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.

To investigate trends in the monitored single-disease quality-control indicators for pediatric community-acquired pneumonia (CAP) across different categories of medical institutions in Shanghai from 2020 to 2025.

Six-year monitoring data on 10 single-disease quality-control indicators for pediatric CAP were collected from 102 medical institutions in Shanghai between January 1, 2020, and December 31, 2025. The indicators included the number of pediatric CAP discharges, proportion of severe CAP cases among hospitalized patients, severity assessment rate, antibiotic use rate, mechanical ventilation rate, blood transfusion rate, in-hospital mortality rate, average length of stay, average hospitalization cost per case, and average medication cost per case. The 102 medical institutions were stratified into four categories: category A (n=44, tertiary general hospitals), category B (n=35, secondary general hospitals), category C (n=3, tertiary children′s specialty hospitals), and category D (n=20, other medical institutions, including traditional Chinese medicine hospitals, maternal and child health institutions, infectious disease hospitals, and public health institutions). Six-year monitoring data for the four categories were extracted from the Shanghai Medical Service Monitoring and Evaluation System, and their annual changes were analyzed. Proportion indicators, including the proportion of severe CAP cases among hospitalized patients and the severity assessment rate, were expressed as percentages and analyzed using the Cochran-Armitage trend test. Quantitative indicators, including average length of stay, average hospitalization cost per case, and average medication cost per case, were expressed as means and analyzed descriptively for annual changes.

① From 2020 to 2025, a total of 183 307 pediatric CAP discharge cases were included from 102 medical institutions in Shanghai. Patients from categories A, B, C, and D institutions accounted for 49.25% (90 279/183 307), 16.89% (30 961/183 307), 33.08% (60 632/183 307), and 0.78% (1 435/183 307), respectively. The proportion of severe CAP cases among hospitalized patients was highest in category C institutions. This proportion decreased significantly in categories A, B, and C institutions (Z=-8.93, -2.84, and -4.64, respectively; all P<0.05). ② The severity assessment rate improved overall across all four categories institutions, with statistically significant annual trends (Z=21.61, 21.76, 25.76, and 10.73, respectively; all P<0.001). The antibiotic use rate decreased in category C institutions but increased in categories B and D, with statistically significant annual trends (Z=-36.84, 19.36, and 15.51, respectively; all P<0.001). ③ The mechanical ventilation rate was generally higher in category C institutions than in the other three categories institutions but showed a decreasing trend (Z=-4.40, P<0.001). Category A institutions showed an increase followed by a decrease (Z=-3.08, P = 0.002). Blood transfusion rates decreased in categories A and C institutions (Z=-9.56 and -21.28, respectively; both P<0.001). ④ In-hospital mortality remained low overall across the four categories and decreased in categories A, B, and C institutions (Z=-17.64, -1.97, and -4.62, respectively; all P<0.05). Average length of stay shortened overall, with more pronounced reductions in categories A and C institutions. Average hospitalization cost per case and average medication cost per case generally decreased in categories A and C institutions, whereas more marked year-to-year fluctuations were observed in categories B and D institutions.

From 2020 to 2025, the monitored single-disease quality-control indicators for pediatric CAP in Shanghai showed an overall improving trend, and a relatively clear stratified admission pattern was observed. Category A institutions undertook the largest share of pediatric CAP admissions, whereas category C institutions played an important role in the management of severe pediatric CAP. Future quality-control efforts should consider the functional roles of different medical institutions, improve the stratified quality-control and information technology-enabled management systems for pediatric CAP, and further enhance the quality and management of regional pediatric CAP care.

To explorer the clinical features of pediatric and adult patients with familial episodic pain syndrome type 3 (FEPS3) caused by SCN11A gene mutations, within a single pedigree.

A proband who presented to the outpatient clinic of Capital Center for Children′s Health, Capital Medical University in July 2017 and was molecularly confirmed to carry an SCN11A gene mutation, along with seven affected family members (the father and grandmother of the proband, the maternal cousin of the proband′s father, the two sisters and brother of the proband′s grandmother, and the grandmother′s deceased mother), were enrolled in this study. A retrospective analysis was performed to evaluate clinical manifestations, genetic test results, therapeutic interventions, and outcomes of all eight patients. Concurrently, a literature review of FEPS3 related pedigrees was conducted using domestic and international databases to summarize the disease profile. This study was approved by the Institutional Ethics Committee of the Capital Center for Children′s Health, Capital Medical University (Approval No. SHERLL2020012).

