Correlation of acid reflux and esophageal motility in patients with gastroesophageal reflux disease

Objective:To explore the relationship between acid reflux and esophageal motility in patients with gastroesophageal reflux disease.Methods:From January 2018 to December 2019,80 patients with typical gastroesophageal reflux symptoms such as reflux and heartburn were randomly selected from the Department of Gastroenterology,First Affiliated Hospital of guangxi university of chinese medicine.The patients were divided into pathological group,sensitive group and physiological group based on the percentage of acid exposure time and reflux-symptom correlation.The GerdQ score,quality of life score,esophageal acid test and esophageal manometry related parameters of the three groups of patients were compared.Results:Compared with the sensitive group and the physiological group,the GerdQ score,DeMeester score,orthostatic acid reflux time,orthostatic acid reflux time,longest acid reflux time and acid reflux times in the pathological group were significantly higher.Sf-36 score,lower esophageal sphincter pressure and effective rate of deglutition were all significantly reduced,with statistically significant differences(P<0.05).Compared with the physiological group,the GerdQ score of the sensitive group was higher.The sf-36 score was low,and the differences were statistically significant(P<0.05).The acid indexes in the sensitive group were higher than those in the physiological group,but the differences were not statistically significant(P>0.05).Compared with the physiological group,the distal contraction integral and the amplitude of the lower esophageal sphincter 3cm above the pathological group and the sensitive group decreased significantly(P<0.05).There were no statistically significant differences in the length of the lower esophageal sphincter,the length of the lower esophageal sphincter in the abdominal segment,the amplitude of the upper esophageal sphincter at 7cm and 11cm and the peristaltic wave velocity of the esophageal body in the three groups(P>0.05).Conclusion:the decrease of lower esophageal sphincter pressure is the key factor leading to pathological acid reflux,and acid reflux is closely related to distal contraction integral and peristaltic amplitude of 3cm on lower esophageal sphincter in patients with gastroesophageal reflux disease.

Anti-apoptotic effect of banhasasim-tang on chronic acid reflux esophagitis

To evaluate the anti-apoptotic effect of banhasasim-tang (BHSST) on chronic acid reflux esophagitis (CARE) using a rat model. METHODSA surgically-induced CARE model was established in Sprague-Dawley rats. The modeled rats were divided into a treatment group or untreated group, and given BHSST (1 g/kg body weight per day) or water, respectively, for 15 consecutive days (n = 7 each group). Changes in expression of proteins related to nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and apoptosis were assessed by western blotting. Changes in esophageal pathology were analyzed by gross and histological examinations. RESULTSThe CARE exposure modeled rats showed increased levels of the NADPH oxidase subunit, NOX4 and p47phox in the esophagus. The BHSST treatment completely resolved these CARE-related increases. The CARE rats also showed markers of cytokine stress, including elevated levels of TNF-α and reactive oxygen species as well as of the consequent increase in JNK activation, and subsequent decrease in pro-survival gene expression, such as of Bcl-2. BHSST treatment resolved the CARE-related changes. BHSST also exerted an anti-apoptotic effect, as evidenced by altered expression of the apoptosis-related genes for bax, cytochrome c, and caspase 3. Finally, the BHSST treatment markedly ameliorated the CARE-related esophageal mucosal ulcerations. CONCLUSIONIn the rat model of CARE, BHSST can suppress development of esophageal mucosal ulceration via regulation of reactive oxygen species-dependent apoptosis.

Prolapse gastropathy syndrome may be a predictor of pathologic acid reflux

AIM： To assess the occurrence of gastric acid reflux into the esophagus in endoscopically confirmed prolapse gastropathy syndrome （PGS）. METHODS： Using ambulatory esophageal pH measurement （BRAVOTM wireless esophageal pH monitoring system）, twenty-six patients with PGS were compared with twenty-one patients with erosive esophagitis （EE） as controls. We assessed several reflux parameters, including the percentage of total time at pH 〈 4, and the DeMeester score. RESULTS： There were no statistical differences between the PGS group and the EE group as to mean age, sex ratio and pH recording time. The EE group showed more severe reflux than the PGS group, as evaluated in terms of the longest duration of reflux, the number of reflux episodes, the number of reflux episodes lasting 〉 5 min, the total time with pH 〈 4 during acid reflux episodes, and the DeMeester score, but none of these parameters showed statistically significant difference. Although 53.8% （14/26） of the PGS group and 76.2% （16/22） of the EE group demonstrated pathologic acid reflux （DeMeester score 〉 14.72）, there was no statistically significant difference between the two groups in the incidence of pathologic acid reflux （P = 0.11）. CONCLUSION： There was no statistically significant difference in pathologic acid reflux between the PGS and EE group. These data suggest that endoscopically diagnosed PGS might be a predictor of pathologic acid reflux.

