1.Construction and Verification of Prediction Model of Qi Deficiency and Blood Stasis Syndrome in Chronic Heart Failure
Tong JIANG ; Xiaodan FAN ; Shijia WANG ; Fengxia LIN ; Zhicong ZENG ; Liangzhen YOU ; Hongcai SHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):154-163
ObjectiveTo construct and validate a clinical prediction model for Qi deficiency and blood stasis syndrome in chronic heart failure (CHF),aiming to assist clinical diagnosis and provide tools and methods for individualized treatment of CHF. MethodsThe clinical data of patients with chronic heart failure treated at Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2022 to January 2024 were retrospectively collected. The patients were randomly divided into a training group and a validation group with a ratio of 7∶3. First, the least absolute shrinkage and selection operator (LASSO) regression analysis was used to preliminarily screen the predictive factors affecting the diagnosis of Qi deficiency and blood stasis syndrome in CHF. Subsequently, the Logistic regression method was applied to conduct a more in-depth and detailed analysis of these factors. Variables with P<0.05 in the results of the multi-factor Logistic regression were carefully selected and included. Based on the regression coefficients obtained from this analysis, a model was constructed, and a nomogram was accurately drawn. Using R software,the receiver operating characteristic (ROC) curve,calibration curve,and decision curve analysis (DCA) were precisely drawn. These analyses were used to comprehensively evaluate the model from three crucial aspects: discrimination,calibration,and clinical applicability. Additionally, the accuracy,specificity,sensitivity,positive predictive value,and negative predictive value of the model were meticulously calculated to conduct a more all-round and comprehensive assessment. ResultsIn total, 168 cases were successfully obtained in the training group, and 71 cases were included in the validation group. After a thorough comparison, it was found that there were no statistically significant differences in the baseline data between the two groups. After being rigorously screened by the LASSO-multivariate logistic regression method, dark red tongue,smoking history,cardiac troponin I,and N-terminal pro-B-type natriuretic peptide (NT-ProBNP) were identified as the influencing factors for diagnosing patients with the Qi deficiency and blood stasis syndrome in CHF. The constructed model demonstrated an area under the curve (AUC) of 0.812 in the training group and 0.719 in the validation group. The calibration curve showed that the predicted curve of the model was close to the actual observed curve. DCA indicated that the model could provide substantial clinical benefits for patients at the decision thresholds ranging from 0.2 to 0.9. ConclusionThe clinical prediction model for Qi deficiency and blood stasis syndrome in chronic heart failure constructed in this study shows good performance. It has certain application value in clinical practice, which may contribute to the improvement of the diagnosis and treatment of CHF patients with this syndrome.
2.Promoting Innovative Development of Traditional Chinese Medicine Case Report Based on China Clinical Cases Library of Traditional Chinese Medicine
Kaige ZHANG ; Hongcai SHANG ; Yong ZHU ; Weijun HUANG ; Xiaoxiao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):190-195
China Clinical Cases Library of Traditional Chinese Medicine is built to promote the establishment of a scientific and technological talent evaluation system oriented on innovative value, ability and contribution in the backgroud of breaking the four only and setting new standards required by the document jointly issued by several national administrations and commissions. In the process of the construction, in order to further consolidate the foundation and ensure the quality and authority of case reports, we need to fully understand the origin and development of Chinese medical cases. Therefore, we clarified the development situation of Chinese medical cases by combing the characteristics of ancient and modern case reports, comparing the differences between Chinese and western medical case reports in terms of content and writing requirements, finally formed the main points of systematic case report norms and quality evaluation system, aiming to fully explore the unique advantages of Chinese medical cases in the fields of discipline development, scientific research innovation, clinical practice and guidance, talent evaluation and training, so as to promote its innovative development in a broader direction.
