1.Measurement of urethral meatus circumference in middle-aged and elderly men scheduled for benign prostatic hyperplasia surgery
Zhe LIU ; Long TIAN ; Quan WAN ; Zejun REN ; Jianbin MA ; Lin YANG
Journal of Modern Urology 2026;31(5):440-442
Objective To measure the urethral meatus circumference in middle-aged and elderly males to undergo surgery for benign prostatic hyperplasia (BPH), and to collect data for developing endoscopic equipment suitable for the male urethra in China. Methods Clinical data were collected from patients (aged ≥50 years) who underwent transurethral resection of prostate in the First Affiliated Hospital of Xi'an Jiaotong University during Jan. and Dec. 2024. All patients had the urethral meatus circumference measured with a metal urethral probe before surgery, followed by the use of a F26.5 endoscopic sheath for surgery. The passage of urethral meatus using different types of metal urethral probes were observed. Results For the 183 patients, the types of endoscopic sheath smoothly passing through the urethral meatus were distributed as follows:42 cases (22.95%) with F26 or above, 66 cases (36.07%) with F25-26, 27 cases (14.75%) with F23-24, 26 cases (14.21%) with F21-22, 22 cases (12.02%) with F20 or below, and the smallest was F17 (1 case). Of all patients, 59.02% (108/183) were able to insert the F26.5 endoscopic sheath smoothly into the urethral meatus (≥F25), 28.96% (53/183) required force or urethral dilation before inserting (F21-F24), and 12.02% (22/183) needed to open the urethral meatus before inserting the endoscopic sheath (≤F20). Conclusion When the most common F26.5 endoscopic sheath is used, 40.98% of the patients have the possibility of urethral injury, which is significantly too big for male transurethral surgery. For patients undergoing transurethral BPH surgery, a thinner sheath should be used to reduce the possibility of urethral injury and secondary iatrogenic urethral stricture.
2.The role of preoperative differentiation in surgical decision-making for testicular tumors: a single-center data analysis of 121 testicular tumor patients
Long TIAN ; Ge TIAN ; Zhe LIU ; Zejun REN ; Jia GUO ; Lin YANG
Journal of Modern Urology 2026;31(6):547-551
Objective To explore the clinical value of preoperative assessment and intraoperative frozen section pathology in screening patients suitable for testicular preservation surgery, so as to provide reference for reducing unnecessary radical orchiectomy in patients with benign testicular tumors. Methods A retrospective analysis was conducted on 121 patients who underwent surgical treatment for testicular tumors in the First Affiliated Hospital of Xi'an Jiaotong University during Jan. 2021 and Sep. 2025. Data were collected, including demographic information, preoperative imaging, serum tumor markers, surgical procedures, intraoperative frozen section, postoperative pathology, and postoperative testicular volume changes. Results Among the 121 patients, 105 underwent radical orchiectomy, with 91 malignant and 14 benign cases confirmed by postoperative pathology; 16 received testicular tumor enucleation, all confirmed as benign. Benign lesions accounted for 24.79% (30/121) of all cases. In patients undergoing tumor enucleation, intraoperative frozen section results were fully consistent with final pathological findings. Conclusion Preoperative differentiation between benign and malignant testicular tumors is crucial for selecting the appropriate surgical approach. For patients with preoperative findings suggesting benign lesions, testicular tumor enucleation combined with intraoperative frozen section can achieve precise treatment while maximizing testicular preservation.
