To investigate the efficacy of anti-reflux mucosal ablation （ARMA） in treating reflux hypersensitivity （RH）.
Method
A retrospective analysis was conducted on the efficacy of 8 RH patients who received endoscopic ARMA treatment at Department of Gastroesophageal Surgery Department of Rocket Force Characteristic Medical Center from August 2022 to August 2023. The subjective relief of gastroesophageal reflux related symptoms， discontinuation rate of acid suppressant， postoperative complications， recurrence， and re treatment were compared before and after ARMA.
Results
There were 3 males and 5 females in this group of RH patients， with a mean of 53 years. The mean follow-up time after ARMA was 18 months， and the subjective relief rates of acid reflux， heartburn， and chest/back pain symptoms in postoperative patients were 72%（38， 10）%， 70%（50， 95）%， and 70%（25， 97）%， respectively. And the symptom scores were significantly lower than before surgery （all P＜0.05）. The postoperative discontinuation rate of acid suppressing drug was 87.5% （7/8）， and the satisfaction rate of therapeutic effect was 75% （6/8）.There were 2 cases of postoperative swallowing pain discomfort， 1 case of abdominal distension， and 1 case of upper abdominal pain， all of which were mild and relieved within 1 week after conservative treatment.There were no cases of postoperative dysphagia. There was 1 case of partial recurrence of symptoms and no cases of anti-reflux reintervention.
Conclusion
ARMA can alleviate the GERD symptoms in most RH patients， with a high satisfaction rate of efficacy and acid suppressing drug discontinuation rate. Postoperative complications are rare and mild. However， further research is needed to determine the more accurate safety and efficacy of ARMA.
To observe the clinical effect of Tiaoben Jiangyi Decoction in treating gastroesophageal reflux disease （GERD） with qi stagnation and phlegm obstruction.
Methods
76 patients with Qi-stagnation and phlegm-blocking GERD were randomly divided into control group and observation group， with 38 cases in each group. The control group was given Esomeprazole enteric-coated capsule and Itopride hydrochloride tablets， and the observation group was combined with Tiobanjiangi Decoction on the basis of the control group， the course of treatment was 8 weeks. After treatment， the clinical effects of the two groups were compared， including Traditional Chinese medicine（TCM） syndrome score， endoscopic esophageal mucosa grading score， GERD quality of life score and the occurrence of adverse reactions before and after treatment.
Results
The total effective rate of observation group was 82.21%， higher than that of control group 68.42%， the difference was statistically significant （P ＜ 0.05）. TCM syndrome， gastroesophageal reflux disease healthrelated quality of life scale （GERD-HRQL） and endoscopic esophageal mucosa grading score after treatment were significantly different from those before treatment in 2 groups （P ＜ 0.05）. TCM syndrome， GERD-HRQL and endoscopic esophageal mucosa grading score in the observation group were better than those in the control group （P ＜ 0.05）. The total incidence of adverse reactions was 39.47% in control group and 21.05% in observation group， and the difference was statistically significant （P ＜ 0.05）.
Conclusion
Tioben Jiangyi Decoction can not only effectively relieve the reflux symptoms of GERD， but also reduce the manifestations of gastroesophageal mucosa under endoscopy， which also plays an important role in improving the quality of life. Compared with conventional treatment， its clinical efficacy is more significant and its safety is better.
To explore the application of Problem based learning （PBL） teaching model in clinical practice teaching of respiratory department， to help students understand the relationship between gastroesophageal reflux disease， asthma and refractory cough， so as to improve learning efficiency.
Methods
Undergraduate students selected for clinical practice in the respiratory center were divided into experimental combination control group. By comparing the scores of students in the two groups and the evaluation of PBL teaching method， PBL teaching mode and the characteristics and implementation methods of traditional clinical practice in respiratory department， as well as the teaching assessment results and teaching feedback.
Results
Under PBL teaching mode， students’ learning initiative and understanding of difficult problems are improved， which is helpful to cultivate and improve students’ clinical thinking ability.
Conclusion
PBL teaching mode is a good supplement to the traditional teaching mode， and the organic combination of the two is suitable for solving the difficult problems in the current clinical practice teaching of respiratory medicine.
To explore the development of performance management in gastroenterology in China through visual analysis.
Methods
“Digestive disease” “gastroenterology”“gastroenterology”“digestive system”“performance” etc. were used as search terms to search for relevant literature in the field of performance assessment in gastroenterology included in CNKI， WanFang，VIP， and CBM. The search period was from January 2010 to December 2023. Based on the principle of bibliometrics， with the help of Citespace and other visualization and analysis software， scientific knowledge mapping is carried out on the amount of relevant research publications， author cooperation， publishing institutions， research hotspots and trends.
Results
A total of 78 Chinese articles were included in this study.It was found that performance appraisal about gastroenterology is getting more and more attention from hospitals. Domestic related literature and research teams， inter-institutional communication and partnership started late. Early domestic studies focused on the performance management of gastroenterology nurses and their influencing factors. Now mostly focus on the performance appraisal model of gastroenterology carried out under the DRG payment model.
Conclusion
With the deepening of public hospital reform and the development of hospital performance management concepts， the degree of attention to the performance management research of various departments has deepened， and the performance management research for gastroenterology has been expanded to a certain extent.