3.Promoting Reform of Talent Evaluation Based on China Clinical Cases Library of Traditional Chinese Medicine
Kaige ZHANG ; Yong ZHU ; Jisheng WANG ; Liangzhen YOU ; Weijun HUANG ; Jie YANG ; Candong LI ; Genping LEI ; Chuan ZHENG ; Shuzhen GUO ; Longtao LIU ; Zhining TIAN ; Xinping QIU ; Wenli SU ; Zuo LI ; Wei YAN ; Hongcai SHANG ; Xiaoxiao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(17):220-226
Talents are the main force for the development of traditional Chinese medicine(TCM), and the construction of TCM talents and the reformation of talent evaluation system are essential to promote the inheritance and innovation of TCM. At present, we are still exploring and developing in the fields of the formulation, implementation and evaluation indicators of TCM talent evaluation system. However, there are shortcomings and difficulties. For instance, insufficient stratification in the evaluation, excessive emphasis on the quantity of achievements, neglecting the quality of the achievements and the actual contribution, imperfect assessment indicators, and the weak characteristics of TCM. Therefore, national ministries and commissions have jointly issued a document requesting to break the four only and set a new standard, in order to promote the construction of a scientific and technological talent evaluation system oriented by innovation value, ability and contribution. For the evaluation of TCM clinical talents, China Association for Science and Technology commissioned China Association of Chinese Medicine to build the China Clinical Cases Library of TCM(CCCL-TCM), which aims at collecting the most authoritative and representative TCM clinical cases and exploring the advantages of applying clinical cases as masterpiece of achievement in TCM clinical talents evaluation. CCCL-TCM can promote the construction of a talent evaluation system that is more in line with the development characteristics of TCM industry, and to carry out relevant pilot in TCM colleges and institutions across the country in order to promote the reformation of TCM talent evaluation system.
4.Issues and Solutions for Symptom Efficacy Evaluation in the Big Data Era of Traditional Chinese Medicine
Xiaoyu ZHANG ; Sichao TIAN ; Liangzhen YOU ; Xi GUO ; Zhao CHEN ; Chunling LIU ; Nannan SHI ; Hongcai SHANG
Journal of Traditional Chinese Medicine 2024;65(8):792-795
Emphasizing symptom efficacy is an important manifestation of the personalized diagnosis and treatment of traditional Chinese medicine (TCM). However, in current clinical practice of TCM, there are challenges such as diverse symptom expressions, difficulty in standardization, inconsistent evaluation standards for symptom efficacy, lack of universal quantitative methods, and complexity in collecting complete and accurate symptom information. These issues hinder the full and effective utilization of symptom information. Addressing the current research status and existing problems of symptom terminology standardization, quantification and grading of symptom efficacy, and collection of symptom information, this paper proposes methodological strategies for effectively recording and utilizing TCM symptom efficacy information in the era of big data. These strategies include collecting TCM symptom information based on patient reporting, standardizing the evaluation of TCM symptom efficacy from measurement scales and evaluation dimensions, integrating TCM symptom efficacy evaluation into clinical diagnosis and treatment processes, and utilizing artificial intelligence technology to acquire and process TCM symptom efficacy information. TCM symptom efficacy evaluation strategies based on patient perspectives and artificial intelligence technology will help fully explore the value of data elements, promote the objective demonstration of the specific efficacy of TCM, and facilitate the discovery of effective patterns.
5.Constitution identification model in traditional Chinese medicine based on multiple features
Anying XU ; Tianshu WANG ; Tao YANG ; Xiao HAN ; Xiaoyu ZHANG ; Ziyan WANG ; Qi ZHANG ; Xiao LI ; Hongcai SHANG ; Kongfa HU
Digital Chinese Medicine 2024;7(2):108-119
Objective To construct a precise model for identifying traditional Chinese medicine(TCM)constitutions,thereby offering optimized guidance for clinical diagnosis and treatment plan-ning,and ultimately enhancing medical efficiency and treatment outcomes. Methods First,TCM full-body inspection data acquisition equipment was employed to col-lect full-body standing images of healthy people,from which the constitutions were labelled and defined in accordance with the Constitution in Chinese Medicine Questionnaire(CCMQ),and a dataset encompassing labelled constitutions was constructed.Second,heat-suppres-sion valve(HSV)color space and improved local binary patterns(LBP)algorithm were lever-aged for the extraction of features such as facial complexion and body shape.In addition,a dual-branch deep network was employed to collect deep features from the full-body standing images.Last,the random forest(RF)algorithm was utilized to learn the extracted multifea-tures,which were subsequently employed to establish a TCM constitution identification mod-el.Accuracy,precision,and F1 score were the three measures selected to assess the perfor-mance of the model. Results It was found that the accuracy,precision,and F1 score of the proposed model based on multifeatures for identifying TCM constitutions were 0.842,0.868,and 0.790,respectively.In comparison with the identification models that encompass a single feature,either a single facial complexion feature,a body shape feature,or deep features,the accuracy of the model that incorporating all the aforementioned features was elevated by 0.105,0.105,and 0.079,the precision increased by 0.164,0.164,and 0.211,and the F1 score rose by 0.071,0.071,and 0.084,respectively. Conclusion The research findings affirmed the viability of the proposed model,which incor-porated multifeatures,including the facial complexion feature,the body shape feature,and the deep feature.In addition,by employing the proposed model,the objectification and intel-ligence of identifying constitutions in TCM practices could be optimized.
