The ambiguity of symptom information in traditional Chinese medicine （TCM） syndrome differentiation can be amplified in the direct reasoning process from symptoms to syndromes in the absence of constraints， which affects the accuracy and stability of intelligent syndrome differentiation. TCM disease concepts， while historically rational， are structurally ambiguous in both their connotation and extension， making it difficult to serve as stable prior knowledge in intelligent modeling. In contrast， modern medical diseases， based on objective testing and quantifiable indicators， have relatively clear boundaries and reproducible standards. This study proposes a disease-syndrome combination model， adopting modern medical diseases as structural prior variables to reconstruct the hierarchical relationships among disease， symptoms， and syndromes. By applying disease constraints， effective screening of information from the four examinations and compressing the reasoning space are achieved. Furthermore， by integrating artificial intelligence technologies， such as multimodal fusion and knowledge graphs， an intelligent syndrome differentiation model driven by both prior knowledge and clinical data is constructed， providing a feasible path to enhance the accuracy of syndrome differentiation and realize the intelligentization of TCM diagnosis and treatment.

A fundamental challenge that arises in biomedicine is the need to characterize compounds in a relevant cellular context in order to reveal potential on-target or off-target effects. Recently, the fast accumulation of gene transcriptional profiling data provides us an unprecedented opportunity to explore the protein targets of chemical compounds from the perspective of cell transcriptomics and RNA biology. Here, we propose a novel Siamese spectral-based graph convolutional network (SSGCN) model for inferring the protein targets of chemical compounds from gene transcriptional profiles. Although the gene signature of a compound perturbation only provides indirect clues of the interacting targets, and the biological networks under different experiment conditions further complicate the situation, the SSGCN model was successfully trained to learn from known compound-target pairs by uncovering the hidden correlations between compound perturbation profiles and gene knockdown profiles. On a benchmark set and a large time-split validation dataset, the model achieved higher target inference accuracy as compared to previous methods such as Connectivity Map. Further experimental validations of prediction results highlight the practical usefulness of SSGCN in either inferring the interacting targets of compound, or reversely, in finding novel inhibitors of a given target of interest.
Drug Delivery Systems ; Proteins ; Transcriptome

Objective:To investigate the peripheral blood inflammatory markers including white blood cell count (WBC), monocytes, neutrophils, lymphocytes, platelets, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), high-density lipoprotein(HDL-C), low-density lipoprotein and fibrinogen (FIB) in Ménière′s disease (MD) patients with and without migraine, and to explore the relationship between the inflammatory response with MD and migraine.Methods:The general physical condition, clinical manifestations, pure-tone audiometry, and peripheral blood inflammatory markers of 92 unilateral MD patients who were hospitalized in Peking University People′s Hospital for surgical treatment from January 2017 to January 2021 were continuously collected. Meanwhile, 50 healthy controls matched with age and sex were included, and their general physical conditions and peripheral blood inflammatory markers were also collected. This study consisted of two parts. First, the differences in epidemical characteristics and peripheral blood inflammatory markers between MD patients and healthy controls were compared by univariate analysis. Second, all 92 MD patients were divided into two subgroups according to whether they were accompanied by migraine. The clinical characteristics and peripheral blood inflammatory markers of MD patients with and without migraine were compared by univariate analysis. Thereafter, binary Logistic regression was used to analyze the related factors of whether MD patients were accompanied with migraine.Results:Compared with the healthy control group, the peripheral blood WBC, neutrophils and FIB of MD patients were significantly increased (all P<0.05). Compared with MD patients without migraine, MD patients with migraine had higher female prevalence, longer disease history, lower low-frequency hearing threshold, higher frequency of vertigo attacks and higher HDL-C levels (all P<0.05), meanwhile, female, frequency of vestibular attacks and HDL-C were independent related factors of whether MD patients were accompanied with migraine. Conclusion:The occurrence of MD and migraine may be related to the inflammatory response. The level of anti-inflammatory factors in the blood of MD patients with migraine are higher, suggesting that the inflammatory response status of MD patients with and without migraine is different.

