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.

The enlightenment of artificial intelligence large-scale model on the research of intelligent eye diagnosis in traditional Chinese medicine

Eye diagnosis is a method for inspecting systemic diseases and syndromes by observing the eyes.With the development of intelligent diagnosis in traditional Chinese medicine(TCM);artificial intelligence(AI)can improve the accuracy and efficiency of eye diagnosis.However;the research on intelligent eye diagnosis still faces many challenges;including the lack of standardized and precisely labeled data;multi-modal information analysis;and artificial in-telligence models for syndrome differentiation.The widespread application of AI models in medicine provides new insights and opportunities for the research of eye diagnosis intelli-gence.This study elaborates on the three key technologies of AI models in the intelligent ap-plication of TCM eye diagnosis;and explores the implications for the research of eye diagno-sis intelligence.First;a database concerning eye diagnosis was established based on self-su-pervised learning so as to solve the issues related to the lack of standardized and precisely la-beled data.Next;the cross-modal understanding and generation of deep neural network models to address the problem of lacking multi-modal information analysis.Last;the build-ing of data-driven models for eye diagnosis to tackle the issue of the absence of syndrome dif-ferentiation models.In summary;research on intelligent eye diagnosis has great potential to be applied the surge of AI model applications.

Development and validation of tongue imaging-based radiomics tool for the diagnosis of insomnia degree:a two-center study

Background:Traditional Chinese medicine(TCM)is commonly used for the diagnosis and treatment of insomnia,with tongue diagnosis being particularly important.The aim of our study was to develop and validate a novel tongue imaging-based radiomics(TIR)method for accurately diagnosing insomnia severity.Methods:This two-center analysis prospectively enrolled 399 patients who underwent tongue imaging between July and October 2021 and divided them into primary and validation cohorts by study center.Here,we referred to the Insomnia Severity Index(ISI)standard and the degree of insomnia was evaluated as absent,subthreshold,moderate,or severe.For developed the TIR diagnostic tool,a U-Net algorithm was used to segment tongue images.Subsequently,seven imaging features were selected from the extracted high-throughout radiomics features using the least absolute shrinkage and selection operator algorithm.Then,the final radiomics model was developed in the primary cohort and tested in the independent validation cohort.Finally,we assessed and compared the diagnostic performance differences between TCM tongue diagnosis and our TIR diagnostic tool with the ISI gold standard.The confusion matrix was calculated to evaluate the diagnostic performance.Results:Seven tongue imaging features were selected to build the TIR tool,with showing good correlations with the insomnia degree.The TIR method had an accuracy of 0.798,a macro-average sensitivity of 0.78,a macro-average specificity of 0.906,a weighted-average sensitivity of 0.798,and a weighted specificity of 0.916,showing a significantly better performance compared to the average performance of three experienced TCM physicians(mean accuracy of 0.458,P<0.01).Conclusions:The preliminary study demonstrates the potential application of TIR in the diagnosis of insomnia degree and measurement of sleep health.The integration of quantitative imaging analysis and machine learning algorithms holds promise for advancing both of TCM and precision sleep medicine.

Application of Thermal Science to Tongue Inspection in Traditional Chinese Medicine

The study on Traditional Chinese Medicine (TCM)by the technology and method of thermal science is a new cut in point in interdisciplinary science, and its purpose is to study the tongue inspection in TCM from the view of the bio heat transfer theory. In this paper human tongues were studied with the infrared thermal imaging technology. And the characteristic relationship between temperature distribution and age, tongue color as well as infrared thermal tongue image concerning the characteristic of viscera was analyzed by the experimental data,which confirms that the change in temperature distribution in different positions of the tongue is related to the diseases of different internal organs of the body. From a series of invasive experiments in animals, the blood perfusion rate was measured with the equipment of CBI 8000 Doppler Blood Flow Meter and MP 100 Physiologic Research System for the first time and the characteristic relationship curve between the temperature on the surface of the tongue and the blood perfusion rate was obtained. From the experiments the temperature on the surface of the tongue reflects objectively the tongue color which is influenced by the blood perfusion rate. This will help to develop some new cognition in the theory of TCM.

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.

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.

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.

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.

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.

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

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.

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.

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

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

As one of the most common types of heart failure, the diagnosis and treatment of Ischemic heart failure are the main focus of clinic. In recent years, the studies on biomarkers have provided supports for clinical diagnosis, prognosis evaluation and stratification. The clinical application of new drugs and the development of non-drug treatment methods have brought more choices conventional treatment. At the same time, under the guidance of Traditional Chinese Medicine syndrome differentiation theory, Traditional Chinese Medicine therapy also plays an increasingly important role and shows its broad prospects .

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).

Advances in Traditional Chinese Medicine for Gout

Gout has an increasing morbidity rate around the world,correlating well with hypertension,hyperlipidemia,atherosclerosis,obesity and insulin resistance,and so on.In view of Traditional Chinese Medicine(TCM),gout belongs to arthromyodynia.Keys to syndrome differentiation of TCM are in differentiation,corporeality and coated tongue(characterized to be damp).According to the dialectical characteristics of gout TCM,this paper summarized the research of gout TCM,including food-based traditional Chinese medicine,bill of lading medicine,drug extraction,optimal herbs and dosage,individual herb and compound prescription,in order to explore and elaborate the objective curative effect and exact mechanism of gout treated by TCM.

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).