Traditional Chinese Medicine Physicians Research Articles

Tongue feature dataset construction and real-time detection.

Tongue diagnosis in traditional Chinese medicine (TCM) provides clinically important, objective evidence from direct observation of specific features that assist with diagnosis. However, the current interpretation of tongue features requires a significant amount of manpower and time. TCM physicians may have different interpretations of features displayed by the same tongue. An automated interpretation system that interprets tongue features would expedite the interpretation process and yield more consistent results. This study applied deep learning visualization to tongue diagnosis. After collecting tongue images and corresponding interpretation reports by TCM physicians in a single teaching hospital, various tongue features such as fissures, tooth marks, and different types of coatings were annotated manually with rectangles. These annotated data and images were used to train a deep learning object detection model. Upon completion of training, the position of each tongue feature was dynamically marked. A large high-quality manually annotated tongue feature dataset was constructed and analyzed. A detection model was trained with average precision (AP) 47.67%, 58.94%, 71.25% and 59.78% for fissures, tooth marks, thick and yellow coatings, respectively. At over 40 frames per second on a NVIDIA GeForce GTX 1060, the model was capable of detecting tongue features from any viewpoint in real time. This study constructed a tongue feature dataset and trained a deep learning object detection model to locate tongue features in real time. The model provided interpretability and intuitiveness that are often lacking in general neural network models and implies good feasibility for clinical application.

Development and testing of a post competency scale for traditional Chinese medicine physicians undergoing standardized training

ObjectiveTo develop and test a post competency scale for traditional Chinese medicine (TCM) physicians undergoing standardized training to provide an applicable tool for scientific evaluation. MethodsBased on literature analysis, behavioral event interviews, and expert consultations, measurement questions were formulated and the initial scale was designed. A questionnaire survey was conducted from July 2022 to May 2023 among TCM physicians undergoing standardized training in China. The rationality of the scale was confirmed through item purification, factor analysis, and tests of reliability and validity. ResultsThe post competency scale consisted of three dimensions (TCM fundamentals and research abilities, TCM thinking and skill abilities, and personal traits and communication abilities) with 21 items. Exploratory factor analysis identified three common factors, accounting for a cumulative variance contribution rate of 62.165%. Confirmatory factor analysis demonstrated that the fit indices of the three-factor model fell within a relatively ideal level. The Cronbach's alpha coefficient of the scale was 0.885. Through convergent validity analysis, the standardized loading coefficients of the 21 items were >0.5, and the average extracted variance (AVE) of the three factors was also >0.5. Moreover, the square roots of the AVE values for each dimension exceeded the correlation coefficients between it and the other dimensions. ConclusionsThe findings suggest that the post competency scale of TCM physicians undergoing standardized training can provide a reliable scientific basis for training and assessment within China.

Images of Traditional Chinese Medicine Doctors in Chinese Literature

Since ancient times, doctors have usually played the image of rescuers who save lives. As a symbol-rich image, "doctor" often enters the scope of writers' creativity and becomes a typical creative theme. This paper explores the image of Traditional Chinese Medicine (TCM) doctors in literature. The purpose of the study is to understand how TCM practitioners are portrayed and represented in literature, to analyze their social and cultural influence and their impact on people's perceptions and attitudes towards TCM. The relevance of this article is that it can help people to better understand the position and image of TCM in different historical periods and cultural environments, as well as its relationship with society, culture and people's lives. The subject of this paper is the image of TCM doctors in literary works of a certain period, region or cultural context such as ancient works, modern literary works and works of specific writers. By analyzing the images in different works, the diversity of such images of TCM physicians such as wise doctors and mysterious healers can be demonstrated. This paper uses methods of literary analysis, including close reading of the text, character analysis, plot and theme study. The text is also studied in the context of historical and cultural context to understand the views and attitudes of the society of the time towards TCM and doctors. The scientific novelty of studying the image of traditional Chinese medicine in Chinese literature gives us an interdisciplinary perspective that integrates literature with medicine and cultural studies and offers new ways to deeply understand TCM culture and human perception of health. The results of the study indicate the diversity of TCM physicians' images in the literature. In addition, the findings may reflect different understandings and evaluations of TCM in different periods and cultural contexts.

