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.

Feasibility and simulation model of a pilot scale membrane bioreactor for wastewater treatment and reuse from Chinese traditional medicine

The lack and pollution of water resource make wastewater reuse necessary. The pilot scale long-term tests for submerged membrane bioreactor were conducted to treat the effluents of anaerobic or aerobic treatment process for the high-strength Chinese traditional medicine wastewater. This article was focused on the feasibility of the wastewater treatment and reuse at shorter hydraulic retention time （HRT） of 5.0, 3.2 and 2.13 h. MLSS growth, membrane flux, vacuum values and chemical cleaning periods were also investigated. The experimental results of treating two-phase anaerobic treatment effluent demonstrated that the CODfilt was less than 100 mg/L when the influent COD was between 500-10000 mg/L at HRT of 5.0 h, which could satisfy the normal discharged standard in China. The experimental results to treat cross flow aerobic reactor effluent demonstrated that the average value of CODfilt was 17.28 mg/L when the average value of influent COD was 192.84 mg/L at HRT of 2.13 h during 106 d, which could completely meet the normal standard for water reuse. The maximum MLSS and MLVSS reached 24000 and 14500 mg/L at HRT of 3.2 h respectively. Membrane flux had maximal resume degrees of 94.7% at vacuum value of 0.02 MPa after cleaning. Chemical cleaning periods of membrane module were 150 d. A simulation model of operational parameters was also established based on the theory of back propagation neural network and linear regression of traditional mathematical model. The simulation model showed that the optimum operational parameters were suggested as follows： HRT was 5.0 h, SRT was 100 d, the range of COD loading rate was between 10.664-20.451 kg/（m3.d）, the range of MLSS was between 7543-13694 mg/L.

Treatment of Chinese traditional medicine wastewater in a submerged membrane bioreactor

A pilot scale test was conducted in a submerged membrane bioreactor SMBR with capacity of 10. 0 m^3/d for 120 days to treat high-strength Chinese traditional medicine wastewater. Performance of the SMBR was investigated with a sludge retention time （ TSR ） of 50 days, a hydraulic retention time （ THR ） of 8.0 h, membrane flux of 8. 0 IV（ m^2 · h） and dissolved oxygen （DO） concentration of 2. 0 - 3. 0 mg/L, respectively. It was observed that the SMBR had high capacity of COD and suspended solid （SS） removal. The influent COD concentration was fluctuated between I 000 and 5 000 mg/L, while the averaged effluent COl） concentration was only 44. 6 mg/L. The influent SS concentration was fluctuated between 1 000 and 1 600 mg/L, while little effluent SS was detected. It was found that the COD remove rate increased with mixed liquor suspended solids （MLSS） and organic loading rate （ROL）. In order to obtain good-quality effluent, the operational conditions of the SMBR were suggested as follows： the temperature was controlled above 10 ℃, MLSS about 7000 mg/L, R,L under 24. 76 kg/（ m^3 · d）, low vacuum value and constant water flux.

Traditional Chinese Medicine nursing protocols for facial paralysis

Facial paralysis is defined as severe or complete loss of facial muscle motor function possibly due to peripheral or central lesions.Currently,there are no effective treatment modalities for facial paralysis in western medicine.In Traditional Chinese Medicine(TCM),it is believed to be associated with malnutrition of facial muscles caused by qi stagnation and blood stasis due to wind-cold invasion.This article primarily investigated the key points of common syndromes,TCM nursing methods and healthy guidance of facial paralysis,aiming at maintaining and developing the strengths of TCM,improving its efficacy and standardizing its behavior.

Progress of mitochondrial and endoplasmic reticulum-associated signaling and its regulation of chronic liver disease by Chinese medicine

The endoplasmic reticulum(ER)is connected to mitochondria through mitochondria-associated ER membranes(MAMs).MAMs provide a framework for crosstalk between the ER and mitochondria,playing a crucial role in regulating cellular calcium balance,lipid metabolism,and cell death.Dysregulation of MAMs is involved in the development of chronic liver disease(CLD).In CLD,changes in MAMs structure and function occur due to factors such as cellular stress,inflammation,and oxidative stress,leading to abnormal interactions between mitochondria and the ER,resulting in liver cell injury,fibrosis,and impaired liver function.Traditional Chinese medicine has shown some research progress in regulating MAMs signaling and treating CLD.This paper reviews the literature on the association between mitochondria and the ER,as well as the intervention of traditional Chinese medicine in regulating CLD.

