A case of an adult patient who was admitted to the hospital with the primary complaint of dysuria was presented. CT imaging of the urinary tract revealed incomplete duplication of the bladder, accompanied by multiple diverticula in the left bladder. Urodynamic studies indicated low detrusor contraction of the bladder. Cystoscopy revealed that the left bladder was connected to the urethra, with both bladders linked by a narrow connection. Laparoscopic expansion of this junction alleviated dysuria; however, it did not significantly reduce bladder residual volume during the short-term follow-up.

A case of an adult patient who was admitted to the hospital with the primary complaint of dysuria was presented. CT imaging of the urinary tract revealed incomplete duplication of the bladder, accompanied by multiple diverticula in the left bladder. Urodynamic studies indicated low detrusor contraction of the bladder. Cystoscopy revealed that the left bladder was connected to the urethra, with both bladders linked by a narrow connection. Laparoscopic expansion of this junction alleviated dysuria; however, it did not significantly reduce bladder residual volume during the short-term follow-up.

Objective To investigate the predictive value of a nomogram model constructed based on imaging combined with prostate-specific antigen(PSA)and its related parameters for biopsy in patients with PSA levels of 4-10 ng/mL.Methods The serological and imaging data of 191 patients who were detected for PSA and related indicators and underwent the first biopsy of prostate by transrectal ultrasound at Zhongshan City People's Hospital and/or Yunfu Hospital of TCM from January 2018 to December 2023 were analyzed retrospectively.Multivariate Logistic regression identified independent risk factors for prostate cancer,and a nomogram model was developed for patients with PSA levels of 4-10 ng/mL.The predictive performance of the model was evaluated using receiver operating characteristic(ROC)curves,calibration curves,and decision curves.Results The multivariate Logistic regression analysis showed that free PSA,prostate volume,transition zone volume,PSA density,and the prostate imaging-reporting and data system(PI-RADS v2.1)score were independent risk factors for prostate cancer.The model incorporating these significant variables demonstrated the best performance,with an area under the curve(AUC)of 0.750(95%CI:0.678-0.821),sensitivity of 72.7%,specificity of 77.2%,and accuracy of 74.9%.The calibration curve indicated good agreement between the predicted probability and the actual probability of prostate cancer;and the decision curve analysis further confirmed that the model had high clinical utility.Conclusion The constructed nomogram prediction model can effectively estimate the preoperative risk of prostate cancer in patients with PSA levels of 4-10 ng/mL,providing clinicians with an intuitive tool to adjust treatment plans based on the assessed risk,thereby optimizing patient outcomes.

Objective To investigate the predictive value of a nomogram model constructed based on imaging combined with prostate-specific antigen(PSA)and its related parameters for biopsy in patients with PSA levels of 4-10 ng/mL.Methods The serological and imaging data of 191 patients who were detected for PSA and related indicators and underwent the first biopsy of prostate by transrectal ultrasound at Zhongshan City People's Hospital and/or Yunfu Hospital of TCM from January 2018 to December 2023 were analyzed retrospectively.Multivariate Logistic regression identified independent risk factors for prostate cancer,and a nomogram model was developed for patients with PSA levels of 4-10 ng/mL.The predictive performance of the model was evaluated using receiver operating characteristic(ROC)curves,calibration curves,and decision curves.Results The multivariate Logistic regression analysis showed that free PSA,prostate volume,transition zone volume,PSA density,and the prostate imaging-reporting and data system(PI-RADS v2.1)score were independent risk factors for prostate cancer.The model incorporating these significant variables demonstrated the best performance,with an area under the curve(AUC)of 0.750(95%CI:0.678-0.821),sensitivity of 72.7%,specificity of 77.2%,and accuracy of 74.9%.The calibration curve indicated good agreement between the predicted probability and the actual probability of prostate cancer;and the decision curve analysis further confirmed that the model had high clinical utility.Conclusion The constructed nomogram prediction model can effectively estimate the preoperative risk of prostate cancer in patients with PSA levels of 4-10 ng/mL,providing clinicians with an intuitive tool to adjust treatment plans based on the assessed risk,thereby optimizing patient outcomes.

