HHO optimized support vector machine classifier for traditional Chinese medicine syndrome differentiation of diabetic retinopathy

AIM:To develop a classifier for traditional Chinese medicine(TCM)syndrome differentiation of diabetic retinopathy(DR),using optimized machine learning algorithms,which can provide the basis for TCM objective and intelligent syndrome differentiation.METHODS:Collated data on real-world DR cases were collected.A variety of machine learning methods were used to construct TCM syndrome classification model,and the best performance was selected as the basic model.Genetic Algorithm(GA)was used for feature selection to obtain the optimal feature combination.Harris Hawk Optimization(HHO)was used for parameter optimization,and a classification model based on feature selection and parameter optimization was constructed.The performance of the model was compared with other optimization algorithms.The models were evaluated with accuracy,precision,recall,and F1 score as indicators.RESULTS:Data on 970 cases that met screening requirements were collected.Support Vector Machine(SVM)was the best basic classification model.The accuracy rate of the model was 82.05%,the precision rate was 82.34%,the recall rate was 81.81%,and the F1 value was 81.76%.After GA screening,the optimal feature combination contained 37 feature values,which was consistent with TCM clinical practice.The model based on optimal combination and SVM(GA_SVM)had an accuracy improvement of 1.92%compared to the basic classifier.SVM model based on HHO and GA optimization(HHO_GA_SVM)had the best performance and convergence speed compared with other optimization algorithms.Compared with the basic classification model,the accuracy was improved by 3.51%.CONCLUSION:HHO and GA optimization can improve the model performance of SVM in TCM syndrome differentiation of DR.It provides a new method and research idea for TCM intelligent assisted syndrome differentiation.

Clinical study on microscopic syndrome differentiation and traditional Chinese medicine treatment for liver stomach disharmony in chronic gastritis

BACKGROUND Chronic gastritis(CG)is a common gastrointestinal disorder characterized by inflammation of the stomach lining.Liver-stomach disharmony(LSD)syndrome is believed to contribute to CG symptoms.AIM To evaluate the efficacy and safety of microcosmic syndrome differentiation and Chinese herbal medicine(CHM)treatment in patients with CG and LSD syndrome.METHODS Sixty-four patients with CG and LSD syndrome were randomly divided into two groups:The treatment group received CHM based on microcosmic syndrome differentiation and the control group received conventional Western medicine.The treatment course lasted 12 wk.The primary outcome was improvement in dyspeptic symptoms,measured using the Nepean Dyspepsia Index.The secondary outcomes included the improvement rate of endoscopic findings,histopathological findings,and microcosmic syndrome scores and the incidence of adverse events.RESULTS After 12 wk of treatment,the treatment group showed significantly greater improvement in dyspeptic symptoms than the control group(93.75%vs 65.63%,P<0.01).The treatment group also showed a significantly higher improvement rate in endoscopic findings than the control group(81.25%vs 53.13%,P<0.05).The improvement rates of histopathological findings and microcosmic syndrome scores were not significantly different between the two groups(P>0.05).No serious adverse events were observed in either group.CONCLUSION Microcosmic syndrome differentiation and CHM treatment can effectively improve dyspeptic symptoms and endoscopic findings in patients with CG and LSD syndrome and have a good safety profile.Further studies with larger sample sizes and longer follow-up periods are required to confirm the long-term efficacy and mechanism of action of this treatment.

Comparing the effectiveness of pattern differentiation treatment and fixed formula treatment for perimenopausal syndrome with Chinese herbal medicine:A study protocol

