Abdominoplasty is one of the most widely performed plastic surgeries globally, with steadily increasing cases in China. Stress urinary incontinence is one important characteristic of pelvic organ prolapse, significantly impacting patients’ quality of life and contributing to increased healthcare burdens on society. This review tries to explore the impact of abdominoplasty on stress urinary incontinence in females and provides more information on their relationship.

Objective:To report the blood group antigen and antibody specificity identification methods for a patient with high-frequency antibodies, and the process of finding and providing compatible blood for the patient.Methods:A patient sent from the Blood Transfusion Department of Shanxi Provincial People′s Hospital to Taiyuan Blood Center in November 2022 was selected for the study. Classical serological methods were used to determine the patient′s blood type, screen for unexpected antibodies, identify antibodies, and perform crossmatching. High-frequency antibody identification was carried out using red blood cells treated with various enzymes. Blood group genotyping was conducted using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF) and Sanger sequencing. Multiple strategies were employed to address the patient′s blood source problem. The study was approved by the Medical Ethics Committee of Taiyuan Blood Center [Ethics No. 2024 Ethics Review No.(2)].Results:①The patient′s blood type was B, RhD positive. Initial screening of the patient′s serum with multiple screening cells and antibody identification cells in saline medium was negative, but positive in antiglobulin medium. The patient′s serum showed varying reaction intensities with red blood cells treated with different enzymes. ②MALDI-TOF mass spectrometry and Sanger sequencing revealed a homozygous nonsense variant c. 376C>T (p.Gln126Ter) in the ABCG2 gene, resulting in the Jr(a-) phenotype. During family donor selection, the patient′s son was found to have a heterozygous variant c. 376C>T (p.Gln126Ter), and another heterozygous variant c. 421C>A (p.Gln141Lys), which predicted a Jr(a+ w) phenotype. ③Crossmatch tests confirmed the compatibility of blood from the patient′s son, which was used to address the urgent blood requirement. Later, rare blood from a Jr(a-) donor from the Guangzhou Blood Center was used for the patient′s ongoing treatment, saving the patient′s life. Conclusion:Combining classic serological testing with blood group gene typing techniques successfully identified the rare Jr(a-) blood type and high-frequency anti-Jra antibodies. Enzyme-treated red blood cell identification methods confirmed the presence of anti-Jra antibodies. By searching within the family and seeking help from other blood centers, compatible blood was found. This approach may provide insights for resolving similar complex blood matching problems in the future.

OBJECTIVE: To report the blood group antigen and antibody specificity identification methods for a patient with high-frequency antibodies, and the process of finding and providing compatible blood for the patient. METHODS: A patient sent from the Blood Transfusion Department of Shanxi Provincial People's Hospital to Blood Transfusion Technology Research Laboratory of Taiyuan Blood Center in November 2022 was selected for the study. Classical serological methods were used to determine the patient's blood type, screen for unexpected antibodies, identify antibodies, and perform crossmatching. High-frequency antibody identification was carried out using red blood cells treated with various enzymes. Blood group genotyping was conducted using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF) and Sanger sequencing. Multiple strategies were employed to address the patient's blood source problem. The study was approved by the Medical Ethics Committee of Taiyuan Blood Center [Ethics No. 2024 Ethics Review No.(2)]. RESULTS: The patient's blood type was B, RhD positive. Initial screening of the patient's serum with multiple screening cells and antibody identification cells in saline medium was negative, but positive in antiglobulin medium. The patient's serum showed varying reaction intensities with red blood cells treated with different enzymes. MALDI-TOF mass spectrometry and Sanger sequencing revealed a homozygous nonsense variant c.376C>T (p.Gln126Ter) in the ABCG2 gene, resulting in the Jr(a-) phenotype. During family donor selection, the patient's son was found to have a heterozygous variant c.376C>T (p.Gln126Ter), and another heterozygous variant c.421C>A (p.Gln141Lys), which predicted a Jr(a+w) phenotype. Crossmatch tests confirmed the compatibility of blood from the patient's son, which was used to address the urgent blood requirement. Later, rare blood from a Jr(a-) donor from the Guangzhou Blood Center was used for the patient's ongoing treatment, saving the patient's life. CONCLUSION Combining classic serological testing with blood group gene typing techniques successfully identified the rare Jr(a-) blood type and high-frequency anti-Jra antibodies. Enzyme-treated red blood cell identification methods confirmed the presence of anti-Jra antibodies. By searching within the family and seeking help from other blood centers, compatible blood was found. This approach may provide insights for resolving similar complex blood matching problems in the future.
Humans ; Blood Grouping and Crossmatching/methods* ; Blood Group Antigens/immunology* ; Blood Transfusion ; Male ; Isoantibodies/blood* ; Female ; Genotype

