1.Construction of the clinical diagnosis and treatment model during the “pre-disease to disease” window period in traditional Chinese medicine: integration of objective multimodal data from the perspective of traditional Chinese medicine stateology
Danyang Li ; Min Ai ; Pai Zhou ; Ying Deng ; Chaoyang Yang ; Qinghua Peng
Digital Chinese Medicine 2026;9(2):173-183
The philosophy of “treating disease before its onset” is a fundamental concept of traditional Chinese medicine (TCM), permeating its diagnostic and therapeutic framework, and is central to clinical practice. However, current TCM diagnostic and treatment models for the “pre-disease to disease” window period face several limitations, including the lack of comprehensive clinical parameters, difficulties in characterizing and integrating heterogeneous multimodal data, and insufficient dynamic precision in interventions and efficacy evaluations. To address these issues, guided by Professor Candong Li’s theory of TCM stateology, this study focuses on integrating objective multimodal data. It proposes a new model for personalized TCM diagnosis and treatment targeting the “pre-disease to disease” window period. This approach first proposes the idea of restructuring the conceptual framework of “symptom” and integrating multi-source heterogeneous data at macroscopic, mesoscopic, and microscopic levels to form a three-dimensional assessment indicator system. By integrating graph neural networks, convolutional neural networks, attention mechanisms, and knowledge graph-guided weight allocation, this approach enables collaborative representation, alignment, and fusion of multi-source data. Subsequently, it plans to construct a multimodal fusion model at both feature and decision levels, in order to establish mappings between indicators and TCM state elements, and to screen key indicators characterizing pathological evolution during the window period. Furthermore, it proposes a technical path for enhancing model interpretability using methods such as SHapley Additive exPlanations (SHAP) and Ablation-CAM++. Finally, with state assessment as the core, it proposes the concept of constructing a dynamic evaluation method for individualized diagnosis and treatment based on time-series data analysis using algorithms such as long short-term memory (LSTM) networks and gated recurrent units (GRUs). Moreover, a causal inference framework and semi-supervised learning strategies are introduced to enable quantitative evaluation of individual intervention effects and to provide interpretable therapeutic feedback, forming a complete technical path from data representation and fusion, weight adjustment, and interpretability analysis, to dynamic diagnosis feedback. This study aims to address deficiencies in the current TCM diagnosis and treatment model during the “pre-disease to disease” window period and to provide an operational framework for the clinical practice of TCM’s “treating disease before its onset”.
2.Attenuation of oxidative injury in retinal photoreceptor cells by Gouqizi (Lycii Fructus) and Danshen (Salviae Miltiorrhizae Radix et Rhizoma) through modulation of ANGPTL4
Jun Peng ; Junjiang Jiang ; Junnan Zhong ; Siyi Zhou ; Tingyan Hu ; Xuyu Chen ; Qinghua Peng ; Yasha Zhou
Digital Chinese Medicine 2026;9(2):290-301
Objective:
To investigate the protective effects of Gouqizi (Lycii Fructus, GQZ)-Danshen (Salviae Miltiorrhizae Radix et Rhizoma, DS) against hydrogen peroxide (H2O2)-induced oxidative injury in 661W retinal photoreceptor cells and to explore whether these effects involve angiopoietin-like 4 (ANGPTL4).
Methods:
Liquid chromatography-mass spectrometry (LC-MS) was used to identify the major components of GQZ-DS aqueous extract. An H2O2-induced oxidative injury model was established in 661W cells. Working concentrations of H2O2 and GQZ-DS were determined using the cell counting kit-8 (CCK-8) assay. Cells were subjected to GQZ-DS, ANGPTL4 knockdown, or ANGPTL4 overexpression as indicated. Flow cytometry was used to analyze cell cycle distribution, apoptotic rate, and intracellular reactive oxygen species (ROS). Colorimetric determination of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity using the thiobarbituric acid (TBA) method was performed. The protein expression level of ANGPTL4 was assessed by immunofluorescence. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was performed to quantify the mRNA level of ANGPTL4. Western blot was used to detect the protein levels of ANGPTL4 and cleaved caspase-3.
