1.Construction of a Disease-Syndrome Integrated Diagnosis and Treatment System for Gastric "Inflammation-Cancer" Transformation Based on Multi-Modal Phenotypic Modeling
Hao LI ; Huiyao ZHANG ; Wei BAI ; Tingting ZHOU ; Guodong HUANG ; Xianjun RAO ; Yang YANG ; Lijun BAI ; Wei WEI
Journal of Traditional Chinese Medicine 2025;66(5):458-463
By analyzing the current application of multi-modal data in the diagnosis of gastric "inflammation-cancer" transformation, this study explored the feasibility and strategies for constructing a disease-syndrome integrated diagnosis and treatment system. Based on traditional Chinese medicine (TCM) phenomics, we proposed utilizing multi-modal data from literature research, cross-sectional studies, and cohort follow-ups, combined with artificial intelligence technology, to establish a multi-dimensional diagnostic and treatment index system. This approach aims to uncover the complex pathogenesis and transformation patterns of gastric "inflammation-cancer" progression. Additionally, by dynamically collecting TCM four-diagnostic information and modern medical diagnostic information through a long-term follow-up system, we developed three major modules including information extraction, multi-modal phenotypic modeling, and information output, to make it enable real-world clinical data-driven long-term follow-up and treatment of chronic atrophic gastritis. This system can provide technical support for clinical diagnosis, treatment evaluation, and research, while also offering insights and methods for intelligent TCM diagnosis.
2.Clinical significance of determining the level of biliary calprotectin in patients with cholangiocarcinoma or choledocholithiasis
Tingting JI ; Bingqing BAI ; Yufang CUI ; Shaofei WANG ; Jianglong HONG ; Yang LI ; Junjun BAO ; Qiao MEI
Journal of Clinical Hepatology 2024;40(3):568-572
ObjectiveTo investigate the difference in the level of biliary calprotectin between patients with cholangiocarcinoma and those with choledocholithiasis. MethodsClinical data and bile samples were collected from 34 patients with cholangiocarcinoma and 78 patients with choledocholithiasis who were diagnosed and treated with endoscopic retrograde cholangiopancreatography in The First Affiliated Hospital of Anhui Medical University from May 2021 to September 2022. Fluorescence lateral flow immunoassay was used to measure the levels of calprotectin, hemoglobin, and lactoferrin in bile. The Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups; the Spearman correlation test was used for correlation analysis; the DeLong test was used for comparison of the area under the ROC curve (AUC). ResultsCompared with the choledocholithiasis group, the cholangiocarcinoma group had significant increases in the levels of calprotectin [4 795.50 (2 286.79 — 20 179.73) ng/mL vs 411.16 (67.03 — 1 991.88) ng/mL, Z=5.572, P<0.001] and fluoride [115.70 (109.10 — 125.50) mmol/L vs 106.60 (98.60 — 114.40) mmol/L, Z=2.702, P=0.007]. The patients with cholangiocarcinoma were further divided into high cholangiocarcinoma group and low cholangiocarcinoma group, and there was no significant difference between the two groups in the level of calprotectin [3 867.71 (2 235.66 — 26 407.40) ng/mL vs 4 795.50 (2 361.15 — 13 070.53) ng/mL, Z=0.129, P>0.05]. Biliary calprotectin level was correlated with white blood cell count, hemoglobin concentration, and lactoferrin concentration in bile (r=0.316, 0.353, and 0.464, all P<0.05). The ROC curve analysis showed that biliary calprotectin (with a sensitivity of 79.4% and a specificity of 75.6%), blood CA19-9 (with a sensitivity of 82.4% and a specificity of 78.2%), and their combination (with a sensitivity of 88.2% and a specificity of 73.1%) had good sensitivity and specificity in the diagnosis of cholangiocarcinoma. ConclusionThere is an increase in the level of biliary calprotectin in patients with cholangiocarcinoma, and therefore, it might become a biomarker for the diagnosis of cholangiocarcinoma.
