Background/Aims: Belching can occur either independently or concurrently with reflux symptoms. This study aims to explore the relationship between belching and reflux and explore the underlying mechanisms involved. Methods: Firstly, patients with isolated belching symptoms or concurrent belching and reflux symptoms were retrospectively enrolled. High-resolution esophageal impedance manometry (HRIM) and 24-hour pH impedance monitoring were used to assess belching types and temporal relationship between belching and reflux. Secondly, subjects with belching disorder were prospectively recruited. Postprandial HRIM monitoring was used to clarify the relationship and underlying mechanisms between belching and reflux. Results: In the initial phase, 139 subjects were enrolled. Regardless of patients' symptom spectrum (with or without gastroesophageal reflux symptoms), the proportion of preceding-reflux belching was significantly higher in those with objective evidence of gastroesophageal reflux disease, compared to those without (both P < 0.05), which indicated that belching could trigger reflux events and led to more severe reflux burden. To clarify the potential mechanisms involved, 44 belching subjects were prospectively enrolled in the second phase of this study. HRIM analysis demonstrated that maximum intragastric pressure, gastric–lower esophageal sphincter pressure gradient and gastric–esophageal pressure gradient were significantly higher in preceding-reflux belching than those in independent belching. Conclusions This study demonstrated that belching might trigger reflux by increasing intragastric pressure, elevating the gastric-sphincter pressure gradient, which enables gastric contents to pass through the esophagogastric junction.These findings have crucial clinical significance, suggesting that reducing the occurrence of belching might be a potential treatment for refractory reflux.

Gastroesophageal reflux disease (GERD) is characterized by significant clinical heterogeneity. Conventional diagnostic approaches, including symptom-based questionnaires, empirical acid suppression trials, and single-modality objective tests, demonstrate limited sensitivity and specificity, often resulting in diagnostic inaccuracies and inefficient resource utilization. To overcome these diagnostic challenges, this article provides a systematic review of recent advancements and ongoing debates in GERD diagnostics, with a focus on the diagnostic value of multimodal parameters as outlined in the Lyon Consensus 2.0. It also explores the clinical relevance of emerging auxiliary diagnostic metrics. We emphasize that integrating clinical symptomatology, endoscopic findings, esophageal physiological measurements, and psychosocial factors (augmented by composite scoring systems and artificial intelligence), offers a promising strategy for accurate diagnosis and personalized treatment of GERD.

Gastroesophageal reflux disease (GERD) is characterized by significant clinical heterogeneity. Conventional diagnostic approaches, including symptom-based questionnaires, empirical acid suppression trials, and single-modality objective tests, demonstrate limited sensitivity and specificity, often resulting in diagnostic inaccuracies and inefficient resource utilization. To overcome these diagnostic challenges, this article provides a systematic review of recent advancements and ongoing debates in GERD diagnostics, with a focus on the diagnostic value of multimodal parameters as outlined in the Lyon Consensus 2.0. It also explores the clinical relevance of emerging auxiliary diagnostic metrics. We emphasize that integrating clinical symptomatology, endoscopic findings, esophageal physiological measurements, and psychosocial factors (augmented by composite scoring systems and artificial intelligence), offers a promising strategy for accurate diagnosis and personalized treatment of GERD.

Objective:To investigate high resolution CT (HRCT) manifestations and clinical features of patients infected with the novel coronavirus B.1.617.2 variant.Methods:A total of 125 patients with the novel coronavirus B.1.617.2 variant in Guangzhou Eighth People′s Hospital from May 21 to June 9, 2021 was enrolled. There were 52 males and 73 females, aged from 1 to 92 years old with a median age of 47 year. The clinical features and HRCT characteristics were analyzed retrospectively.Results:Of the 125 patients, the main clinical manifestations were fever in 54 patients, cough in 50 patients, pharyngeal discomfort in 39 patients, and diarrhea in 5 patients. HRCT showed pneumonia in 96 cases, which predominantly had ground-glass opacities in 92 cases, ground-glass opacities combined with local consolidation in 22 cases, consolidation in 11 cases, intralobular interstitial thickening in 51 cases, centrilobular structural thickening in 23 cases, and cord-like lesions in 33 cases. One patient had pleural effusion, and no enlarged lymph nodes were observed in all patients. The lesions were distributed in the subpleural and/or peripheral lung in 96 cases and along the bronchovascular bundle (middle and inner zone) in 24 cases. The time interval from onset to positive HRCT was 3 (1, 4) days in 96 patients with pneumonia on HRCT. HRCT showed absorption after the imaging findings reaching the peak in 20 patients, and the time interval between the first positive HRCT findings and the peak imaging was 6 (3, 7) days in these 20 patients.Conclusions:The novel coronavirus B.1.617.2 variant has a strong infectivity, short viral latency. Lung injury is decreaseel. People of all ages are susceptible and the diseasemay have rapid pnegression. HRCT mainly shows ground glass opacities, which are more common in subpleural and/or in the lung periphery, with interlobular thickening.

