Gastroesophageal reflux disease (GERD) is a common and frequent clinical disease with complex clinical symptoms and easy recurrence, which has gradually attracted clinical attention. Traditional Chinese medicine in the treatment of GERD has the advantages of improving clinical symptoms, reducing the recurrence rate and improving the quality of life, with good clinical efficacy. This article summarizes the etiology and pathogenesis of traditional Chinese medicine, the progress of traditional Chinese medicine treatment and the mechanism of traditional Chinese medicine in GERD, so as to provide some reference for clinical diagnosis and treatment.

Gastroesophageal reflux disease (GERD) is a clinically common gastrointestinal motility disorder, and esophageal motility disorder is one of its main pathogenesis. Ineffective esophageal motility (IEM) is the most common type of esophageal motility disorder in GERD. The role of IEM in the pathogenesis of GERD is still controversial. This article summarizes the pathophysiology, clinical features, dynamic characteristics and relationship with acid exposure of IEM, and its role in GERD. It provides new ideas and clues for further research on the role of IEM and guiding clinical treatment of GERD.

To explore the application value of abdominal pressure technique in high-resolution esophageal manometry in improving the positive detection rate of sliding hiatal hernia.

200 cases with high-resolution esophageal manometry were collected and divided into control group and observation group with 100 cases in each group (all the cases in the group were cases with esophageal hiatal hernia or cardia relaxation by gastroscopy, or those who were suspected of gastroesophageal reflux disease but were negative by gastroscopy, and were finally treated by gastroscopy or laparoscopic anti-reflux surgery after exclusion of contraindications and discontinuation of propulsive drugs for one week). In the observation group, in the routine operation of high-resolution esophageal manometry, the cases without hernia signs were further subjected to abdominal pressure method to simulate the observation of the morphology of the junction of esophagus and stomach by increasing abdominal pressure. The control group was treated with routine operation techniques. Finally, according to the diagnosis of gastroscopy and laparoscopy, the difference and detection efficiency of the two methods in the positive detection rate of sliding hiatal hernia were compared.

Among the 200 cases, 81 cases (81%) were detected in the observation group by abdominal pressure, and 56 cases (56%) were detected in the control group by routine operation, with significant difference (P＜0.05).

Using abdominal pressure technique to simulate the increase of abdominal pressure in high-resolution esophageal manometry can significantly improve the detection rate of sliding hiatal hernia.

To evaluate the efficacy of Vonoprazan to treat gastroesophageal reflux disease (GERD).

The randomized controlled trials of Vonoprazan in the treatment of gastroesophageal reflux disease were retrieved in the Cochrane Library, PubMed, EMBASE, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and WanFang Data. The key words included "Vonoprazan", "TAK-438","gastroesophageal reflux", "GERD", "erosive esophagitis", "non-erosive reflux disease", "reflux esophagitis". Data extraction and the evaluation of the inclusive literature quality were conducted independently by 2 reviewers . Meta-analysis was carried out by the RevMan software5.4.

we obtained 108 publications through searching the literature dababase and cited references. And after removal of the study with the exclusive criteria, 10 remained. In the main analysis, there was no significant difference (P>0.05) in the efficacy between Vonoprazan and the control group (RR=1.07, 95%CI: 1.01-1.13). In the baseline analysis, the subgroup analysis showed significant effective therapy in the severe esophagitis (LA grade C/D) compared with the proton pump inhibitors (PPIs) (RR=1.14, 95%CI: 1.06-1.22; P<0.05). however, the analysis results indicated that no significant difference cound be seen in different doses of vonoprazan as a therapy in GERD. (P>0.05) (RR=1.36, 95% CI: 1.03-1.79).

Vonoprazan is more effective than PPIs in the treatment of GERD, especially in severe esophagitis (LA grade C/D). The safety is similar to PPIs. And 10mg, 20mg, or 40 mg vonoprazan present with the same efficacy in the treatment of GERD.

Selected the data of adult gastroscopy in our hospital from July 1, 2021 to December 31, 2021, the patients were divided into observation group and control group according to the presence or absence of proximal ectopic gastric mucosa, Statistical analysis was conducted according to age, gender, presence of gastroesophageal reflux disease and anatomical basis of gastroesophageal reflux, and P＜0.05 was considered statistically significant.

