On the premise of respecting the objective law of the occurrence and development of traditional Chinese medicine（TCM） dispensing granules， relevant national departments have gradually formed the research and formulation ideas of national drug standards for dispensing granules based on the experiences and lessons learned in the development process of quality standards， as well as the formation mechanism of national standards for dispensing granules. This has certain reference significance for the formulation path of TCM quality standards. Combined with the general situation of the published standards and specific cases， the research concepts of the national standards for dispensing granules were analyzed and summarized in this paper， and the analysis of the technical characteristics of the issued national standards was focused， including the introduction of standard decoction， the overall quality control of TCM， the whole process quality control and other research ideas. At the same time， it summarized the industry common problems in the research and development process of national standards for dispensing granules， such as the source and process control of medicinal materials， and strived to solve them together， encouraging the demonstration and application of new technological means in the field of TCM dispensing granules. Finally， based on the literature analysis， the shortcomings of the current national standards were discussed， and relevant suggestions were put forward to further improve the national standards for dispensing granules. Through the overall analysis， it is helpful to comprehensively understand the technical characteristics of the national standards for TCM dispensing granules， and provide reference for the scientific exploration and practice of quality control methods for TCM.

ObjectiveBased on modern analytical techniques and a depressed mouse model established by chronic unpredictable mild stress（CUMS）， to evaluate the quality marker（Q-Marker） and pharmacodynamic difference of Baihe Dihuangtang prepared by different processes. MethodsHigh performance liquid chromatography（HPLC） was used to establish the characteristic profiles of Baihe Dihuangtang， and determine the content of Q-Marker in the samples prepared by ancient and modern processes. Seventy C57BL/6J mice were randomly divided into the normal group， model group， fluoxetine group（3 mg·kg^-1）， low and high dose groups of ancient process（6.5， 26 g·kg^-1）， and low and high dose groups of modern process（6.5， 26 g·kg^-1）， with 10 mice in each group. Except for the normal group， CUMS was used to induce depression in mice from the other groups for 28 d. After successful modeling， administration groups were given the corresponding drugs by gavage every day， and the normal and model groups were given an equal volume of pure water by gavage for 21 consecutive days. Change in body mass of mice was recorded， tail suspension test and open field test were used to evaluate the depressive behavior of mice， and enzyme-linked immunosorbent assay（ELISA） was employed to determine the contents of tumor necrosis factor-α（TNF-α）， interleukin（IL）-1β and IL-6 in serum. ResultsCharacteristic profiles of Baihe Dihuangtang prepared by the two processes were established， the similarity between the two was 0.951， and 8 characteristic peaks were recognized with the reference peak of regaloside A. The results of quantitative analysis showed that the Q-Marker content was similar in Baihe Dihuangtang prepared by ancient and modern processes. The results of pharmacodynamics showed that， compared with the normal group， the model group showed increased immobility time in the tail suspension test， reduced total movement distance in the open field test， and elevated IL-1β， IL-6 and TNF-α levels in the serum（P<0.01）. Compared with the model group， the behavioral indicators of mice in the Baihe Dihuangtang treatment group were significantly improved in terms of tail suspension time and open field exercise， and the levels of IL-1β， IL-6 and TNF-α in serum were significantly reduced（P<0.05， P<0.01）. Baihe Dihuangtang prepared by the two processes both had antidepressant effects， and the difference between the two was not statistically significant in improving depressive symptoms. ConclusionQ-Marker of Baihe Dihuangtang prepared by modern and ancient methods are equivalent in content， and the pharmacological effects are consistent， indicating that dried Lilii Bulbus can replace fresh products in the preparation of Baihe Dihuangtang. This study provides a scientific basis for the development of new drugs of Baihe Dihuangtang and a reference for its rational application and clinical use.

