Objective To investigate the primary symptoms of the common syndrome types in chronic gastritis through complex system modeling method,thus to provide evidence for the objectivity of the differentiation of traditional Chinese medicine(TCM)syndrome in chronic gastritis.Methods The complex system modeling methods of random forest,mutual information,rough sets,affinity propagation clustering and discriminant analysis were comprehensively used to screen the primary symptoms for the diagnosis of common syndrome types in chronic gastritis,such as syndrome of damp turbidity obstruction in the middle energizer,syndrome of spleen and stomach qi deficiency,syndrome of deficiency-cold in spleen and stomach,syndrome of liver depression and qi stagnation,and syndrome of stagnated heat in liver and stomach.And then the relationship between symptoms and syndromes types,and the relationship between symptoms and symptoms were mined.The diagnostic efficiency of the primary symptoms of chronic gastritis was evaluated by the discriminant analysis interactive validation method and the area under the receiver operating characteristic curve(AUC).Results The specific symptoms positively correlated with the syndrome of damp turbidity obstruction in the middle energizer were greasy coating,tooth-marked tongue,thick coating and enlarged tongue,while red tongue,thin coating and yellow coating were the identification symptoms negatively correlated with the syndrome,and their prediction accuracy was 79.2%with the AUC value being 0.868.The specific symptoms positively correlated with the syndrome of spleen and stomach qi deficiency were weakness,white coating,tooth-marked tongue,pale lip,and loose stools,while the identification symptoms negatively correlated with the syndrome were greasy moss and red tongue,and their prediction accuracy was 75.5%with the AUC value being 0.830.The specific symptoms positively correlated with the syndrome of deficiency-cold in spleen and stomach were cold limbs,preference of warmth in the epigastrium,and thin coating,while no identification symptoms negatively correlated with the syndrome,and their predictive accuracy was 79.2%with the AUC value being 0.836.The specific symptoms positively correlated with the syndrome of liver depression and qi stagnation were symptom aggravation due to emotional factors,distention or pain over hypochondriac region and belching,while the identification symptoms negatively correlated with the syndrome were weakness and greasy coating,and their predictive accuracy was 74.1%with the AUC value being 0.818.The specific symptoms positively correlated with the syndrome of stagnated heat in liver and stomach were red tongue,distention or pain over hypochondriac region and red lips,while the identification symptoms negatively correlated with the syndrome were greasy coating,white coating and thick coating,and their predictive accuracy was 79.9%with the AUC value being 0.845.The specific symptoms positively correlated with the common syndrome types in chronic gastritis mainly involved spleen,stomach and liver,and the disease-nature syndrome elements covered damp turbidity,qi deficiency,blood deficiency,cold dampness,yang deficiency,qi stagnation and heat.Conclusion The primary symptoms for the common syndrome types in chronic gastritis screened out through comprehensive application of complex system modeling methods are basically consistent with TCM theories,clinical practices and previous diagnostic criteria.Tongue and lip manifestations account for the largest proportion of the primary symptoms,indicating that tongue diagnosis and lip diagnosis are of great significance for the diagnosis of TCM syndrome types in chronic gastritis.

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome