Chinese Medicine Doctors Research Articles

Changing Narratives and Persisting Tensions: Conflicts between Chinese and Western Medicine and Professional Profiles in Chinese Films and Literature, 1949-2009.

This paper analyses the shifting images of Chinese medicine and rural doctors in the narratives of literature and film from 1949 to 2009 in order to explore the persisting tensions within rural medicine and health issues in China. Popular anxiety about health services and the government's concern that it be seen to be meeting the medical needs of China's most vulnerable citizens - its rural dwellers - has led to the production of a continuous body of literary and film works discussing these issues, such as Medical Practice Incident, Spring Comes to the Withered Tree, Chunmiao, and Barefoot Doctor Wan Quanhe. The article moves chronologically from the early years of the Chinese Communist Party's new rural health strategies through to the twenty-first century - over these decades, both health politics and arts policy underwent dramatic transformations. It argues that despite the huge political investment on the part of the Chinese Communist Party government in promoting the virtues of Chinese medicine and barefoot doctors, film and literature narratives reveal that this rustic nationalistic vision was a problematic ideological message. The article shows that two main tensions persisted prior to and during the Cultural Revolution, the economic reform era of the 1980s, and the medical marketisation era that began in the late 1990s. First, the tension between Chinese and Western medicine and, second, the tension between formally trained medical practitioners and paraprofessional practitioners like barefoot doctors. Each carried shifting ideological valences during the decades explored, and these shifts complicated their portrayal and shaped their specific styles in the creative works discussed. These reflected the main dilemmas around the solutions to rural medicine and health care, namely the integration of Chinese and Western medicines and blurring of boundaries between the work of medical paraprofessionals and professionals.

Primary dysmenorrhea and self-care strategies among Chinese college girls: a cross-sectional study

ObjectivesTo explore the prevalence of primary dysmenorrhea (PD), the characteristics of PD and self-care strategies for managing PD among Chinese college girls.DesignCross-sectional study.SettingChangsha, China.ParticipantsA total of 2555 college girls were...

Application of Meridian Electrical Conductance in the Setting of Acute Ischemic Stroke: A Cross-Sectional Study.

Acupuncture is widely used for improving poststroke care. Knowing the condition of meridian can help traditional Chinese medicine (TCM) doctors make a tailored choice of acupoints for every patient. The establishment of an objective meridian energy measurement for acute ischemic stroke that can be used for future acupuncture treatment and research is an important area in stroke-assisted therapy. In this study, a total of 102 subjects diagnosed with acute ischemic stroke within 7 days of onset were recruited, and the meridian energy analysis device (MEAD) was used to record the meridian electrical conductance (MEC) values of twelve meridians on unaffected and affected limbs. We found that the MEC value of the twelve meridians on the affected limbs was significantly higher than that on the unaffected limbs (P=0.001). Compared with the unaffected limbs, there was a higher value of MEC on the affected limbs of the lung meridian, heart meridian, pericardium meridian, and small intestine meridian, with significant differences (P < 0.05, P < 0.001, P < 0.001, and P < 0.05, respectively). Further analysis revealed that the MEC values of both Yin and Yang meridians of the affected limbs were significantly higher than those of the unaffected limbs (P=0.001 and P < 0.05, respectively). Meanwhile, the mean of the index of sympathovagal balance in patients with acute ischemic stroke (5.49 ± 4.21) was higher than the normal range (1–1.5), indicating autonomic imbalance. The results of this study are consistent with TCM theory as well as clinical observation and pathological mechanisms, suggesting that the measurement of MEC values may be used as a supplementary diagnostic method for acupuncture in patients with acute ischemic stroke.

The utilization of complementary and alternative medicine in Taiwan: An internet survey using an adapted version of the international questionnaire (I-CAM-Q).

