[Objective]To investigate the prevalence of high-risk HPV infection among women in Kashgar area,analyze related risk factors,conduct follow-up and health education interventions for positive cases in the past three years,and assess intervention outcomes to improve HPV screening awareness and reduce cervical cancer incidence.[Methods]This study randomly selected 571 women from Kashgar who underwent HPV screening as part of a health check-up in the First People's Hospital of Kashgar between January 2021 and June 2023.High-risk HPV-DNA was detected using the PCR-RDB method.Based on the test results,participants were divided into HPV-negative and HPV-positive groups,and the infection rates and associated risk factors were analyzed.Additionally,follow-up was conducted for women who tested positive for high-risk HPV during the screening to assess the effectiveness of health management interventions.[Results]From 2021 to 2023,the high-risk HPV positive rate among women in Kashgar showed a year-on-year decline,recorded at 19.15%,16.43%,and 11.30%,respectively(P<0.001),with a total of 3,921 cases(16.13%)testing positive for high-risk HPV during this period.Uyghur women had a significantly higher infection rate compared with those of Han nationality and other ethnic minorities(P<0.05).Risk factors included age,age at first sexual activity,number of sexual partners,contraceptive methods,and a history of vaginal inflammation(P<0.05).Health management interventions significantly improved participants'awareness scores regarding cervical cancer prevention and the proportion of women voluntarily receiving HPV vaccination(P<0.05).[Conclusions]High-risk HPV infection among Uyghur women in Kashgar area is relatively high,with single infection of HPV-16 and HPV-52 and mixed infections of HPV-16+HPV-52 and HPV-16+HPV-58 being predominant.Risk factors include age at first sexual activity,number of sexual partners,contraceptive methods,and history of vaginal inflammation.Through triple-education interventions,the incidence of cervical cancer in Kashgar has been effectively reduced,and standards for primary-level diagnosis,treatment,and health supervision have been improved.

Gastroesophageal reflux disease (GERD) is a chronic digestive system disorder triggered by multiple factors, which is clinically prevalent and affects patients' quality of life. Laparoscopic fundoplication serves as the mainstay of surgical treatment for GERD, requiring standardized preoperative examinations to assess patients' reflux status and esophageal motility for individualized selection of fundoplication techniques. Intraoperative regulation of the fundoplication tension with a bougie aims to balance the anti-reflux efficacy and the risk of postoperative dysphagia. Additionally, membranous anatomy research guided by embryonic development facilitates optimization of surgical approaches and provides a theoretical basis for surgical innovation. This article deeply discusses the status of GERD diagnosis and treatment, as well as the surgical anti-reflux mechanisms, from multiple aspects including pathogenesis, diagnosis, and surgical management. We also contemplate the existing challenges in the embryonic development and anatomy of the anti-reflux barrier.

Gastroesophageal reflux disease (GERD) is a chronic digestive system disorder triggered by multiple factors, which is clinically prevalent and affects patients' quality of life. Laparoscopic fundoplication serves as the mainstay of surgical treatment for GERD, requiring standardized preoperative examinations to assess patients' reflux status and esophageal motility for individualized selection of fundoplication techniques. Intraoperative regulation of the fundoplication tension with a bougie aims to balance the anti-reflux efficacy and the risk of postoperative dysphagia. Additionally, membranous anatomy research guided by embryonic development facilitates optimization of surgical approaches and provides a theoretical basis for surgical innovation. This article deeply discusses the status of GERD diagnosis and treatment, as well as the surgical anti-reflux mechanisms, from multiple aspects including pathogenesis, diagnosis, and surgical management. We also contemplate the existing challenges in the embryonic development and anatomy of the anti-reflux barrier.

Hiatal hernia (HH) is a common benign disease in the digestive system, where the stomach or other internal organs bulges and displaces into posterior mediastinum through the esophageal hiatus on the diaphragm, often accompanied by symptoms such as heartburn, acid reflux, and chest pain. Patients with symptoms that are unresponsive to medical treatment require surgical intervention for relief. In recent years, robotic-assisted surgery (RAS) has rapidly advanced, offering precise manipulation, three-dimensional visualization, and a flexible wrist-turning robotic arm, capable of filtering out hand tremors. These advantages have led to the increasing use of RAS in HH repair procedures. This article provides a summary and analysis of RAS for the treatment of HH.

