Objective To investigate the therapeutic efficacy and potential mechanisms of fecal microbiota transplantation(FMT)in patients with type 2 diabetes mellitus(T2DM),and to preliminarily identify the traditional Chinese ...Objective To investigate the therapeutic efficacy and potential mechanisms of fecal microbiota transplantation(FMT)in patients with type 2 diabetes mellitus(T2DM),and to preliminarily identify the traditional Chinese medicine(TCM)syndrome element characteristics of FMT in the treatment of T2DM.Methods Between March 25,2023 and September 30,2024,T2DM patients who met the inclusion and exclusion criteria were enrolled at the Department of Rheumatology and Endocrinology of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine.Participants received oral microbiota capsules as an adjunct to metformin therapy.Information obtained by four diagnostic methods of TCM,along with clinical and laboratory parameters,was collected before and after the intervention.Metagenomic sequencing was employed to analyze the gut microbiota,and Spearman correlation analysis was used to explore the relationship between laboratory indicators and differential bacterial genera.According to the post-treatment reduction in glycosylated hemoglobin(HbA1c),patients were categorized into a response(R)group and a non-response(NR)group.Treatment outcomes,safety indicators,gut microbiota changes,and TCM syndrome element features were compared between the two groups.Results A total of 53 T2DM patients were included in the final analysis,and 30 patients were assigned to R group and 23 to NR group.After treatment,the R group exhibited significant reductions in HbA1c,fasting plasma glucose(FPG),and 2-hour postprandial glucose(2hPG)(P<0.05 or P<0.01).The NR group also showed significant decreases in HbA1c and FPG levels P<0.01 or P<0.05.Compared with the NR group,after treatment,FPG level in the R group demonstrated significant reductions(P<0.01).As compared with before treatment,pancreatic islet function demonstrated enhancement in the R group,a significant increase in the 2-hour pastprandial C-peptide(2hC-P)levels in R group(P<0.05),whereas no marked change was observed in the NR group.Regarding body composition indicators,the R group showed significantly lower waist-hip ratio(WHR),visceral fat(VF),and subcutaneous fat(SF)levels compared with the NR group(P<0.01).After treatment,the NR group exhibited a significant elevation in aspartate aminotransferase(AST)levels(P<0.05).Other safety-related indicators fluctuated within normal reference ranges,and no other adverse events,such as diarrhea,fever,or nausea,were reported.Metagenomic sequencing showed that FMT improved the diversity and richness of the gut microbiota,remodeling its overall structure.At the phylum level,the abundance of p_Firmicutes decreased significantly(P<0.01),while the abundances of p_Bacteroidota and p_Proteobacteria increased significantly(P<0.01).At the family level,among the 125 identified taxa,the abundances of f_Bacteroidaceae,f_Lactobacillaceae,and f_Sutterellaceae were significantly elevated,whereas six families,including f_Lachnospiraceae,f_Ruminococcaceae,and f_Coriobacteriaceae,were significantly decreased(all P<0.05).Among the 367 taxa at the genus level,the top 10 differential genera showed significantly increased abundances of g_Bacteroides and g_Sutterella,and significantly decreased abundances in eight genera,including g_Faecalibacterium,g_Ruminococcus,g_Blautia,and g_Collinsella(all P<0.05).Correlation analysis suggested that the phylum p_Bacillota was positively correlated with improvements in T2DM laboratory parameters,g_norank_f_Prevotellaceae was significantly positively correlated with fasting C-peptide(FC-P)and 2hC-P(P<0.05).HbA1c demonstrated a significantly positive correlation with g_Blautia and g_Gemmiger(P<0.05)and a significantly negative correlation with g_Bacteroides and g_Collinsella(P>0.05).Analysis of syndrome element characteristics revealed that the R group was primarily characterized by pathological patterns of dampness,phlegm,and Yang deficiency.Before treatment,statistically significant reductions in syndrome element scores were observed for dampness,Yang deficiency,spleen,phlegm,Qi deficiency,Qi stagnation,and Yin deficiency(P<0.01),as well as for heat and liver(P<0.05).The NR group was mainly featured with Qi deficiency and Yin deficiency.Statistically significant changes in their syndrome element scores after treatment were noted for Qi deficiency(P<0.01),and for spleen,Qi stagnation,liver,and blood deficiency(P<0.05).In this group,the score changes for Yang deficiency,Yin deficiency,heat,and dampness were not statistically significant(P>0.05).Conclusion The principles of syndrome element differentiation can be effectively applied to predict treatment efficacy and facilitate patient selection for FMT in the treatment of T2DM.Patients with T2DM presented with specific TCM syndrome element characteristics,notably dampness,phlegm,and Yang deficiency,represent a highly responsive population to FMT therapy.展开更多
