The quality of life of obese patients is frequently reduced due to comorbid gastroesophageal reflux disease (GERD), and bariatric metabolic surgery has been widely used as an effective treatment. Currently, whether GERD is complicating the postoperative period of different weight loss procedures is still controversial, making the choice of surgical procedure a key issue in the clinical management of obese patients. In this study, we retrospectively analysed the postoperative efficacy of sleeve gastrectomy, single-anastomosis gastric bypass and sleeve gastrectomy combined with gastrojejunostomy, and their complications of GERD in obese patients at our centre.

We included 95 patients with obesity combined with GERD who underwent bariatric surgery in the Department of Bariatric and Metabolic Surgery, Gulou Hospital, School of Medicine, Nanjing University, from June 2022 to June 2023, and divided them into three groups according to the surgical methods, namely, sleeve gastrectomy (SG) (35 patients), one-anastomosis gastric bypass (OAGB) (28 patients), and single anastomosis sleeve ileal (SASI) (32 patients). The weight, body mass index (BMI), change in waist circumference, and percentage of excess weight loss (EWL%) of the patients in the three groups were compared before surgery, at 6 months after surgery, and at 1 year after surgery, and the patients’ comorbidities of diabetes mellitus, GERD, and esophagitis were compared before and after surgery.

Significant body mass reduction was recorded at 6 and 12 months after surgery in the 3 groups; in addition, patients in the SG group had significant postoperative discomfort, including acid reflux and abdominal distension, whereas those who underwent SASI had more postoperative diarrhea, and the incidence of postoperative gastric colic was higher in the patients in the OAGB group; there was a significant difference in the improvement of GERD among the 3 groups postoperatively (P<0.05); according to postoperative gastroscopy as well as scale assessment results, GERD remission in patients in the SASI group was significantly better than that in the SG and OAGB groups.

Compared with OAGB and SG, SASI is the optimal choice for the treatment of obesity-combined GERD, but its long-term effect remains to be observed. In addition, the size of gastrointestinal anastomosis and the choice of the length of biliopancreatic limb need more careful experience and reasonable evidence-based research.

To investigate the risk factors of hiatal hernia complicated with asthma.

41 cases of hiatal hernia complicated with asthma admitted from February 2015 to December 2019 were retrospectively analyzed as the study group, and 293 cases of hiatal hernia were selected as the control group. Clinical indicators such as gender, age, body mass index, smoking history, drinking history, allergy history, lung function, comorbidities and blood-related indicators were compared between the two groups for analysis. Meanwhile, measurement data were represented by mean ± standard deviation (±s), and count data were represented by use cases (n). Rank sum test was used in univariate analysis and Logistic regression analysis was used in multivariate analysis to analyze risk factors.

There were significant differences between the study group and the control group in gender, allergy history, combined GERD, FVC, FEV1, FEV1/FCV% (<70%), MMEF, blood partial pressure of carbon dioxide, blood partial pressure of oxygen, blood oxygen saturation, and combined chronic bronchitis (P<0.05). Multi-factor analysis: The patient had GERD (OR=7.446,95%CI: 2.143-25.876), gender (OR=1.008,95%CI:1.001~1.019), blood partial pressure of carbon dioxide (OR=1.205, 95%CI:1.065~1.364) were independent risk factors for HH combined with asthma (P<0.05). Blood oxygen saturation (OR=0.837, 95%CI: 0.747-0.937) was an independent protective factor for HH combined with asthma (P<0.05).

Gender, GERD and blood carbon dioxide partial pressure are risk factors for patients with hiatal hernia complicated with asthma. Therefore, early intervention of risk factors should be carried out in clinical practice to stabilize disease control, avoid disease aggravation and improve the quality of life of patients.

To explore the significance and regulatory mechanism of insulin-like growth factor 2 mRNA-binding protein 3 (IGF2BP3) expression in the senescence of colon cancer cells..

