!pip install unsloth
!pip install --force-reinstall --no-cache-dir --no-deps git+https://github.com/unslothai/unsloth.git

from huggingface_hub import login
from kaggle_secrets import UserSecretsClient
user_secrets = UserSecretsClient()
hf_token = user_secrets.get_secret("HUGGINGFACE_TOKEN")
login(hf_token)

import wandb
wb_token = user_secrets.get_secret("wandb")
wandb.login(key=wb_token)
run = wandb.init(
    project='Fine-tune-DeepSeek-R1-Distill-Llama-8B on Medical COT Dataset', 
    job_type="training", 
    anonymous="allow"
)

from unsloth import FastLanguageModel
max_seq_length = 2048 
dtype = None 
load_in_4bit = True
model, tokenizer = FastLanguageModel.from_pretrained(
    model_name = "unsloth/DeepSeek-R1-Distill-Llama-8B",
    max_seq_length = max_seq_length,
    dtype = dtype,
    load_in_4bit = load_in_4bit,
    token = hf_token, 
)

prompt_style = """Below is an instruction that describes a task, paired with an input that provides further context. 
Write a response that appropriately completes the request. 
Before answering, think carefully about the question and create a step-by-step chain of thoughts to ensure a logical and accurate response.
### Instruction:
You are a medical expert with advanced knowledge in clinical reasoning, diagnostics, and treatment planning. 
Please answer the following medical question. 
### Question:
{}
### Response:
<think>{}"""

question = "A 61-year-old woman with a long history of involuntary urine loss during activities like coughing or sneezing but no leakage at night undergoes a gynecological exam and Q-tip test. Based on these findings, what would cystometry most likely reveal about her residual volume and detrusor contractions?"
FastLanguageModel.for_inference(model) 
inputs = tokenizer([prompt_style.format(question, "")], return_tensors="pt").to("cuda")
outputs = model.generate(
    input_ids=inputs.input_ids,
    attention_mask=inputs.attention_mask,
    max_new_tokens=1200,
    use_cache=True,
)
response = tokenizer.batch_decode(outputs)
print(response[0].split("### Response:")[1])

<think>
Okay, so I have this medical question to answer. Let me try to break it down. The patient is a 61-year-old woman with a history of involuntary urine loss during activities like coughing or sneezing, but she doesn't leak at night. She's had a gynecological exam and a Q-tip test. I need to figure out what cystometry would show regarding her residual volume and detrusor contractions.
First, I should recall what I know about urinary incontinence. Involuntary urine loss during activities like coughing or sneezing makes me think of stress urinary incontinence. Stress incontinence typically happens when the urethral sphincter isn't strong enough to resist increased abdominal pressure from activities like coughing, laughing, or sneezing. This usually affects women, especially after childbirth when the pelvic muscles and ligaments are weakened.
The Q-tip test is a common diagnostic tool for stress urinary incontinence. The test involves inserting a Q-tip catheter, which is a small balloon catheter, into the urethra. The catheter is connected to a pressure gauge. The patient is asked to cough, and the pressure reading is taken. If the pressure is above normal (like above 100 mmHg), it suggests that the urethral sphincter isn't closing properly, which is a sign of stress incontinence.
So, based on the history and the Q-tip test, the diagnosis is likely stress urinary incontinence. Now, moving on to what cystometry would show. Cystometry, also known as a filling cystometry, is a diagnostic procedure where a catheter is inserted into the bladder, and the bladder is filled with a liquid to measure how much it can hold (residual volume) and how it responds to being filled (like during a cough or sneeze). This helps in assessing the capacity and compliance of the bladder.
In a patient with stress incontinence, the bladder's capacity might be normal, but the sphincter's function is impaired. So, during the cystometry, the residual volume might be within normal limits because the bladder isn't overfilled. However, when the patient is asked to cough or perform a Valsalva maneuver, the detrusor muscle (the smooth muscle layer of the bladder) might not contract effectively, leading to an increase in intra-abdominal pressure, which might cause leakage.
Wait, but detrusor contractions are usually associated with voiding. In stress incontinence, the issue isn't with the detrusor contractions but with the sphincter's inability to prevent leakage. So, during cystometry, the detrusor contractions would be normal because they are part of the normal voiding process. However, the problem is that the sph

