Objective To assess the therapeutic effect of esomerphrazole in treating patients with gastroesophageal reflux disease (GRED) between Han and Inner Mongolia populations.Methods Those who underwent endoscopic examination and had reflux disease questionnaire (RDQ) >12 from March 2006 to March 2008 were selected. The patients were divided into Han group and Inner Mongolia group with 120 each. All patients were received esomerphrazole 20 mg daily for 6 weeks. The patients were evaluated by RDQ questionnaire at 2nd, 4th and 6th week, and were reexamined by gastroscopy at 6th week. Results After two weeks, effective rate of 50% was achieved in both groups, but it was higher in Han group than in Inner Mongolia group at 4th and 6th week. After 6 weeks, the curative rate of RE was higher in Han group than in Inner Mongolia group. Conclusion The different nations ancl habits result in the different efficacy of esomerphrazole, which may be improved by prolonging time of medication and changing habits.

Objective To investigate the laparoscopie resection of the adrenal tumor effects and clinical experience. Methods Among the 24 cases of Laparoscopic adrenalectomy tumors, there were 8 cases of adrenal adenoma, 7 cases of pheochromoeytoma and 9 eases primary aldosteronism. Results One ease was transit to open operation, the other 23 were successful,each surgerical time was 40～130 min with an average of 98 rain. Hemorrhage was 50～300 mL, 140 ml average, no blood transfusion. It was 1～2 d after sur- gery to remove drainage tubes, and could take some activities and have fresh flow in the second day. The pa- tients didn't appear complications and discharged after 5～7 d. Follow-up of 6～24 months, there was no recurrence and long-term complications. Conclusion Laparoscopic adrenalectomy has the advantages of minor trauma surgery, less bleeding, good demonstrating, convenient operation, fewer complications and quick recovery.

Objective:To explore the care burden of the primary caregivers of maintenance hemodialysis (MHD) patients and its correlation with psychological resilience and social support.Methods:From January 2020 to December 2021, 97 MHD patients and 97 primary caregivers admitted to Zhumadian Central Hospital were selected by convenient sampling. The subjects were investigated with the Zarit Caregiver Burden Interview (ZBI) , Connor-Davidson Resilience Scale (CD-RISC) and Social Support Rating Scale (SSRS) . Pearson correlation analysis was used to explore the correlation between the care burden, psychological resilience and social support of the main caregivers of MHD patients. Model 4 in the PROCESS macro program was used to test the intermediary model, and the significance of the intermediary effect was tested by Bootstrap analysis. A total of 97 questionnaires were distributed, and the effective recovery rate was 100.00%.Results:There were statistically significant differences in the ZBI scores of MHD patients' main caregivers with different ages, with or without other care workers, total care time, daily care time, psychological resilience and social support ( P<0.05) . The total ZBI score of the main caregivers of MHD patients was (42.39±10.61) , of which 1.03% (1/97) had no or very mild burden, 44.33% (43/97) had mild burden, 50.52% (49/97) had moderate burden, and 4.12% (4/97) had severe burden. The total score of CD-RISC of the main caregivers of MHD patients was (53.09±5.69) , of which 79.38% (77/97) of the main caregivers had low-level resilience, and 20.62% (20/97) of the main caregivers had medium-level resilience. The total SSRS score of the main caregivers of MHD patients was (30.33±7.19) , of which 21.65% (21/97) of the main caregivers had low-level social support, 76.29% (74/97) of the main caregivers had medium-level social support, and 2.06% (2/97) of the main caregivers had high-level social support. The care burden of the main caregivers of MHD patients was negatively correlated with psychological resilience and social support, and psychological resilience was positively correlated with social support ( P<0.05) . Social support positively predicted psychological resilience and negatively predicted care burden ( P<0.05) . Psychological resilience negatively predicted care burden ( P<0.05) . The intermediary model (dependent variable was care burden; independent variable was social support; intermediary variable was psychological resilience) had a significant intermediary effect. The indirect effect accounted for 79.23% of the total effect, and the direct effect accounted for 20.77% of the total effect. Conclusions:The main caregivers of MHD patients have moderate care burden, and social support can directly affect the care burden, and also indirectly affect the care burden through the mediation of psychological resilience.