CiteSpace-based Knowledge Graph Analysis of the Current Status and Trends of Chinese Medicine Research in Idiopathic Membranous Nephropathy

Objective:To analyze the current status and development trend of Chinese medicine research in the field of idiopathic membranous nephropathy since 2000.Methods:The literature related to Chinese medicine for idiopathic membranous nephropathy published in China Knowledge Network(CNKI)since 2000 was searched,and CiteSpacewas applied to visualize the publication time,authors,and keywords of the literature and to draw a visual knowledge graph.Results:372 relevant literatures were included.Author analysis showed that there were 343 authors included,and the authors with the highest number of publications published 13 articles,and the core authors accounted for 10.2%of the total number;keyword analysis showed that 15 clusters were formed after burst analysis,and 10 emergent words were formed after keyword emergence analysis.Conclusion:Chinese medicine recognizes and intervenes in idiopathic membranous nephropathy in terms of evidence type,treatment method,common prescriptions and single herbs,auxiliary examination,treatment modality,and clinical research.The development trend lies in the combination of macroscopic and microscopic,the synergy between Chinese and Western,multidisciplinary collision diagnosis and treatment,as well as the use of Chinese medicine to intervene in the disease process at an early stage,and the integration of a worldwide standardized diagnosis and treatment guideline of Chinese medicine for idiopathic membranous nephropathy.

基底膜相关基因在类风湿关节炎不同中医证型中的转录组学分析及药物预测

背景:基底膜基因与类风湿关节炎的发生发展密切相关,但不同中医证型下基底膜相关基因在其发病机制中的作用尚不明确。目的:基底膜基因联合转录组学分析探讨类风湿关节炎5种不同中医证型的发病机制差异,并进行潜在治疗药物预测。方法:基于GEO数据库整理类风湿关节炎相关中医证型芯片数据以及基底膜相关基因,利用R-limma包筛选差异表达基因,Mfuzz包进行表达趋势分析。借助STRING数据库构建PPI网络,UPset筛选关键基因,通过R-clusterProfiler包对差异表达基因进行GSEA及富集分析,同时绘制ROC曲线评估基底膜相关核心靶点对5种证型分别的诊断价值。基于CIBERSORT核心算法计算每种证型的免疫浸润情况。最后,利用SymMap和COREMINE数据库预测可靶向基底膜相关核心基因治疗类风湿关节炎不同证型的潜在中药及小分子药物。结果与结论:①在5种类风湿关节炎中医证型中(风湿痹阻证、寒湿痹阻证、肝肾亏虚证、气血两虚证及血瘀阻络证)分别筛选出67,47,59,57,55个基底膜相关差异表达基因,其中关键靶点分别为5,7,5,3,5个。③各证型中富集最多的为细胞基质黏附、免疫细胞迁移及胶原代谢等生物过程以及细胞外基质受体相互作用、PI3K-Akt、局灶性粘连和Rap1信号通路等。④药物预测结果显示,土茯苓、川乌、绵马贯众及黄精是通过影响基底膜基因治疗5种类风湿关节炎中医证型最具潜力的中药。⑤结果证实,基底膜相关基因的异常表达可能是通过调控细胞附着、免疫细胞迁移及炎症反应等多个途径影响类风湿关节炎的发生和发展,在不同证型中有着差异表现,其中ITGA6可作为5种类风湿关节炎证型中共同的诊断标志物。清热解毒类中药可能是类风湿关节炎不同证型治疗中可以贯穿始终的潜在有效药物。

Accurate construction of cell membrane biomimetic graphene nanodecoys via purposeful surface engineering to improve screening efficiency of active components of traditional Chinese medicine

Biomimetic nanoengineering presents great potential in biomedical research by integrating cell membrane(CM) with functional nanoparticles. However, preparation of CM biomimetic nanomaterials for custom applications that can avoid the aggregation of nanocarriers while maintaining the biological activity of CM remains a challenge. Herein, a high-performance CM biomimetic graphene nanodecoy was fabricated via purposeful surface engineering, where polyethylene glycol(PEG) was used to modifying magnetic graphene oxide(MGO) to improve its stability in physiological solution, so as to improve the screening efficiency to active components of traditional Chinese medicine(TCM). With this strategy, the constructed PEGylated MGO(PMGO) could keep stable at least 10 days, thus improving the CM coating efficiency. Meanwhile, by taking advantage of the inherent ability of He La cell membrane(HM) to interact with specific ligands, HM-camouflaged PMGO showed satisfied adsorption capacity(116.2 mg/g) and selectivity. Finally, three potential active components, byakangelicol, imperatorin,and isoimperatorin, were screened from Angelica dahurica, whose potential antiproliferative activity were further validated by pharmacological studies. These results demonstrated that the purposeful surfaceengineering is a promising strategy for the design of efficient CM biomimetic nanomaterials, which will promote the development of active components screening in TCM.

