The europium-doped LaF3 nanoparticles were prepared by refluxing method in glycerol/water mixture and characterized with X-ray diffraction（XRD）, field emission scanning electron microscopy（FE-SEM）, UV-vis diffuse ...The europium-doped LaF3 nanoparticles were prepared by refluxing method in glycerol/water mixture and characterized with X-ray diffraction（XRD）, field emission scanning electron microscopy（FE-SEM）, UV-vis diffuse reflectance spectrum, and photoluminescence spectra.The results of XRD indicated that the obtained LaF3：Eu^3＋ nanoparticles were well crystallized with a hexagonal structure.The FE-SEM image illustrated that the LaF3：Eu^3＋ nanoparticles were spherical with an average size around 30 nm.Under irradiation of UV light, the emission spectrum of LaF3：Eu^3＋ nanoparticles exhibited the characteristic line emissions arising from the 5D0→7FJ（J=1, 2, 3, 4） transitions of the Eu3＋ ions, with the dominating emission centered at 590 nm.In addition, the emissions from the 5D1 level could be clearly observed due to the low phonon energies（-350 cm^-1） of LaF3 matrix.The optimum doping concentration for LaF3：Eu3＋ nanoparticles was determined to be 20mol.%.展开更多
Flower-like zinc oxalate with a mean diameter of 50 μm was synthesized via the reaction of zinc acetate and dimethyl oxalate in ether-water bilayer refluxing systems at low temperature.Flower-like zinc oxalate micros...Flower-like zinc oxalate with a mean diameter of 50 μm was synthesized via the reaction of zinc acetate and dimethyl oxalate in ether-water bilayer refluxing systems at low temperature.Flower-like zinc oxalate microspheres can be further transformed into the similar morphology to zinc oxide by the decomposition of zinc oxalate at 500℃.Scanning electron microscopy（SEM）,X-ray diffraction（XRD）,thermogravimetric analysisdifferential scanning calorimetric（TG-DSC）,energy dispersive X-ray spectrum（EDX） and Fourier transforminfrared spectroscopy（FT-IR） were used to characterize the structure features and chemical compositions of the as-synthesized products.The UV-Vis and photoluminescence spectrum of flower-like zinc oxide microspheres were studied.The experimental results showed that flower-like zinc oxalate microspheres may be self-assembled by the zinc oxalate flakes.The ether-water volume ratio of 4：1 and refluxing temperature of 40℃ were considered to favor the preparation of flower-like zinc oxalate microspheres.展开更多
The complex fluoride, KNiF3, with perovskite structure was synthesized by refluxing KF and Ni（NO3）2·6H20 in ethanediol. The samples were characterized by X-ray diffraction（XRD）, transmission electron microsc...The complex fluoride, KNiF3, with perovskite structure was synthesized by refluxing KF and Ni（NO3）2·6H20 in ethanediol. The samples were characterized by X-ray diffraction（XRD）, transmission electron microscopy（TEM）, X-ray photoelectron spectroscopy（XPS）, and ultraviolet-visible diffuse reflectance speetroseopy（UV-Vis DRS）. The results indicate that the mean diameter of KNiF3 particles is about 30-60 nm and the oxygen content in the samples is ≤5%. The prepared KNiF3 shows obvious absorption peaks at 400-830 nm.展开更多
Titanium nitride （TiN） nanoparticles were prepared from a novel refluxing-derived precursor.The organic/inorganic hybrid precursor was prepared by a two-stage refluxing method using hydrous TiO2 as titania source an...Titanium nitride （TiN） nanoparticles were prepared from a novel refluxing-derived precursor.The organic/inorganic hybrid precursor was prepared by a two-stage refluxing method using hydrous TiO2 as titania source and n-dodecane as carbon source.The precursor was heat-treated to 1 200 °C in flowing ammonia （NH3） to get TiN nanoparticles.The phase and chemical compositions were investigated by means of XRD,Raman spectroscopy and XPS.Samples microstructure was studied by means of SEM,TEM and SEAD.XRD pattern indicated that the product was face-centered cubic TiN with a lattice constant a = 4.236 · and average crystallite sizes of 35.2 nm.Raman spectra indicated that long time refluxing results in Alkane dehydrogenation and the formation of coke on TiO2 nanoparticles.Oxygen presence in TiN lattice was confirmed by XPS investigation.The particle size that was showed by Electron microscopy photographs ranged from 20 to 60 nm.展开更多
Unique hierarchical mulberry-shaped Na3V2(PO4)2O2F@C nanocomposite was fabricated by a rapid microwave-assisted low-temperature refluxing strategy. The V(acac)3 reverse micelle systems in the water-in-oil microemulsio...Unique hierarchical mulberry-shaped Na3V2(PO4)2O2F@C nanocomposite was fabricated by a rapid microwave-assisted low-temperature refluxing strategy. The V(acac)3 reverse micelle systems in the water-in-oil microemulsions played key roles in forming the self-assembly architectures. The prepared Na3V2(PO4)2O2F@C nanoparticles with the anisotropic growth along the [002] direction were in-situ encapsulated in carbon shells, which greatly contribute to fast Na+/e-transfer in electrodes. And the self-assemblies with high structure stability help to improve the cycle performance and mitigate voltage fading. The initial discharge capacity of Na3V2(PO4)2O2F@C as cathode for sodium ion batteries is about 127.9 m A h g-1 at 0.1 C. Besides, a high rate performance with a capacity of 88.1 mA h g-1 at 20 C has been achieved, and the capacity retains 82.1% after 2,000 cycles. In addition, the reaction kinetics and Na+ transportation mechanism of Na3V2(PO4)2O2F@C were preliminarily investigated by the ex situ X-ray diffraction, X-ray photoelectron spectroscopy and galvanostatic intermittent titration technique. More interestingly, when coupled with Li, the fabricated hybrid Li/Na-ion batteries also exhibit excellent rate and cycling performances. The proposed rapid refluxing strategy to synthesize mulberry-shaped Na3V2(PO4)2O2F@C opens up a new opportunity to develop high-performance electrode materials for the energy storage systems.展开更多
Single phase and well-crystallined todorokite were synthesized by heating and refluxing process from birnessite as a precursor. The average chemical composition of the synthesized todorokites by refluxing for 8 h and ...Single phase and well-crystallined todorokite were synthesized by heating and refluxing process from birnessite as a precursor. The average chemical composition of the synthesized todorokites by refluxing for 8 h and for 24 h was Mg0.19MnO2.11(H2O)1.15 and in0.17-MnO2.10(H2O)0.88, respectively. The crystallinity of the todorokite increased and no other phase was produced with increasing refluxing period. The synthesized todorokites have the same morphologies and the similar structural characteristics with the natural todorokites and hydro-thermally synthesized samples. The chemical compositions of the synthetic tordorokites by refluxing process are close to those of todorokites synthesized by hydrothermal process, except a higher average oxidation state of Mn for the former.展开更多
