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 To explore the value of coronary fat attenuation index(FAI)combined with laboratory indicators in predicting the risk of acute coronary syndrome(ACS)in patients with coronary heart disease(CHD).Methods A retrospective analysis was conducted on 454 patients who were diagnosed with CHD in Guangdong Provincial People's Hospital SCAD group(n=233)and an ACS group(n=221).Univariate and multivariate Logistic regression analyses were performed on the FAI values of the main coronary branches[right coronary artery(RCA),left anterior descending branch(LAD),left circumflex branch(LCX)],laboratory indicators,and clinical data,to identify independent risk factors for ACS in CHD patients.Receiver operating characteristic curves were constructed,and area under the curve(AUC)was calculated to evaluate the predictive performance of the independent risk factors and their combinations.Results LAD-FAI,RCA-FAI,and high-sensitivity C-reactive protein(hs-CRP)were independent influencing factors for ACS in CHD patients.The AUC for the prediction of ACS occurrence in CHD patients based on LAD-FAI,RCA-FAI,and elevated hs-CRP values alone were 0.568,0.703,and 0.749,respectively.When these three factors were analyzed in combination,the AUC was 0.815.Conclusion The combined analysis of LAD-FAI,RCA-FAI,and hs-CRP has good predictive performance for assessing the risk of ACS in CHD patients.

Objective To understand the distribution of HIV-1 subtype in Wuxi city,to predict the local HIV-1 epidemics.Methods Samples were collected from the'CD4+T lymphocyte monitoring cohort study'in Wuxi from April 2013 to July 2016.HIV-1 gene was amplified,sequenced and with HIV-1 sequence database constructed,using both the ChromasPro 1.6 and MEGA 7.0 softwares.Bayesian phylogenetic inference was used to rebuild the history of HIV-1 transmission,while BEAST 1.7.2 and FastTree 2.1.10 software were used for data analysis.Statistical analysis using SPSS 22.0 software.Results Among the 205 subjects of HIV-1 infection,32.68％(67/205) of them were over 50 years old.Seven subtypes (including CRF01_AE,CRF07_BC,CRF67_01B,B,CRF08_BC,CRF68_0B,CRF78_cpx) and one of the unique recombinant forms (URFs) were detected.The main subtypes were CRF01_ AE (51.67％,93/180) and CRF07_BC (17.22％,31/180).Differences between subtypes and ways of transmission were statistically significant (x2=16.99,P≤0.05).The proportion of CRF67_01B (12.78％,23/180) was higher than before.Results from Bayesian phylogenetic inference analysis showed that the evolution rate was 2.29 × 10-3 and Time to the Most Recent Common Ancestor (tMRCA) was 2 003.10.CRF67_01B was probably related to the reference strains from Jiangsu and Anhui provinces,and had been spreading in Wuxi since 2003.Conclusions HIV-1 subtypes seemed complex and diverse in Wuxi city in 2013-2016,with CRF67_01B being pervasive.Continuous molecular monitor program was still needed to provide reference for the prediction of epidemics,from the molecular perspective.

Objective: To assess the prevalence and related factors of HIV infection among male clients of the female sex workers in Hekou Yao autonomous county of Honghe Hani Yi autonomous prefecture (Hekou county) in Yunnan province in China, 2014-2015. Methods: Serial cross-sectional survey was conducted during June 2014 to November 2015. Convenience sampling methods were used to recruit the male clients for this study. Self-reported information on social-demographic characteristics, with sexual and drug behavior patterns, was gathered. Both blood and urine samples were collected for HIV, with for opiate testing. Multivariate logistic regression and Exhaustive CHAID method were used to determine the correlated factors associated with HIV infection. Statistical analysis was used by SPSS 22.0 software and Clementine 12.0 software. Results: The overall HIV prevalence of male clients was 2.06% (16/776). Male clients who keep using condom with female sex worker was estimated as 68.81% (534/776). The last commercial sexual partner of Vietnamese male clients was all Vietnamese female sex workers. Compared with Chinese male clients, Vietnamese male clients have a higher rate of morphine positive. Factors as: age ≥50 years vs. age <30 years (OR=8.11, 95%CI: 1.26-52.16) and testing for morphine positive vs. morphine negative (OR=7.35, 95%CI: 1.42-38.06) were significantly associated with HIV infection through multiple logistic regression analysis. Through Exhaustive CHAID, it confirmed that age was the primary factor that associated with HIV infection of male clients. Conclusions Relationship between morphine and HIV infection indicated that HIV prevalence of male clients in Hekou county was influenced by the combined effect of both illegal drug use and commercial sexual behavior. Special attention should be paid to male clients over 50 years of age, on HIV intervention.

