DeepSeek,a domestically developed generative artificial intelligence(AI)tool,is experiencing rapid growth within China's technological landscape.With its core advantages of open-source accessibility,cost-efficiency,vertical scenario specialization,and Chinese linguistic contextualization,it has been reconfiguring medical education.This development brings nu-merous innovative opportunities to postgraduate medical education,particularly in standardized training of resident physicians.On one hand,DeepSeek creates new possibilities for participants in residency training regarding knowledge acquisition,assisted learning,and teaching methodologies.On the other hand,its implementation raises concerns such as inadequate development of higher-order thinking skills,lack of realistic doctor-patient communication simulations,and diminished roles of clinical instruc-tors.Hospitals with a resident physician training base should promptly adapt to the new situation and move embrace intelligent de-velopment.By addressing the challenges posed by DeepSeek while fully utilizing emerging technologies,they can drive the high-quality development of standardized resident physician training.

Objective To explore the current research status,research hotspots,and development trends of clinician's post-competency in China using CiteSpace visualization analysis,thus providing insights into establishing professional teams and assisting in the high-quality development of hospitals.Methods Relevant literature on clinician post-competency was retrieved from the China National Knowledge Infrastructure(CNKI)database.The CiteSpace software was employed to create visualization maps of the publication volume,authors,and keywords of the relevant research.This analysis included author collaboration net-works,keyword co-occurrence,clustering,and burst analysis.Results A total of 710 articles meeting the inclusion criteria were retrieved.Research on clinician post-competency in China demonstrated a general upward trend from 2013 to 2024.Howev-er,collaboration among authors and institutions remained relatively limited.The primary research hotspots focused on fields such as medical education,teaching reform,and training models.The research frontier encompassed topics like reform of teaching modes,evaluation of post-competency among traditional Chinese medicine practitioners,and competency studies utilizing the Del-phi method.Conclusion Research on clinician post-competency in China grows rapidly,garnering increasing attention.To fur-ther advance this field,researchers should enhance collaboration and communication,conduct systematic investigations into re-search hotspots and cutting-edge issues,and continuously refine medical talent education and evaluation mechanisms.These ef-forts will provide a valuable foundation for promoting the high-quality development of hospitals.

Objective:To characterize the epidemiology of respiratory syndrome across healthcare facilities of different types and tiers in Beijing City, to compare pathogen-testing modalities and their associations with adverse outcomes, and to identify key factors associated with progression to severe illness, thereby informing regional prevention, control, and clinical optimization.Methods:The multicenter observational cohort study was performed using outpatient and emergency department data from five sentinel hospitals in Beijing (Beijing Xiaotangshan Hospital, Beijing Chaoyang District Shuangqiao Hospital, Beijing Haidian Hospital, Beijing You′an Hospital, Capital Medical University (Beijing You′an Hospital), and Beijing Ditan Hospital, Capital Medical University (Beijing Ditan Hospital)) from October 1st, 2023 to April 9th, 2025. Dual-target (two-plex) and triple-target (three-plex) respiratory specimens were collected. Demographic characteristics, visit information, pathogen-testing modalities and results were collected, and the epidemiologic features of patients who progressed to severe illness between the influenza high-incidence season (December to May) and the non-influenza season (June to November) were compared. Categorical variables were analyzed using the chi-square test. Multivariable logistic regression was used to estimate associations between covariates and risk of progression to severe illness.Results:Among the 192 131 cases, patients visited at Beijing You′an Hospital were concentrated in the 16 to 44 year age group, accounting for 66.79%(32 532/48 708). Beijing Xiaotangshan Hospital had a broad age distribution, with older adults comprising up to 22.35% (885/3 960). Of the 47 349 respiratory specimens across the five hospitals, Beijing You′an Hospital had the highest positivity rate for dual-target testing (46.76%(1 585/3 390)), while Beijing Haidian Hospital conducted the largest number of this tests ( n=12 514). For triple-target testing, Beijing You′an Hospital again had the highest positivity rate (45.03%(2 835/6 296)), whereas Beijing Ditan Hospital tested the most specimens ( n=12 011; positivity rate was 29.73%(3 571/12 011)). The influenza season within the same period (November 2023 to January 2024) exhibited a bimodal pattern, with alternating circulation of influenza viruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Among 32 744 outpatients/emergency patients who progressed to severe illness, significant seasonal differences were observed by sex, age, comorbidity status, and infection type ( χ2=6.60, 189.24, 32.71 and 189.99, respectively; all P<0.05). After adjustment for sex, age group, comorbidities, and infection type, testing modality remained significantly associated with risk of progression (dual-target testing, odds ratio ( OR)=0.116, 95% confidence interval ( CI) 0.111 to 0.122, P<0.001); no testing, OR=0.063, 95% CI 0.060 to 0.065, P<0.001). Conclusions:The epidemiological pattern of respiratory pathogens undergo significant changes after October 2023, which is characterized by alternating waves of influenza viruses and SARS-CoV-2 with pronounced seasonality and diversity. Substantial inter-hospital differences are observed in testing modalities and positivity rates. Risk of progression to severe illness varies significantly by sex, age, comorbidity burden, and infection type, and is closely associated with the testing modality. These findings support strengthening multiplex pathogen testing and targeted surveillance of high-risk groups to improve early identification and precise control of febrile-respiratory syndromes.

