Traditional Chinese Medicine Practitioners Research Articles

Classical Medical Cases of Doubt Narrative Foreclosure in Traditional Chinese Medicine and Their Corresponding Narrative Mediation

Abstract: Narrative foreclosure is a phenomenon highlighted within the Chinese narrative medicine system, characterized by a state in which individuals become overly suspicious due to certain events in their development, leading to profound concerns about their health and safety. This article employs the logical discourse framework of Chinese narrative medicine to illustrate the experiences of various patients exhibiting typical instances of narrative foreclosure in traditional Chinese medicine (TCM) cases, such as Bei Gong She Ying (杯弓蛇影 snake shadow in the cup), Wu Qiu Zhi Chong (吴球治虫Wu Qiu treats worms), and Fa Jing Qu She (法靖驱蛇 Fajing drives away snakes). It explores how TCM practitioners leverage narrative wisdom to facilitate patients in dispelling their internal doubts through the concept of Bu Yao Wei Yao (不药为药 healing diseases without medicine). Through these medical cases, the article advocates for the significance of narrative competencies among medical practitioners in diagnosing and treating patients, alongside the use of pharmaceuticals and surgical interventions. Additionally, it outlines the prospects for the future development of narrative approaches in TCM.

Physician-Patient Narrative Re-discovered from Overseas Traditional Chinese Medicine Practices by Non-Chinese Physicians for Non-Chinese Patients

Abstract: In the past decade, the physician-patient narrative has been revisited and appreciated in both the West and the East because of the negative impact of biochemical medicine in the past two centuries in healthcare. Biochemical medical system simply marginalized physicians and patients(Jewson, 2009). More research and practice of "doctor's benevolence" and "humanistic medicine" have called for the return of the physician-patient narrative. This paper interviewed a few non-Chinese overseas Traditional Chinese Medicine (TCM) practitioners, whose clients were non-Chinese, too. We adopted discourse analysis to explore our data. We found that they actively engaged in physician-patient narrative with localized interpretation of TCM. We believe such a return to basic physician-patient narrative is caused by fundamental needs for physician-patient narrative coincidentally goes along with loose control of TCM practices in the studied countries. This discovery can inspire further study on re-establishing physician-patient narratives in each healthcare institution by re-positioning biochemical medicine.

Research progress on knowledge discovery in traditional Chinese medicine medical records based on artificial intelligence

Traditional Chinese Medicine (TCM) medical records represent the clinical practice records of physicians, encapsulaing a wealth of TCM clinical diagnosis and treatment experiences as well as academic thoughts of numerous TCM practitioners. Such various information provide certain basic conditions for the integration of artificial intelligence (AI) technology with TCM. Through analysing successful clinical records, AI technology can extract practical and understandable knowledge. Therefore, this paper summarizes and analyzes the application of information technology in the field of knowledge discovery research from Chinese medical records. It focuses on three key aspects: the resources of TCM Medical Records, the objects of TCM records mining, and the application of AI technology. The aim is to provide beneficial references for maximizing the value of TCM medical records.

Calming the Wind: A Traditional Chinese Medicine Practitioner's Approach to Wartime Acute Stress Disorder Symptoms.

In this narrative essay, a traditional Chinese medicine (TCM) practitioner describes the challenge of treating three survivors of a terror attack, all of whom were presenting various symptoms of acute stress disorder (ASD). Working in new and exceptionally demanding circumstances - with thousands of people injured in an extensive and direct terror attack, with relatives taken hostages and entire communities evacuated from their homes - the practitioner looked for an effective treatment strategy to alleviate symptoms of stress response. He found it in the interface between TCM and the function of the autonomic nervous system.

Survey on the Current Status of Elderly Health Services in 1,305 Medical Institutions in Guangxi.

