Objective:To explore the pathological type and clinical symptoms of heterotopic gastric mucosa in upper esophagus (HGM).Methods:From December 2018 to August 2019, at the First Affiliated Hospital of Xinjiang Medical University, the patients with HGM, reflux esophagitis (RE), Barrett esophagus (BE) and chronic non-atrophic gastritis (CNAG), who underwent gastroscopy were selected. The pathological type of HGM including acid secretion, mucinous and mixed type. The differences in the symptoms among HGM, RE, BE, and CNAG, as well as the differences in the clinical symptoms of different pathological types of HGM were analyzed. Chi-square test and analysis of variance were used for statistical analysis.Results:There were 82, 104, 76, and 178 cases of HGM, RE, BE, and CNAG, respectively. The acid secretion, mucinous and mixed types of HGM were 22, 20 and 40 cases, respectively. The incidence rates of pharyngeal reflux symptoms foreign body sensation in the throat, swallowing discomfort, hoarseness, and cough of HGM patients were higher than those of RE patients (63.4%, 52/82 vs. 14.4%, 15/104; 58.5%, 48/82 vs. 14.4%, 15/104; 50.0%, 41/82 vs. 6.7%, 7/104; 43.9%, 36/82 vs. 12.5%, 13/104), while the incidence rates of gastroesophageal reflux symptoms acid reflux, heartburn and belching were lower than those of RE patients (34.1%, 28/82 vs. 61.5%, 64/104; 14.6%, 12/82 vs. 72.1%, 75/104; 34.1%, 28/82 vs. 67.3%, 70/104), and the differences were statistically significant ( χ2= 47.80, 39.80, 44.80, 23.30, 13.80, 60.90 and 20.20, all P<0.01). The incidence rates of pharyngeal reflux symptoms foreign body sensation in the throat, swallowing discomfort, hoarseness, and cough of HGM patients were higher than those of BE patients (63.4%, 52/82 vs. 22.4%, 17/76; 58.5%, 48/82 vs. 19.7%, 15/76; 50.0%, 41/82 vs. 9.2%, 7/76; 43.9%, 36/82 vs. 6.6%, 5/76), and the incidence rates of reflux symptoms acid reflux, heartburn, belching, and post-sternal burning sensation were lower than those of BE patients (34.1%, 28/82 vs. 61.8%, 47/76; 14.6%, 12/82 vs. 55.3%, 42/76; 34.1%, 28/82 vs. 65.8%, 50/76; 20.7%, 17/82 vs. 42.1%, 32/76), and the differences were statistically significant ( χ2=27.00, 24.80, 31.00, 28.60, 12.10, 28.90, 15.80 and 8.40, all P<0.01). The incidence rates of pharyngeal reflux symptoms foreign body sensation in the throat, swallowing discomfort, hoarseness and cough, gastroesophageal reflux symptoms acid reflux, heartburn, belching and post-sternal burning, and non-reflux symptoms digestion, bloating and abdominal pain of HGM patients were higher than those of CNAG patients (63.4%, 52/82 vs. 5.1%, 9/178; 58.5%, 48/82 vs. 3.9%, 7/178; 50.0%, 41/82 vs. 3.9%, 7/178; 43.9%, 36/82 vs. 4.5%, 8/178; 34.1%, 28/82 vs. 12.4%, 22/178; 14.6%, 12/82 vs. 2.8%, 5/178; 34.1%, 28/82 vs. 3.9%, 7/178; 20.7%, 17/82 vs. 11.2%, 20/178; 30.5%, 25/82 vs. 15.2%, 27/178; 32.9%, 27/82 vs. 14.6%, 26/178; 15.9%, 13/82 vs. 9.6%, 17/178), and the differences were statistically significant ( χ2=106.50, 100.40, 79.10, 62.00, 17.20, 4.10, 74.00, 12.80, 8.20, 11.60 and 2.20, all P<0.01). The incidence rates of pharyngeal reflux symptoms foreign body sensation, swallowing discomfort, and hoarseness of patients with acid secretion type of HGM were higher than those of mucinous type (72.7%, 16/22 vs. 35.0%, 7/20; 72.7%, 16/22 vs. 15.0%, 3/20; 50.0%, 11/22 vs. 20.0%, 4/20), and the differences were statistically significant ( χ2=6.00, 14.10 and 4.10, all P<0.01). The incidence rates of pharyngeal reflux symptoms foreign body sensation in the throat, swallowing discomfort, hoarseness, and cough of mixed type were higher than those of mucinous type (72.5%, 29/40 vs. 35.0%, 7/20; 72.5%, 29/40 vs. 15.0%, 3/20; 65.0%, 26/40 vs. 20.0%, 4/20; 62.5%, 25/40 vs. 15.0%, 3/20), and the differences were statistically significant ( χ2=7.80, 17.70, 10.80 and 12.10, all P<0.01). Conclusions:The pathological classification of HGM patients with clinical symptoms of pharyngeal reflux may be acid secretion type or mixed type, which can be treated with acid suppression drugs or argon plasma coagulation under gastroendoscopy.

