Flexible ureteral lithotripsy (FURL) under general anesthesia (GA) is the dominant method in the treatment of renal and upper ureteral calculi，but some patients cannot tolerate GA.In recent years，there has been a growing interest in the use of local anesthesia (LA) as a safe and effective alternative.And it is also an option for patients who have calculi ≤20 mm with high fragility，lower CT value and better compatibility.Before surgery，it is important to conduct relevant examinations，evaluate the status of patients，prevent infections，and indwell ureteral stents.During surgery，lithotomy position，scissors position，prone leg position and other positions should be selected according to the specific conditions of patients.LA drugs should be used to control physiological pain and relieve psychological anxiety.Patients' breathing state should be carefully monitored，and appropriate ureteroscope and lens sheath should be selected for the success and safety of the operation.In this paper，the perioperative management of FURL under LA is briefly summarized，so as to provide reference for clinical practice.

Objective To explore the clinical efficacy and safety of immediate laparoscopic radical prostatectomy immediately following the diagnosis of locally advanced prostate cancer.Methods A retrospective analysis was performed for 63 patients with locally advanced prostate cancer who met the inclusion criteria diagnosed in The 1st People's Hospital of Qujing City,Yunnan Province from January 2018 to January 2023.All patients were diagnosed via ultrasound-guided transperineal prostate biopsy.The experimental group consisted of 37 patients who underwent immediate laparoscopic radical prostatectomy after pathological diagnosis,followed by postoperative adjuvant hormone therapy.The control group included 26 patients who first received 3 months of neoadjuvant hormone therapy before undergoing radical surgery,followed by adjuvant hormone therapy postoperatively.The two groups were compared in terms of surgical duration,intraoperative blood loss,length of hospital stay,duration of catheterization,positive surgical margin rate,rectal injury,positive lymph node rate,incidence of urinary fistula and lymphatic leakage,changes in PSA level,postoperative urinary control,biochemical recurrence and distant metastasis.Results In the control group,serum PSA levels,prostate volume,and clinical staging significantly decreased after neoadjuvant hormon therapy.The positive surgical margin rate in the experimental group was significantly higher than that in the control group,with a statistically significant difference(P<0.05).There were no statistically significant differences between the two groups in terms of surgical duration,intraoperative blood loss,length of hospital stay,duration of catheterization,rectal injury,positive lymph node rate,incidence of urinary fistula and lymphatic leakage(P>0.05).Follow-up at 18 to 36 months revealed no statistically significant differences between the two groups in terms of serum PSA levels at one month post-surgery,complete urinary control rate at six months post-surgery,and biochemical recurrence and distant metastasis at one and two years post-surgery(P>0.05).Conclusion Immediate laparoscopic radical prostatectomy following the diagnosis of locally advanced prostate cancer is a clinically safe and feasible treatment option.Noadjuvant hormone therapy reduces tumor staging,lowers the positive surgical margin rate,significantly decreases prostate volume,and provides greater operational space without increasing surgical risks.

Objective To evaluate the efficacy and safety of transurethral resection of Prostate(TURP)combined with endocrine therapy in patients with advanced prostate cancer.Methods A retrospective analysis was conducted on 87 cases of late-stage prostate cancer with dysuria admitted between January 2014 and December 2017.We divided them into 2 groups.TURP group(n = 48)received transurethral resection of prostate,followed by regular endocrine therapy.The control group(n = 39)was only given regular endocrine therapy.Comparative analysis of indicators such as prostate-specific antigen before and after treatment,maximum urinary flow rate,residual urine volume,International Prostate Symptom Score(IPSS),and 5-year survival rate was performed between the two groups.Results Three months after TURP surgery,the symptoms of urinary difficulty significantly improved,and various indicators showed significant improvement compared to before the surgery.PSA levels also notably decreased compared to before the surgery.After 3 months of treatment,the TURP group showed significant improvements in IPSS,Qmax,RV,and PSA indicators compared to the control group(P<0.05).Both groups of patients experienced a gradual decrease in PSA levels after receiving standardized treatment.In the first 12 months of treatment,the PSA levels in the TURP group decreased more significantly compared to the control group,but after 12 months of treatment,the comparison difference was not statistically significant in the PSA levels between the two groups(P = 0.056).A 5-year follow-up comparison of the two groups of patients revealed that there was no statistically significant difference in survival(P = 0.734).Conclusion Transurethral resection of Prostate(TURP)combined with regular endocrine therapy can effectively improve the dysuria in prostate cancer patients,improve the quality of life of patients,and will not affect the five-year survival rate.TURP is a safe and effective treatment for advanced prostate cancer.

Objective To investigate the effect of resveratrol on autophagic flux of nasopharyngeal carcinoma CNE-2 cells, and to explore the underlying mechanism. Methods Nasopharyngeal carcinoma CNE-2 cells were divided into control group and resveratrol group. Cells in control group were normally cultured at 37℃and received no further treatment. Resveratrol group was added 40 μmol/L resveratrol 2 h before cells were culture at 37 ℃. Western blot analysis was performed to detect protein expressions of LC3B, p62, Beclin-1, phospho-mTOR (p-mTOR) and phospho-S6 (p-S6). The autophagic flux was detected under the confocal laser scanning microscopy through different color spots, after cells were transfected with adenovirus encoding GFP-mRFP-LC3. Results (1) The protein expression of LC3B was significantly increased and the protein expression of p62 was significantly decreased in resveratrol group compared with those of control group (P<0.05). There was no significant difference in Beclin-1 expression between two groups. (2) Compared to control group, expressions of p-mTOR and p-S6 were significantly decreased in resveratrol group (P<0.05). (3) Compared to control group, the red mRFP puncta were significantly increased, and the yellow GFP puncta were significantly decreased in resveratrol group (P<0.05). Conclusion Resveratrol promotes the autophagic flux of nasopharyngeal carcinoma CNE-2 cells, and the effects are possibly dependent on the activation of mTOR pathway-related proteins.