Constructing a Syndrome Differentiation Model by Combining Latent Structure Analysis of Association Rules： An Example of Kidney Yang Deficiency Syndrome in Primary Osteoporosis / 中医杂志

ObjectiveTo construct a quantitative differentiation model of traditional Chinese medicine （TCM） syndromes by taking primary osteoporosis （POP） with kidney yang deficiency syndrome as an example， and to provide methodological reference for the standardization of syndrome differentiation. MethodsHigh-frequency clinical features of POP were screened by descriptive statistical analysis， and strong association features of POP were obtained by association rule algorithm. On this basis， a latent structure （latent tree） model was established through latent structure analysis， and the implicit and explicit variables （features） related to POP with kidney yang deficiency syndrome were comprehensively clustered， and the clustering results were interpreted by the indexes of mutual information and cumulative information coverage， to explore the primary and secondary symptoms， and to deduce the categories of POP with kidney yang deficiency syndrome based on the probability of the features appearing in the various latent categories. Based on the categories， the clinical feature scores and identification thresholds were calculated， and the syndrome differentiation model of POP with kidney yang deficiency was initially constructed by combining the comprehensive judgment rules. Finally， the results of TCM professionals' judgment were used as the gold standard to further evaluate the effectiveness of the model in assisting the syndrome differentiation. ResultsThe 32 features strongly associated with POP were obtained， and the Bayes information critedon score of the further constructed latent tree model was -15291.93. Based on the mutual information and the cumulative information coverage， the main symptoms of POP with kidney yang deficiency syndrome were bone weakness， fatigue， pale tongue， clear urine， frequent nocturnal urination， cold limbs， thin pulse， white coating， and secondary symptoms were weakness， loss of libido， loose stool， frequent urination， lumbar and knee weakness， and fear of cold. From the probability of the occurrence of each clinical feature in different latent categories of POP with kidney yang deficiency syndrome， the state was introduced as S0 category （none/mild kidney yang syndrome）/ S1 category （moderate kidney yang syndrome）/ S2 category （severe kidney yang syndrome）. Optimizing the preliminary rules of state identification and refining the state of S1 category， the results showed that among 970 patients with POP， there were 520 patients having no/mild kidney yang deficiency syndrome， 224 patients with moderate to mild kidney yang deficiency syndrome， 81 patients with moderate to severe kidney yang deficiency syndrome， and 145 patients with severe kidney yang deficiency syndrome. During the evaluation and validation process， the correct rate of the model assessment index was 0.8835， while the sensitivity was 0.7181， and the specificity was 0.9437. ConclusionCombined with the latent structure analysis of the association rule， the syndrome differentiation model for POP with kidney yang deficiency could be constructed， and the model shows a good quantitative identification effect， which can provide methodological supports for clinicians to improve the efficiency and accuracy of TCM diagnosis.

Checking adjustment sets and finding common adjustment sets based on a causal graph model / 四川精神卫生

The purpose of this paper was to introduce the method of checking adjustment sets based on a causal graph model， finding common adjustment sets and implementing the statistical calculation with SAS software. Firstly， the basic concepts related to the causal graph model were introduced.Secondly， the primary contents of the causal graph theory were given， including the composition and terminology of the causality diagram. Finally， for the two instances and with the help of the CAUSALGRAPH procedure in SAS/STAT， the following two tasks were completed： the first task was to examine the adjustment set and enumerate paths； the second task was to find the adjustment set common to the multiple causal graph models.

Regularity of prescriptions for intermediate and advanced lung cancer based on latent structure combined with association rules / 中国中药杂志

