Renal metastasis of oral adenoid cystic carcinoma is rare. A patient with bilateral renal metastasis secondary to surgery for oral adenoid cystic carcinoma was reported. The left kidney was treated with radiofrequency ablation, and the right kidney was treated with radical nephrectomy. The creatinine was 74 μmol/L at 3 months after surgery. The multidisciplinary comprehensive diagnosis and treatment model adopted in this case provided diagnosis and treatment ideas for patients with bilateral renal secondary malignant tumors.

Objective:To investigate the clinical efficacy of programmed Retzius-sparing robot-assisted radical prostatectomy and " Sandwich" technique of total urethral reconstruction.Methods:The clinical data of 120 consecutive patients who underwent programmed Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) by the same operator at the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2023 to August 2024 were retrospectively analyzed to explore the efficacy and summarize the experience. Baseline characteristics included: mean age (67.2±7.5) years, BMI (25.3±3.1)kg/m 2, prostate volume (32.3±15.8) ml, and PSA (16.6±19.7) ng/ml (57 cases 4-10 ng/ml; 41 >10-20 ng/ml; 22 >20 ng/ml). 28 patients underwent radical prostatectomy without prostate biopsy, while 92 had biopsy-proven cancer (Gleason: 6/7/8/9/10: 18/35/17/17/5). Clinical stages were cT 1(8), cT 2(73), cT 3(39). The surgical method was programmed Retzius-sparing robot-assisted radical prostatectomy and " Sandwich" technique of total urethral reconstruction. The peritoneum was incised slightly above the Douglas pouch and denonvilliers' fascia was dissected closely along the dorsal aspect of prostate, extending to the prostatic apex. Both vas deferens were transected, and the seminal vesicles were isolated. A combination of blunt and sharp dissection was employed to expose the prostatic fascia. The bladder neck was precisely visualized and transected. The urethra was precisely dissected, exposed and divided. Complete urethral reconstruction was performed using the "Sandwich" technique of total urethral reconstruction. The operation time, intraoperative bleeding, catheter preservation time, pathological staging and positive margin rate, and recovery of urinary control immediately after postoperative catheter removal were recorded. Results:In this study, all 120 surgeries were successfully completed, with no cases converted to anterior approach radical surgery or open surgery, and no serious intraoperative complications such as post-shamus hemorrhage or ureteric/rectal injury. The median postoperative follow-up was 16.0(10.0, 20.0)months, and there were no cases of readmission for surgical complications. The average duration of surgery was (93.6±35.9) min, and the average bleeding volume was (85.3±32.1) ml. The mean duration of catheter after surgery was (7.3±1.2)d. Immediate urinary control was achieved in 98 cases when the catheter was removed, and the rate of immediate urinary control was 81.7%. Postoperative urinary control rate was 88.3% at 1 month after surgery, 94.2% at 3 month after surgery, 98.3% at 6 month after surgery. There were 70 cases with pT 2 and 50 cases with pT 3 after postoperative pathological stage. There were 18 cases (15.0%) with positive margins, including 6 cases (8.6%) with positive margins in T 2 and 12 cases (24.0%) with positive margins in T 3 stage. There were no serious complications after surgery, and urinary retention occurred in 3 cases after urinary catheter removal, and the urinary catheter was removed after 1 week. 93.3% (112/120), 90.8% (109/120), and 89.2% (107/120) of patients with PSA < 0.2 ng/ml at 1, 3, and 6 months after surgery, respectively. For postoperative erectile function, we selected patients younger than 60 years of age, who had surgery to preserve unilateral or bilateral vascular nerve bundles, and who were followed for more than 6 months. A total of 18 patients met the above conditions and were followed up for erectile function, among which 4 of the 11 patients (36.4%) who retained unilateral vascular nerve bundles regained erectile function. Among the 7 patients with bilateral vascular nerve bundle preservation, 3 patients (42.9%) regained erectile function. Conclusions:The programmed RS-RARP combined with the " Sandwich" urethral reconstruction technique is technically feasible for patients with localized prostate cancer. Recent follow-up data indicate satisfactory postoperative urinary continence and oncological control outcomes.

Renal metastasis of oral adenoid cystic carcinoma is rare. A patient with bilateral renal metastasis secondary to surgery for oral adenoid cystic carcinoma was reported. The left kidney was treated with radiofrequency ablation, and the right kidney was treated with radical nephrectomy. The creatinine was 74 μmol/L at 3 months after surgery. The multidisciplinary comprehensive diagnosis and treatment model adopted in this case provided diagnosis and treatment ideas for patients with bilateral renal secondary malignant tumors.