3.Clinical correlation of P2X7R and NLRP3 inflammasomes in prostatic hyperplasia tissue
Xuanzhen ZHOU ; Chen HUANG ; Changying MEI ; Yingzhi CHEN ; Zixiang LIU ; Weiqi YIN ; Zejun YAN
National Journal of Andrology 2025;31(11):986-992
Objective The aim of this study is to detect the expression of purinergic 2X7 receptor(P2X7R)and the NLRP3 inflammasome in benign prostatic hyperplasia(BPH)tissues and to analyze the clinical correlations.Methods Twelve patients undergoing surgery for BPH were enrolled.Based on the presence or absence of inflammatory cell infiltration in HE-stained tissue sections,the patients were divided into inflammation group and non-inflammation group.Preoperative routine ex-aminations excluded surgical contraindications,and International Prostate Symptom Score(IPSS)questionnaires,urinary flow rate measurements,expressed prostatic secretions(EPS)analysis,and prostate-specific antigen(PSA)tests were conducted.Prostate tissues obtained during surgery were subjected to HE staining,immunofluorescence/Western blot to detect the expression of NLRP3,P2X7R,Caspase-1,Cleaved-Caspase-1,IL-1 β,and TNF-α,and immunofluorescence to assess lymphocyte infiltra-tion.SPSS 26.0 software was used to analyze correlations between the expression levels of NLRP3 and P2X7R in prostate tissues and indicators including Caspase-1,Cleaved-Caspase-1,IL-1 β,TNF-α,lymphocyte count,IPSS score,urinary flow rate,EPS,and PSA.Results In BPH tissues,the expression levels of NLRP3 and P2X7R were positively correlated(P<0.05).The ex-pression levels of NLRP3 and P2X7R were positively correlated with Caspase-1,Cleaved-Caspase-1,IL-1 β,TNF-α,and lym-phocyte count(P<0.05).NLRP3 and P2X7R expression levels were positively correlated with white blood cell count in EPS,but showed no correlation with IPSS score,lecithin body count in EPS,maximum urinary flow rate and PSA(P<0.05).Conclusion P2X7R and NLRP3 in prostate tissues exacerbate local inflammatory responses,which may be an important mecha-nism in BPH development.However,they are not correlated with IPSS score,lecithin body count in EPS,maximum urinary flow rate and PSA.
4.DICER1-mutant primary intracranial sarcoma: analysis of five cases
Zejun DUAN ; Jing FENG ; Junping ZHANG ; Changxiang YAN ; Fangjun LIU ; Zhong MA ; Lei XIANG ; Zejuan HU ; Junjie YANG ; Xueling QI
Chinese Journal of Pathology 2025;54(6):632-639
Objective:To investigate the clinicopathological characteristics and differential diagnosis of DICER1-mutant primary intracranial sarcoma.Methods:Five cases of DICER1-mutant primary intracranial sarcoma at Sanbo Brain Hospital, Capital Medical University, Beijing, China during May 2013 to November 2024 were collected. The clinical and imaging data were retrieved. Histological evaluation, immunohistochemical staining and next generation sequencing were performed. Additionally, a literature review was conducted.Results:All five DICER1-mutant primary intracranial sarcomas were located in the supratentorial region, with one case involving the basal ganglia. There were two males and three females. The median age at diagnosis was 25 (14.0, 30.5) years. Morphologically, they were characterized by high-grade spindle cell sarcoma, with brisk mitotic activity and cytoplasmic eosinophilic globules. Myxoid degeneration, necrosis, and invasion into surrounding brain tissue were observed in some cases. The tumor cells showed diffuse staining of vimentin and variable expression of myogenic marker (desmin), with or without focal MyoD1 and/or Myogenin expression. Four tumors exhibited diffuse, strong expression of TLE1 and p53, while only three tumors showed loss of ATRX (nuclear) expression. Two cases showed mosaic loss of H3K27me3 expression in neoplastic cells. The Ki-67 proliferation index was high (40%-80%). Various neuronal markers, such as synaptophysin, NF, SOX2 and MAP2, were expressed in all tumor samples. Genetically, all tumors samples harbored biallelic abnormalities of DICER1. One was a hotspot missense mutation in the RNase Ⅲb domain within exon 25 on one allele (p.E1813 or p.D1810), while the other allele had mutations including a germline mutation in one case, a somatic mutation in two cases, and a copy number deletion in two cases. In addition, these sarcomas showed alterations in TP53 (4/5), ATRX (3/5), and the genes of the mitogen-activated protein kinase pathway (3/5). Finally, all five cases were diagnosed as DICER1-mutant primary intracranial sarcoma. All patients underwent craniotomy that led to complete tumor resection. Three patients received adjuvant radiotherapy and chemotherapy, with progression-free survival time of 28, 48, and 50 months, respectively. Patient 2 succumbed to the tumor after 3 months post-surgery due to rapid progression and tumor dissemination. Patient 5 was lost to follow-up 3 months after the surgery.Conclusions:DICER1-mutant primary intracranial sarcoma is a newly defined tumor entity in the fifth edition of the World Health Organization Classification of Central Nervous System Tumors, and commonly occurs in children and young adults. High-grade malignant spindle cells are their typical morphological feature. Eosinophilic cytoplasmic globules and myogenic differentiation can help establish the diagnosis. This study suggests that DICER1-mutant primary intracranial sarcomas exhibit immunophenotypic neuronal differentiation. Rendering the diagnosis of DICER1-mutant primary intracranial sarcoma largely relies on detecting DICER1 pathogenic alterations or DNA methylation profiling.
