Analysis on the traditional Chinese medicine syndromes and Six-Meridian Pattern Identification of coronavirus disease 2019

Zhongjing Zhang’s Shang Han Lun(Treatise on Cold-induced Diseases,an ancient Chinese medical book written by Zhongjing Zhang in the Eastern Han Dynasty)was pioneering to conduct the Six-Meridian Pattern Identification,which provided later generations with a theoretical basis for the treatment of Exogenous Febrile Diseases.The coronavirus disease 2019 belongs to the category of“Pestilence”(the general term for virulent infectious epidemic diseases)in“Febrile Diseases”(the general term for acute externally contracted diseases caused by Warm Pathogens,with fever as the chief manifestation,also known as Warm Diseases)and the treatment of coronavirus disease 2019 is mostly based on the Triple Energizer Pattern Identification(the a categorization of Pattern Identification according to the theory of the Triple Energizer)or Defense,Qi,Nutrient and Blood Pattern Identification(the categorization of Febrile Diseases Pattern Identification according to the theory of Defense,Qi,Nutrient and Blood which indicates the stages of the clinical course with corresponding pathological changes).Although the theory of Cold-induced Diseases(the condition caused by Cold,manifested as chills and fever,absence of sweating,headache and floating-tense pulse)and the theory of Febrile Disease seem to be entirely distinct with each other,Zhongjing Zhang’s theory contained Triple Energizer Pattern Identification or Defense,Qi,Nutrient and Blood Pattern Identification,and Triple Energizer Pattern Identification or Defense Qi,Nutrient and Blood Pattern Identification also contained Zhongjing Zhang’s Six-Meridian Pattern Identification(the categorization of Pattern Identification according to the theory of the Six Meridians,applied to the diagnosis of acute Febrile Diseases at different stages,and also useful for the Pattern Identification of other diseases).The basic principles and therapeutic methods of Cold-induced Diseases and Febrile Diseases are intertwined.Therefore,this paper will combine the two theories to analyze the traditional Chinese medicine syndromes of coronavirus disease 2019,and try to use Six-Meridian Pattern Identification to guide the treatment of this disease.

Constitution identification model in traditional Chinese medicine based on multiple features

Objective To construct a precise model for identifying traditional Chinese medicine(TCM)constitutions;thereby offering optimized guidance for clinical diagnosis and treatment plan-ning;and ultimately enhancing medical efficiency and treatment outcomes.Methods First;TCM full-body inspection data acquisition equipment was employed to col-lect full-body standing images of healthy people;from which the constitutions were labelled and defined in accordance with the Constitution in Chinese Medicine Questionnaire(CCMQ);and a dataset encompassing labelled constitutions was constructed.Second;heat-suppres-sion valve(HSV)color space and improved local binary patterns(LBP)algorithm were lever-aged for the extraction of features such as facial complexion and body shape.In addition;a dual-branch deep network was employed to collect deep features from the full-body standing images.Last;the random forest(RF)algorithm was utilized to learn the extracted multifea-tures;which were subsequently employed to establish a TCM constitution identification mod-el.Accuracy;precision;and F1 score were the three measures selected to assess the perfor-mance of the model.Results It was found that the accuracy;precision;and F1 score of the proposed model based on multifeatures for identifying TCM constitutions were 0.842;0.868;and 0.790;respectively.In comparison with the identification models that encompass a single feature;either a single facial complexion feature;a body shape feature;or deep features;the accuracy of the model that incorporating all the aforementioned features was elevated by 0.105;0.105;and 0.079;the precision increased by 0.164;0.164;and 0.211;and the F1 score rose by 0.071;0.071;and 0.084;respectively.Conclusion The research findings affirmed the viability of the proposed model;which incor-porated multifeatures;including the facial complexion feature;the body shape feature;and the deep feature.In addition;by employing the proposed model;the objectification and intel-ligence of identifying constitutions in TCM practices could be optimized.

