This study is the first phase of research results from the student innovation project“Yunqiao Sunshine Health and Wellness Homestay”group at Chengdu Normal University.By analyzing the current state of the Sunshine H...This study is the first phase of research results from the student innovation project“Yunqiao Sunshine Health and Wellness Homestay”group at Chengdu Normal University.By analyzing the current state of the Sunshine Health and Wellness Tourism Area economy in the Panxi region of Sichuan,local policies,and the current state of Sunshine Health and Wellness homestays and hotels,this paper proposes the possibility of developing Sunshine Health and Wellness homestays and hotels through traditional Chinese medicine(TCM)health preservation methods.It also proposes development strategies for such hotels through a market survey SWOT analysis.展开更多
Objective To explore the differential expression and mechanisms of bone formation-related genes in osteoporosis(OP)leveraging bioinformatics and machine learning methodologies;and to predict the active ingredients of ...Objective To explore the differential expression and mechanisms of bone formation-related genes in osteoporosis(OP)leveraging bioinformatics and machine learning methodologies;and to predict the active ingredients of targeted traditional Chinese medicine(TCM)herbs.Methods The Gene Expression Omnibus(GEO)and GeneCards databases were employed to conduct a comprehensive screening of genes and disease-associated loci pertinent to the pathogenesis of OP.The R package was utilized as the analytical tool for the identification of differentially expressed genes.Least absolute shrinkage and selection operator(LASSO)logis-tic regression analysis and support vector machine-recursive feature elimination(SVM-RFE)algorithm were employed in defining the genetic signature specific to OP.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses for the selected pivotal genes were conducted.The cell-type identification by estimating rela-tive subsets of RNA transcripts(CIBERSORT)algorithm was leveraged to examine the infiltra-tion patterns of immune cells;with Spearman’s rank correlation analysis utilized to assess the relationship between the expression levels of the genes and the presence of immune cells.Coremine Medical Database was used to screen out potential TCM herbs for the treatment of OP.Comparative Toxicogenomics Database(CTD)was employed for forecasting the TCM ac-tive ingredients targeting the key genes.AutoDock Vina 1.2.2 and GROMACS 2020 softwares were employed to conclude analysis results;facilitating the exploration of binding affinity and conformational dynamics between the TCM active ingredients and their biological targets.Results Ten genes were identified by intersecting the results from the GEO and GeneCards databases.Through the application of LASSO regression and SVM-RFE algorithm;four piv-otal genes were selected:coat protein(CP);kallikrein 3(KLK3);polymeraseγ(POLG);and transient receptor potential vanilloid 4(TRPV4).GO and KEGG pathway enrichment analy-ses revealed that these trait genes were predominantly engaged in the regulation of defense response activation;maintenance of cellular metal ion balance;and the production of chemokine ligand 5.These genes were notably associated with signaling pathways such as ferroptosis;porphyrin metabolism;and base excision repair.Immune infiltration analysis showed that key genes were highly correlated with immune cells.Macrophage M0;M1;M2;and resting dendritic cell were significantly different between groups;and there were signifi-cant differences between different groups(P<0.05).The interaction counts of resveratrol;curcumin;and quercetin with KLK3 were 7;3;and 2;respectively.It shows that the interac-tions of resveratrol;curcumin;and quercetin with KLK3 were substantial.Molecular docking and molecular dynamics simulations further confirmed the robust binding affinity of these bioactive compounds to the target genes.Conclusion Pivotal genes including CP;KLK3;POLG;and TRPV4;exhibited commendable significant prognostic value;and played a crucial role in the diagnostic assessment of OP.Resveratrol;curcumin;and quercetin;natural compounds found in TCM;showed promise in their potential to effectively modulate the bone-forming gene KLK3.This study provides a sci-entific basis for the interpretation of the pathogenesis of OP and the development of clinical drugs.展开更多
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...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.展开更多
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 ...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.展开更多
Objective Clinical medical record data associated with hepatitis B-related acute-on-chronic liver failure(HBV-ACLF)generally have small sample sizes and a class imbalance.However,most machine learning models are desig...Objective Clinical medical record data associated with hepatitis B-related acute-on-chronic liver failure(HBV-ACLF)generally have small sample sizes and a class imbalance.However,most machine learning models are designed based on balanced data and lack interpretability.This study aimed to propose a traditional Chinese medicine(TCM)diagnostic model for HBV-ACLF based on the TCM syndrome differentiation and treatment theory,which is clinically interpretable and highly accurate.Methods We collected medical records from 261 patients diagnosed with HBV-ACLF,including three syndromes:Yang jaundice(214 cases),Yang-Yin jaundice(41 cases),and Yin jaundice(6 cases).To avoid overfitting of the machine learning model,we excluded the cases of Yin jaundice.After data standardization and cleaning,we obtained 255 relevant medical records of Yang jaundice and Yang-Yin jaundice.To address the class imbalance issue,we employed the oversampling method and five machine learning methods,including logistic regression(LR),support vector machine(SVM),decision tree(DT),random forest(RF),and extreme gradient boosting(XGBoost)to construct the syndrome diagnosis models.This study used precision,F1 score,the area under the receiver operating characteristic(ROC)curve(AUC),and accuracy as model evaluation metrics.The model with the best classification performance was selected to extract the diagnostic rule,and its clinical significance was thoroughly analyzed.Furthermore,we proposed a novel multiple-round stable rule extraction(MRSRE)method to obtain a stable rule set of features that can exhibit the model’s clinical interpretability.Results The precision of the five machine learning models built using oversampled balanced data exceeded 0.90.Among these models,the accuracy of RF classification of syndrome types was 0.92,and the mean F1 scores of the two categories of Yang jaundice and Yang-Yin jaundice were 0.93 and 0.94,respectively.Additionally,the AUC was 0.98.The extraction rules of the RF syndrome differentiation model based on the MRSRE method revealed that the common features of Yang jaundice and Yang-Yin jaundice were wiry pulse,yellowing of the urine,skin,and eyes,normal tongue body,healthy sublingual vessel,nausea,oil loathing,and poor appetite.The main features of Yang jaundice were a red tongue body and thickened sublingual vessels,whereas those of Yang-Yin jaundice were a dark tongue body,pale white tongue body,white tongue coating,lack of strength,slippery pulse,light red tongue body,slimy tongue coating,and abdominal distension.This is aligned with the classifications made by TCM experts based on TCM syndrome differentiation and treatment theory.Conclusion Our model can be utilized for differentiating HBV-ACLF syndromes,which has the potential to be applied to generate other clinically interpretable models with high accuracy on clinical data characterized by small sample sizes and a class imbalance.展开更多