Results:
LC-MS identified five major constituents in the GQZ-DS aqueous extract: 2-O-β-D-glucopyranosyl-L-ascorbic acid, rutin, D-galactose, salvianolic acid A, and tanshinone IIA. The CCK-8 method selected 300 μmol/L H2O2 as the oxidative stress condition for experiments, and 0.05 and 0.1 g/mL were selected as the low and high doses of GQZ-DS, respectively, for subsequent experiments. The intervention with H2O2 resulted in reduced cell viability, elevated ROS and MDA levels, decreased SOD activity, increased apoptotic rate, upregulated cleaved caspase-3 expression, and G0/G1 phase cell cycle arrest of 661W cells. Both low and high doses of GQZ-DS alleviated these alterations, with high dose exhibiting stronger protective effects (P < 0.05 or P < 0.01). GQZ-DS also downregulated ANGPTL4 expression at both the mRNA and protein levels. Following plasmid transfection of cells, the study further revealed that ANGPTL4 knockdown mitigated oxidative stress and apoptosis-related injury, whereas ANGPTL4 overexpression exacerbated these pathological changes. Moreover, GQZ-DS partially reversed the degree of cellular oxidative damage induced by ANGPTL4 overexpression.
Conclusion
GQZ-DS can alleviate the H2O2-induced oxidative injury of 661W retinal photoreceptor cells, and the effects are related to the down-regulation of ANGPTL4 expression.
3.Current Understanding of Retinitis Pigmentosa in Traditional Chinese and Western Medicine
Qing LI ; Ying DENG ; Li XIAO ; Jing LU ; Min AI ; Yasha ZHOU ; Yuhui QIN ; Qinghua PENG ; Yijing YANG
Journal of Traditional Chinese Medicine 2026;67(14):1567-1573
This paper has summarized current studies on retinitis pigmentosa (RP) from two perspectives, which were disease mechanism insights from western medicine, and etiology, pathogenesis and therapeutic principles in traditional Chinese medicine (TCM). From the perspective of western medicine, the understanding of RP has evolved from an early single-factor explanation focusing on pathogenic gene mutations to a more comprehensive, multifactorial model involving genetic abnormalities, photoreceptor cell degeneration, retinal pigment epithelium dysfunction, oxidative stress, inflammatory responses, microenvironmental imbalance, and vascular insufficiency. In TCM, RP is considered to be a disorder manifested in the eyes but rooted in dysfunction of the zang-fu (脏腑) organs. Its pathogenesis is primarily associated with congenital insufficiency, liver-kidney depletion, impaired spleen function of transportation and transformation, and stasis obstructing the meridians. The core pathological mechanism can be summarized as "deficiency complicated by stasis", emphasizing holistic imbalance, dynamic disease progression, and syndrome differentiation and treatment. The differences and complementarities between the two medical systems in understanding disease progression are further discussed. RP is proposed to be more appropriately regarded as a complex disease characterized by long-term progression, stage-dependent evolution, and persistent decompensation. Western medicine contributes to elucidating the molecular mechanisms underlying RP and provides the foundation for targeted therapeutic interventions, whereas TCM offers a holistic perspective for understanding disease evolution through the assessment of overall functional status, disease-stage stratification, and long-term syndrome-based regulation.
4.Current Understanding of Retinitis Pigmentosa in Traditional Chinese and Western Medicine
Qing LI ; Ying DENG ; Li XIAO ; Jing LU ; Min AI ; Yasha ZHOU ; Yuhui QIN ; Qinghua PENG ; Yijing YANG
Journal of Traditional Chinese Medicine 2026;67(14):1567-1573
This paper has summarized current studies on retinitis pigmentosa (RP) from two perspectives, which were disease mechanism insights from western medicine, and etiology, pathogenesis and therapeutic principles in traditional Chinese medicine (TCM). From the perspective of western medicine, the understanding of RP has evolved from an early single-factor explanation focusing on pathogenic gene mutations to a more comprehensive, multifactorial model involving genetic abnormalities, photoreceptor cell degeneration, retinal pigment epithelium dysfunction, oxidative stress, inflammatory responses, microenvironmental imbalance, and vascular insufficiency. In TCM, RP is considered to be a disorder manifested in the eyes but rooted in dysfunction of the zang-fu (脏腑) organs. Its pathogenesis is primarily associated with congenital insufficiency, liver-kidney depletion, impaired spleen function of transportation and transformation, and stasis obstructing the meridians. The core pathological mechanism can be summarized as "deficiency complicated by stasis", emphasizing holistic imbalance, dynamic disease progression, and syndrome differentiation and treatment. The differences and complementarities between the two medical systems in understanding disease progression are further discussed. RP is proposed to be more appropriately regarded as a complex disease characterized by long-term progression, stage-dependent evolution, and persistent decompensation. Western medicine contributes to elucidating the molecular mechanisms underlying RP and provides the foundation for targeted therapeutic interventions, whereas TCM offers a holistic perspective for understanding disease evolution through the assessment of overall functional status, disease-stage stratification, and long-term syndrome-based regulation.
