Objective: To assess the diagnostic value of joint detection of serum TK1, TSGF, CA199, and CA724 for gastric cancer and its relationship with clinicopathologic features and prognosis. Methods: The 105 gastric cancer patients were enrolled. The diagnostic value of serum TK1, TSGF, CA199, and CA724 for gastric cancer and the relationship between these indicators and the clinicopathologic characteristics of gastric cancer patients were evaluated. During the follow-up period, recurrence, metastasis, and death were considered as poor prognosis. The relationships between serum TK1, TSGF, CA199, and CA724 levels and poor prognosis and factors affecting the poor prognosis of gastric cancer patients were analyzed. Results: TK1, TSGF, CA199, and CA724 levels in the gastric cancer group were higher; serum TK1, TSGF, CA199, and CA724 levels were higher in gastric cancer patients with tumor diameters >= 3 cm, TNM stages III and IV, low/moderate degree of differentiation, infiltration depths of the muscular or plasma layer, and lymphatic metastases; AUC of combined TK1, TSGF, CA199, and CA724 (0.894) was higher than that of the four indicators alone; the percentage of gastric cancer patients with poor prognosis in patients with low serum TK1, TSGF, CA199, and CA724 levels was lower; serum TK1, TSGF, CA199, and CA724 levels were factors influencing poor prognosis of gastric cancer patients (all P < 0.05). Conclusion: Elevated serum levels of TK1, TSGF, CA199, and CA724 are associated with clinicopathologic features and poor prognosis of gastric cancer and may be used as serum biomarkers for prognostic evaluation of gastric cancer patients.

Objective:To investigate the clinical significance of esophageal mean nocturnal baseline impedance (MNBI) in patients with extra-esophageal symptoms of gastroesophageal reflux disease (GERD).Methods:We performed a retrospective study of 210 patients with heartburn, reflux, cough, and hoarseness as their main symptoms who underwent 24-hour multichannel intraluminal impedance and pH monitoring in Beijing ChaoYang hospital from January 2018 to December 2019.According to diagnostic criteria and their main clinical manifestations, patients were divided into four groups, the extra-esophageal symptoms group, the typical symptoms group, the mixed symptom group with both typical and extra-esophageal symptoms, and the control group.We analyzed and compared distal and proximal esophageal MNBI value and other reflux parameters among the four groups.Results:The proximal esophageal MNBI value and mean pH at distal esophagus in GERD extra-esophageal symptoms group were lower than those in the typical symptom group (P<0.05). Correlation analysis showed that the proximal and distal esophageal MNBI value were negatively correlated with DeMeester score, acid exposure time and acid reflux times (P<0.05). According to ROC analysis, for GERD patients with extra-esophageal symptoms, area under curve of the proximal esophagus MNBI value was significantly higher than the area under curve of the distal esophageal MNBI value (P<0.05), the cut-off value for diagnosis was 2484.38 ohms. The sensitivity and accuracy of the proximal esophageal MNBI value in diagnosis GERD patients with extra-esophageal symptoms reached 92.3% and 84%, which were higher than those of the distal esophageal MNBI value.Conclusions:Both the proximal and distal esophagus MNBI values negatively correlate with acid exposure. Proximal esophagus MNBI value can improve the detection rate of multi-channel pH-impedance monitoring for patients with extra-esophageal symptoms of GERD, which has important clinical diagnostic value.

