Objective:To explore the risk factors of adverse events during the perioperative period of transurethral resection of bladder tumor(TURBT)in bladder cancer patients with coronary atherosclerotic heart disease(CAD).Methods:We retrospectively analyzed the clinical data of bladder cancer patients who underwent TURBT in Beijing Anzhen Hospital from June 2022 to September 2024.All patients with bladder cancer and CAD underwent coronary computed tomography angiography(CCTA)for diagnosis and assessment of CAD before surgery.Based on the CCTA results,the patients with bladder cancer and CAD were divided into two groups:those with mild to moderate coronary stenosis and those with severe coronary stenosis.The severe coronary stenosis group was further divided into two subgroups based on whether they received low-molecular-weight heparin(LMWH)bridging therapy or continued their anti-platelet treatment before surgery.Perioperative anticoagulation and antiplatelet strategies were adjusted according to the opinions of the specialists.The incidence of adverse events within 30 days postoperative-ly was followed up and analyzed.Results:A total of 80 bladder cancer patients with CAD who underwent TURBT were included in the study.Among the 80 patients with CAD,55(68.8％)had mild to moder-ate coronary stenosis,and 25(31.2％)had severe coronary stenosis.Compared with those had mild to moderate coronary stenosis,the patients who had severe coronary stenosis had a higher incidence of post-operative bleeding and pulmonary embolism,although the differences were not statistically significant(P＞0.05).However,the incidence of postoperative myocardial infarction was significantly higher in the patients who had severe coronary stenosis(P=0.034).Among the patients with severe coronary stenosis,8(32.0％)received LMWH bridging therapy before TURBT,and 17(68.0％)continued their previous antiplatelet treatment.Compared with those who continued antiplatelet treatment,the patients who re-ceived LMWH bridging therapy had a higher incidence of postoperative bleeding and pulmonary embo-lism,although the differences were not statistically significant(P＞0.05).However,the incidence of postoperative myocardial infarction was significantly higher in the LMWH bridging group(P=0.032).Conclusion:Patients with mild-to-moderate coronary stenosis demonstrate relatively low perioperative risk during TURBT procedures and may safely undergo TURBT following antiplatelet therapy discontinuation.Conversely,those with severe coronary stenosis exhibit significantly higher perioperative risk and require intensive monitoring.In bladder cancer patients with concomitant severe coronary stenosis,perioperative LMWH bridging therapy is associated with increased myocardial infarction risk,whereas continued anti-platelet therapy does not elevate postoperative bleeding risk.Current evidence therefore supports maintai-ning antiplatelet therapy in these patients,with appropriate bleeding risk assessment.

