ObjectiveTo construct a large language model （LLM）-based intelligent pre-consultation system for traditional Chinese medicine （TCM） to improve efficacy of clinical practice. MethodsA TCM large language model was fine-tuned using DeepSpeed ZeRO-3 distributed training strategy based on YAYI 2-30B. A weighted undirected graph network was designed and an agent-based syndrome differentiation model was established based on relationship data extracted from TCM literature and clinical records. An agent collaboration framework was developed to integrate the TCM LLM with the syndrome differentiation model. Model performance was comprehensively evaluated by Loss function， BLEU-4， and ROUGE-L metrics， through which training convergence， text generation quality， and language understanding capability were assessed. Professional knowledge test sets were developed to evaluate system proficiency in TCM physician licensure content， TCM pharmacist licensure content， TCM symptom terminology recognition， and meridian identification. Clinical tests were conducted to compare the system with attending physicians in terms of diagnostic accuracy， consultation rounds， and consultation duration. ResultsAfter 100 000 iterations， the training loss value was gradually stabilized at about 0.7±0.08， indicating that the TCM-LLM has been trained and has good generalization ability. The TCM-LLM scored 0.38 in BLEU-4 and 0.62 in ROUGE-L， suggesting that its natural language processing ability meets the standard. We obtained 2715 symptom terms， 505 relationships between diseases and syndromes， 1011 relationships between diseases and main symptoms， and 1 303 600 relationships among different symptoms， and constructed the Agent of syndrome differentiation model. The accuracy rates in the simulated tests for TCM practitioners， licensed pharmacists of Chinese materia medica， recognition of TCM symptom terminology， and meridian recognition were 94.09%， 78.00%， 87.50%， and 68.80%， respectively. In clinical tests， the syndrome differentiation accuracy of the system reached 88.33%， with fewer consultation rounds and shorter consultation time compared to the attending physicians （P＜0.01）， suggesting that the system has a certain pre- consultation ability. ConclusionThe LLM-based intelligent TCM pre-diagnosis system could simulate diagnostic thinking of TCM physicians to a certain extent. After understanding the patients' natural language， it collects all the patient's symptom through guided questioning， thereby enhancing the diagnostic and treatment efficiency of physicians as well as the consultation experience of the patients.

In 2014, with the approval of the Ministry of Education, China Medical University established the China Medical University-The Queen's University of Belfast Joint College and officially commenced enrollment, with the goal to cultivate international pharmaceutical professionals, and it not only promoted the reform and development of the pharmaceutical major, but also provided new ideas for the process of education internationalization in the university. The China Medical University-Queen's University of Belfast Joint College has set the goal of cultivating top-tier innovative pharmaceutical talents with an international perspective, comprehensively introducing the faculty and curricula from Queen's University of Belfast, implementing a dual-track strategy of "teaching and research", emphasizing the cultivation of "three capabilities" among students, and effectively promoting the strategy of "four synchronizations" for the homogenization of education and teaching. Over the past decade of cooperation, graduates have received high praise from institutions for further studies and employers, and there has been a constant improvement in the quality of talent cultivation.

In 2014, with the approval of the Ministry of Education, China Medical University established the China Medical University-The Queen's University of Belfast Joint College and officially commenced enrollment, with the goal to cultivate international pharmaceutical professionals, and it not only promoted the reform and development of the pharmaceutical major, but also provided new ideas for the process of education internationalization in the university. The China Medical University-Queen's University of Belfast Joint College has set the goal of cultivating top-tier innovative pharmaceutical talents with an international perspective, comprehensively introducing the faculty and curricula from Queen's University of Belfast, implementing a dual-track strategy of "teaching and research", emphasizing the cultivation of "three capabilities" among students, and effectively promoting the strategy of "four synchronizations" for the homogenization of education and teaching. Over the past decade of cooperation, graduates have received high praise from institutions for further studies and employers, and there has been a constant improvement in the quality of talent cultivation.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

