Traditional Chinese medicine （TCM） diagnosis is a cognitive process where practitioners rely on their subjective clinical experience and clinical perception abilities to comprehensively integrate the four examinations and flexibly differentiate syndromes， embodying a simple humanistic concern for the state of life. The essential characteristics of the subjectivity and experience of TCM diagnosis determine that there is a threshold in the syndrome differentiation capability of the artificial intelligence （AI）-based TCM diagnostic systems， which refers to a critical point of capability in the process of simulating the syndrome differentiation thinking， due to its inability to replicate the subjective cognition， clinical perception， and humanistic care of the practitioners. Furthermore， this threshold encompasses both a technical threshold and a theoretical threshold. Based on the above analysis， four human-machine collaborative practice paths are proposed to balance the application of AI technology and the subjectivity of TCM syndrome differentiation， including clarifying the auxiliary diagnosis and treatment positioning of AI， optimizing algorithms to achieve technical adaptation， strengthening the cultivation of the practitioner's subjectivity， and promoting interdisciplinary cross-collaboration， aiming to provide theoretical references for the development of AI-based TCM diagnostic systems towards human-machine collaborative clinical applications.

As the defining characteristic and essence of traditional Chinese medicine(TCM),the integration of disease and syndrome,along with the correlation between syndrome and prescription,forms the foundation for syndrome differentiation and treatment,and guides the clinical diagnosis and treatment practice of TCM.However,key scientific questions remain unresolved regarding the"disease-syndrome-prescription"framework,particularly the biological basis of diseases and syndromes,the active pharmacodynamic constituents of compound formulas,and their mechanism of action.Furthermore,a systematic paradigm for investigating"disease-syndrome-prescription"relationships has not been established,restricting the innovation and development of TCM theory and practice.Xiaoyao Powder,which was first described in a medical book named Taiping Huimin Heji Ju Fang written during the Song Dynasty of China,disperses stagnated liver qi for relieving qi stagnation,thus nourishing the blood and strengthening the spleen,making it a representative prescription for addressing depression due to liver qi stagnation and spleen deficiency under the guidance of correspondence between syndrome and prescription.Therefore,base on the combination of disease and syndrome,and correspondence between syndrome and prescription,investigating the formula-syndrome scientific connotation of Xiaoyao Powder and exploring the research paradigm for the"disease-syndrome-prescription"can provide insights into TCM theory from the perspective of modern science.

As a major global public health concern,the incidence of depression disorder is increasing annually.The pathological mechanism of depression involves bidirectional dysregulation between the hypothalamic-pituitary-adrenal(HPA)and gut-brain axes.According to traditional Chinese medicine(TCM),the liver controls conveyance and dispersion,the spleen governs transportation and transformation,and both jointly maintain the balance between ascending and descending qi movement and zang fu viscera function in the body.Liver qi stagnation and spleen deficiency result in qi movement disorder and a lack of source qi and blood,leading to depression induced by malnutrition of heart spirit.As a classic prescription for soothing the liver,invigorating the spleen,and replenishing blood,Xiaoyao Powder is used to reinforce healthy qi and eliminate pathogenic factors.Xiaoyao Powder not only regulates the"yin in property of liver"but also strengthens the"ascending and descending"of the spleen.As commonly used by ancient and modern physicians,also indirectly inhibits HPA axis upregulation and improves depression-related gastrointestinal dysfunction.This paper systematically expounds the multi-dimensional mechanism of Xiaoyao Powder in treating depression through the two-way regulation of the HPA-gut-brain axis.It reveals the therapeutic characteristics of"multi-component and multi-target"in TCM to provide a novel theoretical basis for the modernization of TCM and the treatment of depression by combining TCM and Western medicine.

