Objective To explore the diagnosis and treatment method of peripelvic cysts.Methods A retrospective analysis was conducted on 65 patients with peripelvic cysts admitted to the Department of Urology at Shanghai Xuhui Central Hospital from January 2019 to January 2023.The diagnostic value of ultrasound,intravenous urography(IVU),and computed tomography urography(CTU)for peripelvic cysts was compared,and the efficacy of different surgical treatments for peripelvic cysts was further evaluated.Results All 65 patients underwent ultrasound examination,which indicated cystic lesions at the renal hilum.55 patients underwent IVU examination,but no cyst enhancement was found.Among them,7 patients underwent retrograde pyelography due to poor imaging of the affected renal pelvis.All 53 patients who underwent CTU examination,which clearly showed the renal pelvis and cysts.Among the 65 patients,5 did not undergo surgical treatment and were followed up,while 60 underwent surgery.Four patients were considered for radical nephrectomy due to suspected malignancy.56 cases underwent renal cysts decompression surgery,including 11 open surgeries,37 laparoscopic surgeries,and 8 Da Vinci robot-assisted laparoscopic surgeries.The operative time in the open surgery group was significantly shorter than that in the laparoscopic surgery group and robot-assisted laparoscopic surgery group.Compared with the open surgery group and laparoscopic surgery group,the robot-assisted laparoscopic surgery group had less intraoperative blood loss,lower postoperative analgesic use,shorter time to first ambulation after surgery,and shorter hospital stay.Conclusions Ultrasound,IVU,and CTU are commonly used effective diagnostic tools for peripelvic cysts.Ultrasound can be used as a routine examination,while CTU is more accurate and has a higher diagnostic accuracy than IVU for this condition.Compared with open surgery,laparoscopic and robot-assisted laparoscopic cyst decompression surgery for peripelvic cysts result in less intraoperative blood loss and faster postoperative recovery.

The clinical practice guidelines of traditional Chinese medicine （TCM） have problems such as limited clinical application and unclear implementation effects， which may be related to the lack of clinical practice evidence. To provide reliable and precise evidence for clinical practice， this article proposes a model of combining TCM guidelines with real-world study， which includes 4 steps. Firstly， during the implementation process of the guidelines， a high-quality research database is established. Secondly， the recommendations in the guidelines are evaluated based on the established database in multiple dimensions， including applicability， effectiveness， safety， and cost-effectiveness， and thus their effectiveness in practical applications can be determined. Thirdly， based on the established database， core prescriptions are identified， and the targeted populations and medication plans are determined. That is， the best treatment regimen is established based on the analysis of abundant clinical data regarding the effects of different medication frequencies， dosages， and duration on efficacy. Fourthly， the guidelines are updated according to the real-world evidence. The research based on this model can provide real-world evidence for ancient and empirical prescriptions， improving their application in clinical practice. Moreover， this model can reduce research costs and improve research efficiency. When applying this model， researchers need to pay attention to the quality of real-world evidence， ensuring that it can truly reflect the situation in clinical practice. In addition， importance should be attached to the clinical application of guideline recommendations， ensuring that doctors can conduct standardized diagnosis and treatment according to the guidelines. Finally， full-process participation of multidisciplinary experts is encouraged to ensure the comprehensiveness and scientificity of the study. In conclusion， the application of this model will contribute to the development of TCM guidelines responsive to the needs of clinical practice and achieve the goal of promoting the homogenization of TCM clinical diagnosis and treatment.

Standardized reporting is a crucial factor affecting the use of patient guidelines （PGs）， particularly in the reporting and presentation of recommendations. This paper introduced the current status of PG reporting， including the research on PG content and presentation formats， and provided comprehensive recommendations for PG reporting from aspects such as overall framework， recommendations， presentation format， and readability. First， the presentation of PG recommendations should include clearly defined clinical questions， recommendations and their rationale， and guidance on how patients should implement the interventions； for specific content in the PG， such as level of evidence， level of recommendation， it is recommended to explain in text the reasons for giving different levels of recommendation， i.e.， to present the logic behind giving the level of recommendation to the patient； additional information needed in the recommendation framework should be supplemented by tracing references or authoritative textbooks and literature that support the recommendations. Subsequently， the PG text should be written based on the Reporting Checklist for Public Versions of Guidelines （RIGHT-PVG） reporting framework. Finally， to enhance readability and comprehension， it is recommended to refer to the Patient Education Materials Assessment Tool （PEMAT） for translating PG content. To enhance the readability of PGs， it is suggested to present the PG content in a persona-lized and layered manner.

Rheumatoid arthritis is a common clinical autoimmune disease characterized by persistent synovitis and pannus formation. In late stage， irreversible destruction and deformation of bone and joint may occur. In this paper， the authors believe that kidney deficiency and essence deficiency is the core mechanism of rheumatoid arthritis bone destruction， and its disease evolution law is summarized as "marrow reduction， flesh flaccid， collaterals blocked". On the basis of modern medical understanding of bone destruction in rheumatoid arthritis， it is considered that the mechanism in Chinese medicine of "marrow reduction， flesh flaccid， collaterals blocked" ultimately leads to bone destruction， is similar to that in the western medicine of abnormal differentiation of osteoclasts， high expression of nuclear factor-κB receptor activator of ligand， and abnormal expression of inflammatory factors. This point of view may provide a more comprehensive and scientific understanding of the key pathogenic mechanism of bone destruction in rheumatoid arthritis.