To understand citizens’awareness,trust and attitude towards Tradition Chinese medicine(TCM),to seek the best penetration path of TCM products and culture,to analyze their influencing factors,and to provide suggestion...To understand citizens’awareness,trust and attitude towards Tradition Chinese medicine(TCM),to seek the best penetration path of TCM products and culture,to analyze their influencing factors,and to provide suggestions and countermeasures,a non-probabilistic judgment sampling method was used to conduct a survey among 459 people online with the help of Questionnaire Star and 434 valid questionnaires were collected.The survey shows that residents have a high degree of recognition and identification of Chinese medicine;citizens are rational when choosing TCM products,and the recognition of the emerging TCM culture infiltration path is low.Different social and demographic factors affect citizens’awareness,trust and attitude towards TCM,as well as the choice of infiltration path(P<0.05).展开更多
Objectives:The widespread usage of traditional Chinese medicine(TCM)and the government's emphasis on TCM in China have created a positive macro-environment and great opportunities to develop and strengthen health ...Objectives:The widespread usage of traditional Chinese medicine(TCM)and the government's emphasis on TCM in China have created a positive macro-environment and great opportunities to develop and strengthen health technology assessment(HTA)in TCM.Over the past ten years,a series of policies have been issued by the government to promote the application of HTA and the development of TCM in China.This study reviews the concepts and characteristics of TCM,summarizes the current status of HTA in TCM,and analyzes the opportunities and challenges faced by HTA development in TCM with respect to deepening of healthcare reforms.Methods:Literature review and website searches were used to acquire information regarding the basic theories of TCM and the current status,opportunities,and challenges for HTA in TCM.Results:The number of articles on HTA in TCM rose substantially,especially those published in China National Knowledge Infrastructure(CNKI).With the optimistic policy environment and huge market demand for TCM,the development of HTA in TCM is expected to flourish in China.However,HTA in TCM also faces numerous challenges such as the absence of a clinical efficacy evaluation system for TCM and insufficient basic research evidence and qualified personnel.Conclusions:TCM has unique characteristic that distinguishes it from Western medicine.Currently,it is important to take all measures to address the existing main challenges and thereby take advantage of the present opportunities to develop and improve HTA in TCM.展开更多
To achieve awareness of the initiative practice for health concept in the Chinese population,traditional Chinese medicine(TCM)doctors should popularize TCM culture and knowledge among young people,people with a low le...To achieve awareness of the initiative practice for health concept in the Chinese population,traditional Chinese medicine(TCM)doctors should popularize TCM culture and knowledge among young people,people with a low level of education,in low-income populations,and in rural populations.展开更多
Hospital-based health technology assessment(HB-HTA)is highly valuable in the application of hospital medical technology,cost control,improvement of medical quality,and protection of medical safety,and its use is incre...Hospital-based health technology assessment(HB-HTA)is highly valuable in the application of hospital medical technology,cost control,improvement of medical quality,and protection of medical safety,and its use is increasing daily globally.However,in China,HB-HTA is still in its infancy,and it is yet to be adopted in traditional Chinese medicine(TCM).Therefore,this article introduces the application and development of HB-HTA,as well as discusses the current situation of TCM and related future development strategies to provide ideas and references for the development of HB-HTA in TCM.We conclude and recommend that all major stakeholders,including the state,health departments,and hospital leaders,support and promote the exploration and development of HB-HTA in TCM hospitals and integrative medicine hospitals.We also suggest the utilization of existing talents and introduction of other necessary talents to promote better and faster organizational development,as well as suggest the formation of a national and internationally recognized HB-HTA guidance manual and toolkit for TCM hospitals based on both the national HTA guidelines and the evaluation of TCM hospitals pilot projects.Moreover,we recommend that HB-HTA pilot study should be executed with Chinese patent medicine as the starting point to form the implementation process and framework in the TCM arena.展开更多
This paper described and discussed the important literature and ideas about the concepts, types and measurement of body constitution, in terms of healthy,sub-healthy and disease status. In view of traditional Chinese ...This paper described and discussed the important literature and ideas about the concepts, types and measurement of body constitution, in terms of healthy,sub-healthy and disease status. In view of traditional Chinese medicine, ‘‘healthy" state is a status of relative balance of Yin and Yang to keep our bodily homeostasis. If there are significant physical and/or psychological stressors, such as loss of a beloved one and failure in study or work, the body can no longer keep its own bodily condition balanced and subsequently enter a state of ‘‘sub-health"(sub-optimal health).‘‘unhealthy" body constitution such as ‘‘Dampnessheat", ‘‘Cold-dampness" and ‘‘Heat- or Cold- dryness"with a subnormal body temperature and humidity and clinical manifestations such as insomnia, malaise and overweight will be presented. Immediate, appropriate strategies such as modification of life-style and seeking medical treatment can prevent evolution of an illness.Otherwise, the body will enter a disease status with a‘‘pathological" body constitution of ‘‘Yin or Yang deficiency'', ‘‘Blood-stasis" and/or ‘‘Phlegm-dampness". To be complimentary with health promotion and disease prevention in Western medicine, understanding about an individual's body constitution, together with itsdeterminants(e.g., healthy eating and lifestyle behaviors), can contribute to a more proactive, holistic and individualized healthcare.展开更多