Objective:To further understand and compare the effectiveness of pattern differentiation treatment and fixed prescription treatment in perimenopausal syndrome.Methods:The study will be conducted in the Hong Kong Federation of Trade Unions Workers'Medical Clinics,Hong Kong Baptist University Chinese Medicine Clinic cum Training and Research Centre(Hong Kong,China).One hundred Chinese women,aged 45-55 years,will be recruited.The participants will be randomized into 2 groups.The intervention group will be administered medication,based on pattern differentiation,by qualified traditional Chinese medicine(TCM)practitioners.After each evaluation,TCM practitioners will evaluate and revise the prescription,based on the participants'patterns.The control group will be given the standard formula,i.e.,the Erxian decoction,which contains 6 herbs.The treatment period and the follow-up period will be 8 weeks each.The primary assessment outcome measure will be the Kupperman Index,and the secondary outcome measure will be the Menopause-specific Quality of Life Questionnaire score.Conclusion:Pattern-differentiated treatment is the basic principle of TCM to understand and treat diseases.The study will show the pattern-differentiated treatment is effectiveness than the fixed prescription.

Study on Epidemiological Profile, Clinical Profile, and Angiographic Patterns in Acute Coronary Syndrome Patients in a Tertiary Health Care Center in Haryana

Background: Cardiovascular diseases are the leading cause of death in India, with coronary artery disease (CAD) accounting for a majority of the deaths. There are few large registries on acute coronary syndrome (ACS) from India. Our aim is to study the clinical and epidemiological profile of ACS PATIENTS presenting to our institute, including their angiographic features. Methods: This hospital-based observational, single tertiary care center, prospective study was conducted on patients admitted in the Department of Cardiology at a tertiary care center in Haryana. The study included 400 patients aged greater than 18 years who were admitted with the diagnosis of ACS, and it was carried out for 1 year. The epidemiological profile, clinical history, risk factors, electrocardiogram findings, and angiographic pattern were studied and analyzed with appropriate statistical tools. Results: The mean age of the study population was 55.12 ± 11.78 years. Male and female ratio was 2.4:1. The majority of the patients came from rural background (80%);24% of the patients were illiterate. Smoking was the most common risk factor (51.5%) in our study population followed by hypertension (40%) and diabetes (28%). Unstable angina was the most common type of ACS, which was found in 68.25% of patients. Premature CAD was found in 27.8% of patients and obstructive CAD was found in 63% of patients. Coronary angiography revealed that 39% had single vessel disease (SVD), 23.5% had double vessel disease (DVD), and 27.5% had triple vessel disease (TVD). LAD was more commonly involved, followed by RCA and LCX. Within the first 24 hours, 67% of patients sought medical assistance and only 38.5% received definitive treatment, suggesting a delay in seeking definitive treatment in our study population. Conclusion: The study suggests that unstable angina is the most common form of ACS in the study population, which is mostly of rural background with significant delay in seeking medical help. Smoking is the most common risk factor in the study population.

The Distribution Pattern of Traditional Chinese Medicine Syndromes in Patients with Hyperlipidemia

Objective: Hyperlipidemia is a representative nutritional metabolic disease in clinic, which is easy to induce atherosclerotic cardiovascular and cerebrovascular diseases, with complex classification. Traditional Chinese Medicine (TCM) syndrome aims to reflect the characteristics of diseases and is the basic principle of TCM treatment of diseases. This study aimed to summarize the distribution pattern of TCM syndromes in patients with hyperlipidemia. Methods: The frequency, characteristics and distribution of all TCM syndromes of 1012 patients with hyperlipidemia were analyzed. Results: The main disease types determined by frequency of 1012 patients included hypertriglyceridemia combined with hypo high-density lipoprotein cholesterolemia (19.76%), hypo high-density lipoprotein cholesterolemia (18.58%), hypercholesterolemia (16.50%), mixed hyperlipidemia (16.40%), and hypertriglyceridemia (15.12%). The distribution of TCM syndromes, in order of frequency, was as follows: Qi-deficiency and blood stasis syndrome (23.52%), liver depression and spleen deficiency (9.88%), syndrome of qi stagnation and blood stasis (9.29%), phlegm stasis syndrome (7.41%), and syndrome of yang deficiency of spleen and kidney (6.92%). Conclusion: Qi-deficiency and blood stasis syndrome and liver depression and spleen deficiency are the most common TCM syndromes in patients with hyperlipidemia.

miR-103-3p regulates the differentiation of bone marrow mesenchymal stem cells in myelodysplastic syndrome