6.Reflection on the Discipline Construction of Traditional Chinese Medicine Cardio-Oncology
Kaige ZHANG ; Liangzhen YOU ; Shuling LIU ; Qianqian XU ; Hongcai SHANG
Journal of Traditional Chinese Medicine 2024;65(13):1313-1317
Cardio-oncology is an emerging cross-discipline, which has received extensive attention and rapid development at home and abroad in recent years, while the construction of related disciplines in the field of traditional Chinese medicine (TCM) is still in its initial stage. By sorting out the construction of oncology and cardiology related disciplines at home and abroad at this stage, and clarifying the significance and main research contents of the discipline, it is proposed that the construction of TCM related disciplines should be oriented to the four main aspects, including clinical practice, scientific research, talent training and promotion of cultural characteristics. Therefore, actively carrying out multidisciplinary crossing, cultivating related professional talent team, and forming TCM diagnosis and treatment guidelines or consensus to support clinical practice is the essential foundation for the construction of TCM cardio-oncology discipline. Meanwhile, fully exploring the characteristics and advantages of TCM is the key to the construction process of the discipline, such as writing and summarising and analysing relevant high-quality clinical case reports of TCM for evidence-based optimisation, as well as widely applying the concept of "treating disease before it arises" of TCM characteristics to the clinical prevention and treatment of the relevant diseases and scientific research, etc., so as to comprehensively guarantee the development of the discipline of TCM cardio-oncology.
7.Digital and Intelligent Generalized Inspection in Traditional Chinese Medicine and Related Equipment Development from Evidence-based Perspective
Xiaowei ZHANG ; Xiaoyu ZHANG ; Chen ZHAO ; Mengqi PENG ; Xue XU ; Hongyuan LIN ; Wenhui WANG ; Hongcai SHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):94-101
As the foremost among the four examinations in traditional Chinese medicine (TCM), inspection and related equipment research face challenges in landing and transformation due to variations in evidence quality, lack of standardization, insufficient algorithm transparency, and poor reliability and stability of decision-making. Against the backdrop of rapid development of emerging technologies such as big data, the internet of things, and artificial intelligence, coupled with macro policy support from the government, digital and intelligent generalized inspection in TCM has emerged, with the aim of utilizing digital technologies to overcome the limitations of naked-eye inspection and comprehensively perceive and analyze facial and bodily expressions. The research in this field intelligently correlates Zang-fu organ functions with health conditions and disease progression and establishes a technical system for digital and intelligent inspection, multi-dimensional and multimodal perception, fusion analysis, and decision-making. This system aims to enhance the accuracy of disease risk warning and diagnosis, bridging the gap between inspection equipment and assistance in clinical decision-making. From an evidence-based perspective, this paper systematically examines the research ideas of digital and intelligent inspection and the development of related equipment, deeply explores how to propose clinical practice-oriented key scientific issues, comprehensively acquire and co-apply multi-dimensional data, establish precise inspection models driven by digital intelligence, optimize standards to enhance equipment interoperability and reliability, construct post-effect evaluation mechanisms to promote improvement, and actively address potential risks such as the black box nature and information security in the application of intelligent technology. This paper not only demonstrates the tremendous potential of digital technologies in improving the accuracy and clinical application efficiency of inspection but also provides new perspectives and ideas for the modernization of inspection in TCM, paving the way for the application of inspection in the global medical and health field.
