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.

[Purpose]To analyze the prevalence and disease burden of malignant tumors in cancer registration areas of Hubei Province in 2020.[Methods]The incidence and mortality data of ma-lignant tumors in cancer registration areas in Hubei Province in 2020 were collected,and the data were quality controlled according to the quality evaluation standards and methods formulated by the National Cancer Center.The data from 24 registries met the inclusion criteria.Using descrip-tive epidemiological methods to calculate incidence/mortality rate,age-specific incidence/mortality rate,standardized incidence/mortality rate by Chinese standard population(ASRC),standardized incidence/mortality rate by world standard population(ASRW).Disability-adjusted life years(DALY)and DALY rates were calculated using formulas provided by the World Health Organization to as-sess the disease burden of malignant tumors.[Results]In 2020,the crude incidence of malignant tumors in cancer registration areas of Hubei Province was 311.36/105,the ASRC was 184.14/105,the ASRW was 197.37/105,and the cumulative rate of 0～74 years old was 20.52％.The age-spe-cific incidence of malignant tumors in the province and rural areas reached its peak in the age group of 75～79 years old,while in urban areas it reached its peak in the age group of 80～84 years old.In 2020,the crude mortality rate of malignant tumors in cancer registration areas of Hubei Province was 184.58/105,the ASRC was 96.91/105,the ASRW was 110.92/105,and the cumulative rate of 0～74 years old was 11.01％.The age-specific mortality rate of malignant tumors in the province and urban areas reached its peak in the age group of above 85 years old,while in rural areas it reached its peak in the age group of 80～84 years old.Lung cancer ranked first in the incidence and mortality of malignant tumors in the province.In the cancer registration area of Hubei Province,the DALY of malignant tumors in 2020 was 641 497 person-years,and the DALY rate was 28.6‰.[Conclusion]Common cancers such as lung cancer,female breast cancer and upper digestive tract cancer have a great impact on the incidence,mortality and disease burden of malignant tumors in Hubei Province.Targeted cancer screening and early diagnosis and treatment are the most effective means to improve social and economic benefits.

[Purpose]To analyze the epidemiological characteristics of lung cancer in 2020 and the trend from 2012 to 2020 in Hubei Province.[Methods]Qualified lung cancer registry data reported by 24 cancer registries in Hubei Province was utilized to estimate the number of new lung cancer cases and deaths.Incidence/mortality rate,age-specific incidence/mortality rate,age-standardized incidence/mortality rate by Chinese standard population(ASIRC and ASMRC)and by world stan-dard population(ASIRW and ASMRW),cumulative rate of 0～74 years old and other indicators of lung cancer in urban and rural areas,different sex,age groups in 2020 were calculated.Annual percentage change(APC),average annual percentage change(AAPC)and 95％confidence interval(CI)were calculated to analyze the trends of incidence and mortality of lung cancer in cancer regi-stration areas of Hubei Province from 2012 to 2020.[Results]In 2020,the estimated number of new lung cancer cases in Hubei Province was 41 531,accounting for 23.17％of all new cancer cases.The incidence rate was 72.13/105,with the ASIRC of 38.19/105 and ASIRW of 42.75/105 respectively.The cumulative incidence rate of 0～74 years old was 4.82％.The estimated number of lung cancer deaths in Hubei Province in 2020 was 31 374,accounting for 29.52％of all cancer deaths.The mortality rate was 54.49/105,with the ASMRC of 27.66/105 and ASMRW of 31.95/105,respectively.The cumulative mortality(0～74 years old)was 3.36％.The incidence of lung cancer was higher in urban areas than that in rural areas,and higher in men than that in women.The in-cidence and mortality of lung cancer increased with age,and reaching the peak in the age groups of 75～79 and 80～85 years old respectively.From 2012 to 2020,the overall trend of crude inci-dence and mortality of lung cancer in Hubei Province was stable.The ASIRC and ASMRC showed a slow decline during 2012-2020,with the AAPCs of-0.51％(95％CI:-1.06％～-0.02％)and-1.84％(95％CI:-2.65％～-0.53％),respectively.The ASIRC showed a slow decline(APC=-1.76％,95％CI:-3.30％～-1.03％)during 2012-2018 and increase trend(APC=3.33％,95％CI:0.61％～5.02％)during 2018-2020,respectively,while ASMRC showed a significant decrease trend(APC=-3.00％,95％CI:-6.58％～-1.13％)during 2016-2020.[Conclusion]The incidence and mortality levels of lung cancer in Hubei Province were relatively high,resulted in a heavy disease burden and no significant downward trend.In the future,we should continue to strengthen the compre-hensive prevention and treatment of lung cancer,and promote lung cancer screening and early diagno-sis and treatment for target populations vigorously,especially in rural areas.