In Taiwan, numerous studies have been conducted to investigate the use of complementary and alternative medicine (CAM). However, most of them focused on specific diseases or the use of particular methods. Therefore, the results of those studies were quite different and difficult to compare with those of studies from other countries. The International CAM Questionnaire (I-CAM-Q), meanwhile, is a unified tool that can provide comparable results for studies conducted worldwide. Thus, the aim of this study was to discover the proportions of people in Taiwan receiving CAM treatments from different types of health care providers by using an adapted version of I-CAM-Q (I-CAM-QT). I-CAM-QT was developed by translating the Korean version of I-CAM-Q (I-CAM-QK) into traditional Chinese language because of the similarity of CAM usage and doctor licensing system. This study had two stages: the first was a pretest survey used to adjust the questionnaire, while the second was an internet-based survey used to collect data from the community. Of the 1200 survey respondents, 37% and 37.7% were prescribed or advised to use Chinese herbal medicine (CHM) by Western medicine (WM) physicians and traditional Chinese medicine (TCM) doctors, respectively. Other than CHM, dietary supplements and massage were the forms of CAM most commonly prescribed or recommended by WM physicians or TCM doctors. Overall, walking and relaxation techniques were the most commonly used self-help practices (used by 61.9% and 40.4% of the respondents, respectively). Additionally, 70.3% of the respondents had used at least one kind of dietary supplement in the past 12 months. Regarding the utilization of CAM in Taiwan, this internet-based survey revealed that CHM, dietary supplements, and massage were the types of CAM most commonly prescribed or recommended by WM physicians or TCM doctors.

A clinical study to assess the influence of acupuncture at \u201cWang\u2019s Jiaji\u201d acupoints on limb spasticity in patients in convalescent stage of ischemic stroke: study protocol for a randomized controlled trial

BackgroundStroke is characterized by high morbidity, high mortality, and high disability. Spasticity, one of the most common complications after stroke, may reduce the potential success of rehabilitation and has a detrimental effect on stroke patients’ daily function and quality of life. Moreover, the long-term management of spasticity is a financial burden to patients and increases societal costs. The current treatments, mainly including physical therapy, oral drugs, drug injection therapy, and surgical interventions, have been used to reduce spasticity. However, every conventional approach has its limitations. Acupuncture at the “Wang’s Jiaji” acupoints, based on the experience of the famous old doctor of traditional Chinese medicine (TCM) Le Ting Wang in treating post-stroke limb spasm, has been widely practiced in our department. This intervention has effectively avoided the controversy around acupuncture at local acupoints on the limbs, and is easy to apply without side effects. Our previous studies had found that acupuncture at the “Wang’s Jiaji-points” can reduce the occurrence and severity of spasticity occurring after stroke in the early stage (the first 21 days). In this study, we chose patients in the convalescent stage, 1–6 months after stroke, so as to study the efficacy and the specific intervention time of “Wang’s jiaji” in the convalescent stage after stroke.MethodsThis is a randomized, controlled, and single-blind study. Patients in the convalescent stage within 1–6 months of ischemic stroke will be selected as subjects. A total of 100 subjects will be randomly assigned to two groups. The acupuncture group will be given acupuncture treatment five times a week; the medicine group will be given 10mg baclofen three times a day. These two groups will continue to receive current usual care for the prevention and treatment of cerebrovascular diseases, but drugs that affect muscle tone will not be allowed. The treatment will last for 2 weeks. The primary outcome measurement is the simplified Fugl-Meyer Assessment. The secondary outcome measurements are the Modified Ashworth Scale, Modified Barthel Scale, and the H-reflex, F response, and H/M ratios of electromyography. All outcome measurements are assessed at baseline, 2 weeks, 4 weeks, and 12 weeks after first treatment except the electromyography, which is assessed at baseline and 2 weeks after first acupuncture.DiscussionThis trial aims to evaluate the effects and the specific intervention time of “Wang’s Jiaji” acupoints on spasticity after stroke.Trial registrationISRCTN registry, ISRCTN31511176. Registered on 29 August 2017.Version number of protocol 2016-2-1161Version date of protocol: 2016-1

Tuina for children with upper respiratory tract infections: A protocol for a systematic review.

