Erchentang is a classic formula widely used by medical practitioners throughout history. In this paper，ancient and modern literature of Erchentang were collected， and bibliometrics was employed to analyze its historic evolution，prescription meaning，herbs origin， processing method，preparation methods， and clinical application. A total of 84 pieces of data were collected， and 58 pieces of data involving 53 ancient medical Chinese books were screened， sorted， and processed. Combined with research of modern scholars，the research has found that the Erchentang originated from the Taiping Huimin Huiye Shijie Fang compiled by the Imperial Medical Bureau of the Song Dynasty. The basic information about the origin of the drugs is quite clear. Pinelliae rhizoma in the formula is the dried tuber of Pinellia ternata. Citri exocarpium rubrum is the dried mature peel of Citrus reticulata and its cultivated varieties， with the inner white membrane removed. Poria is the whitest dry sclerotia of Poria cocos； Glycyrrhizae radix et rhizoma is the dried root and rhizome of the Glycyrrhiza uralensis. The dosage is 5.70 g Pinelliae rhizome and Citri exocarpium rubrum， 3.43 g Poria， and 1.69 g Glycyrrhizae radix et rhizoma praeparata cum melle. During the decoction process， the above-mentioned herbs should be chopped， with 300 mL water， 7 g ginger in thick slices， and 2 g Mume fructus added， and it was then simmered together to 180 mL. After removing the medicinal residue， it can be taken warmly. Erchentang has the effect of drying dampness and resolving phlegm， regulating Qi and harmonizing the middle. It can be used in treating the syndrome of phlegm and dampness，as well as symptoms such as frequent cough，white phlegm，fullness in chest and diaphragm，nausea and vomiting，limb drowsiness，anorexia，dizziness，palpitations，white and greasy tongue coating， and slippery pulse. The above results provide reference for future research and development of Erchentang.

OBJECTIVE To investigate the protective effect and mechanism of saikosaponin C （SSC） on acute liver injury （ALI） in mice induced by carbon tetrachloride （CCl4） based on serum metabolomics. METHODS Forty mice were divided into blank group （water）， model group （water）， positive control drug group （Biphenyl diester drop pills， 150 mg/kg）， and SSC low- and high-dose groups （2.5， 10 mg/kg） using the random number table method， with 8 mice in each group. They were given water/ relevant drugs， once a day， for 7 consecutive days. One hour after the last administration， all mice were intraperitoneally injected with 0.2% CCl4 olive oil to induce ALI model， except for the blank group. After 17 hours of the modeling， the liver index of mice was calculated. The levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， lactate dehydrogenase （LDH）， tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and IL-1β in serum of mice were detected. The histopathological changes of liver tissue were observed. Meanwhile， the serum metabolomics of mice were analyzed by liquid chromatography-mass spectrometry. RESULTS Compared with the blank group， the levels of liver index， ALT， AST， LDH， TNF-α， IL-6， and IL-1β in the model group were significantly increased （P＜0.01）. Hepatocytes were edema， vacuolar degeneration， more necrosis， and a large number of inflammatory cells were infiltrated. Compared with the model group， liver index and serum index levels of mice were significantly decreased （P＜0.05 or P＜0.01）， accompanied by marked improvement in histopathological damage to the liver tissue. The metabolomics results showed that compared with the model group， there were 63 up-regulated and 256 down-regulated differential metabolites in the serum of mice in the SSC high-dose group， including prostaglandin B2， 20-hydroxy-leukotriene B4， 5- hydroxy-L-tryptophan， 7α -hydroxycholesterol， etc.； these metabolites were primarily involved in metabolic pathways such as arachidonic acid metabolism， 5-hydroxytryptamine synapse， primary bile acid biosynthesis. CONCLUSIONS SSC exerts a protective effect against CCl4-induced ALI by down-regulating the level of key metabolites such as prostaglandin B2 and 20-hydroxy-leukotriene B4， and then ruducing metabolic pathways such as arachidonic acid metabolism， 5- hydroxytryptamine synapse， and primary bile acid biosynthesis.

Objective To retrospectively analyze multicenter data from domestic sources, aiming to explore the link between intrahepatic cholangiocarcinoma (ICC) tumor size and prognosis, establishing a classification system based on tumor size. Methods Between December 2011 and September 2018, 280 ICC patients from 13 hospitals were included. The tumor size prognosis cutoff was identified by the minimum P-value method, and the classification's overall survival related effectiveness was assessed by Kaplan-Meier analysis. Results All 280 patients were divided into the group of tumor maximum diameter ≤4 cm and >4 cm. Tumor size was confirmed as an independent prognosis factor by multivariate COX regression analysis (HR=2.110, 95% CI: 1.358-3.280). Conclusions The tumor size dichotomy classification system based on the Chinese patient group can expediently predict ICC prognosis and offers an important basis for selecting post-operative individualized adjuvant therapy and follow up plans.

