Hiatal hernia (HH), as an important etiology of gastroesophageal reflux disease (GERD), has controversies such as confusion and inconsistent interpretation in preoperative examination protocols, which lack standardization and affect the efficacy and safety of surgery. Therefore, the Expert Working Group on Diagnosis and Treatment of Gastroesophageal Reflux Disease of the Surgery Physicians Branch of the Chinese Medical Doctor Association, together with multiple academic societies, organized 104 domestic experts to conduct offline meetings and online voting. With reference to the latest domestic and foreign guidelines, consensuses and clinical research results, an expert consensus was formed on 7 core issues, including 24-hour esophageal pH monitoring, high-resolution esophageal manometry, gastroscopy, upper gastrointestinal radiography, chest and abdominal computed tomography, gastroesophageal junction contrast-enhanced ultrasound, and other auxiliary examinations. This consensus aims to provide a reference for the selection of preoperative examinations for anti-reflux surgery related to hiatal hernia in China. However, the current research evidence is limited with low evidence levels. In the future, more high-quality studies are still needed to promote the precision and standardization of preoperative examinations for HH complicated with GERD, and to provide more optimized diagnosis and treatment strategies for patients.

To compare the short-term efficacy and safety of endoscopic antireflux mucosal ablation (ARMA) versus an optimized, guideline-based step-up proton pump inhibitor (PPI) regimen in patients with refractory or PPI-dependent gastroesophageal reflux disease (GERD) classified as gastroesophageal flap valve (GEFV) grade Ⅰ-Ⅲ.

A prospective, randomized, open-label, active-controlled trial was designed. Fifty patients were planned to be recruited and randomly assigned (1:1) to either the ARMA group or the optimized PPI group. The primary endpoint was the change from baseline in GERD health-related quality of life (GERD-HRQL) score at 6 months post-treatment. Secondary endpoints included symptom scores (GERD-Q), acid exposure time (AET) percentage, DeMeester score, PPI usage status, and adverse events. A prespecified subgroup analysis based on GEFV grade (Ⅰ/Ⅱ vsⅢ) was conducted.

Forty-eight patients completed the 6-month follow-up and were included in the analysis. The improvement in GERD-HRQL score was significantly greater in the ARMA group than in the optimized PPI group (median improvement: 23.5 vs 8.0, P<0.001). Analysis of secondary endpoints showed that the ARMA group was significantly superior to the optimized PPI group in improving objective reflux parameters such as AET (decreased from 20.1% to 4.6%) and DeMeester score, as well as in promoting PPI discontinuation or dose reduction (all P <0.001). Preliminary subgroup analysis showed that the efficacy of ARMA in improving GERD-HRQL was superior to optimized PPI in both GEFV I/II and Ⅲ grade patients (all P<0.05). Treatment-related adverse events occurred in 12.5% (3/24) of patients in the ARMA group, all of which were mild and transient dysphagia.

For patients with refractory GERD and GEFV grade Ⅰ-Ⅲ, ARMA is significantly superior to systematic optimized PPI therapy in improving symptoms, quality of life, and objective reflux parameters within 6 months, with a good safety profile. ARMA provides an effective minimally invasive therapeutic option for patients who remain symptomatic despite adequately optimized medical therapy or who wish to avoid long-term medication dependence.

To screen and identify key genes associated with oxidative stress in ulcerative colitis.

The GSE179285 gene expression profiles were acquired from the gene expression omnibus database. And GEO2R was used to identify differentially expressed genes. We intersected the differentially expressed genes with the oxidative stress-related genes screened in the GeneCard database to find the oxidative stress-related genes in ulcerative colitis. R software was used to conduct gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses of differentially expressed genes. Module of PPI network and analysis of key genes using Cytoscape software. colon mucosal Tissue samples from 30 patients with active ulcerative colitis and healthy control subjects were collected, the expression of Hub genes was verified using quantitative real-time polymerase chain reaction (qPCR).

We identified 95 differentially expressed genes in response to oxidative stress. Five key genes—CD44,CXCL8,hypoxia inducible factor 1 subunit alpha (HIF1α),interleukin-1 beta (IL1β) and angiotensinogen (AGT)—were selected as a result.qPCR analysis revealed that compared with the control group, the mRNA expression of CD44, CXCL8, HIF1α, and IL1β was elevated in the ulcerative colitis group (P<0.0001). There was no significant difference in AGT expression between the two groups (P>0.05).

CD44, CXCL8, HIF1α, and IL1β play critical roles in ulcerative colitis and could serve as potential diagnostic and therapeutic targets for the disease.

To investigate the clinical efficacy of laparoscopic hiatal hernia repair combined with fundoplication in the treatment of patients with hiatal hernia (HH) complicated by gastroesophageal reflux disease (GERD) in primary hospital.

A retrospective analysis was conducted on 46 cases of patients treated with laparoscopic hiatal hernia repair combined with fundoplication for HH complicated by GERD at Linxiang District People’s Hospital from April 2019 to June 2025. The surgical methods and techniques were summarized, and perioperative data were analyzed. Postoperative outcomes were evaluated using the short form health survey (SF-36), GERD questionnaire (GERD-Q), and numerical rating scale (NRS).

