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.

BACKGROUND:The clearance pathway of metabolic waste in the brain is crucial for maintaining neural homeostasis.The accumulation of metabolic waste disrupts this equilibrium,representing a common pathological feature of many central nervous system diseases.In recent years,research focusing on the glymphatic system has emerged as a hotspot in the nervous system field.OBJECTIVE:To construct a knowledge map of glymphatic system research,visually analyze the current state of research,main hotspots,and future development trends within this area.METHODS:Utilizing CiteSpace,VOSviewer,and the Bibliometrix package in the R language environment,this study conducted an in-depth visual analysis of glymphatic system-related literature from the Web of Science Core Collection database,spanning from January 2012 to March 2024.This analysis included authors,institutions,countries,journals,keywords,and co-citation frequencies.RESULTS AND CONCLUSION:A total of 687 related articles were included in this study.The number of publications in this field increased year by year,showing an explosive growth trend in the past three years.The countries,institutions,and authors with the largest number of publications in this research field were the United States,University of Rochester,and Professor Maiken Nedergaard.The journal with the highest number of publications was JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM.The high-frequent and high-central keywords mainly focused on the mechanism such as cerebrospinal fluid hydrodynamics,neurological diseases such as Alzheimer's disease,and imaging techniques such as diffusion tensor imaging.The literature with the highest co-citation frequency was a classic review of the glymphatic system.The above results show that the research of glymphatic system is an emerging and active field,which has attracted wide attention at home and abroad and gradually expand from theoretical research to clinical practice.

Objective To investigate the impact of tubeless technique on male sexual function after transurethral ureteroscopic lithotripsy.Methods 82 male patients from January 2023 to June 2023 with transethral ureteroscopic lithotripsy were selected as the study objects.Prior to surgery,39 male patients without double J tube indwelling after lithotripsy were randomly selected as the tubeless group and 43 male patients with double J tube indwelling were selected as the indwelling group by drawing lots.General clinical data and postoperative complications(lumbago,hematuria,irritation sign of bladder and fever)of the two groups were compared.The International Index of Erectile Function-5(IIEF-5)score,sexual life quality questionnaire(SLQQ)score and premature ejaculation diagnostic tool(PEDT)score of the two groups were statistically analyzed before surgery,1 month after surgery(before excutation in indwelling group),3 months and 6 months after surgery.Results Compared with the indwelling group,patients in the tubeless group had significantly fewer cases of lumbago,hematuria,and irritation sign of bladder 1 month after surgery,and the difference was statistically significant(P<0.05),but there was no significant difference in postoperative fever between the two groups(P>0.05).There were no statistically significant differences in the IIEF-5 score,SLQQ score and PEDT score between the two groups before the operation,3 months after the operation and 6 months after the operation(P>0.05).One month after the operation,the IIEF-5 score and SLQQ score of the tubeless group were significantly higher than those of the indwelling group,while the PEDT score was lower than that of the indwelling group,the differences were statistically significant(P<0.01).There were no statistically significant difference in the IIEF-5 score,SLQQ score and PEDT score at different time points in the tubeless group(P>0.05).The IIEF-5 score and SLQQ score of the indwelling group one month after the operation were significantly lower than those before the operation,while the PEDT score was significantly higher than that before the operation,the IIEF-5 score and SLQQ score of the indwelling group 3 and 6 months after the operation were significantly higher than those at 1 month after the operation,and the PEDT score was significantly lower than that at 1 month after the operation,the differences were statistically significant(P<0.01).There were statistically significant differences in the IIEF-5 score,SLQQ score and PEDT score at different time points in the indwelling group(P<0.05).Conclusion The tubeless technique after ureteroscopy has a relatively small impact on male sexual function and can significantly improve the quality of life of patients,alleviate lumbago,hematuria and irritation sign of bladder.It is worthy of clinical promotion and application.

