Objective:To analyze the short-term efficacy and safety of robot-assisted laparoscopic partial nephrectomy（RAPN）for non-metastatic pathological stage T 3a renal cell carcinoma. Methods:The clinical and pathological data of 45 patients with pathologically confirmed non-metastatic T 3a renal cell carcinoma who underwent RAPN at Sun Yat-sen University Cancer Center between January 2016 and December 2023 were retrospectively reviewed. There were 30 males and 15 females. The average age of the cohort was（54.3±10.7）years，and the average clinical tumor diameter was（4.9±1.8）cm. Of all the patients，35（77.8%）were asymptomatic，7（15.6%）presented with hematuria，and 3（6.7%）presented with lumbar pain. Preoperative imaging assessed 34 patients（75.6%）as having clinical stage T 3a，all suspected of involving the collecting system or perirenal fat invasion；the remaining 11 patients（24.4%）were assessed as having stage T 1-2 disease. The median R.E.N.A.L. nephrectomy score was 8.0（7.0，10.0）. A history of hypertension，diabetes，or chronic kidney disease was present in 18 patients（40.0%）. The primary endpoint was progression-free survival，and the secondary endpoints included postoperative complications and short-term renal function outcomes. Survival curve was estimated using the Kaplan-Meier method，and renal function comparisons were made using the paired t-test. Results:The RAPN was performed through a transabdominal approach in 32 patients（71.1%），with a median estimated blood loss of 150.0（50.0，300.0）ml. Seven（15.6%）patients required intraoperative blood transfusion. The median length of postoperative hospital stay was 4.0（4.0，6.0）days. Postoperative complications occurred in 6 patients（13.3%），including 5（11.1%）with mild complications and 1（2.2%）with a severe complication. Renal function returned to baseline in 24 of 39 evaluable patients（61.5%），while 3 patients（7.7%）developed surgery-related chronic kidney disease 3 to 12 months postoperatively，but none required dialysis. The median follow-up time was 31.8（22.7，50.9）months，12（26.7%）patients received programmed cell death protein 1 inhibitor adjuvant therapy postoperatively. During follow-up，3 patients experienced tumor recurrence，the 3-year progression-free survival rate of the entire cohort was 95.4%.Conclusions:For some carefully selected patients with T 3a renal cell carcinoma，RAPN performed by experienced surgeons is a feasible and safe option，providing excellent short-term oncological outcomes，complication control，and renal function recovery. The long-term efficacy remains to be seen.

Objective To evaluate the short-term outcomes of robot-assisted partial nephrectomy(RAPN)in the treatment of renal cell carcinoma(RCC)involving segmental renal vein invasion,and to summarize relevant diagnostic experience and surgical techniques.Methods A retrospective analysis was conducted on the clinicopathological data of 23 RCC patients who were found to have segmental renal vein invasion during RAPN at Sun Yat-sen University Cancer Center during 2022 and 2024.All procedures were performed by the same experienced urologic surgeon(＞1000 robotic cases).Preoperative computed tomography(CT)scans of all patients failed to reveal segmental renal vein invasion.Two experienced radiologists re-evaluated the imaging postoperatively.The clinical and pathological data of patients were analyzed to preliminarily explore the short-term efficacy,imaging,intraoperative findings and pathological characteristics.Results All surgeries were completed successfully via the transperitoneal approach with renal preservation.The median operation time was 151.0(125.5,182.0)min,and median blood loss was 180.0(100.0,300.0)mL;2 patients(8.7％)required intraoperative transfusion;3(13.0％)experienced postoperative complications,all of which were minor(Clavien-Dindo grade 1-2).Postoperative pathology confirmed venous invasion in 2 patients.The diagnostic rates of segmental renal vein invasion by the two radiologists were 47.8％(11/23)and 21.7％(5/23),respectively,with concordance in only 3 cases.During a mean follow-up of 9.1 months,1 patient developed iliac lymph node metastasis without local recurrence 12.4 months after surgery.After reoperation to remove the metastatic focus,the patient was treated with Axitinib combined with Toripalimab and has survived to date.The remaining patients were followed up for an average of 8.9 months,with no recurrence or metastasis observed.Conclusion Preoperative detection of segmental renal vein invasion in RCC is challenging,and pathological confirmation is often inconsistent with intraoperative findings.For RCC patients with intraoperatively identified segmental renal vein invasion,RAPN performed by experienced surgeons is feasible and safe on the premise of ensuring complete tumor resection,with favorable short-term oncologic outcomes.Long-term results require further follow-up.

