1.Visualization analysis and clinical interpretability evaluation of artificial intelligence-assisted tongue diagnosis
Lihui Liu ; Kaiwen Hu ; Yana Zhou
Digital Chinese Medicine 2026;9(2):223-240
Objective:
To map the research landscape of artificial intelligence (AI)-assisted tongue diagnosis through bibliometric analysis and to quantify its diagnostic accuracy and clinical interpretability through a diagnostic test accuracy (DTA) meta-analysis.
Methods:
For the bibliometric analysis, the Web of Science Core Collection (WoSCC) was queried for English-language articles and reviews on AI-assisted tongue diagnosis published between January 1, 2014 and December 31, 2025, and analysed using Bibliometrix, VOSviewer, and CiteSpace, with major output dimensions including annual publication output and disciplinary distribution, journal and citation characteristics, country/region and institutional collaboration, author networks, keyword co-occurrence, and keyword burst detection. For the DTA meta-analysis, four databases [Scopus, PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI)] were searched in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy (PRISMA-DTA) guidelines. A bivariate random-effects model hierarchical summary receiver operating characteristic (HSROC) was used to pool sensitivity and specificity, with subgroup analyses by disease category, AI model architecture, and sample-size strata. Methodological quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2) tool, and publication bias was evaluated by Deeks’ funnel plot asymmetry test.
Results:
A total of 198 publications met the bibliometric eligibility criteria. Annual output increased 24.5-fold (from 2 in 2014 to 49 in 2025), with the period 2022 – 2025 alone accounting for 65.2% of all publications. China contributed approximately 83.5% of all institutional affiliations, with Shanghai University of Traditional Chinese Medicine and Jiatuo Xu being the most productive institution and author, respectively. Keyword analysis identified four thematic clusters (AI and deep-learning architectures, image processing and segmentation, traditional Chinese medicine (TCM)-specific applications, and disease-specific applications) and a temporal evolution from traditional machine learning to deep learning and transformer-based, explainable, and multimodal AI architectures. Sixteen DTA meta-analysis studies (14 755 participants) covering metabolic and hepatic disorders, oncological and oral lesions, cardiovascular risk, diabetes, and other clinical applications were included in the DTA meta-analysis. The pooled sensitivity was 90.3% [95% confidence interval (CI): 86.7% – 93.1%] and the pooled specificity was 93.0% (95% CI: 90.6% – 94.7%); the area under the summary receiver operating characteristic (SROC) curve (AUC) was 0.961. Heterogeneity was substantial (I2 = 95.8% for sensitivity; I2 = 92.1% for specificity). Subgroup performance was broadly consistent across disease categories, AI architectures, and sample-size strata, and Deeks’ test indicated no significant publication bias (P = 0.258).
Conclusion
AI-assisted tongue diagnosis has progressed rapidly and shows pooled diagnostic performance comparable to established screening modalities, supporting its potential as a complementary and easily accessible decision-support tool.
2.Relationship between AT1-AA levels in uterine fluid and the thickness of endometrium in infertile women with chronic endometritis
Jiahui ZHOU ; Guifang YANG ; De SONG ; Yinan ZHANG ; Yao CHEN ; Xuemin LI ; Yana YU ; Yuhui SHI ; Wenli ZHU ; Xiaoli YANG
Chinese Journal of Obstetrics and Gynecology 2025;60(7):520-527
Objective:To investigate the relationship between the level of angiotensin Ⅱ type 1 receptor autoantibody (AT1-AA) in the uterine fluid and the thickness of endometrium in infertile women with chronic endometritis.Methods:A case-control study was conducted to select 122 patients who underwent hysteroscopy and endometrial tissue biopsy at Assisted Reproduction Center, Taiyuan Central Hospital due to infertility from March 2023 to January 2024 as the study subjects. According to the results of hysteroscopy and endometrial tissue biopsy, the patients were divided into 52 cases in the infertility group with normal endometrium (NE infertility group) and the chronic endometritis combined with infertility group (CE infertility group) with 70 cases. Enzyme-linked immunosorbent assay was used to detect the level of AT1-AA in uterine fluid of the two groups. General clinical data, AT1-AA absorbance value of uterine fluid and uterine related indexes of the two groups were analyzed, and the correlations between AT1-AA level and the variation of indexes were analyzed.Results:Gravidity (median: 1 vs 1; Z=7.029, P=0.030) and parity (median: 0 vs 0; Z=12.258, P=0.002) in CE infertility group were higher than those in NE infertility group. There was AT1-AA in the uterine fluid, and the level of AT1-AA in CE infertility group was significantly higher than that in NE infertility group (median: 2.07 vs 1.44; Z=3.099, P=0.029). The endometrial thickness of CE infertility group was lower than that of NE infertility group (median: 6.0 vs 7.0 mm; Z=-2.179, P=0.029), and there were no statistical differences in other indexes between the two groups (all P>0.05). Further correlation analysis showed that there were no correlation between the level of AT1-AA in uterine fluid and parity, endometrial thickness, gravidity in NE infertility group (all P>0.05). However, the level of AT1-AA in uterine fluid of CE infertility group was positively correlated with parity (Spearman′s r=0.339, P=0.004), and negatively correlated with endometrial thickness (Spearman′s r=-0.499, P<0.001), but not correlated with gravidity ( P>0.05). Conclusions:AT1-AA is present in the uterine fluid of infertile women. The elevated level of AT1-AA in uterine fluid of infertile women with CE is related to the thinning of the endometrium.