Objective To explore the impact of nutritional risk on short-term clinical outcomes after laparoscope-assisted radical gastrectomy for gastric cancer.Methods The retrospective case-control study was conducted.The clinical data of 150 patients who underwent laparoscopic gastrectomy at the First Affiliated Hospital of Wenzhou Medical University between June 2014 and April 2016 were collected.According to nutritional risk screening 2002 (NRS 2002),42 and 108 patients were respectively divided into the nutritional risk group (NRS 2002 score ≥3) and non-nutritional risk group (NRS 2002 score ＜3).Laparoscope-assisted radical subtotal gastrectomy or total gastrectomy was performed based on tumor location.Observation indicators:(1) postoperative short-term clinical outcomes:postoperative complications,duration of postoperative hospital stay,hospital expenses,unplanned readmission within 30 days after discharging.Postoperative complications meant total complications within 30 days postoperatively,grade Ⅰ-Ⅴ of Clavien-Dindo grade was complication classification.Grade Ⅱ and above of Clavien-Dindo grade were analyzed in this research.(2) Risk factors analysis affecting occurrence of postoperative complications of patients.Measurement data with normal distribution were represented as x±s and analyzed using the independent-sample t test.Measurement data with skewed distribution were described as M (Qn) and analyzed using the Mann-Whitney U test.Categorical variables were described as number and percentage and analyzed by the chisquare test.Ranked data were analyzed by the Mann-Whitney U test.Univariate analysis was done by the chi-square test.P＜0.1 of univariate analysis was used to multivariate analysis.COX regression model in multivariate analysis was built using progressive condition method.Results (1) Postoperative short-term clinical outcomes:number of patients with total complications,number of patients with severe complications,duration of postoperative hospital stay,hospital expenses and number of patients with unplanned readmission within 30 days after discharging were 9,2,11 days (9 days,16 days),57 825 yuan (51 894 yuan,66 908 yuan),2 in the nutritional risk group and 16,3,11 days (9 days,13 days),55 067 yuan (49 395 yuan,62 423 yuan),8 in the non-nutritional risk group,respectively,with no statistically significant difference between the 2 groups (X2=0.952,0.010,Z=-1.133,-1.691,X2 =0.048,P＞0.05).Results of univariate analysis showed that age was a risk factor affecting incidence of complications after laparoscope-assisted radical gastrectomy for gastric cancer (X2 =4.468,P＜ 0.05).Results of multivariate analysis showed that preoperative hypoproteinemia was an independent risk factor affecting incidence of complications after laparoscope-assisted radical gastrectomy for gastric cancer (OR =2.797,95％ confidence interval:1.053-7.435,P＜0.05).Conclusion There is little poor impact of nutritional risk on short-term outcomes after laparoscope-assisted radical gastrectomy for gastric cancer,preoperative hypoproteinemia is an independent risk factor affecting occurrence of grade Ⅱ and above of postoperative complications.

Objective:To investigate the effect of atorvastatin on the blood lipid and uric acid levels of elderly patients with coronary heart disease complicated with diabetes mellitus.Methods:116 patients with coronary heart disease and diabetes were randomly divided into the control group and the experimental group,58 cases in each group.Both groups of patients were given blood glucose control,blood pressure and other symptomatic treatment.The control group was treated with Aspirin Enteric-coated Tablets 0.3～0.6 g/times,3 times/d,oral,clopidogrel tablets,2 tablets each time,1 time/d,oral,nitroglycerin,0.25～0.5 g/time,3 times/d,with service;the experimental group was given atorvastatin on the basis of control group,10～20 mg/time,1 time/d,treatment for 4 weeks.During the treatment,the dosage was timely adjusted according to the conditions of patients.The serum low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),triglyceride (TG),total cholesterol (TC),uric acid (UA),glycosylated hemoglobin (HbA1c) levels before and after treatment and the clinical treatment efficiency were observed and compared between two groups.Results:Compared with before treatment,the serum LDL-C,TG,TC,UA,HbA1c levels were decreased ahter treatment in both groups of patients,the HDL-C level was increased (P＜0.05);compared with the control group,the serum LDL-C,TG,TC,UA,HbA1c levels were lower,HDL-C level was higher in the experimental group (P＜0.05);compared with the control group,the effective rate of clinical treatment of the experimental group were higher (P＜0.05).Conclusion:Atorvastatin could effectively reduce the blood glucose,blood lipid,uric acid levels of elderly patients with coronary heart disease complicated with diabetes.

