Case 1, a 63-year-old female patient presented with blisters and bullae arising in erythema all over the body with itching for 2 months. Two years ago, the patient underwent peri-intestinal lymph node dissection for the treatment of malignant melanoma of the rectum and anal canal, and received intravenous injection of toripalimab for preventive treatment for 1 year, and generalized skin lesions occurred 2 weeks after drug withdrawal. Direct immunofluorescence testing of erythema on the upper extremities showed that immunoglobulin G (IgG) was deposited along the basement membrane zone; salt-split indirect immunofluorescence testing of a serum sample showed liner deposition of IgG in the epidermis. Enzyme-linked immunosorbent assay (ELISA) revealed that the serum level of anti-BP180 antibodies was over 200 U/ml. The patient was diagnosed with bullous pemphigoid, but it was doubtful whether the disease was caused by PD-1 inhibitor toripalimab or not. Then, the patient received oral minocycline at a dose of 200 mg/d and prednisolone acetate at a dose of 20 mg/d, and topically applied halometasone cream all over the body. After half-a-month treatment, the blisters crusted over and the erythema darkened in color. Case 2, a 36-year-old female patient presented with generalized blisters and itching for more than 3 months. The skin lesions manifested as tense blisters, bullae, bloody bullae and crusts on the edematous erythema. The patient had a 3-year history of vaginal malignant melanoma, which was stage Ⅳ postoperative melanoma with local recurrence and lymph node metastasis nearby the right iliac vessels. After 2-year treatment with intravenous injection of toripalimab, generalized skin lesions occurred all over the body. Direct immunofluorescence testing of the erythema showed weakly positive staining for IgG, and linear deposition of IgG along the basement membrane zone; salt-split indirect immunofluorescence testing of a serum sample showed liner deposition of IgG in the epidermis. ELISA revealed that the serum level of anti-BP180 antibodies was over 200 U/ml. The case 2 was diagnosed with bullous pemphigoid, but it was also doubtful whether the disease was caused by PD-1 inhibitor toripalimab or not. Then, the case 2 was treated with oral doxycycline at a dose of 200 mg/d and oral prednisolone acetate at a dose of 40 mg/d. After 2-week treatment, the blisters completely crusted over and erythema darkened in color.

Objective To study the volume of total prostate and the volume of its transitional zone in different age groups of elderly men. Methods 213 elderly men of 50 to 79 years of age from a community of Beijing city were divided into 3 groups and studied. The volume of total prostate and the volume of the transitional zone were measured by rectal ultrasonography and the index of the transitional zone was calculated. All the data were evaluated with statistical analysis. Results The number of subjects in the 50～59 age group was 75,in the 60～69 age group 81 and in the 70～79 age group 57.The volume of total prostate was 23.82?8.83,29.16?10.01 and 33.77?11.74 respectively and the transitional zone 1.52?1.19, 3.60?3.66 and 7.25?7.02ml respectively. The index of transitional was 0.10?0.12, 0.13?0.11, 0.20?0.11 respectively. The difference in volume of the total prostate has not been statistically significant whereas the difference in the volume of the transitional zone between the 3 age groups has been significant. Conclusions The volume of total prostate and that of the transitional zone increases with age. The speed of hyperplasia of the transitional zone has been faster than that of the whole prostate.The index of the transitional zone indicates the difference of the whole prostate and the transitional zone in hyperplasia.

Objective To study the prostate volume,prostate weight and the clinical parameters in BPH patients and to investigate the interrelationships between the relevant parameters. Methods The complete data of 80 cases of BPH underwent open surgery were reviewed and analyzed.SPSS software was uesd to make the statistical analysis. Results The volume of surgical specimen has been positively correlated with PV( r=0.872,P

The main nutrient compositions of dry Porphyra haitanensis cultivated in Lianjiang,Fujian Province were analyzed: the total amino acids content was 35.48%. The scores of amino acids were 71 for Ile and 80 for Leu. Crude fatty acids was as low as 0. 5%,in which EPA took 24.8%. Minerals in Porphyra haitanensis were abundant. The content of Ca、Fe、 Zn、Mg were 3. 63、0. 56、0. 095 and 3. 29mg?g～-1. The results indicated that Porphyra haitanensis is a kind of health food with high nutrition.