3.Effects of Moving Pattern on Dipping Thickness Distributions in Polymer Heart Valve
Haiyang WEI ; Zheng LI ; Qianwen HOU ; Yana MENG ; Liangwei ZHU ; Enhui HAN ; Jianjun HU ; Jianye ZHOU
Journal of Medical Biomechanics 2025;40(4):1012-1019
Objective To explore the impact of different moving patterns during the dip-coating process on thickness distributions of polymer heart valves.Methods Based on the volume of fluid(VOF)multiphase flow model,the Eulerian wall-film(EWF)model,and dynamic mesh technology,the dip-coating manufacturing process of polymer heart valves were numerically simulated.The effects of vertical,horizontal,and circular moving patterns on flow characteristics of the surface impregnation liquid and liquid film distributions under self-rotation conditions of the models were mainly studied.Subsequently,seven identical test points were set on each valve leaflet to collect thickness data,and the coefficient of variation(CV)was calculated to evaluate the uniformity of the liquid film thickness.Given that the vertical and horizontal patterns had fewer moving planes,limiting the optimization space,the circular pattern(45°)with richer moving planes was selected as the basis for optimization,and comparative analysis of numerical simulation was conducted.Results In the vertical pattern,the peak CV was 0.461 3;in the horizontal pattern,the CV was 0.060 8;and in the circular pattern,the CV at 30°,45° and 60° were 0.457 5,0.272 8,and 0.255 6,respectively.After optimization,the CV for the circular pattern(45°)decreased to 0.052 5,representing an 80.7%reduction compared to the pre-optimization value.Conclusions The moving patterns significantly affect the uniformity of dip-coating thickness distributions.The horizontal pattern demonstrates the best uniformity,while the vertical pattern shows the poorest uniformity.The CV for the circular pattern decreases as the angle increases,with its uniformity between that of the vertical and horizontal patterns.Optimization of moving pattern parameters based on simulation results has improved the uniformity of thickness distributions.
4.Flow Field Characteristics of Aortic Valve with Eccentric Lower Valve Placement:A PIV Experimental Study
Enhui HAN ; Qianwen HOU ; Yang XIAO ; Yana MENG ; Haiyang WEI ; Yu JIANG ; Jianjun HU ; Jianye ZHOU
Journal of Medical Biomechanics 2025;40(1):25-33
Objective To investigate the impact of eccentric placement for various types of artificial aortic valves on downstream flow dynamics.Methods A physiological pulsatile circulation simulation system was employed and particle image velocimetry(PIV)was utilized to analyze the downstream flow field variations for bioprosthetic and mechanical valves under two placement conditions:centralized placement(0 mm)and eccentric placement(1 mm).Hemodynamic parameters such as velocity,vorticity,and viscous shear stress were assessed to evaluate the flow field characteristics.Results By analyzing the flow field variations at four characteristic time points,namely,early systole,acceleration phase,peak systole,and deceleration phase,a significant difference in flow field distribution between bioprosthetic and mechanical valves was observed.The bioprosthetic valve exhibited a centrally symmetric jet with a higher flow velocity,whereas the mechanical valve displayed a three-jet structure with a lower central flow velocity.Under eccentric placement,the blood flow in the aortic sinus region was sluggish,with a reduction in average velocity,hindering the formation and maintenance of vortices.During the peak systolic phase,the maximum viscous shear stresses in the sinus region for the bioprosthetic and mechanical valves were 0.45 and 0.67 Pa,respectively,approaching the threshold for endothelial cell damage.Conclusions Eccentric placement of both mechanical and bioprosthetic valves resulted in reduced sinus blood flow velocity and diminished viscous shear stress,creating favorable conditions for thrombus formation.In clinical practice,careful attention should be given to the placement of valve replacement to prevent eccentric placement.
