[Objective]To summarize the clinical experience of Dr.QIU Shengliang in treating gastro-esophageal reflux disease(GERD)through regulating Qi dynamics,providing reference for traditional Chinese medicine(TCM)syndrome differentiation and treatment of this condition.[Methods]Through clinical apprenticeships and case analysis combined with classical text research,this paper elucidates the core pathogenesis of"Qi movement disorders"in GERD.It systematically presents Dr.QIU's diagnostic framework centering on regulating Qi dynamics,focusing on spleen-stomach-liver coordination while addressing phlegm-stasis complications.The treatment protocol features flexible herbal applications tailored to syndrome patterns,supported with a representative case study.[Results]Guided by the principle of harmonizing the flow of Qi,Dr.QIU's approach integrates three therapeutic strategies:strengthening the spleen and stomach,soothing liver Qi,and resolving phlegm and blood stasis.The subsequent follow-up revealed that the patient's symptoms were effectively relieved,with no recurrence,thereby validating this method.[Conclusion]Dr.QIU's treatment system emphasizes Qi dynamics regulation as the core principle for GERD management,focusing on visceral functional balance through multi-dimensional interventions encompassing herbal therapy,dietary regulation,emotional management and exercise guidance.This holistic approach demonstrates significant clinical efficacy while embodying TCM's characteristic holistic philosophy and syndrome differentiation principles,offering valuable insights for TCM management of GERD.

[Objective]To investigates the pathogenesis and clinical management of airway remodeling in chronic obstructive pulmonary disease(COPD)through the lens of mitochondrial functionality,based on the theoretical framework of"Xuanfu".[Methods]Through review of modern literature and classical Chinese medical ancient books it explores the link between mitochondrial dysfunction and COPD airway remodeling,examines how the"Xuanfu"theory relates to mitochondrial function in both physiological and pathological contexts,discusses the traditional Chinese medical(TCM)pathogenesis of COPD airway remodeling,summarizes treatment principles,and highlights contemporary studies supporting the role of TCM in modulating mitochondrial function.[Results]Mitochondrial dysfunction is crucial in COPD airway remodeling,with mechanisms and clinical manifestations aligning with"Xuanfu obstruction"and"lung collateral damage"in TCM.Based on the"Xuanfu"theory,the core pathogenesis can be described as"Xuanfu obstruction,lung collateral damage".The treatment should focus on utilizing pungent agents to disperse and ventilate,regulating Qi to open Xuanfu portals,expelling phlegm and resolving static blood,alleviating depression to free collateral vessels,reinforcing healthy Qi while eliminating pathogenic factors,strategically harmonizing unblocking with tonifying interventions.Contemporary studies indicate that intervention with traditional Chinese herbal formulas may repair pulmonary tissue damage and inhibit airway remodeling.These effects are mediated through mechanisms including the enhancement of mitochondrial energy metabolism and the promotion of mitophagy and mitochondrial biogenesis.These findings provide a modern scientific basis for the traditional pathogenesis of"Xuanfu obstruction,lung collateral damage"and its corresponding therapeutic principles in TCM.[Conclusion]The thesis propose mitochondrial dysfunction as the key pathophysiological link between the TCM mechanism of"Xuanfu obstruction,lung collateral damage"and airway remodeling in COPD.This framework establishes mitochondrial homeostasis as a core therapeutic target for TCM interventions,offering a novel basis for integrating traditional theory with modern cellular mechanisms in COPD diagnosis and treatment.

Objective To investigate the effects of low-dose ionizing radiation on the thyroid status and hormone levels of radiation workers. Methods Radiation workers who underwent occupational health examinations at a hospital in Guangzhou from 2015 to 2022 were selected as the subjects of this study. The levels of FT3, FT4 and TSH were analyzed, and the thyroid abnormality status of radiation workers in different groups were compared. Results A total of 1152 participants were included in this study, consisting of 885 (76.82%) males and 267 (23.18%) females, with an average age of (35.26 ± 10.16) years. The prevalence of thyroid abnormalities was 9.38%, which was significantly higher in females (13.86%) than in males (8.02%) (P < 0.05). The TSH level of females [(2.15 ± 1.29) mIU/L] was higher than that of males [(1.85 ± 1.20) mIU/L], while the levels of FT3 [(5.10 ± 0.64) pmol/L] and FT4 [(15.84 ± 2.32) pmol/L] in females were lower than those in males [(5.23 ± 0.63) pmol/L and (16.61 ± 2.75) pmol/L, P < 0.05]. The FT3 of industrial workers [(5.25 ± 0.63) pmol/L] was higher than that of medical workers [(5.10 ± 0.63) pmol/L], while the TSH of industrial workers [(1.80 ± 1.12) mIU/L] was lower than that of medical workers [(2.15 ± 1.37) mIU/L]. FT4 levels decreased with increasing age and duration of occupational exposure. Multivariable logistic regression analysis revealed that sex was a significant independent predictor of thyroid abnormalities among radiation workers. Female workers were more likely to experience thyroid abnormalities (β = −0.62, P < 0.05). Conclusion Low-dose ionizing radiation may have a certain impact on the thyroid status of radiation workers, especially for female workers, which requires further attention and research.