Nutritional intervention with acidic Stigma Maydis polysaccharide (ASMP-1) in membranous nephropathy: Targeting the PI3K/AKT/mTOR pathway

Membranous nephropathy (MN) is a glomerulonephritis characterized by C5b-9-mediated podocyte injury. Stigma Maydis is a medicinal, polysaccharide-based product derived from corn silks, traditionally used by traditional Chinese medicine physicians to treat chronic kidney disease. However, the mechanism through which Stigma Maydis polysaccharides (SMP) alleviates MN remains unclear. This study aimed to verify the potential protective effects of refined acidic SMP (ASMP-1) in vitro and in vivo. An ASMP-1 was successfully isolated by DEAE Sepharose anion exchange and Sephadex G-100 gel permeation chromatography. Our results showed that ASMP-1 suppressed oxidative stress, promoted autophagy, and repressed apoptosis. This mechanism is believed to be associated with the inhibition of the PI3K/Akt/mTOR signaling pathway. Consequently, owing to its enhanced autophagic activity and resources, ASMP-1 has potential as a functional food or nutritional supplement for kidney health preservation.

The lightness distribution of the red color for the nail plate related to human healthy level

The water content of the human nail plate may be a health indicator related to human beings. In Chinese traditional medical science, the traditional Chinese medicine physician usually examines the nail plate conditions combined with other body physical symptoms to determine the physical health level. Usually, for people with healthy bodies, the nail plates appear shining pink color. On the other hand, people get ills, their nail plates will appear in different colors except for shining pink color nail plates. The pink color nail plates have come from the red blood flowing through the body capillaries. A healthy people, the blood flow through capillaries should be very smooth. Obviously, the capillaries inside the human nail plates with a smooth flow of blood will cause the human nail plates to appear pink in color. Inspect the lightness distribution of the digital photo red color for the human nail plates only, a very clear result can be seen from the lightness distribution. The lightness distribution of the red color of the digital photo from the healthy human nail plate is wider than the lightness distribution of the digital photo from the dry nail plate.

Current State and Trends of Gender Differences Among Health Care Personnel in Taiwan

<p>本研究旨在探討臺臺灣醫事人員的性別、年齡結構近況，並探討其未來變化趨勢。資料來源為2014年至2021年衛生福利部統計處公布之醫事人員登記資料。結果發現16類師級人員中，護理師女性占比最高(96.17%)，其次為營養師(90.57%)，最低的三類醫事人員則為中醫師(32.77%)、牙醫師(30.09%)、西醫師(21.16%)。上述五類醫事人員的男女比例在這8年都有逐漸平衡的趨勢，惟推估護理師約需184.5年才能達到男女人數相當，醫師則約需30~40年。此年數可作為職系性別平等的一項參考指標，提醒家庭、學校、社會加強男女醫事人員投入醫療工作的自由平等。</p> <p> </p><p> This study explored the gender and age distributions of health care personnel in Taiwan at present and in the future. Data from the Ministry of Health and Welfare for the 2014–2021 period were retrieved from a database containing the registration information of health care personnel. This study discovered that among 16 types of health care personnel, nurses and nutritionists had the highest and second highest proportions of women, respectively (nurses, 96.17%; nutritionists, 90.57%), whereas traditional Chinese medicine (TCM) physicians, dentists, and physicians had the lowest, second lowest, and third lowest proportions of women, respectively (TCM physicians, 32.77%; dentists, 30.09%; physicians, 21.16%). From 2014 to 2021, the gender distribution for these five types of health care personnel gradually became more balanced. However, the time required to achieve gender parity (indicated by the male-to-female ratio) was estimated to be approximately 184.5 years for nurses and approximately 30–40 years for physicians. These numbers of year can serve as references on the state of gender equality in health care professional fields; they also remind families, schools, and the societies to strengthen the gender freedom and equality for male and female to devote in health care professionals.</p> <p> </p>