The pathogenesis of myelodysplastic syndrome(MDS)may be related to the abnormal expression of microRNAs(miRNAs),which could influence the differentiation capacity of mesenchymal stem cells(MSCs)towards adipogenic and osteogenic lineages.In this study,exosomes from bone marrow plasma were successfully extracted and identified.Assessment of miR-103-3p expression in exosomes isolated from BM in 34 MDS patients and 10 controls revealed its 0.52-fold downregulation in patients with MDS compared with controls(NOR)and was downregulated 0.55-fold in MDS-MSCs compared with NOR-MSCs.Transfection of MDS-MSCs with the miR-103-3p mimic improved osteogenic differentiation and decreased adipogenic differentiation in vitro,while inhibition of miR-103-3p showed the opposite results in NOR-MSCs.Thus,the expression of miR-103-3p decreases in MDS BM plasma and MDS-MSCs,significantly impacting MDS-MSCs differentiation.The miR-103-3p mimics may boost MDS-MSCs osteogenic differentiation while weakening lipid differentiation,thereby providing possible target for the treatment of MDS pathogenesis.

Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD

[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). [Methods] A total of 92 patients with AECOPD who came to Nanchong Chinese Medicine Hospital from March 2022 to February 2023 were selected for the study, and the intervention group (TCM nursing based on syndrome differentiation, 46 cases) and the conventional group (basic nursing, 46 cases) were selected for the study, and the pulmonary function and quality of life of the two groups were compared. [Results] Before nursing, there was no significant difference in levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) between the intervention group and conventional group ( P >0.05). After 3 months of nursing, the levels of FVC, FEV1 and FEV1/FVC in the intervention group were higher than those in the conventional group ( P <0.05). Before nursing, there was no significant difference in the scores of health, emotion and social functions between the two groups ( P >0.05). At three months of nursing, the scores of health, emotion, and social functions in the intervention group were higher than those in the conventional group ( P <0.05). [Conclusions] The implementation of TCM nursing based on syndrome differentiation in patients with AECOPD can effectively improve the pulmonary function and quality of life of patients, and has significant clinical implementation value.

The combination of disease and Zheng (syndrome) on the basic of differentiation of six channels:a new pattern of disease diagnosis and treatment of traditional Chinese medicine

Traditional Chinese medicine(TCM)was formed two thousand years ago,and developed in the following centuries.TCM has a unique way of looking at health and illness.Zheng(syndrome)is the basic unit and key term in TCM theory.Zheng is the pathological generalization of a certain stage in the development of disease.Treatment based on syndrome differentiation and disease differentiation of TCM is the basic principle to know and treat diseases,and a kind of special method to study diseases in TCM.In Han Dynasty(200 AD),doctor Zhang Zhongjing proposed Liujing Bianzheng(the differential diagnosis in accordance with the theory of six channels)to diagnose and treat diseases in Treatise on Febrile and Miscellaneous Diseases.In other words,he divided diseases into six channels diseases based on patient's Zhengs.Six channels diseases almost include all of the disease according to his classification standards.In addition,there are development rules in the progress of six channels diseases.Therefore,we hypothesized that combination of six channels disease and Zheng on the basic of differentiation of six channels is a new pattern of diagnosis and treatment diseases in TCM,which is beneficial to the understanding of a certain disease and makes disease treatment more convenient,fast and effective.

Pathophysiology, clinical features and radiological findings of differentiation syndrome/all-trans-retinoic acid syndrome

In acute promyelocytic leukemia, differentiation thera-py based on all-trans-retinoic acid can be complicated by the development of a differentiation syndrome(DS). DS is a life-threatening complication, characterized by respiratory distress, unexplained fever, weight gain, interstitial lung infiltrates, pleural or pericardial effusions, hypotension and acute renal failure. The diagnosis of DS is made on clinical grounds and has proven to be difficult, because none of the symptoms is pathognomonic for the syndrome without any definitive diagnostic criteria. As DS can have subtle signs and symptoms at presentation but progress rapidly, end-stage DS clinical picture resembles the acute respiratory distress syndrome with extremely poor prognosis; so it is of absolute importance to be conscious of these complications and initiate therapy as soon as it was suspected. The radiologic appearance resembles the typical features of cardiogenic pulmonary edema. Diagnosis of DS remains a great skill for radiologists and haematologist but it is of an utmost importance the cooperation in suspect DS, detect the early signs of DS, examine the patients' behaviour and rapidly detect the complications.

