[Objective] To explore the safety and efficacy of submucosal injection of glycerol and fructose saline in bladder tumor endoscopic submucosal dissection (BT-ESD) with a 450 nm blue laser semiconductor treatment machine in the treatment of non-muscular invasive bladder cancer (NMIBC). [Methods] Clinical data of 20 patients with bladder tumor treated with submucosal injection of glycerol and fructose saline BT-ESD via a 450 nm blue laser semiconductor treatment machine at our hospital during Nov.2023 and Apr.2024 were retrospectively analyzed.The patients included 13 males and 7 females, aged (64.95±6.89) years, tumor diameter (1.02±0.24) cm, and preoperative hemoglobin (Hb) (130.55±4.36) g/L.The operation time, Hb the next day after operation, positive rate of tumor basal biopsy, postoperative bladder irrigation time, catheter indwelling time, postoperative hospital stay, complications and recurrence rate were recorded. [Results] All operations were successful, and 28 lesions were removed.The postoperative pathological results confirmed that all cases were NMIBC, and the basal mucosa biopsies were negative.The operation time was (9.40±3.14) min, postoperative Hb (130.15±4.59) g/L, bladder irrigation time (17.70±1.34) h, catheter indwelling time 1 day, and postoperative hospital stay 1 day.There were no complications such as obturator nerve reflex, bladder perforation.There were no need for blood transfusion, no conversion to open surgery, and no secondary bleeding after operation.No tumor recurrence was found during 6-month postoperative follow up. [Conclusion] Submucosal injection of glycerol and fructose saline BT-ESD with a 450 nm blue laser semiconductor treatment machine is a safe and effective method for the treatment of NMIBC.It has advantages of whole enucleation of bladder tumor, clear basal layer, small amount of bleeding, short operation time and few complications.It can be used as a day surgery and is worthy of clinical promotion.

【Objective】 To investigate the efficacy and safety of 450 nm blue laser with 6 o’clock positioning in the treatment of middle lobe hyperplasia of prostate, in order to promote the clinical application of this surgery. 【Methods】 Clinical data of 20 patients with middle lobe hyperplasia of prostate treated with 450 nm blue laser with 6 o’clock positioning during Mar.and Aug.2023 were retrospectively analyzed.The operation time, postoperative bladder irrigation time, catheter indwelling time, hospital stay, and complications were recorded.The maximum urinary flow rate (Qmax), post-void residual volume (PVR), quality of life scale (QoL), international prostate symptom score (IPSS) before surgery and 1 month after surgery were compared. 【Results】 The operation time was (26.80±7.22) min, and bladder irrigation time was (20.50±1.79) h.The catheter was removed on the next day after surgery and all patients were discharged 2 days after operation.Compared to preoperative, one month after surgery, the Qmax [(7.40±1.05) mL/s vs.(19.60±1.76) mL/s] was significantly higher, PVR [(73.50±12.26) mL vs.(9.25±4.94) mL], QoL [(4.55±1.19) vs.(1.95±0.95)], and IPSS [(26.55±1.88) vs.(10.05±1.36)] were significantly lower, the differences being statistically significant (P<0.05).No complications occurred during operation and 1-month follow-up. 【Conclusion】 The 450 nm blue laser with 6 o’clock positioning is a new, safe and effective surgical treatment of middle lobe hyperplasia of prostate, which is worthy of clinical promotion and application.

Objective To explore the efficacy and safety of"ditching and ridge removal"with 450 nm semiconductor blue laser in the treatment of large volume benign prostatic hyperplasia(BPH),in order to promote the clinical application of this method.Methods A retrospective study was conducted on 30 patients with large volume BPH treated with"ditching and ridge removal"with 450 nm semiconductor blue laser in Yingsheng Branch of Tai'an Central Hospital during Sep.and Dec.2023.The laser operation time,level of hemoglobin before and after operation,bladder irrigation time after operation,urinary catheter indwelling time,postoperative hospital stay,and intraoperative and postoperative complications were recorded.The changes of international prostate symptom score(IPSS),quality of life scale(QoL)score,maximum urinary flow rate(Qmax)and post-void residual volume(PVR)were compared before and 1 month after operation.Results The volume of prostate was(104.5±14.52)mL,the laser operation time was(20.13±2.98)min,and the bladder irrigation time was(20.27±2.56)h.The catheter was removed in all patients 2 days after operation,and all patients were discharged 3 days after operation.One month after operation,the IPSS,QoL,Qmax and PVR were significantly improved as compared with those before operation(P＜0.05).No complications occurred during the follow-up.Conclusion"Ditching and ridge removal"with 450 nm semiconductor blue laser is a new,safe and effective method in the treatment of large volume BPH.

