To evaluate the therapeutic efficacy of applying the "Four-in-One" concept in the repair of hiatal hernia and fundoplication surgery.

A retrospective analysis was conducted on the data and surgical videos of 82 patients who underwent hiatal hernia repair and fundoplication surgery at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2021 to January 2022. Among them, 40 patients underwent fundoplication using laparoscopic modified Nissen fundoplication combined with the "Four-in-One" technique for the treatment of the esophagogastric junction (study group), while 42 patients underwent laparoscopic modified Nissen fundoplication alone (control group). Demographic, perioperative, and quality of life outcome data were analyzed.

Compared to the study group, the control group exhibited a superior trend in terms of operative time and blood loss [(151.86±38.44) minutes vs (171.82±38.07) minutes, P=0.021; (94.50±49.61) ml vs (113.81±56.35) ml, P=0.104]. In the study group, 8 patients (20%) experienced postoperative dysphagia, slightly higher than the 5 cases (11.9%) in the control group. However, at six months postoperatively, the study group demonstrated significantly better Likert prognosis scores compared to the control group (Fisher's exact test, P=0.028). Moreover, 67.5% of the study group's patients self-assessed as asymptomatic (Grade 1) in the past six months, which was significantly higher than the 40.5% in the control group. Additionally, among patients defined as having no improvement/recurrence/deterioration of symptoms (defined as Grades 4 and 5), the control group had 6 cases and 2 cases, while the study group had no patients reporting these two levels of severity.

The application of the "Four-in-One" concept in the treatment of the esophagogastric junction can improve postoperative satisfaction and quality of life for patients, albeit with increased operative time and bleeding risk. Prospective experiments are needed to validate the conclusions of this study.

To explore the principle of two-way communication management in the clinic application value. A tatol of 236 patients admitted to Xinjiang Autonomous Region People's Hospital from January 2017 to December 2018 were selected as the research subjects. Our outpatient department implemented the principle of two-way communication, and recorded and compared the satisfaction of outpatient patients with management before and after implementation.

After the implementation of two-way communication, patients in the outpatient management of all aspects of the degree of satisfaction is significantly higher than before the implementation (P<0.05).

In hospital outpatient department to implement flexible management can achieve good effect, can effectively improve the outpatient service management work efficiency, improve patient satisfaction, which worth clinical promotion.

To investigate the effect of electroacupuncture on weight loss in obese patients pre-laparoscopic sleeve gastrectomy(LSG).

Clinical data of 50 obese patients who underwent LSG in Shanghai Ninth People's Hospital from August 2018 to May 2021 were included and analyzed. There were 25 cases received electroacupuncture combined with LSG (electroacupuncture combined with sleeve stomach group) and 25 cases received LSG (sleeve gastrectomy group). The clinical data of preoperative weight loss, length of LSG, hospital stay, complication rate and postoperative excess weight loss percentage were compared between the two groups.

The preoperative weight loss effect of electroacupuncture combined with sleeve stomach group was significantly better than sleeve stomach group. The operation time, total hospital stay, postoperative hospital stay and postoperative complication rate of electroacupuncture combined with sleeve stomach group were significantly lower than those of sleeve gastrectomy group. The %EWL of electroacupuncture combined with sleeve stomach group was significantly better than that of sleeve gastrectomy group at 6 and 12 months after LSG.

Electroacupuncture can significantly reduce the preoperative weight of obese patients before LSG, shorten the operation time and improve the postoperative weight loss effect. However, further RCTs of multi-center and large sample are still needed for verification.

To compare the efficacy of Anti-reflux mucosectomy (ARMS) and radiofrequency (RF) energy delivery in gastroesophageal reflux disease(GERD).

Patients with refractory GERD (RGERD) were 1:1 randomly assigned to either ARMS group or RF group. GERD questionnaire (GERD-Q) and reflux disease questionnaire (RDQ) were performed before and 2 years after the procedures. Primary outcome was the scores of GERD-Q and RDQ at 2 years postoperatively. The Secondary outcomes were proportions of patients who completely stopped proton pump inhibitor(PPI)use and who were satisfied with the treatment postoperatively.

