Objective To explore the effect of ultrasound assisted liposuction in vivo on clinical aesthetic plastic surgery. Methods Ultrasonic lipoplastics combined with swelling liposuction were used in 153 cases of the beauty seekers. Application of rountine tissue swelling technique with the transduction of ultrasound into fatty areas made atipose cells broken and emulsified, and it also easy to move the atipose tissue rich in connective fibres. Results All the patients were satified with the aesthetic effects after the operation. Smoothness and softness of the operated areas with obvious shrinkage of the skin were found with few complications. Conclusion Ultrasound assisted liposuction is an effective and simplified method and deserves to be widely used.

Objective: To investigate the prevalence of depression and anxiety among transgender populations and the correlation with defense mechanism, so as to provide the evidence for improving mental health among transgender populations. Methods: Transgender populations that visited Psychosexual Outpatient Department of Beijing Huilongguan Hospital for the first time from December 2020 to December 2021 were enrolled. Participants' demographics, depression, anxiety and type of defense mechanisms were collected using self-designed questionnaires, Self-rating Depression Scale, Self-rating Anxiety Scale and Defense Style Questionnaire (DSQ). Factors affecting depression and anxiety were identified using a multivariable logistic regression model. Results: Totally 126 transgender individuals were enrolled, including 95 men (75.40%) with a mean age of (21.53±4.55) years and 31 women (24.60%) with a mean age of (23.58±5.55) years. The prevalence of depression was 46.83% among participants, including 44.07% of participants with mild depression, 30.51% with moderate depression and 25.42% with severe depression, and the prevalence of anxiety was 26.19% among participants, including 60.61% of participants with mild anxiety, 21.21% with moderate anxiety and 18.18% with severe anxiety. The detection of depression was 54.74% among men and 22.58% among women (P<0.05), and the detection of both depression (62.79% vs. 38.55%, P<0.05) and anxiety (41.86% vs. 18.07%, P<0.05) was significantly higher among transgender populations with self-injury or suicide behaviors than among those without. Multivariable logistic regression analysis showed that immature defense mechanisms increased the risk of depression (OR=1.034, 95%CI: 1.018-1.051) and anxiety (OR=1.031, 95%CI: 1.014-1.049) among transgender populations, while mature defense mechanisms reduced the risk of depression (OR=0.887, 95%CI: 0.832-0.946) and anxiety (OR=0.878, 95%CI: 0.821-0.938) among transgender populations. Conclusions The prevalence of depression and anxiety was 46.83% and 26.19% among transgender populations included in this study. Mature defense mechanisms are beneficial to reduce the risk of depression and anxiety among transgender populations. Key words： transgender population depression anxiety defense mechanism

Objective To study a new method of minimally invasive balloon kyphoplasty (PKP)for treatment of chronic osteoporotic vertebral compression fractures. Methods The study involved 27 patients with chronic osteoporotic vertebral compression fractures treated with PKP in our hospital from February 2007 to February 2009. There were 11 males and 16 females, at mean age of 72.4 years (range 55-86 years). The history of chronic osteoporotic vertebral compression fractures ranged 3-17 months (mean 7.6 months). The pathological changes were determined at one stage in 25 patients and at two stage in two. According to the Genant classification, there were 10 patients (11 vertebrae) at grade two and 17 patients (18 vertebrae) at grade three. Before operation, the visual analog scale (VAS) score was average 8.3, the ratio of compression height of the anterior vertebral body to the posterior vertebral body was 39% by X-ray measurement and the kyphosis angle was average 15.60°. All patients received PKP under local anesthesia. Results Patients were followed up for average 11.2 months, which showed that all the patients achieved significant pain relief and ambulation at days 3 or 4 after operation. Cardiorespiratory function was significantly improved, with no reoccurrence of pain or severe complications found.After operation, the VAS score was average 2.8, ratio of compression height of the anterior vertebral body to the posterior vertebral body was average 47.6% and the kyphosis angle was average 15.60°. Conclusions Minimally invasive PKP can achieve rapid relief of pain, help early ambulation, decrease various complications resulting from long-term confinement to bed and improve cardiorespiratory function for elderly patients with chronic osteoporotic vertebral compression fractures of the vertebral body mainly with pain but without nerve injury.