A Discussion on TCM Treatment and the Pathogenesis of Membranous Nephropathy in Primary Nephrotic Syndrome

Objective:To investigate the TCM treatment principle of membranous nephropathy and its effect.Methods:A total of 56 patients were selected from the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine.They were then divided into the control group(western medicine standard therapy)and the study group(Qidi Gushen prescription),with 28 patients in each group.The treatment effect,treatment safety,and patients’satisfaction were observed and compared between the two groups.Results:The results showed that the treatment effect of the study group was 96.43%,which was significantly better compared with the control group(75.00%)(p<0.05);in terms of safety,the probability of adverse events was 7.14%in the study group and 32.14%in the control group,in which the difference was statistically significant(p<0.05);in addition,the study group’s satisfaction with the treatment measures was significantly higher than that of the control group(p<0.05).Conclusion:In treating membranous nephropathy,traditional Chinese medicine can be tailored to its pathogenesis,which is not only beneficial to the treatment effect,but also has a high safety profile.

基于细胞膜色谱技术的中药复杂体系目标物筛选分析装备

中药是临床防治疾病的有效药物。由于中药物质基础的复杂性以及成药过程的多环节因素,实现中药全面质量控制的难度相对较大。如果能够在明确中药有效物质与有害物质的基础上,在成药过程中重点控制其含量和限量,则能在很大程度上“纲举目张”,有效保障中药质量的可控性和重复性。当前,我国药物研发源头创新技术不足,研发效率有待提升,缺乏高通量的精准分析装备。我国医药分析装备长期依赖进口,高端智能分析装备缺乏,亟需构建“医药智能分析系统”。本项目在国家自然科学基金重大仪器研制项目的资助下,利用细胞膜色谱技术的原创性与独创性,结合生物工程技术和人工智能技术,研制二维细胞膜色谱(2D/CMC)分析仪,对成型的“2D/CMC-中药药效物质分析仪”和“2D/CMC-中药注射液类过敏物分析仪”开展了示范应用,提升了中药药效物质和过敏组分的筛选、发现的效率,并同步进行定性、定量分析,为中药提质增效提供高效分析工具。

基于CiteSpace和VOSviewer软件分析中医药治疗特发性膜性肾病研究的现状及趋势

目的基于CiteSpace和VOSviewer可视化分析中医药治疗特发性膜性肾病的研究现状和发展趋势,为未来研究方向提供参考和建议。方法检索中国知网(CNKI)、维普(VIP)、Web of ScienceTM核心合集数据库从建库至2022年12月1日期间发表的以中医药治疗特发性膜性肾病的相关文献,并根据纳入和排除标准进行文献筛选。共纳入中文文献469篇、英文文献36篇,利用CiteSpace 6.1.R3和VOSviewer 1.6.18绘制中医药治疗特发性膜性肾病的知识图谱,对发表时间、研究作者、研究机构、研究关键词进行频数分析、聚类分析、突现分析。结果分析可得年发文量从2016年开始呈大幅度上升趋势,王暴魁是中文文献发文量最多的作者,WANG L(王琳)是英文文献发文量最多的作者;首都医科大学附属北京中医医院团队、上海中医药大学附属龙华医院为领头机构;疾病、病机、治疗为主要研究内容。研究者对名医经验的关注度高,“辨证论治”为近两年热点并有望得到进一步研究和应用。结论未来多中心多元交叉研究网络的构建、高质量真实世界研究和生物机制研究的开展将推动中医药治疗特发性膜性肾病的多维度研究得到进一步深化。

