The integration of TCM and Western medicine in imaging aims to enrich the sources of diagnostic information by utilizing medical imaging technologies,focusing on key elements such as TCM imaging,Western medical imaging,diseases and TCM syndrome types,thereby facilitating the complementary strengths of both systems.With the advancement of digital imaging and artificial intelligence technologies,various research models and methodologies have emerged.This article discussed the development and application of integrated imaging of traditional Chinese and Western medicine,and proposed three primary research paradigms in this field:Analyzing TCM images(e.g.,tongue and face)through manual or image processing techniques to assist in the diagnosis of Western medical diagnosis;Mapping Western medical imaging signs(e.g.,computed tomography,magnetic resonance imaging and ultrasound imaging)to TCM syndrome patterns for objective evidence in TCM diagnosis and treatment;Applying imaging omics to extract and integrate features from both TCM and Western medical images for comprehensive diagnosis.This study reviewed the three paradigms,explained relevant concepts and technologies,and proposed a specific research workflow of integrated imaging omics of traditional Chinese and Western medicine,aiming to provide a reference for innovative development in this field.

Objective:This study aimed to investigate the association between anemia and hypothyroidism during early pregnancy.Methods:We conducted a retrospective analysis of 3,165 pregnant women who registered at Qingdao Women and Children's Hospital from April 2021 to March 2022.Participants were categorized into a hypothyroidism group(n=177)and a euthyroid control group(n=2 988).Maternal demographic data,anemia-related markers(hemoglobin,Hb),and thyroid function parameters(FT3,FT4,TSH)were collected.Statistical analyses included independent t-tests,chi-square tests,Spearman correlation,and multivariate logistic regression.Results:The hypothyroidism group exhibited a significantly higher anemia incidence(10.17%vs 5.02%,P<0.05)and lower mean Hb levels(122.70±10.19 g/L vs 124.60±9.19 g/L,P<0.05)compared to controls.Spearman analysis revealed positive correlations between Hb and FT3(r=0.176)and FT4(r=0.051)(both P<0.05).Multivariate logistic regression identified anemia as an independent risk factor for hypothyroidism(OR=2.038,95%CI:1.202～3.455,P=0.008).Conclusion:Anemia in early pregnancy is associated with the risk of hypothyroidism.We recommend enhanced thyroid function screening and early intervention for anemic pregnant women to mitigate potential complications.

Objective To evaluate the diagnostic performance of the minimum-cost-path-based CT angiography-derived fractional flow reserve(MCP-FFR)and the deep learning-driven CT angiography-derived fractional flow reserve(DeepCL-FFR),and to particularly explore the potential value of the DeepCL algorithm in improving diagnostic accuracy within the"gray zone."Methods A retrospective analysis was conducted on 151 coronary vessels from 109 patients with coronary artery disease,who were hospitalized at the General Hospital of the People's Liberation Army between January 2020 and June 2021.Pearson correlation and Bland-Altman plots were employed to assess the correlation and agreement of the two CT-FFR methods with invasive FFR.A CT-FFR range of 0.70-0.80 was defined as the diagnostic"gray zone."The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value for detecting hemodynamic abnormalities were calculated and analyzed.The DeLong test was used to compare the areas under the receiver operating characteristic curves(AUC)between the two CT-FFR calculation methods.Results Both CT-FFR methods exhibited a positive correlation with invasive FFR(MCP-FFR:r=0.75,P＜0.001;DeepCL-FFR:r=0.86,P＜0.001)and showed good agreement(MCP-FFR:mean difference=0.010,P=0.351;DeepCL-FFR:mean difference=-0.003,P=0.772).Both DeepCL-FFR(AUC 0.97,95％CI 0.94-0.99)and MCP-FFR(AUC 0.92,95％CI 0.88-0.97)demonstrated favorable diagnostic performance for detecting hemodynamic abnormalities(P=0.122).In the"gray zone"for hemodynamic abnormality,the diagnostic accuracy of MCP-FFR was 68.8％,whereas DeepCL-FFR increased it to 89.7％.DeepCL-FFR also exhibited superior diagnostic performance(AUC 0.89,95％CI 0.73-0.99)within the"gray zone,"which was significantly higher than that of MCP-FFR(AUC 0.71,95％CI 0.54-0.87)(P＜0.001).Conclusions The deep learning-driven coronary centerline extraction algorithm,DeepCL,demonstrates superior diagnostic performance in CT-FFR for detecting hemodynamic abnormalities,particularly by significantly improving diagnostic accuracy in the"gray zone."

