Objective To present the initial practice of a novel procedure for the surgical treatment of inguinal hernia-"lateral approach single-incision laparoscopic totally extraperitoneal(L-SILTEP)repair"in certain specific situations.Methods The clinical data of 110 inguinal hernia patients who underwent L-SILTEP in the First Affiliated Hospital of Ningbo University,Shanghai General Hospital affiliated to Shanghai Jiao Tong University School of Medicine,and Shanghai East Hospital affiliated to Tongji University from June 2021 to March 2024 were collected retrospectively.Patients' demographics,surgical details,length of hospital stay,and postoperative outcomes were analyzed respectively.Results All surgeries were completed successfully and there was no conversion.The median surgical time was 55(41.25,70)mins and the intraoperative blood loss was 5(2,10)mL.In surgery,inferior epigastric artery injury occurred in 5 cases(4.5%)and spermatic cord injury occurred in 1 case(0.9%).The mean visual analog scale(VAS)scores pain assessment at 6,24,and 48 h after surgery were 3.0±0.8,1.9±0.7 and 1.1±0.4,respectively.The duration of hospital stay was(3.3±0.7)days.The most common postoperative complication was seroma,which occurred in 9 cases(8.2%).Additionally,extraperitoneal hematoma occurred in 1 case(0.9%)and scrotum effusion in 1 case(0.9%).Conclusions Generally,L-SILTEP is safe,feasible and effective.However,due to its advanced technique-demand,the application of L-SILTEP should be patient-specific and surgeon-specific.The successful implementation of this surgical procedure necessitates extensive training and meticulous attention to the surgical details.

Objective:To develop a transitional care practice protocol for neurosurgical intensive care unit (ICU) patients based on the Secure-Encourage-Collaborate (SEC) model and to explore its effectiveness, providing a reference for clinical practice.Methods:Through literature analysis, expert verification in our hospital, core group discussions, and the Delphi expert consultation method, a transitional care practice protocol for neurosurgical ICU patients based on the SEC model was developed. A convenience sampling method was used to select 160 patients admitted to the Neurosurgical ICU of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from March 2022 to October 2023. Eighty patients admitted from March to December 2022 were designated as the control group, and eighty patients admitted from January to October 2023 were designated as the experimental group. The control group received the routine post-discharge follow-up care protocol, while the experimental group received the transitional care practice protocol based on the SEC model. The ICU quality control indicators, rehabilitation outcomes, adverse events were compared between the two groups.Results:The experimental group had significantly shorter ICU stay and total hospitalization days compared to the control group, and fewer cases of readmission within 48 hours after ICU discharge ( P<0.05). The experimental group showed lower pain scores, higher scores for self-care in daily activities, shorter time to first ambulation after ICU discharge, and longer daily ambulation time within the first week post-discharge compared to the control group, with statistically significant differences ( P<0.05). No statistically significant differences were observed between the two groups in the incidence of stage II or higher pressure injuries, falls/bed falls, unplanned extubations, aspiration, and lower limb deep vein thrombosis ( P>0.05) . Conclusions:The transitional care practice protocol for neurosurgical ICU patients based on the SEC model can effectively improve the quality of care.

Objective:To develop a transitional care practice protocol for neurosurgical intensive care unit (ICU) patients based on the Secure-Encourage-Collaborate (SEC) model and to explore its effectiveness, providing a reference for clinical practice.Methods:Through literature analysis, expert verification in our hospital, core group discussions, and the Delphi expert consultation method, a transitional care practice protocol for neurosurgical ICU patients based on the SEC model was developed. A convenience sampling method was used to select 160 patients admitted to the Neurosurgical ICU of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from March 2022 to October 2023. Eighty patients admitted from March to December 2022 were designated as the control group, and eighty patients admitted from January to October 2023 were designated as the experimental group. The control group received the routine post-discharge follow-up care protocol, while the experimental group received the transitional care practice protocol based on the SEC model. The ICU quality control indicators, rehabilitation outcomes, adverse events were compared between the two groups.Results:The experimental group had significantly shorter ICU stay and total hospitalization days compared to the control group, and fewer cases of readmission within 48 hours after ICU discharge ( P<0.05). The experimental group showed lower pain scores, higher scores for self-care in daily activities, shorter time to first ambulation after ICU discharge, and longer daily ambulation time within the first week post-discharge compared to the control group, with statistically significant differences ( P<0.05). No statistically significant differences were observed between the two groups in the incidence of stage II or higher pressure injuries, falls/bed falls, unplanned extubations, aspiration, and lower limb deep vein thrombosis ( P>0.05) . Conclusions:The transitional care practice protocol for neurosurgical ICU patients based on the SEC model can effectively improve the quality of care.