To investigate the current status of elderly health services in medical institutions at all levels within Guangxi Province, China. Using a purposeful sampling method, a questionnaire survey was conducted from July 24, 2023 to October 24, 2023 on the general situation, human resources, rehabilitation medicine, nursing services, and the development of hospice care at 1305 medical institutions in Guangxi. Among the surveyed 1305 medical institutions in Guangxi, 172 (13.18%) had established departments of geriatrics, while 293 (22.45%) boasted departments of rehabilitation medicine. Furthermore, 909 (69.66%) of these institutions offered annual free physical examination services to individuals aged 65 and above. Notably, a total of 362 medical institutions, encompassing both comprehensive hospitals and grassroots hospitals, were recognized as elderly-friendly institutions, accounting for 31.4% of the surveyed sample.The highest demand for talents in medical institutions at all levels included specialized physicians/general practitioners (74.6%), traditional Chinese medicine practitioners (63.1%), rehabilitation therapists (56.1%), and specialized nurses for the elderly (41.7%). A total of 1038 medical institutions conducted popular science activities on elderly health, accounting for 79.5% of the total, focusing mainly on disease prevention (89.21%), nutritional diets (84.68%), rational medication use (79.77%), physical exercise (68.21%), and mental health (60.79%). Only 88 medical institutions provided hospice care services, accounting for 6.7% of the total. Guangxi medical institutions' elderly services are inadequate. Geriatrics and rehab departments are scarce, talent is lacking, and hospice care is underdeveloped. As aging accelerates, the country and society must support elderly care. Governments should introduce talent incentives, and medical institutions should enhance services, foster a positive work environment, and advance Guangxi's elderly health agenda.

Integrating Traditional Chinese Medicine massage therapy with machine learning: A new trend in future healthcare

The growing demand for healthcare has brought Traditional Chinese Medicine (TCM) massage therapy into the spotlight in academic circles. Numerous studies have underscored the effectiveness of TCM massage in health promotion, disease amelioration, and quality of life enhancement. However, the field faces challenges such as inconsistent training and inadequate transfer of experiential knowledge. Recently, machine learning has shown potential in the medical field and its application in TCM massage therapy offers new developmental opportunities. This paper reviews key research areas exploring the synergy between machine learning and Chinese massage therapy, including acupoint localization and identification, massage practice, and personalized treatment plans. It summarizes progress and identifies the challenges in integrating these technologies. Despite potential risks, merging these technologies is poised to be a trend in future healthcare, driven by advances in computer technology and the needs of TCM practitioners.

Quantifying non-target seahorse fisheries and domestic traditional medicine-based trade in Malaysia

Seahorses (Hippocampus spp.) are sold primarily for traditional medicine (TM) uses in Southeast Asia. Although Malaysia is reportedly an important global seahorse exporter, documentation on the current extent of seahorse catch and trade of seahorse-based TM within the country is limited. This study aimed to quantify patterns of seahorse bycatch, gear-specific biological parameters of caught seahorses, and trade characteristics in Malaysia. Questionnaire-based fisher and TM surveys were administered nationwide from March 2021 to March 2023. Seventy-one percent of fisher respondents (612 out of 860) reported catching seahorses, with gill or drift net fishers (73 %) more likely to have caught seahorses than trawlers (12 %). Significant spatial differences in species composition was observed between Peninsular Malaysia and Malaysian Borneo (Sabah state). The total estimated annual seahorse catch within Malaysia was approximately 3376 kg per year, with 77 % of the catch attributed to gill or drift nets and 23 % to trawling operations. Almost half (40 %) of traditional Chinese medicine (TCM) practitioners/ traders (n = 138), 3 % of Malay TM practitioners (n = 3), and 88 % of other TM traders (n = 7) reported selling seahorse species. This study is one of the first to quantify the often overlooked but critical contribution of small-scale fisheries, especially gill and drift nets, towards seahorse bycatch. The current supply volume and selling price of seahorses were observed to be relatively high, while the present-day demand was reportedly low. Almost half of TCM practitioners/ traders interviewed were still actively selling seahorses, indicating that there is still considerable demand. To ensure the sustainability of seahorse populations in Malaysia, efforts in both small-scale and trawl fisheries must be reduced while strictly enforcing seahorse trade regulations.

Increased risk of major adverse cardiovascular events in young and middle-aged adults with obesity receiving Chinese herbal medicine: A nationwide cohort study.