The present study explored the regularity of prescriptions for the treatment of intermediate and advanced lung cancer to provide references for clinical medication. CNKI, Wanfang, VIP, and CBM were searched for the research papers on the treatment of lung cancer by Chinese medicine published from database inception to May 31, 2021. The relevant information of qualified papers was extracted to establish a database. The Chinese medicines with frequency >3% underwent analysis of the latent structure and association rules by Lantern 5.0 and SPSS Molder 14.1, respectively, and the prescription regularity in the treatment of intermediate and advanced lung cancer was analyzed based on the frequency description. A total of 713 papers were included, involving 327 Chinese medicines with a cumulative frequency of 12 794 and 106 prescriptions with a cumulative frequency of 824. The commonly used Chinese medicines were dominated by deficiency-tonifying, heat-clearing, phlegm-resolving, and cough/dyspnea-relieving drugs, such as Astragali Radix, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Ophiopogonis Radix, Poria, and Hedyotis Diffusa, which are cold, warm, and plain in nature and sweet, bitter, and pungent in flavor, and mainly act on lung, spleen, and stomach meridians. Commonly used prescriptions included Shashen Maidong Decoction, Liujunzi Decoction, and Baihe Gujin Decoction. The latent structure analysis revealed 32 latent variables and 65 hidden classes. Six comprehensive clustering models and 11 core prescriptions were obtained by professional knowledge inference. The common syndromes of intermediate and advanced lung cancer were inferred to be Qi and Yin deficiency in the lung, Qi deficiency in the lung and spleen, Yin deficiency in the liver and kidney, combined phlegm and stasis, phlegm-heat obstructing lung, and Qi stagnation and blood stasis. Forty-four strong associations were screened out by association rules analysis, including four pairwise strong associations(Polygonati Odorati Rhizoma→Ophiopogonis Radix, Polygonati Odorati Rhizoma→Glehniae Radix, Amomi Fructus→Atractylodis Macrocephalae Rhizoma, and Polygonati Rhizoma→Astragali Radix) and 40 triplet strong associations(such as Trichosanthis Radix+Glehniae Radix→Ophiopogonis Radix, Polygonati Odorati Rhizoma+Glehniae Radix→Ophiopogonis Radix, Trichosanthis Radix+Ophiopogonis Radix→Glehniae Radix, and Scutellariae Barbatae Herba+Codonopsis Radix→Hedyotis Diffusa). In the treatment of intermediate and advanced lung cancer, Qi-replenishing and Yin-nourishing drugs are mainly employed, assisted with cancer-resisting, toxin-removing, spleen-invigorating, phlegm/stasis-resolving, and blood-activating drugs based on syndrome differentiation. The roots were treated following the principles of tonifying lungs and replenishing the spleen, and symptoms following the principles of removing the toxin, dispelling stasis, and resolving phlegm.

Common Syndromes of Cerebral Infarction Patients in Rural Areas of Eastern Henan Based on Latent Structure Model and Factor Analysis / 中国实验方剂学杂志

ObjectiveTo explore the common syndromes of patients with cerebral infarction in rural areas of eastern Henan based on latent structure model and factor analysis，and provide reference for clinical differentiation of cerebral infarction. MethodThe data samples of patients with cerebral infarction in rural areas in eastern Henan were preprocessed. With Lantern 5.0 of latent structure method and LTM-EAST algorithm of two-step latent tree analysis， the manifest variable latent structure model of related symptoms was built to interpret different latent nodes， and common syndromes of cerebral infarction were obtained via comprehensive cluster analysis. SPSS 20.0 was used for factor analysis and cluster analysis of related symptoms to infer the distribution of syndrome types. ResultThe data of 888 patients with cerebral infarction were included， involving symptoms， tongue and pulse （88 in total）. The 65 symptoms with a frequency of ≥5% were constructed into a latent structure model， and 31 latent variables were obtained. The Bayesian information criterion （BIC） score was -15 367.17. Based on professional knowledge， s6 common syndrome types were found， namely， syndrome of upward disturbance of wind-fire， Qi deficiency and blood stasis syndrome， syndrome of phlegm and blood stasis blocking collaterals， syndrome of phlegm-heat and fu-organ excess， syndrome of wind phlegm obstructing collaterals， and syndrome of stirring wind due to yin deficiency. In factor analysis， the symptoms with a frequency of >10% were selected， and 13 common factors were obtained and used for systematic cluster analysis. And 5 syndrome types were inferred： syndrome of wind phlegm obstructing collaterals， syndrome of phlegm-heat and fu-organ excess， Qi deficiency and blood stasis syndrome， syndrome of combined phlegm and blood stasis， and syndrome of yin deficiency and internal heat. According to the determination criteria of syndrome types in traditional Chinese medicine （TCM）， 6 common syndrome types of cerebral infarction were finally determined. ConclusionAccording to the severity of the disease， the common syndromes of patients with cerebral infarction in rural areas of Eastern Henan were divided into the following categories： apoplexy involving channel and collateral： syndrome of upward disturbance of wind fire， syndrome of wind phlegm obstructing collaterals， and syndrome of stirring wind due to yin deficiency. Apoplexy involving zang and fu-viscera： syndrome of phlegm-heat and fu-organ excess， and syndrome of phlegm and blood stasis blocking collaterals. Recovery period： Qi deficiency and blood stasis syndrome. This study was basically consistent with the syndrome law in TCM theory， and provided reference for further establishing syndrome diagnostic criteria of cerebral infarction.