Depression is closely associated with a neuro-endocrine-immune(NEI)system imbalance.The"excessive vitality leading to restraint and counter-regulation(Kang Hai Cheng Zhi)"theory elucidates the self-regulating mechanism for maintaining dynamic equilibrium in the body,and serves as an importance principle guiding treatment formulation and medication selection.Based on the correlation between NEI system imbalance and the traditional Chinese medicine pathogenesis of depression,and integrating the"Kang Hai Cheng Zhi"theory,the author posits that the pathogenesis of depression lies in overactive liver invading spleen,earth dampness impeding wood′s ascendancy,and disharmony between body and mind,as well as imbalance in storage and discharge functions of liver and kidney,disharmony between Yin and Yang,and disrupted counter-regulation.This dosely aligns with two key pathological methanisms at the micro level:microglial-limbic system homeostatic imbalance and hypothalamic-pituitary-adrenal axis-inflammatory circuit dysregulation.Clinically,the treatment principle for depression adheres to supporting the counter-regulation to restrain excess,with herbal interventions using strategies such as restraining wood to support earth,dredging earth to unblock wood,and harmonizing pivotal functions,as well as nourishing water to nurture wood,warming kidney to tonify liver,and relieving depression to calm the spirit.These approaches aim to regulate the liver,spleen,and kidney,embodying the core therapeutic tenet of"striving for equilibrium,"thereby restoring the body′s self-regulating capability.

As the defining characteristic and essence of traditional Chinese medicine(TCM),the integration of disease and syndrome,along with the correlation between syndrome and prescription,forms the foundation for syndrome differentiation and treatment,and guides the clinical diagnosis and treatment practice of TCM.However,key scientific questions remain unresolved regarding the"disease-syndrome-prescription"framework,particularly the biological basis of diseases and syndromes,the active pharmacodynamic constituents of compound formulas,and their mechanism of action.Furthermore,a systematic paradigm for investigating"disease-syndrome-prescription"relationships has not been established,restricting the innovation and development of TCM theory and practice.Xiaoyao Powder,which was first described in a medical book named Taiping Huimin Heji Ju Fang written during the Song Dynasty of China,disperses stagnated liver qi for relieving qi stagnation,thus nourishing the blood and strengthening the spleen,making it a representative prescription for addressing depression due to liver qi stagnation and spleen deficiency under the guidance of correspondence between syndrome and prescription.Therefore,base on the combination of disease and syndrome,and correspondence between syndrome and prescription,investigating the formula-syndrome scientific connotation of Xiaoyao Powder and exploring the research paradigm for the"disease-syndrome-prescription"can provide insights into TCM theory from the perspective of modern science.

As a major global public health concern,the incidence of depression disorder is increasing annually.The pathological mechanism of depression involves bidirectional dysregulation between the hypothalamic-pituitary-adrenal(HPA)and gut-brain axes.According to traditional Chinese medicine(TCM),the liver controls conveyance and dispersion,the spleen governs transportation and transformation,and both jointly maintain the balance between ascending and descending qi movement and zang fu viscera function in the body.Liver qi stagnation and spleen deficiency result in qi movement disorder and a lack of source qi and blood,leading to depression induced by malnutrition of heart spirit.As a classic prescription for soothing the liver,invigorating the spleen,and replenishing blood,Xiaoyao Powder is used to reinforce healthy qi and eliminate pathogenic factors.Xiaoyao Powder not only regulates the"yin in property of liver"but also strengthens the"ascending and descending"of the spleen.As commonly used by ancient and modern physicians,also indirectly inhibits HPA axis upregulation and improves depression-related gastrointestinal dysfunction.This paper systematically expounds the multi-dimensional mechanism of Xiaoyao Powder in treating depression through the two-way regulation of the HPA-gut-brain axis.It reveals the therapeutic characteristics of"multi-component and multi-target"in TCM to provide a novel theoretical basis for the modernization of TCM and the treatment of depression by combining TCM and Western medicine.

Depression is closely associated with a neuro-endocrine-immune(NEI)system imbalance.The"excessive vitality leading to restraint and counter-regulation(Kang Hai Cheng Zhi)"theory elucidates the self-regulating mechanism for maintaining dynamic equilibrium in the body,and serves as an importance principle guiding treatment formulation and medication selection.Based on the correlation between NEI system imbalance and the traditional Chinese medicine pathogenesis of depression,and integrating the"Kang Hai Cheng Zhi"theory,the author posits that the pathogenesis of depression lies in overactive liver invading spleen,earth dampness impeding wood′s ascendancy,and disharmony between body and mind,as well as imbalance in storage and discharge functions of liver and kidney,disharmony between Yin and Yang,and disrupted counter-regulation.This dosely aligns with two key pathological methanisms at the micro level:microglial-limbic system homeostatic imbalance and hypothalamic-pituitary-adrenal axis-inflammatory circuit dysregulation.Clinically,the treatment principle for depression adheres to supporting the counter-regulation to restrain excess,with herbal interventions using strategies such as restraining wood to support earth,dredging earth to unblock wood,and harmonizing pivotal functions,as well as nourishing water to nurture wood,warming kidney to tonify liver,and relieving depression to calm the spirit.These approaches aim to regulate the liver,spleen,and kidney,embodying the core therapeutic tenet of"striving for equilibrium,"thereby restoring the body′s self-regulating capability.

