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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.

Aging, a process of functional decline with the increase of chronological age, is a major risk factor for chronic diseases. Aging shows significant individual differences, which is influenced by both genetic and environmental factors. Accurate measurement of physiological age helps identify individuals with accelerated aging and those at high risk for chronic diseases and mortality, which would promote individual health management and precision medicine for healthy aging. In this paper, we summarize the omics-based aging clocks and discuss their current and future applications.

Objective: Explore the expression pattern of transcription factor activator protein 2C (TFAP2C) and identify the roles of Tfap2c during tooth development. Methods: Real-time fluorescence quantitative PCR (RT-qPCR) was used to analyze the relative expression level of Tfap2c in various organs of embryonic day(E)14.5 mouse embryos and mouse molar germs at E12.5-E18.5 and postnatal day (P)0-P7. The expression position of Tfap2c in mouse molar germs was demonstrated by frozen section immunofluorescence staining. Cultured mandibular molar germs were transfected with control small interfering RNA (siRNA) or Tfap2c siRNA to evaluate the effect of Tfap2c on tooth molar germs development, and RT-qPCR was used to detect the relative expression level of genes related to odontoblast expression. Dental mesenchymal cells were isolated from E14.5 molar germs and transfected with control siRNA or Tfap2c siRNA, cell counting kit 8 (CCK-8) and scratch healing test were applied to detect dental mesenchymal cell viability and migration. Results: Tfap2c was highly expressed in the early development period of mouse molar germs. Tfap2c was expressed in the epithelial and mesenchymal tissues of E13.5 mouse molar germs and there was no significant difference of relative expression of Tfap2c between them ( t =1.06, P =0.472). Tfap2c was expressed in mesenchymal tissues of E14.5 mouse molar germs and the relative expression of Tfap2c in mesenchymal tissues was significantly higher than epithelial tissues ( t =37.29, P <0.0001). For molar germs transfected with Tfap2c siRNA, the relative height of cusps (0.708±0.171) and the ratio of cusp height and crown height (0.321±0.068) was significantly lower than control group (1.000±0.287 and 0.483±0.166) ( t =2.79, P =0.012; t =2.85, P =0.015). But there was no significant difference in relative height (1.078±0.206, 0.993±0.254, t =0.83, P =0.419)and relative width (1.000±0.116, 0.999±0.122, t =0.01, P =0.992) of crowns between two groups. The relative expression level of genes related to odontoblast expression was decreased (Dspp: t =15.33, P <0.001; Dmp1: t =13.81, P <0.001). Tfap2c siRNA hinders cell migration in dental mesenchymal cells ( t =29.86, P =0.001), but there was no significant difference in CCK-8 absorbance value between two groups. The relative expression level of genes related to odontoblast expression was also decreased in dental mesenchymal cells transfected with Tfap2c siRNA (Dspp: t =3.86, P =0.031; Dmp1; t =4.36, P =0.022). Conclusions: Tfap2c highly expressed in the early morphogenesis period of mouse molar germs, mainly in mesenchymal tissues. Tfap2c affected the cusps formation of mouse molar germs and migration of dental mesenchymal cells.