Journeying Through Different Mythic Worlds

Abstract: The global mental health movement (GMHM) seeks to close the treatment gap in low- and middle-income countries including those in Southeast Asia. However, the GMHM has been criticized for its overemphasis on a Eurocentric approach to mental health care, ignoring the diversity of knowledge and resources in local communities. Given the pluralistic health care systems in most Southeast Asian countries, people may utilize both Indigenous healing and Western mental health services. Therefore, indigenous healing systems can be integrated into mental health care to offer additional resources to local people to cope with emotional distress. Using a single case study approach, this article aims to explore the therapeutic aspects of indigenous healing systems relevant to mental health care. The case is about Jing, a Chinese woman who simultaneously consulted psychiatrists, a dang-ki (Chinese shaman/spirit medium), and a traditional Chinese medicine physician in Singapore. I attempt to answer three questions. First, what is Jing’s experience of seeking help from different forms of healing systems? Second, what are the therapeutic aspects of indigenous healing systems relevant to mental health care? Third, what are the challenges for reconciling the experiential truth with the empirical truth? Based on her narrative, although these healing systems were structured in different mythic worlds and explanatory models, Jing found all of them helpful without experiencing any cognitive dissonance. This may be because she did not passively respond to the treatments but actively negotiated her expectations with the healers, constructed meanings, and adopted a pragmatic attitude to meet her needs.

Enlightenment of chronic disease prevention from “Jiu Zuo Shang Rou (Long-time Sitting Damages Muscles)”: integrated traditional with modern perspectives

Thousands of years ago, the conception of “Jiu Zuo (久坐)” which can be translated as long-time sitting, has been generated by traditional Chinese medicine (TCM) physicians. It was clearly recorded that “Jiu Zuo Shang Rou (久坐伤肉)” in the ancient book Huang Di Nei Jing (Yellow Emperor’s Inner Canon). TCM physicians believe that long-time sitting can affect the normal circulation of the body’s qi and blood, injures the muscles and dysfunctions the spleen, then cause diseases. Recent years, biomedicine evidences that sedentary behavior, which includes sitting, will affect the endocrine, metabolism, and other physiological functions of human body, leading to chronic diseases possibly. This paper attempts to systematically recapitulate both the ancient records of Jiu Zuo Damages and the latest research of sedentary sitting diseases, enabling better understandings of the relationships between sedentary behavior and health status from both traditional and modern medicinal perspectives. Going beyond this, this work may extend the applications of TCM “Zhi Wei Bing (治未病)” theory in the field of chronic disease prevention and treatment, bringing great benefits to national and local population’s health.

Reveal the mechanisms of prescriptions for liver cancer' treatment based on two illustrious senior TCM physicians.

To explore the core herbs of two illustrious senior Traditional Chinese Medicine (TCM) Physicians for the treatment of liver cancer, and to further clarify the gene targets and pathway mechanisms of liver cancer that the core prescription (CP) may regulate. We used the patient information of two illustrious senior TCM physicians from the Affiliated Hospital of Shandong University of Traditional Chinese Medicine and the Affiliated Hospital of Capital Medical University as the database. The CP was analyzed using the community network algorithm. The pathway mechanism was analyzed using network pharmacology method. And the prognostic survival genes were identified using Single factor cox regression analysis. Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP), Herb, Online Mendelian Inheritance in Man (OMIM), Genecards, Kyoto Encyclopedia of Genes and Genomes (KEGG), Genomic Data Commons (GDC), The Cancer Genome Atlas (TCGA), Gephi and R were used to mine CP, building a pathway network diagram. All the analyses were visualized. We found that the CP consistes of Huangqi (), Danshen (), Shuihonghuazi (), Baihuasheshecao (), Banzhilian (), and Ezhu (), which were attributed to the two physicians respectively. The CP played an anti-cancer role through such pathways as signal transduction, energy metabolism, immune system and other pathways, covering a total of 112 pathways and 176 herb-disease-related genes. Fourteen genes have a significant impact on the prognosis and survival of liver cancer. Based on the liver cancer cases of two illustrious senior TCM physicians, we obtained the CP through data mining. The CP may mainly exert anti-cancer effects by inhibiting inflammatory response, angiogenesis, and enhancing the body's immune response. We screened out 14 genes in the CP that may be related to the prognosis of liver cancer, and these genes may play an important regulatory role in the prognosis of liver cancer.