3.A retrospective study on the evolution of TCM syndrome and TCM syndrome elements in the course of disease in 1,049 patients with psoriasis vulgaris
Jiayue WANG ; Ping LI ; Dongmei ZHOU ; Yanping BAI ; Xingwu DUAN ; Haibing LAN ; Yiding ZHAO ; Jingxia ZHAO ; Yan WANG ; Tingting DI ; Yujiao MENG ; Zhaoxia CHEN
Journal of Beijing University of Traditional Chinese Medicine 2024;47(10):1438-1448
Objective The study aimed to elucidate the evolution of the syndromes in Traditional Chinese Medicine(TCM)and TCM syndrome elements in different chronic stages of psoriasis vulgaris.Methods A database was constructed using electronic medical records collected from July 2019 to March 2024 from 1,049 patients with psoriasis vulgaris.The study used Sankey diagrams and network association graphs to analyze the evolution of TCM syndromes and their elements in patients at the different stages:initial diagnosis,progressive stage(Week 2-3),progressive stage(Week 4-5),skin lesion improvement stage(Week 6-7),and remission stage.The syndrome elements network was constructed using community detection algorithms,and the association rules between local skin lesion syndrome differentiation and overall syndrome differentiation were displayed using heatmaps.Results(ⅰ)Initial diagnosis.In the syndrome differentiation of local skin lesions,blood heat syndrome was the most common(79.79%);among the disease location of TCM syndrome elements(called"disease location"),liver was the most prevalent(35.62%);and among the pathological factors of TCM syndrome elements(called"pathological factors"),fire(heat)was the most common(75.48%).(ⅱ)Active stage(Week 2-3).In the syndrome differentiation of local skin lesions,blood heat syndrome remained the most prevalent(73.13%);among the disease location,liver was still the most prevalent(31.71%);and among the pathological factors,fire(heat)continued to be the most common(82.11%),while dampness(22.26%)and qi stagnation(8.39%)began to increase.(ⅲ)Active stage(Week 4-5).The syndrome differentiation of local skin lesions was dominated by blood heat syndrome(45.91%)and blood dryness syndrome(37.19%);among disease location,the interior was the most prevalent(15.25%);and among the pathological factors,fire(heat)remained the most common(50.66%),with an increase in yin deficiency(34.26%).(ⅳ)Skin lesion improvement stage(Week 6-7).In the syndrome differentiation of local skin lesions,both blood dryness syndrome(49.44%)and blood stasis syndrome(33.33%)increased;among the disease location,meridians increased most significantly and became the most prevalent(13.44%);and among the pathological factors,blood stasis increased most significantly and became the most prevalent(28.20%).(ⅴ)Remission stage.In the syndrome differentiation of local skin lesions,blood stasis syndrome became the primary(55.69%),while the percentage of blood dryness syndrome decreased(21.16%);meridians(25.71%)and blood stasis(62.34%)remained the most predominant syndrome elements related to disease location or pathological factors.Conclusion The overall pattern of TCM syndromes in psoriasis vulgaris evolved from excess to deficiency.From the initial diagnosis to the active phase(Week 2-3),heat syndrome dominated;during the active phase(Week 4-5),heat syndrome coexisted with damp syndrome or yin deficiency syndrome;changes in the syndrome element network were the most significant during the lesion improvement phase,with blood stasis gradually increasing and peaking during the remission phase.Blood stasis,dampness,and qi stagnation were pervasive throughout psoriasis vulgaris;qi stagnation and blood stasis may be the main elements causing further deterioration and prolonged course of the disease during the active phase in patients.
4.Phenotypic characteristics and toxicological mechanisms of herb-induced liver injury
Tingting HE ; Zhaofang BAI ; Jiabo WANG ; Xiaohe XIAO
Journal of Clinical Hepatology 2024;40(8):1525-1532
In order to deal with the problem of the safety of Chinese herbal medicine in a scientific way and further meet the growing health needs of people,it is particularly important to deepen the research on herb-induced liver injury.This article elaborates on the phenotypic characteristics and toxicological mechanisms of herb-induced liver injury and emphasizes that it should not only rely on the previous knowledge of the toxicity of Chinese herbal medicine,but also understand the new types of idiosyncratic toxicity,indirect toxicity,and mixed toxicity,which provide a new perspective for understanding the toxicological mechanisms of herb-induced liver injury and are of great importance to investigate the phenotype and toxicological mechanism of herb-induced liver injury.
