Immunotherapy has demonstrated significant efficacy in hematologic malignancies and certain solid tumors,but its efficacy for prostate cancer remains suboptimal.This is largely due to the immunosuppressive tumor microenvironment,which involves factors such as tumor heterogeneity,a paucity of infiltrating lymphocytes,and the absence of inflammatory features.Therefore,developing novel immunotherapeutic targets and combining multiple immunotherapy modalities to activate the host immune system and reverse the immunosuppressive tumor microenvironment are crucial for improving immunotherapy for prostate cancer.This review systematically summarizes the current research on prostate cancer immunotherapy,covering the challenges and advances of prostate cancer vaccines,the application of immune checkpoint inhibitors,targeted therapeutic strategies involving chimeric antigen receptor T cells,bispecific antibodies,and emerging strategies in prostate cancer immunotherapy.Furthermore,the review discusses the future directions for the development of prostate cancer immunotherapy.

Objective To investigate the relationship between preoperative serum levels of long noncoding RNA(lncRNA)X inactive specific transcript(XIST)and microRNA(miR)-140-3p in acute myocardial infarction(AMI)patients undergoing percutaneous coronary intervention(PCI)and blood glucose,blood lipids,myocardial injury indexes,degree of coronary artery disease and the occurrence of major adverse cardiovascular events(MACE)within 3 years after surgery.Methods A total of 164 patients with AMI(AMI group)and 148 healthy subjects(healthy group)were selected from Hankuang General Hospital of North China Medical and Health Group from November 2018 to February 2021.Clinical data were collected at admission,and blood glucose,blood lipids,myocardial injury indicators,serum lncRNA XIST and miR-140-3p levels in AMI group before PCI and healthy group during physical examination were detected.According to the degree of coronary artery disease,AMI patients were divided into mild coronary artery disease group(n=33),moderate coronary artery disease group(n=76),and severe coronary artery disease group(n=55).Follow up for 3 years after surgery,AMI patients were divided into MACE group(n=36)and non-MACE group(n=128).Clinical data,preoperative PCI blood glucose,blood lipids,myocardial injury indicators,synergy between percutaneous coronary intervention with TAXUS and cardiac surgery(SYNTAX)score,and serum lncRNA XIST and miR-140-3p expression levels of health group and AMI group,AMI patients with different prognoses within 3 years after PCI were compared.The serum lncRNA XIST and miR-140-3p expression levels of AMI patients with different degrees of coronary artery disease before PCI were compared.The correlation between preoperative PCI serum lncRNA XIST and miR-140-3p with blood glucose,blood lipids,myocardial injury indicators,SYNTAX score in AMI patients,the influencing factors of MACE occurrence,and predicting the value of preoperative PCI serum lncRNA XIST and miR-140-3p in predicting MACE occurrence within 3 years after PCI in AMI patients were analyzed.Results Compared with healthy group,the preoperative PCI fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),low density lipoprotein-cholesterol(LDL-C),hypersensitive C-reactive protein(hs-CRP),creatine kinase isoenzyme(CK-MB),homocysteine(Hcy),cardiac troponin I(cTnI),brain natriuretic peptide(BNP),lncRNA XIST expression levels of AMI group were significantly increased(t=2.426～80.642),and high density lipoprotein-cholesterol(HDL-C),left ventricular ejection fraction(LVEF)and miR-140-3pexpression levels were significantly reduced(t=6.166～66.119),the differences were statistically significant(all P<0.05).Before PCI,the expression levels of serum lncRNA XIST were increased successively,and the expression levels of miR-140-3p were decreased successively in