ObjectiveTo investigate the laws of distribution and combination of traditional Chinese medicine (TCM) syndromes of patients with diastolic heart failure (DHF); To research the relevance between TCM syndromes and DHF.Methods A four diagnostic information survey was conducted among 124 DHF patients in order to analyze their basic information and information about TCM four diagnostic methods. Statistical analysis method was used to determine the syndrome types of the DHF patients and the features of syndrome combination.ResultsMost DHF patients were in their sixties or seventies, the number of female patients was larger than that of male patients, and their heart function was in II or III grade. Qi deficiency, phlegm turbidity, Qi stagnation, blood stasis, water stagnation, Yang deficiency and Yin deficiency were the common syndromes. Two-card combination and three-card combination were more common, mainly with Qi deficiency, phlegm turbidity or blood stasis as the main patterns of manifestation. Conclusion This research could provide a clinical basis for the establishment of the standard for the TCM syndromes DHF.

OBJECTIVE: To investigate therapeutic effects of Jinsangsanjie capsule on vocal fold polyps and vocal nodules. METHOD: Seventy-five patients with vocal fold polyps and vocal nodules were treated by taking Jinsangsanjie capsule orally. After the therapeutic course, they were all followed up for 1 month. RESULT: The effective rate of vocal nodule group was 93.8%, the effective rate of vocal fold polyp group was 89.7%, the effective rate of vocal nodule with acute congestion group was 100%, the effective rate of vocal fold polyp with acute congestion group was 100%, and the effective rate of hypertrophy of vocal cords with chronic congestion group was 66.7%. CONCLUSION Jinsangsanjie capsule has definite efficacy for treatment of vocal fold polyps and vocal nodules and deserved to be recommended.
Adult ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Laryngeal Diseases ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Polyps ; drug therapy ; pathology ; Treatment Outcome ; Vocal Cords ; pathology

OBJECTIVE: To investigate the expression of microtuble-associated protein 1 light chain 3 (LC3) in laryngeal squamous cell carcinoma (LSCC). METHOD: The expression of LC3 in 50 cases of LSCC, 45 cases of para-carcinoma, 10 cases of laryngeal papilloma and 16 cases of polyp of vocal cord were detected by immunohistochemistry (MaxVision method). Expression level of LC3 mRNA was assayed by RT-PCR in 41 of LSCC, 41 of para-carcinoma tissue and 11 of polyp of vocal cord. RESULT: The positive rates of LC3 protein expression were 60.0%, 93.3%, 90.0%, 93.8% in LSCC tissue, para-carcinoma, laryngeal papilloma and poly of vocal card tissues, respectively. The positive rates of LC3 were significantly lower in LSCC than in para-carcinoma and poly of vocal cord (chi2 = 18.135, P < 0.01). The mRNA levels of LC3 were significantly lower in LSCC than in para-carcinoma and poly of vocal cord (0.57 +/- 0.08 )vs (0.99 +/- 0.11) and (1.07 +/- 0.05) , F = -255.872, P < 0.01. The expression of LC3 were related to tumor location and pathological grade (P < 0.05), but not related to age, T stage, clinical stage and lymphoid metastasis (P > 0.05). CONCLUSION Expression of LC3 are down-regulated in LSCC. The change of autophagic capacity may play an important role in occurrence and development of LSCC.
Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Microtubule-Associated Proteins ; genetics ; metabolism ; Middle Aged ; Neoplasm Staging

OBJECTIVE: The aim of the study is to explore the establishment of paired-standardized patients (PSPs), which can cover the deficiency of standardized patients. METHOD: The outpatients and standardized patients consist of PSPs. The standard case of PSPs is established by the combination of PSPs and the laboratory and imaging information of the true patients. Then we apply the PBL model and PSPs to the clinic teaching in otorhinolaryngology. RESULT: The study of the ten standard cases of PSPs, which we have established, has enhanced the confidence and interest of medical students in clinical practice. CONCLUSION PSPs can cover the deficiency of standardized patients, which includes lacking of change and lively. At the other hand, PSPs can practice the medical students' clinical skills and the way of evidence-based medicine and can stimulate them to form the good habit of self-regulated learning.
Evidence-Based Medicine ; Humans ; Otolaryngology ; education ; Outpatients ; Problem-Based Learning ; Reference Standards