ObjectiveHistorically documented Zhejiang Atractylodis Macrocephalae Rhizoma（Baizhu） possesses premium characteristics such as phoenix-like head and crane-like neck， pronounced sweetness， and fragrant aroma. However， its current market circulation is low， and the processed products with Zhejiang-style characteristics are at the risk of being lost. This study aims to preserve the ancient Zhejiang-style processing techniques and evaluate them using modern scientific methods. MethodsMultidimensional intelligent sensory evaluation was used to digitally characterize the "quality-structure" of the external appearance of nine-steamed and nine-processed Baizhu medicinal materials（intermediate processed products） and the "odor-taste" of the internal quality of its decoction pieces（slices）， and the appearance parameters were digitally characterized by colorimeter， texture analyzer， electronic nose and electronic tongue， the chemical composition was analyzed via ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS）. Then， cluster analysis on the differences in odor between the medicinal materials（intermediate processed products） and decoction pieces（slices） of nine-steamed and nine-processed Baizhu was conducted， as well as the differences in taste between water-soluble and alcohol-soluble extracts of the decoction pieces（slices）， and the correlation analysis of chroma value-alcohol-soluble extract content-component response value. ResultsThe nine-steamed and nine-processed Baizhu had a dark brown to black epidermis， a brownish-yellow to brownish-gray cross-section， a slightly tough texture， a faint odor， and a slightly sweet， bitter and pungent taste. Texture analyzer measurements revealed minimal adhesion and maximum recovery in the middle section of the characteristic processed Baizhu， consistent with the processing endpoint of thorough steaming and cooking. The head section showed the highest internal hardness， elasticity and chewiness， indicating a denser texture in this area. The electronic nose sensor could clearly distinguish the difference between the medicinal materials and its decoction pieces， with a more significant clustering effect at 60 ℃ for 30 minutes compared to ambient temperature headspace for 2 hours， highlighting the significant impact of the baking degree before slicing on the quality. The electronic tongue taste signal map clearly distinguished the differences between water-soluble and alcohol-soluble extracts of nine-steamed and nine-processed Baizhu decoction pieces， and the addition of auxiliary materials during processing could enhance its alcohol-soluble extract content. A total of 82 chemical components were identified in the characteristic processed Baizhu. After processing， the contents of 58 components increased， while 24 components decreased. Correlation analysis revealed significant negative correlations（P<0.01） between ethanol-soluble extract content and colorimetric values of brightness（L^*）， yellow-bule value（b^*）， and total color difference（E^*_ab）. E^*_ab showed marked negative correlations（P<0.05） with the response values of isochlorogenic acid A and C. ConclusionThis study establishes a modern intelligent sensory evaluation model for multidimensional holographic characterization of nine-steamed and nine-processed Baizhu， clarifying the correlation between increased isochlorogenic acid content and the visual color appearance after different steaming cycles， as well as its intrinsic alcohol-soluble extracts. This provides a reference for quality evaluation and processing standards of the Zhejiang-style characteristic processed products.

Objective To investigate the correlation between gut microbiota characteristics and immunotherapy efficacy in patients with advanced microsatellite stable (MSS) advanced gastrointestinal tumors. Methods Thirty patients with advanced MSS gastrointestinal tumors, including fourteen cases of gastric cancer and sixteen cases of colorectal cancer, who were admitted from November 1, 2022, to July 31, 2025 were enrolled. All patients underwent gut microbiota testing and received corresponding interventions on the basis of the results, followed by treatment with antiangiogenic agents combined with immunotherapy. Some patients additionally received probiotics or fecal microbiota transplantation. The primary endpoints were disease control rate (DCR) and objective response rate (ORR). The secondary endpoints were progression-free survival (PFS) and overall survival (OS). Univariate and multivariate Cox regression analyses were used to assess potential prognostic factors. Results Among the thirty patients, no complete response was observed. Two cases of partial response (PR), twelve cases of stable disease, and sixteen cases of progressive disease were recorded. The ORR was 6.7%, and the DCR was 46.7%. The median PFS was 6.4 months, and the median OS was 8.3 months. Both PR patients were classified as having a medium risk of gut microbiota dysbiosis and exhibited a Bacteroides-dominated enterotype. Multivariate analysis indicated that tumor type, liver metastasis, and bone metastasis were potential prognostic factors for PFS and OS. Conclusion Patients with a medium risk of gut dysbiosis may exhibit a relatively favorable response to immunotherapy, suggesting that gut microbiota status could serve as a potential biomarker for predicting treatment efficacy in advanced MSS gastrointestinal tumors.