Background:Upper respiratory tract infections (URTIs) is a common disease in children, which is also known as the common cold. Pediatric Tuina is a common treatment that Traditional Chinese Medicine (TCM) doctors commonly use for URTIs. However, there has no relevant systematic review studied on its effects and safety been reported. We plan to perform a systematically reviewing of all the clinical evidence on the effectiveness and safety of Tuina for URTIs in children.Methods:We will conduct the literature searching in the following electronic databases: Pubmed, Embase, Cochrane Library, Web of science, Chinese National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biomedical Literature Database (CBM), Chinese Clinical Trial Registry System. The time limit for retrieving studies is from establishment to July 2019 for each database. All published randomized controlled trials (RTCs) related to this review will be included. Review Manager (V.5.3.5) will be implemented for the assessment of bias risk and data analyses. Subgroup analysis and sensitivity analysis will be performed based on the conditions of included data.Results:A high-quality synthesis of current evidence of Tuina for children with URTIs will be provided in this study.Conclusion:This systematic review will provide evidence of whether Tuina is an effective intervention for children with URTIs.PROSPERO registration number:CRD42019126963.

Efficacy and safety of Chou-Ling-Dan granules in the treatment of seasonal influenza via combining Western and traditional Chinese medicine: protocol for a multicentre, randomised controlled clinical trial

IntroductionChou-Ling-Dan (CLD) (Laggerapterodonta) granules are an ethnic herbal medicine from Yunnan province of China. CLD granules have been used for the treatment of inflammatory conditions and feverish diseases in China,...

Gut flora “the second brain” connects Eastern and Western medicine: intestinal hyper-permeability or Qi deficiency can affect brain, mind, and whole body

There are two famous “the Father of Modern Medicine”—Hippocrates (a Greek physician) said “all disease begins in the gut” and Sir William Osler (a Canadian physician) said “a man is as old as his arteries.” It is known that gut microbiota imbalance (dysbiosis) and intestinal hyper-permeability are related to high level of advanced glycation end-products (AGEs) which damage blood vessel’s endothelial function and potentially cause multi-organ dysfunction. On the other hand, Traditional Chinese Medicine (TCM) doctors already knew the importance of digestive system thousands of years ago since the production of “Qi” which is vital energy for whole body largely rely on abdominal condition, and Qi deficiency triggers multiple mental and physical symptoms. It may sound two leading Integrative Medicine (IM) systems, Western IM and TCM use “different languages,” but it is not well known that their essence is very similar (illness is a result of “dis-ease” or “dysfunction of Qi.”). Genome analysis technology, such as DNA sequencing and microbiota researches have enabled us to understand how intestinal dysbiosis is related to obesity, metabolic syndrome, brain disorders, autoimmune diseases, or mood disorders (Brain-Mind-Gut axis). In addition, making the most of artificial intelligence’s (AI) “deep learning” technology might be a potential “prescription” to heal worldwide medical-economical crisis, spend more time with patients (for medical providers), and prevent providers’ burnout. AI-assisted TCM-style history taking computer and portable wrist pulse diagnostic device are about to be used in China. In the new era of preventive medicine, gut microbiota research, precision medicine with genome analysis, AI technology and TCM ancient wisdom can be combined together. Blending the new and the old will make it possible to detect and treat “pre-clinical disease” before real diseases happen since Western IM and TCM are actually using a “same language.”