Characteristics of Acid Reflux in Barrett's Esophagus

To determine the relationship between Barrett'sesophagus (BE) and features of ga stroesophageal acid reflux, 24 h esophageal pH monitoring was performed in 90 pa tients. The patients were divided into 3 groups: 31 subjects with BE, 21 with mi ld esophagitis and 38 with severe esophagitis. The following parameters were eva luated: the percentage time of pH<4; the number of reflux episodes over 5 min; t he duration of longest episodes and DeMeester score over total period and the au terior three parameters in erect and supine position . All these parameters in BE were significantly different from those with mild e sophagitis ( P <0.01) and not significantly different from those with severe esophagitis ( P >0.05). During supine position all the above parameters in BE were significantly different from those with reflux esophagitis ( P <0.05). It is concluded that the quantity of acid reflux is not an important factor in development of BE in gastroesophageal reflux (GER), and the acid reflux in supine position might be important in development of BE in GER.

Acid and non-acid reflux in patients refractory to proton pump inhibitor therapy:Is gastroparesis a factor?

AIM:To determine whether an increased number and duration of non-acid reflux events as measured using the multichannel intraluminal impedance pH(MII-pH)is linked to gastroparesis(GP).METHODS:A case control study was conducted in which 42 patients undergoing clinical evaluation for continued symptoms of gastroesophageal reflux disease(both typical and atypical symptoms)despite acid suppression therapy.MII-pH technology was used over 24 h to detect reflux episodes and record patients’symptoms.Parameters evaluated in patients with documented GP and controls without GP by scintigraphy included total,upright,and supine number of acid and non-acid reflux episodes(pH<4 and pH>4,respectively),the duration of acid and non-acid reflux in a 24-h period,and the number of reflux episodes lasting longer than 5 min.RESULTS:No statistical difference was seen between the patients with GP and controls with respect to the total number or duration of acid reflux events,total number and duration of non-acid reflux events or the duration of longest reflux episodes.The number of nonacid reflux episodes with a pH>7 was higher in subjects with GP than in controls.In addition,acid reflux episodes were more prolonged(lasting longer than 5min)in the GP patients than in controls;however,these values did not reach statistical significance.Thirty-five patients had recorded symptoms during the 24 h study and of the 35 subjects,only 9%(n=3)had a positive symptom association probability(SAP)for acid/non-acid reflux and 91%had a negative SAP.CONCLUSION:The evaluation of patients with a documented history of GP did not show an association between GP and more frequent episodes of non-acid reflux based on MII-pH testing.

Study on Optimization of Ethanol Reflux Extraction of Phenolic Acids from Salvia miltiorrhiza

The extraction technology of phenolic acid compounds from Salvia miltiorrhiza by ethanol reflux was studied. In this experiment, salvianolic acid B standard was used to make the standard curve. Single factor experiment and orthogonal experiment were used to study the extraction of different ethanol concentrations, reflux times and material-to-liquid ratios. The OD value of salvianolic acid compounds was measured with a spectrophotometer. The extraction rate of phenolic acid compounds under different extraction conditions was calculated through a regression equation, so as to obtain the optimal conditions for the ethanol reflux extraction process of Salvia miltiorrhiza. The experimental data can provide a reference for the ethanol reflux extraction process of salvianolic acids in the industry. According to the experiment, the extraction rate of phenolic acids in Salvia miltiorrhiza was the highest when the ethanol concentration was 60%, the reflux time was 1.5 hours, and the ratio of material-to-liquid was 1:10.