5.Expression of long non-coding RNA SFTA1P and its effect on biological functions in lung squamous cell carcinoma
Weiping WAN ; Weijia XIE ; Tingting XIA ; Ying XIANG ; Na WU ; Chengying LI ; Yifan SHAN ; Li BAI ; Yafei LI
Journal of Army Medical University 2024;46(11):1226-1234
Objective To investigate the expression of long non-coding RNA(lncRNA),surfactant associated 1 pseudogene(SFTA1P)in lung squamous carcinoma and its effect on the biological functions of SFTA1P in lung squamous carcinoma cell lines.Methods Based on the cancer genome atlas(TCGA)database,the differential expression of SFTA1P in tumor and normal tissues were compared in patients diagnosed with lung squamous cell carcinoma.Then,the expression of SFTA1P was detected in human normal lung epithelial cell line BEAS-2B and lung squamous cell lines SK-MES-1 and H520 with real-time quantitative polymerase chain reaction(RT-qPCR).SK-MES-1 and H520 cells with overexpression and/or knockdown of SFTA1P were constructed by transfecting the overexpression plasmids(pcDNA3.1-SFTA1P)and small interfering RNAs(si-SFTA1P-1 and si-SFTA1P-2).CCK-8 assay and Transwell assay were used to investigate the effect of SFTA1P on biological functions in lung squamous carcinoma cells.Differential gene expression analysis,correlation analysis and functional enrichment analysis were employed to explore the potential mechanism that SFTA1P may affect biological functions of lung squamous cells.Results Analysis of TCGA showed that the expression of SFTA1P was significantly lower in lung squamous cell carcinoma tissue than adjacent normal tissue(P<0.05).RT-PCR results showed that the expression of SFTA1P was obviously lower in lung squamous carcinoma cells than the human normal lung epithelial cells(P<0.05).And the expression level of SFTA1P was relatively lower in the SK-MES-1 cells than the H520 cells(P<0.05).Overexpression of SFTA1P suppressed the proliferation,migration and invasion of lung squamous carcinoma cells(P<0.05),while its knockdown promoted these abilities(P<0.05).Differential gene expression analysis,correlation analysis and functional enrichment analysis indicated that SFTA1P may inhibit MYC,G2m checkpoints and E2f signaling pathways in lung squamous cell carcinoma.Conclusion SFTA1P shows anti-cancer function in lung squamous cell carcinoma,and it may affect the biological functions of lung squamous cell carcinoma cells through down-regulating MYC,G2m checkpoints and E2f signaling pathways.
6.Effects of Mongolian medicine warm acupuncture on pyroptosis and inflammation in depression model rats
Lixia ZHANG ; Jiuwang YU ; Tingting ZHANG ; Yongfeng BAI
International Journal of Traditional Chinese Medicine 2024;46(11):1469-1474
Objective:To observe the effects of Mongolian medicine warm acupuncture treatment on the behavior and NLRP3, ASC, Caspase-1, GSDMD, and inflammatory factors in hippocampus of the depression model rats; To explore the mechanism.Methods:Totally 40 male SD rats were divided into control group, model group, warm acupuncture group, and fluoxetine group using a random number table method, with 10 rats in each group. Except for the control group, chronic unpredictable stress models were established in all other groups. After 1 hour of daily stress stimulation, the warm acupuncture group received Mongolian medicine warm acupuncture intervention. The fluoxetine group was orally administered with 2.1 mg/kg fluoxetine hydrochloride, while the control group and model group were orally administered with equal volumes of distilled water once a day for 21 days. The body weight of rats was measured, and their behavior was evaluated by sugar water consumption test, open field test, and Morris water maze test. ELISA was used to measure the levels of IL-1 β, IL-18, IL-6, and TNF-α in the serum. Western blot and PCR were used to detect the protein and mRNA levels of NLRP3, ASC, Caspase-1, GSDMD, and IL-1 in the hippocampus.Results:Compared with the model group, the warm acupuncture group and fluoxetine group showed an increase in body weight ( P<0.05), sugar water consumption ( P<0.05), vertical movement frequency and horizontal crossing grid number ( P<0.05), shortened escape latency ( P<0.05), and increased crossing platform frequency ( P<0.05); the levels of serum IL-1β, IL-18, TNF-α, and IL-6 decreased ( P<0.05); the protein and mRNA expressions of NLRP3, Caspase-1, ASC, GSDMD, IL-1β in the hippocampus of rats decreased ( P<0.05). Conclusion:Mongolian medicine warm acupuncture can prevent depressive behaviors in rats by reducing NLRP3-mediated cell death and inflammation.