All 46 patients underwent successful surgery, with an average operative time of (103.17± 26.97) min, average blood loss of (12.71± 8.94) ml, and average time to resume liquid diet of (1.37±0.49) days. Postoperative pain scores on the NRS were (1.97±0.79) points, with 2 cases of pneumothorax and 3 cases of dysphagia. The average postoperative hospitalization duration was (5.40± 1.31) days. Patient satisfaction was high at 6 months postoperatively, with an SF-36 score of (83.88±5.5) points. Postoperative reflux symptoms were significantly alleviated, and the GERD-Q score [(2.11±0.90) points] was markedly lower than the preoperative score [(11.29±2.02) points], with a statistically significant difference (P<0.01).

Laparoscopic hiatal hernia repair combined with fundoplication is safe, feasible, and effective in treating HH complicated by GERD.

To clarify the current awareness status of laryngopharyngeal reflux disease (LPRD) among County-level Hospitals of Southern Xinjiang, and provide a scientific basis for formulating the disease’s prevention and treatment strategies.

A total of 10 county-level medical institutions were enrolled using the cluster sampling method. A cross-sectional survey was conducted among physicians in the departments of otorhinolaryngology, gastroenterology, and gastrointestinal surgery to investigate their awareness of laryngopharyngeal reflux disease (LPRD). Chi-square test and multivariate Logistic regression analysis were performed to identify the factors influencing LPRD awareness. Receiver operating characteristic (ROC) curves were plotted and the area under the curve (AUC) was calculated to evaluate the predictive efficacy of the multivariate Logistic regression model.

171 physicians were surveyed. While 84.21% had heard of LPRD, overall awareness was only 13.5%, with textbooks (72.9%) the most common source. 15.2% knew the reflux symptom index; 33.92% could correctly apply the laryngeal reflux sign scale; 20.5% recognized 24-hour MII-pH monitoring as the diagnostic "gold standard" ; 14.6% knew proton pump inhibitors as first-line therapy. Educational background, specialty, and title influenced LPRD knowledge: Bachelor’s or above degree holders had higher awareness than lower-educated counterparts (OR=12.689); gastrointestinal surgeons had lower awareness than otolaryngologists (OR=0.191); intermediate (OR=15.719) and senior (OR=95.415) title holders outperformed juniors.

Though most relevant specialty physicians in county hospitals are aware of LPRD, overall understanding is suboptimal, needing enhanced screening and treatment capabilities.

To systematically analyze the research status and development trends in the field of laparoscopic fundoplication and anti-reflux surgery in the treatment of gastroesophageal reflux disease (GERD).

The PubMed database was searched for relevant literature from January 2014 to September 2024, and 809 research papers and reviews were included. The R language bibliometrix software package was used for bibliometric analysis, covering publication trends, journal distribution, author contributions, national cooperation, keyword co-occurrence, and topic evolution. The time stratified analysis method is used to calculate the citations per paper (CPP) and the normalized citation impact index (NCLI) according to the year of publication to correct the impact of publication time on citation accumulation.

This field publishes an average of about 73 articles per year, and its activity has increased significantly in the past five years. The main journals publishing articles focus on the field of surgery and minimally invasive surgery, with the "Journal of Laparoendoscopic & Advanced Surgical Techniques" having the highest number of articles (40 articles). Author productivity is in line with Lotka’s law. Highly productive authors are concentrated in a small number of researchers, represented by Omura Nobuo and Yano Fumiaki. Country analysis shows that the United States leads in terms of total number of articles published (356), total number of citations (401 times), and international cooperation; China ranks third in number of articles published (158) and second in total number of citations (229 times). After correction by time-stratified analysis, China’s average citation frequency (1.45 times/article) is still significantly higher than the global average (1.28 times/article). The standardized citation impact index (NCLI=1.13) shows that its academic quality is internationally recognized, but there is still a gap compared with the United States (CPP=3.12, NCLI=1.89). Keyword analysis shows that "fundoplication" , "Nissen fundoplication" and "GERD" are core topics, while "bariatric surgery" and "obesity" are emerging niche directions. The co-citation network shows that the documents of Stefanidis (2010) and Galmiche (2011) play an important role in laying foundation for knowledge.

Research on laparoscopic anti-reflux surgery for the treatment of GERD has continued to develop in the past decade and has formed a centralized academic landscape. The United States occupies a dominant position, and Chinese research shows robust academic influence under standardized indicators. In the future, further attention should be paid to personalized treatment, robot-assisted surgery, GERD and metabolic disease comorbidity management, and international cooperation should be strengthened to increase citation influence and promote innovation in the field.

This article systematically compares the multiple mechanisms by which laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) affect postoperative metabolism in obese patients with obstructive sleep apnea (OSAS). As a key comorbidity of OSAS, gastroesophageal reflux disease (GERD) has a bidirectional pathological exacerbation relationship with OSAS, and the different effects of these two procedures on GERD are directly related to the postoperative remission of OSAS. In addition to reducing upper airway fat deposition and alleviating intermittent hypoxia and systemic inflammation through weight-dependent mechanisms, both procedures directly regulate glucose and lipid metabolism via non-weight-dependent mechanisms such as gastrointestinal hormone remodeling, bile acid signal activation, and gut microbiota regulation. Among them, RYGB shows superior advantages in the regulation of enteric hormones and bile acids, and has a definite anti-reflux effect; while LSG exerts metabolic benefits by strongly inhibiting ghrelin and enhancing GLP-1/PYY responses, and can also inhibit oxidative stress-induced adipose inflammation through regulating the GLP-1/DPP-4 pathway, but carries the risk of inducing or exacerbating GERD. This review aims to provide a comprehensive mechanistic basis for the individualized selection of surgical procedures for obese patients with OSAS, especially those with concomitant GERD.