目的 比较中青年与老年胃食管反流病(gastroesophageal reflux disease,GERD)患者行内镜射频治疗的疗效.方法 选取2017年2月至2022年9月于首都医科大学附属北京朝阳医院接受内镜射频治疗的54例GERD患者,根据年龄分为中青年组(＜60岁)34例和老年组(≥60岁)20例.收集两组患者临床资料,以及射频治疗前和治疗后3个月、6个月时的胃食管反流病问卷(gastroesophageal-reflux disease questionnaire,GerdQ)评分和质子泵抑制剂(proton pump inhibitors,PPI)使用情况等并进行比较.结果 射频治疗后3个月及6个月时,两组患者的GerdQ评分均较治疗前显著降低,且中青年组明显低于老年组,差异有显著性(P＜0.01).在射频治疗后3个月,中青年组和老年组分别有94.1％和80.0％的患者减少PPI用量,射频治疗后6个月,中青年组和老年组分别有88.2％和70.0％的患者减少PPI用量,中青年组减少PPI用量的比例与老年组比较差异无显著性(P＞0.05).两组患者均无严重并发症发生.结论 中青年及老年GERD患者行内镜射频治疗均可改善GerdQ评分,减少PPI用量,该疗效可维持至射频治疗后6个月,安全性较好,且中青年患者的疗效优于老年患者.

目的 比较圈套器冷切除术(cold snare polypectomy,CSP)与圈套器热切除术(hot snare polypectomy,HSP)在治疗直径4～9 mm无蒂结直肠息肉中的疗效.方法 选取2021年6月至2021年11月在首都医科大学附属北京朝阳医院西院区消化科行内镜下息肉切除的187例患者,共284例息肉,其中145例息肉采用CSP治疗,139例息肉采用HSP治疗.本研究主要评价指标为息肉的完整切除率,次要评价指标为标本回收率、操作时间、治疗费用及住院时间,并发症包括术中出血率、迟发出血率及穿孔率.结果 CSP组的完整切除率为90.34％,HSP组为92.09％,两组差异无统计学意义(P=0.336).在术中出血方面,CSP组发生7例,HSP组发生5例,两组差异无统计学意义(P=0.606).CSP组发生迟发出血1例,HSP组无迟发出血.两组均未发生穿孔.所有息肉切除所获标本均成功收回.CSP组平均操作时间短于HSP组(70.6 s vs 75.2 s,P<0.001).CSP组治疗平均费用低于HSP组(1371.00元vs 2434.90元,P<0.001).CSP组平均住院时间短于HSP组(2.9 d vs 3.6 d,P<0.001).结论 CSP与HSP同样为切除直径4～9 mm无蒂结直肠息肉安全、有效的治疗方式,但CSP操作更省时,患者花费更少、住院时间更短.

Gastroesophageal reflux disease (GERD) is a common clinical chronic digestive system disease. It has the characteristics as high prevalence, easy recurrence and diverse clinical manifestations. The diagnosis of GERD with extra-esophageal manifestations as throat discomfort, cough and hoarseness has always been a difficult clinical problem. With the in-depth understanding of GERD and the continuous development of technology, clinical examinations become more diverse. In this paper, we summarize the developments of several commonly used examinations and novel technologies being used to diagnose people with GERD extra-esophageal symptoms in the future.

目的 探讨TIP30、Vav3的表达水平与胃癌临床病理参数及预后的相关性. 方法 收集2015年1月至2016年1月收治的120例行胃癌切除术病人的胃癌组织和癌旁组织,采用免疫组化染色测定TIP30、Vav3表达情况.随访3年,记录病人死亡情况,并分析胃癌组织TIP30、Vav3的表达与胃癌临床病理参数及预后的相关性.结果 所有病人均获得随访,中位随访时间为35个月(2～46个月),死亡48例,存活52例.癌组织的TIP30表达阳性率低于癌旁组织(P＜0.01),Vav3表达阳性率高于癌旁组织(P＜0.01).TIP30阳性表达组和Vav3阳性表达组病人的肿瘤直径、分化程度、TNM分期、淋巴结转移、血管浸润与阴性表达组比较,差异均有统计学意义(P＜0.05或P＜0.01).单因素分析显示,胃癌病人预后与肿瘤直径、TNM分期、淋巴结转移、血管浸润、TIP30、Vav3的表达有关(P＜0.05或P＜0.01).多因素COX回归分析显示,TIP30及Vav3的表达、TNM分期是影响胃癌病人预后的独立危险因素.TIP30、Vav3及联合应用预测胃癌预后的AUC分别为0.834、0.712、0.893. 结论 胃癌组织中TIP30、Vav3表达异常,与肿瘤直径、分化程度、TNM分期、淋巴结转移、血管浸润等病理参数存在相关性,是预测胃癌不良预后的有效指标.