Objective To explore the value of peripheral blood sCD146 as a long-term survival ben-efit marker in elderly patients with acute ST segment elevation myocardial infarction(ASTEMI)after PCI.Methods A total of 210 patients who were diagnosed with ASTEMI and underwent PCI in our hospital from January 2021 to July 2022 were enrolled,and according to the postopera-tive sCD146 level,they were divided into low-,medium-and high-level groups(69,65 and 76 cases respectively).All of them were followed up,with endpoint events including all cause death,cardiac death,and major adverse cardiovascular events(MACE).Kaplan-Meier survival curve was plotted to compare the cumulative survival rate of each group,and COX regression analysis was used to analyze the relationship between peripheral blood sCD146 level and prognosis.Results The mor-tality rate and MACE incidence were significantly higher in the high-level group than the low-and medium-level groups(P＜0.05).Kaplan-Meier curve analysis showed that the high-level group had obviously lower cumulative survival rate than the other two groups(P＜0.05).COX regres-sion analysis revealed that the sCD146 level in peripheral blood after PCI was independently cor-related with the occurrence of death in ASTEMI patients after PCI(OR=1.530,95％CI:1.144-2.044,P=0.004).Conclusion The peripheral blood level of sCD146 is closely related to long-term survival benefits in ASTEMI patients after PCI,and sCD146 can be used as a biomarker to evaluate their long-term survival benefits.

Foregut surgery has emerged as a new discipline in recent years,gaining attention at home and abroad.It mainly focuses on benign diseases of the stomach and esophagus,covering conditions such as gastroesophageal reflux disease,achalasia,and bariatric metabolic surgery.However,in some countries,foregut surgery also includes malignant diseases,such as esophageal and gastric cancers.Robotic surgery,one of the most advanced techniques available,is increasingly applied in clinical practice.The unique ergonomic design of robotic surgical systems allows surgeons to control the instruments with greater precision and finesse,thereby minimizing damage to surrounding vital tissues and organs.Robotic surgery is gradually becoming a major focal point in the field of anterior foregut surgery.However,its curr-ent limitations in China include high equipment and maintenance costs,as well as strict requirements for operator qualifications and operating room conditions.As robotic technology continues to develop and improve,it is expected that robot-assisted surgery will play an increasingly important role in foregut surgery,helping doctors improve the quality of surgery and provide better treatment outcomes for patients.