Objective To investigate enteral or parenteral nutrition therapy effects in the aspects of patients' postoperative nutrition status,incidence of complications and health economics indicators of pancreatic head carcinoma or periampullary carcinoma patients after pancreaticoduodenectomy.Methods The clinical data of patients underwent PD in the First Affiliated Hospital of Harbin Medical University from January 2010 to August 2015 were collected.According to different postoperative nutrition therapy,patients were divided into parenteral followed enteral nutrition group (treatment group) and parenteral nutrition group (control group).Observed indicators such as postoperative nutrition status,liver and kidney function,incidence of complications,length and total cost of hospitalization were assessed.Results This study enrolled 207 cases in treatment group and 92 cases in control group.There was no significant difference in preoperative NRS scores,surgical procedures,pathology and other preoperative clinical indicators (P ＞ 0.05).Postoperative bilirubin reduction(△TB1.10) in treatment group versus control group had significant difference (P ＜ 0.05).Compared with postoperative Day 1,the prealbumin level of Day 7 and Day 10 in treatment group recovered rapidly than control group(△PA7.1,△PA10-1),however the differernce was not significant (P ＞ 0.05).Postoperative complications (pancreatic fistula,post-pancreatectomy hemorrhage,inna-abdominal infection,delayed gastric emptying) in treatment group and control group had no significant difference (P ＞ 0.05).The average and median hospitalization in treatment group [(28 ± 11) d,26 d] versus control group [(32 ± 18) d,29 d] had significant difference (P ＜ 0.05).The total cost of hospitalization in treatment group and control group were not significantly different(P ＞ 0.05).Conclusions This study indicated that postoperative parenteral followed enteral nutrition therapy could significantly enhance the recovery of liver function,shorten the length of hospitalization in patients after PD.Moreover,parenteral followed enteral nutrition therapy did not significantly increase the postoperative complications.

ObjectiveTo probe into the influence of the zero price margin for drugs on the revenue-expenditure structure at primary healthcare organizations.MethodsOne of the pilot districts experimenting with this system in Ningbo city was earmarked as the research object.Within this district,the data of their revenue,expenditure and surplus were collected from 20 primary healthcare organizations prior to and after the zero price margin for drugs was in place for classification analysis.ResultsThe percentage of service revenue among the total revenue has dropped from 68.34％ before the system was in place to 65.44％ after,reducing 4.24％.The percentage of drug revenue has dropped from 71.68％ before to 63.57％ after,reducing 11.31％.The percentage of service surplus has dropped from 15.81％ before to - 23.07％ after,reducing 245.94％.The total standard workload has increased 61.77％.Average medical expense per outpatient and per inpatient has reduced 32.85％ and 57.18％,from 71.44yuan and 2642.08 yuan before to 48.33 yuan and 1131.28 yuan after respectively.ConclusionThe deficit rise and higher percentage of drug revenue at primary healthcare organizations deserve attention.A comprehensive reform is recommended to establish a regular government financial support mechanism,further adjust the revenue-expenditure structure,set up the system of rational drug use,and effectively reduce the medical expense of patients.

Objective To investigate an accurate and applicable localizing method of puncture point for neuroendoscopic third ventriculostomy in neurosurgery so as to ensure that the neuroendoscope is led to the anterior membrane of mammillary body on the base of third ventricle directly. Methods Based on the MR characteristics including multiple directions and angles and high soft tissue resolution, the coordinate of puncture point was measured and calculated for neuroendoscopic third ventriculostomy in MRI. Results~The position of puncture point for neuroendoscopic third ventriculostomy was (127.2?9.9)mm to nasal root, or (17.1?5.6)mm in front of coronal suture and (20.3?4.7)mm to sagittal suture. The angle between the puncturing line and the cerebral falx was (12.3?1.9)?, and the depth from scalp to anterior membrane of mammillary body was (89.3?10.4)mm. Conclusion MRI-guided localization for neuroendoscopic third ventriculostomy is an accurate, simple, safe, painless, and applicable method.