Objective Investigating the role of high-resolution esophageal manometry in the treatment of esophageal hiatus hernia,and to provide a clinical basis for the diagnosis and operation of hiatal hernia.Methods From April 2016 to October 2018,67 patients were diagnosed with esophageal hiatal hernia and performed with laparoscopic esophageal hiatus hernia repair in Beijing Chaoyang Hospital.The above data was analyzed to calculate the diagnosis rate of esophageal hiatal hernia by gastroscopy and high-resolution esophageal manometry,analyze the operation and summarize high-resolution esophageal manometry with high resolution manometry (HRM) technique in laparoscopic treatment of esophageal hiatal hernia.Results The detection rate of HRM was 80.59％ (54/67),the specificity was 100％ (54/54),and the confirmed by gastroscopy was 52.24％ (35/67).Among them,35 patients were diagnosed by gastroscopy and HRM,with 64.81％ (35/54).The detection rate of high-resolution esophageal manometry was significantly higher than that of gastroscopy;48 cases were treated with laparoscopic esophageal hiatal hernia repair,and 7 patients gave up surgery to choose conservative treatment.12 patients complicated with other underlying diseases,took conservative treatment or elective surgery.Conclusion High-resolution esophageal manometry can accurately and intuitively describe the difference of gastroesophageal pressure in patients with hiatal hernia,and the diagnosis rate is high,which can effectively guide the surgical plan.

背景近年来随着人们生活及饮食习惯的改变,反流性食管炎(reflux esophagitis,RE)的发病率逐年上升,影响了人们的生活质量.同时RE发病的相关危险因素及幽门螺杆菌(Helicobacter pylori,H.pylori)的感染与根除同RE的关系是当下的热点问题.目的通过临床大数据分析探究RE发病的相关危险因素及与且pylori感染的关系.方法采用回顾性分析,对2010-03/2018-12在朝阳医院行消化内镜检查的住院患者进行筛选及分组研究.病例组为消化内镜确诊为RE,并且有明确洛杉矶(LosAngeles,LA)分级结果及Hpylori检查结果的住院患者,并进一步将病例组分为轻度RE组(LA-A)和重度RE组(LA-B、LA-C和LA-D);对照组是通过消化内镜检查确认为非RE、有H.pylo检查结果,并且排除了胃食管反流症状的患者.通过大数据平台,分析性别、年龄、体质指数(body mass index,BMI)、血脂、血糖、吸烟饮酒史、基础病、食管裂孔疝和H pylori感染等多种因素同RE的关系.结果单因素Logistic回归分析发现对于RE,男性、BMI、吸烟史、食管裂孔疝是其危险因素,高密度脂蛋白胆固醇为其保护因素,而高血压和高脂血症病史是重度RE的危险因素,甘油三脂升高是轻度RE的危险因素.多因素Logistic回归校正后显示,无论病情程度如何,男性、BMI和食管裂孔疝均是RE的独立危险因素,H.pylori感染是RE的保护因素.结论RE的发病和发展与生活习惯、基础疾病和H.pylori感染等密切相关.

