The Expert Consensus on the Deployment of DeepSeek in Medical Institutions serves as a detailed guideline for the deployment of DeepSeek in medical institutions. It was developed by experts in the fields of healthcare， hospital management， medical information， health policy， law， and medical ethics from nearly 30 leading domestic medical and academic research institutions， based on relevant domestic and international laws and regulations as well as the practices of medical institutions. It aims to provide medical institutions with a scientific， standardized， and secure deployment guideline to ensure that the application of artificial intelligence （AI） technologies in healthcare， including but not limited to DeepSeek， conforms to the unique characteristics of the healthcare industry and effectively promotes the improvement of medical service levels. From the three aspects of pre-deployment evaluation， deployment implementation， and post-deployment management and monitoring， the key factors that medical institutions should consider when introducing DeepSeek were elaborated in detail， including medical demand compatibility， technical capabilities and infrastructure， legal and ethical risks， data preparation and management， model selection and optimization， system integration and training， performance monitoring and continuous optimization， risk management and emergency response， as well as compliance review and evaluation. This provides a comprehensive deployment framework for medical institutions to ensure the safety and effectiveness of technology applications.

Objective:To analyze the medication law of Professor Liu Guangzhen in the treatment of diabetic nephropathy (DN) with qi-yin deficiency and blood stasis syndrome using data mining methods.Methods:From March 2023 to April 2024, the TCM outpatient prescriptions used by Professor Liu to treat DN with qi-yin deficiency and blood stasis syndrome were collected. The database was established by Excel 2019, and the property, taste, meridian, and use frequency of drugs were analyzed through the TCM inheritance assistance system V2.5. The Apriori algorithm in IBM SPSS Modeler 18.0 was used to analyze the association rules and draw the network diagram of high-frequency drugs, and the two-step hidden tree analysis algorithm (LTM-EAST) in the Lantern 5.0 was used to establish the hidden structure model of high-frequency Chinese materia medica. The obtained hidden variables were clustered and interpreted comprehensively, and scored by Bayesian information measure (BIC).Results:A total of 314 prescriptions were included, involving 182 kinds of Chinese materia medica, with a total frequency of 9 242 times. High frequency Chinese materia medica included Astragali Radix, Saposheikovize Radix, Atractylodis Macrocephalae Rhizoma fried with wheat bran, Litchi Semen, Hedyotis diffusa willd, Benincasae Exocarpium, Mori Folium, etc. The medicinal property was mainly warm, the tastes were mainly sweet, bitter and pungent, and the meridian tropism was mainly spleen, stomach, liver and kidney meridians. The efficacy classification was mainly tonic drugs, heat-clearing drugs, water-clearing and dampness-percolating drugs, and blood circulation-activating drugs. There were 150 association rules of high-frequency Chinese materia medica, including Astragali Radix-Saposheikovize Radix, Atractylodis Macrocephalae Rhizoma fried with wheat bran-Hedyotis diffusa willd, Saposheikovize Radix-Benincasae Exocarpium, etc. A total of 15 hidden variables, 30 hidden classes and 5 comprehensive clustering models were obtained by hidden structure model analysis.Conclusions:Professor Liu's treatment of DN withqi-yin deficiency and blood stasis syndrome is mainly based on tonifying qi and yin, tonifying spleen and kidney, removing dampness and turbidity and removing blood stasis. According to different conditions, the focus of medication has changed.