原发性膜性肾病患者血清IL-6与尿蛋白水平的相关性及其与中医证型关系的探讨

目的:探究细胞因子与原发性膜性肾病(primary membranous nephropathy,PMN)患者尿蛋白、中医证型及预后的关系。方法:本研究为前瞻性研究,纳入2021年06月—2022年3月在中日友好医院行肾活检诊断为PMN的患者81例作为疾病组,另纳入健康人群22例为对照组。测量治疗前所有患者血清IL-6、IL-17的水平,并对疾病组进行中医辨证分型及长期随访。运用SPSS 26.0进行数据分析。结果:疾病组血清IL-6水平明显高于对照组(P<0.001),且其IL-6水平与尿蛋白存在相关性。两组在血清IL-17水平上未表现出明显差异。在中医证型上,IL-6升高组以脾肾阳虚证和血瘀证为多见,IL-6正常组多为气虚证。预后方面,相比于IL-6正常组,IL-6升高组的临床缓解率低,达到中位缓解的时间长。结论:PMN患者存在微炎症状态,血清IL-6水平与尿蛋白水平、中医证型及预后显著相关。

耳针疗法辅助治疗急性期周围性面瘫疗效观察

目的观察耳针疗法辅助治疗急性期周围性面瘫的临床疗效。方法将94例急性期周围性面瘫患者按照随机数字表法分为2组,对照组47例采取常规西医治疗,治疗组47例在对照组基础上联合耳针疗法治疗。2组均治疗4周。比较2组治疗效果,比较2组治疗前后面部神经传导速度、红外热成像(前额区、耳周区、口角区、颧区及患侧全区温度)、面瘫改良Portmann评分、面部残疾指数躯体(FDIP)评分、免疫炎性指标[免疫球蛋白(IgA)、IgM、IgG、白细胞介素6(IL-6)、IL-21]水平及世界卫生组织生活质量测定量表简表(WHOQOL-BRFF)评分变化情况,治疗后随访1年,统计对比2组复发率。结果治疗组总有效率95.74%(45/47),对照组总有效率80.85%(38/47),治疗组临床疗效优于对照组(P<0.05)。2组治疗1、2、3、4周面部神经传导速度均较本组治疗前升高(P<0.05),且治疗组治疗1、2、3、4周均高于对照组同期(P<0.05)。2组治疗1、2、3、4周前额区、耳周区、口角区及患侧全区温度均较本组治疗前升高(P<0.05),且治疗组治疗1、2、3、4周均高于对照组同期(P<0.05);2组治疗1、2、3、4周颧区温度均较本组治疗前升高(P<0.05),但2组组间同期比较差异无统计学意义(P>0.05)。2组治疗1、2、3、4周改良Portmann、FDIP评分均较本组治疗前升高,且治疗组治疗1、2、3、4周均高于对照组同期(P<0.05)。2组治疗后血清IgA、IgM、IgG、IL-6、IL-21水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后WHOQOL-BRFF各维度评分均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组复发率比较差异无统计学意义(P>0.05)。结论采用耳针疗法辅助治疗急性期周围性面瘫患者,能显著提高治疗效果,进一步改善患者面部肌群恢复情况,有效改善患者面部温度、神经功能及面部神经传导速度,且能有效抑制免疫炎性损伤,降低复发率,有助于改善患者预后。

基于调控足细胞程序性死亡的中药治疗膜性肾病药理机制研究进展

膜性肾病(membranous nephropathy,MN)是一种以上皮下免疫复合物沉积为典型病理特征的原发性肾小球疾病,其核心机制为免疫复合物沉积进而所造成的足细胞损伤。目前包括糖皮质激素联合免疫抑制药物或生物制剂在内的MN主流治疗方案,存在疗效个体差异较大、停药容易复发及不良反应多等局限性。近年来MN中的足细胞程序性死亡异常在疾病发生发展过程中的潜在作用越来越被重视。中医药对此相关的基础研究也大量展开。当前研究表明,中药单体、中药复方、中成药等可通过磷脂酰肌醇-3-激酶(phosphatidylin-ositol-3-kinase,PI3K)/蛋白激酶B(protein kinase B,AKT)信号通路、核因子E2相关因子(nuclear factor erythroid-derived factor 2-related factor,Nrf2)信号通路、丝裂原活化蛋白激酶(mitogen activated protein kinase,MAPK)信号通路、细胞核转录因子(nuclear factor kappa-B,NF-κB)信号通路、富含亮氨酸重复蛋白3(leucine-rich repetitive protein 3,NLRP3)/天冬氨酸蛋白水解酶1(Caspase-1)信号通路等,调控包括足细胞自噬、调亡、焦亡、铁死亡等一系列细胞程序性死亡过程,进而缓解足细胞损伤,保护肾脏功能。本文从中药单体、中药复方和中成药的角度对干预相关靶点通路治疗MN有关文献进行总结,旨在为中医药抗MN的临床治疗、基础研究及靶向药物的研发提供一定的参考依据。

