Objective To observe the feasibility and effects of tumescent anesthesia on out-patients base in large-volume liposuction. Methods A total of 184 times of large volume liposuction in 154 patients were performed under tumescent technique with 0.05 % lidocaine and 1∶500,000 epinephrine. The whole abdomen, hypochondrium and waist areas or the posterior, lateral, medial aspects of the legs and the subgluteal regions were covered in one operation. The total injected tumescent liquid is from 2 200 ml to 5250 ml, the average was 2 730 ml. The dose of lidocaine was less than 40 mg/kg body weight or less than 2.4g in total. Results Some patients felt little discomfort during tumescent liquid injection, but all patients tolerated the procedure well under lower-concentration lidocaine without assistance of any analgesics or sedatives, the suctioned volume was 1 900～4 200 ml (the average 2 568 ml) and the supernatant of the suctioned volume was 1 200～3 400 (the average 2 036 ml). Conclusions It is practicable to perform large-volume liposuction using lower-concentration lidocaine tumescent technique with good persistent results.

Recently,clinicians pay more and more attention to the treatment effects related to individual differences.Individualized treatment of hepatic carcmoma is becoming the focus of clinical treatment and basic research increasingly.The individualized treatment of surgery,chemotherapy with radiotherapy,targeted therapy,immunotherapy and gene therapy have become new ways for further improving the prognosis of liver cancer.

Objective To assess effects of the different retention time and temperature of the tumescent fluid on surgical blood loss in tumescent liposuction.Methods 20 patients with localized fat deposits received tumescent liposuction and the blood loss were calculated and compared between two treated groups.Results The mean surgical blood loss in 20 patients was (50.27± 18.56) ml with range (21.42-77.26) ml.The blood loss in liposuction with 0.5 hour retention and no retention of tumescent fluids was (19.89±7.52) ml and (26.25±12.07) ml,respectively; the blood loss in liposuction with heated (37℃) and non-heated tumescent fluid (23℃) was (28.60±6.07) ml and (29.93±9.06) ml,respectively.Conclusions A half hour retention of tumescent fluid in subcutaneous tissue after injection could reduce the surgical blood loss and the blood loss amount does not increase in the usage of a pre-heated tumescent fluid.

Objective To observe the effect of the occupational therapy (OT) on people with mental disability in community of Beijing and analyze its related factors. Methods 180 mentally disabled persons from 15 disabled persons' centers (DPCs) in a district of Beijing were studied with a self-developed questionnaire. They were investigated twice with a 6-month interval, and the results were compared. Results 160 questionnaires were valid for analysis. The score of OT improved (P<0.05) in 103 (64.38%) respondents. The main factors related with the effectiveness of the OT included OT categories, age and vocational assessment. Conclusion OT is effective on people with mental disability in the DPCs, and could be improved in some aspects, such as regular vocational assessment.

Objective To discuss the value of pregnantal ultrasonography(US) on fetus' complicate congenital heart diseases(CHD). Methods The uhrasonographic fetures of fetus complicate CHD were analyzed and compared with the pathological diagnosis. Resells Twenty fetus' complicate CHD were diagnosed by pregnantal US. Four cases with single ventricle, two eases with transposition of great arteries,two eases with double outlet right ventricle,two cases with truncus arteriosus,three cases with hypoplastic left heart syndrome, three cases with endocardial cushion defect, two cases with hypoplastic right heart syndrome,one case with tetralogy of Fallot and one case with pulmonary atresia were included. The diagnosing according rate was 100%. Conclusions Pregnantal US can fully evaluate the fetus' complicate CHD.