Postprandial proximal gastric acid pocket and its association with gastroesophageal acid reflux in patients with short-segment Barrett’s esophagus

Objective:To determine the characteristics of postprandial proximal gastric acid pockets(PPGAPs)and their association with gastroesophageal acid reflux in patients with Barrett’s esophagus(BE).Methods:Fifteen patients with BE(defined by columnar lined esophagus of≥1 cm)and 15 healthy individuals that were matched for age,gender,and body mass index,were recruited.The fasting intragastric p H and the appearance time,length,lowest p H,and mean p H of the PPGAP were determined using a single p H electrode pull-through experiment.For BE patients,a gastroesophageal reflux disease questionnaire(Gerd Q)was completed and esophageal 24-h p H monitoring was carried out.Results:The PPGAP was significantly longer(5(3,5)cm vs.2(1,2)cm)and the lowest p H(1.1(0.8,1.5)vs.1.6(1.4,1.9))was significantly lower in patients with short-segment BE than in healthy individuals.The PPGAP started to appear proximally from the gastroesophageal p H step-up point to the esophageal lumen.The acidity of the PPGAP was higher in the distal segment than in the proximal segment.In short-segment BE patients,there were significant correlations between the acidity and the appearance time and length of the PPGAP.The length and acidity of the PPGAP were positively associated with gastroesophageal acid reflux episodes.The acidity of the PPGAP was associated with the De Meester scores,the Gerd Q scores,and the fasting intragastric p H.Conclusions:In patients with short-segment BE,a PPGAP is commonly seen.Its length and acidity of PPGAP are associated with gastroesophageal acid reflux,the De Meester score,and the Gerd Q score in patients with short-segment BE.

Comparative evaluation of intragastric bile acids and hepatobiliary scintigraphy in the diagnosis of duodenogastric reflux

AIM:To assess the diagnostic value of a combination of intragastric bile acids and hepatobiliary scintigraphy in the detection of duodenogastric reflux(DGR).METHODS:The study contained 99 patients with DGR and 70 healthy volunteers who made up the control group.The diagnosis was based on the combination of several objective arguments:a long history of gastric symptoms(i.e.,nausea,epigastric pain,and/or bilious vomiting) poorly responsive to medical treatment,gastroesophageal reflux symptoms unresponsive to protonpump inhibitors,gastritis on upper gastrointestinal(GI) endoscopy and/or at histology,presence of a bilious gastric lake at > 1 upper GI endoscopy,pathologic 24-h intragastric bile monitoring with the Bilitec device.Gas-tric juice was aspirated in the GI endoscopy and total bile acid(TBA),total bilirubin(TBIL) and direct bilirubin(DBIL) were tested in the clinical laboratory.Continuous data of gastric juice were compared between each group using the independent-samples Mann-Whitney U-test and their relationship was analysed by Spearman's rank correlation test and Fisher's linear discriminant analysis.Histopathology of DGR patients and 23 patients with chronic atrophic gastritis was compared by clinical pathologists.Using the Independent-samples Mann-Whitney U-test,DGR index(DGRi) was calculated in 28 patients of DGR group and 19 persons of control group who were subjected to hepatobiliary scintigraphy.Receiver operating characteristic curve was made to determine the sensitivity and specificity of these two methods in the diagnosis of DGR.RESULTS:The group of patients with DGR showed a statistically higher prevalence of epigastric pain in comparison with control group.There was no significant difference between the histology of gastric mucosa with atrophic gastritis and duodenogastric reflux.The bile acid levels of DGR patients were significantly higher than the control values(Z:TBA:-8.916,DBIL:-3.914,TBIL:-6.197,all P < 0.001).Two of three in the DGR group have a significantly associated with each other(r:TBA/DBIL:0.362,TBA/TBIL:0.470,DBIL/TBIL:0.737,all P < 0.001).The Fisher's discriminant function is followed:Con:Y = 0.002TBA + 0.048DBIL + 0.032TBIL 0.986;Reflux:Y = 0.012TBA + 0.076DBIL + 0.089TBIL-2.614.Eighty-four point zero five percent of original grouped cases were correctly classified by this method.With respect to the DGR group,DGRi were higher than those in the control group with statistically significant differences(Z =-5.224,P < 0.001).Twenty eight patients(59.6%) were deemed to be duodenogastric reflux positive by endoscopy,as compared to 37 patients(78.7%) by hepatobiliary scintigraphy.CONCLUSION:The integrated use of intragastric bile acid examination and scintigraphy can greatly improve the sensitivity and specificity of the diagnosis of DGR.

