Miss Wu, 25, tall and thin, with a height of 1 meter 70, but she only eighty pounds. Female colleagues who are busy losing weight often say that she is like “sister Lin”, envy her “eat not fat”. But her pain only she knows, once upon a time she was also a full-figured girl, 3 years ago began to have difficulty swallowing, even if you eat in will spit out, her body is getting weaker and weaker, when serious each time climbing 4 floors home for her are difficult. She was hard pressed to participate in various tasks, but often fell ill, and was criticized by the leadership for this. The most painful time is when she is eating, looking at a table of food but can hardly swallow it, sometimes sleeping in the middle of the night but choking on her own saliva or the food she ate at night and coughing. Looking at a pillow of vomit, she often sat mute until dawn. She said this is a “want to eat can not eat, eat also want to vomit” strange disease, Chinese medicine, Western medicine have tried but no effect. In September of this year, she was introduced by a friend to Professor Zhang Guoxin of the Department of Gastroenterology at Jiangsu Provincial People’s Hospital, and after completing various tests, Professor Zhang told her that she actually had a condition called “cardia inactivation. Based on Ms. Wu’s high-resolution esophageal manometry and ultrasound endoscopy results, Zhang Guoxin decided to perform a modified surgery on her. The surgery took only 50 minutes and was a success. When she ate her first mouthful of porridge, she was so excited that she burst into tears. According to Professor Zhang Guoxin, Miss Wu’s disease is actually not a rare disease, by foreign surveys, the incidence of pancreatic dyscrasia in 1-10/100,000, mostly occurs in young and middle-aged people aged 20-39 years old, and there are even reports of young children suffering from the disease. Many people suffer from the pain of not being able to swallow, but can not do anything about it. In recent years, “transendoscopic esophageal myotomy (POEM)” has been performed to relieve the disease, but the pressure in the lower esophagus remains high in some patients after conventional POEM, which is the main reason for the reappearance of obstruction symptoms. Studies have shown that the recurrence rate of conventional POEM is 20-30%, and the recurrence rate tends to increase with time. Patients therefore need to be operated again, which increases their burden and pain. How to solve this problem? After continuous exploration, Prof. Zhang Guoxin found that the “high-resolution esophageal manometry” technique can reflect the location of esophageal lesions in patients with cardia failure more accurately. Combining the results of esophageal manometry, he pioneered the individualized treatment of cardia in this case by applying the “double tunnel POEM” technique, which involves creating a tunnel in the anterior and posterior walls of the esophagus and cutting through the muscle layer at the same time. After the operation, the patient was able to eat normally, and the pressure in the lower esophagus decreased rapidly on retest. In order to shorten the operation time, he used the method of simultaneous endoscopic “myotomy” and “tunneling”. For patients who have undergone balloon dilatation and stenting, the submucosal layer adheres to the intrinsic muscle layer and it is not easy to establish a tunnel.