① The proband was a male outpatient, evaluated at 2 years and 3 months of age, presented with over 1-year history of paroxysmal crying and limbs pain. His prior medical history was unremarkable. Physical examination and routine laboratory tests revealed no notable abnormalities. Genetic analysis identified a pathogenic missense variant in SCN11A gene, namely c. 665G>A(p.R222H). A confirmed diagnosis of FEPS3 was established based on the combined clinical and genetic findings. The proband was advised to avoid identifiable triggers, including cold exposure and strenuous physical activity, and received oral ibuprofen for symptomatic relief during painful episodes. At the most recent follow up, at over 10 years of age, he still experience intermittent limbs pain predominantly involving the distal portions of the elbows and knees following vigorous exercise. ② Among the four generations of affected family members of proband, seven individuals-including the proband′s father, the maternal cousin of the proband′s father, four members of the grandmother′s generation, and the grandmother′s mother-exhibited pain episodes analogous to those of the proband. Both the father and the grandmother tested positive for the identical SCN11A gene pathogenic variant c. 665G>A(p.R222H), confirming FEPS3 in these two cases. The remaining five affected members were clinically diagnosed as FEPS3 patients based on their clinical presentation and the genetic characteristics of the disease. All seven family members avoided cold and other known triggers, and administered oral ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAID) to relief pain during pain attacks. Notably, limbs pain began to abate between 18 and 30 years of age and resolved completely by the age of 40 in all affected individuals. ③ Literature search results: a total of six FEPS3 relevant literature describing 15 FEPS3 pedigrees confirmed by genetic testing were retrieved. Pooled analysis of these 16 FEPS3 families (including this study) indicated that most patients experienced disease onset during infancy, with episodic limbs pain as the cardinal feature. Pain was frequently exacerbated by cold, fatigue, and illnesses, and was often accompanied by hyperhidrosis, constipation, diarrhea, and abdominal pain. All 16 pedigrees harbored heterozygous missense mutations in SCN11A gene, encompassing 9 distinct variant sites. NSAID provided transient but effective pain control, and the majority of patients exhibited marked symptomatic amelioration or even complete resolution with advancing age.

Patients with FEPS3 caused by SCN11A gene mutations presents as recurrent episodic limbs pain with an early life onset. Early and definite diagnosis can be achieved through molecular genetic testing. FEPS3 has familial inheritance patterns. NSAID offer effective symptomatic management, and pain symptoms tend to significantly diminish or disappear with advancing age.

To investigate the clinical characteristics, diagnosis, treatment, and prognosis of renal infarction in children with systemic juvenile idiopathic arthritis (SJIA).

Three children with SJIA complicated by renal infarction who were diagnosed and treated in the Department of Rheumatology and Immunology, Capital Center for Children′s Health Capital Medical University, from July 2014 to May 2025 were selected into this study. Their clinical data were retrospectively analyzed, including clinical manifestations, laboratory findings, imaging features, treatment, and follow-up outcomes. In addition, Chinese and English databases were searched using " juvenile idiopathic arthritis" " renal infarction", and " arthritis" as search terms to identify studies on SJIA or arthritis complicated by renal infarction, and the retrieved literature was comprehensively analyzed. The study protocol was conducted in accordance with the ethical standards of Capital Center for Children′s Health Capital Medical University, and was approved by its Ethics Committee (Approval No. SHERLLM2021046).

