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.

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 explore the association between different feeding methods during the first six months after birth and the physical growth of children aged 3 to 5 years.Methods:Data were from the "Taicang and Wuqiang mother-child cohort study"(TAWS) in China. Children were enrolled at birth between November 2016 and September 2020 and followed up at 1, 2, 3, 6, 8, 12, 18, and 24 months, as well as at ages 3 to 5 years. Based on feeding methods within six months of age, children were categorized into an "exclusive breastfeeding group" and a "formula-feeding group". Birth-related information and feeding practices between 8 and 24 months were collected, alongside dietary habits, physical activity, and illness during preschool years. Height and weight of preschool children were measured to calculate height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), body mass index-for-age Z-score (BAZ), and the rates of stunting, underweight, wasting, overweight, and obesity. After adjusting for demographic factors, birth-related information, feeding practices between 8 to 24 months, preschool dietary habits, physical activity, and health status, multiple linear regression and logistic regression were adopted to analyze the influence of feeding methods within six months of age on the physical growth of children aged 3 to 5 years.Results:A total of 1 233 children were included, comprising 629 boys and 604 girls. The number of children aged 3, 4, and 5 years was 436, 406, and 391, respectively. About 754 children were categorized into the exclusive breastfeeding group and 479 into the formula-feeding group. Children who were introduced to formula milk within six months of age had higher HAZ (0.09±0.99), WAZ (0.24±1.07) and BAZ (0.26±1.11) scores at ages 3 to 5 compared to the exclusive breastfeeding group [HAZ, WAZ, and BAZ were (-0.04±0.92), (0.06±1.02) and (0.11±1.08), respectively]. After adjusting for confounding factors, multiple linear regression analysis showed that the β (95% CI) values for HAZ, WAZ and BAZ in the formula-feeding group were 0.16 (0.06-0.25), 0.17 (0.06-0.29) and 0.15 (0.02-0.27), respectively, compared to the exclusive breastfeeding group. After adjusting for confounding factors, the results of the multivariate logistic regression model indicated that there were no statistically significant differences in the risks of stunting, underweight, wasting, overweight, and obesity during the preschool years between the exclusive breastfeeding group and the formula-feeding group, with OR (95% CI) values of 1.04 (0.41-2.62), 0.99 (0.27-3.57), 1.63 (0.53-4.95), 1.08 (0.66-1.74), and 1.58 (0.70-3.60), respectively. Conclusion:Exclusive breastfeeding within six months of age does not increase the risk of undernutrition (including stunting, underweight or wasting) during preschool years. However, the introduction of formula feeding within six months of age significantly increases the physical growth level of the preschool stage.

Objective To explore the mediating effect of adversity quotient(AQ)in the relationship between organizational support and professional identity among nurses undergoing standard nursing training and to provide theoretical guidance for enhancing professional identity.Methods A total of 1,031 nurses receiving standardized training from 12 tertiary general hospitals in Jiangsu Province,were recruited using a convenience sampling.Data were collected using the self-rating scale for nurses'adversity,nurses'organizational support perception scale,and nurse professional identity assessment scale.Pearson correlation analysis was performed to examine associations among organizational support,AQ,and professional identity.Structural equation modeling(SEM)was used to test the mediating role of AQ.Results A total of 930 nurses undergoing standardized training completed the survey.The total scores for AQ,organizational support,and professional identity were 132.44±29.78,45.51±9.60,and 100.88±19.52,respectively.Organizational support was positively correlated with professional identity(r=0.753,P<0.01),but negatively with AQ(r=-0.720,P<0.01).AQ was also negatively associated with professional identity(r=-0.772,P<0.01).SEM analysis revealed that AQ partially mediated the relationship between organizational support and professional identity,accounting for 49.20%of the total effect(effect size=0.392).Conclusion Nurses undergoing standardized nursing training exhibit moderate professional identity.AQ serves as a key mediator between organizational support and professional identity.It indicates that improving organizational support and adversity quotient can strengthen their professional identity.

