Abstract:Von Hippel-Lindau(VHL)syndrome is a rare autosomal dominant genetic disorder.Adolescent patients with bilateral adrenal pheochromocytoma should be alert to the possibility of VHL syndrome,and genetic testing is the key to diagnosis.Radical surgical resection is the main treatment,and lifelong follow-up is required after surgery to monitor the oc-currence of multi-organ tumors.This study reports the clinical data,imaging features,pathological and genetic testing results of 2 adolescent VHL syndrome patients presenting with bilateral adrenal pheochromocytoma,and summarizes their diagno-sis,treatment process and follow-up results,aiming to provide a more accurate treatment strategy for this disease.

Abstract:Objective To explore the epidemiological characteristics and influencing factors of urinary calculi among servicemen in a military unit,so as to provide a scientific basis for the prevention and treatment of this disease in ser-vicemen.Methods A questionnaire survey and physical examination report analysis were conducted among servicemen in a military unit from July to October 2024.The results were analyzed using multivariate Logistic regression.Results The preva-lence rate of urinary calculi among the servicemen was 4.57%.Multivariate analysis showed that hyperlipidemia(OR=51.897,95%CI:9.285～290.062),family history of urinary calculi(OR=2.355,95%CI:1.122～4.945),and tea consumption(OR=0.419,95%CI:0.202～0.872)were significantly correlated with urinary calculi.Conclusion Hyperlipidemia and family histo-ry of urinary calculi are risk factors for urinary calculi in servicemen,while tea consumption is a protective factor.Attention should be paid to the risk factors,and interventions should be carried out in terms of lifestyle and behavioral habits to reduce the incidence of urinary calculi among servicemen.

Abstract:Objective To analyze the effect of ureteroscopic holmium laser lithotripsy(URHL)on stress response and renal function in patients with complex ureteral calculi complicated with hydronephrosis.Methods A retrospective study was conducted on 103 patients with complex ureteral calculi complicated with hydronephrosis admitted to Zhangjiakou First Hospital from February 2022 to February 2024.According to different surgical protocols,the patients were divided into the URSL group(54 cases)treated with ureteroscopic pneumatic lithotripsy(URSL)and the URHL group(49 cases)treated with URHL.Both groups were followed up for 1 month.Perioperative indicators,stress response at 1 day before and after sur-gery,renal function and hydronephrosis grading at 1 month before and after surgery,and the incidence of complications at 1 month after surgery were compared between the two groups.Results The URHL group had shorter operation time,shorter hospital stay,and higher complete stone clearance rate,with statistically significant differences(P<0.05).Compared with before surgery,the serum levels of adrenocorticotropic hormone(ACTH),norepinephrine(NE),and cortisol(COR)in both groups increased at 1 day after surgery,but those in the URHL group were lower,with statistically significant differenc-es(P<0.05).At 1 month after surgery,the levels of serum creatinine(Scr),blood urea nitrogen(BUN),urinary kidney in-jury molecule-1(KIM-1),and neutrophil gelatinase-associated lipocalin(NGAL)in both groups decreased,and those in the URHL group were lower,with statistically significant differences(P<0.05).Compared with before surgery,the hydrone-phrosis grading of both groups improved at 1 month after surgery,and the URHL group was superior to the URSL group,with a statistically significant difference(P<0.05).At 1 month after surgery,the incidence of complications in the URHL group[6.12%(3/49)]was lower than that in the URSL group[20.37%(11/54)],with a statistically significant difference(P<0.05).Conclusion Compared with URSL,URHL can reduce the stress response of patients with complex ureteral calculi complicated with hydronephrosis,improve perioperative indicators,enhance renal function,regulate hydronephrosis grad-ing,and reduce the risk of complications.

Abstract:Pediatric inflammatory myofibroblastic tumor(IMT)of the bladder is an extremely rare borderline urinary tract tumor,characterized by non-specific clinical manifestations and imaging findings,which easily leads to misdiagnosis.Immunohistochemistry and molecular pathological detection are the gold standards for diagnosing this disease,and surgical resection of the tumor is the preferred treatment method.This study retrospectively analyzed the clinicopathological features,treatment plan and prognosis of 1 case of pediatric bladder IMT admitted to the Third Affiliated Hospital of Southern Medical University,and conducted a review of relevant literature to improve the understanding of this disease.

