Objective: To explore whether digital facial and tongue diagnostic technologies can support the assessment of coronary heart disease (CHD) patients for coronary artery stenosis severity, and examine potential associations between digital tongue diagnosis features and myocardial biomarkers. Methods: The TFDA-1 face and tongue diagnosis instrument and the TDAS analysis system were used to perform intelligent visual examination and analysis of the facial and tongue in CHD patients who attended the Department of Cardiology at Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine between October 2, 2023 and July 31, 2024. Variables were screened using principal component analysis (PCA) and multicollinearity analysis to construct four machine learning models, including random forest, LightGBM, decision tree, and naive Bayes, for the early prediction of coronary artery stenosis severity. Model performance metrics, including sensitivity, specificity, precision, F1 score, accuracy, and the area under the receiver operating characteristic (ROC) curve (AUC), were evaluated. Visual analyses were performed using the SHapley Additive exPlanations (SHAP) interpreter and decision curve analysis. For patients after percutaneous coronary intervention (PCI), a conceptual model linking cardiac biomarkers and tongue diagnosis was constructed using the partial least squares structural equation modeling (PLS-SEM), and its validity was assessed. Results: A total of 459 CHD patients were enrolled and assigned to a PCI group and a non-PCI group (which comprised two subgroups: mild stenosis or less group, moderate stenosis or greater group). For sublingual vein (SV) features, the PCI group had lower SV-a and SV-b than the other groups (P < 0.01 and P < 0.05, respectively). For tongue surface features, the PCI group had significantly higher tongue body (TB)-L, TB-a, and TB-b (P < 0.05, P < 0.01, and P < 0.001, respectively), as well as higher tongue coating (TC)-a and TC-b (P < 0.01 and P < 0.001, respectively). Age, SV-a, SV-b, creatine kinase-myocardial band (CK-MB), CK, TC-a, lip-L, and lip-b were incorporated in the machine learning models. The random forest model performed best, with an AUC of 0.924, an F1 score of 0.839, precision of 0.807, accuracy of 0.864, sensitivity of 0.873, and specificity of 0.839. Decision curve analysis indicated that both LightGBM and random forest had clinical utility. PLS-SEM confirmed the pathway relationships: myocardial biomarkers → TB and myocardial biomarkers → TC (coefficient = – 0.238, t = 2.239, P = 0.025, and coefficient = – 0.270, t = 2.522, P = 0.012, respectively). Conclusion This study developed a noninvasive early warning model for coronary artery stenosis in patients with CHD. It applied PLS-SEM to investigate the association between post-PCI cardiac biomarkers and tongue diagnosis, and validated the proposed association chain. These findings suggest that intelligent traditional Chinese medicine (TCM) visual diagnosis integrated with modern digital technology may support CHD risk assessment and comprehensive health management.

As a common syndrome type in TCM,blood stasis syndrome is diagnosed based on the four diagnostic methods of TCM,with inspection providing especially intuitive information.In recent years,with the advancement of objectification studies on the four diagnostic methods,inspection techniques for blood stasis syndrome have gradually transitioned from qualitative to quantitative analysis.This article reviewed recent progress in modern research on multi-region inspection for blood stasis syndrome,including facial complexion,tongue characteristics,sublingual collateral vessels,and microcirculation signs.Multi-region inspection technology has progressively established standardized acquisition protocols integrated with artificial intelligence technology,achieving a transition from qualitative to quantitative analysis.These region-specific data demonstrate clear associations with cardiovascular and metabolic diseases,supporting diagnostic objectification of blood stasis syndrome.However,further efforts remain necessary to expand clinical samples,integrate macro-micro data,standardize quantitative criteria,and establish collaborative diagnostic criteria for precise syndrome differentiation.

As a common syndrome type in TCM,blood stasis syndrome is diagnosed based on the four diagnostic methods of TCM,with inspection providing especially intuitive information.In recent years,with the advancement of objectification studies on the four diagnostic methods,inspection techniques for blood stasis syndrome have gradually transitioned from qualitative to quantitative analysis.This article reviewed recent progress in modern research on multi-region inspection for blood stasis syndrome,including facial complexion,tongue characteristics,sublingual collateral vessels,and microcirculation signs.Multi-region inspection technology has progressively established standardized acquisition protocols integrated with artificial intelligence technology,achieving a transition from qualitative to quantitative analysis.These region-specific data demonstrate clear associations with cardiovascular and metabolic diseases,supporting diagnostic objectification of blood stasis syndrome.However,further efforts remain necessary to expand clinical samples,integrate macro-micro data,standardize quantitative criteria,and establish collaborative diagnostic criteria for precise syndrome differentiation.