Satisfaction of patients with diabetic kidney disease with traditional chinese medicine physician visits

BackgroundPatient-centred care is an important part of quality healthcare and patient satisfaction has been shown to be associated with improved clinical outcomes. We aim to explore the satisfaction of patients with diabetic kidney disease (DKD) with their visits to the TCM physician and its association with patients' socio-economic characteristics. MethodsA questionnaire survey was conducted among patients aged >21 years with DKD. Participants' demographic, socioeconomic characteristics and satisfaction scores measured with the self-administered Medical Interview Satisfaction Scale (MISS) were collected after they visited the TCM physician. MISS is a 26-item questionnaire consisting of three domains – cognitive, affective and behavioural which was developed to assess patient satisfaction with medical consultation. Independent samples t-test and one-way analysis of variance (ANOVA) were used to analyse the data. Results137 participants completed the questionnaires and were included in the analysis. The mean satisfaction score was 3.1 out of 5, with the cognitive domain being significantly higher compared to the affective and behavioural domains. The mean satisfaction score of the cognitive domain differed significantly among participants staying in different types of housing and those with previous TCM encounters. The mean satisfaction score of the behavioural domain differed significantly among participants of different ethnicities. The mean satisfaction scores of all the domains were also significantly different among participants with different duration of follow-up with their TCM physicians. ConclusionWe found that ethnicity, types of housing, previous TCM experience and the duration of follow-up with the TCM physician may affect the satisfaction scores of patients with DKD.

TCMFVis: A visual analytics system toward bridging together traditional Chinese medicine and modern medicine

Although traditional Chinese medicine (TCM) and modern medicine (MM) have considerably different treatment philosophies, they both make important contributions to human health care. TCM physicians usually treat diseases using TCM formula (TCMF), which is a combination of specific herbs, based on the holistic philosophy of TCM, whereas MM physicians treat diseases using chemical drugs that interact with specific biological molecules. The difference between the holistic view of TCM and the atomistic view of MM hinders their combination. Tools that are able to bridge together TCM and MM are essential for promoting the combination of these disciplines. In this paper, we present TCMFVis, a visual analytics system that would help domain experts explore the potential use of TCMFs in MM at the molecular level. TCMFVis deals with two significant challenges, namely, (i) intuitively obtaining valuable insights from heterogeneous data involved in TCMFs and (ii) efficiently identifying the common features among a cluster of TCMFs. In this study, a four-level (herb-ingredient-target-disease) visual analytics framework was designed to facilitate the analysis of heterogeneous data in a proper workflow. Several set visualization techniques were first introduced into the system to facilitate the identification of common features among TCMFs. Case studies on two groups of TCMFs clustered by function were conducted by domain experts to evaluate TCMFVis. The results of these case studies demonstrate the usability and scalability of the system.

Machine Learning-Based Technique for the Severity Classification of Sublingual Varices according to Traditional Chinese Medicine.

Tongue diagnosis, a noninvasive examination, is an essential step for syndrome differentiation and treatment in traditional Chinese medicine (TCM). Sublingual vein (SV) is examined to determine the presence of blood stasis and blood stasis syndrome. Many studies have shown that the degree of SV stasis positively correlates with disease severity. However, the diagnoses of SV examination are often subjective because they are influenced by factors such as physicians' experience and color perception, resulting in different interpretations. Therefore, objective and scientific diagnostic approaches are required to determine the severity of sublingual varices. This study aims at developing a computer-assisted system based on machine learning (ML) techniques for diagnosing the severity of sublingual varicose veins. We conducted a comparative study of the performance of several supervised ML models, including the support vendor machine, K-neighbor, decision tree, linear regression, and Ridge classifier and their variants. The main task was to differentiate sublingual varices into mild and severe by using images of patients' SVs. To improve diagnostic accuracy and to accelerate the training process, we proposed using two model reduction techniques, namely, the principal component analysis in conjunction with the slice inverse regression and the convolution neural network (CNN), to extract valuable features during the preprocessing of data. Our results showed that these two extraction methods can reduce the training time for the ML methods, and the Ridge-CNN method can achieve an accuracy rate as high as 87.5%, which is similar to that of experienced TCM physicians. This computer-aided tool can be used for reference clinical diagnosis. Furthermore, it can be employed by junior physicians to learn and to use in clinical settings.