AIM: To observe related influence of eye-use behaviors on the onset and progression of myopia among primary school student in Minhang district, Shanghai under the background of “double reduction”, and evaluate the impact of eye-use habit and behavior on the myopia development in children and adolescents.METHODS:A stratified cluster sampling method was adopted to select study subjects for longitudinal observation. Random sampling was conducted among grade 1-4 students from three primary schools in Minhang District, Shanghai from September to December 2021 after the implementation of the “double reduction” policy, with a 2-year observation period. Annual vision screenings were performed to obtain uncorrected visual acuity, non-cycloplegic refraction data, and spherical equivalent(SE). Biometric measurements were taken to acquire axial length(AL)and corneal curvature(CR). Questionnaires were administered to investigate the eye-use behaviors of participants. Taking myopia ≤-0.50 D as the diagnostic criterion, myopia incidence were calculated. SE and AL changes were used to evaluate myopia progression. Logistic regression analysis was employed to identify risk factors for myopia, and analyze the relationship between eye-use behaviors and myopia development or progression.RESULTS:A total of 2 986 children complete a follow-up for 2 a. The baseline prevalence of poor vision was 32.74%, increasing to 38.92% and 43.73% at 1 and 2 a follow-up, respectively, demonstrating a yearly upward trend. Taking uncorrected visual acuity combined with non-cycloplegic refraction as clinical screening criteria for myopia, the incidence was 24.72%, 27.60%, and 29.64% at baseline, 1, and 2 a follow-ups, respectively. These showed no statistical significant difference compared to the diagnostic standard of cycloplegic refraction SE(23.98%, 27.03%, and 29.17%; all P>0.05). Logistic regression analysis found that daily outdoor and sleep duration were protective factors against myopia(OR=0.54, 0.84, all P<0.05), while age, parental myopia, duration of offline education, online education, electronic device usage, and poor visual posture were identified as risk factors(OR=2.72, 1.54, 1.72, 1.12, 1.47, 1.26, all P<0.001). Further analysis of myopia progression in baseline myopic children over 2 a revealed that age, parental myopia, baseline SE, duration of offline/online education, electronic device usage, and poor visual posture may contribute to rapid myopia progression.CONCLUSION:Under the background of “double reduction”, the eye-use behavior among primary school students in Minhang District, Shanghai has an important impact on the occurrence and development of myopia. In order to effectively prevent and control myopia, it is necessary to further strengthen the education and guidance of eye-use behavior.

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 investigate the safety and efficacy of urinary microbiota transplantation（UMT）in treating interstitial cystitis（IC）.Methods:A retrospective analysis of the clinical data of three patients with IC treated with UMT at the Central Hospital of Jiangnan University from May 2022 to August 2024. Three women（45，62，79 years）presented with urinary frequency（10 - 90 min intervals），urgency，dysuria，lower abdominal pain，and non-organic sleep disorder，with nocturia（2 - 15 episodes）causing sleep difficulty. Disease durations were 3，6，and 21 years. Prior antibiotic therapy failed. Preoperative urinalysis/culture（x2）ruled out bacterial cystitis，and diagnosed as interstitial cystitis（IC），with one of transient positive urine culture. Preoperative scores for case 1 were self-rating depression scale（SDS）of 49，self-rating anxiety scale（SAS）of 31，interstitial cystitis symptom index（ICSI）of 5，interstitial cystitis problem index（ICPI）of 2，brief urological problem scale of 50，genitourinary pain assessment scale of 10，and pain catastrophizing scale（PCS）of 0. For case 2，the scores were 60 of SDS，66 of SAS，9 of ICSI，11 of ICPI，50 of brief urological problem scale，28 of genitourinary pain assessment scale，and 34 of PCS. For case 3，the scores were 44 of SDS，48 of SAS，11 of ICSI，5 of ICPI，33 of brief urological problem scale，27 of genitourinary pain assessment scale，and 21 of PCS. Preoperative bladder hydro-distention showed mucosal hemorrhage including central block hemorrhage（Case 1），numerous spots（Case 2），and distinct sheets（Case 3）. Preoperative urine 16S rRNA sequencing revealed low diversity，increased Gardnerella/ Bacteroides（opportunistic），and decreased Bacillus/ Streptococcus（beneficial）. Two healthy young female donors had normal comprehensive tests covering blood/urine/stool，coagulation，CRP，immunity，liver/kidney function，lipids，infectious diseases，hormones，tumor markers，urine culture，TOUCH，and expanded quantitative urine culture. Donor urine 16S rRNA showed low pathogenic（ Gardnerella/ Bacteroides）abundance. Donor midstream morning urine was catheter-collected，centrifuged，and the bacterial pellet resuspended in saline. Recipients underwent bladder irrigation pre-UMT. On UMT day，donor bacterial suspension was instilled via catheter with adverse event monitoring. Follow-up included clinic visits at 1 month and 1 year for symptom assessment，scale scoring，cystoscopy evaluating mucosal inflammation，hydrodistension checks，and telephone tracking of urinary symptoms every 2 - 3 months. Prognosis was assessed by symptom relief，scale score reduction，and mucosal recovery. Results:No adverse reactions occurred within 24 hours post-UMT in all 3 cases. Two patients showed same-day urinary urgency reduction；three reported relief from urinary frequency/urgency on postoperative day 7，with 2 - 3 hour daytime intervals and 0 - 5 nocturnal voids. Two patients experienced lower abdominal pain alleviation. Postoperative Week 1 urinalysis and urine cultures revealed no abnormalities. The 16S rRNA test showed a decrease in the abundance of harmful bacteria（e.g.， Cupriavidus，Ureaplasm，Mycobacterium，Pseudomonas）and an increase in the abundance of beneficial bacteria（ Dietzia，Halomonas，and Streptococcus），and the overall urobacterial structure was significantly improved and similar to that of the donor. Case 1 was followed up for 20 months，and the lab tests were normal，with SDS scales of 38，SAS of 20，ICSI of 3，ICPI of 2，brief urological problem scale of 44，genitourinary pain assessment scale of 10，PCS of 0，at 9 months post-op follow-up，indicating physical and mental improvement. The bladder hydro-distention revealed intact mucosa with only mild inflammation，which improved versus preoperative situation. Case 2 was followed up for 15 months，and the lab tests were normal，with SDS scales of 44，SAS of 34，ICSI of 4，ICPI of 2，brief scale of urinary problems of 0，genitourinary pain assessment scale of 9，PCS of 7，at 2 months post-op follow-up，showing improved anxiety/depression and quality of life. The hydro-distention showed decreased scattered hemorrhagic dots and mucosal inflammation. Case 3 was followed up for 13 months，with an increased leukocytes of urine and the other being normal for lab tests，and SDS scales of 35，SAS of 46，ICSI of 13，ICPI of 13，brief scale of urinary problems of 10，genitourinary pain assessment scale of 33，PCS of 11，at 13 months post-op follow-up，indicating physical and mental improvement. The hydro-distention revealed mucosal congestion，marked submucosal vasodilation，and inflammation decreased compared with preoperative situation. Conclusions:UMT alleviates urinary frequency，urgency，and pain in IC patients with sustained effects，significantly improves urine microecology，and shows no adverse events，positioning it as a viable intervention for IC.

