Advances in the diagnosis and management of early gastric cancer （EGC） have positioned super minimally invasive surgery （SMIS） as an increasingly preferred therapeutic strategy，owing to its capacity for organ preservation.However，assessing the curability of SMIS in EGC persists as a critical concern for clinicians and researchers.This review aims to explore the SMIS-Cure evaluation system for assessing therapeutic efficacy in EGC，comparing it with the eCure grading system and analyzing its clinical application value.The SMIS-Cure framework stratifies curability into three tiers： Grade A （cure），Grade B（clinical cure），and Grade C（surgical reassessment）.By integrating tumor-specific parameters and preoperative multimodal imaging to stratify lymph node metastasis risk，this system establishes an evidencebased protocol for optimizing SMIS procedural selection.Prospective applications of this framework are anticipated to standardize SMIS practices，foster multidisciplinary collaboration，and ultimately advance EGC treatment paradigms by striking an optimal balance between radical intervention and organ function preservation.
With the increasing incidence of cardiovascular diseases and population aging，antithrombotic drugs have been widely used in China.However，the management of antithrombotic medications in patients undergoing super minimally invasive surgery （SMIS） still faces significant challenges.Based on domestic and international evidence-based medical research，experts from the Chinese Society of Digestive Endoscopology have developed the consensus on perioperative management of antithrombotic therapy in patients undergoing SMIS through extensive discussions.This consensus presents 10 recommendation items covering preoperative evaluation，antithrombotic medication management，surgical risk stratification，and perioperative gastrointestinal protection strategies for SMIS patients.It aims to optimize patient management during SMIS procedures while achieving optimal therapeutic outcomes and ensuring treatment safety.
To expand the therapeutic indications of super minimally invasive surgery（SMIS） for gastric cancer （GC），this study proposed a novel technique termed super minimally invasive stepwise full-thickness resection （sft-SMIR） and evaluated its safety and efficacy in treating early gastric cancer （EGC）.
Methods
Eight EGC patients admitted to the First Medical Center of Chinese PLA General Hospital from August 2023 to September 2024 underwent sft-SMIR.Inclusion criteria included lesion diameter ＜3 cm，no lymph node or distant metastasis，and EGC staging （Tis，T1a，or T1b）.The procedure involved dual marking，stepwise non-full-thickness and full-thickness resection，and defect closure with clips.Postoperative outcomes were assessed using the SMIS-EGC therapeutic efficacy evaluation system，with follow-up for complications and recurrence.
Results
All patients achieved successful en bloc resection（100% rate）.Postoperative evaluation showed 7 cases as SMIS-Cure A （cure） and 1 case as SMIS-Cure B2 （clinical cure）.During a mean follow-up of 8.6 months （range： 4-16 months），no complications or recurrence occurred.One patient with SM3 submucosal infiltration received adjuvant chemotherapy，while others required no additional treatment.
Conclusion
The sft-SMIR technique enables curative en bloc resection of EGC，demonstrating preliminary safety and efficacy.Further multicenter studies with larger cohorts are warranted to validate long-term outcomes.
To investigate the application valve of metal clip in the endoscopic management of esophageal variceal bleeding （EVB）.
Methods
The clinical data of cirrhosis patients with EVB，admitted to the Digestive Endoscopy Center of Jiangsu Provincial Hospital of Chinese Medicine from November 2021 to December 2024，were analyzed retrospectively.The patients were divided into two groups，according to the application of metal clips in the endoscopic management of EVB.The success rate of hemostasis，early rebleeding rate，delayed rebleeding rate，operation time，amount of sclerosant used，number of additional treatments，incidence of postoperative complications were compared between the two groups.
Results
A total of 34 patients were included，with 14 in the study group and 20 in the control group.The study group showed superior outcomes in delayed rebleeding rate，operation time，and amount of sclerosant used，compared to the control group： 0 （0/14） vs. 40% （8/20），（7.07 ± 1.64） min vs. （10.30 ± 4.16） min，（10.43 ± 1.87） ml vs. （18.20 ± 2.88） ml，with statistically significant differences （P＜ 0.05）.However，there were no significant differences between the two groups in terms of success rate of hemostasis，early rebleeding rate，number of additional treatments，or incidence of postoperative complications （P ＞0.05）.