Objective:To observe and evaluate a method that is effective and practical for treatment of cerebral palsied(CP)children in China.Method:The patient's age and disease type and individual specific conditions were c...Objective:To observe and evaluate a method that is effective and practical for treatment of cerebral palsied(CP)children in China.Method:The patient's age and disease type and individual specific conditions were considered in choosingtherapy methods accordingly:Chinese herbs,acupuncture,auricnlar seed pressure,point finger pressing,massage,orthopedichand manipulation,physiotherapy,occupational therapy,language therapy,etc.Meanwhile we created a new CP treatment modelthat combines hospitalized treatment with family therapy.Results:The majority of CP patients improved greatly in motor andsocial adaptation capacities after treatment.Wilcoxon paired rank sum test analysis showed that there were significant differencesbetween the data before and after treatment(P<0.01).Conclusion:This combined therapy method,based on traditional Chinesemedicine and western medicine plus family supplemental therapy,is an effective and practical treatment strategy for CP children inChina.展开更多
Objective:To dig deeper into the traditional Chinese medicine treatment rules of chemotherapy-induced diarrhea with traditional Chinese medicine(TCM)inheritance computing platform system.Methods:Taking“traditional Ch...Objective:To dig deeper into the traditional Chinese medicine treatment rules of chemotherapy-induced diarrhea with traditional Chinese medicine(TCM)inheritance computing platform system.Methods:Taking“traditional Chinese medicine”,“chemotherapy”and“diarrhea”as the theme words,comprehensive search of the database of CNKI,Wanfang and VIP from its inception to November 2020 was conduct-ed.The formulas of external treatment of traditional Chinese medicine for chemotherapy-induced diarrhea were included and the association rule,clustering and factor analysis were carried out.Results:A total of 145 papers,57 prescriptions meeting the inclusion criteria were collected,among which high-frequency drugs including Baizhu(Atractylodis macrocephalae rhizoma),Fuling(Poria),Dangshen(Codonopsisradix),Huanglian(Coptidis rhizoma),Zhigancao(Glycyrrhizae radix et rhizoma praeparata cum melle)were the most commonly used.The confidence level was set as 0.7 and the support level was set as 10,12 core compatibility groups were obtained,and 6 categories were cluster analyzed.Conclusion:The principle of external treatment of chemotherapy-induced diarrhea is mainly“restore deficiency and benefiting qi”,“benefiting water infiltration and dampness”,“clearing heat”and“inducing astringency”.Prescription combination and new prescription combination based on traditional Chinese medicine(TCM)inheritance computing platform system can be used as reference for clinicians and applied in primary hospitals.展开更多
The Quality 4.0 concept is derived from the industrial fourth revolution,i.e.,Industry 4.0.Quality 4.0 is the future of quality,where new digital and disruptive technologies are used to maintain quality in organizatio...The Quality 4.0 concept is derived from the industrial fourth revolution,i.e.,Industry 4.0.Quality 4.0 is the future of quality,where new digital and disruptive technologies are used to maintain quality in organizations.It is also suitable for traditional Chinese medicine(TCM)to maintain quality.This quality revolution aims to improve industrial and service sectors’quality by incorporating emerging technologies to connect physical systems with the natural world.The proposed digital philosophy can update and enhance the entire TCM treatment methodology to become more effective and attractive in the current competitive structure of the pharmaceutical and clinical industries.Thus,in healthcare,this revolution empowers quality treatment during the COVID-19 pandemic.There is a major requirement in healthcare to maintain the quality of medical tools,equipment,and treatment processes during a pandemic.Digital technologies can widely be used to provide innovative products and services with excellent quality for TCM.In this paper,we discuss the significant role of Quality 4.0 and how it can be used to maintain healthcare quality and fulfill challenges during the pandemic.Additionally,we discuss 10 significant applications of Quality 4.0 in healthcare during the COVID-19 pandemic.These technologies will provide unique benefits to maintain the quality of TCM throughout the treatment process.With Quality 4.0,quality can be maintained using innovative and advanced digital technologies.展开更多
Traditional Chinese Medicine (TCM) is the medical science based on theories and practicing experience of traditional Chinese medicine to study transferring principles of health and sickness,as well as prevention, diag...Traditional Chinese Medicine (TCM) is the medical science based on theories and practicing experience of traditional Chinese medicine to study transferring principles of health and sickness,as well as prevention, diagnosis,treatment,rehabilitation and healthcare.TCM is marked with its long history of development,integrated theory system and abundant practicing experience.展开更多
The integrated traditional Chinese and western medicine (ICWM) of obstetrics and gynecology (OBS/GYN) emerged eventually with more than 40 years’ hard struggle, and one of the most promising articles is the integrati...The integrated traditional Chinese and western medicine (ICWM) of obstetrics and gynecology (OBS/GYN) emerged eventually with more than 40 years’ hard struggle, and one of the most promising articles is the integration of the masterpieces of menstrual disorder and infertility in TCM and the virtual explosion of new knowledge and methods in展开更多
Objective:This study is to address the health beliefs and health behavior of Chinese immigrants residing in the Greater Vancouver area of British Columbia(BC)Province in Canada.This article discussed Chinese immigrant...Objective:This study is to address the health beliefs and health behavior of Chinese immigrants residing in the Greater Vancouver area of British Columbia(BC)Province in Canada.This article discussed Chinese immigrants’traditional Chinese medicine(TCM)use,health beliefs,and health behaviors.Methods:Information used in this study is based on data collected in the Chinese-speaking community in the Greater Vancouver area of BC in 2020–2022.Quantitative and qualitative methods were applied to this study.The first stage recruited 314 participants for the quantitative study to cross-validate an instrument tool,followed by the 2nd stage of 20 stratified random sampling out of the 314 participants for TCM-related in-depth qualitative interviews.This study focuses on the second stage of TCM qualitative interviews.Results:Results indicated that TCM health beliefs have cultural and spiritual meanings tied to the Chinese-speaking participants.There are barriers for the Chinese-speaking population to access the existing healthcare services due to their TCM health beliefs and other health needs,for example,family doctors,integrated medicine for better health outcomes,and mental health services especially during the coronavirus disease 2019(COVID-19)pandemic.Conclusion:Integrating TCM health beliefs and behaviors of Chinese-speaking immigrants into existing Canadian mainstream health services are strongly recommended.展开更多
