从《医古文知识》到《中医药文化》:笔尖上的40年

1984年《医古文知识》创刊,2006年更名为《中医药文化》,2024年迎来《中医药文化》创刊40周年。通过与创刊主编段逸山教授进行深入访谈,了解创刊背景和创刊初期面临的挑战、期刊发展过程中内容的定位和演变,探讨《中医药文化》学术工作坊的意义及未来发展策略。段逸山教授对《中医药文化》所取得的各种成绩给予肯定,并对《中医药文化》学术影响力的提升和未来的发展方向提出宝贵意见。

《中医药文化》40年学术推介与办刊理念之辨

1984年,《医古文知识》在广大青年学子和医学工作者对科学与知识的热切期盼中诞生。在其最初发展的22年中,杂志办刊理念从夯实广大从业人员的医古文基础、提高阅读古代文献的能力,逐步转变为宣传中医药知识、熔文史哲医艺于一炉。2006年,杂志更名为《中医药文化》,致力于发展成具有一定影响力的学术期刊。在杂志社同仁和业界的共同努力下,目前《中医药文化》已经成为学界最为重要的学术推介与交流平台之一。杂志介绍宿儒大家的卓越成果,推荐新人的学术力作,联络各个学科专业的杰出学者,擘画医学人文领域研究的前沿课题,搭建海内外学界沟通的桥梁纽带,营造融洽、热烈的学术研究氛围。杂志为中医药学术的发展、通识教育与科学普及书写了浓墨重彩的一笔,其意义与价值必将铭记在中医药人的心中。

裘法祖先生医务思想与当代医院管理

对裘法祖先生医务思想从医德、医学、医才、医识四个方面进行分析,得出裘法祖先生医德高尚,医学精湛,医才卓越,医识独到,这一思想对当代医院管理有借鉴和启示作用。

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.

Deep learning-based recognition of stained tongue coating images

Objective To build a dataset encompassing a large number of stained tongue coating images and process it using deep learning to automatically recognize stained tongue coating images.Methods A total of 1001 images of stained tongue coating from healthy students at Hunan University of Chinese Medicine and 1007 images of pathological(non-stained)tongue coat-ing from hospitalized patients at The First Hospital of Hunan University of Chinese Medicine withlungcancer;diabetes;andhypertensionwerecollected.Thetongueimageswererandomi-zed into the training;validation;and testing datasets in a 7:2:1 ratio.A deep learning model was constructed using the ResNet50 for recognizing stained tongue coating in the training and validation datasets.The training period was 90 epochs.The model’s performance was evaluated by its accuracy;loss curve;recall;F1 score;confusion matrix;receiver operating characteristic(ROC)curve;and precision-recall(PR)curve in the tasks of predicting stained tongue coating images in the testing dataset.The accuracy of the deep learning model was compared with that of attending physicians of traditional Chinese medicine(TCM).Results The training results showed that after 90 epochs;the model presented an excellent classification performance.The loss curve and accuracy were stable;showing no signs of overfitting.The model achieved an accuracy;recall;and F1 score of 92%;91%;and 92%;re-spectively.The confusion matrix revealed an accuracy of 92%for the model and 69%for TCM practitioners.The areas under the ROC and PR curves were 0.97 and 0.95;respectively.Conclusion The deep learning model constructed using ResNet50 can effectively recognize stained coating images with greater accuracy than visual inspection of TCM practitioners.This model has the potential to assist doctors in identifying false tongue coating and prevent-ing misdiagnosis.

Analysis of the hotspots and trends in traditional Chinese medicine immunomodulation research based on bibliometrics

Objective To analyze the intellectual structure,hotspots and trends of traditional Chinese medicine(TCM)in immune regulation research.Methods The data were extracted from the Web of Science Core Collection(WoSCC)and the China National Knowledge Infrastructure(CNKI)and verified by two experienced TCM researchers.The time of literature retrieval is up to 2020.CiteSpace 5.7.R1 and Microsoft Excel 2016 were used for the statistical analysis and bibliometric diagrams,including the co-occurrence network of authors,institutions,countries,keywords,references,dual-map overlays of journals and citation bursts,etc.Results A total of 12270 publications related to TCM in immune regulation were included.The annual number of publications has increased in this field.There was close cooperation of countries and institutions,while the distribution of scholars was scattered.China was the core of the cooperation network.The dual-map overlays analysis of journals showed that core and marginal fields had increased.The keywords and references analysis showed that network pharmacology,metabolism and cancer were the most high-frequency keywords with high-intensity bursts.Conclusion TCM in immune regulation has attracted wider attention,with multi-country,multi-field,multi-disciplinary and multi-level research developing toward informatization.Network pharmacology,metabolism and cancer may be the focus of future research in this field.

