As an emerging discipline that combines traditional diagnostic methods with modern scientific technology,micro syndrome differentiation has good prospects for development,but there are some controversies in the research process.Based on ancient and modern literature,this article reviewed the origin and flow of research on micro syndrome differentiation,and summarized the problems to be improved in the process of research on micro syndrome differentiation from three aspects:application of disease type,guiding ideology and micro indicators.Based on this,the article further expounded the new thinking on"near-micro"syndrome differentiation from three aspects:connotation,scope of application,and links to traditional identification and micro-identification,and pointed out that the modern medical detection basis should be incorporated into the field of TCM syndrome differentiation,and at the same time,it should be based on the overall thinking mode of TCM,which would provide a new idea for the development of modern TCM diagnosis technology.

Objective To explore the performance of a new multimodal feature fusion classification model based on distance matching and discriminative representation learning for differentiating high-grade glioma(HGG)from solitary brain metastasis(SBM).Methods We collected multi-parametric magnetic resonance imaging(MRI)data from 61 patients with HGG and 60 with SBM,and delineated regions of interest(ROI)on T1WI,T2WI,T2-weighted fluid attenuated inversion recovery(T2_FLAIR)and post-contrast enhancement T1WI(CE_T1WI)images.The radiomics features were extracted from each sequence using Pyradiomics and fused using a multimodal feature fusion classification model based on distance matching and discriminative representation learning to obtain a classification model.The discriminative performance of the classification model for differentiating HGG from SBM was evaluated using five-fold cross-validation with metrics of specificity,sensitivity,accuracy,and the area under the ROC curve(AUC)and quantitatively compared with other feature fusion models.Visual experiments were conducted to examine the fused features obtained by the proposed model to validate its feasibility and effectiveness.Results The five-fold cross-validation results showed that the proposed multimodal feature fusion classification model had a specificity of 0.871,a sensitivity of 0.817,an accuracy of 0.843,and an AUC of 0.930 for distinguishing HGG from SBM.This feature fusion method exhibited excellent discriminative performance in the visual experiments.Conclusion The proposed multimodal feature fusion classification model has an excellent ability for differentiating HGG from SBM with significant advantages over other feature fusion classification models in discrimination and classification tasks between HGG and SBM.

Objective To predict microvascular invasion(MVI)in hepatocellular carcinoma(HCC)using a model based on multi-phase dynamic-enhanced CT(DCE-CT)radiomics feature and hierarchical fusion of multiple classifiers.Methods We retrospectively collected preoperative DCE-CT images from 111 patients with pathologically confirmed HCC in Guangzhou First People's Hospital between January,2016 and April,2020.The volume of interest was outlined in the early arterial phase,late arterial phase,portal venous phase and equilibrium phase,and radiomics features of these 4 phases were extracted.Seven classifiers based on different algorithms were trained using the filtered feature subsets to obtain multiple base classifiers under each phase.According to the hierarchical fusion strategy,a multi-criteria decision-making-based weight assignment algorithm was used for fusing each base classifier under the same phase with the model after extracting the phase information to obtain the prediction model.The proposed model was evaluated using a 5-fold cross-validation and assessed for area under the ROC curve(AUC),accuracy,sensitivity,and specificity.The prediction model was also compared with the fusion models using a single phase or multiple phases,models based on a single phase with a single classifier,models with different base classifier diversities,and 8 classifier models based on other ensemble methods.Results The experimental results showed that the performance of the proposed model for predicting HCCMVI was optimal after incorporating the 4 phases and 7 classifiers,with AUC,accuracy,sensitivity,and specificity of 0.828,0.766,0.877,and 0.648,respectively.Comparative experiments showed that this prediction model outperformed the models based on a single phase with a single classifier and other ensemble models.Conclusion The proposed prediction model is effective for predicting MVI in HCC with superior performance to other models.

Objective To explore the performance of a new multimodal feature fusion classification model based on distance matching and discriminative representation learning for differentiating high-grade glioma(HGG)from solitary brain metastasis(SBM).Methods We collected multi-parametric magnetic resonance imaging(MRI)data from 61 patients with HGG and 60 with SBM,and delineated regions of interest(ROI)on T1WI,T2WI,T2-weighted fluid attenuated inversion recovery(T2_FLAIR)and post-contrast enhancement T1WI(CE_T1WI)images.The radiomics features were extracted from each sequence using Pyradiomics and fused using a multimodal feature fusion classification model based on distance matching and discriminative representation learning to obtain a classification model.The discriminative performance of the classification model for differentiating HGG from SBM was evaluated using five-fold cross-validation with metrics of specificity,sensitivity,accuracy,and the area under the ROC curve(AUC)and quantitatively compared with other feature fusion models.Visual experiments were conducted to examine the fused features obtained by the proposed model to validate its feasibility and effectiveness.Results The five-fold cross-validation results showed that the proposed multimodal feature fusion classification model had a specificity of 0.871,a sensitivity of 0.817,an accuracy of 0.843,and an AUC of 0.930 for distinguishing HGG from SBM.This feature fusion method exhibited excellent discriminative performance in the visual experiments.Conclusion The proposed multimodal feature fusion classification model has an excellent ability for differentiating HGG from SBM with significant advantages over other feature fusion classification models in discrimination and classification tasks between HGG and SBM.