[Objective]To study the mechanism of Luhong Formula in relieving myocardial fibrosis after myocardial infarction.[Methods]The myocardial fibrosis model after myocardial infarction was prepared by coronary artery ligation.Sixty SD rats were randomly assigned to sham operation group,model group,Luhong Formula group and Perindopril group.Each group completed the corresponding intervention for 4 weeks.Heart structure and left ventricular ejection fraction were measured by ultrasonic cardiogram.The pathological changes of cardiac fibrosis were observed by hematoxylin-eosin(HE)staining,Masson and Sirius red staining.The secretion of cardiac signal transduction and activator of transcription 3(STAT3)was analyzed by Western blot.Enzyme-linked immunosorbent assay(ELISA)was used to detect the serum levels of pro-fibrotic factor including connective tissue growth factor(CTGF),platelet reactive protein-1(TSP-1)and matrix metalloproteinase inhibitor-1(TIMP-1).[Results]Compared with model group,the intervention of Luhong Formula and Perindopril could inhibit the increase of left ventricular enddiastolic volume and left ventricular enddiastolic diameter,while the value of left ventricular ejection fraction was significantly increased(P<0.05).The effect of Luhong Formula group on improving ventricular dysdilation and increasing left ventricular ejection fraction was similar to that of Perindopril group.HE staining results showed that compared with model group,the number of abnormal cardiomyocytes in Luhong Formula group and Perindopril group was significantly reduced,the interstitial swelling was reduced,and the inflammatory cell infiltration was reduced.Masson and Sirius red staining showed that compared with model group,both Luhong Formula group and Perindopril group could reduce the degree of myocardial fibrosis after intervention.The effect of Luhong Formula group on improving the myocardial pathological changes and alleviating myocardial fibrosis was similar to that of Perindopril group.Western blot results showed that compared with model group,intervention in both Luhong Formula group and Perindopril group could significantly increase the myocardial STAT3 secretion(P<0.05),and the effect of Luhong Formula group on promoting myocardial STAT3 secretion was similar to that of Perindopril group(P>0.05).ELISA results showed that the levels of CTGF,TSP-1 and TIMP-1 in Luhong Formula group and Perindopril group were significantly lower than those in model group(P<0.05),and the inhibitory effects of CTGF,TSP-1 and TIMP-1 in Luhong Formula group were similar to those in Perindopril group(P>0.05).[Conclusion]Luhong Formula can significantly inhibit myocardial fibrosis after myocardial infarction,and its mechanism is related to up-regulating STAT3 level and inhibiting the secretion of pro-fibrotic factors CTGF,TSP-1 and TIMP-1.

Objective: To investigate the prevalence of sleep problems and influencing factors among preschoolers, so as to provide a reference for healthy sleep behaviors among preschoolers. Methods: From December 2017 to June 2018, a questionnaires study was administered to parents of 8 456 preschoolers from kindergartens in Yangzhou, Zhenjiang and Xuzhou by using random cluster sampling method. Demographic characteristics, screen time, sleep patterns and the Children s Sleep Habits Questionnaire (CSHQ) were colleted. Results: The average night sleep duration was (9.91±0.64)h, the rate of sleep deprivation was 51.7%, which increased with age ( χ 2 trend =34.19, P <0.01). The total scores of CSHQ were (49.46±5.02), and the prevalence of sleep problems was 95.0%, with the prevalence of specific sleep problems ranged from 2.3% to 76.4%. Multivariate Logistic regression analysis showed that only child, mothers age, parental education, and household economic status was significantly associated the sleep problems ( P <0.05). Conclusion The prevalence of sleep problems among preschool children is more prominent, varies by only child, parental education and household economic status. Parents and society should raise awareness of sleep problems.

Objective:To evaluate internal fixation via only the modified Stoppa approach in the treatment of central hip dislocation complicated with fracture of the posterior acetabular wall.Methods:A retrospective study was conducted in the 13 patients with central hip dislocation and fracture of the posterior acetabular wall who had been treated at Department of Orthopedic Trauma, Nanfang Hospital between February 2015 and February 2018. They were 10 men and 3 women, aged from 31 to 65 years (average, 46.7 years). All patients were treated with internal fixation via only the modified Stoppa approach. The reduction of double-column and posterior wall fractures was evaluated according to the X-ray Matta scoring system, as well as to the Wiberg central-edge (CE) angles between the vertical line of the center point of the femoral head and the lateral edge of the acetabulum and acetabular tolerance on the normal and affected sides immediately after operation; the hip function was evaluated by the modified Merle d'Aubigne and Postel scoring system at 12 months after operation.Results:All patients were followed up for 16 to 52 months (average, 25.6 months). In all of them, reduction and fixation of central hip dislocation and acetabular fracture was completed successfully, and indirect reduction of posterior wall fracture and acetabular tolerance were satisfactory. Operation time ranged from 130 to 270 min, averaging 155.5 min; intraoperative blood loss from 600 to 5,600 mL, averaging 1,150.5 mL; intraoperative infusion of concentrated red blood cells from 2 to 12 U, averaging 6 U. By the X-ray Matta scoring system immediately after operation, anatomical reduction was achieved in 4 posterior wall fractures and satisfactory reduction in 9 ones. There was no significant difference between the normal and affected sides in the CE angle (43.53°±3.46° for the affected side versus 43.19°±3.28° for the normal side) or in the acetabular tolerance (76.56%±15.50% for the affected side versus 75.32%±16.24% for the normal side) ( P>0.05). The modified Merle d'Aubigne and Postel scores at 12 months after operation ranged from 12 to 18 points, averaging 16.5 points; the hip function was assessed as excellent in 9 cases, as good in 3 and as fair in one. By the last follow-up, none of the 13 patients lost fracture reduction, and their internal fixation was firm with no loosening or breakage. Conclusion:In the treatment of central hip dislocation complicated with fracture of the posterior acetabular wall, internal fixation via only the modified Stoppa approach can lead to satisfactory fracture reduction, firm fixation, good hip joint tolerance, and fine clinical efficacy.