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 explore the early predictive value of lymphocyte subsets for cognitive impairment in cerebral ischemia-reperfusion injury.Methods A study was conducted on 68 patients with cerebral ischemia admitted to Honghe Hospital affiliated to Kunming Medical University from January 2023 to December 2023,divided into observation group(n=30)and control group(n=38).The general situation,lymphocyte subsets detection results and Montreal Cognitive Assessment Scale(MoCA)score were compared.Their correlation,sensitivity,specificity were analyzed.Results The proportion of patients with diabetes and levels of CD3+,CD8+and MoCA score in the observation group were lower than those in the control group(P＜0.05),the levels of CD4+,CD4+/CD8+,NK and CD19+in the observation group were higher than those in the control group(P＜0.05);CD3+and CD8+were positively correlated with MoCA score(P＜0.05);CD4+,CD4+/CD8+,NK and CD19+were negatively correlated with MoCA score(P＜0.05).The sensitivity and specificity of lymphocyte subsets combined detection for the diagnosis of cognitive dysfunction in cerebral ischemia-reperfusion injury were 93.45％and 100.00％,respectively.Conclusion The lymphocyte subsets have good predictive value for the occurrence of cognitive dysfunction in cerebral ischemia-reperfusion injury.It can be used as a specific marker.