Irritable bowel syndrome （IBS） is a functional bowel disorder characterized primarily by abdominal pain and altered defecation habits. In recent years， traditional Chinese medicine （TCM） has made progress in multiple aspects of IBS research and treatment， including syndrome distribution， development of TCM formulas， clinical efficacy evaluation， external therapies， and psychosocial regulation. However， it still faces challenges such as over-reliance on symptomatic manifestations rather than biomarkers for diagnostic criteria， and the lack of high-quality evidence-based data supporting the efficacy of TCM formulas in treating IBS. This paper proposed that TCM diagnosis and treatment of IBS should adhere to the strategy of integrating the holistic concept with syndrome differentiation and treatment， combining TCM external therapies such as acupuncture， moxibustion and acupoint application）， and emphasizing individualized diagnosis and treatment for psychosomatic abnormalities. Future research should integrate multi-omics technologies， artificial intelligence and other methods to deepen the understanding of the pathogenesis of IBS and the mechanisms of TCM formulas， so as to promote the standardization and internationalization of TCM in the diagnosis and treatment of IBS.

Background and purpose:Human papilloma virus(HPV)infection status is crucial for diagnosing cervical precancerous lesions and classifying cervical cancer.High-risk(HR)HPV is often linked to P16 protein overexpression,so P16 detection via immunohistochemistry(IHC)is commonly used to assess HPV infection.However,the differences between HPV status and P16 expression remains unclear.An in-depth study of the correlation between HPV and P16 is essential for clinical guidance.Methods:We retrospectively collected clinical and pathological data of cervical lesions from 618 patients diagnosed at the Department of Pathology,Fudan University Shanghai Cancer Center from January 2020 to December 2023(Ethical number:050432-4-2307E).Polymerase chain reaction(PCR)reverse dot hybridization was used to detect HPV including HR and low-risk(LR)subtypes,and immunohistochemistry was used to detect P16 for comparative analysis.Based on different clinical and pathological diagnoses,the sensitivity and specificity of P16 expression in evaluating HPV infection were evaluated.Among the 618 cases of cervical lesions,there were 92 cases of cervical squamous cell carcinoma,257 cases of cervical adenocarcinoma,79 cases of high-grade squamous intraepithelial lesions(HSIL),105 cases of low-grade squamous intraepithelial lesions(LSIL),and 85 cases of chronic cervical inflammation.Results:According to clinical diagnosis,the HR-HPV positive rate in cervical squamous cell carcinoma was 88.0%(81/92),the P16 positive rate was 91.3%(84/92),and the overall consistency rate between P16 and HPV detection was 90.2%(88/92);for HR-HPV infection,the sensitivity and specificity of P16 were 96.3%and 45.5%.The positive rate of HR-HPV in adenocarcinoma was 54.5%(140/257),the positive rate of P16 was 58.8%(151/257),and the overall consistency rate between P16 and HPV detection was 82.5%(212/257);for HR-HPV infection,the sensitivity and specificity of P16 were 87.9%and 76.1%.In HSIL,the HR-HPV positive rate was 75.9%(60/79),the positive rate of P16 was 70.9%(56/79),and the overall consistency rate between P16 and HR-HPV detection was 82.2%(65/79);for HR-HPV infection,the sensitivity and specificity of P16 were 85.0%and 73.7%.In LSIL,the HR-HPV positive rate was 73.3%(77/105),the positive rate of P16 was 8.5%(9/105),and the overall consistency rate between P16 and HR-HPV detection was 33.3%(35/105);for HR-HPV infection,the sensitivity and specificity of P16 were 10.4%and 96.4%.In chronic cervical inflammation,the HR-HPV positive rate was 20%(17/85),the positive rate of P16 was 0.0%(0/85);for HR-HPV infection,the sensitivity and specificity of P16 were 0.0%and 100.0%.There was a significant positive correlation between P16 positivity and HPV16/18 in cervical squamous cell carcinoma,adenocarcinoma,and HSIL(P=0.000),while there was no significant correlation in LSIL and chronic cervical inflammation(P＞0.05).Conclusion:In cervical squamous cell carcinoma and adenocarcinoma,the consistency of P16 expression and HPV DNA positivity are high,especially in HPV16/18 subtype.There is a good concordance between HR-HPV positivity and P16 protein overexpression.The positive expression of P16 in HSIL may initially reflect HPV infection status.However,in LSIL and chronic cervicitis,P16 expression may not accurately correlate with HPV infection.The inconsistency between P16 and HPV DNA testing could be influenced by multiple factors,including HPV subtypes,histopathological categories,specimen quality,and technical limitations.In clinical practice,it is recommended to conduct comprehensive analysis or employ multiple diagnostic methods to confirm HPV infection status for precise evaluation.