In traditional Chinese medicine(TCM),ophthalmic syndrome differentiation is an ophthalmology-specific method for identifying syndromes based on the“Five Orbiculi”theory.It was devised by Professor Qing-Hua PENG thro...In traditional Chinese medicine(TCM),ophthalmic syndrome differentiation is an ophthalmology-specific method for identifying syndromes based on the“Five Orbiculi”theory.It was devised by Professor Qing-Hua PENG through an unprecedented combination of syndrome element differentiation and ophthalmic clinical practices,based on the Clinical Terminology of Chinese Medical Diagnosis and Treatment-Syndromes of the National Standards of the People's Republic of China.This approach integrates an ophthalmic syndrome differentiation system with digital Chinese medicine(DCM),and proposes the extraction of syndrome elements of ophthalmic diseases from research on DCM.These elements are then quantified and organized to form a model of digital diagnosis and treatment specific to ophthalmology,which should help to achieve synergistic development of the ophthalmic syndrome differentiation system and DCM.展开更多
Objective Natural language processing (NLP) was used to excavate and visualize the core content of syndrome element syndrome differentiation (SESD). Methods The first step was to build a text mining and analysis envir...Objective Natural language processing (NLP) was used to excavate and visualize the core content of syndrome element syndrome differentiation (SESD). Methods The first step was to build a text mining and analysis environment based on Python language, and built a corpus based on the core chapters of SESD. The second step was to digitalize the corpus. The main steps included word segmentation, information cleaning and merging, document-entry matrix, dictionary compilation and information conversion. The third step was to mine and display the internal information of SESD corpus by means of word cloud, keyword extraction and visualization. Results NLP played a positive role in computer recognition and comprehension of SESD. Different chapters had different keywords and weights. Deficiency syndrome elements were an important component of SESD, such as "Qi deficiency""Yang deficiency" and "Yin deficiency". The important syndrome elements of substantiality included "Blood stasis""Qi stagnation", etc. Core syndrome elements were closely related. Conclusions Syndrome differentiation and treatment was the core of SESD. Using NLP to excavate syndromes differentiation could help reveal the internal relationship between syndromes differentiation and provide basis for artificial intelligence to learn syndromes differentiation.展开更多
基金National Natural Science Foundation of Joint Fund in China (U22A20376)。
文摘Objective To investigate the therapeutic efficacy and potential mechanisms of fecal microbiota transplantation(FMT)in patients with type 2 diabetes mellitus(T2DM),and to preliminarily identify the traditional Chinese medicine(TCM)syndrome element characteristics of FMT in the treatment of T2DM.Methods Between March 25,2023 and September 30,2024,T2DM patients who met the inclusion and exclusion criteria were enrolled at the Department of Rheumatology and Endocrinology of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine.Participants received oral microbiota capsules as an adjunct to metformin therapy.Information obtained by four diagnostic methods of TCM,along with clinical and laboratory parameters,was collected before and after the intervention.Metagenomic sequencing was employed to analyze the gut microbiota,and Spearman correlation analysis was used to explore the relationship between laboratory indicators and differential bacterial genera.According to the post-treatment reduction in glycosylated hemoglobin(HbA1c),patients were categorized into a response(R)group and a non-response(NR)group.Treatment outcomes,safety indicators,gut microbiota changes,and TCM syndrome element features were compared between the two groups.Results A total of 53 T2DM patients were included in the final analysis,and 30 patients were assigned to R group and 23 to NR group.After treatment,the R group exhibited significant reductions in HbA1c,fasting plasma glucose(FPG),and 2-hour postprandial glucose(2hPG)(P<0.05 or P<0.01).The NR group also showed significant decreases in HbA1c and FPG levels P<0.01 or P<0.05.Compared with the NR group,after treatment,FPG level in the R group demonstrated significant reductions(P<0.01).As compared with before treatment,pancreatic islet function demonstrated enhancement in the R group,a significant increase in the 2-hour pastprandial C-peptide(2hC-P)levels in R group(P<0.05),whereas no marked change was observed in the NR group.Regarding body composition indicators,the R group showed significantly lower waist-hip ratio(WHR),visceral fat(VF),and subcutaneous fat(SF)levels compared with the NR group(P<0.01).After treatment,the NR group exhibited a significant elevation in aspartate aminotransferase(AST)levels(P<0.05).Other safety-related indicators fluctuated within normal reference ranges,and no