1.A machine learning-based depression recognition model integrating spirit-expression features from traditional Chinese medicine
Minghui YAO ; Rongrong ZHU ; Peng QIAN ; Huilin LIU ; Xirong SUN ; Limin GAO ; Fufeng LI
Digital Chinese Medicine 2026;9(1):68-79
Objective:
To develop a depression recognition model by integrating the spirit-expression diagnostic framework of traditional Chinese medicine (TCM) with machine learning algorithms. The proposed model seeks to establish a TCM-informed tool for early depression screening, thereby bridging traditional diagnostic principles with modern computational approaches.
Methods:
The study included patients with depression who visited the Shanghai Pudong New Area Mental Health Center from October 1, 2022 to October 1, 2023, as well as students and teachers from Shanghai University of Traditional Chinese Medicine during the same period as the healthy control group. Videos of 3 – 10 s were captured using a Xiaomi Pad 5, and the TCM spirit and expressions were determined by TCM experts (at least 3 out of 5 experts agreed to determine the category of TCM spirit and expressions). Basic information, facial images, and interview information were collected through a portable TCM intelligent analysis and diagnosis device, and facial diagnosis features were extracted using the Open CV computer vision library technology. Statistical analysis methods such as parametric and non-parametric tests were used to analyze the baseline data, TCM spirit and expression features, and facial diagnosis feature parameters of the two groups, to compare the differences in TCM spirit and expression and facial features. Five machine learning algorithms, including extreme gradient boosting (XGBoost), decision tree (DT), Bernoulli naive Bayes (BernoulliNB), support vector machine (SVM), and k-nearest neighbor (KNN) classification, were used to construct a depression recognition model based on the fusion of TCM spirit and expression features. The performance of the model was evaluated using metrics such as accuracy, precision, and the area under the receiver operating characteristic (ROC) curve (AUC). The model results were explained using the Shapley Additive exPlanations (SHAP).
Results:
A total of 93 depression patients and 87 healthy individuals were ultimately included in this study. There was no statistically significant difference in the baseline characteristics between the two groups (P > 0.05). The differences in the characteristics of the spirit and expressions in TCM and facial features between the two groups were shown as follows. (i) Quantispirit facial analysis revealed that depression patients exhibited significantly reduced facial spirit and luminance compared with healthy controls (P < 0.05), with characteristic features such as sad expressions, facial erythema, and changes in the lip color ranging from erythematous to cyanotic. (ii) Depressed patients exhibited significantly lower values in facial complexion L, lip L, and a values, and gloss index, but higher values in facial complexion a and b, lip b, low gloss index, and matte index (all P < 0.05). (iii) The results of multiple models show that the XGBoost-based depression recognition model, integrating the TCM “spirit-expression” diagnostic framework, achieved an accuracy of 98.61% and significantly outperformed four benchmark algorithms—DT, BernoulliNB, SVM, and KNN (P < 0.01). (iv) The SHAP visualization results show that in the recognition model constructed by the XGBoost algorithm, the complexion b value, categories of facial spirit, high gloss index, low gloss index, categories of facial expression and texture features have significant contribution to the model.
Conclusion
This study demonstrates that integrating TCM spirit-expression diagnostic features with machine learning enables the construction of a high-precision depression detection model, offering a novel paradigm for objective depression diagnosis.
