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Purpose: Incisional hernia is a common postoperative complication; however, few transcriptomic studies have been conducted on it. In this study, we used second-generation high-throughput sequencing to explore the pathogenesis and potential therapeutic targets of incisional hernias. Methods: Superficial fasciae were collected from 15 patients without hernia and 21 patients with an incisional hernia. High-throughput sequencing of the fascia was performed to generate an expression matrix. We analyzed the matrix to identify differentially expressed genes (DEGs) and performed gene ontology and enrichment analyses of these DEGs. Additionally, an external dataset was utilized to identify key DEGs. Results: We identified 1,823 DEGs closely associated with extracellular matrix (ECM) imbalance, bacterial inflammatory response, and fibrillar collagen trimerization. TNNT3, CMAY5, ATP1B4, ASB5, CILP, SIX4, FBN1 and FNDC5 were identified as key DEGs at the intersection of the two expression matrices. Moreover, non-alcoholic fatty liver disease-related, TNF, and IL-17 signaling pathways were identified as key enrichment pathways. Conclusions: We identified eight key DEGs and three pathways associated with incisional hernias. Our findings offer new insights into the pathogenesis of incisional hernias and highlight potential targets for their prevention and treatment. [ABSTRACT FROM AUTHOR]

The interrelationship between tourism urbanization (TU) and the ecological environment is extremely complex. Some studies have analyzed the interaction between them but ignored the ecosystem services. Therefore, exploring the coupling coordination relationship between TU and ecosystem services value (ESV) is significant. In this research, we established a coupling coordination degree (CCD) model between TU and ESV and used exploratory spatial data analysis (ESDA), spatial variogram model, and obstacle degree model to evaluate the evolution characteristics of CCD and its obstacle factors in the Wuling Mountain area of Hunan Province (WMAHP). The results are as follows: (1) the comprehensive TU level shows an upward trend, and TU levels in the west are generally higher than in the east. The total ESV shows a fluctuating upward trend, and the average ESV is relatively low in the west and southeast. (2) The comprehensive CCD shows an increasing trend, and the coupling coordination relationship has changed from uncoordinated to coordinated in most counties. Spatially, the global spatial autocorrelation and spatial variation degree of CCD are insignificant. Wulingyuan and Yongding are uplift areas, and a subsidence area is in the southeast. It is worth noting that the problem of TU lag generally exists. (3) For the whole area, TU and economy are always the primary obstacle factors in the system and category layer, respectively, but the obstacle degree of the population has gradually increased. At the county level, TU restricts the CCD improvement in most counties, and the proportion of counties where the economy is the primary obstacle in the criterion layer exceeds 60%. Policymakers need to formulate targeted promotion strategies based on the coupling coordination and relative development level between TU and ESV for different counties. This paper provides valuable references for achieving coordinated development between TU and ESV in ecologically fragile areas worldwide. [ABSTRACT FROM AUTHOR]

Venous thromboembolism (VTE) is an important postoperative complication. We investigated and analyzed the current inguinal hernia treatment methods and occurrence of early postoperative VTE in Chinese adults. This study involved data for patients with inguinal hernia hospitalized in 58 general hospitals in mainland China from January 1st, 2017 to December 31st, 2017. Data were retrospectively analyzed using a questionnaire. After data inputting and cleaning, we stratified and statistically analyzed patients' data using Caprini scores to create a high-, middle-, and low-risk group. A total of 14,322 patients with inguinal hernia were admitted to the 58 participating hospitals. After data collation and cleaning, 13,886 patients (97.0%) met our inclusion and exclusion criteria. The percentages of laparoscopic surgery and open surgery were 51.2% and 48.8%, respectively. 16 VTEs occurred during the hospitalization, accounting for 0.1% of all adverse events (95% confidence interval (CI) 0.11–0.13). The incidence of VTE was 0.2% (95% CI 0.18–0.2) in the high-risk group and 0.02% (95% CI 0.01–0.03) in the middle-risk group, based on Caprini scoring, with a significant difference (p < 0.0001). No VTE occurred in the low-risk group. Only 3,250 (23.4%) patients underwent Caprini risk assessment regarding treatment, with 13.2% receiving any prevention and only 1.2% receiving appropriate prevention. The treatment of inguinal hernia in Chinese adults has progressed somewhat; however, the evaluation and prevention of perioperative VTE was seriously neglected, in our study, and the incidence of postoperative VTE was underestimated postoperatively. Risk factors continue to be inadequately considered. [ABSTRACT FROM AUTHOR]

We aim to summarize the available literature on patients treated with robotic bariatric surgery (RBS) or laparoscopic bariatric surgery (LBS) and compare the clinical outcomes between RBS and LBS. A systematic literature was conducted in accordance with the PRISMA guidelines. Thirty-four observational studies met our inclusion criteria, and 27 studies of 27,997 patients were included in the meta-analysis. There were no significant differences between RBS and LBS regarding overall postoperative complications, major complications, the length of hospital stay, reoperation, conversion, and mortality. Nevertheless, RBS was burdened by longer operative times and higher hospital costs when compared with LBS. On the contrary, the incidence of anastomotic leak was lower in RBS than in LBS. Further studies with a longer follow-up are recommended. [ABSTRACT FROM AUTHOR]

We determine the sizes of orbits from the action of subgroups of PSL(2, q) on projective line X = GF( q) ∪ {∞} with q a prime power and congruent to 1 modulo 4. As an example of its application, we construct some new families of simple 3-designs admitting PSL(2 , q) as automorphism group. [ABSTRACT FROM AUTHOR]