Gastroesophageal reflux disease(GERD)affects both adults and children,although the symptoms differ significantly between these groups.While adults typically experience heartburn and regurgitation,children may present ...Gastroesophageal reflux disease(GERD)affects both adults and children,although the symptoms differ significantly between these groups.While adults typically experience heartburn and regurgitation,children may present with more subtle signs,such as failure to thrive,chronic cough,wheezing,and Sandifer syn-drome.Diagnosing GERD in children necessitates a multifaceted approach due to the diverse symptomatology and challenges in communication.Clinical assess-ment serves as the cornerstone of diagnosis,supported by tools like pH moni-toring,esophageal impedance testing,and upper gastrointestinal endoscopy.Imaging studies,such as barium swallow,can also provide valuable insights into anatomical abnormalities and the extent of reflux.Treatment strategies for pe-diatric GERD include lifestyle adjustments,pharmacotherapy,and,in severe cases,surgical interventions.Lifestyle adjustments may involve changes in fee-ding patterns,positional therapy,and weight management.Pharmacological options range from acid suppression with proton pump inhibitors or histamine-2 receptor antagonists to surgical procedures like fundoplication for refractory cases.Personalized management is essential,considering the child’s age,sym-ptom severity,and the presence of complications.This article aims to offer a comprehensive understanding of pediatric GERD by utilizing current research to enhance clinical approaches and improve patient outcomes.展开更多
The complex pathophysiology and diverse manifestations of esophageal disorders pose challenges in clinical practice,particularly in achieving accurate early diagnosis and risk stratification.While traditional approach...The complex pathophysiology and diverse manifestations of esophageal disorders pose challenges in clinical practice,particularly in achieving accurate early diagnosis and risk stratification.While traditional approaches rely heavily on subjective interpretations and variable expertise,machine learning(ML)has emerged as a transformative tool in healthcare.We conducted a comprehensive review of published literature on ML applications in esophageal diseases,analyzing technical approaches,validation methods,and clinical outcomes.ML demonstrates superior performance:In gastroesophageal reflux disease,ML models achieve 80%-90%accuracy in potential of hydrogen-impedance analysis and endoscopic grading;for Barrett’s esophagus,ML-based approaches show 88%-95% accuracy in invasive diagnostics and 77%-85% accuracy in non-invasive screening.In esophageal cancer,ML improves early detection and survival prediction by 6%-10% compared to traditional methods.Novel applications in achalasia and esophageal varices demonstrate promising results in automated diagnosis and risk stratification,with accuracy rates exceeding 85%.While challenges persist in data standardization,model interpretability,and clinical integration,emerging solutions in federated learning and explainable artificial intelligence offer promising pathways forward.The continued evolution of these technologies,coupled with rigorous validation and thoughtful implementation,may fundamentally transform our approach to esophageal disease management in the era of precision medicine.展开更多
Gastroesophageal reflux disease(GERD)poses a substantial global health challenge,with prevalence rates exhibiting geographical variation.Despite its widespread recognition,the exact prevalence and associated risk fact...Gastroesophageal reflux disease(GERD)poses a substantial global health challenge,with prevalence rates exhibiting geographical variation.Despite its widespread recognition,the exact prevalence and associated risk factors remain elusive.This article comprehensively analyzed the global burden of GERD,shedding light on its risk factors,underlying pathophysiological mechanisms,current diagnostic modalities,evolving management strategies tailored to diverse patient profiles,and complex determinants contributing to treatment failures.A deeper comprehension of GERD is achieved by dissecting these intricate facets,paving the way for enhanced clinical management and improved patient outcomes.展开更多
BACKGROUND Abnormal gastric acid reflux into the esophagus causes symptoms of gastroeso-phageal reflux disease(GERD)such as heartburn and regurgitation and also leads to mucosal damage.This damage can further lead to ...BACKGROUND Abnormal gastric acid reflux into the esophagus causes symptoms of gastroeso-phageal reflux disease(GERD)such as heartburn and regurgitation and also leads to mucosal damage.This damage can further lead to complications such as Bar-rett’s esophagus and esophagitis.Conventional proton pump inhibitors(PPIs)often fail to reduce nocturnal acid production,leaving patients with unresolved symptoms that worsen at night and decreased satisfaction.Happi ER,a novel dual delayed-release(DDR)formulation of rabeprazole,aims to address these limitations by providing both immediate and prolonged acid suppression.AIM To evaluate the safety and effectiveness of rabeprazole DDR 20 mg capsule in patients with GERD.METHODS This study involved a multicenter,real-world,prospective,observational design over an eight-week period.A total of 1022 GERD patients were treated with rabeprazole DDR 20 mg capsules(Happi ER),as prescribed by their physicians.We included adult patients with confirmed GERD and persistent heartburn symptoms despite prior PPI use.Outcome measures included heartburn severity,frequency of night-time awakenings,use of rescue medications,and overall patient satisfaction.RESULTS Rabeprazole DDR 20 mg capsules(Happi ER)were shown to be highly effective in treating GERD symptoms.At the end of the study,the mean heartburn score improved significantly from 2.46±0.67 at baseline to 0.16±0.39(P<0.0001).The median number of night-time awakenings decreased to 0(P<0.0001).More than 93%of patients rated the therapy as“excellent”or“very good”,reflecting high satisfaction.No significant adverse effects were reported,and the safety profile was comparable to that of traditional PPIs.CONCLUSION By providing both rapid and sustained acid suppression,Happi ER effectively treats GERD,particularly with respect to night-time symptoms.Its safety and efficacy profile make it a viable option for individuals with mild-to-moderate GERD,significantly improving the quality of life and symptom management.展开更多