7.Correlation between serum Irisin,pentraxin3,metastasis-associated lung ad-enocarcinoma transcript 1 levels and the severity of diabetic retinopathy and the value of combined diagnosis
Bo LI ; Mingyuan LIU ; Xing LI ; Xinqiao ZHANG ; Tingting CAO ; Xi WANG ; Zhaoxia LI ; Ling BAI
Recent Advances in Ophthalmology 2024;44(6):470-475
Objective To investigate the correlation between serum Irisin,long pentraxin 3(PTX3),human metas-tasis-associated lung adenocarcinoma transcript 1(MALAT1)levels and the severity of diabetic retinopathy(DR)and the value of combined diagnosis.Methods Eighty-five patients with type 2 diabetes mellitus(T2DM)combined with DR at Cangzhou Central Hospital from April 2022 to April 2023 were selected as the DR group,85 patients with T2DM alone were selected as the non-DR group,and 85 healthy volunteers were selected as the control group during the same period.Pa-tients in the DR group were further divided into the proliferative DR(PDR)group(38 patients)and the non-PDR group(47 patients)based on whether DR was in the proliferative phase.Clinical data of patients in the DR group were collected,including gender,diastolic pressure,age,systolic pressure,disease course,fasting plasma glucose(FPG),body mass in-dex,hemoglobin A1c(HbA1c),smoking history,triglyceride(TG),drinking history,peak systolic velocity(PSV),peak end-diastolic velocity(PEDV),resistance index(RI),fasting insulin(FINS),family history of diabetes,total cholesterol(TC),and homa-insulin resistance(HOMA-IR).Enzyme-linked immunosorbent assay was used to detect serum levels of Irisin and PTX3 in each group of patients,and real-time quantitative polymerase chain reaction was used to detect the ser-um level of MALAT1.The correlations between serum levels of Irisin,PTX3 and MALAT1 and the severity of DR were ana-lyzed using the Pearson correlation coefficient.The influencing factors of the DR severity were identified using the Logistic regression.The value of serum Irisin,PTX3,and MALAT1 levels in diagnosing DR alone was analyzed using the receiver operating characteristic(ROC)curve.The value of regimens containing and not containing serum Irisin,PTX3,and MAL-AT1 levels in diagnosing DR was analyzed using the ROC curve,net reclassification index(NRI),and integrated discrimina-tion improvement(IDI)index.Results The serum levels of Irisin,PTX3,and MALAT1 were compared among the three groups of patients,and the differences were statistically significant(all P<0.001).The disease course of patients in the PDR group was longer than that in the non-PDR group,the PSV,PEDV and serum Irisin level were lower than those in the non-PDR group,while the RI,FPG,HbA1c,TG,FINS,HOMA-IR,and serum PTX3 and MALAT1 levels were higher than those in the non-PDR group(all P<0.05).The serum Irisin level in DR patients was negatively correlated with the severity of DR(r=-0.512,P<0.001),while the PTX3 and MALAT1 levels were positively correlated with the severity of DR(r=0.497,0.573,both P<0.05).The Logistic regression analysis showed that the disease course,FPG,HbA1c,TG,FINS,HOMA-IR,PSV,PEDV,RI,and serum levels of Irisin,PTX3 and MALAT1 were influencing factors for the DR progression(allP<0.05).The area under the curve(AUC)of serum Irisin,PTX3,and MALAT1 levels in diagnosing DR was 0.743,0.811,and 0.773,respectively.Compared with conventional diagnostic protocols,the AUC of the new diagnostic protocol containing serum levels of Irisin,PTX3,and MALAT1 significantly increased(Z=2.708,P=0.007),and the NRI and IDI were 0.039(95%CI:0.022-0.069)and 0.026(95%CI:0.014-0.047),respectively(all P<0.05).Conclusion The serum Irisin level in DR patients decreases,while the serum PTX3 and MALAT1 levels increase,which are closely related to the severity of DR.Diagnostic plans containing serum Irisin,PTX3,and MALAT1 indicators have high diagnostic value.