Objective:To investigate the changes in plasma ghrelin and influencing factors of weight loss effects after laparoscopic sleeve gastrectomy combined with fundoplication surgery (LSGFD).Methods:The retrospective cohort study was conducted. The clinical data of 115 obesity patients who were admitted to the People′s Hospital of Xinjiang Uygur Autonomous Region from April to June 2023 were collected. There were 37 males and 78 females, aged (37±9)years. Of 115 pati-ents, 93 cases undergoing laparoscopic sleeve gastrectomy (LSG) were divided into the LSG group, and 22 cases undergoing LSGFD were divided into the LSGFD group. Measurement data with normal distribution were represented as Mean± SD, and the independent sample t test was used for com-parison between groups. Count data were described as absolute numbers, and the chi-square test was used for comparison between groups. Repeated measurement data were analyzed using the repeated ANOVA, and their variances were tested using a spherical test. The Logistic regression model was used for univariate and multivariate analyses. Results:(1) Changes in preoperative and postoperative plasma ghrelin in two groups of patients. The plasma ghrelin of patients at preopera-tive and postoperative 6 months changed from (16±14)×10 2 ng/L to (10±4)×10 2 ng/L in the LSG group and changed from (12±11)×10 2 ng/L to (11±3)×10 2 ng/L in the LSGFD group. There was no significant difference in the time effect, inter group effect, and interaction effect of changes in plasma ghrelin between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=2.199, Fgroup=0.001, Finteraction=0.793, P>0.05). There was a significant difference in plasma ghrelin in the LSG group before and after surgery at 6 months ( t=4.148, P<0.05), and there was no significant difference in plasma ghrelin in the LSGFD group before and after surgery at 6 months ( t=0.622, P>0.05). (2) Changes in preoperative and postoperative weight loss and metabolic related indicators in two groups of patients. ① There was a significant difference in the time effect of changes in body mass between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=242.285, P<0.05), and there was no significant difference in the inter group effect and interaction effect of changes in body mass between the LSG group and the LSGFD group before and after surgery at 6 months ( Fgroup=1.163, Finteraction=0.606, P>0.05). There were significant differences in body mass in the LSG group or the LSGFD group before and after surgery at 6 months ( t=23.597, 14.680, P<0.05). ② There was a significant difference in the time effect of changes in body mass index (BMI) between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=382.431, P<0.05), and there was no significant difference in the inter group effect and interaction effect of changes in BMI between the LSG group and the LSGFD group before and after surgery at 6 months ( Fgroup=1.619, Finteraction=1.085, P>0.05). There were significant differences in BMI in the LSG group or the LSGFD group before and after surgery at 6 months ( t=25.645, 16.628, P<0.05). ③ There was a significant difference in the time effect of changes in excess weight loss (%EWL) between the LSG group and the LSGFD group after surgery at 1 to 6 months ( Ftime=666.136, P<0.05), and there was no significant difference in the inter group effect and interaction effect of changes in %EWL between the LSG group and the LSGFD group after surgery at 1 to 6 months ( Fgroup=0.127, Finteraction=0.498, P>0.05). ④ There was no significant difference in the time effect, inter group effect, and interaction effect of changes in fasting blood glucose between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=1.573, Fgroup=1.872, Finteraction=0.948, P>0.05). There was a significant difference in fasting blood glucose in the LSG group before and after surgery at 6 months ( t=2.675, P<0.05), and there was no significant difference in fasting blood glucose in the LSGFD group before and after surgery at 6 months ( t=1.074, P>0.05). ⑤ There were significant differences in the inter group effect and interaction effect of changes in triglyceride between the LSG group and the LSGFD group before and after surgery at 6 months ( Fgroup=8.419, Finteraction=3.180, P<0.05), and there was no significant diffe-rence in the time effect of changes in triglyceride between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=1.398, P>0.05). Results of individual effect shown that there was no significant difference in triglyceride in the LSG group or the LSGFD group before and after surgery at 3 months ( F=2.956, 3.248, P>0.05), and there were significant differences in trigly-ceride in the LSG group or the LSGFD group after surgery at 1 month and 6 months ( F=14.152, 3.477, P<0.05). There was a significant difference in triglyceride in the LSG group before and after surgery at 6 months ( t=3.164, P<0.05), and there was no significant difference in triglyceride in the LSGFG group before and after surgery at 6 months ( t=0.023, P>0.05). ⑥ There were significant differences in the time effect and inter group effect of changes in total cholesterol between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=3.662, Fgroup=7.591, P<0.05), and there was no significant difference in the interaction effect of changes in total cholesterol between the LSG group and the LSGFD group before and after surgery at 6 months ( Finteraction=0.626, P>0.05). There was a significant difference in cholesterol in the LSG group before and after surgery at 6 months ( t=3.253, P<0.05), and there was no significant difference in total cholesterol in the LSGFG group before and after surgery at 6 months ( t=1.567, P>0.05). ⑦ There were significant differences in the time effect and inter group effect of changes in uric acid between the LSG group and the LSGFD group before and after surgery at 6 months ( Ftime=15.306, Fgroup=4.244, P<0.05), and there was no significant difference in the interaction effect of changes in uric acid between the LSG group and the LSGFD group before and after surgery at 6 months ( Finteraction=0.968, P>0.05). There were significant differ-ences in uric acid in the LSG group or the LSGFG group before and after surgery at 6 months ( t=6.152, 3.660, P<0.05). (3) Analysis of influencing factors on postoperative weight loss effects. Results of multivariate analysis showed that preoperative BMI, postoperative 6 months plasma ghrelin were independent protective factors for postoperative weight loss effects ( odds ratio=0.881, 0.673, 95% confidence interval as 0.817-0.950, 0.577-0.787, P<0.05). Conclusions:The decrease in plasma ghrelin in patients after LSGFD is not as obvious as that in patients after LSG, but it can achieve the same weight loss and metabolic improvement effects as after LSG. The lower preoperative BMI and postoperative 6 months plasma ghrelin are independent protective factors for postoperative weight loss effects.

