Objective: To analyze the risk factors of recurrence after transurethral resection of bladder tumor (TURBT) in patients with non-muscle-invasive bladder cancer (NMIBC)，and establish a risk prediction model，so as to optimize the clinical detection and management of NMIBC. Methods: A total of 174 patients with initial diagnosis of NMIBC who underwent TURBT in the First Affiliated Hospital of Xinjiang Medical University during Jan.2020 and Oct.2022 were followed up for 24 months，and were then divided into the recurrence group (n=74) and non-recurrence group (n=100).After univariate analysis and multivariate logistic regression，risk factors of recurrence were identified，a nomogram was established，and the calibration curve was plotted，which was verified with receiver operator characteristic (ROC) curve. Results: The 2-year recurrence rate was 42.53%.Logistic regression showed high body mass index (BMI)，poor differentiation，multiple tumors，and tumor diameter greater than 3 cm were risk factors of recurrence (P<0.05，OR≥1)，while immediate postoperative intravesical instillation was a protective factor (P<0.05).The C-index of the nomogram was 0.893 (95%CI:0.851-0.938)，the area of ROC curve (AUC) was 0.894 (95%CI：0.847-0.941)，the sensitivity was 82.4%，and the specificity was 83.0%. Conclusion: The prediction model based on BMI，tumor stage，grade，number，diameter，and immediate postoperative intravesical instillation fits well and can provide reference for predicting the risk of tumor recurrence.

Objective To observe the safety and the feasibility of biplane transrectal ultrasonography-guided transperineal biopsy for diagnosing women pelvic space-occupying lesions.Methods Data of 14 female patients with pelvic space-occupying lesions who underwent biplane transrectal ultrasonography-guided transperineal biopsy were retrospectively analyzed.The location of pelvic space-occupying lesions,the causes for not performing biopsy transabdominally nor transvaginally,the time consuming and complications of biplane transrectal ultrasonography-guided transperineal biopsy as well as pathological results were collected.Results Among 14 cases,there were 4 cases of rectum mass,3 cases of unilateral or bilateral ovaries masses,5 cases of cervix or lower uterus mass,1 case of mass at the lateral wall of the vagina and 1 case of mass at the posterior part of the bladder.Since vagina abnormalities including severe bleeding,fungal infections,deformities,edema or after vaginal resection,or deep location of lesions and high risk of intestinal tubes injuries,transabdominal or transvaginal puncturing and biopsy were not performed.The time consuming of puncturing and biopsy were(29.50±6.05)min.During the procedures,bleeding in the puncturing tract and vagal reflex occurred each in 1 case,while no obvious complication was observed during 6-month follow-up.Biopsy pathology reported 5 cases of squamous cell carcinoma,2 cases of high grade serous carcinoma,1 case of malignant melanoma,1 case of low grade serous carcinoma,1 case of adenocarcinoma and 1 case of spindle cell tumor,as well as 3 cases of chronic inflammation,all were consistent to post operation pathology or follow-up results.Conclusion Biplane transrectal ultrasonography-guided transperineal biopsy was safe and feasible for diagnosing women pelvic space-occupying lesions.

