Based on the "regulating the pivot and unblocking the stomach" theory， this article proposes that the core pathogenesis of bile reflux gastritis （BRG） is disharmony of the three pivots and imbalance between the gallbladder and the stomach. Specifically， the pivot of zang-fu （脏腑） organs （spleen and stomach） exhibits abnormal ascending and descending functions， while the pivot of opening and closing （shaoyang） shows impaired flow， and the pivot of mind （heart and brain） has disordered regulation. These three pivots interact， ultimately leading to bile reflux attacking the stomach， injuring the gastric mucosa， and causing symptoms such as epigastric distension， pain， acid regurgitation， and heartburn. Clinically， the treatment principle is unblocking and regulating the three pivots， harmonizing the gallbladder and descending stomach qi， which closely follows the different pathomechanisms of three-pivot dysregulation， applying treatment according to syndrome differentiation. The regulation of the pivot of zang-fu organs focuses on fortifying the spleen and harmonzing stomach， raising the clear and directing the turbid downward. The regulation of the opening-and-closing pivot emphasizes harmonizing shaoyang， promoting gallbladder function and bowel movement. The regulation of the mind pivot centers on calming the heart and the mind， and harmonizing the stomach to ensure smooth qi flow. "Unblocking and regulating three pivots" method aims to restore the physiological functions of the gallbladder and stomach， providing a conceptual framework for the clinical management of BRG.

Objective To analyze the characteristics of colorectal adenoma onset,traditional Chinese medicine(TCM)syndromes,and factors influencing advanced colorectal adenoma.Methods A cross-sectional study was conducted to retrospectively analyze the data of 480 patients with colorectal adenoma admitted to the Department of Gastroenterology of Wangjing Hospital,China Academy of Chinese Medical Sciences,between January 2024 and January 2025 who met the inclusion and exclusion criteria.The hospital case system was used to collect demographic information,basic medical history,general conditions associated with colorectal adenoma,and records of TCM syndrome types,which were compiled into a clinical information Excel spreadsheet.Descriptive statistics were calculated to determine the distribution of demographic information,basic medical history,and TCM syndrome types.The chi-square test or Monte Carlo simulation method was used to analyze the differences in the number,size,pathological type and location of colorectal adenomas,as well as the distribution of TCM syndrome types.Univariate chi-square test was used to analyze the related factors of patients with advanced colorectal adenoma,and the statistically significant variables were included in the multivariate logistic regression analysis to analyze the influencing factors of advanced colorectal adenoma.Results Among the 480 patients with colorectal adenoma,296 were male with an onset age of(60.51±11.17)years,and 184 were female with age of(61.65±11.87)years.There were 233 patients(46.46％)aged 45 to 64.There were 269 cases(56.04％)of overweight individuals.Adenomas smaller than 1 cm accounted for 73.33％(352/480).Among the number of adenomas,single adenomas accounted for 66.46％(319/480).Among the pathological types,tubular adenoma accounted for 86.67％(416/480).The left colon accounted for 80.0％(384/480)of the affected sites.The main clinical manifestations included abdominal distension(20.63％,99/480),abdominal pain(16.25％,78/480),diarrhea(9.79％,47/480),among others.The main syndrome types in traditional Chinese medicine are damp-heat syndrome of the large intestine(25.83％,124/480)and spleen deficiency with excessive dampness syndrome(22.94％,110/480).There was a statistically significant difference in the distribution of TCM syndrome types among patients of different age groups(P=0.010).Multitype adenoma(OR=4.504,95％CI:2.819～7.198,P<0.001)and the right colon site(OR=2.166,95％CI:1.146～4.092,P<0.05)are independent risk factors for advanced colorectal adenoma.Conclusion Colorectal adenomas are more common in men and tend to occur in middle-aged people.Adenomas under 1 cm are the most common.Single adenomas and tubular adenomas are more common.The left half of the colon is a common site of occurrence.Common clinical symptoms include abdominal distension,abdominal pain,diarrhea,etc.Damp-heat syndrome of the large intestine is the most common type of syndrome in traditional Chinese medicine.The number of multiple adenomas and the location of the right colon are independent risk factors for advanced colorectal adenomas.