Idiopathic intracranial hypertension (IIH) is an unexplained clinical syndrome with intracranial hypertension as the main sign, often accompanied by headache, pulsating tinnitus, vision and visual field changes and other clinical manifestations. A large number of studies have shown that cerebral venous sinus stenosis is closely associated with IIH, and more than 90% of IIH patients are accompanied by cerebral venous sinus stenosis. Although the causal relationship between the two is still uncertain, a comprehensive surgical treatment system with venous sinus stenting as the core is gradually formed. This article reviews the stenting treatment of IIH complicated with cerebral venous sinus stenosis.

Objective: To investigate the initial HRCT manifestations and clinical features of imported novel coronavirus pneumonia (NCP) in Guangzhou. Methods: A retrospective analysis of 91 NCP patients admitted to the Guangzhou Eighth People’s Hospital from January 22 to 30, 2020 was performed including 39 males and 52 females, with a median age of 50 (33-62) years, then their clinical features and HRCT characteristics were analyzed. Results: The main clinical presentations included fever in 70 cases and cough in 57 cases(mainly dry coughin39 cases). The first time HRCT showed that 24 cases with NCP were normal, however other 67 cases were abnormal. The ground glass opacity in the lung on HRCT was found in 65 cases, including 64 cases with dilated blood vessel crossing the lesion, 50 cases with thickened adjacent pleura, and 47 cases with thickening of interstitial septum. The patchy opacity was seen in 42 cases, and no enlarged lymph nodes were observed in all patients. As for the lesion distribution, there were two cases with bilateral diffuse changes, 57 cases with multiple lesions, 8 cases with the lesion in only one lobe. The lesions were mainly located under the pleura area in 46 cases, including 39 cases in the lower lobe and other 7 cases in the upper lobe. And there were 13 cases without characteristic distribution in the lung. Conclusions The initial images of NCP in Guangzhou mainly showed multiple ground glass opacity, which were mostly seen in the subpleural and lower lung fields, most of them with thickened pulmonary interstitium. Guangzhou has a higher proportion of NCP patients with mild and general patients, and some confirmed patients show negative HRCT for the first time. Patients without HRCT changes should be reviewed in a timely manner.

Objective:To investigate the initial high resolution CT (HRCT) manifestations and clinical features of imported COVID-19 in Guangzhou.Methods:A retrospective analysis of 91 COVID-19 patients admitted to the Guangzhou Eighth People's Hospital from January 22 to 30, 2020 was performed including 39 males and 52 females, with a median age of 50 (33-62) years,then their clinical features and HRCT characteristics were analyzed.Results:The main clinical presentations included fever in 70 cases and cough in 57 cases(mainly dry cough in 39 cases). The first time HRCT showed that 24 cases with COVID-19 were normal, however other 67 cases were abnormal. The ground glass opacity in the lung on HRCT was found in 65 cases, including 64 cases with dilated blood vessel crossing the lesion, 50 cases with thickened adjacent pleura, and 47 cases with thickening of interstitial septum. The patchy opacity was seen in 42 cases, and no enlarged lymph nodes were observed in all patients. As for the lesion distribution, there were two cases with bilateral diffuse changes, 57 cases with multiple lesions, 8 cases with the lesion in only one lobe. The lesions were mainly located under the pleura area in 46 cases, including 39 cases in the lower lobe and other 7 cases in the upper lobe. And there were 13 cases without characteristic distribution in the lung.Conclusion:The initial images of COVID-19 in Guangzhou mainly showed multiple ground glass opacity, which were mostly seen in the subpleural and lower lung fields, most of them with thickened pulmonary interstitium. Guangzhou has a higher proportion of COVID-19 patients with mild and general patients, and some confirmed patients show negative HRCT for the first time. Patients without HRCT changes should be reviewed in a timely manner.

