1.Comparison of Automatic Evaluation Methods for Pattern Hallucinations of Large Language Models in Traditional Chinese Medicine Syndrome Differentiation
Qinwei WU ; Yuzhu GAO ; Xingyue GOU ; Junyu YAO ; Chuangan ZHOU ; Zhengchun XUE ; Zhirong XU ; Xinlin CHEN ; Dong CAO
Journal of Traditional Chinese Medicine 2026;67(17):1845-1852
ObjectiveTo compare the performance of different automatic evaluation methods for detecting pattern hallucinations generated by large language models (LLMs) in traditional Chinese medicine (TCM) syndrome differentiation and to identify a strategy with higher overall discriminative performance against expert manual judgment. MethodsA standardized TCM syndrome-differentiation dataset containing 598 cases was constructed from case reports published in Chinese core journals indexed by Peking University Core Journals or Chinese Science Citation Database. Each of the 598 cases was submitted to five Chinese LLMs, with each model generating one syndrome-pattern output per case, yielding 2990 outputs in total. The 598 outputs generated by Qwen3-Next-80B-A3B-Thinking were independently annotated for syndrome-pattern hallucinations by two licensed TCM physicians with intermediate or higher professional titles. Disagreements were adjudicated by a third licensed TCM physician with a senior associate professional title and more than 10 years of clinical experience. The resulting consensus annotations served as the reference labels for training and validating the automated evaluation method. Based on these reference labels, three categories of automated evaluation methods were developed and compared following a progressive strategy from text-level semantic similarity, to syndrome-element structural consistency, and finally multi-feature fusion. Method A employed sentence-embedding models based on semantic similarity between pattern texts. Method B adopted a rule-based threshold method using weighted Jaccard coefficients of disease-location and disease-nature syndrome elements. Method C utilized a machine-learning classifier integrating syndrome-element matching scores, missing and redundant syndrome-element counts, and multiple semantic-similarity features. Five-fold cross-validation was used to evaluate the discriminative performance of each method against manual judgment. The optimal method was then applied to uniformly assess the pattern hallucination rates of five LLMs. ResultsIn method A, text2vec-large-chinese showed best overall performance, with an area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (PR-AUC), F1-score, sensitivity, and specificity of 0.849, 0.884, 0.794, 0.801, and 0.691, respectively. In method B, the corresponding metrics of the rule-based syndrome-element Jaccard threshold method were 0.848, 0.851, 0.817, 0.845, and 0.684, respectively; those of the LLM-based syndrome-element Jaccard method were 0.872, 0.906, 0.795, 0.764, and 0.780, respectively. In method C, the multilayer perceptron (MLP) classifier showed the best overall performance, with AUROC, PR-AUC, F1-score, sensitivity, and specificity of 0.933, 0.951, 0.871, 0.857, and 0.846, respectively. Under the unified evaluation framework combining DeepSeek-R1 syndrome-element extraction and MLP classifier, the estimated pattern hallucination rates of the five LLMs ranged from 56.0% to 77.4%. ConclusionAmong the three automatic evaluation methods, Method C integrating syndrome-element discrepancy features and text semantic features using an MLP classifier showed the highest overall discriminative performance against manual judgment, and is more suitable for evaluating syndrome hallucinations in LLM-based TCM syndrome differentiation tasks.
2.Expert consensus on non-surgical treatment for acute lateral ankle sprain (version 2025)
Hui CHE ; Wenge DING ; Shiming FENG ; Xueping GU ; Qinwei GUO ; Jianchao GUI ; Yinghui HUA ; Yuefeng HAO ; Qinglin HAN ; Bo HU ; Xiaojun LIANG ; Guoping LI ; Yunxia LI ; Qi LI ; Yanlin LI ; Xin MA ; Jun MA ; Xudong MIAO ; Jianzhong QIN ; Xiaodong QIN ; Xu SUN ; Kefu SUN ; Weidong SONG ; Dai SHI ; Zhongmin SHI ; Youlun TAO ; Xu WANG ; Youhua WANG ; Liheng WANG ; Anli WANG ; Aiguo WANG ; Weidong WU ; Yajun XU ; Weidong XU ; Renjie XU ; Yongsheng XU ; Tengbo YU ; Lianqi YAN ; Xiaodong YUAN ; Yuan ZHU ; Mingzhu ZHANG ; Hongtao ZHANG ; Xintao ZHANG ; Xiaofei ZHENG
Chinese Journal of Trauma 2025;41(6):517-529
Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.