Objective To study the predictive value of the Prognostic Assessment Scale for Patients with Spontaneous Intracerebral Hemorrhage(ICH-LR2S2)and the Prehospital Risk Assessment Scale for Prehospital Deterioration Risk Assessment Scale(ICH-APS)for the development of stroke-associated pneu-monia(SAP)in patients with spontaneous intracerebral hemorrhage.Methods A total of 349 patients with spontaneous intracerebral hemorrhage who were hospitalized for the first time in this hospital from July 2023 to July 2024 were selected as the research subjects.The general demographic data and medical documentations of the patients were collected,and ICH-LR2S2 score and ICH-APS score were carried out within 48 hours after admission.According to whether pneumonia occurred within 7 days after admission,the patients were divided into the SAP group and the non-SAP group,and the diagnostic efficiency of the ICH-LR2S2 score and ICH-APS score for SAP in patients with spontaneous intracerebral hemorrhage was evaluated.Results Among the 349 patients with spontaneous intracerebral hemorrhage,98 patients(28.08％)had pneumonia.The results of multivariate logistic regression analysis showed that age,history of chronic obstructive pulmonary disease(COPD),nasogastric tube,tracheal intubation,National Institutes of Health Stroke Scale(NIHSS)score,Glasgow Coma Scale(GCS)score,C-reactive protein,fasting blood glucose,dysphagia,ICH-LR2S2 score,ICH-APS-A score,and ICH-APS-B score were independent influencing factors for SAP in patients with spontane-ous intracerebral hemorrhage(P＜0.05).The results of the receiver operating characteristic(ROC)curve showed that the ICH-LR2S2 score had the highest diagnostic efficiency for SAP in patients with spontaneous intracerebral hemorrhage,with an area under the curve(AUC)of 0.837,a sensitivity of 0.827,a specificity of 0.783,and a Youden index of 0.610.Conclusion ICH-LR2S2 score has a high predictive value for the occur-rence of SAP in patients with spontaneous intracerebral hemorrhage.

Objective:To investigate the role of connective tissue growth factor (CTGF) and PI3K/Akt signaling pathways in paraquat (PQ) -induced alterations in alveolar epithelial cell mesenchymalization (EMT) .Methods:In February 2023, RLE-6TN cells were divided into 2 groups, which were set as uncontaminated group and contaminated group (200 μmol/L PQ), and cellular EMT alteration, CTGF and PI3K/Akt signaling pathway related molecules expression were detected by cell scratch assay, qRT-PCR and western-blot assay. Using shRNA interference technology to specifically inhibit the expression of CTGF, RLE-6TN cells were divided into four groups: control group, PQ group (200 μmol/L PQ), interference group (transfected with a plasmid with shRNA-CTGF+200 μmol/L PQ), and null-loaded group (transfected with a plasmid with scramble- CTGF+200 μmol/L PQ), qRT-PCR and western blot were used to examine the alteration of the cellular EMT and the expression of molecules related to the activity of PI3K/Akt pathway. The PI3K/Akt signaling pathway was blocked by the PI3K inhibitor LY294002, and the expression of EMT-related molecules in cells of the control group, PQ group (200 μmol/L PQ), and inhibitor group (200 μmol/L PQ+20 μmol/L LY294002) was examined by qRT-PCR and western blot.The t-test was used to compare the differences between the two groups, while the analysis of variance (ANOVA) was applied to compare the differences among multiple groups. For further pairwise comparisons, the Bonferroni method was adopted.Results:The results of cell scratch test showed that compared with the uncontaminated group, RLE-6TN cells in the contaminated group had faster migration rate, lower mRNA and protein expression levels of E-Cadherin, and higher mRNA and protein expression levels of α-SMA, CTGF, PI3K and Akt, with statistical significance ( P<0.05). After specific inhibition of CTGF expression, the mRNA and protein expression of CTGF, PI3K, Akt, and α-SMA in the cells of the interference group were significantly lower than that of the PQ group and the null-loaded group ( P<0.05/6), whereas that of E-Cadherin was higher than that of the PQ group and the null-loaded group ( P<0.05/6). Specifically blocking the PI3K/Akt signaling pathway, the mRNA and protein expression of PI3K, Akt and α-SMA in the cells of the inhibitor group was decreased compared with that of the PQ group ( P<0.05/3), while the expression of E-Cadherin was elevated compared with that of the PQ group ( P<0.05/3) . Conclusion:CTGF may promote PQ-induced alveolar epithelial cell EMT through activation of the PI3K/Akt signaling pathway. Inhibition of CTGF expression or blockade of PI3K/Akt signaling pathway activity can alleviate the extent of PQ-induced alveolar epithelial cell EMT.

