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.

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 establish the ultra-high liquid chromatography （UPLC） characteristic spectrum of Uncariae Ramulus Cum Uncis from different producing areas， to conduct chemical pattern recognition analysis， and to identify the medicinal materials of their different origins and counterfeit products. METHODS UPLC method was adopted to establish the characteristic spectra of 43 batches of Uncariae Ramulus Cum Uncis from different origins； cluster analysis combined with principal component analysis were used to analyze their quality； Uncariae Ramulus Cum Uncis from different origins and counterfeit products were identified. RESULTS UPLC specific spectrum of Uncariae Ramulus Cum Uncis was established， and 13 common peaks were calibrated； peak 2 was identified as catechin， peak 3 as chlorogenic acid， peak 4 as cryptochlorogenic acid， peak 7 as isochlorogenic acid B， peak 8 as isodehydroguotenine， peak 9 as isooguotenine， peak 10 as dehydroguotenine， peak 11 as isochlorogenic acid C， peak 12 as goutenine， and peak 13 as camptothecin. Through cluster analysis， the medicinal materials of 43 batches of Uncariae Ramulus Cum Uncis could be divided into 5 categories according to their different origins. Further principal component analysis revealed that the principal component comprehensive scores of Uncariae Ramulus Cum Uncis produced in Jiangxi and Hunan were relatively high， ranging from 0.264 to 2.904. The specific chromatogram could effectively distinguish among the different origins and their counterfeit products of Uncariae Ramulus Cum Uncis. CONCLUSIONS The established UPLC specific chromatogram can be used for quality control of Uncariae Ramulus Cum Uncis， and the study found that the quality of Uncariae Ramulus Cum Uncis from Jiangxi and Hunan provinces is relatively good.

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.

Objective:To summarize and analyze the current application status of oral mucosal graft (OMG) technique in the repair of ureteral strictures in China, and clarify the feasibility, safety and effectiveness of this technique.Methods:The 175 patients who underwent repair of ureteral stricture using oral mucosal patches from June 2015 to February 2022 were etrospectively analyzed in 14 medical centers in China, including 49 cases in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 32 cases in Affiliated Seventh Medical Center of PLA General Hospital, 3 cases in The Second Hospital of Anhui Medical University, 6 cases in The First Affiliated Hospital of Zhengzhou University, 56 cases in Peking University First Hospital, 3 cases in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 cases in Shanghai Sixth People' s Hospital, 4 cases in General Hospital of Estern Theater Command, 4 cases in Lanzhou University Second Hospital, 2 cases in Guizhou Province People 's Hospital, 2 cases in Peking University People' s Hospital, 5 cases in Jinzhou First People's Hospital, 5 cases in The First Affiliated Hospital of Wannan Medical College, 1 case in Shandong Provincial Hospital. In this study, 127 patients (72.6%) used lingual mucosal patches, 32(18.3%) labial mucosa, and 16(9.1%) buccal mucosa. The surgical approach for OMG ureteral reconstruction was mainly minimally invasive, with robot-assisted laparoscopy in 84 patients (48.0%), traditional laparoscopic surgery in 87 patients (49.7%), and open surgery in only 4 patients (2.3%). There were 133 males and 42 females with an average age of (35.0±17.2) years. The mean body mass index (BMI) and stenosis length were (23.1±4.1) kg/m 2 and (4.7±1.8) cm, respectively. The stricture was located in the left ureter in 116 patients, right ureter in 58 case and bilateral ureter in 1 case. The most common causes of ureteral stricture were endoscopic surgery in 88(50.3%)patients, congenital stricture in 55(31.4%)patients, failed ureteroplasty in 29(16.6%)patients, history of extracorporeal shock wave lithotripsy in 13(7.4%)patients, radiotherapy history in 3(1.7%)patients and other causes in 6(3.4%)patients. Strictures were mainly located in the upper ureter, accounting for 61.7% (108/175 cases), followed by 36.0% (63/175) at the ureteropelvic junction and 2.3%(4/175)in the middle ureter. According to the surgical methods, the patients were divided into robot-assisted laparoscopic surgery group ( n=84), traditional laparoscopic surgery group ( n=87)and open surgery group ( n=4). Subgroup analysis of patients in robot-assisted laparoscopic and traditional laparoscopic surgery groups was performed. There were no significant difference in preoperative data between the two groups except for age (32.0±18.3) years vs.(37.0±15.9)years, P=0.040], BMI[(22.5±4.3)kg/m 2 vs. (23.7±3.6)kg/m 2, P=0.028], and etiology of stenosis [endoscopic injury, 34(40.5%) vs. 53(60.9%), P=0.012]. Preoperative hydronephrosis and stricture length were assessed by CTU and ureterography. Ureterography 7-9 weeks after surgery showed patency of the reconstructed segment, or no recurrence of hydronephrosis was judged as success. Evaluate the operation method, operation time, success rate, length of OMG in repairing ureteral stricture between laparoscopic and robot-assisted groups. Results:The overall success rate of oral mucosal graft repair surgery reached 97.7%(171/175). The success rate of ureteral reconstruction in the two groups were 96.4%(81/84)and 98.9%(86/87), respectively ( P=0.351), and the difference was not statistically significant. There was no significant difference for operation time, intraoperative blood loss, and mean oral mucosal length between the robotic and laparoscopic groups[(244.7±85.8) min and (222.7±83.5)min ( P=0.116), (58.9±38.6) ml and (68.4±45.5) ml ( P=0.217), (5.0±2.0) cm and (4.6±1.5) cm ( P=0.350)], respectively.Postoperative complications were reported in 23 (13.1%) patients, such as fever, urinary leakage, lymphatic leakage, infection, but only 2 (1.4%) cases patients had complications of Clavien-Dindo score ≥ Ⅲ. The two patients developed urinary stricture after surgery with failed conservative treatment, and no urinary stricture occurred following endoscopic treatment.The short-term (three months after surgery)incidence of complications in the site where the oral mucosa was taken, such as difficulty in opening mouth, pain, and swelling, was 12.0% (21/175), and there was no significant difference for oral complications between patients harvesting different length of mucosal graft. Conclusions:Ureteroplasty with oral mucosal graft is a safe, feasible and reliable technique for ureteral reconstruction. At present, minimally invasive technology is the main surgical approach for ureteroplasty, and there is no significant difference in operation time and success rate between robotic surgery and laparoscopic surgery.