Objective:To investigate the prognostic value of aldosterone synthase (CYP11B2) immunohistochemical expression in adrenal specimens for surgical outcomes of primary aldosteronism (PA).Methods:The clinical data of 99 patients who underwent total unilateral adrenalectomy from June 2022 to January 2023 at Beijing Anzhen Hospital was retrospectively analysed. The clinical data of 99 patients who underwent unilateral total adrenalectomy at Beijing Anzhen Hospital from June 2022 to January 2023 were retrospectively analyzed.There were 59 patients in the PA group, age (53.02±10.56) years, body mass index (BMI) (26.28±4.33) kg/m 2, preoperative aldosterone 29.0(15.9, 61.5)ng/dl, plasma renin 1.3(0.6, 2.8)μIU/ml, aldosterone renin ratio (ARR) 19.3(9.1, 59.2) μg/μIU, preoperative potassium (3.60±0.69) mmol/L, and systolic blood pressure (156.54±21.39) mmHg (1 mmHg=0.133 kPa).There were 40 cases in the nonfunctioning adenoma (NFA) group, age (57.23±9.39) years, BMI (27.07±3.46) kg/m 2, preoperative aldosterone 9.0(7.2, 14.1) ng/dl, plasma renin 18.0(5.2, 47.6)μIU/ml, ARR 0.6(0.2, 1.4) μg/μIU, preoperative potassium (4.17±0.41) mmol/L, and systolic blood pressure (157.97±26.87) mmHg. The differences between the two groups were statistically significant for potassium ( P<0.01), aldosterone ( P=0.012), renin ( P<0.01), and ARR ( P<0.01).Surgical outcomes were assessed using the Consensus on the Outcome of Surgery for Primary Aldosteronism (PASO) (complete/partial/no success for clinical and biochemical outcomes). CYP11B2 expression was evaluated by immunohistochemistry using the 2022 World Health Organization's histopathology of primary aldosteronism (HISTALDO) criteria. The correlation between the expression of CYP11B2 and surgical outcomes was assessed. Results:The mean follow-up of 99 patients was (11.73±4.92) months. Of these, 36 out of 59 PA patients had positive CYP11B2 expression in their adrenal specimens, while 23 were negative; all 40 NFA patients were negative for CYP11B2. Among the 36 CYP11B2-positive PA patients, there were 19 cases of aldosterone-producing adenomas, 3 aldosterone-producing nodules, 4 aldosterone-producing micronodules, 8 multiple aldosterone-producing micronodules, and 2 aldosterone-producing diffuse hyperplasia. 36 cases of CYP11B2-positive PA patients had complete clinical success in 15 cases, partial success in 20 cases, and no success in 1 case, and complete biochemical success in 24 cases, partial success in 11 cases, and no success in 1 case; 23 CYP11B2-negative PA patients had complete clinical success in 4 cases, partial success in 15 cases, and no success in 4 cases, and complete biochemical success in 6 cases, partial success in 15 cases, and no success in 2 cases. Adrenal specimens from CYP11B2-positive PA patients had significantly better clinical ( P=0.038) and biochemical ( P=0.008) success rates than CYP11B2-negative PA patients. Patients with aldosterone-producing adenomas had complete clinical success in 8 cases, partial success in 11 cases, and no success in 0 cases, and biochemical success was completely achieved in 16 cases, partially achieved in 2 cases, and not successful in 1 case. They also had significantly higher clinical ( P=0.028) and biochemical ( P<0.01) success rates compared to CYP11B2-negative PA patients. Conclusions:Patients with PA who had immunohistochemical staining for CYP11B2 positivity and high expression in adrenal specimens had a better postoperative clinical and biochemical prognosis. Patients with aldosterone-producing adenomas had the greatest postoperative outcome of all pathological subtypes of PA.

Objective:To explore the risk factors of adverse events during the perioperative period of transurethral resection of bladder tumor(TURBT)in bladder cancer patients with coronary atherosclerotic heart disease(CAD).Methods:We retrospectively analyzed the clinical data of bladder cancer patients who underwent TURBT in Beijing Anzhen Hospital from June 2022 to September 2024.All patients with bladder cancer and CAD underwent coronary computed tomography angiography(CCTA)for diagnosis and assessment of CAD before surgery.Based on the CCTA results,the patients with bladder cancer and CAD were divided into two groups:those with mild to moderate coronary stenosis and those with severe coronary stenosis.The severe coronary stenosis group was further divided into two subgroups based on whether they received low-molecular-weight heparin(LMWH)bridging therapy or continued their anti-platelet treatment before surgery.Perioperative anticoagulation and antiplatelet strategies were adjusted according to the opinions of the specialists.The incidence of adverse events within 30 days postoperative-ly was followed up and analyzed.Results:A total of 80 bladder cancer patients with CAD who underwent TURBT were included in the study.Among the 80 patients with CAD,55(68.8％)had mild to moder-ate coronary stenosis,and 25(31.2％)had severe coronary stenosis.Compared with those had mild to moderate coronary stenosis,the patients who had severe coronary stenosis had a higher incidence of post-operative bleeding and pulmonary embolism,although the differences were not statistically significant(P＞0.05).However,the incidence of postoperative myocardial infarction was significantly higher in the patients who had severe coronary stenosis(P=0.034).Among the patients with severe coronary stenosis,8(32.0％)received LMWH bridging therapy before TURBT,and 17(68.0％)continued their previous antiplatelet treatment.Compared with those who continued antiplatelet treatment,the patients who re-ceived LMWH bridging therapy had a higher incidence of postoperative bleeding and pulmonary embo-lism,although the differences were not statistically significant(P＞0.05).However,the incidence of postoperative myocardial infarction was significantly higher in the LMWH bridging group(P=0.032).Conclusion:Patients with mild-to-moderate coronary stenosis demonstrate relatively low perioperative risk during TURBT procedures and may safely undergo TURBT following antiplatelet therapy discontinuation.Conversely,those with severe coronary stenosis exhibit significantly higher perioperative risk and require intensive monitoring.In bladder cancer patients with concomitant severe coronary stenosis,perioperative LMWH bridging therapy is associated with increased myocardial infarction risk,whereas continued anti-platelet therapy does not elevate postoperative bleeding risk.Current evidence therefore supports maintai-ning antiplatelet therapy in these patients,with appropriate bleeding risk assessment.