不同地区对膜性肾病影响因素及中医药治疗

膜性肾病(membranous nephropathy,MN)是我国肾病综合征的主要原因之一,该病病因复杂,治疗效果欠佳,给社会公共卫生和患者的生活带来了严重的负担。随着大量研究不断深入,各地方文献日益丰富,现对多个单中心肾病病理类型回顾性研究进行统计,对不同地区MN中医证候分布规律及中医治疗进行总结,浅析不同地区对MN病因病机的影响,不同地区MN中医治疗特点,结合主客观因素给中医药治疗膜性肾病提供更多诊疗思路和治疗方法。

电针联合中药外敷治疗特发性面神经麻痹的临床疗效观察

[目的]评价电针联合中药外敷治疗特发性面神经麻痹的临床疗效和安全性。[方法]符合纳入与排除标准的180名特发性面神经麻痹患者按1∶1∶1比例被随机分为治疗1组、治疗2组和对照组,治疗1组采用电针治疗,治疗2组采用电针联合中药外敷治疗,对照组采用西药口服治疗,3组患者均接受3周的治疗。主要结局指标为Sunnybrook面部分级系统(SFGS)评分,次要结局指标为House-Brackmann分级量表(HBGS)评分,Nottingham System评分和不良事件发生率。[结果]164人完成了3周的治疗,其中治疗1组56例,治疗2组53例,对照组55例,3组患者的基线特征一致。治疗3周后,3组患者的SFGS评分、HBGS评分和Nottingham System评分均优于治疗前(P<0.01),且治疗2组的各评分优于治疗1组和对照组(P<0.05),差异均具有统计学意义;研究过程中3组患者均未出现不良反应。[结论]电针联合中药外敷是一种安全有效的特发性面神经麻痹治疗方案,可以促进面神经功能的恢复,为进一步改善特发性面瘫患者的预后提供了新的治疗思路。

中医药治疗膜性肾病的研究进展

膜性肾病(MN)是成人肾病综合征常见的病理类型之一,病情迁延难愈。传统医学认为,MN的主要病位在肾,与肺脾相关,病性为本虚标实,病机多为脾肾亏虚、邪实内阻。现代医学认为,MN的发病机制与足细胞损伤和抗原沉积有关,具体机制仍在探究。近年来临床上多采用中西医结合方法治疗MN,并取得了较好的临床效果。中医药可通过调控相关信号通路修复受损足细胞、延缓肾纤维化,进而延缓MN进展,并减轻免疫抑制剂和激素等引发的不良反应。因此,未来仍应进一步探索中医药治疗MN的机制,以为MN的临床诊疗提供新思路。

从肝论治周围性面瘫浅析

周围性面瘫是面部神经管内面神经的非特异性炎症导致的周围性面肌瘫痪。西医目前尚未完全阐明其发病机制,多采用糖皮质激素、抗病毒、营养神经等药物行对症治疗,但仍有30%的患者会出现反复发作,甚者遗留较重后遗症,带来身心损伤。中医学善立足于经络、脏腑等,整体论治,取得了较大的成效。然各医家多擅从阳明论治面瘫,从肝论治者少。作者结合临床观察,认为周围性面瘫与肝的关系十分密切。文章从周围性面瘫的病因病机、临床表现及治疗方面,浅析其与肝的关系,为中医药诊治该病提供新方向。

基于“玄府-络脉”理论探讨针灸治疗面瘫后遗症

基于“玄府-络脉”理论探讨面瘫后遗症的病机及针灸治疗策略,认为玄府闭郁、气血不畅、络脉受阻是面瘫后遗症的基本病机,当以开玄通络(开通玄府、祛瘀通络)为治。具体针灸治疗方法包括拔罐法、梅花针叩刺法、腕针配合双侧透刺法、毫火针刺络放血法、扶正通络针法、通元针法、麦粒灸、热敏灸、穴位埋线疗法等。玄府及络脉畅通,气血调和,疾病自愈。