To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

室性心律失常作为心脏性猝死的主要诱因，其治疗始终是心血管领域的重大挑战。尽管抗心律失常药与常规消融技术已经成为当前治疗的基石，但仍有缺陷。脉冲电场消融（PFA）凭借其独特的非热消融机制，为突破现有治疗瓶颈提供了新方向。本文系统阐述PFA在室性心律失常领域的研究进展，并对其临床转化路径进行探讨。

相较于阵发性心房颤动（房颤），尽管在肺静脉隔离的基础上增加额外消融，导管消融治疗持续性房颤的效果仍不理想。随着对持续性房颤发病机制认识的不断深入，新型的消融能量与消融策略也陆续出现，本综述旨在概述导管消融在治疗持续性房颤中的现状与挑战。

To evaluate the efficacy and safety of liposomal bupivacaine for postoperative analgesia in patients undergoing open tension-free inguinal herniorrhaphy (Lichtenstein repair) via ultrasound-guided transversus abdominis plane block (TAPB).

A prospective, single-center, randomized, double-blind, positive-controlled clinical trial was conducted. Eighty-two patients scheduled for unilateral Lichtenstein herniorrhaphy in the Second Department of Gastrointestinal Surgery, Tianjin Nankai Hospital between May 2024 and March 2025 were enrolled. Using block randomization, patients were assigned to one of three groups: Group A (20 ml sterile water for injection), Group B (10 ml 7.5 mg/ml hydrochloride bupivacaine+10 ml normal saline), and Group C (10 ml 13.3 mg/ml liposomal bupivacaine+ 10 ml sterile water for injection ). Resting pain scores (using the numeric rating scale method) were assessed 14 times at 1, 2, 3, 4, 5, 6, 8, 10, 12, 24, 36, 48, 72, and 96 hours postoperatively, and pain profiles were plotted. The cumulative burden of pain scores [area under the curve (AUC)], opioid drugs consumption, and incidence of adverse reactions during the 0-96-hour postoperative period were compared.

No statistically significant differences were observed in preoperative general characteristics among the three groups (P>0.05). The AUC in Group C (172.18) was significantly lower than that in Group A (233.42, P<0.001) and Group B (228.90, P<0.001), whereas no significant difference was found between Group A and Group B (P=0.752). Among the three groups of patients, Group C had the lowest rescue medication rate, with a statistically significant difference (P<0.05). The time to first rescue medication in Group C was significantly longer than that in Groups A and B. Group C had better postoperative pain control effect, and a higher proportion of patients did not require rescue medication. The incidence of postoperative analgesic-related adverse events has no significant difference among the three groups (P>0.05).

Preoperative administration of liposomal bupivacaine under ultrasound- guided TAPB effectively alleviates pain after open tension-free herniorrhaphy, with superior efficacy compared to conventional bupivacaine and a comparable safety profile.

Lumbar hernia is a rare condition, and considerable controversy remains regarding its optimal surgical management. This study aimed to evaluate the feasibility and clinical outcomes of single-incision laparoscopic totally extraperitoneal sublay (SIL-TES) mesh repair for the treatment of lumbar hernia.

A retrospective analysis was conducted on the clinical data of 22 patients with lumbar hernia who underwent SIL-TES mesh repair between April 2020 and August 2024 at four hospitals: the First Affiliated Hospital of Ningbo University, Shanghai First People's Hospital, Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and Shanghai East Hospital. The surgical technique and procedural details were described. Perioperative outcomes, postoperative complications, patient satisfaction, and quality of life were evaluated. Quality of life was assessed preoperatively and at 1 week, 1 month, 6 months, and 1 year postoperatively using the Carolina Comfort Scale (CCS), including domains of foreign-body sensation, pain, and movement limitation.