Many patients with obesity in Taiwan seek Chinese herbal medicines (CHM) from traditional Chinese medicine (TCM) clinics. This study aimed to estimate the risk of major adverse cardiovascular events (MACEs) in adults diagnosed with obesity, with or without CHM. Patients with obesity aged 18 to 50 years were identified using diagnostic codes from Taiwan's National Health Insurance Research Database between 2008 and 2018. We randomized 67,655 patients with or without CHM using propensity score matching. All patients were followed up from the start of the study until MACEs, death, or the end of 2018. A Cox proportional regression model was used to evaluate the hazard ratios of MACEs in the CHM and non-CHM cohorts. During a median follow-up of 4.2 years, the CHM group had a higher incidence of MACEs than the non-CHM control cohort (9.35 versus 8.27 per 1,000 person-years). The CHM group had a 1.13-fold higher risk of MACEs compared with the non-CHM control (adjusted hazard ratio [aHR] = 1.13; 95% confidence interval [CI]: 1.07-1.19; p <0.001), especially in ischemic stroke (aHR = 1.18; 95% CI: 1.07-1.31; p <0.01), arrhythmia (aHR = 1.26; 95% CI: 1.14-1.38; p <0.001), and young adults aged 18 to 29 years (aHR = 1.22; 95% CI: 1.05-1.43; p <0.001). Although certain CHMs offer cardiovascular benefits, young and middle-aged obese adults receiving CHM exhibit a higher risk of MACEs than those not receiving CHM. Therefore, TCM practitioners should be cautious when prescribing medications to young patients with obesity, considering their potential cardiovascular risks.

An Image Dataset and an Effective Detection Algorithm for Human Body Acupoints

With the development of artificial intelligence, computer vision technology has been widely used in the fields of security monitoring, automatic driving and wisdom city. However, there has not been a research on the detection of the meridians in human bodies by using the computer vision technology. In order to promote the use of the computer vision technology in human meridian detection, this paper first releases a dataset based on human meridians, which makes up for the gap in the field of human meridian detection using image processing technology. Moreover, the human meridian detection dataset is manually annotated and proofread by experienced Traditional Chinese Medicine (TCM) practitioners according to the position and direction of the human meridians, so that the annotated human meridians are as accurate as possible. The released human meridian dataset label’s 12 meridians, including spleen meridian, pericardium meridian, stomach meridian, lung meridian, heart meridian, kidney meridian, gallbladder meridian, liver meridian, triple energizer meridian, bladder meridian, large intestine meridian and small intestine meridian. A total of 296 acupoints were labeled. At last, this paper proposes a method for data augmentation, especially for datasets with a small amount of data, wherein the data amount can be augmented by enhancing the underlying edge visual features of the data. Experimental results show that human meridians can be detected by using image processing technology, and the proposed method for data augmentation can effectively improve the detection accuracy of human meridians. The dataset can be downloaded from https://www.zksylf.com/col.jsp?id=127 .

TCM practitioners’ attitudes and perceptions regarding the use of Ephedra sinica Stapf: An observational study

ObjectiveTo understand the attitudes and perceptions of traditional Chinese medicine (TCM) practitioners in Beijing TCM hospitals regarding the use of Ephedra sinica Stapf (E. sinica, Ma Huang). MethodsA two-stage cross-sectional study was conducted using a questionnaire survey of TCM practitioners in Beijing TCM hospitals between April 2023 and March 2024. The questionnaire included demographic information, the clinical background of TCM practitioners, and the clinical application of E. sinica. Logistic regression analysis was used to analyze the relevant influencing factors when using E. sinica. ResultsOf the 465 questionnaires collected, 441 were valid. Among these, 84.81% (374/441) reported having used E. sinica in clinical practice at least once. The commonly used doses of E. sinica—excluding the pediatric department—were 10 g for high doses, 6 g for medium, and 3 g for low. The three most frequently used formulas for E. sinica included Maxing Shigan decoction, Mahuang decoction, and Xiao Qing Long decoction. The most common TCM patterns treated with a high dose of E. sinica were wind-cold fettering the exterior, wind-cold invading the lung, and cold congealing in the meridian. The top three Western medical diagnoses when using E. sinica for treatment were common cold, pneumonia, and upper respiratory tract infections. Nearly half of the respondents reported experiencing adverse reactions from the oral administration of E. sinica, with the most common being palpitations, insomnia, and restlessness. Starting with a low dose and gradually increasing it as appropriate was identified as an effective approach. According to the respondents, the most important factor affecting the efficacy of E. sinica is the dose used. ConclusionThis study investigated the attitudes and perceptions of TCM practitioners in Beijing TCM hospitals regarding the dose–efficacy–adverse reaction relationship of E. sinica, providing a reference for the safe and effective clinical use of E. sinica.