2.Clinical and epidemiological characteristics of human bocavirus in hospitalized children with acute lower respiratory tract infection at a hospital in Shanghai from 2021 to 2023
Shan ZHANG ; Yujuan HUANG ; Lei SHEN ; Li LIU ; Jie WANG ; Huilin ZHOU ; Leijun MENG ; Tingting CHEN
Shanghai Journal of Preventive Medicine 2026;38(3):193-198
ObjectiveTo investigate the epidemiological and clinical characteristics of human bocavirus (HBoV) in hospitalized children with acute lower respiratory tract infection (ALRTI) at a single-center children’s hospital in Shanghai, thereby providing evidence for the diagnosis, treatment, and prevention of HBoV infection. MethodsA retrospective study was conducted on 19 537 hospitalized children with ALRTI at Shanghai Children’s Hospital from January 2021 to December 2023. Multiplex polymerase chain reaction (PCR) combined with capillary electrophoresis was used to detect HBoV and 12 other common respiratory viruses /atypical pathogens. The positive detection rate, demographic characteristics (sex, age), temporal distribution (year, season) of HBoV, as well as the clinical characteristics of severe and non-severe pneumonia were analyzed. ResultsThe overall HBoV-positive rate was 2.57% (503/19 537), with 59.44% (299/503) being single infections and 40.56% (204/503) being co-infections. The positive detection rate was significantly higher in boys than that in girls (2.78% vs 2.33%, χ²=3.88, P=0.049). The highest infection rate was observed in toddlers, followed by infants (χ²=379.57, P<0.001). The positive rate peaked in 2021 and reached its lowest point in 2023 (χ²=45.49, P<0.001), with epidemics mainly prevalent in summer and autumn. The main clinical symptoms were cough (90.06%, 453/503), fever (75.94%, 382/503), and wheezing (39.96%, 201/503). Children with severe pneumonia showed a higher incidence of wheezing compared with the non-severe group (P<0.001), while underlying diseases and co-infections had no significant association with disease severity (P>0.05). ConclusionHBoV was an important pathogen of ALRTI in children, predominantly affecting infants and toddlers, with higher susceptibility in boys and seasonal peaks in autumn and summer. The main clinical manifestations included cough, fever, and wheezing, with wheezing being more prevalent in children with severe pneumonia.
3.A systematic review of validation studies on the performance of GLIM criteria for malnutrition assessment
Yongshuai MENG ; Yanjuan LU ; Chunlei LIU ; Huilin JIA ; Mengying SUN ; Xiaoge HE ; Xiaoya SHENG ; Linna ZHANG ; Yinan MA ; Sangsang KE ; Lichuan ZHANG ; Qian LU
Chinese Journal of Clinical Nutrition 2025;33(4):290-298
Objective:To systematically evaluate studies validating the performance of the Global Leadership Initiative on Malnutrition (GLIM) in diagnosing malnutrition.Methods:Seven Chinese and English databases including Embase, Web of Science (WOS), PubMed, CINAHL, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP Database were searched for articles on the validation of GLIM criteria published between September 2018 and September 2024. Two researchers independently performed literature screening and data extraction. The concurrent and predictive validity of the criteria was analyzed.Results:A total of 136 papers were included for analysis. The GLIM criteria for diagnosing malnutrition had a sensitivity of 77%, a specificity of 87%, and an area under the curve (AUC) of 0.90. Malnutrition diagnosed by the GLIM criteria predicted prolonged hospital and intensive care unit (ICU) stays, increased readmission and complication rates (both overall and infectious), reduced survivals (median, overall, and disease-free), and increased in-hospital and follow-up mortalities. Both moderate and severe malnutrition predicted decreased overall survival. However, only three studies analyzed the impact of nutritional therapy on the clinical outcomes of malnourished patients.Conclusions:The GLIM criteria accurately differentiate malnutrition and are a valid predictive tool of clinical outcomes. However, the validity criteria in these validation studies were questionable, along with high methodological heterogeneity. Furthermore, there is a lack of studies validating the role of nutritional therapy in improving the clinical outcomes of malnourished patients.
