Objective: To investigate methods for constructing a high-quality instructional dataset for traditional Chinese medicine (TCM) mental disorders and to validate its efficacy. Methods: We proposed the Fine-Med-Mental-T&P methodology for constructing high-quality instruction datasets in TCM mental disorders. This approach integrates theoretical knowledge and practical case studies through a dual-track strategy. (i) Theoretical track: textbooks and guidelines on TCM mental disorders were manually segmented. Initial responses were generated using DeepSeek-V3, followed by refinement by the Qwen3-32B model to align the expression with human preferences. A screening algorithm was then applied to select 16 000 high-quality instruction pairs. (ii) Practical track: starting from over 600 real clinical case seeds, diagnostic and therapeutic instruction pairs were generated using DeepSeek-V3 and subsequently screened through manual evaluation, resulting in 4 000 high-quality practice-oriented instruction pairs. The integration of both tracks yielded the Med-Mental-Instruct-T&P dataset, comprising a total of 20 000 instruction pairs. To validate the dataset’s effectiveness, three experimental evaluations (both manual and automated) were conducted: (i) comparative studies to compare the performance of models fine-tuned on different datasets; (ii) benchmarking to compare against mainstream TCM-specific large language models (LLMs); (iii) data ablation study to investigate the relationship between data volume and model performance. Results: Experimental results demonstrate the superior performance of T&P-model fine-tuned on the Med-Mental-Instruct-T&P dataset. In the comparative study, the T&P-model significantly outperformed the baseline models trained solely on self-generated or purely human-curated baseline data. This superiority was evident in both automated metrics (ROUGE-L > 0.55) and expert manual evaluations (scoring above 7/10 across accuracy). In benchmark comparisons, the T&P-model also excelled against existing mainstream TCM LLMs (e.g., HuatuoGPT and ZuoyiGPT). It showed particularly strong capabilities in handling diverse clinical presentations, including challenging disorders such as insomnia and coma, showcasing its robustness and versatility. Data ablation studies showed that T&P-model performance had an overall upward trend with minor fluctuations when training data increased from 10% to 50%; beyond 50%, performance improvement slowed significantly, with metrics plateauing and approaching a saturation point. Conclusion This study has successfully constructed the specialized Med-Mental-Instruct-T&P instruction dataset for TCM mental disorders proposed the systematic Fine-Med-Mental-T&P methodology for its development, effectively addressing the critical challenge of high-quality, domain-specific data scarcity in TCM, and providing essential data support for developing intelligent TCM diagnostic and therapeutic systems.

Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

This article is based on modern psychology and TCM emotional theory,combined with facial expression recognition technology,to apply deep learning methods to the digital research of TCM emotions to more accurately capture and analyze patients'emotional states.A cross-disciplinary framework was established by synthesizing facial expression-emotion correlations from psychological and TCM perspectives.The methodology included:Data annotation of TCM-defined emotional expressions using standardized coding systems;Facial expression acquisition,spatiotemporal feature extraction and emotion classification through a 3D convolutional neural network(3D CNN).The framework achieved 91.43%accuracy in video-based emotion classification.High-arousal emotional states demonstrated superior recognition performance,with anger showing optimal recall(1.000 0)and F1-score(0.946 3),while surprise attained the highest precision(0.976 0).These findings aligned with TCM pathological characteristic of"anger induces qi ascending,surprise disrupts qi flow".The digital recognition framework for TCM emotional quantification based on facial expression recognition technology exhibits strong alignment with TCM observation diagnosis,providing clinicians with an objective tool to assess the"seven emotions"and elucidating emotion-facial correlations in classical TCM theory.Future research should focus on longitudinal validation across diverse populations and establish development pathways for AI-assisted TCM diagnostic systems.

Objective:To investigate the clinical features and pathogenesis of a child with Stargardt disease caused by variants of ABCA4 gene. Methods:A child presented at Shenzhen Eye Hospital between September 5, 2020, and April 3, 2023 was selected as the study subject. Clinical data of the child were collected. Whole exome sequencing was performed on peripheral blood samples from the child and his parents. Candidate variants were validated by Sanger sequencing and bioinformatic analysis. This study was approved by the Medical Ethics Committee of Shenzhen Eye Hospital (Ethics No.: 2022KYPJ072).Results:The child was a 10-year-old male presenting with uncorrected visual acuity of 0.1 in both eyes without improvement with refractive correction. Fundus photography showed diffusely distributed yellow-white flecks in the macular region. FAF revealing central hypofluorescence surrounded by a hyperfluorescent ring, and OCT demonstrating significant foveal thinning (right eye: 45 μm; left eye: 50 μm) with ellipsoid zone disruption. Whole exome sequencing and Sanger sequencing revealed that the child has harbored compound heterozygous variants of the ABCA4 gene, namely c. 2384G>T (p.Gly795Val) and c. 2903G>A (p.Arg968Glu), which were inherited from his phenotypically normal parents and consistent with an autosomal recessive inheritance. This specific combination of the variants was previously unreported. According to the guidelines from the American College of Medical Genetics and Genomics (ACMG) guidelines, both variants were classified as likely pathogenic (PM2_Supporting+ PM3+ PP3+ PP4; PM1+ PM2_Supporting+ PP3+ PP4). Conclusion:The novel compound heterozygous variants of the ABCA4 gene probably underlay the genetic etiology of Stargardt disease type 1 in this child. Above finding has expanded the mutational spectrum of the ABCA4 gene among the Chinese population and provided further evidence for understanding the genetic heterogeneity and genotype-phenotype correlation of the Stargardt disease.

