Objective:Based on data from the Global Burden of Disease Study 2021 (GBD 2021), this study aims to analyze the epidemiological trends of inflammatory bowel diseases (IBD) in China from 1990 to 2021 and to assess the projected disease burden.Methods:Data on incidence, prevalence, mortality, and disability-adjusted life years (DALY) for IBD in China from 1990 to 2021 were extracted from the GBD 2021 database. Annual percent change (EAPC) and Bayesian age-period-cohort (BAPC) analyses were employed to evaluate these trends. Additionally, predictions for the disease burden over the next 25 years were made.Results:The age-standardized incidence rate of IBD in China rose from 0.74 per 100 000 in 1990 to 1.40 per 100 000 in 2021, an 89.19% increase. The age-standardized prevalence rate increased from 5.59 per 100 000 in 1990 to 9.16 per 100 000 in 2021, marking a 63.86% rise. Conversely, the age-standardized case fatality rate decreased from 0.75 per 100 000 in 1990 to 0.33 per 100 000 in 2021, a reduction of 56.00%. The total DALYs decreased from 162 186 in 1990 to 136 932 in 2021, a decline of 15.57%, while the age-standardized DALY rate fell from 18.38 per 100 000 in 1990 to 7.68 per 100 000 in 2021, a decrease of 58.22%. Analysis by age group revealed that the age-standardized incidence rate for the 35-39 years cohort increased most significantly, with an EAPC of 3.23%. The age-standardized prevalence rate for the 50-54 years cohort increased most significantly, with an EAPC of 2.85%. Gender analysis indicated that from 1990 to 2021, the age-standardized prevalence rate was higher among females than males, but the age-standardized case fatality rate rate was higher among males. From 2004 to 2021, the age-standardized DALY rate declined for both sexes, though it remained higher in males. By 2046, the number of new cases is projected to be slightly higher in males, while case fatality rate and DALYs are expected to remain low for both genders.Conclusions:Over the past three decades, the disease burden of IBD in China has increased significantly, particularly in terms of incidence and prevalence. Despite a general decrease in case fatality rates, the burden of IBD may increase in the elderly population due to aging demographics. Therefore, effective preventive measures, early screening, and aggressive treatment are crucial, especially for the elderly.

Objective:Based on data from the Global Burden of Disease Study 2021 (GBD 2021), this study aims to analyze the epidemiological trends of inflammatory bowel diseases (IBD) in China from 1990 to 2021 and to assess the projected disease burden.Methods:Data on incidence, prevalence, mortality, and disability-adjusted life years (DALY) for IBD in China from 1990 to 2021 were extracted from the GBD 2021 database. Annual percent change (EAPC) and Bayesian age-period-cohort (BAPC) analyses were employed to evaluate these trends. Additionally, predictions for the disease burden over the next 25 years were made.Results:The age-standardized incidence rate of IBD in China rose from 0.74 per 100 000 in 1990 to 1.40 per 100 000 in 2021, an 89.19% increase. The age-standardized prevalence rate increased from 5.59 per 100 000 in 1990 to 9.16 per 100 000 in 2021, marking a 63.86% rise. Conversely, the age-standardized case fatality rate decreased from 0.75 per 100 000 in 1990 to 0.33 per 100 000 in 2021, a reduction of 56.00%. The total DALYs decreased from 162 186 in 1990 to 136 932 in 2021, a decline of 15.57%, while the age-standardized DALY rate fell from 18.38 per 100 000 in 1990 to 7.68 per 100 000 in 2021, a decrease of 58.22%. Analysis by age group revealed that the age-standardized incidence rate for the 35-39 years cohort increased most significantly, with an EAPC of 3.23%. The age-standardized prevalence rate for the 50-54 years cohort increased most significantly, with an EAPC of 2.85%. Gender analysis indicated that from 1990 to 2021, the age-standardized prevalence rate was higher among females than males, but the age-standardized case fatality rate rate was higher among males. From 2004 to 2021, the age-standardized DALY rate declined for both sexes, though it remained higher in males. By 2046, the number of new cases is projected to be slightly higher in males, while case fatality rate and DALYs are expected to remain low for both genders.Conclusions:Over the past three decades, the disease burden of IBD in China has increased significantly, particularly in terms of incidence and prevalence. Despite a general decrease in case fatality rates, the burden of IBD may increase in the elderly population due to aging demographics. Therefore, effective preventive measures, early screening, and aggressive treatment are crucial, especially for the elderly.