Objective To compare the efficacy and safety of different Chinese patent medicines in the treatment of benign prostatic hyperplasia(BPH)by Bayesian network Meta-analysis.Methods PubMed,EMbase,Cochrane Library,CNKI,SinoMed,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)of Chinese patent medicine in the treatment of BPH from inception to January 1,2023.Two researchers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Bayesian network Meta-analysis was performed using Stata 15.0 and GeMTC 14.3 software.Results A total of 51 RCTs involving 12 kinds of Chinese patent medicines and 4 927 patients were included.The results of direct Meta-analysis showed that Chinese patent medicine combined with conventional western medicine was superior to conventional western medicine alone in reducing international prostate symptom score(MD=-4.44,95％CI-5.09 to-3.79,P＜0.001),improving maximum urinary flow rate(MD=3.16,95％CI 2.71 to 3.61,P＜0.001),reducing residual urine volume(MD=-8.27,95％CI-9.62 to-6.92,P＜0.001)and prostate volume(MD=-3.89,95％CI-4.60 to-3.18,P＜0.001).The results of the network Meta-analysis showed that the Longbishu capsules combined with conventional western medicine had the best effect in reducing the international prostate symptom score.In terms of improving maximum urinary flow rate,Xialiqi capsules combined with conventional western medicine had the best effect.Zegui Longshuang capsules combined with conventional western medicine had the best effect in reducing residual urine volume.In terms of reducing prostate volume,Relinqing granules combined with conventional western medicine had the best effect.The incidence of adverse reactions in the Chinese patent medicine combined with conventional western medicine group(8.27％)was lower than that in the conventional western medicine group(11.98％).Conclusion The existing evidence shows that compared with conventional western medicine alone,Chinese patent medicine combined with conventional western medicine is better than conventional western medicine alone in improving various clinical symptoms of BPH,and has better safety.Various proprietary Chinese patent medicines have different therapeutic focuses,and individualized medication can be used according to the specific symptoms of BPH patients in clinical treatment.Limited by the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality studies.

OBJECTIVE To explore the potential geographic distribution of Pinellia Ternata (Thunb.) Breit. in Gansu province, clarify its habitat requirements, and provide a theoretical basis for rational cultivation. METHODS Based on 100 geographic distribution points of Pinellia Ternata (Thunb.) Breit. and 39 environmental variables (including 19 bioclimatic variables, 17 soil variables and 3 topographic variables), the maximum entropy model(MaxEnt) and ArcGIS geographic information system software were used to make the habitat suitable for its evaluation and classification of suitable areas, the result of Jackknife test was used to evaluate the environmental variables that affect the habitat of Pinellia Ternata (Thunb.) Breit., the area under the ROC curve(AUC) was used to evaluate the degree of reliability of the prediction results. RESULTS The AUC was 0.993, indicating that the prediction results of the MaxEnt model were reliable. Monthly average daily temperature difference, isotherm, standard deviation of seasonal variation of temperature, annual precipitation, the wettest month precipitation, the driest month precipitation, the driest season precipitation, the coldest season precipitation and altitude were the main environmental variables affecting the growth of Pinellia Ternata (Thunb.) Breit.. The suitable areas for Pinellia Ternata (Thunb.) Breit. in Gansu were mainly concentrated in Longnan, Tianshui and Pingliang, where the areas of high, medium and low suitable areas were 16 180.4, 15 413.96, 21 204.84 km2, respectively. CONCLUSION The research results can provide a theoretical reference for the protection and standardized cultivation of Pinellia Ternata (Thunb.) Breit. resources.

