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 evaluate the incidence of cytomegalovirus (CMV) infection in the early postoperative period following pediatric heart transplantation, and to explore the association between CMV infection and peripheral blood lymphocyte subsets.

A retrospective study analyzed 60 pediatric recipients who underwent heart transplantation between 2021 and 2024 in Fuwai Hospital, Chinese Academy of Medical Sciences. The recipients could be categorized into two groups depending on CMV-DNAemia occurred in the early postoperative period (within 180 days) following pediatric heart transplantation (CMV infection group, n=24; non- CMV infection group: n=36), and the differences of lymphocyte subsets (CD4⁺ T cells, CD8⁺ T cells, CD4⁺ /CD8⁺ ratio, CD19⁺ B cells, CD56⁺ NK cells) were compared at different time points (preoperation, postoperative 1, 3, 7, 14, 30, 90, 180 days). The recipients could be categorized into two groups depending on pretransplant serologic recipient CMV status (CMV-IgG positive group, n=47; CMV-IgG negative group, n=13), and the differences of CMV infection incidence were compared. For the comparison between groups, the Wilcoxon rank-sum test was used for non-normally distributed continuous data, and the chi-square test was used for categorical data. P<0.05 was considered statistically significant.

The incidence of postoperative CMV infection was 40.0% (24/60) in the early postoperative period following pediatric heart transplantation, and more common at 30-90 days. There were no statistically significant differences in preoperative general data (age, weight, height, BMI, disease type, degree of heart failure, immunosuppressive therapy, and length of stay) between infection and non-infection groups (χ²/Z=0.188, -0.417, -0.294, -0.936, -0.589, 1.405, 0.188, 0.262, and -1.238; all P>0.05). The CD4⁺ /CD8⁺ ratio in the CMV infection group was lower at 180 days after surgery (Z=-2.233), and the absolute value of CD56⁺ NK cells was higher (Z=-2.414, -2.535), and the differences were statistically significant (all P<0.05). The proportion of positive CMV DNAemia in the preoperative CMV-IgG positive group and the negative group was 17/47 and 7/13, respectively, and there was no statistically significant difference (χ²=1.326, P>0.05).

CMV infection is common in pediatric heart transplantation. A decrease in the CD4⁺ /CD8⁺ ratio in pediatric recipients with early CMV infection indicates the immunosuppression. Recipients with negative pre-transplant CMV-IgG antibody have a higher risk of CMV infection after surgery. Children who have undergone heart transplantation can have their lymphocyte subsets regularly monitored to assess their immune function and predict the risk of CMV infection.

To investigate the current status of antimicrobial stewardship (AMS) in kidney transplant centers and provide a reference for further standardizing the rational use of antimicrobial agents.

From April 4 to May 12, 2023, an online survey was conducted for clinical pharmacists specializing in kidney transplantation from 50 hospitals of the National Alliance of Transplant Pharmacists to collect information on AMS-related practices in their respective hospitals and kidney transplant centers. A questionnaire on the current status of AMS in kidney transplant centers was designed and distributed via the " Wenjuanxing" platform. The content included basic information about the responding pharmacists and their hospitals, evaluation indicators and completion status of clinical application management of antimicrobial agents, intervention measures taken by pharmacists and the effectiveness, as well as the rationality evaluation and suggestions from pharmacists on the perioperative infection prevention protocols for kidney transplantation.

A total of 23 transplant pharmacists from 23 teaching hospitals with Grade IIIA participated in the survey. AMS was implemented in 21 hospitals (91.3%), while only 10 hospitals (43.5%) had AMS programs in renal transplant centers. There were substantial differences in the target values for antimicrobial use intensity among the centers, and 5 centers (21.7%) failed to reach the standard. Twenty-two pharmacists had implemented interventions to improve the rational use of antimicrobial agents. Specific interventions included: training programs (19 cases, 86.4%), administrative interventions (12 cases, 54.5%), and the use of rational medication software to support AMS management (6 cases, 27.3%). The effects of interventions were mainly reflected as: shortened treatment courses (18 cases, 81.8%), adjustment of drug choice (12 cases, 54.5%), reduction in the number of combined antimicrobial agents (11 cases, 50.0%), and decreased dosage (6 cases, 27.3%). Twelve pharmacists (52.2%) approved of the current routine infection prophylaxis protocols for kidney transplantation in their centers, however, evaluations of the same protocol varied among different pharmacists.

The implementation rate of AMS in kidney transplant centers in China remains low, and there are substantial differences in AMS goals and implementation. High-quality studies are needed to explore homogeneous management strategies to standardize the rational use of antimicrobial agents.