"Yi"is defined in traditional Chinese medicine theory as the general pathological conditions of epidemics.Throughout thousands of years of history,TCM has been playing an essential role in preventing and tre..."Yi"is defined in traditional Chinese medicine theory as the general pathological conditions of epidemics.Throughout thousands of years of history,TCM has been playing an essential role in preventing and treating epidemics in China.Showing significant efficacy against severe acute respiratory syndrome(SARS)in 2002 and 2003,a medical intervention involving TCM was applied at the beginning of the pandemic of the corona virus disease 2019(COVID-19),and has been found with good preventive and curative value in clinical practice.In this study,the etiology and pathogenic mechanism of COVID-19 was discussed on a TCM theory basis,and the clinically effective prevention and treatment methods/prescriptions were summarized.It is suggested that TCM has been playing a unique and vital role in preventing and treating COVID-19,and thus contributes greatly to public health.展开更多
The purpose of this study was to reach a better understanding of how minor mental health problems (MMP) are perceived in China by professionals practicing Traditional Chinese Medicine (TCM) and by well-educated people...The purpose of this study was to reach a better understanding of how minor mental health problems (MMP) are perceived in China by professionals practicing Traditional Chinese Medicine (TCM) and by well-educated people living in three urban locations. The results derive from interviews with three TCM doctors, three TCM students and eight other students. Psychological problems are separated into two different categories: “serious” and “not serious”. MMP are labelled not as disorders or illnesses but looked upon as ordinary problems in daily living or as “heart problems”. MMP seem to have less serious consequences according to the Chinese than from a modern Western perspective. “Problems of life” rather than sickness was the category that best summarized perceptions of MMP. TCM professionals’ advice to change lifestyle and most Chinese regulate by themselves less serious mental problems. Both lay people and TCM professionals associate serious problems with pathological mental function in a disease perspective. Some reasons for and consequences of these comprehensions are discussed.展开更多
The prevention and treatment of diseases in traditional Chinese medicine pay attention to the"due to people due to time and place".With its unique natural resources,climate and ecological environment,as well...The prevention and treatment of diseases in traditional Chinese medicine pay attention to the"due to people due to time and place".With its unique natural resources,climate and ecological environment,as well as its unique lifestyle,Hainan Island residents'health should have strong local characteristics.Through reviewing the literature,this paper finds that:the residents of Hainan Island have more Yin deficiency,qi deficiency and damp-heat deficiency;The pathogeny and disease syndrome of residents in Hainan Island are also different from other regions.Therefore,the maintenance and intervention of residents'health in Hainan Island has unique characteristics.展开更多
Objective:This study aimed to systematically review and depict the current studies of traditional Chinese medicine for the mental health of patients with coronavirus disease 2019(COVID-19).Methods:A scoping review was...Objective:This study aimed to systematically review and depict the current studies of traditional Chinese medicine for the mental health of patients with coronavirus disease 2019(COVID-19).Methods:A scoping review was conducted by searching PubMed,Web of Science,CNKI,Wanfang database,VIP database,and SinoMed,with the retrieval time being from the establishment of the database to April 18,2022.The basic information of the included studies,objective,design,types of patients,interventions,outcomes,etc.,was reviewed and summarized narratively.Methodological quality was assessed using the Cochrane Risk of Bias assessment tool,the methodological index for nonrandomized studies or the Newcastle-Ottawa scale.Results:We identified 30 traditional Chinese medicine(TCM)studies from six databases.Among them,finished randomized controlled trials(n=16)accounted for most of the studies,followed by single-arm studies(n=9).In terms of study theme,20 studies defined the mental health of patients with COVID-19 as the research theme.Psychological assessment was included in the inclusion criteria(performed before participation)of nine studies,whereas the other studies only mentioned the mental outcomes.TCM interventions included TCM exercises(Yijinjing,Baduanjin,Liuzijue,Taichi),acupoint stimulation(auricular and body points),moxibustion,decoction,or granules based on TCM syndrome differentiation,decoction,or granules with fixed formulae(Baidu Jieduan granules,Xuanfei Baidu decoction,and Qingfei Paidu decoction),Chinese patent medicine(Jinhua Qinggan granules),TCM psychological therapy(TCM ideological therapy,TCM five-tone therapy,and TCM psychological sand table),and TCM nursing(dialectical care,dialectical diet,and psychological counseling).Anxiety and depression were the main outcomes evaluated in regard to mental health in patients with COVID-19.The limitations of methodological quality were predominantly from follow-up,blinding,and registration.Positive results were reported by 27 studies(90%,n=30).Conclusion:We summarized the existing literature about the impact of TCM on mental health in patients with COVID-19.The number of studies evaluating the impact of TCM on mental health is encouraging,but overall methodological quality was low.Several TCM interventions warrant further evaluation,particularly among populations outside of China,for the purpose of establishing supporting evidence.More importantly,research with stronger methodological quality needs to be developed.展开更多
文摘This study is the first phase of research results from the student innovation project“Yunqiao Sunshine Health and Wellness Homestay”group at Chengdu Normal University.By analyzing the current state of the Sunshine Health and Wellness Tourism Area economy in the Panxi region of Sichuan,local policies,and the current state of Sunshine Health and Wellness homestays and hotels,this paper proposes the possibility of developing Sunshine Health and Wellness homestays and hotels through traditional Chinese medicine(TCM)health preservation methods.It also proposes development strategies for such hotels through a market survey SWOT analysis.
