Yes / Symptoms and signs (symptoms in brief) are the essential clinical manifestations for individualized diagnosis and treatment in traditional Chinese medicine (TCM). To gain insights into the molecular mechanism of symptoms, we develop a computational approach to identify the candidate genes of symptoms. This paper presents a network-based approach for the integrated analysis of multiple phenotype-genotype data sources and the prediction of the prioritizing genes for the associated symptoms. The method first calculates the similarities between symptoms and diseases based on the symptom-disease relationships retrieved from the PubMed bibliographic database. Then the disease-gene associations and protein-protein interactions are utilized to construct a phenotype-genotype network. The PRINCE algorithm is finally used to rank the potential genes for the associated symptoms. The proposed method gets reliable gene rank list with AUC (area under curve) 0.616 in classification. Some novel genes like CALCA, ESR1, and MTHFR were predicted to be associated with headache symptoms, which are not recorded in the benchmark data set, but have been reported in recent published literatures. Our study demonstrated that by integrating phenotype-genotype relationships into a complex network framework it provides an effective approach to identify candidate genes of symptoms. / NSFC Project (61105055, 81230086), China 973 Program (2014CB542903), The National Key Technology R&D Program (2013BAI02B01, 2013BAI13B04), the National S&T Major Special Project on Major New Drug Innovation (2012ZX09503-001-003), and the Fundamental Research Funds for the Central Universities.

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本研究之方向係探究建置大型中醫藥倉儲所需之後設資料(Metadata)，並透過此一初探，瞭解與描述其中所需之分析方法，本研究設想Zachman Framework為合適之資料倉儲開發方法，因而由5W1H面向來衍生該專業領域所需之概念。此類概念可再透過一分析程序，確立後設資料。 因時間之限制，本研究採用「本草備要」、「醫方集解」為範例文件進行相關分析，以減少中醫流派林立及中文本身不準確性帶來之問題，當然，本研究在其中亦力求在整體架構上維持其他中醫藥典籍之適用性。 為達成目標，本研究首先探討了至今中草藥資料庫、資料倉儲、電子超文件領域之發展，因而本研究決定將個別之中醫典籍視為「資料專櫃」，而將分類樹、Metadata描述性資料置於目次(catalog)的概念之下，這樣的做法有利於整合其他典籍及其後設資料於大型資料倉儲中。 首先，本研究由重要中醫藥典籍導出基礎性中草藥概念與名詞，其後透過典藏面及應用面之統計分析，確認範例典籍中的Metadata。在實作方面，本研究以BNF來描述和定義Metadata，並以XML為工具完成雛型以供測試之。其中，本研究發現，基於資料倉儲觀點所擷取之後設資料的分析單位較傳統圖書典藏所得之為小。此外，本研究擷取過程中所涉及之Metadata，以功能性者為多，本研究亦採取了若干語言分析以期同時能維持典籍之文字結構。 / The objective of this research work is to acquisit and design Metadata for the construction of data warehouse of Traditional Chinese Medicine (TCM) literatures in the context of knowledge management. In order to solve the problem of preservation and utilization of TCM literatures, this work aims to designate the Metadata based on the viewpoint of knowledge engineering and data warehouse. In this work, the characteristics of the TCM regarding Metadata result in the 5W1H’s principle, while this work argues for its advantages for deriving more functional descriptions and keeping the syntax structure of the originals at the same time. To minimize the constraints of time, this work chooses “Ben Cao Bei Yao” and “Yi Fang Ji Jie” as the target to analyze. In constructing a prototype, the tacit knowledge in the example TCM literatures is converted through an analytic process explicitly into the organizational knowledge that can be easily preserved and processed by machines. Therefore, a statistical process is employed to derive and verify the Metadata in the context of the example TCM literatures. Then, the components regarding the Metadata are implemented with XML tools to develop the prototype. Last but not the least, this work presents its findings as follows: 1. The unit of analysis for deriving Metadata related to data warehouse is usually in a smaller degree of finesse in comparison to what is addressed in the area of traditional library management. 2. Through the Metadata derived in this work based on a data warehouse approach presents more functional elements, we can still maintain the linguistic structure of the example literatures with some careful linguistically analyses in the last step.

Title: Using of alternative therapeutic techniques to vertebrovisceral links of liver and gallbladder diseases Objectives: The aim of this thesis is to find out a sufficient amount of information on the subject of functional liver and gallbladder diseases, possibilities of conventional treatment and alternative treatment options. Another goal of this thesis is to compile an assessment protocol, based on the theoretical background, according to which it is possible to diagnose patients with functional liver and gallbladder diseases. An additional goal of this thesis is to create a treatment concept for patients with functional liver and gallbladder diseases. This treatment concept will be based on the knowledge of yoga and traditional Chinese medicine. Last goal is to compare conventional physiotherapy with the concept created. Methods: The theoretical part of this thesis focuses on the issue of functional disease of liver and gallbladder. In takes into account the current research and data found in Czech and foreign literature. The practical part looks into the effects of complex therapy methods using experiments. The therapy itself includes changes of the patients' lifestyles, which are based on traditional Chinese medicine and yoga asanas, which were compiled for the purposes of this thesis for...