To investigate the effects of double plasma exchange (DFPP) and plasma exchange (PE) on the clearance efficiency of blood group antibodies, and long-term therapeutic outcomes in the recipients of ABO-incompatible living donor kidney transplantation (ABOi-LDKT).

A retrospective analysis was conducted on clinical data of 14 ABOi-LDKT recipients who underwent sole PE pretreatment and 18 ABOi-kidney transplant recipients who underwent sole DFPP pretreatment at the First Hospital of Jilin University from March 2021 to September 2023. Both groups received regular follow-up for 12 months, and the clearance efficiency of blood group antibodies, incidence of adverse reactions during plasma pretreatment, levels of IgG and IgM blood group antibodies, renal function, coagulation indicators, acute antibody-mediated rejection (AMR), and infection rates were analyzed.

The PE group and DFPP group underwent 39 and 51 plasma pretreatments, respectively, with no severe complications occurring after transplantation. Compared with the DFPP group, the PE group had a shorter single treatment duration but higher single plasma consumption. The DFPP group outperformed the PE group in terms of single plasma pre-processing volume and body weight-corrected single plasma pre-processing volume, with statistically significant differences (Z=-5.006, t=45.64, -26.16, and -9.16, all P<0.05). The titers of IgG and IgM in both groups were markedly reduced after plasma pretreatment, IgG clearance efficiencies of the PE group and the DFPP group were 0.62±0.14 and 1.08±0.67, respectively, and IgM clearance efficiencies were 1.05±0.47 and 1.23±0.75, with no statistically significant differences (all P>0.05). The incidence of adverse reactions in the PE and DFPP groups was 42.9% (6/14) and 44.4% (8/18), respectively (P>0.05). No significant difference in coagulation parameters was observed between the PE and DFPP groups before plasma pretreatment; however, significant differences emerged at transplantation. The levels of serum creatinine and estimated glomerular filtration rate showed no statistically significant differences between the two groups of recipients before plasma pretreatment and at various time points after transplantation. Within 12 months post-transplantation, two cases of AMR occurred in the PE group, while no cases were observed in the DFPP group, and the infection rates in the PE group and DFPP group were 42.9% (6/14) and 33.3% (6/18), respectively (P>0.05).

Both DFPP and PE pre-treatment significantly reduced blood group antibody titers in ABOi-LDKT recipients, with long-term improvements in blood creatinine and glomerular filtration rate. However, the DFPP group exhibited more significant impacts on coagulation indicators. Supplementing fibrinogen and monitoring coagulation function can further ensure the safety of transplantation.

To compare the preservation efficacy of a novel ex vivo organ preservation solution (Solution A) was compared with that of University of Wisconsin solution (UW solution) and hypertonic citrate adenine solution (HCA solution) on isolated rat kidneys.

The physicochemical properties and stability of the novel ex vivo organ preservation solution developed at our center were validated by measuring its ion concentration, pH value, and osmolality. The cytotoxicity and apoptosis effects of Solution A on human embryonic renal epithelial cell line (293T) and renal tubular epithelial cells (HK-2) were investigated using the CCK-8 assay. A rat kidney donor model was established. A total of 30 kidneys from 15 rats were randomly divided into three groups (UW solution group, HCA solution group, and Solution A group) using a random number table method, with 10 kidneys in each group. The isolated kidneys were placed in the corresponding preservation solutions, and renal tissue samples were collected at 0, 6, 12, 24, 48, and 72 hours. Histopathological damage was assessed by HE staining, ATPase activity and malondialdehyde (MDA) content were determined using colorimetric assays. Apoptosis was quantitatively analyzed by TUNEL staining, and the expression of apoptosis-related proteins (Caspase-3, Cleaved Caspase-3, Bax, Bcl-2) as well as inflammatory factors (HO-1, TNF-α) was detected by Western blotting. All experimental data were obtained from at least three indepent replicates. Comparisons of experimental data among multiple groups were performed using analysis of variance (ANOVA), followed by pairwise comparisons using Dunnett′s test. A P value <0.05 was considered statistically significant.