8.Mental health service utilization of patients with five mental disorders in Inner Mongolia communities
Yinxia BAI ; Lu TONG ; Zhaorui LIU ; Jie YAN ; Ruiqi WANG ; Tingting ZHANG ; Hua DING ; Lixia CHEN ; Jiahui YAO ; Xiaojuan GAO ; Dongsheng LYU ; Zhijian BAI ; Ziyu LI ; Xiaojie SUI ; Yueqin HUANG
Chinese Mental Health Journal 2024;38(5):419-425
Objective:To describe the current situation of mental health service utilization of community pa-tients with five mental disorders in Inner Mongolia Autonomous Region and provide reference for health education and formulating relevant policies.Methods:The multistage stratified sampling method with unequal probability was used to select a total of 12 315 community residents aged 18 and over in Inner Mongolia Autonomous Region.Using Composite International Diagnostic Interview,mood disorders,anxiety disorders,substance use disorders,intermit-tent explosive disorders,and eating disorders,and health service utilization were investigated.Descriptive statistics was completed by single factor analysis method.Results:The lifetime rates of consultation and treatment of any mental disorder were 18.7%and 10.2%,respectively.The highest proportion of patients received treatment by non-medical professionals was 31.4%,followed by psychiatrists in psychiatric hospital or psychologists in general hospitals.Among the patients,1.1%of them received medication,and 2.5%received psychotherapy.Conclusion:The utilization rate of mental health services in community patients with five mental disorders is relatively low.It is necessary to conduct health education for medical help seeking properly.
9.Effectiveness of pneumatic compression therapy combined with infrared irradiation in preventing lower extremity deep vein thrombosis in critically ill patients
Lingzhi LAI ; Tingting CHEN ; Yaling BAI ; Huangen LI
Chinese Journal of Medical Physics 2024;41(11):1415-1420
Objective To explore the preventive effect of pneumatic compression therapy combined with infrared irradiation against lower extremity deep vein thrombosis(DVT)in critically ill patients.Methods A total of 150 critically ill patients from January 2021 to January 2023 in the Intensive Care Unit,Quanzhou First Hospital Affiliated to Fujian Medical University were selected and divided into control group and observation group,with 75 cases in each group.The control group patients were treated with conventional rehabilitation measures combined with the boot-type intermittent pneumatic compression therapy device for intermittent inflation and compression therapy,while the observation group patients received the bioinformatic feedback infrared therapy besides the treatment in control group.The incidence of DVT,the average time for swelling and pain reduction,the average time for swelling and pain disappearance,total hospitalization time,the hemodynamic indexes of the lower extremities,coagulation indexes,D-dimer,the recurrence rate of swelling and pain,satisfaction with the rehabilitation,and therapeutic efficacy were recorded.Results After 3 months of discharge,the rate of post-discharge swelling and pain recurrence in observation group was 2.67%(2/75),obviously lower than 10.66%(8/75)in control group(P<0.05).After 14 days of intervention,the lower extremity deep vein blood flow velocity and peak blood velocity of the two groups increased significantly as compared with those before intervention(P<0.05),and those were greater in observation group than in control group(P<0.05).After 14 days of intervention,the coagulation indexes(PT,TT,FIB)and D-dimer level were significantly lower or shorter in both groups as compared with those before intervention(P<0.05);and observation group had shorter PT and TT,and lower levels of FIB and D-dimer than control group(P<0.05).The average time for swelling and pain reduction,the average time for swelling and pain disappearance,and the total hospitalization time were shorter and the incidence of DVT was obviously lower in observation group as compared with control group(P<0.05).The overall response rates of 14-day intervention in observation group vs control group were 97.33%(73/75)vs 88.00%(66/75)(P<0.05).At the discharge,the satisfaction rates in observation group vs control group were 96.00%vs 85.34%(P<0.05).Conclusion The combination of bioinformatic feedback infrared therapy and boot-type intermittent pneumatic compression therapy device for intermittent inflation and compression therapy can shorten the average time for swelling and pain reduction,the average time for swelling and pain disappearance and the total hospitalization time,enhance the hemodynamics of the lower extremities,improve the coagulation function and D-dimer level,and improve the satisfaction with the rehabilitation and clinical efficacy,worthy of clinical promotion.