Objective:Accelerating the cultivation and development of new quality productive forces is an inherent requirement for the coordinated development of health care industry and economic society in the new era.Methods:Based on the technology-organization-environment framework,it explores the complex causal mechanism of multi-factor synergy affecting the allocation of medical resources and the coordinated development of economy and society driven by new quality productive forces.By constructing the"time+space"two-dimensional dynamic coupling coordination degree model and grey prediction model,the specific improvement path of the allocation of medical resources and the coordinated development of economy and society in the"13th Five-Year Plan","14th Five-Year Plan"and"15th Five-Year Plan"periods are explored from the perspective of configuration.Results:During the period from the"13th Five-Year Plan"to the"15th Five-Year Plan",the degree of coordination between medical resource allocation and economic and social coupling 31 provinces(cities)generally showed an upward trend,but there were large regional disparities.From the grouping results,it can be seen that the grouping path of the coordinated development of medical resource allocation and economy and society in the"13th Five-Year Plan"and"14th Five-Year Plan"periods shows significant differences.It is expected that technology-organization-driven,technology-environment-driven and organization-environment-driven paths will be formed in the"15th Five-Year Plan"period.Conclusion:It is necessary to accelerate the formation of the agglomeration advantage of technology and talent factors,appropriately increase the financial support for the western region,and achieve coordinated development of regional integration.

Objective:To explore the temporal characteristics,spatial effects,spatial correlation patterns and dynamic evolution laws of the coordinated development of medical resource allocation and economic society in China from 2010 to 2021,and to provide scientific references for promoting the coordinated and orderly development of medical and health services and economic society.Methods:The coupling coordination theory is introduced to construct a"time+space"dual-dimensional dynamic coupling coordination degree model,and the spatial correlation analysis method is used to analyze the spatial and temporal evolution characteristics of China's medical resource allocation and economic and social coupling coordination level from 2010 to 2021.On this basis,the grey prediction model is used to dynamically predict the future development and changes of the coupling coordination level of 31 provinces from 2024 to 2028.Results:From 2010 to 2021,the level of coupling and coordination between medical resource allocation and economic and social development has been steadily increased,but the overall coordination level is low,the regional gap is large,and the benign resonance coupling and coordinated and orderly development have not been fully realized;there is a significant spatial positive correlation and spatial agglomeration effect between the allocation of medical resources and the level of economic and social coupling and coordination,mainly based on the spatial correlation mode of high-high agglomeration and low-low agglomeration.From 2024 to 2028,the gap of interregional coupling coordination level will be narrowed,and the western region will still be in the stage of imbalance.Conclusion:We should focus on regional geospatial differences,improve the cross-regional multilateral coordinated development mechanism,promote mutual assistance and sharing of medical resources,technology,capital and management experience,establish and improve the investment mechanism suitable for the level of economic and social development,and promote the coordinated and orderly development of medical and health undertakings and economic society.