Objective To explore the effects of transurethral blue laser vaporization of prostate for benign prostatic hyperplasia(BPH)on the sexual function and lower urinary tract symptoms.Methods A retrospective analysis was conducted on 91 BPH patients admitted to our department during Mar.and Aug.2023.The patients were divided into two groups,46 in the blue laser group,and 45 in the transurethral plasmakinetic resection of prostate(PKRP)group.The operation time,bladder irrigation time,catheter indwelling time and postoperative hospitalization time of the two groups were compared.Postvoid residual(PVR),maximum urinary flow rate(Qmax),international prostatic symptoms score(I PSS),quality of life score(QoL),international index of erectile function-5(IIEF-5)score,the Chinese index of premature ejaculation(CIPE)score and incidence of retrograde ejaculation were compared before and 6 months after operation.Results The operation time[(24.66±5.38)min vs.(62.50±3.85)min],bladder irrigation time[(20.40±2.78)h vs.(51.93±5.02)h],catheter indwelling time(1.65±0.89)d vs.(6.73±2.98)d]and postoperative hospitalization time[(4.26±1.57)d vs.(8.45±2.28)d]were significantly shorter in the blue laser group than in the PKRP group(P＜0.05).There were no significant differences in Qmax,PVR,QoL and IPSS between the two groups before and 6 months after operation(P＞0.05).Six months after surgery,the IIEF-5 score and CIPE score of the blue laser group were higher than those of the PKRP group[(20.02±2.63)vs.(17.64±1.75);(30.88±3.45)vs.(26.25±3.51)],but the incidence of retrograde ejaculation was lower(4.35％vs.35.60％),with statistical significance(P＜0.05).Conclusion Blue laser vaporization of the prostate can improve lower urinary tract symptoms and protect sexual function.

Objective To compare the clinical efficacy and safety of transurethral blue laser vaporization of prostate and transurethral resection of prostate(TURP)in the treatment of benign prostatic hyperplasia(BPH).Methods The clinical data of 142 BPH patients undergoing surgery in our hospital during Jan.and Aug.2023 were retrospectively analyzed.The patients were divided into blue laser group(n=72)and TURP group(n=70).The operation time,hemoglobin(Hb)decrease,bladder irrigation time,catheter indwelling time and postoperative hospital stay were compared between the two groups.The changes of international prostate symptom score(IPSS),quality of life score(QoL),maximum urinary flow rate(Qmax),postvoid residual volume(PVR),international index of erectile function-5(IIEF-5)score and complications before and 6 months after operation were also compared.Results Six months after operation,the IPSS,QoL,Qmax and PVR were significantly improved in both groups(P＜0.05),but there were no significant differences between the two groups(P＞0.05).Compared with the TURP group,the blue laser group had shorter operation time[(47.04±4.03)min vs.(25.46±5.84)min],shorter postoperative bladder irrigation time[(54.17±4.99)h vs.(21.18±4.11)h],shorter catheter indwelling time[5(5,6)d vs.2(2,2)d],shorter postoperative hospital stay[7(7,8)d vs.4(3,4)d],less Hb decrease[(9.61±2.16)g/L vs.(4.31±2.34)g/L],and lower incidence of complications(51.4％vs.4.2％),with significant differences(P＜0.05).Six months after surgery,the blue laser group had higher IIEF-5 score than that the TURP group[(20.06±2.13)vs.(18.93±1.85)],with significant difference(P＜0.05).Conclusion Both transurethral blue laser vaporization of prostate and TURP can effectively treat BPH,but the former is more effective,for it has advantages of short recovery time,few complications and small impact on the sexual function of patients.

A 14-year-old boy presented with coma and convulsion following a 3-day high fever of unknown origin was initially diagnosed with a central nervous system infection with uncertain pathogen. Direct microscopic examination of wet slides of cerebrospinal fluid cytology revealed active amoeboid trophozoites with different shapes. The amoeba trophozoite could be seen at high magnification after Wright′s-Giemsa staining. A diagnosis of primary amoebic meningoencephalitis was made according to the cellular morphology results of the cerebrospinal fluid, imaging data, and clinical symptoms. After high-throughput gene detection targeting the infection pathogen and specific PCR verification of amoeba species, it was confirmed that the infection was caused by Naegleria fowleri. Timely antiamoebic treatment and other related treatments were implemented, but the patient progressed to brain death after 50 days, leading to the discontinuation of treatment by the family.

Objective To investigate the effect of perineal nerve electroacupuncture combined with tolterodine in the treatment of female overactive bladder(OAB).Methods A total of 150 female OAB patients treated in Huzhou Hospital of Traditional Chinese Medicine,Zhejiang Chinese Medical University from April 2020 to May 2021 were selected and divided into control group and study group according to random number table method,with 75 cases in each group.The control group was treated with tolterodine,and the study group was treated with pudendal nerve electroacupuncture combined with tolterodine.Clinical symptoms,urinary symptoms,and urodynamic indicators[maximum cystometric capacity(MCC),maximum urethral closure pressure(Pura clos max),maximum detrusor pressure(Pdet max),and maximum urine flow rate(Qmax)],bladder function indicators(initial bladder sensation volume,bladder volume during strong micturition desire),nerve growth factor(NGF)mediated transient receptor potential(TRP)pathway indicators[NGF,NGF/urine creatinine(UCr),TRPV1,TRPV4]and clinical efficacy of two groups were compared.Results After treatment,the number of night urination and urgent urination in study group were significantly less than those in control group,and the average volume of urination was significantly more than that in control group(P＜0.05).The overactive bladder symptom scores and visual analogue scale scores of study group were significantly lower than those of control group(P＜0.05).The MCC and Pura·clos·max in study group were significantly higher than those in control group,while Pdet max and Qmax were significantly lower than those in control group(P＜0.05).The initial bladder sensation volume and bladder volume during strong micturition desire in study group were higher than those in control group(P＜0.05).NGF,NGF/UCr,positive expression rates of TRPV1 and TRPV4 in study group were lower than those in control group(P＜0.05).The total effective rate was significantly higher in study group than in control group,(x2=5.374,P=0.020).There was no significant difference in the incidence of total adverse reactions between two groups(x2=0.362,P=0.547).Conclusion Perineal nerve electroacupuncture combined with tolterodine can significantly improve bladder function and inhibit clinical symptoms in female OAB patients,possibly by inhibiting bladder sensitivity caused by NGF-mediated increase of TRP channel proteins TRPV1 and TRPV4.

