Objective To explore the clinical diagnostic value of peripheral blood procalcitonin(PCT)and neutrophil lymphocyte ratio(NLR)levels in elderly patients with strangulated inguinal hernia.Methods The clinical data of 112 elderly patients with acute incarcerated inguinal hernia from January 2019 to December 2022 were retrospectively analyzed,and were divided into strangulated group and non-strangulated group according to the intraoperative exploration.Multivariate Logistic regression analysis of risk factors of strangulated inguinal hernia in the elderly.Evaluation of PCT and NLR levels in peripheral blood by ROC curve in the clinical diagnosis of strangulated inguinal hernia in the elderly.Results The NLR and PCT in the strangulation group[(4.54±1.67)and(6.74±2.42)ng/ml]were higher than those in the non-strangulation group[(3.78±1.48)and(4.97±2.53)ng/ml](P＜0.05).Multivariate Logistic regression analysis showed that preoperative NLR and PCT levels were risk factors for strangulated inguinal hernia in the elderly(P＜0.05).Both NLR and PCT have high clinical diagnostic value for strangulated inguinal hernia in the elderly(AUC＞0.7),and the combined detection of NLR and PCT can improve the diagnostic efficiency(AUC=0.792).Conclusion PCT and NLR levels in peripheral blood have high clinical diagnostic value for strangulated inguinal hernia in the elderly,and combined detection of NLR and PCT can improve the diagnostic efficiency.

Objective To investigate the effect of laparoscopic Roux-en-Y gastric bypass surgery(LRYGB)in the treatment of obese diabetes.Methods The clinical data of 20 obese diabetic patients who received LRYGB from 2012 to 2018 in the Minimally Invasive and Herniac Abdominal Surgery Center of Xinjiang People's Hospital were retrospectively analyzed.Result The all 20 surgeries were successfully completed,and 1 case was converted to open surgery.The surgical time ranged from 60 to 420 minutes,with an average of(150±105.64)minutes,the intraoperative blood loss ranged from 20 to 100,with an average of(37.5±20.99)ml,and the postoperative hospital stay ranged from 5 to 15,with an average of(8.25±2.51)days.Complications occurred in 7 cases(35.00％)within 5 years after surgery,all of which were Clavien Dindo grade Ⅱ.The body weight,BMI,glycosylated blood glucose,fasting blood glucose,and the percentage of total weight loss(TWL％)at 1,3,and 5 postoperatively improved compared with those before surgery(P＜0.05).15 cases(75.00％)of type 2 diabetes were completely relieved by LRYGB 5 years after operation.Conclusion Laparoscopic gastric bypass surgery is an effective way to reduce weight and blood sugar in obese patients with type 2 diabetes.