Objective To predict microvascular invasion(MVI)in hepatocellular carcinoma(HCC)using a model based on multi-phase dynamic-enhanced CT(DCE-CT)radiomics feature and hierarchical fusion of multiple classifiers.Methods We retrospectively collected preoperative DCE-CT images from 111 patients with pathologically confirmed HCC in Guangzhou First People's Hospital between January,2016 and April,2020.The volume of interest was outlined in the early arterial phase,late arterial phase,portal venous phase and equilibrium phase,and radiomics features of these 4 phases were extracted.Seven classifiers based on different algorithms were trained using the filtered feature subsets to obtain multiple base classifiers under each phase.According to the hierarchical fusion strategy,a multi-criteria decision-making-based weight assignment algorithm was used for fusing each base classifier under the same phase with the model after extracting the phase information to obtain the prediction model.The proposed model was evaluated using a 5-fold cross-validation and assessed for area under the ROC curve(AUC),accuracy,sensitivity,and specificity.The prediction model was also compared with the fusion models using a single phase or multiple phases,models based on a single phase with a single classifier,models with different base classifier diversities,and 8 classifier models based on other ensemble methods.Results The experimental results showed that the performance of the proposed model for predicting HCCMVI was optimal after incorporating the 4 phases and 7 classifiers,with AUC,accuracy,sensitivity,and specificity of 0.828,0.766,0.877,and 0.648,respectively.Comparative experiments showed that this prediction model outperformed the models based on a single phase with a single classifier and other ensemble models.Conclusion The proposed prediction model is effective for predicting MVI in HCC with superior performance to other models.

OBJECTIVE To study the correlation between processing time, chroma value and UPLC fingerprint map of Dipsaci Radix. METHODS Established the UPLC fingerprint of Dipsaci Radix. Monitored the changes of chemical components in the processing process of wine and salt processed Dipsaci Radix, spectrophotometer was used to objectively quantify the chroma value of different processed products. SPSS 20.0 and SIMCA 14.0 statistical software was used to analyze the correlation between processing time and chroma value and fingerprint. RESULTS In the process of processing, the decoction pieces color of the powder deepened and L*, b* and E* values decreased. The correlation analysis showed that the processing time was significantly correlated with the chroma value and fingerprint of decoction pieces. CONCLUSION The method of UPLC fingerprint is stabled and reliabled, combines with the objective discriminant analysis of the chroma value of the Dipsaci Radix processed products, which lay the foundation for standardizing the processing technology of wine and salt processed products and evaluating the quality of Dipsaci Radix.

Objective:To compare the clinical efficacy between robot-assisted and free-hand percutaneous cannulated screwing (PCS) in the treatment of femoral neck fractures in the middle-aged and young patients.Methods:A retrospective study was conducted to analyze the clinical data of 53 patients with femoral neck fracture who had been treated with PCS from May 2020 to May 2022 at Department of Traumatic Surgery, Maoming Hospital Affiliated to Southern Medical University. In the robot group of 25 patients subjected to robot-assisted PCS, there were 11 males and 14 females with an age of (48.2 ± 11.9) years; in the free-hand group of 28 patients subjected to free-hand PCS, there were 13 males and 15 females with an age of (48.5 ± 9.8) years. The 2 groups were compared in terms of operation time, intraoperative bleeding, intraoperative guide drills, intraoperative fluoroscopy frequency, fracture union time, Harris hip score at the last follow-up and postoperative complications. Postoperative imaging examination was performed to evaluate distribution accuracy of the cannulated screws in the femoral neck (deviation between the screws and the femoral neck axis, parallelism between the screws and distance between the screws and the neck cortex).Results:There was no statistically significant difference between the robot and free-hand groups in the general clinical data before operation, showing comparability ( P>0.05). The robot group showed significantly shorter operation time [(32.7 ± 4.8) min], significantly less intraoperative bleeding [(14.6 ± 4.8) mL], significantly less intraoperative guide drillings [(3.5 ± 0.7) times] and significantly less intraoperative fluoroscopy frequency [(7.9 ± 1.4) times] than the free-hand group [(56.9 ± 11.3) min, (27.0 ± 7.3) mL, (9.1 ± 1.8) times and (16.3 ± 6.0) times)] (all P<0.05). Postoperative imaging showed that the deviation between the screws and the femoral neck axis was 4.4° ± 1.1° on the anteroposterior X-ray film and 3.2° ± 0.8° on the lateral X-ray film, the parallelism between the screws 4.9° ± 0.8° on the anteroposterior X-ray film and 3.0° ± 0.7° on the lateral X-ray film, and the distance between the screws and the femoral neck cortex (10.4 ± 2.7) mm in the robot group, all significantly smaller than those in the free-hand group [10.5° ± 2.8°, 4.9° ± 1.1°, 12.1° ± 4.0°, 5.1° ± 1.3°, and (15.4 ± 3.2) mm] (all P<0.05). All the 53 patients were followed up for (22.2 ± 8.5) months. All fractures got united. The fracture union time in the robot group [(20.6 ± 4.6) weeks] was insignificantly shorter than that in the free-hand group [(23.7 ± 7.7) weeks] ( P>0.05). At the last follow-up, the Harris hip score in the robot group [(88.6 ± 5.6) points] was significantly higher than that in the free-hand group [(84.8 ± 6.3) points] ( P<0.05). Follow-ups revealed 2 cases of internal fixation loosening, 1 case of screw head cutting and 1 case of femoral head necrosis in the free-hand group but none of such complications in the robot group. Conclusion:In the treatment of femoral neck fractures in the middle-aged and young patients, compared with free-hand PCS, robot-assisted PCS shows advantages of shorter intraoperative time, less bleeding, less fluoroscopic radiation, higher accuracy of screw placement, a lower incidence of postoperative complications and better functional recovery of the hip joint.

