Objective:To investigate the effect of ligation combined with peroral endoscopic cardial constriction (PECC) on the improvement of symptoms in patients with refractory gastroesophageal reflux disease(GERD).Methods:The clinical data of 42 patients with refractory GERD admitted to Zhejiang Zhoushan Hospital from March 2019 to March 2023 were collected retrospectively. Among them, 21 patients were treated with conventional drugs (control group), and 21 patients were treated with ligation combined with PECC on the basis of the control group(study group). The frequency and time of reflux, symptom score, frequency of reflux occurrence, and clinical efficacy of the two groups were compared before and after treatment.Results:After treatment, the longest regurgitation time, acid regurgitation time, total regurgitation times, acid regurgitation times, non-acid regurgitation times and weak acid regurgitation times in the study group were lower than those in the control group: (2.14 ± 0.12)min vs. (4.23 ± 1.03) min, (49.22 ± 5.13) min vs. (60.15 ± 6.21) min, (25.13 ± 2.11) times vs. (30.53 ± 3.52) times, (8.11 ± 0.63) times vs. (9.84 ± 0.85) times, (6.11 ± 0.51) times vs. (8.01 ± 0.72) times, (10.11 ± 1.12) times vs. (23.14 ± 1.29) times, there were statistical differences ( P<0.05). After treatment, the scores of GERD Health Quality of Life Scale (GERD-HRQL), Reflux Disease Questionnaire (RDQ) and Reflux Symptom Index Scale (RSI) in the study group were lower than those in the control group: (5.19 ± 0.42) scores vs. (11.34 ± 1.35) scores, (4.15 ± 0.34) scores vs. (10.66 ± 1.63) scores, (3.27 ± 0.24) scores vs.(7.51 ± 0.56) scores, there were statistical differences ( P<0.05). After treatment, the frequency of liquid-gas reflux, liquid reflux and gas reflux in the study group after treatment were lower than those in the control group: (10.14 ± 1.15) times/24 h vs. (14.39 ± 1.33) times/24 h, (5.12 ± 0.42) times/24 h vs. (6.06 ± 0.74) times/24 h, (7.62 ± 0.72) times/24 h vs. (10.43 ± 1.34) times/24 h, there were statistical differences ( P<0.05). The total effective rate in the study group was higher than that in the control group: 90.48%(19/21) vs. 57.14%(12/21), there was a statistical difference ( χ2 = 5.02, P<0.05). Conclusions:Ligation combined with PECC in patients with GERD has an ideal effect, which can effectively improve the frequency and symptom score of patients with reflux, reduce the frequency and time of reflux, and improve clinical efficacy.

Objective:To investigate the effect of ligation combined with peroral endoscopic cardial constriction (PECC) on the improvement of symptoms in patients with refractory gastroesophageal reflux disease(GERD).Methods:The clinical data of 42 patients with refractory GERD admitted to Zhejiang Zhoushan Hospital from March 2019 to March 2023 were collected retrospectively. Among them, 21 patients were treated with conventional drugs (control group), and 21 patients were treated with ligation combined with PECC on the basis of the control group(study group). The frequency and time of reflux, symptom score, frequency of reflux occurrence, and clinical efficacy of the two groups were compared before and after treatment.Results:After treatment, the longest regurgitation time, acid regurgitation time, total regurgitation times, acid regurgitation times, non-acid regurgitation times and weak acid regurgitation times in the study group were lower than those in the control group: (2.14 ± 0.12)min vs. (4.23 ± 1.03) min, (49.22 ± 5.13) min vs. (60.15 ± 6.21) min, (25.13 ± 2.11) times vs. (30.53 ± 3.52) times, (8.11 ± 0.63) times vs. (9.84 ± 0.85) times, (6.11 ± 0.51) times vs. (8.01 ± 0.72) times, (10.11 ± 1.12) times vs. (23.14 ± 1.29) times, there were statistical differences ( P<0.05). After treatment, the scores of GERD Health Quality of Life Scale (GERD-HRQL), Reflux Disease Questionnaire (RDQ) and Reflux Symptom Index Scale (RSI) in the study group were lower than those in the control group: (5.19 ± 0.42) scores vs. (11.34 ± 1.35) scores, (4.15 ± 0.34) scores vs. (10.66 ± 1.63) scores, (3.27 ± 0.24) scores vs.(7.51 ± 0.56) scores, there were statistical differences ( P<0.05). After treatment, the frequency of liquid-gas reflux, liquid reflux and gas reflux in the study group after treatment were lower than those in the control group: (10.14 ± 1.15) times/24 h vs. (14.39 ± 1.33) times/24 h, (5.12 ± 0.42) times/24 h vs. (6.06 ± 0.74) times/24 h, (7.62 ± 0.72) times/24 h vs. (10.43 ± 1.34) times/24 h, there were statistical differences ( P<0.05). The total effective rate in the study group was higher than that in the control group: 90.48%(19/21) vs. 57.14%(12/21), there was a statistical difference ( χ2 = 5.02, P<0.05). Conclusions:Ligation combined with PECC in patients with GERD has an ideal effect, which can effectively improve the frequency and symptom score of patients with reflux, reduce the frequency and time of reflux, and improve clinical efficacy.