Construction of TCM Institution Image: A Corpus-Based Comparative Critical Discourse Study of Chinese and Western Mainstream Media Reports

This study conducts a corpus-assisted comparative analysis of the media images of Traditional Chinese Medicine (TCM) institutions in Chinese and Western media contexts. Applying Fairclough’s three-dimensional critical discourse analysis (CDA) model alongside the TCM Social Image Evaluation Index System, this study explores media image construction and ideological factors shaping the perception of TCM institutions globally through an analysis of linguistic features in keywords, evaluative collocates and modal verbs. It’s found that Chinese media present TCM institutions in a positive light, depicting them as multifaceted organizations with a rich cultural legacy and robust capabilities in medical and scientific research. They showcase TCM institutions as cooperative, promising in integration with modern healthcare, efficient, rapid, flexible, innovative, and imbued with humanitarian values especially during the COVID-19 epidemic. Western media, however, adopt a more cautious stance. They tend to frame TCM institutions as providers of alternative medicine and temporary solutions, with a focus on health preservation, leisure and overall well-being. Concerns have also been raised about the potential illicit activities associated with some massage schools. These disparities in presenting TCM institutions reflect cultural, political and audience demand differences between China and the West. The results of this study contribute to a deeper understanding of the media portrayal of TCM institutions, provide insights into the challenges facing the global recognition and acceptance of TCM institutions, and suggest strategies for Chinese media, TCM practitioners, and policymakers to enhance their international image.

The Provision and Perceptions of Telemedicine Services Among Traditional Chinese Medicine Practitioners During COVID-19: A Cross-Sectional Study in Hong Kong, China.

Objectives: Telemedicine has been widely used during the COVID-19 pandemic. Among other health care professionals, Chinese medicine practitioners (CMPs) face practical challenges in providing telemedicine consultations. This study aims to explore CMPs' experience and perceptions of telemedicine service provision before and during the pandemic. Methods: A territory-wide cross-sectional online survey was conducted in Hong Kong between April and May 2022. A structured questionnaire with open-ended questions was used to investigate the provision of and perception on telemedicine service, as well as usability of telemedicine among CMPs. Results: A total of 195 CMPs participated the survey. Before COVID-19, 42% (81/195) had been providing telemedicine services, and the proportion doubled during COVID-19. CMPs in the private sector are the main providers. Mobile apps including WhatsApp, WeChat, and Zoom were commonly used for consultations (75%, 120/161). Barriers in providing telemedicine included inability of conducting physical examination on patients (69%, 134/195), legal and ethical concerns over medical negligence (61%, 118/195), and patients' incompetence on e-literacy (50%, 98/195). Respondents urged professional and regulatory bodies to provide an explicit clinical guideline that demonstrate best practice in traditional Chinese medicine telemedicine, and to clarify legal and ethical implications of such practice. Conclusions: CMPs demonstrated their competency in telemedicine, and most of them provided telemedicine during COVID-19. Development of appropriate guidelines on the provision of telemedicine would support CMPs to continue provision after the pandemic, whereas a user-friendly and comprehensive telemedicine e-platform would enhance quality of such service. Facilitating patients with lower e-literacy to access telemedicine is key to reduce disparities.

A protocol for a multidisciplinary early intervention during chemotherapy to improve dietary management behavior in breast cancer patients: a two-arm, single-center randomized controlled trial

BackgroundAdverse reactions are prone to occur in the early stage of chemotherapy and can negatively affect the dietary intake and nutritional status of breast cancer (BC) patients. Consequently, they need to participate in health self-management and lifestyle promotion programs. Early multidisciplinary interventions aim to enhance dietary management behavior and quality of life in chemotherapy-treated BC patients.MethodsThis single-blinded, single-center, randomized controlled trial will include 88 females who have not yet started the early or middle stage of the chemotherapy cycle. A random number table will be used randomly assign females to the intervention group or usual group at a 1:1 ratio. The intervention elements are based on the theoretical guidance of the Integrated Theory of Health Behavior Change (ITHBC). A multidisciplinary team (MDT) comprising oncologists, dietitians, nurses, traditional Chinese medicine (TCM) practitioners, and psychologists will provide the intervention. Intervention sessions will be conducted once a week for 8 weeks, beginning in the early or middle stage of the chemotherapy cycle and continuing through admission and a home-based interval chemotherapy period. The intervention includes face-to-face discussions, online meetings, WeChat messaging, and telephone calls. The themes target adverse reactions, dietary information and habits, self-care self-efficacy, treatment self-regulation, dietary supplement and TCM use, social support, weight management, and outcome expectations. The primary outcome is dietary management behavior measured by the Dietary Management Behavior Questionnaire (DMBQ). Secondary outcomes are self-care self-efficacy assessed by the Strategies Used by People to Promote Health (SUPPH); quality of life measured by the Functional Assessment of Cancer Therapy-Breast (FACT-B); and body mass index (BMI) measured by an electronic meter. All participants will be assessed at baseline and immediately, 1 month, 3 months, 6 months, and 12 months after the intervention.DiscussionEarly dietary intervention is needed, as diet is one of the most common health self-management behaviors influenced by chemotherapy. Early multidisciplinary interventions may provide a foundation for dietary self-management and improve nutritional status in the survival period.Trial registrationThis intervention protocol was registered with the Chinese Clinical Trials Registry (ChiCTR2300076503, October 10, 2023).