A total of 215 patients were included in the observation group and the control group, with an average age of (43.4±10.7) years in the observation group and (42.8±11.7) years in the control group, and there was no significant difference in age between the two groups (P=0.211). There was no significant difference in gender composition between the two groups (P=0.845). In the observation group, 49.8% (107/215) had the gastroesophageal reflux disease or the anatomical basis of gastroesophageal, while 39.5% (85/215) of the control group had the gastroesophageal reflux disease or the anatomical basis of gastroesophageal, the difference was statistically significant (P=0.042).

Proximal esophageal ectopic gastric mucosa may be the result of metaplasia under the impact of gastroesophageal reflux, proximal esophageal ectopic gastric mucosa suggests the possibility of proximal esophageal reflux.

To study the relationship between ectopic gastric mucosa of proximal esophagus and gastroesophageal reflux.

To analyze the possible risk factors of atrial fibrillation (AF) in patients with Gastroesophageal reflux disease (GRED).

A total of 7417 patients with GERD were enrolled according to strict inclusion and exclusion criteria. Logistic regression model was used for statistical analysis.

The mean age of our subjects was 59 years, 54.8% were male, 14.2% had diabetes mellitus, 32.5% had hypertension, and 12.1% had coronary artery disease (CAD). 54 patients were diagnosed with AF. After controlling for traditional risk factors of AF (age, sex, smoking, alcohol consumption, history of diabetes, history of hypertension, history of coronary heart disease, low density lipoprotein cholesterol, and total cholesterol), multivariate logistic regression indicated that age (OR: 1.06, 95%CI: 1.04-1.09), glutamic oxalacetic transaminase (AST) (OR: 1.004, 95%CI: 1.001-1.005) and γ-glutamyl transferase (γ-GGT) (OR: 1.001, 95%CI: 1.000-1.003) were risk factors for AF in patients with GERD.

This study suggestsed that advanced age, AST and γ-GGT levels may be risk factors for AF in GERD patients.

0bjecfive To explore the clinical basis for the diagnosis of gastroesophageal reflux disease combined with hiatal hernia and the selection of laparoscopic fundus folding surgery by high-resolution esophageal manometer (HRM) combined with 24-hour pH impedance technique.

From April 2015 to October 2019,167 patients were diagnosed with gastroesophageal reflux disease combined with hiatal hernia and performed operations in Weifang people's hospital. The diagnosis rate of gastroesophageal reflux disease combined with hiatal hernia by gastroscopy and HRM combined with 24-hour pH impedance was calculated, and the status and role of gastroesophageal reflux disease combined with hiatal hernia in minimally invasive treatment of hiatal hernia were summarized.

The detection rate of HRM combined with 24-Hour pH impedance technique was 83.32% (139/167), and the specificity was 100% (139/139),and the confirmed by gastroscopy was 67.06% (112/167).Among them,112 patients were diagnosed by gastroscopy and HRM ,accounting for 80.57% (112/139).The detection rate of HRM combined with 24-Hour pH impedance technique was significantly higher than gastroscopy;105 cases were treated with laparoscopic esophageal hiatal hernia repair combined with gastric fundus folding ,and 7 patients gave up surgery to choose conservative treatment.

Compared with gastroscope, HRM examination combined with 24-hour pH impedance technique has higher specificity in the diagnosis of gastroesophageal reflux disease combined with hiatal hernia, and can effectively guide the gastric fundus folding operation..

Obesity is considered to be the main risk factor for gastroesophageal reflux disease (GERD) and its complications. In recent years, the prevalence of GERD has been increasing, and it is closely related to the rising prevalence of obesity. Bariatric surgery is an effective way to treat morbid obesity. Due to its controversial effect on obese patients with GERD, the choice of surgical treatment for obesity with GERD has become a difficult problem. In order to overcome this problem, the researchers designed a variety of new surgical methods, including Laparoscopic Nissen fundoplication with gastric plication, laparoscopic Sleeve-Collis-Nissen gastroplasty, laparoscopic sleeve gastrectomy with fundoplication, and Anterior Phrenoesophageal Ligament Preservation During Hiatus Hernia Repair in Laparoscopic Sleeve Gastrectomy. This article mainly summarizes the research progress of traditional bariatric surgery and new surgery in the treatment of obesity combined with GERD.