Artificial intelligence meets traditional Chinese medicine: a bridge to opening the magic box of sphygmopalpation for pulse pattern recognition

Artificial intelligence(AI) aims to mimic human cognitive functions and execute intellectual activities like that performed by humans dealing with an uncertain environment. The rapid development of AI technology provides powerful tools to analyze massive amounts of data, facilitating physicians to make better clinical decisions or even replace human judgment in healthcare.Advanced AI technology also creates novel opportunities for exploring the scientific basis of traditional Chinese medicine(TCM) and developing the standardization and digitization of TCM pulse diagnostic methodology. In the present study, we review and discuss the potential application of AI technology in TCM pulse diagnosis. The major contents include the following aspects:(1) a brief introduction of the general concepts and knowledge of TCM pulse diagnosis or palpation,(2) landmark developments in AI technology and the applications of common AI deep learning algorithms in medical practice,(3) the current progress of AI technology in TCM pulse diagnosis,(4) challenges and perspectives of AI technology in TCM pulse diagnosis. In conclusion, the pairing of TCM with modern AI technology will bring novel insights into understanding the scientific principles underlying TCM pulse diagnosis and creating opportunities for the development of AI deep learning technology for the standardization and digitalization of TCM pulse diagnosis.

General Situation of Traditional Chinese Medicine Identification Methods

Traditional Chinese medicines are the material basis for the treatment of diseases under theoretical direction, as well as the raw materials of traditional Chinese medicine decoction pieces and Chinese patent medicines. The quality of traditional Chinese medicine directly influences clinical efficacy. Therefore, the identification of traditional Chinese medicine is the responsibility of medicinal workers. The identification method develops from observation, tasting, smelling and listening to firing method and testing with water, and the construction of fingerprints of traditional Chinese medicines and molecular biological techniques. The development and evolution of traditional Chinese medicine identification methods was reviewed in this paper.

Perceptions and Controversies on Cholera in the Traditional Chinese Medicine Field in the Late Qing Dynasty

At the beginning of the initial cholera outbreak in China,Wang Qingren(王清任),after years of clinical trials,became an early representative who discovered the infectious characteristics and observed the course of cholera in the field of traditional Chinesse medicine(TCM).Kou Langao(寇兰皋)and Xu Zimo(徐子默),both medical practitioners,constructed a diagnosis and treatment system for cholera with cold patterns under the theory of typhoid.They represented“School of Cholera with Cold Patterns”(SCCP).In the 1860s,with the influence of Wang Shixiong’s(王士雄)studies on the nature of cholera under the theory of epidemic febrile disease,the“School of Cholera with Heated Patterns”(SCHP)prevailed thereafter.The two schools complemented each other in theories and contributed to the integrity of TCM in cholera diagnosis and treatment.By reviewing previous literature,books,clinical cases,and historical materials in medical field,this article aims 1)to summarise the influence of TCM on the cognitive development towards cholera in the late Qing dynasty;2)to explore the origin of the controversy between SCCP and SCHP from historical evidence;3)to summarize the historical lessons from the debate over cholera in TCM based on the principle of treatment based on pattern identification,and offer suggestions for the current prevention and treatment of new diseases using TCM.

Distribution patterns and industry planning of commonly used traditional Chinese medicinal plants in China

Medicinal plants are the primary material basis for disease prevention and treatment in traditional Chinese medicine(TCM).The conservation and sustainable utilization of these medicinal plants is critical for the development of the TCM industry.However,wild medicinal plant resources have sharply declined in recent decades.To ameliorate the shortage of medicinal plant resources,it is essential to explore the development potential of the TCM industry in different geographical regions.For this purpose,we examined the spatial distribution of commonly used medicinal plants in China,the number of Chinese medicinal material markets,and the number of TCM decoction piece enterprises.Specifically,multispecies superimposition analysis and Thiessen polygons were used to reveal the optimal range for planting bulk medicinal plants and the ideal regions for building Chinese medicinal material markets,respectively.Furthermore,we quantitatively analyzed mismatches between the spatial distribution of commonly used medicinal plant richness,Chinese medicinal material markets,and TCM decoction piece enterprises.We found that the areas suitable for growing commonly used medicinal plants in China were mainly distributed in Hengduan Mountain,Nanling Mountain,Wuling Mountain,and Daba Mountain areas.The Thiessen polygon network based on Chinese medicinal material market localities showed there are currently fewer markets in southwestern,northwestern,and northeastern China than in central and southern China.TCM decoction piece enterprises are concentrated in a few provinces,such as Hebei and Jiangxi.We found that the distribution of commonly used medicinal plants,Chinese medicinal material markets and TCM decoction piece enterprises are mismatched in Henan,Shaanxi,Hunan,Hubei,Zhejiang,Fujian,Chongqing,and Xizang.We recommend strengthening development of the TCM industry in Henan,Hunan,Zhejiang,Shaanxi,Hubei,Chongqing,Fujian,and Xizang;building more Chinese medicinal material markets in southwestern,northwestern,and northeastern China;and establishing medicinal plant nurseries in resource-rich provinces to better protect and domesticate local medicinal plants.