Sweet syndrome and differentiation syndrome in a patient with acute promyelocytic leukemia

The differentiation syndrome is an inflammatory reaction with increased capillary permeability that occurs in up to 25% of patients with acute promyelocytic leukemia treated with all-trans retinoic acid. A 50-year-old man with acute promyelocytic leukemia underwent chemotherapy with idarubicin and all-trans retinoic acid. On day +21 the patient developed pruritic prepatelar papules as well as several 10 mm subcutaneous nodules in both thighs accompanied by persistent fever. On the day +25 the patient presented with bilateral pulmonary crackles, infiltrates in the right lower lobe and severe hypotension which required dopamine infusion. Biopsy of one of the thighs nodules was performed. A Sweet syndrome associated to a differentiation syndrome was suspected. All-trans retinoic acid therapy was discontinued and dexamethasone was administered. In 48 h the patient showed remission of the fever and the infiltrates and the skin lesions acquired a residual aspect. It is debatable whether these two syndromes are distinct entities with common mechanisms or whether they are poles of the same spectrum. Dermatologists and hematologists must be aware of these two syndromes and its pathophysiologic association.

Ophthalmic Syndrome Differentiation System and Digital Chinese Medicine

In traditional Chinese medicine(TCM),ophthalmic syndrome differentiation is an ophthalmology-specific method for identifying syndromes based on the“Five Orbiculi”theory.It was devised by Professor Qing-Hua PENG through an unprecedented combination of syndrome element differentiation and ophthalmic clinical practices,based on the Clinical Terminology of Chinese Medical Diagnosis and Treatment-Syndromes of the National Standards of the People's Republic of China.This approach integrates an ophthalmic syndrome differentiation system with digital Chinese medicine(DCM),and proposes the extraction of syndrome elements of ophthalmic diseases from research on DCM.These elements are then quantified and organized to form a model of digital diagnosis and treatment specific to ophthalmology,which should help to achieve synergistic development of the ophthalmic syndrome differentiation system and DCM.

Nursing Based on Syndrome Differentiation Combined with Auricular Plaster Therapy in Alleviating Insomnia

Objective:To observe the effect of auricular point pressing combined with nursing based on syndrome differentiation in the treatment of insomnia patients.Methods:Totally 92 patients with insomnia were randomly divided into the observation groupgiven auricular point pressing combined with nursing care based on syndrome differentiation and the control group treated with auricular point pressing alone.The improvement of Pittsburgh Sleep Quality Index(PSQI),TCM Syndrome Score and nursing satisfaction were compared between the 2 groups.Results:The time effect of PSQI total score and 6 factors in both groups were statistically significant(P<0.05).The time effect,interaction effect and inter-group effect of subjective sleep quality,PSQI total score were statistically significant(P<0.05);the 4 inter-group factors of sleep quality,sleep latency,sleep duration and daytime function were statistically significant(P<0.05).The total score of TCM syndromes in the observation group was lower than that in the control group(P<0.05),and the satisfaction rate in the observation group higher than that in the control group(80.43%vs.60.86%,P<0.05).Conclusion:Auricular point pressing combined withnursing based on syndrome differentiation can effectively improve the sleep quality of insomnia patients,and has significant advantages in improving TCM syndromes,as well as gained higher nursing satisfaction from patients.

