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.

OBJECTIVE To evaluate the cost-utiliby of capivasertib combined with fulvestrant for the second-line treatment of hormone receptor-positive/human epidermal growth factor receptor-2-negative （HR+/HER2－） advanced breast cancer from the perspective of the Chinese healthcare system. METHODS A partitioned survival model was constructed using clinical data from the CAPItello-291 trial. Costs and quality-adjusted life years （QALYs） were used as the output indicators of the model， and the incremental cost-effectiveness ratio （ICER） was used as the evaluation indicator of the model. Using three times the per capita gross domestic product （GDP） of China in 2024 as the willingness-to-pay threshold （WTP）， this study analyzed the cost-utility of capivasertib combined with fulvestrant versus fulvestrant monotherapy in the treatment of HR+/HER2－ advanced breast cancer， and conducted sensitivity analysis and scenario analysis under conditions where the price of capivasertib was reduced by 50%， 60%， 70% and 95%， respectively. RESULTS The results of the basic analysis showed that compared with the fulvestrant monotherapy regimen， the ICER of capivasertib combined with fulvestrant was 843 038.46 yuan/QALY， which was higher than the WTP（287 247 yuan/QALY）. The one-way sensitivity analysis revealed that the top three factors with the most substantial influence on ICER were the utility value in the progression disease state， the price of capivasertib， and the utility value inthe progression free survival state. Probabilistic sensitivity analysis demonstrated the robustness of the basic analysis results. Scenario analysis revealed that even if the price of capivasertib were reduced by 95%， capivasertib combined with fulvestrant did not exhibit cost-effectiveness at the current WTP. CONCLUSION At a WTP of three times China’s GDP per capita in 2024， compared to fulvestrant monotherapy， capivasertib combined with fulvestrant as the second-line treatment for HR+/ HER2－ advanced breast cancer is not cost-effective.

To analyze the impact of salt reduction interventions on the knowledge, attitude and behavior regarding the salt reduction of students′ parents based on the home-school interaction model. In April 2021, parents of students in grades 3-5 from three primary schools in Yichang City were selected as the target population using a cluster sampling method, and the parent population was divided into an intervention group and a control group. In the intervention group, a comprehensive home-school interaction salt reduction intervention was implemented, and in the control group, no intervention measures were taken for students′ parents. Baseline and final surveys were conducted before and after the intervention period, which included general information, previous salt reduction interventions received, and salt reduction knowledge, attitude and behavior. Difference-in-difference (DID) method was used to compare the knowledge, attitude and behavior status of two groups before and after the intervention, and stratified analysis of parents with different literacy levels was conducted to assess the net effect of intervention implementation. The results showed that 740 parents completed the baseline and final surveys, with 231 in the intervention group and 509 in the control group. After propensity score matching, there were 231 (33.33%) in the intervention group and 462 (66.67%) in the control group. After the intervention, the proportion of the intervention group who obtained salt control spoons and pots, as well as salt reduction knowledge and advice through school, was 87.45%, 86.58% and 75.45%, respectively, which was significantly higher than that in the control group ( P<0.05). After the intervention, the proportion of parents with a high school and lower education who obtained salt control pots was higher in the intervention group (89.23%) than in the control group (74.49%), with significant differences ( P<0.05). The proportion of parents with a college degree or above who obtained salt control spoons and pots, as well as salt reduction knowledge and advice through school, was higher than that of the control group ( P<0.05). The results of DID method showed that after controlling for monthly income and other factors, the scores of parents′ salt reduction-related knowledge and low-salt behavior in the intervention group increased significantly higher than those in the control group, with DID values (95% CI) of 1.18 (0.15-2.21) and 0.62 (0.16-1.09), respectively, indicating a significant net effect of intervention implication. After stratification according to the education level of parents, this difference still existed in the college degree or above group, with DID values (95% CI) of 1.39 (0.13-2.66) and 0.76 (0.16-1.36), respectively. The home-school interaction model for salt reduction measures can improve the salt-related knowledge and low-salt behavioral choices of students′ parents.

