Neurophysiology and new techniques to assess esophageal sensory function: an update

Development and dysfunction of structural cells in eosinophilic esophagitis

Eosinophilic esophagitis (EoE) is a disorder characterized by dysfunction and chronic local inflammation of the esophagus. The incidence and prevalence of EoE are increasing worldwide. The mechanisms responsible are poorly understood, and effective treatment options are limited. From the lumen outward, the esophagus comprises stratified squamous epithelium, lamina propria, and muscle. The tissue-specific nature of EoE strongly suggests that structural cells in the esophagus are involved in the EoE diathesis. Epithelial basal cell hyperplasia and dilated intercellular spaces are cardinal features of EoE. Some patients with EoE develop lamina propria fibrosis, strictures, or esophageal muscle dysmotility. Clinical symptoms of EoE are only weakly correlated with peak eosinophil count, implying that other cell types contribute to EoE pathogenesis. Epithelial, endothelial, muscle, and fibroblast cells can each initiate inflammation and repair, regulate tissue resident immune cells, recruit peripheral leukocytes, and tailor adaptive immune cell responses. A better understanding of how structural cells maintain tissue homeostasis, respond to cell-intrinsic and cell-extrinsic stressors, and exacerbate and/or resolve inflammatory responses in the esophagus is needed. This knowledge will facilitate the development of more efficacious treatment strategies for EoE that can restore homeostasis of both hematopoietic and structural elements in the esophagus.

Clinical effects of PDCA cycle-based nursing care in elderly gastroesophageal reflux disease patients with anxiety and depression

AIM

To observe the clinical effects of PDCA cycle-based nursing care in elderly gastroesophageal reflux disease (GERD) patients with anxiety and depression.

METHODS

Seventy-two GERD patients with anxiety and depression were selected and randomly divided into a control group and an observation group, with 36 cases in each group. Both groups received routine nursing care, and the observation group was additionally given PDCA cycle-based nursing care. The quality of life score, clinical symptom scores, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores and compliance were compared between the two groups.

RESULTS

SAS and SDS scores were significantly lower in both groups after nursing than before nursing (P < 0.05), and SAS and SDS scores were significantly lower in the observation group than the control group (P < 0.05). Clinical symptoms and quality of life scores were significantly improved in both groups after nursing (P < 0.05), and the improvement was more significant in the observation group (P < 0.05). Compared with the control group, patient compliance was significantly better in the observation group (P < 0.05).

CONCLUSION

PDCA cycle-based nursing care can improve clinical symptoms, reduce anxiety and depression, and improve patient compliance in elderly GERD patients with anxiety and depression.