Objective:To investigate the killing effects in vitro of a new photosensitizer black titanium dioxide b-TP-700-mediated photodynamics on prostate cancer cell line PC-3 cells.Methods:The b-TP-700 was successfully prepared by using solid phase in situ thermal reduction method. PC-3 cells were treated with 31.25, 62.5, 125, 250, 500, 1 000 μg/ml b-TP-700 for 12, 24, 48 h. The cell activity was detected by using CCK-8 method, and the morphology of PC-3 cells was observed by using confocal fluorescence microscope, the toxicity of b-TP-700 to PC-3 cells was also judged. PC-3 cells were treated with different concentrations of b-TP-700 (31.25, 62.5, 125, 250, 500 μg/ml) and irradiated with laser (1 W/cm, 808 nm) for 1, 3, 5, 7 min. The cell activity was detected by using CCK-8 method. The production of reactive oxygen species in PC-3 cells cultured in 250 μg/ml b-TP-700 after laser irradiation for 5 min was detected by using confocal fluorescence microscopy. The non-laser irradiation cells were selected as the control group.Results:There were no statistically significant differences in cell activity of PC-3 cells treated with different concentrations of b-TP-700 for the same time ( F value was 1.26, 0.39 and 0.37, respectively; all P > 0.05). PC-3 cells were treated with 1 000 μg/ml b-TP-700 for 24 h, no obvious morphological changes and no obvious dead cells were observed under fluorescence microscope. When PC-3 cells were treated with the same concentration of b-TP-700, the activity of PC-3 cells was decreased with the extension of laser excitation time. Under the same laser excitation time, the activity of PC-3 cells was decreased with the increase of b-TP-700 concentration (all P < 0.05). Under laser irradiation, obvious green fluorescence could be detected in the PC-3 cells treated with 250 μg/ml b-TP-700, while almost no green fluorescence could be observed in the control group. Conclusions:A new photosensitizer b-TP-700 has the good reactive oxygen generation ability. b-TP-700-mediated photodynamics show obvious killing effects on prostate cancer PC-3 cells in vitro, which is expected to be a new method for the treatment of prostate cancer.

Objective Through studying the extracorporeal membrane oxygenation (ECMO)alleviating kidney damage caused by unstable circulation function following brain deaths to improve the utilization rate of donation after brain death (DBD) for renal transplantation.Methods Randomly selected 60 DBD patients with unstable circulatory function were randomly divided into 3 groups according to the time of perfusion by ECMO.The first group used ECMO perfusion for 2 h,group 24 h and group 36 h.At the same time,20 cases of stable DBD were randomly selected as the control group.The incidence of primary graft failure,delayed graft function and acute rejection,renal function recovery time,urine volume on the first day after surgery,creatinine and urea nitrogen one year after surgery were compared between two groups.Results The incidence of delayed recovery of renal function in experimental groups 1,2,3 and control group was 10％ (2/20),15％ (3/20),5％(1/20) and 10％ (2/20) respectively.The incidence of acute rejection in experimental groups 1,2,3 and control group was 30％ (6/20),25％ (5/20),35％ (7/20) and 25％ (5/20) respectively.There were no statistically significant differences between the experimental groups and the control group (P ＞0.05).The mean renal function recovery time in the experimental groups 1,2,3 and control group was (9.6 ± 2.0),(9.7 ± 2.7),(9.5 ± 1.9) and (7.3 ± 3.1) days respectively.The average urine volume in experimental groups 1,2,3 and control group was (3 405 ± 755),(3 300 ±600),(3 810±825),and (3 600 ± 80) mL respectively.In experimental groups 1,2,3 and control group,the average creatinine level was (92 ± 28),(92 ± 28),(101 ± 31),and (98 ± 30) μmol/L respectively.The average urea nitrogen in experimental groups 1,2,3 and control group was (4.2 ± 2.2),(5.6 ± 2.6),(5.2 ± 2.6) and (5.5 ± 2.5) mmol/L respectively.The recovery time of renal function in the experimental groups was longer than that in the control group (P＜0.05),but there was no significant difference among the experimental groups (P＞0.05).There was no statistically significant difference between the experimental groups and the control group in urine volume one day after surgery and kidney function one year after transplantation (P＞0.05).Only recovery time after operation of the DBD with the unstable circulation function assisted by EMCO was slightly longer than that with stable circulation function,while the rest indexes showed no statistically significant difference.Conclusion DBD with unstable circulation function with ECMO auxiliary circulatory function can protect the renal function and increase the utilization rate of donor organs.