[目的]探讨无效食管动力(IEM)和非酸反流与胃食管反流性咳嗽(GERC)的关系.[方法]共纳入90例GERD患者,分为以咳嗽为主诉的GERC组(41例)和以典型烧心(HB)为主诉的HB组(49例),入组患者均完善24h的pH阻抗监测检查及高分辨食管压力(HRM)测定,根据芝加哥分类3.0标准将GERC组进一步分为伴IEM亚组(30例),不伴IEM亚组(11例),对pH阻抗及HRM测定结果进行统计学差异性检验及相关性分析.[结果]GERC组非酸反流时间百分比(NAET％)、非酸反流次数高于HB组,差异均有统计学意义(P＜0.05).GERC组的IEM发生率73.2％高于HB组的44.9％,差异有统计学意义(x2=6.201,P＜0.01).GERC组中伴IEM亚组的NAET％、非酸反流次数高于不伴IEM亚组,差异均有统计学意义(P＜0.05).GERC组NAET％与年龄呈负相关(r=-0.33,P=0.03),与液体食团完全传输率(CBT)呈负相关(r=-0.397,P=0.01),与远端收缩积分(DCI)＜100mmHg·s-1·cm-1百分比呈正相关(r=0.351,P=0.02).[结论]IEM和非酸反流与GERC相关,在其发病机制中起重要作用.

胃溃疡患者少喝咖啡 胃或十二指肠溃疡,上腹部疼痛是消化性溃疡的主要症状,疼痛时为钝痛、灼痛,偶尔剧痛.其发作诱因有受寒、精神刺激、劳累、饮食不当及感染等.此类患者不宜食用粗糙、过冷过热的食物,并避免刺激胃酸分泌的食物,包括酒、咖啡、浓茶、辛辣调味品和太甜、太酸、高油脂的食物. 为减少胃酸对胃黏膜的刺激,可吃一些易消化、营养丰富的食物中和胃酸.五谷杂粮、豆浆、蛋、鱼、瘦肉、动物肝脏等都很适合.

胃食管反流病（GERD）是常见的消化系统疾病，是由胃、十二指肠内容物反流入食管引起不适症状和（或）食管黏膜病理改变的一类临床状态。最典型的症状为烧心、反酸，部分患者也仅表现为胸痛、上腹痛、嗳气等不典型症状，也可伴有咳嗽、哮喘、喉炎等食管外症状。2015年世界胃肠病学组织（WGO）指南指出，当患者出现每周≥2次烧心和反流症状发作即提示 GERD。GERD 临床上可分为：（1）糜烂性食管炎（EE），也称反流性食管炎（RE），即反流物导致食管黏膜损伤，如食管糜烂、溃疡、狭窄等；（2）Barrett 食管（BE），是 GERD 相关并发症，即食管下段复层鳞状上皮被化生的单层柱状上皮取代，是食管腺癌发病密切相关的癌前病变之一；（3）非糜烂性反流病（NERD），即存在反流相关不适症状，但无食管黏膜破损及 BE。GERD 的发病机制主要是食管抗反流功能下降，其中包括下食管括约肌（LES）压力下降，一过性下食管括约肌松弛（TLESR）增多及胃食管交界处结构改变。同时，食管清除能力降低、食管黏膜防御作用减弱、食管感觉异常及胃排空延迟等因素，也同样会造成胃、十二指肠内容物反流至食管，使食管黏膜损伤。目前随着我国国民生活水平的提高，GERD 的发病率日渐增高。因此规范 GERD 的治疗极为必要。关于 GERD的治疗，其目标包括有效缓解症状、治愈食管炎、维持缓解、提高生命质量和预防并发症。治疗方式包括：（1）生活方式的改变；（2）药物治疗；（3）手术和内镜治疗［1-5］。本文主要从 GERD 治疗的药物选择及其临床注意事项，包括药物使用规范、可能的不良反应等方面加以阐述。