Essence of progress in geriatric cardiology

1 Introduction Prior to 1970,the slow,steady and substantial development of medical knowledge over centuries for improved well being and survival from birth was not matched by the elderly population.Since 1970,however,the elderly have also shared in these developments,exhibiting substantial improvement in survival among people over 60 years of age.It is also been since 1970 that geriatric cardiology has experienced dynamic progress.This is indicated by the US vital statistics,Table 1.

A medical understanding on the wuxing theory in cell

Yinyang theory and wuxing theory are the core parts in the Traditional Chinese Medicine(TCM) and giving the accurate interpretation on these theories is one of directions for the modernization of TCM.In the cell,energy metabolism and gene expression are the fundamental processes which are regarded as yin and yang respectively.Furthermore,energy agents,oxygen,end metabolic products,energy releasing as well as genes are the five basic factors for maintaining the undergoing of all biochemistries in cell.Because these factors are the substrates of five essential pathways for the survival of living cell and the abnormalities of any pathways will cause the death of cells,wuxing theory should be translated as five essential pathways in cell.These medical understandings on wuxing theory will not only give some novel viewpoints on the living cell but also promote the development of system biology in future.

A Barefoot Doctor’s Manual as a“Medical Bible”:Medical Politics and Knowledge Transmission in China

This paper examines the origin,compilation,and circulation of A Barefoot Doctor’s Manual(Chijiao yisheng shouce赤脚医生手册),exploring the relationship between medical politics and knowledge transmission in China,and its impact on the promotion of Chinese medicine across the world.Barefoot doctors were a special group of rural medical practitioners active in a very special socio-political context.Various editions of barefoot doctor manuals and textbooks were published across China after the first publication of the Manual in 1969.The publication of these manuals and textbooks became an indelible hallmark of the“Cultural Revolution”(1966–1976),when political publications predominated.The Manual was not only a guide for barefoot doctors in their daily study and practice,but also a primary source of medical knowledge for ordinary people.In the middle of the 1970s,the Manual was translated into many languages and published worldwide.This paper argues that the publication of A Barefoot Doctor’s Manual embodied a public-oriented mode of knowledge transmission that emerged and was adopted during a very specific era,and though it was eventually substituted by a mode of training embedded in the formal medical education system,it demonstrated the impact of politics on medicine and health in the context of resource scarcity and low literacy.Changes in China’s geopolitical status,the West’s pursuit of alternative approaches to medicine and health,and the World Health Organization’s(WHO’s)concern over health universality and equity all contributed to the translation and circulation of the Manual,facilitating the dissemination of Chinese medicine worldwide.The paper thus presents empirical and theoretical contributions to research on the relationship between medical politics and knowledge transmission in China.

Magnets, children and the bowel: A dangerous attraction?

Reports of magnet ingestion are increasing rapidly globally. However, multiple magnet ingestion, the subsequent potential complications and the importance of the early identification and proper management remain both under-recognized and underestimated. Published literature on such cases could possibly represent only the tip of an iceberg with press reports, web blogs and government documents highlighting further occurrence of many more such incidents. The increasing number of complications worldwide being reported secondary to magnet ingestion point not only to an acute lack of awareness about this condition among the medical profession but also among parents and carers who will be in most cases the first to pick up on magnet ingestion. There still seems to be no consensus on the management of magnet ingestion with several algorithms being proposed for management. Prevention of this condition remains a much better option than cure. Proper education and improved awareness among parents and carers and frontline medical staff is key in addressing this rapidly emerging problem. The goal of managing such cases of suspected magnet ingestion should be aimed at reducing delays between ingestion time, diagnosis time and intervention time.

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.

Ethnobotanical and Indigenous Knowledge of Important Plants in East Hararghe, Eastern Ethiopia