Thirty-four patients were analyzed, with 18 in ARMS group and 16 in RF group. In both groups, the operation success rate was 100%. Compared to RF group, the length of stay in ARMS group was significantly longer [(7.50±1.76) vs (6.06±2.24) d, P=0.044], and the incidence rate of dysphagia was higher (27.78% vs 0%, P=0.046). At 2 years postoperatively, the scores of GERD-Q and RDQ did not differ between the two groups [(9.56±7.16) vs (8.06±6.64) points, (10.00±6.00) vs (9.81±4.71) points; P all >0.05]. The PPIs cessation and patient satisfaction rates did not differ between ARMS and RF group (61.11% vs 68.75%, 61.11% vs 62.50%; P all>0.05).

The clinical efficacy of ARMS and RF for RGERD is equivalent. ARMS, the efficacy of which could be maintained for at least 2 years, is a promising endoscopic management for RGERD.

To study the effectiveness and safety of biological mesh in laparoscopic hiatal hernia repair.

Prospectively collect clinical data of 60 patients with hiatal hernia combined with gastroesophageal reflux disease who were seen at the Department of Hernia and Abdominal Wall Surgery of the Affiliated Zhongda Hospital of Southeast University from Jan. 1, 2022, to Sept. 30, 2023, and follow up the patients, all of whom were treated by laparoscopic hiatal hernia repair and biological mesh was applied during the operation, respectively. All patients underwent laparoscopic hiatal hernia repair with gastric fundoplication and intraoperative reinforcement of the diaphragm with a biological mesh, and the patients were followed up at the 1^st, 3^rd and 6^th months after the operation, including acid reflux, heartburn, vomiting, chest pain, Overall satisfaction, recurrence and mesh-related complications and comparing the preoperative and postoperative indexes.

All patients successfully completed the surgery without intermediate openings, the mean preoperative age of the patients was (61.85±15.83) years, the mean body mass index was (24.44±3.65) kg/m², the mean operative time was (125.83±45.67) min, the mean hernia width was (3.10±1.27) cm, sliding hiatal hernia was 31(51.67%) cases, the total hospitalization time was (9.44±3.32) d, and the mean postoperative follow-up was (10.68±6.15) months, the completion rate of postoperative follow-up was 100% at 1 month after the operation, the completion rate of postoperative follow-up was 98.33% at 3 months after the operation, and the completion rate of postoperative follow-up was 78.33% at 6 months after the operation, and the patients' postoperative symptoms of acid reflux and heartburn improved significantly compared with the preoperative ones, All of them improved significantly compared with the preoperative period. The overall satisfaction score of the patients before surgery was median 3 (2-4), and the overall satisfaction score of the patients at 6 months after surgery was median 10 (9-10), Overall postoperative satisfaction was significantly higher and the difference was statistically significant (P<0.05), a total of 3 patients had recurrence, including 1 patient with symptomatic plus radiographic recurrence, and no patient had mesh-related complications.

The use of biological mesh in laparoscopic hiatal hernia repair was effective and safe, with no mesh-related complications and high overall patient satisfaction during the follow-up period, which, of course, needs to be longer.

To analyze the clinical and endoscopic features of patients with severe reflux esophagitis complicated with peptic ulcer.

Data on severe reflux esophagitis diagnosed and treated in the Department of Gastroenterology of Xinjiang Uygur Autonomous Region People's Hospital from March 2015 to February 2021 were collected and divided into 2 groups,combined with peptic ulcer and without combined with peptic ulcer,and the patients' gender,age,and status of Helicobacter pylori infection were analyzed. The ulcer sites and stages of patients with severe reflux esophagitis combined with peptic ulcer were analyzed.

Among 1866 patients with severe reflux esophagitis, 334 patients had combined peptic ulcers, accounting for 17.90% of the patients with severe reflux esophagitis, and the male-to-female ratio was 4.39∶1, which showed a certain difference in the gender composition compared with that of the patients with no combined peptic ulcers (P<0.01), and there was no significant difference in the age (P>0.05). The peak age of onset of the disease was between 40 and 70 years old. Among the combined peptic ulcers, there were 260 cases of duodenal bulb ulcers, accounting for 77.84%; 186 cases of active ulcers, accounting for 53.76%; 108 cases of peptic ulcers with upper gastrointestinal obstruction, accounting for 32.34%,and 269 cases of Helicobacter pylori infections in severe reflux esophagitis combined with peptic ulcers, accounting for 80.54%;735 cases of severe reflux esophagitis without combined peptic ulcers Helicobacter pylori infection, accounting for 47.98%;there was a certain difference between the two groups (P<0.01).