① Among the 3 children, 2 were female and 1 was male, aged 7, 6, and 15 years, respectively. All 3 children were in the active phase of SJIA, presenting with recurrent fever, rash, and arthritis, accompanied by multisystem involvement. Laboratory tests showed marked inflammatory responses in all 3 children, as indicated by elevated white blood cell count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and serum ferritin (SF) levels. Abnormalities of the coagulation and fibrinolytic systems were also observed in all 3 children, manifested by increased D-dimer (D-D) and fibrin degradation product (FDP) levels. Among the 3 children, 2 had abdominal pain, of whom 1 also had low back pain and renal percussion tenderness, and 1 had hematuria and proteinuria; the remaining child had no obvious abdominal symptoms. Contrast-enhanced abdominal CT showed wedge-shaped low-density areas or hypoenhancing perfusion defects in the kidney in all 3 children, with right kidney involvement in 1 case, left in 1 case, and bilateral in 1 case. Renal abscess was initially considered in all 3 children. However, after antimicrobial therapy, the above clinical symptoms and renal lesions showed no obvious improvement. After active control of SJIA activity combined with anticoagulant therapy, with antiplatelet therapy added in some cases, fever, abdominal pain, and joint symptoms were relieved. During follow-up, renal lesions decreased in size or resolved in all 3 children, and no renal dysfunction was observed. The literature review identified no published reports of renal infarction in children with SJIA. After expanding the search to arthritis-related rheumatic diseases, only one adult case of rheumatoid arthritis complicated by renal infarction was identified.

Renal infarction in children with SJIA is rare and has nonspecific clinical manifestations, which may lead to misdiagnosis or delayed diagnosis. Renal infarction may represent a complication during the active phase of SJIA. Contrast-enhanced abdominal CT is useful for early diagnosis. Timely control of SJIA disease activity, together with anticoagulant or antiplatelet therapy based on coagulation status, may help improve renal outcomes.

To investigate the clinical characteristics, diagnosis and treatment strategies of pregnant women with thyroid hormone resistance syndrome (SRTH).

One pregnant woman with SRTH (patient 1) who visited the Department of Internal Medicine of Longgang District Maternity & Child Healthcare Hospital of Shenzhen City in November 2023 was selected. A retrospective analysis was conducted to collect the clinical data of pregnant woman 1, and to summarize and analyze her clinical manifestations, diagnosis and treatment process. Chinese and English keywords including " resistance to thyroid hormone" " pregnant woman" and " resistance to thyroid hormone in pregnancy" were used to retrieve relevant literature about pregnancy complicated with SRTH from CNKI, Wanfang Data Knowledge Service Platform, PubMed and Web of Science (WoS). The retrieval period covered September 1, 2004 to July 1, 2026. The retrieved literature was systematically analyzed to summarize the clinical characteristics and key diagnosis-treatment points of pregnant women with SRTH. The protocol of this study complied with the requirements of the Helsinki Declaration of the World Medical Association revised in 2013.