Syndrome Distribution of 9 323 Cough Cases in Ancient Chinese Medical Books Based on Latent Structure Model and Logistic Regression Analysis / 中国实验方剂学杂志

Objective:To explore the syndrome distribution of cough cases in ancient Chinese medical books. Method:A total of 9 323 cough cases in the database of lung diseases in ancient Chinese medical books were extracted. Lantern 5.0 was used to construct the latent structure model for the 100 manifest variables based on the first 50 symptoms and 50 Chinese herbal medicines， and different latent nodes were interpreted. The syndrome differentiation patterns of syndromes with symptoms and Chinese herbal medicine （formula） were quantitatively revealed by the comprehensive clustering weights of latent structure. The correlation of diseases with syndromes was fitted through the binary Logistic regression analysis. Result:There were 204 syndromes involved in 9 323 cough cases with 18 syndromes showing a frequency higher than 100. As demonstrated by the model established on the first 50 symptoms and 50 Chinese herbal medicines， 35 latent variables， 98 latent classes， and 10 comprehensive clustering models were obtained， where <italic>Z</italic>5<italic> </italic>was the highest in the threshold value （6.7）， <italic>Z</italic>6 in the information coverage of productive cough （52%）， and <italic>Z</italic>7 in the score （19）. The binary Logistic regression model fitted the correlation between different disease types and five syndromes， where the dominance ratio of external wind to the syndrome of wind-heat invading lung reaching up to 88.919， those of syndrome of phlegm-heat accumulating in lung to diseased heat and sputum 51.594 and 15.861， and those of the syndrome of phlegm-dampness obstructing lung to dampness， phlegm， and fluid retention 31.415， 34.370， and 4.936， respectively. Conclusion:The newly discovered cough syndromes included lung heat and yin deficiency， external cold and internal fluid retention， weakness of spleen and stomach， and phlegm and blood stasis in lung. In most cases， multiple syndromes were observed clinically， such as syndrome of deficiency of both Qi and Yin in lung combined with yin deficiency in lung and kidney. Since differentiation of traditional Chinese medicine （TCM） syndrome is subjective， the weight can indicate the difference in the contributions of different symptoms to the syndrome， which is of guiding significance for syndrome inference. The latent structure model combined with Logistic regression analysis can solve the problem of quantification in TCM syndrome differentiation and can be used to explore the syndrome distribution of diseases.

Latent cephalofacial structure of the albanian population of Kosovo / Estructura cefalofacial latente de la población albana de Kosovo

Anthropometric studies began as a methodology in biological anthropology for comparing of the anthropological features of the today's nations and previous nations too, as well as in screening and diagnosing of malnutrition. It is evident that a large number of studies have been performed on measures of body height, weight, trunk and limb dimensions, subcutaneous fatness and body composition, etc., but less attention has been paid to cephalofacial measurements. The purpose of this research was to study and explain the latent structure of the humans' cephalofacial variables.On 754 healthy entities (561 male entities and 193 female entities), aged 18-35 years, were measured 11 cephalofacial variables. The collected data were analyzed through descriptive parameters, Correlation analysis, and Factorial analyses. Correlation analysis confirms the existing of some variables' sets, which are characterized with the higher correlations between variables within the set. Through the principal component analysis of the Factor Analysis (rotation method direct obliging, Keiser criterion) were extracted four latent factors which explain 66.39 % of the total variance: Factor of intracranial capacity; Transversal factor of the face; Longitudinal factor of the face.Conclusion: The composition of the extracted factors was compatible with the scientific explanation of the anthropologists regarding the development of the head.