熊去氧胆酸联合常规西医治疗胆汁反流性胃炎合并幽门螺旋杆菌感染的疗效及对IL-8、PGE2的影响

目的探讨熊去氧胆酸联合常规西医治疗胆汁反流性胃炎(BRG)合并幽门螺旋杆菌(Hp)感染的疗效及对白细胞介素-8(IL-8)、PGE2(前列腺素E2)的影响。方法选取2019年5月—2021年5月巴彦淖尔市医院收治的100例Hp呼吸试验为阳性的BRG患者进行研究,应用随机数表法将其分为观察组与对照组,每组50例。对照组采取常规西医治疗(克拉霉素+奥美拉唑+阿莫西林),观察组在常规西医治疗基础上增加熊去氧胆酸素治疗,对比两组患者临床疗效,并应用酶联免疫吸附法检测治疗前后血清白细胞介素-8(IL-8)、PGE2(前列腺素E2)表达水平,对比胃泌素(GAS)、胃动素(MTL)、胆囊收缩素(CCK)表达水平以及不良反应情况。结果观察组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05);治疗后两组患者血清IL-8水平降低,观察组低于对照组,PGE2水平升高,观察组高于对照组(P<0.05);治疗后两组患者血清CCK水平降低,观察组低于对照组,MTL、GAS水平升高,观察组高于对照组,差异有统计学意义(P<0.05);两组患者均无严重不良反应发生,且轻度不良反应比较,差异无统计学意义(P>0.05),但观察组Hp根除率高于对照组(P<0.05)。结论对胆汁反流性胃炎合并Hp感染患者在常规西医治疗的基础上增加熊去氧胆酸能够提升其临床疗效,降低患者炎症反应,提升胃动力,调节胃肠激素,提升Hp根除率,且安全性较高。

探索回流法提取绿原酸的最佳工艺

目的:为了获得回流法提取金银花中绿原酸的最佳工艺参数。方法:设计了回流法提取金银花中绿原酸的单因素实验和正交实验,单因素实验采用固定四个因素中的三个因素不变,先后分别只改变A(回流温度)、B(回流时间)、C(乙醇浓度)和D(液料比)这四个因素中的一个因素的水平的方法,探索单因素对绿原酸提取效果的影响。再在单因素实验的基础之上进行回流法正交实验设计先后考查回流温度(℃)、回流提取时间(h)、乙醇浓度(%)和液料比(倍)对绿原酸提取率的影响,研究回流法提取贵州金银花中绿原酸的最佳工艺参数。结果:回流提取单因素实验结果显示,回流法提取金银花中绿原酸的最佳温度是70℃,最佳时间是1.5 h,最佳乙醇浓度为70%,最佳液料比为10倍。正交实验中影响因素大小为B>D>A>C。结论:回流提取绿原酸的最佳提取工艺参数为A1B2C2D2,回流提取温度为70℃,提取时间为1.5 h,乙醇浓度为70%,液料比为10倍。本工艺参数的优化为回流提取单因素实验和正交实验提取贵州金银花中的绿原酸提供了理论依据和数据支持。

肝胃同治中药复方对胆汁反流大鼠胆汁酸代谢的影响

目的观察并探讨柴胡疏肝散与旋覆代赭汤的组合中药复方对胆汁反流大鼠外周血胆汁酸代谢的影响。方法选取74只SD雄性大鼠,24只假手术组行腹腔切开和缝合术、50只进行全胃切除+食管十二指肠吻合术造模,造模成功后分为模型组和中药组。术后2周、4周、8周的模型组与假手术组使用生理盐水分别灌胃0周、2周、6周;术后8周中药组以生药量9.3 g/(kg·d)的肝胃同治复方予以灌胃,连续给药6周。各组大鼠灌胃量均为10 mL/(kg·d),经腹腔注射2%戊巴比妥钠麻醉后,开腹取食管和腹主动脉血。对食管组织进行脱水、包埋、切片和苏木素—伊红染色,观察大鼠食管组织病理学改变及癌前病变和癌变的出现率,同时用液相色谱—串联质谱法测定大鼠血清中11种胆汁酸的水平。结果术后2周到术后8周,模型组大鼠食管黏膜损伤严重程度递增,食管癌前病变和癌变的出现率逐渐上升,模型组术后8周食管癌变出现率显著高于术后2周的模型组(P<0.05);中药组大鼠食管黏膜损伤改善,食管癌变出现率与模型组相比较显著降低(P<0.05)。血清胆汁酸结果显示,与同期假手术组相比,模型组术后2周牛磺胆酸水平升高(P<0.05),牛磺鹅脱氧胆酸、脱氧胆酸水平下降(P<0.05);术后4周牛磺熊脱氧胆酸、牛磺脱氧胆酸水平升高(P<0.05),术后8周牛磺胆酸水平升高(P<0.05);与术后8周模型组比较,中药组甘氨胆酸、牛磺胆酸、牛磺鹅脱氧胆酸、牛磺脱氧胆酸水平都有所下降,但无统计学意义(P>0.05);胆酸、脱氧胆酸、熊脱氧胆酸、鹅脱氧胆酸、石胆酸、牛磺石胆酸水平有所升高,但无统计学意义(P>0.05)。结论肝胃同治中药复方具有防治胆汁反流引起食管癌变的效应,并可影响血清胆汁酸的代谢。