Objective:To report the blood group antigen and antibody specificity identification methods for a patient with high-frequency antibodies, and the process of finding and providing compatible blood for the patient.Methods:A patient sent from the Blood Transfusion Department of Shanxi Provincial People′s Hospital to Taiyuan Blood Center in November 2022 was selected for the study. Classical serological methods were used to determine the patient′s blood type, screen for unexpected antibodies, identify antibodies, and perform crossmatching. High-frequency antibody identification was carried out using red blood cells treated with various enzymes. Blood group genotyping was conducted using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF) and Sanger sequencing. Multiple strategies were employed to address the patient′s blood source problem. The study was approved by the Medical Ethics Committee of Taiyuan Blood Center [Ethics No. 2024 Ethics Review No.(2)].Results:①The patient′s blood type was B, RhD positive. Initial screening of the patient′s serum with multiple screening cells and antibody identification cells in saline medium was negative, but positive in antiglobulin medium. The patient′s serum showed varying reaction intensities with red blood cells treated with different enzymes. ②MALDI-TOF mass spectrometry and Sanger sequencing revealed a homozygous nonsense variant c. 376C>T (p.Gln126Ter) in the ABCG2 gene, resulting in the Jr(a-) phenotype. During family donor selection, the patient′s son was found to have a heterozygous variant c. 376C>T (p.Gln126Ter), and another heterozygous variant c. 421C>A (p.Gln141Lys), which predicted a Jr(a+ w) phenotype. ③Crossmatch tests confirmed the compatibility of blood from the patient′s son, which was used to address the urgent blood requirement. Later, rare blood from a Jr(a-) donor from the Guangzhou Blood Center was used for the patient′s ongoing treatment, saving the patient′s life. Conclusion:Combining classic serological testing with blood group gene typing techniques successfully identified the rare Jr(a-) blood type and high-frequency anti-Jra antibodies. Enzyme-treated red blood cell identification methods confirmed the presence of anti-Jra antibodies. By searching within the family and seeking help from other blood centers, compatible blood was found. This approach may provide insights for resolving similar complex blood matching problems in the future.

Abdominoplasty is one of the most widely performed plastic surgeries globally, with steadily increasing cases in China. Stress urinary incontinence is one important characteristic of pelvic organ prolapse, significantly impacting patients’ quality of life and contributing to increased healthcare burdens on society. This review tries to explore the impact of abdominoplasty on stress urinary incontinence in females and provides more information on their relationship.

Objective To analyze the risk factors of pulmonary infection in elderly patients with heart fail-ure with reduced left ventricular ejection fraction heart failure,and establish a risk predicting model of pulmonary infection in those patients by decision tree CART algorithm.Methods 320 elderly patients with heart failure with reduced left ventricular ejection fraction admitted from January 2020 to December 2022 were retrospectively selected as study objects,and were divided into an infection group and a non-infection group according to whether the patients were complicated with pulmonary infection.Logistic regression model and decision tree CART model were used to construct a prediction model of heart failure with reduced left ventricular ejection fraction complicated with pulmonary infection,and 5-fold cross-validation method was used for internal verification.The prediction effi-ciency of the models was compared.Results In the 320 patients,the incidence of pulmonary infection was 30.94％.The data on age,smoking history,diabetes mellitus,cardiac function grades,COPD,invasive procedures,length of hospital stay were compared between the infection and non-infection groups(P＜0.05).logistic regression analysis showed that age of ≥ 75 years smoking history,complications with diabetes or/and COPD,cardiac function gradeⅢ/Ⅳ,invasive procedures,and hospital stay of ≥ 14 days were independent risk factors for pulmonary infection in the patients(P＜0.05).Probability forecasting model P=1/[1+e(-3368+0.763*X1+0.814*X2+0.652*X3+1.05*X4+0.865*X5+1.027*X6+0.652*X7)],with an overall accurate rate of prediction of 80.9％.The Omnibus test showed P＜0.001.The accuracy of predic-tion was 73.6％after the cross-validation of 5 fold.The decision tree model showed that invasive procedures were the most important influencing factors for pulmonary infection in elderly patients with heart failure with reduced left ventricular ejection fraction,with an information gain of 0.280.The ROC showed that the AUC value of logistic regression model was slightly higher than that of the decision tree(Z=2.850,P=0.004),and the prediction efficiency of both models was medium.Conclusions Age,smoking history,complications with diabetes mellitus or/and COPD,cardiac function grades,invasive procedures,and length of hospital stay are all influencing factors for pulmonary infection in elderly patients with heart failure with reduced left ventricular ejection fraction.The deci-sion tree model constructed in this study has a better efficiency for risk prediction,and it can provide reference for early clinical screening and intervention of heart failure with reduced left ventricular ejection fraction.