10.Analysis on the Medication Law of Bai Changchuan in the Treatment of Chronic Gastritis Based on Data Mining
Lili ZHANG ; Rui YU ; Minghua NAN ; Tingting JIANG ; Ming KANG ; You YU ; Changchuan BAI
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(6):39-46
Objective To summarize the medication law and prescription thinking of Professor Bai Changchuan in the treatment of chronic gastritis.Methods Effective medical records of chronic gastritis treated by Professor Bai Changchuan from January 2017 to December 2022 were selected.Frequency statistics,hidden structure model,association rules were used for data mining.Interview of Professor Bai Changchuan for the treatment of chronic gastritis was analyzed from the aspects of basic principles,core prescriptions and prescription thinking.Results Totally 328 medical cases were included,involving 1 128 prescriptions,among which 904 prescription were HP positive,209 prescription were bile reflux,268 prescriptions were located in the cardia,9 prescriptions in the gastric body,and 896 prescriptions in the gastric antrum.The pathological changes were erosion in 524 prescriptions,atrophy in 354 prescriptions,and intestinal metaplasia in 208 prescriptions.108 kinds of Chinese materia medica were involved.The properties were mainly warm,cold,and mild,the tastes were mainly bitter,sweet and pungent,and the main meridians were spleen meridian,lung meridian,and stomach meridian,involving 20 kinds of efficacy.20 hidden variables were obtained from the hidden structure model of high-frequency Chinese materia medica.There were 210 association rules high-frequence between Chinese materia medica.The core combination was ginger Pinelliae Rhizoma-Codonopsis Radix-Citri Reticulatae Pericarpium-Poria-Glycyrrhizae Radix et Rhizoma Praeparata cum Melle-fried Atractylodis Macrocephalae Rhizoma.Different etiology,disease location and pathological changes were associated with Liujunzi Decoction.The association of HP-Pogostemonis Herba,Amomi Fructus,fried Coicis Semen;bile reflux-Magnoliae Officinalis Corte,Aurantii Fructus Immaturu,Aucklandiae Radix,Galli Gigerii Endothelium Corneumm,Bupleuri Radix,fried Crataegi Fructus;gastric antrum-Pogostemonis Herba,Cyperi Rhizoma,Linderae Radix,Typhae Pollen;cardia-Fritillariae Thunbergii Bulbus,Nelumbinis Folium,Curcumae Radix,Aurantii Fructus Immaturu,Magnoliae Officinalis Corte;erosion-Fritillariae Thunbergii Bulbus,Sepiae Endoconcha,Magnoliae Officinalis Corte,Aurantii Fructus Immaturu,Aucklandiae Radix,fried Paeoniae Radix Alba,Catechu;atrophy-Aucklandiae Radix,Magnoliae Officinalis Corte,Fritillariae Thunbergii Bulbus,Cinnamomi Ramulus,Ophiopogonis Radix;intestinal transformation-Aucklandiae Radix,Magnoliae Officinalis Corte,Aurantii Fructus Immaturu,Galli Gigerii Endothelium Corneumm,Fritillariae Thunbergii Bulbus,Linderae Radix,Faeces Trogopterori,Typhae Pollen also had clinical significance.Conclusion Professor Bai Changchuan treats chronic gastritis with a combination of cold and warm,treating both symptoms and root causes,and applying both attack and tonics.The basic principle is to"promote spleen and stomach circulation,eliminate accumulation and stagnation",and the core prescription is Liujunzi Decoction.Combined with microscopic syndrome differentiation,he selects appropriate drugs for treatment.

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