北京大学学报（医学版）最新文献

{"title":"[A multi-level study of androgen deprivation therapy on the immune microenvironment in prostate cancer].","authors":"Zhongyu Tan, Yiqing DU, Caipeng Qin, Tao Xu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the impact of androgen deprivation therapy (ADT) on the immune microenvironment of prostate cancer at the levels of systemic immunity, animal model transcriptomics, and single-cell omics, and to elucidate the characteristics of ADT-mediated tumor immune remodeling.</p><p><strong>Methods: </strong>Twelve prostate cancer patients who received ADT at Peking University People' s Hospital were enrolled. Dynamic monitoring of serum prostate specific antigen (PSA), testosterone levels, peripheral blood immune cell proportions, and cytokine expression changes was performed. Transcriptomic data from patient-derived tumor xenograft (PDX) models before and after castration (GSE41193, 5 cases in total) were downloaded from the gene expression omnibus (GEO) database for relevant bioinformatics analyses. Single-cell RNA sequencing (scRNA-seq) was performed on 4 prostate cancer tissue samples (2 received neoadjuvant ADT, 2 untreated) to analyze tumor microenvironment cell composition and T-cell functional states.</p><p><strong>Results: </strong>ADT significantly reduced serum PSA and testosterone levels in the patients, but had no significant effect on peripheral blood immune cell proportions or most cytokines. PDX model analysis showed that differentially expressed genes after castration were enriched in neural-related and immune regulation pathways, with trending changes observed in the infiltration characteristics of various immune cells. scRNA-seq results indicated a decreased proportion of intratumoral effector CD8⁺ T cells after ADT treatment, with downregulated expression of cytotoxicity-related genes, such as <i>GZMA</i>, <i>GZMB</i>, <i>GNLY</i>, and <i>NKG7</i>, while regulatory T cells (Tregs) were relatively enriched. Hallmark pathway analysis revealed suppression of interferon signaling pathways.</p><p><strong>Conclusion: </strong>The preliminary results of this study suggest that ADT can induce a trend of change in the tumor immune microenvironment of prostate cancer, characterized by weakened T-cell killing function and enrichment of immunosuppressive cells. This suggests that ADT may promote the formation of an immunosuppressive tumor immune microenvironment (TIME), providing a theoretical basis for ADT combined with immune-modulating therapeutic strategies.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"770-778"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Development of a 36-gene signature for predicting recurrence in non-muscle-invasive bladder cancer and validation in a Chinese cohort].","authors":"Liyuan Dong, Yun Peng, Yuxuan Song, Xiaoyang Li, Yiqing DU, Tao Xu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To develop a transcriptomic-based recurrence prediction model for non-muscle-invasive bladder cancer (NMIBC), to comprehensively validate its efficacy in an independent Chinese cohort, and to explore the underlying biological mechanisms driving tumor recurrence.</p><p><strong>Methods: </strong>Transcriptome profiling data from the multicenter European Urothelial Cancer Molecular Classification Consortium (UROMOL) cohort (<i>n</i>=535) were used as the training cohort. The least absolute shrinkage and selection operator (LASSO) Cox regression was employed to identify prognostic genes and construct a risk score model. Internal validation was strictly performed using Bootstrap resampling and 10-fold cross-validation. External validation was conducted in an independent Chinese cohort (<i>n</i>=85) from Peking University People ' s Hospital. Gene set enrichment analysis (GSEA) was applied to elucidate the distinct biological differences between high- and low-risk groups.</p><p><strong>Results: </strong>A 36-gene prognostic signature was identified from 12 170 genes to construct the risk score model. In the training cohort, the model achieved a concordance index (C-index) of 0.702 (95%<i>CI</i>: 0.664-0.740), with 1-, 3-, and 5-year areas under the receiver operating characteristic curve (AUC) of 0.782, 0.811, and 0.799, respectively. The 5-year recurrence-free survival (RFS) rates for the high- and low-risk groups were 35.2% and 72.8%, respectively (Log-rank <i>P</i> < 0.001). Internal validation via Bootstrap (C-index=0.702) and 10-fold cross-validation (C-index=0.708) demonstrated robust stability. In the independent Chinese validation cohort, the model maintained a favorable C-index of 0.685 (95%<i>CI</i>: 0.631-0.739), with 1-, 3-, and 5-year AUC of 0.705, 0.743, and 0.665, respectively. Its predictive performance was comparable to the traditional European Organization for Research and Treatment of Cancer (EORTC) risk score (C-index=0.652). GSEA revealed that the low-risk group was enriched in energy metabolism and protein homeostasis pathways, while the high-risk group was associated with extracellular matrix (ECM) remodeling and cell adhesion pathways.