[Purpose]To analyze the opportunistic screening results of upper gastrointestinal can-cer in Hubei Province from 2022 to 2023.[Methods]The data of upper gastrointestinal cancer opportunistic screening program in Hubei Province from January 1,2022 to December 31,2023 were summarized.The biopsy rate,positive lesion detection rate and early diagnosis rate were ana-lyzed.The differences in rates between/among different sexes,age groups and regions were com-pared by x2 test,trend x2 test.[Results]A total of 372 507 people were included in the oppor-tunistic screening of upper gastrointestinal cancer from 2022 to 2023.Among them,100 379 in-dividuals underwent biopsy histopathological examination,with a biopsy rate of 26.95％.A total of 4 678 positive cases(high-grade intraepithelial neoplasia,early-stage cancer and advanced can-cer)were detected in the opportunistic screening,with a positive lesion detection rate of 1.26％.The detection rates of positive lesion in the esophagus,cardia and stomach were 0.61％,0.07％and 0.58％,respectively.There were 721 cases of early upper gastrointestinal cancer(high-grade intraepithelial neoplasia,early-stage cancer),representing an early diagnosis rate of 15.41％.The early diagnosis rates for the esophagus,cardia and stomach were 14.53％,11.96％and 16.89％,respectively.[Conclusions]The implementation of opportunistic screening for upper gastrointesti-nal cancer is conducive to expanding the coverage of screening.It is necessary to strengthen stan-dardized and homogeneous training and complete high-quality endoscopic examination to improve the detection rate and early diagnosis rate of opportunistic screening program for upper gastroin-testinal cancer.

Malignant tumors,as chronic diseases that seriously affect human life and health,are one of the most serious public health problems worldwide in the 21st century.Hubei Province at-taches great importance to the prevention and control of chronic diseases such as cancer,and launched the"323"campaign in 2021.This paper reviews the progress of cancer prevention and control in the"323"campaign from 2021 to 2024 from the aspects of science popularization,tu-mor registration,cancer screening,standardized diagnosis and treatment,and grassroots capacity improvement,and explores the key points of cancer prevention and control work in Hubei Province in the next step.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

ObjectiveTo assess the therapeutic effectiveness and safety of the traditional Chinese medicine compound Shenlong decoction in addressing the symptoms of pulmonary deficiency and stasis in patients with idiopathic pulmonary fibrosis （IPF）. MethodsSixty eligible patients with lung deficiency and collateral stasis syndrome of IPF were randomly assigned to the observation （30 patients） and control groups （30 patients）. All patients underwent standard Western medical therapy. Additionally，the observation group received Shenlong decoction granules，while the control group received a placebo. Both treatments were packaged in four doses of 10.5 g each，taken twice daily for three months. The indexes of the patients during the treatment cycle were observed，and the main indexes include traditional Chinese medicine （TCM） syndrome scores and 6 min walk test （6MWT）. The secondary indexes include pulmonary function test ［actual value/expected value of total lung volume （TLC%），actual value/expected value of vital capacity（FVC%），actual/predicted diffusing capacity of the lung for carbon monoxide（DLCO%），actual/predicted forced expiratory volume in one second （FEV₁%），and FEV₁/ forced vital capacity （FVC）］，blood gas analysis ［arterial blood diathesis partial pressure of oxygen （PaO₂），partial pressure of carbon dioxide （PaCO₂），and arterial oxygen saturation （SaO₂）］，serum inflammatory factors ［transforming growth factor-β₁ （TGF-β₁），interleukin-4 （IL-4），interleukin-13 （IL-13），interleukin-12 （IL-12），and gamma-interferon （IFN-γ）］，and quality of survival evaluation ［St George's Respiratory Questionnaire （SGRQ） score］. The patients' clinical manifestations were determined at the end of the treatment， and the occurrence of adverse events was recorded. ResultsA total of 53 patients completed the study，comprising 27 in the control group and 26 in the observation group. Upon completion of the treatment period，the control group achieved a total effective rate of 33.33% （9/27），whereas the observation group demonstrated a total effective rate of 53.85% （14/26），which was statistically superior to the control group （χ²=4.034，P<0.05）. After the treatment，the TCM syndrome scores，6MWT，DLCO%，FEV₁%，PaO₂，PaCO₂，TGF-β₁，IL-4，IL-13，IL-12，and IFN-γ in the two groups were all significantly improved （P<0.01）. Compared with those in the control group after treatment at the same period，the TCM syndrome scores，6MWT，PaO₂，and PaCO₂ were significantly improved in the observation group after 60 days and 90 days of medication （P<0.01）. Three months after the end of medication，the SGRQ score in the observation group showed significant improvement when compared to that in the control group （P<0.05），and no severe adverse events were reported during the follow-up period. ConclusionCompound Shenlong decoction can alleviate clinical symptoms such as shortness of breath and wheezing in patients with lung deficiency and collateral stasis syndrome of IPF，enhance exercise tolerance，improve the quality of life，and have certain potential advantages in improving pulmonary function.