①Patient 1 was a 29-year-old primipara with last menstrual period on September 17, 2023. She presented to the internal medicine outpatient department of our hospital on November 22, 2023 with a chief complaint of abnormal thyroid function for more than 10 years. Her thyroid dysfunction was first detected on physical examination more than 10 years ago, without obvious clinical manifestations, and she did not receive standardized management at that time. Six years prior to presentation, she developed goiter and prominent hypermetabolic symptoms accompanied by elevated serum free thyroxine (FT4), and was misdiagnosed with hyperthyroidism at an outside hospital. After radioactive iodine-131 therapy, her hypermetabolic symptoms resolved completely, without subsequent generalized edema or cold intolerance. During pre-pregnancy preparation in May 2021, a physical examination at another hospital revealed elevated levels of serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and FT4, while plain and contrast-enhanced pituitary MRI showed no remarkable abnormalities. Starting from March 2023, the outside hospital initiated levothyroxine (LT4) replacement therapy at a dose of 50 μg/d under the tentative diagnosis of hypothyroidism post radioactive iodine-131 ablation, with regular thyroid function monitoring. Her serum TSH remained persistently elevated despite treatment. The LT4 dosage was gradually titrated up to 175 μg/d in November 2023; dose escalation only induced a mild reduction in serum TSH while further raising serum FT4. Therefore, LT4 was discontinued in December 2023, and serum FT4 levels returned to normal after discontinuation of the drug. In March 2024, the gene test results of pregnant woman 1 showed that there was a c. 1036C>T(p.Leu346Phe) mutation (NM_001128177.1) in the thyroid hormone receptor β (THRβ) gene (chr3: 24169098), and she was diagnosed as SRTH patient. In June 2024, she delivered a male neonate vaginally at 39 weeks of gestation. Neonatal thyroid function test results were unremarkable, with only mild elevation of thyroid autoantibodies. Genetic screening of the newborn showed no pathogenic variants in the THRβ gene. The infant was followed up to 1 year of age, presenting with normal physical growth and consistently normal thyroid function. ② Literature review: Three relevant studies involving 17 pregnant women with SRTH (patients 2 to 18) were retrieved per the predefined search strategy. Together with patient 1, a total of 18 pregnant women with SRTH were included for comprehensive analysis. These 18 pregnant women had a total of 23 singleton pregnancies. Thyroid function characteristics during pregnancy: 1 case (patient 1) had synchronously elevated serum FT4 and TSH levels; 1 case (patient 2) had typical hyperthyroidism; 1 case (patient 3) had normal thyroid function; 1 case (patient 5) had mildly elevated serum FT4 in early pregnancy; and the remaining 14 patients had normal serum TSH levels and elevated serum FT4 levels. SRTH management during pregnancy: Two cases (patients 10 and 12) used LT4 to improve hypothyroidism symptoms during pregnancy; three cases (patients 2, 15, and 18) used propylthiouracil to treat hyperthyroidism; two cases (the first pregnancy of patient 7 and patient 17) used methimazole to suppress high FT4 levels; three cases (patients 6, 8, and 9) did not report SRTH management during pregnancy; and the remaining pregnancies did not receive any SRTH-targeting drug treatment. Pregnancy outcomes: Except for stillbirth in the first pregnancy of patient 7, preterm birth in patient 2 and the second pregnancy of patient 14, and no reported pregnancy outcomes in four cases (patients 6, 9-11), all other pregnancies had good outcomes. Neonatal thyroid function: Except for elevated serum TSH levels in newborns delivered by patient 7 in the second pregnancy, patient 14 in their first and second pregnancies and patients 16 and 17, and no reported thyroid function in newborns delivered by patients 6, 9-11, and the first pregnancy of patient 7, all other newborns had normal thyroid function.

Pregnant woman with SRTH is relatively rare, and its pathogenesis is not yet clear, but often accompanied by THRβ gene abnormalities. For pregnant women with suspected SRTH, thorough medical history collection combined with auxiliary examinations is required to guide individualized targeted treatment. Regular prenatal surveillance is essential for dynamic disease assessment throughout gestation of SRTH pregnant woman. Postpartum comprehensive thyroid function screening should be completed for all neonates born to mothers with SRTH.

To investigate the mechanism of microRNA-383 (miR-383) in regulating soluble fms-like tyrosine kinase-1 (sFlt-1)-mediated phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway in the development of preeclampsia (PE).

A total of 58 pregnant women with PE who delivered at the Department of Obstetrics of Hainan Western Central Hospital from January to December 2022 were selected as the study subjects. They were included into the severe PE group (n=29) and mild PE group (n=29) according to the severity of PE. Twenty-nine healthy pregnant women who were hospitalized and delivered in the same hospital during the same period were enrolled as controls and assigned to control group 1. In parallel, 12 specific pathogen-free (SPF) healthy female pregnant Kunming mice on day 5 of gestation were selected as the study subjects and randomly included in the following groups: model + transfection group 1 [n=3, mice were first treated with tail vein injection of phosphatidylserine (PS)/phosphatidylcholine (PC) emulsion microdroplets to establish a PE-like pathological model, and then administered with the miR-383 mimics transfection complex], model + transfection group 2 (n=3, mice were first treated with tail vein injection of PS/PC emulsion microdroplets to establish a PE-like pathological model, and then administered with the NC agomir mimics transfection complex), model group (n=3, mice were first treated with tail vein injection of PS/PC emulsion microdroplets to establish a PE-like pathological model, and then administered with saline), and control group 2 (n=3, treated with tail vein injection of saline). Serum sFlt-1 protein levels in the three groups of pregnant women and four groups of pregnant mice were measured by enzyme-linked immunosorbent assay (ELISA). The relative expression levels of miR-383 and sFlt-1 mRNA in placental tissues from the three groups of pregnant women and four groups of pregnant mice were determined by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR). The relative protein expression levels of PI3K, phosphorylated PI3K (p-PI3K), Akt, and phosphorylated Akt (p-Akt) in placental tissues of four groups of pregnant mice were measured by Western blot. One-way ANOVA method was used to statistically compare the above examination results of the three groups of pregnant women and the four groups of pregnant mice. Further pairwise comparisons were performed using the Student-Newman-Keuls q test. This study was approved by the Ethics Committee of Hainan Western Central Hospital (Approval No. LLKY-2023-10), and written informed consents were obtained from all pregnant women. There were no statistically significant differences in general clinical data, including maternal age, proportion of primiparas and multiparas, and ethnicity, among the three groups of pregnant women (all P>0.05).

