Objective To analyze the effect and safety of phloroglucinol on the observation of the esophagogastric junction during painless gastroscopy. Method A control group consisting of 135 cases underwent painless gastroscopy, and an observation group consisting of 115 cases(painless gastroscopy plus phloroglucinol) was randomly formed from patients who underwent painless gastroscopy between September 2022 and February 2023 based on the odd-evenness of their registration numbers. The esophagogastric junction observation effect, lesion detection rate, endoscopic features of lesions, pathological outcomes, and intraoperative and postoperative adverse responses of the two patient groups were noted and monitored. Result This portion of the observation group had a greater observation rate of the esophagogastric junction and a higher rate of lesion detection than the control group, and the difference was statistically significant (P=0.038, P=0.035). In comparison to the control group, the observation group had a greater detection rate of non-red lesions; this difference is statistically significant (P=0.003). Between the two groups, there was no statistically significant difference in the occurrence of adverse responses or pathological results (P>0.05). The difference was statistically significant (P=0.003). The incidence of adverse responses and abnormal outcomes did not change statistically significantly between the two groups (P>0.05). Conclusion The esophagogastric junction's observation impact can be enhanced by applying phloroglucinol before the painless gastroscopy, which will increase the likelihood of lesions being discovered. Finding easily overlooked non-red lesions is one of its specific uses. Additionally, it is more secure and has fewer adverse effects.

Objective To investigate the effect of skeletal muscle contusion on iron metabolism and its correlation with ferroptosis in rats. Methods Male SD rats were randomly divided into control group and blunt contusion model group. The model group was selected at 1d, 3d, 5d, 7d and 14d after injury, respectively. HE staining was used to observe the pathological changes of the injured tissue, and Prussian blue staining was used to observe the iron ion deposition in the injured area. ELISA method was used to detect the changes of serum ferritin, muscle tissue reactive oxygen species, α-ketoglutarate and heat shock protein 1. Results HE staining showed the rupture of muscle membrane, nucleolysis and inflammatory cell infiltration in the contusion area, which began to decrease after 5 days. The number of new skeletal muscle cells in the contusion area increased further on 14 days, and the number of intercellular collagen fibers increased. Prussian blue staining showed that iron deposition increased gradually after contusion, the highest in fifth day group, and then decreased. ELISA results showed that serum ferritin, ROS and α-KG in the model group increased gradually after injury, and the difference was statistically significant compared with the control group (P<0.01). HSPB1 first increased and then decreased after injury, and the difference was statistically significant compared with the control group (P<0.01). Conclusion Abnormal iron metabolism is closely related to ferroptosisafter skeletal muscle contusion, and cell ferroptosis also occurs after skeletal muscle acute injury.

Objective To comparatively analyze the effects of laparoscopic and open left hepatectomy on intrahepatic bile duct stones. Methods Ninety-one patients with intrahepatic bile duct stones were divided into observation group (48 cases) and control group (43 cases) according to different surgical methods. The patients in observation group underwent laparoscopic left hepatectomy and the patients in control group underwent traditional open left hepatectomy. The intraoperative conditions (operation time, intraoperative blood loss), postoperative conditions (postoperative exhaust time, postoperative time of leaving bed, postoperative hospitalization time), postoperative complications (pneumonia, incision infection, bile leakage, abdominal bleeding), residual stones and recurrence of stones of two groups were compared. Results The operation time of patients in observation group was significantly longer than control group (P<0.05); While the postoperative exhaust time, postoperative time of leaving bed and postoperative hospital stay of were significantly shorter (P<0.05). There was no significant difference in intraoperative blood loss, the incidence of postoperative complications, the residual stone rate, and the recurrence rate between two groups (P>0.05). Conclusion Treating intrahepatic bile duct stones with laparoscopic left hepatectomy has the advantages of less trauma and rapid postoperative recovery, and is worthy of popularization and application in hospitals with conditions.

Objective: To investigate the preventive effects of rectal administration of indomethacin on pancreatitis and hyperamylasemia after endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with choledocholithiasis. Methods: 70 elderly patients with choledocholithiasis undergoing ERCP were randomly divided into indomethacin group (35 cases) and placebo group (35 cases). The patients in indomethacin group were given indomethacin through rectum 30 minutes before ERCP, the patients were given placebo through rectum. The serum amylase level of patients before ERCP, 3h and 24h after ERCP were detected; and to determine whether patients with pancreatitis and hyperamylasemia. Results: The serum amylase level of patients in indomethacin group 3h and 24h after ERCP were obviously lower than placebo group (P<0.05). The incidence rate of pancreatitis and hyperamylasemia after ERCP of patients in indomethacin group were respectively 5.71% (2/35) and 17.14% (9/35), which were all obviously lower than placebo group (P<0.05). Conclusions: Rectal administration of indomethacin before ERCP can remarkably reduce the incidence of pancreatitis and hyperamylasemia, so it is worth of clinical promotion.