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Background This study aim to evaluate the efficacy and safety of urethra-sparing robot-assisted simple prostatectomy (US-RASP) compared to conventional robot-assisted simple prostatectomy (RASP) for treating large-volume benign prostatic hyperplasia (BPH), with particular attention to preserving ejaculatory function. Methods A thorough search was conducted across PubMed, Web of Science, EMBASE, and Cochrane Library databases for studies published until September 26, 2024. Five cohort studies involving 771 patients met the inclusion criteria. Data on perioperative outcomes, International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF), Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD), Maximum Flow Rate (Qmax), Post-Void Residual Volume (PVR), Quality of Life (QoL) and complications were extracted and analyzed using RevMan 5.3 and Stata 15. Results The meta-analysis revealed that US-RASP was markedly more effective than RASP in preserving ejaculatory function (MSHQ-EjD, WMD 8.09, 95% CI 5.92–10.26, p  < 0.0001). No notable differences were identified between the two approaches regarding IPSS, IIEF, Qmax, PVR, QoL, operative time, or intraoperative blood loss and complications. Nonetheless, US-RASP showed benefits in shortening hospital stay and catheterization time. Conclusions US-RASP offers significant benefits in preserving ejaculatory function and is comparable to RASP in terms of safety and efficacy. It is a preferable option for younger patients or those desiring ejaculatory preservation, pending further validation through large-scale, prospective randomized trials.

In the process of bone regeneration, new bone formation is largely affected by physico-chemical cues in the surrounding microenvironment. Tissue cells reside in a complex scaffold physiological microenvironment. The scaffold should provide certain circumstance full of structural cues to enhance multipotent mesenchymal stem cell (MSC) differentiation, osteoblast growth, extracellular matrix (ECM) deposition, and subsequent new bone formation. This article reviewed advances in fabrication technology that enable the creation of biomaterials with well-defined pore structure and surface topography, which can be sensed by host tissue cells (esp., stem cells) and subsequently determine cell fates during differentiation. Three important cues, including scaffold pore structure (i.e., porosity and pore size), grain size, and surface topography were studied. These findings improve our understanding of how the mechanism scaffold microenvironmental cues guide bone tissue regeneration.

PurposeThe purpose of this paper is to quantitatively measure the vulnerability level of the whole rural social-ecological system in Yunnan Province and to analyze the spatial differences of the vulnerability in different regions.Design/methodology/approachBased on the “exposure-sensitivity-adaptability” vulnerability assessment framework, this paper establishes the index system of rural social-ecological system vulnerability to climate change. Combined with the questionnaire survey and meteorological data, the entropy method was used to measure and analyze the vulnerability level and influencing factors of the overall rural social-ecological system in Yunnan Province. At the same time, the vulnerability level of social-ecological system in Yunnan Province is divided into five levels, and the spatial differences of vulnerability level of 16 states (cities) in Yunnan Province are analyzed.FindingsThe results show that: the social-ecological system has high exposure to climate change (0.809), strong sensitivity (0.729), moderate adaptability (0.297) and overall system vulnerability is at a medium level (0.373). Yunnan Province is divided into five levels of social-ecological system vulnerable areas. The areas of extreme, severe, moderate, mild and slight vulnerability account for 21.45%, 24.65%, 36.82%, 13.18% and 3.90% of the whole province, respectively. The geographical division and vulnerability division of Yunnan Province are basically consistent in space.Originality/valueComprehensive evaluation of the vulnerability of the social-ecological system of Yunnan Province to climate change is the scientific basis for the country to formulate countermeasures against climate change, and it is also the need to improve the adaptability of the social and economic system of the fragile area, reduce the vulnerability and realize the sustainable development of national social economy. The research results can provide a basis for decision-making of climate adaptation in Yunnan and other regions and provide methods and indicators for the assessment of social-ecological system vulnerability under the background of climate change.

