This article systematically reviews the current research status as well as diagnosis and treatment strategies of traditional Chinese medicine （TCM） for gastroesophageal reflux disease （GERD）. Studies demonstrate that TCM， based on the "disease-syndrome combination" approach， exhibits multi-target advantages in alleviating symptoms of various GERD subtypes， promoting mucosal repair， regulating emotions， and facilitating the reduction of western medication. To address clinical challenges such as symptom overlap and limited therapeutic efficacy， strategies have been proposed including "treating different diseases with the same method" and integrated regulation based on viscera correlation. Future efforts should focus on elucidating the mechanisms of compound prescriptions， promoting TCM drug development under the "three-combination" evaluation framework that integrates TCM theory， human experience and clinical trial evidence， and optimizing integrated traditional and western medicine models to enhance GERD management.

Objective:Taking naval officers and soldiers who participate in military continuing education as an example, to compare the distribution of sensory learning style of learners with different personality in order to provide suggestions and references for online course teaching.Methods:By using convenient sampling method, MBTI (Myers-Briggs Type Indicator) and VARK (Visual, Aural, Read/Write, Kinesthetic questionnaire) were measured in the Navy. A total of 10 000 questionnaires were distributed and 8 124 valid ones were collected. Through analysis of SPSS 25.0 software, the personality dimensions and personality types were analyzed for personality analysis, and the main indicators of sensory learning style analysis were tendency multiplicity, the intensity and distribution of single sensory learning style, and specific sensory learning styles. The Chi-square test was adopted, with test level of α=0.05. Results:It showed statistical differences in the tendency multiplicity and intensity of single style among officers and soldiers in the three dimensions of extroversion-introversion, sensing-intuition and judging-perception ( χ 2=12.37, 18.02, 22.97, 12.57, 12.73, 24.45, P=0.005, <0.001, <0.001, =0.006, =0.005, <0.001). It showed statistical differences in the distribution of single style and the specific sensory learning styles among officers and soldiers in all the four dimensions of extroversion-introversion, sensing-intuition, thinking-feeling, and judging-perception ( χ 2=28.30, 36.96, 11.40, 41.95, 53.76, 75.48, 43.11, 77.29, P <0.001, <0.001, =0.022, <0.001, <0.001, <0.001, <0.001, <0.001). It showed statistical differences in the tendency multiplicity, the intensity and distribution of single style, and the specific sensory learning styles among naval officers and soldiers with different personality types ( χ 2=86.63, 96.22, 147.41, 363.76, all P<0.001). Conclusions:Personality dimension has influence on sensory learning style, especially for extroversion-introversion, sensing-intuition, and judging-perception dimensions. Personality type has an important influence on the tendency multiplicity, distribution type and performance intensity of sensory learning style. It is integral part of online course teaching to meet the diversified and personalized learning needs of officers and soldiers.

Leukocyte differentiation antigen CD109(CD109)is a glycosylphosphatidylinositol(GPI)-associated cell surface antigen,belonging to the α-2 macroglobulin/C3,C4 and C5 super family complex,and is a transfor-ming growth factor(TGF)-β/Smads co-receptor.CD109 regulates the occurrence and development of glioma and is closely related to drug resistance and recurrence of glioma.As a cell membrane protein,CD109 can be directly la-beled by specific antibodies or enzymes,and may also be recognized by targeted vectors for drug delivery,which is expected to become an effective diagnostic molecular marker and pharmacological therapeutic target.

Objective: This study aimed to evaluate the validity and predictive value of different methods for myopia screening, and to provide the most effective method of myopia screening. Methods: A total of 7 441 students of grade 1-12 selected from 36 primary and middle schools in 12 counties in Jiangsu Province were enrolled in this study for ophthalmological examination, and uncorrected visual acuity (UCVA, Plan A), noncycloplegic autorefraction (NCAR, Plan B) and combination of UCVA and NCAR (Plan C) were included in the examination. Receiver operating characteristics (ROC) curve was performed to determine the cut-off values (The gold standard is cycloplegic refraction: SE≤0.5 D), and positive predictive value, sensitivities, specificities and other indicators of three screening tests were compared and calculated. Results: The AUC of the combination test for uncorrected visual acuity(UCVA) and noncycloplegic autorefraction (NCAR) was nearly 1(0.91, 95%CI=0.90-0.92), and the sensitivity, specificity, Yoden index, diagnostic coincidence rate, positive predictive value and negative predictive value were 92.4%，89.5%，0.82，91.1%，91.3%，90.8%, respectively, but the index of the younger pupils in primary schools was relatively low. The result of screening plan A for students of middle and high school students was the closest to that of myopia diagnosis. Conclusion Combination test, which was recommended by China National Health Commission, can be a practical solution for school students for myopic screening. Under the condition of no mydriatic refraction, Plan A could be considered for myopia screening especially for middle and high school students. For the younger pupils, it is suggested to use the internationally recommended myopia screening strategy, that is, SE ≤ 0.50D after mydriasis.

