消化系疾病涉及范围广,疑难疾病多,尤其是消化系肿瘤的早期诊断和治疗技术方面,至今尚存在诸多难题。日本利用胃肠气钡双对比造影染色内镜、窄带内镜、激光共聚焦内镜等技术细致检查,使早期胃癌的手术率达到50%甚至更高;并对早期消化系肿瘤进行内镜下的黏膜切除术及黏膜下剥离术,大大提高了消化系早期肿瘤的治疗效果。为了进一步提高消化系肿瘤的诊疗水平,缩小与先进国家的差距,本刊从2008年第7期开始(本病例讨论刊登在我刊2009年第5期),委托我刊共同主编、上海交通大学附属瑞金医院及上海胃肠肿瘤重点学科吴云林教授组织消化系肿瘤的疑难病例讨论,欢迎广大同行参加。并以此为契机,进一步将讨论内容拓展到所有消化系相关的疾病,在不断总结经验和教训的过程中提高诊疗水平。疑难病例讨论具体形式:①答题时不仅要写出诊断名称、还要列举诊断依据。②采用有奖问答。所有参与者均赠送期刊1年,对于答对者随机抽取一等奖1名(500元)、二等奖3名(300元)、三等奖5名(100元)。连续5期答对者将给予国家Ⅱ级学分5分。③疑难病例每隔一期(单月)进行一次,病例内容刊登在正刊上,并择期刊登正确答案、获奖人员名单及部分参与讨论者的答题内容,同时在我刊网站(www.wcbx.cn)公布相关信息。④参与答题者可以通过电子邮件(wcbx@chinajournal.net.cn)或邮局来信,将病例讨论的答案寄到编辑部。胃肠病学和肝病学杂志编辑部 Digestive diseases cover a wide range of difficult diseases, especially in the early diagnosis and treatment of digestive cancer technology, there are still many problems. Japan’s use of gastrointestinal barium double contrast imaging stained endoscopy, narrow-band endoscopy, laser confocal endoscopy and other technical careful examination, the early gastric cancer surgery rate of 50% or more; and early digestive tumors endoscopic Mucosal resection and submucosal dissection, greatly improving the treatment of early digestive tumors. In order to further improve the diagnosis and treatment of digestive system tumors and narrow the gap with advanced countries, this issue starts from No. 7 in 2008 (this case is discussed in my issue No.5, 2009), entrusts me to co-editor, Shanghai Jiao Tong University Affiliated Ruijin Hospital and Shanghai Key Laboratory of Gastrointestinal Cancer Professor Wu Yunlin organized difficult cases of gastrointestinal cancer discussion, welcome to join the majority of peers. And as an opportunity to further expand the discussion to all gastrointestinal related diseases, improve the level of diagnosis and treatment in the process of constantly sum up experience and lessons learned. The specific form of difficult case discussion: ① answer not only to write out the name of the diagnosis, but also cite the basis for diagnosis. ② using the prize quiz. All participants presented their periodicals for one year, randomly selected first prize (500 yuan), second prize (300 yuan) and third prize (100 yuan) for those who answered correctly. Five consecutive respondents will be given a national grade 5 credits. ③ difficult cases every other period (once a month) once, the case content is published in the print, and essays published the correct answer, the list of winners and part of the participants in the answer content, and in my website (www.wcbx. cn) announced the relevant information. ④ Those who participate in the question-answering can send an email to the editorial office by email (wcbx@chinajournal.net.cn) or post office letter. Editorial Department of Gastroenterology and Hepatology