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.

Probiotics have shown excellent application prospects in preventing and treating many diseases. However, their sensitivity to the harsh environment in vivo always leads to a massive loss of viability and insufficient therapeutic effect. Fortunately, modified probiotics have emerged and provide multiple possibilities for their use in various diseases. Modification not only endows probiotics with extra capacity to resist severe environments but also gives them exogenous characteristics, such as prolonged retention time and improved therapeutic effects. Modified probiotics could combine with other therapies, which has opened up new avenues to enhance the efficacy of probiotic-based therapy. In this review, we have summarized the current physicochemical and biological modification strategies of probiotics. In addition, the progress of research on probiotic-based combination therapy has also been extensively reviewed, which contributes to the enhanced delivery of probiotics or other active constituents and provides new ideas for disease treatment, bioimaging, and diagnosis.

Objective To explore the clinical effect of cold treatment of replacement fluid in continuous blood purification(CBP)of patients with heat stroke.Methods Clinical data of 46 patients with heat stroke who were treated with CBP in Hainan Hospital of PLA General Hospital from July 2018 to September 2022 were retrospectively analyzed.The patients were assigned to control group(23 cases,conventional treatment for heat stroke and CBP with room temperature replacement fluid)and observation group(23 cases,conventional treatment for heat stroke and CBP with cooling replacement fluid).The body temperatures were compared between the two groups before treatment and 30 min,2 h,6 h,12 h and 24 h after treatment.The prothrombin activity(PTA),activated partial thromboplastin time(APTT),D-dimer(D-D),fibrinogen(FIB)and platelet count(PLT)before treatment and at 24 h(T1),3 d(T2)and 7 d(T3)after treatment,as well as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)score at 7 d after treatment were also compared between the two groups.Results There was no significant difference in temperature or coagulation function between the two groups before treatment(P>0.05).The temperature of the observation group was significantly different from that of the control group at 2 h,6h and 12h after treatment(P<0.05).After treatment,the levels of PTA,FIB and PLT in the observation group at T1,T2 and T3 were higher than those in the control group,while the level of D-D in the observation group was lower than that in the control group,and the APPT at T1 and T2 was significantly shorter than that in the control group(P<0.05).PTA,APPT,D-D,FIB and PLT of the two groups were improved after treatment(P<0.05).Conclusion The cold treatment of replacement fluid can quickly shorten the cooling time of patients with heat stroke during CBP,and significantly improve coagulation function.It is worthy of clinical promotion so as to improve the progrosis of patients with heat strok.

Objective: To explore the prevalence of body weight control behaviors (BWCB) among middle school students in Jiangsu province. Methods: The database was established part from the surveillance of adolescent common disease and health related factors in Jiangsu province in 2017 and analysis were carried out to describe the prevalence rates of four basic BWCB and their comorbidity. Results: Among 18 855 investigators, 75.8% middle school students reported having taken at least one kind of BWCB within 30 days before investigation, the report rates of BWCB of middle school students among male and female were 77.3% and 74.3%(P<0.01), showed decreasing tendency from grade 1 of junior middle school to grade 3 of senior middle school (Kendall’s tau-c=-0.10, P<0.01), those of malnutrition, normal body weight, overweight and obesity were 57.2%, 72.8%, 83.8%, 86.7% respectively and showed increasing tendency(Kendall’s tau-c=0.13, P<0.01). Reported rate of Changing diet structure, physical exercise, reducing diet and taking slimming drug prevalence were 58.7%, 61.0%, 17.9%, 2.6%, orderly. There are 15 combinations of BWCB based on those 4 kinds of behavior. In the highest five types list ,changing diet structure & physical exercise (35.2%) was the most common type, and followed by physical exercise(13.0%), Changing diet structure(9.2%), Changing diet structure & physical exercise & reducing diet(8.6%), Changing diet structure & physical exercise & reducing diet(3.4%), others 6.5%. The proportions of top five kinds of BWCB among middle school students taken BWCB were 46.4%, 17.1%, 12.2%, 11.3%, 4.5%, respectively, accounting for 91.5%. The probabilities of different types of BWCB were similar between urban and town(χ2=9.13, P=0.10), different among sex(χ2=351.17, P<0.01), districts(χ2=140.20, P<0.01), school type and nutrition status(χ2=343.95, 309.62, P<0.01). Conclusion Some overweight or obesity students report on control body weight, while some report taking medicine and reducing diet behavior. Health education on healthy body weight should be implemented for middle school students to cultivate healthy body image so as to keep healthy body weight.