Purpose: This study was aimed to investigate long-term survivals and toxicities of early-stage nasopharyngeal carcinoma (NPC) in endemic area, evaluating the role of chemotherapy in stage II patients. Materials and Methods: Totally 187 patients with newly diagnosed NPC and restaged American Joint Committee on Cancer/ International Union Against Cancer 8th T1-2N0-1M0 were retrospectively recruited. All received intensity-modulated radiotherapy (IMRT)±chemotherapy (CT) from 2001 to 2010. Results: With 15.7-year median follow-up, 10-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were 93.3%, 93.5%, 92.9% and 88.2%, respectively. Multivariable analyses showed cervical lymph nodes positive and pre-treatment prognostic nutritional index ≥ 52.0 could independently predict DMFS (p=0.036 and p=0.011), DSS (p=0.014 and p=0.026), and OS (p=0.002 and p < 0.001); Charlson comorbidity index < 3 points could predict DSS (p=0.011); age > 45 years (p=0.002) and pre-treatment lactate dehydrogenase ≥ 240 U/L (p < 0.001) predicted OS. No grade 4 late toxicity happened; grade 3 late toxicities included subcutaneous fibrosis (4.3%), deafness or otitis (4.8%), skin dystrophy (2.1%), and xerostomia (1.1%). No differences on survivals were shown between IMRT+CT vs. IMRT alone in stage II patients, even in T2N1M0 (p > 0.05). Unsurprising, patients in IMRT+CT had more acute gastrointestinal reaction, myelosuppression, mucositis, late ear toxicity, and cranial nerve injury (all p < 0.05) than IMRT alone group. Conclusion Superior tumor control and satisfying long-term outcomes could be achieved with IMRT in early-stage NPC with mild late toxicities. As CT would bring more toxicities, it should be carefully performed to stage II patients.

According the practice of ethical review work in Guangdong Provincial Hospital of Chinese Medi-cine, this article summarized the following experiences: It should keep pace with the times and constantly adjust the type of Ethics Committee to adapt to the development of medical research; accept international and domestic certification to promote construction by certification; enhance the researchers' consciousness of ethical review and the subjects' protection awareness;conduct effective sites visits to professional group or research group;communi-cate and collaborate among multi -disciplinary to promote the development of ethical review work and so on. Through the above practices, the quantity and quality of Ethics Committee' s ethical review in the hospital had been improved greatly, and it is hoped that these practical experiences could provide reference for ethics committee in other institutions.

AIM:To explore the effects of decorin on procollagen type I (PcI), mRNA expression,collagen type I synthesis and proliferation of synovial type B cells of stiff knee joint synovial membrane.METHODS:Type B cells of synovial membrane were isolated from the stiff knee joint synovial membrane and cultured in vitro.The cells were treated with decorin at concentrations of 0.1 mg/L, 5 mg/L and 10 mg/L.After cultured for 24 h, 48 h and 72 h, the cell proli-feration rates were measured by MTT colorimetric determination.Cell cycle distribution and apoptosis were analyzed by flow cytometry.The mRNA level of Pc I was detected by RT-PCR, while collagen type I was measured by Western blot.RE-SULTS:The proliferation of synovial type B cells was significantly inhibited, the percentage of synovial type B cells at G1 phase was significantly increased by 5 mg/L and 10 mg/L decorin (P<0.05), and PcⅠmRNA expression and collagen type I synthesis were significantly decreased.The cells with late apoptosis were not found in control group and experimental groups.CONCLUSION:Recombinant human decorin inhibits synovial type B cell proliferation and decreases PcⅠmRNA expression and collagen type I synthesis in synovial type B cells of stiff knee joint synovial membrane in vitro, suggesting that decorin potentially contributes to the therapy of human knee stiffness.