Objective:To examine the validity and reliability of the Chinese version of the Transgender Atti-tudes and Beliefs Scale(TABS)in the general adult population.Methods:A total of 1 656 residents aged≥18 years were recruited by convenient sampling method,and were equally divided into sample 1 and sample 2 accord-ing to age group.The total sample was used for item analysis and internal consistency reliability test.Sample 1 was used for exploratory factor analysis,Sample 2 was used for confirmatory factor analysis,and 60 residents were se-lected for retesting at a 2-week interval.Results:The TABS Chinese version included a total of 26 items,with the content validity index(I-CVI)of each item ranging from 0.83 to 1.00,and the content validity index(S-CVI)of the scale being 0.98.Exploratory factor analysis extracted 3 common factors,namely interpersonal comfort,gender beliefs,and human value,with a cumulative total variance of 57.13％.Confirmatory factor analysis showed that the scale fit was acceptable(x2/df=2.95,RMSEA=0.05,GFI=0.92,AGFI=0.90).The Cronbach α coefficients of the total score of the scale and the scores of the 3 factors were 0.95,0.95,0.88 and 0.86.The retest reliabilities were 0.88,0.78,0.65 and 0.91.Conclusion:The Chinese version of the Transgender Attitudes and Beliefs Scale(TABS)has good validity and reliability in assessing general adults'attitudes toward the transgender community.

Objective:To examine the validity and reliability of the Chinese version of the Transgender Atti-tudes and Beliefs Scale(TABS)in the general adult population.Methods:A total of 1 656 residents aged≥18 years were recruited by convenient sampling method,and were equally divided into sample 1 and sample 2 accord-ing to age group.The total sample was used for item analysis and internal consistency reliability test.Sample 1 was used for exploratory factor analysis,Sample 2 was used for confirmatory factor analysis,and 60 residents were se-lected for retesting at a 2-week interval.Results:The TABS Chinese version included a total of 26 items,with the content validity index(I-CVI)of each item ranging from 0.83 to 1.00,and the content validity index(S-CVI)of the scale being 0.98.Exploratory factor analysis extracted 3 common factors,namely interpersonal comfort,gender beliefs,and human value,with a cumulative total variance of 57.13％.Confirmatory factor analysis showed that the scale fit was acceptable(x2/df=2.95,RMSEA=0.05,GFI=0.92,AGFI=0.90).The Cronbach α coefficients of the total score of the scale and the scores of the 3 factors were 0.95,0.95,0.88 and 0.86.The retest reliabilities were 0.88,0.78,0.65 and 0.91.Conclusion:The Chinese version of the Transgender Attitudes and Beliefs Scale(TABS)has good validity and reliability in assessing general adults'attitudes toward the transgender community.

Objective To investigate the impact of tubeless technique on male sexual function after transurethral ureteroscopic lithotripsy.Methods 82 male patients from January 2023 to June 2023 with transethral ureteroscopic lithotripsy were selected as the study objects.Prior to surgery,39 male patients without double J tube indwelling after lithotripsy were randomly selected as the tubeless group and 43 male patients with double J tube indwelling were selected as the indwelling group by drawing lots.General clinical data and postoperative complications(lumbago,hematuria,irritation sign of bladder and fever)of the two groups were compared.The International Index of Erectile Function-5(IIEF-5)score,sexual life quality questionnaire(SLQQ)score and premature ejaculation diagnostic tool(PEDT)score of the two groups were statistically analyzed before surgery,1 month after surgery(before excutation in indwelling group),3 months and 6 months after surgery.Results Compared with the indwelling group,patients in the tubeless group had significantly fewer cases of lumbago,hematuria,and irritation sign of bladder 1 month after surgery,and the difference was statistically significant(P<0.05),but there was no significant difference in postoperative fever between the two groups(P>0.05).There were no statistically significant differences in the IIEF-5 score,SLQQ score and PEDT score between the two groups before the operation,3 months after the operation and 6 months after the operation(P>0.05).One month after the operation,the IIEF-5 score and SLQQ score of the tubeless group were significantly higher than those of the indwelling group,while the PEDT score was lower than that of the indwelling group,the differences were statistically significant(P<0.01).There were no statistically significant difference in the IIEF-5 score,SLQQ score and PEDT score at different time points in the tubeless group(P>0.05).The IIEF-5 score and SLQQ score of the indwelling group one month after the operation were significantly lower than those before the operation,while the PEDT score was significantly higher than that before the operation,the IIEF-5 score and SLQQ score of the indwelling group 3 and 6 months after the operation were significantly higher than those at 1 month after the operation,and the PEDT score was significantly lower than that at 1 month after the operation,the differences were statistically significant(P<0.01).There were statistically significant differences in the IIEF-5 score,SLQQ score and PEDT score at different time points in the indwelling group(P<0.05).Conclusion The tubeless technique after ureteroscopy has a relatively small impact on male sexual function and can significantly improve the quality of life of patients,alleviate lumbago,hematuria and irritation sign of bladder.It is worthy of clinical promotion and application.