BACKGROUND Reflux hypersensitivity(RH)constitutes roughly 14%of patients with heartburn and 34%of those with refractory heartburn,yet it is inadequately comprehended.AIM To investigate the clinical characteristics and...BACKGROUND Reflux hypersensitivity(RH)constitutes roughly 14%of patients with heartburn and 34%of those with refractory heartburn,yet it is inadequately comprehended.AIM To investigate the clinical characteristics and risk factors associated with RH.METHODS We conducted a retrospective analysis of 109 patients with RH and 384 healthy controls from three medical centers between January 2022 and December 2023.Comprehensive data encompassing symptoms,motility,impedance-pH monitoring,and psychological evaluations were collected.RESULTS RH patients encountered a greater frequency of weakly acidic reflux(WAR)events compared to acidic reflux or nonacidic reflux(NAR)events.Upright reflux time(1.22%)exceeds supine reflux time(0.54%)(P<0.05).Extraesophageal symptoms were more prevalent among younger patients and those with elevated NAR(P<0.05).The acidic reflux,WAR,NAR,and peristaltic contraction break length in male patients exceeded those in female patients(P<0.05).Age[odds ratio(OR)=5.633],hiatal hernia(OR=13.103),and anxiety(OR=17.342)constituted independent risk factors for RH.CONCLUSION WAR and NAR are pivotal in RH.Patients with increased NAR are more likely to experience extraesophageal symptoms.Age,hiatal hernia,and anxiety are significant independent risk factors for RH.展开更多
BACKGROUND The rising global prevalence of gastroesophageal reflux disease(GERD)has been closely linked to lifestyle changes driven by globalization.GERD imposes a substantial public health burden,affecting quality of...BACKGROUND The rising global prevalence of gastroesophageal reflux disease(GERD)has been closely linked to lifestyle changes driven by globalization.GERD imposes a substantial public health burden,affecting quality of life and leading to potential complications.Early intervention through lifestyle modification can prevent disease onset;however,there is a lack of effective risk prediction models that emphasize primary prevention.AIM To develop and validate a GERD Risk Scoring System(GRSS)aimed at identifying high-risk individuals and promoting primary prevention strategies.METHODS A 45-item questionnaire encompassing major lifestyle and demographic risk factors was developed and validated.It was administered to healthy controls and GERD patients.Two regression models-one using continuous variables and another using categorized variables-were used to develop a computational prediction equation and a clinically applicable scoring scale.An independent validation cohort of 355 participants was used to assess model performance in terms of discrimination(C-index),calibration,sensitivity,specificity,internal consistency(Cronbach's alpha),and test-retest reliability(intraclass correlation coefficient,Bland-Altman analysis).RESULTS Significant associations were observed between GERD and key lifestyle factors.The derived GRSS equation and scoring scale demonstrated strong discriminative ability,with high sensitivity and specificity.The scoring system exhibited excellent internal consistency(Cronbach’s alpha)and strong test-retest reliability.The C-index indicated excellent predictive accuracy in both derivation and validation cohorts.CONCLUSION GRSS offers a novel and validated approach to GERD risk prediction,combining a robust equation for digital applications and a practical scale for clinical use.Its ability to accurately identify at-risk individuals supports a paradigm shift toward primary prevention,underscoring its significance in addressing the growing burden of GERD at the population level.展开更多
BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladd...BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladder stones.AIM To explore the computed tomography(CT)imaging characteristics of gallbladder stones in patients diagnosed with OPBR.METHODS We analyzed 362 patients undergoing cholecystectomy(November 2020 to January 2022).Intraoperative bile samples were assayed for amylase(>110 U/L indicated OPBR).CT features,including stone density and visibility,were compared between 54 OPBR and 308 controls.Stone attenuation(HU)was measured under standardized conditions(uCT-780,120 kVp,160 mAs).Logistic regression and receiver operating characteristic curve analysis identified independent OPBR predictors,forming a validated nomogram.RESULTS OPBR patients exhibited significantly higher rates of CT-invisible stones(35.2%vs 12.3%)and uniform stones(87%vs 73.1%)along with lower overall stone density(P=0.01).Logistic regression identified stone visibility,uniformity,and density as independent predictors.A nomogram integrating these features with patient age achieved high diagnostic accuracy(area under the curve=0.71).CONCLUSION CT imaging distinctly identifies gallbladder stone density,indicating a heightened risk of OPBR in patients with uniform and CT-invisible stones.Such imaging is crucial for preoperative assessments to evaluate potential recurrent biliary pathologies post-cholecystectomy.展开更多
Per oral endoscopic myotomy(POEM)is rapidly emerging as the treatment of choice for achalasia cardia,but its success is marred by problematic reflux.Although symptomatic reflux rates are low and often comparable to th...Per oral endoscopic myotomy(POEM)is rapidly emerging as the treatment of choice for achalasia cardia,but its success is marred by problematic reflux.Although symptomatic reflux rates are low and often comparable to that after laparoscopic Hellers myotomy(LHM),a high incidence of pathologic reflux has been noted after POEM.This poses a dilemma as to what is true reflux,and in determining the indications and optimal endpoints for managing post-POEM reflux.The two pertinent reasons for the difference in reflux rates between LHM and POEM are the variation in length and location of myotomy and the absence of an anti-reflux procedure in POEM.Proton pump inhibitor remains the most sought-after treatment of POEM derived reflux.Nevertheless,modifications in the procedural technique of POEM and the addition of endoscopic fundoplication can probably emerge as a game changer.This article briefly reviews the incidence,causes,controversies,predictive factors,and management strategies related to post-POEM reflux.展开更多
Bile reflux gastritis (BRG) is a gastro-intestinal condition especially characterized by the reflux of bile into the stomach, further leading to mucosal inflammation along with various other clinical manifestations. D...Bile reflux gastritis (BRG) is a gastro-intestinal condition especially characterized by the reflux of bile into the stomach, further leading to mucosal inflammation along with various other clinical manifestations. Despite its increasing recognition, BRG remains understudied, with limited understanding of its epidemiology, pathophysiology, and optimal therapeutic strategies. Present narrative review aimed to comprehensively examine the available literature on BRG, focusing on its prevalence, risk factors, pathophysiology, clinical presentation, diagnostic modalities, and available therapeutic strategies. A comprehensive literature search was conducted using PubMed, Embase, Google Scholar and Cochrane databases. Relevant studies were included based on predefined inclusion and exclusion criteria. A narrative synthesis was conducted to summarize and interpret the findings. The prevalence of BRG remains uncertain due to diagnostic challenges. Risk factors include impaired gastrointestinal motility, sphincteric dysfunction (pyloric sphincter and the lower oesophageal sphincter), biliary tract disease, and certain medications. The pathophysiology involves bile acid-induced mucosal injury, inflammation, and impaired gastric defence mechanisms. Clinical manifestations are often nonspecific. Diagnostic modalities primarily include endoscopy and bile acid reflux testing. Management strategies encompass lifestyle modifications, medical therapy, and in severe cases, surgery. BRG is a complex condition with significant clinical implications. Further research is needed to refine diagnostic criteria, elucidate pathophysiological mechanisms, and develop effective therapeutic interventions. Addressing knowledge gaps in epidemiology, risk factors, and long-term outcomes is crucial for improving patient care.展开更多
