To investigate the time from symptom onset to visit doctor and diagnosis of gastric cancer in Jiading district of Shanghai.To understand the influencing factors and analyze the reasons for its gap with the international community.

The clinical data of 1 279 patients with gastric cancer diagnosed by pathology in the Ruijin Hospital North Affiliated to Shanghai Jiao Tong University School of Medicine from December 2012 to April 2020 were collected.The symptoms of patients first visit(according to common " gastric cancer alarm symptoms" : abdominal pain, abdominal distension, acid regurgitation, belching, nausea and vomiting, hematemesis and melena, weakness and poor appetite, etc.), visiting time and diagnosis time(endoscopic biopsy or surgical pathological diagnosis)were investigated.Multivariate Logistic regression model and other methods were used for statistical analysis of the factors influencing the visiting and diagnosis of patients.

The main symptoms of 1 279 patients were abdominal pain in 556(43.47%), bloating, acid regurgitation and belching in 389(30.42%), black stools, hematemesis and fatigue in 205(16.03%), food obstruction, nausea and vomiting in 87(6.80%), and elevated tumor indexes found by physical examination in 42(3.28%). The average medical visit time was(1.25±0.55)months, which was related to the patients′ symptoms, the distance and the way of payment of medical expenses.The average diagnosis time was(4.76±1.85)months, which was related to the time of the patients′ visit and whether the first visit was performed by gastroscopy.Logistic regression analysis showed that symptoms(OR=1.545, 95% CI: 1.341-1.781)and medical expenses payment method(OR=1.939, 95% CI: 1.021-3.681)were risk factors for timely diagnosis of gastric cancer.Medical treatment distance(OR=1.695, 95% CI: 1.509-1.989)and the choice of gastroscopy for first visit(OR=1.008, 95% CI: 1.049-1.124)were protective factors for timely diagnosis of gastric cancer.

The symptoms of gastric cancer patients in Jiading area of Shanghai are mainly abdominal pain, distension, regurgitation of acid, belching, hematemesis, black stools, and fatigue.The time of visit and diagnosis was longer than that in foreign countries, which was related to the patients′ awareness of gastric cancer and gastroscopy, medical treatment distance, medical expense payment route and other factors.

To analyze the clinical, pathological and endoscopic features of fungal esophagitis, summarize diagnostic and treatment experienceand improve the understanding of fungal esophagitis.

A retrospective analysis of 40 cases of fungal esophagitis patients were conducted.All cases were diagnosed in Endoscopy Center of Minhang Branch of Zhongshan Hospital Affiliated to Fudan University from January 2016 to January 2018.Moreover, gastroscope and etiological examination were performed, and the pathology results have been confirmed by pathologists.

The 40 patients were diagnosed with fungal esophagitis.There were 28 males(70.0%)and 12 females(30.0%), and males were more than females.Tthe age ranged from 32 to 88 years old(median age: 64 years old). Among these cases, 30-50 years old patients accounted for 27.5%(11 cases), 50-70 years old patients accounted for 50.0%(20 cases)and>70 years old accounted for 22.5%(9 cases). The main symptoms of fungal esophagitis included upper abdominal discomfort(25.0%)and acid reflux(35.0%). Endoscopic classification was mainly concentrated in type Ⅱ(67.5%), and most of the patients were commonly with diabetes(40.0%)and followed by ulcerative colitis(25.0%).

Fungal esophagitis is more common in men.Endoscopic findings plus pathogenic examination is the main method to diagnose this disease.The most common pathogen is Candida albicans.Therefore, the first-line treatment is fluconazole, which is used for antifungal treatment.At the same time, it is necessary to cure the combined diseases.There is still a lack of consensus on the application of proton pump inhibitors for fungal esophagitis patients.For those who have not fully recovered after a long time treatment, physicians should be alert to the possibility of human immunodeficiency virus(HIV)infection.

To study the curative effect and safety of small endoscopic sphincterotomy (SEST) combined with biliary balloon dilatation by endoscopy on bile duct calculus in old patients.

Old patients with bile duct calculus were administered with endoscopic retrograde cholangiopancreatography (ERCP) in Gastroenterology Department of Third Affiliated Hospital of Shihezi University from 2014 to 2016, and the clinical data of whom were retrospectively analyzed.

ERCP was performed in 57 old patients with bile duct calculus, and 55 cases (96%) were successfully treated by cholangiography.Among them, 46 cases were treated by SEST and biliary balloon dilatation.The one-time stone removal rate was 83.6%.The changes of liver function, blood amylase, urine amylase before and after operation were observed (P<0.05).

SEST combined with biliary balloon dilatation by endoscopy is a safe and effective treatment method for bile duct calculus in old patients.

To investigate the clinical features and endoscopic findings of fungal esophagitis.

The clinical data and endoscopic findings of 650 patients with fungal esophagitis diagnosed by endoscopy in Endoscopy Center of People′s Hospital of Ningxia Hui Autonomous Region from January 2015 to December 2018 were retrospectively analyzed.

A total of 650 patients with fungal esophagitis were included, and the number of patients detected increased year by year.The total detection rate was 1.3%.However, the annual detection rate was not statistically significant, mainly in men, and more common in patients aged 40-60 years.The upper abdominal pain and post-sternal discomfort were the main clinical symptoms, which occurred in the whole esophagus.The microscopic Kodsi classification was mainly grade Ⅰ and Ⅱ.The main combined disease was chronic gastritis.Among them, 39 cases were positive for Helicobacter pylori in 95 patients.

The number of detected fungal esophagitis is increasing year by year, and it has certain clinical features that can provide clinical diagnostic decisions for clinicians.