① There were statistically significant differences among the three groups of pregnant women in systolic blood pressure, diastolic blood pressure, gestational age at delivery, and 24-hour urinary protein levels (F=214.94, 226.74, 9.40, 449.76; all P<0.001). ② Serum sFlt-1 protein levels in the pregnant women of severe PE group, mild PE group, and control group 1 were (2 941.3±490.1), (2 189.5±455.3), and (1 409.1±318.1) ng/L, respectively, with a statistically significant difference among the three groups (F=93.08, P<0.001). Further pairwise comparisons revealed that serum sFlt-1 protein levels were highest in the severe PE group, followed by the mild PE group and the control group 1, and all the differences were statistically significance (all P<0.001). ③ The relative expression levels of miR-383 and sFlt-1 mRNA in placental tissues of the three groups of pregnant women were compared overall, respectively, and both the differences were statistically significant (P<0.001). Further pairwise comparisons showed that the relative expression levels of miR-383 were lowest in the severe PE group, followed by the mild PE group and the control group 1, while the relative expression levels of sFlt-1 mRNA were highest in the severe PE group, followed by the mild PE group and the control group 1, and all the differences were statistically significant (all P<0.05). ④ Overall comparison of serum sFlt-1 protein levels among the four groups of pregnant mice revealed a statistically significant difference (F=136.49, P<0.001). Further pairwise comparisons showed that the model + transfection group 1 had had significantly lower serum sFlt-1 protein level than the model + transfection group 2 and model group, control group 2 had significantly lower serum sFlt-1 protein levels than the other three groups, and with all differences being statistically significant (all P<0.001). ⑤ Overall comparisons of relative expression levels of placental miR-383 and sFlt-1 mRNA among the four groups of pregnant mice showed statistically significant differences (both P<0.001). Further pairwise comparisons revealed that, for miR-383 expression, model + transfection group 1 had significantly higher levels than the other 3 groups, and the control group 2 had higher level than the model + transfection group 2 and the model group, and all the differences were statistically significant (all P<0.001). For sFlt-1 mRNA expression, the model + transfection group 1 had significantly lower level than the model + transfection group 2 and the model group, and the control group 2 had lower level than the other three groups, and all the differences were statistically significant (all P<0.001). ⑥ Overall comparisons of relative expression levels of placental PI3K, p-PI3K, Akt, and p-Akt protein among the four groups of pregnant mice showed statistically significant differences (all P<0.001). Further pairwise comparisons demonstrated that the model + transfection group 1 had significantly higher levels of these four proteins than the model + transfection group 2 and the model group, the control group 2 had higher levels of these four proteins than the other three groups, and all the differences were statistically significant (all P<0.05).

miR-383 and sFlt-1 play important roles in the pathogenesis of PE in pregnant mice and women. Downregulation of miR-383 leads to upregulation of sFlt-1, which in turn mediates the downregulation of the PI3K/Akt signaling pathway, thereby contributing to the onset and progression of PE in pregnant mice and women.