mild,moderate,and severe coronary artery lesions group,the differences were statistically significant(F=174.600,231.138,all P<0.05).The serum lncRNA XIST of AMI patients before PCI was positively correlated with FPG,TC,TG,LDL-C,hs-CRP,CK-MB,Hcy,cTnI,BNP and SYNTAX scores(r=0.235～0.681,all P＜0.05),and negatively correlated with miR-140-3p,HDL-C and LVEF(r=-0.571,-0.262,-0.513,all P＜0.05).miR-140-3p was negatively correlated with FPG,TC,TG,LDL-C,hs-CRP,CK-MB,Hcy,cTnI,BNP and SYNTAX scores(r=-0.672～-0.209,all P＜0.05),and positively correlated with HDL-C and LVEF(r=0.245,0.524,all P＜0.05).Compared with non-MACE group,the hs-CRP,CK-MB,Hcy,cTnI,BNP,SYNTAX scores and lncRNA XIST expression levels before PCI in MACE group were significantly increased(t=3.032～26.330),while the LVEF and miR-140-3p expression levels were significantly reduced(t=2.821,13.318),the differences were statistically significant(all P<0.05).LVEF and miR-140-3p were independent protective factors for MACE in AMI patients within 3 years after PCI(Wald χ2=6.098,7.851,all P＜0.05),while CK-MB,Hcy,cTnI,BNP,SYNTAX score and lncRNA XIST were independent risk factors for MACE in AMI patients within 3 years after PCI(Wald χ2=4.263～7.853,all P＜0.05).Compared with the area under curve(AUC)of serum lncRNA XIST and miR-140-3p before PCI separately predicting MACE occurrence within 3 years after PCI in AMI patients,the combined prediction of MACE occurrence within 3 years after PCI in AMI patients was higher,and the differences were statistically significant(Z=2.059,2.017,all P<0.05).Conclusion The expression of lncRNA XIST in the serum of AMI patients is increased while the expression of miR-140-3p is decreased.Both are associated with blood glucose,blood lipids myocardial injury indicators,degree of coronary artery disease,and the occurrence of MACE within three years after PCI.They have high value in predicting the occurrence of MACE within three years after PCI surgery.

Immunotherapy has demonstrated significant efficacy in hematologic malignancies and certain solid tumors,but its efficacy for prostate cancer remains suboptimal.This is largely due to the immunosuppressive tumor microenvironment,which involves factors such as tumor heterogeneity,a paucity of infiltrating lymphocytes,and the absence of inflammatory features.Therefore,developing novel immunotherapeutic targets and combining multiple immunotherapy modalities to activate the host immune system and reverse the immunosuppressive tumor microenvironment are crucial for improving immunotherapy for prostate cancer.This review systematically summarizes the current research on prostate cancer immunotherapy,covering the challenges and advances of prostate cancer vaccines,the application of immune checkpoint inhibitors,targeted therapeutic strategies involving chimeric antigen receptor T cells,bispecific antibodies,and emerging strategies in prostate cancer immunotherapy.Furthermore,the review discusses the future directions for the development of prostate cancer immunotherapy.

Objective To investigate the relationship between preoperative serum levels of long noncoding RNA(lncRNA)X inactive specific transcript(XIST)and microRNA(miR)-140-3p in acute myocardial infarction(AMI)patients undergoing percutaneous coronary intervention(PCI)and blood glucose,blood lipids,myocardial injury indexes,degree of coronary artery disease and the occurrence of major adverse cardiovascular events(MACE)within 3 years after surgery.Methods A total of 164 patients with AMI(AMI group)and 148 healthy subjects(healthy group)were selected from Hankuang General Hospital of North China Medical and Health Group from November 2018 to February 2021.Clinical data were collected at admission,and blood glucose,blood lipids,myocardial injury indicators,serum lncRNA XIST and miR-140-3p levels in AMI group before PCI and healthy group during physical examination were