基金National Natural Science Foundation of China(81960877).
文摘Objective To explore the differential expression and mechanisms of bone formation-related genes in osteoporosis(OP)leveraging bioinformatics and machine learning methodologies;and to predict the active ingredients of targeted traditional Chinese medicine(TCM)herbs.Methods The Gene Expression Omnibus(GEO)and GeneCards databases were employed to conduct a comprehensive screening of genes and disease-associated loci pertinent to the pathogenesis of OP.The R package was utilized as the analytical tool for the identification of differentially expressed genes.Least absolute shrinkage and selection operator(LASSO)logis-tic regression analysis and support vector machine-recursive feature elimination(SVM-RFE)algorithm were employed in defining the genetic signature specific to OP.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses for the selected pivotal genes were conducted.The cell-type identification by estimating rela-tive subsets of RNA transcripts(CIBERSORT)algorithm was leveraged to examine the infiltra-tion patterns of immune cells;with Spearman’s rank correlation analysis utilized to assess the relationship between the expression levels of the genes and the presence of immune cells.Coremine Medical Database was used to screen out potential TCM herbs for the treatment of OP.Comparative Toxicogenomics Database(CTD)was employed for forecasting the TCM ac-tive ingredients targeting the key genes.AutoDock Vina 1.2.2 and GROMACS 2020 softwares were employed to conclude analysis results;facilitating the exploration of binding affinity and conformational dynamics between the TCM active ingredients and their biological targets.Results Ten genes were identified by intersecting the results from the GEO and GeneCards databases.Through the application of LASSO regression and SVM-RFE algorithm;four piv-otal genes were selected:coat protein(CP);kallikrein 3(KLK3);polymeraseγ(POLG);and transient receptor potential vanilloid 4(TRPV4).GO and KEGG pathway enrichment analy-ses revealed that these trait genes were predominantly engaged in the regulation of defense response activation;maintenance of cellular metal ion balance;and the production of chemokine ligand 5.These genes were notably associated with signaling pathways such as ferroptosis;porphyrin metabolism;and base excision repair.Immune infiltration analysis showed that key genes were highly correlated with immune cells.Macrophage M0;M1;M2;and resting dendritic cell were significantly different between groups;and there were signifi-cant differences between different groups(P<0.05).The interaction counts of resveratrol;curcumin;and quercetin with KLK3 were 7;3;and 2;respectively.It shows that the interac-tions of resveratrol;curcumin;and quercetin with KLK3 were substantial.Molecular docking and molecular dynamics simulations further confirmed the robust binding affinity of these bioactive compounds to the target genes.Conclusion Pivotal genes including CP;KLK3;POLG;and TRPV4;exhibited commendable significant prognostic value;and played a crucial role in the diagnostic assessment of OP.Resveratrol;curcumin;and quercetin;natural compounds found in TCM;showed promise in their potential to effectively modulate the bone-forming gene KLK3.This study provides a sci-entific basis for the interpretation of the pathogenesis of OP and the development of clinical drugs.
基金National Key Research and Development Program of China(2022YFC3502302)National Natural Science Foundation of China(82074580)Graduate Research Innovation Program of Jiangsu Province(KYCX23_2078).
文摘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.
基金National Natural Science Foundation of China(82274265 and 82274588)Hunan University of Traditional Chinese Medicine Research Unveiled Marshal Programs(2022XJJB003).
文摘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.
基金Key research project of Hunan Provincial Administration of Traditional Chinese Medicine(A2023048)Key Research Foundation of Education Bureau of Hunan Province,China(23A0273).