In order to facilitate comprehensive research, it is imperative to procure 50 tissue specimens from patients suffering from colon cancer, who have been attended to within our gastroenterology department between January 2022 and December 2024. Concomitantly, an equivalent number of contiguous tissue samples should be gathered.Subsequently, a subset consisting of 5 samples from each category should be earmarked for transcriptome sequencing, aimed at the identification and screening of differentially expressed genes and their corresponding proteins. HCT116 cells were incubated and passaged in an incubator, and HCT116 cell suspension was prepared for transfection. After transfection,they were divided into three groups:control group (without any treatment), IGF2BP3 interference group, and IGF2BP3 interference empty group. Cell migration assay (Trenswell) was used to detect the invasion ability of HCT116 cells, Detection of reactive oxygen species (ROS) expression levels using flow cytometry, ELISA was used to detect the content of CXCR8, transforming grouth factor-β(TGF-β), IL-17, IL-6, and soluble intercellular adhesion molecule siCAM-1 in the cell supernatant,transmission electron microscopy was used to observe the morphological changes of different groups of cells, RT-PCR and WB were used to detect the gene and protein expression levels of IGF2BP3 in each group, and immunohistochemistry was used to detect the expression of IGF2BP3 in colon cancer tissue and adjacent tissues. Expression level.

Compared with the adjacent tissues,there were 821 differentially expressed genes in the cancer tissue group,including 485 up-regulated genes and 336 down regulated genes.The five genes with the highest significant upregulation were SIM2 ANKRD18EP, IGKV1D-8, MMP3, CYP24A1, The 5 genes with the highest significant downregulation of expression are CMAHP LINC02490, G6PC1, PTPRQ, LGSN. Biological process analysis shows that these differentially expressed genes mainly function in cellular processes, biological regulation, metabolic processes, cell parts, membranes, organelles, cell parts, organelles, membranes, organelle parts, membrane parts, protein-containing complexes, extracellular region parts, and extracellular regions. KEGG pathway analysis mainly clusters the disease types in endocrine and metabolic diseases, cancer diseases, immune diseases, digestive system, immune system, endocrine system, cell growth and death, lipid metabolism, replication and repair, and other pathways. The cell experiment results showed that compared with the control group,the invasion ability of cells in the IGF2BP3 interference group was significantly reduced (P<0.01), the levels of reactive oxygen species were significantly elevated, the contents of CXCR8, TGF-β, IL-17, IL-6, and siCAM-1 were significantly reduced (all P<0.05), and the expression levels of IGF2BP3 gene and protein were significantly reduced (P<0.01).

The genes expressed in colon cancer tissues are enriched in DNA replication, cell cycle,neuroactive ligand receptor interactions, rheumatoid arthritis, and Wnt signaling pathways. The interaction between these signaling pathways and IGF2BP3 gene may regulate cellular aging, leading to changes in the tumor micro environment of colon cancer and promoting its occurrence and development.

To investigate the effectiveness of using a 36F Bougie tube during laparoscopic hiatal hernia repair in reducing and preventing postoperative dysphagia and swallowing dysfunction.

A total of 40 patients with gastroesophageal reflux disease combined with hiatal hernia who underwent hiatal hernia repair combined with anti-reflux surgery at the Department of Minimally Invasive, Hernia and Abdominal Wall Surgery of the Xinjiang Uygur Autonomous Region People’s Hospital between June 2023 and January 2024 were enrolled. They were randomly divided into two groups: the laparoscopic hiatal hernia repair plus Nissen fundoplication group without the support tube (20 cases) and the laparoscopic hiatal hernia repair plus Nissen fundoplication group with the support of a 36F Bougie tube (20 cases). The χ² test was used to compare differences in swallowing function evaluations between the two groups at 1 week, 1 month, and 3 months postoperatively, while the t-test was employed to compare the differences in Gastroesophageal Reflux Disease Questionnaire (GERD-Q) scores between the two groups preoperatively and at 1 week, 1 month, and 3 months postoperatively, as well as the differences between postoperative and preoperative scores.