Abstract:Objective To compare the efficacy,surgical safety,and postoperative quality of life between retroperito-neal laparoscopic partial nephrectomy(RLPN)and retroperitoneal laparoscopic radical nephrectomy(RLRN)in patients with T1b stage renal cell carcinoma performed by a single surgeon.Methods A retrospective analysis was conducted on the clinical data of 214 patients with T1b stage renal cell carcinoma admitted to the Department of Urology,Affiliated Hospital of Qingdao University,from April 2018 to February 2023.All surgeries were performed by a single surgeon,including 117 pa-tients who underwent RLPN(RLPN group)and 97 patients who underwent RLRN(RLRN group).Surgical data,complica-tions,histological results,changes in renal function,and survival status were collected and analyzed.Postoperative complica-tions were evaluated according to the Clavien-Dindo classification system,and postoperative quality of life was assessed us-ing the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC QLQ-C30).Results There were no statistically significant differences in general clinical data and perioperative related factors be-tween the two groups(P>0.05).The total incidence of surgical complications in the RLPN group was higher than that in the RLRN group,with a statistically significant difference(P=0.032).There was no statistically significant difference in the inci-dence of severe postoperative complications(Clavien classification≥grade Ⅲ)between the two groups(P>0.05).At 1 day,3 months,6 months,and 12 months after surgery,the serum creatinine level in the RLPN group was significantly lower than that in the RLRN group,with statistically significant differences(P<0.05).The EORTC QLQ-C30 scores showed that the postoperative global health status score and functional domain scores in the RLPN group were significantly better than those in the RLRN group,with statistically significant differences(P<0.05).There were no statistically significant differenc-es in 1-year survival rate,recurrence and metastasis rate,or cancer-specific survival rate between the two groups(P>0.05).Conclusion Both RLPN and RLRN are safe and effective surgical methods for the treatment of T1b stage renal cell carcino-ma,and both can achieve good oncological control effects.Although the incidence of severe postoperative complications is comparable between the two groups,RLPN has significant advantages in protecting postoperative renal function and improv-ing patients'quality of life.

Abstract:Methods:Clinical studies on single-use flexible ureteroscopic holmium laser lithotripsy combined with flexible negative pressure aspiration sheath(combined group)versus PCNL(PCNL group)for upper urinary tract calculi,published from January 2010 to February 2025 at home and abroad,were retrieved.Data were extracted according to the Co-chrane systematic review method,and Meta-analysis was performed using RevMan 5.6 statistical software to compare indica-tors such as operation time,stone clearance rate,total complications,postoperative fever,postoperative hemoglobin de-cline,blood loss,and hospital stay between the two groups.Results:A total of 7 Chinese studies involving 994 patients(538 in the combined group and 456 in the PCNL group)were finally included in the Meta-analysis.There were no statistically sig-nificant differences in operation time(MD=6.43,95%CI:-6.56 to 19.42,P=0.33)or stone clearance rate(OR=1.24,95%CI:0.50 to 3.05,P=0.65)between the two groups.Compared with the PCNL group,the combined group had a lower incidence of total complications(MD=0.33,95%CI:0.23 to 0.48,P<0.001),a lower incidence of postoperative fever(OR=0.54,95%CI:0.30 to 1.00,P=0.05),a smaller postoperative hemoglobin decline(MD=-4.28,95%CI:-6.83 to-1.73,P=0.001),less blood loss(MD=-9.98,95%CI:-10.78 to-9.19,P<0.001),and a shorter hospital stay(MD=-2.25,95%CI:-3.21 to-1.30,P<0.001).Objective:To compare the efficacy and safety of single-use flexible ureteroscope combined with flexible negative pressure as-piration sheath in holmium laser lithotripsy versus percutaneous nephrolithotomy(PCNL)for upper urinary tract calculi(2-3 cm).Conclusion:The two surgical methods have similar effects in terms of operation time and stone clearance.Compared with PCNL,flexible negative pressure aspiration sheath combined with flexible ureteroscopic holmium laser lithotripsy has obvious advantages in postoperative fever,hospital stay,blood loss,total complication rate,and hemoglobin decline.