ObjectiveBased on modern analytical techniques and a depressed mouse model established by chronic unpredictable mild stress（CUMS）， to evaluate the quality marker（Q-Marker） and pharmacodynamic difference of Baihe Dihuangtang prepared by different processes. MethodsHigh performance liquid chromatography（HPLC） was used to establish the characteristic profiles of Baihe Dihuangtang， and determine the content of Q-Marker in the samples prepared by ancient and modern processes. Seventy C57BL/6J mice were randomly divided into the normal group， model group， fluoxetine group（3 mg·kg^-1）， low and high dose groups of ancient process（6.5， 26 g·kg^-1）， and low and high dose groups of modern process（6.5， 26 g·kg^-1）， with 10 mice in each group. Except for the normal group， CUMS was used to induce depression in mice from the other groups for 28 d. After successful modeling， administration groups were given the corresponding drugs by gavage every day， and the normal and model groups were given an equal volume of pure water by gavage for 21 consecutive days. Change in body mass of mice was recorded， tail suspension test and open field test were used to evaluate the depressive behavior of mice， and enzyme-linked immunosorbent assay（ELISA） was employed to determine the contents of tumor necrosis factor-α（TNF-α）， interleukin（IL）-1β and IL-6 in serum. ResultsCharacteristic profiles of Baihe Dihuangtang prepared by the two processes were established， the similarity between the two was 0.951， and 8 characteristic peaks were recognized with the reference peak of regaloside A. The results of quantitative analysis showed that the Q-Marker content was similar in Baihe Dihuangtang prepared by ancient and modern processes. The results of pharmacodynamics showed that， compared with the normal group， the model group showed increased immobility time in the tail suspension test， reduced total movement distance in the open field test， and elevated IL-1β， IL-6 and TNF-α levels in the serum（P<0.01）. Compared with the model group， the behavioral indicators of mice in the Baihe Dihuangtang treatment group were significantly improved in terms of tail suspension time and open field exercise， and the levels of IL-1β， IL-6 and TNF-α in serum were significantly reduced（P<0.05， P<0.01）. Baihe Dihuangtang prepared by the two processes both had antidepressant effects， and the difference between the two was not statistically significant in improving depressive symptoms. ConclusionQ-Marker of Baihe Dihuangtang prepared by modern and ancient methods are equivalent in content， and the pharmacological effects are consistent， indicating that dried Lilii Bulbus can replace fresh products in the preparation of Baihe Dihuangtang. This study provides a scientific basis for the development of new drugs of Baihe Dihuangtang and a reference for its rational application and clinical use.

Generative artificial intelligence (GAI) represents a prominent research focus in medicine, with medical education being a key application area. GAI demonstrates potential to enhance residency training efficacy through personalized instruction, automated assessment item generation, question bank updating, and intelligent scoring systems. However, current limitations exist regarding output accuracy and content consistency. To address these constraints, strategic measures are required: continuous GAI model refinement, development of standardized usage guidelines, enhanced data quality control, and implementation of human verification protocols for generated content. Concurrently, residents should proactively acquire GAI utilization skills to strengthen the practical application of theoretical knowledge. With these advancements, GAI is anticipated to evolve into a valuable asset for improving the efficiency and quality of residency training programs.

Objective: To investigate the knowledge, attitude and practice of infectious disease prevention and control among primary and middle school students in Gongshu District, Hangzhou City, so as to provide the evidence for implementing health education on infectious disease prevention and control in schools. Methods: Students from 12 primary and middle schools in Gongshu District were selected using a random cluster sampling method. Basic information, knowledge, attitude and practice of infectious disease middle and control were collected through questionnaire surveys. Influencing factors of practice of primary and middle school students' infectious disease prevention and control were analyzed using multivariable logistic regression model. Results: A total of 3 439 primary and middle school students were surveyed, including 1 717 boys (49.93%) and 1 722 girls (50.07%). There were 1 237 primary school students (35.97%), 1 092 junior high school students (31.75%), and 1 110 senior high school students (32.28%). The awareness of infectious disease prevention and control knowledge, the percentage of attitude towards infectious disease prevention and control, and the percentage of practice towards infectious disease prevention and control were 73.22%, 96.83%, and 60.19%, respectively. Multivariable logistic regression analysis revealed that girls (OR=1.460, 95%CI: 1.265-1.685), those who had received health education on infectious disease prevention (OR=2.088, 95%CI: 1.656-2.632), those with adequate knowledge (OR=2.129, 95%CI: 1.816-2.496), and those with positive attitude (OR=4.320, 95%CI: 2.683-6.957) were more likely to form practice for the prevention and control of infectious disease. Conversely, senior high school students (OR=0.667, 95%CI: 0.561-0.794) and those with poor self-rated health status (OR=0.678, 95%CI: 0.495-0.930) were less likely to form practice for the prevention and control of infectious disease. Conclusions The attitude towards infectious disease prevention and control among primary and middle school students in Gongshu District is relatively high, but their awareness and practice are low. It is recommended to strengthen health education on infectious disease prevention and control knowledge in a targeted manner to promote the formation of prevention and control practice among senior high school students and primary and middle school students who self-assess their health status as poor.