The prevalence rate of severe reflux esophagitis was significantly higher in males than in faremals. The peak age of patients is 40 to 70 years old. Ulcers in the duodenal bulb are common, mostly active ulcers, and are often combined with upper gastrointestinal obstruction and a high rate of H. pylori infection.

Restoration of gastrointestinal motility is an important indication of postoperative recovery. This study investigated the effects and mechanisms of vagus nerve stimulation (VNS) on postoperative recovery from Nissen fundoplication in rats.

20 rats were undergone Nissen fundoplication and separated to two groups which were iVNS group (brief 30 minutes VNS was performed during surgery) and sham-iVNS group (same surgical procedure without conducting electricity to VNS lead ). at specific postoperative periods, Animal's behaviors were monitored. Electrocardiogram (ECG) and gastric slow waves (GSWs) were recorded; Inflammatory cytokines were assessed in blood samples.

(1) iVNS shortened the time to start eating and drinking (P<0.05), increased the amount of feces (P<0.05) and increased the content of water in the feces (P<0.05). (2) iVNS improved gastric electrical activity 6 hours after operation, and the percentage of normal gastric slow waves in the experimental group was higher than that in the sham group (P<0.05). (3) Compared with the sham group, the inflammatory cytokines in the iVNS group were significantly inhibited 24 hours after operation (P<0.05). (4) Compared with the sham -iVNS group, the vagal tone was significantly increased 6 hours and 24 hours after iVNS (P<0.05). Increased vagal tone was associated with faster postoperative initiation of drinking (r=-0.635, P<0.05) and eating (r = -0.647, P<0.05). Diarrhea did not occur in all experimental rats.

Transient iVNS accelerates postoperative recovery by improving postoperative animal behavior, improving gastrointestinal motility and inhibiting inflammatory cytokines, enhancing vagal tone.

To investigate the status quo and influencing factors of oral health-related quality of life in patients with gastroesophageal reflux disease (GERD), and to provide reference for clinical development of oral health-related quality of life in patients with GERD.

A total of 136 patients with gastroesophageal reflux treated in our hospital from May 2020 to December 2021 were selected as research objects by convenience sampling method, and the patients were investigated by oral health impact scale (HIP-14).

The total score of HIP-14 in 136 patients with gastroesophageal reflux was (14.42±7.14). Multiple linear regression analysis showed that age, per capita monthly family income, oral disease, residence and tooth loss were all factors influencing oral health-related quality of life in patients with gastroesophageal reflux (P<0.05), accounting for 42.55% of the total variation.

Oral health-related quality of life of patients with gastroesophageal reflux remains to be improved, and its influencing factors are relatively numerous. Medical staff can formulate corresponding preventive measures for patients with gastroesophageal reflux according to the above factors, which will help to improve oral health-related quality of life of patients and improve their prognosis.

To explore the role of establishing experimental animal models based on the characteristics of gastroesophageal reflux disease and the application of related basic experimental techniques in improving the scientific research ability of medical postgraduates.

23 medical postgraduate students and 3 doctoral students whom received standardized training in our hospital from September 2017 to July 2021 were selected as the training objects. All students are trained under the guidance of teachers. The training courses include the establishment of experimental animal models, routine anesthesia, blood collection and dissection, specimen processing, hematoxylin eosin (H&E) staining, real-time quantitative RT-PCR and other experimental technologies, as well as the theoretical principles and application operations of SPSS statistical software. Through the use of theory and operation ability tests and teaching satisfaction questionnaires and other methods to analyze the teaching effect.

After the training of experimental theoretical knowledge and practical skills, the excellent rate and qualified rate of students markedly high than before training (P<0.05). After the training, the application ability of all postgraduates to the above technologies has been greatly improved. The students' interest in experiment and operation training courses, their mastery and application of statistical software and experimental operation steps, their inspiration to research thinking, and their satisfaction with teaching methods were significantly improved (P<0.05).