With the specialization of orthopedics and the increasing complexity of foot and ankle disease profiles, traditional fragmented diagnosis and treatment models face challenges such as low efficiency and poor patient experience. By integrating a multidisciplinary collaboration model with digital-intelligent technologies such as artificial intelligence, big data, and 3D printing, the integrated diagnosis and treatment center emerges as an innovative, modern healthcare service model centered on the patient. It achieves a "one-stop" closed-loop management spanning specialized outpatient care, precision surgery, and remote rehabilitation. Intelligent surgical planning, robot-assisted therapy, and digital rehabilitation systems have significantly enhanced the precision and continuity of care. This article details the current construction status and development trends of integrated digital-intelligent diagnosis and treatment centers in the field of foot and ankle surgery. As medical models and innovative technologies continue to advance, these centers will play an even greater role in the future, bringing improved health outcomes to patients.

Objective To explore the application and effectiveness of the apprenticeship education model in Chinese herbal medicine teaching at Western medical college.Methods By comparing classic lecture-based teaching with a combined approach integrating apprenticeship education,the study assesses the impact on student learning outcomes.Participants included students from the 2018 cohort of the eight-year clinical medicine program and the 2022 cohort of the"4+4"pilot program at Peking Union Medical College,who received classic teaching methods and apprenticeship case-based teaching methods,respectively.Upon course completion,students completed a 14-item multiple-choice questionnaire covering essential theory of Chinese medicine,as well as specific categories such as qi-regulating,blood-activating herbs,among others.Results The overall accuracy rate in the apprenticeship case-based teaching group was significantly higher than that in the classic teaching group(P＜0.01).Conclusions The apprenticeship education model of Traditional Chinese Medicine has a positive effect on teaching of Chinese herbal medicine at West-ern medical college and warrants further promotion and application.

The apprenticeship education of Traditional Chinese medicine(TCM)is an important pathway for the cultivation of talents in TCM education.The combination of institutional education and apprenticeship education is considered to be the most suitable educational model that aligns with the inherent characteristics of TCM education.The current status of TCM education in western medical institutions and the main challenges include the difficulty in transitioning between western and Chinese medical reasoning and limited clinical internship hours for TCM.The strengths and features of TCM apprenticeship education lie in cultural heritage,classical teachings,mentorship,practice orientation and personalized education.Therefore,integration of TCM apprenticeship education and clinical internships for western medical students represents a new educational model for medical undergraduates.

Tingli Dazao Xiefeitang is a classic formula for treating lung abscesses and thoracic fluid retention， recognized throughout history and included in the Catalogue of Ancient Classic Formulas （Second Batch）. This article employs bibliometric methods to investigate and analyze the source， origin， and key information of Tingli Dazao Xiefeitang， providing a theoretical basis for the development and application of this renowned formula. The results show that Tingli Dazao Xiefeitang first appears in Synopsis of the Golden Chamber （Jin Kui Yao Lue）， where three clinical applications are recorded. The original text clearly states that this formula is used to treat lung abscesses and thoracic fluid retention， with symptoms such as inability to lie down due to wheezing， chest and rib fullness， facial edema， inability to rest due to thoracic fluid retention， and cough inversion. This aligns with findings from ancient application research. In later generations， the methods proposed by ZHANG Zhongjing were predominantly used for medication and formulation. Modern applications of Tingli Dazao Xiefeitang focus primarily on the respiratory system， with pleural effusion being the most common condition. For the preparation and decoction， a single dose of 5 g of Descurainiae Semen Lepidii Semen （dried and mature seeds of Lepidium apetalum） processed as stir-fried seeds and 36 g of Jujubae Fructus （dried and mature fruit of Ziziphus jujuba） prepared as raw materials were recommended. Then 600 mL of water was added and Jujubae Fructus was first boiled until the volume reduced to 400 mL. After filtering out the residue， the supernatant was retained and mixed with stir-fried Descurainiae Semen Lepidii Semen， followed by boiling to 200 mL， which should be consumed all at once. This research provides a theoretical basis for the development and application of this formula.