Objective:To investigate the clinicopathological characteristics, diagnosis and differential diagnosis of intravascular large B-cell lymphoma (IVLBCL) and its collision tumors.Methods:Five cases of IVLBCL were collected, including 2 cases of collision tumors, and 1 case complicated with liver cirrhosis. The morphology and immunophenotype were analyzed. The related literature was reviewed.Results:There were 2 females and 3 males, aged from 53 to 73 years, with a median age of 65 years. The tumors were located in the lower extremities, right cerebellar hemisphere, left kidney, bilateral nasal cavity, and liver, respectively. Cases 2 and 3 were incidentally found in meningioma and renal cell carcinoma tissues, respectively. Case 5 had a background of liver cirrhosis. Morphologically, atypical large lymphoid cells were located in small blood vessels and capillary lumen, with little cytoplasm, hyperchromasia, prominent nucleoli, and obvious mitotic figures. Immunohistochemically, the IVLBCL tumor cells expressed CD20 and PAX5; 2 cases were CD5 positive. One of the 5 cases was GCB phenotype, and 4 cases were non-GCB phenotype. All cases expressed C-MYC (positive rate was 10%-40%). PD-L1 was positive in 4 cases (positive rate was 60%-90%). Ki-67 proliferation index was 70%-90%. CKpan, CD3, TDT, and CD34 were negative. In case 2, meningioma cells were positive for PR, EMA, and vimentin, but negative for CKpan and PD-L1. In case 3, renal carcinoma cells were positive for CKpan, PAX8, EMA, vimentin, CAⅨ and CD10, while PD-L1 was negative. No EBER expression (by in situ hybridization) or C-MYC gene translocation (FISH, break-apart probe) was detected in any of the 5 cases. Three patients were followed up, and all died within 1-13 months.Conclusions:IVLBCL is a highly aggressive lymphoma, with occult clinical manifestations and poor prognosis. Collision tumors of IVLBCL are extremely rare. A better understanding of IVLBCL would help pathologists avoid misdiagnoses.

Objective:To design a systematic emotion management training (EMT) targeted the characteristics of coping strategies based on rehabilitation assistant and explore the feasibility of online EMT in improving cognitive coping strategies, mental health, and social support of patients with coronary heart disease(CHD).Methods:From June 2021 to December 2022, a total of 106 CHD patients were screened from cardiovascular units of a hospital in Zhengzhou. All participants were divided into the intervention group ( n=53) and control group ( n=53) using the coin toss method. The patients in intervention group received 7 weeks emotion management training on the basis of routine health education, the patients in control group received 7 weeks routine health education. The scores of cognitive coping strategies, anxiety, depression, and social support were measured at baseline and post-intervention. Statistical analysis was conducted using SPSS 24.0 software.The cognitive coping strategies, mental health and social support scores between two groups were compared using independent sample t-tests or paired t-test. Pearson analysis was used to examine the correlation between cognitive coping strategies, mental health and social support. Results:The scores of adaptive coping strategies, maladaptive coping strategies, depression, anxiety, insomnia and social support in patients with CHD were (69.52±7.60), (35.22±6.15), (8.82±2.66), (8.78±1.99), (10.97±2.86), and (57.48±9.79), respectively. After intervention, the scores of maladaptive coping strategies, self-blame, rumination, catastrophizing, blaming others, putting into perspective, insomnia, anxiety, and depression in the intervention group were significantly lower than those in the control group( t=-7.742, -4.395, -4.781, -6.105, -6.256, -5.327, -6.017, -7.288, -7.749, all P<0.05). The scores of adaptive coping strategies, positive reappraisal, refocusing on planning and social support were significantly higher than those of the control group( t=7.314, 6.733, 5.874, 3.562, all P<0.05). In the intervention group, there were statistically significant differences in cognitive coping strategies, anxiety, depression, insomnia and social support scores before and after the test(all P<0.05) and they were not statistically significantly different in the control group(all P>0.05). Correlation analysis showed that maladaptive coping strategies were positively correlated with depression and anxiety scores ( r=0.421, 0.408, both P<0.05). Adaptive coping strategies were negatively correlated with depression and insomnia scores ( r=-0.225, -0.240, both P<0.05), and positively correlated with social support ( r=0.219, P=0.034) among patients with CHD. Conclusion:The online EMT based on rehabilitation assistant may be a useful intervention for patients with CHD which can promote psychological health, social support as well as positively transforming maladaptive coping strategies into adaptive coping strategies.