Famous veteran traditional Chinese medicine doctors' medication rules in treating spermatorrhea

To explore famous veteran traditional Chinese medicine( TCM) doctors' medication rules in treating spermatorrhea based on the medical cases about spermatorrhea collected from Hundred TCM Clinical Doctors of Hundred Years in China and Proven Cases and National Medical Master Test Case. Researchers extracted such data as medicinal and therapies from these cases according to the inclusion and exclusion criteria. Then,Excle 2010,SPSS Clementine 12. 0 and SPSS 22. 0 were adopted respectively for frequency analysis,association rules analysis,cluster analysis and factor analysis. Cluster analysis was carried out by Ochiai algorithm of binary variable data,one of the systematic clustering methods. And principal component analysis was used for factor analysis. Finally,27 medical cases and 41 prescriptions were included in total. The frequency analysis showed that the most common therapy was the astringent therapy( n = 28),which was followed by the tonifying method,tranquilizing method,heat-clearing method,damp-dispelling method and Qiregulating method. The top three kinds of high-frequency traditional Chinese medicines were Poria,Ostreae Concha and Dioscoreae Rhizoma. The association rules analysis found out 11 association rules of medicine pairs,23 association rules of medicine combinations of the three kinds of herbs and 6 association rules of medicine combinations of five kinds of herbs. Among them,the representatives were Rubi Fructus→Fossilia Ossis Mastodi,Rehmanniae Radix Praeparata + Corni Fructus→Dioscoreae Rhizoma,and Pinelliae Rhizoma→Citri Reticulatae Pericarpium,which showed the therapeutic characteristics of astringing,tonifying the kidney and replenishing essence,fortifying the spleen and dispelling dampness. Moreover,7 medicine groups with relevance were extracted from the tree map generated by cluster analysis,including " Phellodendri Chinensis Cortex and Anemarrhenae Rhizoma" and " Angelicae Sinensis Radix,Rehmanniae Radix,Bupleuri Radix and Glycyrrhizae Radix et Rhizoma",which demonstrated the effects of nourishing Yin and purging fire,tonifying and soothing the liver. Besides,totally 12 common factors were obtained according to factor analysis,including 14 drug combinations,like " Amomi Fructus,Anemarrhenae Rhizoma and Phellodendri Chinensis Cortex" and " Nelumbinis Stamen,Moutan Cortex,Poria and Scrophulariae Radix",which indicated the compatibility characteristics of tonifying the spleen and purging fire,dispelling dampness and clearing heat. In conclusion,data mining techniques( including frequency analysis,association rules analysis,cluster analysis and factor analysis) were used to comprehensively analyze the famous veteran TCM doctors' medication rules in treating spermatorrhea,which was helpful for guiding the clinical practice of treating spermatorrhea in TCM.

Experience of Professor Fan Yongsheng in treating arthralgia with insect drugs

National-level famous traditional Chinese medicine( TCM) doctor Professor Fan Yong-sheng has high-level accomplishments in the treatment of arthralgia. According to clinical diagnosis and dialectic,TCM with appropriate medicinal properties were flexibly applied,with a remarkable efficacy. Especially in the application of insect drugs,he has accumulated abundant clinical experience.According to the main syndromes of arthralgia and pathogenic site,patient' s constitution,Scorpio,Scolopendra,Pheretima,Vespae Nidus,Bombyx Batryticatus,Manis Squama,Bungarus Parvus,Zaocys,Agkistrodon,Cicadae Periostracum,Aspongopus,Eupolyphaga Steleophaga,Silkworm Sand were properly selected. Attention was also paid to the compatibility between insect drugs and antirheumatic drugs,blood-activating drugs and tonifying drugs. In the premise of safe and effective application in the treatment of arthralgia,insect drugs show such efficacies as antipyretic,activating collaterals and relieving pain.

Hand-Eye-Force Coordination of Acupuncture Robot

Acupoint is the intersection point of the main and collateral channels in a human body, through which energy circulates according to eastern philosophy. Acupuncture is the essential traditional Chinese method to treat disease by sticking the proper acupoints on the patient’s body, having achieved a great therapeutic effect. Normally, acupuncture is mainly performed by skilled doctors of traditional Chinese medicine, which are far from enough for requirements. Hence it is natural to resort to robots to perform acupuncture work. There has no complete theoretical guidance for the development of an acupuncture robot so far. Thus, this paper digs out that acupuncture is essentially a visual servoing task with force constraints and the hand-eye-force coordination framework is first proposed. With the guidance of the framework, the acupuncture task is divided into three parts: hand-eye coordination, eye-force coordination, and hand-force coordination. The hand represents the end-effector of the acupuncture robot, the eye represents the visual sensor of the acupuncture robot, and the force represents the interaction between the acupuncture robot and the patient’s body. The hand-eye coordination is the visual servoing control, eye-force coordination is to estimate force by vision, and hand-force coordination is the acupuncture operation with force constraint. The acupuncture task can be completed only when the three coordinations are well organized. The solutions are proposed for the three coordination tasks, which are finally validated by the experiments.