In vitro experiments demonstrated that the cell viability of the Solution A group was significantly higher than that of the UW solution group and lower than that of the HCA solution group (all P<0.05). In vitro rat kidney preservation experiments showed that at 48 hours of preservation, the degree of tubular vacuolization in the Solution A group was significantly lower than that in the HCA solution group (P<0.05), but no statistically significant difference was observed compared to the UW solution group (P>0.05). For oxidative stress indicators, the ATPase activity of the Solution A group was significantly higher than that of the UW solution and HCA solution groups at 48 and 72 hours of preservation (all P<0.05). In addition, the MDA accumulation rate in the Solution A group was lower than that in the HCA and UW solution groups, and the MDA content at 48 and 72 hours (0.27%, 0.28%) was significantly lower than that of the HCA solution group (0.42%, 0.42%) (all P<0.05). After 24 hours of preservation, the Solution A group exhibited a significantly lower TUNEL apoptosis index and a higher Bcl-2/Bax ratio compared with the HCA solution group (all P<0.05), as well as a lower relative expression level of Cleaved Caspase-3 protein compared with both the UW and HCA solution groups (P<0.05). In terms of inflammatory factors, the TNF-α expression level in the Solution A group was significantly lower than that in the HCA solution group (P<0.05), and the HO-1 expression level was significantly lower than that in both the UW and HCA solution groups (P<0.05).

The novel organ preservation solution exhibited renal protective potential comparable to, or even better than, that of commercially available classic preservation solutions within 48 hours in rats. Under prolonged preservation conditions up to 72 hours, the novel solution further exhibited excellent renal protective efficacy by maintaining ATPase activity, reducing MDA content, and regulating apoptosis-related pathways.

As a key component of the innate immune system, natural killer (NK) cells play a central role in human immune defense, and immunomodulatory agents and immunosuppressive regimens administered to organ transplant recipients may significantly affect their functions and biological effects. Clarifying the dual roles of NK cells and the potential impact of immunosuppressive therapies on their functions is particularly critical for infection prevention and management in this patient population. This review comprehensively explores the multifaceted involvement of NK cells in transplantation immunology, evaluates the effects of immunosuppression on NK cell activity, and provides valuable references for future studies focusing on the anti-infective capabilities of NK cells and their roles in immune signaling pathways in the context of transplantation medicine.

A scoping review of physical activity among liver transplant recipients was conducted to examine the current status, influencing factors, measurement tools and intervention methods, thereby providing a reference basis for improving patients′ physical activity levels.

This scoping review was conducted in accordance with the PRISMA extension for scoping reviews. The following databases were searched up to December 15, 2025: PubMed, the Cochrane Library, Scopus, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data, VIP Database, China Biomedical Literature Service System. Literature screening, summarization, and analysis were collaboratively conducted by two researchers.

A total of 29 articles were included. Two assessment tools were identified, including the International Physical Activity Questionnaire and wearable devices. The factors influencing patient physical activity included demographic, physiological, psychological and other factors. The intervention methods included preoperative prehabilitation, postoperative exercise interventions, and information-based exercise intervention technologies.

Insufficient physical activity is a prevalent issue among liver transplant recipients, influenced by multiple factors. It is necessary to strengthen the research on localized measurement tools, timely identify liver transplant recipients with insufficient physical activity. The existing intervention strategies are characterised by a lack of standardised protocols, brief follow-up periods, and inadequate exercise adherence.

To assess the intraoperative and postoperative safety and efficacy of robotic-assisted sleeve gastrectomy combined with fundoplication and hiatal hernia repair (SGFD+HHR).

This single-center retrospective cohort study included 76 patients with obesity and hiatal hernia who underwent either robotic-assisted or laparoscopic SGFD+HHR at the People's Hospital of Xinjiang Uygur Autonomous Region between January 2020 and July 2024. The patients were divided into a laparoscopic group (n=51) and a robotic group (n=25) based on the surgical approach. Perioperative parameters, postoperative weight loss efficacy, complication rates, Gastroesophageal Reflux Disease Questionnaire (GerdQ) scores, and reflux improvement were compared between the two groups.

There were no statistically significant differences between the two groups in baseline characteristics, operative duration, time to meeting discharge criteria, body weight and body mass index at baseline and 6 and 12 months postoperatively, percentage of excess weight loss (%EWL), percentage of total weight loss (%TWL) at 6 and 12 months postoperatively, the incidence of early and long-term postoperative complications, GerdQ score, or reflux improvement at 12 months postoperatively (all P>0.05). However, the robotic group had less intraoperative blood loss than the laparoscopic group (Z=-3.913, P<0.001). In both groups, GerdQ scores at 12 months postoperatively were significantly lower than baseline scores (Z=-3.650 and -3.611, respectively; both P<0.001).

For patients with obesity and hiatal hernia, both robotic-assisted and laparoscopic SGFD+HHR achieved satisfactory weight loss and anti-reflux outcomes. No significant differences were observed between the two approaches in postoperative weight loss efficacy or complication rates, whereas robotic-assisted surgery was associated with reduced intraoperative blood loss.

