Machine learning models for stroke detection by observing the eye-movement features under five-color visual stimuli in traditional Chinese medicine

Objective:To develop a novel diagnostic modality to identify and diagnose stroke in daily life scenarios for improving the therapeutic effects and prognoses of patients.Methods:In this study,16 stroke patients and 24 age-matched healthy participants as controls were recruited for comparative analysis.Leveraging a portable eye-tracking device and integrating traditional Chinese medicine theory with modern color psychology principles,we recorded the eye movement signals and calculated eye movement features.Meanwhile,the stroke recognition models based on eye movement features were further trained by using random forest(RF),k-nearest neighbors(KNN),decision tree(DT),gradient boosting classifier(GBC),XGBoost,and CatBoost.Results:The stroke group and the healthy group showed significant differences in some eye movement features(P<.05).The models trained based on eye movement characteristics had good performances in recognizing stroke individuals,with accuracies ranging from 77.40%to 88.45%.Under the red stimulus,the eye movement model trained by RF became the best machine learning model with a recall of 84.65%,a precision of 86.48%,a F1 score of 85.47%.Among the six algorithms,RF and CatBoost performed better in classification.Conclusion:This study pioneers the application of traditional Chinese medicine's five-color stimuli to visual observation tasks.On the basis of the combined design,the eye-movement models can accurately identify stroke,and the developed high-performance models may be used in daily life scenarios.

Traditional Chinese Medicine Automated Diagnosis Based on Knowledge Graph Reasoning

Syndrome differentiation is the core diagnosis method of Traditional Chinese Medicine(TCM).We propose a method that simulates syndrome differentiation through deductive reasoning on a knowledge graph to achieve automated diagnosis in TCM.We analyze the reasoning path patterns from symptom to syndromes on the knowledge graph.There are two kinds of path patterns in the knowledge graph:one-hop and two-hop.The one-hop path pattern maps the symptom to syndromes immediately.The two-hop path pattern maps the symptom to syndromes through the nature of disease,etiology,and pathomechanism to support the diagnostic reasoning.Considering the different support strengths for the knowledge paths in reasoning,we design a dynamic weight mechanism.We utilize Naïve Bayes and TF-IDF to implement the reasoning method and the weighted score calculation.The proposed method reasons the syndrome results by calculating the possibility according to the weighted score of the path in the knowledge graph based on the reasoning path patterns.We evaluate the method with clinical records and clinical practice in hospitals.The preliminary results suggest that the method achieves high performance and can help TCM doctors make better diagnosis decisions in practice.Meanwhile,the method is robust and explainable under the guide of the knowledge graph.It could help TCM physicians,especially primary physicians in rural areas,and provide clinical decision support in clinical practice.

Application of artificial intelligence in tongue diagnosis of traditional Chinese medicine:A review

Tongue diagnosis is an important process to non-invasively assess the condition of a patient’s internal organs in traditional Chinese medicine(TCM)and each part of the tongue is related to corresponding internal organs.Due to continuing computer technological advances,especially the artificial intelligence(AI)methods have achieved significant success in tackling tongue image acquisition,processing,and classification,novel AI methods are being introduced in traditional Chinese medicine tongue diagnosis medical practices.Traditional tongue diagnose depends on observations of tongue characteristics,such as color,shape,texture,moisture,etc.by traditional Chinese medicine physicians.The appearance of the tongue color,texture and coating reflects the improvement or deterioration of patient’s conditions.Moreover,AI can now distinguish patient’s condition through tongue images,texture or coating,which is all possible increasingly with help from traditional Chinese medicine physicians under the traditional Chinese medicine tongue theory.AI has enabled humans to do what was previously unimagined:traditional Chinese medicine tongue diagnosis with feeding a large amount of tongue image and tongue texture/coating data to train the AI modes.This review focuses on the research advances of AI in TCM tongue diagnosis thus far to identify the major scientific methods and prospects.In this article,we tried to review the AI application in resolving the tongue diagnosis of traditional Chinese medicine on color correction,tongue image extraction,tongue texture/coating segmentation.