Objective:To explore the association between different feeding methods during the first six months after birth and the physical growth of children aged 3 to 5 years.Methods:Data were from the "Taicang and Wuqiang mother-child cohort study"(TAWS) in China. Children were enrolled at birth between November 2016 and September 2020 and followed up at 1, 2, 3, 6, 8, 12, 18, and 24 months, as well as at ages 3 to 5 years. Based on feeding methods within six months of age, children were categorized into an "exclusive breastfeeding group" and a "formula-feeding group". Birth-related information and feeding practices between 8 and 24 months were collected, alongside dietary habits, physical activity, and illness during preschool years. Height and weight of preschool children were measured to calculate height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), body mass index-for-age Z-score (BAZ), and the rates of stunting, underweight, wasting, overweight, and obesity. After adjusting for demographic factors, birth-related information, feeding practices between 8 to 24 months, preschool dietary habits, physical activity, and health status, multiple linear regression and logistic regression were adopted to analyze the influence of feeding methods within six months of age on the physical growth of children aged 3 to 5 years.Results:A total of 1 233 children were included, comprising 629 boys and 604 girls. The number of children aged 3, 4, and 5 years was 436, 406, and 391, respectively. About 754 children were categorized into the exclusive breastfeeding group and 479 into the formula-feeding group. Children who were introduced to formula milk within six months of age had higher HAZ (0.09±0.99), WAZ (0.24±1.07) and BAZ (0.26±1.11) scores at ages 3 to 5 compared to the exclusive breastfeeding group [HAZ, WAZ, and BAZ were (-0.04±0.92), (0.06±1.02) and (0.11±1.08), respectively]. After adjusting for confounding factors, multiple linear regression analysis showed that the β (95% CI) values for HAZ, WAZ and BAZ in the formula-feeding group were 0.16 (0.06-0.25), 0.17 (0.06-0.29) and 0.15 (0.02-0.27), respectively, compared to the exclusive breastfeeding group. After adjusting for confounding factors, the results of the multivariate logistic regression model indicated that there were no statistically significant differences in the risks of stunting, underweight, wasting, overweight, and obesity during the preschool years between the exclusive breastfeeding group and the formula-feeding group, with OR (95% CI) values of 1.04 (0.41-2.62), 0.99 (0.27-3.57), 1.63 (0.53-4.95), 1.08 (0.66-1.74), and 1.58 (0.70-3.60), respectively. Conclusion:Exclusive breastfeeding within six months of age does not increase the risk of undernutrition (including stunting, underweight or wasting) during preschool years. However, the introduction of formula feeding within six months of age significantly increases the physical growth level of the preschool stage.