Objective: To explore the safety and feasibility of the disconnection of the left renal artery preferentially during robot-assisted inferior vena cava (IVC) thrombectomy for patients with left renal cell carcinoma and tumor emboli. Methods: Clinical data of 7 patients who underwent robot-assisted IVC thrombectomy and radical nephrectomy in the First Affiliated Hospital of Zhengzhou University during Dec.2021 and Oct.2024 were retrospectively analyzed.Thrombectomy was performed first，followed by nephrectomy. The “IVC-first, kidney-last”robotic technique was developed to minimize chances of IVC thrombus. When patients in left lateral decubitus position, the left renal artery was severed from the right side through the inferior vena cava and abdominal aorta. After removal of thrombus from IVC was completed, patients changed to the right lateral position to complete radical left nephrectomy. Results: Imaging examinations revealed that the median diameter of the renal cell carcinomas was 83(46-99) mm; the median length of the inferior vena cava cancerous emboli was 49(2-91) mm.According to the Mayo classification，the cancerous emboli were gradeⅠ in 2 cases，gradeⅡ in 4 cases，and grade Ⅲ in 1 case.All surgeries were successful.The median operation time was 248(201-331) minutes，blood loss 500(200-1000) mL，and 6 cases required intraoperative blood transfusion.The median time for transition into the intensive care unit was 1(1-4) days，and drainage tube removal 6(5-12) days.Serum creatinine increased significantly in 5 cases，4 of which returned to normal after 1 week，but 1 had renal insufficiency (creatinine 166 μmol/L).Chylous fistula occurred in 1 patient，and lower extremity venous thrombosis developed in 3 patients.Pathological examinations indicated 6 cases of renal cell carcinoma and 1 case of MiT family translocation renal cell carcinoma.During the median follow-up of 17(1-35) months，5 cases were tumor-free，while 2 had lung and retroperitoneal metastases.They received targeted therapy of axitinib combined immunotheraphy and lived with tumors. Conclusion: In the left lateral position for left renal cell carcinoma with cancerous emboli，robot-assisted laparoscopic thrombectomy by crossing the inferior vena cava and abdominal aorta and disconnecting the left renal artery first is safe and feasible.

Objective To analyze the pollution characteristics of 16 polycyclic aromatic hydrocarbons (PAHs) in atmospheric PM_2.5 in Yanta District and Lianhu District of Xi'an City, and assess their health risks to exposed populations through inhalation pathways. Methods From 2020 to 2022, monitoring sites were set up in Yanta District and Lianhu District of Xi'an City, and PM_2.5 samples were collected regularly every month. The mass concentrations of PAHs were determined. The analysis and evaluation were carried out according to different years, regions, and seasons. The sources of PAHs in the atmosphere were identified by calculating characteristic ratios. Health risk assessments through inhalation routes were conducted for certain polycyclic aromatic hydrocarbons and their total carcinogenic equivalent concentrations. Results The average mass concentrations of PAHs in Yanta District and Lianhu District were 6.38 ng/m³ and 6.06 ng/m³, respectively, with no statistically significant difference (P>0.05). Except for fluoranthene, there was no statistically significant difference in other PAHs between regions (P>0.05). Except for acenaphthylene and anthracene, the concentrations of other PAHs showed a decreasing trend year by year (P<0.05). The total mass concentration of PAHs in both urban areas showed a trend of winter>spring>autumn>summer (P<0.05), and all categories of PAHs showed the highest levels in winter and the lowest levels in summer (P<0.05). The proportion of 5-ring PAHs was the highest in summer, while the proportion of 4-ring PAHs was the highest in winter. The main sources of atmospheric PAHs in the two districts were a mixture of coal combustion, motor vehicle emissions, and biomass burning. The HQ values of benzo[a]pyrene and TEQs in both districts were less than 1. The carcinogenic risk through inhalation pathways for TEQs was 1.15×10^-6, exceeding the acceptable level (1×10^-6). Conclusion The pollution of PAHs in Yanta District and Lianhu District of Xi'an City continues to decrease, with seasonal differences. The main sources are mixed sources of coal combustion, motor vehicle emissions, and biomass burning, and overall PAHs pose a potential carcinogenic risk to residents.