Introduction of metals as biomaterials has been known for a long time. In the early development, sufficient strength and suitable mechanical properties were the main considerations for metal implants. With the development of new generations of biomaterials, the concepts of bioactive and biodegradable materials were proposed. Biological function design is very import for metal implants in biomedical applications. Three crucial design criteria are summarized for developing metal implants: (1) mechanical properties that mimic the host tissues; (2) sufficient bioactivities to form bio-bonding between implants and surrounding tissues; and (3) a degradation rate that matches tissue regeneration and biodegradability. This article reviews the development of metal implants and their applications in biomedical engineering. Development trends and future perspectives of metallic biomaterials are also discussed.

It is well known that stem cells reside within tissue engineering functional microenvironments that physically localize them and direct their stem cell fate. Recent efforts in the development of more complex and engineered scaffold technologies, together with new understanding of stem cell behavior in vitro, have provided a new impetus to study regulation and directing stem cell fate. A variety of tissue engineering technologies have been developed to regulate the fate of stem cells. Traditional methods to change the fate of stem cells are adding growth factors or some signaling pathways. In recent years, many studies have revealed that the geometrical microenvironment played an essential role in regulating the fate of stem cells, and the physical factors of scaffolds including mechanical properties, pore sizes, porosity, surface stiffness, three-dimensional structures, and mechanical stimulation may affect the fate of stem cells. Chemical factors such as cell-adhesive ligands and exogenous growth factors would also regulate the fate of stem cells. Understanding how these physical and chemical cues affect the fate of stem cells is essential for building more complex and controlled scaffolds for directing stem cell fate.

Establishing a valid in vitro model to represent tumor heterogeneity and biology is critical but challenging. Tumor organoids are self‐assembled three‐dimensional cell clusters which are of great significance for recapitulating the histopathological, genetic, and phenotypic characteristics of primary tissues. The organoid has emerged as an attractive in vitro platform for tumor biology research and high‐throughput drug screening in cancer medicine. Organoids offer unique advantages over cell lines and patient‐derived xenograft models, but there are no standardized methods to guide the culture of organoids, leading to confusion in organoid studies that may affect accurate judgments of tumor biology. This review summarizes the shortcomings of current organoid culture methods, presents the latest research findings on organoid standardization, and proposes an outlook for organoid modeling.

Hepatocellular carcinoma (HCC) is one of the most deadly tumors. Transarterial chemoembolization (TACE) is effective for unresectable HCC. In recent years, miRNAs have been proposed as novel diagnostic and prognostic tools for HCC. This study aimed to identify whether microRNAs (miRNAs) can serve as biomarkers to reliably predict outcome before HCC patients are treated with TACE. Eleven miRNAs (miR-, miR-19a, miR-101-3p, miR-199a-5p, miR-200a, miR-21, miR-214, miR-221, miR-222, miR-223 and miR-, -5p) were quantified by quantitative real-time PCR (qRT-PCR) in 136 HCC patients' serum before they received TACE therapy. Univariate and multivariate analysis were used to identify the prognostic value of clinical parameters and miRNAs. Area under the receiver operating characteristic curve (AUC) was used to evaluate the prediction potency. The levels of some miRNAs were dramatically associated with clinicopathologic features regarding Child-Puge class, AFP, tumor size and satellite nodules. Univariate analysis revealed that miR-200a, miR-21, miR-122 and miR-224-5p were significantly associated with patients' survival. Multivariate analysis demonstrated that AFP, satellite nodules and miR-200a were the independent prognostic factors associated with survival in this cohort (p = 0.000, 0.001, 0.000, respectively). The probability of the prognostic accuracy of miR-200a was 81.64% (74.47% specificity and 88.76% sensitivity), which was higher than the classifier established by combination of AFP and satellite nodules (76.87% probability, 70.21% specificity and 69.66% sensitivity). Furthermore, the combination of AFP, satellite nodules and miR-200a demonstrated as a classifier for HCC prognosis, yielding a ROC curve area of 88.19% (93.62% specificity and 68.54% sensitivity). Our study indicated that serum miR-200a may prognosticate disease outcome in HCC patients with TACE therapy. Therefore, miR-200a can potentially guide individualized treatment for HCC patients with a high risk of TACE treatment failures.