</p><p><strong>Conclusion: </strong>The 36-gene signature developed in this study demonstrates favorable predictive performance and stability across both the training and independent Chinese cohorts. While exhibiting comparable predictive efficacy to the traditional EORTC scoring system, the model serves as an independent prognostic factor that provides crucial supplementary molecular stratification. Furthermore, the model underscores the critical roles of energy metabolism and ECM remodeling in NMIBC recurrence, providing a valuable molecular basis for precise individualized management of NMIBC patients in China.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"794-802"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Long-term survival achieved with benmelstobart plus anlotinib in a patient with advanced clear cell renal cell carcinoma: A case report].","authors":"Huichun Tian, Jiaran Zhang, Juan Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clear cell renal cell carcinoma (ccRCC) is the most common histological subtype of renal cell carcinoma. Patients classified as intermediate- or poor-risk according to the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC), particularly those with multiple organ metastases, generally have an unfavorable prognosis. Here, we report a case of advanced ccRCC in an IMDC poor-risk patient who achieved an unexpectedly prolonged survival with combination therapy followed by maintenance immunotherapy. A 65-year-old male developed multiple metastases involving the lungs, liver, and bone shortly after undergoing radical nephrectomy for right-sided renal cancer. Laboratory findings revealed anemia, neutrophilia, and thrombocytosis, and the IMDC score was 5, indicating poor-risk disease. The patient received first-line treatment with the programmed death-ligand 1 (PD-L1) inhibitor benmelstobart in combination with the multi-target tyrosine kinase inhibitors (TKIs) anlotinib. After 6 weeks of therapy, radiological evaluation demonstrated a partial response (PR), with an overall tumor reduction of approximately 48%. Subsequent imaging assessments confirmed a durable PR, accompanied by significant improvement in clinical symptoms and performance status. During treatment, the patient developed progressive proteinuria, with a maximum 24-hour urinary protein level of 5.18 g. Despite stepwise dose reduction of anlotinib, proteinuria recurred, necessitating discontinuation of the TKIs. Following cessation of anlotinib, the patient continued benmelstobart monotherapy as maintenance therapy and maintained sustained deep remission. After approximately 3 years of treatment, serum creatinine levels gradually increased, reaching a peak of 228 μmol/L. Considering the possibility of treatment-related renal toxicity and the durable disease control achieved, immunotherapy was subsequently discontinued. No further antitumor treatment was administered. The patient eventually experienced disease progression and died in September 2024, with an overall survival of 44 months. This case suggests that the combination of benmelstobart and anlotinib can induce rapid and durable antitumor responses in patients with IMDC poor-risk advanced ccRCC. Notably, in patients who respond well to combination therapy, discontinuation of TKIs due to intolerable adverse events followed by maintenance immunotherapy may still provide long-term disease control. This sustained benefit may be associated with tumor microenvironment remodeling and the establishment of immunological memory induced by anti-angiogenic therapy. Furthermore, this case highlights the importance of vigilant monitoring of renal toxicity and individualized treatment adjustment during combined targeted therapy and immunotherapy.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"865-871"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Feasibility and clinical value of a prostate cancer screening model based on biparametric magnetic resonance imaging combined with prostate-specific antigen in a Chinese population].","authors":"Mingjian Ruan, Yudong Cao, Jinchao Ma, Chen Lin, Shuo Wang, Peng DU","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the feasibility and clinical value of a prostate cancer screening model incorporating total prostate-specific antigen (tPSA) and biparametric magnetic resonance imaging (bpMRI) in a Chinese population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between May 2024 and May 2025, 2 251 men aged 50 years or older from three community health service centers in Beijing were enrolled, who were randomly assigned to the precise screening group and the standard screening group in a 2 ∶ 1 ratio in the community health service centers. In the precision screening group, participants with tPSA≥4 μg/L underwent bpMRI; those with a prostate imaging reporting and data system (PI-RADS) score≥3 were recommended to undergo systematic combined with targeted biopsy, while those with tPSA≥10 μg/L and PI-RADS &lt; 3 were recommended to undergo systematic biopsy alone. In the standard screening group, participants with tPSA≥4 μg/L were recommended to undergo systematic biopsy. The number of participants who actually underwent biopsy, biopsy positivity rate, and Gleason score concordance rate was recorded. The primary outcome measure was the detection rate of clinically significant prostate cancer (csPCa), and the