Bladder tumor within inguinal bladder hernia is rare. This article reports a case of a male patient who was admitted to hospital due to gross hematuria，accompanied by lower abdominal pain when straining to urinate for two months. Physical examination revealed a irreducible mass in the left inguinal region. Ultrasound and MRI examinations suggested an inguinal bladder hernia complicated by multiple bladder lesions. Cystoscopy revealed extensive tumors，and pathological examination indicated high-grade urothelial carcinoma with carcinoma in situ. PET-CT confirmed pelvic lymph node metastasis. The patient underwent three cycles of neoadjuvant therapy followed by laparoscopic radical cystectomy combined with hernia repair. There was no evidence of recurrence of the hernia or tumor after one year of follow-up.

Bladder tumor within inguinal bladder hernia is rare. This article reports a case of a male patient who was admitted to hospital due to gross hematuria，accompanied by lower abdominal pain when straining to urinate for two months. Physical examination revealed a irreducible mass in the left inguinal region. Ultrasound and MRI examinations suggested an inguinal bladder hernia complicated by multiple bladder lesions. Cystoscopy revealed extensive tumors，and pathological examination indicated high-grade urothelial carcinoma with carcinoma in situ. PET-CT confirmed pelvic lymph node metastasis. The patient underwent three cycles of neoadjuvant therapy followed by laparoscopic radical cystectomy combined with hernia repair. There was no evidence of recurrence of the hernia or tumor after one year of follow-up.

Objective To explore the factors that affect the coordinated development of blood banks and apheresis plas-ma collection banks(hereinafter referred to as plasma banks),and explore feasible measures for the coordinated develop-ment of blood banks and plasma banks.Methods The blood information management system and blood source information management system were used to retrieve related data of blood and plasma donation from 9 cities in Shandong province from 2017 to 2021.The number of blood donors and plasma donors and the intersection of them were analyzed.The data analysis was performed using chi-square test,and a questionnaire survey was conducted to investigate the policies and information status,as well as expectations for coordinated development for blood and plasma donation.Results From 2017 to 2021,the total number of blood donors in 9 cities was higher than that of plasma donors,both have been increasing year by year,and the increase in plasma donors was significantly higher than that of blood donors(131.78%vs 23.90%,P<0.05).The inter-section proportion of blood and plasma donors had increased from 0.45%in 2017 to 1.04%in 2021,with an increase of 131.11%.Among the administrative regions where the participating blood and plasma banks located,94.2%have not re-leased relevant policy to promote the coordinated development of blood and plasma donation.The majority(63%)expected blood banks and plasma banks to be set at a distance more than 50 km apart.The top four functional requirements for the in-terconnection between blood banks and plasma banks management information system were blood test results(94.61%),ID number(87.54%),blood and plasma donation records(85.51%)and health consultation/examination results(82.15%).The top four elements of coordinated development between blood and plasma banks were policy support(96.25%),informa-tion networking(92.36%),top-level design(87.44%)and cultural construction(86.58%).Conclusion The number of donors who donate both blood(mainly whole blood)and plasma has been increasing year by year,which deserves our close attention.To achieve the coordinated development of blood donation and plasma donation,policy support is the most crucial and fundamental means.Establishment of a standard system and the share of blood and plasma donation information is neces-sary for blood informatization construction.It was critical to promote the coordinated development of blood and plasma dona-tion and ensure blood safety with improving legislation,formulating policies for coordinated development,strengthening top-level design,standardizing the publicity of blood and plasma donation and establishing the idea that blood and plasma dona-tion are equally honorable.

[Objective]The clinical characteristics and the possible risk factors were explored for the low triiodothyronine syndrome(LTS)in elderly patients with chronic heart failure(CHF),and the risk prediction model of LTS was established.[Methods]For this research,291 elderly patients with CHF were selected as sample and retrospectively reviewed was used as analytical method.According to the thyroid function of admission patients,two groups including LTS group(n=107)and normal thyroid function group(n=184)were divided.The general information and biochemical indicators of patients were collected and recorded,and the risk factors for LTS were assigned scores,in which numerical variables(except age)were grouped by median.The chi-squared test was used for statistical analysis of each variable,and multivariate regression model was used to analyze the independent risk factors of LTS in elderly patients with CHF,then the nomogram model for LTS was established based on the results from the final regression analysis.Furthermore,the prediction model was evaluated using C-index,calibration curve and receiver operating characteristic(ROC)curve.[Result]Serum creatinine(Scr),C-reactive protein(CRP),interleukin-6(IL-6)and the cardiac functional grading according to the New York Heart Association(NYHA)were positively correlated with LTS(OR values were 1.893,2.356,1.021 and 1.815,respectively,P<0.05),serum Albumin(Alb)was negatively correlated with LTS(OR=0.412,P<0.05).This means that,the LTS was easily occurred as the serum Alb level declined.When introduce the above statistically significant variables into nomogram obtained the C index with 0.807[95%CI=(0.757,0.856)].The calibration curve verified by internal verification showed that the calibration degree of this prediction model was well calibrated.ROC curve analysis showed that the prediction model was well differentiated.[Conclusion]The Scr,CRP,IL-6,Alb and cardiac functional grading in elderly CHF patients may be risk factors for incidence of LTS,while serum Alb may be a protective factor for LTS.Based on the above risk factors,the nomogram model for predicting the occurrence of LTS in elderly CHF patients had good differentiation and accuracy,and can provide guidance for clinical individualized prevention and treatment.