Objective:To investigate the clinical efficacy of programmed Retzius-sparing robot-assisted radical prostatectomy and " Sandwich" technique of total urethral reconstruction.Methods:The clinical data of 120 consecutive patients who underwent programmed Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) by the same operator at the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2023 to August 2024 were retrospectively analyzed to explore the efficacy and summarize the experience. Baseline characteristics included: mean age (67.2±7.5) years, BMI (25.3±3.1)kg/m 2, prostate volume (32.3±15.8) ml, and PSA (16.6±19.7) ng/ml (57 cases 4-10 ng/ml; 41 >10-20 ng/ml; 22 >20 ng/ml). 28 patients underwent radical prostatectomy without prostate biopsy, while 92 had biopsy-proven cancer (Gleason: 6/7/8/9/10: 18/35/17/17/5). Clinical stages were cT 1(8), cT 2(73), cT 3(39). The surgical method was programmed Retzius-sparing robot-assisted radical prostatectomy and " Sandwich" technique of total urethral reconstruction. The peritoneum was incised slightly above the Douglas pouch and denonvilliers' fascia was dissected closely along the dorsal aspect of prostate, extending to the prostatic apex. Both vas deferens were transected, and the seminal vesicles were isolated. A combination of blunt and sharp dissection was employed to expose the prostatic fascia. The bladder neck was precisely visualized and transected. The urethra was precisely dissected, exposed and divided. Complete urethral reconstruction was performed using the "Sandwich" technique of total urethral reconstruction. The operation time, intraoperative bleeding, catheter preservation time, pathological staging and positive margin rate, and recovery of urinary control immediately after postoperative catheter removal were recorded. Results:In this study, all 120 surgeries were successfully completed, with no cases converted to anterior approach radical surgery or open surgery, and no serious intraoperative complications such as post-shamus hemorrhage or ureteric/rectal injury. The median postoperative follow-up was 16.0(10.0, 20.0)months, and there were no cases of readmission for surgical complications. The average duration of surgery was (93.6±35.9) min, and the average bleeding volume was (85.3±32.1) ml. The mean duration of catheter after surgery was (7.3±1.2)d. Immediate urinary control was achieved in 98 cases when the catheter was removed, and the rate of immediate urinary control was 81.7%. Postoperative urinary control rate was 88.3% at 1 month after surgery, 94.2% at 3 month after surgery, 98.3% at 6 month after surgery. There were 70 cases with pT 2 and 50 cases with pT 3 after postoperative pathological stage. There were 18 cases (15.0%) with positive margins, including 6 cases (8.6%) with positive margins in T 2 and 12 cases (24.0%) with positive margins in T 3 stage. There were no serious complications after surgery, and urinary retention occurred in 3 cases after urinary catheter removal, and the urinary catheter was removed after 1 week. 93.3% (112/120), 90.8% (109/120), and 89.2% (107/120) of patients with PSA < 0.2 ng/ml at 1, 3, and 6 months after surgery, respectively. For postoperative erectile function, we selected patients younger than 60 years of age, who had surgery to preserve unilateral or bilateral vascular nerve bundles, and who were followed for more than 6 months. A total of 18 patients met the above conditions and were followed up for erectile function, among which 4 of the 11 patients (36.4%) who retained unilateral vascular nerve bundles regained erectile function. Among the 7 patients with bilateral vascular nerve bundle preservation, 3 patients (42.9%) regained erectile function. Conclusions:The programmed RS-RARP combined with the " Sandwich" urethral reconstruction technique is technically feasible for patients with localized prostate cancer. Recent follow-up data indicate satisfactory postoperative urinary continence and oncological control outcomes.

ObjectiveTo review the classification of orthopedic insoles, common techniques of 3D printing orthopedic insoles, common materials and their application for flatfoot. MethodsLiteratures were retrieved from PubMed, Web of Science, CNKI and Wanfang Data from 2012 to 2022, and the relevant contents were summarized. ResultsA total of ten studies were finally included, from 5 countries, involving 290 participants, which published from 2019 to 2022. Orthotic insoles were classified as prefabricated, semi-custom, and custom, while custom ones were classified as traditional custom and 3D printed custom. 3D printed orthotic insoles were often made with selective laser sintering, fused deposition modeling (FDM) and PolyJet printing technologies, and commonly used materials included ethylene-vinyl acetate (EVA), polylactic acid, thermoplastic polyurethane, polyamide, and polypropylene. For flatfoot, 3D printed orthotic insoles could improve plantar pressure, relieve foot pain and the combined use of insole posting could control rearfoot valgus. Conclusion3D printed custom insoles can be made more efficiently and accurately than traditional custom insoles. The printing technologies and materials often chosen for 3D printed orthotic insoles are mainly FDM and EVA. 3D printed orthotic insoles is effective on plantar pressure, comfort and foot movement function of flatfoot.