Objective:To investigate the protective effect of myrislignan（MRL）on concanavalin A（Con A）-induced autoimmune hepatitis（AIH）.Methods:C57BL/6J mice were divided into the following groups using a random number table，with five mice in each group：control group，MRL group，model group（Con A group），and MRL pretreatment group（MRL+Con A group）. MRL was injected intraperitoneally at a dose of 30 μg/g；3 h after pretreatment，Con A（18 μg/g）was administrated by intravenous injection；mouse livers and serum samples were collected 12 h after injection for measuring serum transaminase levels and liver cell apoptosis. The mRNA and protein expression levels of IL-6，IL-12，and TNF-α were measured using qRT-PCR and ELISA. Flow cytometry was performed to detect the proportion and activation status of macrophages in liver tissues. Bone marrow-derived macrophages（BMDMs）were isolated and induced in vitro to analyze the regulatory effect of MRL on macrophages. One-way analysis of variance was used to compare the differences in various indicators among groups. Results:Compared with the Con A group，MRL（30 μg/g）pretreatment significantly reduced alanine aminotransferase（ P<0.05）and aspartate transaminase（ P<0.01）levels，attenuated liver oxidative stress（increased superoxide dismutase activity，while decreased levels of malondialdehyde and myeloperoxidase；all P<0.05），and suppressed hepatocyte apoptosis（ P<0.01）. Both in vivo and in vitro experiments confirmed that MRL（30 μg/g）could reduce the proportion of M1 macrophages（ in vivo： P<0.05； in vitro：all P<0.001）and inhibit macrophage activation（ in vivo： P<0.01； in vitro：all P<0.05）. Conclusion:MRL effectively prevents Con A-induced autoimmune hepatitis by inhibiting liver cell apoptosis，attenuating liver oxidative stress，suppressing M1 macrophage polarization，and reducing inflammatory cytokine expression.

With the continuous progress of modern science and technology, the research of TCM inspection is gradually moving towards a new stage of objectification and intelligence. By systematically sorting out the key technologies involved in the objectification of inspection and diagnosis, and summarizing its clinical application progress in the three core areas of face diagnosis, tongue diagnosis and visual diagnosis, it is found that the inspection and diagnosis of TCM can not only significantly improve the efficiency and accuracy of clinical diagnosis with the help of modern technology, but also achieve more results in disease differentiation, constitution identification and efficacy evaluation. The key technologies include digital image processing, infrared thermal imaging, spectroscopy, photoelectric volume and artificial intelligence (AI) technology. In terms of clinical application, facial diagnosis focuses on image and infrared thermography feature analysis, tongue diagnosis involves image, spectral feature research and AI model construction, and eye diagnosis focuses on white eye collaterals extraction, fundus sign analysis and eye movement information research. However, there are still some problems, such as imperfect standardization system, bottleneck of multi-modal fusion and interpretation, insufficient clinical verification and practicability. In the future, the deep integration of TCM observation and modern science and technology should be promoted by means of technological integration and innovation and strengthening interdisciplinary cooperation, so as to help the modernization of TCM diagnosis.

Objective:To analyze the clinical features of nasal pleomorphic adenoma and to share clinical insights into its diagnosis and treatment.Methods:This was a case series study. Clinical data of 12 patients with nasal pleomorphic adenoma, confirmed by histopathology, admitted to the Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Qingdao University from 2014 to 2023, were retrospectively analyzed. This cohort included 3 males and 9 females, aged 12-84 years old. The pathogenesis, clinical manifestations, imaging features, pathological features, treatment methods and prognosis were analyzed.Results:Among the 12 patients with nasal pleomorphic adenoma, the most common symptom was nasal obstruction (8 cases), and the most common site was nasal septum (7 cases). Of the 12 patients, 9 had benign tumors, and 3 had malignant tumors. Postoperative follow-up ranged from 10 months to 9 years. One benign case recurred at 5 years after surgery and was left untreated after recurrence. The remaining 11 cases had shown no recurrence to date.Conclusions:Nasal pleomorphic adenoma is rare in clinical practice, typically occurring in the nasal septum. The primary symptom is nasal obstruction. Diagnosis is primarily based on histopathology, and surgical resection is the primary treatment.