8.Multi-evidence Integration Methodology for Traditional Chinese Medicine: the MERGE Framework
Honghao LAI ; Zhe WANG ; Ying LI ; Wenjing TANG ; Beibei WANG ; Peidong SUN ; Mingyao SUN ; Jiajie HUANG ; Zhipan XIAO ; Ying LI ; Chen ZHAO ; Hongcai SHANG ; Kehu YANG ; Jie LIU ; Long GE
Medical Journal of Peking Union Medical College Hospital 2024;15(1):172-182
In the era of evidence-based medicine, it is necessary to explore the unique advantages of traditional Chinese medicine (TCM) based on standardized technical methods and operating procedures in order to achieve the modernization and internationalization of TCM and benefit all humanity. The proposal of a three-pronged evidence system combining TCM theory, human experience and experimental evidence marks an important progress in the thinking method of the TCM evaluation system. The multi-evidence body integrated through appropriate methods provides a strong support for the clinical guideline recommendations and evidence-based health decision-making in TCM. Based on the current methodological progress of international evidence synthesis and grading, this paper proposes a novel approach for integrating multi-evidence in TCM: the MERGE framework. The aim is to establish a solid foundation for the development of this methodology and provide guidance for the advancement of evidence-based medicine framework in TCM.
9.Online pharmaceutical process analysis of Chinese medicine using a miniature mass spectrometer:Extraction of active ingredients as an example
Wangmin HU ; Junling HOU ; Wenjing LIU ; Xuan GU ; Yulei YANG ; Hongcai SHANG ; Mei ZHANG
Journal of Pharmaceutical Analysis 2023;13(5):535-543
The automation of traditional Chinese medicine(TCM)pharmaceuticals has driven the development of process analysis from offline to online.Most of common online process analytical technologies are based on spectroscopy,making the identification and quantification of specific ingredients still a challenge.Herein,we developed a quality control(QC)system for monitoring TCM pharmaceuticals based on paper spray ionization miniature mass spectrometry(mini-MS).It enabled real-time online qualitative and quantitative detection of target ingredients in herbal extracts using mini-MS without chromatographic separation for the first time.Dynamic changes of alkaloids in Aconiti Lateralis Radix Praeparata(Fuzi)during decoction were used as examples,and the scientific principle of Fuzi compatibility was also investigated.Finally,the system was verified to work stably at the hourly level for pilot-scale extraction.This mini-MS based online analytical system is expected to be further developed for QC applications in a wider range of pharmaceutical processes.
10.The traditional Chinese medicines treat chronic heart failure and their main bioactive constituents and mechanisms.
Jie CHEN ; Xiaohong WEI ; Qian ZHANG ; Yuzhuo WU ; Guiyang XIA ; Huan XIA ; Lingyan WANG ; Hongcai SHANG ; Sheng LIN
Acta Pharmaceutica Sinica B 2023;13(5):1919-1955
Chronic heart failure (CHF) is a severe public health problem with increasing morbidity and mortality, any treatment targeting a single session is insufficient to tackle this. CHF is characterized by reduced cardiac output resulting from neurohumoral dysregulation and cardiac remodeling, which might be related to oxidative stress, inflammation, endoplasmic reticulum stress, apoptosis, autophagy, mitochondrial function, and angiogenesis. These molecular mechanisms interact with each other through crosstalk. Historically, Chinese medicinal herbs have been widely applied in the treatment of CHF, and therapeutic effects of Chinese medicinal herbs and their ingredients have been scientifically confirmed over the past decades. Traditional Chinese medicine (TCM) with multiple components can confront the different pathogenesis of CHF through multiple targets. This review analyzes commonly used TCM patent drugs and TCM decoctions that are applicable to different stages of CHF based on clinical trials. Diverse bioactive ingredients in Chinese medicinal herbs have been found to treat CHF via multiple molecular mechanisms. This review comprehensively covers the key works on the effects and underlying mechanisms of TCM, herbal ingredients and synergistic effects of constituent compatibility in treating CHF, providing additional ideas to address this threat.

Result Analysis
Print
Save
E-mail