Objective To construct a diagnostic model based on the information of the TCM four diagnoses in hyperactive liver yang syndrome in patients with essential hypertension.Methods Syndromic investigation was carried out in patients with essential hypertension in some hospitals in Fujian and Beijing,and diagnostic information such as age,gender,symptoms,tongue and pulse were collected.On the basis of statistical analysis,this study adopted C5.0,CRT,CHAID and QUEST decision tree models respectively.After evaluating the stability and performance consistency of the models,the accuracy of the models was measured by diagnostic rate,and the optimal model of hyperactivity of liver yang in essential hypertension was selected.Results Totally 533 patients with essential hypertension were included,including 198 patients with hyperactive liver yang syndrome and 335 patients without hyperactive liver yang syndrome.The diagnostic rates of the four models were 75.2%,66.2%,67.7%and 65.0%,respectively.The diagnostic efficiency of C5.0 was better than that of CRT,CHAID and QUEST models."Aggravation after emotional excitement,poor complexion,string-like pulse,irritability,head swelling pain,bitter mouth,heavy pulse,fatigue,dark tongue,irritability,dizziness,thin pulse,yellow fur"could be regarded as the specific items of the syndrome model of hyperactive liver yang in essential hypertension.Conclusion The C5.0 decision tree model can clearly and intuitively identify the hyperactive liver yang syndrome in essential hypertension patients based on clinical TCM four diagnostic information data,and summarize diagnostic rules.

This paper discusses the necessity of artificial intelligence(AI)technology empowering the field of traditional Chinese medicine(TCM)in the context of the intelligent era,the connotation and tasks of smart TCM,and the progress of related research and transformation.It closely follows the national orientation,rigid needs and problems,conducts top-level design,and proposes popular AI technologies that can be used in the field of TCM in the future and the research directions that smart TCM will focus on in the fu-ture,in order to further promote the integration of multidisciplinary cross-innovation and help realize the modernization,inheritance and innovation of TCM and lay the foundation.

This paper discusses the necessity of artificial intelligence(AI)technology empowering the field of traditional Chinese medicine(TCM)in the context of the intelligent era,the connotation and tasks of smart TCM,and the progress of related research and transformation.It closely follows the national orientation,rigid needs and problems,conducts top-level design,and proposes popular AI technologies that can be used in the field of TCM in the future and the research directions that smart TCM will focus on in the fu-ture,in order to further promote the integration of multidisciplinary cross-innovation and help realize the modernization,inheritance and innovation of TCM and lay the foundation.

Lung cancer has brought tough challenges to human health due to its high incidence and mortality rate in the current practice. Nowadays, computed tomography (CT) imaging is still the most preferred diagnostic tool for early screening of lung cancer. However, a great challenge brought from accumulative CT imaging data can not meet the demand of the current clinical practice. As a novel kind of artificial intelligence technique aimed to deal with medical images, a computer-aided diagnosis has been found to provide useful auxiliary information, attenuate the workload of doctors, and significantly improve the efficiency and accuracy for clinical diagnosis of lung cancer. Therefore, an effective combination of computer-aided techniques and CT imaging has increasingly become an active area of investigation in early diagnosis of lung cancer. This review aims to summarize the latest progress on the diagnostic value of computer-aided technology with regard to early stage lung cancer from the perspectives of machine learning and deep learning.