other adverse events,such as diarrhea,fever,or nausea,were reported.Metagenomic sequencing showed that FMT improved the diversity and richness of the gut microbiota,remodeling its overall structure.At the phylum level,the abundance of p_Firmicutes decreased significantly(P<0.01),while the abundances of p_Bacteroidota and p_Proteobacteria increased significantly(P<0.01).At the family level,among the 125 identified taxa,the abundances of f_Bacteroidaceae,f_Lactobacillaceae,and f_Sutterellaceae were significantly elevated,whereas six families,including f_Lachnospiraceae,f_Ruminococcaceae,and f_Coriobacteriaceae,were significantly decreased(all P<0.05).Among the 367 taxa at the genus level,the top 10 differential genera showed significantly increased abundances of g_Bacteroides and g_Sutterella,and significantly decreased abundances in eight genera,including g_Faecalibacterium,g_Ruminococcus,g_Blautia,and g_Collinsella(all P<0.05).Correlation analysis suggested that the phylum p_Bacillota was positively correlated with improvements in T2DM laboratory parameters,g_norank_f_Prevotellaceae was significantly positively correlated with fasting C-peptide(FC-P)and 2hC-P(P<0.05).HbA1c demonstrated a significantly positive correlation with g_Blautia and g_Gemmiger(P<0.05)and a significantly negative correlation with g_Bacteroides and g_Collinsella(P>0.05).Analysis of syndrome element characteristics revealed that the R group was primarily characterized by pathological patterns of dampness,phlegm,and Yang deficiency.Before treatment,statistically significant reductions in syndrome element scores were observed for dampness,Yang deficiency,spleen,phlegm,Qi deficiency,Qi stagnation,and Yin deficiency(P<0.01),as well as for heat and liver(P<0.05).The NR group was mainly featured with Qi deficiency and Yin deficiency.Statistically significant changes in their syndrome element scores after treatment were noted for Qi deficiency(P<0.01),and for spleen,Qi stagnation,liver,and blood deficiency(P<0.05).In this group,the score changes for Yang deficiency,Yin deficiency,heat,and dampness were not statistically significant(P>0.05).Conclusion The principles of syndrome element differentiation can be effectively applied to predict treatment efficacy and facilitate patient selection for FMT in the treatment of T2DM.Patients with T2DM presented with specific TCM syndrome element characteristics,notably dampness,phlegm,and Yang deficiency,represent a highly responsive population to FMT therapy.
文摘In traditional Chinese medicine(TCM),ophthalmic syndrome differentiation is an ophthalmology-specific method for identifying syndromes based on the“Five Orbiculi”theory.It was devised by Professor Qing-Hua PENG through an unprecedented combination of syndrome element differentiation and ophthalmic clinical practices,based on the Clinical Terminology of Chinese Medical Diagnosis and Treatment-Syndromes of the National Standards of the People's Republic of China.This approach integrates an ophthalmic syndrome differentiation system with digital Chinese medicine(DCM),and proposes the extraction of syndrome elements of ophthalmic diseases from research on DCM.These elements are then quantified and organized to form a model of digital diagnosis and treatment specific to ophthalmology,which should help to achieve synergistic development of the ophthalmic syndrome differentiation system and DCM.
基金the funding support from the National Natural Science Foundation of China (No. 81874429)Digital and Applied Research Platform for Diagnosis of Traditional Chinese Medicine (No. 49021003005)+1 种基金2018 Hunan Provincial Postgraduate Research Innovation Project (No. CX2018B465)Excellent Youth Project of Hunan Education Department in 2018 (No. 18B241)
文摘Objective Natural language processing (NLP) was used to excavate and visualize the core content of syndrome element syndrome differentiation (SESD). Methods The first step was to build a text mining and analysis environment based on Python language, and built a corpus based on the core chapters of SESD. The second step was to digitalize the corpus. The main steps included word segmentation, information cleaning and merging, document-entry matrix, dictionary compilation and information conversion. The third step was to mine and display the internal information of SESD corpus by means of word cloud, keyword extraction and visualization. Results NLP played a positive role in computer recognition and comprehension of SESD. Different chapters had different keywords and weights. Deficiency syndrome elements were an important component of SESD, such as "Qi deficiency""Yang deficiency" and "Yin deficiency". The important syndrome elements of substantiality included "Blood stasis""Qi stagnation", etc. Core syndrome elements were closely related. Conclusions Syndrome differentiation and treatment was the core of SESD. Using NLP to excavate syndromes differentiation could help reveal the internal relationship between syndromes differentiation and provide basis for artificial intelligence to learn syndromes differentiation.