文摘Objective Clinical medical record data associated with hepatitis B-related acute-on-chronic liver failure(HBV-ACLF)generally have small sample sizes and a class imbalance.However,most machine learning models are designed based on balanced data and lack interpretability.This study aimed to propose a traditional Chinese medicine(TCM)diagnostic model for HBV-ACLF based on the TCM syndrome differentiation and treatment theory,which is clinically interpretable and highly accurate.Methods We collected medical records from 261 patients diagnosed with HBV-ACLF,including three syndromes:Yang jaundice(214 cases),Yang-Yin jaundice(41 cases),and Yin jaundice(6 cases).To avoid overfitting of the machine learning model,we excluded the cases of Yin jaundice.After data standardization and cleaning,we obtained 255 relevant medical records of Yang jaundice and Yang-Yin jaundice.To address the class imbalance issue,we employed the oversampling method and five machine learning methods,including logistic regression(LR),support vector machine(SVM),decision tree(DT),random forest(RF),and extreme gradient boosting(XGBoost)to construct the syndrome diagnosis models.This study used precision,F1 score,the area under the receiver operating characteristic(ROC)curve(AUC),and accuracy as model evaluation metrics.The model with the best classification performance was selected to extract the diagnostic rule,and its clinical significance was thoroughly analyzed.Furthermore,we proposed a novel multiple-round stable rule extraction(MRSRE)method to obtain a stable rule set of features that can exhibit the model’s clinical interpretability.Results The precision of the five machine learning models built using oversampled balanced data exceeded 0.90.Among these models,the accuracy of RF classification of syndrome types was 0.92,and the mean F1 scores of the two categories of Yang jaundice and Yang-Yin jaundice were 0.93 and 0.94,respectively.Additionally,the AUC was 0.98.The extraction rules of the RF syndrome differentiation model based on the MRSRE method revealed that the common features of Yang jaundice and Yang-Yin jaundice were wiry pulse,yellowing of the urine,skin,and eyes,normal tongue body,healthy sublingual vessel,nausea,oil loathing,and poor appetite.The main features of Yang jaundice were a red tongue body and thickened sublingual vessels,whereas those of Yang-Yin jaundice were a dark tongue body,pale white tongue body,white tongue coating,lack of strength,slippery pulse,light red tongue body,slimy tongue coating,and abdominal distension.This is aligned with the classifications made by TCM experts based on TCM syndrome differentiation and treatment theory.Conclusion Our model can be utilized for differentiating HBV-ACLF syndromes,which has the potential to be applied to generate other clinically interpretable models with high accuracy on clinical data characterized by small sample sizes and a class imbalance.
基金2020 Shenyang Philosophy and Social Science Planning Fund project SZ202001L.
文摘To understand citizens’awareness,trust and attitude towards Tradition Chinese medicine(TCM),to seek the best penetration path of TCM products and culture,to analyze their influencing factors,and to provide suggestions and countermeasures,a non-probabilistic judgment sampling method was used to conduct a survey among 459 people online with the help of Questionnaire Star and 434 valid questionnaires were collected.The survey shows that residents have a high degree of recognition and identification of Chinese medicine;citizens are rational when choosing TCM products,and the recognition of the emerging TCM culture infiltration path is low.Different social and demographic factors affect citizens’awareness,trust and attitude towards TCM,as well as the choice of infiltration path(P<0.05).
文摘Objectives:The widespread usage of traditional Chinese medicine(TCM)and the government's emphasis on TCM in China have created a positive macro-environment and great opportunities to develop and strengthen health technology assessment(HTA)in TCM.Over the past ten years,a series of policies have been issued by the government to promote the application of HTA and the development of TCM in China.This study reviews the concepts and characteristics of TCM,summarizes the current status of HTA in TCM,and analyzes the opportunities and challenges faced by HTA development in TCM with respect to deepening of healthcare reforms.Methods:Literature review and website searches were used to acquire information regarding the basic theories of TCM and the current status,opportunities,and challenges for HTA in TCM.Results:The number of articles on HTA in TCM rose substantially,especially those published in China National Knowledge Infrastructure(CNKI).With the optimistic policy environment and huge market demand for TCM,the development of HTA in TCM is expected to flourish in China.However,HTA in TCM also faces numerous challenges such as the absence of a clinical efficacy evaluation system for TCM and insufficient basic research evidence and qualified personnel.Conclusions:TCM has unique characteristic that distinguishes it from Western medicine.Currently,it is important to take all measures to address the existing main challenges and thereby take advantage of the present opportunities to develop and improve HTA in TCM.
基金Supported by the 2021 Shanghai University of Traditional Chinese Medicine Postgraduate Innovation and Entrepreneurship Training Project,No.Y2021070。
文摘To achieve awareness of the initiative practice for health concept in the Chinese population,traditional Chinese medicine(TCM)doctors should popularize TCM culture and knowledge among young people,people with a low level of education,in low-income populations,and in rural populations.
基金This study was supported by China Center for Evidence Based Traditional Chinese Medicine,CCEBTCM(2020YJSZX-2).
文摘Hospital-based health technology assessment(HB-HTA)is highly valuable in the application of hospital medical technology,cost control,improvement of medical quality,and protection of medical safety,and its use is increasing daily globally.However,in China,HB-HTA is still in its infancy,and it is yet to be adopted in traditional Chinese medicine(TCM).Therefore,this article introduces the application and development of HB-HTA,as well as discusses the current situation of TCM and related future development strategies to provide ideas and references for the development of HB-HTA in TCM.We conclude and recommend that all major stakeholders,including the state,health departments,and hospital leaders,support and promote the exploration and development of HB-HTA in TCM hospitals and integrative medicine hospitals.We also suggest the utilization of existing talents and introduction of other necessary talents to promote better and faster organizational development,as well as suggest the formation of a national and internationally recognized HB-HTA guidance manual and toolkit for TCM hospitals based on both the national HTA guidelines and the evaluation of TCM hospitals pilot projects.Moreover,we recommend that HB-HTA pilot study should be executed with Chinese patent medicine as the starting point to form the implementation process and framework in the TCM arena.