The establishment of animal models and the mastery and application of basic experimental techniques can effectively help the students to practice their experiments, and better cultivate their scientific research innovation ability.

To explore the efficacy of continuation nursing intervention on the improvement of gastroesophageal reflux disease (GERD) symptoms, quality of life and weight loss after weight loss metabolism.

Retrospective analysis was made on 65 obese patients who received weight loss and metabolic surgery in the People's Hospital of Xinjiang from January 2020 to November 2022. They were randomly divided into the control group (31 cases) and the observation group (34 cases) by using the digital table method. The control group patients were given routine nursing methods (during hospitalization - during hospital follow-up after discharge); The study group patients were given continuous care intervention treatment in combination with the control group (during hospitalization, after discharge, and at home chain management for a period of 6 months). Both groups of patients collected and analyzed changes in waist circumference, hip circumference, blood sugar, blood pressure, GERD symptom score, and health promoting lifestyle scale (HPLP - II) before and after treatment.

The body weight, body mass index (BMI), waist circumference, hip circumference, percentage of extra weight loss (%EWL), fasting blood sugar (FPG), blood pressure, GERD score and HPLP - Ⅱ score in the two groups were significantly different from those before surgery in 6 months of follow-up (P<0.05). Compared with the control group, the differences in indicators such as body weight, BMI, waist circumference, hip circumference, and %EWL in the observation group were statistically significant (P<0.05). Compared with the control group, the difference in GERD score and HPLP - II score between the observation group was statistically significant (P<0.05). Compared with the control group, the observed total effective rate was significantly higher (97.06% vs 90.32%, P<0.05).

The long-term weight loss effect of continuous nursing intervention after weight loss surgery is good, effectively improving the occurrence of GERD symptoms in patients and improving their quality of life.

To investigate the efficacy of acid suppression and pulmonary function in patients with asthma combined with acid reflux after clinical treatment with esomeprazole in combination with mosapride.

Patients with asthma combined with GERD (51 cases) hospitalized in the Respiratory and Critical Care Medicine Center of the People's Hospital of Xinjiang Uygur Autonomous Region from June 2020 to December 2021 were retrospectively analyzed and further divided into a control group (given conventional asthma treatment) and a study group (given esomeprazole combined with mosapride citrate on top of the control group) according to the treatment modality. General clinical information, lung function, GERDQ scale, asthma control test (ACT) score and Medical research association dyspnea scale (mMRC) were collected. Patients in both groups were treated for 8 weeks, and the improvement of the above indicators was collected and analyzed before and after treatment in both groups.

The improvement of acid reflux symptoms (GERD-Q) score, ACT score, and mMRC score indicators in the research group was significantly better than that in the control group, and the differences were statistically significant (P<0.05). Two groups of patients underwent pulmonary function analysis before and after treatment, and it was found that compared with the control group, the study group significantly improved lung function indicators: first second forced expiratory volume/forced vital capacity (FEV1/FVC), oxygen partial pressure, and carbon dioxide partial pressure. The differences were statistically significant (P<0.05). The total effective rate of the control group was 64.00%, while that of the study group was 88.46%, with a statistically significant difference (P<0.05).

The use of esomeprazole combined with mosapride citrate in the treatment of asthma combined with GERD is more effective than conventional treatment and deserves further clinical application.

Exploring the application and role of group teaching and training in improving research abilities of medical professional graduate students.

A total of 23 graduate students of minimally invasive surgery major whom received standardized training in the People's Hospital of Xinjiang Uygur Autonomous Region from September 2017 to July 2021 were selected and randomly divided into the control group (12 students) and the control group (11 students) using the numerical table method; Traditional teaching and group teaching are adopted respectively. Through theoretical examination, practical application (including literature retrieval and statistical software) and questionnaire survey, the teaching effect of the two groups was compared and analyzed.

The excellent and qualified rate of theoretical examination and practical operation ability of the students in the study group was markedly high as compare to control group (P<0.05); The students in the research group showed a higher degree of interest in the group teaching and research improvement ability course, inspiration for scientific research thinking and satisfaction with teaching methods (P<0.05), suggesting that the students were more interested in scientific research and effectively improved their scientific research innovation thinking.

Compared with traditional teaching, group teaching can improve students' interest in scientific research and better cultivate their innovative ability in scientific research.