Objective: To explore the safety and feasibility of stereotactic radiation therapy (SBRT) strategy for irradiating porcine ventricular septum, see if can provide a preliminary experimental evidence for clinical SBRT in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: Five male pigs (39-49 kg, 6 months old) were used in this study. Pigs were irradiated at doses of 25 Gy ( n =2) or 40 Gy ( n =3). Delineation of the target volume was achieved under the guidance of 3-dimensional CT image reconstruction, and SBRT was then performed on defined target volume of porcine ventricular septum. Blood biomarkers, electrocardiogram and echocardiography parameters were monitored before and after SBRT. Pathological examination (HE staining, Masson staining) was performed on the target and non-target myocardium at 6 months post SBRT. Results: SBRT was successful and all animals survived to the designed study endpoint (6 months) after SBRT. Serum cardiac troponin T (cTnT) level was significantly higher than the baseline level at 1 day post SBRT, and reduced at 1 week after SBRT, but was still higher than the baseline level( P <0.05). Serum N-terminal pro-B type natriuretic peptide (NT-proBNP) was also significantly increased at 1 day post SBRT ( P <0.05) and returned to baseline level at 1 week post SBRT. The serum NT-proBNP level was (249±78), (594±37) and (234±46) pg/ml, respectively, and the cTnT was (14±7), (240±40) and (46±34) pg/ml, respectively at baseline, 1 day and 1 week after SBRT in the 40 Gy dose group. The serum NT-proBNP level was (184±20), (451±49) and (209±36) pg/ml, respectively, the cTnT values ​​were (9±1), (176±29) and (89±27) pg/ml, respectively at baseline, 1 day and 1 week after SBRT in the 25 Gy dose group. Both NT-proBNP and cTnT values tended to be higher post SBRT in the 40 Gy dose group as compared with the 25 Gy dose group, but the difference was not statistically significant ( P >0.05). The left ventricular ejection fraction and the left ventricular end-diastolic diameter remained unchanged before and after SBRT ( P >0.05). The interventricular septum thickness showed a decreasing trend at 6 months after SBRT, but the difference was not statistically significant ((9.54±0.24) mm vs. (9.82±8.00) mm, P >0.05). The flow velocity of the left ventricular outflow tract, and the valve function and morphology were not affected by SBRT. At 6 months after SBRT, HE staining revealed necrosis in the irradiated target area of ​​the myocardium in the 40 Gy dose group and the 25 Gy dose group, and the degree of necrosis in the irradiated interventricular septum was more obvious in the 40 Gy dose group as compared with the 25 Gy group. The combined histological analysis of the two groups showed that the necrotic area of ​​the irradiated target area accounted for (26±9)% of the entire interventricular septum area, which was higher than that of the non-irradiated area (0) ( P <0.05). There was no damage or necrosis of myocardial tissue outside the target irradiation area in both groups. The results of Masson staining showed that the percentage area of myocardial fibrosis was significantly higher in the irradiated target area than non-irradiated area ((12.6±5.3)% vs. (2.5±0.8)%, P <0.05). Conclusion: SBRT is safe and feasible for irradiating porcine ventricular septum.

Objective: To examine the clinical application effects of two-complex and one-plane technique for the renal artery dissected location in transperitoneal laparoscopic radical nephrectomy(LRN). Methods: Clinical data of patients diagnosed as renal tumor between January 2016 and December 2019 that treated with transperitoneal LRN and the two-complex and one-plane technique was performed to locate and dissect the renal arteries were analyzed retrospectively. A total of 206 qualified patients were enrolled, included 71 cases from Kaifeng Central Hospital and 135 cases from the First Affiliated Hospital of Zhengzhou University. There were 126 males and 80 females with median age of 54 years (range: 35 to 82 years). Renal tumor lived at left kidney in 102 cases and at the right in 104 cases, with a maximum tumor diameter of (6.8±2.5)cm (range: 3.0 to 12.7 cm). During the procession of transperitoneal LRN, The genital veins was followed to locate renal veins, soon the renal vein complex and renal lower pole complex and psoas major muscle plane that named as "two-complex and one-plane"anatomical markers were applied to the dissected location of renal arteries. The established application of two-complex and one-plane technique for renal artery location, and the anatomical features along with its locational time of renal artery, as well as vascular-related complications were recorded and analysed. The χ 2 test or t test was used to compare the results of different lateral operations. Results: The surgical procedures were successful in all 206 patients. The operation time was (54.4±13.6) minutes (range:22 to 116 minutes), no injury to liver, spleen or intestine. Two-complex and one-plane technique was used to complete renal arteries location of 206 patients that accompanied with one or more arterial branch in the procession of transperitoneal LRN. Single renal artery branch was found in 163 cases, two or more renal artery branches were found in 43 cases, and 60 branches of accessory renal artery that in addition to the main trunks were detected in 14 cases (13.7%, 14/102) on left-side and 29 cases (27.9%, 29/104) on the right(χ²=6.251, P =0.012).The main branch of renal artery that directly been located inferior or posterior to renal vein in 165 cases, and the other 41 cases that born with higher-position of main branch been located through an upper"window-opening"of renal veins complex. Of the 60 accessory renal artery, 46 branch (76.6%, 46/60) been located inferior or posterior to renal veins, and the other 14 branch with higher-position (23.3%, 14/60) been located by a"window-opening"technique. The renal artery dissected location time was (21.2±9.4) minutes (range:11 to 43 minutes) in left-side and (17.5±9.3) minutes (range:9 to 32 minutes) in the right ( t =2.840, P =0.005).The intraoprative bleeding was (51.8±25.2) ml (range:20 to 400 ml). There were 4 cases of vascular injury occured and treated with laporoscopy, only one need blood transfusion. Conclusions: The anatomical markers of renal vein complex and renal lower pole complex and psoas major muscle plane that can apply to locate various anatomical position types of renal artery in transperitoneal LRN effectively. The exactly application of two-complex and one-plane technique that could shorten the operational time of renal artery location and reduce the complications of vascular injury.