从虚、郁、瘀论治胃食管反流病

胃食管反流病是消化科常见的疾病之一,中医在治疗胃食管反流病方面具有一定的优势。此文从“虚、郁、瘀”理论出发,认为脾虚为发病之本,肝郁推动疾病发展,血瘀使疾病难愈;临床应以健运脾胃、条达肝气、活血祛瘀为治疗原则,使正气得复、邪气得除,以提高临床治疗胃食管反流病的效果,为中医治疗胃食管反流病提供新的角度。

Impact of gastroesophageal reflux control through tailored proton pump inhibition therapy or fundoplication in patients with Barrett's esophagus

AIM To determine the impact of upwards titration of proton pump inhibition(PPI) on acid reflux, symptom scores and histology, compared to clinically successful fundoplication.METHODS Two cohorts of long-segment Barrett's esophagus(BE) patients were studied. In group 1(n = 24), increasing doses of PPI were administered in 8-wk intervals until acid reflux normalization. At each assessment, ambulatory 24 h p H recording, endoscopy with biopsies and symptom scoring(by a gastroesophageal reflux disease health related quality of life questionnaire, GERD/HRLQ) were performed. Group 2(n = 30) consisted of patients with a previous fundoplication. RESULTS In group 1, acid reflux normalized in 23 of 24 patients, resulting in improved GERD/HRQL scores(P = 0.001), which were most pronounced after the starting dose of PPI(P < 0.001). PPI treatment reached the same level of GERD/HRQL scores as after a clinically successful fundoplication(P = 0.5). Normalization of acid reflux in both groups was associated with reduction in papillary length, basal cell layer thickness, intercellular space dilatation, and acute and chronic inflammation of squamous epithelium. CONCLUSION This study shows that acid reflux and symptom scores co-vary throughout PPI increments in long-segment BE patients, especially after the first dose of PPI, reaching the same level as after a successful fundoplication. Minor changes were found among GERD markers at the morphological level.

胆汁反流发病机制与诊断及治疗研究进展

胆汁反流是由于胆汁逆行运动到胃及其以上部位,长期的胆汁反流除了引起胆汁反流性胃炎外,还可导致肠化、Barrett食管,甚至是胃癌、食管癌、咽喉癌的高危因素。长期频繁的胆汁反流应视为病理性胆汁反流,胆汁反流分为原发性反流和继发性反流。临床上胆汁反流常见的症状包括腹胀、口苦、上腹痛、恶心呕吐等。原发性胆汁反流无胃手术即可发生,而继发性胆汁反流通常在胃肠手术后发生。本文对胆汁反流发病机制与诊断和治疗进展进行综述。

刘华一教授降气疏肝法治疗胃食管反流病病案举隅

胃食管反流病(Gastroesophageal Reflux Disease,GERD)为临床常见消化系统疾病,随着人们社会压力的增加和工作生活节奏的加快,GERD发病率呈逐年递增趋势,具有普遍性、难治性的特点。常见的西医治疗手段是抑制胃酸分泌、增强食管及胃肠动力、抗反流手术等,但往往存在一定的局限性,症状反复难愈,困扰患者日常生活,降低了生活质量。中医通过辨证论治,有效缓解因反流所致食管内外症状,并力求恢复脾胃及肝的正常生理功能,以减少疾病复发、阻止病程进展,实现标本兼治,且中医药治疗具有不良反应少等优势,值得临床推广。刘师认为中焦气机升降对于本病的发生发展至关重要,临床总结出降气疏肝以和胃为治疗大法,再根据不同证型制订具体经验用方,针对兼证加减用药,且肝胃同治、五脏同调,整体与部分相结合,重视患者治疗前情绪、不良饮食习惯等致病因素及治疗后的日常调护。本研究归纳总结GRED的中医病因病机及刘师临证对于此病之中虚气逆、肝胃不和、寒热错杂等证,分别予补中降逆、疏肝和胃、辛开苦降等法以调节中焦气机,使气机得畅、肝胃调和,疾病向愈。总结刘师临床经验用对药,并附验案一则,以冀为GERD的中医辨证论治提供理论依据,为临床治疗GERD提供诊疗新思路。