detected.According to the degree of coronary artery disease,AMI patients were divided into mild coronary artery disease group(n=33),moderate coronary artery disease group(n=76),and severe coronary artery disease group(n=55).Follow up for 3 years after surgery,AMI patients were divided into MACE group(n=36)and non-MACE group(n=128).Clinical data,preoperative PCI blood glucose,blood lipids,myocardial injury indicators,synergy between percutaneous coronary intervention with TAXUS and cardiac surgery(SYNTAX)score,and serum lncRNA XIST and miR-140-3p expression levels of health group and AMI group,AMI patients with different prognoses within 3 years after PCI were compared.The serum lncRNA XIST and miR-140-3p expression levels of AMI patients with different degrees of coronary artery disease before PCI were compared.The correlation between preoperative PCI serum lncRNA XIST and miR-140-3p with blood glucose,blood lipids,myocardial injury indicators,SYNTAX score in AMI patients,the influencing factors of MACE occurrence,and predicting the value of preoperative PCI serum lncRNA XIST and miR-140-3p in predicting MACE occurrence within 3 years after PCI in AMI patients were analyzed.Results Compared with healthy group,the preoperative PCI fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),low density lipoprotein-cholesterol(LDL-C),hypersensitive C-reactive protein(hs-CRP),creatine kinase isoenzyme(CK-MB),homocysteine(Hcy),cardiac troponin I(cTnI),brain natriuretic peptide(BNP),lncRNA XIST expression levels of AMI group were significantly increased(t=2.426～80.642),and high density lipoprotein-cholesterol(HDL-C),left ventricular ejection fraction(LVEF)and miR-140-3pexpression levels were significantly reduced(t=6.166～66.119),the differences were statistically significant(all P<0.05).Before PCI,the expression levels of serum lncRNA XIST were increased successively,and the expression levels of miR-140-3p were decreased successively in mild,moderate,and severe coronary artery lesions group,the differences were statistically significant(F=174.600,231.138,all P<0.05).The serum lncRNA XIST of AMI patients before PCI was positively correlated with FPG,TC,TG,LDL-C,hs-CRP,CK-MB,Hcy,cTnI,BNP and SYNTAX scores(r=0.235～0.681,all P＜0.05),and negatively correlated with miR-140-3p,HDL-C and LVEF(r=-0.571,-0.262,-0.513,all P＜0.05).miR-140-3p was negatively correlated with FPG,TC,TG,LDL-C,hs-CRP,CK-MB,Hcy,cTnI,BNP and SYNTAX scores(r=-0.672～-0.209,all P＜0.05),and positively correlated with HDL-C and LVEF(r=0.245,0.524,all P＜0.05).Compared with non-MACE group,the hs-CRP,CK-MB,Hcy,cTnI,BNP,SYNTAX scores and lncRNA XIST expression levels before PCI in MACE group were significantly increased(t=3.032～26.330),while the LVEF and miR-140-3p expression levels were significantly reduced(t=2.821,13.318),the differences were statistically significant(all P<0.05).LVEF and miR-140-3p were independent protective factors for MACE in AMI patients within 3 years after PCI(Wald χ2=6.098,7.851,all P＜0.05),while CK-MB,Hcy,cTnI,BNP,SYNTAX score and lncRNA XIST were independent risk factors for MACE in AMI patients within 3 years after PCI(Wald χ2=4.263～7.853,all P＜0.05).Compared with the area under curve(AUC)of serum lncRNA XIST and miR-140-3p before PCI separately predicting MACE occurrence within 3 years after PCI in AMI patients,the combined prediction of MACE occurrence within 3 years after PCI in AMI patients was higher,and the differences were statistically significant(Z=2.059,2.017,all P<0.05).Conclusion The expression of lncRNA XIST in the serum of AMI patients is increased while the expression of miR-140-3p is decreased.Both are associated with blood glucose,blood lipids myocardial injury indicators,degree of coronary artery disease,and the occurrence of MACE within three years after PCI.They have high value in predicting the occurrence of MACE within three years after PCI surgery.