The median operative time was 97.50 (67.75, 110.00) minutes. No conversion to open surgery or severe intraoperative complications occurred. The follow-up duration ranged from 3 to 54 months, with a median follow-up of 21.00 (10.75, 46.25) months. No hernia recurrence or surgical-site infection was observed. Comparisons of CCS domain scores and total scores at different follow-up time points showed statistically significant differences (foreign-body sensation: F=6.62, P=0.013; pain: F=62.88, P<0.001; movement limitation: F=19.52, P<0.001; total score: F=36.30, P<0.001), with all scores demonstrating significant and sustained improvement over time. The mean patient satisfaction score was (4.58±0.58), and the mean cosmetic satisfaction score was (9.29±0.91), indicating high overall satisfaction.

SIL-TES mesh repair is a safe and effective minimally invasive option for the treatment of lumbar hernia, with satisfactory short-term outcomes. By combining direct visualization with coordinated hand–eye manipulation, this technique provides a reliable therapeutic alternative. Further studies are required to evaluate its long-term outcomes.

To investigate the clinical efficacy of laparoscopic mesh repair via different surgical approaches for the treatment of lumbar hernia.

A retrospective analysis was performed on the clinical data of four patients with lumbar hernia who underwent laparoscopic surgery at the 901st Hospital of the Joint Logistics Support Force of the PLA between May 2015 and May 2021. Two patients underwent laparoscopic trans-abdominal partial extra-peritoneal (TAPE), while the remaining two received laparoscopic retroperitoneal totally extraperitoneal surgery (R-TEP). The therapeutic outcomes of different laparoscopic approaches were evaluated.

All four patients successfully completed surgery. The operative time was 70 minutes for both patients who received TAPE, while that for the 2 R-TEP patients was 95 minutes and 170 minutes (bilateral case), respectively. The visual analog scale (VAS) pain scores at 24 and 48 hours postoperatively were 4, 3 points and 3, 2 points for the 2 TAPE patients, and 2, 2 points and 1 point(for case 3, the patient was discharged within 48 hours after surgery, and the corresponding measurement was not conducted) for the 2 R-TEP patients, respectively. The postoperative hospital stay was 5 days for both TAPE patients, compared with 1 day and 2 days for the R-TEP patients. The time to first postoperative flatus was 2 days in both TAPE patients and 1 day in both R-TEP patients. No complications such as fever, operative-site hematoma or incision infection were observed. Postoperative pain in all patients resolved within 3 months. During a follow-up period of 36-84 months, no activity limitation or hernia recurrence was reported.

Both surgical approaches are effective in the treatment of lumbar hernia. Laparoscopic R-TEP may be more minimally invasive, associated with faster postoperative recovery and lower costs, but further research and verification are still required.

To compare the efficacy of rectus abdominis suspension and pubic comb ligament suture in the treatment of pseudohernia sac of direct inguinal hernia.

A prospective controlled study was conducted on 60 patients with direct inguinal hernia who were admitted to Chongqing Hospital, The First Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2021 to May 2022. Using a random number table, the patients were randomly divided into observation group and control group, with 30 cases per group. The observation group was treated with rectus abdominis suspension method, and the control group was treated with pubic comb ligament suture method. The operation time, consumables cost, hernia recurrence and postoperative complications of the two groups were compared.

The operation time and consumables cost of the observation group were significantly lower than those of the control group [(1.58±0.56) minutes vs (2.83±0.59) minutes; (6.23±0.43) yuan vs (819.33±17.21) yuan; all P<0.001]. There were no differences in intraoperative bleeding, visual analog scale scores for postoperative pain, postoperative urinary retention, and chronic pain between the two groups (P>0.05). There were no postoperative seromas, wound infections or hernia recurrences in the two groups.

The method of rectus abdominis suspension for the treatment of pseudohernia sac of direct inguinal hernia not only has the exact effect of avoiding postoperative seroma, but also is simple, quick, economical and practical, and reduces the medical cost.

To exploration the preliminary outcomes of a novel surgical approach—the laparoscopic transabdominal preperitoneal (TAPP) repair for umbilical hernia.

This retrospective case series included 12 patients who underwent laparoscopic TAPP umbilical hernia repair at the Gastrointestinal Minimally Invasive Surgery Center of the Third People's Hospital of Chengdu between May 2022 and March 2024. All procedures were performed by the same surgical team. Baseline characteristics, perioperative data, postoperative recovery, and complications were systematically collected and retrospectively analyzed using the electronic medical record system.