Clinical distribution and molecular profiling on postoperative colorectal cancer patients with different traditional Chinese medicine syndromes

Background:Traditional Chinese medicine(TCM)syndrome,also named syndrome,are comprehensive and integral analyses of clinical information which helps to guide different individualized treatment prescriptions.Methods:Thirty healthy controls and 80 colorectal cancer(CRC)patients(including 33 Spleen Qi Deficiency syndrome,23 Dampness Heat syndrome,17 Blood Stasis syndrome and 7 other syndrome)were enrolled into this study.Human mRNAs were extracted from peripheral blood mononuclear cells.The gene expression for CRC patients with different TCM syndrome was determined by microarray and qRT-PCR.Results:Spleen Qi Deficiency,Dampness Heat and Blood Stasis were the most common syndromes in CRC patients.There is a significant difference was found in mRNA expression levels(especially for PIK3CA,STAT3,SOX9 and KDM5C)among Spleen Qi Deficiency,Dampness Heat and Blood Stasis syndrome groups.The higher mRNA levels of JNK1,TP53,MLH1,MSH6,PMS2,SOCS3,TCF7L2,FAM123B,PSAP,FBXW7,SALL4 and the lower expression of inflammatory cytokine IL-6 were found in Spleen Qi Deficiency group but not other syndrome types.The higher mRNA levels of KRAS,MUC16,EGFR,GRASP65,PIK3CA,MAPK7,CD24,STAT3,SLC11A1,Bcl-2,TXNDC17 and some inflammatory cytokines(IL-6,IL-23,TNF-a,CXCR4)were found in Dampness Heat group but not other syndrome types.Blood Stasis syndrome showed higher expression of SOX9,MLH1,MSH6,KDM5C,PCDH11X,PSAP and SALL4,and lower mRNA levels of PIK3CA,CD24,STAT3,CXCR4,TXNDC17 and TP53.The CRC patients with Dampness Heat syndrome might have a poor prognosis than other syndrome types.Conclusion:The identification of syndrome conditions had different impacts on CRC prognosis,and which might be related with different mRNA expression levels.Some oncogenes and pro-inflammatory cytokines were highly expressed in Dampness Heat group but not other syndrome types,suggesting that the CRC patients with Dampness Heat syndrome might have a poor prognosis.Our results prelimitarily uncovered the molecular basis of syndrome differences in CRC prognosis,a better understanding for TCM treatment of CRC.

A Preliminary Study on Legitimacy Identification Standards for Unconventional Treatment Technologies in Traditional Chinese Medicine

Compared with western medicine with objective and standardized theories,traditional Chinese medicine(TCM)places more emphasis on subjective thinking.Moreover,there are several academic schools under TCM,and ancient secret prescriptions and proven prescriptions play important roles in TCM treatments.However,the drugs used by some academic schools and some ancient secret prescriptions and proven prescriptions often contradict mainstream theories,and some TCM treatment methods do not significantly conform to the methods that are considered safe by the Chinese Pharmacopoeia(2015 edition),medical textbooks and other canonical books.Despite the long history and abundant successful experiences of TCM treatments,controversies regarding these unconventional treatment technologies,specifically when these breach the safety standards of treatment,exist considering that several medical adverse effects are observed when performing these unconventional treatments.In view of this,distinguishing“welldefined technological breakthrough”from“medical fault”is considered necessary.This study discusses the issue and raises constructive suggestions on the corresponding identification standards for unconventional treatment strategies in TCM.

Perspectives in application of biosensors for the modernization of traditional Chinese medicine

Biosensor is an instrument which is sensitive to biological material and converts its concentration into electrical signals.Organisms such as enzymes, antibodies, tissues, cells and so on can selectively identify specific substances. Thesemolecular recognition functions can be combined with the target, such as the binding of antibodies and antigens, and thebinding of enzymes to the substrate through the recognition process. Biosensor has the advantages of high specificity,high sensitivity, fast reaction speed, low cost and easy operation. It has wide application prospect in food, pharmacy,chemical industry, clinical examination, biomedicine, environmental monitoring and so on, especially as a newtechnology means, in the field of modern herbal medicine research influence. Studies have demonstrated that thebiosensing technology has been applied to, traditional Chinese medicine （TCM） targets, isolation and purification ofTCM, the mechanism of TCM, quality control of TCM, the active ingredients detection of TCM and other basicresearches. Biosensor technology has made an important contribution to the research of modern herbal medicine, and hasbecome a Hot-spot in future research.

