Objective To explore the influencing mechanism of Zhengan Xifeng Decoction on blood pressure and gastrointestinal motility in SHR. Methods After 15 WKY and 90 SHR rats were were randomly divided into normal control group, model group, Benner Pury group, amlodipine group, Zhengan Xifeng Decoction high, middle, and low dose groups. The normal control group and model group were fed with distilled water daily. Rats in treatment group were administered with corresponding drugs daily. Blood pressure, gastric residual and intestinal propulsive ratio of rats was detected after eight-week intervention. Results Compared with the blank control group, systolic pressure, diastolic pressure, and mean arterial pressure were significantly higher than WKY rats of same age (P<0.05). Compared with the model group, the systolic pressure, diastolic pressure, and mean arterial pressure of treatment groups were significantly reduced (P<0.05). Compared with the blank control group, gastric residual rate of rats in the model group significantly decreased (P<0.05). Compared with the model group, the gastric residual rate in Zhengan Xifeng high dose group increased significantly, and intestinal propulsive ratio significantly increased (P<0.05), without statistical significance in the other treatment groups. Conclusion Zhengan Xifeng Decoction can reduce blood pressure in SHR, and regulate gastrointestinal motility.

Objective:To explore the clinical features of recurrence after choledocholithotomy and to analyze the risk factors.Methods:The clinical data of 730 patients with choledocholithiasis who were treated in our hospital from January 2005 to July 2016 were analyzed retrospectively,550 cases who were received choledocholithotomy were defined as laparotomy group,30 cases with laparoscopic common bile duct exploration (LCBDE) were defined as the LCBDE group,and 150 cases with endoscopic sphincterotomy (EST) were defined as EST group.The recurrence rate of the three groups were compared.The patients of three groups were divided into recurrence group (n=227) and non recurrence group (n=503) according to the recurrent situation,then the clinical features and risk factors of recurrent patients were analyzed by univariate and multivariate Logistic regression analysis.Results:The recurrence rate of EST group was 38.67％,which was significantly higher than that of LCBDE group with 26.67％ and the laparotomy group with 29.27％,and there was statistical difference (P＜0.05).The results of univariate analysis showed that there were statistically significant differences in age,history of HBV infection,jaundice,abnormal total bilirubin,peripapillary diverticulum,biliary infection,biliary stricture,papillary stenosis,sphincter of Oddis dysfunction,history of biliary surgery,cholecystectomy,bile duct diameter ≥ 15 mm,bile duct angle ≤120°,operation type,stone quantity ≥ 2 grains,stone diameter ≥ 10 mm,with or without gallstones (P＜0.05).The results of Logistic multivariate regression analysis showed that age,having peripapillary diverticulum,having history of biliary surgery,bile duct diameter ≥ 15 mm,stone quantity ≥ 2grains and EST operation type were the independent risk factors of the recurrence after choledocholithotomy (P＜0.05).Conclusion:There are many risk factors of recurrence after choledocholithotomy,and operation method should be based on the size and the number of the stones,and the constitution of patients.Preventive measures should be strengthened to control the recurrence after choledocholithotomy.

Objective To study the safety and efficacy of peroral endoscopic cardial constriction (PECC) for gastroesophageal reflux disease (GERD). Methods A total of 27 patients with GERD who visited the Affiliated Hospital of Inner Mongolia Medical University from August 2016 to December 2017 and met the inclusion criteria received PECC. The 24 h esophageal pH-resistance monitoring ( DeMeester ) scores, GERD health-related quality of life ( GERD-HRQL ) scores, GERD-questionnaires ( GERD-Q ) symptom scores and clinical efficacy before and after operation were compared. Results DeMeester score at 3 months ( Z=-6. 940, P=0. 001) and 6 months ( Z=-6. 307, P=0. 001) after treatment, GERD-HRQL score at 3 months ( t=11. 499, P=0. 001) and 6 months ( t=10. 959, P=0. 001) as well as GERD-Q symptom score at 3 months ( t=30. 647, P=0. 001) and 6 months ( t=27. 217, P =0. 001) after surgery significantly decreased, compared with those before. The curative rates were 81. 5％ ( 22/27) and 77. 8％(21/27) at 3 months and 6 months after operation. Conclusion PECC, a new method for the treatment of GERD with good short-term effect, safety and feasibility,can be recommended for clinical application.

Objective:To study the safety and efficacy of hiatal hernia-endoscopic submucosal dissection (HH-ESD) for the treatment of giant hiatal hernia (>3 cm in length) complicated with refractory gastroesophageal reflux disease (GERD).Methods:Patients with giant hiatal hernia complicated with refractory GERD who voluntarily received HH-ESD at the Digestive Endoscopy Center of the Affiliated People's Hospital of Inner Mongolia Medical University from April 2018 to March 2020 were included in the clinical study. The completion of HH-ESD and the occurrence of complications were observed, and the changes of indicators before and after the treatment were observed, including gastroesophageal reflux disease-health related quality of life (GERD-HRQL) score, gastroesophageal reflux disease questionnaire (GERD-Q) score, endoscopy results, 24 h esophageal pH monitoring results, esophageal high-resolution manometry results and proton pump inhibitor (PPI) usage.Results:Data of 10 patients were collected during the study, with a medical history of 2-10 years. All patients successfully underwent HH-ESD treatment. No adverse events such as perforation and massive bleeding occurred during the operation, and the hospital stay was 6-12 days. Dysphagia occurred in 3 cases after the operation, which was relieved spontaneously within 3 or 6 months. The preoperative GERD-HRQL scores ranged from 19 to 29, which were reduced to 0-14 and 0-8 at 3 and 12 months after the operation, respectively. The preoperative GERD-Q score was 9-17, and the scores at 3 and 12 months after the operation were all 6-9, which were significantly lower than those before. Gastroscopy showed that esophagitis was improved in all patients, hernia sac was reduced, and Hill grade was reduced compared with that before. The preoperative DeMeester score was 30.3-247.1, and the postoperative 12-month score was 0.2-29.9, which was significantly lower than that before. The long diameter of hiatal hernia was 3.0-6.0 cm before the operation and 0-5.0 cm at 12 months after, which was smaller than that before. At 12 months of the follow-up, 7 patients had stopped PPI, and the remaining 3 had changed to intermittent oral PPI.Conclusion:Preliminary results show that HH-ESD is safe and effective for the treatment of giant hiatal hernia complicated with refractory GERD.