The exact worldwide prevalence of gastroesophageal reflux disease(GERD)re-mains uncertain,despite its recognition as a common condition.This conundrum arises primarily from the lack of a standardized definition for GE...The exact worldwide prevalence of gastroesophageal reflux disease(GERD)re-mains uncertain,despite its recognition as a common condition.This conundrum arises primarily from the lack of a standardized definition for GERD.The gold standard diagnostic tests for GERD,such as pH impedance testing and endo-scopy,are cumbersome and impractical for assessing community prevalence.Consequently,most epidemiological studies rely on symptom-based screening tools.GERD symptoms can be both esophageal and extraesophageal,varying widely among individuals.This variability has led to multiple symptom-based definitions of GERD,with no consensus,resulting in prevalence estimates ranging from 5%to 25%worldwide.Most systematic reviews define GERD as experi-encing heartburn and/or regurgitation at least once weekly,yielding a calculated prevalence of 13.98%.In 2017,the global age-standardized prevalence of GERD was estimated at 8819 per 100000 people(95%confidence interval:7781-9863),a figure that has remained stable from 1990 to 2017.Prevalence increases with age,leading to more years lived with disability.GERD significantly impairs quality of life and can lead to multiple complications.Additionally,it imposes a severe economic burden,with the United States alone estimated to spend around 10 billion dollars annually on diagnosis and treatment.In summary,GERD preva-lence varies greatly by region and even within different areas of the same province.Determining the exact prevalence is challenging due to inconsistent diagnostic criteria.However,it is well-documented that GERD poses a significant global burden,affecting the quality of life of individuals and creating a substantial healthcare cost.展开更多
The diagnosis of gastroesophageal reflux(GERD)in children is a complex and challenging task that requires meticulous attention to detail and a deep un-derstanding of pediatric physiology.It is absolutely crucial to di...The diagnosis of gastroesophageal reflux(GERD)in children is a complex and challenging task that requires meticulous attention to detail and a deep un-derstanding of pediatric physiology.It is absolutely crucial to distinguish between the benign chalasia of infancy and the more serious pathologic GERD.Recent advancements have shown that Combined Multichannel Intraluminal Impedance and pondus hydrogenii measurement offer superior diagnostic accuracy.The role of nuclear scans in diagnosing GERD remains an area of ongoing research.The management of GERD in children follows a stepwise approach,starting with medical therapy and progressing to surgical intervention if necessary.展开更多
BACKGROUND Gastroesophageal reflux disease(GERD)is common among neonates,particularly those requiring mechanical ventilation.Pepsin,a reliable marker of gastric aspi-ration,may help detect GER episodes in ventilated n...BACKGROUND Gastroesophageal reflux disease(GERD)is common among neonates,particularly those requiring mechanical ventilation.Pepsin,a reliable marker of gastric aspi-ration,may help detect GER episodes in ventilated neonates and assess associated clinical outcomes.AIM To determine the incidence of GERD,associated risk factors,and morbidities among full-term mechanically ventilated neonates by detecting pepsin in endo-tracheal aspirates(ETA).METHODS This study included 97 full-term neonates admitted to the neonatal intensive care unit at Cairo University Hospitals from April 2023 to March 2024.ETA samples were collected at three intervals:Immediately post-intubation(Sample A),48 hours after intubation(Sample B),and just before extubation(Sample C).Pepsin concentration was measured using enzyme-linked immunosorbent assay.Clinical data,including hospital stay duration and feeding parameters,were correlated with pepsin levels.RESULTS Pepsin was detected in 76(78.4%)of Sample A,78(81.3%)of Sample B,and 47(68.1%)of Sample C.A significant positive correlation was found between pepsin levels and FiO_(2) in Sample B(r=0.203,P=0.047).Prolonged hospital stay was also associated with pepsin detection in Samples B and C(P<0.05).A negative correlation was observed between feeding amount and pepsin levels across all samples(P<0.05).CONCLUSION The incidence of GERD in full-term mechanically ventilated neonates is high,correlating with pepsin levels,FiO_(2),feeding intolerance,and hospital stay,highlighting the importance of early detection.展开更多
This review emphasizes the exemplary safety and efficacy of rebamipide in the treatment of gastric ulcers and other mucosa-related disorders,positioning it as a viable candidate for inclusion in treatment guidelines a...This review emphasizes the exemplary safety and efficacy of rebamipide in the treatment of gastric ulcers and other mucosa-related disorders,positioning it as a viable candidate for inclusion in treatment guidelines across India and globally.An in-depth literature review of rebamipide was carried out on PubMed and Google Scholar.Rebamipide has a multifaceted mechanism of action,including prostaglandin synthesis,scavenging free radicals,and enhancing mucin produc-tion,leading to enhanced mucosal protection and ulcer healing.Rebamipide serves as a highly effective and safe treatment option for gastric ulcers and gas-troesophageal reflux disease.The efficacy of this drug in treating ulcers often surpasses that of routinely used agents such as pantoprazole,sucralfate,misop-rostol,famotidine,lansoprazole,and esomeprazole.This superiority of rebami-pide can be attributed to the low rate of adverse events associated with it and its mild side effects,contributing to its widespread adoption across Southeast Asia and Russia.This popularity extends to its application beyond gastrointestinal ailments.Notably,it has been successfully employed in the treatment of ophthal-mological,oncological,and bone regeneration-related issues.Rebamipide's exemplary safety and efficacy in treating gastric ulcers and other mucosa-related disorders support its potential for inclusion in treatment guidelines,not only in India but also globally.展开更多