5.Self-Supervised Multi-Organ Segmentation in Pediatric Abdominal CT Based on Vision Foundation Models
Qinghua ZHANG ; Ming LI ; Zhedian ZHOU ; Jian ZHENG ; Huadan XUE ; Qiuxia WANG ; Yu DU ; Zhen LI
Medical Journal of Peking Union Medical College Hospital 2026;17(4):954-962
To address the scarcity of annotated data for pediatric abdominal CT imaging and the insufficient generalization capability of existing models, we constructed a self-supervised pretraining architecture tailored for pediatric CT domain adaptation based on the visual foundation model DINOv3, and validated its performance in the task of pediatric abdominal multi-organ segmentation. We built a general-purpose radiological visual representation using the large-scale adult CT dataset CT-3M, and introduced a Gram-anchoring mechanism that employs a frozen adult pretrained model as a structural teacher to guide domain alignment of local topological structures on unlabeled pediatric CT data. Combined with a multi-scale feature aggregation strategy and a lightweight Primus decoder, downstream segmentation tasks were evaluated on a public pediatric CT dataset. Based on case-wise paired results, we compared the mean Dice similarity coefficient (DSC) and mean intersection over union (IoU) between our model and the baseline nnU-Net using the Wilcoxon signed-rank test, and computed the relative performance improvements. A total of 867 abdominal CT imaging cases were collected, constituting a pretraining dataset comprising 367 588 two-dimensional CT slices. On the public Pediatric-CT-SEG dataset (359 cases), our model achieved a mean DSC of (71.38±1.08)% and a mean IoU of (63.73±1.01)%, representing improvements of 3.22% and 3.59% over the baseline nnU-Net, respectively, with statistically significant differences ( The self-supervised pretraining framework proposed in this study effectively alleviates the domain shift between adult and pediatric abdominal CT images, significantly enhances segmentation accuracy for pediatric abdominal multi-organs-particularly small organs and structures with complex boundaries-and provides a reliable technical solution for intelligent pediatric imaging analysis in scenarios with limited annotated data.
6.Objective Data Analysis of Tongue Manifestations and Complexions in the Population with Yang Deficiency Constitution
Xuan TENG ; Tianfeng PENG ; Yuxuan ZHOU ; Xinying YI ; Jingyi YANG ; Meiyan ZENG ; Qinghua PENG ; Houpan SONG
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(4):797-802
Objective To conduct an analysis on objective data of tongue manifestations and complexions among college students with yang deficiency constitution and balanced constitution,thus to explore the correlation between yang deficiency constitution and the objective data of tongue manifestations and complexions among college students.Methods From August 2023 to January 2024,data collection was carried out in 325 cases of yang deficiency constitution(yang deficiency group)and 175 cases of balanced constitution(balanced group)from college students of Hunan University of Chinese Medicine,Central South University,Hunan Normal University,Hunan University and Changsha University of Science and Technology in Hunan Province.YM-MA-Ⅰ digital detection system for tongue manifestations and complexions of traditional Chinese medicine(TCM)was utilized for data collection and image analysis,and the differences in the Lab parameters of tongue color,tongue shape,tongue coating color,complexions,and lip color were compared between yang deficiency group and balanced group.Of the Lab parameters,letter"L"stands for luminance,which expresses the luminance from absolute black to absolute white,and takes the value of 0-100;letter"a"and letter"b"stand for two color channels,letter"a"represents the color from dark green to grey then to bright pink,and takes a value from-128 to 127,and letter"b"represents the color from bright blue to grey then to yellow,and also takes a value from-128 to 127.Results(1)The analysis of tongue manifestations showed that in comparison with the balanced group,enlarged tongue(72.62%),tooth-marked tongue(83.69%),and greasy coating(59.38%)were frequently seen in the yang deficiency group,and the differences were all statistically significant(P<0.05 or P<0.01).(2)The analysis of complexions showed that in comparison with the balanced group,lusterless complexion(79.08%)and pale lip(42.15%)were frequently seen in the yang deficiency group,with statistically significant differences(P<0.01).(3)The yang deficiency group had higher L value of tongue color,L value of tongue coating color,L value of complexions,and L and b values of lip color than the balanced group,and the differences were all statistically significant(P<0.05),indicating that the tongue color,complexions,and lip color of the yang deficiency group were all pale.Conclusion The objective data and image analysis of tongue manifestations and complexions can accurately identify the population of yang deficiency constitution from college students,and the results will provide approaches and references for the identification of other TCM constitutions from the population.