Objective:The study aimed to investigate the clinical efficacy of integrated trilobal method for composite reduction labiaplasty.Methods:This study was a single-center, retrospective and observational study. The clinical data of patients diagnosed with hypertrophy of the labia minora and clitoral hood who underwent trilobal labiaplasty at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences from April 2019 to January 2024 were retrospectively analyzed. In this technique, three flaps were designed at the junction of the clitoral hood and labia minora (M flap), as well as the medial (I flap) and lateral surfaces (E flap) of the labia minora. The goal was to preserve the clitoral-labial triangle while selecting and retaining tissues with optimal texture and color for reshaping the clitoral hood and labia minora. Patients were followed up 7-10 days and 3 months post-surgery, during which pre- and postoperative appearance comparisons, symptom improvement, complications and satisfaction questionnaires. At 3 months post-surgery, the patients completed the female genital self-image scale (FGSIS) score, which has a total score range of 7-28 points, with higher score indicating a more positive genital self-image. A total score of ≥21 points indicated satisfaction with the surgical outcome. SPSS 29.0 software was used to analyze the data. Age and operation time were reported as Mean ± SD. Preoperative and postoperative FGSIS scores were described as M ( Q1, Q3) and compared using the Wilcoxon Signed Rank test. Statistical significance was set at P<0.05. Results:A total of 556 patients were enrolled in this study, aged 18-53 years, with a mean age of (29.3±7.7) years. The primary concerns included poor aesthetic appearance, pain or discomfort, difficulty in cleaning, urinary deviation, and sexual discomfort. The procedure was performed smoothly with minimal bleeding. Small hematomas (≤2 cm 2) developed in the M flap in 8 cases within 24 hours post-procedure. Two patients returned to the hospital for hematoma removal, while 6 patients did not require additional treatment, which did not affect the healing of the incision. Postoperative wound dehiscence was observed in 2 cases at the junction of three flaps. However, the dehiscence was short (0.3-0.8 cm) and superficial, with no reports of secondary infection or poor wound healing. A total of 540 patients (97.12%) were followed up for 3 months, and no serious complications or deformities were reported. Six patients (1.11%) underwent a secondary repair surgery due to bilateral incomplete symmetry. The FGSIS score for the 540 patients was 26 (23, 27) points at 3 months post-operation, significantly higher than the preoperative score of 14 (9, 15) points before the operation ( Z=-20.38, P<0.001). Among these, 506 patients (93.70%) achieved FGSIS scores of ≥21 points, indicating satisfaction with both the cosmetic results and functional improvements. Conclusion:The trilobal method, featuring an integrated design for composite reduction labiaplasty, effectively removes redundant tissue in both the horizontal and vertical directions of the labia minora. Additionally, it addresses the lateral folds of the clitoral hood, resulting in fewer complications and high levels of postoperative functional and aesthetic satisfaction.