In recent years， with the gradual development of bariatric surgery and the increase in the number of surgical cases， how to choose the appropriate surgical approach for patients with obesity and hiatus hernias （HH） or gastroesophageal reflux disease（GERD） has become a hot topic in the academic community. Current research shows that for patients with obesity and HH or GERD， laparoscopic sleeve gastrectomy（LSG）， whether combined with hiatus hernias repair or not， is not as effective as Roux-en-Y gastric bypass （RYGB） in improving GERD， and may lead to the emergence of new GERD. For patients who undergo revision surgery due to GERD or HH after LSG， RYGB can achieve good control of GERD and is superior to one anastomosis gastric bypass. Therefore， for obese patients with HH or GERD， RYGB may be a more appropriate weight loss surgery.
Esophageal cancer is a common malignant tumor of the upper gastrointestinal tract，and in Asian countries， over 90% of esophageal cancer pathological manifestations are esophageal squamous cell carcinoma ESCC. Although significant progress has been made in the diagnostic technology and comprehensive management methods of ESCC， the overall 5-year survival rate of ESCC is still not satisfactory. At present， the specific mechanism of the onset and progression of ESCC is still unclear，and many studies have explained its pathogenic mechanism from the perspectives of oxidative stress，mitochondria， iron death， chronic inflammation， etc.
Robot assisted surgery technology has brought breakthrough progress to the field of minimally invasive surgery. In recent years， it has been widely used in the repair of hiatal hernia combined with gastric folding surgery. Research has shown that robot assisted repair of esophageal hiatal hernia combined with gastric folding surgery has advantages over traditional laparoscopic and open surgery in terms of precision， shorter surgical time， shorter hospital stay， and less bleeding compared to a new and more minimally invasive approach. However， at present， due to the complexity of robotic equipment and high surgical costs， the advantages of laparoscopic surgery are not significant enough. Therefore， some people believe that robotic surgical systems are not recommended for esophageal hiatal hernia surgery. There is still no standard surgical strategy for hiatal hernia. In addition， individualized surgical plans， selecting suitable surgical methods， reducing postoperative complications， and improving patients’ quality of life are extremely important considerations in clinical practice. So the potential clinical value of robotic systems in esophageal hiatal hernia repair surgery is even more important
To explore the application effect of Failure Mode and Effects Analysis（FMEA） in nursing cooperation for esophageal hiatal hernia repair surgery assisted by da Vinci robots.
Methods
Retrospective analysis of clinical data of patients who underwent da Vinci robot assisted esophageal hiatal hernia repair surgery in our hospital from April 2021 to December 2023. A total of 100 patients from April 2021 to July 2022 were given routine care as the routine group， and 100 patients from August 2022 to December 2023 were given FMEA care as the FMEA group. Compare the risk priority number （RPN） values of two groups before and after implementation， including improper implementation of protective measures for intraoperative acquired pressure injuries， non-standard counting of surgical items，improper installation of sterile instrument arms， improper implementation of intraoperative hypothermia prevention measures， and improper operation of electrical surgical equipment in the da Vinci robotic surgical system， The incidence of nursing adverse events （including acquired pressure injuries， discrepancies in the number of surgical items counted， contamination of sterile barriers， intraoperative hypothermia， and intraoperative electric burns）， and the satisfaction of doctors with the work of operating room nurses.
Results
After taking targeted improvement measures， the corresponding RPN values decreased and the difference was statistically significant （P＜0.05）； The incidence of nursing adverse events such as IAPI，discrepancy in the number of surgical items counted， contamination of sterile barriers， intraoperative hypothermia， and intraoperative electric burns decreased significantly （P＜0.05）； The satisfaction of doctors with surgical nurses has improved， and the difference is statistically significant （P＜0.05）.
Conclusion
The application of failure mode and effect analysis method in the nursing coordination of esophageal hiatal hernia repair surgery assisted by da Vinci robot has shown good results， effectively reducing the incidence of adverse events， improving the quality of surgical care and doctor satisfaction， and is worthy of promotion.
To explore the preventive effect of cluster nursing on aspiration pneumonia in patients with gastroesophageal reflux disease.
Methods
A total of 90 patients with intensive care unit treated in Xinjiang Uygur Autonomous region people’s Hospital from January 2022 to July 2022 were randomly divided into observation group and control group. The observation group was given cluster nursing and the control group was given routine nursing. The incidence of aspiration pneumonia， anxiety score and clinical symptom score were compared between the two groups.
Results
After the implementation of cluster nursing， the incidence of aspiration pneumonia in the observation group （6.67%） was significantly lower than that in the control group （17.78%） （P＜0.05）. After cluster nursing， the anxiety score in the observation group was significantly lower than that in the control group ［（49.71 ±2.65） points vs （53.47 ±3.24）points，P＜ 0.05］. After cluster nursing， the scores of clinical symptoms in the observation group were lower than those in the control group， and the difference was statistically significant （P＜ 0.05）.
Conclusion
The implementation of cluster nursing measures can effectively reduce the incidence of aspiration pneumonia，relieve negative emotion， improve clinical symptoms and improve the quality of life of patients with gastroesophageal reflux disease.