Objective:To investigate the relationship between carotid atherosclerosis(CAS)and subclinical left ventricular(LV)dysfunction in type 2 diabetes mellitus patients with preserved LV ejection fraction(LVEF).Methods:A total of 120 patients with type 2 diabetes mellitus who had LVEF≥50% were selected in the Department of Endocrinology, the First Affiliated Hospital of Air Force Medical University from June 2021 to October 2021. The global longitudinal strain(GLS)was obtained by two-dimensional speckle tracking echocardiography(STE)to assess subclinical LV systolic function. The mitral ratio of peak early to late diastolic filling velocity(E/A), and mitral velocity to early diastolic velocity of the mitral annulus(E/E′)ratio were obtained by pulsed tissue Doppler echocardiography to assess LV diastolic function. Acrroding to bilateral carotid ultrasound examination, the subjects were divided into normal carotid arteries group( n=46) and CAS group( n=74). Demographics and biochemical parameters were compared between two groups. Binary logistic regression and Pearson correlation analysis were used to evaluate the relationship between CAS and subclinical LV dysfunction. Results:The CAS group had a higher proportion of men, older age, and a longer duration of diabetes than the normal carotid arteries group(all P<0.05). There was no difference in LVEF and GLS between the two groups [normal carotid arteries group vs CAS group, LVEF: (60.72±4.73)% vs(60.07±4.28)%; GLS: (18.24±3.72)% vs(17.81±3.47)%, respectively; both P>0.05]. However, compared with normal carotid arteries group, E/A ratio was decreased and E/E′ ratio was significantly increased in CAS group(both P<0.01). Pearson correlation analysis showed that GLS was not correlated with carotid plaque thickness and carotid intima-media thickness(CIMT; both P>0.05). By contrast, E/E′ ratio was positively correlated with carotid plaque thickness and CIMT(both P<0.05). Binary logistic regression analysis showed that GLS and E/E′ ratio were not associated with CAS( both P>0.05). However, decreased E/A ratio was significantly associated with the existence of CAS( OR=0.09, 95% CI 0.01-0.67, P=0.018). Conclusions:In type 2 diabetes mellitus patients without overt heart failure and with preserved LVEF, the occurrence of CAS is not associated with subclinical LV systolic impairment assessed by GLS, but is significantly associated with LV diastolic dysfunction, and is independent of traditional cardiovascular risk factors.