Objective To evaluate the short-term outcomes of robot-assisted partial nephrectomy(RAPN)in the treatment of renal cell carcinoma(RCC)involving segmental renal vein invasion,and to summarize relevant diagnostic experience and surgical techniques.Methods A retrospective analysis was conducted on the clinicopathological data of 23 RCC patients who were found to have segmental renal vein invasion during RAPN at Sun Yat-sen University Cancer Center during 2022 and 2024.All procedures were performed by the same experienced urologic surgeon(＞1000 robotic cases).Preoperative computed tomography(CT)scans of all patients failed to reveal segmental renal vein invasion.Two experienced radiologists re-evaluated the imaging postoperatively.The clinical and pathological data of patients were analyzed to preliminarily explore the short-term efficacy,imaging,intraoperative findings and pathological characteristics.Results All surgeries were completed successfully via the transperitoneal approach with renal preservation.The median operation time was 151.0(125.5,182.0)min,and median blood loss was 180.0(100.0,300.0)mL;2 patients(8.7％)required intraoperative transfusion;3(13.0％)experienced postoperative complications,all of which were minor(Clavien-Dindo grade 1-2).Postoperative pathology confirmed venous invasion in 2 patients.The diagnostic rates of segmental renal vein invasion by the two radiologists were 47.8％(11/23)and 21.7％(5/23),respectively,with concordance in only 3 cases.During a mean follow-up of 9.1 months,1 patient developed iliac lymph node metastasis without local recurrence 12.4 months after surgery.After reoperation to remove the metastatic focus,the patient was treated with Axitinib combined with Toripalimab and has survived to date.The remaining patients were followed up for an average of 8.9 months,with no recurrence or metastasis observed.Conclusion Preoperative detection of segmental renal vein invasion in RCC is challenging,and pathological confirmation is often inconsistent with intraoperative findings.For RCC patients with intraoperatively identified segmental renal vein invasion,RAPN performed by experienced surgeons is feasible and safe on the premise of ensuring complete tumor resection,with favorable short-term oncologic outcomes.Long-term results require further follow-up.

Objective:To analyze the short-term efficacy and safety of robot-assisted laparoscopic partial nephrectomy（RAPN）for non-metastatic pathological stage T 3a renal cell carcinoma. Methods:The clinical and pathological data of 45 patients with pathologically confirmed non-metastatic T 3a renal cell carcinoma who underwent RAPN at Sun Yat-sen University Cancer Center between January 2016 and December 2023 were retrospectively reviewed. There were 30 males and 15 females. The average age of the cohort was（54.3±10.7）years，and the average clinical tumor diameter was（4.9±1.8）cm. Of all the patients，35（77.8%）were asymptomatic，7（15.6%）presented with hematuria，and 3（6.7%）presented with lumbar pain. Preoperative imaging assessed 34 patients（75.6%）as having clinical stage T 3a，all suspected of involving the collecting system or perirenal fat invasion；the remaining 11 patients（24.4%）were assessed as having stage T 1-2 disease. The median R.E.N.A.L. nephrectomy score was 8.0（7.0，10.0）. A history of hypertension，diabetes，or chronic kidney disease was present in 18 patients（40.0%）. The primary endpoint was progression-free survival，and the secondary endpoints included postoperative complications and short-term renal function outcomes. Survival curve was estimated using the Kaplan-Meier method，and renal function comparisons were made using the paired t-test. Results:The RAPN was performed through a transabdominal approach in 32 patients（71.1%），with a median estimated blood loss of 150.0（50.0，300.0）ml. Seven（15.6%）patients required intraoperative blood transfusion. The median length of postoperative hospital stay was 4.0（4.0，6.0）days. Postoperative complications occurred in 6 patients（13.3%），including 5（11.1%）with mild complications and 1（2.2%）with a severe complication. Renal function returned to baseline in 24 of 39 evaluable patients（61.5%），while 3 patients（7.7%）developed surgery-related chronic kidney disease 3 to 12 months postoperatively，but none required dialysis. The median follow-up time was 31.8（22.7，50.9）months，12（26.7%）patients received programmed cell death protein 1 inhibitor adjuvant therapy postoperatively. During follow-up，3 patients experienced tumor recurrence，the 3-year progression-free survival rate of the entire cohort was 95.4%.Conclusions:For some carefully selected patients with T 3a renal cell carcinoma，RAPN performed by experienced surgeons is a feasible and safe option，providing excellent short-term oncological outcomes，complication control，and renal function recovery. The long-term efficacy remains to be seen.