Daoism in Latin America

Daoism in Latin America1 Matheus Oliva da Costa (bio) Many Daoist traditions and lineages of masters formed over its 2000 years of development as a historical community. Which of them, represented by whom, arrived in Latin Amercia when? Are there any empirical or academic studies about them? The following outlines the development of Daoist traditions as they arrived and grew in various Latin American countries. The study goes back to research beginning in 2011, originally focusing on Brazil and from there expanding through the continent. Chinese Migration The first contact of Chinese with Latin America occurred in 1565, lasting until the 17th century. Called the Manila-Acapulco Connection (Lai and Tan 2010), it involved Chinese workers from the Philippines, in mercantile migration, moving to labor in what would later become Mexico. The migration reflected the connection between the two places as a result of Spanish colonialism. Unfortunately, so far, we have no knowledge of Daoists or even single Daoist elements that migrated at this time. Next, there was the Macao-Brazil-Portugal Connection. This allowed a rich cultural exchange, in which Brazil received many impulses both directly from China—especially from Canton—and also indirectly through the Portuguese and other European people. According to Gilberto Freyre (2013) and José Leite (1994), in sparked an intense propagation [End Page 197] of Chinese techniques, products, and images during the formation of colonial Brazil. Freyre thinks of Brazil as a "tropical China," while Leite goes went deeper, affirming that cultures from the south of China and India had more impact even than European societies among the main social references of the Brazilian colonial period. This held true until the 19th century, when British, French, and later American models of civilization became the dominant paradigms for the formation of independent Brazil. In the early period, then, there was the first official migration of a Chinese group to Brazil: Cantonese or Hakka moving to Rio in 1812 (Yang 1977; Piza 2013). In a similar way, many immigrants arrived in other South American countries during the 19th and 20th centuries. The first to arrive came to the Caribbean country of Trinidad and Tobago in 1806. After that, groups arrived in Brazil (1812), Cuba (1847), and especially Peru (1849). Later migrants also settled in Argentina, Mexico, and other countries, but they were smaller in number. Two countries stand out particularly. First, Brazil housed the largest number of overseas Chinese in the late 20th and early 21st centuries (Costa 2015b, 2017). Second, Peru is the country with the most expansive interaction between the two cultures, both in terms of intensity and continuous contact. One result of this is the Chinese-Peruvian cuisine, generically called chifa2 (Pastor 2005). Brazil and other Latin American countries welcomed Chinese immigrants, but migration remained limited for a long time. The strongest flows of overseas Chinese occurred from the mid-20th to the early 21st centuries. Migrants commonly moved through other Asian regions, especially Taiwan and Hong Kong, or African countries before arriving in Europe or the Americas. Only in this last wave of immigrants, who overall had reached a higher level terms of education and professional training, did cultural Chinese aspects begin to have an impact on Brazil. It included doctors of Chinese medicine and teachers of martial arts (wushu 武術 or gongfu 功夫) as well as artists, scholars, sales people, and more. [End Page 198] Early Waves Daoism, brought along by these immigrants, only appeared in its institutional form in the end of the 20th century. Before that, it existed dominantly in single elements and indirect or informal modes. To organize the complexity of transmission, I distinguish three waves of contact, especially in Brazil (Costa 2015a), but also expanded to the study of Latin America in general. The three waves are: 1) from the colonial era to the 1960s, Daoist elements were present in a rather diffuse mode, such as in architecture, art work, images, and literature; 2) from the 1960s, Chinese immigration increased, creating a font of knowledge of traditional techniques; at the same time, Latin American culture came under the influence of the New Age movement, leading to the informal and...