Objective To explore the feasibility of using the prospective space-time analysis and early warning in health emer-gency command system in Chongqing .Methods Prospective space-time scan analysis method was used for the early detection of disease outbreaks in mumps patients from 5 districts(Jiangbei ,Shapingba ,Dadukou ,Jiulongpo ,Nan′an ,) in Chongqing in 2006 ,then verified the aggregation using the actual reported mumps outbreaks .Results The results showed that 3 early warning signals at October 9th ,November 13th ,December 4th ,involving a total of 5 locations(streets/towns) .The strongest warning happened on Oc-tober 9th in Zengjia town of Shapingba district ,and Jingfeng town of Jiulongpo district ,the recurrence interval was 1 916 495 550 992 471 years .There were 2 mumps outbreaks have been reported in the surveyed areas .Both the the 2 outbreaks were detected by the prospective space-time scan statistic 5-6 days early than the actually occurred time .Conclusion The prospective space-time scan analysis method could be applied to the disease monitoring and early warning in health emergency command decision-making system in Chongqing .

ObjectivesTo study the relationship between the allele frequencies and genotype distribution of transforming growth factor-beta 1(TGF-β1) gene promoter polymorphisms in Chinese patients with heptocellular carcinoma(HCC),and to analyze the association of the serum levels and genotype of TGF-β1 with HCC.MethodsThe polymorphisms of TGF-β gene,including polymorphisms of TGF-[β1 gene -800G/A、-509C/T,were analyzed by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)methods in 102 patients with HCC and 110 healthy controls,and the serum level of TGF-β1 was determined by enzyme-linked immunosorbent assay (ELISA). ResultsThe HCC group showed significantly higher serum levels of TGF-β1 than control group [(51.06 ± 9.74)μg/L,(22.12 ± 8.67 )μg/L,t=22.884, P＜0.01], The distributions of TGF-β gene -800G/A polymorphisms were not different significantly between HCC group and control group, but TGF-β1 -509C/T gene polymorphism was significantly different. The relative risk suffered from HCC of C allele was 1.822 times of the T allele (OR=1.822,95 ％CI:1.238-2.682,t=22.884,P＜0.01), the serum level of TGF-β1 T allele carriers was significantly higher than that of no carriers [(53.52:±:10.07)μg/L,(43.57±9.89)μ.g/L,t=3.898, P＜0.01]. ConclusionTGF-β1 gene -509C/T polymorphism is associated with HCC, and T allele may be a risk factor for HCC, in which the TGF-β1 T allele carriers may have increased risk by enhancing the TGF-β1 expression in the pathogenesis of HCC.

Objective To investigate the diagnosis rate of early gastric calleer(EGC)with mucosa biopsy after compound staining under gastroseopy.Methods Two hundreds and six pafients who suspected tO be EGC by gastroscopy were randomly divided into two groups,the mucosa in control group(n=103)was biopsy directly under gastrescopy,and the experimental group(n=103)was biopsy after compound staining.Compared the diagnosis rate of ECG between these two groups.Results Twelve cases were confirmed to be EGC by surgery plus pathology among all the patients.Two cases were from control group,the other ten cases were from experimental group.Type Ⅱ c+Ⅲ accounted for 58.3%of twelve EGG.Eleven cases(91.7%)were positive with helicobacter pylori(Hp).Conclusion Compound staining may improve diagnosis rate of ECG.There is significant deference between directed and mueosa biopsy after compound staining under gastrescopy(P=0.033).TypeⅡc+Ⅲwere main type in endoscope of EGC.Hp infection is closely related to early gastric cancer.