Low-level laser therapy(LLLT),a noninvasive photobiomodulation technique,employs red or near-infrared(NIR)light(600-1 000 nm)with power outputs ranging from 5 to 500 mW.It exerts therapeutic effects through molecular mechanisms,specifically the activation of cytochrome C oxidase(CCO)and the modulation of intracellular signaling pathways.By enhancing mitochondrial adenosine triphosphate(ATP)synthesis,LLLT mitigates oxidative stress,regulates the reactive oxygen species(ROS)/glutathione peroxidase(GSH-Px)/superoxide dismutase(SOD)axis,and activates key path-ways,including phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt)and mitogen-activated pro-tein kinase/extracellular signal-regulated kinase(MAPK/ERK).These mechanisms confer antioxidant,anti-inflammatory,and pro-regenerative properties to LLLT,making it a viable intervention for dermato-logical conditions,oncological therapies,and musculoskeletal disorders.Recent preclinical studies un-derscore LLLT's potential in male reproductive health.Specifically,it ameliorates cavernosal fibrosis and endothelial dysfunction in erectile dysfunction(ED)models by upregulating the PI3K/Akt and MAPK/ERK pathways.In the context of sperm biology,LLLT enhances motility and acrosomal integrity in both fresh and cryopreserved spermatozoa.This is achieved through mitochondrial metabolic reprogramming,such as CCO-mediated electron transport chain activation,redox homeostasis restoration,and epigenetic modulation involving DNA methylation and histone acetylation.Additionally,LLLT alleviates scrotal heat-induced oligospermia by promoting seminiferous epithelial differentiation,elevating serum testoster-one levels,and suppressing lipid peroxidation.These findings highlight the translational potential of LLLT in regenerative medicine,particularly for male sexual and reproductive disorders.Future research efforts should focus on interdisciplinary collaborations spanning life sciences,engineering,and physics.The goal is to optimize laser parameters,including wavelength,irradiance,and treatment duration,and establish standardized protocols.Rigorous preclinical and clinical investigations are paramount to validate the safety,efficacy,and long-term outcomes of LLLT,ultimately paving the way for its integration into precision medicine frameworks for urological and reproductive therapies.

Low-level laser therapy(LLLT),a noninvasive photobiomodulation technique,employs red or near-infrared(NIR)light(600-1 000 nm)with power outputs ranging from 5 to 500 mW.It exerts therapeutic effects through molecular mechanisms,specifically the activation of cytochrome C oxidase(CCO)and the modulation of intracellular signaling pathways.By enhancing mitochondrial adenosine triphosphate(ATP)synthesis,LLLT mitigates oxidative stress,regulates the reactive oxygen species(ROS)/glutathione peroxidase(GSH-Px)/superoxide dismutase(SOD)axis,and activates key path-ways,including phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt)and mitogen-activated pro-tein kinase/extracellular signal-regulated kinase(MAPK/ERK).These mechanisms confer antioxidant,anti-inflammatory,and pro-regenerative properties to LLLT,making it a viable intervention for dermato-logical conditions,oncological therapies,and musculoskeletal disorders.Recent preclinical studies un-derscore LLLT's potential in male reproductive health.Specifically,it ameliorates cavernosal fibrosis and endothelial dysfunction in erectile dysfunction(ED)models by upregulating the PI3K/Akt and MAPK/ERK pathways.In the context of sperm biology,LLLT enhances motility and acrosomal integrity in both fresh and cryopreserved spermatozoa.This is achieved through mitochondrial metabolic reprogramming,such as CCO-mediated electron transport chain activation,redox homeostasis restoration,and epigenetic modulation involving DNA methylation and histone acetylation.Additionally,LLLT alleviates scrotal heat-induced oligospermia by promoting seminiferous epithelial differentiation,elevating serum testoster-one levels,and suppressing lipid peroxidation.These findings highlight the translational potential of LLLT in regenerative medicine,particularly for male sexual and reproductive disorders.Future research efforts should focus on interdisciplinary collaborations spanning life sciences,engineering,and physics.The goal is to optimize laser parameters,including wavelength,irradiance,and treatment duration,and establish standardized protocols.Rigorous preclinical and clinical investigations are paramount to validate the safety,efficacy,and long-term outcomes of LLLT,ultimately paving the way for its integration into precision medicine frameworks for urological and reproductive therapies.

Retzius-sparing robot assisted radical prostatectomy (RS-RARP) can significantly improve the immediate urinary continence without increasing the positive rate of surgical margin.However, the learning curve is long, and fewer than 10% of the surgeons can master it.Therefore,we have optimized the procedures of RS-RARP, applying radical prostatectomy with retrograde release of neurovascular bundle to preserve it to the maximum extent.Urethral anastomosis can be performed with only one suture, which eliminates the need for Hem-o-lok and reduces subsequent complications.Our team routinely carries out this operation, and conlcudes that this surgical method can achieve good tumor control, good urinary continence, fast recovery of sexual function, few complications, and strong operability.This article details the key steps and operation experience of this technique.

