Objective: To systematically characterize the developmental trajectory and interdisciplinary integration of intelligent diagnosis in traditional Chinese medicine (TCM) through quantitative topic evolution analysis, we addressed the fragmentation of existing research and clarified the long-term research structure and evolutionary patterns of the field. Methods: A topic evolution analysis was performed on Chinese-language literature pertaining to intelligent diagnosis in TCM. Publications were retrieved from the China National Knowledge Infrastructure (CNKI), Wanfang Data, and China Science and Technology Journal Database (VIP), covering the period from database inception to July 3, 2025. A hybrid segmentation approach, based on cumulative publication growth trends and inflection point detection, was applied to divide the research timeline into distinct stages. Subsequently, the latent Dirichlet allocation (LDA) model was used to extract research topics, followed by alignment and evolutionary analysis of topics across different stages. Results: A total of 3 919 publications published between 2003 and 2025 were included, and the research trajectory was divided into five stages based on data-driven breakpoint detection. The field exhibited a clear evolutionary shift from early rule-based systems and tongue-pulse image and signal analysis (2006 – 2010), to machine-learning-based syndrome and prescription modeling (2011 – 2015), followed by deep-learning-driven pattern recognition and formula association (2016 – 2020). Since 2021, research has increasingly emphasized knowledge-graph construction, multimodal integration, and intelligent clinical decision-support systems, with recent studies (2024 – 2025) showing the emergence of large language models and agent-based diagnostic frameworks. Topic evolution analysis further revealed sustained cross-stage continuity in syndrome modeling and prescription association analysis, alongside the progressive consolidation of integrated intelligent diagnostic platforms. Conclusion By identifying key technological transitions and persistent core research themes, our findings offer a structured reference framework for the design of intelligent diagnostic systems, the construction of knowledge-driven clinical decision-support tools, and the alignment of AI models with TCM diagnostic logic. Importantly, the stage-based evolutionary insights derived from this analysis can inform future methodological choices, improve model interpretability and clinical applicability, and support the translation of intelligent TCM diagnosis from experimental research to real-world clinical practice.

To investigate the risk factors for acute kidney injury (AKI) following the use of amphotericin B deoxycholate and to develop a predictive model to guide clinical monitoring and intervention.

ObjectiveTo explore the effects of Jingui Shenqiwan （JSW） and Liuwei Dihuangwan （LDW） on the reproductive ability and brain function of normal mice and compare the actions of the two medications. MethodsSeven groups of female and male mice were divided at a ratio of 2∶1. Except for the control group， the other six groups were as follows： a group of both males and females receiving JSW （3.0 g·kg^-1）， a group of both males and females receiving LDW （4.5 g·kg^-1）， a group of males receiving water and females receiving JSW， a group of males receiving water while females receiving LDW， a group of females receiving water while males receiving JSW， and a group of females receiving water while males receiving LDW. Each group was administered the drug for 14 days and then caged together at a 2∶1 （female∶male） ratio to detect the number of pregnant mice and calculate the pregnancy rate. Pregnant mice continued receiving the drug until they naturally gave birth， which was followed by the observation of newborn mice， calculation of their average number， and the measurement of the offspring's preference for sugar water and neonatal recognition index. At the end of the experiment， the weights of the thymus and spleen were measured to calculate the organ coefficients， and mRNA or protein expression was analyzed in the brain and testes or ovaries. A 1% sucrose solution was used to examine the euphoria of their brain reward systems， while novel object recognition test （NOR） was applied to assess their memory capabilities. mRNA expression was detected using real-time quantitative polymerase chain reaction （Real-time PCR） assay， and protein expression was analyzed with Western blot. ResultsCompared with the control group， oral administration of JSW to both male and female mice for 14 days significantly increased the pregnancy rate of female mice on day 2 after being caged together （P<0.05）， while LDW showed a trend but no statistical significance. Additionally， compared with the control group， JSW could upregulate the gene expression of gonadotropin-releasing hormone （GnRH） in the thalamus， as well as reproductive stem cell factor （SCF） and tyrosine kinase receptor （c-Kit） in the testes and reproductive stem cell marker mouse vasa homologue （MVH） in the ovaries， upregulate the expression of proteins influencing neuronal functional activity， such as brain-derived neurotrophic factor （BDNF）， in hippocampal neurons （P<0.05）， and enhance sucrose preference in male mice （P<0.05）. Compared with the control group， JSW significantly increased sucrose preference and novel object recognition index in offspring mice （P<0.05）， which was related to the upregulation of hippocampal dopamine D1 receptor （D1R） and N-methyl-D-aspartate receptor （Nmdar） gene expression. Compared with the control group， both JSW and LDW could upregulate the protein expression of glucocorticoid receptor （GR）， BDNF， and tyrosine kinase receptor B （TrkB） in the hippocampus of offspring mice （P<0.05）. ConclusionJSW significantly enhances the reproductive ability of normal mice， which is not only related to the release of gonadotropin but also associated with its regulation of brain function. Additionally， JSW has a certain regulatory effect on the brain function of the offspring mice.