Objective To explore the influence factors of timed up and go test(TUG)in patients with maintenance hemodialysis(MHD).Methods Cross-sectional investigation method was used to select patients who underwent regular hemodialysis in Beijing Luhe Hospital,Capital Medical University from June 1,2023 to January 31,2024,with complete data and cooperation.The patients were respectively treated with a simple mental state checklist and 5 times sit to stand test(STS-5)and TUG scale were used to assess cognitive function,lower limb muscle strength,balance and gait function.Grouping was carried out according to the results of TUG.If TUG 12s,it is judged as the TUG normal group;if TUG＞12s,it is judged as the TUG prolonged group.Multi-factor Logistic regression was used to analyze the influencing factors in the TUG prolonged group,and the predictive value of influencing factors to TUG prolonged patients was analyzed by receiver operating characteristic(ROC)curve.Results A total of 146 patients with MHD were included in this study,including 86 patients in TUG prolonged group and 60 patients in TUG normal group.Gender,age,combined hypertension,combined diabetes,blood glucose,education level,Minimum Mental State Examination(MMSE)score,C-reactive protein were compared between groups.Serum albumin,serum creatinine,serum sodium,whole parathyroid hormone,low density lipoprotein-cholesterol,serum uric acid,STS-5 results,and single urea clearance index(Kt/V)had statistical differences(P＜0.05).Multivariate Logistic regression showed that old age,female,low MMSE score,low Kt/V,and STS-5 duration were independent risk factors for TUG prolonged(P＜0.05).ROC curve showed that the area under the curve(AUC)of age,gender,total MMSE score and STS-5 time in predicting TUG prolongation in MHD patients were 0.825,0.678,0.777 and 0.836,respectively(P＜0.01),which had high predictive value.The AUC of Kt/V in predicting TUG prolongation was 0.602(P=0.037),has a certain predictive value;AUC of TUG prolongation in MHD patients predicted by the above 5 indicators as a global model was 0.923(P＜0.01).Conclusions The age,gender,MMSE score,STS-5 prolongation and Kt/V level of MHD patients are independent risk factors for TUG prolongation,and may be biological indicators for predicting TUG prolongation.

The integration of TCM and Western medicine in imaging aims to enrich the sources of diagnostic information by utilizing medical imaging technologies,focusing on key elements such as TCM imaging,Western medical imaging,diseases and TCM syndrome types,thereby facilitating the complementary strengths of both systems.With the advancement of digital imaging and artificial intelligence technologies,various research models and methodologies have emerged.This article discussed the development and application of integrated imaging of traditional Chinese and Western medicine,and proposed three primary research paradigms in this field:Analyzing TCM images(e.g.,tongue and face)through manual or image processing techniques to assist in the diagnosis of Western medical diagnosis;Mapping Western medical imaging signs(e.g.,computed tomography,magnetic resonance imaging and ultrasound imaging)to TCM syndrome patterns for objective evidence in TCM diagnosis and treatment;Applying imaging omics to extract and integrate features from both TCM and Western medical images for comprehensive diagnosis.This study reviewed the three paradigms,explained relevant concepts and technologies,and proposed a specific research workflow of integrated imaging omics of traditional Chinese and Western medicine,aiming to provide a reference for innovative development in this field.