With the rapid advancement of artificial intelligence technology, chatbots have shown great potential in the healthcare sector. From personalized health advice to chronic disease management and psychological support, chatbots have demonstrated significant advantages in improving the efficiency and quality of healthcare services. As the scope of their applications expands, the relationship between technological complexity and practical application scenarios has become increasingly intertwined, necessitating a more comprehensive evaluation of both aspects. This paper, from the perspective of he althcare applications, systematically reviews the technological pathways and development of chatbots in the medical field, providing an in-depth analysis of their performance across various medical scenarios. It thoroughly examines the advantages and limitations of chatbots, aiming to offer theoretical support for future research and propose feasible recommendations for the broader adoption of chatbot technologies in healthcare.

The development of new quality productive forces is an inherent requirement for achieving high-quali-ty development in China's medical and health fields,and is also an important driving force for building a healthy Chi-na.The new quality productivity of medical and health care is high technology,high efficiency,with the basic pur-pose of providing high quality and efficient medical and health services,and has the characteristics of innovation,in-tegration,digital intelligence and leadership.To accelerate the formation of new quality productivity in medical and health care,it needs to start with the reaction of production relations on productivity and the three factors of produc-tivity,deepen the reform of institutional mechanisms,consolidate the foundation of talent training,promote the construction of digital health care,and innovate the collaborative management model.

Generative Artificial Intelligence ishows a broad application prospect in the field of healthcare and has become an important technical means to promote the development of medical informatization.It addresses the multi-faceted challenges of medical record documentation,including efficiency,quality,and doctor-patient communica-tion.It analyzes the adaptability and feasibility of Generative Artificial Intelligence in different clinical scenarios of intelli-gent medical record generation.Additionally,it explores the issues present in current applications and proposes corre-sponding solutions,providing references for the effective application and continuous optimization of Generative Artifi-cial Intelligence in medical record documentation.This provides a theoretical foundation for further expanding the appli-cation scenarios of automatic medical record documentation in China's healthcare industry.

The development of new quality productive forces is an inherent requirement for achieving high-quali-ty development in China's medical and health fields,and is also an important driving force for building a healthy Chi-na.The new quality productivity of medical and health care is high technology,high efficiency,with the basic pur-pose of providing high quality and efficient medical and health services,and has the characteristics of innovation,in-tegration,digital intelligence and leadership.To accelerate the formation of new quality productivity in medical and health care,it needs to start with the reaction of production relations on productivity and the three factors of produc-tivity,deepen the reform of institutional mechanisms,consolidate the foundation of talent training,promote the construction of digital health care,and innovate the collaborative management model.

Generative Artificial Intelligence ishows a broad application prospect in the field of healthcare and has become an important technical means to promote the development of medical informatization.It addresses the multi-faceted challenges of medical record documentation,including efficiency,quality,and doctor-patient communica-tion.It analyzes the adaptability and feasibility of Generative Artificial Intelligence in different clinical scenarios of intelli-gent medical record generation.Additionally,it explores the issues present in current applications and proposes corre-sponding solutions,providing references for the effective application and continuous optimization of Generative Artifi-cial Intelligence in medical record documentation.This provides a theoretical foundation for further expanding the appli-cation scenarios of automatic medical record documentation in China's healthcare industry.

Objective To analyze the characteristics of colorectal adenoma onset,traditional Chinese medicine(TCM)syndromes,and factors influencing advanced colorectal adenoma.Methods A cross-sectional study was conducted to retrospectively analyze the data of 480 patients with colorectal adenoma admitted to the Department of Gastroenterology of Wangjing Hospital,China Academy of Chinese Medical Sciences,between January 2024 and January 2025 who met the inclusion and exclusion criteria.The hospital case system was used to collect demographic information,basic medical history,general conditions associated with colorectal adenoma,and records of TCM syndrome types,which were compiled into a clinical information Excel spreadsheet.Descriptive statistics were calculated to determine the distribution of demographic information,basic medical history,and TCM syndrome types.The chi-square test or Monte Carlo simulation method was used to analyze the differences in the number,size,pathological type and location of colorectal adenomas,as well as the distribution of TCM syndrome types.Univariate chi-square test was used to analyze the related factors of patients with advanced colorectal adenoma,and the statistically significant variables were included in the multivariate logistic regression analysis to analyze the influencing factors of advanced colorectal adenoma.Results Among the 480 patients with colorectal adenoma,296 were male with an onset age of(60.51±11.17)years,and 184 were female with age of(61.65±11.87)years.There were 233 patients(46.46％)aged 45 to 64.There were 269 cases(56.04％)of overweight individuals.Adenomas smaller than 1 cm accounted for 73.33％(352/480).Among the number of adenomas,single adenomas accounted for 66.46％(319/480).Among the pathological types,tubular adenoma accounted for 86.67％(416/480).The left colon accounted for 80.0％(384/480)of the affected sites.The main clinical manifestations included abdominal distension(20.63％,99/480),abdominal pain(16.25％,78/480),diarrhea(9.79％,47/480),among others.The main syndrome types in traditional Chinese medicine are damp-heat syndrome of the large intestine(25.83％,124/480)and spleen deficiency with excessive dampness syndrome(22.94％,110/480).There was a statistically significant difference in the distribution of TCM syndrome types among patients of different age groups(P=0.010).Multitype adenoma(OR=4.504,95％CI:2.819～7.198,P<0.001)and the right colon site(OR=2.166,95％CI:1.146～4.092,P<0.05)are independent risk factors for advanced colorectal adenoma.Conclusion Colorectal adenomas are more common in men and tend to occur in middle-aged people.Adenomas under 1 cm are the most common.Single adenomas and tubular adenomas are more common.The left half of the colon is a common site of occurrence.Common clinical symptoms include abdominal distension,abdominal pain,diarrhea,etc.Damp-heat syndrome of the large intestine is the most common type of syndrome in traditional Chinese medicine.The number of multiple adenomas and the location of the right colon are independent risk factors for advanced colorectal adenomas.