Objective To explore the protective effect of extracorporeal membrane oxygenation (ECMO) on donor kidneys from non-controllable donation after cardiac death (DCD). Methods A total of 60 non-controllable DCD donors were selected and divided into 3 groups randomly based on the in vivo perfusion time of ECMO: test group 1 received EMCO perfusion for 2 h, test group 2 for 4 h and test group 3 for 6 h, with 20 cases in each group. Corresponding recipients were also divided into 3 groups, with 20 cases in each group. Meanwhile, 20 recipients from donation after brain death (DBD) with stable circulatory function were randomly selected as control group. Incidence of delayed graft function (DGF), primary graft nonfunction (PNF) and acute rejection of the recipients in different groups was compared. The indexes including graft function recovery time, urine volume on day 1 and graft function within 1 year after renal transplantation were compared for the recipients in different groups. And 1-year survival rate of the recipients and grafts after renal transplantation was compared. Results Compared with the control group, various test groups presented no significant differences in the incidence of PNF, DGF and acute rejection (all P>0.05). Compared with the control group, graft function recovery time prolonged significantly in each test group, which presented statistically significant differences (all P<0.05), while the urine volume on day 1 and graft function within 1 year after renal transplantation presented no statistically significant difference in each test group (all P>0.05). The 1-year survival rate of the recipients and grafts after renal transplantation was 100％ in various test groups and control group, which presented no statistically significant difference (all P>0.05). Conclusions ECMO can protect donor kidneys effectively through assisting the circulatory or respiratory function of non-controllable DCD, and improve their utilization rate.

Objective To investigate the safety and efficacy of nephron-sparing surgery (NSS)for selective T2 stage renal tumor.Methods The surgical database of 26 patients treated with NSS for clinical T2 stage renal cell carcinomas between March 2010 and May 2013 were collected and analyzed retrospectively.There were 17 males and 9 females,with a mean age of 52 years (39-74 years),mean tumor size of 10.3 cm(7.2-16.5 cm),and mean R.E.N.A.L score of 7.5 (6-10).Patients'demographics,clinical characteristics,oncologic outcomes,renal function were reviewed.Results The renal masses were removed successfully and the surgical margins were negative.There were 21 (80.8％) cases of clear cell carcinoma,4 (15.4％) papillary carcinoma and 1 (3.8％) chromophobe carcinoma.The mean ischemia time was (28.3 ± 12.5) minutes (7 patients were clamp-free).Three patients needed transfusion,one experienced urine fistula and cured by conservative treatment,and one patient's renal function got progressive worsening and required long-term hemodialysis.The average serum creatinine was 121 μ mol/L before and 136 μmol/L after surgery (P =0.06).After a period of 22-47 months' follow-up,no patient had local recurrence or metastasis.Conclusions NSS can be safely performed and provide effective oncologic outcomes for selective patients with clinical T2 stage renal cell carcinomas.R.E.N.A.L nephrometry is an important factor and should be used to evaluate the feasibility of NSS.

Objective:To investigate whether different type of chronic prostatitis could have a deleterious effect on semen quality. Methods: Forty-nine patients diagnosed as suffering from chronic prostatitis were included and di-vided into groups according to the presence of infection and/or cellular autoimmune response against prostate anti-gens. Healthy normal individuals were included as controls. Measurements for sperm concentration, motility, morphology, prostate and seminal vesicle markers, antisperm antibodies, white blood cells and pro-inflammatory cytokines were performed accordingly. Results:The most severe abnormalities were found in patients with no evi-dent infection and an autoimmune response against prostate antigens. Moreover, significantly increased levels of pro-inflammatory cytokines were detected in seminal plasma from these patients. Conclusions: This study shows that chronic prostatitis patients with cellular autoimmune response to prostate antigens present important altera-tions in their semen quality parameters and may affect male fertility.

In this paper, the constitution and operation principle of an automatic ventilation system for excimer laser therapeutic instrument are introduced. With high accuracy, stability and reliability, the system benefits the performance and service life of the instrument.