An ethnobotanical study was conducted in East Hararghe, Ethiopia to identify and investigate the use of various plants by the traditional healers and communities engaged in domestic, pesticide and medicinal use. A total of 78 species were observed to be used by the local inhabitants in the region for the treatments of various ailments. Out of these, herbs constitute 49% followed by trees(36%) and shrubs only 15%. However, most frequently used plant parts were leaf and aerial parts(20) followed by seed(13), fruit(12), other parts(10), rhizome(7) and bark(1). Most of the plants were found to be used for medicinal, aromatic and food flavouring(spices, condiments) purposes. Out of 78 species recorded in the present study, 11 were reported to cure stomachache, seven for cold, cough and respiratory problem, six for diarrhoea and five species were found capable of curing fever. Fabaceae was the largest family contributing to medicinal plant use with seven species followed by Solanaceae, Myrtaceae,(5 spp.), and Zingiberaceae, Asteraceae, Liliaceae(4 spp. each). Some of the important plants utilized for taking care of variety of ailments are Azadirachta indica, Brassica nigra, Balanites aegyptiaca, Maytenus ovatus, Rosmarinus officinalis and Trigonella foenum graecum. Most of these medicinal and aromatic plants(MAPs) play a significant role in the household economy and were observed to be very popular among the people. Unpopular plants were left out of the study. This study provides useful and basic information on usage of different plants for conducting further studies aimed at conservation and documentation of traditional medicine system and economic welfare of rural peoples of the East Hararghe, Ethiopia. It also revealed that indigenous practices contributed to sustainable management of plants.

Research on knowledge reasoning of TCM based on knowledge graphs

With the widespread use of Internet,the amount of data in the field of traditional Chinese medicine(TCM)is growing exponentially.Consequently,there is much attention on the collection of useful knowledge as well as its effective organization and expression.Knowledge graphs have thus emerged,and knowledge reasoning based on this tool has become one of the hot spots of research.This paper first presents a brief introduction to the development of knowledge graphs and knowledge reasoning,and explores the significance of knowledge reasoning.Secondly,the mainstream knowledge reasoning methods,including knowledge reasoning based on traditional rules,knowledge reasoning based on distributed feature representation,and knowledge reasoning based on neural networks are introduced.Then,using stroke as an example,the knowledge reasoning methods are expounded,the principles and characteristics of commonly used knowledge reasoning methods are summarized,and the research and applications of knowledge reasoning techniques in TCM in recent years are sorted out.Finally,we summarize the problems faced in the development of knowledge reasoning in TCM,and put forward the importance of constructing a knowledge reasoning model suitable for the field of TCM.

Community nurses＇ knowledge need toward traditional chinese medicine and related factors in China： A cross-sectional survey

Purpose：The aim of the study was to examine the knowledge need toward Traditional Chinese Medicine （TCM） in nurses who worked in Community Health Centers, and to explore the related factors in the current situation of China. Subject and setting： Participants worked in five community health centres across Chaoyang Beijing, and each com- munity health centre includes 4-7 health stations. A questionnaire survey was administered to 218 registered commu- nity nurses using cluster sampling. The investigation was conducted after obtaining informed consent from each par- ticipant. Design： A descriptive cross-sectional design was used to gather data in this study. Instruments： The survey tool was a 5-point Likert-type questionnaire designed by experts in TCM and related fields, which had good face va- lidity and internal consistency. Results： The nursing technology of TCM scored highest score in our research （42.87±5.74）. Next came disease prevention in TCM （21.02±2.67）. The lowest mean score was for the usage of Chinese herbal medicine （15.03±2.77）. The significant related factors for nurses＇ knowledge need towards TCM were educa- tional background （P 〈 0.05）, working unit （P 〈 0.01）, ＂on-the-job training on TCM＂ （P 〈 0.01） and ＂have studied lit- erature on Chinese medicine＂ （P 〈 0.05）. Conclusion： This results suggest nurses working in community care would like to learn more about TCM. Improving community nurses＇ understanding and learning of TCM can promote the application and promotion of TCM nursing technology in the community. Therefore, we could adopt targeted education for community nurses, in order to meet their knowledge needs, and to promote the application of traditional Chinese medicine knowledge to the community.

我院门诊病人抑郁、焦虑状况调查分析

目的:了解我院门诊病人抑郁、焦虑发病率。方法:随即抽取我院门诊病人500例,按汉密尔顿抑郁量表(HAMD),评定总分大于等于8分为有抑郁,汉密尔顿焦虑量表(HAMA),评定总分大于14分为有焦虑。结果:500例患者中,抑郁患病率为20.6%,焦虑患病率30.6%。结论:我院门诊病人抑郁、焦虑患病率较高,临床医生应重视对其识别及处理能力。