OBJECTIVE:To study the absorption features of Silymarin enteric coated-polyllactic-co-glycolic acid (PLGA) nanoparticles in rat in situ intestine perfusion model and colonic adenoma Caco-2 cell model. METHODS:HPLC method was used to determine the content of silymarin. The absorption rate constant(Ka)and apparent absorption coefficient(Kapp)of Silymarin sus-pension,Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles were investigated in duodenum,jejunum, ileum and colon of rat in situ intestine perfusion model;the apparent permeability coefficient (Papp) of those drugs containing low-concentration,medium-concentration and high-concentration(20,40,60 μg/mL)of silymarin in Caco-2 cell model were also investigated. RESULTS:Compared with Silymarin suspension,Ka and Kapp of Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles were all increased in duodenum,jejunum,ileum and colon(P<0.05);compared with the correspond-ing concentration Silymarin suspension,two-way Papp of Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanopar-ticles containing low-concentration,medium-concentration and high-concentration of silymarin were all increased in Caco-2 cell model (P<0.05);there was no statistical significance between Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles (P>0.05). CONCLUSIONS:Silymarin enteric coated-PLGA nanoparticles can effectively increase the intestinal ab-sorption,cellular uptake and transmembrane transport rate of silymarin.

Objective To investigate the levels of trace element in calcium, magnesium, zinc, iron and copper in maternal blood of pregnant women of different pregnancy and ages of pregnant women , and its relation to the pregnancy the age of pregnant women. Methods Calcium, magnesium, zinc, iron and copper in serum in 10 131 cases of pregnant women (3 565 cases in the first pregnancy, 6 566 cases in second pregnancy) were measured. All cases (both first pregnancy and second pregnancy) were analysed according to three age periods (less than or equal to 25, 25 to 35 years old, more than or equal to 35). Results (1)Comparing to the cases in second pregnancy, Copper in serum of the cases in first pregnancy was lower, while zinc, magnesium and iron were higher (P < 0.05). But the level of calcium had no difference (P > 0.05). (2) For the cases in the first pregnancy in different age periods, all 5 kinds of trace elements were compared. Only the zinc level in serum in the groups of 25 ~ 35 years old and more than or equal to 35 years old was higher than that in the group of less than or equal to 25 years old (P < 0.05). No difference was found in the rest of trace elements in different age groups (P > 0.05). (3) For the cases in the first pregnancy in different age stages , all 5 kinds of trace elements were compared basis on the age periods. the zinc and iron levels in serum in the groups of 25 to 35 years and more than or equal to 35 years old were higher than those in less than or equal to 25 years old (P < 0.05). No difference (P > 0.05) was found in the other three kinds of trace elements in different age periods. Conclusions (1)There are differences in trace elements, magnesium, zinc, iron and copper, and no difference in calcium in the first and second pregnancy. (2)Trace elements in serum of pregnant women in different age periods are different. (3)According to the characteristics of various trace elements in serum of pregnant women of different pregnancy and age periods, trace elements shall be supplemented to meet the needs of the pregnant women and fetus.