OBJECTIVE To provide a detailed report and interpretation of the method and results for determining the weights of the technical indicators from the “multi-dimensional and multi-criteria comprehensive evaluation index system （first edition）” stated in Guideline for Multi-dimensional and Multi-criteria Comprehensive Evaluation of Chinese Patent Medicine. METHODS Normalization calculations were performed on the comprehensive weight values calculated by the analytic hierarchy process and expert weighting method to obtain the objective weights of the indicators. RESULTS The weight results of the six primary dimensions in the current comprehensive evaluation indicator system of Chinese patent medicine showed effectiveness dimension＞ safety dimension＞standard dimension＞application dimension＞scientific dimension＞economic dimension， with weight values of 0.281 0， 0.268 5， 0.195 8， 0.107 3， 0.096 1 and 0.051 3 respectively， consistent with the results of most researches currently. CONCLUSIONS The process of weight determination in this indicator system is scientifically reasonable， with clear methods and clear interpretations， and is worthy of further optimization and widespread application.

Objective To investigate the effects of miR-4531/CX3CL1 signaling pathway on the vascular injury in preeclampsia, and to search possible targets for early diagnosis and prevention of preeclampsia. Methods Placental tissue samples were obtained from 10 patients with late-onset preeclampsia and 10 normal pregnant women in the Obstetrics and Gynecology Department of Minhang Hospital, Fudan University from October 2021 to December 2022. The levels of miR-4531 and CX3CL1 were evaluated by qRT-PCR. Cell transfection was performed by lipofectamine 2000 in vitro. The binding relationship between miR-4531 and CX3CL1 was determined by luciferase reporter assay. The apoptosis of neutrophils, the migration, repair, colony formation and cell-free DNA (cfDNA) release of human umbilical vein endothelial cells (HUVECs) were detected. Results MiR-4531 was significantly downregulated, and CX3CL1 was upregulated in placental tissues of preeclampsia patients (P＜0.05). Luciferase report assay confirmed the direct binding relationship between miR-4531 and CX3CL1. Upregulation of miR-4531significantly promoted the migration, proliferation, repair, and inhibited cfDNA release of HUVECs and neutrophils apoptosis in medium under hypoxic condition (P＜0.05). However, downregulation of miR-4531 obviously inhibited the proliferation, migration, repair, and enhanced cfDNA release of HUVECs and neutrophils apoptosis in medium under hypoxic condition (P＜0.05). Conclusions The miR-4531is downregulated in placental tissues of preeclampsia parients and is a potential therapeutic target for preeclampsia. It might cause endothelial damage and an abnormal hypercoagulable state under hypoxic condition by targeting and regulating the CX3CL1 pathway.

To reduce the subjectivity and uncertainty present in the current international methods of drug value pricing when converting value into monetary prices,based on the hedonic pricing theory,it considers the post-negotiation price between manufacturers and payers as a reasonable price reference in the value pricing of Chinese patent medicine.By constructing an indicator system for the characteristics of Chinese patent medicine,it selects and measures the value characteristic variables that affect the price of Chinese patent medicine.It serves as the theoretical foundation and research basis for establishing a Hedonic price model between characteristic price variables and negotiation prices,thereby promoting the enhancement of rationality and objectivity in value-guided pricing of Chinese patent medicine.

Objective The purpose is to sort out the key steps and core indicators of priority setting for health technology assessment,and provide references for the research of priority setting for health technology assessment in China.Methods To search information from the official website of the World Health Organization,the websites of international health technology assessment agencies/organizations,and CNKI,Wanfang,Pubmed,Embase and other databases related for the setting of health technology assessment priority topics,and the key steps and core indicators of the setting of priority topics were analyzed by descriptive statistical analysis.Results 21 priority setting schemes for health technology assessment were finally incorporated,and the key steps were extracted to set indicators for collecting evaluations.Ratings and rankings and review decisions.The core indicators are disease burden,economic impact and clinical/health impact.Conclusion The key steps and core indicators of international priority setting provide rich practical experience for China's health technology assessment priority setting,which should be actively used for reference to promote evidence-based and scientific decision-making of health technology assessment in China.

To reduce the subjectivity and uncertainty present in the current international methods of drug value pricing when converting value into monetary prices,based on the hedonic pricing theory,it considers the post-negotiation price between manufacturers and payers as a reasonable price reference in the value pricing of Chinese patent medicine.By constructing an indicator system for the characteristics of Chinese patent medicine,it selects and measures the value characteristic variables that affect the price of Chinese patent medicine.It serves as the theoretical foundation and research basis for establishing a Hedonic price model between characteristic price variables and negotiation prices,thereby promoting the enhancement of rationality and objectivity in value-guided pricing of Chinese patent medicine.

Objective The purpose is to sort out the key steps and core indicators of priority setting for health technology assessment,and provide references for the research of priority setting for health technology assessment in China.Methods To search information from the official website of the World Health Organization,the websites of international health technology assessment agencies/organizations,and CNKI,Wanfang,Pubmed,Embase and other databases related for the setting of health technology assessment priority topics,and the key steps and core indicators of the setting of priority topics were analyzed by descriptive statistical analysis.Results 21 priority setting schemes for health technology assessment were finally incorporated,and the key steps were extracted to set indicators for collecting evaluations.Ratings and rankings and review decisions.The core indicators are disease burden,economic impact and clinical/health impact.Conclusion The key steps and core indicators of international priority setting provide rich practical experience for China's health technology assessment priority setting,which should be actively used for reference to promote evidence-based and scientific decision-making of health technology assessment in China.