Objective:To compare the effectiveness and recurrence rate of different types of mesh or without mesh in laparoscopic hiatal hernia repair.Methods:From Jan 2016 to Mar 2022 at the three hospital 90 patients with hiatal hernia, including 26 cases without mesh, 29 cases using synthetic mesh, and 35 cases using biological mesh underwent laparoscopic hiatal hernia repair.Results:The surgical procedures was successful in all the 90 cases without conversion to open surgeny. There were no statistically significant differences in operative time, intraoperative blood loss and postoperative hospital stay among the three groups ( P>0.05), and there were statistically significant differences in hospital cost between the group without mesh and synthetic mesh and biological mesh ( P<0.05). Long-term follow-up was achieved in 87 patients, with a follow-up rate of 96.7% (87/90), and a median follow-up time of 44 months. There were no significant differences in the incidence of postoperative complications (diarrhea, dysphagia, abdominal distension, chest pain), recurrence rate of symptoms (acid reflux, heartburn) and patient satisfaction among the three groups ( P>0.05). Conclusion:In laparoscopic hiatal hernia repair, the mesh should be carefully selected according to the specific intraoperative situation for a satisfactory clinical efficacy.

Objective To study the inner ear appearance on three-dimensional real inversion recovery(3D re-al IR)imaging in patients with sudden sensorineural hearing loss,and to investigate the relationship between blood-labyrinth barrier permeability and pathogenesis and prognosis of sudden hearing loss.Methods A total of 41 pa-tients with sudden sensorineural hearing loss received 3D real IR at 3.0 T MRI,and the signal intensity of inner ear were recorded.We respectively measured cochlear signal intensity in affected and healthy ears,and medullary signal intensity,and calculated the cochlear/medulla ratio(CM ratio)separately.On the basis of CM ratio,we evaluated hearing levels at initial and after treatment,and the relationship between CM ratio and hearing prognosis.Results Among the 41 patients,33 cases(occupying 80.48％)individually had a higher CM ratio in the affected ear than in the healthy one.The CM ratio of the affected side was not higher than that of the healthy side in 8 cases,and the ef-fective rate was 100％,eighteen cases had below 1.5 times the CM ratio in affected ears as in healthy ears,with 77.78％effective rate of treatment;seven cases had 1.5 to 1.75 times,with 100％effective rate;two cases had 1.75 to 2 times,with 50％effective rate;and the rest 14 cases had over 2 times,with 14.28％effective rate(P＜0.05).Conclusion The variation of blood-labyrinth barrier permeability in patients with sudden hearing loss can be read on the 3D Real IR,and it indicates that 80.48％patients have higher-intensity signals in lateral cochlea.The CM ratio can be adopted to evaluate the extent of inner ear damage of patients more accurately.As the CM ratio ri-ses,patients'prognosis become worse,and patients with over 1.75 times the CM ratio in the affected ear as in the healthy one,mostly suffer poor prognosis.