Objective:To evaluate the feasibility of pelvic floor muscle reconstruction for women with vaginal laxity accompanied by stress urinary incontinence (SUI).Methods:A prospective cohort clinical study was conducted to collect clinical data from patients with vaginal laxity and SUI admitted to the Urogenital Reconstructive and Gender-affirming Department at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and the Department of Urology, Third Medical Center, Chinese PLA General Hospital, from January 2019 to September 2022. Patients underwent surgical treatment for pelvic floor muscle reconstruction. The cough provocation test and the patient global impression of improvement (PGI-I) scale were utilized as objective and subjective indicators of treatment effecacy, respectively. The urinary incontinence quality of life scale (I-QOL) and the pelvic organ prolapse and urinary incontinence sexual function questionnaire 12(PISQ-12) were used to evaluate the changes in quality of life and sexual funtion. The changes in pelvic floor anatomical structure were evaluated by pelvic floor ultrasound. Data analysis was performed using SPSS version 23.0. The I-QOL and PISQ-12 scores, posterior vesicourethral angle, urethral rotation angle, and bladder neck motion before and after surgery were analyzed using paired t-test, with P<0.05 was considered statistically significant. Results:A total of 36 female patients were included, with an average age of 41.7 years (ranged 24-51 years) and an average body mass index of 23.8 kg/m 2. The average operation time was 76.2 minutes, and the average blood loss was 84.5 milliliters. After 12-27 months of postoperative follow-up, the objective and subjective cure rates were 86.1% (31/36) and 88.9% (32/36), respectively. The sexual function and quality of life of the patients were significantly improved compared with the preoperative results, and postoperative pelvic floor ultrasound results showed significant improvement. The I-QOL and PISQ-12 scores 12 months after surgery were statistically significant compared with those before surgery ( P<0.01). Postoperative pelvic floor ultrasonography revealed statistically significant differences in posterior vesicourethral angle, urethral rotation angle, and bladder neck motion during maximum Valsalva maneuver compared to preoperative data ( P<0.01). Conclusion:Pelvic floor muscle reconstruction is a safe and effective surgical method for patients with vaginal laxity combined with SUI. This procedure can significantly improve sexual quality of life and alleviates SUI symptoms, restores anatomical structure in the female pelvic floor, and enhances overall quality of life.

Objective:To explore the independent risk factors of acute respiratory distress syndrome (ARDS) in patients with sepsis, establish an early warning model, and verify the predictive value of the model based on synthetic minority oversampling technique (SMOTE) algorithm.Methods:A retrospective case-control study was conducted. 566 patients with sepsis who were admitted to Jinan People's Hospital from October 2016 to October 2022 were enrolled. General information, underlying diseases, infection sites, initial cause, severity scores, blood and arterial blood gas analysis indicators at admission, treatment measures, complications, and prognosis indicators of patients were collected. The patients were grouped according to whether ARDS occurred during hospitalization, and the clinical data between the two groups were observed and compared. Univariate and binary multivariate Logistic regression analysis were used to select the independent risk factors of ARDS during hospitalization in septic patients, and regression equation was established to construct the early warning model. Simultaneously, the dataset was improved using the SMOTE algorithm to build an enhanced warning model. Receiver operator characteristic curve (ROC curve) was drawn to validate the prediction efficiency of the model.Results:566 patients with sepsis were included in the final analysis, of which 163 developed ARDS during hospitalization and 403 did not. Univariate analysis showed that there were statistically significant differences in age, body mass index (BMI), malignant tumor, blood transfusion history, pancreas and peripancreatic infection, gastrointestinal tract infection, pulmonary infection as the initial etiology, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, albumin (Alb), blood urea nitrogen (BUN), mechanical ventilation therapy, septic shock and length of intensive care unit (ICU) stay between the two groups. Binary multivariate Logistic regression analysis showed that age [odds ratio ( OR) = 3.449, 95% confidence interval (95% CI) was 2.197-5.414, P = 0.000], pulmonary infection as the initial etiology ( OR = 2.309, 95% CI was 1.427-3.737, P = 0.001), pancreas and peripancreatic infection ( OR = 1.937, 95% CI was 1.236-3.035, P = 0.004), septic shock ( OR = 3.381, 95% CI was 1.890-6.047, P = 0.000), SOFA score ( OR = 9.311, 95% CI was 5.831-14.867, P = 0.000) were independent influencing factors of ARDS during hospitalization in septic patients. An early warning model was established based on the above risk factors: P1 = -4.558+1.238×age+0.837×pulmonary infection as the initial etiology+0.661×pancreas and peripancreatic infection+1.218×septic shock+2.231×SOFA score. ROC curve analysis showed that the area under the ROC curve (AUC) of the model for ARDS during hospitalization in septic patients was 0.882 (95% CI was 0.851-0.914) with sensitivity of 79.8% and specificity of 83.4%. The dataset was improved based on the SMOTE algorithm, and the early warning model was rebuilt: P2 = -3.279+1.288×age+0.763×pulmonary infection as the initial etiology+0.635×pancreas and peripancreatic infection+1.068×septic shock+2.201×SOFA score. ROC curve analysis showed that the AUC of the model for ARDS during hospitalization in septic patients was 0.890 (95% CI was 0.867-0.913) with sensitivity of 85.3% and specificity of 79.1%. This result further confirmed that the early warning model constructed by the independent risk factors mentioned above had high predictive performance. Conclusions:Risk factors for the occurrence of ARDS during hospitalization in patients with sepsis include age, pulmonary infection as the initial etiology, pancreatic and peripancreatic infection, septic shock, and SOFA score. Clinically, the probability of ARDS in patients with sepsis can be assessed based on the warning model established using these risk factors, allowing for early intervention and improvement of prognosis.