OBJECTIVE: To summarize the clinical characteristics, differential diagnosis, and treatment methods of finger flexion contracture caused by three kinds of forearm flexor diseases. METHODS: Between December 2008 and August 2021, 17 patients with finger flexion contracture were treated, including 8 males and 9 females, aged 5-42 years, with a median of 16 years. The disease duration ranged from 1.5 months to 30 years, with a median of 13 years. The etiology included 6 cases of Volkmann's contracture, all of which were flexion deformity of the 2nd to 5th fingers, accompanied by limitation of thumb dorsiflexion in 3 cases and limitation of wrist dorsiflexion in 3 cases; 3 cases of pseudo-Volkmann's contracture, including 2 cases of flexion deformity of middle, ring, and little fingers, and 1 case of flexion deformity of ring and little fingers; 8 cases of ulnar finger flexion contracture caused by forearm flexor disease or anatomical variations, all of which were flexion deformity of middle, ring, and little fingers. Operations such as slide of flexor and pronator teres origin, excision of abnormal fibrous cord and bony prominence, and release of entrapped muscle (tendon) were performed. Hand function was evaluated according to WANG Haihua's hand function rating standard or modified Buck-Gramcko classification standard, and muscle strength was evaluated according to British Medical Research Council (MRC) muscle strength rating standard. RESULTS: All patients were followed up 1-10 years (median, 1.5 years). At last follow-up, 8 patients with contracture caused by forearm flexor disease or anatomical variations and 3 patients with pseudo-Volkmann's contracture achieved excellent hand function, with muscle strength of grade M5 in 6 cases and grade M4 in 5 cases. One patient with mild Volkmann's contracture and 3 patients with moderate Volkmann's contracture without severe nerve damage had excellent hand function in 2 cases and good in 2 cases, with muscle strength of grade M5 in 1 case and grade M4 in 3 cases. Two patients with moderate or severe Volkmann's contracture had poor hand function, with 1 case of muscle strength of grade M3 and 1 case of grade M2, which improved when compared with those before operation. The overall excellent and good rate of hand function and the proportion of patients with muscle strength of grade M4 and above were 88.2% (15/17), respectively. CONCLUSION The finger flexion contracture caused by different etiology can be differentiated by analyzing the history, physical examination, radiographs, and intraoperative findings. After different surgical treatments, such as resection of contracture band, release of compressed muscle (tendon), and downward movement of flexor origin, most patients have a good outcome.
Male ; Female ; Humans ; Forearm/surgery* ; Contracture/surgery* ; Ischemic Contracture/surgery* ; Fingers/surgery* ; Muscle, Skeletal/surgery*

Objective:To investigate the effect of conventional treatment plus long-term transcranial direct current stimulation (tDCS) on consciousness recovery in patients with minimally conscious state (MCS) after traumatic brain injury (TBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 60 patients with MCS after TBI admitted to Zhejiang Armed Police Corps Hospital from January 2019 to December 2020, including 38 males and 22 females, aged 19-60 years [(45.7±11.4)years]. Course of disease was 3-6 months [(4.6±0.9)months]. Of all, 30 patients received internal medicine, hyperbaric oxygen, rehabilitation and other conventional treatment (conventional treatment group), and 30 patients received tDCS stimulation on the basis of conventional treatment (tDCS treatment group). The tDCS stimulation contained 4 cycles for 28 days with each cycle lasting for 7 days (stimulation for 5 days, rest for 2 days). Coma recovery scale-revised (CRS-R) total score, brainstem auditory evoked potential (BAEP) score and clinical effictive rate (significantly effective+effective) were compared between the two groups before treatment, during 4 cycles of treatment and at 6 months and 12 months after treatment. Complications induced by tDCS were also evaluated.Results:There was no significant difference in CRS-R total score and BAEP score between the two groups before treatment (all P>0.05). CRS-R total score and BAEP score in tDCS treatment group were significantly higher than those in conventional treatment group during 4 cycles of treatment and at 6 months and 12 months after treatment (all P<0.05). CRS-R total score and BAEP score in both groups gradually increased during 4 cycles of treatment and at 6 months and 12 months after treatment (all P<0.05). The clinical effective rate in tDCS treatment group was 73% (22/30) when compared to 57% (17/30) in conventional treatment group ( P<0.05). In tDCS treatment group, 10 patients had local reversible slight redness at the cathodal position, while no other serious adverse effects, such as local burns, ulceration, exudation or epilepsy. Conclusion:Compared with conventional treatment, conventional treatment plus long-term tDCS can be more effective in improving the state of consciousness without serious adverse effects for MCS patients after TBI.