OBJECTIVE: To investigate the feasibility and effectiveness of bilateral facial perforator artery flap in repairing large area defect in middle and lower part of nose. METHODS: The clinical data of 18 patients with large area defect in middle and lower part of nose repaired by bilateral facial perforator artery flap between January 2019 and December 2022 were retrospectively analyzed. Among them, there were 13 males and 5 females, the age ranged from 43 to 81 years, with an average of 63 years. There were 3 cases of nasal trauma, 4 cases of basal cell carcinoma, 8 cases of squamous cell carcinoma, 1 case of lymphoma, and 2 cases of large area solar keratosis. The size of the defect ranged from 3.0 cm×3.0 cm to 4.5 cm×4.0 cm; the size of unilateral flap ranged from 3.0 cm×1.3 cm to 3.5 cm×2.0 cm, and the size of bilateral flaps ranged from 3.3 cm×2.6 cm to 4.5 cm×4.0 cm. RESULTS: One patient developed skin flap necrosis after operation, and a frontal skin flap was used to repair the wound; 1 case gradually improved after removing some sutures due to venous congestion in the skin flap, and the wound healing was delayed after dressing change; the remaining 16 cases of bilateral facial perforator artery flaps survived well and all wounds healed by first intention, without any "cat ear" malformation. All 18 patients had first intention healing in the donor area, leaving linear scars without obvious scar hyperplasia, and no facial organ displacement. All patients were followed up 3-12 months, with an average of 6 months. Due to the appropriate thickness of the flap, none of the 18 patients underwent secondary flap thinning surgery. All flaps had good blood circulation, similar texture and color to surrounding tissues, symmetrical bilateral nasolabial sulcus, and high patient satisfaction. CONCLUSION The bilateral facial perforator artery flaps for repairing large area defect in middle and lower part of nose can achieve good appearance and function, and the operation is relatively simple, with high patient satisfaction.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Plastic Surgery Procedures ; Skin Transplantation ; Retrospective Studies ; Soft Tissue Injuries/surgery* ; Perforator Flap/blood supply* ; Arteries/surgery* ; Cicatrix/surgery* ; Treatment Outcome ; Skin Neoplasms/surgery*

Cognitive impairment after infectious meningitis seriously affects the activities of daily living for survivors. There has been lack of systematic researches on the cognitive impact of infectious meningitis so far, it is not clear how to early identify and evaluate the cognitive impairment after meningitis, how to properly carry out early rehabilitative intervention to improve the activities of daily living and to reduce the social and economic burden of patients. This article reviews the characteristics, evaluation methods and rehabilitative interventions of cognitive impairment in patients after infectious meningitis, to provide reference for clinical application.

Objective:To translate the English version and cross-cultural adaptation of Readiness for Return-To-Work Scale (RRTW) into Chinese and tested the reliability and validity of the Chinese version of RRTW in young and middle-aged stroke patients.Methods:RRTW was translated into Chinese with standard translation-retroversion. From August to December 2020, 235 stroke patients in the First Affiliated Hospital, College of Medicine, Zhejiang University were recruited by convenient sampling. The scale was tested by the reliability and validity.Results:The Chinese version of RRTW for stroke was composed of two parts: The first part was divided into four dimensions, with a total of 13 entries; For the unworked stroke population, the second part was divided into two dimensions, with a total of nine entries for the reworked stroke population. The content validity index (CVI) for each item was from 0.875 to 1.000. The total CVI for all items was 0.994. The Pearson correlation coefficient between dimension and scale was from 0.523 to 0.876. Four common factors were obtained from the first part and the cumulative contribution rate was 62.563%. Two common factors were obtained from the second part and the cumulative contribution rate was 49.908%. The Cronbach α coefficient in the first part was 0.760 and in the second part was 0.693.Conclusions:The Chinese version of RRTW for stroke patients has good reliability and validity, which can be used to assess the readiness level of stroke patients to return to work in Chinese society.