Los estudios antropométricos comenzaron como una metodología en antropología biológica para comparar las características antropológicas de las naciones modernas y también de las naciones en la antigüedad, así como para el cribado y diagnóstico de desnutrición. Se han realizado una gran cantidad de estudios sobre medidas de altura corporal, peso, dimensiones del tronco y las extremidades, grasa subcutánea y composición corporal, etc., pero se ha prestado menos atención a las medidas cefalofaciales. El propósito de esta investigación fue estudiar y explicar la estructura latente de las variables cefalofaciales de los humanos. Se midieron 11 variables cefalofaciales en 754 sujetos sanos (561 hombres y 193 mujeres), de 18 a 35 años. Los datos recolectados fueron analizados mediante parámetros descriptivos, análisis de correlación y análisis factoriales. El análisis de correlación confirma la existencia de algunos conjuntos de variables, que se caracterizan por tener las correlaciones más altas entre las variables dentro del conjunto. Mediante el análisis de componentes principales del Análisis Factorial se extrajeron cuatro factores latentes que explican el 66,39% de la varianza total: Factor de capacidad intracraneal; Factor transversal de la cara; Factor longitudinal del rostro. Conclusión: La composición de los factores extraídos fue compatible con la explicación científica de los antropólogos sobre el desarrollo de la cabeza.

Prescriptions and Syndromes of 9 323 Cough Cases in Ancient Chinese Medical Books Based on Rules of Latent Structure Differentiation / 中国实验方剂学杂志

Objective:To explore cough cases recorded in ancient traditional Chinese medicine (TCM) books based on the Rules of Latent Structure Differentiation. Method:The 9 323 cough cases in the database of ancient TCM books and pulmonary diseases were extracted. At first, Lantern 5.0 software was used to construct the top 120 TCM hidden structure model with the frequency>100. Then, the obtained hidden variables were comprehensively clustered and interpreted. Result:The 46 hidden variables and 114 hidden classes were obtained through the modeling of 120 traditional Chinese medicines. According to the bayesian information measure (BIC) score, the model score was -161 242.92. The model diagram was formed with Y0, Y5, Y7, Y13, Y35 and Y38 as the cores, and Y36, Y38, Y24, Y19 and Y17 involved 4 hidden classes. Ten comprehensive clustering models were summarized according to the hidden structure flow chart, among which the highest score of Z5 external cold and internal decoction syndrome was 8.4, indicating that the result of syndrome differentiation rules of Z5 had a high degree of support, and the highest mutual information degree and information coverage of Pinellia sinensis were 0.31 and 63%. Z2 had a low score for the syndrome of deficiency of lung qi and Yin, which was -2， and Schisandra had the lowest score of -15, indicating that the syndrome differentiation rules of Z2 was less supportive. Forsythia and Notopterygium both had the highest score of Z6 wind-heat attack lung syndrome and Z10 phlegm and blood-stasis pulmonary syndrome, which was 19.1, indicating that these two TCMs had a great contribution to it. According to the test, the common syndromes of cough were cold and dryness attacking the lung, kidney-Yin deficiency, kidney-Yin deficiency of the lung, cold and internal decoction, wind heat invading the lung, liver fire invading the lung, lung heat burning, phlegm-dampness blocking the lung, phlegm-stasis blocking the lung. The newly discovered cough syndromes were external cold and internal rheum syndrome and phlegm-stasis blocking the lung syndrome. Conclusion:Based on the syndrome differentiation rules of hidden structure, the improved classification of cough syndromes provides ideas for the demonstration of tacit knowledge of TCM and methodological reference for the improvement of syndromes of other diseases, and is conducive to the development of valuable new prescriptions.

Acupoint selection pattern of chronic atrophic gastritis based on data mining methods of latent structure model and frequency item set / 中国针灸