5.Clinical correlation of P2X7R and NLRP3 inflammasomes in prostatic hyperplasia tissue
Xuanzhen ZHOU ; Chen HUANG ; Changying MEI ; Yingzhi CHEN ; Zixiang LIU ; Weiqi YIN ; Zejun YAN
National Journal of Andrology 2025;31(11):986-992
Objective The aim of this study is to detect the expression of purinergic 2X7 receptor(P2X7R)and the NLRP3 inflammasome in benign prostatic hyperplasia(BPH)tissues and to analyze the clinical correlations.Methods Twelve patients undergoing surgery for BPH were enrolled.Based on the presence or absence of inflammatory cell infiltration in HE-stained tissue sections,the patients were divided into inflammation group and non-inflammation group.Preoperative routine ex-aminations excluded surgical contraindications,and International Prostate Symptom Score(IPSS)questionnaires,urinary flow rate measurements,expressed prostatic secretions(EPS)analysis,and prostate-specific antigen(PSA)tests were conducted.Prostate tissues obtained during surgery were subjected to HE staining,immunofluorescence/Western blot to detect the expression of NLRP3,P2X7R,Caspase-1,Cleaved-Caspase-1,IL-1 β,and TNF-α,and immunofluorescence to assess lymphocyte infiltra-tion.SPSS 26.0 software was used to analyze correlations between the expression levels of NLRP3 and P2X7R in prostate tissues and indicators including Caspase-1,Cleaved-Caspase-1,IL-1 β,TNF-α,lymphocyte count,IPSS score,urinary flow rate,EPS,and PSA.Results In BPH tissues,the expression levels of NLRP3 and P2X7R were positively correlated(P<0.05).The ex-pression levels of NLRP3 and P2X7R were positively correlated with Caspase-1,Cleaved-Caspase-1,IL-1 β,TNF-α,and lym-phocyte count(P<0.05).NLRP3 and P2X7R expression levels were positively correlated with white blood cell count in EPS,but showed no correlation with IPSS score,lecithin body count in EPS,maximum urinary flow rate and PSA(P<0.05).Conclusion P2X7R and NLRP3 in prostate tissues exacerbate local inflammatory responses,which may be an important mecha-nism in BPH development.However,they are not correlated with IPSS score,lecithin body count in EPS,maximum urinary flow rate and PSA.
6.Qualitative study on the dilemmas and needs of wound ostomy incontinence specialist nurses in the application of convex baseplates
Xue ZHANG ; Jiaqi XU ; Qian LU ; Chen PEI ; Ning LI ; Yuan LIU ; Zejun XU ; Yujie ZHOU
Chinese Journal of Modern Nursing 2025;31(16):2122-2126
Objective:To explore the difficulties and needs of wound ostomy incontinence specialist nurses when applying convex baseplates, with the aim of providing a basis for standardizing ostomy care.Methods:Purposeful sampling was used to select 13 wound ostomy incontinence specialist nurses from tertiary hospitals in Hebei, Jilin, Hunan, Beijing, and Tianjin for semi-structured interviews between November and December 2024. Content analysis was used to analyze the data.Results:Two main themes were identified: application dilemmas and application needs. Application dilemmas included four subthemes: insufficient understanding of convex baseplate characteristics, unclear indications and contraindicated populations, lack of unified standards for assessment timing, and inadequate awareness of health education. Application needs included two subthemes: urgent need for related evidence-based evidence and a desire for clinical guidelines and expert consensus.Conclusions:Currently, wound ostomy incontinence specialist nurses in China face challenges in understanding the characteristics of convex baseplates, scope of application, identifying contraindications, determining the optimal timing for application assessment, and providing patient education. Administrators should develop clinical application standards for convex baseplates based on these challenges. Furthermore, researchers should develop relevant clinical guidelines or expert consensus for convex baseplate application in China, providing a basis for the standardized use of ostomy care products.