train_prompt_style = """Below is an instruction that describes a task, paired with an input that provides further context. 
Write a response that appropriately completes the request. 
Before answering, think carefully about the question and create a step-by-step chain of thoughts to ensure a logical and accurate response.
### Instruction:
You are a medical expert with advanced knowledge in clinical reasoning, diagnostics, and treatment planning. 
Please answer the following medical question. 
### Question:
{}
### Response:
<think>
{}
</think>
{}"""

EOS_TOKEN = tokenizer.eos_token  # 必须添加 EOS_TOKEN
def formatting_prompts_func(examples):
    inputs = examples["Question"]
    cots = examples["Complex_CoT"]
    outputs = examples["Response"]
    texts = []
    for input, cot, output in zip(inputs, cots, outputs):
        text = train_prompt_style.format(input, cot, output) + EOS_TOKEN
        texts.append(text)
    return {
        "text": texts,
    }
    

from datasets import load_dataset
dataset = load_dataset("FreedomIntelligence/medical-o1-reasoning-SFT","en", split = "train[0:500]",trust_remote_code=True)
dataset = dataset.map(formatting_prompts_func, batched = True,)
dataset["text"][0]

"Below is an instruction that describes a task, paired with an input that provides further context. nWrite a response that appropriately completes the request. nBefore answering, think carefully about the question and create a step-by-step chain of thoughts to ensure a logical and accurate response.nn### Instruction:nYou are a medical expert with advanced knowledge in clinical reasoning, diagnostics, and treatment planning. nPlease answer the following medical question. nn### Question:nA 61-year-old woman with a long history of involuntary urine loss during activities like coughing or sneezing but no leakage at night undergoes a gynecological exam and Q-tip test. Based on these findings, what would cystometry most likely reveal about her residual volume and detrusor contractions?nn### Response:n<think>nOkay, let's think about this step by step. There's a 61-year-old woman here who's been dealing with involuntary urine leakages whenever she's doing something that ups her abdominal pressure like coughing or sneezing. This sounds a lot like stress urinary incontinence to me. Now, it's interesting that she doesn't have any issues at night; she isn't experiencing leakage while sleeping. This likely means her bladder's ability to hold urine is fine when she isn't under physical stress. Hmm, that's a clue that we're dealing with something related to pressure rather than a bladder muscle problem. nnThe fact that she underwent a Q-tip test is intriguing too. This test is usually done to assess urethral mobility. In stress incontinence, a Q-tip might move significantly, showing urethral hypermobility. This kind of movement often means there's a weakness in the support structures that should help keep the urethra closed during increases in abdominal pressure. So, that's aligning well with stress incontinence.nnNow, let's think about what would happen during cystometry. Since stress incontinence isn't usually about sudden bladder contractions, I wouldn't expect to see involuntary detrusor contractions during this test. Her bladder isn't spasming or anything; it's more about the support structure failing under stress. Plus, she likely empties her bladder completely because stress incontinence doesn't typically involve incomplete emptying. So, her residual volume should be pretty normal. nnAll in all, it seems like if they do a cystometry on her, it will likely show a normal post-void residual volume, as stress incontinence typically does not involve issues with bladder emptying. Additionally, since stress urinary incontinence is primarily related to physical exertion and not an overactive bladder, you would not expect to see any involuntary detrusor contractions during the test.n</think>nCystometry in this case of stress urinary incontinence would most likely reveal a normal post-void residual volume, as stress incontinence typically does not involve issues with bladder emptying. Additionally, since stress urinary incontinence is primarily related to physical exertion and not an overactive bladder, you would not expect to see any involuntary detrusor contractions during the test.<｜end▁of▁sentence｜>"