Inflammatory bowel disease (IBD) is an idiopathic intestinal inflammatory condition with chronic and relapsing manifestations and is characterized by a disturbance in the interplay between the intestinal microbiota, the gut, and the brain. The microbiota-gut-brain axis involves interactions among the nervous system, the neuroendocrine system, the gut microbiota, and the host immune system. Increasing published data indicate that psychological stress exacerbates the severity of IBD due to its negative effects on the microbiota-gut-brain axis, including alterations in the stress response of the hypothalamic-pituitary-adrenal (HPA) axis, the balance between the sympathetic nervous system and vagus nerves, the homeostasis of the intestinal flora and metabolites, and normal intestinal immunity and permeability. Although the current evidence is insufficient, psychotropic agents, psychotherapies, and interventions targeting the microbiota-gut-brain axis show the potential to improve symptoms and quality of life in IBD patients. Therefore, further studies that translate recent findings into therapeutic approaches that improve both physical and psychological well-being are needed.
Humans ; Inflammatory Bowel Diseases/metabolism* ; Stress, Psychological/microbiology* ; Gastrointestinal Microbiome/physiology* ; Brain/metabolism* ; Hypothalamo-Hypophyseal System ; Pituitary-Adrenal System ; Animals

In 2025， the European Liver and Intestine Transplant Association released the guidelines on the utilization and evaluation of deceased donor livers. The guidelines focus on the definition of high-risk donor livers and the strategies and criteria for dynamic liver assessment， aiming to provide standardized guidance for clinicians. This article gives an excerpt of the key recommendations in the guidelines.

Objective:To analyze the correlation between psychological resilience and stigma, self-efficacy and self-esteem in patients with constipation after lower limb fracture surgery, and to determine nursing counter measures.Methods:A total of 102 patients who underwent lower limb fracture surgery in Jingdezhen Hospital of Traditional Chinese Medicine from April 2020 to March 2023 were convenience sampling selected as the study objects by a cross-sectional survey. They were divided into constipation group and normal group according to whether postoperative constipation was complicated. Baseline data, Psychological Resilience Scale (CD-RISC), Social Impact Scale (SIS), General Self-efficacy Scale (GSES), and Pearson ′s method was used to analyze the correlation between CD-RISC score and SIS score, GSES score, and RSES score in patients with constipation. Results:Totally 102 survey subjects aged 18-75 (38.87 ± 6.83), including 57 males and 45 females. Postoperative constipation occurred in 37 patients, accounting for 36.27% (37/102). The average age, constipation secret history rate, postoperative analgesic use rate, CD-RIS, SIS, GSES and RSES scores of the constipation group were (50.74 ± 5.52) years, 72.97% (27/37), 62.16% (23/37), (42.11 ± 5.03) points, (59.78 ± 6.40) points, (22.74 ± 3.57) points, (20.15 ± 2.32) points, respectively. The normal group was (37.81 ± 7.45) years old, 40.00% (26/65), 41.54% (27/65), (78.43 ± 5.95) points, (36.10 ± 4.03) points, (28.26 ± 3.53) points, (27.05 ± 5.29) points, respectively. The difference between the two groups was statistically significant ( t values were 7.52-31.29, χ2 values were 10.27 and 4.01, all P<0.05). In the constipation group, CD-RISC score was negatively correlated with SIS score, and positively correlated with GSES score and RSES score ( r values were -0.869, 0.608, 0.582, all P<0.05). Conclusions:The incidence of constipation after lower limb fracture is high, and its psychological resilience is related to stigma, self-efficacy and self-esteem. Clinical nursing intervention is needed to improve the prognosis of patients.