intergroup comparisons were performed using the Mann-Whitney &lt;i&gt;U&lt;/i&gt; test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 2 251 men were included in the analysis, with a median age of 68 years (range: 57-90 years). In the precision screening group (&lt;i&gt;n&lt;/i&gt;=985), 115 (11.7%) participants had tPSA≥4 μg/L, of whom 30 underwent bpMRI. The recommended biopsy rate was 2.9% (29/985), and 20 participants actually underwent prostate biopsy. A total of 15 prostate cancer cases were detected, including 14 csPCa and one clinically insignificant prostate cancer. In the standard screening group (&lt;i&gt;n&lt;/i&gt;=1 266), 111 (8.8%) participants had tPSA ≥4 μg/L, with a recommended biopsy rate of 8.8% (111/1 266); 26 of them underwent systematic biopsy, and 14 prostate cancer cases were detected, including 7 csPCa and 7 clinically insignificant prostate cancer. The overall positive biopsy rate in the precision screening group was 75.0%, which was not statistically significant compared with that in the standard screening group (58.3%, &lt;i&gt;P&lt;/i&gt;=0.141). However, the csPCa detection rate in the precision screening group reached 70.0%, which was significantly higher than that in the standard screening group (26.9%), and the difference was statistically significant (&lt;i&gt;P&lt;/i&gt;=0.004). Among the 29 diagnosed prostate cancer patients, 17 (58.6%) had localized disease, 10 (34.5%) had locally advanced disease, and 2 (6.9%) had metastatic disease. Among the 21 patients who underwent radical surgery, the concordance rate between biopsy and post-operative pathological Gleason scores was 70.0% in the precision screening group, higher than that in the standard screening group (36.4%), although the difference was not statistically significant (&lt;i&gt;P&lt;/i&gt;=0.198).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conc","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"779-786"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Genetic analysis of 46, XX, t(1;6;14) complex translocation: A case report].","authors":"Yingnan Zhai, Hongru Li, Jinzhi Lv, Shuang Yu, Li Wang","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;This report details the cytogenetic and familial investigation of a 31-year-old female presenting with primary infertility of eight years' duration. Previous extensive evaluations, including assessment of hormonal profiles, tubal patency, and partner semen analysis, yielded no explanatory findings, prompting a genetic etiology workup. High-resolution G-banding chromosome analysis was subsequently performed. The patient's karyotype was characterized by a complex, apparently balanced, three-way re-arrangement involving chromosomes 1, 6, and 14. The precise nomenclature was 46, XX, der(1)(pter→q12:: q32→qter), der(6)(6pter→6q13:: 14p13→14pter), der(14)(6qter→6q13:: 1q12→1q32:: 14p13→14qter), formally interpreted as 46, XX, t(1;6;14). This result indicated a reciprocal translocation in which segments of chromosomes 1, 6, and 14 were rearranged, resulting in three derivative chromosomes: der(1), der(6), and der(14). To establish the inheritance pattern and provide accurate familial risk assessment, karyotypic analysis was extended to the proband's parents and her younger sister. Her father (46, XY) and sister (46, XX) were both found to have normal chromosomal constitutions. Crucially, her phenotypically normal mother was identified to carry an identical chromosomal re-arrangement: 46, XX, t(1;6;14). This confirmed a maternal origin and classified the mother as a balanced translocation carrier. The patient, inheriting this derivative chromosome complement, was thus also a balanced carrier. Her primary infertility, in the absence of a history of recurrent miscarriage, was highly likely attributable to this cytogenetic anomaly. The proposed mechanism is a markedly increased risk of producing gametes with unbalanced chromosomal segregation during meiosis, leading to conceptions with lethal aneuploidy or subviable genomic imbalances that precluded successful implantation or result in very early, undetected pregnancy loss. This case highlights several critical principles in reproductive genetics. First, it reaffirms that conventional karyotype analysis remains a fundamental and indispensable diagnostic tool in the evaluation of idiopathic primary infertility, capable of revealing cryptic balanced structural rearrangements that are not detectable by molecular karyotyping (chromosomal microarray). Second, it underscores the absolute necessity of systematic familial cytogenetic studies following the identification of an index case. Such studies are vital for distinguishing de novo from inherited rearrangements, providing precise recurrence risk quantification, and enabling comprehensive genetic counseling for all at-risk family members. Finally, for identified carriers of such translocations seeking biological parenthood, preimplantation genetic testing (PGT) for structural rearrangements represents the cornerstone of modern reproductive management. PGT allows for the selective transfer of embryos with a balanced or normal chromosomal complement, thereb","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"881-884"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cystic