文摘This paper described and discussed the important literature and ideas about the concepts, types and measurement of body constitution, in terms of healthy,sub-healthy and disease status. In view of traditional Chinese medicine, ‘‘healthy" state is a status of relative balance of Yin and Yang to keep our bodily homeostasis. If there are significant physical and/or psychological stressors, such as loss of a beloved one and failure in study or work, the body can no longer keep its own bodily condition balanced and subsequently enter a state of ‘‘sub-health"(sub-optimal health).‘‘unhealthy" body constitution such as ‘‘Dampnessheat", ‘‘Cold-dampness" and ‘‘Heat- or Cold- dryness"with a subnormal body temperature and humidity and clinical manifestations such as insomnia, malaise and overweight will be presented. Immediate, appropriate strategies such as modification of life-style and seeking medical treatment can prevent evolution of an illness.Otherwise, the body will enter a disease status with a‘‘pathological" body constitution of ‘‘Yin or Yang deficiency'', ‘‘Blood-stasis" and/or ‘‘Phlegm-dampness". To be complimentary with health promotion and disease prevention in Western medicine, understanding about an individual's body constitution, together with itsdeterminants(e.g., healthy eating and lifestyle behaviors), can contribute to a more proactive, holistic and individualized healthcare.
文摘Objective:To observe and evaluate a method that is effective and practical for treatment of cerebral palsied(CP)children in China.Method:The patient's age and disease type and individual specific conditions were considered in choosingtherapy methods accordingly:Chinese herbs,acupuncture,auricnlar seed pressure,point finger pressing,massage,orthopedichand manipulation,physiotherapy,occupational therapy,language therapy,etc.Meanwhile we created a new CP treatment modelthat combines hospitalized treatment with family therapy.Results:The majority of CP patients improved greatly in motor andsocial adaptation capacities after treatment.Wilcoxon paired rank sum test analysis showed that there were significant differencesbetween the data before and after treatment(P<0.01).Conclusion:This combined therapy method,based on traditional Chinesemedicine and western medicine plus family supplemental therapy,is an effective and practical treatment strategy for CP children inChina.
基金National Natural Science Foundation of China Youth Science Foundation Project(No.81904001)Capital Health Development Scientific Research Project(No.first issue 2018-1-4061)+1 种基金State Administration of Traditional Chinese Medicine Clinical Collaboration Project of TCM and Western Medicine for Major and Intractable Diseases(No.2019-ZX-005)In-Hospital Project of China-Japan Friendship Hospital(No.2019-1-QN-56)。
文摘Objective:To dig deeper into the traditional Chinese medicine treatment rules of chemotherapy-induced diarrhea with traditional Chinese medicine(TCM)inheritance computing platform system.Methods:Taking“traditional Chinese medicine”,“chemotherapy”and“diarrhea”as the theme words,comprehensive search of the database of CNKI,Wanfang and VIP from its inception to November 2020 was conduct-ed.The formulas of external treatment of traditional Chinese medicine for chemotherapy-induced diarrhea were included and the association rule,clustering and factor analysis were carried out.Results:A total of 145 papers,57 prescriptions meeting the inclusion criteria were collected,among which high-frequency drugs including Baizhu(Atractylodis macrocephalae rhizoma),Fuling(Poria),Dangshen(Codonopsisradix),Huanglian(Coptidis rhizoma),Zhigancao(Glycyrrhizae radix et rhizoma praeparata cum melle)were the most commonly used.The confidence level was set as 0.7 and the support level was set as 10,12 core compatibility groups were obtained,and 6 categories were cluster analyzed.Conclusion:The principle of external treatment of chemotherapy-induced diarrhea is mainly“restore deficiency and benefiting qi”,“benefiting water infiltration and dampness”,“clearing heat”and“inducing astringency”.Prescription combination and new prescription combination based on traditional Chinese medicine(TCM)inheritance computing platform system can be used as reference for clinicians and applied in primary hospitals.
文摘The Quality 4.0 concept is derived from the industrial fourth revolution,i.e.,Industry 4.0.Quality 4.0 is the future of quality,where new digital and disruptive technologies are used to maintain quality in organizations.It is also suitable for traditional Chinese medicine(TCM)to maintain quality.This quality revolution aims to improve industrial and service sectors’quality by incorporating emerging technologies to connect physical systems with the natural world.The proposed digital philosophy can update and enhance the entire TCM treatment methodology to become more effective and attractive in the current competitive structure of the pharmaceutical and clinical industries.Thus,in healthcare,this revolution empowers quality treatment during the COVID-19 pandemic.There is a major requirement in healthcare to maintain the quality of medical tools,equipment,and treatment processes during a pandemic.Digital technologies can widely be used to provide innovative products and services with excellent quality for TCM.In this paper,we discuss the significant role of Quality 4.0 and how it can be used to maintain healthcare quality and fulfill challenges during the pandemic.Additionally,we discuss 10 significant applications of Quality 4.0 in healthcare during the COVID-19 pandemic.These technologies will provide unique benefits to maintain the quality of TCM throughout the treatment process.With Quality 4.0,quality can be maintained using innovative and advanced digital technologies.
文摘Traditional Chinese Medicine (TCM) is the medical science based on theories and practicing experience of traditional Chinese medicine to study transferring principles of health and sickness,as well as prevention, diagnosis,treatment,rehabilitation and healthcare.TCM is marked with its long history of development,integrated theory system and abundant practicing experience.