OBJECTIVES: To summarize our experience with the sural neurofasciocutaneous flap for reconstructing the soft tissue defects over the forefoot distal to the connecting line of midpoints in the metatarsal bones, and to compare the outcomes between the flap for resurfacing the defects distal and proximal to the connecting line. METHODS: The clinical data of 425 sural neurofasciocutaneous flaps for repairing the soft tissue defects in the middle and lower leg, ankle, and foot between Apr. 2002 and Apr. 2020 were reviewed. Based on the connecting line of midpoints of the metatarsals, the sural neurofasciocutaneous flaps were divided into a forefoot group (flaps with furthest edges distal to the connecting line) and a peri-ankle group (flaps with the furthest edges proximal to the connecting line). RESULTS: The partial necrosis rate in the forefoot group (14.5%, 10/69) was significantly higher than that in the peri-ankle group (7.0%, 25/356), with significant difference (P<0.05). Using the flap alone or in combination with a simple salvage treatment, the ratio of successful coverages of the defects was 98.6% (68/69) in the forefoot group, and 97.8% (348/356) in the peri-ankle group, respectively, with no statistical difference (P>0.05). CONCLUSIONS The sural neurofasciocutaneous flap is a better choice for covering the soft tissue defects over the forefoot distal to the connecting line of midpoints of the metatarsal bones. The survival reliability of the sural neurofasciocutaneous flap reconstructing the soft tissue defect proximal to the connecting line is superior to that of the flap reconstructing the defect distal to the connecting line.
Ankle/surgery* ; Humans ; Reconstructive Surgical Procedures ; Reproducibility of Results ; Soft Tissue Injuries/surgery* ; Surgical Flaps

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become one major threat to human population health. The RNA-dependent RNA polymerase (RdRp) presents an ideal target of antivirals, whereas nucleoside analogs inhibitor is hindered by the proofreading activity of coronavirus. Herein, we report that corilagin (RAI-S-37) as a non-nucleoside inhibitor of SARS-CoV-2 RdRp, binds directly to RdRp, effectively inhibits the polymerase activity in both cell-free and cell-based assays, fully resists the proofreading activity and potently inhibits SARS-CoV-2 infection with a low 50% effective concentration (EC

To explore early prevention and control of coronavirus disease 2019 （COVID-19） outbreak based on system dynamics model analysis. The data of early outbreak of COVID-19 were collected from the World Health Organization，covering countries of the China，United States，United Kingdom，Australia，Serbia and Italy. The susceptible-exposed-infected-recovered （SEIR） model was generalized and then its parameters were optimized. According to the parameters in the basic infection number expression，the sensitivity in the system dynamics model was used to quantitatively analyze the influence of the protection rate，infection rate and average quarantine time on the early spread of the outbreak. Based on the analysis results，targeted prevention and control measures for the early outbreak of COVID-19 were proposed. The generalized SEIR model had a good fit for the early prediction and evaluation of COVID-19 outbreaks in six countries. The spread of COVID-19 was mainly affected by the protection rate，infection rate and average quarantine time. The improvement of the protection rate in the first ays was the most important:the greater the protection rate，the fewer the number of confirmed cases. The infection rate in the first 5 days was the most critical:the smaller the infection rate，the fewer the number of confirmed cases. The average quarantine time in the first 5 days was very important:the shorter the average quarantine time，the fewer the number of confirmed cases. Through the comparison of key parameters of six countries，Australia and China had implemented strict epidemic prevention policies，which had resulted in good epidemic prevention effects. In the early stage of the outbreak，it is necessary to improve the protection rate，shorten the average quarantine time，and implement strict isolation policies to curb the spread of COVID-19.
COVID-19 ; China/epidemiology* ; Disease Outbreaks ; Humans ; Quarantine ; SARS-CoV-2

Objective: To evaluate the role of tuberculin skin test prified protein derivative (PPD) in defining the screening scope of close contacts of tuberculosis cases in disposal of tuberculosis outbreak in schools. Methods: In a senior middle school in August 2019, 1 553 students of the grade two were tested by PPD because of a school tuberculosis outbreak. PPD results were compared to grade one students without any association with this tuberculosis epidemic, who were also tested by PPD when beginning school. Potential association between PPD distribution characteristics and tuberculosis case distribution were analyzed. Results: Twenty nine grade two students were diagnozed as tuberculosis infection, seven of which were PPD positive, and with the same MIRU-VNTR genotype. In grade one, 0.1 % (1/796) student showed strong PPD positive, 34.3% (273/796) student showed positive. For grade two students, significant higher rate of strong PPD positive [5.9% (45/757)], and PPD positive [52.0% (394/757)] were observed ( χ 2=45.71, 49.90, P <0.01). Proportion of strong PPD positive in the first floor of the teaching building ( 19.4 %), where tuberculosis cases clustered, was significantly higher than that in other floors ( χ 2=89.81, P <0.01); Number of strong PPD positive students increased with TB cases in each floor of the teaching building ( r =0.99, P <0.01). Proportion of strong PPD positive and PPD positive in floors of the dormitory, where TB cases lived, was significantly higher than in other floors ( χ 2=49.4, 64.9 , P <0.01). Number of strong PPD positive and PPD positive students increased with TB cases in each floor of the teaching building ( r =0.84, 0.56, P <0.01). Conclusion Strong PPD positive rate well reflects tuberculosis infection of close contacts, and is recommended for defining the scope of screening.