Objective To explore the independent risk factors for long-term adverse prognosis after percutaneous renal artery angioplasty in patients with transplant renal artery stenosis(TRAS).Methods We retrospectively collected medical records and surgery details of TRAS patients who underwent renal artery angioplasty at the Department of Peripheral Vascular Diseases,The First Affiliated Hospital of Xi'an Jiaotong University,from January 2017 to June 2021.All patients were followed up for 3 years post-operation.Multivariate Cox regression analyses were performed to find the independent predictive factors for long-term adverse prognosis after renal artery angioplasty in the TRAS patients.Results A total of 45 TRAS patients who underwent percutaneous renal artery angioplasty were included in this study.During the five-year follow-up period,10 patients(22.2％)experienced long-term adverse events.These consisted of 3 patients(6.7％)who died from any cause,1 patient(2.2％)who developed transplant renal artery dissection,6 patients(13.3％)who had restenosis of the transplant renal artery,and 1 patient(2.2％)who lost the transplant kidney and received dialysis again.Multivariate Cox regression analysis showed that male gender(HR=4.915,95％CI:1.036-23.328,P=0.045)and balloon angioplasty alone(HR=8.594,95％CI:2.191-33.710,P=0.002)were independent risk factors for long-term adverse prognosis after renal artery angioplasty in TRAS patients.Conclusion Male gender and balloon angioplasty alone are independent risk factors for long-term adverse prognosis after renal artery angioplasty in TRAS patients.

Objective To explore the predictive value of ultra-sound(US)combined with multi-sequence MRI in a clinical-deep learning radiomics nomogram(DLRN)for the short-term efficacy of neoadjuvant chemotherapy(NAC)in patients with triple-negative breast cancer(TNBC).Methods A total of 122 TNBC patients from five hospitals were retrospectively analyzed,and divided into training group(72 cases)and validation group(50 cases).The clinical and pathological data,NAC regimens,and imaging data were collected.The lesions and its surrounding 10-unit voxels from US and MRI images were retained as the region of interest(ROI).Pyradiomics software and a ResNet152 convolutional neural network(CNN)framework were used to extract radiomics and deep learning features to construct a clinical-DLRN with outcome dimension fusion.The receiver operating characteristic(ROC)curve and calibration curve were plotted,and five-fold cross-validation decision curve were used to verify the model's clinical effec-tiveness.Results The clinical-DLRN constructed by US combined with multi-sequence MRI showed that area under the curve(AUC)was 0.967[95％confidence interval(CI)0.782-0.967]and accuracy(ACC)was 0.900,respectively.The five-fold cross-validation decision curve showed good generalization,with the highest clinical net benefit between risk thresholds of 0.72 and 0.96.Conclusion The clinical-DLRN integrating US and multi-sequence MRI has the best efficacy in predicting the short-term efficacy of NAC in TNBC patients,which offering potential guidance for personalized TNBC treatment.

Objective:To evaluate the effectiveness of a patient-family-centered visiting model in improving caregivers'beliefs and attitudes toward visiting patients with mental disorders.Methods:A total of 140 caregivers of inpatients diagnosed with mental disorders according to the ICD-10 were randomly assigned to an intervention group(n=71)and a control group(n=69).The intervention group participated a patient-family-centered visiting model for 4 weeks,while the control group followed routine visitation.Caregivers' beliefs and attitudes were assessed using the Beliefs and Attitudes toward Visitation in ICU Questionnaire(BAVIQ)was used to assess the improvement in caregivers' beliefs and attitudes before the intervention and at the end of the 1st,2nd,3rd,and 4th weeks after the intervention.Results:Repeated measures ANOVA showed that the belief score and attitude score of the BAVIQ questionnaire in the intervention group were significantly higher than those in the control group(Ps＜0.05)across time points.Chi-square test further confirmed that the improvement in the intervention group were significantly bet-ter than in the control group(Ps＜0.05).Conclusion:The patient-family-centered visiting model is more effective than routine visiting model in improving the caregivers' visiting beliefs and attitudes in mental health settings.

Objective To explore the path of expanding the forms and optimizing the effects of children's health science popularization,further enhance the dissemination effect of science popularization,and improve children's health literacy.Meth-ods The WeChat public account of a tertiary pediatric hospital in Tianjin was selected as the research object.Using case analy-sis and data collection methods,statistics on the proportion of health science articles,the proportion of forms,reading volume,and other data were collected.Quantitative analysis was conducted on the dissemination effect of health science popularization.Strategies were proposed based on the problems reflected in the data.Results In this study,184 articles were studied,and 61 science popularization articles were analyzed in depth.In terms of science content,there were 2 articles with a total reading vol-ume of over 100 000.The average reading volume was mostly distributed in the range of 1 000-3 000 views,and the number of forwards and views maintained a low level of 4-15 views.In terms of the form of science popularization,the average reading vol-ume of video content was about 3 600 views,and the average reading volume of comic content was about 8 800 views,both lower than the average reading volume of traditional graphic content.Conclusion Based on the problems of low accuracy of children's health science content and insufficient formal innovation,an optimization path centered on the audience to optimize content and expand forms is proposed.This provides a reference for medical institutions to further leverage the role of WeChat public accounts and improve the level of children's health science popularization.