BACKGROUND Chinese surgeons often rely on intraoperative exploration of the esophageal hiatus to determine the need for concurrent type I hiatal hernia(HH)repair during laparoscopic sleeve gastrectomy.However,no stand...BACKGROUND Chinese surgeons often rely on intraoperative exploration of the esophageal hiatus to determine the need for concurrent type I hiatal hernia(HH)repair during laparoscopic sleeve gastrectomy.However,no standardized criteria for the esophageal hiatus size or indications for exploration exist in China.AIM To investigate normal anatomical parameter ranges of the esophageal hiatus in patients with obesity.METHODS A total of 158 patients,aged 20-49 years,was analyzed from January 2020 to June 2024.The patients were classified into the no reflux esophagitis(RE)no HH group(HHG),RE group,and type I HHG.The transverse and sagittal diameters and cross-sectional area of the esophageal hiatus were measured using multiplanar reconstruction of the computed tomography images.RESULTS Body mass index was positively correlated with area and transverse and sagittal diameters of the esophageal hiatus(r=0.72,0.69,and 0.54,respectively;P<0.01).In the no RE no HHG and RE group,the esophageal hiatus size in the subgroup with obesity was greater than that in the non-obesity subgroup(area:326.15±78 mm2 vs 208.12±64.44 mm2,transverse diameters:15.97±2.06 mm vs 13.37±1.99 mm,sagittal diameters:15.7±2.08 mm vs 11.73±2.08 mm;P<0.01).Patients with obesity showed no significant differences in esophageal hiatus size with or without RE or HH.CONCLUSION The esophageal hiatus size increased with body mass index and was larger in patients with obesity than in those without obesity.展开更多
基金supported by the Natural Science Foundation of Henan Province (082300440130, 2008A180039, 2007150049)Startup Fund for Doctoral Program of Zhoukou Normal University
文摘The europium-doped LaF3 nanoparticles were prepared by refluxing method in glycerol/water mixture and characterized with X-ray diffraction（XRD）, field emission scanning electron microscopy（FE-SEM）, UV-vis diffuse reflectance spectrum, and photoluminescence spectra.The results of XRD indicated that the obtained LaF3：Eu^3＋ nanoparticles were well crystallized with a hexagonal structure.The FE-SEM image illustrated that the LaF3：Eu^3＋ nanoparticles were spherical with an average size around 30 nm.Under irradiation of UV light, the emission spectrum of LaF3：Eu^3＋ nanoparticles exhibited the characteristic line emissions arising from the 5D0→7FJ（J=1, 2, 3, 4） transitions of the Eu3＋ ions, with the dominating emission centered at 590 nm.In addition, the emissions from the 5D1 level could be clearly observed due to the low phonon energies（-350 cm^-1） of LaF3 matrix.The optimum doping concentration for LaF3：Eu3＋ nanoparticles was determined to be 20mol.%.
基金supported by the National Natural Science Fundation of China (No. 20773109)the Natural Science Foundation of Jiangsu Educational Committee of China (No. 08KJB150005)
文摘Flower-like zinc oxalate with a mean diameter of 50 μm was synthesized via the reaction of zinc acetate and dimethyl oxalate in ether-water bilayer refluxing systems at low temperature.Flower-like zinc oxalate microspheres can be further transformed into the similar morphology to zinc oxide by the decomposition of zinc oxalate at 500℃.Scanning electron microscopy（SEM）,X-ray diffraction（XRD）,thermogravimetric analysisdifferential scanning calorimetric（TG-DSC）,energy dispersive X-ray spectrum（EDX） and Fourier transforminfrared spectroscopy（FT-IR） were used to characterize the structure features and chemical compositions of the as-synthesized products.The UV-Vis and photoluminescence spectrum of flower-like zinc oxide microspheres were studied.The experimental results showed that flower-like zinc oxalate microspheres may be self-assembled by the zinc oxalate flakes.The ether-water volume ratio of 4：1 and refluxing temperature of 40℃ were considered to favor the preparation of flower-like zinc oxalate microspheres.
基金Supported by the National Natural Science Foundation of China(No.20671069)
文摘The complex fluoride, KNiF3, with perovskite structure was synthesized by refluxing KF and Ni（NO3）2·6H20 in ethanediol. The samples were characterized by X-ray diffraction（XRD）, transmission electron microscopy（TEM）, X-ray photoelectron spectroscopy（XPS）, and ultraviolet-visible diffuse reflectance speetroseopy（UV-Vis DRS）. The results indicate that the mean diameter of KNiF3 particles is about 30-60 nm and the oxygen content in the samples is ≤5%. The prepared KNiF3 shows obvious absorption peaks at 400-830 nm.
基金Funded by Key Technologies Research and Development Program of Sichuan Province (No.2006Z02-17)
文摘Titanium nitride （TiN） nanoparticles were prepared from a novel refluxing-derived precursor.The organic/inorganic hybrid precursor was prepared by a two-stage refluxing method using hydrous TiO2 as titania source and n-dodecane as carbon source.The precursor was heat-treated to 1 200 °C in flowing ammonia （NH3） to get TiN nanoparticles.The phase and chemical compositions were investigated by means of XRD,Raman spectroscopy and XPS.Samples microstructure was studied by means of SEM,TEM and SEAD.XRD pattern indicated that the product was face-centered cubic TiN with a lattice constant a = 4.236 · and average crystallite sizes of 35.2 nm.Raman spectra indicated that long time refluxing results in Alkane dehydrogenation and the formation of coke on TiO2 nanoparticles.Oxygen presence in TiN lattice was confirmed by XPS investigation.The particle size that was showed by Electron microscopy photographs ranged from 20 to 60 nm.
基金supported by the National Natural Science Foundation of China (21303042, 21875097, 21671096 and 21603094)Guangdong Special Support for the Science and Technology Leading Young Scientist (2016TQ03C919)the Basic Research Project of the Science and Technology Innovation Commission of Shenzhen (JCYJ20170412153139454 and JCYJ20170817110251498)
文摘Unique hierarchical mulberry-shaped Na3V2(PO4)2O2F@C nanocomposite was fabricated by a rapid microwave-assisted low-temperature refluxing strategy. The V(acac)3 reverse micelle systems in the water-in-oil microemulsions played key roles in forming the self-assembly architectures. The prepared Na3V2(PO4)2O2F@C nanoparticles with the anisotropic growth along the [002] direction were in-situ encapsulated in carbon shells, which greatly contribute to fast Na+/e-transfer in electrodes. And the self-assemblies with high structure stability help to improve the cycle performance and mitigate voltage fading. The initial discharge capacity of Na3V2(PO4)2O2F@C as cathode for sodium ion batteries is about 127.9 m A h g-1 at 0.1 C. Besides, a high rate performance with a capacity of 88.1 mA h g-1 at 20 C has been achieved, and the capacity retains 82.1% after 2,000 cycles. In addition, the reaction kinetics and Na+ transportation mechanism of Na3V2(PO4)2O2F@C were preliminarily investigated by the ex situ X-ray diffraction, X-ray photoelectron spectroscopy and galvanostatic intermittent titration technique. More interestingly, when coupled with Li, the fabricated hybrid Li/Na-ion batteries also exhibit excellent rate and cycling performances. The proposed rapid refluxing strategy to synthesize mulberry-shaped Na3V2(PO4)2O2F@C opens up a new opportunity to develop high-performance electrode materials for the energy storage systems.