Objective:To evaluate the technical feasibility and perioperative safety of pyeloplasty assis-ted by the CarinaTM modular laparoscopic surgical robotic system in patients with ureteropelvic junction obstruction(UPJO).Methods:From November to December 2024,five consecutive patients diagnosed with UPJO underwent robot-assisted pyeloplasty using the CarinaTM modular laparoscopic surgical system at Peking University First Hospital.Data on patient demographics,intraoperative parameters(including docking time,console time,and estimated blood loss),perioperative outcomes,follow-up results,and surgeons' subjective evaluations of system performance were prospectively collected.Descriptive statistics were used;continuous variables were presented as median(range),and categorical variables as frequen-cy and percentage.Results:The cohort included four females and one male.All the patients successfully completed the robotic procedure without conversion to open or conventional laparoscopic surgery.The me-dian age was 32 years(24-37 years),and the median body mass index was 21.6 kg/m2(15.8-27.3 kg/m2).The median docking time was 8 min(3-12 min),and the median console time was 91 min(71-125 min).Intraoperative blood loss was uniformly 20 mL.The median postoperative drainage du-ration was 3 d(0-4 d),and the median length of hospital stay was 4 d(4-9 d).No Clavien-Dindo grade Ⅲ or higher complications occurred.All the patients had their double-J stents removed at 2 months postoperatively,and pain in the ipsilateral flank,reported preoperatively by all the five patients,was al-leviated.The subjective surgical success rate was 100％.Surgeons reported stable system performance throughout all the procedures,with no instances of mechanical arm interference or visual drift affecting surgical fluency.Conclusion:Preliminary findings indicate that pyeloplasty using the domestically deve-loped CarinaTM modular laparoscopic robotic system is technically feasible and perioperatively safe for the treatment of UPJO.

Objective:To summarize the surgical strategies and to evaluate the clinical outcomes of up-per urinary tract reconstruction in patients with stone-related ureteral strictures.Methods:This retro-spective study included 71 patients diagnosed with ureteral strictures secondary to urinary stones who un-derwent upper urinary tract reconstructive surgery at Peking University First Hospital between March 2014 and November 2023.Patient data were collected,including demographic characteristics,clinical presen-tation,laboratory results,imaging findings,surgical procedures,and follow-up outcomes.Ureteral stric-tures were classified according to anatomical location into upper,middle,lower,or multiple segments.Surgical procedures were carried out depending on the stricture characteristics.Surgical success was de-fined as resolution or improvement of clinical symptoms,radiographic improvement or stabilization of hy-dronephrosis,and maintenance of normal and stable renal function.Results:Among the 71 patients,36(50.7％)had strictures in the upper ureter,9(12.7％)in the middle ureter,15(21.1％)in the lower ureter,and 11(15.5％)had multifocal ureteral strictures.The median stricture length was 5.0 cm(interquartile range:3.0-15.0 cm).Surgical approach selection was individualized based on the location and extent of the stricture.For upper ureteral strictures,the most frequently employed techniques were oral mucosal graft ureteroplasty(13/36,36.1％)and appendiceal flap ureteroplasty(8/36,22.2％).Other options included ureteroureterostomy and ileal ureter replacement for longer or more complex strictures.In middle ureteral strictures,treatment was stratified by length:balloon dilation(1/9,11.1％)and ureteroureterostomy(1/9,11.1％)were applied in shorter strictures,while oral mucosal graft ureteroplasty(3/9,33.3％)and ileal ureter replacement(4/9,44.4％)were reserved for longer segments.For lower ureteral strictures,ureteral reimplantation into the bladder was the most common approach(10/15,66.7％),often combined with a psoas hitch or Boari flap when necessary.All the patients with multiple segmental strictures underwent ileal ureter replacement due to the extensive nature of the disease.The median follow-up period was 14.2 months(range:6.1-107.1 months).During follow-up,69 of 71 patients(97.2％)achieved surgical success.Conclusion:Stone-related ure-teral strictures present with considerable heterogeneity in terms of anatomical location,length,and com-plexity.Careful preoperative evaluation and individualized surgical planning are critical to successful re-construction.With appropriate selection of surgical methods,favorable long-term clinical outcomes can be achieved in the majority of patients.