Abstract:Objective:To explore the safety and feasibility of robotic partial nephrectomy combined with venous thrombus extraction in the treatment of renal angiomyolipoma(RAML)complicated with venous thrombus.Methods:A ret-rospective analysis was performed on the clinical data of 5 patients with RAML complicated with venous thrombus who under-went robot-assisted nephron-sparing surgery with thrombectomy in Senior Department of Urology,PLA General Hospital be-tween June 2018 and March 2025.One patient was male and 4 were female,with a median age of 42(range:34-61)years.All renal tumors were located on the right side,with a median maximum diameter of the primary tumor of 2.1(range:0.5-5.7)cm.Venous thrombi were classified according to the"301 Classification System":1 case of grade 0,1 case of grade I,and 3 cas-es of grade II.Results:All 5 patients successfully completed the surgery without conversion to open surgery or radical ne-phrectomy.The median operation time was 145(range:95-175)minutes,median blood loss was 300(range:50-600)mL,me-dian right renal artery clamping time was 27(range:20-31)minutes,median inferior vena cava clamping time was 7(range:3-20)minutes,and median postoperative hospital stay was 5(range:4-7)days.No perioperative severe complications(Clavien-Dindo grade Ⅲ-Ⅴ)occurred in any of the 5 patients,and there was no postoperative hematuria or urinary fistula.Postopera-tive pathology confirmed RAML in all 5 patients.The renal function of the patients recovered to the baseline level at 1 day,1 month,and 3 months after surgery,and no tumor recurrence was observed during follow-up.Conclusion:This study initially verifies that robotic partial nephrectomy combined with venous thrombus extraction is safe and feasible for the treatment of RAML complicated with venous thrombus,and this surgical approach can achieve better renal function preservation.

Abstract:Objective:To explore the key points and application value of retroperitoneal single-plane precision ana-tomical adrenalectomy.Methods:Clinical data of 53 patients with adrenal tumors admitted to Zhongnan Hospital of Wuhan University from April to September 2024 were retrospectively analyzed,all with unilateral lesions(28 cases of left-sided tu-mors and 25 cases of right-sided tumors).All patients underwent retroperitoneal single-plane precision anatomical adrenalecto-my.The operative time,intraoperative blood loss,duration of retroperitoneal drainage tube indwelling,postoperative hospi-tal stay,and postoperative complications were observed.Results:All 53 operations were successfully completed without con-version to open surgery.The mean operative time was(48.3±10.5)min,the mean intraoperative blood loss was(25.8±7.3)ml,the mean duration of retroperitoneal drainage tube indwelling was(1.2±0.3)d,and the mean postoperative hospital stay was(3.1±0.5)d.No complication such as peritoneal injury,renal pedicle injury,or subcutaneous hematoma occurred dur-ing or after the operation in all patients.Conclusion:Retroperitoneal single-plane precision anatomical adrenalectomy is char-acterized by short operative time,clear surgical field,and high safety,which is worthy of further in-depth research.

Abstract:Diagnosis of Turner syndrome relies on sex chromosome karyotyping and imaging studies,with treatment tailored to the specific comorbidities and clinical manifestations.This study aims to enhance understanding of the condition and provide a reference for clinical diagnosis and treatment through a retrospective analysis of a case of Turner syndrome com-plicated by horseshoe kidney,left duplex kidney,and right megaloureter.

Abstract:Urolithiasis is is a common urinary system disease,often leading to complications such as urinary tract in-fection,hydronephrosis,and renal function impairment.Its etiology is complex,and the formation process is affected by mul-tiple factors,with high incidence and recurrence rates.This study reviews the current research on urinary calculi in genomics,microbiomics,metabolomics,proteomics,and radiomics,aiming to provide new ideas and strategies for the diagnosis,treat-ment,and prevention of stone recurrence.