基金This work was supported by the National Natural Science Foundation of China(Grant Nos.40101017 and 40071048) by the Research Fund for the Doctoral Program of Higher Education(Grant No.2002050411).
文摘Single phase and well-crystallined todorokite were synthesized by heating and refluxing process from birnessite as a precursor. The average chemical composition of the synthesized todorokites by refluxing for 8 h and for 24 h was Mg0.19MnO2.11(H2O)1.15 and in0.17-MnO2.10(H2O)0.88, respectively. The crystallinity of the todorokite increased and no other phase was produced with increasing refluxing period. The synthesized todorokites have the same morphologies and the similar structural characteristics with the natural todorokites and hydro-thermally synthesized samples. The chemical compositions of the synthetic tordorokites by refluxing process are close to those of todorokites synthesized by hydrothermal process, except a higher average oxidation state of Mn for the former.
文摘Gastroesophageal reflux disease(GERD)affects both adults and children,although the symptoms differ significantly between these groups.While adults typically experience heartburn and regurgitation,children may present with more subtle signs,such as failure to thrive,chronic cough,wheezing,and Sandifer syn-drome.Diagnosing GERD in children necessitates a multifaceted approach due to the diverse symptomatology and challenges in communication.Clinical assess-ment serves as the cornerstone of diagnosis,supported by tools like pH moni-toring,esophageal impedance testing,and upper gastrointestinal endoscopy.Imaging studies,such as barium swallow,can also provide valuable insights into anatomical abnormalities and the extent of reflux.Treatment strategies for pe-diatric GERD include lifestyle adjustments,pharmacotherapy,and,in severe cases,surgical interventions.Lifestyle adjustments may involve changes in fee-ding patterns,positional therapy,and weight management.Pharmacological options range from acid suppression with proton pump inhibitors or histamine-2 receptor antagonists to surgical procedures like fundoplication for refractory cases.Personalized management is essential,considering the child’s age,sym-ptom severity,and the presence of complications.This article aims to offer a comprehensive understanding of pediatric GERD by utilizing current research to enhance clinical approaches and improve patient outcomes.
基金Supported by the Central Funds Guiding the Local Science and Technology Development,No.202207AB110017Key Research and Development Program of Yunnan,No.202302AD080004+1 种基金Yunnan Academician and Expert Workstation,No.202205AF150023the Scientific and Technological Innovation Team in Kunming Medical University,No.CXTD202215.
文摘The complex pathophysiology and diverse manifestations of esophageal disorders pose challenges in clinical practice,particularly in achieving accurate early diagnosis and risk stratification.While traditional approaches rely heavily on subjective interpretations and variable expertise,machine learning(ML)has emerged as a transformative tool in healthcare.We conducted a comprehensive review of published literature on ML applications in esophageal diseases,analyzing technical approaches,validation methods,and clinical outcomes.ML demonstrates superior performance:In gastroesophageal reflux disease,ML models achieve 80%-90%accuracy in potential of hydrogen-impedance analysis and endoscopic grading;for Barrett’s esophagus,ML-based approaches show 88%-95% accuracy in invasive diagnostics and 77%-85% accuracy in non-invasive screening.In esophageal cancer,ML improves early detection and survival prediction by 6%-10% compared to traditional methods.Novel applications in achalasia and esophageal varices demonstrate promising results in automated diagnosis and risk stratification,with accuracy rates exceeding 85%.While challenges persist in data standardization,model interpretability,and clinical integration,emerging solutions in federated learning and explainable artificial intelligence offer promising pathways forward.The continued evolution of these technologies,coupled with rigorous validation and thoughtful implementation,may fundamentally transform our approach to esophageal disease management in the era of precision medicine.
文摘Gastroesophageal reflux disease(GERD)poses a substantial global health challenge,with prevalence rates exhibiting geographical variation.Despite its widespread recognition,the exact prevalence and associated risk factors remain elusive.This article comprehensively analyzed the global burden of GERD,shedding light on its risk factors,underlying pathophysiological mechanisms,current diagnostic modalities,evolving management strategies tailored to diverse patient profiles,and complex determinants contributing to treatment failures.A deeper comprehension of GERD is achieved by dissecting these intricate facets,paving the way for enhanced clinical management and improved patient outcomes.
文摘BACKGROUND Abnormal gastric acid reflux into the esophagus causes symptoms of gastroeso-phageal reflux disease(GERD)such as heartburn and regurgitation and also leads to mucosal damage.This damage can further lead to complications such as Bar-rett’s esophagus and esophagitis.Conventional proton pump inhibitors(PPIs)often fail to reduce nocturnal acid production,leaving patients with unresolved symptoms that worsen at night and decreased satisfaction.Happi ER,a novel dual delayed-release(DDR)formulation of rabeprazole,aims to address these limitations by providing both immediate and prolonged acid suppression.AIM To evaluate the safety and effectiveness of rabeprazole DDR 20 mg capsule in patients with GERD.METHODS This study involved a multicenter,real-world,prospective,observational design over an eight-week period.A total of 1022 GERD patients were treated with rabeprazole DDR 20 mg capsules(Happi ER),as prescribed by their physicians.We included adult patients with confirmed GERD and persistent heartburn symptoms despite prior PPI use.Outcome measures included heartburn severity,frequency of night-time awakenings,use of rescue medications,and overall patient satisfaction.RESULTS Rabeprazole DDR 20 mg capsules(Happi ER)were shown to be highly effective in treating GERD symptoms.At the end of the study,the mean heartburn score improved significantly from 2.46±0.67 at baseline to 0.16±0.39(P<0.0001).The median number of night-time awakenings decreased to 0(P<0.0001).More than 93%of patients rated the therapy as“excellent”or“very good”,reflecting high satisfaction.No significant adverse effects were reported,and the safety profile was comparable to that of traditional PPIs.CONCLUSION By providing both rapid and sustained acid suppression,Happi ER effectively treats GERD,particularly with respect to night-time symptoms.Its safety and efficacy profile make it a viable option for individuals with mild-to-moderate GERD,significantly improving the quality of life and symptom management.
基金Supported by the Foundation of the Second Affiliated Hospital of Xi’an Jiaotong University,No.YJ(ZD)202301.