Conclusion
The application of metal clips demonstrates significant efficacy in the endoscopic management of EVB，with minimal risk.It significantly reduces the delayed rebleeding rate，shortens operation time，and decreases the amount of sclerosant used，making it worthy of clinical application.
To evaluate the differences between the three types of guided endotracheal intubation techniques：traditional laryngoscope，conventional gastroscope and nasal gastroscope.
Methods
The patients with tracheal intubation who underwent general anaesthesia for painless endoscopic surgery at The 960th Hospital of the PLA between January 2024 and December 2024 were enrolled.Patients were randomised into three groups.The conventional laryngoscope group （n=36） was treated with conventional laryngoscope-assisted tracheal intubation，the ordinary gastroscope group （n=45） was treated with ordinary gastroscope-assisted tracheal intubation，and the nasal gastroscope group （n=33） was treated with nasal gastroscope-assisted tracheal intubation.
Results
The success rate of one-time intubation in the conventional gastroscopy group and the nasal gastroscopy group was higher than that in the traditional laryngoscope group （97.8%，100% and 86.1%，χ2 = 5. 426，P=0.046），and the intubation time was There was no significant difference in hemodynamic indexes （HR，MAP，SpO2）among the three groups before anesthesia induction，before tracheal intubation and 5 min after tracheal intubation（P ＞0.05）.In terms of intubation-related complications，there was no significant difference in the incidence of dry mouth，mucosal bleeding，hoarseness，and bloody cuff during extubation among the three groups （P ＞ 0.05）.However，the number of patients with cough and the total number of complications in the traditional laryngoscope group （7 cases，17 cases） were higher than those in the conventional gastroscopy group（3 cases，8 cases） and the nasal gastroscopy group （1 case，4 cases），and the difference was statistically significant（χ2=6.363，P=0.041；χ2=14.267，P＜0.001）.
Conclusion
conventional gastroscopy and nasal gastroscopy improve the success rate of intubation within a certain range，shorten the time of tracheal intubation under general anesthesia，and reduce the complications related to tracheal intubation.It is worth promoting in the endoscopy center.
To explore the clinical application value of different needle extension lengths in cap-assisted endoscopic sclerotherapy for third-degree internal hemorrhoids.
Methods
The clinical data of 120 patients with third-degree internal hemorrhoids，admitted to Baotou Central Hospital Inner Mongolia from January 2019 to December 2022，were collected and randomly divided into three groups，with 40 cases in each group.Group A underwent sclerotherapy with needle extension length of 9 mm，Group B underwent sclerotherapy with needle extension length of 4 mm，and Group C underwent traditional surgical treatment.The differences in operation time，surgical cost，hospital stay，clinical efficacy，and complication rates were compared among the groups.
Results
The improvement rates of internal hemorrhoid prolapse and internal hemorrhoid hematochezia in Group A+B were 85%，91.25%，compared to 90%，97.5% in Group C，both with no significant differences （P＞0.05）.The complication rates in Group A+B was 8.75%，which was obviously lower than that in Group C（25%） ，and the differences was statistically significant （P＜0.05）.In subgroup analysis，Group A and Group B were both superior to Group C in terms of operation time，hospital stay，surgical cost，however，there were all no significant statistical difference between Group A and Group B.In terms of the improvement rate of internal hemorrhoid prolapse，Group A was significantly better than Group B（95% vs. 75%）.While，there was no significant statistical difference between Group A and Group B in internal hemorrhoid hematochezia （95% vs. 87.5%）.
Conclusion
Endoscopic sclerotherapy is effective for the management of third-degree internal hemorrhoids，with a low incidence of complication.It is superior to traditional surgical treatment and is worthy of clinical promotion and application.In addition，in internal hemorrhoid sclerotherapy，needle extension length of 9 mm is more valuable in improving the symptoms of prolapse of internal hemorrhoids than needle extension length of 4 mm.
To explore and construct a sufficient animal model of esophageal stenosis associated with endoscopic submucosal dissection （ESD）.
Methods
Bama mini pigs weighing 25-30 kg（n=6） were used in this study.Each porcine was made a wound with a length of 8 cm and circumference of 5/6 on the esophageal through endoscopy.Endoscopic examination was performed on postoperative days 7，14，and 21 to evaluate wound healing and scar formation.On the 21st day，the animals were sacrificed and esophageal tissues were taken to measure and calculate the mucosal stricture rate.Performed pathological examination to evaluate the formation of scar tissue.
