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.

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.

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 explore the expression and significance of integrin subunit β6 (ITGB6) in gastric cancer.Methods:The expression levels of ITGB6 were measured in 408 gastric cancer tissues and 211 adjacent normal tissues in the gene expression profiling interactive analysis (GEPIA) database. The relationship between the expression of ITGB6 and the survival rate of the patients was determined using the Kaplan-Meier method. The glass sections of gastric cancer tissues and adjacent normal tissue wax blocks from the gastric adenocarcinoma patients (78 cases) who underwent radical tumor resection in the Department of Gastrointestinal Surgery of the Second Hospital of Tianjin Medical University from October 2013 to October 2019 were collected. The expression of ITGB6 in gastric cancer tissues and adjacent normal tissues was examined by immunohistochemical staining, and the relationship between the expression of ITGB6 and clinicopathological features of gastric cancer patients was analyzed. MGC-803 and AGS cells were selected, and the expression of ITGB6 gene was inhibited by silencing ITGB6 gene by transfection of lentiviral vectors and control vectors with short hairpin RNA (shRNA). The relative expression levels of mRNA and protein of ITGB6 were detected by real-time reverse transcription-PCR (RT-qPCR) and Western blotting, respectively. The effect of ITGB6 on the proliferation of MGC-803 and AGS cells in vitro was detected by clonal formation assay and MTT assay, and the effects of ITGB6 on tumor volume in mice were further verified by animal experiments. Results:The relative expression level of ITGB6 in gastric cancer tissues was higher than that in normal tissues, and the difference was statistically significant ( P<0.05). High expression of ITGB6 was significantly associated with shorter disease-free survival of patients ( P=0.006 5). Immunohistochemical staining showed that the expression level of ITGB6 was higher in gastric cancer tissues than that in adjacent normal tissues. Compared with the low expression group, ITGB6 expression in the high expression group was positively correlated with tumor differentiation ( χ2=4.468, P=0.035) and tumor stage ( χ2=6.056, P=0.014). In MGC-803 and AGS cells, the relative expression levels of ITGB6 mRNA in transfection group (0.4±0.1, 0.5±0.1) were lower than those in control group (1.0±0.1, 1.0±0.1), and the differences were statistically significant (all P<0.05). The relative expression levels of ITGB6 protein in transfection group (0.3±0.1, 0.3±0.1) were lower than those in control group (1.0±0.1, 1.0±0.1), and the differences were statistically significant (all P<0.05). In MGC-803 and AGS cells, the numbers of cloned cells in transfection group [(26±2, 29±3) unit] were lower than those in control group [(93±9, 112±10) unit], and the differences were statistically significant (all P<0.05). The absorbance ( A) values in the transfection group (0.3±0.1, 0.4±0.1) were lower than those in the control group (1.0±0.2, 1.0±0.1), and the differences were statistically significant (all P<0.05). The tumor volume in transfection group [(184±14) cm 3] was smaller than that in the control group [(252±26) cm 3], and the difference was statistically significant ( P<0.05). The relative level of ITGB6 protein expression in the transfection group (0.3±0.1) was lower than that in the control group (1.0±0.2), and the difference was statistically significant ( P<0.05). Conclusions:The expression of ITGB6 is increased in gastric cancer tissues, and the proliferation of gastric cancer cells can be inhibited by knocking down ITGB6.

Objective:To investigate the combined therapy of calcium dobesilate capsules, oral administration of Dahuoluo capsules, and intravenous drip of Danhong injection in treatment of patients with nonproliferative diabetic retinopathy.Methods:106 cases were randomly selected from the patients with nonproliferative diabetic retinopathy admitted in Traditional Chinese and Western Hospital of Dazhou City from Jan. 2019 to Dec. 2019. Based on the random numbers table, the cases were divided into control group and intervention group, with each group 53 patients. They were respectively treated with the therapy of calcium dobesilate capsules alone and the combined therapy of calcium dobesilate capsules, oral administration of Dahuoluo capsules and intravenous drip of Danhong injection, and the therapeutic effects were compared.Results:After treatment, the visual acuity of patients in both groups significantly improved ( P<0.05) , and the visual acuity of patients in the intervention group was higher than that of patients in the control group ( P<0.05) ; after treatment, the peak systolic velocity (PSV) and end diastolic velocity (EDV) of the central retinal artery (CRA) and posterior ciliary artery (PCA) of the patients in both groups significantly increased ( P<0.05) , while RI significantly reduced ( P<0.05) , and PSV and EDV of CRA and PCA in the intervention group were significantly higher than those of the control group ( P<0.05) , while RI was significantly lower than that of the control group ( P<0.05) . After treatment, the therapeutic efficiency of the intervention group was 96.23%, significantly higher than 79.25% in the control group ( χ2=7.102, P<0.05) . The incidence of adverse reactions in the intervention group was 9.43%, which had no significant difference with 3.78% in the control group ( χ2=1.377, P>0.05) . After targeted treatment was given, the adverse reactions disappeared. Conclusion:The combined therapy of calcium dobesilate capsules, oral administration of Dahuoluo capsules, and intravenous drip of Danhong injection was significantly effective in treatment of patients with nonproliferative diabetic retinopathy.