Objective To evaluate smooth muscle protein of 22 kDa (SM22) in the diagnosis of acute intestinal ischemia.Methods 96 healthy adult SD rats were evenly divided into experimental group and control group,with each group subdivided into 6 subgroups,subject respectively to superior mesenteric artery ligation or sham operation.The venous blood samples were extracted from each group rats' right heart atO.5,1,2,4,8,12 h after the operation,for SM22 testing and small intestines tissues for direct immunofluorescence staining of SM22.Results The serum SM22 concentration reached a peak at 4 h (265 ± 15) mg/L,then gradually decreased (P ＜ 0.05).The I-FABP was mainly expressed in the epithelium of intestinal mucosa.During the 4 hours of intestinal ischemia,The number of SM22 positive particles did not change.After 4 hours,the number of SM22 positive granules had gradually decreased compared with the control group (all P ＜ 0.05).Conclusion SM22 mainly exists in the smooth muscle of intestinal,during the ischemic necrosis of the intestinal muscle layer SM22 leaks into blood stream,resulting in high serum levels of SM22 facilitating early diagnosis of acute intestinal ischemia.

Objective:To investigate the short-term efficacy of left-sided three-port total laparoscopic distal gastrectomy (TPTLDG).Methods:The prospective randomized controlled study was conducted. The 68 patients undergoing laparoscopic distal gastrectomy in the First Affiliated Hospital of Air Force Medical University from March 2022 to March 2023 were collected. All patients were randomly assigned to the TPTLDG group with a double number, and to the five-port laparoscopic distal gastrectomy (FPLDG) group with a single number, respectively. Observation indicators: (1) grouping situations of the enrolled patients; (2) comparison of perioperative condition; (3) comparison of complications during postoperative 30 days; (4) comparison of pathological examination. Measure-ment data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or continuous correction chi-square test. Comparison of ordinal data was analyzed using the non‐parameter rank sum test. Results:(1) Grouping situations of the enrolled patients. A total of 59 patients of gastric cancer were selected for eligibility. There were 40 males and 19 females, aged 59.00(52.00, 67.00)years. The gender (male, female), age, body mass index (BMI), Caprini score (≤2, ≥3), nutritional risk screening 2002 (<3, ≥3), Eastern Coopera-tive Oncology Group performance status (0, 1), preoperative hypersensitive C-reactive protein, preoperative IL-6, preoperative white blood cell count, preoperative albumin were 19, 11, 59.00(51.25,65.25)years, 21.92(20.93,22.73)kg/m 2, 7, 23, 24, 6, 18, 12, 0.78(0.78,1.46)mg/L, 3.07(1.50,10.56)μg/L, 6.07(4.94,7.19)×10 9/L, 44.30(40.83, 46.15) g/L in the 30 patients of TPTLDG group, versus 21, 8, 57.00(51.00, 67.00)years, 21.90(20.95, 23.35)kg/m 2, 11, 18, 24, 5, 17, 12, 1.13(0.78,11.40)mg/L, 5.56(1.88,15.12)μg/L, 5.54(4.71,6.70)×10 9/L, 43.55(40.25,44.88)g/L in the 29 patients of FPLDG group, showing no significant difference in the above indicators between the two groups ( χ2=0.557, Z=-0.444, -0.805, χ2=1.482, 0.074, 0.012, Z=-1.259, -1.262, -0.819, -1.199, P>0.05), confounding bias ensured comparability between the two groups. (2) Comparison of perioperative condition. The length of incision, time to removing drainage tube, IL-6 at postoperative day 3, cost of hospital stay were 6.65(6.48,6.93)cm, 3.00(0,3.00)days, 29.18 (13.67, 43.53)μg/L, 84 164.15(73 084.72, 96 782.14)yuan in the TPTLDG group, versus 8.00(7.50,8.35)cm, 3.00(3.00,4.00)days, 47.56(21.31,85.79)μg/L, 92 120.43(87 069.33, 113 089.74)yuan in the FPLDG group, showing significant differences in the above indicators between the two groups ( Z=-11.065, -2.141, -2.940, -2.220, P<0.05). (3) Comparison of complications during postoperative 30 days. The incidence rate of complications during postoperative 30 days was 30.00%(9/30) and 24.14%(7/29) in the TPTLDG group and FPLDG group, respectively, showing no significant difference between the two groups ( χ2=0.256, P>0.05). (4) Comparison of pathological examination. Cases with pathological N staging as 0 stage, 1 stage, 2 stage, 3 stage were 22, 2, 4, 2 in the TPTLDG group, versus 13, 7, 4, 5 in the FPLDG group, showing a significant difference between the two groups ( Z=-2.021, P<0.05). Conclusion:TPTLDG is safe and feasible for gastric cancer, with a good short-term efficacy.