Objective:The study aimed to investigate the clinical efficacy of integrated trilobal method for composite reduction labiaplasty.Methods:This study was a single-center, retrospective and observational study. The clinical data of patients diagnosed with hypertrophy of the labia minora and clitoral hood who underwent trilobal labiaplasty at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences from April 2019 to January 2024 were retrospectively analyzed. In this technique, three flaps were designed at the junction of the clitoral hood and labia minora (M flap), as well as the medial (I flap) and lateral surfaces (E flap) of the labia minora. The goal was to preserve the clitoral-labial triangle while selecting and retaining tissues with optimal texture and color for reshaping the clitoral hood and labia minora. Patients were followed up 7-10 days and 3 months post-surgery, during which pre- and postoperative appearance comparisons, symptom improvement, complications and satisfaction questionnaires. At 3 months post-surgery, the patients completed the female genital self-image scale (FGSIS) score, which has a total score range of 7-28 points, with higher score indicating a more positive genital self-image. A total score of ≥21 points indicated satisfaction with the surgical outcome. SPSS 29.0 software was used to analyze the data. Age and operation time were reported as Mean ± SD. Preoperative and postoperative FGSIS scores were described as M ( Q1, Q3) and compared using the Wilcoxon Signed Rank test. Statistical significance was set at P<0.05. Results:A total of 556 patients were enrolled in this study, aged 18-53 years, with a mean age of (29.3±7.7) years. The primary concerns included poor aesthetic appearance, pain or discomfort, difficulty in cleaning, urinary deviation, and sexual discomfort. The procedure was performed smoothly with minimal bleeding. Small hematomas (≤2 cm 2) developed in the M flap in 8 cases within 24 hours post-procedure. Two patients returned to the hospital for hematoma removal, while 6 patients did not require additional treatment, which did not affect the healing of the incision. Postoperative wound dehiscence was observed in 2 cases at the junction of three flaps. However, the dehiscence was short (0.3-0.8 cm) and superficial, with no reports of secondary infection or poor wound healing. A total of 540 patients (97.12%) were followed up for 3 months, and no serious complications or deformities were reported. Six patients (1.11%) underwent a secondary repair surgery due to bilateral incomplete symmetry. The FGSIS score for the 540 patients was 26 (23, 27) points at 3 months post-operation, significantly higher than the preoperative score of 14 (9, 15) points before the operation ( Z=-20.38, P<0.001). Among these, 506 patients (93.70%) achieved FGSIS scores of ≥21 points, indicating satisfaction with both the cosmetic results and functional improvements. Conclusion:The trilobal method, featuring an integrated design for composite reduction labiaplasty, effectively removes redundant tissue in both the horizontal and vertical directions of the labia minora. Additionally, it addresses the lateral folds of the clitoral hood, resulting in fewer complications and high levels of postoperative functional and aesthetic satisfaction.