A presente tese tem por objetivos: identificar concepções sobre Medicina Convencional e Acupuntura que contribuem para o entendimento dos motivos que levam médicos a procurarem conhecer ou se especializar em medicina chinesa, identificar expectativas dos médicos investigados com relação ao exercício da Acupuntura e desvelar o significado dos discursos sobre prática médica e sobre mudança de especialidade médica. Com a hipótese de que os médicos que buscam especialização em Medicina Chinesa - Acupuntura objetivam exercer Acupuntura de forma integrada à Medicina Convencional, o que se dá a partir de uma nova visão de mundo, tendo por referência o contexto de uma prática médica mais abrangente e com relação médico-paciente mais humanista. O tema estudado é de relevância, visto que atualmente é crescente a procura de médicos por especialização em práticas médicas não convencionais, mais freqüentemente, Acupuntura. Também porque tem aumentado o afluxo de pacientes para estas especialidades e, finalmente, porque a discussão do humanismo na medicina é bastante presente na atualidade. Neste contexto, interessa-nos estudar o médico que tem formação na medicina convencional e busca se especializar-se em Acupuntura. Dada a natureza do problema, a pesquisa realizada é quanti-qualitativa. Foram pesquisados 175 médicos do 'Curso de Desenvolvimento em Medicina Chinesa-Acupuntura' do Center-AO - Centro de Pesquisa e Estudo da Medicina Chinesa e UNIFESP - EPM, com questionários composto por perguntas abertas e fechadas. Os dados obtidos foram analisados estatisticamente com metodologia que se aplicou no caso específico do presente estudo, bem como, com técnica de coleta de material denominada do tipo temática, baseada nas respostas dos médicos. As respostas foram analisadas com a técnica de análise de conteúdo, buscando desvelar unidades de significado, e a partir daí, estabelecemos categorias gerais e específicas, que passaram a dar significado aos discursos. Dessa forma obtivemos três grupos categoriais: "Aprimoramento profissional", "Ampliar seu próprio horizonte de vida" e "Compreender o paciente em uma dimensão mais abrangente". Nossos dados revelaram que médicos de especialidades médicas cognitivas e intermediárias são mais atraídos para a especialização em Acupuntura. Também revelaram que os médicos de nosso estudo pretendem exercer Acupuntura em diversos espaços de prática como consultório e outros espaços da medicina privada, SUS, hospitais, pesquisa e docência, entre outros, de forma integrada à Medicina Convencional, no bojo da qual a Acupuntura se firma como especialidade médica. / The main goal of the thesis is to identify conceptions relating to Conventional Medicine and Acupuncture that contributes to the understanding of reasons why doctors search for or specialize in Chinese medicine, identify expectations of the doctors researched in connection with the practice of Acupuncture and reveal the meaning of speeches about medical practice and changes of medical specialization. Assuming as a hypothesis that doctors specialize in Chinese medicine aims to practice Acupuncture integrated with Conventional Medicine, which comes from a new view of the world, having as base a more broaden medical practice in view of a more humanistic doctor-patient relationship. The subject is relevant in view of the current growth in number of doctors searching for specialization in unconventional medical practices, most frequently, Acupuncture. In addition to that, the number of patients of such practices is increasing and, finally, since the discussion of humanistic values in medicine is a current matter. In view of the above, it is important to study the doctor who has as a base the conventional medicine and who searches for specialization in Acupuncture. Due to the nature of the problematic a quantitative-qualitative research was carried on. 175 doctors from 'Curso de Desenvolvimento em Medicina Chinesa-Acupuntura' of Center-AO - Centro de Pesquisa e Estudo da Medicina Chinesa e UNIFESP - EPM- São Paulo, was researched and subjected to a questionnaire of open and closed questions. The obtained data was statistically analyzed with the methodology applicable to the concrete case of the present study, in addition to the applicable collection of material denominated thematic, based on the doctor's answers. Such answers were analyzed in face of the "content analysis" method, seeking to reveal significance units, and from than on, establishing general and specific categories, which leads to the meaning of speeches. In face of that, 3 categories were established: "Professional Improvement", "Broaden self life horizon" and "Understand patients in a more broaden dimension". The data collected reveals that doctors who specialize in cognitive and intermediary medical practices are more drawn to Acupuncture specialization. The data also revealed that doctors subject to the present study aim to practice Acupuncture in several environments, such as private offices and clinics, public hospitals (SUS), academic research, among others, in an integrated way with Conventional Medicine, which establishes Acupuncture as a medical specialization.