ObjectiveTo assess the therapeutic effectiveness and safety of the traditional Chinese medicine compound Shenlong decoction in addressing the symptoms of pulmonary deficiency and stasis in patients with idiopathic pulmonary fibrosis （IPF）. MethodsSixty eligible patients with lung deficiency and collateral stasis syndrome of IPF were randomly assigned to the observation （30 patients） and control groups （30 patients）. All patients underwent standard Western medical therapy. Additionally，the observation group received Shenlong decoction granules，while the control group received a placebo. Both treatments were packaged in four doses of 10.5 g each，taken twice daily for three months. The indexes of the patients during the treatment cycle were observed，and the main indexes include traditional Chinese medicine （TCM） syndrome scores and 6 min walk test （6MWT）. The secondary indexes include pulmonary function test ［actual value/expected value of total lung volume （TLC%），actual value/expected value of vital capacity（FVC%），actual/predicted diffusing capacity of the lung for carbon monoxide（DLCO%），actual/predicted forced expiratory volume in one second （FEV₁%），and FEV₁/ forced vital capacity （FVC）］，blood gas analysis ［arterial blood diathesis partial pressure of oxygen （PaO₂），partial pressure of carbon dioxide （PaCO₂），and arterial oxygen saturation （SaO₂）］，serum inflammatory factors ［transforming growth factor-β₁ （TGF-β₁），interleukin-4 （IL-4），interleukin-13 （IL-13），interleukin-12 （IL-12），and gamma-interferon （IFN-γ）］，and quality of survival evaluation ［St George's Respiratory Questionnaire （SGRQ） score］. The patients' clinical manifestations were determined at the end of the treatment， and the occurrence of adverse events was recorded. ResultsA total of 53 patients completed the study，comprising 27 in the control group and 26 in the observation group. Upon completion of the treatment period，the control group achieved a total effective rate of 33.33% （9/27），whereas the observation group demonstrated a total effective rate of 53.85% （14/26），which was statistically superior to the control group （χ²=4.034，P<0.05）. After the treatment，the TCM syndrome scores，6MWT，DLCO%，FEV₁%，PaO₂，PaCO₂，TGF-β₁，IL-4，IL-13，IL-12，and IFN-γ in the two groups were all significantly improved （P<0.01）. Compared with those in the control group after treatment at the same period，the TCM syndrome scores，6MWT，PaO₂，and PaCO₂ were significantly improved in the observation group after 60 days and 90 days of medication （P<0.01）. Three months after the end of medication，the SGRQ score in the observation group showed significant improvement when compared to that in the control group （P<0.05），and no severe adverse events were reported during the follow-up period. ConclusionCompound Shenlong decoction can alleviate clinical symptoms such as shortness of breath and wheezing in patients with lung deficiency and collateral stasis syndrome of IPF，enhance exercise tolerance，improve the quality of life，and have certain potential advantages in improving pulmonary function.