Objective To evaluate the etiology and CT features of thoracic lymphadenopathy in patients with acquired immunodeficiency syndrome (AIDS).Methods CT features of thoracic lymphadenopathy in 178 AIDS patients were retrospectively analyzed.Results Of 668 AIDS patients with thoracic lymphadenopathy,174 were proved to be infections including Penicilliosis marneffei (n =117),tuberculosis (n =42),cryptococcosis (n =10) and non-tuberculous mycobacteria (n =5).Four were proved to be tumors including 3 Kaposi's sarcomas and 1 lymphoma.The enlarged mediastinal and hilar lymph node presented as homogeneous soft-tissue density in 140 patients,with central low attenuation in 29 patients,as extreme low attenuation in 9 patients on plain CT scan and showed homogeneous enhancement in 28 patients,rim enhancement in 19 patients,non enhancement in 2 patients on enhanced CT scan.Accompanied CT findings included diffuse pulmonary micro-nodules (n =45),primary complex or similar primary complex (n =13),pleural effusion (n =59),pericardial effusion (n =24),sandwich sign in the small bowel mesentery (n =31).The CT findings of penicilliosis marneffei and tuberculosis were compared with chisquare test.There were significant differences on homogeneous soft-tissue density,central low attenuation,homogeneous enhancement,rim enhancement,diffuse pulmonary micro-nodules,primary complex or similar primary complex,sandwich sign,pleural effusion (x2 =32.62,43.82,12.13,15.72,11.76,11.06,5.44,4.07,P ＜ 0.05).Conclusions Thoracic lymphadenopathy can be caused by infections and tumors in AIDS.CT plays an important role for the differential diagnosis.

ObjectiveTo investigate the in vivo biological performance of 5 porous bioceramic scaffolds,which were bioglass,β-tricalcium phosphate (β-TCP),hydroxyapatite (HA),β-calcium silicate (β-CS) and α-CS,implanted in rabbit dorsal muscle.MethodsThe 5 porous bioceramic scaffolds were fabricated by adding pore-forming materials and sintering,and then were investigated by X-ray diffraction,porosity mensuration and biomechanics test.The scaffolds were implanted into rabbit dorsal muscle for 4,8,12,16 weeks,respectively.The samples were analyzed by X-ray,Micro-CT,histological analysis,scanning electron microscope (SEM) and energy dispersive spectrometer (EDS).The expression of bone morphogenetic protein(BMP-2) and BMP-7 in the muscle in touch with bioceramic scaffolds were also investigated by polymerase chain reaction(PCR).ResultsThe characteristic analysis of 5 scaffolds showed that the sequence of compressive strength was bioglass＞α-CS＞β-CS＞β-TCP＞HA,the sequence of elasticity modulus was α-CS＜β-TCP＜HA＜β-CS＜bioglass.It was confirmed by X-ray,Micro-CT and histological analysis that the sequence of biodegradability was β-CS＞α-CS＞β-TCP＞bioglass＞HA.The histological observation showed no new bone formation in five scaffolds.A Ca-P layer was formed in the surface of bioglass,α-CS and β-CS,which suggested their in vivo bioactivity.After 16 weeks,the expression of BMP-2 and BMP-7 was found only in β-CS.Conclusion The porous calcium silicate scaffold,which was promising for bone tissue engineering,was with good in vivo bioactivity and biodegradability,without in vivo osteoinductivity.

ObjectiveTo summarize X-ray and CT findings of soft tissue and bone infections secondary to acquired immunodeficiency syndrome (AIDS).MethodsThe data of X-ray and CT findings of soft tissue and bone infections in 18 patients with AIDS were retrospectively collected and analyzed.ResultsOf 18 patients with AIDS,the CT features of soft tissue demonstrated that subcutaneous patchy high density in 1 case which considered as cellulitis,round low density lesions with ring enhancement in 6 cases which considered as soft tissue abscesses,heterogeneous density lesions with peripheral enhancement in 1 case which considered as pyomyositis.Of 18 patients with AIDS,septic arthritis was found in 4 cases involving knee lesion in 3 cases and hip lesion.In the 4 case,the X-ray films showed bony destruction in 2 cases and the CT showed bone destruction in 3 cases and arthroedema in 4 cases.Of 18 patients with AIDS,osteomyelitis was found in 9 cases of which tuberculosis was considered in 8 cases and vertebral involvement in 6 cases.In the 9 cases,the X-ray films and CT displayed bony destruction,hyperostosis,small sequestra,and intervertebral space narrowing.Of 18 patients with AIDS,costal lesions were found in 3 cases in which the CT showed expandable bony destruction.Of 18 patients with AIDS,ilium and cacroihac joint lesions were found in 1 case in which the X-ray films and CT showed bony destruction,sequestra,and joint widening.Of 18 patients with AIDS,chronic pyogenic osteomyelitis of femur was found in 1 case in which the X-ray films showed bony destruction,hyperostosis osteosclerosis,and periosteal reaction.Conclusion The X-ray and CT features of soft tissue and bone infections secondary to AIDS are characterized.The X-ray and CT are useful tools to early diagnose soft tissue and bone infections secondary to AIDS.