文摘BACKGROUND Reflux hypersensitivity(RH)constitutes roughly 14%of patients with heartburn and 34%of those with refractory heartburn,yet it is inadequately comprehended.AIM To investigate the clinical characteristics and risk factors associated with RH.METHODS We conducted a retrospective analysis of 109 patients with RH and 384 healthy controls from three medical centers between January 2022 and December 2023.Comprehensive data encompassing symptoms,motility,impedance-pH monitoring,and psychological evaluations were collected.RESULTS RH patients encountered a greater frequency of weakly acidic reflux(WAR)events compared to acidic reflux or nonacidic reflux(NAR)events.Upright reflux time(1.22%)exceeds supine reflux time(0.54%)(P<0.05).Extraesophageal symptoms were more prevalent among younger patients and those with elevated NAR(P<0.05).The acidic reflux,WAR,NAR,and peristaltic contraction break length in male patients exceeded those in female patients(P<0.05).Age[odds ratio(OR)=5.633],hiatal hernia(OR=13.103),and anxiety(OR=17.342)constituted independent risk factors for RH.CONCLUSION WAR and NAR are pivotal in RH.Patients with increased NAR are more likely to experience extraesophageal symptoms.Age,hiatal hernia,and anxiety are significant independent risk factors for RH.
文摘BACKGROUND The rising global prevalence of gastroesophageal reflux disease(GERD)has been closely linked to lifestyle changes driven by globalization.GERD imposes a substantial public health burden,affecting quality of life and leading to potential complications.Early intervention through lifestyle modification can prevent disease onset;however,there is a lack of effective risk prediction models that emphasize primary prevention.AIM To develop and validate a GERD Risk Scoring System(GRSS)aimed at identifying high-risk individuals and promoting primary prevention strategies.METHODS A 45-item questionnaire encompassing major lifestyle and demographic risk factors was developed and validated.It was administered to healthy controls and GERD patients.Two regression models-one using continuous variables and another using categorized variables-were used to develop a computational prediction equation and a clinically applicable scoring scale.An independent validation cohort of 355 participants was used to assess model performance in terms of discrimination(C-index),calibration,sensitivity,specificity,internal consistency(Cronbach's alpha),and test-retest reliability(intraclass correlation coefficient,Bland-Altman analysis).RESULTS Significant associations were observed between GERD and key lifestyle factors.The derived GRSS equation and scoring scale demonstrated strong discriminative ability,with high sensitivity and specificity.The scoring system exhibited excellent internal consistency(Cronbach’s alpha)and strong test-retest reliability.The C-index indicated excellent predictive accuracy in both derivation and validation cohorts.CONCLUSION GRSS offers a novel and validated approach to GERD risk prediction,combining a robust equation for digital applications and a practical scale for clinical use.Its ability to accurately identify at-risk individuals supports a paradigm shift toward primary prevention,underscoring its significance in addressing the growing burden of GERD at the population level.
基金Supported by Key Specialty Construction Project of Shanghai Pudong New Area Health Commission,No.PWZzk2022-17Shanghai East Hospital Clinical Research Project,No.DFLC2022019the Featured Clinical Discipline Project of Shanghai Pudong District,No.PWYts2021-06.
文摘BACKGROUND Occult pancreaticobiliary reflux(OPBR)is characterized by the absence of congenital anomalies at the pancreaticobiliary junction yet leads to altered bile composition and an increased incidence of gallbladder stones.AIM To explore the computed tomography(CT)imaging characteristics of gallbladder stones in patients diagnosed with OPBR.METHODS We analyzed 362 patients undergoing cholecystectomy(November 2020 to January 2022).Intraoperative bile samples were assayed for amylase(>110 U/L indicated OPBR).CT features,including stone density and visibility,were compared between 54 OPBR and 308 controls.Stone attenuation(HU)was measured under standardized conditions(uCT-780,120 kVp,160 mAs).Logistic regression and receiver operating characteristic curve analysis identified independent OPBR predictors,forming a validated nomogram.RESULTS OPBR patients exhibited significantly higher rates of CT-invisible stones(35.2%vs 12.3%)and uniform stones(87%vs 73.1%)along with lower overall stone density(P=0.01).Logistic regression identified stone visibility,uniformity,and density as independent predictors.A nomogram integrating these features with patient age achieved high diagnostic accuracy(area under the curve=0.71).CONCLUSION CT imaging distinctly identifies gallbladder stone density,indicating a heightened risk of OPBR in patients with uniform and CT-invisible stones.Such imaging is crucial for preoperative assessments to evaluate potential recurrent biliary pathologies post-cholecystectomy.
文摘Per oral endoscopic myotomy(POEM)is rapidly emerging as the treatment of choice for achalasia cardia,but its success is marred by problematic reflux.Although symptomatic reflux rates are low and often comparable to that after laparoscopic Hellers myotomy(LHM),a high incidence of pathologic reflux has been noted after POEM.This poses a dilemma as to what is true reflux,and in determining the indications and optimal endpoints for managing post-POEM reflux.The two pertinent reasons for the difference in reflux rates between LHM and POEM are the variation in length and location of myotomy and the absence of an anti-reflux procedure in POEM.Proton pump inhibitor remains the most sought-after treatment of POEM derived reflux.Nevertheless,modifications in the procedural technique of POEM and the addition of endoscopic fundoplication can probably emerge as a game changer.This article briefly reviews the incidence,causes,controversies,predictive factors,and management strategies related to post-POEM reflux.
文摘Bile reflux gastritis (BRG) is a gastro-intestinal condition especially characterized by the reflux of bile into the stomach, further leading to mucosal inflammation along with various other clinical manifestations. Despite its increasing recognition, BRG remains understudied, with limited understanding of its epidemiology, pathophysiology, and optimal therapeutic strategies. Present narrative review aimed to comprehensively examine the available literature on BRG, focusing on its prevalence, risk factors, pathophysiology, clinical presentation, diagnostic modalities, and available therapeutic strategies. A comprehensive literature search was conducted using PubMed, Embase, Google Scholar and Cochrane databases. Relevant studies were included based on predefined inclusion and exclusion criteria. A narrative synthesis was conducted to summarize and interpret the findings. The prevalence of BRG remains uncertain due to diagnostic challenges. Risk factors include impaired gastrointestinal motility, sphincteric dysfunction (pyloric sphincter and the lower oesophageal sphincter), biliary tract disease, and certain medications. The pathophysiology involves bile acid-induced mucosal injury, inflammation, and impaired gastric defence mechanisms. Clinical manifestations are often nonspecific. Diagnostic modalities primarily include endoscopy and bile acid reflux testing. Management strategies encompass lifestyle modifications, medical therapy, and in severe cases, surgery. BRG is a complex condition with significant clinical implications. Further research is needed to refine diagnostic criteria, elucidate pathophysiological mechanisms, and develop effective therapeutic interventions. Addressing knowledge gaps in epidemiology, risk factors, and long-term outcomes is crucial for improving patient care.