Objective To explore the efficacy and safety of bifidobacterium tetragenous viable bacteria tablets (BTVBT) in blood glucose control in patients with type 2 diabetes mellitus (T2DM).Methods This study was a randomized, double-blind, placebo parallel comparison, multicentre clinical research.The subjects were T2DM patients who were using anti-hyperglycemic drugs.They were randomly divided into observation group and control group according to 1∶1 ratio.The subjects accepted the therapy of BTVBT or placebo by oral administration (3 tablets, tid) for eight weeks, followed up for 4 weeks, during which the basic treatment maintained unchanged.The primary outcomes: the changes of glycosylate hemoglobin A1c (HbA1c) from baseline.Results Totally 234 subjects (116 cases in observation group and 118 cases in control group) from 7 centers were included in the study.The baseline characteristics were comparable between these two groups.The HbA1c was (8.00±1.08)％ and (7.99±1.03)％ in observation group and control group, respectively, at baseline, and was (7.28±1.28)％ and (7.36±1.02)％ after 12 weeks of treatment [(-0.66±1.38)％ vs.(-0.64±1.14)％,P=0.914 5].The secondary outcomes were as follows: the fasting blood glucose (FBG) in the observation group were (7.91±1.87)mmol/L and (8.05±2.33)mmol/L at baseline and after 12 weeks of treatment;while in the control group, the FBG were (8.51±1.68)mmol/L and (8.00±2.02)mmol/L, and comparisons between two groups showed no significant change (P>0.05).The glycated albumin in the observation group and control group were (21.38±5.74)％ and (21.93±6.51)％ at baseline;after 4 weeks of treatment, they were (20.08±6.05)％ and (20.58±7.30)％ (the changes from baseline in these two groups were (-1.19±4.37)％ and (-1.20±5.08)％];after 8 weeks of treatment, they were (19.07±5.56)％ and (20.83±8.74)％ [the changes from baseline were (-2.09±4.51)％ and (-0.98±6.85)％];after 12 weeks of treatment, they were (19.03±5.19)％ and (19.36±6.14)％ [the changes from baseline were (-2.18±4.60)％ and (-2.47±5.20)％], there were no significant differences between two groups (P>0.05).The subgroup analysis showed that in those patients with the characteristics including body mass index (BMI)≥25 kg/m2 at baseline, the duration of diabetes mellitus longer than 8 years, fasting blood glucose less than 8 mmol/L and using insulin at baseline, the changes of HbA1c from baseline to the end of 12 weeks therapy in the observation group were more than in the control group.There were no significant differences between the two groups in terms of safety profiles, including the vital signs and laboratory findings (blood cell counts, liver function, and kidney function, all P>0.05).Conclusion Administration of BTVBT in T2DM patients for 12 weeks does not remarkably improve the HbA1c.

Objective:To evaluate the efficacy of SVF-gel and Coleman fat in facial volume filling.Methods:This investigation presents a retrospective study of facial fat transplantation in 186 patients (114 cases of SVF-gel transplantation and 72 cases of Coleman fat transplantation) from December 2018 to September 2020 in Shanghai Basilica Clinic. Patient satisfaction was evaluated with the satisfaction questionnaire and secondary operation rates were tallied.Results:Facial augmentation and contour were improved in all patients. The satisfaction rate among the patients in the SVF-gel group was 93.0%, while that among the patients in the Coleman fat transplantation group was only 56.9% (χ 2=8.694, P<0.05). Patients in the SVF-gel group experienced less swelling and there was a lower secondary operation rate in the SVF-gel group than those in the Coleman fat transplantation group (1.75% vs 18.1%) (χ 2=13.467, P<0.001). Conclusions:SVF-gel has obvious advantages over traditional fat transplantation in facial volume filling and rejuvenation.

Purpose: Pancreatic cancer (PC) is a common malignant tumor of the digestive system, and its 5-year survival rate is only 4%. N6-methyladenosine (m6A) RNA methylation is the most common post-transcriptional modification and dynamically regulates cancer development, while its role in PC treatment remains unclear. Materials and Methods: We treated PC cells with gemcitabine and quantified the overall m6A level with m6A methylation quantification. Real-time quantitative reverse transcription polymerase chain reaction and Western blot analyses were used to detect expression changes of m6A regulators. We verified the m6A modification on the target genes through m6A-immunoprecipitation (IP), and further in vivo experiments and immunofluorescence (IF) assays were applied to verify regulation of gemcitabine on Wilms’ tumor 1–associated protein (WTAP) and MYC. Results: Gemcitabine inhibited the proliferation and migration of PC cells and reduced the overall level of m6A modification. Additionally, the expression of the “writer” WTAP was significantly downregulated after gemcitabine treatment. We knocked down WTAP in cells and found target gene MYC expression was significantly downregulated, m6A-IP also confirmed the m6A modification on MYC. Our experiments showed that m6A-MYC may be recognized by the “reader” IGF2BP1. In vivo experiments revealed gemcitabine inhibited the tumorigenic ability of PC cells. IF analysis also showed that gemcitabine inhibited the expression of WTAP and MYC, which displayed a significant trend of co-expression. Conclusion Our study confirmed that gemcitabine interferes with WTAP protein expression in PC, reduces m6A modification on MYC and RNA stability, thereby inhibiting the downstream pathway of MYC, and inhibits the progression of PC.