lymphangioma of the penis in an adult: A case report].","authors":"Qingkai Yang, Jian Lu, Min Lu, Kai Hong","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Lymphangioma is a congenital vascular malformation arising from aberrant lymphatic deve-lopment, with a reported incidence of approximately 1 in 4 000. The condition predominates in the pedia-tric population, with the head and neck representing the most frequently affected anatomical regions. By contrast, scrotal lymphangioma in adults is exceedingly rare and remains highly susceptible to misdiagnosis or diagnostic omission in clinical settings. Here, we report a case of cystic lymphangioma of the penis in a 42-year-old male who presented with a mass at the penile root persisting for over 30 years, with marked enlargement over the preceding six months. Physical examination revealed a cystic mass measuring approximately 7 cm×4 cm×5 cm on the left aspect of the penile root, with a positive transillumination sign. Bilateral testes, epididymides, and spermatic cords were unremarkable. Ultrasonography demonstrated an irregular cystic anechoic lesion at the penoscrotal junction with well-defined margins. Magnetic resonance imaging (MRI) revealed a multilocular cystic lesion at the scrotal root measuring approximately 5.6 cm×3.8 cm×6.3 cm. Both imaging modalities were consistent with cystic lymphangioma. The patient underwent complete surgical resection under epidural anesthesia. Intraoperatively, the mass was confirmed to be multilocular and contained taupe-colored fluid. Histopathological analysis revealed endothelial cell lining of the cyst wall, and immunohistochemical staining was positive for CD31, establishing the definitive diagnosis of cystic lymphangioma. Genomic profiling identified a somatic heterozygous missense mutation in the &lt;i&gt;PIK3CA&lt;/i&gt; gene at codon E545 (GAG&gt;GCG), consistent with the established pathogenic mechanism underlying lymphangioma. Mechanistically, somatic &lt;i&gt;PIK3CA&lt;/i&gt; mutations activate downstream signaling cascades, driving aberrant proliferation of lymphatic endothelial cells and culminating in cystic lesion formation. Clinically, lymphangioma typically manifests as a painless, slowly enlarging cystic mass. Definitive diagnosis relies on integrated imaging and histopathological evaluation, with differential diagnoses encompassing indirect inguinal hernia, hydrocele, and varicocele. Complete surgical resection remains the first-line therapeutic strategy and is associated with a substantially reduced recurrence rate. For patients deemed ineligible for surgery, sclerotherapy or molecularly targeted agents, including sirolimus and alpelisib, represent viable alternatives. The patient achieved an uneventful postoperative recovery with no evidence of recurrence at one-month follow-up. Although adult scrotal cystic lymphangioma is a rare clinical entity, it exhibits characteristic clinical, radiological, and pathological features that, in conjunction with molecular genetic analysis, enable accurate diagnosis. Early complete resection confers a favorable prognosis. Heightened clinical awareness and standardized management ","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"872-876"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of modified hot-etching treatment on the mechanical properties of zirconia and zirconia/resin bond strength].","authors":"Xin Yang, Yu Wu, Pin Lv","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of modified hot-etching treatment on the flexural strength and surface crystalline phase proportions of zirconia and zirconia/resin bond strength.</p><p><strong>Methods: </strong>Zirconia specimens were divided into three groups according to different surface treatments, including blank group, sandblasting treatment group and modified hot-etching treatment group. A scanning electron microscope (SEM) was used to observe the surface morphology of the treated zirconia, an X-ray diffractometer (XRD) was employed to detect the surface crystalline phase proportions, and a universal mechanical testing machine was utilized to measure the three-point flexural strength of the zirconia specimens of different treatment groups. A bonding surface was prepared with bovine enamel, and the zirconia specimens were bonded using resin cement. Half of the bonded specimens underwent 5 000 cycles of thermal cycling fatigue test, and the immediate and fatigued shear bond strengths (SBS) were detected by using a universal mechanical testing machine.</p><p><strong>Results: </strong>SEM observations revealed that the surface of the control group was smooth, the surface of sandblasting treatment group exhibited irregular scratches, and the surface of modified hot-etching treatment group showed a honeycomb-like etched morphology. XRD results indicated that the monoclinic phase proportions were 8.18% for the control group, 28.34% for the sandblasting treatment group, and 9.69% for the modified hot-etching treatment group. The flexural strength of the sandblasting treatment group [(316.40±58.37) MPa] was significantly (<i>P</i> < 0.01) lower than that of the blank group [(415.30±47.64) MPa] and the modified hot-etching treatment group [(398.77±47.94) MPa]. The immediate SBS of the modified hot-etching treatment group [(53.77±8.36) MPa] was higher (<i>P</i> < 0.01) than that of blank group[(35.50±4.72) MPa] and sandblasting treatment group [(42.97±6.95) MPa]. After thermal cycling fatigue test, the fatigued SBS of the blank group [(21.65±4.01) MPa] was lower (<i>P</i> < 0.01) than that of the modified hot-etching treatment group [(30.69±7.36) MPa] and the sandblasting treatment group [(29.37±5.73) MPa].