Objective To systematically analyze and identify key risk factors for postoperative pulmonary hemorrhage u-sing a combination of the random forest(RF)model and traditional logistic regression analysis,so as to provide data support for clinical practice.Methods This study included patients who underwent needle biopsy of lung masses from January 2020 to December 2023 in the Department of Interventional Therapy,Cancer Hospital,Tianjin Medical University.There were 844 cases,including 387 males and 457 females,ranging in age from 39 to 82 years.Clinical data and puncture-related characteristics were collected,including tumor size,puncture depth,puncture angle,presence of emphysema,lesion loca-tion in the lung,body position during puncture,whether the puncture passed through the interlobar fissure,and the number of punctures.The RF model was used to rank the importance of all variables,identifying those with the highest predictive value.Subsequently,a multivariate logistic regression model was applied to the top-ranked important variables to further e-valuate their independent impact on postoperative pulmonary hemorrhage.Results The RF model results showed that tumor size and puncture depth had the highest importance in predicting the risk of postoperative pulmonary hemorrhage.Multivari-ate logistic regression analysis further confirmed that smaller tumor size(HR:0.980,95％CI:0.971-0.989,P＜0.05)was significantly associated with a lower risk of hemorrhage,while greater puncture depth(HR:1.146,95％CI:1.063-1.235,P＜0.05)was closely related to a higher risk of hemorrhage.Additionally,other factors such as puncture angle,age,lesion location in the lung and presence of emphysema showed some influence but did not reach statistical significance in the multi-variate analysis.Conclusion This study successfully identified tumor size and puncture depth as independent risk factors for postoperative pulmonary hemorrhage by combining the RF model with multivariate logistic regression analysis.The appli-cation of the RF model improved the accuracy of feature selection,allowing us to focus on the most contributory predictive variables.These findings provide important support for preoperative risk assessment,suggesting that clinicians should priori-tize these key factors in preoperative evaluations to develop safer and more effective surgical plans,thereby reducing the risk of postoperative hemorrhage and other complications.

Hepatitis C is distributed worldwide and possesses a hidden characteristic. The traditional methods of screening and diagnosis of hepatitis C infection commonly used in clinics are based on anti-HCV antibody and HCV RNA detection. Advances in HCV antigen detection technologies can apparently reduce the window period for anti-HCV antibodies, providing new clinical evidence for the early detection, diagnosis, and treatment of HCV infection. This article is a current review of HCV antigen detection methodologies, clinical applications, and detection strategies.

Objective To investigate the relationship between early infant eczema and cord blood interleukin(IL)-36γ level.Methods Fifty-nine full-term healthy newborns were selected as the study subjects.General information was collected including gender,birth weight,delivery method,gestational age,maternal age,physical fitness during pregnancy(diabetes,infection,hyperthyroidism and other complications),family history of allergies and intake times of seafood during pregnancy≥3 times.The level of IL-36γ in umbilical cord blood after birth was detected by enzyme-linked immunosorbent assay.The presence and severity of eczema within 42 days were followed up.Multivariate Logistic regression was performed to analyze the influencing factors of early infant eczema,and receiver operating characteristics(ROC)were plotted to evaluate the diagnostic effectiveness.Results Among 59 infants,40 had eczema,of which 35 were mild,5 were moderate and 19 were eczema free.The proportion of seafood intake times≥3 and the level of IL-36γ in umbilical cord blood were higher in the eczema group than those in the no-eczema group(P＜0.05).There was no significant difference in IL-36γ level in cord blood between mild and moderate eczema patients.Multivariate Logistic regression analysis showed that the increased level of IL-36γ in umbilical cord blood and≥3 intake times of seafood during pregnancy were risk factors for early infant eczema(P＜0.05).ROC results showed that the AUC(95%CI)of umbilical cord blood IL-36γ was 0.743(0.611-0.874),sensitivity was 87.6%,specificity was 57.9%,and truncation value was 103.823 ng/L.Conclusion The elevated level of IL-36γ in umbilical cord blood is an independent risk factor for early infant eczema,and early detection is valuable for predicting the occurrence of infantile eczema.

Laelapinae mites are involved in transmission of microbial diseases between wildlife and humans, with an impact on public health. In this study, 5 mite members in the subfamily Laelapinae (laelapin mites; LM) were morphologically identified by light microscopy, and the phylogenetic relationship of LM was analyzed in combination with the sequence information of part of the LM cytochrome oxidase subunit I (cox1) gene. The morphological identification revealed that 5 mites belonged to the genera Laelaps and Haemolaelaps, respectively. Sequence analysis showed that the ratio of non-synonymous mutation rate to synonymous mutation rate of LM was less than 1, indicating that the LM cox1 gene had undergone purifying selection. Phylogenetic analysis showed that the Laelapinae is a monophyletic group. The genera Haemolaelaps and Hyperlaelaps did not separated into distinct clades but clustered together with species of the genus Laelaps. Our morphological and molecular analyses to describe the phylogenetic relationships among different genera and species of Laelapinae provide a reference for the improvement and revision of the LM taxonomy system.

