Huang Yuanyu, a famous TCM doctor in the Qing Dynasty, believed that the human body's qi system revolves around the spleen and stomach as the pivot, with the liver, heart, lungs, and kidneys as the four major organs, and the circulation is constant. TCM guided therapy regulates qi and blood by regulating the body, heart, and breath, which is in line with this theory. Based on Huang Yuanyu's "pivot movement" theory, this article explored the application of guided therapy in refractory gastroesophageal reflux disease (rGERD). Guided by the "pivot movement" theory, which includes the left path wood fire rising and falling, the right path gold water converging and falling, and the adjustment of the focal point through the mediation of earth and qi, and referring to the guidance movement methods in the Ba Duan Jin and Zhu Bing Yuan Hou Lun, a "pivot guidance method" for rGERD patients is developed, five movements: adjusting the body and heart, turning the waist and benefiting the kidneys, including rubbing the abdomen and regulating the spleen, soothing the liver and bending the knees, and tightening the lungs and reducing reflux. The aim is to promote smooth circulation of qi throughout the body and improve symptoms of gastroesophageal reflux. In clinical practice, guided therapy should be applied under the guidance of a doctor, with slow and gentle movements, attention to regulating breathing, and long-term persistence.

Objective To investigate the safety and prognostic analysis of surgical resection after conversion therapy and downgrad-ing of initial unresectable advanced hepatocellular carcinoma.Methods Clinical data was retrospectivly collected from 53 unresectable advanced hepatocellular carcinoma patients who received combined treatment with tyrosine kinase inhibitor(TKI)and programmed death-1(PD-1)inhibitors in the Affiliated Hospital of Xuzhou Medical University from January 2019 to December 2021.Tumor re-sponse and resectability were evaluated through modified response evaluation criteria in solid tumors(mRECIST).Emphasis was placed on analyzing the clinical characteristics,effects of conversion therapy,adverse drug reactions,surgical outcomes,postoperative complica-tions and survival of patients undergoing surgical resection,in order to evaluate surgical safety and prognosis.Results Among 53 patients with initially unresectable advanced liver cancer,12 patients(22.6％)underwent R0 resection surgery within 101(92,153)days after the start of combination therapy.At the initial examination,the median maximum tumor diameter of these 12 patients was 8.2(4.7,10.3)cm,and 6 patients of them were in CNLC Ⅲ a stage;4 patients were in CNLC Ⅲ b stage,including 3 patients of retroperitoneal lymph node metastasis and 1 patient of left adrenal metastasis.Preoperative evaluation:2 patients showed complete remission,9 patients showed partial remission,and 1 patient showed stable disease.There were 3 patients of postoperative complications of grade Ⅱ or above.The cumulative postoperative survival rates at 6months,1 year,and 2 years were 100.0％,91.7％,and 66.7％,respectively.The re-currence-free survival rates at 6months,1 year,and 2 years were 91.7％,66.7％,and 50.0％,respectively.Conclusion After full preoperative evaluation,surgical resection is safe and effective for the initial unresectable advanced liver cancer after conversion therapy and downgrading.

Objective To investigate the safety and prognostic analysis of surgical resection after conversion therapy and downgrad-ing of initial unresectable advanced hepatocellular carcinoma.Methods Clinical data was retrospectivly collected from 53 unresectable advanced hepatocellular carcinoma patients who received combined treatment with tyrosine kinase inhibitor(TKI)and programmed death-1(PD-1)inhibitors in the Affiliated Hospital of Xuzhou Medical University from January 2019 to December 2021.Tumor re-sponse and resectability were evaluated through modified response evaluation criteria in solid tumors(mRECIST).Emphasis was placed on analyzing the clinical characteristics,effects of conversion therapy,adverse drug reactions,surgical outcomes,postoperative complica-tions and survival of patients undergoing surgical resection,in order to evaluate surgical safety and prognosis.Results Among 53 patients with initially unresectable advanced liver cancer,12 patients(22.6％)underwent R0 resection surgery within 101(92,153)days after the start of combination therapy.At the initial examination,the median maximum tumor diameter of these 12 patients was 8.2(4.7,10.3)cm,and 6 patients of them were in CNLC Ⅲ a stage;4 patients were in CNLC Ⅲ b stage,including 3 patients of retroperitoneal lymph node metastasis and 1 patient of left adrenal metastasis.Preoperative evaluation:2 patients showed complete remission,9 patients showed partial remission,and 1 patient showed stable disease.There were 3 patients of postoperative complications of grade Ⅱ or above.The cumulative postoperative survival rates at 6months,1 year,and 2 years were 100.0％,91.7％,and 66.7％,respectively.The re-currence-free survival rates at 6months,1 year,and 2 years were 91.7％,66.7％,and 50.0％,respectively.Conclusion After full preoperative evaluation,surgical resection is safe and effective for the initial unresectable advanced liver cancer after conversion therapy and downgrading.

Traditional Chinese Medicine (TCM) non-drug therapy for gastroesophageal reflux mainly includes appropriate TCM techniques, such as conventional acupuncture, moxibustion, fire needle, etc. Emotional therapy, such as regulating emotion, transforming the patient's spirit and change the state of qi, the five-element music therapy, etc; exercise therapy, such as Baduanjin and Zhanzhuang, can be used alone, or in combination, or in combination with oral administration of Chinese materia medica. By reducing the probability of esophageal sphincter relaxation, inhibiting gastric acid secretion, improving esophageal motility disorder, reducing visceral hypersensitivity, immune regulation and other effects, it can alleviate the symptoms of acid reflux, heartburn and pharyngeal discomfort, and help to improve the patients' anxiety, depression and other negative emotions. It has the characteristics of simplicity and fewer adverse reactions, at the same time, according to the patient's condition and compliance to choose the appropriate therapy. The mechanism of TCM non-drug therapy in the treatment of this disease needs to be further explored, so as to better guide clinical popularization and application.

Objective: To apply DNA barcoding to identifying the rodents in Zhejiang Province. Methods : Rodents were captured from Jiashan,Longyou,Yunhe and Ninghai counties in Zhejiang Province. The DNA was extracted from ears of rodent samples,and was amplified and sequenced with mitochondrial cytochrome C oxidase subunit I（COI）genes. The obtained sequences were compared with the related sequences in GenBank,and neighbour-joining evolutionary tree was constructed. Then the results by DNA barcoding and by morphological identification were compared. Results : A total of 22 COI gene samples were amplified. The evolutionary tree constructed by 18 samples was consistent with the morphological identification results and 4 samples were different：Suncus murinus should be Crocidura lasiura,infant rats of Rattus losea and Rattus tanezumi was re-identified as Rattus rattus,infant rats of Microtus fortis（sample number：NH-1）needs further identification. Conclusion DNA barcoding can effectively correct the errors of morphological identification,thus combining the two methods could improve the accuracy of rodent identification.