Practicing traditional Chinese medicine in the COVID-19 pandemic in Switzerland – an exploratory study

BackgroundTo curb the spread of the first wave of the COVID-19 pandemic, the Swiss government declared a state of health emergency and ordered a legal restriction concerning the opening of healthcare institutions. In this study, we aimed to assess the proportion of traditional Chinese medicine (TCM) physicians and therapists who consulted patients regarding COVID-19 during the first wave of the pandemic in 2020 in Switzerland, as well as the extent to which COVID-19 affected their practices during the same period.MethodsA retrospective study was performed by using a questionnaire from January to April 2021 among a random sample of TCM physicians and therapists based in Switzerland. The survey included questions on demographic characteristics, opening status of practices, channels of communication used for the medical encounter, and experience in managing the prevention, acute, and recovery stages of COVID-19 infection.ResultsAmong the 320 participants, 76% consulted a patient regarding COVID-19 at least once. Overall, physicians and therapists consulted more patients during recovery (76.3%) and prevention (67.8%) than during the acute stage (19.8%) of the disease. Acupuncture was the most frequently used technique among TCM therapists and physicians consulting for prevention (80.4%) and recovery (92.5%), whereas Chinese pharmacopeia was the most used technique among those consulting for the acute stage (59.3%). Of those who closed their practices from March to April 2020 but kept consulting, telephone (30.4%) and home visits (29.9%) were the two principal methods of consultation.ConclusionsThe restriction concerning the opening of practices induced a loss of the health workforce, especially among TCM therapists. Nonetheless, TCM therapists and physicians consulted patients regarding COVID-19, especially during the recovery stage. As there is a demand for the use of TCM in the context of COVID-19, it raises the need for a better consideration of TCM in the Swiss health care system.

Realgar (As4S4), a traditional Chinese medicine, induces acute promyelocytic leukemia cell death via the Bcl-2/Bax/Cyt-C/AIF signaling pathway in vitro.

Acute promyelocytic leukemia (APL) is a specific subtype of acute myelogenous leukemia (AML) characterized by the proliferation of abnormal promyelocytes. Realgar, a Chinese medicine containing arsenic, can be taken orally. Traditional Chinese medicine physicians have employed realgar to treat APL for over a thousand years. Therefore, realgar may be a promising candidate for the treatment of APL. Nevertheless, the underlying mechanism behind realgar therapy is largely unclear. The present study aimed to investigate the effect of realgar on cell death in the APL cell line (NB4) in vitro and to elucidate the underlying mechanism. In this study, after APL cells were treated with different concentrations of realgar, the cell survival rate, apoptotic assay, morphological changes, ATP levels and cell cycle arrest were assessed. The expression of Bcl-2, Bax, Cytochrome C (Cyt-C) and apoptosis-inducing factor (AIF) at the mRNA and protein levels were also measured by immunofluorescence, quantitative PCR (qPCR) and Western blotting. We found that realgar could significantly inhibit APL cell proliferation and cell death in a time- and dose-dependent manner. Realgar effectively decreased the ATP levels in APL cells. Realgar also induced APL cell cycle arrest at the S and G2/M phases. Following realgar treatment, the mRNA and protein levels of Bcl-2 were significantly downregulated, whereas the levels of Bax, Cyt-C, and AIF were significantly upregulated. In summary, realgar can induce APL cell death via the Bcl-2/Bax/Cyt-C/AIF signaling pathway, suggesting that realgar may be an effective therapeutic for APL.

An action recognition method for manual acupuncture techniques using a tactile array finger cot

The current measurement systems for the physical parameters (rotation frequency, and amplitude) of Traditional Chinese Medicine (TCM) manual acupuncture tend to cause disturbance and inconvenience in clinical application and do not accurately capture the tactile signals from the physician's finger during manual acupuncture operations. In addition, the literature rarely discusses classification of the four basic manual acupuncture techniques (reinforcing by twirling and rotating (RFTR), reducing by twirling and rotating (RDTR), reinforcing by lifting and thrusting (RFLT), and reducing by lifting and thrusting (RDLT)). To address this problem, we developed a multi-PVDF film-based tactile array finger cot to collect piezoelectric signals from the acupuncturist's finger-needle contact during manual acupuncture operations. In order to recognize the four typical TCM manual acupuncture techniques, we developed a method to capture piezoelectric signals in related “windows” and subsequently extract features to model acupuncture techniques. Next, we created an ensemble learning-based action classifier for manual acupuncture technique recognition. Finally, the proposed classifier was employed to recognize the four types of manual acupuncture techniques performed by 15 TCM physicians based on the piezoelectric signals collected using the tactile array finger cot. Among all the approaches, our proposed feature-based CatBoost ensemble learning model achieved the highest validation accuracy of 99.63% and the highest test accuracy of 92.45%. Moreover, we provide the efficiency and limitations of using this action recognition method.