Objective:To evaluate the efficacy and safety of SPOT (GI Supply, USA), a new carbon-based permanent marker approved by the Food and Drug Administration (FDA), in the endoscopic marking for gastrointestinal lesions.Methods:A total of 115 patients with gastrointestinal lesions who underwent endoscopic treatment or surgery in Beijing Friendship Hospital or Beijing Chao-Yang Hospital from April 2019 to November 2019 were enrolled in the study. SPOT was used to mark the lesions, and marking points were found during endoscopic treatment or surgery to calculate the effective marking rate by single-group target value method. Adverse events after marking were recorded, and the changes of blood routine test, liver and kidney functions before and after marking were compared.Results:The effective rate of endoscopic marking with SPOT was 99.13% (114/115). The longest marking time was 57 days. There was no puncture of intestinal wall or injection into abdominal cavity during the marking process. One patient developed mild fever after marking. The incidence of adverse events was 23.48% (27/115), which were all unrelated to the test equipment. There was no significant difference in blood routine tests or liver and kidney functions before and after marking ( P>0.05). Conclusion:SPOT produced by GI Supply can effectively mark gastrointestinal lesions without serious adverse events, which meets the requirements of clinical use.

OBJECTIVE To evaluate the quality of Amomum tsao -ko from different origins and harvesting periods comprehensively. METHODS The contents of total volatile oil in A. tsao -ko were determined by volatile oil measurement method A stated in 2020 edition of Chinese Pharmacopoeia （part Ⅳ）；the contents of total flavonoids and total polyphenols in A. tsao -ko were determined by aluminum nitrate-sodium nitrite colorimetry and folin-ciocalteu method. The contents of α-pinene，β-pinene， 1，8-cineole，α-terpineol，geraniol and trans-nerolidol in the volatile oil of A. tsao -ko were determined by gas chromatography ；the contents of protocatechuate and vanillic acid in A. tsao -ko were determined by ulta high performance liquid chromatography. The above 11 indicators were selected ，and entropy weight TOPSIS method was used to comprehensively evaluate the quality of 16 batches of A. tsao -ko. RESULTS The contents of total volatile oil ，total flavonoids ，total polyphenols ，α-pinene，β-pinene， 1，8-cineole，α-terpineol，geraniol，trans-nerolidol，protocatechuate and vanillic acid in 16 batches of A. tsao -ko were 15.833 3- 28.000 0 μL/g，29.100 5-78.199 6 mg/g，6.789 8-35.797 7 mg/g，0.088 7-0.401 3 mg/g，0.106 3-0.408 0 mg/g，3.709 6-8.533 1 mg/g，0.259 8-0.599 6 mg/g，0.314 8-1.324 1 mg/g，0.272 3-0.576 4 mg/g，9.301 2-19.818 5 μg/g，8.180 9-27.666 3 μg/g， respectively. Entropy weight TOPSIS results showed that the top three of relative closeness rankings were A. tsao -ko produced by Yunnan Baoshan in July ，Yunnan Honghe in October ，Yunnan Wenshan in September ；the last three of relative closeness rankings were A. tsao -ko produced by Yunnan Dehong in September ，Yunnan Dehong in November ，Yunnan Dehong in December. CONCLUSIONS A. tsao -ko produced by Yunnan Baoshan in July ，Yunnan Honghe in October and Yunnan Wenshan in September present better quality.

The occurrence, development and outcome of most diseases are a complex process. It is the advantage of traditional Chinese medicine to establish complex interventions that are consistent with the characteristics of disease development. The specific steps are as follows: quantitative research on literature research, establishment of interview framework; focus on interviews, specificization of interview outlines; semi-structured interviews, preliminary construction of complex intervention programs; evaluation of efficacy of complex interventions. The introduction of semi-structured interviews and other qualitative research methods into the modernization of traditional Chinese medicine, combined with quantitative methods such as text analysis and data mining, is also helpful in formulating the standard of diagnosis and treatment system with Chinese characteristics.