Plain combined with three-phase contrast-enhanced CT is the most commonly used imaging technique for the diagnosis of renal masses, and it also plays an important role in predicting the malignancy and aggressiveness of renal tumors. The pathological findings of renal tumors are important in determining treatment options as well as prognosis. This article reviews current research and summarizes common CT variables for renal tumors, including tumor diameter, growth rate, enhancement characteristics, tumor margins, the proportion of cystic components, and variables related to the R. E.N.A.L. score. This paper aims to analyze the role of these variables in predicting the pathological malignancy and aggressiveness of the renal tumor.

Objective:Based on multi-parametric prostate magnetic resonance imaging (mpMRI) and related clinical indicators, a nomogram model for patients with PI-RADS ≥3 and PSA 4-20ng/ml was developed and validated, and the predictive value of the model in diagnosing clinically significant prostate cancer was evaluated.Methods:The clinical and pathological data of 865 patients who underwent ultrasound-guided transperineal prostate biopsy for the first time at the Department of Urology, Second Hospital of Tianjin Medical University from January 2020 to August 2023, with PI-RADS scores ≥3 and PSA levels between 4-20 ng/ml were retrospectively analyzed. These 865 patients were included in Cohort A, and from them, 437 patients with PHI were selected in Cohort B. In Cohort A, the median age was 68(64, 73); the median f/tPSA was 14.36 (10.63, 19.74); the median PSAD was 0.17(0.11, 0.25); 375 cases (43.35%) with PV≤50 ml and 490 cases (56.65%) with PV>50 ml; PSA fluctuation <-50% 84 cases (9.71%), -50%--20% in 206 cases (23.82%), and >-20% in 575 cases (66.47%); PI-RADS v2.1 3 scores 546 cases (63.12%), 4 in 230 cases (23.59%), and 5 in 89 cases (10.29%); localization of suspicious lesions on mpMRI in the peripheral zone in 619 cases (71.56%), transitional zone in 181 cases (20.92%), others in 42 cases (4.86%), and both peripheral and transitional zones in 23 cases (2.66%). In Cohort B, the median PSAD was 0.17 (0.12, 0.25); the median D-dimer was 310.00 (230.00, 411.48); the median PHI was 49.75 (35.90, 73.27); with 198 cases (45.31%) with PV≤50 ml and 239 cases (54.69%) with PV>50 ml; PSA fluctuation<-50% was in 40 cases (9.15%), -50%--20% in 107 cases (24.49%), and>-20% in 290 cases (66.39%); PI-RADS v2.1 scores 3 was in 289 cases (66.13%), 4 in 103 cases (23.57%), and 5 in 45 cases (10.30%).Patients in cohorts A and B were randomly assigned to the training set and validation set using R language with " 123" as the random number seed, at a ratio of 7∶3.There was no statistically significant difference between the clinical data of the training and validation sets for both groups ( P>0.05).Univariate and multivariate logistic regression analyses were used to identify independent risk factors for CsPCa, and a nomogram model was constructed using R. The diagnostic performance of the prediction model was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis(DCA).External validation of the model was conducted in the validation set. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and missed diagnosis rate analyses were performed on nomogram models A and B, as well as PSAD and PHI, under different thresholds. Results:Cohort A training set has 608 cases, and the validation set has 257 cases.The results of multivariate backward regression analysis in the training set show that age( OR=1.06, P=0.001), f/tPSA( OR=0.96, P=0.008), prostate volume (PV)>50ml( OR=0.36, P<0.01), prostate-specific antigen density(PSAD)( OR=145.19, P<0.01), PSA fluctuation(-50%--20%: OR=1.97, P=0.234; >-20%: OR=6.81, P<0.01), PI-RADS v2.1 score(4: OR=10.65, P<0.01; 5: OR=21.20, P<0.01), and localization of suspicious lesions on mpMRI(TZ: OR=0.57, P=0.074; Others: OR=0.26, P=0.022) were all risk factors for CsPCa. Nomogram A was developed based on these risk factors and had an area under the ROC curve (AUC) of 0.905 (95% CI 0.881-0.928) for the training set and 0.893 (95% CI 0.854-0.931) for the validation set. Cohort B training set developed based on age( OR=1.05, P=0.053), PV>50ml( OR=0.18, P<0.01), PSAD( OR=54.14, P=0.021), PSA fluctuation(-50%--20%: OR=4.78, P=0.100; >-20%: OR=20.37, P=0.001), PHI( OR=1.02, P=0.002), D-Dimer( OR=1.00, P=0.031), and PI-RADS scores(4: OR=11.35, P<0.01; 5: OR=57.61, P<0.01) as risk factors for CsPCa. Nomogram B had an AUC of 0.933(95% CI 0.906-0.959) for the training set and 0.908 (95% CI 0.859-0.958) for the validation set.The two nomogram models mentioned above both have excellent discrimination, and the calibration curves also indicated that the calibration of the two models were good.Moreover, both nomogram A and nomogram B demonstrate good clinical net benefits in the DCA curves of the training and validation sets, especially when applying nomogram B to predict CsPCa, with an accuracy rate of up to 85.82%. Conclusions:The two nomogram models developed in study, based on mpMRI and related clinical indicators, both have excellent predictive value for the diagnosis of clinically significant prostate cancer prior to prostate biopsy in patients with PI-RADS≥3 and PSA 4-20ng/ml.

