Objective To study and summarize the successful experience and the safety, easibility, practicality and operation skills of totally laparoscopic extraperitoneal herniorrhaphy (TEP). Methods From October 2006 to May 2008,225 patients in our two hospitals were performed TEP (265 totally laparoscopic extraperitoneal hernia repairs for inguinal hernia), including 55 direct inguinal hernia, 197 indirect inguinal hernia and 13 complex inguinal hernia operations. Among the 225 patients, 185 patients had unilateral hernia and 40 patients had bilateral hernias, including 29 recurrent hernia. Results The operations were lasted for 30 to 182 minutes(the average operating duration was 48 minutes for unilateral hernia and 106 minutes for bilateral hernia). The patients stayed in hospital for 2 to 8 days(the average inpatient hospital stay was 3.0 ± 1.2 days). The most common complication was scrotum bematomas,which appeared in 18 cases. Urinary re-tention appeared in 21 cases. Inguinal pain appeared in 5 cases. Bladder injury appeared 1 case. All the pa-tients were followed up for 3 months- 3 years. There was only 1 case of recurrence. Conclusions The proce-dure of TEP is safe,with faster postoperative recover,less pain,lower incidence of pain,better comfort quality and lower recurrence rate. TEP should be the main laparoscopic procedure for inguinal hernia repair.

Renal fibrosis is a devastating consequence of progressive chronic kidney disease,representing a major public health challenge worldwide.The underlying mechanisms in the pathogenesis of renal fibrosis remain unclear,and effective treatments are still lacking.Renal tubular epithelial cells(RTECs)maintain kidney function,and their dysfunction has emerged as a critical contributor to renal fibrosis.Cellular quality control comprises several components,including telomere homeostasis,ubiquitin-proteasome system(UPS),autophagy,mitochondrial homeostasis(mitophagy and mitochondrial metabolism),endoplasmic reticulum(ER,unfolded protein response),and lysosomes.Failures in the cellular quality control of RTECs,including DNA,protein,and organelle damage,exert profibrotic functions by leading to senescence,defective autophagy,ER stress,mitochondrial and lysosomal dysfunction,apoptosis,fibro-blast activation,and immune cell recruitment.In this review,we summarize recent advances in un-derstanding the role of quality control components and intercellular crosstalk networks in RTECs,within the context of renal fibrosis.

Objective:To compare the accuracy and generalized robustness of three predictive models of knowledge-based treatment strategies for radiotherapy for optimized model selection.Methods:The clinical radiotherapy plans of 45 prostate cancer (PC) cases and 25 nasopharyngeal cancer (NPC) cases were collected, and analyzed using three models (Z, L and S model), proposed by Zhu et al, Appenzoller et al and Shiraishi et al, respectively, to predict the dose-volume histogram (DVH) of bladder and rectum on PC cases and that of left and right parotid on NPC cases. The prediction error was measured by the difference of area under the predicted DVH and the clinical DVH curves (|V (pre_DVH)-V (clin_DVH)|), where a smaller prediction error implies a greater prediction accuracy. The accuracies of these three models were compared on the single organ at risk (OAR), and the generalized robustness of models was evaluated and compared by calculating the standard deviation of the prediction accuracy on different OAR. Results:For bladder and rectum, the prediction error of L model (0.114 and 0.163, respectively) was significantly higher than those values of Z and S models (≤0.071, P<0.05); for left parotid gland, the predicted error of S model (0.033) did not present significant difference from those values of Z and L models (≤0.025, P>0.05); for right parotid gland, S model (0.033) demonstrated significantly higher prediction error than those of Z and L models (≤0.028, P<0.05). Regarding different OAR, S model showed a lower standard deviation of prediction accuracy when comparing to Z and L models (0.016, 0.018 and 0.060, respectively). Conclusions:In the prediction of DVH in bladder and rectum of PC, Z and S models were more accurate than L model. In contrast, Z and L models demonstrated higher accuracy than S model in the prediction of left and right parotid glands of NPC. In respect to different OAR, the generalized robustness of S model was superior than the other two models.

Objective To compare the accuracy of maxillary dentition defect models obtained by digital impression and traditional pressure impression,analyzing the influencing factors.Methods Twenty patients with maxillary dentition defects(25 free ends and 18 non-free ends)were selected.Digital impression and traditional pressure impression were utilized to fabricate models of maxillary denti-tion defects.Digital impressions were obtained through intraoral scanning(TRIOS2,3Shape).For the same patient,traditional pressure impression and perfusion plaster model were used for window scanning(SHINING 3D),and the resulting STL format digital model was exported.In Geomagic Control X software,conversion fit and best fit analyses were conducted on the two digital models using the remai-ning abutment as reference landmarks.The total deviation(T)between the two digital models was measured,and positional deviations of the alveolar crest in mesial(M),central(C),distal(D),and maxillary palate(P)regions of the defect area were calculated.A com-parison was made between free end defect area and non-free end defect area,followed by statistical analysis using t-test.Results When the remaining abutments were utilized as reference points for conversion fitting,the total deviation between the two digital models was measured at 0.03 mm,while the positional deviations of M,C,D,P positions amounted to 0.47 mm,0.65 mm,1.48 mm and 0.07 mm respectively.In the best fitting,the total deviation between the two digital models was 0.03 mm,while the positional devia-tions of M,C,D,P,were measured to be 0.50 mm,0.66 mm,1.43 mm and 0.08 mm respectively.The two fitting methods exhibited no statistically significant distinction(P＞0.05).The comparison results between the free end defect area and the non-free end defect ar-ea revealed that the mean deviations of C and D sites in the free end defect area were 1.07 mm and 2.38 mm,respectively,which ex-ceeded those observed in the non-free end defect area(0.08 mm and 0.11 mm,P＜0.05)with statistically significant difference.Conclusion The digital impression for maxillary dentition defect model exhibits a greater deviation compared to the traditional pressure impression model,particularly in the central and distal regions of the free end defect area.