Objective To compare the clinical efficacy of laparoscopic high ligation of the hernia sac combined with intraperitoneal onlay mesh(IPOM)and local anesthesia Lichtenstein repair for the treatment of inguinal hernia after total cystectomy in male patients.Methods A total of 59 male patients who underwent total cystectomy were included in this study and randomly divided into two groups:the laparoscopic high ligation of the hernia sac combined with IPOM group(IPOM group,30 cases)and the local anesthesia Lichtenstein repair group(local anesthesia group,29 cases).The patient age,surgical time,postoperative ambulation time,visual analogue scale score for pain on the 1st to 3rd days and 3 months after operation,time to first mobilization post-operation,pain scores on postoperative day 1,2 and 3,pain scores at 3 months post-operation were observed and compared between the two groups.Data of intraoperative blood loss,hospital stay,time to return to daily activities,total surgery costs,recurrence rates at 1 year after operation and complications were also observed and compared in two groups of patients.The results were analyzed to determine the optimal surgical method.Results The IPOM group demonstrated better outcomes in terms of surgical time,time to first mobilization,pain scores on postoperative days 1,2 and 3,pain scores at 3 months,intraoperative blood loss,hospital stay and time to return to daily activities compared to those of the local anesthesia group(P＜0.01).However,the total cost of the operation was higher in the IPOM group than those of the local anesthesia group(P＜0.01).There were no significant differences in postoperative complications between the two groups(P＞0.05).The recurrence rate of the IPOM group one year after surgery was better than that of the local anesthesia group(P＜0.05).Conclusion Laparoscopic IPOM with high ligation of the hernia sac is superior to the traditional Lichtenstein repair in reducing postoperative pain and recurrence rates.This surgical method should be the first choice when economic conditions permit.

This article comprehensively discusses the concept of workplace ostracism, measurement tools, theoretical basis, the current situation of workplace ostracism among nurses, and research on related variables. It proposes targeted strategies to address workplace ostracism among nurses, aiming to reduce the occurrence of workplace ostracism incidents among nurses. This is of great significance for constructing a harmonious work environment and promoting individual mental health.

Objective:To investigate and analyze the relationship between genotype and phenotype in patients with early-onset high myopia (eoHM) associated with hereditary eye diseases.Methods:A family-based study was conducted among 30 families diagnosed with eoHM at Department of Ophthalmology of People's Hospital of Ningxia Hui Autonomous Region from January 2022 to June 2023. Seven families (23.3%, 7/30), all probands, and their 14 parents were included. These seven families were unrelated. Detailed patient and family histories were collected. All participants underwent comprehensive ophthalmic examinations, including best-corrected visual acuity, color vision testing, fundus color photography, optical coherence tomography, fluorescein fundus angiography, and fundus autofluorescence imaging. Full-field electroretinography was performed in four cases. Peripheral venous blood samples were collected from patients and their parents for whole-genome DNA extraction and whole-exome sequencing. Potential pathogenic variants were identified, and their pathogenicity was analyzed and confirmed by Sanger sequencing. The pathogenicity of newly discovered gene variants was evaluated according to the guidelines of the American College of Medical Genetics and Genomics (ACMG). Literature on previously reported eoHM associated with hereditary eye diseases was reviewed to analyze the relationship between variant genes and clinical phenotypes.Results:Among the seven families, three exhibited X-linked inheritance, two showed autosomal recessive inheritance, and two demonstrated autosomal dominant inheritance. All the patients were male. Among the seven patients, one case each was identified with congenital stationary night blindness (CSNB), Bornholm eye disease, X-linked retinitis pigmentosa (XL-RP), cone-rod dystrophy, Knobloch syndrome, familial exudative vitreoretinopathy (FEVR), and Stickler syndrome. Genetic testing revealed nine gene variants highly correlated with the observed phenotypes. The genetic testing results revealed that all patients were found to carry nine gene variants highly associated with the phenotype, including: a hemizygous missense variant NYX c.647A>T (p.N216I) (M1), an OPN1LW LIAVA haplotype variant (M2), a hemizygous frameshift variant RPGR c.3096_3097del (p.E1033RfsTer45) (M3), compound heterozygous variants TTLL5 c.1588_1589del (p.L531EfsTer24) and c.850G>C (p.D284H) (M4, M5), compound heterozygous variants COL18A1 c.2118dup (p.G707RfsTer23) and c.3523_3524del (p.L1175VfsTer72) (M6, M7), a heterozygous missense mutation FZD4 c.1499C>T (p.T500I) (M8), and a heterozygous frameshift variant COL11A2 c.966dup (p.T323HfsTer19) (M9). Among them, M2, M4, M5, M8 and M9 were newly discovered mutation sites, and M1, M3, M6 and M7 were known mutation sites. According to the classification standards and guidelines of genetic variation issued by ACMG, M2, M3, M4, M6, M7, and M9 were judged to be pathogenic variants, while M1, M5, and M8 were of unknown clinical significance. Through literature review, it was found that eoHM was more common among the clinical phenotypes of 4 types of hereditary retinal diseases, including CSNB, Stickler syndrome, FEVR and XL-RP. Conclusion:eoHM is intricately associated with inherited eye diseases and may serve as the earliest indicator of such conditions.