DeepSeek,a domestically developed generative artificial intelligence(AI)tool,is experiencing rapid growth within China's technological landscape.With its core advantages of open-source accessibility,cost-efficiency,vertical scenario specialization,and Chinese linguistic contextualization,it has been reconfiguring medical education.This development brings nu-merous innovative opportunities to postgraduate medical education,particularly in standardized training of resident physicians.On one hand,DeepSeek creates new possibilities for participants in residency training regarding knowledge acquisition,assisted learning,and teaching methodologies.On the other hand,its implementation raises concerns such as inadequate development of higher-order thinking skills,lack of realistic doctor-patient communication simulations,and diminished roles of clinical instruc-tors.Hospitals with a resident physician training base should promptly adapt to the new situation and move embrace intelligent de-velopment.By addressing the challenges posed by DeepSeek while fully utilizing emerging technologies,they can drive the high-quality development of standardized resident physician training.

Objective To explore the current research status,research hotspots,and development trends of clinician's post-competency in China using CiteSpace visualization analysis,thus providing insights into establishing professional teams and assisting in the high-quality development of hospitals.Methods Relevant literature on clinician post-competency was retrieved from the China National Knowledge Infrastructure(CNKI)database.The CiteSpace software was employed to create visualization maps of the publication volume,authors,and keywords of the relevant research.This analysis included author collaboration net-works,keyword co-occurrence,clustering,and burst analysis.Results A total of 710 articles meeting the inclusion criteria were retrieved.Research on clinician post-competency in China demonstrated a general upward trend from 2013 to 2024.Howev-er,collaboration among authors and institutions remained relatively limited.The primary research hotspots focused on fields such as medical education,teaching reform,and training models.The research frontier encompassed topics like reform of teaching modes,evaluation of post-competency among traditional Chinese medicine practitioners,and competency studies utilizing the Del-phi method.Conclusion Research on clinician post-competency in China grows rapidly,garnering increasing attention.To fur-ther advance this field,researchers should enhance collaboration and communication,conduct systematic investigations into re-search hotspots and cutting-edge issues,and continuously refine medical talent education and evaluation mechanisms.These ef-forts will provide a valuable foundation for promoting the high-quality development of hospitals.