Objective To evaluate the diagnostic performance of the minimum-cost-path-based CT angiography-derived fractional flow reserve(MCP-FFR)and the deep learning-driven CT angiography-derived fractional flow reserve(DeepCL-FFR),and to particularly explore the potential value of the DeepCL algorithm in improving diagnostic accuracy within the"gray zone."Methods A retrospective analysis was conducted on 151 coronary vessels from 109 patients with coronary artery disease,who were hospitalized at the General Hospital of the People's Liberation Army between January 2020 and June 2021.Pearson correlation and Bland-Altman plots were employed to assess the correlation and agreement of the two CT-FFR methods with invasive FFR.A CT-FFR range of 0.70-0.80 was defined as the diagnostic"gray zone."The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value for detecting hemodynamic abnormalities were calculated and analyzed.The DeLong test was used to compare the areas under the receiver operating characteristic curves(AUC)between the two CT-FFR calculation methods.Results Both CT-FFR methods exhibited a positive correlation with invasive FFR(MCP-FFR:r=0.75,P＜0.001;DeepCL-FFR:r=0.86,P＜0.001)and showed good agreement(MCP-FFR:mean difference=0.010,P=0.351;DeepCL-FFR:mean difference=-0.003,P=0.772).Both DeepCL-FFR(AUC 0.97,95％CI 0.94-0.99)and MCP-FFR(AUC 0.92,95％CI 0.88-0.97)demonstrated favorable diagnostic performance for detecting hemodynamic abnormalities(P=0.122).In the"gray zone"for hemodynamic abnormality,the diagnostic accuracy of MCP-FFR was 68.8％,whereas DeepCL-FFR increased it to 89.7％.DeepCL-FFR also exhibited superior diagnostic performance(AUC 0.89,95％CI 0.73-0.99)within the"gray zone,"which was significantly higher than that of MCP-FFR(AUC 0.71,95％CI 0.54-0.87)(P＜0.001).Conclusions The deep learning-driven coronary centerline extraction algorithm,DeepCL,demonstrates superior diagnostic performance in CT-FFR for detecting hemodynamic abnormalities,particularly by significantly improving diagnostic accuracy in the"gray zone."

Objective To explore the influence factors of timed up and go test(TUG)in patients with maintenance hemodialysis(MHD).Methods Cross-sectional investigation method was used to select patients who underwent regular hemodialysis in Beijing Luhe Hospital,Capital Medical University from June 1,2023 to January 31,2024,with complete data and cooperation.The patients were respectively treated with a simple mental state checklist and 5 times sit to stand test(STS-5)and TUG scale were used to assess cognitive function,lower limb muscle strength,balance and gait function.Grouping was carried out according to the results of TUG.If TUG 12s,it is judged as the TUG normal group;if TUG＞12s,it is judged as the TUG prolonged group.Multi-factor Logistic regression was used to analyze the influencing factors in the TUG prolonged group,and the predictive value of influencing factors to TUG prolonged patients was analyzed by receiver operating characteristic(ROC)curve.Results A total of 146 patients with MHD were included in this study,including 86 patients in TUG prolonged group and 60 patients in TUG normal group.Gender,age,combined hypertension,combined diabetes,blood glucose,education level,Minimum Mental State Examination(MMSE)score,C-reactive protein were compared between groups.Serum albumin,serum creatinine,serum sodium,whole parathyroid hormone,low density lipoprotein-cholesterol,serum uric acid,STS-5 results,and single urea clearance index(Kt/V)had statistical differences(P＜0.05).Multivariate Logistic regression showed that old age,female,low MMSE score,low Kt/V,and STS-5 duration were independent risk factors for TUG prolonged(P＜0.05).ROC curve showed that the area under the curve(AUC)of age,gender,total MMSE score and STS-5 time in predicting TUG prolongation in MHD patients were 0.825,0.678,0.777 and 0.836,respectively(P＜0.01),which had high predictive value.The AUC of Kt/V in predicting TUG prolongation was 0.602(P=0.037),has a certain predictive value;AUC of TUG prolongation in MHD patients predicted by the above 5 indicators as a global model was 0.923(P＜0.01).Conclusions The age,gender,MMSE score,STS-5 prolongation and Kt/V level of MHD patients are independent risk factors for TUG prolongation,and may be biological indicators for predicting TUG prolongation.