4.Effect of scalp acupuncture combined with computer-assisted training on memory impairment after stroke
Lanqun LIU ; Yanli LI ; Jiaqi LIANG ; Shuang CHEN ; Huilin LIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(7):862-868
Objective To observe the effect of scalp acupuncture points including Shenting(GV24),Benshen(GB13)and Sishen-cong(EX-HN1)combined with computer-assisted training on memory impairment after stroke.Methods From May,2023 to December,2024,62 patients with post-stroke memory dysfunction who received rehabilita-tion treatment in Beijing Bo'ai Hospital were selected and divided into control group(n=31)and observation group(n=31)randomly.Both groups received conventional treatment and computer-assisted training,while the observation group received additional scalp acupuncture treatment,for four weeks.They were evaluated with Montreal Cognitive Assessment(MoCA),auditory memory span,and modified Barthel Index(MBI)before and after treatment.Results No adverse reaction occured during treatment.After treatment,the total score of MoCA and the memory dimen-sion score,and auditory memory span score improved in both groups(|t|>3.838,P<0.001),and the d-value was more in the observation group than in the control group(|t|>2.160,P<0.05);the score of MBI improved in both groups(|t|>7.471,P<0.001),however,there was no significant difference between two groups(P>0.05).Conclusion Computer-assisted training could significantly improve the cognitive function of patients with post-stroke memory dysfunction,especially the memory function,and is more effective while combining with scalp acupunc-ture.
5.Treatment of Obese Type 2 Diabetes Based on the Theory of"Maintaining the Sweet and Restoring the Body Fluids"
Bin LIU ; Xiru HUANG ; Deliang LIU ; Huilin LI
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(4):555-560
Obese type 2 diabetes belongs to the category of"consumptive thirst"in traditional Chinese medicine,and obesity is its main cause.This paper summarizes the pathogenesis of obese type 2 diabetes from three aspects:thirst caused by fat evil,deficiency caused by fat evil,and fat evil causing various pathogens.That is to say,the congestion of fat evil produces heat and hurts Yin,lead-ing to consumptive thirst.The accumulation of ointment and fat will damage Yang in the middle energizer and hinder spleen transport.Phlegm and dampness originate from spleen deficiency,which gather in veins and generate blood stasis and heat.The com-plicated combination of phlegm,blood stasis and heat leads to the relapse or development of consumptive thirst.Based on the theory of"maintaining the sweet and restoring the body fluids",this paper skillfully uses sweet herbs and cooperates with other nature and flavors to treat the pathogenesis of"thirst,deficiency and blood stasis"caused by fat evil injuring body fluids,to achieve the purposes of clear-ing away heat and nourishing Yin,strengthening spleen and protecting middle energizer,removing turbidity and blood stasis.Finally,the body fluid is continuously produced,transported smoothly,and the consumptive thirst is relieved.
6.Relationship between nurses' electronic health literacy and health education competence based on canonical correlation analysis
Huilin ZHANG ; Xiaoli LIU ; Yusheng WANG ; Yunhua ZHANG
Chinese Journal of Modern Nursing 2025;31(9):1227-1233
Objective:To explore the correlation between nurses' electronic health literacy and their health education competence.Methods:A convenience sampling method was used to select nurses from 24 secondary and tertiary hospitals in Jincheng for the study from July to August 2022. The Mobile-e Health Literacy Scale and the Nurse Health Education Competence Self-assessment Scale were used to survey the subjects. Pearson correlation analysis was performed to analyze the correlation between nurses' electronic health literacy and their health education competence. Canonical correlation analysis was employed to build a standardized canonical correlation model, conduct canonical structure analysis, and canonical redundancy analysis to explore the relationship between electronic health literacy and health education competence in nurses.Results:A total of 705 questionnaires were distributed, 74 were excluded due to short response times (<120 seconds), regular responses, or incorrect fillings, leaving 631 valid questionnaires, with an effective response rate of 89.5%. The total score of the Mobile-e Health Literacy Scale for 631 nurses was (50.40±8.75), with scores of (12.69±2.41) for self-perception, (21.35±3.70) for information acquisition, and (16.36±3.29) for interaction judgment. The total score for the Nurse Health Education Competence Self-assessment Scale was (366.32±57.51), with subscale scores of (29.71±4.77) for knowledge and experience, (95.65±14.20) for comprehensive quality, and (240.97±40.85) for skills and abilities. The total score of electronic health literacy and the scores of each dimension were positively correlated with the scores of each subscale of health education competence ( P<0.01). Canonical correlation analysis identified three pairs of canonical variables, with correlation coefficients of 0.750, 0.279, and 0.067 for the first, second, and third pairs, respectively. The correlation coefficients of the first and second pairs were statistically significant ( P<0.01). Nurses' electronic health literacy was primarily determined by interaction judgment ( r=-0.982), while health education competence was primarily determined by skills and abilities ( r=-0.995) . Conclusions:There is a positive correlation between nurses' electronic health literacy and health education competence. Enhancing nurses' electronic health literacy is of significant importance for improving their health education competence.