Objectives To review our initial experience with the Ho:YAG laser in treating superficial bladder tumors.Methods Ho:YAG laser was applied for treating 52 cases of bladder tumors which were confirmed by cystoscopy and pathology with totally 87 tumors.All tumors were in stage Ta～T 2 and tumors grade G1～G2.The optical fiber was put into bladder through cystoscopy.Ho:YAG laser was used endoscpically to cut and vaporize bladder tumor and normal bladder mucosa near the tumor.Results Nine of 52 patients were performed under local anesthesia in outpatient.Operation time was apparently short (mean 25 minutes) Histopathology of biopsies showed no cancer cells left.There were no intraoperative complication such as bleeding,perforation and delay complication.Catheter time is very short,about 1～3 days or without catheter at all.None of the ureteral orifice were damaged in seven cases of bladder tumors near the ureteral orifice.Six patients were recrred during our follow-up in 50 patients (12%).Conclusions It has been demonstrated that Ho:YAG laser therapy is provided with advantages of simple procedure,the absence of complication,high patient satisfaction,and ability to be used in the outpatient.It is more convenience than TUR-Bt in tumors in the neck of bladder or apex of bladder.

Objective To explore the validity and reliability of Nursing Professional Values Scale in registered nurses.Methods Demographic questionnaires and the Revised Nursing Professional Values Scale were used among 280 registered nurses.Results The Cronbach's α was 0.94.The factor analysis extracted 4 factors which could account for 59.55％ variances.These four factors were defined as professional characteristic,providing care,behaviorist,and trust.The Cronbach's α for these four factors were 0.89,0.87,0.86 and 0.70 respectively.Conclusions The Revised Nursing Professional Values Scale possesses desirable validity and reliability in registered nurses,and is a psychometric good instrument of professional value.

Objective To study the relationship between the bladder outlet obstruction(BOO)and the area under the curve of detrusor during voiding related parameters. Methods One hundred and thirty-eight patiens with benign prostate hyperplasia(BPH) underwent clinical evaluation, including physical examination, flow rate and post-void residual volume measurement. Pressure flow studies were performed. Mean patient age was 68 years (range 56 to 82). The AG number and the LinPURR were recorded to classify the patients into 3 groups, namely unobstructed, equivocal obstructed and obstructed, as the traditional classification. Two new parameters including the area under the curve of detrusor pressure during voiding(AUCdet) and the area under the curve of detrusor pressure during voiding adjusted for voided volume(AUCdet/Vol) were calculated and compared with the traditional classification using the Linear discriminant analysis. Results According to the traditional classification, there were 33 unobstructed, 32 equivocal and 44 obstructed cases. The AUCdet and AUCder/Vol of the 3 groups were different(P＜0.001). Linear discriminant analysis showed that of the cases, 90. 9%(30/33), 43.8%(14/32) and 70. 5%(31/44) were identically categorized by the traditional and the AUCdet/Vol classifications in the unobstructed, equivocal and obstructed groups, respectively. Conclusions The area under the curve of detrusor pressure during voiding related parameters appear to be good parameters of the BOO in patients with BPH. Further studies are needed to test the reliability and validity of these new parameters.