Kuhn＇s Notion of Theory Choice and the Dual-Process Theory of Cognition

In The Structure of Scientific Revolutions, Kuhn claimed that theory choice is a conversion experience and depends upon the personality or psychology of the individual scientist making the choice. Critics charged Kuhn with an irrational and a relativistic position concerning theory choice, arguing he advocated a subjective instead of an objective approach to how scientists choose one theory over another and thereby undercut epistemic accounts for the generation of scientific knowledge. In response to critics Kuhn insisted that his approach, although subjective, was still rational in that the criteria----vomposed of epistemic values--determining theory choice operate both objectively and subjectively. Recent work in cognitive neuropsychology, particularly in the dual-process theory of cognition, supports Kuhn＇s notion of theory choice. In this paper, I initially discuss Kuhn＇s approach to theory choice, along with criticism of it and his response to the criticism, followed by an examination of the dual-process theory of cognition. I then explore the application of dual-process theory to Kuhn＇s notion of theory choice, especially in terms of a historical case study from the biomedical sciences. I finally discuss briefly the implications of the dual-process theory for contemporary philosophy of science.

The investigation of 1027 medical staff about knowledge grasping and attitude of cancer pain

Objective: To get the message of knowledge and attitude about pain of the medical members from basic medi- cal service sites by questionnaire investigation. To point out concrete directions for generalization and post-education of the three-tiered principles of analgesics treatment of WHO. Methods: We designed a questionnaire about cancer pain treatment. We used it to make inquire in 1040 medical staff from different medical agencies. SPSS software was used to analyze all data. Results: 1027 questionnaires were fit for data analysis. 91.4% of staff working in the primary medical agencies, 95.0% with professional title of assistant professor or lower title, and 83.7% younger than 50-year old. The data displayed that basic knowledge of cancer pain are poorly mastered. More than half investigates cannot evaluate the pain degrees correctly, and have many erroneous understandings about pain. Conclusion: The training of pain treatments for the medical staff working in primary medical agencies should be enhanced because of their poor grasping. Primary agencies should increase the varieties of analgesic drugs and change their attitude and conception of analgesic drugs administration.

Using Icons in a Knowledge Based System for Traditional Medicine

MedTrad＋ is an expert system for African Traditional Medicine where actors are often illiterate. Its originality lies in the use of icons instead of textual content of facts. It has been created by GExpert＋ which is An Expert system Generator based on the use of icons in a Web environment. With its iconic interface GExpert＋ allows any user to overcome any intermediary for the management and the use of its knowledge base. Traditional healers from Yamoussoukro region are working toward its validation.

Patients’ Level of Knowledge of State-Funded Screening Programs in Family Physician’s Practice

Introduction： Screening tests have been shown to find cancer early and to reduce the risk of dying from cancer. In Latvia from 2000-2015 registered oncological patients had increased. At the end of year 2015, the 74,540 patients with oncology were registered. Aim： To evaluate respondents’ knowledge about screening and the reasons for non-use screening. Materials and methods： A cross-sectional study uses a survey of family physician’s patients. Responded data were summarized and processed with IBM SPSS 23 descriptive and analytical statistics. Results： In this study 102 patients’ survey data are used, at age group from 50 to 74 years. And 67% （n = 68） from of overall respondents were women, and 33% （n = 34） of respondents were men. The 35% of respondents visited family doctor 5 to 10 times per year, 29%-2-5 times per year, 19%-more than 10 times per year and 17%-once per year. Knowledge about screening programs of all respondents： 21% （n = 21） rated it as good, 26% （n = 27） rated it as bad and 53% （n = 54） rated it as average. And 49% of respondents said that screening includes colorectal cancer test, 65% that screening includes cervical cancer test, and 62% noted that screening includes mammography. Respondents identified the following reasons why they cannot use screening： 22% lack of informative material, 11% fear that diagnosed oncology, 14% do not feel that this is important, another 53% of respondents always use screening. Correlation was found between the number of family doctor’s visit per year and respondent’s knowledge about screening programs （p = 0.015, r = 0.24）. Conclusions： Despite the increased number of health improvement campaigns, lack of knowledge about screening programs still exists. The results show that half of respondents still do not use screening. Population health and knowledge can be improved by regular health check through family physician.

Hospital System Vulnerability to a Moderate Earthquake

This research aims at proposing to the technical manager of a hospital, a method for assessing the vulnerability of the hospital system in the case of a moderate earthquake. A primary case study on a hospital centre has allowed us to define the methodological basis. Also, it concludes to the need for a systematic method due to the complexity of hospital system and the specific knowledge. This ＂screening method＂ exits but it is applicable to the context of a major earthquake, where the main objective is to save life, while ours is to guarantee the continuity of hospital services. Other aims are to adapt this method in order to introduce the concept of a moderate earthquake, to take into account the environmental interactions of the hospital system and to improve the knowledge base. Subsequently, a software tool has to be developed to facilitate the implementation for the technical manager.