The Tibet Autonomous Region (hereinafter referred to as Tibet) is located on the border of the country, with a harsh natural environment and an average elevation of over 4 000 meters. Currently, the total permanent population of the region is about 3.65 million, distributed over 1.2 million square kilometers of land. The land is vast and sparsely populated, making it extremely difficult to allocate medical resources. The above objective reasons make it difficult for patients in Tibet to seek medical treatment in a timely manner, and there are multiple complications when seeking medical treatment. In terms of inguinal hernia disease, the proportion of patients with inguinal incarcerated hernia is relatively high. Due to poor medical conditions, patients have poor awareness of seeking medical treatment, and lack of understanding of the disease, leading to serious complications and even death caused by inguinal incarcerated hernia. With the releasing of clinical guidelines, advances in equipment and materials, and updates in treatment concepts and anatomical understanding, laparoscopic inguinal hernia repair has been vigorously promoted. The promotion of new medical technologies in Tibet is relatively lagging behind. In recent years, with the strong support of the China Hernia Society and the Chinese Hernia Collegen of Surgeons, minimally invasive treatment related to hernia disease has been promoted in Lhasa since 2016, especially for inguinal hernia. At present, minimally invasive technology for treating inguinal hernia has been widely promoted to tertiary hospitals in Tibet. Through publicity, patients can seek medical attention in a timely manner, significantly reducing the incidence of inguinal incarcerated hernia. Based on litera-tures and clinical practice, the authors explore the promotion, application, and historical significance of minimally invasive surgery for hernia in Tibet.

Objective:To provide the reference for aeromedical support to long-distance delivery to plateau by comparing the changes of pulmonary artery pressure and right heart correlation parameters of military personnel between the states of pre-entering and different time periods on plateau.Methods:The correlation indexes on pulmonary artery pressure of 23 healthy military personnel were measured before and after entering plateau, including blood flow acceleration time (ACT) of pulmonary artery, right ventricular ejection time (RVET) and right ventricular pre-ejection period (RVPEP). The systolic pulmonary artery pressure (SPAP) and mean pulmonary artery pressure (MPAP) were calculated. The right ventricular outflow tract (RVOT), main pulmonary artery diameter (MPAD), right ventricular diameter (RVD) and right atrium diameter (RAD) were measured. According to the different stationed time, the military personnel were divided into 3 groups: 10 cases for 2 months, 7 cases for 3 months and 6 cases for 8 months. The changes of pulmonary artery pressure of military personnel were compared among the different time periods, as well as before and after stationed on plateau for each group that distinguished the states on plain and plateau.Results:After entering plateau, ACT of subjects was significantly reduced ( F=3.25, P<0.01), RVPEP was increased, the difference was significant ( F=4.51, P<0.05), SPAP and MPAP were significantly increased, and the differences were statistically significant ( F=4.19, 2.69, P<0.01). Two months after entering plateau, ROVT and RVD of subjects were significantly increased ( t=1.442, 2.643, P<0.05), but the MPAD and RAD were not different as compared those before entering plateau (P>0.05). Conclusions:① The hypoxic and low-pressure in plateau areas cause the significantly higher pulmonary artery pressure of military personnel than that in plain areas, and the right ventricular structure is also changed accordingly. ② The pulmonary artery pressure shows insignificant difference with the progresses of body adaptation and the time stationed on plateau. ③ Pulmonary hypertension occurs in the early stage of stationing on plateau. So preventing or alleviating the occurrence of pulmonary hypertension at the early stage of plateau stationing is important for the military personnel assigned via air delivery.

Objective:To provide the reference for aeromedical support to long-distance delivery to plateau by comparing the changes of pulmonary artery pressure and right heart correlation parameters of military personnel between the states of pre-entering and different time periods on plateau.Methods:The correlation indexes on pulmonary artery pressure of 23 healthy military personnel were measured before and after entering plateau, including blood flow acceleration time (ACT) of pulmonary artery, right ventricular ejection time (RVET) and right ventricular pre-ejection period (RVPEP). The systolic pulmonary artery pressure (SPAP) and mean pulmonary artery pressure (MPAP) were calculated. The right ventricular outflow tract (RVOT), main pulmonary artery diameter (MPAD), right ventricular diameter (RVD) and right atrium diameter (RAD) were measured. According to the different stationed time, the military personnel were divided into 3 groups: 10 cases for 2 months, 7 cases for 3 months and 6 cases for 8 months. The changes of pulmonary artery pressure of military personnel were compared among the different time periods, as well as before and after stationed on plateau for each group that distinguished the states on plain and plateau.Results:After entering plateau, ACT of subjects was significantly reduced ( F=3.25, P<0.01), RVPEP was increased, the difference was significant ( F=4.51, P<0.05), SPAP and MPAP were significantly increased, and the differences were statistically significant ( F=4.19, 2.69, P<0.01). Two months after entering plateau, ROVT and RVD of subjects were significantly increased ( t=1.442, 2.643, P<0.05), but the MPAD and RAD were not different as compared those before entering plateau (P>0.05). Conclusions:① The hypoxic and low-pressure in plateau areas cause the significantly higher pulmonary artery pressure of military personnel than that in plain areas, and the right ventricular structure is also changed accordingly. ② The pulmonary artery pressure shows insignificant difference with the progresses of body adaptation and the time stationed on plateau. ③ Pulmonary hypertension occurs in the early stage of stationing on plateau. So preventing or alleviating the occurrence of pulmonary hypertension at the early stage of plateau stationing is important for the military personnel assigned via air delivery.