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.

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.

Study on the Correlation between Syndrome Differentiation of Malignant Pleural Effusion Treated by External Treatment of Traditional Chinese Medicine and Immunohistochemistry of Biopsy Tissue Based on Medical Video-assisted Thoracoscope

Objective:Guided by the theory of syndrome differentiation of yin and yang in traditional Chinese medicine surgery,through visual observation of internal medicine thoracoscope,comprehensive observation of pleural cavity and immunohistochemistry of biopsy tissue,to classify malignant pleural effusion according to syndrome differentiation,and to explore the scientific nature of its theory.Methods:From March 1,2014 to February 28,2015,40 cases of malignant pleural effusion were treated in Beijing Chaoyang Hospital affiliated to Capital Medical University.According to the proposed TCM diagnostic criteria for yin and yang syndrome differentiation,and collect age,gender,course of disease,clinical symptoms,tumor primary focus,histomorphological manifestations and immunohistochemical results and other related information,and carry out statistical data processing.Results:The positive syndrome was mainly metastatic lung adenocarcinoma,which accounted for the majority of all MPE cases,up to 75%.The immunohistochemical results of biopsy tissues were mainly CEA and TTF-1 positive;While pleural effusion caused by pleural mesothelioma was the main type of yin syndrome,and the results of immunohistochemistry combined with biopsy were mainly positive for D2-40,Calretinin,WT-1 and CK5/6.Conclusion:TCM syndrome differentiation of MPE based on internal thoracoscopy combined with biopsy immunohistochemical results has sufficient theoretical basis and certain scientific nature,and further clinical research is needed to verify its effectiveness and practicability in the future.

Analysis on the Law of Chinese Medicine Use of Ulcerative Colitis and TCM Syndrome Differentiation and Treatment

Ulcerative colitis is a kind of inflammatory bowel disease.The disease is slow and easy to relapse.Western medicine treatment mainly focuses on symptomatic treatment,which has certain side effects on liver and kidney function.Ulcerative colitis has unique advantages in disease,so by studying a large amount of information,mainly from the law of traditional Chinese medicine use of UC,and a brief summary of the treatment of TCM syndromes,this article provide s ideas and basis for clinical diagnosis and treatment of the disease.

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.

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.

Traditional Chinese medicine syndromes of chronic hepatitis B with precore mutant

ABM: This study aims at exploring the distribution of TCM syndromes in CHB patients with HBV pre-core mutation (1896) and the relationship between pre-core mutation and T lymphocytes subgroup, through which to provide objective data on clinical syndrome differentiation of TCM, and further to suggest the therapeutic principle and guide clinical treatment. METHODS: One hundred and forty CHB patients were evenly divided into two study groups, HBV pre-core mutant group and HBV pre-core wild-type group. Besides, 30 healthy blood donors were selected as a healthy control group. HBV-labeled compound, T lymphocytes subgroup, and HBV-DNA pre-core mutant were tested in the study groups. T lymphocytes subgroup were also tested in the control group. All the patients were both diagnosed by syndrome differentiation of TCM and western medicine. RESULTS: The most common syndrome in mutant group was damp-heat combined with blood stasis, and the most common syndrome in the wild-type group was damp-heat stasis in the middle-jiao. There were more cases of medium and severe hepatitis in mutant group than that in wild-type group. The content of CD4+ lymphocytes and CD4+/CD8+ ratio were decreased gradually (healthy control group>wild-type group>mutant group). In the wild-type group, severe and medium CHB patients had considerably lower level of them than mild CHB patients. However, in the mutant group, the opposite result appeared. Meanwhile, the content of HBV-DNA in mutant group was higher than that in wild-type group. CONCLUSION: Damp, heat, toxin and blood stasis were the basic pathogens of CHB, whether pre-core mutant or not. CHB with precore mutant may lead to more severe hepatitis. The decreased content of CD4+ lymphocytes and ratio of CD4+/CD8+ may be taken as one of the indices in confirming the deficiency syndrome of CHB patients with pre-core mutation.