Objective To investigate the role and mechanism of metastasis-associated protein in colorectal cancer 1(MACC1)in the proliferation and migration of colorectal cancer.Methods The expression of MACC1 in colorectal cancer samples and para-cancerous samples from TCGA database was analyzed.The survival difference between the groups with high and low expression of MACC1 was studied.HCT116 cells were divided into Vector group(no treatment group)and MACC1 OE group(transfected with pcDNA3.1-MACC1 plasmid),si-NC group(negative control group),and si-MACC1 group(transfected with MACC1 siRNA).MTT assay was used to detect cell viability;EDU and cell clonal formation assay were used to detect cell proliferation.The migration and invasion of cells were detected by scratch and invasion assays,respectively.The mRNA expression level of cellular-mesenchymal epithelial transition factor(c-MET)was detected by RT-qPCR,and the protein expression of MACC1 and c-MET was detected by Western blotting.Colon cancer cell HCT116 transfected with MACC1 OE was inoculated subcutaneously into nude mice to establish tumor model,and the volume and weight of tumor tissue were measured.Results The expression level of MACC1 was upregulated in colorectal cancer tissue and cells(P＜0.05).Patients with high MACC1 expression had shorter overall survival than those with low MACC1 expression(P=0.003).Overexpression of MACC1 significantly increased cell viability(F=86.070,P＜0.001).Compared with those in si-NC group,the proliferation rate,migration,invasion and number of clone formation of HCT116 in si-MACC1 group were significantly decreased(P＜0.01).The expression of MACC1 protein was positively correlated with the expression of c-MET protein in colorectal cancer(r=0.802,P=0.002).Overexpression of MACC1 promoted the c-MET expression(t=13.532,P＜0.001),while knockdown of MACC1 inhibited the c-MET expression(t=14.626,P＜0.001).Luciferase reports assay demonstrated that c-MET was a transcriptional target of MACC1.MACC1 overexpression increased the tumor volume and weight of nude mice(P＜0.01).Conclusion MACC1 can promote the invasion and migration of colorectal cancer through hepatocyte growth factor/c-MET pathway.

Objective:To investigate the clinical characteristics and genetic etiology of fetal Dandy-Walker spectrum (DWS) anomalies.Methods:This retrospective cohort study analyzed 28 fetuses with ultrasonographically confirmed DWS (ten classic Dandy-Walker malformations and 18 Dandy-Walker variants) at the First Affiliated Hospital, Zhengzhou University from January 2019 to June 2024. All cases underwent systematic ultrasonographic evaluation. Genetic analyses included chromosomal karyotyping alone ( n=4) or combined with copy number variation sequencing (CNV-seq) ( n=10). Descriptive statistics and Chi-square tests (or Fisher's exact test) with Bonferroni correction were applied. Results:(1) Among 28 fetuses, seven (25.0%) had isolated DWS and 21 (75.0%) non-isolated DWS. Central nervous system anomalies were most common (53.6%, 15/28). (2) Karyotyping identified abnormalities in four cases (4/14), including two triploidies, one case of mosaicism for a derivative chromosome der(1;10), and one 17p deletion. CNV-seq detected anomalies in six cases (25.0%, 6/24), four of which were missed by karyotyping: 3q23 deletion (encompassing ZIC1/ ZIC4), 13q11 duplication, and other critical variants. (3) Combined testing yielded a higher detection rate (28.6%, 8/28) than karyotyping alone (4/14, χ2=4.62, P=0.032) or CNV-seq alone (25.0%, 6/24, χ2=4.83, P=0.028) ( P=0.048 and 0.044 after Bonferroni correction). Conclusions:DWS demonstrates significant genetic heterogeneity, primarily involving chromosomal numerical anomalies (e.g., triploidy) and copy number variations (e.g., 3q23 deletion). Combined karyotyping and CNV-seq improves detection rates of genetic abnormalities.

Chronic gastritis is a chronic inflammation of the gastric mucosa caused by various etiologies and can be categorized into chronic non-atrophic gastritis and chronic atrophic gastritis.Chronic atrophic gastritis is a common disorder of the digestive system characterized by gastric mucosal gland atrophy,mucosal thinning,and basal layer thickening.The development of intestinal metaplasia and atypical hyperplasia on this basis is recognized as a precancerous lesion of gastric cancer and represents a key stage in the"inflammation-cancer transformation"of chronic gastritis.However,universally recognized and effective treatment strategies for this"inflammation-cancer transformation"process are lacking in clinical practice.This study integrates Correa′s cascade reaction with clinical practice,summarizing the pathogenesis of the"inflammation-cancer transformation"of chronic gastritis as weakness of the middle jiao and blood stasis.It suggests that the"inflammation-cancer transformation"process involves the pathological development of spleen and stomach deficiency,transportation and transformation dysfunction,turbid phlegm,blood stasis,and the gradual formation of cancerous toxins,with spleen and stomach weakness as the core mechanism and phlegm and blood stasis as the crucial pathological link.Based on an in-depth exploration of the deficiency of the middle jiao and blood stasis,supported by pharmacological research and clinical experience,this paper proposes the therapeutic approach of strengthening the spleen and replenishing qi,expelling phlegm and activating blood.It discusses the related prescriptions in preventing and treating the"inflammation-cancer transformation"of chronic gastritis.This study aims to provide new perspectives and insights for the prevention and treatment of chronic gastritis with traditional Chinese medicine,offering a novel framework for clinical treatment.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To establish and compare rat models of psoriasis with blood-heat syndrome and blood-stasis syndrome.Methods The blood-heat syndrome model was induced by compound heat potion decoction and imiquimod.The blood-stasis syndrome model was induced by fatigue,hunger,cold dampness,panic and imiquimod.The groups were evaluated for TCM syndromes,psoriasis lesions,pathological tissue,spleen index,hemorheology and key gene expression levels.Results The blood-heat syndrome model group showed significant differences from the control group in syndrome manifestations,PASI score,Baker score,spleen index and plasma viscosity(P<0.05).The blood-stasis model group showed significant differences from the control group in syndrome manifestations,body weight,PASI score,Baker score,spleen index,whole blood viscosity(60s-1),whole blood viscosity(10s-1)and plasma viscosity(P<0.05).The key gene expression levels were different among all syndrome groups.Conclusion The animal models had the typical features of psoriasis and matched the signs of blood-heat syndrome and blood-stasis syndrome of TCM.The models can provide a basis for explaining the scientific meaning of TCM syndrome differentiation in treating psoriasis.