OBJECTIVE： To systematically evaluate the efficacy and safety of rivaroxaban versus low molecular weight heparin in the prevention of venous thromboembolism （VTE） in patients with hip fractures， and to provide evidence-based reference for clinical application. METHODS： Retrieved from Cochrane library， PubMed， Embase， CNKI， VIP and Wanfang database， randomized controlled trials （RCTs） about rivaroxaban （test group） versus low molecular weight heparin （control group） in the prevention of VTE in patients with hip fracture were collected during database establishment to Jun. 2018. After data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was performed by using Rev Man 5.3 statistical software for the incidence of  deep venous thrombosis （DVT）， postoperative discharge， activated partial thromboplastin time （APTT）， prothrombin time （PT） and the incidence of ADR. RESULTS： Totally 8 RCTs were included， involving 949 patients. Results of Meta-analysis showed that compared with low molecular weight heparin， rivaroxaban could significantly decreased the incidence of DVT [RR＝0.55， 95％CI （0.36， 0.83）， P＝0.004]. There was no statistical significance in postoperative discharge [MD＝－0.24， 95％CI （－5.27， 4.8）， P＝0.93]， APTT [MD=0.56， 95％CI （－0.75， 1.86）， P＝0.40]， PT [MD＝0.04， 95％CI（－0.03， 0.11）， P＝0.25] or the incidence of ADR [RR=1.73，95％CI（0.15，20.48）， P＝0.66] between 2 groups. CONCLUSIONS： Rivaroxaban has a better preventive effect on VTE in patients with hip fracture than low molecular weight heparin， and has a similar safety as low molecular weight heparin.

To prepare recombinant human retinol binding protein 4 (RBP4) by using the baculovirus expression system and to detect its immunogenicity, the fusion DNA fragment of secretory signal peptide SS64 and human RBP4 gene was subcloned into a baculovirus transfer vector pFastBac-dual(pFBd), and the corresponding recombinant transfer plasmid was transformed into E. coli strain DH10bac, after transposition recombinant shuttle bacmid was screened out. The logarithmic phase Sf9 cells were transfected with the recombinant bacmid and then the recombinant baculovirus containing hRBP4 expression box were generated. After amplification of recombinant baculovirus, the recombinant baculovirus seeds were obtained. To express human RBP4, logarithmic phase Sf9 cells were infected with the virus seeds and SDS-PAGE and Western blotting were used to detect and identify the expression. Finally, to prepare a batch of RBP4 protein, logarithmic phase Sf9 cells in suspension culture were infected with recombinant baculovirus seeds and the supernatant was harvested after 120 hours post-infection for purification. Finally for preparation of polyclonal antibody and evaluation of immunogenicity, the recombinant hRBP4 from insect cells and from E. coli were immunized rabbits. Restriction enzyme digestion and sequencing confirmed that the recombinant baculovirus transfer plasmid was constructed correctly, and subsequently recombinant RBP4-bacmid was generated successfully. SDS-PAGE and Western blotting analysis suggested that human RBP4 protein was highly expressed in Sf9 cells with the molecular weight of approximately 23 kDa. The recombinant RBP4 protein could be secreted into the medium efficiently, and the expression level was calculated amount of 100 mg/L. Finally the rabbit antiserum was harvested after recombinant RBP4 immunization, therein the titer of antiserum against baculovirus recombinant RBP4 is 1:100 000 whereas the titer of antiserum against E. coli recombinant RBP4 is only 1:10 000. Overall, human RBP4 was high efficiently expressed successfully with good antigenicity in baculovirus system, and high affinity antiserum was obtained. A solid foundation was laid for the next step of the preparation of human serum RBP4 detection kit.
Animals ; Baculoviridae ; genetics ; Blotting, Western ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; Genetic Vectors ; Humans ; Immune Sera ; Insecta ; Rabbits ; Recombinant Proteins ; biosynthesis ; immunology ; Retinol-Binding Proteins, Plasma ; biosynthesis ; immunology ; Sf9 Cells ; metabolism ; Transfection

Objective To study the effects of resin micro-leakage of different angles of cavity margins with composite resin filling.Methods Thirty extracted human molar with occlusal surfaces preparing hole into 3mm × 3mm × 3mm.Specimens were randomly divided into 3 groups,1 mm slopes of cavity margins were designed respectively,and three kinds of angles of cavity margins(45°,70°,90°)were filled on the ocelusive surfaces,then using Prime&Bond NT and Composite resin(ChrismaA2)to repair the holes directly.After 500 thermal cycling,all specimens were immersed in Indian ink for one week and the penetration depth was examined under stereo microscope.Results Cavity margin angles of 70°was better than those of 90° and 45°,the results was statistically significant(t=3.530,4.179,all P＜0.05).Conclusion To reduce the occurrence of the resin micro-leakage,cavity margin angles should be designed as short slant with an angle of 70°or so.