Objective:To explore the safety and clinical effects of extensive and large-volume liposuction.Methods:From October 2011 to June 2021 in the Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, patients receiving liposuction exceeding 15% of the body surface area and/or volume of aspirate exceeding 5 liters in a single operative session were retrospectively reviewed. All patients received liposculpture procedure under general anesthesia plus sequential infiltration of 0.025 2% low-concentration lidocaine tumescent solution. The total volume of tumescent solution injected, total volume of aspirates, volume of aspirated fat and fluid, complications as well as patient satisfaction were analyzed.Results:A total of 313 patients, 5 males and 308 females, were included in the study. The average age was 30.6±8.2 years and average body mass index was 23.9±3.5 kg/m 2. A total of 360 operations were performed. Among them, 271 cases underwent 1 operation, 37 cases underwent 2 operations, and 5 cases underwent 3 operations. The tumescent fluid volume was (8 741.6±1 559.8) ml with the maximum usage of lidocaine of 3 200 mg. The aspirates volume was (6 582.4±1 515.0) ml, of which the volume of supranatant fat and infranatant fluid were (3 662.1±1 230.8) ml and (2 936.0±765.4) ml, respectively. The ratio of infiltrate to aspirate was 1.37±0.23. Aspirate volume exceeded 10.00 L in 13 operations (3.61%), ranged from 7.50 to 9.99 L in 73 operations (20.28%), 5.00 to 7.49 L in 259 operations (71.94%) and less than 5.00 L in 15 operations (4.17%). Except for one patient (0.28%) receiving transfusion of red blood cell suspension due to postoperative anemia, no severe complications were observed. There were 10 cases (2.78%) of minor complications, including mild irregularities (5 cases), local seromas (2 cases), poor incision healing or scar hyperplasia (2 cases) and mild pigmentation caused by skin burn during radiofrequency skin tightening (1 case). The satisfaction rate of the patients was 97.2% (350/360). Conclusions:The results of this study indicate that large volume and extensive liposuction are safe. The satisfaction of the patients is very high. Sequential infiltration of tumescent solution with 0.025 2% low-concentration of lidocaine tumescent solution is safe in reducing the risk of lidocaine toxicity.

Objective:To explore the safety and clinical effects of extensive and large-volume liposuction.Methods:From October 2011 to June 2021 in the Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, patients receiving liposuction exceeding 15% of the body surface area and/or volume of aspirate exceeding 5 liters in a single operative session were retrospectively reviewed. All patients received liposculpture procedure under general anesthesia plus sequential infiltration of 0.025 2% low-concentration lidocaine tumescent solution. The total volume of tumescent solution injected, total volume of aspirates, volume of aspirated fat and fluid, complications as well as patient satisfaction were analyzed.Results:A total of 313 patients, 5 males and 308 females, were included in the study. The average age was 30.6±8.2 years and average body mass index was 23.9±3.5 kg/m 2. A total of 360 operations were performed. Among them, 271 cases underwent 1 operation, 37 cases underwent 2 operations, and 5 cases underwent 3 operations. The tumescent fluid volume was (8 741.6±1 559.8) ml with the maximum usage of lidocaine of 3 200 mg. The aspirates volume was (6 582.4±1 515.0) ml, of which the volume of supranatant fat and infranatant fluid were (3 662.1±1 230.8) ml and (2 936.0±765.4) ml, respectively. The ratio of infiltrate to aspirate was 1.37±0.23. Aspirate volume exceeded 10.00 L in 13 operations (3.61%), ranged from 7.50 to 9.99 L in 73 operations (20.28%), 5.00 to 7.49 L in 259 operations (71.94%) and less than 5.00 L in 15 operations (4.17%). Except for one patient (0.28%) receiving transfusion of red blood cell suspension due to postoperative anemia, no severe complications were observed. There were 10 cases (2.78%) of minor complications, including mild irregularities (5 cases), local seromas (2 cases), poor incision healing or scar hyperplasia (2 cases) and mild pigmentation caused by skin burn during radiofrequency skin tightening (1 case). The satisfaction rate of the patients was 97.2% (350/360). Conclusions:The results of this study indicate that large volume and extensive liposuction are safe. The satisfaction of the patients is very high. Sequential infiltration of tumescent solution with 0.025 2% low-concentration of lidocaine tumescent solution is safe in reducing the risk of lidocaine toxicity.