model = FastLanguageModel.get_peft_model(
    model,
    r=16,  
    target_modules=[
        "q_proj",
        "k_proj",
        "v_proj",
        "o_proj",
        "gate_proj",
        "up_proj",
        "down_proj",
    ],
    lora_alpha=16,
    lora_dropout=0,  
    bias="none",  
    use_gradient_checkpointing="unsloth",  # True 或 "unsloth" 用于非常长的上下文
    random_state=3407,
    use_rslora=False,  
    loftq_config=None,
)

from trl import SFTTrainer
from transformers import TrainingArguments
from unsloth import is_bfloat16_supported
trainer = SFTTrainer(
    model=model,
    tokenizer=tokenizer,
    train_dataset=dataset,
    dataset_text_field="text",
    max_seq_length=max_seq_length,
    dataset_num_proc=2,
    args=TrainingArguments(
        per_device_train_batch_size=2,
        gradient_accumulation_steps=4,
        # 使用 num_train_epochs = 1, warmup_ratio 用于完整训练运行！
        warmup_steps=5,
        max_steps=60,
        learning_rate=2e-4,
        fp16=not is_bfloat16_supported(),
        bf16=is_bfloat16_supported(),
        logging_steps=10,
        optim="adamw_8bit",
        weight_decay=0.01,
        lr_scheduler_type="linear",
        seed=3407,
        output_dir="outputs",
    ),
)

question = "A 61-year-old woman with a long history of involuntary urine loss during activities like coughing or sneezing but no leakage at night undergoes a gynecological exam and Q-tip test. Based on these findings, what would cystometry most likely reveal about her residual volume and detrusor contractions?"
FastLanguageModel.for_inference(model)  # Unsloth 有 2 倍的推理速度！
inputs = tokenizer([prompt_style.format(question, "")], return_tensors="pt").to("cuda")
outputs = model.generate(
    input_ids=inputs.input_ids,
    attention_mask=inputs.attention_mask,
    max_new_tokens=1200,
    use_cache=True,
)
response = tokenizer.batch_decode(outputs)
print(response[0].split("### Response:")[1])

<think>
Okay, so let's think about this. We have a 61-year-old woman who's been dealing with involuntary urine loss during things like coughing or sneezing, but she's not leaking at night. That suggests she might have some kind of problem with her pelvic floor muscles or maybe her bladder.
Now, she's got a gynecological exam and a Q-tip test. Let's break that down. The Q-tip test is usually used to check for urethral obstruction. If it's positive, that means there's something blocking the urethra, like a urethral stricture or something else.
Given that she's had a positive Q-tip test, it's likely there's a urethral obstruction. That would mean her urethra is narrow, maybe due to a stricture or some kind of narrowing. So, her bladder can't empty properly during activities like coughing because the urethral obstruction is making it hard.
Now, let's think about what happens when her bladder can't empty. If there's a urethral obstruction, the bladder is forced to hold more urine, increasing the residual volume. That's because her bladder doesn't empty completely```
So, her residual volume is probably increased.
Also, if her bladder can't empty properly, she might have increased detrusor contractions. These contractions are usually stronger to push the urine out. So, we expect her detrusor contractions to be increased.
Putting it all together, if she has a urethral obstruction and a positive Q-tip test, we'd expect her cystometry results to show increased residual volume and increased detrusor contractions. That makes sense because of the obstruction and how her bladder is trying to compensate by contracting more.
</think>
Based on the findings of the gynecological exam and the positive Q-tip test, it is most likely that the cystometry would reveal increased residual volume and increased detrusor contractions. The positive Q-tip test indicates urethral obstruction, which would force the bladder to retain more urine, thereby increasing the residual volume. Additionally, the obstruction can lead to increased detrusor contractions as the bladder tries to compensate by contracting more to expel the urine.<｜end▁of▁sentence｜>

new_model_local = "DeepSeek-R1-Medical-COT"
model.save_pretrained(new_model_local) 
tokenizer.save_pretrained(new_model_local)
model.save_pretrained_merged(new_model_local, tokenizer, save_method = "merged_16bit",)

new_model_online = "kingabzpro/DeepSeek-R1-Medical-COT"
model.push_to_hub(new_model_online)
tokenizer.push_to_hub(new_model_online)
model.push_to_hub_merged(new_model_online, tokenizer, save_method = "merged_16bit")