7.Analysis of Animal Models of Primary Dysmenorrhea Based on Clinical Features in Traditional Chinese and Western Medicine
Qinghua WANG ; Yu HUAN ; Shuangling ZHOU ; Ting ZUO ; Mingsan MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):220-226
ObjectiveTo systematically review the modeling methods and analyzes the model alignment with clinical features of primary dysmenorrhea (PD) in both traditional Chinese medicine (TCM) and western medicine, providing theoretical and practical guidance for establishing the animal models of PD that better reflect the diagnostic and therapeutic characteristics of both TCM and western medicine. MethodsThe literature on PD animal models was searched against domestic and international databases such as PubMed, CNKI, and Wanfang Data. According to the diagnostic criteria of TCM and western medicine, the modeling methods in the literature were summarized, evaluated for strengths and weaknesses, and systematically assessed for clinical concordance rates to identify suitable reference models. ResultsThe available animal models of PD showed the average clinical concordance rates of 43.64% and 61.27% with the clinical features in TCM and western medicine, respectively. Commonly used modeling methods included estrogen administration, physical stimulation, and surgical intervention, with the estrogen combined with oxytocin model and the ice-water bath model being the most studied. The model of Qi stagnation and blood stasis syndrome that was established with the comprehensive stimulation method demonstrated the highest clinical concordance rate. ConclusionCurrent PD animal models primarily replicate dysmenorrhea and simulate menstruation, but they differ from human menstruation to some extent and cannot fully reflect the pathogenesis and physiological characteristics of PD. Moreover, except the cold coagulation and dampness stagnation syndrome and Qi stagnation and blood stasis syndrome, no animal models for other TCM syndromes have been reported, which limits comprehensive TCM research on this disease to a certain extent.
8.Analysis of Animal Models of Primary Dysmenorrhea Based on Clinical Features in Traditional Chinese and Western Medicine
Qinghua WANG ; Yu HUAN ; Shuangling ZHOU ; Ting ZUO ; Mingsan MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):220-226
ObjectiveTo systematically review the modeling methods and analyzes the model alignment with clinical features of primary dysmenorrhea (PD) in both traditional Chinese medicine (TCM) and western medicine, providing theoretical and practical guidance for establishing the animal models of PD that better reflect the diagnostic and therapeutic characteristics of both TCM and western medicine. MethodsThe literature on PD animal models was searched against domestic and international databases such as PubMed, CNKI, and Wanfang Data. According to the diagnostic criteria of TCM and western medicine, the modeling methods in the literature were summarized, evaluated for strengths and weaknesses, and systematically assessed for clinical concordance rates to identify suitable reference models. ResultsThe available animal models of PD showed the average clinical concordance rates of 43.64% and 61.27% with the clinical features in TCM and western medicine, respectively. Commonly used modeling methods included estrogen administration, physical stimulation, and surgical intervention, with the estrogen combined with oxytocin model and the ice-water bath model being the most studied. The model of Qi stagnation and blood stasis syndrome that was established with the comprehensive stimulation method demonstrated the highest clinical concordance rate. ConclusionCurrent PD animal models primarily replicate dysmenorrhea and simulate menstruation, but they differ from human menstruation to some extent and cannot fully reflect the pathogenesis and physiological characteristics of PD. Moreover, except the cold coagulation and dampness stagnation syndrome and Qi stagnation and blood stasis syndrome, no animal models for other TCM syndromes have been reported, which limits comprehensive TCM research on this disease to a certain extent.