Objective:To develop a quality control model for anal sphincter ultrasound images and validate its diagnostic performance across multiple centers.Methods:A retrospective analysis was conducted on anal sphincter ultrasound images from seven medical centers in China between May 2019 and June 2022. A total of 7 040 images from 3 116 patients were included and divided into a training set（4 912 images）and a validation set（2 128 images）. The images were classified as standard or non-standard images by three experts. Three models were developed based on different image feature extraction methods：a single-branch model，a multi-branch weighted model，and a multi-branch ensemble model. The diagnostic performance of each model was evaluated using the area under the ROC curve（AUC），sensitivity，specificity，accuracy，positive predictive value，and negative predictive value，respectively. The optimal model was selected and compared with the performance of 4 doctors with varying experience levels. Sixty days later，the images with the assistance of the model's output were reassessed by the doctors to evaluate its impact on manual quality control.Results:① Among the 3 models，the multi-branch ensemble model demonstrated the highest AUC and sensitivity，with an AUC of 0.966（95% CI=0.958 - 0.974），a sensitivity of 91.83%，and a specificity of 91.41%. This model was named M quality. ② M quality's AUC was slightly lower than that of Senior A and B（0.966 vs. 0.976，0.976，and P<0.05），its sensitivity was slightly lower than that of Senior A（91.83% vs. 95.61%， P<0.001）but comparable to Senior B（91.83% vs. 92.89%， P=0.315），its specificity was slightly lower than Senior A and B（91.41% vs. 94.44%，98.18%，and P<0.05）. However，M quality significantly outperformed Junior A and B in AUC and sensitivity（AUC：0.966 vs. 0.850，0.818；sensitivity：91.83% vs. 84.90%，61.46%；all P<0.001），its specificity was higher than that of Junior A（91.41% vs. 80.28%， P<0.001）but lower than that of Junior B（91.41% vs. 95.96%， P<0.001）. ③ With model assistance，Senior B's sensitivity（92.89% vs. 94.20%， P=0.001）and Senior A's specificity（94.44% vs. 96.56%， P<0.001）improved significantly. Junior A and B showed significant improvements in AUC and sensitivity（AUC：0.931 vs. 0.850，0.914 vs. 0.818；sensitivity：91.83% vs. 84.90%，89.53% vs. 61.46%；all P<0.001）. After model assistance，Junior A's specificity increased（93.62% vs. 80.28%， P<0.001），while Junior B's specificity decreased（91.60% vs. 95.96%， P=0.013）. Conclusions:This study develops a quality control model for anal sphincter ultrasound images with robust diagnostic performance，approaching the level of seniors. The model significantly enhances the image quality assessment capabilities of juniors，demonstrating promising clinical application potential.

Objective To extract the core elements and connotation definitions of the concept of organizational resilience of County Medical Community (CMC),in order to explore effective ways to enhance the organizational resilience of CMC.Methods Based on the Atomic spectrum,as of October 31,2023,52 articles related to organizational resilience in the health system were included for concept images extraction,calculating the frequency and occurrence rate of concept images,extracting the concept of organizational resilience in the health system,and deducing the core elements and definitions of the concept of organizational resilience in CMC were derived through the comparison of similarities and differences.Results Although both the healthcare system and the CMC are composite organizations,there are differences in environmental pressure,organizational size,and resource reserves.The concept of organizational resilience of CMC is defined as the advanced process of resilience functions exhibited by CMC in response to emergencies,internal and external threats,and social pressures that constrain the sustainable development of the organization,including redundant preparation,stable recovery,and response to growth,as well as their ability to absorb,adapt,and transform disruptive events.This not only maintains the basic structure and functions of the organization,but also enables the organization to grow against the trend.Conclusion Breaking through the traditional hierarchical structure in terms of structural resilience,achieving a deep integration and coordination mechanism of the medical community horizontally and vertically.Breaking through traditional static planar functions in terms of functional resilience,enhancing the driving force within the medical community through dynamic growth mechanisms.

Lupus nephritis (LN) is the most common complication of systemic lupus erythematosus (SLE). The immune pathogenesis is closely related to the progression and clinical treatment of LN. This review reviews the relevant literature on the role of immune cells in the pathogenesis of LN at home and abroad. This paper summarized and analyzed the pathogenesis of immune cells in the pathogenesis of LN and the research progress of related targeted therapy, aiming to improve the understanding of the pathogenesis of immune cells in LN, improve the treatment status of LN and better improve the prognosis.