Objective:To compare the efficacy and safety between WangShiBaoChiWan and mosapride in the treatment of functional dyspepsia (FD).Methods:From September 2019 to September 2020, patients with postprandial fullness and early satiation who met the Rome Ⅳ criteria for FD diagnosis were enrolled from 15 hospitals, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical College. The subjects were randomly divided into WangShiBaoChiWan (experimental) group and mosapride (control) group in the ratio of 1∶1. The treatment regimens were WangShiBaoChiWan+ mosapride simulator, WangShiBaoChiWan simulator+ mosapride, respectively with a treatment period of 2 weeks. The primary efficacy outcome was the improvement rates of main symptoms before and after treatment, the secondary efficacy primary efficacy outcome was the total clinical effective rate and the change of the single symptom score. And the safety indicator included adverse events. Independent sample t-test, paired t-test and chi-square test were used for statistical analysis. Results:A total of 251 FD patients were enrolled in the full analysis set, including 124 in the experimental group and 127 in the control group; 241 FD patients were in the per-protocol analysis set, including 117 in the experimental group and 124 in the control group. The analysis of per-protocol analysis set showed that the improvement rates of the main symptoms of the experimental group and the control group were (66±29)% and (60±30)%, respectively, and the difference was not statistically significant ( P>0.05). The improvement rate of the main symptoms of the experimental group reached 117% of that of the control group, which exceeded the expected non-inferiority standard of 80%. The total clinical effective rates of the experimental group and the control group were 76.07% (89/117) and 75.81% (94/124), respectively, and the difference was not statistically significant ( P>0.05). The results of full analysis set showed that the incidence of adverse events of the experimental group and the control group was 1.62% (2/124) and 1.57% (2/127), respectively, and the difference was not statistically significant ( P>0.05). There were no serious adverse events in the two groups. Conclusion:The improvement rate of the main symptoms of WangShiBaoChiWan is not inferior to that of mosapride in the treatment of FD, and it has good safety.

Objectives:To analyze the factors relative to the short-term preservation of ipsilateral renal function after partial nephrectomy.Methods:The clinical data of 83 patients who were treated with partial nephrectomy from December 2014 to December 2019 in the Department of Urology, Sun Yat-sen University Cancer Center were retrospectively analyzed. There were 54 males and 29 females, aging ( M (IQR)) 49 (17) years (range: 27 to 74 years). The ischemia time in operation was 25 (18) minutes (range: 10 to 67 minutes). Emission computed tomography scan and CT scan were performed before (within 1 month) and after (3 to 12 months) surgery. The volume of the ipsilateral and contralateral kidney was measured on the basis of preoperative and postoperative CT scans. The glomerular filtration rate (GFR) specifically in each kidney was estimated by emission computed tomography. Recovery from ischemia is determined by the formula: GFR preservation/volume saved×100%. Linear regression was used to explore the factors ralative to the short-term preservation of ipsilateral renal function after partial nephrectomy. Results:The GFR preservation of the ipsilateral kidney was 80.9 (25.2) % (range: 31.0% to 109.4%). The volume loss of the kidney resulted in a decrease of 12.0% (5.8 ml/(min×1.96 m 2)) of GFR, while the ischemic injury resulted in a decrease of 6.5% (2.5 ml/(min×1.96 m 2)) of GFR. The volume saved from the ipsilateral kidney was 87.1 (12.9) % (range: 27.0% to 131.7%). Recovery from ischemia was 93.5 (17.5) % (range:44.3% to 178.3%). In multivariate analysis, GFR preservation of the ipsilateral kidney was significantly correlated with the volume saved of the ipsilateral kidney ( β=0.383, 95% CI: 0.144 to 0.622, P=0.002). It was not related to the ischemia time ( β=0.046, 95% CI:-0.383 to 0.475, P=0.831). Conclusion:In the condition of limited ischemic time, in the short term ipsilateral renal function after partial nephrectomy is mainly determined by the loss of kidney volume, while ischemic injury only plays a minor role.