Analysis on the medication rule of traditional Chinese medicine in the treatment of COVID-19 patients

Objective: To describe patterns of utilization of traditional Chinese medicine(TCM) in the treatment of patients with coronavirus disease 2019(COVID-19).Methods: Adult patients with COVID-19 who received TCM treatment were divided into a non-serious group(mild and moderate types) and a serious group(severe and critical types) according to their admission conditions. The medical records and prescriptions of these patients were investigated to determine their TCM utilization patterns.Results: In all, 3,872 COVID-19 patients were included. Oral Chinese traditional patent medicine(CPM) was the most commonly used type of TCM(83.2%), fol owed by decoction(64.4%). As for medication pattern, the proportion of multi-drug combinations was higher than single drug use(55.0% vs. 45.0%). Decoction combined with oral CPM was the most common combination(39.1%,1,514/3,872). Oral y administered, injected, and external y applied CPM were significantly more common in the serious group than in the non-serious, while decoction and non-drug TCM treatments were more common in the non-serious than in the serious group.Multi-drug combinations were used for the majority of patients in both groups, mainly in the form of decoction combined with oral CPM.Serious patients were analysed by three groups of different prognoses and outcomes, including discharged after improvement,discharged after relapse and improvement, died final y. The two most common medication patterns were decoction combined with oral CPM and oral CPM alone in the two final y discharged groups. Oral CPM alone or used in combination with injected CPM were seen most commonly in the death group. Significant differences were established in medication patterns among patients in these three groups.Conclusions: Oral CPM was the mainly used TCM for COVID-19 patients, followed by decoction. More common medication pattern was multi-drug combination, especially decoction combined with oral CPM. The treatment measures and medication patterns of TCM commonly used in COVID-19 patients with the range of conditions found in this study should be further explored in the future to provide a more complete reference for COVID-19 treatment.

Research hotspots andfrontiersanalysisoftraditional Chinese medicine constitution identification:Avisual analysis of literature based on CiteSpaceand vosviewer

Objective:To explore the development and hotspots in the field of traditional Chinese medicine(TCM)constitution identification since the year 2000.Methods:Using CiteSpace and VOSviewer software,literature from five prominent databases including VIP,WanFang,China National Knowledge Infrastructure(CNKI),PubMed,and Web ofScience was analyzed.Visual methods were used to examine the annual publications,keywords,authors,and collaborative networks.Results:After deduplication with EndNotes,a total of 5,747 articles meeting the criteria were included.Since 2000,the publications of TCM constitution identification shown three major stages:a significant increasing trend with the year before 2016,a fluctuating trend from 2016 to 2021,and a decreasing trend with the year after 2021.The co-occurrence analysis ofkeywords revealed health management,hypertension,and constitution as hot directions in this field of research.CiteSpace was used for keyword clustering and burst analysis,health management,medical life,and constitution emerged as the latest hotspots in the past three years,which will be the main development directions in the future.Clusters such as hypertension,preventive treatment,and health management were identified,representing the main research themes at present.VOSviewer and CiteSpace were used for co-occurrence and clustering analysis of authors,revealing collaborative research networks,with prominent groups represented by WANG Qi,WANG Ji,LI Lingru,HOU Shujuan,ZHU Yanbo,etc.Conclusion:Research related to TCM constitution identification is developing rapidly,involving various aspects of medical care and daily life.However,there is still a need to build an extensive academic platform,strengthen the dissemination of Chinese medicine culture,standardize,intellectualize and universalize the identification of TCM constitution assessments,and construct a health service system with Chinese characteristics.