Objective To study the protective effect of chlorogenic acid(CGA)on the apoptosis of PC12 cells induced byβ-amyloid protein23-35(Aβ25-35)and its mechanism. Methods The cells model of death was estab-lished by Aβ25-35 (20 μmol/L)-induced PC12 cells. The cells were interfered with 5 different concentrations of CGA. CCK-8 assay was used to detect cells viability to determine the 3 concentrations of CGA in future experi-ments. The cells were divided randomly into control group ,model group and interference groups with 3 different concentrations of CGA. Cells apoptosis rates were detected by flow cytometry;colorimetry method was used to detect MDA,SOD and GSH-Px. The mitochondrial membrane potential(MMP)was detected by fluorescent staining and the expression of caspase-3 by western blot. Results Compared with model group,the cells viability of CGA groups were increased but the apoptosis rates were reduced;the activity of SOD and GSH-Px were increased but the level of MDA,MMP and caspase-3 were decreased(P<0.05). Conclusions CGA has a protective effect on Aβ25-35-induced PC12 cells apoptosis and it may be related to the improvement of cellular antioxidation capacity and mitochondrial damage.

Objective Rapamycin can improve characteristic pathology of AD by improving the level of autophagy.But, its internal mechanism still needs further study.This study was aimed to observe the protective effect of Rapamycin (RAPA) on the injury of rat pheochromocytoma (PC12) cells induced by β-amyloid protein25-35 (Aβ25-35).Methods PC12 cells in the logarithmic phase were randomly divided into 5 groups: control group(similar free-serum DMEM), model group, 10μmol/L RAPA treated group, 40μmol/L RAPA treated group and 160μmol/L RAPA treated group(add 10μmol/L, 40μmol/L RAPA, 160μmol/L respectively).Except the control group, each group was cultured with 20μmol/L Aβ25-35 to established the cell injury model.Results ①Compared with the survival rate of cells[(51.47±2.59)%] and the apoptosis rate of cells[(52.22±2.33)%] of the model group,the survival rate of cells in 10、40、160μmol/L RAPA treated groups and control group[(54.64±2.42)%, (64.79±2.91)% ,(56.50±2.55)% and (99.98±0.73)%] significantly increased, but the apoptosis rate of cells [(45.33±2.83)%, (36.89±2.85)%, (48.00±2.83)% and (3.33±2.45)%] significantly decreased(All P<0.05).②In model group,the expressions of p-PKB is 0.33±0.01, p-mTOR is 1.97±0.05, p-tau is 2.09±0.19.Compared with model group, in 10、40、160μmol/L RAPA treated groups and control group,these expressions of p-PKB (0.37±0.01, 0.42±0.01, 0.40±0.01 and 0.44±0.02) were significantly increased, however p-mTOR (1.64±0.05, 0.66±0.04, 0.35±0.01 and 0.62±0.01) and p-tau (2.02±0.15, 1.79±0.05, 1.86±0.06 and1.53±0.04) were decreased(All, P<0.05).ConclusionRAPA can increase Aβ25-35-induced PC12 cells viability, decrease cells apoptosis rates, and have a protective effect on Aβ25-35-induced PC12 cells death.The mechanism of its protective effect may be related to the inhibition of mTOR regulating PI3K/PKB/mTOR signal transduction pathway by negative feedback and the reduction of tau protein hyperphosphorylation.