Objective:To explore the clinical efficacy of retzius-sparing robot-assisted laparoscopic radical prostatectomy with retrograde release of the neurovascular bundle.Methods:From January 2021 to January 2022, the clinical data of 113 patients with retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RARP) was retrospectively analyzed. The ages of the optimized group and the standard group were (67.5±6.4) years and (67.7±6.1) years, and the body mass index (BMI) was (25.0±3.2) kg/m 2 and (24.9±3.1) kg/m 2, respectively. The prostate volume was (42.8±15.4) ml and (41.0±17.9) ml, the preoperative PSA was (13.5±13.1) ng/ml and (11.9±16.0) ng/ml, and the preoperative IIEF-5 score was (15.0±4.0) and (14.8±4.2) points, respectively. Gleason scores were (7.2±0.8) points and (7.1±0.9) points, respectively, with no statistical significance ( P>0.05). The clinical stages of cT 2 and cT 3 were 35 and 40 cases in the optimized group and 16 and 22 cases in the standard group, respectively. There were 5 and 11 cases of preoperative neoadjuvant therapy, respectively, with no statistical significance ( P>0.05). The optimized RS-RARP is the blunt dissection of the denonvilliers fascia and forward to the apex of prostate, and retrograde release of the NVB. The operation time, intraoperative blood loss, drainage tube retention time, days of hospital stay, positive rate of pathological margin and incidence of complications were compared. The recovery of urinary continence was evaluated at 2 weeks after the catheter was removed, and the postoperative IIEF-5 score and PSA were followed up at 1 month after the surgery. Immediate urinary continence was defined as the use of 1 pad on the day of radical prostatectomy. Follow-up intervals were no more than 3 months. The log-rank test compared urinary incontinence rates between the two modalities. Results:All 113 cases of surgery were completed, and median follow-up was 16 months. The operation time was (79.7±26.6) min and (149.8±40.1) min, and the intraoperative blood loss was (54.9±24.7) ml and (110.0±83.2) ml, respectively, and the difference was statistically significant ( P<0.01). The retention time of postoperative drainage tube was (5.3±2.1) d and (5.5±2.1) d in the optimal group and the standard group, and the days of hospital stay was (7.6±2.1) d and (8.5±2.3) d, respectively. The positive rate of postoperative pathological margin was 19.6% (10/51) and 24.2% (15/62), respectively. There was no significant difference ( P>0.05). immediate urinary continence was 86.3% (44/51) and 69.4% (43/62) in the optimized group and the standard group, respectively, and the difference was statistically significant ( P=0.033). Postoperative IIEF-5 scores were (13.2±3.3) and (11.0±4.3), respectively, and the difference was statistically significant ( P=0.012). Kaplan-Meier analysis showed that the risk of urinary incontinence was lower in the optimized group ( P=0.02). Conclusions:The optimized RS-RARP might shorten the operation time, reduce intraoperative bleeding, and help the recovery of urinary continence and sexual function to a great extent.