Research on Text Mining of Syndrome Element Syndrome Differentiation by Natural Language Processing

Objective Natural language processing (NLP) was used to excavate and visualize the core content of syndrome element syndrome differentiation (SESD). Methods The first step was to build a text mining and analysis environment based on Python language, and built a corpus based on the core chapters of SESD. The second step was to digitalize the corpus. The main steps included word segmentation, information cleaning and merging, document-entry matrix, dictionary compilation and information conversion. The third step was to mine and display the internal information of SESD corpus by means of word cloud, keyword extraction and visualization. Results NLP played a positive role in computer recognition and comprehension of SESD. Different chapters had different keywords and weights. Deficiency syndrome elements were an important component of SESD, such as "Qi deficiency""Yang deficiency" and "Yin deficiency". The important syndrome elements of substantiality included "Blood stasis""Qi stagnation", etc. Core syndrome elements were closely related. Conclusions Syndrome differentiation and treatment was the core of SESD. Using NLP to excavate syndromes differentiation could help reveal the internal relationship between syndromes differentiation and provide basis for artificial intelligence to learn syndromes differentiation.

The Comparative Study on Two Models of Syndrome Differentiation of the Hand, Foot and Mouth Disease: An Investigation Analysis of the Signs and Symptoms on 2325 Cases

Objective To realize the characteristics of "zheng" differentiation-treatment for hand, foot and mouth disease(HFMD), a new methodology of syndrome differentiation for different stages of HFMD has been explored. Methods Total of 2 325 cases with HFMD were recorded by distributing them into exterior syndrome stage, interior syndrome stage, severe syndrome stage and recovered syndrome stage, respectively, and the main symptoms and subsidiary symptoms of different stages of HFMD have been observed. The major and minor pathogenesis of HFMD in different stages were obtained, and compared with the "2010 Guideline for the Diagnosis and Treatment of HFMD". Results It was found that the major pathogenesis of exterior stage was defined as "the invation of the wenevil to the defender of the body with the collaterals got involved ", and the minor as "qi deficiency"; in interior stage, "the fury of Gan-Yang" was the main pathogenesis, and "qi in chaos and qi deficiency" was the minor; in severe syndrome stage, "the damage of heart, liver and lung" was the main pathogenesis, and "qi in chaos" was the minor; and the pathogenesis of recovered stage was "qi-yin deficiency". Compared with the "2010 Guideline for the Diagnosis and Treatment of HFMD", it showed that "the obstruction of the fei-pi qi by the mixture of shi-re evil" and "the mixture of shi-re" in vivo was quite difficult to be explained in completely different context in the general situation; in the severe stage, the TCM clinical characteristics of syndrome differentiation might lose; in the early acute severe cases, the phenomenon that xin-yang and fei-qi almost ran out was difficult to be observed, then, the line between the severe and the acute severe became vague.Conclusions The theory of syndrome differentiation by stages of HFMD was reasonable in the actual situation of clinical description on HFMD which was expected to be further tested and widely applied in the "zheng" differentiation-treatment of HFMD in the future.

Clinical Observation on Quality of Life in Coronary Artery Bypass Grafting Patients Treated According to Syndrome Differentiation of TCM

Objective: To evaluate the clinical effect and quality of life (QOL) in coronary artery bypass grafting (CABG) patients treated according to syndrome differentiation of TCM. Methods: Eighty-two CABG patients were allocated in the control group (n = 39) treated with conventional method of western medicine, and the TCM-treated group (n

Design of a WeChat Learning Platform for Syndrome Differentiation

Objective To design a WeChat mini program called Chinese Syndrome Differentiation Learning Platform(CSDLP)on smartphone to improve health literacy.Methods The developer tools of WeChat(Version:v1.01.170925)were used for designing and debugging the mini program.SPSS17.0 was used for statistical purposes.“View container”“Basic content”“Form component”“Navigation”and“Media components”were used for the development of the WeChat mini program.The detailed method was referred to https://mp.weixin.qq.com/debug/wxadoc/dev/.Results A WeChat mini program called CSDLP was developed.This program has three major functions which are WeChat reading,WeChat class and WeChat syndrome differentiation.The official test report showed that there were no functionality errors for the seven android smartphones(referred to as A,B,C,D,E,F and G)that CSDLP was tested on.Statistical analysis results showed that the average memory in D,E,F and G was lower than in A,B and C.Average ratio was the highest in F and the lowest in G.The average loading time was the same for all smartphones.The audio database for diagnostics using traditional Chinese medicine(TCM)and a lecture video database were based on diagnostic textbook.Our team built a syndrome differentiation database which included 51 diseases.Conclusion CSDLP can improve knowledge visualization,studying process,and information sharing in terms of the training and development of new techniques for syndrome differentiation and treatment in TCM,and it can provide a better illustration for people to understand TCM.