</p><p><strong>Conclusion: </strong>The modified hot-etching treatment could enhance the immediate zirconia/resin SBS, exhibited similar resistance to thermal fatigue test with sandblasting treatment group, could not significantly reduce the flexural strength, and did not obviously alter the surface crystalline phase proportions.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"855-859"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Preliminary clinical experience of domestic robot-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy].","authors":"Zhuo Liu, Shuai Liu, Guoliang Wang, Xiaojun Tian, Hongxian Zhang, Lei Liu, Lulin Ma, Shudong Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To preliminarily investigate the safety and feasibility of domestic Jingfeng MP1000 multi-port robotic surgical system-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy.</p><p><strong>Methods: </strong>Clinical data of 15 patients with renal cell carcinoma (RCC) and venous tumor thrombus who underwent Jingfeng MP1000 robot-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy at the Department of Urology, Peking University Third Hospital from June 2024 to January 2026 were retrospectively analyzed. The primary outcomes were the success rate of the robotic procedure, overall complication rate, and major complication rate (Clavien-Dindo ≥ grade Ⅲ). Secondary outcomes included operative time, estimated blood loss, and length of hospital stay. Baseline characteristics, perioperative outcomes, pathological results, and postoperative complications were collected and analyzed using descriptive statistical methods.</p><p><strong>Results: </strong>All the 15 procedures were successfully completed with robotic assistance, with no conversions to open surgery. The success rate of robotic-assisted surgery was 100%. The median patient age was 60 years, and the median body mass index was 25.6 kg/m². Ten patients had right-sided and 5 had left-sided tumors, with a median tumor diameter of 9.1 cm. According to the Mayo classification, there were 5 cases of grade 0, 4 of grade Ⅰ, 5 of grade Ⅱ, and 1 of grade Ⅲ thrombus. The median operative time was 233.0 min, the median estimated blood loss was 250.0 mL, and 5 patients (33.3%) received blood transfusions. The median postoperative hospital stay was 6 days. Only one patient (6.7%) experienced a Clavien-Dindo grade Ⅱ complication (lymphatic leakage), with no grade ≥Ⅲ severe complications or perioperative mortality. Postoperative pathology revealed clear cell renal cell carcinoma in 12 cases, and venous wall invasion was confirmed in 8 patients (53.3%). After a median follow-up of 4.4 months, one patient developed duodenal metastasis 10 months postoperatively.</p><p><strong>Conclusion: </strong>The domestic Jingfeng MP1000 multi-port robotic system-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy is technically safe and feasible, with favorable perioperative outcomes and a low complication rate. Its long-term oncological efficacy requires further validation through large-scale, prospective studies.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"716-722"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical approaches to different foreign bodies in the urinary bladder: A report of 2 cases].","authors":"Shen Wang, Xinyi Song, Xiaona Sun, Jilu Zheng, Ji Lv","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;We reported the clinical records of 2 patients each with a foreign body in the urinary bladder admitted to Qingdao Central Hospital, University of Health and Rehabilitation Sciences. The size and shape of each foreign body in the urinary bladder were different, thus we chose different surgical approaches to remove them. Case 1 was a 21-year-old male patient. He presented to the outpatient service with urodynia. The patient currently complained of urodynia, and narrated that a foreign body was self-inserted &lt;i&gt;via&lt;/i&gt; the urethra 2 days before. Physical examination revealed suprapubic pain. Ultimately he was admitted to the Department of Urology with a diagnosis of \"bladder foreign body\". A computed tomography (CT) scan of the pelvis was performed and the results demonstrated a linear metallic structure, mea-suring 4.2 cm in length, within the urinary bladder. Under general anesthesia, the patient was placed in lithotomy position and a rigid cystoscope was inserted into the bladder &lt;i&gt;via&lt;/i&gt; urethra. The foreign body was a metal tubular structure and was located within the urinary bladder. Removal by foreign body forceps was attempted and long axis of the foreign body should be parallel to cystoscope. Removal was carefully performed after several attempts due to the smooth surface of the metal foreign