3.Expert consensus on non-surgical treatment for acute lateral ankle sprain (version 2025)
Hui CHE ; Wenge DING ; Shiming FENG ; Xueping GU ; Qinwei GUO ; Jianchao GUI ; Yinghui HUA ; Yuefeng HAO ; Qinglin HAN ; Bo HU ; Xiaojun LIANG ; Guoping LI ; Yunxia LI ; Qi LI ; Yanlin LI ; Xin MA ; Jun MA ; Xudong MIAO ; Jianzhong QIN ; Xiaodong QIN ; Xu SUN ; Kefu SUN ; Weidong SONG ; Dai SHI ; Zhongmin SHI ; Youlun TAO ; Xu WANG ; Youhua WANG ; Liheng WANG ; Anli WANG ; Aiguo WANG ; Weidong WU ; Yajun XU ; Weidong XU ; Renjie XU ; Yongsheng XU ; Tengbo YU ; Lianqi YAN ; Xiaodong YUAN ; Yuan ZHU ; Mingzhu ZHANG ; Hongtao ZHANG ; Xintao ZHANG ; Xiaofei ZHENG
Chinese Journal of Trauma 2025;41(6):517-529
Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.
4.Comparison of the clinical efficacy between biopsy forceps polypectomy with submucosal injection and traditional biopsy forceps polypectomy for diminutive colorectal polyps
Qiuli WU ; Yuanli LI ; Chenwei ZHENG ; Xiangbo CHEN ; Qinwei XU
Chinese Journal of Digestive Endoscopy 2024;41(12):979-984
Objective:To explore the clinical efficacy of biopsy forceps polypectomy with submucosal injection for diminutive colorectal polyps.Methods:The patients with diminutive colorectal polyps (long diameter≤5 mm in size) who received polypectomy in Quanzhou First Hospital Affiliated to Fujian Medical University from May 2021 to May 2022 were prospectively recruited and divided into the observation group (biopsy forceps polypectomy with submucosal injection) and the control group (traditional biopsy forceps polypectomy). The location, morphology, long diameter, the complete polypectomy rate under direct vision, the time of resection and endoscopy withdrawal, pathological results, specimen collection rate, the incidence of complications and endoscopic treatment cost were analyzed. The clinical efficacy of the two methods were compared.Results:A total of 292 patients were included in the study, with 146 in the observation group and 146 in the control group. There were 258 polyps in the observation group and 252 polyps in the control group. The complete polypectomy rate was higher in the observation group than that in the control group [100.0% (258/258) VS 90.1% (227/252), χ2=26.915, P=0.001] with clear vision. The incidence of complications in the observation group was lower than that in the control group (1/146 VS 13/146, χ2=10.804, P=0.001) , along with the lower treatment cost (173.7±15.9 yuan VS 184.0±53.8 yuan, Z=-2.777, P=0.005). The resection time in the observation group was longer than that in the control group, but the difference was not statistically significant [10 (9,11) min VS 9 (9,11) min, Z=-0.528, P=0.597]. There was no significant difference in the polyp position, long diameter, morphology, pathological classification, or the specimen collection rate between the two groups ( P>0.05). Conclusion:Biopsy forceps polypectomy with submucosal injection is safe for diminutive colorectal polyps, and it demonstrates a higher complete polypectomy rate, lower complication rates, and reduced treatment costs compared with traditional biopsy forceps polypectomy. It is a new perspective for managing diminutive colorectal polyps.
