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Patients with motility disorders of the lower esophageal sphincter (LES) have abnormal resting LES pressures and abnormal residual LES relaxations after a vomiting effort. These abnormalities in LES motility may be the primary cause of symptoms. To assess the contribution of the vagus nerves to normal LES relaxation, residual LES relaxation, and LES response to sequential stimuli. In 20 normal volunteers, we studied residual LES relaxation immediately and 7 minutes after a vomiting effort. The amplitude of residual LES relaxation and the timing and rate of occurrence of residual LES relaxation were similar before and after the vomiting effort. The concomitant rapid rise in the amplitude of transient LES relaxation during the vomiting effort was delayed in later responses. In patients with abnormal residual LES relaxation, residual LES relaxation was abnormal in both timing and amplitude. Within the LES relaxation, there was a delayed concomitant rise in the amplitude of the transient relaxation and a rapid increase in its duration. These effects were usually seen in patients with more severe symptoms. The concomitant decrease in the amplitude of the continuous relaxation and its delay in occurrence in patients with abnormal residual LES relaxation are consistent with a postcontractile phase to the LES relaxation and suggest a role for the vagus in the initiation and maintenance of the continuous relaxation. The amplitude of the vagally mediated transient relaxation is reduced in patients with abnormal LES relaxation, suggesting a failure of parasympathetic stimulation. The concomitant decrease in the amplitude of the continuous relaxation and delay of its onset suggest a role for the vagus in parasympathetic modulation of LES relaxation. this study, implying that *H. parasuis* was in the same transmission line of STHV. This study is the first to describe STHV as a potential vaccine target.

The authors wish to thank Dr. Zhang from the Henan Academy of Agricultural Sciences for supporting this work.

Xing Wang, Liping Jia, Xiaojie Hu and Mei Jiang designed the experiment; Liping Jia and Xiaojie Hu contributed

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