The establishment of recent knowledge of acupoint anatomy and its impact

ABSTRACT The content of acupuncture points has been a long concerned issue in China. The ancients’ descriptions of acupuncture points in medical literature were all based on their observation of the body’s surface, and they didn’t have the modern concept of “acupuncture points” independent of body tissue. In modern times, with the foundation of anatomy in China, physicians of traditional Chinese medicine (TCM) gradually developed the thinking paradigm of knowing the body through anatomy. Meanwhile, the acupuncture circle in Japan combined anatomy with their understanding of acupuncture points and added anatomical content to the entries on acupuncture points. After the translation and introduction of Japanese acupuncture literature, their understanding of anatomical acupuncture added to the Chinese physicians’ acupuncture knowledge in the Republican time. During this process, elite physicians and educators in the acupuncture community played a vital role. According to the Actor-Network Theory, the construction of anatomical knowledge of acupuncture points in the Republic of China resulted from multi-factor interaction. In the meantime, the conception of acupuncture point anatomy changed people’s original cognition of acupuncture points and resulted in the paradigm shift in TCM physicians’ body cognition.

Strengthening of Traditional Chinese Medicine in the Health System Reform: Effect on Health Outcomes and Financial Protection.

Background The challenges of modern medicine in addressing chronic diseases necessitate a shift of attention towards traditional medicine (TM) and other supplementary care systems. China has prioritized the strengthening of traditional Chinese medicine (TCM) in the health system reform since 2009. This study sought to assess the effects of the reform on TCM and the resultant effect of a strengthened TCM on health outcomes and financial protection. Methods Longitudinal data were obtained from the China Statistical Yearbook, China Health Statistical Yearbook, China Population Statistical Yearbook, and Statistical Extract of Traditional Chinese Medicine in 31 provinces of mainland China between 2002 and 2016. Dependent variables included health outcomes measured by age-standardized excess mortality and life expectancy at birth and financial protection measured by the proportion of health expenses in total consumption expenses. The independent variables consisted of the number and proportion of TCM physicians. The fixed effects (FEs) models were established to identify the effect of the independent variables on outcomes. Results From 2009 to 2016, the number and proportion of TCM physicians increased from 22 to 36 physicians per 100,000 population and from <12% to >15%, respectively. The changes were more rapid and higher than that in the period before the reform. An increase of 1 TCM physician per 100,000 population was associated with a decrease of 1.944 excess deaths, a 5.84-day increase in male life expectancy, and a decrease of 0.051% of health expenses among both urban and rural residents. An increase in proportion of 1% of TCM physicians was associated with a decrease of 5.097 excess deaths, a 17.52-day increase of life expectancy (both genders), an increase of 21.535-day in life expectancy (males) per 100,000 population, and a decrease of 0.082% of health expenses among rural residents. Conclusion During China's health system reform, the increased physician number has strengthened TCM. Higher TCM physician supply was associated with improved health outcomes and financial protection, which implies that the reform may have important implications on health system performance in China.

Traditional Chinese Medicine Automated Diagnosis Based on Knowledge Graph Reasoning

Syndrome differentiation is the core diagnosis method of Traditional Chinese Medicine (TCM). We propose a method that simulates syndrome differentiation through deductive reasoning on a knowledge graph to achieve automated diagnosis in TCM. We analyze the reasoning path patterns from symptom to syndromes on the knowledge graph. There are two kinds of path patterns in the knowledge graph: one-hop and two-hop. The one-hop path pattern maps the symptom to syndromes immediately. The two-hop path pattern maps the symptom to syndromes through the nature of disease, etiology, and pathomechanism to support the diagnostic reasoning. Considering the different support strengths for the knowledge paths in reasoning, we design a dynamic weight mechanism. We utilize Naïve Bayes and TF-IDF to implement the reasoning method and the weighted score calculation. The proposed method reasons the syndrome results by calculating the possibility according to the weighted score of the path in the knowledge graph based on the reasoning path patterns. We evaluate the method with clinical records and clinical practice in hospitals. The preliminary results suggest that the method achieves high performance and can help TCM doctors make better diagnosis decisions in practice. Meanwhile, the method is robust and explainable under the guide of the knowledge graph. It could help TCM physicians, especially primary physicians in rural areas, and provide clinical decision support in clinical practice.