Objective To explore the path of expanding the forms and optimizing the effects of children's health science popularization,further enhance the dissemination effect of science popularization,and improve children's health literacy.Meth-ods The WeChat public account of a tertiary pediatric hospital in Tianjin was selected as the research object.Using case analy-sis and data collection methods,statistics on the proportion of health science articles,the proportion of forms,reading volume,and other data were collected.Quantitative analysis was conducted on the dissemination effect of health science popularization.Strategies were proposed based on the problems reflected in the data.Results In this study,184 articles were studied,and 61 science popularization articles were analyzed in depth.In terms of science content,there were 2 articles with a total reading vol-ume of over 100 000.The average reading volume was mostly distributed in the range of 1 000-3 000 views,and the number of forwards and views maintained a low level of 4-15 views.In terms of the form of science popularization,the average reading vol-ume of video content was about 3 600 views,and the average reading volume of comic content was about 8 800 views,both lower than the average reading volume of traditional graphic content.Conclusion Based on the problems of low accuracy of children's health science content and insufficient formal innovation,an optimization path centered on the audience to optimize content and expand forms is proposed.This provides a reference for medical institutions to further leverage the role of WeChat public accounts and improve the level of children's health science popularization.

Sinopodophyllum hexandruma is a traditional Chinese medicine in China,which is mostly distributed in Gansu,Shaanxi,Sichuan,Qinghai,Yunnan and Xizang,etc.In recent years,with the gradual deepening of the research on the chemical composition and pharmacology-toxicology of Sinopodophyllum hexandruma,its antitumour and antiviral pharmacodynamic evaluation has increasingly become a research hotspot in the industry.Based on the chemical structure,pharmacological properties and the theoretical basis of quality markers(Q-markers),this paper presents an in-depth literature review and analysis of the chemical composition,pharmacological activities and Q-markers of Sinopodophyllum hexandruma,and systematically explores and predicts the Q-markers of Sinopodophyllum hexandruma.It is proposed that Podophyllotoxin,picropodophyllotoxin,podophyllotoxinone,quercetin,kaempferol,quercetin-3-O-β-glucoside can be used as the Q-marker of Sinopodophyllum hexandruma.In the later stage,these index components can be selected to control the whole quality of Sinopodophyllum hexandrum,and provide some data support and theoretical reference for the quality evaluation of Sinopodophyllum hexandrum.

With the rapid development of artificial intelligence(AI),how to digitize the teaching of Medical Immunology is a new challenge posed by the times and education.This study is based on the advanced teaching model of Medical Immunology,which includes lectures-PAD class-flipped classrooms-expert lecture.By introducing knowledge mapping and AI teaching assistant into the entire learning process,the students not only deepen their understanding of the knowledge system of Medical Immunology,but also ex-ercise their ability to apply immunological knowledge to solve practical clinical problems,enhance their self-learning ability,expres-sion ability,communication ability,on-site performance ability,and cultivate a spirit of unity,cooperation,and exploration.The practice of empowering Medical Immunology teaching with digital intelligence achieves the integration of theory and application,the linkage between in class and out of class teaching,the connection between commonalities and individualities,and the union of abili-ties and qualities in Medical Immunology teaching.It also provides practical basis for exploring the implementation path of digital intel-ligence empowerment in Medical Immunology teaching.

Objective:To explore the effectiveness of a modified puncture method in hemodialysis patients with difficult internal fistula.Methods:From January 2022 to October 2023, patients with difficult internal fistula undergoing dialysis at the Blood Purification Center of Qingdao Municipal Hospital were selected for the study using the convenience sampling method. According to the hemodialysis time, patients dialyzed on Mondays, Wednesdays, and Fridays were included in the conventional group, and patients dialyzed on Tuesdays, Thursdays, and Saturdays were included in the experimental group, with 56 cases in each group. Internal fistula puncture was performed in the conventional group using the traditional puncture method and in the experimental group using the modified puncture method. The success rate of one-time puncture of internal fistula and the injury rate of internal fistula were compared between the two groups of patients.Results:The success rate of one-time puncture of internal fistula in the experimental group was higher than that in the conventional group, with a statistical difference ( P<0.05). The injury rate of the internal fistula vessel of the experimental group was lower than that of the conventional group, and the difference was statistically significant ( P<0.05) . Conclusions:Modified puncture methods have a positive effect on increasing the success rate of a one-time puncture of the internal fistula and decreasing the rate of internal fistula injuries in patients with difficult internal fistula.