Objective To study the change of clinical and urodynamic parameters in the patients with lower urinary tract symptom (LUTS) caused by detrusor overactivity (DO). Methods Two hundred and twenty-seven patients with LUTS underwent clinical evaluation from October 2006 to December 2008, including Prostate Volume (PV), International Prostate Symptom Score (IPSS), Peak Flow rate (PF) and Residual Urine (RU) measurement. Pressure flow studies were performed. The detrusor overactivity was recorded to classify the patients into 2 groups, DO group and none DO group. The clinical and urodynamic parameters were compared between the two groups. Results Mean patient age was 70 years (range 52 to 89). According to the urodynamic results, there were 126 patients in DO group and 101 patients in none DO group. The mean patients age was older in DO group than the none DO group(P＜0.05). Adjusted by age, the PV, PF, and RU were no different between the two groups(P>0.05). The mean first sensation of bladder, bladder compliance, cystometric capacity, bladder outlet obstruction parameters, single voiding volume and max detrusor pressure during contraction were different between the two groups(P＜0.05). Conclusions The main risk factors of DO are the ageing and BOO. The non invasive parameters such as PV、 PF、 and RU could not be used to judge DO. The changes of urodynamic parameters caused by DO were hyperaesthesia of bladder、lower bladder compliance、 higher max detrusor pressure and lower max cystometric capacity. This study emphasis the importance of the urodynamic studies in the aged patients with LUTS.

Objective To study the efficacy and safety of intravesical chemotherapy combined with intravenous chemotherapy for high grade T1 (T1G3) bladder cancer after transurethral resection of bladder tumor(TURBT).Methods From January 2012 to December 2015,111 patients with high grade T1 (T1 G3) bladder cancer were retrospectively reviewed.Thirty-six patients received TURBT and intravesical chemotherapy and intravenous chemotherapy (group A),75 patients received TURBT and intravesical chemotherapy(group B).In group A,there were 28 males and 8 females,with average age 66.2 years;in group B,there were 59 males and 16 females,with mean age 67.9 years.There was no statistical difference between the two groups in age,sex,smoking history,tumor diameter,tumor number.1-year recurrence-free survival (RFS),1-year progression-free survival (PFS),intravenous chemotherapy adverse reaction were analyzed.Results All the patients were followed-up for 12 months.9 patients relapsed in group A,1-year RFS rate 75％,and the median RFS of the 9 patients was 9 (3-11) months.36 patients relapsed in group B,1-year RFS rate 52％,and the median RFS of the 36 patients was 7 (3-11) months.There was statistically significant difference between the two group(P =0.02).One patient progressed in group A,1-year PFS rate 97.2％,and the PFS was 9 months.Six patients progressed in group B,1-year PFS rate 92％,and the median PFS was 9.5(6-12) months.There was no statistically significant difference (P =0.305) between the two group.Only 1 case (3％) appeared Ⅲ° or above intravenous chemotherapy adverse reaction.Conclusions Intravesical chemotherapy combined with intravenous chemotherapy offers a better RFS rate than the intravesical chemotherapy alone for patients with T1G3 bladder cancer after TURBT,and there are very low rates of serious side effects.Intravenous chemotherapy may be considered as a new therapy strategy for T1G3 bladder cancer after TURBT.

Objective To compare the clinical efficacy of Rivaroxaban and Warfarin in the treatment of lower extremity deep vein thrombosis.Methods From January to December 2015,51 patients of deep vein thrombosis of the lower limb divided into.Warfarin group (21 cases) and Rivaroxaban group (30 cases).The time of each therapy lasted for 3 months or longer.The characteristics and the change of lower limb venous patency rate in two groups of patients were analyzed to evaluate the curative effect.Results Rivaroxaban group had shorter therapy time than Warfarin group.The lower limb venous patency rate in Rivaroxaban group were higher than that in Warfarin group (85.7％ vs.60％,P ＜0.05).Ultrasonography showed partial patency in 5 mixed thrombus patients of Warfarin group,while complete patency in 2 and partial patency in 3 of Rivaroxaban group.Normalized rate in peripheral venous thrombosis patients of Rivaroxaban group were higher than Warfarin group (84％ vs.25 ％ P ＜ 0.001).Conclusions Rivaraxaban is superior to Warfarin in the complete recanalization of DVT,while safe and reliable.