In the mechanized construction of tunnels, due to limitations in mechanical equipment parameters, the distance from the palm face to the inverted arch and secondary lining does not meet the safety distance specified in the regulations. In order to obtain the deformation of surrounding rocks and the stress laws of support structures under the safety distance out of specification of mechanized construction, the paper first analyzed the parameters of mechanized construction equipment and the safety distance of adjacent equipment. The safety distance between the three arm rock drill trolley equipment parking area and the inverted arch was 50 m, and the safety distance to the secondary lining was 150 m. The distance from the palm face to the inverted arch and the secondary lining needs to increase the distance of the blasting flying stone based on the original safety distance. Then, based on the Qilinguan tunnel, numerical simulation was used to study the distance from the palm surface to inverted arch and the secondary lining. The results showed that the deformation difference of surrounding rock and the force difference of supporting structures under different distance from the palm face to the inverted arch and the secondary lining obtained in the paper were small, and the deformation of surrounding rock is within the allowable range of the specification. Finally, the rationality of numerical simulation and the distance from the palm surface to inverted arch and the secondary lining was verified. The research of the paper can provide reference for mechanized tunnel construction.Article HighlightsAccording to the parameters of tunnel mechanized construction equipment and the safety distance between adjacent equipments, the safety distance from the three arm rock drill trolley to the inverted arch is 50 m, and the safety distance to the secondary lining is 150 m.Based on the blasting flying stone distance obtained from the Qilinguan Tunnel, combined with the characteristics of mechanical equipment and the safety distance of adjacent equipments, the safe distances between the palm face and the inverted arch and secondary lining are 80–100 m and 180–200 m, respectively.Based on the actual engineering, the rationality of the safety distance between the palm face and the inverted arch and secondary lining proposed in the paper is verified through numerical simulation and on-site monitoring.

Vascular stents have many applications in treating arterial stenosis and other vascular-related diseases. The ideal vascular stent for clinical application should have radial support and axial bending mechanical properties that meet the requirements of vascular deformation coordination. The materials used for vascular stents implanted in the human body should have corresponding biocompatibility to ensure that the stents do not cause coagulation, hemolysis, and other reactions in the blood. This study fabricated four types of vascular stents, including inner hexagon, arrowhead, quadrilateral, and outer hexagonal, using fused filament fabrication technology and thermoplastic polyurethane (TPU) as materials. By evaluating the effects of edge width and wall thickness on the radial support and axial bending performance, it was found that the inner hexagonal stent exhibited the best radial support and axial bending performance under the same conditions. The design and fabrication of vascular stents based on 3D printing technology have promising application prospects in personalized customized vascular repair therapy.

Large-segment bone defect caused by trauma or tumor is one of the most challenging problems in orthopedic clinics. Biomimetic materials for bone tissue engineering have developed dramatically in the past few decades. The organic combination of biomimetic materials and stem cells offers new strategies for tissue repair, and the fate of stem cells is closely related to their extracellular matrix (ECM) properties. In this study, a photocrosslinked biomimetic methacrylated gelatin (Bio-GelMA) hydrogel scaffold was prepared to simulate the physical structure and chemical composition of the natural bone extracellular matrix, providing a three-dimensional (3D) template and extracellular matrix microenvironment. Bone marrow mesenchymal stem cells (BMSCS) were encapsulated in Bio-GelMA scaffolds to examine the therapeutic effects of ECM-loaded cells in a 3D environment simulated for segmental bone defects. In vitro results showed that Bio-GelMA had good biocompatibility and sufficient mechanical properties (14.22kPa). A rat segmental bone defect model was constructed in vivo . The GelMA-BMSC suspension was added into the PDMS mold with the size of the bone defect and photocured as a scaffold. BMSC-loaded Bio-GelMA resulted in maximum and robust new bone formation compared with hydrogels alone and stem cell group. In conclusion, the bio-GelMA scaffold can be used as a cell carrier of BMSC to promote the repair of segmental bone defects and has great potential in future clinical applications.