Objective To evaluate the efficacy,safety,and economic efficiency of toripalimab therapy for advanced esophageal cancer by rapid health technology assessment(rHTA),so as to provide clinical reference for drug use.Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data,VIP databases and official websites of health technology assessment institutions were electronically searched to collect high-quality clinical evidence and economic evaluation literature of toripalimab therapy for advanced esophageal cancer from inception to September 30,2025.Two reviewers independently identified studies,extracted data,assessed the quality of included studies,then the results were summarised and analysed using qualitative descriptive methods.Results A total of 18 articles were included,including 9 systematic reviews/Meta-analysis and 9 economic studies.In terms of efficacy,compared with the simple chemotherapy regimen,the combination chemotherapy regimen of toripalimab could significantly prolong the overall survival(OS)and progression free survival(PFS)of patients with advanced esophageal cancer,while improving the objective response rate(ORR)of patients.In terms of safety,there was no significant difference in the incidence of serious adverse events and overall adverse events between combination chemotherapy with toripalimab and chemotherapy alone.Moreover,compared with other immunotherapy combination therapies,the incidence of adverse events in combination chemotherapy with toripalimab was lower.In terms of economy,the combination of toripalimab and chemotherapy not only improves the clinical symptoms of advanced esophageal cancer patients,but also offers economic advantages.Conclusion Toripalimab is effective,safe and economical in the treatment of advanced esophageal cancer.

To analyze the impact of salt reduction interventions on the knowledge, attitude and behavior regarding the salt reduction of students′ parents based on the home-school interaction model. In April 2021, parents of students in grades 3-5 from three primary schools in Yichang City were selected as the target population using a cluster sampling method, and the parent population was divided into an intervention group and a control group. In the intervention group, a comprehensive home-school interaction salt reduction intervention was implemented, and in the control group, no intervention measures were taken for students′ parents. Baseline and final surveys were conducted before and after the intervention period, which included general information, previous salt reduction interventions received, and salt reduction knowledge, attitude and behavior. Difference-in-difference (DID) method was used to compare the knowledge, attitude and behavior status of two groups before and after the intervention, and stratified analysis of parents with different literacy levels was conducted to assess the net effect of intervention implementation. The results showed that 740 parents completed the baseline and final surveys, with 231 in the intervention group and 509 in the control group. After propensity score matching, there were 231 (33.33%) in the intervention group and 462 (66.67%) in the control group. After the intervention, the proportion of the intervention group who obtained salt control spoons and pots, as well as salt reduction knowledge and advice through school, was 87.45%, 86.58% and 75.45%, respectively, which was significantly higher than that in the control group ( P<0.05). After the intervention, the proportion of parents with a high school and lower education who obtained salt control pots was higher in the intervention group (89.23%) than in the control group (74.49%), with significant differences ( P<0.05). The proportion of parents with a college degree or above who obtained salt control spoons and pots, as well as salt reduction knowledge and advice through school, was higher than that of the control group ( P<0.05). The results of DID method showed that after controlling for monthly income and other factors, the scores of parents′ salt reduction-related knowledge and low-salt behavior in the intervention group increased significantly higher than those in the control group, with DID values (95% CI) of 1.18 (0.15-2.21) and 0.62 (0.16-1.09), respectively, indicating a significant net effect of intervention implication. After stratification according to the education level of parents, this difference still existed in the college degree or above group, with DID values (95% CI) of 1.39 (0.13-2.66) and 0.76 (0.16-1.36), respectively. The home-school interaction model for salt reduction measures can improve the salt-related knowledge and low-salt behavioral choices of students′ parents.