Use of Non-Verbal Representations to Define Concept of Pulse Conditions in Traditional Chinese Medicine Standards

The standardization of terms and definitions is fundamental to all activities in the domain of traditional Chinese medicine(TCM).For decades,definitions of TCM terminology relied on conventional verbal representations to differentiate between related concepts.However,the ancient Chinese is obscure and comprises a massive volume of information,making it difficult to convey the definition accurately in other languages.This article proposes a potential solution that the definition for pulse terminology can be supplemented by modern means of non-verbal representation,i.e.,using pulse waveform graphs and parameters to complete the definition of each pulse.A discussion of the challenges of obtaining reliable data is also included.

Progress in diagnosis and treatment of small cell lung cancer with integrated traditional Chinese and Western medicine

Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for about 20%of the total number of patients with lung cancer,the mortality rate is much higher than that of patients with NSCLC.Integrated traditional Chinese and Western medicine has obvious advantages in the treatment of patients with SCLC.According to the relevant literature reports on the treatment of SCLC in recent years,this article will summarize the research progress of integrated traditional Chinese and western medicine in the treatmentof SCLC from the aspects of traditional Chinese medicine(TCM)combined with surgery,chemotherapy,radiotherapy,and molecular targeted therapy.

Doctors’Dilemma in Auspicious Pulse Diagnosis Represented in Ming-Qing Fiction

Auspicious pulse diagnosis/pregnancy diagnosis in traditional Chinese medicine involves such issues as medical skills,narrative skills,family decency,and ethics.It is an excellent case for the exploration of ethical dilemmas in traditional Chinese medical practice.The early classical medical texts such as Su Wen(Basic Questions)and Ling Shu Jing(Spiritual Pivot Canon)provide a principle-based ethical guide for doctor-patient communication,while popular fiction such as Hong Lou Meng(A Dream of Red Mansions),Yu Mu Xing Xin Bian(Stories:Entertain to Enlighten),and Feng Yue Meng(Courtesans and Opium)in the Ming and Qing dynasties present literary examples for solving ethical dilemmas.This article will analyze these texts from three perspectives.First,the doctors in the text were subject to gender order and other delicate etiquette and customs,therefore were unable to make the diagnosis without embarrassing the patients and jeopardizing family decency.Second,the narrator tends to attribute pregnancy misdiagnosis to three reasons:incomplete patient information,doctors’poor narrative competence,and doctors’corrupted medical ethics.Finally,the Ming-Qing fiction proposes three methods to solve this moral dilemma:clear pulse reading,tactful speech,and taboo challenging.This discussion of moral dilemmas in pregnancy diagnosis in traditional Chinese medical practice can be used as a reference for the localization of narrative medicine.

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 REVIEW ON TRADITIONAL CHINESE MEDICINE IN PREVENTION AND TREATMENT OF MULTIPLE SCLEROSIS

Multiple sclerosis(MS),a diseaseaffecting the central nervous system,ischaracterized by patches of demyelinationand sclerosis of gliosis desseminatedthroughout the white matter of brain andspinal cord.In 1968,Charcot firstdescribed its clinical and pathologicalcharacteristics.Its incidence is very high,especially in Europe and America.Thereis no epidemic data of this

Treating Principles and Methods of Traditional Chinese Medicine in Treatment of Peripheral Vascular Diseases

Peripheral vascular disease embraces a variety of conditions such as thromboangiitis obliterans, Raynaud's disease, thrombophlebitis, aorto-arteritis, obliterate atherosclerosis, varix or phlebothrombosis of the lower limb. Although the affected blood vessel may be arterial or venous one and caused either by inflammation or degenerate changes, they share common symptoms and signs, such as blood stasis, ischemia, thrombosis, ecchymosis, swelling, constriction or obliteration of blood vessels due to circulatory impairment. Since they share common characteristics, the treating principles and methods will be discussed as follows.

Annual meeting of the Japan Traditional Chinese Medicine Association: Quantifying and objectifying traditional Chinese medicine

Five researchers reported on their studies to quantify and objectify traditional medicine at the symposium 'Verification of Traditional Chinese Medicine' during the 2016 annual meeting of the Japan Traditional Chinese Medicine Association.Takao Namiki reported on a methodology to quantify tongue diagnosis.Tetsuhiro Yoshino presented work on predictive prescribing two Kampo formulas for dysmenorrhea,Tangkuei and Peony Powder (Danggui Shaoyao San) and Cinnamon Twig and Poria Pill (Guizhi Fuling Wan).Koh Iwasaki presented work on validation of a questionnaire for assessing qi stagnation and Mitsuyuki Takamura reported on application of the questionnaire to evaluate the efficacy of Pinellia and Magnolia Bark Decoction (Banxia Houpo Tang).Kaoru Sakatani presented research on near-infrared spectroscopy as a diagnostic tool for wei bing,a concept of pre-symptomatic state in traditional Chinese medicine.