The positive role of traditional Chinese medicine as an adjunctive therapy for cancer.

Traditional Chinese medicine (TCM), especially Chinese herbal medicines and acupuncture, has been traditionally used to treat patients with cancers in China and other East Asian countries. Numerous studies have indicated that TCM not only alleviates the symptoms (e.g., fatigue, chronic pain, anorexia/cachexia, and insomnia) of patients with cancer and improves their quality of life (QOL) but also diminishes adverse reactions and complications caused by chemotherapy, radiotherapy, or targeted-therapy. Therefore, Chinese herbal medicines and acupuncture and other alternative therapies need to be understood by TCM physicians and other health care providers. This review mainly summarizes the experimental results and conclusions from literature published since 2010, and a search of the literature as been performed in the PubMed, MEDLINE, Web of Science, Scopus, Springer, ScienceDirect, and China Hospital Knowledge Database (CHKD) databases. Some Chinese herbal medicines (e.g., Panax ginseng, Panax quinquefolius, Astragali radix, Bu-zhong-yi-qi-tang (TJ-41), Liu-jun-zi-tang (TJ-43), Shi-quan-da-bu-tang (TJ-48), and Ban-xia-xie-xin-tang (TJ-14)) and some acupuncture points (e.g., Zusanli (ST36), Zhongwan (CV12), Neiguan (PC6) and Baihui (GV20)) that are commonly used to treat cancer-related symptoms and/or to reduce the toxicity of chemotherapy, radiotherapy, or targeted-therapy are highlighted and summarized. Through a review of literature, we conclude that TCM can effectively alleviate adverse gastrointestinal reactions (including diarrhea, nausea, and vomiting) to these anti-cancer therapies, decrease the incidence of bone marrow suppression, alleviate cardiotoxicity, and protect against chemotherapy-induced peripheral neuropathy and radiation-induced pneumonitis. Moreover, TCM can alleviate epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI)-related acneiform eruptions, diarrhea, and other adverse reactions. The hope is that this review can contribute to an understanding of TCM as an adjuvant therapy for cancer and that it can provide useful information for the development of more effective anti-cancer therapies. However, more rigorously designed trials involving cancer treatment must be conducted in the future, including complete quality control and standardized models at the cellular, organic, animal and clinical levels, in order to study TCM in multiple forms and at multiple levels.

Clinical application of Aconitum carmichaelii Debx. (Fu Zi in Chinese) by traditional Chinese medicine physicians--A cross-sectional questionnaire survey in Beijing

To investigate clinical application of aconite root ( Aconitum carmichaelii Debx.; hereinafter “aconite”) by traditional Chinese medicine (TCM) physicians in TCM hospitals in Beijing and explore the specific use of aconite and the effect of different doses on decoction time. This was a cross-sectional study using two-stage sampling. Questionnaires were administered among TCM physicians from TCM hospitals in Beijing between September 2020 and August 2021. The questionnaire mainly included general demographics, clinical backgrounds of TCM physicians, and clinical application of aconite. The data analyses were performed using SPSS 20.0. A total of 387 questionnaires were collected, of which 385 were valid. Of the 385 participating TCM physicians, 331 (85.97%) used aconite in clinical practice. The top three medical diagnoses treated with aconite were heart failure, diarrhea without cause, and chronic gastritis. The TCM pattern treated most frequently with a high dose of aconite was spleen-kidney yang deficiency, and the TCM pattern treated most frequently with a low dose was spleen yang deficiency, while spleen-kidney yang deficiency was treated most frequently with a common dose of aconite. The top three common formulas were Sini decoction, Mahuang Xixin Fuzi decoction, and Zhenwu decoction. Hei Shun Pian was the most common herbal pieces of aconite. The highest frequency of the maximum dose of aconite was 15 g, that of the minimum dose was 3 g, and that of the common dose was 10 g. There was a certain correlation between decoction time and the dose of aconite. Most TCM physicians advised their patients to take medicine twice a day. In this study, we refined and quantified the use of aconite and enriched the exploration of the clinical application of aconite besides its provisions in the Pharmacopoeia of the People's Republic of China .