Treatment Principles of Obesity with Chinese Herbal Medicine: Literature Analysis by Text Mining

Obesity represents a social health problem worldwide, associated with serious health risks and increased mortality. The prevalence of obesity is reported to be increasing in both developed and developing countries. Obesity is associated with a significant range of comorbidities and is linked with increases in mortality, thus the treatment of obesity is very important. Chinese herbal medicine (CHM) has been used for weight management both in China and in western countries for many years, the effectiveness and safety of CHMs in obesity have been proved. Yet the principles of treating obesity with CHMs are hard to manage due to the complexity of TCM theory. In this study, a novel text mining method was developed based on a comprehensive collection of literatures in order to explore the treatment principles more intuitively. Networks of TCM patterns and CHMs which are most frequently used in obesity treatment are built-up and analyzed, two major principles are explored in treating obesity: one is resolving phlegm and dampness, the other is clearing heat and reinforcing deficiency. These findings might guide the clinicians in treatment of obesity.

Herbal medicine prescribing patterns from contemporary famous old TCM doctors for treating coronary heart disease: an analysis based on data mining

To analyze the herbal medicine prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease,based on data mining technology,so as to provide useful insights into the clinical practice.Methods:Databases,including Medline(January 1966 to December 2019),Wanfang(January 1982 to December 2019),VIP Database(January 1989 to December 2019),CNKI(January 1979 to December 2019),CBMdisc(January 1978 to December 2019),and Classic Case Collection from Contemporary Famous Old Traditional Chinese Medicine Doctors were searched,and 224 eligible studies involving 416 patients were entered into the case study database after data processing.Frequency analysis and association rule analysis were used to investigate the prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease.Results:In total 290 kinds of Chinese herbal drugs and 19 core drugs were used in the cases studied.The most commonly used categories were“Qi-Tonifying Drugs”,“Blood-Activating Drugs”,and“Phlegm-Eliminating Drugs”.The association rule analysis identified 14 commonly used herbal pairs,19 three-drug combinations,and 1 four-drug combination.Conclusion:Contemporary famous old traditional Chinese medicine doctors considered warming heart yang as an extremely important approach to treat coronary heart disease based on Zhang Zhongjing’s treatment for chest painful obstruction caused by“Inactivity of Chest Yang”(blockade of phlegm turbidity).Both symptoms and root causes were addressed in the formulas prescribed by these doctors.“Tonifying Qi,Nourishing Yin,Activating Blood,and Eliminating Phlegm”were the most commonly used therapeutic methods for patients with coronary heart disease.

Effect of Chinese Medicine Treatment Based on Pattern Identification on Cellular Immunophenotype of Myelodysplastic Syndrome

Objective： To observe the influence of treatment based on Chinese medicine pattem identification on cellular immunophenotype of the myelodysplastic syndrome （MDS）. Methods： Sixty patients with MDS were randomly and equally assigned to the treatment group and the control group using a randomized digital table. Thirty patients in each group included 3 risk levels （low, moderate and high risks） with each level 10 patients according to the international prognostic scoring system. The control group was given conventional therapy which was also used in the treatment group. While the treatment group was given Zuogui Pill （左归丸） and Yougui Pill （右归丸） for low risk patients; Qingwen Baidu Decoction （清瘟败毒饮） and Bazhen Decoction （八珍汤） for moderate risk patients; Gexia Zhuyu Decoction （膈下逐瘀汤） and Qinghao Biejia Decoction （青蒿鳖甲汤） combined with Shiquan Dabu Decoction （十全大补汤 ） for high risk patients. After the treatment, the differences of overatl response rate and immunophenotype （CD13, CD14, CD15, CD33 and CD34） of each group were analyzed. Results： The overall response rate of the treatment group was significantly higher than the control group in low risk and moderate risk patients （P=0.029）, there was no statistical differences of overall response rate between the treatment group and the control group in high risk patients （P=0.089）. The expressions of CD13, CD14, CD33 and CD34 in all three risk levels of the treatment group were obviously decreased after the treatment, while CD15 in all three risk levels of the treatment group was obviously increased after the treatment （P〈0.05 or P〈0.01）. Meanwhile, the difference values of CD13 and CD33 in low risk level of the treatment group, CD33 and CD34 in moderate risk level of the treatment group as well as CD34 and CD15 in high risk level of the treatment group, were all greater than the control groups and they were statistically significant （P〈0.05 or P〈0.01）. Conclusions： It shows a better therapeutic effect if the MDS patients treated with Chinese medicine pattern identification in addition to conventional therapy. Since the treatment may inhibit the malignant clones and improve the dysmaturity of granulocyte differentiation, it is a feasible option in clinical practice.

