Gastroesophageal reflux disease (GERD) is a gastrointestinal motility disorder that results from the reflux of stomach contents into the esophagus or oral cavity, causing symptoms or complications. The typical symptoms of GERD are heartburn and regurgitation of gastric contents into the oropharynx. Heartburn is the sensation of burning or discomfort behind the sternum. Heartburn may radiate into the neck, is typically worse after meals or when in a reclining position, and may be eased by antacids. Regurgitation is the backflow of gastric contents into the mouth or hypopharynx. Epigastric pain can also be a symptom of GERD. Extraesophageal symptoms of GERD include dental erosions, laryngitis, cough, and asthma. In recent years, great progress has been made in understanding the molecular basis of GERD, suggesting that its pathogenesis is more complex and multifactorial. In this paper, the molecular pathogenesis was taken as the starting point, including the mechanism of genes in the pathogenesis and development of GERD, the mechanism of NF-κB pathway in the pathogenesis and development of GERD, the role of proteinase-activated receptor-2 in the pathogenesis of GERD, the association between abnormal serotonin pathway and GERD, and the relationship between reactive oxygen species and GERD, to summarize the pathogenesis of gastroesophageal reflux disease.

Objective: To investigate the application and surgical experience of total laparoscopic pancreaticoduodenectomy (TLPD) in treating children with solid pseudopapillary neoplasm (SPN) of pancreas. Methods: Clinical data 4 children with SPN who underwent TLPD in Jilin University First Hospital from April 2017 to June 2018 were retrospectively analyzed. Results: Among the 4 children, a case was male and 3 cases were female. Their age ranged from 9 to 14 year-old, the height ranged from 1.2 to 1.7 meters, and body weight ranged from 30 to75 kg. All patients complained of upper abdominal pain, one child had nausea and vomiting, and one child had abdominal mass. All patients underwent abdominal enhanced CT scan before operation, which showed a mass-like low-density shadow or mixed density shadow in the pancreatic head, with slightly uneven enhancement or no obvious enhancement. All 4 patients underwent TLPD, and the operation was successful without conversion to open surgery. The duration of operation time ranged from 250 to 365 minutes, the intraoperative blood loss ranged from 80 to 120 ml, the tumor size ranged from 4 to 8 cm, and the hospital stay ranged from 10 to 22 days. One patient developed grade B pancreatic fistula after surgery and was cured after conservative treatment. Pathological examinations of all patients confirmed the diagnosis of pancreatic SPN. All patients were followed up until February 2019, and no significant discomfort was observed and no recurrence or metastasis was found. Conclusions TLPD was safe and feasible in children in relatively large pancreatic surgery centers with extensive laparotomy and TLPD experience.

ObjectiveTo evaluate the current situation of human resource allocation in district and county centers for disease control and prevention （CDCs） in Kashgar ， identify existing problems and influencing factors， and to provide scientific evidence for optimizing the human resource allocation. MethodsA survey was conducted among all CDCs in Kashgar in February 2022. The questionnaire included the institutional and individual questions. ResultsThe overall staff size approved for the CDCs in Kashgar was 604， with a staffing rate of 76.17%， among which the staffing rates in 5 county CDCs were less than 60%. Currently， there were a total of 524 approved staff members in all CDCs， resulting in a vacancy rate of 13.25%. In the district CDC， 85 staff members were on duty， while the median of staff on duty was 34 in each county CDC. The staff in the district CDC was ageing， of which those aged over 45 accounted for 67.06%. The staff in the county CDCs was generally young， of which those aged less than 35 accounted for 54.22%. Moreover， the proportion of staff with bachelor’s degree or above in the district and county CDCs was 31.76% and 24.95%， respectively. The proportion of staff without professional title was 32.94% and 48.03%， respectively. In contrast， the proportion of those with middle and senior professional title was 57.89% and 22.02%， respectively. In addition， in recent 3 years， 24 staff members resigned in the CDCs， all of whom had professional titles. ConclusionHuman resources are insufficient in CDCs in Kashgar. Furthermore， staff structure is unreasonable， with a serious loss of human resources. In particular， the district CDC needs to optimize the allocation of human resources.

ObjectiveTo determine the current status and characteristics of tuberculosis （TB） registration and treatment in Kashgar， and to provide scientific evidence for targeted prevention and control measures in future. MethodsKashgar registered TB cases information in 2011 to 2020 was exported from the National Tuberculosis Management Information System. Descriptive epidemiological analysis was conducted using Stata 12.0. ResultsFrom 2011 to 2020， number of Kashgar registered TB patients showed rising trend， followed by a falling one. Average proportion of annual decline in registered TB incidence was 40.48% from 2018 to 2020. From 2011 to 2016， number of registered TB patients in women was always higher than that in men， with a gender ratio （male ： female） of about 0.90. In 2017， the gender ratio was 1.00. From 2018 to 2020， the gender ratios were 1.05， 1.20， and 1.12， respectively. Moreover， number of registered TB cases increased with age （χ²=547.79， P<0.001）. Proportion of registered TB cases was relatively large in Shache County （16.43%‒23.64%）， Yengisar County （9.51%‒13.87%） ， Kashgar City （8.11%‒11.40%）， Yecheng County （6.98%‒13.40%） and Bachu County（4.92%‒16.65%）. Proportion of recurrent TB cases in Kashgar had increased to 27.29%， 20.77% and 28.39% in 2018， 2019 and 2020， respectively. Multivariate analysis showed that age， drug resistance， calendar year and etiological diagnosis were significantly correlated with the proportion of recurrent cases （all P<0.05）. ConclusionSince 2018， TB incidence has decreased significantly due to the increasing efforts for identification and treatment of TB cases. However， Kashgar remains facing a high TB incidence. TB cases that are elderly， drug-resistant and positive for pathogen are susceptible to recurrent treatment. In future， targeted prevention and control measures should be improved for these groups.