At 1 week postoperatively, 5 patients in the non-support tube group experienced mild dysphagia and 2 patients experienced moderate dysphagia, whereas in the support tube group, only 1 patient experienced mild dysphagia. This difference was statistically significant (χ²=8.633, P=0.013). At 1 month postoperatively, the GERD-Q score in the support tube group was higher than that in the non-support tube group [(5.30±0.65) points vs (5.15±1.18) points], and this difference was statistically significant (t=-0.496, P=0.011). However, comparisons between the two groups at 1 week and 3 months postoperatively showed no statistically significant differences (P>0.05). Within-group comparisons revealed that the GERD-Q scores in the non-support tube group at 1 week (7.25±0.85), 1 month (5.15±1.18), and 3 months (4.85±0.87) postoperatively differed significantly from the preoperative score (11.95±1.39, P<0.001). Similarly, the GERD-Q scores in the support tube group at 1 week (6.90±1.02), 1 month (5.30±0.65), and 3 months (4.65±0.58) postoperatively also differed significantly from the preoperative score (11.90±1.48, P<0.001).

The use of a 36F Bougie support tube during hiatal hernia repair combined with Nissen fundoplication effectively reduces the incidence of postoperative swallowing dysfunction while ensuring an adequate anti-reflux effect.

To investigate the expression of integrin α2 (ITGA2) and its clinical significance in gastrointestinal stromal tumors (GIST).

A total of 96 surgically resected GIST tissue specimens were collected from patients diagnosed and surgically treated at the People’s Hospital of Xinjiang Uygur Autonomous Region between January 2014 and December 2024. Based on postoperative pathological reports, 41 patients with ITGA2-positive expression were assigned to the observation group, and 55 patients with ITGA2-negative expression were assigned to the control group. Immunohistochemistry (IHC) was performed to determine the expression of ITGA2 protein in the tumor tissues. Chi-square tests were used to compare differences in clinicopathological features between the two groups, including analysis of correlations between ITGA2 expression and age, gender, tumor location, depth of invasion, tumor size, tumor risk grade, mitotic count, and expression of SMA, DOG-1, CD34, CD117, S-100, and Desmin.

The positive expression rate of ITGA2 protein in 96 GIST patients was 42.7% (41/96). The proportion of patients with tumor maximum diameter >5 cm in the ITGA2-positive group was significantly higher than that in the ITGA2-negative group [63.4%(26/41) vs 38.2%(21/55), χ²=13.486, P=0.004). The proportion of high-risk patients in the ITGA2-positive group was significantly higher than that in the ITGA2-negative group [58.5%(24/41) vs 27.3%(15/55), χ²=10.518, P=0.001). The ITGA2-positive rate in patients with mitotic count >5/50 HPF was significantly higher than that in patients with mitotic count ≤5/50 HPF [71.4%(10/14) vs 37.8%(31/82), χ²=5.525, P=0.019]. The SMA-positive rate in the ITGA2-positive group was significantly lower than that in the ITGA2-negative group [0(0/41) vs 18.2%(10/55), χ²=8.322, P=0.004). The DOG-1-positive rate in the ITGA2-positive group was significantly higher than that in the ITGA2-negative group [82.9%(34/41) vs 61.8%(34/55), χ²=5.066, P=0.040]. There were no significant different with patient age, gender, tumor location, depth of invasion, or expression of CD34, CD117, S-100, and Desmin between two groups (all P>0.05).

ITGA2 is highly expressed in the tissues of gastrointestinal stromal tumor, and its high expression is closely related to the risk grade of the tumor, which may become a new target for the specific treatment of gastrointestinal stromal tumor.

To compare the treatment costs and effectiveness of Rabeprazole combined with either Jiawei Zuojin Pill or Vonoprazan Fumarate Tablets as maintenance phase regimens.