Abstract:Objective:To analyze the efficacy of the intelligent pressure-controlled ureteral manometry access sheath and the tip-flexible ureteral access sheath in flexible ureteroscopic lithotripsy.Methods:A prospective study was conducted on 122 patients with ureteral calculi(calculus diameter:1-3 cm)admitted to the Department of Urology,Tongliang Hospital of the First Affiliated Hospital of Chongqing Medical University,from October 2023 to October 2024.All patients were ran-domly divided into two groups and received different treatments:Group A(69 cases)used a pressure-measurable flexible ure-teroscopic suction sheath,and Group B(53 cases)used a tip-flexible negative-pressure suction sheath.Intraoperative indica-tors(operation time,intraoperative blood loss,injury status)and postoperative complications(fever,urosepsis,residual cal-culi,etc.)were recorded and compared.Data were analyzed using SPSS 26.0,with chi-square test and t-test applied for statis-tical analysis.Results:Compared with Group B,Group A had less intraoperative blood loss and shorter operation time,with statistically significant differences(P<0.05).Postoperatively,the fever rate and urosepsis-related indicators(white blood cell count and C-reactive protein level)in Group A were lower than those in Group B,with statistically significant differences(P<0.05).Regarding postoperative residual calculi,the calculus diameter in Group A at 24 hours and 3 months after surgery was significantly smaller than that in Group B,with statistically significant differences(P<0.05).There were no statistically significant differences in the complete stone clearance rate and residual stone rate between the two groups(P>0.05).The in-cidence of ureteral stricture and calculus recurrence in Group A at 6 and 12 months after surgery was lower than that in Group B(P<0.05).Conclusion:Compared with the tip-flexible negative-pressure suction sheath,the pressure-measurable flexible ureteroscopic suction sheath has obvious advantages in operation time and blood loss,causes less injury during surgery,and is free from postoperative fever and urosepsis.These findings suggest that it is safer and more effective in the treatment of 1-3 cm ureteral calculi.

Abstract:Objective:To explore the reliability of the modified Arda scoring system in evaluating testicular viability during testicular torsion surgery and compare it with intraoperative biopsy-based pathological tissue viability grading.Meth-ods:A prospective study was conducted,including 25 cases of testicular torsion diagnosed by clinical and imaging examina-tions who underwent emergency surgical detorsion at the 940th Hospital of the Joint Logistic Support Force from October 2018 to October 2023.After testicular detorsion,testicular tunica albuginea incision and decompression were performed dur-ing the recovery period.Testicular tissue viability was quantitatively evaluated using the Arda scoring system based on the ob-servation of medullary arterial oozing.For patients with Arda Grade Ⅲ,microscopic spermatic vein thrombolysis was further performed.According to the recovery of medullary blood flow after thrombolysis,those with recovered medullary arterial oozing were classified as Arda Ⅲa,and the others as Arda Ⅲb;this classification was used to assess testicular viability and determine testicular salvage or resection.Testes with Arda Grade Ⅰ,Ⅱ,and Ⅲa were preserved,while those with Grade Ⅲb were resected.Meanwhile,intraoperative testicular biopsy was performed,and histopathological diagnosis was used as the reference standard to evaluate testicular viability using the Mikuz classification.Results:Among the 25 patients with testicu-lar torsion,the duration of torsion ranged from 6 to 72 hours(median,12 hours),and the torsion degree ranged from 360° to 1080°.There were 5 cases with Arda Grade Ⅰ and 11 cases with Grade Ⅱ,all of which were preserved and underwent orchido-pexy.Among the 9 cases with Arda Grade Ⅲ,4 were reclassified as Grade Ⅲa after thrombolysis and preserved,while 5 were reclassified as Grade Ⅲb and underwent orchiectomy.Intraoperative biopsy confirmed that among the 4 Arda Ⅲa cases,1 was Mikuz Grade 1 and 3 were Mikuz Grade 2.Compared with direct decision-making based on the original Arda score,the modified method showed a numerical trend of improving testicular salvage rate(64.0%vs.80.0%),but the difference was not statistically significant(P=0.207).There was also no significant difference in the testicular atrophy rate 3 months after sur-gery(31.25%vs.30.0%,P=0.081).Conclusion:Compared with the traditional Arda score,secondary evaluation of testicu-lar viability after microscopic venous thrombolysis may help improve the possibility of testicular salvage after detorsion,with-out an observed increase in complication rates.These results need to be further verified by larger-sample studies.Based on the current evidence level,this modified protocol can be used as an alternative strategy in clinical practice pending higher-level evidence.