Results
All experimental animals had successfully performed esophageal stenosis associated with ESD，and there had been no serious complications such as massive bleeding and perforation.The esophageal mucosal stricture rate was （63.2±2.9）%，which was satisfactory.Pathological results showed that scar tissue hyperplasia occurred on the wound，leading to esophageal stenosis，which is consistent with the process and mechanism of human.
Conclusion
A wound with a length of 8 cm and a circumference of 5/6 on the esophagus of the Bama mini pig through endoscopy is a stable animal model for the formation of esophageal stenosis，which can be applied to the study of the mechanism of esophageal stenosis after ESD surgery and the exploration of related prevention and treatment methods.Its application potential still needs further research.
To observe the effectiveness and safety of Magnesium sulfate and sodium phosphate for bowel preparation before colonoscopy in elderly patients.
Method
A total of 254 elderly patients undergoing colonoscopy in the second medical center of PLA General Hospital were randomly divided into Magnesium sulfate group and sodium phosphate groups.The general information，completion of bowel preparation，adverse reactions，lesion detection rate，incidence of adverse reactions，patient satisfaction and abnormal changes of blood electrolyte after colonoscopy were compared between the two groups.
Result
There was no significant difference in age，gender，body mass index （BMI） between the two groups； After bowel preparation，the average number of bowel movements in the Magnesium sulfate group was （7.9±1.3） times，which was less than that in the sodium phosphate group （9.5±1.9） times，and the difference was statistically significant （P ＜0.05）.The average time required for the magnesium sulfate group to complete bowel preparation was （123.6±23.7） minutes，which was shorter than that of the sodium phosphate group （138.2 ± 25.5） minutes，and the difference was statistically significant （P=0.016）.The total score for Boston bowel preparation of Magnesium sulfate group was （8.11 ± 0.71），slightly higher than that of the sodium phosphate group （7.98 ± 0.69），and the difference was not statistically significant（P＜ 0.05）； The detection rates of bowel polyps and micro polyps （diameter＜5 mm） in the Magnesium sulfate group were 46/128 （35.9%） and 40/128 （31.2%），respectively，which were higher than those in the sodium phosphate group （38/126 （30.1%） and 31/126 （24.6%），and the differences were statistically significant （all P＜0.05）； The incidence of discomfort symptoms such as nausea，abdominal distension，and abdominal pain in the magnesium sulfate group was not significantly different from that in the sodium phosphate group，but the incidence of vomiting was lower than that in the sodium phosphate group，and the difference was statistically significant （P＜0.05）.The satisfaction rate of patients in the Magnesium sulfate group with intestinal preparation reached 95.3%，with no significant difference compared to the sodium phosphate group （96.8%）.The incidence of abnormal blood potassium and phosphorus in the sodium phosphate group was higher than that in the Magnesium sulfate group，while the incidence of abnormal blood Magnesium was higher in the Magnesium sulfate group，and the differences were statistically significant （P＜0.05）.
Conclusion
The use of magnesium sulfate or sodium phosphate in divided oral doses for bowel preparation in elderly patients has good medication compliance and tolerance，high hygiene quality，fewer adverse reactions，and is relatively safe，making it suitable for clinical application.
To analyze the efficacy of adjustable infusion infusion and micropump somatostatin in the treatment of mild acute pancreatitis （AP）.
Methods
This paper adopts a retrospective analysis of 180 mild AP patients admitted to the gastroenterology department of the PLA General Hospital from June 2021 to June 2024.Different infusion methods were divided into control group （n=90 cases，conventional therapy + adjustable precision infusion infusion somatostatin） and observation group （n =90 cases，conventional therapy+micropump continuously pumped somatostatin），and observe and compare the levels of inflammatory factors，laboratory indicators，efficacy and adverse reactions of treatment before and after treatment.
Results
The level of inflammatory factors and laboratory indicators in the observation group were significantly better than that in the control group，and the disappearance time of abdominal pain and the recovery time of eating were shorter.The incidence of adverse reactions in the observation group was 3.33%，lower than 11.11% in the control group.The above differences were statistically significant （P＜0.05）.
Conclusion
Compared with the infusion of somatostatin，the continuous treatment of somatostatin by micropump can significantly reduce the level of inflammatory factors，rapidly control the development of inflammation，reduce the incidence of adverse reactions，and be safer and more efficient.