[目的]观察马来酸曲美布汀对伴有无效食管动力的胃食管反流病患者食管运动功能的影响.[方法]对经内镜、24 h食管pH-阻抗监测诊断为胃食管反流病,并行高分辨率食管压力测定(high resolution manometry, HRM),依据芝加哥3.0版标准诊断为无效食管动力的16例患者,给予马来酸曲美布汀0.2 g tid、埃索美拉唑20mg、bid治疗2周后复查HRM,比较治疗前后下食管括约肌静息压(LESP)、食管体部各段波幅及时限、吞咽成功率、失蠕动比例、弱蠕动比例以及远端收缩积分(DCI)值等指标的变化.[结果]16例患者治疗前后LESP变化差异无统计学意义(P＞0.05),在LESP明显降低的7例患者中,与治疗前相比,治疗后LESP明显增加[(1.8±0.9)mmHg(1 mmHg=0.133 kPa):(8.2±5.4)mmHg],差异有统计学意义(P＜0.05);液体吞咽中,食管中段收缩波幅较治疗前明显增加[(33.7±11.4)mmHg:(42.7±19.9)mmHg)],P＜0.05;黏性吞咽中,食管远端收缩波幅较治疗前明显增加[(44.7±18.4)mmHg:(57.5±23.4) mmHg],P＜0.05;液体吞咽时,失蠕动比例较治疗前均显著下降,P＜0.05;液体及黏性吞咽时,DCI值均较治疗前明显增加,P＜0.05.在液体吞咽时,吞咽成功率较治疗前增加,差异有统计学意义,P＜0.05.[结论]马来酸曲美布汀可能增加合并下食管括约肌低压的GERD患者的LESP,通过增加食管体部收缩波幅,改善合并无效食管动力的GERD患者食管体部的廓清功能.

Objective. To investigate the esophageal function tests in British and Chinese patients with gastroesophageal reflux disease (GERD). Methods. Patients with GERD were selected from the functional gut clinic, London, and digestive department, Beijing Chao-Yang Hospital, after taking the examinations of High-resolution Manometry and Impedance (HRiM) and 24-hour Multi-Channel Intraluminal Impedance and pH Recording (MII/pH) between 2013 and 2014. Chinese healthy volunteers who undertook HRiM were also selected as control group. Results. Fifty-nine British and 82 Chinese patients with GERD and 62 Chinese healthy volunteers were entered. Values for British patients, Chinese patients, and healthy volunteers were as follows: Lower esophageal sphincter pressure (LESP) 16.0±8.6, 16.5±10.0, and 26.4±10.9 mmHg, peristalsis (normal/small break/large break) 24/12/23, 44/10/28, and 57/1/4, total bolus transit time (TBTT) 7.3±1.3, 7.6±1.2, and 6.9±0.9 s, and complete bolus transit rate (CBTR) 66.7±37.8, 61.7±36.4, and 90.3±14.0%, respectively. Stepwise linear regression analysis showed that age, gender, and ethnicity did not have significant effect on LESP, TBTT, esophageal peristalsis, and CBTR in patients with GERD. Conclusions. British and Chinese patients with GERD presented similar values of LESP, TBTT, and impaired esophageal peristalsis and CBTR.

Background The cause of idiopathic pulmonary fibrosis (IPF) remains unknown, yet gastro-esophageal reflux disease (GERD) is highly prevalent in this population. GERD prevalence was studied, and esophageal function tests (EFT) were assessed in Chinese IPF patients. Methods We prospectively studied 69 IPF patients who undertook both stationary High Resolution esophageal Manometry/Impedance (HRiM) and 24-hour esophageal Multi-Channel Intraluminal Impedance with pH Recordings (MII/pH). Patients were divided into GERD+ and GERD- groups according to pH results. Controls were HRiM treated healthy volunteers, and patients without IPF received HRiM and MII/pH diagnosed with GERD. Results 69 IPF patients, 62 healthy volunteers, and 88 IPF negative GERD patients were selected. GERD prevalence in IPF was 43/69 (62.3%), and 58.1% of patients presented with at least one typical symptom. Symptoms had a sensitivity of 58.1%, a specificity of 61.6%, a positive predictive value of 71.4% and a negative predictive of 47.1%. Compared with healthy volunteers, IPF patients had significantly decreased lower esophageal sphincter pressure (LESP), upper esophageal sphincter pressure (UESP) and complete bolus transit rate (CBTR). By contrast, IPF patients had increased total bolus transit time and prevalence of weak peristalsis. MII/pH showed that one third of IPF patients had abnormal distal and proximal reflux, especially non-acid reflux. Compared with GERD patients without IPF, GERD patients with IPF had significantly decreased CBTR and UESP with increased bolus exposure time. Conclusions GERD prevalence in IPF was high, but symptoms alone were an unreliable predictor of reflux. IPF patients had lower LESP and UESP, impaired esophageal peristalsis and bolus clearance function with more proximal reflux events.