Objective:To characterize the epidemiology of respiratory syndrome across healthcare facilities of different types and tiers in Beijing City, to compare pathogen-testing modalities and their associations with adverse outcomes, and to identify key factors associated with progression to severe illness, thereby informing regional prevention, control, and clinical optimization.Methods:The multicenter observational cohort study was performed using outpatient and emergency department data from five sentinel hospitals in Beijing (Beijing Xiaotangshan Hospital, Beijing Chaoyang District Shuangqiao Hospital, Beijing Haidian Hospital, Beijing You′an Hospital, Capital Medical University (Beijing You′an Hospital), and Beijing Ditan Hospital, Capital Medical University (Beijing Ditan Hospital)) from October 1st, 2023 to April 9th, 2025. Dual-target (two-plex) and triple-target (three-plex) respiratory specimens were collected. Demographic characteristics, visit information, pathogen-testing modalities and results were collected, and the epidemiologic features of patients who progressed to severe illness between the influenza high-incidence season (December to May) and the non-influenza season (June to November) were compared. Categorical variables were analyzed using the chi-square test. Multivariable logistic regression was used to estimate associations between covariates and risk of progression to severe illness.Results:Among the 192 131 cases, patients visited at Beijing You′an Hospital were concentrated in the 16 to 44 year age group, accounting for 66.79%(32 532/48 708). Beijing Xiaotangshan Hospital had a broad age distribution, with older adults comprising up to 22.35% (885/3 960). Of the 47 349 respiratory specimens across the five hospitals, Beijing You′an Hospital had the highest positivity rate for dual-target testing (46.76%(1 585/3 390)), while Beijing Haidian Hospital conducted the largest number of this tests ( n=12 514). For triple-target testing, Beijing You′an Hospital again had the highest positivity rate (45.03%(2 835/6 296)), whereas Beijing Ditan Hospital tested the most specimens ( n=12 011; positivity rate was 29.73%(3 571/12 011)). The influenza season within the same period (November 2023 to January 2024) exhibited a bimodal pattern, with alternating circulation of influenza viruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Among 32 744 outpatients/emergency patients who progressed to severe illness, significant seasonal differences were observed by sex, age, comorbidity status, and infection type ( χ2=6.60, 189.24, 32.71 and 189.99, respectively; all P<0.05). After adjustment for sex, age group, comorbidities, and infection type, testing modality remained significantly associated with risk of progression (dual-target testing, odds ratio ( OR)=0.116, 95% confidence interval ( CI) 0.111 to 0.122, P<0.001); no testing, OR=0.063, 95% CI 0.060 to 0.065, P<0.001). Conclusions:The epidemiological pattern of respiratory pathogens undergo significant changes after October 2023, which is characterized by alternating waves of influenza viruses and SARS-CoV-2 with pronounced seasonality and diversity. Substantial inter-hospital differences are observed in testing modalities and positivity rates. Risk of progression to severe illness varies significantly by sex, age, comorbidity burden, and infection type, and is closely associated with the testing modality. These findings support strengthening multiplex pathogen testing and targeted surveillance of high-risk groups to improve early identification and precise control of febrile-respiratory syndromes.

Objective To explore the effects of internal fixation in surgical treatment of intertrochanteric fractures by proximal femoral locking compression plate (PFLCP) and proximal femoral nail anti-rotation (PFNA) on fracture morphological fea-tures. Methods 43 patients with femoral intertrochanteric fractures were treated with PFLCP or PFNA from January 2013 to De-cember 2015. There were 23 patients treated with PFLCP and 20 cases with PFNA. There were 29 males and 14 females, the aver-age age was 62.6 years old (ranged from 46-85 years). Observed the fracture type (AO/OTA, Evans, the lateral trochanteric wall in-jury), the direction of key fracture line (lateral superior to medial inferior/medial superior to lateral inferior), preoperative days, pre-operative bone mineral density value, operation time, the volume of intraoperative blood loss, the supportive contact rate at the me-dial cortex of proximal femur after surgery, the surgical intervention rate for medial cortical fracture, postoperative partial load bearing time, full weight bearing time, complications of internal fixation and Harris scores. And analyzed the relationship between the direction of key fracture line and the internal fixation failure. SPSS13.0 software was used for statistical analysis. Results No statistical significance was found in age distribution, fracture types, preoperative days, preoperative bone mineral density value, the internal fixation failure rate (loss of fracture reduction, screw cutting or plate fracture). The operative time of PFLCP group was obviously longer than that of PFNA group and the difference was statistically significant (t=2.216, P=0.032). The intraoperative blood loss was more in PFLCP group than PFNA group and significant difference was found between the two groups(t=4.142, P=0.000).Though the initial postoperative partial load bearing time is earlier in the PFNA group than PFLCP group, but no statistical difference bewtween the two groups (t=0.833, P=0.902). Full weight bearing time had no statistical difference between the two groups. Harris scores in the PFNA group was slightly lower than in the PFLCP group, but there was no statistical difference ( t=0.833, P=0.902). The postoperative medial cortical support rate was higher in the PFLCP group than PFNA group, but no statisti-cal difference between them. The surgical intervention rate for medial cortical fracture was higher in the PFLCP group and differ-ence was statistically significant (χ2=4.768, P=0.029). No correlation had found between invalid support at medial cortex and the direction of key fracture line in all internal fixation failure cases. Distribution of the direction of key fracture line in the two groups had no statistical difference, while the relative risk ratio in terms of internal fixation failure between 2 types of the direction of key fracture line (OR=lateral superior to medial inferior/ medial superior to lateral inferior) had statistical difference (χ2=6.081, P=0.014;OR=9.600, P=0.037). Conclusion The direction of key fracture line can foresee the underlying displacement direction of intertrochanteric fractures at postsurgical load bearing, combining with restore the supportive contact at the medial cortex of the proximal femur and timing of load bearing may be determined to avoid internal fixation failure.