Endoscopic resection for colorectal polyps has been proven to significantly reduce the incidence and mortality of colorectal cancer （CRC）.Cold snare polypectomy （CSP） is a highly feasible，effective，and safe option，becoming the first-line technique for resecting small colorectal polyps due to its advantages of simple operation，short procedure time，high complete resection rate，low complication rate，and rapid postoperative healing.This review elaborates on the findings regarding the effectiveness and safety of CSP in treating non-pedunculated polyps with a diameter of ＜10 mm，the potential expanded indications of CSP in the future，the technical points and standard procedures that need attention when performing CSP，including the selection of snares，specimen retrieval after resection，and two new techniques associated with CSP.
Chronic kidney disease （ CKD ） is a global public health problem.Epidemiological studies have shown that the prevalence of CKD in the general population is increasing.Upper gastrointestinal bleeding （ UGIB ） is the most common complication of CKD，and CKD is an independent predictor of upper gastrointestinal bleeding.The incidence，mortality and rebleeding rate of upper gastrointestinal bleeding in patients with chronic kidney disease are higher.At present，the mechanism of upper gastrointestinal bleeding in patients with chronic kidney disease is not clear，but it is generally believed to be related to the accumulation of uremic toxins，platelet dysfunction，increased gastrointestinal hormones，gastrointestinal dysfunction，and the use of anticoagulant drugs during dialysis.Patients with end-stage renal disease have more underlying diseases and late complications.This article summarizes the research progress of chronic kidney disease complicated with upper gastrointestinal bleeding at home and abroad in recent years，and summarizes the pathogenesis，etiology，treatment，prevention and other aspects，so that clinicians can understand this disease and achieve the purpose of early diagnosis and professional treatment.
To explore the effectiveness of flushing laxative medications solution under colonscopy as a remedial measure to achieve the purpose of examination in patients with inadequate bowel preparation during colonoscopy.
Method
A retrospective analysis of 76 patients who underwent colonoscopy at the 980th Hospital of the Joint Logistics Support Force between January 2018 and June 2024 and were found to have inadequate bowel preparation，with subsequent endoscopic rescue measures taken.The study subjects were divided into an experimental group and a control group based on whether they were flushing laxative medications solution under colonscopy or not.The experimental group and the control group were flushed with laxative medications solution and physiological saline，respectively.Compare the Boston bowel preparation scores，operation time，completion rate of examination targets，and summarize nursing experience between two groups.
Result
42 cases were included in the experimental group and 34 cases were included in the control group.There was no statistical difference in gender and age between the two groups.Among the patients included，54 cases （71.1%） underwent emergency colonoscopy，15 cases （19.7%） underwent routine examination，and 7 cases （9.2%） underwent polypectomy.In the experimental group，23 cases（54.8%） used compound polyethylene glycol electrolyte，and 19 cases （45.2%） used magnesium sulfate.The bowel preparation score for the experimental group was 2.02±0.81，while the control group's score was 1.74±0.75，with no significant statistical difference between the two groups.The average time for colonoscopy in the experimental group was 54.58 ± 12.80 minutes； The average time consumption of the control group was 66.98 ± 16.38 minutes，and there was a significant statistical difference in surgical time between the two groups.The completion rate of colonoscopy target examination of the experimental group was 95.2% and control group was 82.4%，with a statistically significant difference between the two groups.
Conclusion
The remedial measure of flushing laxative medications solution in patients with inadequately prepared colon during colonoscopy has the advantages of shortening operation time and high completion rate of examination，but it demands higher standards of nursing care.
To explore the application of multi-module stepped teaching mode in the training of core competence of nurses specializing in digestive endoscopy，and to provide reference for improving the core competence of nurses specializing in digestive endoscopy.
Methods
A training base for specialized nurses of digestive endoscopy was established，the training outline was formulated，and the multimodule and stepped training method was adopted for teaching.Competency Inventory for Registered Nurse（CIRN） was used to assess the trainees before and after the training.And through the basic theory，operation skills and scientific research ability of the three modules to test the students.
Results
After the implementation of the multi-module stepped teaching mode，the students' scores in the three modules were higher than before the training，and the scores and total scores of the seven dimensions of the CIRN scale were higher than before the training，with statistical significance （P ＜0.05）.
Conclusion
The multi-module stepped teaching mode can effectively improve the training quality of endoscopy nurses，comprehensively improve the core competence of gastroendoscopy nurses，and improve the satisfaction of students.