Objective To analyze the pollution characteristics of 16 polycyclic aromatic hydrocarbons (PAHs) in atmospheric PM_2.5 in Yanta District and Lianhu District of Xi'an City, and assess their health risks to exposed populations through inhalation pathways. Methods From 2020 to 2022, monitoring sites were set up in Yanta District and Lianhu District of Xi'an City, and PM_2.5 samples were collected regularly every month. The mass concentrations of PAHs were determined. The analysis and evaluation were carried out according to different years, regions, and seasons. The sources of PAHs in the atmosphere were identified by calculating characteristic ratios. Health risk assessments through inhalation routes were conducted for certain polycyclic aromatic hydrocarbons and their total carcinogenic equivalent concentrations. Results The average mass concentrations of PAHs in Yanta District and Lianhu District were 6.38 ng/m³ and 6.06 ng/m³, respectively, with no statistically significant difference (P>0.05). Except for fluoranthene, there was no statistically significant difference in other PAHs between regions (P>0.05). Except for acenaphthylene and anthracene, the concentrations of other PAHs showed a decreasing trend year by year (P<0.05). The total mass concentration of PAHs in both urban areas showed a trend of winter>spring>autumn>summer (P<0.05), and all categories of PAHs showed the highest levels in winter and the lowest levels in summer (P<0.05). The proportion of 5-ring PAHs was the highest in summer, while the proportion of 4-ring PAHs was the highest in winter. The main sources of atmospheric PAHs in the two districts were a mixture of coal combustion, motor vehicle emissions, and biomass burning. The HQ values of benzo[a]pyrene and TEQs in both districts were less than 1. The carcinogenic risk through inhalation pathways for TEQs was 1.15×10^-6, exceeding the acceptable level (1×10^-6). Conclusion The pollution of PAHs in Yanta District and Lianhu District of Xi'an City continues to decrease, with seasonal differences. The main sources are mixed sources of coal combustion, motor vehicle emissions, and biomass burning, and overall PAHs pose a potential carcinogenic risk to residents.

Objective To compare the clinical efficacy and postoperative urinary control between robot-assisted radical prostatectomy(RARP)with posterior-anterior-lateral(PAL)approach and with anterior(conventional)approach using propensity score matching method.Methods Clinical data of 145 patients undergoing RARP in our hospital during Jan.2020 and Jan.2023 were retrospectively analyzed,including 122 patients in the conventional group and 23 in the PAL group.The patients were matched by 2∶1 propensity score matching,including 46 cases in the conventional group and 23 in the PAL group.The perioperative outcomes were compared of prostate cancer(PCa)patients undergoing RARP surgery with different approaches before and after matching,including operation time,intraoperative blood loss,pelvic drainage time,hospitalization days,preservation of neurovascular bundles(NVB)during surgery,deep dorsal venous complex(DVC)suture,reconstruction of bladder neck,and postoperative urinary control recovery rate after extubation immediately,and 1,3,and 6 months after surgery.Results There were no significant differences in baseline data,operation time,bleeding volume,pelvic drainage time,hospitalization days,preservation of NVB,and reconstruction of bladder neck between the two groups(P＞0.05).The PAL group used less DVC suture during surgery(30.4％vs.100％,P＜0.001),but had better urinary control recovery rate immediately after extubation,1,3 and 6 months after surgery(P＜0.05).Conclusion RARP with PAL approach is as safe and effective as the conventional approach,and has significant advantages in early postoperative urinary control.

New quality productivity force is an advanced form of productive force that is innovation-driven, characterized by high technology, high efficiency, and high quality. It aligns with the new development philosophy and represents an advanced state of productivity. Within the medical sphere, this concept is epitomized by the progressive evolution of surgical instruments and techniques. In recent years, the rapid development of new quality productivity forces in the medical field has generated significant anticipation for innovations in urological robotic surgery instruments and techniques. Advancements in domestically produced robotic surgery systems, remote robotic surgery, single-port robotic surgery, and pediatric-specific robotic surgery exemplify the critical application of new quality productivity forces in urology. The integration of artificial intelligence, haptic feedback technology, and sensory enhancement technologies has further enhanced the safety and precision of surgeries. Driven by these new quality productivity forces, the development of urological robotic surgery instruments and techniques has reached a new milestone, potentially setting a new gold standard for urological surgeries and providing patients with safer, more efficient, and personalized medical care. However, certain emerging technologies still face challenges in their application, necessitating further research and clinical validation.