Abstract:Objective:To explore the impact of shared decision-making(SDM)on disease knowledge level,satisfac-tion,and treatment adherence intention of patients with prostate cancer during whole-course management,and to reveal the learning curve characteristics of both patients and physicians as the frequency of SDM implementation increases.Methods:A non-randomized pretest-posttest intervention study combined with interviews was conducted among 40 patients with prostate cancer and 4 physicians.Patients were divided into an observation group and a control group(20 patients in each group)based on the results of the Decision Expectation Scale.Each group was randomly assigned 1 senior physician and 1 junior phy-sician.The observation group adopted the SDM model,while the control group used the traditional diagnosis and treatment model.The patient-centered outcomes of the two groups and the learning curves of physicians'skills were evaluated.Results:The SDM model improved patients'satisfaction(P<0.001)and increased disease-related knowledge level(P<0.001),but had no significant impact on treatment adherence intention.Meanwhile,SDM shortened the communication time(P=0.003).The learning curve showed that as the number of SDM implementations increased,the willingness to implement SDM also in-creased,but there were differences in the change trends between senior and junior physicians.Conclusion:The SDM model benefits patients and reduces physicians'burden.In the future,attention should be paid to policy support,hierarchical train-ing,and optimization of decision aid tool design to promote its effective implementation and sustainable development in clini-cal practice.

Abstract:Methods:A retrospective analysis was performed on the clinical data of 18 patients with symptomatic horseshoe kidney admitted to the First Affiliated Hospital of Anhui Medical University from June 2015 to June 2024.All pa-tients underwent transperitoneal robot-assisted laparoscopic surgery,and the isthmus of the horseshoe kidney was transected using a linear cutting stapler during the operation.Clinical data including operation time,postoperative hospital stay,and he-moglobin levels before and after surgery were summarized and analyzed,and a literature review was conducted.Results:All operations were successfully completed without severe intraoperative or postoperative complications,or injuries to important organs or large blood vessels.The average operation time was 253.8 minutes,the average postoperative hemoglobin reduction was 13.8 g/L,the average postoperative ventilation time was 2.3 days,and the average postoperative hospital stay was 7.6 days.Postoperative follow-up showed favorable outcomes.Conclusion:Robot-assisted laparoscopy combined with a linear cutting stapler is safe and effective for the treatment of symptomatic horseshoe kidney,with fewer complications and faster re-covery.Objective:To explore the safety and efficacy of robot-assisted laparoscopy combined with a linear cutting stapler in the treatment of symptomatic horseshoe kidney.

Abstract:Methods:An online follow-up database system for urinary calculi was designed and established,with an improved information entry interface.While ensuring data security,modules for statistical analysis visualization,establish-ment of clinical cohort research projects,and research implementation were provided.More than 10 institutions,including the PLA General Hospital,the General Hospital of the Eastern Theater Command,and Wenzhou People's Hospital,jointly conducted real-time data entry.Emphasis was placed on quality control and management of database information entry to achieve database resource sharing and multi-center data connection.Results:A real-time online urinary calculi database was initially established.The data items include patients'basic information,preoperative and postoperative imaging information,laboratory results,surgical information,adverse reaction records,postoperative follow-up data,metabolic assessment,and stone composition analysis.From September 2022 to October 2024,a total of 1,104 cases were included in the database.Conclusion:The establishment of this database can provide data support for the clinical practice and scientific research of uri-nary calculi,assist in clinical diagnosis,formulation and improvement of treatment strategies,and also build a homogeneous scientific research platform,which is conducive to further carrying out clinical research on urinary calculi.Objective:By constructing and preliminarily applying a follow-up database for urinary calculi,this study aims to realize the whole-process information management of patients with urinary calculi,provide data support for clinical practice and scientific research,and build a homogeneous clinical and scientific research platform for multiple hospitals participating in the database.