A review of Aconiti Lateralis Radix Praeparata (Fuzi) for kidney disease: phytochemistry, toxicology, herbal processing, and pharmacology.

Aconiti Lateralis Radix Praeparata, commonly known as Fuzi in. traditional Chinese medicine (TCM), is widely utilized in clinical practice despite its inherent toxicity. Since ancient times, TCM practitioners have explored various processing techniques to broaden its clinical applications and enhance its safety profile. This review aims to summarize the effects of processing on the chemical composition, toxicity, and pharmacological properties of Fuzi, as well as investigate potential underlying mechanisms. Data on phytochemistry, toxicology, pharmacology, and processing methods of Fuzi were gathered from the literature of electronic databases, including Web of Science, PubMed, and CNKI. Fuzi contains over 100 kinds of chemical compounds, including alkaloids, flavonoids, and polysaccharides, among which alkaloids are the main active compounds. Diester-diterpenoid alkaloids are the main contributors to Fuzi's toxicity and have side effects on some organs, such as the heart, liver, kidneys, nervous system, and reproductive system. The chemical composition of aconite, particularly its alkaloid content, was changed by hydrolysis or substitution reaction during processing to enhance its efficacy and reduce its toxicity. Salted aconite could enhance the therapeutic efficacy of Fuzi in treating kidney diseases and influence its pharmacokinetics. Processing plays an important role in increasing the efficiency and decreasing toxicity of aconite. Further studies are needed to elucidate the changes of aconite before and after processing and the underlying mechanisms of these changes, thereby providing evidence for the clinical safety of drug use.

AI: Bridging Ancient Wisdom and Modern Innovation in Traditional Chinese Medicine.

The pursuit of groundbreaking health care innovations has led to the convergence of artificial intelligence (AI) and traditional Chinese medicine (TCM), thus marking a new frontier that demonstrates the promise of combining the advantages of ancient healing practices with cutting-edge advancements in modern technology. TCM, which is a holistic medical system with >2000 years of empirical support, uses unique diagnostic methods such as inspection, auscultation and olfaction, inquiry, and palpation. AI is the simulation of human intelligence processes by machines, especially via computer systems. TCM is experience oriented, holistic, and subjective, and its combination with AI has beneficial effects, which presumably arises from the perspectives of diagnostic accuracy, treatment efficacy, and prognostic veracity. The role of AI in TCM is highlighted by its use in diagnostics, with machine learning enhancing the precision of treatment through complex pattern recognition. This is exemplified by the greater accuracy of TCM syndrome differentiation via tongue images that are analyzed by AI. However, integrating AI into TCM also presents multifaceted challenges, such as data quality and ethical issues; thus, a unified strategy, such as the use of standardized data sets, is required to improve AI understanding and application of TCM principles. The evolution of TCM through the integration of AI is a key factor for elucidating new horizons in health care. As research continues to evolve, it is imperative that technologists and TCM practitioners collaborate to drive innovative solutions that push the boundaries of medical science and honor the profound legacy of TCM. We can chart a future course wherein AI-augmented TCM practices contribute to more systematic, effective, and accessible health care systems for all individuals.