7.Effect of external attentional focus strategy on walking function after stroke
Yue WANG ; Tong ZHANG ; Huilin LIU ; Jianhua LIU ; Xiaomin ZHU ; Jun ZHAO
Chinese Journal of Rehabilitation Theory and Practice 2025;31(10):1206-1213
Objective To explore the effect of external attentional focus strategy on walking function after stroke.Methods From July to December 2024,40 stroke patients admitted in Beijing Bo'ai Hospital were randomly divided into control group(n=20)and experimental group(n=20).Both groups underwent conventional rehabilitation.On this basis,the control group received conventional walking training,while the experimental group received walk-ing training based on external attentional focus strategy,for three weeks.Before and after training,they were as-sessed with Gait Watch 3D gait analysis,Timed Up and Go Test(TUGT),Berg Balance Scale(BBS)and Fugl-Meyer Assessment-Lower Extremities(FMA-LE).Results After training,the step speed,step frequency,walking cycle,time of TUGT,and the scores of BBS and FMA-LE improved in both groups(|t|>3.098,P<0.01),and the step speed,step frequency,walking cycle and the score of FMA-LE improved more in the experimental group than in the control group(|t|>2.572,P<0.05).Conclusion External attentional focus strategy can improve the walking function of patients with stroke.
8.Correlations between post-doctoral talent cultivation and high-quality development of public hospitals
Ning HUANG ; Keying WANG ; Jialing CHEN ; Huilin FU ; Weixin LIU
Modern Hospital 2025;25(2):322-325
Objective To explore the role of postdoctoral talent cultivation in high-quality development of public hospi-tals.Methods The data of 165 postdoctoral fellows were analyzed from Zhongshan Ophthalmology Center,Sun Yat-sen Univer-sity over the past decade.The analysis involved examining the entire management process from recruitment to completion,inclu-ding the improvement of relevant systems,evaluation standards,implementation of hierarchical management,mentor-student in-teractions,and academic exchanges,as well as studying the quality enhancement of the postdoctoral talent pool,research output,and employment analysis.Results The standardized management of whole postdoctoral cultivation process and the continuous improvement of systems significantly enhanced the achievements of postdoctoral fellows in research,publications,and commer-cialization of the scientific and research findings.For instance,from 2018 to 2022,the number of National Science Foundation-funded programs that the postdoctoral fellows obtained accounted for 26.7%of the total number,while the number of provincial and ministerial funded programs accounted for 73.3%.In 2020,the proportion of postdoctoral researchers who obtained the Na-tional Natural Science Foundation of China's Youth Program was 80%of the total.In 2021,the proportion of postdoctoral fellows who published papers with an impact factor of above 10 as the first author or co-first author was 45.83%.Conclusion The training of high-level medical postdoctoral talents is crucial for high-quality development of public hospitals,improving interdisci-plinary adaptability of postdoctoral fellows and collaborative mentorship awareness.