To systematically evaluate the impact of the "group-based " medical assistance program for Xizang, conducted by Peking Union Medical College Hospital, on the implementation outcomes of standardized residency training (SRT) at the Xizang Autonomous Region People′s Hospital, and to provide evidence-based decision-making references and policy optimization recommendations for medical education support models in border ethnic minority regions.

This paper summarizes professor LIU Zhibin's clinical experience in treating Parkinson's disease with festinating gait by acupuncture combined with tuina based on the theory of the eight hollow spaces. Professor LIU holds that the disease involve the channel sinews and joints， and that the key pathogenesis lies in dysfunction of the eight hollow spaces， impairment of mechanical pivots and contraction of channel sinews. Clinically， these manifestations are characterized by impaired function of the hip and popliteal regions with dysregulation of gait initiation and termination， as well as impaired function of the axillary and elbow regions with discoordination of postural balance and movement. The therapeutic principle is regulating the spirit， unblocking the collaterals， and facilitating the eight hollow spaces. Acupuncture focuses on awakening the brain， regulating the spirit， unblocking the eight hollow spaces and dredging the sinew channels， whereas tuina focuses on releasing sinew knots around the hip and popliteal regions and restoring the movement of mechanical pivots. Particular emphasis is placed on the sequential application of acupuncture and tuina and the integration of static and dynamic approaches， with physical movement used to facilitate regulation of the spirit and gait training employed to consolidate therapeutic effects. This approach provides a new perspective for the treatment of festinating gait in Parkinson's disease with traditional Chinese medicine.

Objective: To analyze the bidirectional association between sleep status and depressive symptoms among primary school students, so as to provide scientific evidence for developing targeted intervention and health education on children s mental health. Methods: In December 2021, 1 787 students in grades 2 and 3 selected from three primary schools in a district of Tianjin by a convenient sampling method were investigated in a baseline questionnaire survey, which was followed by a one year follow up in December 2022. The survey content included sociodemographic characteristics, lifestyle, etc., and the Children s Sleep Habits Questionnaire and the Center for Epidemiologic Studies Depression Scale for Children were used to assess students sleep quality, sleep duration, social jetlag and depressive symptoms. Linear regression model was applied to examine the association between sleep status and depressive symptoms score in primary school students, and cross lagged panel model was adopted to analyze the bidirectional association between sleep status and depressive symptoms. Results: At baseline, the sleep quality score among primary school students was 43.00(39.00, 47.00), the daily sleep duration was 9.42(9.12, 9.76) h, the social jetlag was 0.58( 0.29 , 0.92) h, and the depressive symptoms score was 5.00(2.00, 9.00). At the oneyear followup, the score of sleep quality among primary school students was 42.00(38.00, 47.00), the daily sleep duration was 9.43(9.12, 9.78)h, the social jetlag was 0.50 (0.25, 0.78)h, and the score of depressive symptoms was 4.00(2.00, 9.00). After adjusting for confounding factors such as gender, parental education level, and monthly family income, linear regression analyses showed that the baseline sleep quality score was positively associated with follow up depressive symptoms scores ( β =0.25) among primary school students, while baseline sleep duration ( β =-0.06) and baseline social jetlag ( β =-0.08) were both negatively associated with follow up depressive symptoms score (all P <0.05). Cross lagged regression models indicated that baseline sleep quality score positively predicted depressive symptoms score at the 1 year follow up ( β =0.10), and baseline depressive symptoms score positively predicted follow up sleep quality score ( β = 0.08 )(both P <0.05). Conclusions There is a bidirectional association between sleep quality and depressive symptoms among primary school students. Improving sleep quality may help alleviate children s depressive symptoms.

Objective:To analyze risk factors associated with false-positive results of quantitative fecal immunochemical testing (FIT), evaluate its performance for detecting advanced colorectal neoplasia across different subgroups, and explore the optimal positivity thresholds for each subgroup.Methods:Individuals who participated in the Zhejiang Colorectal Cancer Screening Program in 2020-2021, completed questionnaire-based risk assessment and quantitative FIT for initial screening, and undertook colonoscopy for confirmed diagnosis were included in this study. The information of individuals, including demographic characteristics, lifestyles, history of diseases, and family history of colorectal cancer (CRC), was collected by using questionnaires. The diagnostic outcomes of the individuals were obtained through colonoscopy and pathological examination. Multivariate logistic regression analyses were conducted to identify factors associated with false-positive FIT results. The optimal threshold of FIT was determined based on the receiver operating characteristic (ROC) curve and 10-fold cross-validation. The effectiveness of FIT screening in different subgroups was compared using the unified threshold of 100 ng/ml or optimal positivity thresholds.Results:There were 25 874 individuals included in the analysis, with 14 694 (56.79%) having fecal hemoglobin concentrations ≥100 ng/ml. A total of 3 830 advanced adenoma cases (14.80%) and 362 CRC cases (1.40%) were identified. Age below 60 years old, females, underweight, smoking, drinking, use of nonsteroidal anti-inflammatory drugs, no family history of CRC, no history of intestinal disease, no history of hypertension, and physical inactivity were associated with an elevated risk of false-positive results in FIT ( P<0.05). Compared to the predetermined threshold of 100 ng/ml, the false positive rate (FPR) of quantitative FIT decreased from 52.3% to 37.3% in all individuals, and decreased by more than 20% in females, individuals with normal weight, smokers, and those without a history of intestinal disease when adopting the optimal threshold (all P<0.001). Conclusion:The risk of false-positive results in quantitative FIT varies across different subgroups. Adopting the optimal thresholds could improve the specificity and reduce the FPR of quantitative FIT for CRC screening.