New quality productivity force is an advanced form of productive force that is innovation-driven, characterized by high technology, high efficiency, and high quality. It aligns with the new development philosophy and represents an advanced state of productivity. Within the medical sphere, this concept is epitomized by the progressive evolution of surgical instruments and techniques. In recent years, the rapid development of new quality productivity forces in the medical field has generated significant anticipation for innovations in urological robotic surgery instruments and techniques. Advancements in domestically produced robotic surgery systems, remote robotic surgery, single-port robotic surgery, and pediatric-specific robotic surgery exemplify the critical application of new quality productivity forces in urology. The integration of artificial intelligence, haptic feedback technology, and sensory enhancement technologies has further enhanced the safety and precision of surgeries. Driven by these new quality productivity forces, the development of urological robotic surgery instruments and techniques has reached a new milestone, potentially setting a new gold standard for urological surgeries and providing patients with safer, more efficient, and personalized medical care. However, certain emerging technologies still face challenges in their application, necessitating further research and clinical validation.

Immunoscenescence plays a key role in the initiation and development of tumors. Furthermore, immunoscenescence also impacts drug delivery and cancer therapeutic efficacy. To reduce the impact of immunosenescence on anti-tumor therapy, this experimental plan aimed to use neutrophils with tumor tropism properties to deliver sialic acid (SA)-modified liposomes into the tumor, kill tumor cells via SA-mediated photochemotherapy, enhance infiltration of neutrophils into the tumor, induce immunogenic death of tumor cells with chemotherapy, enhance infiltration of CD8⁺ T cells into the tumor-draining lymph nodes and tumors of immunosenescent mice, and achieve SA-mediated photochemotherapy. We found that CD8⁺ T cell and neutrophil levels in 16-month-old mice were significantly lower than those in 2- and 8-month-old mice; 16-month-old mice exhibited immunosenescence. The anti-tumor efficacy of SA-mediated non-photochemotherapy declined in 16-month-old mice, and tumors recurred after scabbing. SA-mediated photochemotherapy enhanced tumor infiltration by CD8⁺ T cells and neutrophils, induced crusting and regression of tumors in 8-month-old mice, inhibited metastasis and recurrence of tumors and eliminated the immunosenescence-induced decline in antitumor therapeutic efficacy in 16-month-old mice via the light-heat-chemical-immunity conversion.

Background::CD5L (CD5 molecular-like) plays an important role in lipid metabolism and immune regulation. This study aimed to investigate the roles of CD5L on liver hepatocellular carcinoma (LIHC).Methods::We analyzed the CD5L mRNA expression and its potential prognostic value based on The Cancer Genome Atlas and Gene Expression Omnibus databases. Immunohistochemical analysis was used to investigate the CD5L levels in LIHC tissues. Serum CD5L levels in LIHC were detected by enzyme-linked immunosorbent assay. Cell Counting Kit-8 (CCK-8) assay was used to investigate the effect of CD5L treatment on HepG2 and QSG-7701 cell proliferation. CD5L expression correlated genes were exhumed based on the LinkedOmics. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses for CD5L associated genes were performed. The correlation between CD5L and tumor immune infiltration was analyzed by using Tumor Immune Estimation Resource (TIMER) 2.0.Results::CD5L mRNA and protein levels were significantly decreased in LIHC tumor tissue compared with non-tumor control tissues. Moreover, serum CD5L levels were significantly lower in LIHC patients than that in healthy subjects. Gene Expression Profiling Interactive Analysis 2 and Kaplan-Meier plotter analysis showed that a high-CD5L expression was correlated with favorable overall survival in LIHC patients, except the LIHC patients with hepatitis virus. CCK-8 results showed that CD5L treatment significantly decreased HepG2 cell proliferation in a concentration-dependent manner, and CD5L treatment had no effect on the proliferation of non-tumor hepatocyte line QSG-7701. CD5L associated genes were enriched in the immune response biological process, and CD5L expression levels were positively correlated with the immune infiltrates of CD8 + T cell and M1 macrophage cells but negatively correlated with CD4 + T cells and M0 macrophage cell infiltration. Conclusions::Exogenous CD5L inhibits cell proliferation of hepatocellular carcinoma. CD5L may act as a role of prognostic marker.