A total of 200 patients with gastroesophageal reflux disease (GERD) entering the maintenance phase were enrolled from the People's Hospital of Xinjiang Uygur Autonomous Region between January 2020 and September 2023. The patients were randomly divided into two groups: Group A received Rabeprazole combined with Jiawei Zuojin Pill, while Group B received Rabeprazole combined with Vonoprazan Fumarate Tablets. The treatment costs and effectiveness of the two groups were comprehensively evaluated by comparing symptoms (heartburn, chest pain, acid regurgitation, etc.), esophageal mucosal healing, and improvements in quality of life before and after treatment.

The overall response rate was 88% in Group A and 72% in Group B, with a statistically significant difference (P<0.05). The cost-effectiveness ratio (CER) was 20.05% in Group A and 22.03% in Group B, showing no statistically significant difference (P>0.05). There was no statistically significant difference in the CER between the two groups (P<0.05).

While the combination therapy of Rabeprazole and Jiawei Zuojin Pill yielded a higher overall response rate and treatment cost compared to Rabeprazole combined with Vonoprazan Fumarate Tablets, the cost-effectiveness ratios between the two regimens were comparable. When cost is not a primary consideration, the combination of Jiawei Zuojin Pill and Rabeprazole is the preferred maintenance therapy option.

Hernia repair is one of the most common surgical procedures in general surgery, and tension-free hernia repair has become the mainstream surgical option in modern hernia surgery. The primary goals of hernia repair are to repair and reconstruct abdominal wall defects, restore the physiological structure of the fascia layer, and recover abdominal wall function. Therefore, selecting a mesh material that conforms to human anatomy, has good biocompatibility, and is associated with low rates of infection, erosion, and pain is crucial for enhancing patients' postoperative quality of life. Furthermore, the ability of such a material to benefit different types of hernias, various surgical procedures, and diverse patient populations through a single mesh, thereby reducing postoperative complications and improving quality of life, remains a significant challenge for hernia surgeons. During the more than 20 years of development in abdominal wall surgery in China, over 200 types of hernia meshes have been widely used in clinical practice. In recent years, biological mesh, as one of the emerging materials in hernia surgery, has offered promise for a broad spectrum of hernia patients and demonstrated satisfactory clinical outcomes, becoming a focal point within the field. However, its application is still largely in the exploratory stage and warrants further investigation. This article aims to provide a focused overview of the application of biological mesh in hernia surgery.

To explore the effect of intraoperative preventive nursing intervention on postoperative complications of lower limb deep vein thrombosis and pressure injury in obese patients with gastroesophageal reflux disease(GERD).

100 obese patients with GERD who underwent laparoscopic gastric volume reduction surgery at the People’s Hospital of Xinjiang Uygur Autonomous Region from January to December 2023 were selected as the research subjects. They were randomly divided into an experimental group and a control group, with 50 cases in each group. The control group received routine nursing intervention, while the experimental group received intraoperative preventive nursing intervention on the basis of the control group. Independent sample t-test was used to compare postoperative D-dimer levels, lower limb deep vein flow velocity, lower limb DVT incidence, DVT diameter, and pressure injury incidence between two groups of patients.

The average level of D-dimer in the experimental group after surgery was lower than that in the control group [(1.14±0.23) mg/L vs (1.23±0.21)mg/L]. The lower limb deep vein velocity in the experimental group after surgery was faster than that in the control group [(22.17±3.26)m/s vs (20.43±1.88)m/s]. The incidence of DVT detected in the experimental group after surgery was lower than that in the control group (2 cases vs 10 cases). The DVT diameter in the experimental group after surgery was smaller than that in the control group [(0.37±0.14)cm vs (0.46±0.09)cm], and the differences were statistically significant (t=2.138, P=0.035; t=-3.269, P=0.001; χ²=3.774, P=0.028; t=4.010, P<0.001). The incidence of pressure injury in the experimental group was lower than that in the control group (2% vs 16%), and the differences were statistically significant (χ²=3.481, P=0.031).

Intraoperative preventive nursing intervention can reduce the incidence of lower limb deep vein thrombosis and pressure injury in obese patients with GERD after surgery, and improve the prognosis of patients.