9.Reproductive toxicity of clothianidin on two generations of Wistar rats
Yinghua LIU ; Qinghua ZHOU ; Shufei LI ; Miao ZHAO ; Dianming ZHOU ; Zhiyong QIAN
Journal of Public Health and Preventive Medicine 2025;36(5):18-22
Objective To investigate the reproductive and developmental effects of Clothianidin in rats. Methods Clothianidin was administrated by diet to both parental and first filial (F 1) generations of rats at the dosages of 0, 30.51, 110.84 and 304.26 mg/(kg·d) in females, and 0, 26.45, 92.69 and 279.42 mg/(kg·d) in males. Clothianidin was administered through diet to male and female rats for 8 weeks before mating. Clothianidin was administered to female rats in the parental and F1 generations during mating, gestation and lactation periods. During the test, toxicity performance was observed, reproduction index was calculated, and pathological examination was carried out. Results The body weights of rats in the parent and F1 generations in the high-dose group were lower than those in the control group during pre-mating exposure and at various time points during pregnancy and lactation (P<0.05). The pregnancy rates of parental and F1 generations in the high-dose group were lower than those of the control group (48.57% vs 71.43%, 45.71% vs 80.00%, P<0. 05). Sperm concentration and sperm motility of the parental generation were lower than those of the control group [(42.55±12.87) vs (53.84±7.65) ×106/ml, (58.94±10.59) vs (65.59±6.03), (P<0.05)]. Sperm concentration and sperm motility of the F1 generation were lower than those of the control group [(41.64±12.42) vs (53.09±9.48), (55.13±9.19) vs (64.53±6.31), (P<0.05). Conclusion Exposure to clothianidin has reproductive toxicity to Wistar rats, and the no-observed adverse effect level (NOAEL) in the two-generation reproductive toxicity test is 92.69 mg/kg·BW for males and 110.84 mg/kg·BW for females in Wistar rats.
10.Burden and trend of lower respiratory tract infections attributable to non-optimal temperature risk in China,1990-2021
Tianyu LIU ; Junyun ZHOU ; Qinghua WANG ; Jian LI
Chinese Journal of Nosocomiology 2025;35(15):2330-2335
OBJECTIVE To elucidate the burden of lower respiratory tract infections(LRIs)attributable to non-op-timal temperature risk and its changing trends in China from 1990 to 2021,and to provide insights for identifying susceptible populations.METHODS The changing trends in mortality and disability-adjusted life years(DALYs)of LRIs attributed to non-optimal,low and high temperature risks were analyzed through the 2021 global burden of disease(GBD)database.Joinpoint software was used to analyze the trend changes of time series and explore the standardized mortality rate and the standardized DALYs rate of LRIs attributed to non-optimal temperature risk.RESULTS In 2021,LRIs mortality and DALYs rates attributable to non-optimal temperature risk in China were 1.92 per 100,000(down 66.80%from 5.76 per 100,000 in 1990)and 37.99 per 100,000(down 90.47%from 398.77 per 100,000 in 1990),respectively.The burden of LRIs attributed to non-optimal temperature risks was higher in males than that in females,with the mortality rates of 2.86 per 100,000 and 2.48 per 100,000,and DA-LYs rates of 44.90 per 100,000 and 30.75 per 100,000,respectively.The burden of LRIs increased significantly in children under 5 years old and elderly individuals aged 75 and above.From 1990 to 2021,the standardized mortali-ty rate and the standardized DALYs rate of LRIs attributed to non-optimal temperature factors in China showed a declining trend[average annual percentage change(AAPC):-5.04%and-7.33%,respectively].CONCLUSIONS The overall burden of LRIs attributable to non-optimal temperature in China has generally declined from 1990 to 2021.with higher burden in males than that in females,and higher burden in individuals under 5 years old and those aged 75 and above.In China,low temperature risk plays an important role in the non-optimal temperature effect.To reduce the burden of LRIs disease,early intervention measures should be implemented for males,the middle-aged and elderly people and children,and early protection for susceptible populations should be provided based on changes in external environmental temperature,which are of significant public health importance for re-ducing disease burden.


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