Aim To study the effect of diazoxide on the apoptosis of PC12 cells induced by oxygen-glucose deprivation(OGD)and expression of Bcl-2 protein.Methods Cultured PC12 cells,treated with OGD,diazoxide and 5-HD,were divided into A(control group),B(OGD group),C(OGD+diazoxide group)and D(OGD+diazoxide+5-HD group).Neuronal apoptosis was detected by Annexin V-FITC/PI double-dyed flow cytometry,and the expression of Bcl-2 protein was detected by immunofluorescence and Western blot.Results The number of apoptotic PC12 cells increased after OGD in B,C,D group.C group and B,D groups were significantly different(P

Objective To explore the efficacy and safety of greenlight photoselective vaporization of prostate (PVP) in high-risk elder patients with benign prostatic hyperplasia (BPH). Methods A total of 120 high-risk elder patients with BPH underwent PVP procedure. The operating time, blood 1oss, indwelling catheterization and operation-related complications were monitored. The variables such as international prostate symptom score (IPSS), Quality of life (QOL) score, maximum urinary flow rate (Qmax) and residual urine volume (RUV) were recorded and compared pre- and post-operatively. Results All the 120 patients had a good peri-operative condition. The mean operating time was (52. 6 ± 5.8 )min, intraoperative blood loss was (20.4 ±9.5) ml. Among the 120 cases,26 did not received postoperative catheterization. In the other 94 cases received postoperative catheterization, the mean catheterization time was (24. 5 ± 15.9) hour. IPSS and QOL scores decreased from (28.5 ± 3.8) and (5.0 ± 0.8) preoperatively to (7.2 ± 1.8) and (1.5 ± 0.6)postoperatively. Qmax increased from ( 5.2 ± 3.1 ) ml/s to ( 15.2 ± 4.3 ) ml/s, and RUV decreased from ( 118.6 ± 15.2) ml to ( 16. 5 ± 4. 6) ml. There was significant difference for these parameters before and after the operation (Ps ＜ 0. 05 ). Conclusion The PVP is considered to be a safe, effective and minimally invasive procedure to treat BPHin high-risk elder patients. It is easy to manipulate, with advantages of shorter operating time,less blood loss, better tolerance and rapid recovery, especially for high-risk elder patients with BPH.

Objective To evaluate the efficacy of epidural anesthesia combined with different doses ropivacaine and sufentanil for stepwise labor analgesia in latent phase.Methods Two hundred and ten ASA Ⅰ or Ⅱ primiparas with a singleton and vertex presentation at full term in our hospital from February 201 5 to April 201 5 were randomized into seven groups (n =30 each):0.125% ropiva-caine with 0.5 μg/ml sufentanil (group 1);0.075% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation < 3 cm),0.125% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation ≥ 3 cm) (group 2);0.1% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation < 3 cm),0.125% ropiv-acaine with 0.5 μg/ml sufentanil (cervical dilatation≥3 cm)(group3);0.1 5% ropivacaine with 0.5μg/ml sufentanil (group 4);0.075% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation < 3 cm),0.1 5% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation≥ 3 cm)(group 5 );0.1%ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation<3 cm),0.1 5% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation≥3 cm)(group 6);0.125% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation<3 cm),0.1 5% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation≥3 cm) (group 7).The intensity of pain was assessed by visual analog scale (VAS).Meanwhile,1abor process,postpartum hemorrhage,Bromage score,postpartum adverse reactions and Apgar score of the neonates were also observed.Results No significant difference was found in VAS score after epi-
dural block between groups at each time.The latent period of group 2 and 3 were shorter than that in group 1 (P <0.05)and that of group 5 and 6 were shorter than that in group 4 (P <0.05);the ac-tive phase of group 4 were longer than that in group 1 (P <0.05 ).The postpartum hemorrhage of group 2 and 3 were less than that in group 1 (P <0.05),the postpartum hemorrhage of group 5,6 and 7 were more than that in group 2 (P <0.05)and group 3 (P <0.05).The motor nerve block of group 2 and 3 were slightly less than that in group 1 (P <0.05)and the motor nerve block of group 5,6 and 7 were slightly less than that in group 4 (P <0.05).There was no difference of the postpar-tum adverse reactions of maternal and Apgar score in the neonates.Conclusion The dosage of 0.075% or 0.1% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation < 3 cm),0.125% ropiv-acaine with 0.5 μg/ml sufentanil (cervical dilatation ≥ 3 cm),while producing the exact analgesic effect,hardly interferes with the 1abor process,the amount of postpartum hemorrhage and the lower limb activity,thus they have no significant effect on the safety of the maternal and the infant.