Congenital disorders of glycosylation (CDG) are a group of inherited diseases caused by abnormalities in the glycosylation of proteins, lipids, or glycosylphosphatidylinositol anchors. CDG may contribute to epileptogenesis through multiple pathways, including impaired neurodevelopment, altered ion channel and receptor function, disrupted synaptic transmission, cellular stress, and neuroinflammation. Some CDG-related epilepsies may manifest as early-onset, drug-resistant developmental and epileptic encephalopathy (DEE). Their pathogenesis is thought to be associated with glycosylation defects that disrupt multiple cellular and molecular processes, including neuronal membrane integrity, signaling pathways, synaptic transmission, neurodevelopment, and metabolism, often accompanied by multisystem involvement. Recent studies have shown that glycosylation abnormalities may not only participate in the pathogenesis of CDG-related epilepsy, but seizure-related changes in glycosylation modifications in brain tissue may also affect synaptic plasticity and the stability of local neural circuits. As brain networks in children are still undergoing development and remodeling, these changes may be associated with phenotypic evolution and long-term neurodevelopmental outcomes; however, direct clinical evidence remains limited. This review summarizes the pathogenic mechanisms, age-related clinical features, diagnostic strategies, etiology-directed treatment, long-term management, and prognostic evaluation of CDG-related pediatric epilepsy, with the aim of providing a reference for clinicians in early recognition, stratified diagnosis and treatment, and long-term management of this condition.

To explore the correlation between visceral fat area(VFA) and the occurrence of incisional hernia after colorectal cancer surgery.

A retrospective analysis was conducted on the clinical data of 246 patients who underwent laparoscopic radical resection for colorectal cancer in the Sixth Affiliated Hospital of Sun Yat-sen University in 2020. Patients were divided into groups according to the occurrence of incisional hernia, and multivariate analysis was performed to identify the risk factors for incisional hernia. According to VFA, patients were classified into the high-fat group (VFA≥130 cm²) and the low-fat group (VFA<130 cm²). Propensity score matching (PSM) method was adopted with a 1:1 matching ratio, using seven indicators including age, gender, body mass index, preoperative neoadjuvant chemotherapy, postoperative surgical site infection, diabetes mellitus, and cardiovascular disease as covariates, and the matching tolerance was set at 0.02. Eventually, 49 pairs of patients were successfully matched, and the incidence of incisional hernia was compared between the two groups.

Multivariate analysis showed that incision infection (OR=15.807, 95% CI 3.372-74.095, P<0.001) and VFA≥130 cm² (OR=2.487, 95% CI 1.249-4.951, P=0.010) were independent risk factors for incisional hernia. After PSM, the baseline data of the two groups were balanced and comparable (P>0.05). The incidence of incisional hernia in the high-fat group (46.9%) was significantly higher than that in the low-fat group (22.4%), with a statistically significant difference (OR=3.06, P=0.01).

VFA≥ 130 cm² is an important risk factor for incisional hernia after colorectal cancer surgery. Prophylactic mesh placement may reduce the risk of incisional hernia in such patients.

To explore the short-term clinical feasibility of laparoscopic trans- abdominal preperitoneal hernia repair (TAPP) combined with laparoscopic inguinal canal posterior wall reconstruction based on the Bassini principle (transabdominal preperitoneal Bassini, TAPB) in the treatment of inguinal hernias at high risk of recurrence.

A retrospective analysis was conducted on the clinical data of 20 patients with inguinal hernias at high risk of recurrence who were admitted to the Department of General Surgery, the Second People's Hospital of Futian District, Shenzhen, from September 2025 to January 2026. All patients underwent TAPP combined with TAPB. Synthetic mesh or biological mesh was selected individually according to patients' age, hernia classification, characteristics of abdominal wall defect, and clinical needs. Transversus abdominis plane block was performed intraoperatively in all patients, and standardized analgesia was administered postoperatively. The operation time, blood loss, visual analogue scale (VAS) scores, hospital stay, perioperative complications, and short-term hernia recurrence rate were uniformly observed and recorded.

All 20 patients completed the surgery successfully without conversion to open surgery. The operation time was (133±49) minutes, intraoperative blood loss was (2±1) ml, and postoperative hospital stay was (4±2) days. The VAS scores on the day of surgery and the first postoperative day were both (2±1) points, indicating a mild degree of pain. One case of inferior epigastric vein injury occurred intraoperatively, which was treated with Hemolock clipping for hemostasis and had a good prognosis. No severe perioperative complications were observed. All patients completed 3-9 months of follow-up, and no hernia recurrence was observed during the follow-up period.