<p><b>OBJECTIVE</b>To explore the acupoint selection pattern of chronic atrophic gastritis and provide reference for clinical treatment of chronic atrophic gastritis.</p><p><b>METHODS</b>The literature regarding acupuncture for chronic atrophic gastritis published before September 5th of 2016 was searched in the databases of CNKI, CBM, PubMed, etc. The information of symptoms and acupoint selection was extracted to establish medical database of chronic atrophic gastritis. The data mining methods of latent structure model and frequency item set were applied to analyze the acupoint selection pattern of chronic atrophic gastritis.</p><p><b>RESULTS</b>A total of 42 papers were collected in preliminary screening, and 32 papers were included, involving 604 medical cases. The data mining indicated 215 symptoms were involved in medical cases, including 16 high-frequency symptoms (stomach pain, stomach distension and hiccup, etc.), and the latent structure model of chronic atrophic gastritis symptoms was established. Fifty-two acupoints were identified, and high-frequency acupoints included Zusanli (ST 36), Zhongwan (CV 12), Neiguan (PC 6) and Weishu (BL 21), etc. Five frequency item sets of symptom-acupoint were identified, including stomach pain+stomach distension+Zusanli (ST 36)+Zhongwan (CV 12), etc. Six frequency item sets of symptom-syndrome-acupoint were identified, including stomach distension+dry mouth+dry defecation+insufficiency of stomach +Sanyinjiao (SP 6).</p><p><b>CONCLUSION</b>Acupuncture for chronic atrophic gastritis selected Zusanli (ST 36), Zhongwan (CV 12) and Neiguan (PC 6) as main acupoints, and selected other acupoints based on clinical symptoms. This could provide reference for clinical treatment of chronic atrophic gastritis.</p>

The latency of the female's cephalofacial variables / Latencia de variables cefalofaciales en mujeres

The human craniofacial bones are certainly the most important part of the body, as well as the foundation for the soft tissues of the face and head. This part of the body is extremely complex structure, which has a number of important functions, such are: diet, special senses, protection, communication. The main purpose of this research was to study and explain the latent structure of the cephalofacial measurements of female subjects. On 193 female subjects aged 18-35 years, we measured 11 cephalofacial measurements. The collected data are analyzed through descriptive parameters, Correlation analysis, and Factorial analyses. According to the results of the basic parameters the measured subjects are characterized with long, large and medium height head. Correlation analysis confirms some sets of variables that realize the higher correlations with each other. According to the principal component analysis of the Factor Analysis, with the rotation method direct oblimin, and using the Keiser criterion have been extracted four latent factors that explain 66.39 percent of the total variance: The cranial factor; The factor of intracranial capacity; The transversal factor of the face; The longitudinal factor of the face. The composition of the extracted factors is compatible with the anthropological explanation of the anthropologists regarding the development of these tissues of the head.

Los huesos craneofaciales humanos son sin duda la parte más importante del cuerpo, así como las bases para los tejidos blandos de la cara y el cráneo. Esta parte del cuerpo es una estructura extremadamente compleja, que tiene un número importante de funciones tales como alimentación, sensorial, protección y comunicación. El objetivo principal de esta investigación fue estudiar y explicar las estructuras latentes de mediciones cefalofaciales en mujeres. En 193 mujeres, con edades entre 18-35 años, se realizaron 11 mediciones cefalofaciales. Los datos recogidos se analizaron a través de parámetros descriptivos, análisis de correlación y análisis factorial. De acuerdo con los resultados los parámetros básicos de las mujeres estudiadas se caracterizaron con alturas de cabeza largas, grandes y medianas. El análisis de correlación confirma algunos conjuntos de variables que señalan las correlaciones más altas entre sí. De acuerdo con el análisis de componentes principales del análisis factorial, con el método de rotación directa de oblimin, y utilizando el criterio de Keiser se extrajeron cuatro factores latentes que explican el 66,39 por ciento de la varianza total: factor craneal, factor de capacidad intracraneal, factor transversal de la cara y factor longitudinal de la cara. La composición de los factores extraídos es compatible con la explicación antropológica respecto al desarrollo de estos tejidos de la cabeza.

The Latent Structure of Sense of Coherence in China / 中国临床心理学杂志

Objective: To explore the latent structure of Antonovsky's Sense of Coherence(SOC) Scale(13-items) in China.Methods: Data from 656 Chinese subjects were analysed by EFA(exploratory factor analysis) and CFA(confirmatory factor analysis).Results: As a global construct,Antonovsky's theory that an individual's SOC is composed of meaningfulness,comprehensibility and manageability was supported.Conclusion: On the whole,Antonovsky's Sense of Coherence(SOC) Scale(13-items) was suitable to Chinese subjects,however several items of the scale were found to be unfit to the Chinese subjects,and revision of them should be done in further study.