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.

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.

Structural and functional characteristics of microbiota in oropharynx of sub-healthy children with gastrointestinal heat retention syndrome differentiated by traditional Chinese medicine

Objective:To explore the structural and functional characteristics of microbiota in oropharynx of subhealthy children with gastrointestinal heat retention syndrome(GHRS)differentiated by traditional Chinese medicine,and screen the biometric operational taxonomic units(OTUs)to assist the clinical diagnosis.Methods:We recruited children according to the“GHRS diagnostic scale”,collected their oropharyngeal swabs,and sequenced the 16 SrDNA V4 region.We described the bacterial structure with alpha-indexes,beta-distances,and relative abundances;moreover,we screened the differential genera/OTUs with Wilcoxon rank-sum test,Metagenome Seq analysis,and linear discriminant analysis effect size(LEf Se)analysis,in which biometric OTUs were selected to construct the receiver operating characteristic curve to verify the diagnostic value.The bacterial function was predicted with Kyoto Encyclopedia of Genes and Genomes pathways according to 16S rDNA gene by using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States.Results:The study population was composed of 10 children with GHRS and 10 healthy control children.GHRS children were more likely to overeat(gluttony,P=.033).Alpha-indexes,such as Sobs,abundancebased coverage estimator,Bootstrap,and Qstat,were significantly higher in the GHRS group,while betadistances did not exhibit any significant intergroup differences.There were 9 differently distributed nonpredominant genera between the groups in Wilcoxon rank-sum test,as well as 13 non-predominant genera in Metagenome Seq analysis and 3 non-predominant OTUs in LEfSe analysis.OTU44 and OTU196 were used to construct the receiver operating characteristic curve,and the area under curve was 0.92.Predicted functions showed that pathways related to oxidative phosphorylation and carbon metabolism were enriched in healthy control samples,while the pathway related to renin secretion was remarkably enriched in GHRS samples.Conclusion:Unique oropharyngeal microbial structure and function were identified in GHRS children.OTU44 and OTU196 were specific OTUs,which could be used as biomarkers of GHRS to assist clinical diagnosis.

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.

Clinical Experience in the Treatment of Vulvovaginal Candida Disease with Integrated Traditional Chinese and Western Medicine

Summarizing two cases of vaginal candidiasis,cured by integrated traditional Chinese and western medicine in clinical work,it is found that the combination of traditional Chinese and western medicine has a significant effect on the treatment of this disease.The curative effect is outstanding,and the recurrence rate is significantly reduced,which can be used as a reference for gynecological medical workers.

Can TCM Treatment be Performed on the Basis of Differential Diagnosis of the Diseases Instead of the Syndromes?

Great advances have been achieved in the integration of western and traditional Chinese medicine (TCM).More and more TCM physicians in their practice accept the term 'differential diagnosis of the diseases' instead of the syndromes since western medicine has been introduced into the TCM circle.

Biologic basis of TCM syndromes and the standardization of syndrome classification

Traditional Chinese medicine(TCM)syndrome is an integral and essential component of TCM theory,and goes beyond philosophic concepts.This article reviews the concept of TCM syndromes and summarizes research findings on the biologic foundation of syndromes.In addition,insight is provided into the promotion of standardization of syndrome classification by enforcing uniformity of TCM terminology,applying standardized diagnostic criteria and operating procedures to minimize subjective effects.Also incorporating interdisciplinary approaches such as data mining and structure modeling,as well as integrating findings on biomarker research are discussed.Consideration is made of the fundamental TCM aspects of syndrome elements,symptoms,phenotypic features,as well as diseases,to form an integral process in the diagnostic path.We believe that better understanding of the biologic basis of the TCM syndrome and standardization of syndrome classification will improve diagnosis,which in turn will enhance therapeutic efficacy and disease prognosis.

CLINICAL ANALYSIS ON THE TREATMENT OF HIV/AIDS BY TRADITIONAL CHINESE MEDICINE

From Jan.1991 to Dec.1995,we treatedwith TCM nearly one thousand confirmedHIV/AIDS patients in Muhimbili MedicalCenter,Tanzania.Of them,437 cases withcomplete data have been summarized

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.