A 68-year-old female patient with invasive urothelial carcinoma received immune treatments with disitamab vedotin 120 mg and toripalimab 240 mg intravenously on the first day, and 14 days was a cycle. Nineteen days after the first medication, the patient complained of lower back muscle soreness. Laboratory tests showed creatine kinase (CK) 1 079 U/L and CK-MB 33 U/L. The 2nd cycle of immunotherapy was suspended and prednisone 20 mg orally once daily was given. Five days later, the patient felt chest tightness, and laboratory tests showed CK 3 366 U/L, CK-MB 91 U/L, lactic dehydrogenase 518 U/L, myoglobin 1 282 μg/L, high-sensitivity troponin T 0.068 μg/L, and N-terminal pro-brain natriuretic peptide 148 ng/L. Myocarditis caused by the combination of disitamab vedotin and toripalimab was considered, referring to the cardiac color Doppler ultrasound examination. Prednisone was switched to IV infusion of methylprednisolone 160 mg once daily. The above laboratory test indicators gradually decreased, but the electrocardiogram showed ectopic heart rhythm. Amiodarone was added. After 11 days of methylprednisolone treatment by IV infusion, methylprednisolone 20 mg orally once daily was given, which was gradually reduced and discontinued finally. Four days later, the patient′s laboratory indicators and electrocardiogram showed no abnormalities in the re-examination.

A 68-year-old female patient with invasive urothelial carcinoma received immune treatments with disitamab vedotin 120 mg and toripalimab 240 mg intravenously on the first day, and 14 days was a cycle. Nineteen days after the first medication, the patient complained of lower back muscle soreness. Laboratory tests showed creatine kinase (CK) 1 079 U/L and CK-MB 33 U/L. The 2nd cycle of immunotherapy was suspended and prednisone 20 mg orally once daily was given. Five days later, the patient felt chest tightness, and laboratory tests showed CK 3 366 U/L, CK-MB 91 U/L, lactic dehydrogenase 518 U/L, myoglobin 1 282 μg/L, high-sensitivity troponin T 0.068 μg/L, and N-terminal pro-brain natriuretic peptide 148 ng/L. Myocarditis caused by the combination of disitamab vedotin and toripalimab was considered, referring to the cardiac color Doppler ultrasound examination. Prednisone was switched to IV infusion of methylprednisolone 160 mg once daily. The above laboratory test indicators gradually decreased, but the electrocardiogram showed ectopic heart rhythm. Amiodarone was added. After 11 days of methylprednisolone treatment by IV infusion, methylprednisolone 20 mg orally once daily was given, which was gradually reduced and discontinued finally. Four days later, the patient′s laboratory indicators and electrocardiogram showed no abnormalities in the re-examination.

Objective To analyze the effects of painting and medication intervention on psycho-logical state,compliance and quality of life in patients with generalized anxiety disorder(GAD).Methods A total of 70 patients with GAD from May 2020 to September 2022 were included as study subjects,among whom 35 patients receiving single drug intervention were included in single group,and 35 patients receiving painting combined drug intervention were included in combined group.The psychological state scores and intervention compliance of the subjects in the two groups were ana-lyzed,the life quality scores and serum factor expression levels of the subjects in the two groups were compared before and after intervention,and the changes in sleep quality of the two groups were ob-served before and after intervention.Results After intervention,the scores of Hamilton Anxiety Rat-ing Scale(HAMA),Hamilton Depression Rating Scale(HAMD)in the two groups were decreased compared with those before intervention,but their scores in the combined group were lower,and the differences were statistically significant(P＜0.05).The total compliance rate of the combined group was higher than that of the single group(P＜0.05).After intervention,the 36-item Shot-form Health Status Survey(SF-36)scores of the two groups were improved compared with that before intervention,and the SF-36 score of the combined group was higher,the difference was statistically significant(P＜0.05).After intervention,the expression levels of brain derived neurotrophic factor(BDNF)and malondialdehyde(MDA)in the combined group were lower than those in the single group,and the expression level of superoxide dismutase(SOD)was higher than those in the single group(P＜0.05).After intervention,the sleep quality of the two groups was improved compared with that be-fore intervention,but the improvement degree of the combined group was higher(P＜0.05).Conclusion Painting combined with drug intervention can effectively improve the adverse psycho-logical state of GAD patients,improve their intervention compliance,and further improve their qual-ity of life and sleep quality.