Objective To investigate the effects of climate change on the geographical distribution of Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Gansu Province,and predict its potential habitat;To provide a theoretical basis for resource conservation of cultivation of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao.Methods Based on the distribution data of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao from field surveys,the maximum entropy model and geographic information system were used to simulate its potential habitat in Gansu Province for the current(1970-2000)and future(2041-2060)periods,and the contribution of environmental factors and the results of the knife-cut test were integrated to assess the important factors governing the distribution of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao.Results The dominant environmental variables governing the geographical distribution of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao were precipitation in the wettest month,average temperature in the wettest season,and elevation.The potential suitable area of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Gansu Province under current climatic conditions was 65 902.66 km2,and the high suitable area was mainly concentrated in Dingxi District.In the future period,the suitable areas of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao under the scenarios of SSP126,SSP370 and SSP585 all showed a decreasing trend,especially the area of the high suitable areas decreased significantly.Conclusion Future climate change will lead to a significant reduction in the suitable habitat for A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao in Gansu Province.The suitable habitat will mainly move towards high-altitude mountainous areas,and the continuity of A.membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao resources can be maintained by establishing ecological protection zones.

Objective:To investigate the role of connective tissue growth factor (CTGF) and PI3K/Akt signaling pathways in paraquat (PQ) -induced alterations in alveolar epithelial cell mesenchymalization (EMT) .Methods:In February 2023, RLE-6TN cells were divided into 2 groups, which were set as uncontaminated group and contaminated group (200 μmol/L PQ), and cellular EMT alteration, CTGF and PI3K/Akt signaling pathway related molecules expression were detected by cell scratch assay, qRT-PCR and western-blot assay. Using shRNA interference technology to specifically inhibit the expression of CTGF, RLE-6TN cells were divided into four groups: control group, PQ group (200 μmol/L PQ), interference group (transfected with a plasmid with shRNA-CTGF+200 μmol/L PQ), and null-loaded group (transfected with a plasmid with scramble- CTGF+200 μmol/L PQ), qRT-PCR and western blot were used to examine the alteration of the cellular EMT and the expression of molecules related to the activity of PI3K/Akt pathway. The PI3K/Akt signaling pathway was blocked by the PI3K inhibitor LY294002, and the expression of EMT-related molecules in cells of the control group, PQ group (200 μmol/L PQ), and inhibitor group (200 μmol/L PQ+20 μmol/L LY294002) was examined by qRT-PCR and western blot.The t-test was used to compare the differences between the two groups, while the analysis of variance (ANOVA) was applied to compare the differences among multiple groups. For further pairwise comparisons, the Bonferroni method was adopted.Results:The results of cell scratch test showed that compared with the uncontaminated group, RLE-6TN cells in the contaminated group had faster migration rate, lower mRNA and protein expression levels of E-Cadherin, and higher mRNA and protein expression levels of α-SMA, CTGF, PI3K and Akt, with statistical significance ( P<0.05). After specific inhibition of CTGF expression, the mRNA and protein expression of CTGF, PI3K, Akt, and α-SMA in the cells of the interference group were significantly lower than that of the PQ group and the null-loaded group ( P<0.05/6), whereas that of E-Cadherin was higher than that of the PQ group and the null-loaded group ( P<0.05/6). Specifically blocking the PI3K/Akt signaling pathway, the mRNA and protein expression of PI3K, Akt and α-SMA in the cells of the inhibitor group was decreased compared with that of the PQ group ( P<0.05/3), while the expression of E-Cadherin was elevated compared with that of the PQ group ( P<0.05/3) . Conclusion:CTGF may promote PQ-induced alveolar epithelial cell EMT through activation of the PI3K/Akt signaling pathway. Inhibition of CTGF expression or blockade of PI3K/Akt signaling pathway activity can alleviate the extent of PQ-induced alveolar epithelial cell EMT.