Objective:To establish reference values for clot waveform analysis (CWA) and analyze their diagnostic efficacy in distinguishing acquired hemophilia A (AHA) and lupus anticoagulant (LA)-positive patients.Methods:Case-Control Study. A total of 391 healthy individuals(260 males and 131 females) with a mean age of 45.53±14.85 years were enrolled at Nanyang central Hospital between January 6, 2023 and October 10, 2024. Prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT) were measured to establish reference ranges for the CWA parameters, including maximal reaction velocity (Min1), maximal reaction acceleration (Min2), and maximal reaction deceleration (Max2). A total of 158 definitively diagnosed AHA and LA-positive patients (mean age:42.46±14.83 years), including 34 AHA patients and 124 LA-positive patients, were recruited. The Mann Whitney U test was used to analyze the differences in the CWA parameters between the two groups. The diagnostic efficacy of CWA parameters in distinguishing AHA and LA-positive patients was evaluated using the area under the receiver operating characteristic(ROC) curve AUC and the cut-off values were calculated. Results:The reference values for PT-Min1, APTT-Min1, APTT-Min2, APTT-Max2, TT-Min1, TT-Min2, TT-Max2 were 203.41-516.89, 144.63-324.03, 526.46-1 190.03, -404.96±157.22, 159.17±60.34, 272.29-686.99, and -289.47--113.76, respectively. Compared with the CWA parameters in AHA patients, APTT-Max2 was significantly lower in LA-positive patients [-422.74(-577.50, -239.22) vs. -68.87(-92.85,30.28), Z=-7.43, P<0.01], while PT-Min1, APTT-Min1, APTT-Min2, TT-Min1, TT-Min2 were significantly elevated [287.01(188.03, 382.50) vs. 107.45(90.20, 151.39), 972.88(601.20, 1 351.19) vs. 229.10(118.38, 371.67), Z=6.68, 6.69, all P<0.01]. ROC analysis demonstrated the APTT-CWA parameter exhibited high diagnostic efficacy in patients with AHA (AUC>0.900 for both).Additionally, APTT-Min1 and APTT-Max2 were found to be useful in distinguishing between AHA patients and those with LA-positive status accompanied by APTT prolongation (AUC=0.660, 0.700, respectively). Conclusions:Reference values for CWA parameters were successfully established. The APTT-CWA is useful for differentiating between AHA and LA-positive patients and APTT-Max2 demonstrated a good diagnostic value in differentiating AHA patients from those with LA-positive status accompanied by APTT prolongation.

OBJECTIVE To investigate the diagnosis and treatment of small cell neuroendocrine carcinoma(SNEC)of nasal cavity and paranasal sinuses.METHODS The clinical data of 5 patients with SNEC diagnosed at Tianjin People's Hospital and Medical University General Hospital from December 2016 to August 2022 were retrospectively analyzed.There were 4 male patients and 1 female patient.The age range was 40-70 years,with an average age of 55 years.Among them,there were 4 stage ⅣA and 1 stage ⅣC.Two patients underwent surgery plus radiotherapy and chemotherapy,one patient underwent radiotherapy followed by chemotherapy,one patient underwent concurrent radiotherapy and chemotherapy,and one patient refused treatment.The follow-up period was 4-60 months.RESULTS By the end of the follow-up,2 patients died,2 patients relapsed,and 1 patient had no recurrence.CONCLUSION Nasal cavity and paranasal sinus neuroendocrine tumors are rare,and small cell neuroendocrine carcinoma is even rarer.The clinical symptoms are not typical,and it is usually discovered at an advanced stage.The malignancy is high,and it is generally treated with a comprehensive approach that includes radiotherapy and chemotherapy.The treatment effect is poor.

The bottom-up construction of artificial cells to mimic signal transduction is of great significance for a deep understanding of the communication networks of complex living systems.The dynamic coupling of signal secretion and response among artificial cells poses an important challenge.In this work,two types of artificial cells were constructed through a bio-artificial hybrid strategy.One was an artificial cell as an AI-2 signal sender(sender),which contained bacteria capable of autonomously synthesizing AI-2 signaling molecules.The other was an artificial cell as an AI-2 signal receiver(receiver),which contained bacteria expressing green fluorescent protein in response to the corresponding AI-2 signal.When the ratio of senders to receivers was 4∶1,the fluorescent signal of the receivers gradually increased over time and reached a plateau at 240 minutes.The artificial cells capable of sending and receiving quorum sensing signaling molecules constructed in this work laid a foundation for the study of complex signal communication within artificial cell populations.