Understanding of Traditional Chinese Medicine and Western Medicine on Swimming Shoulder

Swimming shoulder refers to shoulder pain syndrome which is caused by repeated impinges on shoulder joints among swimmers.It is one of the most common causes of shoulder pain among swimmers with high incidence.Swimming shoulder can affect the systematization of swimmers’training and the improvement of their training level and performance,which is a difficult problem for many swimmers,coaches,medical staff and sports medical doctors.Therefore,attention should be paid to the treatment of swimming shoulder in daily diagnosis and treatment.

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

ADVANCES IN TREATMENT OF DIABETIC NEUROPATHY BY TRADITIONAL CHINESE MEDICINE

Diabetic neuropathy (DN) is the most commonly seen complication in diabetes mellitus (DM), and can occur in its early stage. With the prolongation of the course of the disease, the incidence of DN can reach 90％. The lesion can involve any location of neural system, it can occur

Clinical research progress of ischemic heart failure and prospect of traditional Chinese medicine

缺血性心力衰竭作为心力衰竭最常见的类型之一,如何诊疗始终为临床关注的重点。近年来,对于生物标志物的研究为临床诊断、病理分层和评价预后提供了帮助。常规治疗方面,新药物的临床应用及非药物治疗方式的发展带来了更多选择。同时,在中医辨证理论的指导下,中医药治疗也发挥着越来越重要的作用,展现了广阔前景。

TRADITIONAL CHINESE MEDICINE IN TREATMENT OF BRONCHITIS AND BRONCHIAL ASTHMA

According to the onset, acute or chronic, and the disease course, long or short, bronchitis can be divided into acute and chronic bronchitis, with their common main symptoms of cough, expectoration and oppression in the chest, and basically they belong to the category of 'cough' in traditional Chinese medicine (TCM).

A Protocol for Digitalized Collection of Traditional Chinese Medicine(TCM)Pulse Information Using Bionic Pulse Diagnosis Equipment

Pulse diagnosis equipment used in Traditional Chinese Medicine(TCM)has long been developed for collecting pulse information and in TCM research.However,it is still difficult to implement pulse taking automatically or efficiently in clinical practice.Here,we present a digital protocol for TCM pulse information collection based on bionic pulse diagnosis equipment,which ensures high efficiency,reliability and data integrity of pulse diagnosis information.A four-degree-of-freedom pulse taking platform together with a wrist bracket can satisfy the spatial positioning and angle requirements for individually adaptive pulse acquisition.Three-dimensional reconstruction of a wrist surface and an image localization model are combined to provide coordinates of the acquisition position and detection direction automatically.Three series elastic joints can not only simulate the TCM pulse taking method that“Three fingers in a straight line,the middle finger determining the‘Guan’location and finger pulp pressing on the radial artery,”but also simultaneously carry out the force-controlled multi-gradient pressing process.In terms of pulse information integrity,this proposed protocol can generate rich pulse information,including basic individual information,pulse localization distribution,multi-gradient dynamic pulse force time series,and objective pulse parameters,which can help establish the fundamental data sets that are required as the pulse phenotype for subsequent comprehensive analysis of pulse diagnosis.The implementation of this scheme is beneficial to promote the standardization of the digitalized collection of pulse information,the effectiveness of detecting abnormal health status,and the promotion of the fundamental and clinical research of TCM,such as TCM pulse phenomics.