Objective To investigate the esophageal function tests in British and Chinese patients with gastroesophageal reflux disease (GERD). Methods Patients from November 2013 to June 2014 in Digestive Department of Beijing Chao-Yang Hospital, Capital Medical University and patients in London Functional Gut Clinic at the same period were selected as the study objects, all the patients were taken the examinations of high-resolution manometry and impedance (HRiM) and 24-hour multi-channel intraluminal impedance and pH recording (MII/pH) in their hospital. Patients with GERD were selected according the results of MII/pH. Values of lower esophageal sphincter pressure (LESP), hiatus hernia rate, peristalsis (normal/small break/large break), total bolus transit time (TBTT), complete bolus transit rate (CBTR) were compared. Data were compared using independent sample t-test and chi-square test. Stepwise regression analysis was used to e-valuate the influence factors of HRiM and MII/pH. Results 82 Chinese patients and 59 British patients completed the inspection, values for Chinese patients and British patients were as follows:LESP were (16.5±10.0) mm Hg and (16.0±8.6) mm Hg (P=0.758), hiatus hernia rate were 10.9%and 10.1% (P=0.878), peristalsis (normal/small break/large break) were 44/10/28 and 24/12/23 (P=0.237), total bolus transit time were (7.6±1.2) s and (7.3±1.3) s (P=0.229), complete bolus transit rate were (61.7±36.4)%, (66.7±37.8)%(P=0.471), respectively. Stepwise linear regression analysis showed that, age, gender, and ethnicity did not have significant effect on LESP, total bolus transit time, esophageal function of peristalsis and bolus clearance in patients with GERD. Conclusion Chinese and British patients with GERD presented similar values of LESP, hiatus hernia rate, TBTT, and impaired esophageal function of peristalsis and bolus clearance.

The aim of this study was to investigate the normal high-resolution manometry and impedance (HRiM) values in the supine and sitting positions in the population of Northern China, and to investigate the influence of different body positions and bolus consistency on esophageal HRiM findings. In this study, healthy volunteers in the supine position underwent esophageal HRiM examination of 10 swallows of 5 mL normal saline solution and 10 swallows of 5 mL synthetic gel of known viscosity, and in the sitting position of an additional five swallows of a synthetic gel of known viscosity. Total bolus transit time (TBTT), complete bolus transit rate (CBTR), distal contractile integral (DCI), distal esophageal amplitude (DEA), and integrated relaxation pressure (IRP) were measured. Sixty-two healthy volunteers were examined in the supine position and 45 of these performed additional swallows of the viscous gel in the sitting position. In the supine position, normal values for swallowing the liquid and viscous boli were as follows: TBTT 6.9 ± 0.9 and 8.0 ± 1.2 s (P < 0.001), CBTR 90.3 ± 14.0 and 77.9 ± 20.3% (P < 0.001), DCI 1891.5 ± 1131.9 and 1967.8 ± 1140.1 mmHg.s.cm (P = 0.227), DEA 95.3 ± 35.4 and 98.7 ± 37.5 mmHg (P = 0.148), and IRP 10.4 ± 4.9 and 9.0 ± 4.2 mmHg (P < 0.001), respectively. For swallows of the viscous boli in the sitting position, TBTT, DCI, DEA, and IRP were significantly decreased, while CBTR was unchanged (P = 0.075). Normal HRiM values of the population of Northern China were established. Esophageal transit times of viscous boli were significantly slower, more often incomplete and produced less normal peristalsis in the supine position than swallows of liquid boli. Independent reference values for different manometric systems, body positions, and population need to be established before clinical application.