喻斌教授治疗反流性食管炎并焦虑抑郁经验

目的 探析喻斌教授以半夏厚朴汤合左金丸论治反流性食管炎合并焦虑抑郁的临证思路与用药经验。方法 通过跟师,收集整理全程医案,查阅相关文献,总结喻教授治疗反流性食管炎的理论思想,治法特色,用药经验,并附有临床医案。结果 喻斌教授认为,应从气、痰、火3个病理因素论治反流性食管炎。根据反流性食管炎最典型症状,喻教授治疗此病首取理气化痰,舒咽喉,畅情志;次以疏肝泻火,调和胃络止痛。结论 喻教授治疗反流性食管炎的经验丰富,独具特色,值得临床推广应用。

郭天禄从水血互病探讨旋覆代赭汤治疗难治性反流性食管炎机制

难治性反流性食管炎为胃食管反流病的一种,病情反复,迁延难愈。旋覆代赭汤为中医治疗该病的首选方剂。目前,对于旋覆代赭汤的认识多局限于和胃降逆、化痰下气。此文通过梳理历代医家对此方的认识,结合临床实践,宗仲景“血不利则为水”之旨,从“水血互病”角度阐释旋覆代赭汤对难治性反流性食管炎的治疗机制,进一步提高中医临床运用该方治疗难治性反流性食管炎的效果。

谢晶日教授治疗胃食管反流病经验

胃食管反流病是我国高发疾病,是中医治疗的优势病种。本文从“诸呕吐酸,皆属于热”提炼出本病的病机以郁、酸、热、逆为主的病机特点,旨在总结谢晶日教授对胃食管反流病病因病机的认识和临床治疗特点。提出本病的发生与情志密切相关,治疗从肝胃出发,主要采用疏肝解郁、调和肝胃以泄郁热制酸,和胃降逆、通腑降气以畅中焦气机的治疗方法。在治疗的同时,谢晶日注重身心调养。其疗效确切,以资借鉴。

食管胃黏膜异位的临床特征分析及与吸烟的关系

目的探讨食管胃黏膜异位的流行病学情况、内镜下的表现以及与临床症状间的关系,探讨食管胃黏膜异位与吸烟的关系。方法整理分析了2022年1月至2023年6月在洛阳市第一人民医院内镜中心行胃镜检查的9652例患者资料,将152例胃镜检查诊断为食管胃黏膜异位的患者列为观察组,将同时期165例来我院体检中心正常体检行胃镜检查,未发现食管胃黏膜异位的患者列为对照组,并对两组的病例资料进行汇总分析。结果9652例胃镜患者中有152例(1.57%)发现了食管胃黏膜异位,其中男性103例(79.61%),女性49例(30.24%),126例(82.89%)为食管上段胃黏膜异位。观察组中有121例(79.61%)患者出现反酸、烧心等咽喉反流症状,有108例(71.05%)患者出现咽喉部异物感症状,有75(49.34%)例出现持续清嗓或者咳嗽症状,中青年较老年人更容易出现反酸、烧心、咽喉部异物感、咳嗽等典型临床症状。对照组中有25(15.16%)例患者出现反酸、烧心等咽喉反流症状,有36例(21.82%)患者出现咽喉部异物感症状,有11例(6.67%)出现持续清嗓或者咳嗽症状。观察组中吸烟患者的比例以及吸烟平均指数均高于对照组。结论食管胃黏膜异位在男性患者中的发病率明显高于女性,食管胃黏膜异位的发生部位多位于食管上段,内镜下见食管黏膜出现岛状或者片状红斑样改变。反酸、烧心等咽喉反流症状是食管胃黏膜异位患者最常出现的临床症状,并且发生率明显高于非食管胃黏膜异位患者。吸烟与食管胃黏膜异位的发生呈正相关。

煤化工酸水汽提装置回流系统腐蚀成因分析及对策

针对某煤化工酸水回流系统设备及管线腐蚀泄漏频发的问题,通过对回流系统设备腐蚀形貌、产物及工艺介质进行检测分析,并结合实际工艺过程,探究了酸水汽提装置回流系统诱发腐蚀的根本原因。结果表明:酸水汽提装置的腐蚀主要源自于硫化物和氰化物构建的电化学腐蚀循环作用,其中氰根离子的强络合作用进一步加剧了回流系统设备的腐蚀失效。基于以上成因,提出了相应的防护建议。