Objective To explore the clinical effect and safety of 4K high-definition laparoscopic-assisted transabdominal preperitoneal repair in the treatment of elderly inguinal hernia.Methods A retrospective analysis was conducted on the medical records of 92 elderly patients with inguinal hernia.They were divided into control group(n=42)and study group(n=50)according the treatment plan.Conventional laparoscopic preperitoneal repair was applied in the control group.4K high-definition laparoscopic-assisted transabdominal preperitoneal repair was used in the study group.Operation related indexes,postoperative pain(visual analogue scale[VAS]),blood gas indexed(arterial partial pressure of carbon dioxide[PaCO2],arterial partial pressure of oxygen[PaO2],and pH value),serum inflammatory factor levels(C-reactive protein[CRP]and interleukin-6[IL-6])were compared between the two groups.The incidence of postoperative complications was recorded.Results The study group had longer operation time and shorter exercise time leaving bed and hospitalization time than the control group(P<0.05).There was no statistically significant difference in the PaCO2,PaO2 or pH value between the two groups before and 48 h after operation(P>0.05).The VAS scores of the study group at 24 h,48 h and 72 h after operation were lower than those of the control group(P<0.05).The levels of CRP and IL-6 at 48 h after operation were decreased in both groups,and the parameters in the study group were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of postoperative complications or recurrence rate between the two groups(P>0.05).Conclusion 4K high-definition laparoscopic-assisted transabdominal preperitoneal repair has more advantages in promoting postoperative recovery and reducing postoperative pain in elderly patients with inguinal hernia.Compared with conventional laparoscopic preperitoneal repair,its operation time is slightly longer.

Objective To explore the relationship between serum tenascin C(TN-C),irisin(Irisin) and the severity and prognosis of patients with acute ischemic stroke(AIS).Methods 203 AIS patients admitted to our hospital(January 2017 to December 2019) were selected as the AIS group.According to the National Institutes of Health Stroke Scale(NIHSS) and Modified Rankin Scale(mRS),they were divided into severe group(n=52),moderate group(n=87),mild group(n=64) good prognosis group(n=125) and poor prognosis group(n=78),another 74 healthy people at the same period were selected as the control group,and the serum TN-C and Irisin level were compared between the groups,Pearson correlation analysis was used to analyze the correlation between serum TN-C and Irisin levels and NIHSS,mRS scores,ROC curve analysis was used to analyze the prognostic value of serum TN-C and Irisin levels in AIS.Results The serum TN-C levels in the AIS group were significantly higher than those in the control group,and the Irisin levels were significantly lower than those in the control group(P<0.05);the serum TN-C levels in the severe group were significantly higher than those in the moderate group,and the Irisin levels were significantly lower than those in the moderate group(P<0.05);the serum TN-C levels in the moderate group were significantly higher than those in the mild group,and the Irisin levels were significantly lower than those in the mild group(P<0.05);the serum TN-C levels in the poor prognosis group were significantly higher than those in the good prognosis group,Irisin levels were significantly lower than those in the good prognosis group(P<0.05);pearson correlation analysis showed that the serum TN-C level in the AIS group was positively correlated with NIHSS and mRS scores (P<0.05);the serum Irisin level was negatively correlated with NIHSS and mRS scores(P<0.05);ROC curve showed that the AUC,sensitivity and specificity of TN-C+Irisin predicting the prognosis of AIS were higher than those predicted by TN-C and Irisin alone.Conclusion Elevated serum TN-C level and decreased irisin level can reflect the severity of AIS and adverse prognosis,the combined determination of the two can improve the predictive value of the prognosis of AIS patients,and can be used as an indicator to evaluate the prognosis.