Extracellular vesicles (EVs) are phospholipid bilayer vesicles actively secreted by cells, that contain a variety of functional nucleic acids, proteins, and lipids, and are important mediums of intercellular communication. Based on their natural properties, EVs can not only retain the pharmacological effects of their source cells but also serve as natural delivery carriers. Among them, plant-derived nanovesicles (PNVs) are characterized as natural disease therapeutics with many advantages such as simplicity, safety, eco-friendliness, low cost, and low toxicity due to their abundant resources, large yield, and low risk of immunogenicity in vivo. This review systematically introduces the biogenesis, isolation methods, physical characterization, and components of PNVs, and describes their administration and cellular uptake as therapeutic agents. We highlight the therapeutic potential of PNVs as therapeutic agents and drug delivery carriers, including anti-inflammatory, anticancer, wound healing, regeneration, and antiaging properties as well as their potential use in the treatment of liver disease and COVID-19. Finally, the toxicity and immunogenicity, the current clinical application, and the possible challenges in the future development of PNVs were analyzed. We expect the functions of PNVs to be further explored to promote clinical translation, thereby facilitating the development of a new framework for the treatment of human diseases.

【Objective】 To evaluate the clinical efficacy of 200 W blue laser vaporization of prostate and the possibility of developing such surgery into day surgery. 【Methods】 The clinical data of 30 patients treated during Aug. and Sep.2022 were retrospectively reviewed. The residual urine volume, urine flow rate, International Prostate Symptom Score (IPSS) and Quality of Life Scale(QoL) score before and after surgery were compared. The operation time and postoperative routine urinary red blood cell count were recorded. 【Results】 All surgeries were successful and the catheter was moved 1 day after surgery. The operation time was (12.2±5.1) min, postoperative bladder irrigation time (20.0±4.2) h, and urinary red blood cell count (806.2±16.3)/μL. Recatheter was needed in 1 patient. The urinary flow rate before surgery, immediately and 1-month after surgery were (10.6±3.5) mL/s, (24.2±5.6) mL/s, and (27.2±3.1) mL/s, respectively. The residual urine was (57.3±3.2) mL before surgery and (5.6±3.1) mL 1-month after surgery. The average preoperative IPSS and QoL scores were (25.1±1.6) and (5.4±0.7), and were (9.5±1.4) and (2.9±0.6), respectively, 3-months after surgery. 【Conclusion】 Transurethral 200 W blue laser vaporization of the prostate is a practical and feasible surgical technique for the treatment of benign prostatic hyperplasia. It is effective, rapid and safe, and can greatly shorten the length of hospital stay and improve perioperative safety. With the improvement of clinical application technology, it can be a choice of prostatic day surgery.

【Objective】 To explore the effects of sexual function-preserving 450 nm blue laser vaporization of the prostate on the postoperative sexual function of patients with benign prostatic hyperplasia (BPH), and to evaluate the clinical efficacy, safety and feasibility of this procedure. 【Methods】 The clinical data of 20 BPH patients treated in our department during Jan. and Mar.2023 were analyzed. The International Prostate Symptom Score (IPSS), Quality of Life Scale (QoL) score, maximum urinary flow rate (Qmax), residual urine volume (PVR) and International Index of Erectile Function (IIEF-5) data were compared before and after the operation. The operation time, postoperative catheter indwelling time, and hospital stay were recorded. The ejaculation status 2 months after operation was followed up. 【Results】 All 20 patients completed the operation successfully. The operation time was (13.41±4.30) min, catheter indwelling time (1.2±0.4) d, and hospital stay (3.0±0.6) d. The IPSS, QoL, PVR and Qmax data 1 month after operation were significantly improved compared with those before operation (P<0.01). Two months after operation, all patients had sex and ejaculated, and no retrograde ejaculation occurred. The erection function remained unchanged (P>0.05). 【Conclusion】 The modified 450 nm blue laser vaporization of the prostate can improve the urination symptoms of BPH patients while retaining sexual function. It is a safe and feasible technique for BPH patients who have sexual needs, and provides an alternative surgical approach for those looking to preserve sexual function.