Treatment of oral ulcer based on TCM syndrome differentiation

Oral ulcer is a kind of ulcerative injury that occurs in the oral mucosa and is very common in clinic.In severe case,it can affect the quality of life of the patients.Western medicine treatment of oral ulcer is often prone to relapse,while the effect of traditional Chinese medicine treatment is remarkable.

Regularity of syndrome differentiation and treatment of traditional Chinese medicine for Henoch-Schonlein purpura based on data mining techniques

Objective:This study aims to explore the regularity of syndrome differentiation and treatment of traditional Chinese medicine(TCM)for allergic purpura.Methods:CNKI,Weipu Chinese science and technology database,wanfang medical network database,and Chinese biomedical literature database were searched for eligible studies.Medical records including complete patient personal information,patient symptoms,TCM syndromes,treatment,and medication were included.The data was analyzed using the Chinese medicine heritage support platform provided by the Chinese Academy of Chinese medicine(V2.5).Results:Differentiation of health gas camp blood was the most commonly used method of differentiation of symptoms and signs in famous veteran TCM.The treatment included cooling blood,activating blood circulation,clearing heat and detoxifying toxins,removing blood stasis and stopping bleeding.Honeysuckle,Forsythia suspensa,cicada slough and other drugs were interrelated.Potential drug pair combinations and drug networks showed the basic drug composition of Qingying Decoction.According to the entropy cluster analysis,28 core drug combination and 12 new formulations were obtained.Conclusion:The regularity of syndrome differentiation and treatment of traditional Chinese medicine for Henoch-Schonlein purpura based on the famous and old TCM doctors was complex.Further researches are still needed.

Analysis of 278 Cases of Clinical Application of Western Medicine with Traditional Chinese Medicine Syndrome Differentiation

Since the beginning of the Western Learning, modern medicine has developed rapidly in China, and the integration of Chinese and western medicine has become inevitable. Since Zhang Xichun's "Medicine in the West", using traditional Chinese medicine theory to guide the practice of western medicine, through long-term clinical diagnosis, we gradually realized the advantages of applying western medicine according to TCM syndrome differentiation. Therefore, 278 patients from the Second People's Hospital of Gansu Province from July 2015 to December 2017 were enrolled in the relevant departments of the Department of Internal Medicine. On the basis of routine treatment, TCM was obtained through inspection, inquiry, listening and smelling, palpation and pulse-taking. The syndrome type is based on the medicinal properties, menstruation and ef?cacy of more than ten kinds of western medicines, so that they can reach Chinese medicine[1]. Therefore, this paper aims to improve the accuracy of western medicine use, reduce the incidence of adverse reactions, discover the new ef?cacy of western medicine,and promote the integration of Chinese and western medicine.

ACUPUNCTURE TREATMENT ON 40 CASES OF IRRITABLE COLON SYNDROME ACCORDING TO DIFFERENTIATION OF SYMPTOMS AND SIGNS

Irritable intestinal tract syndrome was classified and treated with acupuncture according to differentiation of symptoms and signs.Of the 40 cases treated,28 were cured,11 improved,and 6 ineffective.The total effective rate was 85％.The syndrome was classified into fourtypes:weakness of the spleen and stomach,disharmony of the liver spleen,Yang deficiency ofthe spleen and kidney,and retention of dampness and heat.There was no statistically significant difference in therapeutic effects among the four types of syndromes.However,the curative effect in theacupuncture group was better than that in the medication group,and the difference was of statisticalsignificance.