Objective:To evaluate the clinical value of Xing's ureteroileal anastomosis technique in radical cystectomy.Methods:The data of 38 patients who underwent radical cystectomy with Xing's ureteroileal anastomosis technique at Cancer Hospital, Chinese Academy of Medical Sciences and Beijing Chaoyang Hospital from July 2013 to June 2021 were retrospectively reviewed. There were 30 males and 8 females. The mean age was 61.6±15.1 years old. The mean body mass index (BMI) was 25.1±2.7 kg/m 2. The American Society of Anesthesiology (ASA) graded 25 cases as grade 1, 10 cases as grade 2 and 3 cases as grade 3. There were 35 cases with stage cT 2N 0M 0 and 3 cases with cT 3N 0M 0. All patients underwent radical cystectomy and ileal conduit, and the ureteroileal anastomosis was performed using the Xing's ureteroileal anastomosis technique. Afferent loop entry was divided equally into two lumens. After 1.5 cm-long lengthwise incisions, each ureter was directly and end-to-end anastomosed to the aforementioned lumens. Postoperative information was recorded, including ureteric stricture, ureteric reflux, hydronephrosis, anastomotic leakage, renal calculus, urinary tract infection, and pyelonephritis. Results:Ureteroileal anastomosis was performed successfully in 38 cases with 76 units. The median follow-up time was 35.6 (17.0, 46.3) months. Three patients developed unilateral anastomotic stenosis after operation. Five patients had unilateral ureteral reflux. Two patients had unilateral hydronephrosis. No anastomotic leakage, urinary tract infection, or pyelonephritis occurred after the operation. Renal calculus appeared in 3 cases, all on the left unit.Conclusions:Xing's ureteroileal anastomosis technique is a simple method with few postoperative and good functional outcomes.

This study aimed to develop a portable, accurate and easy-to-operate scheme for rapid detection of respiratory virus nucleic acid. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to verify the effect of extraction-free respiratory virus treatment reagent (RTU) on viral nucleic acid treatment and the effect of ultra-fast fluorescence quantitative PCR instrument (FQ-8A) on nucleic acid amplification, respectively. RTU and FQ-8A were combined to develop a rapid detection scheme for respiratory virus nucleic acid, and the positive detection rate was judged by C_t value using a fluorescence quantitative PCR instrument, and the accuracy of the scheme in clinical samples detection was investigated. The results showed that RTU had comparable sensitivity to the automatic nucleic acid extraction instrument, its extraction efficiency was comparable to the other 3 extraction methods when extracting samples of different virus types, but the extraction time of RTU was less than 5 min. FQ-8A had good consistency in detection respiratory syncytial virus (RSV) and adenovirus (ADV) compared with the control instrument ABI-7500, with kappa coefficients of 0.938 (P < 0.001) and 0.887 (P < 0.001), respectively, but the amplification time was only about 0.5 h. The RTU and FQ-8A combined rapid detection scheme had a highly consistent detection rate with the conventional detection scheme, with a sensitivity of 91.70% and specificity of 100%, and a kappa coefficient was 0.944 (P < 0.001). In conclusion, by combining RTU with FQ-8A, a rapid respiratory virus nucleic acid detection scheme was developed, the whole process could be completed in 35 min. The scheme is accurate and easy-to-operate, and can provide important support for the rapid diagnosis and treatment of respiratory virus.
Humans ; Respiratory Syncytial Virus Infections/diagnosis* ; Respiratory Syncytial Virus, Human/genetics* ; Nucleic Acid Amplification Techniques ; Real-Time Polymerase Chain Reaction ; Adenoviridae ; Sensitivity and Specificity