Objective To understand the prevalence of osteoporosis and its influence factors in residents of Chongqing, and to provide the reference for osteoporosis prevention and treatment. Methods The data were from ^“An epidemiological survey of osteoporosis in Chongqing in 2018^”, and the multi-stage stratified cluster random sampling method was used to select 1885 subjects (≥20 years old) from 32 villages/neighborhood committee in 4 areas (countries) of Chongqing. The investigation was performed by questionnaire (sociodemographic factors, lifestyle factors, history of orthopedics) and the bone mineral density was measured by QDR 4 500A dual energy X-ray absorptiometry. The chi-square test and multi factor multi-variant logistic regression analysis were utilized to analyze the data, the used software was SPSS 25.0. Results The morbidities of osteoporosis and osteopenia in residents (>20 years old) of Chongqing in China were 12.99% and 48.70%, respectively. The osteoporosis morbidity (19.08%) in females was significantly higher than that (4.42%) in males, and increased with age. The multi-variant logistic regression indicated that women (OR=6.10, 95% CI:4.08-9.14), the past medical history of fracture (OR=1.79, 95%CI:1.18-2.73) and age (OR=16.80, 95% CI:9.19-30.77) were risk factors for osteoporosis; milk intake (OR=0.65, 95%CI:0.47-0.89), overweight (OR=0.51, 95%CI:0.36-0.93)and obesity (OR=0.30, 95%CI:0.19-0.47), as compared with ≤primary school group, junior high school group (OR=0.57, 95%CI:0.39-0.82);≥high school group (0.40, 95%CI:0.26-0.61) were considered to be protective factors for osteoporosis. Conclusion The prevalence of osteoporosis among residents with age above 50 years old of Chongqing was very high. Health education and behavior intervention should be focused on the elderly or female residents to promote the formulation of healthy lifestyle.

Objective: To investigate the awareness of adolescent sexual knowledge among primary school students in Hangzhou City, so as to provide insights into adolescent sex education. Methods: In May 2021, grades 5 and 6 students were sampled from 5 primary schools in urban areas and 5 primary schools in suburban areas of Hangzhou City. The demographic features, awareness of adolescent sexual knowledge and sources of acquiring adolescent sexual knowledge were investigated using electronic questionnaires, and the awareness of adolescent sexual knowledge were analyzed among primary school students. Results: Totally 1 812 students completed valid questionnaires, including 861 grade 5 students ( 47.52% ) and 951 grade 6 students ( 52.48% ), 936 boys ( 53.86% ) and 836 girls (46.14%), and 912 students living in urban areas (50.33%) and 900 students living in suburban areas ( 49.67% ). The awareness rates of adolescent physiological knowledge, adolescent health knowledge, private parts and sexual harassment behaviors were 53.20%, 46.30%, 60.49% and 92.55%, respectively, and the awareness rates of adolescent physiological knowledge ( 69.52% vs. 39.14%; χ2=168.001), adolescent health knowledge (55.74% vs. 38.22%; χ2=55.619 ), private parts ( 72.49% vs. 50.20%; χ2=93.550 ) and sexual harassment behaviors ( 96.05% vs. 89.55%; χ2=27.621 ) were significantly higher in girls than in boys ( all P<0.05 ). The awareness rates of adolescent physiological knowledge ( 63.72% vs. 41.58%; χ2=88.989 ), private parts ( 64.56% vs. 55.98%; χ2=13.926 ) and sexual harassment behaviors ( 93.80% vs. 91.17%; χ2=4.509 ) were significantly greater among grade 6 students than among grade 5 students ( all P<0.05 ), and the awareness rates of adolescent physiological knowledge ( 69.96% vs. 36.22%; χ2=207.041 ), adolescent health knowledge (58.99% vs. 33.44%; χ2=118.903 ) and sexual harassment behaviors ( 96.16% vs. 88.89%; χ2=34.754 ) were significantly higher among students living in urban areas than among students living in suburban areas ( all P<0.05 ). Primary school students mainly acquired sexual knowledge from their parents ( 1 208 students, 66.67% ) and teachers ( 1 161 students, 64.07%), and the source of life was the predominant demand for sexual knowledge ( 969 students, 53.48% ). Conclusions The awareness of adolescent sexual knowledge remains to be increased among grade 5 and 6 primary school students in Hangzhou City. More attention paid to male students and students living in suburban areas, and building a school-family-community educational network are recommended to increase the awareness of adolescent sexual knowledge among primary school students.