Objective To investigate the effect of ifenprodil in the mice of bone cancer pain.Methods 96 male C3H/HeJ mice were divided randomly into tumor group( Group T),control group( Group C) and sham group( Group S).The α-minimal essence media(ct-MEM) with 2 × l05 osteosarcoma NCTC 2472 cells were implanted into the intramedullary space of the right femurs of mice to induce ongoing bone cancer related pain behaviors.The sham group was inoculated by α-MEM without any cells.On the 14th d after inoculation,pain ethology indexes such as the spontaneous lifting behaviors,the paw withdrawal mechanical threshold(PWMT) and the paw withdrawal thermal latency (PWTL)were observed on 1 d before inoculation and on 3 d,5 d,7 d,10 d,14 d,17 d,19 d,23 d after inoculation.Lumbar intumescentia of mice in each group were taken out to investigate the expression level of NR2B western blot after pain behaviors tests at the same time point after intrathecal injection.Results ( 1 ) At day14 after the operation,the obvious increasing of spontaneous lifting behaviors ( ( 12.88 ±1.64) ) and the expression of NR2B (2.12 ±0.13),the significant decreasing of PWMT( (0.39 ±0.17)g) and PWTL( ( 11.59 ± 1.67 ) s ) were observed in group T compared with group S and preoperative base level (P ＜ 0.05 ).(2) At day 17,day 19 and day 23 after the operation,compared with the basal level of dayl4 before administration and group C,the spontaneous lifting behaviors ( (5.13 ± 1.38),(4.70 ± 1.58),(5.64 ± 1.17) ) of group T were obviously decreased,PWMT ( ( 1.10 ± 0.65 ) g,( 0.95 ± 0.56 ) g,( 1.05 ± 0.26 ) g) and PWTL ( ( 15.17 ± 1.27) s,( 15.93 ± 2.18 ) s,( 16.28 ± 1.48 ) s ) were increased,the expression of NR2B ( ( 1.42 ± 0.17),(1.67 ±0.53),(1.14 ±0.79) ) were significantly decreased(P＜0.05).Conclusion Repeated intratheal injection of ifenprodil can efficiently relieve spontaneous lifting behaviors,mechanical hyperalgia and thermal hyperalgia and decrease the expression of lumbar intumescentia NR2B in the mouse model of bone cancer pain.

Objective To investigate the analgesic efficacy of intrathecal injection of RC-13,a competitive kinesin superfamily protein 17 antagonist,in a mouse model of bone cancer pain.Methods Forty male C3H/HeJ mice,aged 6-8 weeks,weighing 20-25 g,were randomly divided into 5 groups (n=8 each): sham operation group (group S); bone cancer pain + 5 μl dimethyl sulfoxide (DMSO) group (group R0); bone cancer pain + 2.5 μg RC-13 group (group R1); bone cancer pain + 5 μg RC-13 group (group R2) and bone cancer pain + 10 μg RC-13 group (group R3).In groups R0-3,bone cancer pain was induced by implantation of α-min-imal essence medium (α-MEM) containing osteosarcomaNCTC 2472 cells into the intramedullary space of right femur.In group S,culture medium α-MEM containing no cancer cell was injected instead.10％ DMSO 5 μl and RC-13 2.5 μg/5 μl,5μg/5μ1 and 10 μg/5 μ1 dissolved in 10％ DMSO were injected intrathecally in groups R0-3,respectively,once a day for 3 consecutive days starting from 14th day after inoculation of the tumor cells.Pain behavior was assessed by the paw withdrawal mechanical threshold (PWMT) and spontaneous lifting times (SLTs) measured at 1 day before inoculation and at 3,5,7,10,14 days after inoculation.The same tests were also performed at 1,3,5 and 7 days after administration in groups R0-3.Results Compared with group S,PWMT was significantly decreased and SLTs were increased at 7-14 days after inoculation in the other groups (P ＜ 0.05).Compared with group R0,PWMT was significantly increased and SLTs were reduced at 1 day after administration in group R1,at 1and 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R1,PWMT was significantly increased and SLTs were reduced at 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R2,PWMT was significantly increased and SLTs were reduced at 1 and 3 days after administration in group Rs (P ＜ 0.05).Conclusion Intrathecal RC-13,a competitive kinesin superfamily protein 17 antagonist,has a good analgesic efficacy in a mouse model of bone cancer pain and the efficacy is dose-dependent.