor recurrence was observed.Conclusion Thulium laser-assisted laparoscopic nephron-sparing surgery is safe and feasible in the treatment of exophytic renal AML without renal artery clamping,which may have promising advantages in the protection of renal function.

Objective To explore the clinical efficacy and safety of thulium laser-assisted versus traditional laparoscopic nephron-sparing surgery for the treatment of exophytic renal angiomyolipoma(AML),so as to provide reference for the treatment selection of this disease.Methods The clinical data of 43 AML patients admitted to our hospital during Jan.2022 and Nov.2024 were retrospectively analyzed,including 10 cases in the thulium laser group and 33 cases in the traditional laparoscopic group.In the thulium laser group,renal artery clamping was not performed,while the traditional laparoscopic group underwent conventional renal artery clamping.The general and perioperative data of the two groups were compared.Results All 43 patients successfully underwent surgery,with postoperative pathological confirmation of AML and no severe complications.There were no statistically significant differences between the two groups in terms of operation time,intraoperative blood loss,hemoglobin decline on the first day postoperatively,catheter indwelling time,and postoperative hospital stay.The thulium laser group had shorter warm ischemia time[0 min vs.(21.88±3.84)min,P＜0.01]and less decline in estimated glomerular filtration rate(eGFR)3 months after operation[(0.62±2.42)mL/(min·1.73 m2)vs.(5.74±4.84)mL/(min·1.73 m2),P＜0.01]than the traditional laparoscopic group.During a follow-up of 4-34 months,no tumor recurrence was observed.Conclusion Thulium laser-assisted laparoscopic nephron-sparing surgery is safe and feasible in the treatment of exophytic renal AML without renal artery clamping,which may have promising advantages in the protection of renal function.

Nine compounds were isolated from the n-butanol fraction of 95% ethanol extract of the fruit of Alpinia oxyphylla Miq. with a combination of various chromatographic approaches, including MDS resin, silica gel, reverse phase C18 and preparative HPLC. On the basis of spectroscopic data analysis, they were elucidated as (1R, 4R, 10R)-1β, 4α-dihydroxy-11, 12, 13-trinor-5, 6-eudesmen-7-one (1), 1β, 4β-dihydroxy-11, 12, 13-trinor-8, 9-eudesmen-7-one (2), oxyphyllenone A (3), oxyphyllenone B (4), rhamnocitrin (5), staphylionoside D (6), benzyl-1-O-β-D-glucopyranoside (7), 2-O-β-D-glucopyranosyl-(1S)-phenylethylene glycol (8), and (S)-1-phenylethyl-β-D-glucopyranoside (9). Among them, compound 1 is a new sesquiterpene, named as oxyphyllenone C; compounds 8 and 9 are new natural products; compounds 2 and 6 were isolated from the genus Alpinia for the first time, and compound 7 was isolated from A. oxyphylla for the first time.

Objective To study pathologic changes of gastric mucosa in duodenal ulcer(DU).Methods Pathologic changes of 650 cases of gastric mucosa in DU confirmed by pathology after subtotal gastrectomy were analyzed.Results There were 100% patients with complication of gastritis.Among them,506% patients accompanied with gastric mucosa chronic atrophic gastritis and 209% patients with gastric mucosa intestinal metaplasia.Conclusion DU is always accompanied by antral gastritis,the pathologic changes of gastric mucosa in DU relateed tightly with helicobacter pylori(Hp) infection and patient's age.