body. Case 2 was a 42-year-old male patient. He presented to the outpatient service with dysuria and urodynia and was admitted to the Department of Urology. The patient narrated that a foreign body was self-inserted &lt;i&gt;via&lt;/i&gt; the urethra 1 day before, and currently complained of dysuria, urodynia, and slight hematuria. A CT scan of the urologic system was performed and the results demonstrated a metal tubular structure, measuring 21.5 cm in length. The length of the foreign body was long (from top of iliac crest to perineum) and both ends were sharp, thus bladder perforation could not be excluded. Besides, with smooth metal surface, it was difficult to remove &lt;i&gt;via&lt;/i&gt; cystoscopy and the risk of iatrogenic bladder perforation would increase simultaneously. Therefore, laparoscopic surgery was chosen to detect whether there would be a bladder perforation and could remove the foreign body. Under general anesthesia, the patient was placed in supine position and supraumbilical incision of 1 cm was performed. Pneumoperitoneum needle was used to establish a pneumoperitoneum and insufflation CO&lt;sub&gt;2&lt;/sub&gt; pressure was maintained at 12 mmHg. The peritoneum was accessed and a 10-mm trocar and laparoscopic camera were inserted. A 5-mm trocar was inserted at 2 cm below the umbilical level of lateral margin of left rectus abdominis muscle. While a 12-mm trocar was inserted at symmetrical site of his right rectus abdominis muscle. Under laparoscope, dome of the bladder was lifted into the abdominal cavity by the foreign body, then the bladder wall was incised to expose the foreign body. We pushed the bottom of the foreign body from the perineum extracorp","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"877-880"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Long-term evolution, effect analysis and future trend of the burden of gastritis and duodenitis in China: An analysis based on GBD 2023].","authors":"Qinghua Wang, Tiantian Shen, Xiaowei Lu, Congcong Liao, Shiwei Xu, Yan Li","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the evolutionary trends of the disease burden of gastritis and duodenitis (GD) in China from 1990 to 2023, to clarify the driving factors of changes in this burden, to predict the disease burden situation from 2024 to 2040, and to provide data support for formulating GD prevention and control strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Based on the Global Burden of Disease Study (GBD) 2023 data, the Joinpoint regression model was applied to analyze the annual average percentage change (AAPC) of age-standardized incidence rate, age-standardized prevalence rate, age-standardized mortality rate, and age-standardized disability-adjusted life years (DALY) rate of GD in China from 1990 to 2023. The age-period-cohort model was used to investigate the effects of age, period, and cohort on incidence, prevalence, and mortality risks. Three factors-population structure change, epidemiological change, and population growth-were identified to determine their driving effects on the disease burden. The auto-regressive integrated moving average (ARIMA) time series model was employed to forecast the future disease burden.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From 1990 to 2023, the number of GD incident cases in China increased from 6.158 8 million to 9.354 5 million, the number of prevalent cases rose from 8.770 6 million to 13.145 9 million, the number of deaths decreased from 19 800 to 17 200, and the number of DALY slightly declined from 902 400 person-years to 851 600 person-years. The AAPCs of age-standardized incidence rate, age-standardized prevalence rate, age-standardized mortality rate, and age-standardized DALY rate were -1.08%, -1.18%, -3.81%, and -2.89%, respectively (all &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Joinpoint regression analysis showed that all age-standardized rates presented a phased downward trend. Age-period-cohort model analysis revealed that the incidence and prevalence risks peaked in the 55-59 years age group, while the mortality risk increased significantly with age. The period effect of incidence and prevalence risks first increased and then decreased, whereas the period effect of mortality risk showed a conti-nuous downward trend; the cohort risk exhibited a decreasing trend across all the groups. Decomposition analysis indicated that population growth and structural change promoted the increase in incident and prevalent cases (the overall contribution rates to the incident cases were 165.66% and 167.00%, respectively), while epidemiological change was the main factor driving their decrease (with an overall contribution rate of -232.66% to the incident cases). Additionally, epidemiological change was the core factor for the reduction in deaths (with an overall contribution rate of 490.07%). The ARIMA time series model predicted that by 2040, the number of incident cases would rise to 11.086 1 million, the number of prevalent cases to 15.279 6 million, the mortality rate to 0.48 per 100 000 population, and the DA","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 4","pages":"833-841"},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}