9.The effect of orbital suspension training on muscle thickness,balance,and walking ability in stroke pa-tients with hemiplegia
Yanan WANG ; Huilin LIU ; Ning SUN
Chinese Journal of Rehabilitation Medicine 2025;40(8):1189-1195
Objective:To investigate the effect of orbital suspension training on muscle thickness,balance and walking ability in stroke patients with hemiplegia.Method:From October 2023 to January 2025,40 stroke patients with hemiplegia,having a Holden walking function grade of ≥1 and<3 were randomly divided into a treatment group and a control group,with 20 pa-tients in each group.Both groups received conventional physiotherapy,while the treatment group was received orbital suspension training on this basis for 4 weeks.The Berg balance scale(BBS)and Holden walking func-tion grading were used for efficacy evaluation before and after treatment.Muscle thickness of the bilateral ab-dominal muscle thickness,rectus femoral,tibialis anterior,biceps long head,and medial head thickness of gastrocnemius was measured using musculoskeletal ultrasound.Result:After treatment,the thickness of the external oblique muscles on both sides,the thickness of the rec-tus femoris muscle on the affected side,BBS score,and Holden walking function grading score improved in both groups(P<0.05).The treatment group showed significant improvement compared to the control group in the thickness of the extemal oblique muscles on both sides,the internal oblique muscle on the affected side,the rectus femoris muscle on the affected side,the tibialis anterior muscle on the unaffected side,and the thickness of rectus femoris muscle to the long head of the biceps femoris muscle(P<0.05).There was a mod-erate correlation between the difference in thickness of the rectus femoris muscle and the BBS score in both two groups(r:0.592,0.552).In the treatment group,the difference in thickness between the external oblique muscle and the healthy anterior tibialis muscle was related to the difference in BBS score(r:0.467,0.592).In the control group,the difference in thickness both the bilateral transverse abdominis muscles was related to the difference in BBS scores(r:0.581,0.499).Conclusion:Orbital suspension training can effectively improve balance and walking function.It also enhances the thickness of bilateral lateral oblique muscle,rectus femoris on the affected side,tibialis anterior muscle and thickness ratio of the rectus femoris to the biceps femoris on both sides.The change in thickness of rec-tus femoris muscle is related to the improvement of balance function.
10.Effect of preoperative exercise on patients undergoing ventriculoperitoneal shunt
Xueqin LÜ ; Tong ZHANG ; Huilin LIU ; Jianhua LIU ; Da LI ; Huawei WANG
Chinese Journal of Rehabilitation Theory and Practice 2025;31(8):958-964
Objective To observe the effect of preoperative exercise on consciousness,lung function and recovery efficiency of patients undergoing ventriculoperitoneal shunt.Methods A total of 54 patients undergoing elective ventriculoperitoneal shunt in Beijing Bo'ai Hospital from October,2024 to March,2025 were randomly divided into control group(n=27)and prerehabilitation group(n=27).The control group received routine preoperative treatment and nursing,while the prerehabilitation group additionally received exercise for two weeks.They were assessed with Coma Recovery Scale-Revised(CRS-R),and observed diaphragm mobility with sonography,before and three days after operation;and the time to first ambulation after surgery and length of stay in hospital were compared between two groups.Results CRS-R scores improved in both groups after operation(|t|>5.451,P<0.001),and it was greater in the prehabilitation group than in the control group(t=2.812,P<0.01).CRS-R subscale scores improved in auditory and motor functions in the control group(|Z|>2.000,P<0.05),and they were improved in auditory,visual,motor,verbal and arousal functions in the prehabilitation group(|Z|>2.282,P<0.01).CRS-R subscale scores were greater in motor and arousal in the prehabilitation group than in the control group(|Z|>2.320,P<0.05).Diaphragmatic mobility improved in the prehabilitation group(t=-7.782,P<0.001),and it was better than in the control group(t=2.044,P<0.05).The time to first ambulation after surgery and length of stay in hospital were shorter in the prehabilitation group than in the control group(|t|>3.654,P<0.01).Conclusion Preoperative exercise for patients undergoing elective ventriculoperitoneal shunt can improve the consciousness after operation,especially the level of motor and arousal,as well as the lung function,and accelerate the recovery process.

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