Objective:To evaluate the anti-reflux effect of digestive tract reconstruction using esophageal-tubular gastric asymmetric anastomosis after radical resection of esophageal and esophagogastric junction cancer.Methods:The main steps were as follows:(1)oblique incision of the lower esophagus;(2)curved incision of the tubular anterior gastric wall;(3)the lower end of the esophagus was anastomosed to the tubular gastric incision with a 90-degree torsion; (4)The anterior wall of the anastomosis was reinforced with a transverse-inverted suture,the posterior wall with a folded suture,and the corners of the gastric stump were buried with sutures.The anastomosis operation time,postoperative complications and postoperative hospital stay were recorded;the reconstructed structure and anti-reflux effect of the anastomosis were observed by digestive tract radiography,gastroscopy and follow-up investigation.Results:The Department of Gastrointestinal and Thoracic Surgery of Huaian First People's Hospital, affiliated to Nanjing Medical University, treated 5 patients of esophagogastric junction cancer and 20 esophageal cancer cases between August 2022 and November 2024, including 19 men and 6 women, with a mean age of (66.7±7.4) years. The mean anastomosis time was (35.4±5.9) minutes, the intraoperative blood loss was (117.6±33.4) ml and the mean postoperative hospital stay was(16.6±5.2) days, with no complications such as anastomotic leakage and bleeding. Postoperative digestive tract radiography (Trendelenburg position)showed that all the patients had no contrast reflux,gastroscopy showed no signs of reflux esophagitis and bile reflux gastritis, the anastomosis showed an inverted whiskers valve-like structure. The median follow-up time was (16.8±6.3) months, and all patients had no reflux symptoms such as acid reflux and belching,and no acid suppressive medication was needed.Conclusion:The esophageal-tubular gastric asymmetric anastomosis is a safe and effective antireflux reconstruction technique.

Objective:To evaluate the anti-reflux effect of digestive tract reconstruction using esophageal-tubular gastric asymmetric anastomosis after radical resection of esophageal and esophagogastric junction cancer.Methods:The main steps were as follows:(1)oblique incision of the lower esophagus;(2)curved incision of the tubular anterior gastric wall;(3)the lower end of the esophagus was anastomosed to the tubular gastric incision with a 90-degree torsion; (4)The anterior wall of the anastomosis was reinforced with a transverse-inverted suture,the posterior wall with a folded suture,and the corners of the gastric stump were buried with sutures.The anastomosis operation time,postoperative complications and postoperative hospital stay were recorded;the reconstructed structure and anti-reflux effect of the anastomosis were observed by digestive tract radiography,gastroscopy and follow-up investigation.Results:The Department of Gastrointestinal and Thoracic Surgery of Huaian First People's Hospital, affiliated to Nanjing Medical University, treated 5 patients of esophagogastric junction cancer and 20 esophageal cancer cases between August 2022 and November 2024, including 19 men and 6 women, with a mean age of (66.7±7.4) years. The mean anastomosis time was (35.4±5.9) minutes, the intraoperative blood loss was (117.6±33.4) ml and the mean postoperative hospital stay was(16.6±5.2) days, with no complications such as anastomotic leakage and bleeding. Postoperative digestive tract radiography (Trendelenburg position)showed that all the patients had no contrast reflux,gastroscopy showed no signs of reflux esophagitis and bile reflux gastritis, the anastomosis showed an inverted whiskers valve-like structure. The median follow-up time was (16.8±6.3) months, and all patients had no reflux symptoms such as acid reflux and belching,and no acid suppressive medication was needed.Conclusion:The esophageal-tubular gastric asymmetric anastomosis is a safe and effective antireflux reconstruction technique.

Clinical data of 83 patients with obscure gastrointestinal bleeding (OGIB) undergoing capsule endoscopy were reviewed retrospectively.The results showed that the overall detection rate of gastrointestinal lesions for OGIB by capsule endoscopy was 81.9％ (68/83), most lesions (77. 1％, 64/83 )were located in small intestine. Of all the small intestinal lesions, arteriovenous malformation (AVM) was the most common (22 cases, 26.5％ ),followed by small intestinal space-occupying lesion (18 cases,21.7％ ) and single or multiple ulcers of small intestine ( 16 cases, 19. 3％ ). Four cases (4. 8％ ) had lesions outside of the small intestine. Small intestinal AVM was the leading cause of OGIB in patients ＞ 50 y,space-occupying lesion was the most common in patients aged 30 -50 y, while ulcer was the leading cause in patients ＜ 30 y. Bowel obstruction was not found in this group of patients. The results indicate that capsule endoscopy has great diagnostic value in detecting causes of OGIB. Small intestinal AVM is the most common cause of OGIB, followed by space-occupying lesion and ulcer.