To evaluate the clinical value and significance of the "3+2+1" anatomical dissection and suturing strategy in totally robotic hiatal hernia repair combined with fundoplication.

This is a single-center retrospective observational study. A total of 52 patients with gastroesophageal reflux disease (GERD) who underwent totally robotic hiatal hernia repair combined with fundoplication at the Department of General SurgeryⅡ, Yan'an Hospital Affiliated to Kunming Medical University, from January to December 2025 were enrolled. All procedures were performed using the "3+2+1" anatomical dissection and suturing strategy. Perioperative indicators, postoperative symptom improvement, and patient satisfaction were analyzed.

All surgeries were completed successfully without conversion to open surgery or complications, with 100% patient satisfaction. The mean robotic operating time was (82.03±32.91) minutes, intraoperative blood loss was 5 (5,5) ml, and postoperative hospital stay was (3.80±1.70) days. Gastroesophageal reflux disease questionnaire and gastroesophageal reflux disease-health related quality of life scores at 1, 3, 6, and 12 months postoperatively were significantly lower than preoperative values (all P<0.001).

Totally robotic hiatal hernia repair combined with fundoplication utilizing the "3+2+1" anatomical dissection and suturing strategy is safe and reliable, effectively alleviating reflux symptoms in patients with GERD, promoting rapid recovery, and achieving high patient satisfaction.

To share and discuss the surgical safety and clinical experience of the robotic "3+1" mode in hiatal hernia repair.

This study was a single-center retrospective case series. A total of 145 patients who underwent da Vinci robot-assisted laparoscopic hiatal hernia repair in the Department of Minimally Invasive, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, from January 2022 to January 2025 were included. All patients underwent trocar placement using the "3+1" mode, and the operations were completed accordingly. Postoperative improvement, hernia recurrence, and complications were followed up through outpatient appointments, online consultations, and telephone calls. The follow-up deadline was December 2025.

All 145 patients successfully underwent robot-assisted laparoscopic hiatal hernia repair combined with fundoplication, without conversion to open abdominal or thoracic surgery. Among them, 137 patients underwent Nissen fundoplication, 2 underwent Dor fundoplication, and 6 underwent Toupet fundoplication. The mean hernia defect area was (47.5±17.3) cm², the mean operative time was (67.5±18.8) min, the mean intraoperative blood loss was (15.0±5.0) ml, the mean postoperative hospital stay was (6.5±2.5) days, and the mean surgical cost was RMB (6.8±1.0)×10⁴ yuan. The mean postoperative follow-up duration was (30.5±7.5) months. Postoperative symptoms such as acid reflux, heartburn, and chest pain were markedly improved compared with those before surgery. During follow-up, no pleural effusion, pulmonary infection, wound infection, or recurrence was observed.

Robot-assisted hiatal hernia repair using the robotic "3+1" mode has high surgical safety. The trocar placement method is simple, standardized, highly reproducible, and highly operable.

To investigate the feasibility of preserving the hepatic branch of the vagus nerve during laparoscopic hiatal hernia repair combined with fundoplication and its effect on postoperative gallbladder function.

This retrospective cohort study included 73 patients with gastroesophageal reflux disease complicated by hiatal hernia who underwent laparoscopic hiatal hernia repair in the Department of General Surgery, Shenzhen Hospital, Southern Medical University, from January 2019 to December 2023. Seventeen patients who underwent other concomitant procedures and two patients with recurrent hernia or type IV hernia were excluded. The remaining 54 patients were divided into the hepatic branch of the vagus nerve preservation group (n=17) and the hepatic branch of the vagus nerve resection group (n=37) according to whether the hepatic branch of the vagus nerve was preserved during surgery. Operative time, intraoperative blood loss, length of hospital stay, postoperative complications, and other indicators were compared between the two groups. All patients underwent routine outpatient follow-up at 1, 6, 12, and 36 months after surgery, and abdominal ultrasonography or computed tomography (CT) was performed to monitor gallbladder status. The incidence of gallstones was recorded.

There were no statistically significant differences between the hepatic branch of the vagus nerve preservation group and the resection group in operative time, intraoperative blood loss, length of hospital stay, or complications (P>0.05). In the hepatic branch of the vagus nerve resection group, two cases of asymptomatic gallstones were detected at the 6-month postoperative follow-up. With prolonged follow-up, the number of patients with gallstones increased. At the 3-year follow-up, gallstones were detected in nine patients (24.30%). No imaging evidence of gallstones or other gallbladder lesions was observed in the remaining patients. At 3 years after surgery, the incidence of gallstones in the hepatic branch of the vagus nerve resection group was significantly higher than that in the hepatic branch of the vagus nerve preservation group (24.30% vs. 0.0%), and the difference was statistically significant (P<0.05).