Objective:To summarize clinical experience in the management of Abernethy malformation combined with focal nodular hyperplasia (FNH).Methods:Three patients with Abernethy malformation combined with FNH who were managed in the Department of Hepatobiliary Surgery, the First Medical Center of Chinese PLA General Hospital from January 2010 to December 2018 entered into this study. There were one male aged 35 years and two females aged 21 years and three years and nine months, respectively. Patients underwent digital subtraction angiography (DSA) with balloon dilation, shunt vasulature ligation, portal vein (PV) pressure measurement and other investigations were performed to study the changes of PV pressure before and after treatment.Results:DSA indicated that the congenital portal shunt of the patients was Abernethy deformity Ⅱ and Ⅰb, respectively, and with combined FNH diagnosed preoperatively. One patient was admitted to hospital for partial hepatectomy 5 years ago for the treatment of FNH, which presented with recurrent abdominal pain. The PV pressure increased from 8.5, 9.0, 20.0 cmH 2O(1 cmH 2O=0.098 kPa) to 15.0, 21.0, 25.0 cmH 2O after portal cavity shunt vasculature/portal vein ligation and splenic artery ligation/portal body shunt ligation, respectively. The PV blood flow into the liver increased, and DSA suggested shunt vessel occlusion. On follow-up, all patients survived well. Conclusion:Ligation or constriction of shunt vessels significantly improved the flow of PV into liver in Abernethy malformation patients with FNH. The treatment benefited long-term survival.

Objective:To investigate the value of neutrophil-to-lymphocyte ratio (NLR) in the diagnosis and prognosis evaluation of primary hepatocellular carcinoma.Methods:The clinical data of 100 patients pathologically diagnosed as primary liver cancer who were admitted to the First Medical Center of Chinese PLA General Hospital from January 2013 to December 2015 were retrospectively analyzed. Serum alpha fetoprotein (AFP), a conventional marker for hepatocellular carcinoma diagnosis was used as the control. The fourfold table diagnostic test was applied to analyze the sensitivity and specificity of serum NLR in the diagnosis of hepatocellular carcinoma, and the correlation with the degree of tumor differentiation was also analyzed.Results:The proportion of patients with high NLR (≥1.70) [56% (56/100)] was higher than the proportion of patients with positive AFP [44% (44/100)] in all 100 hepatocellular carcinoma patients, but the difference was not statistically significant ( χ2 = 2.88, P = 0.08). Among AFP-positive patients, the median survival time of patients with low and high NLR was 59 and 48 months, respectively, and the difference was statistically significant ( χ2 = 3.91, P = 0.048), and high NLR was an independent risk factor affecting the prognosis of hepatocellular carcinoma patients ( HR = 1.232, 95% CI 1.055-1.438, P = 0.008). Conclusions:The detection of NLR combined with AFP can improve the diagnostic rate of hepatocellular carcinoma before surgery. High NLR is an independent risk factor affecting the prognosis of patients with primary hepatocellular carcinoma.

Objective To indentify the cognitive status of Chinese patients to acne and the influencing factors to theirs' cognitive status,so as to provide solid evidences for the prevention and treatment of acne.Methods A self-designed questionnaire was made to conduct this survey of 16,156 acne patients,who seeked to the treatment in the dermatological departments from 112 hospitals in China.The survey consisted of several parts,including the general status of patients,the patients' cognition of occurrence,development and risk factors of acne,whether the first choice was seeking treatment at the hospital when the patients had acne and the condition of selection of skin care products.The factors were analyzed,which could impact the cognition of the patients' behavior of treatment,how did the patients' cognition to influence their medical behavior and skin care as well as the consistency of assessment of the severity of acne by doctors and patients themselves.Results The acne patients studied had the best knowledge of "acne is a skin disease","it not only occurs in the period of adolescence" and "the disease can be prevented and cured",which accordingly accounted for 80.65％,69.16％ and 65.49％ of the total patients respectively.However,the awareness of acne patients to heredity,high sugar and dairy products as risk factors for acne was insufficient,which accounted for 48.72％,42.40％ and 18.25％ of the total patients,respectively.Gender,age,educational level,occupation and health knowledge were the main factors affecting the cognitive level of patients;the survey also found that men,patient with educational level of junior high or even lower educational condition,occupation of labor workers or farmers and patients were lack of health education with poor knowledge of the genetics and dietary were risk factors for acne;patients with age over 36 years or with mild illness had poor knowledge of dietary risk factors for acne;the difference was statistically significant (P＜0.05).The analysis of the influence of cognitive status on medical treatment behavior and skin care showed that the better the cognition,the higher the probability of patients would choose medical treatment as the first choice as well as choosing functional skin care products;the difference was statistically significant (P＜0.05).The consistency of assessment of the severity of acne by doctors and patients was poor (Kappa value ＜0.4),and the assessment of severity of acne by patients was more serious than doctors' assessment.Conclusions Patient's cognitive status will affect their medical behavior and skin care,and there is also a phenomenon that patients have a more serious assessment of their acne condition.It is suggested that health education for acne patients should be strengthened in clinical medicine so as to improve their knowledge of acne as well as preventing from acne effectively.