All patients successfully completed laparoscopic TAPP umbilical hernia repair. The mean operative time was (82±25) minutes, and the median postoperative hospital stay was 3 (3, 3.5) days. One patient developed postoperative seroma at 1 month. No hernia recurrence, incision infection, or serious complications such as intra-abdominal hemorrhage, intestinal obstruction, or enteric fistula were observed. During a 6-month follow-up period, 11 patients completed follow-up and none experienced hernia recurrence; one patient was lost to follow-up.

Preliminary results suggest that laparoscopic TAPP repair is a feasible approach for the treatment of umbilical hernia. However, further studies with larger sample sizes are required to confirm its efficacy and safety.

To investigate the efficacy of truss compression therapy in reducing the incidence of postoperative seroma in patients with indirect inguinal hernia undergoing laparoscopic transabdominal preperitoneal (TAPP) repair.

From May 2021 to May 2022, 50 adult male patients with indirect inguinal hernia who underwent TAPP at the Tongxiang First People's Hospital were selected and randomly divided into an experimental group and a control group. Both groups received the same TAPP procedure. In the experimental group, a truss was applied to compress the inguinal region for one week postoperatively; in the control group, routine sandbag compression was applied for 12 hours after surgery. The two groups were compared in terms of baseline characteristics, size of the hernia ring defect, whether the hernia sac was completely dissected, operative time, intraoperative blood loss, postoperative hospital stay, incidence and classification of postoperative seroma, and hernia recurrence rate.

There were no statistically significant differences between the two groups in baseline characteristics, intraoperative parameters, or length of postoperative hospital stay (all P>0.05). The incidence of postoperative seroma was 8% in the experimental group, with no cases of type III seroma; in contrast, the control group had a 32% incidence of postoperative seroma, including a 16% incidence of type III seroma, and these differences were statistically significant (P<0.05). Four cases of seroma in the control group were cured after aspiration and drainage. No hernia recurrence was observed in either group during follow-up.

For patients with indirect inguinal hernia undergoing TAPP, postoperative truss compression can effectively reduce the incidence of seroma, with good safety and definite efficacy. It has achieved satisfactory short-term results in clinical practice and shows promising prospects for clinical application.

To summarize the surgical technique and treatment experience of single-incision laparoscopic totally extra-peritoneal inguinal hernia repair via inferior arcuate line approach.

The clinical data, operation and postoperative recovery of 60 patients admitted to the Department of hernia and Abdominal Wall Surgery in the Affiliated Hospital of Guangdong Medical University from July 1, 2023 to July 1, 2024 who received single-incision totally extra-peritoneal inguinal hernia repair via inferior arcuate line approach were analyzed retrospectively. The key points of operation were summarized. At the same time, the curative effect of this surgical approach was further discussed.

The operation was completed successfully in all 60 patients, and the average operation time was (57.73±15.97) minutes. Intraoperative peritoneal damage occurred in 4 cases. Intraoperative blood loss was (3.89±1.78) ml. Postoperative hospital stay was (2.62±0.87) days. VAS pain score on the first day after surgery was (1.90±0.60) points. Postoperative seroma occurred in 2 cases. Postoperative subcutaneous emphysema of scrotum occurred in 1 case. No patients had postoperative hematoma or incision infection. During the follow-up for 2 months to 1 year, there were no recurrent cases or postoperative incisional hernia cases.

Using single incision laparoscopic totally extra-peritoneal inguinal hernia repair via inferior arcuate line approach is safe and feasible, and has certain technological advantages, which is worthy of reference for clinicians.

To investigate the effect of body position in sliding hiatal hernia (SHH).