Incorporating Pattern Identification of Chinese Medicine into Precision Medicine:An Integrative Model for Individualized Medicine

On 20 January, 2015, U.S. President Obama announced an ambitious plan called ＂Precision Medicine （PM） Initiative＂, aiming to deliver genetics- based medical treatments. PM has shown a promising prospect by tailoring disease treatments and preventions to individuals. However, a predominantly genetics-based method restricts its benefit and applicability in most chronic and complex diseases. Pattern identification （PI） is one of the representative characteristics of Chinese medicine implying the concept of holism and individualized treatment. It is another classification method taking environmental, psychosocial and other individual factors into account. Integrating PI with disease diagnosis of Western medicine will provide a strong complement to genetics-based PM, thus establish an integrative model for individualized medicine. PI provides new perspectives for PM, not only in clinical practice, but also in new drug development and clinical trial design. It is for sure that the integrative approach will ultimately lead to a safer, more convenient and effective patient-centered healthcare and most patients will benefit in the era of PM.

Distribution of Traditional Chinese Medicine patterns in 324 cases with hepatitis B-related acute-on-chronic liver failure:a prospective,cross-sectional survey

OBJECTIVE： To determine the distribution of Tradi- tional Chinese Medicine （TCM） patterns in hepatitis B-related acute-on-chronic liver failure （HB-ACLF） in different stages for guiding clinical prescriptions and treatments. METHODS： A prospective, cross-sectional survey method was used in this study. A total of 324 cases with HB-ACLF in China were involved. RESULTS： The general frequency of TCM patterns in HB-ACLF were as follows： Heat Toxin Stagnation Pattern （134/324, 41.36%）, Damp-heat Obstruction Pattern （66/324, 20.37% ）, Yong Qi Deficiency Pat- tern （52/324, 16.05%）, and Liver and Kidney Yin De- ficiency Pattern （26/324, 8.02%）. In the early stage of HB-ACLE there was a remarkably higher percent- age of excessive patterns than those in the middle and late stage. The incidence of Heat Toxin Stagna- tion reached 58.57% （82/140） in the early stage, while it was 33.96% （36/106） in the middle stage and 20.51% （16/78） in the late stage. In the early stage of HB-ACLF, excessive patterns, such as the Heat Toxin Stagnation Pattern, were more preva- lent than those in the middle and late stages （P〈a＇= 0.003）. However, in the late stage of HB-ACLE defi- cient patterns, such as the Yang Qi Deficiency Pat- tern, were more prevalent than those in the early and middle stages. The Yang Qi Deficiency Pattern had a higher rate of 41.03% （32/78） in the late stage compared with that of 20.75% （22/106） in the middle stage and 8.57% （12/140, P〈a＇ =0.003） in the early stage. The distribution of the other pat- terns was not significant between the three stages （P〉0.003）. CONCLUSIONS： There are four major patterns of HI3-ACLF, including the Heat Toxin Stagnation Pat- tern, the Damp-heat Obstruction Pattern, the Yang Qi Deficiency Pattern, and the Liver and Kidney Yin Deficiency Pattern. The Heat Toxin Stagnation and Yang Qi Deficiency Patterns are the representative patterns in the early and late stages of HB-ACLF. In the middle stage of HB-ACLF, the TCM patterns vary in a complicated manner, with no significant differ- ence among the patterns. Treatment for HB-ACLF should vary with the different representative pat- terns in the early and late stages.

Effect of polypeptide 2B1 on condition of dampness pattern in rats in terms of Traditional Chinese Medicine

OBJECTIVE： This study investigated how polypeptide 2B1 is involved in regulating and governing dampness in rat models with dampness pattern defined in terms of Traditional Chinese Medicine. METHODS： We randomly divided 48 SPF 10-week-old male Sprague-Dawley （SD） rats into a normal group, normal ＋ Aristolochic acid I （AA-I） for 5 min group, normal ＋ AA-I for 60 min group, dampness pattern group （DS-Group）, dampness pattern ＋ AA-I for 5 rain tern ＋ AA-I for 60 min group, and dampness pat- group. Groups were then treated accordingly. We took out the lung, stom- ach, liver, spleen, kidney, large intestine, and small intestine tissues to detect gene and protein expres- sion of organic anion transporter polypeptide 2B1 （OATP2B1）. RESULTS= Gene expression of OATP2B1 in spleen, kidney, and small intestine of rats with dampness pattern was lower than that in normal rats （P〈0.05）. The gene expressions of OATP2B1 in liver, stomach, large intestine, and small intestine were lower than that in control rats at different time points after being stimulated by AA-I （P〈0.05）. CONCLUSION There is coordination among multiple viscera in handling the condition of dampness, and the mechanism underlying the action may rely on regulating the expression of OATP2B1.