Abstract:Objective:To explore the clinical efficacy of laparoscopic-assisted nerve-sparing radical prostatectomy(LabNSRP)versus laparoscopic radical prostatectomy(LRP)in the treatment of prostate cancer.Methods:A prospective study was conducted on 216 patients with prostate cancer admitted to Guangyuan First People's Hospital from January 2019 to March 2023.They were divided into a study group and a control group according to the random number table method,with 108 cases in each group.The control group was treated with LRP,and the study group was treated with LabNSRP.The periop-erative indicators,serum tumor markers[carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),prostatic acid phosphatase(PAP),total prostate-specific antigen(TPSA),free prostate-specific antigen(FPSA)],immune function indi-cators(CD3+,CD4+,CD4+/CD8+),prognosis-related markers[granulin 88(GP88),phosphoglycerate kinase 1(PGK-1),α-methylacyl-CoA racemase(AMACR),platelet-to-lymphocyte ratio(PLR)],International Prostate Symptom Score(IPSS),Quality of Life Score(QOL),International Index of Erectile Function-5(IIEF-5)score,and postoperative compli-cations were compared between the two groups.The patients were followed up for 12 months,and the recurrence rates of the two groups were statistically compared.Results:The intestinal function recovery time in the study group[(2.39±0.76)days]was shorter than that in the control group[(3.24±0.88)days],and the difference was statistically significant(P<0.05).There were no statistically significant differences in operation time,positive surgical margin rate,blood loss,postoper-ative drainage volume,or length of hospital stay between the two groups(P>0.05).On the 3rd day after surgery,the levels of CD3+,CD4+,and CD4+/CD8+in the study group were higher than those in the control group(P<0.05).There were no statistically significant differences in peripheral blood PLR and serum levels of AMACR,GP88,PGK-1,PAP,CEA,TP-SA,and NSE between the two groups at 1 month after surgery(P>0.05).At 3 months after surgery,the IPSS score in the study group was lower than that in the control group,while the IIEF-5 and QOL scores were higher than those in the control group(P<0.05).Within 3 months after surgery,the incidence of complications in the study group was lower than that in the control group(P<0.05).There was no statistically significant difference in the recurrence rate between the two groups(P>0.05).Conclusion:LabNSRP in the treatment of prostate cancer can effectively promote the recovery of postoperative uri-nary control and erectile function,reduce postoperative immune dysfunction,lower the risk of postoperative complications,and improve the quality of life.

Abstract:Methods:A prospective study was conducted,enrolling 169 patients with complex renal calculi admitted to Yibin Second People's Hospital from January 2020 to August 2022.According to the random number table method,the pa-tients were divided into the percutaneous nephrolithotomy group(56 cases),the flexible ureteroscope group(57 cases),and the combined group(56 cases).All groups were followed up for 2 years after surgery.The t-test or χ² test was used to com-pare the clinical efficacy,surgery-related indicators,renal function,levels of high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor(TNF)-α,angiotensin(Ang)Ⅰ,and Ang Ⅱ at 24 hours before and after surgery,as well as complica-tions at 1 month and 2 years after surgery and stone clearance at 7 days after surgery among the groups.Results:The total clinical effective rate of the combined group(92.86%)was higher than that of the percutaneous nephrolithotomy group(69.64%)and the flexible ureteroscope group(70.18%),with statistically significant differences(P<0.05).The operation time and lithotripsy time in the combined group were longer than those in the flexible ureteroscope group and the percutane-ous nephrolithotomy group;the lithotripsy time in the flexible ureteroscope group was longer than that in the percutaneous nephrolithotomy group.The exhaust time and hospital stay in the combined group were shorter than those in the flexible ure-teroscope group and the percutaneous nephrolithotomy group;the flexible ureteroscope group had shorter times than the per-cutaneous nephrolithotomy group,with statistically significant differences in all the above indicators(P<0.05).At 24 hours after surgery,the serum levels of β2-microglobulin(BMG),blood urea nitrogen(BUN),neutrophil gelatinase-associated li-pocalin(NGAL),serum creatinine(Scr),and urinary kidney injury molecule-1(KIM-1)in all groups were increased com-pared with those before surgery,and the combined group had lower levels than the flexible ureteroscope group and the percu-taneous nephrolithotomy group(P<0.05).At 24 hours after surgery,the serum levels of hs-CRP,TNF-α,Ang Ⅰ,and Ang Ⅱin all groups were higher than those before surgery,and the combined group had lower levels than the flexible ureteroscope group and the percutaneous nephrolithotomy group,with statistically significant differences(P<0.05).The stone clearance rate in the combined group(89.29%)was higher than that in the percutaneous nephrolithotomy group(64.29%)and the flexi-ble ureteroscope group(66.67%),with statistically significant differences(P<0.05).Conclusion:Minimally invasive per-cutaneous nephrolithotomy combined with flexible ureteroscopic lithotripsy and stone extraction has more advantages in alle-viating inflammatory stress response,protecting renal function,and improving stone clearance rate in the treatment of com-plex renal calculi.Objective:To analyze the clinical efficacy of minimally invasive percutaneous nephrolithotomy(mPCNL)alone and in combination with flexible ureteroscopic lithotripsy(fURL)in the treatment of patients with complex renal calculi.