This study was a retrospective controlled study. A total of 153 patients with suspected gastroesophageal reflux disease who attended the Department of Gastroesophageal Surgery at the PLA Rocket Force Characteristic Medical Center between March 2, 2022, and March 6, 2023, were enrolled. All patients underwent upper gastrointestinal endoscopy and high-resolution esophageal manometry (HREM) in both the seated and supine positions. The upward displacement length of the esophagogastric junction (EGJ) was measured by endoscopy. Data including esophageal length, lower esophageal sphincter (LES) length and pressure, and the crural diaphragm-LES (CD-LES) separation distance were collected. Based on an EGJ upward displacement greater than 2 cm on endoscopy and the presence of CD-LES separation on HREM, patients were divided into the SHH group (62 cases) and the non-SHH group (91 cases). Differences in the above parameters between seated and supine positions within each group, as well as differences between the two groups, were analyzed.

Among the 153 patients, SHH was detected in 62 cases (62/153, 40.52%). The detection rate of SHH by supine HREM (30.01%) was significantly higher than that by endoscopy (24.18%) and seated HREM (12.41%), with statistically significant differences (P<0.05). In the SHH group, esophageal length and intra-abdominal LES length measured in the supine position were shorter than those measured in the seated position, while the CD-LES separation distance was longer in the supine position. The minimum and mean LES resting pressures and LES residual pressure were all higher in the supine position than in the seated position, with statistically significant differences (P<0.05). In the non-SHH group, esophageal length measured in the supine position was shorter than that in the seated position, whereas the minimum and mean LES resting pressures and LES residual pressure were higher in the supine position, with statistically significant differences (P<0.05). Regardless of body position, the CD-LES separation distance in the SHH group was longer than that in the non-SHH group, while esophageal length, LES length, and intra-abdominal LES length were shorter in the SHH group. In addition, the minimum and mean LES resting pressures and LES residual pressure were lower in the SHH group than in the non-SHH group, with statistically significant differences (P<0.05).

Body position can influence sliding in hiatal hernia. Compared with the seated position, the supine position causes the EGJ to shift further toward the thoracic cavity, increases the extent of herniation into the thorax, and enlarges the volume of the hernia sac.

This article analyzed and summarized the clinical characteristics, diagnosis and treatment methods of obturator hernia, in order to provide reference for the diagnosis and treatment of this disease.

The clinical data of 13 patients with obturator hernia who were admitted to the Affiliated Hospital of Yangzhou University and were confirmed by surgery from February 2017 to May 2022 were retrospectively analyzed. The operation time, intraoperative blood loss, hospital stay, follow-up time and recurrence were recorded.

All 13 patients underwent surgical treatment, 8 underwent traditional laparotomy, and 5 underwent TAPP repair. There was 1 case of postoperative incision infection, 1 case of postoperative pulmonary infection, both recovered after symptomatic treatment. One patient died the next day after being transferred to the ICU due to respiratory failure caused by underlying diseases, and the remaining 12 patients recovered and were discharged. The hospital stays ranged from 4 to 25 days, with an average of (11.5±5.8) days. All patients were cured and discharged, and were followed up for 1 to 63 months with a mean of (35.3±22.9) months. No hernia recurrence was observed during the follow-up period.

Obturator hernia is a rare disease in clinical practice, and its clinical manifestations are not specific. The diagnosis of obturator hernia should be considered in elderly and infirm multiparous women presenting with unexplained symptoms of small bowel obstruction. Preoperative abdominal and pelvic CT examination is helpful for early diagnosis of obturator hernia. Surgery should be performed as soon as possible after a clear diagnosis, and laparoscopic exploration and repair are recommended if the patient's conditions permit. According to the specific circumstances of the operation, if there is no contraindication, in order to prevent recurrence, a mesh can be used to enhance the repair effect.

Stoma prolapse is one of the most common long-term complications following stoma creation and can severely impair patients’ quality of life. General surgeons should have a thorough understanding of the pathophysiological mechanisms and current treatment strategies for stoma prolapse. This article reviews relevant domestic and international literature to explore the risk factors associated with stoma prolapse, focusing on patient-related factors and surgical techniques. In addition, treatment strategies for stoma prolapse are discussed, with particular emphasis on both surgical and conservative management. Recent advances in the treatment of stoma prolapse are also systematically summarized.