OBJECTIVE: To investigate the clinical features and pathogenesis of a child with Stargardt disease caused by variants of ABCA4 gene. METHODS: A child presented at Shenzhen Eye Hospital between September 5, 2020, and April 3, 2023 was selected as the study subject. Clinical data of the child were collected. Whole exome sequencing was performed on peripheral blood samples from the child and his parents. Candidate variants were validated by Sanger sequencing and bioinformatic analysis. This study was approved by the Medical Ethics Committee of Shenzhen Eye Hospital (Ethics No.: 2022KYPJ072). RESULTS: The child was a 10-year-old male presenting with uncorrected visual acuity of 0.1 in both eyes without improvement with refractive correction. Fundus photography showed diffusely distributed yellow-white flecks in the macular region. FAF revealing central hypofluorescence surrounded by a hyperfluorescent ring, and OCT demonstrating significant foveal thinning (right eye: 45 μm; left eye: 50 μm) with ellipsoid zone disruption. Whole exome sequencing and Sanger sequencing revealed that the child has harbored compound heterozygous variants of the ABCA4 gene, namely c.2384G>T (p.Gly795Val) and c.2903G>A (p.Arg968Glu), which were inherited from his phenotypically normal parents and consistent with an autosomal recessive inheritance. This specific combination of the variants was previously unreported. According to the guidelines from the American College of Medical Genetics and Genomics (ACMG) guidelines, both variants were classified as likely pathogenic (PM2_Supporting+PM3+PP3+PP4; PM1+PM2_Supporting+PP3+PP4). CONCLUSION The novel compound heterozygous variants of the ABCA4 gene probably underlay the genetic etiology of Stargardt disease type 1 in this child. Above finding has expanded the mutational spectrum of the ABCA4 gene among the Chinese population and provided further evidence for understanding the genetic heterogeneity and genotype-phenotype correlation of the Stargardt disease.
Humans ; Male ; Child ; ATP-Binding Cassette Transporters/genetics* ; Stargardt Disease/genetics* ; Heterozygote ; Mutation ; Exome Sequencing ; Macular Degeneration/congenital*

Objective:To analyze the clinical features of patients with traumatic optic neuropathy (TON) and to explore its clinical patterns and treatment outcomes.Methods:A retrospective analysis was conducted on data from 323 patients (334 eyes) with TON, who were treated in the Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University from April 1999 to October 2024. Among these patients, 288 were male and 35 were female, with ages ranging from 4 to 70 years. All patients were followed up for a period of 6 to 24 months, with the final follow-up visual acuity recorded as the ultimate visual outcome. The visual acuity evaluation criteria were classified into five levels: no light perception, light perception, hand movement in front of the eye, counting fingers at 1 meter, and "chart-visible acuity". A treatment outcome was deemed effective if the post-treatment visual acuity improved by one level or more compared to pre-treatment, or if the chart-visible acuity improved by two lines or more on the logMAR chart. The clinical characteristics of patients, causes of injury, complications, treatment methods, and changes in visual acuity before and after treatment were summarized. Logistic regression analyses were performed to identify the influencing factors affecting treatment efficacy.Results:TON occurred mostly in young (215/323, 66.56%) males (288/323, 89.16%), the majority of patients came from villages and towns (236/323, 73.07%). Traffic accidents (232/323, 71.83%) remained the main etiology. Most patients had craniofacial injuries and other bodily injuries. The effective rate of vision improvement was 50.30% (168/334). Multiple logistic regression analyses identified that residual vision (light perception or better) at presentation ( OR=3.26, P<0.001) and receiving treatment within 7 days after injury ( OR=2.04, P=0.008) were protective factors on visual acuity recovery, while the presence of orbital wall fracture was a risk factor for visual acuity recovery ( OR=0.26, P<0.001). Additionally, undergoing surgical treatment was a protective factor for visual improvement in patients with no light perception ( OR=2.94, P=0.007). For patients with residual vision at presentation, orbital wall fracture was a significant risk factor ( OR=0.28, P=0.009). Conclusions:TON is more prevalent in young males and is primarily caused by traffic accidents, leading to a poor prognosis. Timely medical intervention following injury significantly influences prognostic outcomes. Early surgical intervention (within 7 days) is recommended, particularly for patients with no light perception at presentation.

Objective To analyze the quality of medical record home pages for discharged patients in a tertiary hospital in Guangzhou in 2023 based on the dual dimensions of Diagnosis-Related Groups(DRG)and Disease Intervention Program(DIP),and to provide a basis for improving the refinement of medical record home page quality management.Methods Dis-charge medical records from a tertiary general hospital in 2023 were selected.All medical records were grouped using DRG,while medical records under Guangzhou medical insurance and cross-province medical insurance implemented under DIP were simulated for DIP grouping.The writing defects in the discharge medical records were analyzed,as well as the DRG grouping,RW,and DIP standard scores of medical records with home page filling defects.Results Among 172 230 discharge medical records,171 786 were grouped into DRG,91 768 were grouped into DIP,and 91 604 were grouped into both DRG and DIP.A significant positive correlation was found between RW and DIP standard scores(r2=0.681,P＜0.001).Among the 91 604 medical records grouped into both DRG and DIP,1 942(2.12％)had writing defects,including 837(0.91％)with home page defects.DRG groups with more home page defect records included NC15,HK2,EJ13,EB15,HJ13,and RE19.Conclusion Quality defects in medical record home pages impact the accuracy of DRG and DIP grouping.Systematic measures such as strengthening medical record writing training and establishing scientific reward and punishment mechanisms should be implemented to provide data sup-port for the further advancement of DRG/DIP payment reform.