5.Experimental Evaluation of the Clinical Laboratory ELISA Assay Using A Randomization Quality Control Method for Indoor Quality Control
Zhijun GAO ; Jianjun LI ; Yin CAI ; Yana REN ; Mengchen XIE ; Lan ZHENG ; Guoping ZHOU
Journal of Modern Laboratory Medicine 2025;40(3):199-202
Objective To evaluate the application of ELISA randomized quality control,and continuously improve the laboratory testing capacity and quality assurance,in order to gradually improve the application of randomized quality control to the daily testing of ELISA.Methods Collected the quality control data of KEHUA HBsAg,compared the difference between randomized quality control data and immobilized quality control data.Group comparison of randomization quality control between rows and columns.The randomized quality control data were analyzed retrospectively and the quality control chart was established by using the randomized quality control data.Analyzed and compared the lost-control situation of randomized quality control and immobilized quality control.Results Randomized quality control S/CO value(2.831±0.343)and immobilized quality control S/CO value(2.651±0.260)in the same microplate,the difference between two was statistically significant(t=5.970,P<0.05).The differences between randomized quality control and immobilized quality control in columns 2 to 8 were statistically significant(t=2.285~5.536,all P<0.05).There were no statistically significant differences between randomized quality control and immobilized quality control in column 9 to 12(t=0.031~1.605,all P>0.05).There was no statistically significant difference in randomization quality control among all lines(F=0.858,P>0.05).The randomized quality control data was used to establish a quality control chart.Within the time range of the collected data,the randomized quality control was out of control for 6 times,all were greater than+3s,and the loss of control rate was 4.72%(6/127).Fixed position quality control lost control 9 times during the same period,all of which were greater than+3s,with a loss of control rate of 0.61%(9/1 481).Conclusion The randomized quality control has a greater possibility to reflect the factors affecting all the samples on the microporous plate.Random quality control can be used to find possible systematic errors in testing.Randomized quality control can gradually be fully applied to daily indoor quality control,but the loss of control rate and coefficient of variation may increase.
6.Relationship between AT1-AA levels in uterine fluid and the thickness of endometrium in infertile women with chronic endometritis
Jiahui ZHOU ; Guifang YANG ; De SONG ; Yinan ZHANG ; Yao CHEN ; Xuemin LI ; Yana YU ; Yuhui SHI ; Wenli ZHU ; Xiaoli YANG
Chinese Journal of Obstetrics and Gynecology 2025;60(7):520-527
Objective:To investigate the relationship between the level of angiotensin Ⅱ type 1 receptor autoantibody (AT1-AA) in the uterine fluid and the thickness of endometrium in infertile women with chronic endometritis.Methods:A case-control study was conducted to select 122 patients who underwent hysteroscopy and endometrial tissue biopsy at Assisted Reproduction Center, Taiyuan Central Hospital due to infertility from March 2023 to January 2024 as the study subjects. According to the results of hysteroscopy and endometrial tissue biopsy, the patients were divided into 52 cases in the infertility group with normal endometrium (NE infertility group) and the chronic endometritis combined with infertility group (CE infertility group) with 70 cases. Enzyme-linked immunosorbent assay was used to detect the level of AT1-AA in uterine fluid of the two groups. General clinical data, AT1-AA absorbance value of uterine fluid and uterine related indexes of the two groups were analyzed, and the correlations between AT1-AA level and the variation of indexes were analyzed.Results:Gravidity (median: 1 vs 1; Z=7.029, P=0.030) and parity (median: 0 vs 0; Z=12.258, P=0.002) in CE infertility group were higher than those in NE infertility group. There was AT1-AA in the uterine fluid, and the level of AT1-AA in CE infertility group was significantly higher than that in NE infertility group (median: 2.07 vs 1.44; Z=3.099, P=0.029). The endometrial thickness of CE infertility group was lower than that of NE infertility group (median: 6.0 vs 7.0 mm; Z=-2.179, P=0.029), and there were no statistical differences in other indexes between the two groups (all P>0.05). Further correlation analysis showed that there were no correlation between the level of AT1-AA in uterine fluid and parity, endometrial thickness, gravidity in NE infertility group (all P>0.05). However, the level of AT1-AA in uterine fluid of CE infertility group was positively correlated with parity (Spearman′s r=0.339, P=0.004), and negatively correlated with endometrial thickness (Spearman′s r=-0.499, P<0.001), but not correlated with gravidity ( P>0.05). Conclusions:AT1-AA is present in the uterine fluid of infertile women. The elevated level of AT1-AA in uterine fluid of infertile women with CE is related to the thinning of the endometrium.
