Primary health care institutions should be the main force of China's medical and health service system and the cornerstone of the national health care system. During the COVID-19 epidemic, China's primary health care institutions have played a huge role， but at the same time, many deficiencies and weaknesses have also been highlighted. Through systematic literature search and analysis， this article found that China's primary health care institutions have some problems such as low demand for patient care, weak integration of the health system, weak service foundation, and insufficient emergency response capacity for public health emergencies, etc. Accordingly, we put forward a strategy for the construction of primary health care institutions based on the “Three Forces Theory”, which will help to improving the primary medical and health care service system, upgrading the capacity of primary medical and health care services, and better fulfilling the strategic goal of “Healthy China 2030”.

This study conducted a comprehensive assessment of the current state of health standards in China by systematically searching the National Health Commission's Health Standards website and various literature databases. By identifying key issues within the domain of health standards， this study subsequently presented targeted strategies and recommendations. These findings serve as a valuable reference for refining China's health standard system and developing policies related to health standards.

Bone age is the most commonly used and effective indicator for understanding children's growth and development, and plays an important role in the diagnosis and efficacy evaluation of various growth and development disorders.Clinically, X-rays of the left hand and wrist are mostly taken for bone age assessment, but there is a certain radiation risk. Ultrasound can clearly display the epiphysis and secondary ossification center, and can conveniently perform multi-site scanning and dynamic measurement without radiation. In recent years, great progress has been made in the research and clinical application of bone age assessment using ultrasound. This article reviews the latest literature to discuss the value of musculoskeletal ultrasound and quantitative ultrasound in bone age assessment, and puts forward the problems in the study of ultrasound assessment of bone age and improve direction.

Respiratory tract infection is one of the most prevalent medical conditions. Rapid and accurate diagnosis of pathogens is crucial prerequisite for precise and effective treatment. However, the sensitivity of traditional microbiological and immunological techniques for respiratory pathogens detection is low. The development and clinical applications of nucleic acid testing technology have dramatically improved the diagnostic ability of respiratory pathogens. The rational usage of appropriate nucleic acid testing techniques, based on the underlying diseases, the type of respiratory tract infections, and pathogen spectrum, as well as correct understanding its diagnostic significance, has become an important clinical problem. For this, the Committee of Chinese Laboratory Medical Education initiated a multi-disciplinary Chinese expert consensus. Basing on the both domestic and international guidelines and literature, the expert consensus conducted an analysis of the clinical application scenarios, technical characteristics, and performance validation requirements pertaining to real-time fluorescence polymerase chain reaction (PCR), isothermal amplification technology, digital PCR, nucleic acid point-of-care testing, and metagenomics Next Generation Sequencing. Furthermore, the consensus of experts also examined the wide-ranging applications of these techniques in diagnosing and managing respiratory tract infections, including acute upper respiratory tract infections, tracheobronchitis, community-acquired pneumonia, hospital-acquired pneumonia/ventilator-associated pneumonia, acute exacerbation of chronic obstructive pulmonary disease, tuberculosis, and respiratory infections in immunocompromised adults. We hope the consensus will provide helpful reference to the clinicians.

Metabolic associated fatty liver disease (MAFLD) was renamed from the nonalcoholic fatty liver disease (NAFLD). At present， about the pathogenesis of MAFLD， people generally accept the "multiple strike" theory， which involves the interaction of genetic and environmental factors. These attacks include insulin resistance， lipid disorder， oxidative stress， intestinal microbiota， etc. However， there is no approved drug for MAFLD. Recent studies have found that vitamin D is involved in many metabolic processes， which may be involved in the development of MAFLD by influencing liver lipid metabolism， promoting insulin resistance and inflammatory response， participating in immune regulation， gene regulation and maintaining intestinal homeostasis. Therefore， this article summarizes the relationship between vitamin D and MAFLD， reveals the potential mechanism of vitamin D in the pathogenesis of MAFLD， and provides clinical ideas for the treatment of MAFLD.

Online adaptive radiotherapy（ OART） is considered to be a revolutionary technology after intensity-modulated radiotherapy. The first Chinese OART platform based on iterative cone beam computed tomography (iCBCT） has been applied in clinical treatment in Peking Union Medical College Hospital. This article reports the workflow and efficacy of first case with cervical cancer who received radical OART. After treatment, the patient achieved clinical complete remission with only a grade 1 radiation toxicity in the lower gastrointestinal tract. This article analyzes and discusses the clinical treatment process and follow-up data of this patient, aiming to provide clinical evidence for the subsequent large-scale application of artificial intelligence-driven CBCT-guided OART technology.

Vaccine is the most effective method to prevent the spread of communicable diseases， but the immune response it induces varies significantly among individuals and populations in different regions. Recent studies have shown that the composition and function of the gut microbiota play a key role in the immune response following vaccination. This article aims to explain the differences in gut microbiota among different populations and animals when vaccinated， discuss how the gut microbiota affects the immune efficacy of the vaccine， and summarize strategies for targeting the gut microbiota to improve vaccine efficacy.

Micro RNAs are involved in the pathophysiological processes of many diseases. Stably present in tissues, cells and blood, they can be used as potential markers of many diseases. They play an important role in the pathogenesis of liver fibrosis caused by various chronic liver diseases. It has been shown that miRNAs can participate in the process of liver fibrosis by targeting the down-regulation of liver fibrosis-related gene expression. In this review, we discuss the research progress on the role of miRNAs in liver fibrosis, with the hope of providing reference for diagnosis and molecularly targeted treatment.

In the era of evidence-based medicine， it is necessary to explore the unique advantages of traditional Chinese medicine (TCM) based on standardized technical methods and operating procedures in order to achieve the modernization and internationalization of TCM and benefit humanity. The proposal of a three-pronged evidence system combining TCM theory， human experience and experimental evidence marks an important progress in the thinking method of the TCM evaluation system. The multi-evidence body integrated through appropriate methods is a strong support for the clinical guideline recommendations and evidence-based health decisionmaking in TCM. Based on the current methodological progress of international evidence synthesis and grading， this paper proposes a novel approach for integrating multi-evidence in traditional Chinese medicine： the MERGE framework. The aim is to establish a solid foundation for the development of this methodology and to provide guidance for the advancement of the evidencebased medicine framework in traditional Chinese medicine.