文摘The exact worldwide prevalence of gastroesophageal reflux disease(GERD)re-mains uncertain,despite its recognition as a common condition.This conundrum arises primarily from the lack of a standardized definition for GERD.The gold standard diagnostic tests for GERD,such as pH impedance testing and endo-scopy,are cumbersome and impractical for assessing community prevalence.Consequently,most epidemiological studies rely on symptom-based screening tools.GERD symptoms can be both esophageal and extraesophageal,varying widely among individuals.This variability has led to multiple symptom-based definitions of GERD,with no consensus,resulting in prevalence estimates ranging from 5%to 25%worldwide.Most systematic reviews define GERD as experi-encing heartburn and/or regurgitation at least once weekly,yielding a calculated prevalence of 13.98%.In 2017,the global age-standardized prevalence of GERD was estimated at 8819 per 100000 people(95%confidence interval:7781-9863),a figure that has remained stable from 1990 to 2017.Prevalence increases with age,leading to more years lived with disability.GERD significantly impairs quality of life and can lead to multiple complications.Additionally,it imposes a severe economic burden,with the United States alone estimated to spend around 10 billion dollars annually on diagnosis and treatment.In summary,GERD preva-lence varies greatly by region and even within different areas of the same province.Determining the exact prevalence is challenging due to inconsistent diagnostic criteria.However,it is well-documented that GERD poses a significant global burden,affecting the quality of life of individuals and creating a substantial healthcare cost.
文摘The diagnosis of gastroesophageal reflux(GERD)in children is a complex and challenging task that requires meticulous attention to detail and a deep un-derstanding of pediatric physiology.It is absolutely crucial to distinguish between the benign chalasia of infancy and the more serious pathologic GERD.Recent advancements have shown that Combined Multichannel Intraluminal Impedance and pondus hydrogenii measurement offer superior diagnostic accuracy.The role of nuclear scans in diagnosing GERD remains an area of ongoing research.The management of GERD in children follows a stepwise approach,starting with medical therapy and progressing to surgical intervention if necessary.
文摘BACKGROUND Gastroesophageal reflux disease(GERD)is common among neonates,particularly those requiring mechanical ventilation.Pepsin,a reliable marker of gastric aspi-ration,may help detect GER episodes in ventilated neonates and assess associated clinical outcomes.AIM To determine the incidence of GERD,associated risk factors,and morbidities among full-term mechanically ventilated neonates by detecting pepsin in endo-tracheal aspirates(ETA).METHODS This study included 97 full-term neonates admitted to the neonatal intensive care unit at Cairo University Hospitals from April 2023 to March 2024.ETA samples were collected at three intervals:Immediately post-intubation(Sample A),48 hours after intubation(Sample B),and just before extubation(Sample C).Pepsin concentration was measured using enzyme-linked immunosorbent assay.Clinical data,including hospital stay duration and feeding parameters,were correlated with pepsin levels.RESULTS Pepsin was detected in 76(78.4%)of Sample A,78(81.3%)of Sample B,and 47(68.1%)of Sample C.A significant positive correlation was found between pepsin levels and FiO_(2) in Sample B(r=0.203,P=0.047).Prolonged hospital stay was also associated with pepsin detection in Samples B and C(P<0.05).A negative correlation was observed between feeding amount and pepsin levels across all samples(P<0.05).CONCLUSION The incidence of GERD in full-term mechanically ventilated neonates is high,correlating with pepsin levels,FiO_(2),feeding intolerance,and hospital stay,highlighting the importance of early detection.
文摘This review emphasizes the exemplary safety and efficacy of rebamipide in the treatment of gastric ulcers and other mucosa-related disorders,positioning it as a viable candidate for inclusion in treatment guidelines across India and globally.An in-depth literature review of rebamipide was carried out on PubMed and Google Scholar.Rebamipide has a multifaceted mechanism of action,including prostaglandin synthesis,scavenging free radicals,and enhancing mucin produc-tion,leading to enhanced mucosal protection and ulcer healing.Rebamipide serves as a highly effective and safe treatment option for gastric ulcers and gas-troesophageal reflux disease.The efficacy of this drug in treating ulcers often surpasses that of routinely used agents such as pantoprazole,sucralfate,misop-rostol,famotidine,lansoprazole,and esomeprazole.This superiority of rebami-pide can be attributed to the low rate of adverse events associated with it and its mild side effects,contributing to its widespread adoption across Southeast Asia and Russia.This popularity extends to its application beyond gastrointestinal ailments.Notably,it has been successfully employed in the treatment of ophthal-mological,oncological,and bone regeneration-related issues.Rebamipide's exemplary safety and efficacy in treating gastric ulcers and other mucosa-related disorders support its potential for inclusion in treatment guidelines,not only in India but also globally.
文摘BACKGROUND Chinese surgeons often rely on intraoperative exploration of the esophageal hiatus to determine the need for concurrent type I hiatal hernia(HH)repair during laparoscopic sleeve gastrectomy.However,no standardized criteria for the esophageal hiatus size or indications for exploration exist in China.AIM To investigate normal anatomical parameter ranges of the esophageal hiatus in patients with obesity.METHODS A total of 158 patients,aged 20-49 years,was analyzed from January 2020 to June 2024.The patients were classified into the no reflux esophagitis(RE)no HH group(HHG),RE group,and type I HHG.The transverse and sagittal diameters and cross-sectional area of the esophageal hiatus were measured using multiplanar reconstruction of the computed tomography images.RESULTS Body mass index was positively correlated with area and transverse and sagittal diameters of the esophageal hiatus(r=0.72,0.69,and 0.54,respectively;P<0.01).In the no RE no HHG and RE group,the esophageal hiatus size in the subgroup with obesity was greater than that in the non-obesity subgroup(area:326.15±78 mm2 vs 208.12±64.44 mm2,transverse diameters:15.97±2.06 mm vs 13.37±1.99 mm,sagittal diameters:15.7±2.08 mm vs 11.73±2.08 mm;P<0.01).Patients with obesity showed no significant differences in esophageal hiatus size with or without RE or HH.CONCLUSION The esophageal hiatus size increased with body mass index and was larger in patients with obesity than in those without obesity.