7.Experimental Evaluation of the Clinical Laboratory ELISA Assay Using A Randomization Quality Control Method for Indoor Quality Control
Zhijun GAO ; Jianjun LI ; Yin CAI ; Yana REN ; Mengchen XIE ; Lan ZHENG ; Guoping ZHOU
Journal of Modern Laboratory Medicine 2025;40(3):199-202
Objective To evaluate the application of ELISA randomized quality control,and continuously improve the laboratory testing capacity and quality assurance,in order to gradually improve the application of randomized quality control to the daily testing of ELISA.Methods Collected the quality control data of KEHUA HBsAg,compared the difference between randomized quality control data and immobilized quality control data.Group comparison of randomization quality control between rows and columns.The randomized quality control data were analyzed retrospectively and the quality control chart was established by using the randomized quality control data.Analyzed and compared the lost-control situation of randomized quality control and immobilized quality control.Results Randomized quality control S/CO value(2.831±0.343)and immobilized quality control S/CO value(2.651±0.260)in the same microplate,the difference between two was statistically significant(t=5.970,P<0.05).The differences between randomized quality control and immobilized quality control in columns 2 to 8 were statistically significant(t=2.285~5.536,all P<0.05).There were no statistically significant differences between randomized quality control and immobilized quality control in column 9 to 12(t=0.031~1.605,all P>0.05).There was no statistically significant difference in randomization quality control among all lines(F=0.858,P>0.05).The randomized quality control data was used to establish a quality control chart.Within the time range of the collected data,the randomized quality control was out of control for 6 times,all were greater than+3s,and the loss of control rate was 4.72%(6/127).Fixed position quality control lost control 9 times during the same period,all of which were greater than+3s,with a loss of control rate of 0.61%(9/1 481).Conclusion The randomized quality control has a greater possibility to reflect the factors affecting all the samples on the microporous plate.Random quality control can be used to find possible systematic errors in testing.Randomized quality control can gradually be fully applied to daily indoor quality control,but the loss of control rate and coefficient of variation may increase.
8.Effects of Moving Pattern on Dipping Thickness Distributions in Polymer Heart Valve
Haiyang WEI ; Zheng LI ; Qianwen HOU ; Yana MENG ; Liangwei ZHU ; Enhui HAN ; Jianjun HU ; Jianye ZHOU
Journal of Medical Biomechanics 2025;40(4):1012-1019
Objective To explore the impact of different moving patterns during the dip-coating process on thickness distributions of polymer heart valves.Methods Based on the volume of fluid(VOF)multiphase flow model,the Eulerian wall-film(EWF)model,and dynamic mesh technology,the dip-coating manufacturing process of polymer heart valves were numerically simulated.The effects of vertical,horizontal,and circular moving patterns on flow characteristics of the surface impregnation liquid and liquid film distributions under self-rotation conditions of the models were mainly studied.Subsequently,seven identical test points were set on each valve leaflet to collect thickness data,and the coefficient of variation(CV)was calculated to evaluate the uniformity of the liquid film thickness.Given that the vertical and horizontal patterns had fewer moving planes,limiting the optimization space,the circular pattern(45°)with richer moving planes was selected as the basis for optimization,and comparative analysis of numerical simulation was conducted.Results In the vertical pattern,the peak CV was 0.461 3;in the horizontal pattern,the CV was 0.060 8;and in the circular pattern,the CV at 30°,45° and 60° were 0.457 5,0.272 8,and 0.255 6,respectively.After optimization,the CV for the circular pattern(45°)decreased to 0.052 5,representing an 80.7%reduction compared to the pre-optimization value.Conclusions The moving patterns significantly affect the uniformity of dip-coating thickness distributions.The horizontal pattern demonstrates the best uniformity,while the vertical pattern shows the poorest uniformity.The CV for the circular pattern decreases as the angle increases,with its uniformity between that of the vertical and horizontal patterns.Optimization of moving pattern parameters based on simulation results has improved the uniformity of thickness distributions.