TAPP combined with laparoscopic inguinal canal posterior wall reconstruction based on the Bassini principle is safe and feasible in the short term, which can provide a minimally invasive treatment option for clinical practice. The long-term efficacy and safety need to be further verified by prospective studies with larger sample sizes and longer follow-up periods.

To investigate the impact of the waterproof properties of α-cyanoacrylate isobutyl ester medical adhesive on postoperative incision management and early quality of life in patients undergoing laparoscopic tension-free inguinal hernia repair.

The study included 40 adult patients who underwent elective laparoscopic tension-free inguinal hernia repair at the Seventh Affiliated Hospital of Sun Yat-sen University between December 2025 and March 2026. The patients were divided into an observation group (n=20, with incisions closed using α-cyanoacrylate isobutyl ester medical adhesive) and a control group (n=20, with incisions closed using traditional interrupted sutures). Patients in the observation group were permitted to shower starting on the third postoperative day, while those in the control group had their sutures removed on the seventh postoperative day and were permitted to shower starting on the eighth day. Postoperative incision healing, complication rates, scores on each dimension of the 1-month postoperative SF-36 health status questionnaire, and satisfaction with incision care were compared between the two groups.

Postoperative incisions in both groups achieved Grade A healing, with no cases of deep infection, seroma, or incision dehiscence; there was no statistically significant difference in the overall incidence of incision complications between the two groups (P>0.05). One month postoperatively, the observation group had higher scores on the SF-36 questionnaire in the physical health, physical function, physical pain, and social function than those of the control group, with statistically significant differences [(85.5±3.9) points vs (81.5±3.9) points, (87.5±4.0) points vs (84.6±4.0) points, (85.4±3.0) points vs (83.2±3.0) points, (85.4±3.0) points vs (83.2±3.0) points; all P<0.05].

The use of α-cyanoacrylate isobutyl ester medical adhesive in laparoscopic tension-free inguinal hernia repair creates a reliable waterproof barrier at the surgical incision site. This allows for safe and feasible showering in the early postoperative period without increasing the incidence of incision complications. It significantly simplifies nursing procedures and improves patients' quality of life in the early postoperative period, aligning with the principles of enhanced recovery after surgery.

To preliminarily explore the efficacy and safety of posterior sheath posterior approach single-incision laparoscopic totally extraperitoneal mesh repair (SIL-TEP) in the treatment of inguinal hernia.

From May 2024 to August 2024, 20 patients with inguinal hernia who underwent posterior sheath posterior approach SIL-TEP at the First Affiliated Hospital of Wannan Medical College were selected. We collected and analyzed the clinical data of these patients, standardized and statistically analyzed the clinical data, and shared surgical experiences and insights.

Among the 20 patients, 16 were male and 4 were female, with an average age of (68.10±10.32) years. All patients had unilateral indirect inguinal hernia (9 cases on the right side and 11 cases on the left side). All operations were completed successfully, with an average operation time of (55.85±15.89) min and an average intraoperative blood loss of (3.85±1.13) ml. The average time to get out of bed after surgery was (22.50±8.87) h. All patients had mild pain after surgery, with a visual analogue scale (VAS) score of (1.20±0.52) points on the first day after surgery. The average postoperative hospital stay was [1(1, 1)] d. No postoperative complications occurred. During an average follow-up period of 14.5 months (ranging from 13 to 16 months), there was no hernia recurrence, chronic pain, mesh infection, or incisional hernia.

The posterior sheath posterior approach SIL-TEP is a safe, effective, and reliable surgical method for inguinal hernia, which is worthy of promotion.

To observe the clinical efficacy and safety of laparoscopic preperitoneal hernia repair (TAPP) in the treatment of elderly patients with acute incarcerated inguinal hernia.

This retrospective controlled clinical study included 80 elderly patients with acute incarcerated inguinal hernia who were admitted to the Department of Emergency Medicine, Lianyungang Hospital of Jiangsu Provincial Hospital of Traditional Chinese Medicine, from April 2022 to June 2025. The surgical approach was determined by the physician in charge based on a comprehensive assessment of each patient's clinical condition, and informed consent was obtained from all patients. According to the surgical approach, the patients were divided into the control group, which underwent conventional open tension-free hernia repair (n=38), and the experimental group, which underwent TAPP (n=42). Surgical-related indicators, early postoperative pain scores, stress indicators, gastrointestinal function recovery, intestinal mucosal barrier function indicators, and postoperative complications were compared between the two groups.