Objective:Accelerating the cultivation and development of new quality productive forces is an inherent requirement for the coordinated development of health care industry and economic society in the new era.Methods:Based on the technology-organization-environment framework,it explores the complex causal mechanism of multi-factor synergy affecting the allocation of medical resources and the coordinated development of economy and society driven by new quality productive forces.By constructing the"time+space"two-dimensional dynamic coupling coordination degree model and grey prediction model,the specific improvement path of the allocation of medical resources and the coordinated development of economy and society in the"13th Five-Year Plan","14th Five-Year Plan"and"15th Five-Year Plan"periods are explored from the perspective of configuration.Results:During the period from the"13th Five-Year Plan"to the"15th Five-Year Plan",the degree of coordination between medical resource allocation and economic and social coupling 31 provinces(cities)generally showed an upward trend,but there were large regional disparities.From the grouping results,it can be seen that the grouping path of the coordinated development of medical resource allocation and economy and society in the"13th Five-Year Plan"and"14th Five-Year Plan"periods shows significant differences.It is expected that technology-organization-driven,technology-environment-driven and organization-environment-driven paths will be formed in the"15th Five-Year Plan"period.Conclusion:It is necessary to accelerate the formation of the agglomeration advantage of technology and talent factors,appropriately increase the financial support for the western region,and achieve coordinated development of regional integration.

The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

Objective To investigate the clinical features and genetic characteristics of West syndrome(WS)caused by CLCN6 mutations.Methods A case of WS caused by CLCN6 mutations was reported.And the literatures were reviewed.The clinical features and gene mutation characteristics of CLCN6 associated WS were analyzed.Results This patient,a male,presented with symptoms at 7 months of age,and exhibited clinical features including spasms,developmental delay,and high-amplitude disorganized of EEG.At 11 months of age,a combination of topiramate and clonazepam controlled the seizures.By 1-year-old,the EEG normalized,and at 39 months of age,the patient discontinued medication without experiencing further seizures;however,language development remained delayed.Whole exome sequencing identified a de novo missense mutation in CLCN6(c.761T＞C,p.F54S),which was highly conserved.Multiple online prediction tools classified this mutation as deleterious.According to the guidelines of the American college of medical genetics and genomics,this variant was classified as likely pathogenic(PS2+PM2+PP3).A literature review included three cases(including this one).Clinical features included spasms(3/3,with 2 cases evolved into tonic-clonic and myoclonic seizures),intellectual or global developmental delay(3/3),behavioral disorders(1/3),sleep disorders(1/3),visual impairment(1/3),microcephaly(2/3),high-amplitude disorganized of EEG(3/3),and enlarged subarachnoid spaces on head MRI(2/3).After treatment,seizures in one patient were controlled,while two cases developed drug-resistant epilepsy.The CLCN6 mutations reported include c.533A＞C,c.599A＞C,and c.761T＞C,all of which are de novo missense mutations located in the transmembrane domains.Conclusions WS caused by CLCN6 mutations is associated with a poor neurodevelopmental prognosis.The mutations are primarily de novo missense mutations.Early genetic diagnosis is crucial for improving the prognosis.

Objective: To investigate the status quo and associated factors of drinking water knowledge, attitude and behavior among primary school students in rural areas, so as to provide evidence for health behavioral intervention of drinking water in primary school. Methods: Twentythree primary schools in rural area from Hebei, Henan, Shandong and Shanxi provinces were selected by using purposive sampling method from March 1 to April 27 in 2023. Selfdesigned questionnaires regarding knowledge, attitude and behavior of drinking water were distributed to all students in grade 3-6, and 2 173 valid questionnaires were obtained. Multivariate Logistic regression was used to analyze the influencing factors of drinking water knowledge, attitude and behavior of primary school students. Results: The attainment rates of drinking water knowledge, attitude and behavior level were 20.02%, 26.65%, and 31.20%, respectively, among primary school students. The median of daily water intake was 1 000 mL, and the average daily water intake was (1 172.99±771.89)mL. In addition, 66.31% of students water intake reached the minimum standard of 800 mL recommended. The results of multiple Logistic regression indicated that drinking water accessibility in school, health education of drinking water, and individual selfcontrol ability were positively correlated with the knowledge (OR=1.31, 1.57, 1.58), attitude (OR=2.07, 1.65, 1.73), behavior (OR=1.40, 1.49, 1.91) of drinking water and daily water intake (OR=1.41, 1.38, 1.20) (P<0.05). Conclusions Primary school students in rural areas are generally lack of appropriate health awareness on drinking water including knowledge, attitude and behavior. Schools should take targeted measures to focus on the cultivation of students selfcontrol ability, so as to improve students knowledge and attitudes of drinking water, and furthermore help students shape their healthy behaviors of drinking water.