To explore the application effect of training simulation of laparoscopic minimally invasive surgery for postgraduate students.

Laparoscopic simulation training for minimally invasive surgery professional degree postgraduate of 24 students, and evaluation of teaching effective, teaching satisfaction survey, compared before and after of training , and assessment of student achievement.

The average score, passing rate, excellent rate, subjective to their basic operation proficiency score, satisfaction score after training were higher than before training, and the difference were statistically significant (P<0.001).

Combined with clinical teaching theory and simulation training can effectively improve the basic ability of laparoscopic training study and improve the basic skills of operation, and achieved good teaching effect, should be widely spread, but the assessment standard still needs to be perfected.

To observe the incidence of type of gastroesophageal reflux disease in elderly male patients of Han and Uygur nationality and analyze the related risk factors.

A retrospective analysis of gastroesophageal reflux disease in elderly male patients from People′s Hospital of Xinjiang Uygur Autonomous Region was performed, and effective 469 cases were collected, among which 256 were Uygur nationality and 213 were Han nationality, compared the incidence and differences of three types, Logistic regression analysis was used to analyze the high-risk factor of them.

The Uygur elderly male patients with reflux esophagitis were higher than that of Han elderly men, and the Han nationalities with Barrett esophagus were higher than Uygur elderly men, the difference was statistically significant(P<0.05). Multivariable Logistic analysis showed that eating too much, eating before sleeping, greasy food, high body mass index(BMI), hiatus hernia were the important risk factors in Uygur elderly men, and smoking, drinking, high BMI were the important risk factors in Han elderly men.

There are different in three types of GERD of Uygur, Han elderly men, and the risk factors are different, but are all closely related with body mass index and unhealthy life habit.

To compare the efficacy of simple suture and mesh repair for esophageal hiatal hernia and to evaluate recurrence and complications.

The study retrospectively included 77 patients with gastroesophageal reflux disease who underwent laparoscopic esophageal hiatal hernia repair from January 2002 to December 2012. According to the application of mesh reinforcement, patients were divided to 2 groups. Thirty-one patients who underwent simple suture were allocated into A group while 46 patients who underwent mesh reinforcement were allocated into B group. Recurrence and complications were both evaluated.

For the short-term results, Visick score was higher in B group compared with that in A group (P=0.007). Reflux symptoms significantly improve. Hiatal hernia recurrence was higher in A group compared with B group, but without significantly difference. Postoperative dysphagia failed to show significantly statistical difference between 2 groups. For the long-term results, degree of operative satisfaction was significantly higher in B group compared with A group (P=0.019). Recurrence of hiatal hernia was higher in A group, which tends to be a significantly statistical difference (P=0.05). The rate of postoperative dysphagia was not significantly different between 2 groups.

Mesh reinforcement of hiatal hernia could significantly relief reflux-related symptoms, improve degree of operative satisfaction and decrease risk of recurrence of hiatal hernia. However, mesh-related complications did not increase. The improvement of mesh texture, indication and repair techniques contribute to these results.

To evaluate the clinical value of the method of surgical treatment in patients with sliding esophageal hiatal hernia by laparoscopy via pneumoperitoneum and non-pneumoperitoneum through abdominal wall lifting.

The clinical data of 17 cases of laparoscopic esophageal hiatal hernia repair combined with and gastric folding via pneumoperitoneum and non-pneumoperitoneum through abdominal wall lifting was collected between May 2012 and May 2014, including 15 cases of Nissen operation and, 2 cases of Toupet operation.

Surgeries in all patients were successfully completed, no transferring laparotomy, the average operation time was 45 to 220 minutes, intraoperative blood loss was less than 50 ml, there were no postoperative complications, all patients were cured and discharged, and the average hospitalization time was 10 days. Follow-up period was between 1 to 24 months. Clinical symptoms in 16 patients disappeared completely, and clinical symptoms in 1 case partly relieved, with no relapsed case.

Sliding esophageal hiatal hernia by laparoscopy via pneumoperitoneum and non-pneumoperitoneum through abdominal wall lifting is a safe and effective surgical treatment, and has wide value of popularization.

To explore the validation of the gastroesophageal reflux disease questionnaires (GerdQ) for the diagnosis of gastroesophageal reflux disease (GERD).

A total of 1 000 patients who existed of reflux symptoms were surveyed of in The People′s Hospital of the Xinjiang Uygur Autonomous Region from June 2013 to October 2014, which was used to investigate reflux - related symptoms including heartburn, reflux, epigastric pain, nausea, sleep disturbance, and additional medicine (over the counter medication). The results of their upper gastrointestinal endoscopy and 24-hour esophageal pH-impedance monitoring were compared with GerdQ score to determine the diagnostic cut- off score for GERD and analyze the validation of the GerdQ for the diagnosis of GERD.

GerdQ scores of GERD group focused primarily on 7-12 points, GerdQ scores of control group focused primarily on the following six points, the difference was statistically significant (P<0.05). Taking 8 as GerdQ cut- off score for GERD, we got the maximal Youden index (0.51), in which the area under ROC was 0.765, with a sensitivity of 81.32% and specificity of 70.21%, the true positive diagnostic rate 83.24%, while true negative diagnostic rate 61.53%.

GerdQ is simple, easy, effective method, it can be used as the preliminary clinical diagnosis of GERD.

To explore an effective, safe and convenient method to stablish a reflux esophagitis model.

Twenty New Zealand rabbits were divided into 2 groups. Twelve rabbits which underwent catheter balloon dilatation were allocated into A group while 8 rabbits which underwent sham operation were allocated into B group. In A group, rabbits were intubated with a 10Fr double lumen catheter. Lower esophageal sphincter was confirmed after opening abdominal cavity. In B group, laparotomy was performed. Then abdominal cavity was closed after lower esophageal sphincter was confirmed. All rabbits received 2-hour pH monitoring on postoperative day 10 and was sacrificed in postoperative week 4. Esophageal tissues were taken out and stained with HE. The rate of esophagitis was evaluated.

Survival was not significantly statistical different between 2 groups (A group: 91.7% vs B group: 100%, P=1.000). The data of 2-hour pH monitoring including total time of pH < 4 (%) in 24-hours, number of reflux episodes and number of reflux episodes > 5 min showed significantly statistical difference between 2 groups (t=3.98, 4.91, 4.99; P=0.001, <0.001, <0.001). The success rate of reflux esophagitis model establishment was 75% in A group. Excluding dead rabbits, success rate of reflux esophagitis model establishment was 81.8%.

Forley catheter balloon dilatation is an effective way to establish esophageal reflux model. This method which reserves intact antireflux barrier of gastroesophageal junction does not change normal physiologic anatomy. This method is suitable for the investigation of surgical therapy for reflux esophagitis.

探讨延续护理模式在腹腔镜抗反流术后出院患者中的应用效果。

选取2013年12月至2014年8月，新疆维吾尔自治区人民医院因胃食管反流病合并食管裂孔疝行腹腔镜抗反流手术治疗的90例患者，随机分为对照组和干预组。对照组采取传统的电话随访模式，干预组采取延续护理模式，比较二组患者的遵依行为和对护士的满意度。

干预组患者的遵医行为、满意度优于对照组，差异有统计学意义(P<0.05)。

对腹腔镜抗反流术后出院患者实施延续护理可以提高患者依从性，提高患者对护士的满意度，值得在临床推广。