With the advancement of the "New Medical Science" reform, the "Medicine+X" model has emerged as a key direction for the future development of medical education. Multidisciplinary integration places higher demands on both educators and students. Emerging technologies, such as intelligent tutoring systems, adaptive learning platforms, intelligent campus management systems, and ChatGPT, have made personalized learning possible. Such approaches offer notable advantages, including improving learning efficiency, enhancing motivation, eliminating the spatiotemporal constraints of clinical education, and alleviating teachers′ workloads. Nevertheless, the application of artificial intelligence in personalized medical education still faces multiple challenges, such as issues of data quality and reliability, the need for faculty development, shifts in educational paradigms, and ethical considerations. This study explored the current status of artificial intelligence in personalized medical education and offered recommendations to promote its development, including strengthening the integration of technology and education, enhancing the digital literacy of educators, establishing ethical guidelines, and fostering multi-stakeholder collaboration.

In traditional teaching, medical students have limited opportunities to interact with patients, which constrains the development of their clinical skills. Virtual standardized patients offer a potential solution to this limitation. This article analyzes the advantages of virtual standardized patients and their application in clinical teaching.

Medical students often struggle to understand and master the relevant knowledge and skills in teaching, especially in surgical teaching. Emerging 3D printing technology can help students to understand and master surgical techniques. The problem-based learning (PBL) teaching method helps students to develop their independent thinking and teamwork skills. The combination of these methods has already achieved significant success. Therefore, this article discusses the application and combining 3D printing technology with the PBL teaching method in medical teaching, particularly in urological surgery education, and provides new ideas and references for future, more diverse, and high-tech medical education.

With the advancement of the "New Medical Science" reform, the "Medicine+X" model has emerged as a key direction for the future development of medical education. Multidisciplinary integration places higher demands on both educators and students. Emerging technologies, such as intelligent tutoring systems, adaptive learning platforms, intelligent campus management systems, and ChatGPT, have made personalized learning possible. Such approaches offer notable advantages, including improving learning efficiency, enhancing motivation, eliminating the spatiotemporal constraints of clinical education, and alleviating teachers′ workloads. Nevertheless, the application of artificial intelligence in personalized medical education still faces multiple challenges, such as issues of data quality and reliability, the need for faculty development, shifts in educational paradigms, and ethical considerations. This study explored the current status of artificial intelligence in personalized medical education and offered recommendations to promote its development, including strengthening the integration of technology and education, enhancing the digital literacy of educators, establishing ethical guidelines, and fostering multi-stakeholder collaboration.

In traditional teaching, medical students have limited opportunities to interact with patients, which constrains the development of their clinical skills. Virtual standardized patients offer a potential solution to this limitation. This article analyzes the advantages of virtual standardized patients and their application in clinical teaching.

Medical students often struggle to understand and master the relevant knowledge and skills in teaching, especially in surgical teaching. Emerging 3D printing technology can help students to understand and master surgical techniques. The problem-based learning (PBL) teaching method helps students to develop their independent thinking and teamwork skills. The combination of these methods has already achieved significant success. Therefore, this article discusses the application and combining 3D printing technology with the PBL teaching method in medical teaching, particularly in urological surgery education, and provides new ideas and references for future, more diverse, and high-tech medical education.