Objective To evaluate the feasibility of application of single and dual antiplatelet aggregation therapy in high sensitive C-reactive protein (hs-CRP) level in patients with angina pectoris. Methods Ninety-six hospitalized patients with angina 6~48 h (hs-CRP< 2 mg/L) were selected and randomly divided into single aspirin group (aspirin 100 mg/d, n=48) and aspirin plus clopidogrel combination therapy group (aspirin 100 mg/d and clopidogrel 75 mg/d, n=48). The efficacy was evaluated after 30-day treatment. Data of composite end points were analyzed by follow-up in patients within 6 months. Results The total effective rates were 85.42%for combination therapy group and 81.25%for single aspirin group. There was no significant difference in total effective rate between two groups (P>0.05). There were no significant differences in events of composite end points in patients after treatment between two groups (P > 0.05). Conclusion For angina pectoris patients with hs-CRP<2 mg/L, the risk of cardiovascular events is relatively little. There is no obvious difference in curative effect between single and dual antiplatelet aggreration therapies.

To investigate hematopoiesis and cytogenetics changes in staff of interventional radiology.A total of 121 intervention radiation workers, 245 common radiation workers and 100 medical personnel (healthy control) without exposure to radiation were enrolled in the study. The peripheral lymphocyte chromosomal aberrations and micronucleus were detected, and the result of white blood cells examination was analyzed.Compared with common radiation group and healthy control group, decreases in white blood cells count, neutrophil ratio, and increase in lymphocyte ratio were observed in intervention radiation group (all<0.05). Intervention radiation group had higher chromosome aberration rate and micronuclear rate than common radiation group and healthy control group (all<0.05). Most common chromosome aberrations were dicentric chromosome, acentric ring, fragments and minute chromosome. Abnormal rates in chromosome aberration and micronucleus rates were increased with the rise of length of service, but no statistically significant difference was observed (>0.05).Long term exposure to ionizing radiation may lead to changes in the human hematopoietic system and cause human chromosome aberration, and the severity of such injuries may be associated with the dose of ionizing radiation.
Adult ; Chromosome Aberrations ; radiation effects ; Dose-Response Relationship, Radiation ; Female ; Hematopoiesis ; radiation effects ; Humans ; Leukocyte Count ; statistics & numerical data ; Leukocytes ; pathology ; radiation effects ; Lymphocytes ; pathology ; radiation effects ; ultrastructure ; Male ; Micronuclei, Chromosome-Defective ; radiation effects ; Occupational Exposure ; adverse effects ; Radiation Exposure ; adverse effects ; statistics & numerical data ; Radiation, Ionizing ; Radiologists ; statistics & numerical data ; Time Factors

Objective To explore the effect of neonatal exposure to different doses of Bisphenol A (BPA)on the hypothalamic -pituitary -testis axis in toddler and adolescent male rats.Methods Neonatal male Sprague -Daw-ley rats were randomly divided into 5 groups through random digital table method:control group,vehicle group,low -dose BPA [25 μg/(kg · d)]group,medium -dose BPA [50 μg/(kg · d)]group and high -dose BPA [250μg/(kg·d)]group.The rats were subcutaneously injected with respective agents on postnatal days 1 -7 (PND 1 -7).Pups were sacrificed on PND 22 and PND 50.The hypothalamus and testis were taken and weighed.The hypotha-lamic Kiss -1 mRNA and the testis androgen receptor (AR)mRNA were tested by using real -time fluorescence quan-titative and the levels of serum luteinizing hormone (LH),follicle stimulating hormone (FSH),testosterone (T)were tested by using radio immunity method,and inhibin B was measured by using enzyme linked immunosorbent assay. Results Compared with the controls,the level of serum FSH [(1 .610 0 ±0.693 2)IU /L,(1 .574 3 ±0.675 0)IU /L vs (2.362 9 ±0.580 3)IU /L](F =3.314,P =0.026),LH [(3.876 3 ±0.908 0)IU /L,(3.603 8 ±1 .350 2)IU /L vs (5.302 5 ±0.768 4)IU /L](F =3.1 39,P =0.027)and T [(0.383 8 ±0.1 77 8)μg/L,(0.442 5 ±0.21 4 1 )μg/L vs (0.782 5 ±0.282 1 )μg/L](F =5.1 06,P <0.01 )of medium and high -dose BPA groups,were decreased in PND 22,and the organ coefficient of testis [(0.952 90 ±0.049 1 5)%,(0.969 20 ±0.045 82)% vs (1 .022 80 ± 0.01 1 08)%](F =1 0.326,P <0.01 )and serum T [(1 .758 6 ±0.369 6)μg/L,(1 .71 8 8 ±0.395 7)μg/L vs (3.357 5 ±0.749 8)μg/L](F =1 3.799,P =0.01 2)were significantly decreased in PND 50.In high -dose BPA group of PND 22,the expression of hypothalamic Kiss -1 mRNA (0.068 80 ±0.01 1 79)was increased compared with the other groups (F =272.1 25,P <0.01 ),while in PND 50,compared with control group,the Kiss -1 mRNA (0.002 00 ±0.000 25,0.001 90 ±0.000 48 vs 0.001 40 ±0.000 1 7)of medium -and high -dose BPA groups was decreased(F =1 91 .826,P <0.01 ).Conclusions Neonatal exposure to the medium and high -dose BPA may impair the function of testis in toddler and adolescent male rats,and affect the hypothalamus -pituitary -testis axis.Neonatal exposure to the low -dose BPA does not have a significant influence on the hypothalamus -pituitary -testis axis.