BACKGROUND:The clearance pathway of metabolic waste in the brain is crucial for maintaining neural homeostasis.The accumulation of metabolic waste disrupts this equilibrium,representing a common pathological feature of many central nervous system diseases.In recent years,research focusing on the glymphatic system has emerged as a hotspot in the nervous system field.OBJECTIVE:To construct a knowledge map of glymphatic system research,visually analyze the current state of research,main hotspots,and future development trends within this area.METHODS:Utilizing CiteSpace,VOSviewer,and the Bibliometrix package in the R language environment,this study conducted an in-depth visual analysis of glymphatic system-related literature from the Web of Science Core Collection database,spanning from January 2012 to March 2024.This analysis included authors,institutions,countries,journals,keywords,and co-citation frequencies.RESULTS AND CONCLUSION:A total of 687 related articles were included in this study.The number of publications in this field increased year by year,showing an explosive growth trend in the past three years.The countries,institutions,and authors with the largest number of publications in this research field were the United States,University of Rochester,and Professor Maiken Nedergaard.The journal with the highest number of publications was JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM.The high-frequent and high-central keywords mainly focused on the mechanism such as cerebrospinal fluid hydrodynamics,neurological diseases such as Alzheimer's disease,and imaging techniques such as diffusion tensor imaging.The literature with the highest co-citation frequency was a classic review of the glymphatic system.The above results show that the research of glymphatic system is an emerging and active field,which has attracted wide attention at home and abroad and gradually expand from theoretical research to clinical practice.

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 relation of depressive and anxiety symptoms to defense mechanism in transgender population.Methods:Totally 451 transgender patients in the sexual and psychological outpatient depart-ment of a hospital were selected.They were assessed with the self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS)and Defense Mechanism Scale(DSQ).The SDS standard score of ≥53 was classified as having depressive symptoms,and the SAS standard score of ≥50 was classified as having anxiety symptoms.Re-sults:The detection rates of depression and anxiety were 46.8％and 28.8％respectively.Multiple linear regression analysis showed that SDS scores were positively correlated with DSQ scores of projection,conceit,complaint,with-drawal,somatization,control,isolation and identity(β=0.08-0.22),while SDS scores were negatively correlated with DSQ scores of sublimation,depression,omnipotence with incompetence and denial(0=-0.09--0.19).The SAS scores were positively correlated with the DSQ scores of projection,latent manifestation,somatization,control,isolation,identity,and consumption tendency(0=0.09-0.26),while the SAS scores were negatively cor-related with the DSQ scores of sublimation,depression,omnipotence accompanied by incompetence,and denial(β=-0.09--0.15).Conclusion:The proportion of depression and anxiety symptoms detected in the transgender group is higher,which may be related to the use of some defenses.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.