There are few reports in China on the laparoscopic Burch procedure in the treatment of female stress urinary incontinence. Twenty-two female stress urinary incontinence patients admitted to our hospital were treated with laparoscopic Burch procedure, with an overall effective rate of 100%. The score of the International Continence Advisory Committee Urinary Incontinence Questionnaire-Short Form (ICI-Q-SF) at one month after treatment was lower compared to that before the procedure. There were no complications during two months of follow-up.

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 risk factors of chronic postoperative inguinal pain for laparoscopic trans-abdominal preperitoneal hernia repair and establish a nomogram prediction model for it.Methods:The clinical data of 576 patients who underwent laparoscopic trans-abdominal preperitoneal hernia repair for inguinal pain at the First Hospital of Lanzhou University from January 2015 to December 2020 were analyzed retrospectively. According to different postoperative outcomes, patients were divided into chronic pain group ( n=54) and non-chronic pain group ( n=522), compared two groups of patients in the material, including gender, age, BMI, smoking history, history of drinking, hypertension, diabetes, chronic bronchitis, abdominal surgery history, history of inguinal hernia, hernia type, the hernial sac size, prophylactic use of antibiotics, VAS score, mesh fixation techniques, operation time, length of stay. Measurement data with normal distribution were expressed as ( ± s) and independent sample t test was used for comparison between groups. Measurement data with skewed distribution were expressed as M( Q1, Q3), and the Mann-Whitney U test was used for comparision between groups. Chi-square test was used to compare the measurement data of counting data.Multivariate logistic regression was used to analyze the independent risk factors for chronic postoperative inguinal pain. R software was used to establish the drawing of the nomogram prediction model, and the consistency index, calibration chart and area under the receiver operating characteristic curve was used to evaluate the predictive ability of the nomogram prediction model. Results:According to the results of the Logistic regression analysis, age≤45 years ( OR=2.202, 95% CI: 1.080-4.491), BMI≥24 kg/m 2 ( OR=2.231, 95% CI: 1.204-4.134), hernial sac≤5 cm ( OR=2.623, 95% CI: 1.309-5.257), recurrent hernia ( OR=2.769, 95% CI: 1.118-6.860), preoperative pain ( OR=4.121, 95% CI: 2.004-8.476), suture fixation ( OR=2.204, 95% CI: 1.151-4.219)and Postoperative acute pain (VAS>3) ( OR=5.814, 95% CI: 2.532-13.350) were independent risk factors for chronic postoperative inguinal pain ( P<0.05). Based upon the above independent risk factors, the nomogram prediction model was established and verified. The area under the curve of the nomogram prediction model was 0.779 (95% CI: 0.718-0.840, P<0.01). After internal verification, the concordance index value of the prediction model was 0.779. Conclusion:age≤45 years, BMI ≥24 kg/m 2, hernial sac≤5 cm, recurrent hernia, preoperative pain, suture fixation and Postoperative acute pain (VAS>3) are independent risk factors for chronic postoperative inguinal pain for laparoscopic trans-abdominal preperitoneal hernia repair, the nomogram prediction model has a good accuracy and discrimination with a high value of clinical application.

Objective:To evaluate the visibility of intracranial deep medullary vein (DMV) by sensitivity weighted imaging (SWI), and explore its correlation with recent small subcortical infarct (RSSI).Methods:From March 2021 to May 2022, 277 patients with cerebral small vascular disease (CSVD) confirmed by cranial MRI in Department of Neurology, Third Hospital of Hebei Medical University, were consecutively enrolled. These patients were divided into RSSI group ( n=128) and non-RSSI group ( n=149) according to RSSI presence or not within one week of onset. According to the DMV scores, these patients were divided into mild-moderate DMV group (0-12 scores, n=199) and severe DMV group (13-18 scores, n=78). The clinical and imaging data of these groups were analyzed retrospectively and compared. Multivariate Logistic regression analysis was used to determine the correlation between DMV and RSSI, as well as the independent influencing factors for DMV grading. Results:The cerebral microbleed (CMB), periventricular white matter hyperintensity (WMH) scores, deep WMH scores, total WMH scores, total CSVD burden scores, and DMV scores in patients of the RSSI group were significantly higher than those in the non-RSSI group ( P<0.05); and patients in the RSSI group had significantly younger age and significantly lower high density lipoprotein cholesterol (HDL-C) level than those in the non-RSSI group ( P<0.05). Multivariate Logistic regression analysis showed that DMV score ( OR=1.142, 95%CI: 1.026-1.271, P=0.016) was an independent influencing factor for RSSI after adjusting for HDL-C and deep WMH scores. The severe DMV group had significantly older age, statistically higher percentages of patients having history of hypertension, CMB, lacuna and moderate to severe EPVS in basal ganglia, and significantly higher periventricular WMH scores, deep WMH scores, total WMH scores, and total CSVD burden scores as compared with the mild-moderate DMV group ( P<0.05). Multivariate Logistic regression analysis showed that age ( OR=1.101, 95%CI: 1.060-1.143, P<0.001) and total CSVD burden scores ( OR=3.589, 95%CI: 2.506-5.141, P<0.001) were independent influencing factors for DMV scores. Conclusion:DMV is involved in the mechanism of RSSI, and DMV visibility can be used as an indicator to diagnose RSSI and evaluate RSSI progression.

Eyelid and surrounding tissue injury caused by trauma, burn, infection and other reasons will lead to different degrees of eyelid ectropion and incomplete eyelid closure after scar formation. At present, surgical treatment is the main treatment for cicatricial ectropion, but there is still the risk of scar formation again after operation. We used early ion beam drug introduction to treat 1 case of cicatricial ectropion after trauma, and achieved satisfactory result.

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.

Eyelid and surrounding tissue injury caused by trauma, burn, infection and other reasons will lead to different degrees of eyelid ectropion and incomplete eyelid closure after scar formation. At present, surgical treatment is the main treatment for cicatricial ectropion, but there is still the risk of scar formation again after operation. We used early ion beam drug introduction to treat 1 case of cicatricial ectropion after trauma, and achieved satisfactory result.

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 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.

Topical compound lidocaine cream is commonly used for pain relief before laser treatment for scar. In January, 2020, one 4-year-old girl with large area scar was admitted to the Department of Plastic Surgery, Taizhou Hospital of Zhejiang Province. Severe adverse drug reaction such as convulsions, cyanosis of the lips, loss of consciousness, and urination incontinence occurred, after 1.5 hours of topical application of compound lidocaine cream before laser treatment. She was recoved after emergency treatment.