5.Comparison of the clinical efficacy between biopsy forceps polypectomy with submucosal injection and traditional biopsy forceps polypectomy for diminutive colorectal polyps
Qiuli WU ; Yuanli LI ; Chenwei ZHENG ; Xiangbo CHEN ; Qinwei XU
Chinese Journal of Digestive Endoscopy 2024;41(12):979-984
Objective:To explore the clinical efficacy of biopsy forceps polypectomy with submucosal injection for diminutive colorectal polyps.Methods:The patients with diminutive colorectal polyps (long diameter≤5 mm in size) who received polypectomy in Quanzhou First Hospital Affiliated to Fujian Medical University from May 2021 to May 2022 were prospectively recruited and divided into the observation group (biopsy forceps polypectomy with submucosal injection) and the control group (traditional biopsy forceps polypectomy). The location, morphology, long diameter, the complete polypectomy rate under direct vision, the time of resection and endoscopy withdrawal, pathological results, specimen collection rate, the incidence of complications and endoscopic treatment cost were analyzed. The clinical efficacy of the two methods were compared.Results:A total of 292 patients were included in the study, with 146 in the observation group and 146 in the control group. There were 258 polyps in the observation group and 252 polyps in the control group. The complete polypectomy rate was higher in the observation group than that in the control group [100.0% (258/258) VS 90.1% (227/252), χ2=26.915, P=0.001] with clear vision. The incidence of complications in the observation group was lower than that in the control group (1/146 VS 13/146, χ2=10.804, P=0.001) , along with the lower treatment cost (173.7±15.9 yuan VS 184.0±53.8 yuan, Z=-2.777, P=0.005). The resection time in the observation group was longer than that in the control group, but the difference was not statistically significant [10 (9,11) min VS 9 (9,11) min, Z=-0.528, P=0.597]. There was no significant difference in the polyp position, long diameter, morphology, pathological classification, or the specimen collection rate between the two groups ( P>0.05). Conclusion:Biopsy forceps polypectomy with submucosal injection is safe for diminutive colorectal polyps, and it demonstrates a higher complete polypectomy rate, lower complication rates, and reduced treatment costs compared with traditional biopsy forceps polypectomy. It is a new perspective for managing diminutive colorectal polyps.
6.Analysis of the use of antidepressants and its influencing factors among depressive patients
Yu ZHOU ; Qinwei XU ; Chuandong WU
Chinese Journal of Behavioral Medicine and Brain Science 2018;27(9):830-833
Objective To analyze the use of antidepressants and its influencing factors in patients with depressive disorders in Haikou City,and to provide some reference for clinical rational drug use.Methods 310 patients with depressive disorder in Haikou were selected.All patients were assessed with the selfdesigned General Situation and Drug Use Questionnaire,General Self-efficacy Scale (GSES),Quality of Life Questionnaire for Psychiatric Patients (QOL-P) and Hamilton Depression Scale (HAMD-17).Results (1)The usage rate of serotonin reuptake inhibitors (SSRIs) was 53.22%,30.32% for tricyclic antidepressants (TCAs) and 16.45% for other new antidepressants.(2)Patients'self-efficacy (β=-0.473,OR=0.713,P=0.030),social function (β=0.371,OR=1.437,P=0.036),family income (β=-1.242,OR=0.423,P=0.001) were the factors influencing patients' choice of TCAs;family income (β=-1.762,OR=0.234,P=0.001),payment method (β =0.248,OR =1.157,P =0.030) were the factors influencing the choice of SSRIs drugs;self-efficacy (β=0.563,OR=1.913,P=0.041) and depression (β=0.543,OR=2.225,P=0.026) were the factors influencing the choice of other new antidepressants.Conclusion Traditional antidepressants such as serotonin reuptake inhibitors and tricyclic antidepressants are still widely used in patients with depressive disorders.Self-efficacy,social function,income,and payment methods can influence the drug selection of depressive patients.
7.Study on capillary endothelium injury in the lung with ischemia-reperfusion
Jian WU ; Yi JIN ; Ying SUN ; Qinwei ZHENG ; Xinhong TAN
Chinese Journal of Pathophysiology 1986;0(04):-
AIM: To confirm the effects of capillary endothelium injury in the lung with ischemia reperfusion. METHODS: The rabbits pulmonary models of ischemia reperfusion (I-R)injury were established. Plasma nitric oxide and endothelin levels, arterial oxygen tension and wet/dry weight ratios were determined in different periods in control and I-R groups, and the pulmonary ultrastructure abnormities were analyzed under electromicroscope. RESULTS: The plasma levels of NO and ET-1 in I-R animals increased significantly ,compared with those in sham treated control groups. The level of ET-1 had significantly negative correlation with PaO 2 and positive correlation with the value of the wet/dry weight ratios. The swelling and karyopyknosis of capillary endothelium in the lung with I-R groups were observed in ischemia periods. The injuries of endotheliums and typeⅠandⅡ alveolar cells in 0 5 h of reperfusion were more severe than those in ischemia time, and the injuries began to repair in 2 h of reperfusion time. CONCLUSION: In the I-R group, pulmonary capillary endothelium have been injuried, which may play a prominent role in I-R injury and dysfunction of the lung.

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