Preserving the hepatic branch of the vagus nerve during laparoscopic hiatal hernia repair combined with fundoplication is feasible. In the short term, it may reduce the impact on gastrointestinal function and facilitate postoperative recovery. In the long term, it may help reduce the formation of gallstones; however, whether this effect is attributable to preservation of the hepatic branch of the vagus nerve requires further investigation.

To explore the mid-term efficacy of laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia.

This study is a retrospective case series study. A total of 62 patients with typeⅢ hiatal hernia who underwent laparoscopic hiatal hernia repair with synthetic mesh in the Center for Obesity and Hernia Surgery , Department of General Surgery, Huashan Hospital, Fudan University from January 2017 to December 2023 were included. The perioperative conditions, postoperative complications, and follow-up results of the patients were analyzed.

All 62 patients successfully completed laparoscopic surgery without conversion to open surgery. The average operation time was (114.5±35.7) minutes, and the average postoperative hospital stay was 5.0(4.0, 6.0) days. The average follow-up period was (72±24.6) months. The GerdQ score after surgery was significantly lower than that before surgery [(6.4±1.0) points vs (8.6±2.1) points, P<0.05], and the number of patients requiring proton pump inhibitor treatment significantly decreased (7 vs 41). The postoperative anatomical recurrence rate was 8.2% (5/61), the symptom recurrence rate was 8.2% (5/61), and the incidence of dysphagia was 16.4% (10/61). Patient-related factors were not significantly correlated with recurrence or dysphagia.

Laparoscopic repair with synthetic mesh for type Ⅲ hiatal hernia is safe and feasible. It can effectively improve clinical symptoms, and reduce the risk of recurrence.

To investigate the influence of an intervention model based on Orem's self-care theory on postoperative self-efficacy, pain, and psychological status in patients with hiatal hernia (HH).

This study adopted a retrospective cohort design to select 96 HH patients who were admitted to Bainiaohu Hospital and Xinjiang Uygur Autonomous Region People's Hospital from July 2024 to June 2025 as the research subjects. These patients were divided into the control group and the experimental group, with 48 cases in each group, based on the different intervention methods. The control group received routine nursing care, while the experimental group was given an intervention model based on Orem's self-care theory for 1 week. Paired-sample and independent-sample t-tests were used to compare self-efficacy, pain intensity, psychological status, and self-care ability within and between the two groups before and after the intervention.

After 1 week of intervention, the experimental group had significantly higher general self-efficacy scale (GSES) score (28.48±4.14) points and exercise of self-care agency (ESCA) score (102.54±13.07) points than the control group GSES score (25.38±3.87) points, ESCA score (95.21±11.36) points (t=3.790, 2.933, both P<0.05). The changes in GSES and ESCA scores from baseline to post-intervention were compared between the two groups. The corresponding values were (5.02±3.02) vs (9.06±4.42) points and (7.67±5.78) vs (16.04±13.85) points, with statistically significant differences (t=5.229, 3.864; all P<0.001; Cohen's d≈1.07, 0.80). The scores of depression (8.98±0.67) points, anxiety (9.85±0.95) points, and stress (10.75±1.39) points in the depression-anxiety-stress scale (DASS-21) in the experimental group were significantly lower than those in the control group depression (9.44±0.77) points, anxiety (11.85±1.38) points, stress (12.58±1.47) points (t=3.082, 8.229, 6.233, all P<0.05). The visual analog scale (VAS) scores at 12 h (4.96±0.68) points, 24 h (3.92±0.58) points, and 48 h (2.73±0.45) points after operation in the experimental group were significantly lower than those in the control group at 12 h (5.38±0.76) points, 24 h (4.54±0.62) points, and 48 h (3.63±0.53) points after operation (t=2.853、5.059、8.968, P<0.05). Repeated-measures ANOVA revealed significant main effects of time, group, and time-group interaction on VAS scores (F_time=254.171, P_time<0.001; F_group=80.352, P_group=0.026; F_interaction=3.702, P_interaction= 0.026). In addition, the duration of pain in the experimental group was significantly shorter than that in the control group (t=7.093, P<0.001).

The nursing intervention based on Orem's self-care theory significantly enhances self-efficacy, strengthens self-care ability, alleviates negative emotional states, and improves pain control in postoperative HH patients, thereby providing scientific and high-quality psychological nursing support.