Differentially Expressed Serum Protein Profiling in Esophageal Squamous Cell Carcinoma Patients with Different Chinese Medicine Syndromes

Objective:Esophageal carcinoma is the eighth most common malignant tumor and ranked the sixth cause of death in the worldwide careinoma.To find out effective serum markers for early diagnosis and targeted treatment is important to improve esophageal carcinoma survival rate.The aim of this study was to screen differ-entially expressed serum protein profiling in esophageal squamous cell careinoma(ESCC)patients with differ-ent Chinese medicine syndrome and establish ESCC syndrome diagnosis model,to explore the signifcance of ESCC serum differential protein in traditional Chinese medicine(TCM)syndrome diagnosis and provide exper-imental and theoretical basis for the diagnosis,clinical treatment of ESCC.Methods:Serum specimens of 80 ES-CC patients with different syndrome and 20 healthy people were selected according to distribution of their sex and age.Magnetic beads based weak cation exchange combined w ith matrix-assist ed laser desorption/ionization time-of-flight mass spectrometry prot eomic technology and Autoflex Analysis and ClinProTools software were applied to screen differentially expressed serum protein profiling.Then establishing each syndrome group diag-nosis model and verifying with new samples to evaluate the diagnosis value of each syndrome group diagnosis model.Results:18 significantly differential expression protein peaks were screened between the whole ESCC patients sera and the healthy control group.Compared with normal control group,among which,ten were signif-cant down-regulation with m/z values of4210,4267,4054,4248,2106,4091,2991,5337,3952,822,and eight were significant up-regulation with m/z values of 2900,2883,1467,1617,2862,2600,895,811.There were 16,12,11,15 differentially expressed protein peaks in phlegm and qi stagnat ion syndrome(Group P),fluid insufficiency and heat agglomeration syndrome(Group F),blood stasis syndrome(Group B),qi and yang deficiency syndrome(Group Q),respectively.Protein with m/z of4210,4091,4054 and 5337 presen-ted obviously low expression in all syndrome groups,while protein with m/z of2883,1617 presented obvious-y high expression.Protein with m/z of 4644 is an obvious and significative biomarker in the comparison of dif-ferent syndrome of ESCC.Establishing ESCC each syndrome serum different ial protein profiling diagnosis mod-el showed that the specificity and veracity in four syndrome groups were all≥80.00%.Conclusion:Our study achieved differentially expressed protein profiling in ESCC patients with different TCM syndromes,established relatively high sensitivity and specificity of different syndrome of ESCC serum differential protein profiling diag-nosis model,which implied the screened syndrome related serum differential expression protein in TCM syn-drome differentiation and diagnosis had great clinical meaning,could be the assistant diagnosis biomarker of ESCC.

Quantitative and Qualitative Investigation of Traditional Chinese Medicine Nursing Protocols for Type 2 Diabetes Mellitus

Objective:To analyze the implementation status of traditional Chinese medicine(TCM)nursing protocols for type 2 diabetes mellitus.Methods:Totally 420 hospitalized patients with type 2 diabetes mellitus were given TCM nursing protocols by syndrome differentiation.A quantitative and qualitative investigation was conducted to patients who received TCM nursing and nurses who performed TCM nursing techniques.Results:According to the self-evaluation outcomes of patients,TCM nursing protocols were effective to relieve polydipsia,polyuria,fatigue and other symptoms.Patients exhibited a high level of compliance with nursing techniques such as auricular point pressing,acupoint massage,Chinese herbal foot-bath and moxibustion.The interview showed that patients could benefit from the TCM nursing protocols,and nurses considered that application of TCM nursing protocols could enhance their awareness of TCM knowledge and practice skills.Conclusion:The application of TCM nursing protocols is effective to relieve clinical symptoms of type 2 diabetes mellitus.It can also improve the knowledge level and practice skills of nurses in TCM hospitals.