Both groups of patients successfully underwent surgery and completed the 3-month follow-up and no drop-out cases were found. The operation time, the time of the first postoperative ambulation, and the postoperative hospital stay in the experimental group were all shorter than those in the control group, and the differences were statistically significant (P<0.05). The visual analogue scale scores for pain in the experimental group on the 1st day, 1st week, and 3rd month after surgery were lower than those in the control group, and the differences were statistically significant (F=0.816, P=0.041). On the 1st day after surgery, the levels of substance P and neuropeptide Y in both groups decreased significantly compared to those before the operation, and the levels in the experimental group were lower, with statistically significant differences (P<0.05). The first defecation time and the recovery time of bowel sounds in the experimental group were better than those in the control group, and the differences were statistically significant (P<0.05). The levels of epinephrine, cortisol, and serum malondialdehyde in both groups significantly increased on the 1st day after surgery, but the levels in the experimental group were lower than those in the control group, with statistically significant differences (P<0.05). The levels of diamine oxidase and serum D-lactic acid in both groups significantly decreased on the 1st day after surgery, and the levels in the experimental group were lower than those in the control group, with statistically significant differences (P<0.05). There were no cases of partial intestinal obstruction or recurrence of hernia in both groups. The complication and recurrence rates between groups were 11.90% (5/42) and 7.89% (3/38), there was no statistically significant difference (Fisher's exact test, P=0.715).

Compared with conventional open surgery, TAPP is superior in alleviating early postoperative pain and stress response and promoting gastrointestinal function recovery in elderly patients with acute incarcerated inguinal hernia, while providing comparable safety.

To investigate the analgesic efficacy of artificial intelligence- patient-controlled analgesia (Ai-PCA) versus conventional analgesia in patients undergoing laparoscopic inguinal hernia repair, and to systematically analyze the differences between these two analgesic modalities in terms of pain control, analgesia-related complications, and early postoperative recovery.

This study was a retrospective cohort study. A total of 60 patients who underwent laparoscopic TAPP repair with postoperative intravenous patient-controlled analgesia (PCA) and complete medical records in the Department of Hernia and Abdominal Wall Surgery, Peking University First Hospital Taiyuan Hospital between July 2025 and January 2026 were selected. Based on the postoperative analgesia protocol, patients were divided into an intelligent analgesia group (using an AI-PCA smart analgesia pumps, n=30) and a conventional analgesia group (using a traditional electronic PCA pumps, n=30). Visual Analog Scale (VAS) scores for pain and discomfort, analgesia-related complications (nausea, vomiting, dry mouth, etc.), postoperative rehabilitation indicators, and patient satisfaction were compared between the two groups.

Repeated measures ANOVA revealed that the VAS scores for pain and discomfort at 2, 6, 12, 24, and 48 hours postoperatively were significantly lower in the intelligent analgesia group compared with the conventional analgesia group (Between-group F=32.15, 42.68; both P<0.05; and partial η² for between- group effects=0.358, 0.422). In the intelligent analgesia group, the overall incidence of analgesia-related complications was 13.33% (4/30), which was significantly lower than that in the conventional analgesia group (43.33%, 13/30) (P<0.05; Cramer's V=0.333). The time to first flatus, the time to first ambulation, and the length of hospital stay in the intelligent analgesia group were all significantly shorter than those in the conventional analgesia group, with statistically significant differences (P<0.05; Cohen's d=1.78, 1.43, and 0.97, respectively). Patient satisfaction in the intelligent analgesia group was higher than that in the conventional analgesia group (P<0.05; Cramer's V=0.268).

The application of an intelligent analgesia system after inguinal hernia repair can effectively control postoperative pain, enhance postoperative comfort, reduce the incidence of postoperative analgesia-related complications, accelerate early patient recovery, and significantly improve patient satisfaction.