Objective:To investigate the prognostic value of aldosterone synthase (CYP11B2) immunohistochemical expression in adrenal specimens for surgical outcomes of primary aldosteronism (PA).Methods:The clinical data of 99 patients who underwent total unilateral adrenalectomy from June 2022 to January 2023 at Beijing Anzhen Hospital was retrospectively analysed. The clinical data of 99 patients who underwent unilateral total adrenalectomy at Beijing Anzhen Hospital from June 2022 to January 2023 were retrospectively analyzed.There were 59 patients in the PA group, age (53.02±10.56) years, body mass index (BMI) (26.28±4.33) kg/m 2, preoperative aldosterone 29.0(15.9, 61.5)ng/dl, plasma renin 1.3(0.6, 2.8)μIU/ml, aldosterone renin ratio (ARR) 19.3(9.1, 59.2) μg/μIU, preoperative potassium (3.60±0.69) mmol/L, and systolic blood pressure (156.54±21.39) mmHg (1 mmHg=0.133 kPa).There were 40 cases in the nonfunctioning adenoma (NFA) group, age (57.23±9.39) years, BMI (27.07±3.46) kg/m 2, preoperative aldosterone 9.0(7.2, 14.1) ng/dl, plasma renin 18.0(5.2, 47.6)μIU/ml, ARR 0.6(0.2, 1.4) μg/μIU, preoperative potassium (4.17±0.41) mmol/L, and systolic blood pressure (157.97±26.87) mmHg. The differences between the two groups were statistically significant for potassium ( P<0.01), aldosterone ( P=0.012), renin ( P<0.01), and ARR ( P<0.01).Surgical outcomes were assessed using the Consensus on the Outcome of Surgery for Primary Aldosteronism (PASO) (complete/partial/no success for clinical and biochemical outcomes). CYP11B2 expression was evaluated by immunohistochemistry using the 2022 World Health Organization's histopathology of primary aldosteronism (HISTALDO) criteria. The correlation between the expression of CYP11B2 and surgical outcomes was assessed. Results:The mean follow-up of 99 patients was (11.73±4.92) months. Of these, 36 out of 59 PA patients had positive CYP11B2 expression in their adrenal specimens, while 23 were negative; all 40 NFA patients were negative for CYP11B2. Among the 36 CYP11B2-positive PA patients, there were 19 cases of aldosterone-producing adenomas, 3 aldosterone-producing nodules, 4 aldosterone-producing micronodules, 8 multiple aldosterone-producing micronodules, and 2 aldosterone-producing diffuse hyperplasia. 36 cases of CYP11B2-positive PA patients had complete clinical success in 15 cases, partial success in 20 cases, and no success in 1 case, and complete biochemical success in 24 cases, partial success in 11 cases, and no success in 1 case; 23 CYP11B2-negative PA patients had complete clinical success in 4 cases, partial success in 15 cases, and no success in 4 cases, and complete biochemical success in 6 cases, partial success in 15 cases, and no success in 2 cases. Adrenal specimens from CYP11B2-positive PA patients had significantly better clinical ( P=0.038) and biochemical ( P=0.008) success rates than CYP11B2-negative PA patients. Patients with aldosterone-producing adenomas had complete clinical success in 8 cases, partial success in 11 cases, and no success in 0 cases, and biochemical success was completely achieved in 16 cases, partially achieved in 2 cases, and not successful in 1 case. They also had significantly higher clinical ( P=0.028) and biochemical ( P<0.01) success rates compared to CYP11B2-negative PA patients. Conclusions:Patients with PA who had immunohistochemical staining for CYP11B2 positivity and high expression in adrenal specimens had a better postoperative clinical and biochemical prognosis. Patients with aldosterone-producing adenomas had the greatest postoperative outcome of all pathological subtypes of PA.