OBJECTIVE:To optimize the formulation of entecavir PLGA sustained-release microspheres,and explore its drug release in vitro. METHODS:PLGA sustained-release microspheres was prepared by emulsification-solvent evaporation method. Us-ing composite score of entrapment efficacy and drug loading as indexes,orthogonal test was designed to optimize drug amount, drug-PLGA mass ratio,PLGA mass concentration,oil phase-aqueous phase volume ratio and polyvinyl alcohol (PVA) concentra-tion;and validation test was also conducted. The prepared microsphere morphology,particle size and durg release in vitro were de-tected. RESULTS:The optimized formulation was entecavir 20 mg,entecavir-PLGA mass ratio 1∶10,PLGA mass concentration 200 mg/ml,oil phase-aqueous phase volume ratio 1∶10,and PVA concentration 2%;entrapment efficacy was (86.52 ± 3.25)%, drug loading was(18.36±1.37)%,RSDs were lower than 5.0%(n=3);it was round and smooth in appearance with average par-ticle size of 58.35 μm;Q10 h,Q96 h and Q360 h were 9.6%,42.9% and 89.6%,and the drug release in vitro fitted to Higuchi model (r2=0.965 8). CONCLUSIONS:Entecavir PLGA sustained-release microspheres prepared by optimized formulation has good sus-tained-release performance.

Objective To study the relationship between bisphenol A and precocious puberty in 6-8 years girls. Meth-ods Atotal of 103 girls aged 6-8 years with precocious puberty in our Endocrine clinic from August to December 2012 were se-lected. According to the classiifcation standard of precocious puberty, girls are divided into idiopathic central precocious puberty (ICPP) group (n=47) and permature thelarche (PT) group (n=56), 53 girls with no puberty development were chosen as control group. BPA concentrations were determined with HPLC-MS-MS, sex hormones were determined with chemiluminescence meth-od and Kisspeptin concentrations were determined with ELISA, then the differences among the three groups were compared and the relationships between bisphenol A and sex hormones and Kisspeptin were analyzed. Results The BPA relevance ratio and concentration in ICPP group were higher than those of PT group and control group (P<0.05). The peak concentration of LH and LH/FSH in ICPP group were higher than those of PT group (P<0.05). The concentration of E2 in ICPP group and PT group were higher than that of control group (P<0.05). The concentration of Kisspeptin in ICPP group was higher than that of PT group and control group (P<0.05). There were no relationship between the concentrations of bisphenol A and Kisspeptin and FSH peak con-centration (P>0.05). There were correlations between the concentrations of BPA and E2 and LH peak concentration and LH/FSH (P<0.05). Conclusions There is a certain correlation between the concentrations of BPA and ICPP.

Clinically rare with an acute or subacute onset,Hashimoto's encephalopathy (HE) is characterized as autoimmune encephalopathy with elevated anti-thyroid autoantibodies.If timely diagnosed and treated,its prognosis is often fair.Four HE cases admitted from January 2012 to June 2014 were analyzed with a literature review.HE 4 cases had a significantly higher level of thyroperoxidase (TPO) while the lowest increase over four folds.There were cognitive decline,memory loss and even coma.And 50％ had abnormal electroencephalogram (EEG) consistent with radiographic lesions.In short,EEG may aid an early diagnosis of HE.

Graphene ( GN) and multiwalled carbon nanotubes ( MWCNT) composites were coated on glassy carbon electrode ( GCE ) and then poly ( nicotinic acid ) ( PNA ) was electrodeposited on the modified electrode. The electrochemical behavior of pyridoxine hydrochloride ( VB6 ) was investigated at the modified electrode by cyclic voltammetry ( CV ) and differential pulse voltammetry ( DPV ) . Results showed the oxidation current of VB6 at the GN-MWCNT/PNA/GCE was obviously larger than that at GCE, PNA/GCE and GN/MWCNT/GCE. The oxidation process of VB6 was an irreversible diffusion-controlled process involving one electron and two protons. The liner range between the peak current intensity of DPV and the concentration of VB6 was 0 . 05-200 μmol/L with a detection limit of 0 . 02 μmol/L ( S/N=3 ) . The modified electrode showed a good reproducibility with a relative standard deviation of 3 . 1% ( n=8 ) . The proposed method was applied to the analysis of vitamin B6 in vitamin B6 tablets and compound vitamin B tablets with recoveries between 96 . 1%-104 . 5%.