Objective? To investigate the nutritional risk status and nutritional support status of stroke patients during hospitalization so as to provide appropriate post-disease nutritional support for stroke patients and to avoid the risk of malnutrition. Methods? A total of 93 stroke patients admitted in a Class III Grade A hospital in Harbin from December 1st 2017 to September 1st 2017 were selected as the research objects in this study. Traditional evaluation method and comprehensive evaluation method were adopted to investigate and analyze the stroke patients' nutritional risk status, incidence of malnutrition and nutritional support status, and to understand the stroke patients' risk factors for malnutrition and status of getting nutritional support. Results? In 93 stroke patients,14.0% (13/93) patients had varying degrees of malnutrition; the proportion of malnutrition risk was 36.56%(34/93). Upon discharge, the handgrip strength, calf circumference and upper arm circumference were lower than those at admission and the differences were statistically significant (P＜0.05);the stroke inpatients receiving nutritional support accounted for 11.83%. Conclusions? The risk of malnutrition in patients post-stroke is high and the proportion of them who receive nutritional support is low, their nutritional status should be paid more attention to.

OBJECTIVETo find a rational way in early detecting the residual tumor in patients with nasopharyngeal carcinoma (NPC) after radiotherapy.

METHODSA total of 47 NPC patients who were diagnosed residual tumor after radiotherapy and treated in our hospital from Dec 2009 to Aug 2012 were included in this study and their clinicopathological and follow-up data were reviewed and analyzed. The patients were checked by nasopharynx MRI, FDG PET-CT and were examined by biopsy of the residual tumors within two weeks after radiotherapy. The diagnosis of relapses was determined by pathological re-examination.

RESULTSAll the 47 patients were followed up for 10-42 months. Three of them had nasopharynx relapse. The others had not tumor relapse and their residual tumors disappeared completely. The specificity of MRI, FDG PET-CT and pathological tumor response in diagnosing residual tumors were 9.1%, 77.3%, and 95.5% (P<0.001). Their accuracy rates were 14.9%, 78.9%, and 95.7%, respectively (P<0.001). The M of SUVmax in the team who had moderate and severe pathologic tumor response (team A) was 3.05 and that in the team who had mild pathologic tumor response (team B) was 4.68 (P=0.012). None of patients in the team A had nasopharynx relapse. Three patients in the team B who had SUVmax ≥4 had nasopharynx relapses, and in other 2 patients who had SUVmax <4, the residual tumors disappeared during the following-up. The specificity and accuracy in diagnosing residual tumors were increased when mild pathologic tumor response combined with SUVmax4 were used.

CONCLUSIONPET-CT combined with pathologic tumor response is beneficial for early diagnosis of residual nasopharyngeal tumors after radiotherapy.

Carcinoma ; Fluorodeoxyglucose F18 ; Humans ; Magnetic Resonance Imaging ; Nasopharyngeal Neoplasms ; diagnosis ; diagnostic imaging ; radiotherapy ; Neoplasm Recurrence, Local ; Neoplasm, Residual ; diagnosis ; diagnostic imaging ; radiotherapy ; Positron-Emission Tomography ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Objective To investigate the infection status of Mycoplasma pirum among male HIV/AIDS patients in Jiangsu and analyze the risk factors.The genome sequencing of Mycoplasma pirum was completed for the first time.Methods Male HIV infected individuals and AIDS patients confirmed in Jiangsu province were enrolled for 4 repeated cross-sectional studies by means of detecting the first flow urine sample and venous blood sample collected and questionnaire survey after informed consent.Genome sequencing was conducted for Mycoplasma pirum by using Illumina Hiseq 2000 sequencing platform.Results A total of 1 541 HIV/AIDS patients were surveyed in this study.The infection rates of Mycoplasma pirurm was 15.4％.The patients who received no HAART had higher risk to be infected with Mycoplasma pirum (OR=1.344,95％CI:1.008-1.792).Otherwise,high CD4+T counts was a protective factor for Mycoplasma pirum infection (OR=0.600,95％CI:0.444-0.810).Based on the sequencing result,the genome size of Mycoplasma pirum was 850 704 bp,the GC content was 24.21％ the genome contained 708 genes,the total length of genes was 734 085 bp,the average length was 1 037 bp,accounting for 86.29％ of genome.Conclusion More attention should be paid to the high infection rate of Mycoplasma pirum among male HIV/AIDS patients in the future AIDS prevention and control.The first genome sequencing of standard Mycoplasma pirum strain was completed in this study (registering Serial number:AZHZ00000001),which can provide evidence for the further research of gene function and pathogenic mechanism of Mycoplasma pirum.