Objective To extract the core elements and connotation definitions of the concept of organizational resilience of County Medical Community (CMC),in order to explore effective ways to enhance the organizational resilience of CMC.Methods Based on the Atomic spectrum,as of October 31,2023,52 articles related to organizational resilience in the health system were included for concept images extraction,calculating the frequency and occurrence rate of concept images,extracting the concept of organizational resilience in the health system,and deducing the core elements and definitions of the concept of organizational resilience in CMC were derived through the comparison of similarities and differences.Results Although both the healthcare system and the CMC are composite organizations,there are differences in environmental pressure,organizational size,and resource reserves.The concept of organizational resilience of CMC is defined as the advanced process of resilience functions exhibited by CMC in response to emergencies,internal and external threats,and social pressures that constrain the sustainable development of the organization,including redundant preparation,stable recovery,and response to growth,as well as their ability to absorb,adapt,and transform disruptive events.This not only maintains the basic structure and functions of the organization,but also enables the organization to grow against the trend.Conclusion Breaking through the traditional hierarchical structure in terms of structural resilience,achieving a deep integration and coordination mechanism of the medical community horizontally and vertically.Breaking through traditional static planar functions in terms of functional resilience,enhancing the driving force within the medical community through dynamic growth mechanisms.

Lupus nephritis (LN) is the most common complication of systemic lupus erythematosus (SLE). The immune pathogenesis is closely related to the progression and clinical treatment of LN. This review reviews the relevant literature on the role of immune cells in the pathogenesis of LN at home and abroad. This paper summarized and analyzed the pathogenesis of immune cells in the pathogenesis of LN and the research progress of related targeted therapy, aiming to improve the understanding of the pathogenesis of immune cells in LN, improve the treatment status of LN and better improve the prognosis.

[Objective]To summarize the clinical experience of Dr.QIU Shengliang in treating gastro-esophageal reflux disease(GERD)through regulating Qi dynamics,providing reference for traditional Chinese medicine(TCM)syndrome differentiation and treatment of this condition.[Methods]Through clinical apprenticeships and case analysis combined with classical text research,this paper elucidates the core pathogenesis of"Qi movement disorders"in GERD.It systematically presents Dr.QIU's diagnostic framework centering on regulating Qi dynamics,focusing on spleen-stomach-liver coordination while addressing phlegm-stasis complications.The treatment protocol features flexible herbal applications tailored to syndrome patterns,supported with a representative case study.[Results]Guided by the principle of harmonizing the flow of Qi,Dr.QIU's approach integrates three therapeutic strategies:strengthening the spleen and stomach,soothing liver Qi,and resolving phlegm and blood stasis.The subsequent follow-up revealed that the patient's symptoms were effectively relieved,with no recurrence,thereby validating this method.[Conclusion]Dr.QIU's treatment system emphasizes Qi dynamics regulation as the core principle for GERD management,focusing on visceral functional balance through multi-dimensional interventions encompassing herbal therapy,dietary regulation,emotional management and exercise guidance.This holistic approach demonstrates significant clinical efficacy while embodying TCM's characteristic holistic philosophy and syndrome differentiation principles,offering valuable insights for TCM management of GERD.

[Objective]To investigates the pathogenesis and clinical management of airway remodeling in chronic obstructive pulmonary disease(COPD)through the lens of mitochondrial functionality,based on the theoretical framework of"Xuanfu".[Methods]Through review of modern literature and classical Chinese medical ancient books it explores the link between mitochondrial dysfunction and COPD airway remodeling,examines how the"Xuanfu"theory relates to mitochondrial function in both physiological and pathological contexts,discusses the traditional Chinese medical(TCM)pathogenesis of COPD airway remodeling,summarizes treatment principles,and highlights contemporary studies supporting the role of TCM in modulating mitochondrial function.[Results]Mitochondrial dysfunction is crucial in COPD airway remodeling,with mechanisms and clinical manifestations aligning with"Xuanfu obstruction"and"lung collateral damage"in TCM.Based on the"Xuanfu"theory,the core pathogenesis can be described as"Xuanfu obstruction,lung collateral damage".The treatment should focus on utilizing pungent agents to disperse and ventilate,regulating Qi to open Xuanfu portals,expelling phlegm and resolving static blood,alleviating depression to free collateral vessels,reinforcing healthy Qi while eliminating pathogenic factors,strategically harmonizing unblocking with tonifying interventions.Contemporary studies indicate that intervention with traditional Chinese herbal formulas may repair pulmonary tissue damage and inhibit airway remodeling.These effects are mediated through mechanisms including the enhancement of mitochondrial energy metabolism and the promotion of mitophagy and mitochondrial biogenesis.These findings provide a modern scientific basis for the traditional pathogenesis of"Xuanfu obstruction,lung collateral damage"and its corresponding therapeutic principles in TCM.[Conclusion]The thesis propose mitochondrial dysfunction as the key pathophysiological link between the TCM mechanism of"Xuanfu obstruction,lung collateral damage"and airway remodeling in COPD.This framework establishes mitochondrial homeostasis as a core therapeutic target for TCM interventions,offering a novel basis for integrating traditional theory with modern cellular mechanisms in COPD diagnosis and treatment.