SDTM: A Novel Topic Model Framework for Syndrome Differentiation in Traditional Chinese Medicine

Syndrome differentiation is the most basic diagnostic method in traditional Chinese medicine (TCM). The process of syndrome differentiation is difficult and challenging due to its complexity, diversity, and vagueness. Recently, artificial intelligent methods have been introduced to discover the regularities of syndrome differentiation from TCM medical records, but the existing DM algorithms failed to consider how a syndrome is generated according to TCM theories. In this paper, we propose a novel topic model framework named syndrome differentiation topic model (SDTM) to dynamically characterize the process of syndrome differentiation. The SDTM framework utilizes latent Dirichlet allocation (LDA) to discover the latent semantic relationship between symptoms and syndromes in mass of Chinese medical records. We also use similarity measurement method to make the uninterpretable topics correspond with the labeled syndromes. Finally, Bayesian method is used in the final differentiated syndromes. Experimental results show the superiority of SDTM over existing topic models for the task of syndrome differentiation.

Signaling Potential Therapeutic Herbal Medicine Prescription for Treating COVID-19 by Collaborative Filtering

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has aggressed in more than 200 countries and territories since Dec 2019, and 30 million cases of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 have been reported, including 950,000 deaths. Supportive treatment remains the mainstay of therapy for COVID-19. There are no small-molecule–specific antiviral drugs available to prevent and treat COVID-19 until recently. Herbal medicine can facilitate syndrome differentiation and treatment according to the clinical manifestations of patients and has demonstrated effectiveness in epidemic prevention and control. The National Health Commission (NHC) of China has recommended “three TCM prescriptions and three medicines,” as a group of six effective herbal formulas against COVID-19 in the released official file “Diagnosis and Treatment Protocol for COVID-19 Patients: Herbal Medicine for the Priority Treatment of COVID-19.” This study aimed to develop a collaborative filtering approach to signaling drug combinations that are similar to the six herbal formulas as potential therapeutic treatments for treating COVID-19. The results have been evaluated by herbal medicine experts’ domain knowledge.

Syndrome Differentiation and Treatment Regularity in Traditional Chinese Medicine for Type 2 Diabetes: A Text Mining Analysis

ObjectiveThe goal of this study was to systematically summarize and categorize the syndrome differentiation, medication rules, and acupoint therapy in the domestic traditional Chinese medicine (TCM) literature on type 2 diabetes mellitus (T2DM), such that guidelines and new insights can be provided for future practitioners and researchers.MethodsTaking randomized controlled trials (RCTs) on the treatment of T2DM in TCM as the research theme, we searched for full-text literature in three major clinical databases, including CNKI, Wan Fang, and VIP, published between 1990 and 2020. We then conducted frequency statistics, cluster analysis, association rules extraction, and topic modeling based on a corpus of medical academic words extracted from 3,654 research articles.ResultsThe TCM syndrome types, subjective symptoms, objective indicators, Chinese herbal medicine, acupuncture points, and TCM prescriptions for T2DM were compiled based on invigorating the kidney and Qi, nourishing Yin, and strengthening the spleen. Most TCM syndrome differentiation for T2DM was identified as “Zhongxiao” (the lesion in the spleen and stomach) and “Xiaxiao” (the lesion in the kidney) deficiency syndromes, and most medications and acupoint therapies were focused on the “Spleen Channel” and “Kidney Channel.” However, stagnation of liver Qi was mentioned less when compared with other syndromes, which did not have symptomatic medicines.ConclusionThis study provides an in-depth perspective for the TCM syndrome differentiation, medication rules, and acupoint therapy for T2DM and provides practitioners and researchers with valuable information about the current status and frontier trends of TCM research on T2DM in terms of both diagnosis and treatment.