Objective To compare perioperative outcomes and complications between intracorporeal and extracorporeal orthotopic ileal neobladder after laparoscopic radical cystectomy (LRC) from one center.Methods We retrospectively analysis patients' clinical and follow-up data who underwent laparoscopic radical cystectomy (LRC) in our hospital from January 2011 to May 2017,of whom 25 cases underwent intracorporeal orthotopic ileal neobladder (ICIN) and 20 cases underwent extracorporeal orthotopic ileal neobladder (ECIN).The patients' characteristics,perioperative data,postoperative pathological results,postoperative complications and oncologic outcomes were compared and analyzed.The mean age of ECIN group was (59.9 ± 10.5)years,mean BMI was (24.7 ±3.3)kg/m2,the ASA level was less than Ⅱ in 19 cases and level Ⅲ in 1 case,the mean preoperative CCI was 4.5 ± 1.6,3 patients got preoperative neoadjuvant chemotherapy.The mean age of ICIN group was (59.0 ± 9.8) years,mean BMI was (25.3 ±4.3)kg/m2,the ASA level was less than Ⅱ in 25 cases and no level Ⅲ,mean preoperative CCI was 4.0 ±1.3,3 patients got preoperative neoadjuvant chemotherapy.There was no statistical difference between the two groups in patients' characteristics.All operations were performed under general anesthesia.After LRC was accomplished,an additional 12 mm trocar was placed 1 cm crania to the pubic symphysis for EndoGIA in ICIN group.An ileal segment 60 cm long was isolated 25 cm proximal to the ileocecum.The continuity of the small bowel was restored with side to side anastomosis.The proximal 10 cm was moved to the distal end of the ileal segment for the right isoperistaltic afferent limb,and the remaining proximal 10 cm ileal segment was reserved for the left isoperistaltic afferent limb.Then,the remaining length of the 40 cm ileal segment was detubularized along its antimesenteric border.The anterior wall of the neobladder was folded forward and the free edges were sutured to achieve a spherical configuration.After single J ureteric stents were inserted into the ureters,the urethra and ureters were sutured with neobladder successively.For ECIN,the ileal segment is removed via a midline laparotomy below the umbilicus 5-10 cm.The construction method of neobladder was the same with ICIN group.Results All 45 cases were successfully operated.There was no statistical difference between ICIN group and ECIN group in operation time [(374.2 ± 74.6) min vs.(360.3 ±83.6)min,P =0.557] and extraction time of pelvic drainage tube[(12.5 ±5.9)d vs.(11.8 ±4.5)d,P =0.686].Patients in the ICIN group had less intraoperative blood loss [(186.0 ± 140.3)ml vs.(272.0 ±110.7) ml,P =0.030],shorter oral intake time [(4.2 ± 2.2) d vs.(6.1 ± 1.6) d,P =0.002],shorter postoperative hospital stay [(13.7 ± 4.2) d vs.(19.9 + 7.6) d,P =0.001].There was no significant difference in the early postoperative complications (P =0.345).The median follow-up time of ICIN group and ECIN group were 30 months and 52.5 months,respectively.The day-time and night-time continence rate were 97.4％ and 86.8％ respectively in the first year after surgery without significant difference.A total of 6 patients suffered distant metastasis,of whom 4 patients suffered multiple metastases,1 case bone metastases and 1 case pelvic lymph node metastasis.Seven patients died,five of whom died of tumor recurrence or metastasis.There was no statistical difference between the two groups in cancer specific survival rates (P =0.644) and recurrence free survival rates (P =0.981).Conclusions Comparing with extracorporeal orthotopic ileal neobladder,intracorporeal orthotopic ileal neobladder has advantages of less blood loss and faster intestinal function recovery,without significantly increased operative time and complications.No significant difference was found in the function of neobladder and oncological outcomes.Randomized controlled trial with large sample and long-term follow-up is needed to verify the advantages of intracorporeal neobladder construction.

OBJECTIVE To investigate the use ofultrasonically activated scalpel (UAS) in open thyroid surgery. METHODS From February 2004 to March 2005, thyroidectomy were performed in 77 cases by the same operation team. Forty seven cases received UAS thyroidectomy and 30 cases underwent conventional thyroidectomy. The operation time, estimated blood loss in operation, postoperative draining volume within the 24 hours, the length of hospitalization and postoperative complications between two groups were compared. RESULTS The average operation time of lobectomy and total/subtotal thyroidectomy in the UAS group were 61?4.34 and 85?3.02 minutes, and in conventional group were 82?3.37 and 121? 2.51 minutes. There was a significant difference in average operation time (P0.05). CONCLUSION The use of UAS in thyroid surgery was safe and can reduce the operation time.