Radial artery pulse wave age-related assessment for diabetic patients based on multiple linear regression time domain analysis method

The global incidence of diabetes increases yearly. About 10 % of adults are affected. This study established a multiple linear regression (MLR) time domain analysis model of radial artery pulse wave characteristic parameters in CUN, GUAN and CHI based on traditional Chinese medicine (TCM) to assess diabetes. Pulse signals of diabetic subjects were collected by a pulse instrument. The locations of CUN, GUAN and CHI were determined by a TCM practitioner, and all pulse signals were normalized. Measurement data from 100 male and 100 female patients were used to establish a new time domain analysis method for extracting pulse wave characteristic parameters called equal pressure pulse transit time (EP-PTT). For these mentioned samples, the EP-PTT is different for male and female diabetic subjects, it was smaller for male diabetic subjects than those of female diabetic subjects. EP-PTT1 and EP-PTT6 are relevant to predicting age based on CUN, GUAN and CHI signals, which showed a linear negative correlation (P < 0.05). The EP-PTTi (i = 2, 3, 4) of female diabetic subjects are linearly correlated with age, and all of these are positively correlated (P < 0.05). These observations were clearly different from observations in healthy controls. The pulse waveform of CUN, GUAN and CHI of diabetic subjects can explore the relationship between the age of diabetic subjects and EP-PTT. The preliminary findings will provide foundational data for type 2 diabetes assessment based on CUN, GUAN and CHI pulse signals of radial artery, and the proposed new analysis method can be used for assessing type 2 diabetes.

Deep learning-based recognition of stained tongue coating images

ObjectiveTo build a dataset encompassing a large number of stained tongue coating images and process it using deep learning to automatically recognize stained tongue coating images. MethodsA total of 1 001 images of stained tongue coating from healthy students at Hunan University of Chinese Medicine and 1 007 images of pathological (non-stained) tongue coating from hospitalized patients at The First Hospital of Hunan University of Chinese Medicine with lung cancer, diabetes, and hypertension were collected. The tongue images were randomized into the training, validation, and testing datasets in a 7 : 2 : 1 ratio. A deep learning model was constructed using the ResNet50 for recognizing stained tongue coating in the training and validation datasets. The training period was 90 epochs. The model’s performance was evaluated by its accuracy, loss curve, recall, F1 score, confusion matrix, receiver operating characteristic (ROC) curve, and precision-recall (PR) curve in the tasks of predicting stained tongue coating images in the testing dataset. The accuracy of the deep learning model was compared with that of attending physicians of traditional Chinese medicine (TCM). ResultsThe training results showed that after 90 epochs, the model presented an excellent classification performance. The loss curve and accuracy were stable, showing no signs of overfitting. The model achieved an accuracy, recall, and F1 score of 92%, 91%, and 92%, respectively. The confusion matrix revealed an accuracy of 92% for the model and 69% for TCM practitioners. The areas under the ROC and PR curves were 0.97 and 0.95, respectively. Conclusion: The deep learning model constructed using ResNet50 can effectively recognize stained coating images with greater accuracy than visual inspection of TCM practitioners. This model has the potential to assist doctors in identifying false tongue coating and preventing misdiagnosis.

A ternary correlation multi-symptom network strategy based on in vivo chemical profile identification and metabolomics to explore the molecular basis of Ephedra herb against viral pneumonia.

Ephedra herb (EH), an important medicine prescribed in herbal formulas by Traditional Chinese Medicine practitioners, has been widely used in the treatment of viral pneumonia in China. However, the molecular basis of EH in viral pneumonia remains unclear. In this study, a ternary correlation multi-symptom network strategy was established based on in vivo chemical profile identification and metabolomics to explore the molecular basis of EH against viral pneumonia. Results showed that 143 compounds of EH and 70 prototype components were identified in vivo. EH could reduce alveolar-capillary barrier disruption in rats with viral pneumonia and significantly downregulate the expression of inflammatory factors and bronchoalveolar lavage fluid. Plasma metabolomics revealed that EH may be involved in the regulation of arachidonic acid, tryptophan, tyrosine, nicotinate, and nicotinamide metabolism. The multi-symptom network showed that 12 compounds have an integral function in the treatment of viral pneumonia by intervening in many pathways related to viruses, immunity and inflammation, and lung injury. Further verification demonstrated that sinapic acid and frambinone can regulate the expression of related genes. It has been shown to be a promising representative of the pharmacological constituents of ephedra.

Refining the rheological characteristics of high drug loading ointment via SDS and machine learning.