Objectives:To examine the feasibility of using foundation model in computer vision for echocardiographic left ventricular ejection fraction measurement. Methods:Based on the most extensive publicly accessible repository of echocardiographic loops,EchoNet-Dynamic,featuring 10024 recordings from individual patients,a foundation model in computer vision,VideoMAE V2,was fine-tuned,validated,tested using 7460,1288,and 1276 echocardiographic loops,respectively. Results:The mean absolute error between left ventricular ejection fraction measurements of VideoMAE V2 and expert's measurements was 3.94％ (95％CI:3.79％-4.11％).The Pearson's correlation coefficient was 0.91 (95％CI:0.89-0.92).Additionally,VideoMAE V2 demonstrated exceptional accuracy in identifying patients with a left ventricular ejection fraction below 50％,achieving an AUC of 0.96 (95％CI:0.95-0.97). Conclusions:This study validates the feasibility of using foundation model in computer vision for measuring left ventricular ejection fraction in echocardiographic loops and lays the foundation for the development of a generalized multimodal automated interpretation system for echocardiography.

ObjectiveTo explore the effect and regulatory mechanism of notoginseng total saponins on apoptosis of mammary gland cells in rats with mammary gland hyperplasia. MethodSixty female non-pregnant SD rats were randomly divided into control group， model group， Notoginseng total saponins low-， medium- and high-dose （10， 20， 40 mg·kg^-1， respectively） groups and tamoxifen group （1.8 mg·kg^-1）， 10 rats per group. Rat model of mammary gland hyperplasia was established by intramuscular injection of estradiol benzoate and progesterone. Oral administration was performed according to the experimental dose of each group， once a day for 30 consecutive days. The rats in the control group and the model group were given equal volume of normal saline by gavage every day. After administration， the diameter of the second pair of nipples of the rats was measured with vernier calipers， and breast tissue samples were collected and stained with hematoxylin and eosin （HE） to observe the pathological changes. Immunohistochemistry was used to determine the expression of apoptosis regulators B-cell lymphoma-2 （Bcl-2）-associated X （Bax） and Bcl-2， and Western blot was conducted to detect the expression of phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR） signaling pathway-related proteins. ResultCompared with the control group， the model group had increased diameter of the second pair of nipples （P<0.05）， elevated volume of mammary lobules and number of acinus， diffuse mammary gland hyperplasia， and up-regulated expression of Bcl-2 protein， increased ratio of p-PI3K/PI3K， p-Akt/Akt， p-mTOR/mTOR （P<0.05） and decreased expression of Bax in the mammary gland （P<0.05）. Compared with the conditions in the model group， the diameter of the second pair of nipples of the rats in the notoginseng total saponins low-， medium- and high-dose groups and tamoxifen group was decreased （P<0.05）， and the number of mammary lobules and acinus and the amount of secretions were reduced. In addition， the mammary gland hyperplasia was alleviated， and a decrease was observed in the expression of Bcl-2 protein and the ratio of p-PI3K/PI3K， p-Akt/Akt， p-mTOR/mTOR （P<0.05）， and an increase in the expression of Bax （P<0.05）. ConclusionNotoginseng total saponins could improve mammary gland hyperplasia in rats， and its mechanism was related to regulating PI3K/Akt/mTOR pathway and promoting apoptosis of mammary gland cells.