Objective:Adverse cardiovascular events are the leading cause of death in peritoneal dialysis patients.Identifying indicators that can predict adverse cardiovascular events in these patients is crucial for prognosis.This study aims to assess the value of dual-specificity phosphatase 6(DUSP6)in peripheral blood mononuclear cells as a predictor of adverse cardiovascular events after peritoneal dialysis in diabetic nephropathy patients. Methods:A total of 124 diabetic nephropathy patients underwent peritoneal dialysis treatment at the Department of Nephrology of the First Affiliated Hospital of Hebei North University from June to September 2022 were selected as study subjects.The levels of DUSP6 in peripheral blood mononuclear cells were determined using Western blotting.Patients were categorized into high-level and low-level DUSP6 groups based on the median DUSP6 level.Differences in body mass index,serum albumin,high-sensitivity C-reactive protein,and dialysis duration were compared between the 2 groups.Pearson,Spearman,and multiple linear regression analyses were performed to examine factors related to DUSP6.Patients were followed up to monitor the occurrence of adverse cardiovascular events,and risk factors for adverse cardiovascular events after peritoneal dialysis were analyzed using Kaplan-Meier and Cox regression. Results:By the end of the follow-up,33(26.61%)patients had experienced at least one adverse cardiovascular event.The high-level DUSP6 group had higher body mass index,longer dialysis duration,and higher high-sensitivity C-reactive protein,but lower serum albumin levels compared to the low-level DUSP6 group(all P<0.05).DUSP6 was negatively correlated with serum albumin levels(r=-0.271,P=0.002)and positively correlated with dialysis duration(rs=0.406,P<0.001)and high-sensitivity C-reactive protein(rs=0.367,P<0.001).Multiple linear regression analysis revealed that dialysis duration and high-sensitivity C-reactive protein were independently correlated with DUSP6 levels(both P<0.05).The cumulative incidence of adverse cardiovascular events was higher in the high-level DUSP6 group than in the low-level DUSP6 group(46.67%vs 7.81%,P<0.001).Cox regression analysis indicated that low serum albumin levels(HR=0.836,95%CI 0.778 to 0.899),high high-sensitivity C-reactive protein(HR=1.409,95%CI 1.208 to 1.644),and high DUSP6(HR=6.631,95%CI 2.352 to 18.693)were independent risk factors for adverse cardiovascular events in peritoneal dialysis patients. Conclusion:Dialysis duration and high-sensitivity C-reactive protein are independently associated with DUSP6 levels in peripheral blood mononuclear cells of diabetic nephropathy patients undergoing peritoneal dialysis.High DUSP6 levels indicate a higher risk of adverse cardiovascular events.

Objective To develop a deep learning network based on attention mechanism to identify the number of the vertical man-dibular third molar(MTM)roots(single or double)on panoramic radiographs in an automatic way.Methods The sample consisted of 1 045 patients with 1 642 MTMs on paired panoramic radiographs and Cone-beam computed tomography(CBCT)and were randomly grouped into the training(80%),the validation(10%),and the test(10%).The evaluation of CBCT was defined as the ground truth.A deep learning network based on attention mechanism,which was named as RN-MTMnet,was trained to judge if the MTM on pano-ramic radiographs had one or two roots.Diagnostic performance was evaluated by accuracy,sensitivity,specificity,and positive predict value(PPV),and the receiver operating characteristic(ROC)curve with the area under the ROC curve(AUC).Its diagnostic perform-ance was compared with dentists'diagnosis,Faster-RCNN,CenterNet,and SSD using evaluation metrics.Results On CBCT images,single-rooted MTM was observed on 336(20.46%)sides,while two-rooted MTM was 1 306(79.54%).The RN-MTMnet achieved an accuracy of 0.888,a sensitivity of 0.885,a specificity of 0.903,a PPV of 0.976,and the AUC value of 0.90.Conclusion RN-MTM-net is developed as a novel,robust and accurate method for detecting the numberof MTM roots on panoramic radiographs.