Objective To study the application value of lightweight mesh in the ventral hernia tension-free hernia repair in middle-age and elderly patients. Methods The retrospective cohort study method was used to analyze the clinical data and followed information about 284 cases of tension-free hernia repair in our hospital. The patients were randomly divid-ed into experimental group and control group. The lightweight mesh and heavyweight mesh were used in experimental group and control group respectively. The information was collected including age, sex, inguinal hernia type, combined chronic dis-ease, operative time, blood loss, the duration of hospitalization, surgical expenses and other indicators. Data were followed up in patients including postoperative chronic pain, limited mobility, surgical numbness, the recurrent, foreign body sensation. Results The average cost of surgery was higher in experimental group[ (9 404.54±314.87) yuan]than that in control group [(7 613.94±329.68) yuan]. There were no significant differences in the operative time, blood loss and length of hospital stay between two groups. Results of follow-up data showed that the early postoperative chronic pain, early and long-term activity limitation, long-term surgery area numbness and foreign body sensation were lower in experimental group than those in con-trol group. Conclusion The cost of lightweight mesh was higher than that of heavyweight mesh in the ventral tension-free hernia repair therapy. It is worth to apply the lightweight mesh, which can reduce the incidence of postoperative pain, numb-ness and other adverse reactions.

Objective To evaluate the role of preoperative serological indexes in predicting long-term survival and tumor recurrence of hepatocellular carcinoma (HCC) patients after liver transplantation, aiming to explore its significance in expanding the Milan criteria. Methods Clinical data of 669 recipients undergoing liver transplantation for HCC were retrospectively analyzed. The optimal cut-off value was calculated by the receiver operating characteristic (ROC) curve. The risk factors affecting the overall survival and recurrence-free survival rates of HCC patients after liver transplantation were identified by univariate and multivariate regression analyses. The correlation between preoperative serum liver enzymes and pathological characteristics in HCC patients was analyzed. The predictive values of alpha-fetoprotein (AFP) combined with γ -glutamyl transferase (GGT) and different liver transplant criteria for the survival and recurrence of HCC patients after liver transplantation were compared. Results Exceeded Milan criteria, total tumor diameter (TTD) > 8 cm, AFP > 200 ng/mL and GGT > 84 U/L were the independent risk factors for the overall survival and recurrence-free survival rates of HCC patients after liver transplantation (all P < 0.05). Correlation analysis showed that preoperative serum GGT level was correlated with TTD, number of tumor, venous invasion, microsatellite lesions, capsular invasion, tumor, node, metastasis (TNM) stage, Child-Pugh score and exceeded Milan criteria (all P < 0.05). Milan-AFP-GGT-TTD (M-AGT) criteria were proposed by combining Milan criteria, TTD with serum liver enzyme indexes (AFP and GGT). The 5-year overall survival and recurrence-free survival rates of HCC recipients who met the M-AGT criteria (111 cases of exceeded Milan criteria) were significantly higher than those who met Hangzhou criteria (both P < 0.05), whereas had no significant difference from their counterparts who met the University of California at San Francisco (UCSF) criteria (both P > 0.05). Conclusions Preoperative serological indexes of AFP and GGT could effectively predict the long-term survival and tumor recurrence of HCC patients after liver transplantation. Establishing the M-AGT criteria based on serological indexes contributes to expanding the Milan criteria, which is convenient and feasible.