9.Flow Field Characteristics of Aortic Valve with Eccentric Lower Valve Placement:A PIV Experimental Study
Enhui HAN ; Qianwen HOU ; Yang XIAO ; Yana MENG ; Haiyang WEI ; Yu JIANG ; Jianjun HU ; Jianye ZHOU
Journal of Medical Biomechanics 2025;40(1):25-33
Objective To investigate the impact of eccentric placement for various types of artificial aortic valves on downstream flow dynamics.Methods A physiological pulsatile circulation simulation system was employed and particle image velocimetry(PIV)was utilized to analyze the downstream flow field variations for bioprosthetic and mechanical valves under two placement conditions:centralized placement(0 mm)and eccentric placement(1 mm).Hemodynamic parameters such as velocity,vorticity,and viscous shear stress were assessed to evaluate the flow field characteristics.Results By analyzing the flow field variations at four characteristic time points,namely,early systole,acceleration phase,peak systole,and deceleration phase,a significant difference in flow field distribution between bioprosthetic and mechanical valves was observed.The bioprosthetic valve exhibited a centrally symmetric jet with a higher flow velocity,whereas the mechanical valve displayed a three-jet structure with a lower central flow velocity.Under eccentric placement,the blood flow in the aortic sinus region was sluggish,with a reduction in average velocity,hindering the formation and maintenance of vortices.During the peak systolic phase,the maximum viscous shear stresses in the sinus region for the bioprosthetic and mechanical valves were 0.45 and 0.67 Pa,respectively,approaching the threshold for endothelial cell damage.Conclusions Eccentric placement of both mechanical and bioprosthetic valves resulted in reduced sinus blood flow velocity and diminished viscous shear stress,creating favorable conditions for thrombus formation.In clinical practice,careful attention should be given to the placement of valve replacement to prevent eccentric placement.
10.Prevention of Spontaneous Premature Birth With Cervical Pessary:A Single-Center Prospective Cohort Study
Zhiwei XUE ; Yana LIU ; Ke WANG ; Linyi YANG ; Jie RUAN ; Xinghui LIU ; Shu ZHOU
Journal of Sichuan University (Medical Sciences) 2024;55(4):1007-1013
Objective To study and compare the clinical effects of cervical pessary and progesterone for preventing preterm birth in singleton pregnant women with a short cervical length(CL).Methods This study was a prospective cohort study.A total of 148 pregnant women with CL≤25 mm,as determined by ultrasound examination performed before 28 weeks of pregnancy,were included in the study.All subjects were admitted to West China Second Hospital,Sichuan University between August 2020 and December 2022.According to their treatment plans,the pregnant women were divided into a cervical pessary group(n=55)and a progesterone group(n=93).Spontaneous preterm birth before 37 weeks of pregnancy was defined as the main outcome index.Preterm birth(abortion)or spontaneous preterm birth(abortion)before 37,34,32,30,and 28 weeks of pregnancy,mean extended gestational age,neonatal morbidity,and neonatal mortality were the secondary outcome indicators.The pregnancy outcomes and the neonatal outcomes of the two groups were compared and statistically analyzed.Results There was no statistically significant difference in the incidence of preterm birth(including iatrogenic preterm birth,spontaneous preterm birth,and abortion)before 37,34,32,30,and 28 weeks between the cervical pessary group and the progesterone group.When iatrogenic preterm birth was excluded,the incidence of spontaneous preterm birth before 37 weeks was lower in the cervical pessary group(23.6%)than that in the progesterone group(41.9%),with the difference between the two groups being statistically significant(P=0.024).There was no statistically significant difference in the incidence of spontaneous preterm birth(including miscarriage)before 34,32,30,and 28 weeks.There was no statistically significant difference in the incidence of neonatal morbidity,the rate of transfer to the neonatal care unit after birth,and the neonatal mortality rate between the two groups.Multivariate logistic analysis showed that treatment with cervical pessary was a protective factor for spontaneous preterm birth before 37 weeks compared to progesterone therapy.Conclusion Using cervical pessary to prevent spontaneous preterm birth in singleton pregnant women with a short cervical length in the second trimester can significantly reduce the incidence of spontaneous preterm birth before 37 weeks.

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