Objectives:To analyze the factors relative to the short-term preservation of ipsilateral renal function after partial nephrectomy.Methods:The clinical data of 83 patients who were treated with partial nephrectomy from December 2014 to December 2019 in the Department of Urology, Sun Yat-sen University Cancer Center were retrospectively analyzed. There were 54 males and 29 females, aging ( M (IQR)) 49 (17) years (range: 27 to 74 years). The ischemia time in operation was 25 (18) minutes (range: 10 to 67 minutes). Emission computed tomography scan and CT scan were performed before (within 1 month) and after (3 to 12 months) surgery. The volume of the ipsilateral and contralateral kidney was measured on the basis of preoperative and postoperative CT scans. The glomerular filtration rate (GFR) specifically in each kidney was estimated by emission computed tomography. Recovery from ischemia is determined by the formula: GFR preservation/volume saved×100%. Linear regression was used to explore the factors ralative to the short-term preservation of ipsilateral renal function after partial nephrectomy. Results:The GFR preservation of the ipsilateral kidney was 80.9 (25.2) % (range: 31.0% to 109.4%). The volume loss of the kidney resulted in a decrease of 12.0% (5.8 ml/(min×1.96 m 2)) of GFR, while the ischemic injury resulted in a decrease of 6.5% (2.5 ml/(min×1.96 m 2)) of GFR. The volume saved from the ipsilateral kidney was 87.1 (12.9) % (range: 27.0% to 131.7%). Recovery from ischemia was 93.5 (17.5) % (range:44.3% to 178.3%). In multivariate analysis, GFR preservation of the ipsilateral kidney was significantly correlated with the volume saved of the ipsilateral kidney ( β=0.383, 95% CI: 0.144 to 0.622, P=0.002). It was not related to the ischemia time ( β=0.046, 95% CI:-0.383 to 0.475, P=0.831). Conclusion:In the condition of limited ischemic time, in the short term ipsilateral renal function after partial nephrectomy is mainly determined by the loss of kidney volume, while ischemic injury only plays a minor role.

BACKGROUND: At present, bone defects usually repaired by autologous bone, allogenic bone, synthetic bone substitutes and other methods, which received poor clinical results. Preliminary studies have shown that adipose-derived mesenchymal stem cells (ADSCs) possess strong proliferation ability and differentiation potential, and can be induced differentiate into bone. OBJECTIVE: To analyze the application of ADSCs in bone tissue engineering, and to identify whether ADSCs can be used as seed cells in bone tissue engineering. METHODS: The databases of PubMed (1999-01/2008-12) and Tongfang (2003-01/2008-12) was retrieved using key words of "adipose tissue-derived mesenchymal stem cells, adipose mesenchymal stem cells, adipose stem cell; osteogenic induction, osteogenic inducement, bone induction, osteoblastic induced; chondroblast induction, cartilage induction; bone tissue engineering, tissue engineering bone, tissue engineering of bone". RESULTS AND CONCLUSION: A total of 361 literatures were collected, including 246 in Chinese and 115 in English. Totally 29 literatures were accordant with the study criteria. ADSCs is a truly multi-directional differentiation potential cells, which possess strong amplification and self-renewal potential, and can be directional differentiated into osteoblasts, cartilage cells, bone cells and muscle cells. It can be used as seed cells in bone tissue engineering when matching appropriate stents.