To systematically evaluate the therapeutic effect of peroral endoscopic cardial constriction (PECC) on reflux esophagitis (RE).

We searched the randomized controlled trial (RCT) studies of PECC in the treatment of RE from January 1, 2013 to March 10, 2022 in databases of CNKI, VIP, Wanfang Data knowledge service platform, China biomedicine, the Cochrane Library, Ovid, PubMed and EMBASE by computer. Data extraction and quality evaluation were conducted for the literatures that met the inclusion criteria. We used Revman 5.4 software to perform meta-analysis on the data.

This meta-analysis included in 5 articles and a total of 352 patients. Results of meta-analysis showed that the effective rate of RE in PECC group was higher than that in proton pump inhibitor (PPI) control group (OR=5.55,95%CI:1.90-16.22), and the recurrence rate was lower than that in control group (OR=0.11,95%CI:0.04-0.35).

PECC has a good clinical therapeutic effect on RE. The literatures and studies included in this meta-analysis are few, so we need to collect more relevant studies for verification in the future.

Obstract　chronic cough is one of the common extra-esophageal symptom of gastroesophageal reflux disease, and possess a variety of etiologies, among the etiologies of chronic cough, respiratory disease is the most common one, followed by gastroesophageal reflux. For chronic cough that may be caused by gastroesophageal reflux, anti-reflux treatment is needed. While laparoscopic fundoplication can solve 90% of regurgitation and/or heartburn, its effectiveness for chronic cough that may be caused by gastroesophageal reflux is variable. The aim of this study was to investigate the overall effectiveness of anti-reflux surgery for chronic cough in patients with gastroesophageal reflux disease and/or hiatal hernia in our center, and explore its related predictive factors.

the overall effectiveness of anti-reflux surgery for chronic cough was determined through telephone interview, and the predictive factors was determined through Logistic regression analysis.

information from 230 patients was included for analysis in total. All of them had chronic cough before operation, among which 152 (66.1%) were cured, 30 (13.0%) were significantly improved. At the multivariate level (cured +excellent vs fair +poor), regurgitation was an independent predict factors for the effectiveness of anti-reflux surgery (OR=3.326, 95% CI=1.483-7.462, P=0.004).

anti-reflux surgery is highly effective for chronic cough in patients with GERD or HH, and regurgitation is an independent predictive factor. However, objective evidence of GERD or HH (either isolate or combined) seems to be irrelevant to the improvement of chronic cough. Further prospective studies should focus on the role of PPI response for chronic cough, postural cough, regurgitation induced cough and reflux-cough correlation based on objective recorded cough.

To investigate the safety and clinical effect of Da Vinci robot system-assisted laparoscopic sleeve gastrectomy.

A retrospective analysis of the clinical data of 40 patients who underwent the fourth-generation Da Vinci robot-assisted laparoscopic sleeve gastrectomy and sleeve gastric surgery in the Minimally Invasive, Hernia and Abdominal Surgery Department of the People's Hospital of Xinjiang Uygur Autonomous Region from April to September 2021.

All the 40 patients successfully completed robot-assisted laparoscopic sleeve gastrectomy without conversion to laparotomy, including simple sleeve gastrectomy (LSG) in 21 cases, combined with partial gastric fundus folding (Dor) and esophageal hiatal herniorrhaphy in 10 cases. Combined fundus preservation (Dor) and esophageal hiatus hernia repair and "His angle" reconstruction in 1 case. Combined gastric fundus folding (Nisson) and esophageal hiatus hernia repair in 1 case. Combined "His angle" reconstruction in 5 cases. Combined cholecystectomy in 2 cases. Postoperative complications occurred in 1 case (6.67%), that is, abdominal hemorrhage and abdominal wall hemorrhage occurred within 48 hours after surgery, which was cured after conservative treatment. The average postoperative hospital stay was 5 days, and the average operation time was 2.5 hours.

Compared with traditional surgery, the Da Vinci robot-assisted laparoscopic sleeve gastrectomy is a safer and more effective minimally invasive surgery which has the advantages of finer anatomy, flexible operation and clearer intraoperative vision.