Correlation between Traditional Chinese Medicine symptom patterns and serum concentration of zinc,iron,copper and magnesium in patients with hepatitis B and associated liver cirrhosis

OBJECTIVE:To investigate the correlation between the patterns of Traditional Chinese Medicine(TCM)syndromes and the serum concentration of zinc,iron,copper and magnesium of patients with chronic hepatitis B(CHB) and hepatitis B virus(HBV)-induced liver cirrhosis.METHODS:A total of 86 patients were included in the study between March 1,2009 and January 1,2010.All were diagnosed with CHB or HBV-induced liver cirrhosis according to the diagnosis standard of the Chinese Medical Association.Fasting serum concentrations of zinc,iron,copper and magnesium were measured.Patients were classified into different patterns of TCM symptoms according to TCM theory and clinical experience.RESULTS:In the HBV-induced liver cirrhosis group,the mean zinc concentration in patients with the TCM pattern of stagnation of fluid-Dampness was lower than that in patients with obstruction of collaterals by Blood stasis(P < 0.034).In the CHB group,the mean magnesium concentration in patients with toxic Heat flourishing was significantly lower than that in those with Damp-Heat in the Liver and Gallbladder,and those with Liver depression and Spleen deficiency(P < 0.021).The concentrations of iron and copper showed little difference among the different TCM symptom patterns.CONCLUSION:The serum zinc and magnesium concentrations correlated with certain TCM patterns of symptoms in patients with HBV-induced liver cirrhosis and CHB.It may be helpful to interpret the pathogenic change in the TCM symptom patterns in liver cirrhosis and CHB,and also to conduct clinical treatment of the diseases based on identified TCM patterns.

Logical thinking in pattern differentiation of Traditional Chinese Medicine

OBJECTIVE: To discuss the application of logic to pattern differentiation for treatment in Traditional Chinese Medicine (TCM). METHODS: Comparing logic reasoning of syllogism with the logical thinking ofTCM pattern differentiation for treatment. RESULTS:TCM logical thinking depends on symbolic and intuitive judgment with abstractive reasoning integrated into the process. Although it lacks quantitative measurement, it pays great attention to the comprehensive analysis of a disease's cause and its development patterns to get insight into the essence of illness. CONCLUSION: TCM diagnosis reasoning methodmay lack rigorousness, continuity, systematic induction and deduction, but its logical thinking still can attain its goal following a process with rigorous, regulated and scientific formal logic.

Perception of pattern identification in traditional medicine:a survey of Korean medical practitioners

OBJECTIVE: To survey assesses the perception of pattern identification(PI) diagnosis of Traditional Medicine(TM)by Korean medical doctors(KMDs).METHODS: A total of 14 485 KMDs affiliated with the Association of Korean Medicine were sent surveys via email, and 1646(11.1%) responded to the questionnaire on their perception of PI diagnosis.RESULTS: Of the 1646 respondents, more than ninety percent(1562, 94.9%) reported that they treated patients using PI.The most critical problem with PI diagnosis was the lack of objective diagnostic indicators(561, 34.1%). Ninety percent had issues diagnosing patients because of different diagnoses between KMDs(1491, 90.5%). The majority of respondents thought herbal medicine was most related to PI(1528, 92.8%). Half of the respondents answered that PI of Ba Gang was the most commonly used PI system. Participants reported that it was most important to study standardisation of PI diagnosis and to develop standardised PI diagnoses using the classification system of the Korean Standard Classification of Diseases. The foremost PI type that physicians thought should be included in standardisation and objectification of PI of TKM was the PIof Ba Gang.CONCLUSION: Our data suggest that we should focus on the standardisation of PI diagnosis and PI of Ba Gang in future research on PI diagnosis inTM.However, we cannot completely discount the possibility that a biased selection of subjects and a low response rate limit the generalisability of the findings.