Objective:To investigate the status of height and weight of 3-18-year-old children and adolescents in urban China, and to provide a basis for establishing puberty phase specific curves for age-specific height and age-specific weight.Methods:A cross-sectional survey of 218 185 children and adolescents aged 3-18 years in urban China was conducted by using the method of stratified random cluster sampling from January 2017 to December 2019. The sampling areas included 12 provinces municipalities in China and autonomous regions in total. Data were collected on weight, height, waist circumference, hip circumference and secondary sexual characteristics. The generalized additive model for location, scale, and shape (GAMLSS) was employed to establish percentile reference values and growth curves of height and weight for boys and girls aged 3-18 years. Wilcoxon rank sum test was applied to compare the P 50 value of height and weight between children of each Tanner stage and children of the same age ignoring the different puberty phase. Results:The 3rd, 50th, and 97th percentile curves for height and weight for age were developed for boys and girls aged 3-18 years. The 3rd, 50th, and 97th percentile curves for age-specific height and age-specific weight for each puberty phase were developed for boys and girls. Compared with all children ignoring the different puberty phase, boys aged 9 and over and girls aged 7 and over who are at Tanner stage 1 showed shorter height and lighter weight than those of the same age group (all P<0.01), the difference ranges of height at P 50 are -4.0 to -0.6 cm for boys, and -4.4 to 0.5 cm for girls; the difference ranges of weight are -4.8 to 0.4 kg for boys, and -4.0 to -0.3 kg for girls; children at Tanner stage 2 & 3 initially were taller and heavier than those of the same age group; and later grew shorter and lighter than those of the same age group, the two sets of curves cross over; boys aged 16 and under and girl aged under 14 who are at Tanner stage 4 were taller and heavier than those of the same age group (all P<0.01), the difference ranges of height at P 50 are 0.2 to 10.0 cm for boys, and 0.2 to 9.4 cm for girls; the difference ranges of weight at P 50 are 0.7 to 10.9 kg for boys, and 1.0 to 11.2 kg for girls, and the differences showed narrowing trend with age. Conclusion:The puberty phase specific growth curves of age-specific height and age-specific weight for boys and girls aged 3-18 years are established, it is useful for clinical work to evaluate physical development of children at different puberty phases.

Objective:To study the feasibility, safety and effectiveness of single-port laparoscopic retroperitoneal debridement for infectious necrotizing pancreatitis.Methods:The clinical data of 63 patients with residual infectious stage of infectious necrotizing pancreatitis treated at the Qilu Hospital of Shandong University from October 2012 to August 2017 were retrospectively analyzed. A total of 33 patients who underwent single-port laparoscopic retroperitoneal debridement were classified as the study group, while the remaining 30 patients who underwent traditional open surgery served as the control group.Results:One patient in the study group died 20 days after surgery, while three patients in the control group died after surgery. The operation time, intraoperative blood loss, hospitalization cost, surgical site infection rate, postoperative hospital stay and other parameters in the study group were significantly lower than those in the control group (all P<0.05). There were no significant differences in the incidences of postoperative colon fistula, incisional hernia and gastroparesis between the two groups (all P>0.05). After a follow-up which ranged from 6.0 to 48.0 months, there was no newly diagnosed diabetic patients in the study group, but 2 in the control group. The difference was not significantly different ( P>0.05). Conclusion:Single-port laparoscopic retroperitoneal debridement had the advantages of safety, feasibility and fast postoperative recovery with significant curative effects.