目的:分析不同年龄组胃食管反流病患者的临床特点及24hpH监测、食管测压的特点.方法:回顾性分析北京朝阳医院2005-2010年220例胃食管反流病患者的临床资料及24hpH监测、食管测压的资料.结果:（1）随年龄增长,内镜下LA-B至LA-D级食管炎比例逐渐增加,并且青年组与老年组间的差异有统计学意义（7.1%vs36.5%,P=0.005）;（2）随年龄增长,老年组DeMeester积分明显高于青、中年组,差异有统计学意义（41.99±26.52vs31.08±26.86;29.69±17.63,P=0.038;0.000）.老年组pH＜4的卧位时间百分比及立位酸清除时间百分比均明显高于中年组,差异有统计学意义（P=0.004;0.005）;（3）随年龄增长,食管中下段蠕动波幅逐渐下降,非传导性收缩百分比逐渐增加,但差异无统计学意义.老年组与青年组相比,下食管括约肌压力明显降低,差异有统计学意义（12.79±6.20vs16.88±8.86,P=0.007）.结论:随年龄增长,食管动力障碍逐渐加重,食管酸暴露时间逐渐延长,中重度食管炎发生率逐渐增加.

Background To investigate the relationship between health-related quality of life (HRQOL) and survival in Chinese patients with chronic liver disease (CLD). Methods HRQOL was measured with the Chinese version of Short Form 36 (SF-36). SF-36 scores, demographic and clinical data were collected at baseline and after 18 months follow-up. Kaplan-Meier and Cox Proportional Hazard Regression survival analyses were used for interpretation of data. Surviving patients were censored in the analyses. Results A total of 415 Chinese patients with CLD and 86 healthy controls were enrolled. During the follow-up period 50 patients died. SF-36 scores in healthy controls and surviving patients were higher compared with those in deceased patients. Scores of physical component summary (PCS) in healthy controls, surviving and deceased patients were 54.1 ± 5.2, 48.9 ± 7.7 and 33.5 ± 8.2 respectively (p < 0.001). Scores of mental component summary (MCS) in healthy controls, surviving and deceased patients were 56.6 ± 8.2, 53.0 ± 5.6 and 37.1 ± 12.1 (p < 0.001) respectively. Survival was significantly associated with PCS and MCS scores, and the presence of ascites. Conclusions HRQOL was associated with survival in patients with CLD. PCS and MCS scores were predictors of survival.

Objectlve To review the clinical characteristics,esophageal motility and acid exposure in elderly patients with gastroesophageal reflux disease (GERD).Methods Two hundred and sixty patients aged 18 -81 years were diagnosed as gastroesophageal reflux disease from 2005 to 2011 in outpatient clinic,the patients were divided into elderly group ( ≥ 60 y) and control group ( ＜ 60 y).The incidence of esophagitis,severity of esophagitis,esophageal motility and esophageal acid exposure were analyzed and compared between two groups.Results The incidence of esophageal hiatal hernia,non-typical reflux symptoms and extra-esophageal symptoms in elderly group were higher than that of control group(45.1％ vs.30.6％,36.3％ vs.27.2％ and 37.1％ vs.25.2％,P =0.016,0.005 and 0.037,respectively).There was no significant difference in esophagitis incidence between two group (55.8％ vs.50.3％,P =0.250).The incidence of esophagitis graded as LA-B to LA-D were higher in elderly group( 19.5％ vs.10.2％ and 8.8％ vs.2.7％,P =0.034 and 0.030,respectively).The percentage of upright acid clearance time,supine reflux time of pH ＜4 and the DeMeester score of elderly group were higher than those of control group (P =0.000,0.006 and 0.001,respectively).Lower esophageal sphincter pressure (LESP) of elderly group was lower than that of control group ( 13.36 ±6.39 vs.15.57 ±7.01,P =0.009).Conclusion In comparison with young and middle-aged patients,the elderly GERD patients have lower esophageal motility,longer esophageal acid exposure time and higher frequency of severer esophagitis.