An Expert Consensus of Integrated Chinese and Western Medicine Treatment on Lung Cancer

Lung cancer is a malignant tumor of the lung originating from the bronchial mucosa,glands or alveolar epithelium.With the population aging and environmental pollution getting increasingly severe,lung cancer has become the malignant tumor with the highest incidence and mortality rate in China,seriously endangering people’s life and health.However,there is no standardized guideline for the integrated Chinese and Western medicine treatment of lung cancer in China.In order to standardize and improve integrated Chinese and Western medicine diagnosis and treatment of lung cancer in China,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,together with oncologists from the Sun Yat-sen University Cancer Center,compiled this consensus under the coordination of the Medical Policy Department of the National Administration of Traditional Chinese Medicine,taking into account the main results of the pilot project of Chinese and Western Medicine Clinical Collaboration for Major Difficult Diseases(lung cancer).

Investigation of the Test–Retest Reliability and Inter-Rater Agreement of Traditional Chinese Medicine-Based Pulse Practitioners

Objective:The objective of this study was to assess the test–retest reliability and inter-rater agreement between the traditional Chinese medicine(TCM)pulse diagnosis between two Indian TCM practitioners.Methods:A total of 300 participants were evaluated for their bilateral pulse based on TCM independently by two investigators with similar years of experience but who graduated from different medical schools.The investigators who were blinded diagnosed the participants as per TCM based on the depth,rate,and strength of their pulse.Cronbachαand weighted kappa were used for assessing the reliability and repeatability.Results:The data of all the 300 participants were included in the analysis.The test–retest reliability computed using Cronbach's alpha indicated high reliability between the investigators(α=0.963).There were a total of 37 different types of diagnoses identified by both investigators.The investigators diagnoses matched for 116 participants out of 300 participants;whereas 184 cases were not matched between the investigators.The inter-rater agreement for the TCM diagnosis tested by weighted Kappa did not returned any significant agreement(Kappa=0.370).Discussion:The present study shows higher reliability between the pulse diagnoses between the investigators.However,the inter-rater agreement for TCM diagnosis based on pulse diagnosis was not significant probably due to the variation in subjective assessments.This calls for the standardization of training in TCM diagnostic methods among practitioners.Future studies should include the differences in training,medical education,and experience among the practitioners while determining the reliability of pulse diagnosis.

Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline(updated version)

The novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the cause of a rapidly spreading illness,coronavirus disease 2019(COVID-19),affecting more than seventeen million people around the world.Diagnosis and treatment guidelines for clinicians caring for patients are needed.In the early stage,we have issued"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)";now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline.We formed a working group of clinical experts and methodologists.The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas:chemoprophylaxis,diagnosis,treatments,and discharge management.We searched the literature for direct evidence on the management of COVID-19,and assessed its certainty generated recommendations using the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach.Recommendations were either strong or weak,or in the form of ungraded consensus-based statement.Finally,we issued 34 statements.Among them,6 were strong recommendations for,14 were weak recommendations for,3 were weak recommendations against and 11 were ungraded consensus-based statement.They covered topics of chemoprophylaxis(including agents and Traditional Chinese Medicine(TCM)agents),diagnosis(including clinical manifestations,reverse transcription-polymerase chain reaction(RT-PCR),respiratory tract specimens,IgM and IgG antibody tests,chest computed tomography,chest X-ray,and CT features of asymptomatic infections),treatments(including lopinavirritonavir,umifenovir,favipiravir,interferon,remdesivir,combination of antiviral drugs,hydroxychloroquine/chloroquine,interleukin-6 inhibitors,interleukin-1 inhibitors,glucocorticoid,qingfei paidu decoction,lianhua qingwen granules/capsules,convalescent plasma,lung transplantation,invasive or noninvasive ventilation,and extracorporeal membrane oxygenation(ECMO)),and discharge management(including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge).We also created two figures of these recommendations for the implementation purpose.We hope these recommendations can help support healthcare workers caring for COVID-19 patients.

Interpretation of Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7)

On March 3,2020,the National Health Commission and the National Administration of Traditional Chinese Medicine of China jointly promulgated the Notice on Printing and Distributing the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7).The content has been revised and supplemented on the basis of the Version 6,including etiological characteristics and pathological changes in lung,heart,kidney,spleen,liver,gallbladder,esophagus,stomach and intestinal mucosal epithelium.In particular,the diagnosis and treatment methods of traditional Chinese medicine are supplemented.It provides an evidence-based diagnosis and treatment protocol for the treatment and recovery of suspected and confirmed cases of novel coronavirus pneumonia with traditional Chinese medicine and Western medicine.