Traditional chinese medicine syndromes classification associates with tumor cell and microenvironment heterogeneity in colorectal cancer: a single cell RNA sequencing analysis

Background Colorectal cancer (CRC) is one of the common gastrointestinal malignancies, tumor heterogeneity is the main cause of refractory CRC. Syndrome differentiation is the premise of individualized treatment of traditional Chinese medicine (TCM), but TCM syndrome lacks objective identification in CRC. This study is to investigate the correlation and significance of tumor heterogeneity and TCM syndromes classification in CRC. Methods In this study, we using scRNA-seq technology, investigate the significance of tumor heterogeneity in TCM syndromes classification on CRC. Results The results showed that 662 cells isolated from 11 primary CRC tumors are divided into 14 different cell clusters, and each cell subtype and its genes have different functions and signal transduction pathways, indicating significant heterogeneity. CRC tumor cell clusters have different proportions in Excess, Deficiency and Deficiency-Excess syndromes, and have their own characteristic genes, gene co-expression networks, gene functional interpretations as well as monocle functional evolution. Moreover, there were significant differences between the high expressions of MUC2, REG4, COL1A2, POSTN, SDPR, GPX1, ELF3, KRT8, KRT18, KRT19, FN1, SERPINE1, TCF4 and ZEB1 genes in Excess and Deficiency syndrome classification in CRC (P < 0.01). Conclusions The Excess and Deficiency syndromes classification may be related to tumor heterogeneity and its microenvironment in CRC.

Professor Xiaofeng’s Zhang Experience in Treating Postpartum Body Pain

Postpartum physical pain is common in clinic, mostly manifested in pain, numbness or weight, swelling and so on of limbs and joints during puerperium, and some of them fail to heal over the years, becoming stubborn “puerperal fever.” Mr. Zhang has been a doctor for more than 30 years. He has superb medical skills and has unique opinions on postpartum diseases. The author is lucky to follow-up. Now, his experience in syndrome differentiation and treatment of postpartum body pain is analyzed as follows, and the tested case is attached.

Chief Physician Wang Defen’s Experience in Treating Thyroid Nodules based on Syndrome Differentiation

To summarize the experience of Chief Physician Wang Defen in the treatment of thyroid nodules. According to many years of clinical experience, Chief Physician Wang Defen believes that the occurrence of thyroid nodules is mostly affected by emotional factors. Qi stagnation, liver depression and fire, phlegm and Qi are the pathogenesis of the disease, which is closely related to liver Qi stagnation. Based on the basic treatment principle of Nourishing Yin, clearing heat, soothing liver and strengthening spleen, the prescription chose Danzhi Xiaoyao Powder plus or minus can often achieve good clinical efficacy.

The Challenges of Ethical Review in Clinical Research of Traditional Chinese Medicine

The ethical review of TCM (traditional Chinese medicine) clinical research in China is highly consistent with that of Western medicine, but it lacks the characteristics and culture of TCM. Compared with modern medicine, TCM has its own characteristics, such as the theory of Yin-Yang and the five elements, the treatment of syndrome differentiation, and the compatibility of prescriptions. These characteristics determine the ethical particularity of TCM clinical research. This article discusses the challenges in the ethical review of TCM clinical research, such as scientific design, efficacy evaluation, risk assessment, informed consent, and placebo use. We propose opportunities and difficulties in the ethical review of TCM clinical research and provide some relevant suggestions.

Prevention of Diabetes in Overweight/Obese Adults through Traditional Chinese Patent Medicine: Study Protocol for a Prospective Cohort Study

Background. Early intervention in prediabetes can prevent or delay the incidence of type 2 diabetes mellitus (T2DM). Traditional Chinese patent medicine (TCPM) is widely used in China to prevent T2DM. This study aims to evaluate the efficacy and safety of TCPMs for preventing T2DM. Method/Design. This study is a multicenter, cohort study with two arms. A total of 600 participants will be recruited. The participants will be divided into either intervention or control groups according to their own desire, and the exposure factor is the application of TCPMs. All participants will be encouraged to lead a healthy lifestyle, and the intervention group also used TCPMs based on syndrome differentiation. Incident diabetes and normalization of blood glucose are indexes of end point. Safety assessments and adverse event monitoring will also be conducted. The treatment duration is set for 24 weeks, and we will follow-up for another 2 years. Discussion. This trial may provide initial evidence regarding the efficacy and safety of TCPMs plus lifestyle intervention (LI) compared to LI alone for preventing T2DM and provide a comprehensive intervention plans that choose suitable TCPMs for diabetes prevention according to syndrome differentiation. Trial Registration Number. Chinese Clinical Trial Registry ID: ChiCTR1900023541, registered on 1 Jun 2019. The version identifier is 2018121702.