To analyze the clinical efficacy of laparoscopic hiatal hernia (HH) repair combined with fundoplication in the treatment of HH combined with gastroesophageal reflux disease (GERD).

The clinical data of 78 patients with HH combined with GERD who were hospitalized and operated in the Department of General Surgery of Bayin’guoleng Mongol Mongol People’s Autonomous Prefecture Hospital in Xinjiang from January 2008 to December 2023 were retrospectively analyzed. The Gastroesophageal Reflux Disease Questionnaire (GERD-Q), Reflux Disease Questionnaire (RDQ), Reflux Symptom Index Questionnaire (RSIQ) scores, body mass, and Body Mass Index (BMI) of the patients at the preoperative and postoperative follow-ups were recorded, Paired t-tests were used to compare the differences in these indicators between the preoperative and postoperative periods. Bivariate Pearson correlation analysis was used to assess the correlation between RDQ and RSI scale scores, body weight, BMI, and symptom severity (GERD-Q score).

Postoperatively, the GERD-Q score decreased from (11.27±1.95) to (6.51±1.18), the RDQ score from (17.78±3.71) to (8.76±2.23), the RSIQ score from (18.94±3.84) to (9.11±2.31), and body mass from (68.67±10.33) kg to (63.73±6.84) kg, and BMI decreased from (24.01±4.12) kg/m² to (22.30±3.17) kg/m², all of which were statistically significant differences compared with the preoperative period (t = 22.501, 27.589, 23.993, 7.807, and 7.726, all P<0.001); correlation analyses of GERD-Q scores showed that RDQ, RSI scale score, body weight, and BMI were positively correlated with Gerd symptom severity, and the difference was statistically significant (r=0.557, 0.514, 0.283, 0.386, P<0.001, <0.001, = 0.012, <0.001).

Laparoscopic HH repair combined with fundoplication can be effective in treating HH combined with GERD and achieve improvement of reflux symptoms and weight loss.

To investigate the causal relationship between dietary habits and phenotypes of gastroesophageal reflux disease using Mendelian randomization.

A total of 24 dietary patterns, including cereal, meat (poultry, beef, pork, oily fish, non-oily fish, processed meat, and lamb/mutton intakes), vegetable (salad/raw vegetable and cooked vegetable intakes), fresh fruit, and beverage (alcohol intake frequency, alcoholic drinks per week, tea intake, and coffee, water, fizzy drink, and milk intakes) intakes, another food intake (cheese, starchy food, dark chocolate, and ice cream intakes), and type of diet (salt added to food, hot drink temperature, and low-calorie diet), were included from the Integrative Epidemiology Unit and UK Biobank. The GERD dataset was obtained from the FinnGen Consortium Release 9, and a Mendelian randomization approach was employed to analyze the causal association between these dietary factors and the risk of GERD. The main method of Mendelian randomization analysis was inverse variance weighting (IVW). The stability of the instrumental variables was tested by calculating the F-value statistic, and the heterogeneity was tested by Cochran’s Q statistics. In addition, weighted medians (WM). and MR-Egger regression and leave-one-out methods were used to assess sensitivity and pleiotropy. The Steiger test detects reverse causality.

IVW showed that salad/raw vegetable intake (OR=0.411, 95%CI: 0.189-0.894; P=0.025), and the IVW, WM and MR-Egger regression were in the same direction. Steiger test found no evidence of reverse causality (steiger pval=2.11×10^-50). The results of sensitivity analyses were robust, and there was no heterogeneity, pleiotropy, or reverse causality.

The results of Mendelian randomization analysis support a potential causal relationship between salad/raw vegetable intake and gastroesophageal reflux disease.

To investigate the real-world effectiveness of the microservice-based "Cloud Anytime Practice" platform in improving the clinical procedural skills and learning efficiency of standardized residents.

Aligned with the hospital’s standardized training model, we developed the Cloud Anytime Practice platform using a microservice architecture that integrates rubric management, multimodal skill-content management, mobile learning and practice, and video-assignment submission with remote feedback. Thirty 2024-cohort socialized residents from the People’s Hospital of Xinjiang Uygur Autonomous Region were randomly recruited. They used the platform for fragmented learning, simulation training, and video-assignment submission, while instructors provided remote comments and assessments. Pre- and post-training scores (0–100) were compared for four stations—head-and-neck, cardiac, chest, and abdominal examinations by t-test. A questionnaire gauged user acceptance.

Post-training scores for all four stations rose significantly (t=-12.65, -10.29, -13.71, -8.94, all P<0.001), head-and-neck examination improved from 68.53±6.25 to 84.45±2.91; cardiac examination from 59.93±7.86 to 77.46±5.04; chest examination from 70.73±5.15 to 85.78±3.10; and abdominal examination from 69.30±5.85 to 81.58±4.74. Mean clinical skill scores increased by more than 10 points. Survey results showed high resident ratings for the platform’s convenience and practicality, and instructors strongly endorsed its educational value.