Objective: To investigate the awareness of monkeypox prevention knowledge and its influencing factors among inbound personnel, so as to provide insights into intensified health education for monkeypox prevention and control. Methods: Inbound personnel at ages of 16 years and older were sampled using a convenient sampling method from centralized medical isolation observation points in Gongshu District, Hangzhou City in November and December 2022. Participants' demographic features, history of travel in countries where monkeypox cases were reported and awareness of monkeypox prevention knowledge were collected through questionnaire surveys, and factors affecting the awareness of monkeypox prevention knowledge were identified using a multivariable logistic regression model. Results: A total of 306 questionnaires were allocated, and 293 valid questionnaires were recovered, with an effective response rate of 95.75%. The respondents included 192 men (65.53%) and 101 women (34.47%), and hand a median (interquartile range) age of 36 (16) years. The overall awareness of monkeypox prevention knowledge was 44.71%, and the awareness rates of preventive measures, source of infection, transmission route, susceptible populations and clinical manifestations were 82.94%, 79.18%, 75.09%, 60.75% and 60.07%, respectively. Multivariable logistic regression analysis showed that workers (OR=0.179, 95%CI: 0.040-0.800), self-employed individuals (OR=0.090, 95%CI: 0.018-0.451), and those with other occupations (OR=0.157, 95%CI: 0.034-0.728) had lower awareness of monkeypox prevention knowledge than students, and individuals who had never heard of monkeypox (OR=0.056, 95%CI: 0.007-0.447) had lower awareness of monkeypox prevention knowledge than those who had heard of it. In addition, individuals who were not concerned about monkeypox epidemics (OR=0.048, 95%CI: 0.004-0.563) had lower awareness than those who were very concerned. Conclusions Inbound personnel have low awareness of monkeypox prevention knowledge, and occupation, having heard of monkeypox and concern about monkeypox epidemics may affect the awareness of monkeypox prevention knowledge. Intensified health education about monkeypox is required to improve the preventive awareness among inbound personnel.

Objective:To explore the common signaling pathways of Helicobacter pylori(Hp) infection and rosacea and screen Hub genes by bioinformatic analysis. Methods:Gene expression data sets related to Hp (GSE70394) and rosacea (GSE65914) were downloaded from GEO database. The common differentially expressed genes (DEGs) were screened by using the limma package of R and Venn diagram. Metascape database was used for gene ontology(GO) enrichment analysis, and clusterProfiler package of R was used for Kyoto encyclopedia of genes and genomes(KEGG) analysis on up-regulated and down-regulated genes. Subsequently, STRING and Cytoscape software were used to establish protein-protein interaction(PPI) network and its internal plug-in MCODE and Cytohubba were applied to screen key functional modules and Hub genes, then Hub genes were imported into GeneMANIA to construct Hub genes co-expression network. Finally, GO and KEGG enrichment analysis of Hub genes were performed again.Results:GSE70394 and GSE65914 data sets included three samples of AGS cells without Hp infection and three samples of AGS cells 24 hours after Hp infection, skin tissues from nineteen rosacea patients and ten healthy volunteers, respectively. Finally, 139 common DEGs were obtained including 93 up-regulated genes and 46 down-regulated genes. GO enrichment analysis mainly focused on smooth muscle cell regulation, vascular development and lipid metabolism. KEGG enrichment analysis mainly involved lipid and atherosclerosis, inflammatory response and immune-related pathways, such as PPAR signaling pathway, cytokine-cytokine receptor interaction, Th17 cell differentiation, IL-17 signaling pathway and NF-κB signaling pathway. Total of 16 Hub genes were identified by Cytohubba, including SPRR1B, GCLM, KRT16, GPX2, S100A2, SOD2, MMP1, MSMO1, HMOX1, GLRX, IL-1β, CXCL1, PPARγ, HMGCS1, SRXN1 and SPRR3.Conclusion:There is a link existing between Hp infection infection and rosacea. Hp may be involved in the occurrence and development of rosacea by mediating inflammatory immune response and regulating lipid metabolism, the selected Hub genes and related signaling pathways may provide a theoretical reference for subsequent correlation analysis.

Acute and chronic wounds seriously threaten patients' life health and quality of life, therefore, wound repair has become a hot topic of research for scholars at home and abroad in recent years. With the development of material science and tissue engineering, more and more biomaterials prepared from natural ingredients were used in basic research and clinical treatment of wound repair. Such biomaterials can be used as templates for wound tissue regeneration to induce autologous cell adhesion and migration, and promote the deposition of extracellular matrix, which have broad clinical application prospects. This paper reviews the characteristics and application advance of natural biomaterials which are popular in the field of wound repair, aiming to provide ideas for the research and development of new wound dressing and tissue engineering skin.