Objective:To analyze the changes in the variables of venous thromboembolism (VTE) management among inpatients after implementing clinical care classification (CCC) system, and to explore the impacts.Methods:This was a quasi experimental study. Based on the network monitoring data in Zhongshan Hospital, Fudan University, all the inpatients were included in this study from January 2022 to June 2023. According to the date of implementing CCC, we took July 2022 as the intervention cut-off point, and two phases of pre-CCC (January 2022 to June 2022) and post-CCC (July 2022 to June 2023) were defined. The interrupted time series (ITS) analysis was used to evaluate the impacts of implementing CCC system on VTE management among inpatients.Results:ITS analysis showed that in the period of post-CCC (August 2022 to June 2023), the slope of VTE evaluation rate was 0.000 415 5, with a significant upward trend ( t=2.49, P<0.05). In the month of CCC system launched (July 2022), the implementation rate of VTE preventive measures increased significantly, with a significant statistical difference ( t=3.10, P<0.05). In the post-CCC phase (August 2022 to June 2023), the slope of VTE preventive measures implementation rate was -0.012 876, with no significant statistical difference ( P>0.05). The implementation of CCC system had no significant impacts on the overall and high-risk incidence of VTE among inpatients. Conclusions:After the implementation of the CCC system, the VTE evaluation rate of inpatients increased significantly, which suggesting that the CCC system standardized the clinical VTE management among inpatients.

Objective To analyze the differences in static balance plantar pressure characteristics between female adolescent idiopathic scoliosis(AIS)patients with moderate Lenke 3CN and healthy adolescents of the same age,and provide a scientific basis for scoliosis screening,assessment,treatment,and prognosis evaluation.Methods A total of 30 female patients with moderate Lenke 3CN AIS as the AIS group and 30 healthy female adolescents of the same age as the control group were selected,respectively.The plantar pressure data of the subjects were collected,and the characteristics of equilibrium plantar pressure distributions in two groups were comparatively analyzed.Results Regarding the plantar pressure characteristics,the average pressure(P<0.05)and hindfoot pressure(P<0.05)of the left and right foot in the AIS group were significantly greater than those of the control group,the forefoot pressure was significantly lower than that of the control group(P<0.05),and the symmetry index(SI)of both feet was significantly greater than that of the control group(P<0.05).The plantar pressure of the left foot in the AIS group was significantly larger than that of the control group in the medial mid-foot area and 1st toe area(P<0.05),and significantly smaller than that of the control group in the 1st,2nd,3rd,4th and 5th metatarsal areas(P<0.05);the plantar pressure of the right foot in the AIS group was significantly greater than that of the control group in the medial heel area and the1st toe area(P<0.05),and significantly smaller than that of the control group in the lateral mid-foot area,the 3rd,4th,5th metatarsal area and 3rd,4th,5th toe area(P<0.05);and the plantar pressure in the right foot of the AIS group was significantly smaller than that of the control group in the medial heel area and 1st toe area(P<0.05).The plantar pressures at lateral midfoot area,the 3rd,4th,5th metatarsal area and the 3rd,4th,5th toe area of the right foot were significantly larger than those of the control group(P<0.05).Regarding the center of pressure(COP),the length of the COP trajectory,the ellipse area of the 95%confidence interval,the maximum distance of COP left-right movement(COP-X),and the maximum distance of COP anterior-posterior movement(COP-Y)of the AIS group were significantly larger than those of the control group(P<0.05).Conclusions There are significant differences in static balance plantar pressure characteristics between female AIS patients with moderate Lenke 3CN and healthy female adolescents of the same age,with foot pressure favoring the side of the lateral convexity,poorer symmetry and stability of the feet,and weaker balance control.

Objective To explore the value of multi-parameter spectral CT for differentiating grade G2-3 pancreatic neuroendocrine tumor(pNET)and pancreatic neuroendocrine carcinoma(pNEC).Methods Preoperative double-layer detector spectral CT(DLCT)data of 35 patients with pNET(pNET group,including 25 cases of G2 grade and 10 cases of G3 grade)and 17 patients with pNEC(pNEC group)were retrospectively analyzed.Conventional CT and spectral CT parameters were compared between groups,and those being significant different between groups according to univariate analysis were respectively incorporated into multivariate logistic regression to select the independent predictors for identifying grade G2-3 pNET and pNEC.Conventional CT model and spectral CT model were constructed,and the combined model was constructed based on the two.The efficacy of each model for distinguishing grade G2-3 pNET and pNEC was evaluated.Results CT values of lesions during venous phase(OR=0.939,P=0.025)and vascular invasion(OR=5.049,P=0.027)shown on conventional CT were both independent predictors,and conventional CT model was constructed,its area under the curve(AUC)for distinguishing grade G2-3 pNET and pNEC was 0.808.Normalized iodine concentration during venous phase(OR=0.603)and normalized effective atomic number during venous phase(OR=0.847)on spectral CT were both independent predictors(both P＜0.05),and spectral CT model was constructed.The AUC of spectral CT model was 0.894,higher than that of conventional CT model(Z=2.127,P=0.033).The AUC of combined model was 0.924,higher than that of conventional CT model(Z=2.302,P=0.021)but not significantly different with that of spectral CT model(Z=0.827,P=0.408).Conclusion Multi-parameter spectral CT could effectively differentiate grade G2-G3 grade pNET and pNEC.