Ren (仁 ), the benevolent thought of traditional Chinese medicine

This article offers a brief introduction to the evolution of Ren(仁), which is not only the core of Confucian ethics but also the top moral principle observed by traditional Chinese medicine doctors, holding that feasible solutions to cultural conflicts could be worked out under the guidance of Ren.

Professor Lu Aiping: be a good Chinese medicine doctor, need more Western medicine knowledge

The 3 rd Longhua International Forum on Digestive Disease wassuccessfully held in Shanghai on December 1 st to 2 nd ,2018, gathering many leading experts and scholars in the area of digestivedisease to share experience and techniques in this field ( Figure 1 ).This meeting is of great significance to promoting the deep exchange ofdiagnosis and treatment of chronic diseases with the combined therapy ofChinese and Western medicine. We are honored to interview Prof. Lu Aiping ( Figure2 ) during the Forum. Watch the video to learn more information ( Figure 3 ).

Professor Lu Aiping: Be a good Chinese medicine doctor, need more Western medicine knowledge

The 3 rd Longhua International Forum on Digestive Disease wassuccessfully held in Shanghai on December 1 st to 2 nd ,2018, gathering many leading experts and scholars in the area of digestivedisease to share experience and techniques in this field ( Figure 1 ).This meeting is of great significance to promoting the deep exchange ofdiagnosis and treatment of chronic diseases with the combined therapy ofChinese and Western medicine. We are honored to interview Prof. Lu Aiping ( Figure2 ) during the Forum. Watch the video to learn more information ( Figure 3 ).

Inequalities in the geographic distribution of hospital beds and doctors in traditional Chinese medicine from 2004 to 2014

ObjectivesThis study identifies inequities in the provincial-level geographical distribution of traditional Chinese Medicine (TCM) hospital beds and doctors in China from 2004 to 2014. This provides policy implications of the optimal allocation of TCM health care resources.MethodsOur study used province level data on TCM hospital beds and doctors from 2004 to 2014. These data were obtained from the China TCM Yearbook 2004–2014 and the China Statistical Yearbook 2004–2014.Global and local spatial autocorrelation was performed by using Moran’s index and the local Moran’s index to describe the spatial distribution of TCM hospital beds (doctors) as well as their density. A Gini coefficient was used to estimate inequalities in the geographic distribution of TCM hospital beds (doctors) based on their density. Correlations of the Gini coefficients between TCM hospital beds and doctors were calculated by Pearson correlation analysis.ResultsAll indicators of TCM hospital beds and doctor density have increased over the past 11 years. The number of TCM hospital beds per 10,000 populations increased the fastest. Geographical clustering was not obvious in the density distribution of TCM hospital beds or doctors, as no significant spatial autocorrelation was found. Gini coefficients showed that from 2004 to 2014 the distribution of TCM hospital beds per 10,000 population and doctors per 10,000 populations were equitable between different regions. A large gap existed in the distribution inequality of TCM hospital beds (doctors) per square kilometer among different regions.ConclusionTargeted health policy with equitable distribution of TCM hospital beds (doctors) per square kilometer and the balance and coordination of related resources should be a priority in shaping China’s healthcare system reform.

Analysis on prescription rules of Chen Baogui's prescriptions for treating epigastric fullness based on data mining