Objective:To compare the curative effect of local anesthesia Lichtenstein, modified Kugel and general anesthetic transabdominal preperitoneal(TAPP) hemioplasty in the treatment of primary unilateral inguinal hernia in elderly patients.Methods:Six hundred and twenty-one patients with unilateral primary inguinal hernia admitted at Second Hospital of Tianjin Medical University from January 2021 to December 2023 were randomly divided into 3 groups before operation: Lichtenstein group, Modified-Kugel group, TAPP group,207 patients in each group. The clinical data were compared.Results:The average operation time of the Lichtenstein and modified Kugel hernia repair groups was significantly shorter than that of TAPP group ( P<0.01), and the hospitalization cost was also significantly lower than that of TAPP group. The postoperative pain score, time spent in the ground and hospital stay in TAPP group were significantly lower than those in Lichtenstein and modified Kugel groups ( P<0.05). There were no serious complications in the 3 groups. Conclusions:Three kinds of hernia repair are all safe and effective in the treatment of elderly patients with unilateral primary inguinal hernia. TAPP has lighter postoperative pain and quicker recovery. Lichtenstein and Modified-Kugel hernia repair under local anesthesia are suitable for those who cannot tolerate general anesthesia.

Objective To compare the clinical efficacy of laparoscopic high ligation of the hernia sac combined with intraperitoneal onlay mesh(IPOM)and local anesthesia Lichtenstein repair for the treatment of inguinal hernia after total cystectomy in male patients.Methods A total of 59 male patients who underwent total cystectomy were included in this study and randomly divided into two groups:the laparoscopic high ligation of the hernia sac combined with IPOM group(IPOM group,30 cases)and the local anesthesia Lichtenstein repair group(local anesthesia group,29 cases).The patient age,surgical time,postoperative ambulation time,visual analogue scale score for pain on the 1st to 3rd days and 3 months after operation,time to first mobilization post-operation,pain scores on postoperative day 1,2 and 3,pain scores at 3 months post-operation were observed and compared between the two groups.Data of intraoperative blood loss,hospital stay,time to return to daily activities,total surgery costs,recurrence rates at 1 year after operation and complications were also observed and compared in two groups of patients.The results were analyzed to determine the optimal surgical method.Results The IPOM group demonstrated better outcomes in terms of surgical time,time to first mobilization,pain scores on postoperative days 1,2 and 3,pain scores at 3 months,intraoperative blood loss,hospital stay and time to return to daily activities compared to those of the local anesthesia group(P＜0.01).However,the total cost of the operation was higher in the IPOM group than those of the local anesthesia group(P＜0.01).There were no significant differences in postoperative complications between the two groups(P＞0.05).The recurrence rate of the IPOM group one year after surgery was better than that of the local anesthesia group(P＜0.05).Conclusion Laparoscopic IPOM with high ligation of the hernia sac is superior to the traditional Lichtenstein repair in reducing postoperative pain and recurrence rates.This surgical method should be the first choice when economic conditions permit.

This article comprehensively discusses the concept of workplace ostracism, measurement tools, theoretical basis, the current situation of workplace ostracism among nurses, and research on related variables. It proposes targeted strategies to address workplace ostracism among nurses, aiming to reduce the occurrence of workplace ostracism incidents among nurses. This is of great significance for constructing a harmonious work environment and promoting individual mental health.

Objective:To investigate and analyze the relationship between genotype and phenotype in patients with early-onset high myopia (eoHM) associated with hereditary eye diseases.Methods:A family-based study was conducted among 30 families diagnosed with eoHM at Department of Ophthalmology of People's Hospital of Ningxia Hui Autonomous Region from January 2022 to June 2023. Seven families (23.3%, 7/30), all probands, and their 14 parents were included. These seven families were unrelated. Detailed patient and family histories were collected. All participants underwent comprehensive ophthalmic examinations, including best-corrected visual acuity, color vision testing, fundus color photography, optical coherence tomography, fluorescein fundus angiography, and fundus autofluorescence imaging. Full-field electroretinography was performed in four cases. Peripheral venous blood samples were collected from patients and their parents for whole-genome DNA extraction and whole-exome sequencing. Potential pathogenic variants were identified, and their pathogenicity was analyzed and confirmed by Sanger sequencing. The pathogenicity of newly discovered gene variants was evaluated according to the guidelines of the American College of Medical Genetics and Genomics (ACMG). Literature on previously reported eoHM associated with hereditary eye diseases was reviewed to analyze the relationship between variant genes and clinical phenotypes.Results:Among the seven families, three exhibited X-linked inheritance, two showed autosomal recessive inheritance, and two demonstrated autosomal dominant inheritance. All the patients were male. Among the seven patients, one case each was identified with congenital stationary night blindness (CSNB), Bornholm eye disease, X-linked retinitis pigmentosa (XL-RP), cone-rod dystrophy, Knobloch syndrome, familial exudative vitreoretinopathy (FEVR), and Stickler syndrome. Genetic testing revealed nine gene variants highly correlated with the observed phenotypes. The genetic testing results revealed that all patients were found to carry nine gene variants highly associated with the phenotype, including: a hemizygous missense variant NYX c.647A>T (p.N216I) (M1), an OPN1LW LIAVA haplotype variant (M2), a hemizygous frameshift variant RPGR c.3096_3097del (p.E1033RfsTer45) (M3), compound heterozygous variants TTLL5 c.1588_1589del (p.L531EfsTer24) and c.850G>C (p.D284H) (M4, M5), compound heterozygous variants COL18A1 c.2118dup (p.G707RfsTer23) and c.3523_3524del (p.L1175VfsTer72) (M6, M7), a heterozygous missense mutation FZD4 c.1499C>T (p.T500I) (M8), and a heterozygous frameshift variant COL11A2 c.966dup (p.T323HfsTer19) (M9). Among them, M2, M4, M5, M8 and M9 were newly discovered mutation sites, and M1, M3, M6 and M7 were known mutation sites. According to the classification standards and guidelines of genetic variation issued by ACMG, M2, M3, M4, M6, M7, and M9 were judged to be pathogenic variants, while M1, M5, and M8 were of unknown clinical significance. Through literature review, it was found that eoHM was more common among the clinical phenotypes of 4 types of hereditary retinal diseases, including CSNB, Stickler syndrome, FEVR and XL-RP. Conclusion:eoHM is intricately associated with inherited eye diseases and may serve as the earliest indicator of such conditions.

