Objective To analyze the curative effect of suspended airless laparoscopic surgery on inguinal hernia in children.Methods 180 children with inguinal hernia who received treatment at the Fourth Affiliated Hospital of Guangzhou Medical University from June 2020 to February 2023 were selected.Random number table method was used to divide the patients into two groups,90 cases in each group.The control group underwent laparoscopic high ligation of hernia sac,the observation group was treated with suspended airless laparoscopic surgery,and the clinical efficacy and surgical situation,postoperative pain and stress index levels,as well as the impact on testicular volume and quality of life,complications,and recurrence rate were compared between the two groups.Results There was no statistically significant difference in clinical efficacy between the two groups of children(P＞0.05).The surgical performance of the observation group was better than that of the control group(P＜0.05).The scores of the simplified McGill pain questionnaire were(23.23±5.11)points and(25.51±5.21)points in the observation group and control group 12 hours after surgery,and(20.02±4.55)points and(22.73±4.46)points on the first day after surgery,respectively.3 days after surgery,the scores were(11.76±1.71)points and(12.63±1.82)points,respectively,and the difference between the two groups was statistically significant(P＜0.05).On the second day after surgery,the elevated levels of stress indicators such as interleukin-6(IL-6),interleukin-10(IL-10),cortisol(Cor),and malondialdehyde(MDA)in the observation group were lower than those in the control group[(29.03±4.21)ng/L vs(30.86±4.15)ng/L,(30.12±4.23)ng/L vs(32.02±4.41)ng/L,(47.11±6.63)mmol/L vs(50.17±6.71)mmol/L,(24.31±5.18)μmol/L vs(26.63±5.25)pmol/L](all P＜0.05).There was no statistically significant difference in testicular volume between the two groups(P＞0.05),while the quality of life score of the observation group was lower than that of the control group(P＜0.05).The incidence and recurrence rates of complications such as scrotal edema and inguinal pain in the observation group were not statistically significant compared to the control group(P＞0.05),but the subcutaneous emphysema rate in the observation group was lower than that in the control group(P＜0.05).Conclusion Suspended gasless laparoscopic surgery and laparoscopic high ligation of hernia sac have good therapeutic effects in treating pediatric inguinal hernia,while the former has advantages in reducing postoperative pain and stress response.

ObjectiveTo understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District， Shanghai， and to provide references for promoting the utilization of preconception healthcare services under the new population policy. MethodsA questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District， Shanghai. The results were statistically analyzed. ResultsThe average age of the women was （31.7±4.5） years， 30.2% of whom were ≥35 years old. The proportion of women having their third or subsequent children was low， at 16.4%. A significant majority， 92.4%， were found to have various risk factors during initial pregnancy screening. The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%. Awareness of the free preconception check-up program in Jiading District was also low at 28.6%， and the utilization rate for these services was even lower at 7.69%. Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services， accounting for 63.6%. The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged ≤29 years old （OR=1.789， 95%CI： 1.033‒3.099）. Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy （OR=4.164， 95%CI： 2.627‒6.602）. Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy （OR=7.534， 95%CI： 4.954‒11.456）. Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services （OR=1.903， 95%CI： 1.083‒3.345）. ConclusionUnder the context of three-child policy， the proportion of women seeking three or more children in Jiading District is low. Most of these women have risk factors identified during initial pregnancy screenings. The utilization rate of preconception healthcare services and the awareness of the free preconception screening program in Jiading District are both low. Unplanned pregnancies remain the primary reason for failing to receive timely preconception healthcare services. Age， whether the pregnancy was planned， whether the women had received preconception healthcare services before their first baby and family history of chronic diseases are the main factors affecting the utilization of preconception healthcare services. Relevant departments should enhance the promotion of preconception healthcare service programs， especially for women of childbearing age who have not yet given birth， so as to improve the utilization rate of preconception health care services.

Objective To explore the risk factors of central venous catheter related thrombosis in the patients undergoing gastrointestinal tract surgery,and to construct a risk prediction model based on machine learning algorithms.Methods A total of 385 patients receiving gastrointestinal tract surgery and central ve-nous catheter indwelling in this hospital from May 2018 to March 2024 were selected as the study subjects and divided into the thrombus group(n=62)and non-thrombus group(n=323)based on whether or not the catheter-related thrombosis forming.The age,body mass index(BMI),comorbidities,current tumors,neutro-phil/lymphocyte ratio(NLR),surgery time,catheterization vein,systemic immune inflammation index(SII),D-dimer and catheter indwelling time of the patients were collected,and the differences in baseline data were compared between the two groups.The research subjects were randomly divided into the training set and tes-ting set by a 7∶3 ratio.Based on the training set,the logistics regression model,random forest,support vector machine,decision tree and naive Bayes risk prediction models were established.The area under the operating characteristic curve(AUC),accuracy,sensitivity,specificity and F1 value in predicting catheter-related throm-bosis were compared among different models in the testing set.The importance of the predictive factors in the best prediction model conducted the visualized ranking.Results There were statistically significant differences in the proportion of tumor patients,NLR,surgical time and D-dimer level in the baseline data between the two groups(all P＜0.05).The AUC values of the five risk prediction models from great to small were the random forest(0.773),logistics regression model(0.734),support vector machine(0.680),naive Bayes(0.666)and decision tree(0.650).Among them,the accuracy(0.853),sensitivity(0.599),specificity(0.877)and F1 val-ue(0.414)of the random forest model were the highest.D-dimer,surgery time,current tumor and NLR were the top four important predictive factors in the random forest model.Conclusion The constructed random forest model for central venous catheter-related thrombosis in the patients undergoing gastrointestinal tract surgery demonstrates good performance,and the D-dimer,surgery time,current tumor and NLR are the main predictive factors.