OBJECTIVE:To optimize the formulation optimization of Nicorandil sustained-release matrix tablet,and evaluate its drug release properties in vitro. METHODS:Based on single factor test,powder direct compression method was used,using nicorandil cumulative release rate (Q) in 1,4,8,12 h as evaluation indexes,central composite design-response surface method was adopted to optimize the amount of hydroxypropyl methylcellulose(HPMC)and ethyl cellulose(EC);Q values within 12 h in different pH (1.0,5.0,6.8,7.4) media were compared. RESULTS:The optimized formulation (every tablet) was nicorandil 10 mg,HPMC 150 mg,EC 90 mg,microcrystalline cellulose 80 mg,lactose 60 mg,magnesium stearate 2%. Q1 h,Q4 h,Q8 h and Q12 h of the obtained formulation were 23.6%,51.3%,83.7% and 96.9%,respectively;deviation from the predicted values were 2.1%,1.6%,1.0%,0.2%. Q values were similar in pH 1.0-7.4 at different time points. CONCLUSIONS:The obtained Nicor-andil sustained-release matrix tablet by optimal formulation shows sustained-release effect,and the change of pH 1.0-7.4 has no in-terference in the release characteristics of main drug.

Objective To investigate the effects of ultraviolet irradiation on the morphology, cell proli-feration, mutation frequency and level of expression of ATP mRNA in human fibroblasts. Methods The infant foreskin fibroblasts were cultured and irradiated with different doses of ultraviolet A or B (UVA or UVB). Light microscopy was used for observing the morphologic change and cell counting of cell proliferation, HPRT-mutagenesis assay for the mutation detection, and RT-PCR for the expression of ATP mRNA. Results Compared with the control group, the irradiated cultured fibroblasts were damaged, cell growth was retarded (MTT assay showed 2.4 fold increase in the control group but only 0.2 fold in the UVB group 72 h after irradiation). Mutation frequency in 106 colony forming cells was increased from 20.4 ? 6.7 at 20 mJ/cm2 to 97.7 ? 7.1 under 60 mJ/cm2 of UVB irradiation. The expression level of ATP mRNA was down-regulated after UV irradiation. There was an increase of mutation frequency which was UVB dose-dependenct, and decrease of ATP mRNA expression which was dose- and time-dependent. Conclusions After UV irradiation of the cultured fibroblasts, the cell damage and growth inhibition are induced, and the mutation frequency is increased in a UVB dose-depen-dent maaner. The expression of ATP mRNA shows down-regulation in both dose- and time-dependent manner.

Objective To investigate the photo-protective mechanisms of hydroxychloroquine and epigallocatechin gallate (EGCG) on HaCaT cells damaged from UVB irradiation. Methods Subconfluent HaCaT cells were irradiated with different doses of UVB irradiation and treated with the above listed agents. The mRNA expression levels of p53, p21, c-fos and GADPH genes were evaluated by reverse transcription-polymerase chain reaction (RT-PCR). Results UVB irradiation induced mRNA expression of p53, p21 and c-fos in cultured HaCaT cells, which were alleviated by hydroxychloroquine and EGCG treatment in UVB irradiation group. Conclusions The photo-protective effects of hydroxychloroquine and EGCG on HaCaT cells by UVB irradiation might be related to inhibition of the expression of p53,p21 and c-fos genes.