This paper presents an optimized preparation process for external ointment using the Definitive Screening Design (DSD) method. The ointment is a Traditional Chinese Medicine (TCM) formula developed by Professor WYH, a renowned TCM practitioner in Jiangsu Province, China, known for its proven clinical efficacy. In this study, a stepwise regression model was employed to analyze the relationship between key process factors (such as mixing speed and time) and rheological parameters. Machine learning techniques, including Monte Carlo simulation, decision tree analysis, and Gaussian process, were used for parameter optimization. Through rigorous experimentation and verification, we have successfully identified the optimal preparation process for WYH ointment. The optimized parameters included drug ratio of 24.5%, mixing time of 8 min, mixing speed of 1175 rpm, petroleum dosage of 79 g, liquid paraffin dosage of 6.7 g. The final ointment formulation was prepared using method B. This research not only contributes to the optimization of the WYH ointment preparation process but also provides valuable insights and practical guidance for designing the preparation processes of other TCM ointments. This advanced DSD method enhances the screening approach for identifying the best preparation process, thereby improving the scientific rigor and quality of TCM ointment preparation processes.

Abstract PS18-08: Bridging Disparities in Survivorship Care: Leveraging Telehealth for Diverse Patients in Safety Net Hospital

Abstract Background There are 3.8 million breast cancer survivors (BCS) in the United States and 67-88% of them report unmet needs in survivorship care. With advancements in breast cancer treatment and improved survival rates, there is a growing need to expand survivorship care to address the long-term physical, psychosocial, and medical needs of cancer survivors. There is a significant disparity in access to high-quality survivorship care, particularly for diverse patient populations in safety net hospitals. BCS in marginalized communities experience worse health-related quality of life (HRQOL) outcomes following cancer treatment in the management of symptoms, complications of treatment, and overall health-related distress. Thus, new models that leverage complex care management principles and novel care delivery systems, such as telehealth, are needed to provide multidisciplinary care and support for self-management. Methods We conducted a single-arm, pilot intervention trial of telehealth group medical visits (tGMV) in a safety net hospital serving low-income and racially and ethnically diverse BCS. The study team included physicians, advanced practitioners, PCPs, clinical psychologists, nurses, dieticians, exercise instructors, Traditional Chinese Medicine practitioners, sexual health counselors, research coordinators, and patient navigators. We enrolled a total of 6 cohorts of 7-10 BCS for the tGMV intervention (2 cohorts each in English, Spanish, and Cantonese). Each cohort had four weekly sessions on the following topics: 1) Reclaiming your health after cancer, 2) Managing emotional health, 3) Sexual health and relationship, and 4) Food is medicine. All participants were trained on the telehealth video conference platform. The curriculum was culturally adapted in the Spanish and Cantonese cohorts. Study staff followed up with participants by phone after each session. We evaluated feasibility and acceptability as primary outcomes with prespecified thresholds for &amp;gt;90 % completion of planned sessions and &amp;gt;70% attendance. Participants’ evaluation of the intervention and self-efficacy were secondary outcomes, which are not reported in this abstract. Results Fifty-three women with stage I-III breast cancer were enrolled in the study. The age was 37 to 75 (median: 58). There were 14 (26%) English-speaking participants, 19 (36%) Spanish-speaking participants, and 20 (38%) Cantonese-speaking participants. Eight (15%) participants identified as White, three (5.7%) Black A/A, 23 (43%) Asians, and 19 (36%) Hispanic; 43 (81%) participants were foreign-born. Twenty-seven (51%) participants reported food insecurity on the screening survey. The overall attendance rate was 98% (English: 97%, Spanish: 97%, and Cantonese: 100%). Of the 53 participants, 41 (77%) found the telehealth format acceptable, 47 (88%) agreed/strongly agreed that it was easy to log in and stay connected, 53 (100%) agreed/strongly agreed that tGMV were a good use of their time, 52 (98%) understood the purpose of the telehealth format, and 50 (94%) felt the information was easy to understand. Conclusions Telehealth-delivered group medical visits are feasible and acceptable in a safety net setting and are a promising intervention that may help in addressing the unmet needs of cancer survivors. We also found that despite the reported low uptake of telehealth in safety net settings, emphasis on training and technical support during sessions can increase the utilization of telehealth. Citation Format: Ivan Leung, Evelin Trejo, Ana Velázquez Mañana, Elizabeth Castillo, Barbara Cicerelli, Robin McBride, Piera Wong, Huiyu Xie, Lily Zhang, Nancy Burke, Niharika Dixit. Bridging Disparities in Survivorship Care: Leveraging Telehealth for Diverse Patients in Safety Net Hospital [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS18-08.