Objective:To compare the curative effect of local anesthesia Lichtenstein, modified Kugel and general anesthetic transabdominal preperitoneal(TAPP) hemioplasty in the treatment of primary unilateral inguinal hernia in elderly patients.Methods:Six hundred and twenty-one patients with unilateral primary inguinal hernia admitted at Second Hospital of Tianjin Medical University from January 2021 to December 2023 were randomly divided into 3 groups before operation: Lichtenstein group, Modified-Kugel group, TAPP group,207 patients in each group. The clinical data were compared.Results:The average operation time of the Lichtenstein and modified Kugel hernia repair groups was significantly shorter than that of TAPP group ( P<0.01), and the hospitalization cost was also significantly lower than that of TAPP group. The postoperative pain score, time spent in the ground and hospital stay in TAPP group were significantly lower than those in Lichtenstein and modified Kugel groups ( P<0.05). There were no serious complications in the 3 groups. Conclusions:Three kinds of hernia repair are all safe and effective in the treatment of elderly patients with unilateral primary inguinal hernia. TAPP has lighter postoperative pain and quicker recovery. Lichtenstein and Modified-Kugel hernia repair under local anesthesia are suitable for those who cannot tolerate general anesthesia.

Objective To investigate the expression of transcription factor forkhead box protein O(FOXO)genes in gastric cancer tissues and their correlation and clinical significance with Helicobacter pylori(Hp)infection.Methods The expression levels of FOXOs genes(including FOXO1,FOXO3,FOXO4,and FOXO6)were detected by immunohistochemistry in cancer tissues and paracancerous tissues from 41 gastric cancer patients with Hp(-)and 29 gastric cancer patients with Hp(+),as well as in gastric tissues from 30 healthy individuals.The correlation between FOXOs expression and Hp infection,clinical pathological features was analyzed.The relationship between FOXOs expression and survival prognosis of gastric cancer patients was analyzed using the Kaplan-Meier plotter.Results Compared with those in the Hp(-)gastric cancer tissues,the expression levels of FOXO1,FOXO4,and FOXO6 were higher in the Hp(+)gastric cancer tissues(P<0.05).Meanwhile,the expression levels of FOXO1,FOXO3,and FOXO4 in the Hp(+)gastric cancer tissues were lower than that in the paracancerous tissues(P<0.05)and normal tissues(P<0.0001).The expression of FOXOs in gastric cancer tissues was closely correlated with the degree of differentiation,depth of infiltration,lymph node metastasis,and TNM stage of gastric cancer(P<0.05).Meanwhile,FOXO1/3 was associated with the survival prognosis of patients with gastric cancer.Conclusion Hp infection promotes the expression of FOXO1/4/6 in gastric cancer tissues.The high expression of tumor suppressor genes FOXO1/4 may be one of the reasons for better prognosis in Hp(+)gastric cancer patients.FOXOs genes are widely involved in regulating the disease progression of gastric cancer,which has certain value for disease treatment.

Exosomes are lipid bilayer structures containing various bioactive molecules that can be secreted by almost all cells.However,exosomes released by different types of cells perform differ-ent biological functions,and have been confirmed to participate in physiological processes such as immune response,antigen presentation,cell migration and differentiation,and hair growth through ligand receptor binding.Recent research reports have shown that exosomes can also be secreted from the fetus and placenta,playing an important role in embryo implantation and development,as well as in the treatment of animal pregnancy diseases.In order to offer recommendations for endan-gered and unique economic animals in the diagnosis and treatment of pregnancy and pregnancy-re-lated illnesses,this paper reviewed the most recent developments and innovative theories about the use of extracellular vesicles in pregnancy.