7.Survey study on the selection and use of convex baseplates by clinical nurses
Longmei SI ; Qian LU ; Lina QIAO ; Yajuan WENG ; Miaomiao LI ; Yuan LIU ; Zejun XU ; Yujie ZHOU
Chinese Journal of Modern Nursing 2025;31(16):2126-2132
Objective:To investigate the current status of convex baseplate selection and use among clinical nurses.Methods:A convenience sampling method was employed to survey 1 873 nurses from 180 hospitals across China between November and December 2024 using a general information questionnaire and a self-designed questionnaire on convex baseplate selection and use. A total of 1 873 questionnaires were distributed, and 1 860 valid responses were collected, yielding a response rate of 99.31% (1 860/1 873) .Results:Among the 1 860 nurses, 88.98% (1 655/1 860) had access to convex baseplates in clinical practice. However, only 8.82% (146/1 655) used them immediately postoperatively, and only 4.53% (75/1 655) chose convex baseplates without considering any product features. The five common clinical indications for convex baseplate use included stoma retraction (96.62%, 1 599/1 655) , peristomal skin folds or depressions (96.56%, 1 598/1 655) , flush stomas (80.12%, 1 326/1 655) , leakage (70.03%, 1 159/1 655) , and abdominal laxity (66.89%, 1 107/1 655) . Common contraindications for use included peristomal varicose veins (77.46%, 1 282/1 655) , peristoma pressure injuries (75.35%, 1 247/1 655) , stoma prolapse (74.50%, 1 233/1 655) , parastomal hernia (72.87%, 1 206/1 655) , and pyoderma gangrenosum (67.01%, 1 109/1 655) . Key assessment areas when selecting convex baseplates included the stoma itself (97.28%, 1 610/1 655) , peristomal skin (96.50%, 1 597/1 655) , abdominal wall contour (95.41%, 1 579/1 655) , excretion patterns (87.37%, 1 446/1 655) , and previous convex baseplate use (82.36%, 1 363/1 655) . Measures commonly used by nurses to enhance adhesion included the use of stoma belts (95.29%, 1 577/1 655) , barrier rings or paste (94.80%, 1 569/1 655) , smoothing peristomal skin folds (90.57%, 1 499/1 655) , advising patients to limit bending (82.96%, 1 373/1 655) , and abdominal binders (57.28%, 948/1 655) .Conclusions:The clinical application of convex baseplates requires further promotion. Nursing administrators should strengthen training on the selection, characteristics, and indications of convex baseplates, with particular emphasis on the understanding of the five key product features.
8.Interpretation of use of a convex pouching system in the postoperative period: a national consensus
Zejun XU ; Yajuan WENG ; Longmei SI ; Yujie ZHOU ; Yuan LIU
Chinese Journal of Modern Nursing 2025;31(16):2133-2135
In June 2022, the Journal of Wound, Ostomy and Continence Nursing published the use of a convex pouching system in the postoperative period: a national consensus (hereinafter referred to as the "consensus") . The consensus recommends the use of convex ostomy products immediately after surgery and within the first six months following ostomy formation. It also establishes principles for selecting the most appropriate ostomy product for patients. This article interprets the background and significance of the consensus and highlights its key points, aiming to provide a reference for the standardized use of convex ostomy products postoperatively.