Objective:To establish and validate a risk prediction model of disseminated intravascular coagulation (DIC) by the screening independent risk factors for the occurrence of DIC in patients with electrical burns.Methods:The retrospective case series study was conducted. The clinical data of 218 electrical burn patients admitted to Baogang Hospital of Inner Mongolia from January 2015 to January 2023 who met the inclusion criteria were collected, including 198 males and 20 females, with the age of (38±14) years. The patients were divided into DIC group and non DIC group based on whether they were diagnosed with DIC during the treatment period. The following data of patients of two groups were collected and compared, including age, gender, total burn area, full-thickness burn area, injury voltage, whether osteofascial compartment syndrome occurred within 1 day after injury, duration of stay in burn intensive care unit, total length of hospital stay, whether combined with inhalation injury and multiple injuries, whether shock occurred upon admission, the abbreviated burn severity index score, and the acute physiology and chronic health evaluation Ⅱ score. The laboratory examination data of the patients within 24 hours after admission were also collected, including blood routine indexes: white blood cell count (WBC), hemoglobin level, platelet count (PLT), and neutrophil count; coagulation indexes: activated partial thromboplastin time (APTT), prothrombin time, thrombin time, and levels of D-dimer and fibrinogen (FIB); blood biochemistry indexes: aspartic transaminase, alanine transaminase, direct bilirubin, total bilirubin, total protein, albumin, blood glucose, creatinine, and urea nitrogen; blood gas analysis indexes: blood pH value, arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide, bicarbonate, and base excess; and cardiac zymogram indexes: levels of myoglobin, troponin, lactate dehydrogenase, creatine kinase (CK), and α-hydroxybutyrate dehydrogenase. Data were statistically analyzed with chi-square test, Fisher's exact probability test, independent sample t test, and Mann-Whitney U test. For the variables with statistically significant differences in single factor analysis, the least absolute value selection and shrinkage operator (LASSO) regression was used to reduce the dimension, and the predictive factors for DIC in 218 patients with electrical burns were screened. The above-mentioned predictors were included in multivariate logistic regression analysis to find out the independent risk factors for DIC in 218 patients with electrical burns, and to draw the prediction model nomograms. The performance of the prediction model was evaluated by the receiver operating characteristic (ROC) curve and the area under the ROC curve, and the prediction model was validated by the calibration curve and clinical decision curve analysis (DCA). Results:Compared with those in non DIC group, the total burn area, full-thickness burn area, total length of hospital stay, and the proportions of high voltage caused injury, occurrence of osteofascial compartment syndrome within 1 day after injury, combination of inhalation injury, and occurrence of shock upon admission of patients in DIC group were significantly increased/prolonged (with Z values of -2.53, -4.65, and -2.10, respectively, with χ2 values of 11.46, 16.00, 7.98, and 18.93, respectively, P<0.05). Compared with those in non DIC group, the APTT, level of D-dimer, myoglobin, WBC, PLT, and levels of FIB, total bilirubin, and CK of patients within 24 hours after admission in DIC group were significantly prolonged/increased (with Z values of -2.02, -4.51, and -3.82, respectively, with t values of -3.84, -2.34, -2.77, -2.70, and -2.61, respectively), and the level of total protein and blood pH value were significantly reduced ( t=-2.85, Z=-2.03), P<0.05. LASSO regression analysis was carried out for the above 17 indicators with statistically significant differences. The results showed that injury voltage, the occurrence of shock upon admission, the occurrence of osteofascial compartment syndrome within 1 day after injury, and levels of D-dimer and total protein within 24 hours after admission were predictive factors for the occurrence of DIC in 218 patients with electrical burns (with regression coefficients of 0.24, 0.52, 0.35, 0.13, and -0.001, respectively). Multivariate logistic regression analysis showed that injury voltage, the occurrence of shock upon admission, the occurrence of osteofascial compartment syndrome within 1 day after injury, and D-dimer level within 24 hours after admission were independent risk factors for DIC in 218 patients with electrical burns (with odds ratios of 3.33, 4.24, 2.68, and 1.38, respectively, with 95% confidence intervals of 1.43-7.79, 1.78-10.07, 1.17-6.13, and 1.19-1.61, respectively, P<0.05). Based on the aforementioned four independent risk factors, the nomogram of prediction model for evaluating the probability of DIC in patients was drawn. The area under the ROC curve of prediction model was 0.88, and the 95% confidence interval was 0.82-0.95, indicating that the model had good predictive ability; the curve of prediction model tended to be near the ideal curve, indicating that the model had a high calibration degree; the clinical DCA of prediction model showed that the threshold probability of patients ranged from 4% to 97%, indicating that the model had good predictive ability. Conclusions:The injury voltage, the occurrence of shock upon admission, the occurrence of osteofascial compartment syndrome within 1 day after injury, and D-dimer level within 24 hours after admission are independent risk factors for the occurrence of DIC in patients with electrical burns. The prediction model established based on the above indicators can provide early warning for the occurrence of DIC in these patients.