To summary and analyze the prescription rules of Professor Chen Baogui, a famous traditional Chinese medicine (TCM) doctor, for treating epigastric fullness. Professor Chen Baogui's prescriptions for treating epigastric fullness were collected and the treatment data were input into traditional Chinese medicine inheritance support system (TCMISS) to analyze the rules of the prescriptions by using data mining methods. Based on the screened 214 cases, the treatment experience of Professor Chen Baogui for treating epigastric fullness was summarized and analyzed. It was found that Professor Chen gave priority to recuperation of Qi activity. The results of four properties and five tastes showed Professor Chen's medication compatibility rules: one was simultaneous use of cold and warm drugs, and the other was simultaneous use of pungent drugs for dispersion and bitter drugs for purgation. In drug use, the basic prescriptions had the efficacy of promoting Qi circulation and regulating viscera function, additionally with the drugs with functions of eliminating digestion and inducing stagnation, activating blood circulation to dissipate blood stasis, replenishing Qi and nourishing Yin, tranquilizing mind, strengthening muscles and bones according to the TCM syndrome type. The clinical experience of Professor Chen for treating epigastric fullness was objectively summarized with the help of TCMISS, which was significant for analyzing and inheriting academic thinking and medication experience from famous TCM doctors.

Comparing doctor-elderly patient communication between traditional Chinese medicine and Western medicine encounters: Data from China.

Effective doctor-patient communication has been widely endorsed as pivotal for optimal medical care and the building of a positive and lasting relationship between caregivers and patients. While the literature suggests that traditional Chinese medicine (TCM) doctors have better interpersonal skills than Western medicine (WM) doctors, and that the doctor-patient relationship in TCM is more lasting, a comparison of specific communication behaviors in both encounters has not yet been carried out. This paper examines the similarities and differences in communication behaviors between these two types of consultations in relation to doctor-elderly patient communication. Forty-five consultations were included for analysis using the Roter Interaction Analysis System (RIAS). Significant differences were found in communication behaviors at the level of lifestyle and psychosocial exchanges, type of questions, non-medical small talk, and emotional disclosure. The study's limitations and implications are discussed.

Tooth-Marked Tongue Recognition Using Multiple Instance Learning and CNN Features.

Tooth-marked tongue or crenated tongue can provide valuable diagnostic information for traditional Chinese Medicine doctors. However, tooth-marked tongue recognition is challenging. The characteristics of different tongues are multiform and have a great amount of variations, such as different colors, different shapes, and different types of teeth marks. The regions of teeth mark only appear along the lateral borders. Most existing methods make use of concave regions information to classify the tooth-marked tongue which leads to inconstant performance when the region of teeth mark is not concave. In this paper, we try to solve these problems by proposing a three-stage approach which first makes use of concavity information to propose the suspected regions, then use a convolutional neural network to extract deep features and at last use a multiple-instance classifier to make the final decision. Experimental results demonstrate the effectiveness of the proposed method.

Assessment of Intermingled Phlegm and Blood Stasis Syndrome in Coronary Heart Disease: Development of a Diagnostic Scale.

Background Intermingled Phlegm and Blood Stasis Syndrome (IPBSS) is a common feature in patients with coronary heart disease (CHD). In clinical practice, the diagnostic agreement of clinical doctor of Chinese Medicine (CM) is poor. We previously developed a IPBSS diagnostic scale for use by general practitioner. ObjectivesTo assess a IPBSS diagnostic scale that we previously developed for use by non-experts. Methods This is a multicenter, prospective study involving eight study sites across China. Eligible patients were adults (≥18 years) with CHD as demonstrated by a history of myocardial infarction, stenosis, or past coronary revascularization. IPBSS was assessed using a scale that consisted of 14 items in two domains (e.g., phlegm and blood stasis). The score range for each item was 0 to 3 points. Maximum total score was 72 points. Diagnostic accuracy was verified using consensus opinion by two independent experts as reference. Results A total of 1,142 CHD patients were included. IPBSS was established in 729 subjects using the IPBSS diagnostic scale. In ROC curve analyses, at the optimal cut-off of 25.5, the sensitivity and specificity of the IPBSS scale were 67.6% and 72.4%, respectively. The area under the ROC curve was 0.741 (95%CI: 0.711-0.772). Conclusions The newly developed IPBSS scoring system showed moderate performance in diagnosing IPBSS in CHD patients. Data from further large-scale diagnostic test accuracy studies are warranted. This trial is registered with ChiCTR-OOC-15006599.