Protease activating receptor (PAR) is a member of G protein-coupled receptor family, which includes four subtypes, namely PAR1, PAR2, PAR3 and PAR4. Except PAR2 trypsin receptor, other subunits belong to thrombin receptor. These receptors exist widely in various tissues of the body, especially in the digestive system to play a certain biological effect. In recent ten years, studies have shown that PAR1 and PAR2 play a key role in immune inflammatory response, which has aroused people′s attention. At present, it is of clinical value to study the development of gastroesophageal reflux disease (GERD) by exploring the unique activation mode of PAR2 in the pathological processes of esophageal mucosal damage, pain transmission, immune inflammatory response, stress and so on. This review aims to elucidate the molecular mechanism of PAR2 in gastroesophageal inflammation.

Protease activating receptor (PAR) is a member of G protein-coupled receptor family, which includes four subtypes, namely PAR1, PAR2, PAR3 and PAR4. Except PAR2 trypsin receptor, other subunits belong to thrombin receptor. These receptors exist widely in various tissues of the body, especially in the digestive system to play a certain biological effect. In recent ten years, studies have shown that PAR1 and PAR2 play a key role in immune inflammatory response, which has aroused people′s attention. At present, it is of clinical value to study the development of gastroesophageal reflux disease (GERD) by exploring the unique activation mode of PAR2 in the pathological processes of esophageal mucosal damage, pain transmission, immune inflammatory response, stress and so on. This review aims to elucidate the molecular mechanism of PAR2 in gastroesophageal inflammation.

ObjectiveTo investigate the incidence and influencing factors of postpartum depression and anxiety in Urumqi during the coronavirus disease （COVID-19） epidemic period in 2020. MethodsResearch subjects were the parturients who underwent postpartum health checkups in a third class hospital in Urumqi from January 2020 to December 2020. The maternal socio demographic and obstetric information were collected， and PHQ-9 and GAD-7 scales were used for screening of PPD and PPA. Calcaneal bone mineral density of the parturients was measured by French Pegasus ultrasonic bone densitometer. After univariate analysis of the related influencing factors of PPD and PPA， multivariate binary logistic regression analysis was used to explore the relationship between mental disorders and various influencing factors. ResultsA total of 2 490 puerpera participated in the survey. The incidences of PPD and PPA in 2020 were 13.4 % and 10.8 %， respectively. Six factors with statistical differences after univariate analysis were included in multivariate binary logistic regression analysis. The final results suggested that age over 35 （OR=1.707，95%CI：1.142‒2.551）， unemployment （OR=1.478，95%CI：1.003‒2.205）， multipara（OR=1.340，95%CI：1.037‒1.733）， bone loss and osteoporosis （OR=1.434，95%CI： 1.076‒1.910） were the risk factors of PPD， while breastfeeding （OR=0.466，95%CI： 0.301‒0.721） was a protective factor. Ages between 18‒24 （OR=1.559，95%CI：1.282‒3.097） and cesarean section （OR=1.433，95%CI： 1.105‒1.859） were the risk factors of PPA， while ages between 30‒34 years old （OR=0.524，95%CI： 0.332‒0.827）， occupation as medical staff （OR=0.282，95%CI： 0.807‒0.919）， breastfeeding （OR=0.530，95%CI： 0.330‒0.850） were protective factors. ConclusionIncidences of PPD and PPA are in middle-low levels during COVID-19 epidemic period. Age， occupation， delivery mode， delivery times， feeding pattern and bone mineral density are the influencing factors. Screen coverage of PPD and PPA in special period should be strengthened， and measures should be taken to reduce the risk.