Objective To investigate chromosome aberration and micronucleus frequency in peripheral blood lymphocytes in workers engaged in radiation for a long time,to reduce occupational hazard caused by ionizing radiation,and to further strengthen health surveillance.Methods A total of 366 members of medical staff engaged in radiation work who underwent physical examinations in Hangzhou Hospital of Prevention and Treatment of Occupation Diseases from 2014 to 2015 were enrolled as radiation group,consisting of staff engaged in X-ray diagnosis,diagnostic radiology,radiotherapy,and interventional radiology.Another 100 members of medical staff without exposure to radiation were enrolled as control group.Whole blood culture was used to measure chromosome aberration and micronucleus frequency in peripheral blood lymphocytes.Results The radiation group had a significantly higher rate of chromosome aberration than the control group(0.30％ vs 0.09％,x2=13.43,P＜0.01),as well as a significantly higher micronucleus frequency than the control group (2.09‰ vs 0.08‰,x2=74.4,P＜0.01).The abnormal rates of chromosome aberration and micronucleus showed no significant differences across radiation workers with different working years (P＞0.05).The staff engaged in X-ray diagnosis,diagnostic radiology,radiotherapy,and interventional radiology had rates of chromosome aberration of 0.25％,0.25％,0.23％,and 0.41％,respectively,which showed a significant difference between the staff at these four posts (x2=8.22,P＜0.05);the micronucleus frequencies in the staff at these four posts were 1.36‰,1.28‰,1.14‰,and 3.79‰,respectively,and showed a significant difference between the staff at these four posts (x2=251.09,P＜0.01).Conclusion Radiation workers are exposed to low-dose ionizing radiation for a long time,which may cause significant increases in the rate of chromosome aberration and micronucleus frequency in peripheral blood lymphocytes.

Objective To investigate chromosome aberration and micronucleus frequency in peripheral blood lymphocytes in workers engaged in radiation for a long time,to reduce occupational hazard caused by ionizing radiation,and to further strengthen health surveillance.Methods A total of 366 members of medical staff engaged in radiation work who underwent physical examinations in Hangzhou Hospital of Prevention and Treatment of Occupation Diseases from 2014 to 2015 were enrolled as radiation group,consisting of staff engaged in X-ray diagnosis,diagnostic radiology,radiotherapy,and interventional radiology.Another 100 members of medical staff without exposure to radiation were enrolled as control group.Whole blood culture was used to measure chromosome aberration and micronucleus frequency in peripheral blood lymphocytes.Results The radiation group had a significantly higher rate of chromosome aberration than the control group(0.30％ vs 0.09％,x2=13.43,P＜0.01),as well as a significantly higher micronucleus frequency than the control group (2.09‰ vs 0.08‰,x2=74.4,P＜0.01).The abnormal rates of chromosome aberration and micronucleus showed no significant differences across radiation workers with different working years (P＞0.05).The staff engaged in X-ray diagnosis,diagnostic radiology,radiotherapy,and interventional radiology had rates of chromosome aberration of 0.25％,0.25％,0.23％,and 0.41％,respectively,which showed a significant difference between the staff at these four posts (x2=8.22,P＜0.05);the micronucleus frequencies in the staff at these four posts were 1.36‰,1.28‰,1.14‰,and 3.79‰,respectively,and showed a significant difference between the staff at these four posts (x2=251.09,P＜0.01).Conclusion Radiation workers are exposed to low-dose ionizing radiation for a long time,which may cause significant increases in the rate of chromosome aberration and micronucleus frequency in peripheral blood lymphocytes.

Intellectual property in medical institutions has been getting more attention in research activity.Large general hospitals have made significant achievements in intellectual property,and the management of intellectual property right has also gradually become the norm.This article discussed the possibility to carry out the intellectual property management in the primary health care sector,based on their current status and characteristics,proposed an evaluation system which suitable for the primary health care sector.We described the structure and method of this system,explored a standardized intellectual property management process used in primary health care institutions.