文摘The integrated traditional Chinese and western medicine (ICWM) of obstetrics and gynecology (OBS/GYN) emerged eventually with more than 40 years’ hard struggle, and one of the most promising articles is the integration of the masterpieces of menstrual disorder and infertility in TCM and the virtual explosion of new knowledge and methods in
基金This research project entitled “Cross-cultural Validation Methods for Generic PROMS”(PCM-010) was funded for 2020–2022 by the BC Support Unit Methods Cluster under Michael Smith Health Research BC
文摘Objective:This study is to address the health beliefs and health behavior of Chinese immigrants residing in the Greater Vancouver area of British Columbia(BC)Province in Canada.This article discussed Chinese immigrants’traditional Chinese medicine(TCM)use,health beliefs,and health behaviors.Methods:Information used in this study is based on data collected in the Chinese-speaking community in the Greater Vancouver area of BC in 2020–2022.Quantitative and qualitative methods were applied to this study.The first stage recruited 314 participants for the quantitative study to cross-validate an instrument tool,followed by the 2nd stage of 20 stratified random sampling out of the 314 participants for TCM-related in-depth qualitative interviews.This study focuses on the second stage of TCM qualitative interviews.Results:Results indicated that TCM health beliefs have cultural and spiritual meanings tied to the Chinese-speaking participants.There are barriers for the Chinese-speaking population to access the existing healthcare services due to their TCM health beliefs and other health needs,for example,family doctors,integrated medicine for better health outcomes,and mental health services especially during the coronavirus disease 2019(COVID-19)pandemic.Conclusion:Integrating TCM health beliefs and behaviors of Chinese-speaking immigrants into existing Canadian mainstream health services are strongly recommended.
文摘"Yi"is defined in traditional Chinese medicine theory as the general pathological conditions of epidemics.Throughout thousands of years of history,TCM has been playing an essential role in preventing and treating epidemics in China.Showing significant efficacy against severe acute respiratory syndrome(SARS)in 2002 and 2003,a medical intervention involving TCM was applied at the beginning of the pandemic of the corona virus disease 2019(COVID-19),and has been found with good preventive and curative value in clinical practice.In this study,the etiology and pathogenic mechanism of COVID-19 was discussed on a TCM theory basis,and the clinically effective prevention and treatment methods/prescriptions were summarized.It is suggested that TCM has been playing a unique and vital role in preventing and treating COVID-19,and thus contributes greatly to public health.
文摘The purpose of this study was to reach a better understanding of how minor mental health problems (MMP) are perceived in China by professionals practicing Traditional Chinese Medicine (TCM) and by well-educated people living in three urban locations. The results derive from interviews with three TCM doctors, three TCM students and eight other students. Psychological problems are separated into two different categories: “serious” and “not serious”. MMP are labelled not as disorders or illnesses but looked upon as ordinary problems in daily living or as “heart problems”. MMP seem to have less serious consequences according to the Chinese than from a modern Western perspective. “Problems of life” rather than sickness was the category that best summarized perceptions of MMP. TCM professionals’ advice to change lifestyle and most Chinese regulate by themselves less serious mental problems. Both lay people and TCM professionals associate serious problems with pathological mental function in a disease perspective. Some reasons for and consequences of these comprehensions are discussed.
基金018 Scientific Research Cultivation Fund of Hainan Medical University,Application Research of Small Splint of Traditional Chinese Medicine Based on 3D Printing in Pre-Hospital First Aid,Project no.:HY2018-25.
文摘The prevention and treatment of diseases in traditional Chinese medicine pay attention to the"due to people due to time and place".With its unique natural resources,climate and ecological environment,as well as its unique lifestyle,Hainan Island residents'health should have strong local characteristics.Through reviewing the literature,this paper finds that:the residents of Hainan Island have more Yin deficiency,qi deficiency and damp-heat deficiency;The pathogeny and disease syndrome of residents in Hainan Island are also different from other regions.Therefore,the maintenance and intervention of residents'health in Hainan Island has unique characteristics.
基金The National Natural Science Foundation of China(82074583)Tianjin Government Youth Talents Project(201504)Supported by Shanxi Provincial Key Laboratory of classical prescription strengthening yang(Grant No.202104010910011)funded this review.
文摘Objective:This study aimed to systematically review and depict the current studies of traditional Chinese medicine for the mental health of patients with coronavirus disease 2019(COVID-19).Methods:A scoping review was conducted by searching PubMed,Web of Science,CNKI,Wanfang database,VIP database,and SinoMed,with the retrieval time being from the establishment of the database to April 18,2022.The basic information of the included studies,objective,design,types of patients,interventions,outcomes,etc.,was reviewed and summarized narratively.Methodological quality was assessed using the Cochrane Risk of Bias assessment tool,the methodological index for nonrandomized studies or the Newcastle-Ottawa scale.Results:We identified 30 traditional Chinese medicine(TCM)studies from six databases.Among them,finished randomized controlled trials(n=16)accounted for most of the studies,followed by single-arm studies(n=9).In terms of study theme,20 studies defined the mental health of patients with COVID-19 as the research theme.Psychological assessment was included in the inclusion criteria(performed before participation)of nine studies,whereas the other studies only mentioned the mental outcomes.TCM interventions included TCM exercises(Yijinjing,Baduanjin,Liuzijue,Taichi),acupoint stimulation(auricular and body points),moxibustion,decoction,or granules based on TCM syndrome differentiation,decoction,or granules with fixed formulae(Baidu Jieduan granules,Xuanfei Baidu decoction,and Qingfei Paidu decoction),Chinese patent medicine(Jinhua Qinggan granules),TCM psychological therapy(TCM ideological therapy,TCM five-tone therapy,and TCM psychological sand table),and TCM nursing(dialectical care,dialectical diet,and psychological counseling).Anxiety and depression were the main outcomes evaluated in regard to mental health in patients with COVID-19.The limitations of methodological quality were predominantly from follow-up,blinding,and registration.Positive results were reported by 27 studies(90%,n=30).Conclusion:We summarized the existing literature about the impact of TCM on mental health in patients with COVID-19.The number of studies evaluating the impact of TCM on mental health is encouraging,but overall methodological quality was low.Several TCM interventions warrant further evaluation,particularly among populations outside of China,for the purpose of establishing supporting evidence.More importantly,research with stronger methodological quality needs to be developed.