Objective To investigate the effects and value of enhance recovery after surgery (ERAS) application in patients with hepatocellular carcinoma underwent liver resection.Methods One hundred and seventy-two patients with hepatocellular carcinoma underwent liver resection in the first affiliated hospital of Harbin medical university from June 2013 to June 2015,ERAS group (92 cases) and control group (80 cases) were retrospectively studied.Laboratory indicators (ALT,AST,TBIL,ALB,PA,lymphocyte count),postoperative complications,postoperative hospitalization days and total hospitalization expenses were compared between two groups.Results For postoperative liver functional indicators (ALT,AST,TBIL),ERAS group Day 1 and Day 7 were respectively (216.3±141.7) U/Land (70.1 ±29.4) U/L,(184.0±155.8) U/Land (39.1 ±17.5) U/L,(22.4± 8.7) μmol/L and (20.0 ± 7.5) μmol/L,control group were respectively (304.5 ± 226.2) U/L and (83.9 ± 48.5) U/L,(294.1 273.0) U/L and (49.2 ±33.8) U/L,(26.9 ±15.6) μmol/L and (24.6 ± 10.8) μmol/L,the difference between two groups was statistically significant (F =9.33,9.84,9.26,P ＜ 0.05).For postoperative nutritional indicators (ALB,PA),ERAS group Day 7 were respectively (35.3 ± 4.4) g/Land (136.3 ±34.1) mg/L,control group were respectively (33.6 ±4.2) g/L and (108.0 ± 32.5) mg/L,the difference was statistically significant (F =4.97,4.54,P ＜ 0.05).For postoperative immune indicators (lymphocyte count),ERAS group Day 1 and Day 7 were respectively (0.9 ±0.3) × 109/L and (1.5 ± O.5) × 109/L,control group were respectively (0.7 ± 0.3) × 109/L and (1.3 ± 0.5) × 109/L,the difference was statistically significant (F =7.37,P ＜ 0.05).For postoperative complications (hemorrhage,bile fistula,hepatic dysfunction,infection) were no statistically significant differences (P ＞ 0.05),however,ascites had statistically significant difference (x2 =7.609,P ＜ 0.05).Off bed time,postoperative exhaust time,postoperative hospitalization time and total hospitalization expense of ERAS group were respectively (1.7 ± 0.5) days,(2.3 ± 0.6) days,(9.8 ± 2.3) days,(4.6 ± O.9) × 104 RMB,control group were respectively (3.0 ± 0.7) days,(3.4 ± 0.8) days,(17.6 ± 5.8) days,(6.3 ± 2.1) × 104 RMB,the difference was statistically significant (t =13.032,10.937,11.371,7.118,P ＜ 0.05).Conclusions Application of ERAS in patients with HCC underwent liver resection is safe and effective.ERAS effectively reduce stress reaction of patients,promote the recovery of liver function,improve the postoperative immune and nutrition status,shorter postoperative hospitalization time,and reduce the total cost of hospitalization.