Objective To find a rational way in early detecting the residual tumor in patients with nasopharyngeal carcinoma ( NPC ) after radiotherapy.Methods A total of 47 NPC patients who were diagnosed residual tumor after radiotherapy and treated in our hospital from Dec 2009 to Aug 2012 were included in this study and their clinicopathological and follow-up data were reviewed and analyzed.The patients were checked by nasopharynx MRI, FDG PET-CT and were examined by biopsy of the residual tumors within two weeks after radiotherapy.The diagnosis of relapses was determined by pathological re-examination.Results All the 47 patients were followed up for 10-42 months.Three of them had nasopharynx relapse.The others had not tumor relapse and their residual tumors disappeared completely. The specificity of MRI, FDG PET-CT and pathological tumor response in diagnosing residual tumors were 9.1%,77.3%, and 95.5%( P <0.001).Their accuracy rates were 14.9%,78.9%, and 95.7%, respectively (P<0.001).The M of SUVmax in the team who had moderate and severe pathologic tumor response (team A) was 3.05 and that in the team who had mild pathologic tumor response (team B) was 4.68(P=0.012).None of patients in the team A had nasopharynx relapse.Three patients in the team B who had SUVmax≥4 had nasopharynx relapses, and in other 2 patients who had SUVmax <4, the residual tumors disappeared during the following-up.The specificity and accuracy in diagnosing residual tumors were increased when mild pathologic tumor response combined with SUVmax4 were used.Conclusion PET-CT combined with pathologic tumor response is beneficial for early diagnosis of residual nasopharyngeal tumors after radiotherapy.

Objective To find a rational way in early detecting the residual tumor in patients with nasopharyngeal carcinoma ( NPC ) after radiotherapy.Methods A total of 47 NPC patients who were diagnosed residual tumor after radiotherapy and treated in our hospital from Dec 2009 to Aug 2012 were included in this study and their clinicopathological and follow-up data were reviewed and analyzed.The patients were checked by nasopharynx MRI, FDG PET-CT and were examined by biopsy of the residual tumors within two weeks after radiotherapy.The diagnosis of relapses was determined by pathological re-examination.Results All the 47 patients were followed up for 10-42 months.Three of them had nasopharynx relapse.The others had not tumor relapse and their residual tumors disappeared completely. The specificity of MRI, FDG PET-CT and pathological tumor response in diagnosing residual tumors were 9.1%,77.3%, and 95.5%( P <0.001).Their accuracy rates were 14.9%,78.9%, and 95.7%, respectively (P<0.001).The M of SUVmax in the team who had moderate and severe pathologic tumor response (team A) was 3.05 and that in the team who had mild pathologic tumor response (team B) was 4.68(P=0.012).None of patients in the team A had nasopharynx relapse.Three patients in the team B who had SUVmax≥4 had nasopharynx relapses, and in other 2 patients who had SUVmax <4, the residual tumors disappeared during the following-up.The specificity and accuracy in diagnosing residual tumors were increased when mild pathologic tumor response combined with SUVmax4 were used.Conclusion PET-CT combined with pathologic tumor response is beneficial for early diagnosis of residual nasopharyngeal tumors after radiotherapy.

BACKGROUND:It is reported that tailless-like protein (TLX) plays critical roles in the regulation of early developmental processes in vertebrates, and it plays a key role in stem cells proliferation and differentiation into neurons. OBJECTIVE: To construct recombinant plasmid pEGFPN1-TLX and study the transfection into dermal multipotential stem cells. DESIGN, TIME AND SETTING: Cytogene experiment was performed at the Department of Pathogen Biology, School of Basic Medical Science, the Third Military Medical University of Chinese PLA from March to December 2007. MATERIALS: An adult SD was obtained from the Experimental Animal Center of the Third Military Medical University of Chinese PLA; dermal moltipotential stem cells (DMSCs) were cultured by the Institute of Combined Injury of the Third Military Medical University of Chinese PLA; pEGFPN1 and DH5α was gifted by professor Xu.METHODS: Total RNA was extracted from rat brain tissue to amplify TLX-coded cDNA sequence using RT-PCR. T/A was cloned on pMD18-T vector and determined using BamHI and Hindlll. The products were positive recombinant plasmid pMD18-T-TLX segments, which were sub-cloned in pEGFPN1 to construct recombinant plasmid pEGFPN1-TLX. Finally, pEGFPN1-TLX was transfected into DMSCs.MAIN OUTCOME MEASURES: The fluorescence protein expression was observed under fluorescence microscope at 24 hours after transfection; TLX mRNA expression was detected using RT-PCR; neuronal differentiation was observed using immunohistochemical staining.RESULTS: TLX full length cDNA was successfully cloned into pEGFPN1, and pEGFPN1-TLX was successfully constructed by means of sequence analysis and enzyme cutting identification. As compared with non-transfected DMSCs, pEGFPN1-TLX transfected DMSCs were observed after 10 days, formed resistant clones after 15 days, and shown a green fluorescent protein expression. However, non-transfected DMSCs died at day 10. RT-PCR indicated that pEGFPN1-TLX transfected DMSCs could express TLX mRNA. At day 3 after induction, NF200 positive cells were increased, but glial fibrillary acidic protein positive cells were decreased after induction of pEGFPN1-TLX transfected DMSCs.CONCLUSION: TLX was successfully constructed and transfected into DMSCs. After transfection, neuronal differentiation of DMSCs was enhanced, and the differentiation to gliocytes was inhibited.