9.Exploring and practicing a"1+1"joint-building model for Party branches in university-affiliated hos-pitals
Zejun LIU ; Zhenzhen MA ; Ya'nan GAO
Modern Hospital 2025;25(11):1676-1678,1682
The Party branch constitutes the most grassroots organization of the Communist Party of China(CPC)in uni-versity-affiliated hospitals.This study preliminarily analyzes the current configuration of Party branches,clarifies the concept of joint building,and delineates its significance for hospital governance.Drawing on our institutional experience,we summarize the"1+1"joint-building model from two perspectives—intra-hospital and extra-hospital collaboration—covering administrative branch joint building,clinical branch joint building,faculty-student branch joint building,and joint building with primary-lev-el hospital branches.The findings offer a replicable framework and practical reference for strengthening Party construction in pub-lic hospitals.
10.DICER1-mutant primary intracranial sarcoma: analysis of five cases
Zejun DUAN ; Jing FENG ; Junping ZHANG ; Changxiang YAN ; Fangjun LIU ; Zhong MA ; Lei XIANG ; Zejuan HU ; Junjie YANG ; Xueling QI
Chinese Journal of Pathology 2025;54(6):632-639
Objective:To investigate the clinicopathological characteristics and differential diagnosis of DICER1-mutant primary intracranial sarcoma.Methods:Five cases of DICER1-mutant primary intracranial sarcoma at Sanbo Brain Hospital, Capital Medical University, Beijing, China during May 2013 to November 2024 were collected. The clinical and imaging data were retrieved. Histological evaluation, immunohistochemical staining and next generation sequencing were performed. Additionally, a literature review was conducted.Results:All five DICER1-mutant primary intracranial sarcomas were located in the supratentorial region, with one case involving the basal ganglia. There were two males and three females. The median age at diagnosis was 25 (14.0, 30.5) years. Morphologically, they were characterized by high-grade spindle cell sarcoma, with brisk mitotic activity and cytoplasmic eosinophilic globules. Myxoid degeneration, necrosis, and invasion into surrounding brain tissue were observed in some cases. The tumor cells showed diffuse staining of vimentin and variable expression of myogenic marker (desmin), with or without focal MyoD1 and/or Myogenin expression. Four tumors exhibited diffuse, strong expression of TLE1 and p53, while only three tumors showed loss of ATRX (nuclear) expression. Two cases showed mosaic loss of H3K27me3 expression in neoplastic cells. The Ki-67 proliferation index was high (40%-80%). Various neuronal markers, such as synaptophysin, NF, SOX2 and MAP2, were expressed in all tumor samples. Genetically, all tumors samples harbored biallelic abnormalities of DICER1. One was a hotspot missense mutation in the RNase Ⅲb domain within exon 25 on one allele (p.E1813 or p.D1810), while the other allele had mutations including a germline mutation in one case, a somatic mutation in two cases, and a copy number deletion in two cases. In addition, these sarcomas showed alterations in TP53 (4/5), ATRX (3/5), and the genes of the mitogen-activated protein kinase pathway (3/5). Finally, all five cases were diagnosed as DICER1-mutant primary intracranial sarcoma. All patients underwent craniotomy that led to complete tumor resection. Three patients received adjuvant radiotherapy and chemotherapy, with progression-free survival time of 28, 48, and 50 months, respectively. Patient 2 succumbed to the tumor after 3 months post-surgery due to rapid progression and tumor dissemination. Patient 5 was lost to follow-up 3 months after the surgery.Conclusions:DICER1-mutant primary intracranial sarcoma is a newly defined tumor entity in the fifth edition of the World Health Organization Classification of Central Nervous System Tumors, and commonly occurs in children and young adults. High-grade malignant spindle cells are their typical morphological feature. Eosinophilic cytoplasmic globules and myogenic differentiation can help establish the diagnosis. This study suggests that DICER1-mutant primary intracranial sarcomas exhibit immunophenotypic neuronal differentiation. Rendering the diagnosis of DICER1-mutant primary intracranial sarcoma largely relies on detecting DICER1 pathogenic alterations or DNA methylation profiling.

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