[摘 要] 目的：探讨干扰B7-H4表达对乳腺癌细胞增殖、凋亡、周期以及相关下游分子表达的影响。方法：利用脂质体转染技术分别将特异性靶向B7-H4的siRNA（siB7-H4）及其阴性对照（siNC）转染至对数生长期的乳腺癌T47D和MCF-7细胞，分别命名为T47D-siB7-H4、T47D-siNC、MCF-7-siB7-H4和MCF-7-siNC组。用qPCR法和WB法验证siRNA干扰效果及其对细胞周期分子cyclin D1表达的影响，CCK-8法和FCM分别检测干扰B7-H4表达对T47D和MCF-7细胞增殖、周期和凋亡的影响，qPCR法检测B7-H4干扰对E2F家族相关转录因子表达的影响。结果：成功构建干扰B7-H4表达的乳腺癌T47D和MCF-7细胞。与T47D-siNC和MCF-7-siNC组相比，T47D-siB7-H4和MCF-7-siB7-H4组细胞中B7-H4 mRNA和蛋白表达水平均显著降低、细胞增殖能力显著降低（均P<0.01），并伴有G1/S期细胞周期阻滞以及cyclin D1表达下调（均P<0.01），但细胞凋亡率差异无统计学意义（均P>0.05）。与T47D-siNC相比，干扰B7-H4后T47D细胞中E2F1、E2F2、E2F7和E2F8 mRNA水平有不同程度的降低（均P<0.01）；与MCF-7-siNC相比，干扰B7-H4后MCF-7细胞中E2F1、E2F2、E2F3、E2F7和E2F8 mRNA水平均有不同程度的降低（P<0.05或P<0.01）。结论：干扰乳腺癌细胞B7-H4表达可下调cyclin D1和E2F家族相关转录因子的表达，导致细胞周期阻滞并抑制细胞增殖。

Objective:To explore new methods of treating Graves′ disease (GD) by targeting thyroid stimulating hormone receptor (TSHR) and intercellular adhesion molecule-1 (ICAM-1).Methods:The small interfering RNA (siRNA) targeting TSHR and the ICAM-1 monoclonal antibody (mAb) were designed and synthesized. Thirty GD model mice were randomly divided into siRNA treatment group, ICAM-1 mAb treatment group, and untreated GD group (10 mice in each group), and 10 normal mice were taken as blank control. Serum thyroxine (T 4), thyroid stimulating hormone (TSH), TSH receptor-stimulating antibody (TSAb) and TSH-stimulation blocking antibody (TSBAb) were measured before and after treatment. At the end of the treatment, body mass and heart rate of mice in each group were measured, and thyroid uptake of 99Tc mO 4-, thyroid size and pathological changes were evaluated. Independent-sample t test, paired t test and one-way analysis of variance were used to analyze data. Results:After three treatments, the body mass of mice in siRNA group and ICAM-1 mAb group were significantly lower than that of normal mice ( F=3.50, P=0.025); the heart rates of the mice in two groups were significantly lower than that of untreated GD mice ( F=24.73, P<0.001). Heart rate of mice treated with siRNA decreased significantly, close to that of normal mice. After treatment, the serum T 4((27.58±1.94) vs (65.71±6.89) μg/L, (27.24±3.50) vs (70.84±8.46) μg/L), TSAb ((331.44±43.38) vs (457.33±45.85) mU/L, (275.16±45.80) vs (443.91±42.32) mU/L) and TSBAb ((13.94±1.11) vs (15.83±5.92) mU/L, (14.59±1.02) vs (17.05±6.16) mU/L) levels of mice in both siRNA group and ICAM-1 mAb group significantly decreased ( t values: 4.45-10.87, all P<0.05), while the serum TSH levels of mice in two groups significantly increased ((0.13±0.05) vs (0.04±0.05) mU/L, (1.46±0.34) vs (0.06±0.03) mU/L; t values: -2.22, -5.87, P values: 0.007, <0.001). The elevated TSH level and decreased TSAb level of mice treated with ICAM-1 mAb were significantly different from those treated with siRNA ( t values: 1.03, -1.63, P values: 0.002, 0.031). After treatment, the uptake of 99Tc mO 4- in part of the thyroid lobes of mice was decreased, and the enlargement degree of the corresponding lobes was reduced. The thyroid pathology of mice in the treated groups showed that the absorption vacuoles of thyroid follicles were reduced, and the phenomenon of thinner colloids was improved. No obvious damage was observed in the heart, liver and kidneys of the mice. Conclusions:Both the siRNA targeting TSHR and ICAM-1 mAb have therapeutic effects on GD model mice. The siRNA is better at controlling heart rate, and ICAM-1 mAb is better at increasing TSH and decreasing TSAb. Each of the above treatment methods is safe and effective, which can provide new ideas for GD targeted therapy.