The Cloud Anytime Practice platform effectively transcends time and location constraints. Through personalized learning paths, simulation training, and real-time feedback, it significantly enhances the clinical skills and assessment results of residents in Xinjiang, earning broad recognition from both learners and faculty. It represents a viable tool for optimizing local standardized training programs and mitigating uneven distribution of medical education resources.

Laparoscopic anti-reflux surgery is an important treatment option for hiatal hernia combined with gastroesophageal reflux disease. With the increase in the number of anti-reflux surgeries performed, the failure of anti-reflux surgery has become an urgent problem that needs to be addressed. This article reviews domestic and international literature on the failure of antireflux surgery. It comprehensively elaborates on the diagnosis, classification, causes, prevention, and treatment of anti-reflux surgery failure, aiming to contribute to the advancement of anti-reflux surgery in China.

Artificial Intelligence (AI) has demonstrated great potential in the diagnosis and treatment of gastroesophageal reflux disease (GERD). By leveraging algorithms such as machine learning and deep learning, AI occupies a pivotal position in understanding the pathogenesis, diagnosis, treatment, and prognosis assessment of GERD. Although challenges related to ethics, data, and legal aspects still exist, with the advancements of AI technology, AI is expected to provide more precise evidence to support the entire course of diagnosis, treatment, and management system for GERD, thereby improving patient outcomes.

Ulcerative colitis (UC) and gastroesophageal reflux disease (GERD) are two prevalent gastrointestinal disorders, affecting the intestinal tract and the esophagus-stomach region, respectively. However, recent studies have revealed potential intricate connections between them in terms of pathophysiological mechanisms, shared risk factors, pharmacological impacts, and complications. This review systematically synthesizes the latest research advancements, with a particular focus on the pivotal role of gut microbiota in the interplay between UC and GERD. Research findings suggest that impaired intestinal barrier function, neuroendocrine dysregulation, and gut microbiota-mediated immune-inflammatory responses may constitute the core mechanisms underlying the co-pathogenesis of these two conditions. Furthermore, shared risk factors such as diet, psychological factors, and medication use exacerbate their mutual influence. This review aims to provide a theoretical foundation for clinical diagnosis and treatment, and calls for future research to delve deeper into the molecular mechanisms of gut microbiota in the association between UC and GERD, thereby paving new avenues for the prevention and treatment of gastrointestinal diseases.

To investigate the efficacy of enhanced recorery after surgery (ERAS) nursing in patients undergoing robot-assisted hiatal hernia repair (RHHR).

A retrospective analysis was conducted on 60 patients who were hospitalized for RHHR in the Minimally Invasive Surgery Department, Hernia and Abdominal Wall Surgery Department of Xinjiang Uygur Autonomous Region People’s Hospital from October 2022 to December 2024. The patients were divided into an ERAS group and a control group, with 30 patients in each group, based on their nursing care. The control group received routine nursing care, while the ERAS group received ERAS-based nursing care in addition to routine care. Comparison of postoperative first oral intake time, first defecation time, postoperative hospital stay, total hospitalization duration, economic benefits, postoperative pain scores, venous thromboembolism (VTE) risk, and incidence of postoperative cough and sputum production between the two groups by Wilcoxon signed rank sum test, t-test and χ² test.

ERAS group demonstrated significantly improved postoperative recovery, with earlier first oral intake [8.0(6.0, 15.0)h vs 14.0(10.0, 21.0)h; Z=-5.440, P<0.001], first flatus [10.0(9.0, 12.0)h vs 20.0(16.0, 23.0)h; Z=-5.598, P<0.001], and first bowel movement [12.0(10.0, 13.0)h vs 21.0(17.7, 25.0)h; Z=,-5.687 P<0.001] when compared to the control group, furthermore, the ERAS group experienced significantly shorter postoperative hospital stay [3.5(2.0, 4.2)d vs 6.0(4.0, 10.5)d; Z=-3.858, P<0.001] and total hospitalization duration [12.5(9.0, 14.3)d vs 19.0(14.0, 23.0)d; Z=-3.880, P<0.001], when compared to the control group. Economically, total costs were significantly lower in the ERAS group [(59 111±11 670)yuan vs (73 533±14 632)yuan] compared to the control group (t=-4.220, P<0.001). Pain scores were significantly lower in the ERAS group on postoperative days [2.0(2.0, 4.0)vs 4.0(4.0, 4.0); Z=-3.768, P<0.001] and 2 [1.0(0, 1.0)vs 2.0(1.7, 2.0); Z=-6.134, P<0.001], and also on day 3 [0(0, 1.0) vs 1.0(0, 1.0); Z=-2.531, P=0.011], when compared to the control group. The ERAS group also showed a lower VTE score on discharge day [0(0, 1) vs 1(0, 1); Z=-2.393, P=0.017] and a significantly lower incidence of postoperative cough and sputum (1/30 vs 7/30; χ²=5.192, P=0.023) when compared to the control group.

ERAS perioperative nursing can promote gastrointestinal function recovery, shorten hospital stay, reduce postoperative pain and hospitalization cost in patients undergoing robotic hiatal hernia repair.