Objective To analyze the curative effect of suspended airless laparoscopic surgery on inguinal hernia in children.Methods 180 children with inguinal hernia who received treatment at the Fourth Affiliated Hospital of Guangzhou Medical University from June 2020 to February 2023 were selected.Random number table method was used to divide the patients into two groups,90 cases in each group.The control group underwent laparoscopic high ligation of hernia sac,the observation group was treated with suspended airless laparoscopic surgery,and the clinical efficacy and surgical situation,postoperative pain and stress index levels,as well as the impact on testicular volume and quality of life,complications,and recurrence rate were compared between the two groups.Results There was no statistically significant difference in clinical efficacy between the two groups of children(P＞0.05).The surgical performance of the observation group was better than that of the control group(P＜0.05).The scores of the simplified McGill pain questionnaire were(23.23±5.11)points and(25.51±5.21)points in the observation group and control group 12 hours after surgery,and(20.02±4.55)points and(22.73±4.46)points on the first day after surgery,respectively.3 days after surgery,the scores were(11.76±1.71)points and(12.63±1.82)points,respectively,and the difference between the two groups was statistically significant(P＜0.05).On the second day after surgery,the elevated levels of stress indicators such as interleukin-6(IL-6),interleukin-10(IL-10),cortisol(Cor),and malondialdehyde(MDA)in the observation group were lower than those in the control group[(29.03±4.21)ng/L vs(30.86±4.15)ng/L,(30.12±4.23)ng/L vs(32.02±4.41)ng/L,(47.11±6.63)mmol/L vs(50.17±6.71)mmol/L,(24.31±5.18)μmol/L vs(26.63±5.25)pmol/L](all P＜0.05).There was no statistically significant difference in testicular volume between the two groups(P＞0.05),while the quality of life score of the observation group was lower than that of the control group(P＜0.05).The incidence and recurrence rates of complications such as scrotal edema and inguinal pain in the observation group were not statistically significant compared to the control group(P＞0.05),but the subcutaneous emphysema rate in the observation group was lower than that in the control group(P＜0.05).Conclusion Suspended gasless laparoscopic surgery and laparoscopic high ligation of hernia sac have good therapeutic effects in treating pediatric inguinal hernia,while the former has advantages in reducing postoperative pain and stress response.

Objective To analyze the impact of hepatitis B virus (HBV) replication and its coded X gene (HBx) expression on cell gene expression profile,especially the immune related gene expression level changes.Methods Overexpressed HBx gene was transiently transfected through lenti-virus and pcDNA3,the RNA-Seq and RT-qPCR methods were used to detect the expression levels of immune related genes,which were verified in HBV replication cell line.Results This study found that the HBV replication and HBx expression suppressed the expression of immune checkpoint PD-1 ligand gene (PD-L1/CD274) in a dose-dependent manner,while the expression of H-box mutant in HBx gene lost this inhibition effect.Conclusion HBV/HBx possesses the ability for inhibiting PD-L1/CD274 ligand gene expression,may relieve the checkpoint of antigen-specific T cell activation in viral infection acute stage,activates cytotoxic T cells,which may cause that T cell attack and clear highly replicated cells,helps virus to enter the lower replication status,and reaches the balance status between virus-host and lays a basis of HBV chronic infection.

Objective To investigate the correlation of serum levels of retinol binding protein 4 (RBP4) and andomen?tin-1 with ischemic stroke and carotid artery stenosis. Methods Healthy adult (n=50) were selected as the control group while ischemic stroke patients with different degrees of carotid artery stenosis (n=143) were enrolled as the disease group. According to the ultrasonic Doppler performance, these ischemic stroke patients were divided into three groups:mild steno?sis group (carotid artery stenosis was normal or less than 50%, n=67), moderate stenosis group (carotid artery stenosis was 50%to 70%, n=45), severe stenosis group (carotid artery stenosis was 70%to total occlusion, n=31). BMI index, hyperten?sion, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and fasting blood glucose (FPG) were detected by Automatic biochemical analyzer and serum levels of RBP4 and omentin-1 were measured by ELISA. Results Hypertensive population in carotid artery stenosis group was larger than that in control group (P<0.05). Serum TC, TG, LDL, FPG and RBP4 levels were significantly higher while omentin-1 level decreased remarkably in disease group than those in the control group (P<0.05). Logistic regression analysis showed that TC and RBP4 were the risk factors of ischemic stroke with carotid artery stenosis, while omentin-1 was a protective factor. Conclusion RBP4 is a risk factor for ischemic stroke with carotid artery stenosis and omentin-1 is a protective factor.

Objective To detect the in vitro effect of the traditional Chinese medicine on the tachyzoites of Toxoplasma gondii. Methods Supernatant (1^5 ml) of different doses of the traditional Chinese medicine (Changqing capsule) was collected by normal saline immersion and 2^5?10+4 Toxoplasma gondii tachyzoites were added in each paste well for 8 hours. Spiramycin, pyrimethamine and azithromycin in different doses were used as controls. Normal saline was used as negative control. Mice were inoculated with drug-treated tachyzoites intraperitoneally or intragastrically. The normal mice were subcultured after 8 days for 3 generations. Results The incident number of the infected mice was significantly different among groups with different drugs and doses: 2/60, 16/60, 10/60 and 10/60 in the groups of Changqing capsule, spiramycin, pyrimethamine and azithromycin respectively (P