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Shén神 é uma categoria chinesa de sentidos múltiplos e abrangentes, presente na filosofia e na medicina. Direcionaria o processo de surgimento de todas as coisas no universo, como uma força configuradora. Na pessoa, atuaria sobre todos os estágios de desenvolvimento corporal e pessoal, do nascimento até a morte, caracterizando-a como pessoa única no universo. Teve seus sentidos reduzidos pela Medicina Chinesa Contemporânea, hegemônica na China e instituída após a Revolução comunista. Costuma ser traduzida como Espírito ou Mente no ocidente e é indissociável do corpo físico. Está presente em todas as dimensões da Racionalidade Médica Chinesa, observando-se na literatura convencional, grande abrangência de sentidos quando tratada pela dimensão cosmológica, porém costuma ser reduzida aos sentidos de mente, segundo definições ocidentais, quando tratada pelas dimensões de ordem prática: diagnose e terapêutica. O desafio desta tese foi elaborar uma síntese entre os sentidos cosmológicos e as dimensões práticas. Para isso, procedeu a uma pesquisa teórico conceitual, a partir de leituras e interpretações ocidentais de textos clássicos chineses, elaboradas por autores com critério filológico apurado. Observou-se que os sentidos de Shén神 se fazem presentes em ressonância recíproca com diversas outras categorias da Doutrina Médica Chinesa, como Qì氣, Xuè血, Jīng精, Qìng情, Emoções, Zàng-Fǔ贓腑, Órgãos e Vísceras, entre outras. Cada uma delas com atribuições específicas, que, porém, se reorganizariam em ressonância com as outras. Assim, ao proceder a diagnose e instituir uma terapêutica direcionada a cada uma dessas categorias, o terapeuta estaria interferindo diretamente sobre Shén神 e vice versa. Shén神 poderia assumir sentidos diversos, numa visão de totalidade. A partir daí, percebeu-se a necessidade de estudar essas categorias em ressonância com Shén神, além da própria diagnose e da terapêutica, à luz das premissas do Pensamento Chinês. Categorias como processo, totalidade, potencial ou eficácia ajudaram a apreender, não só os amplos sentidos de Shén神, e suas ressonâncias, mas também as peculiaridades do ato de diagnosticar e tratar na Racionalidade Médica Chinesa. Foi, então, elaborada uma visão da Diagnose e da Terapêutica capaz de contemplar Shén神 e suas ressonâncias, que se espera poder utilizar nos serviços de saúde, contribuindo para estratégias de promoção da saúde, estreitamento de vínculos terapeuta-paciente e maior eficácia terapêutica na prática da Racionalidade Médica Chinesa. / Shén神 is a chinese category of multiple and ample senses, present in the philosophy and medicine. It would direct the process of the appearance of all the things in the universe, as a shaper force. In the person, it acts in all the phases of corporal and personal development, from birth to death, featuring him as the unique person in the universe. It had its meanings reduced by Contemporary Chinese Medicine, hegemonic in China and established after the communistic Revolution. It is often translated as Spirit or Mind, in the West, and it is never dissociated from the physical body. It is present in all dimensions of the Chinese Medical Rationality, and a great range of senses is mentioned, in the conventional literature, when referred to the cosmological dimension, but, it is often reduced to the senses of the mind, according to occidental definitions, when referred to the dimensions of practical order: diagnosis and therapy. The challenge of this thesis was to elaborate a synthesis among the cosmological senses and the practical dimensions. For that, a theoretical-conceptual research was carried out from occidental readings and interpretations of classical chinese texts, created by authors with highly accurate philological criterion. It was noticed that, the senses of Shén神 are present in reciprocal resonance with several other categories of the Chinese Medicine Doutrine, as Qì氣, Xuè血, Jīng精, Qìng情, Emotions, Zàng-Fǔ贓腑, Organs and Visceras, among others. Each one of them with specific attributions, which, however, would reorganize themselves, in resonance with the others. Thus, proceeding the diagnosis and initiating a therapy directed to each one of these categories, the therapist would be interfering, directly on Shén神 and vice versa. Shén神 might assume various meanings, in a vision of totality. From this point on, we understood the need of studying these categories, in resonance with Shén神, beyond the own diagnosis and therapy, in the light of the Chinese Thought premises. Categories like process, totality, potential or efficacy have helped to apprehend, not only the wide meanings of Shén神, and their resonances, but also the peculiarities of the act of diagnosing and treating in the Chinese Medical Rationality. Then, it was elaborated a vision of the Diagnosis and Therapy capable of contemplating Shén神 and its resonances, that we expect can be used in the healthcare services, contributing to health promoting strategies, straitening the therapist-patient biding and more therapeutical efficacy in the practice of the Chinese Medical Rationality.

A presente tese tem por objetivos: identificar concepções sobre Medicina Convencional e Acupuntura que contribuem para o entendimento dos motivos que levam médicos a procurarem conhecer ou se especializar em medicina chinesa, identificar expectativas dos médicos investigados com relação ao exercício da Acupuntura e desvelar o significado dos discursos sobre prática médica e sobre mudança de especialidade médica. Com a hipótese de que os médicos que buscam especialização em Medicina Chinesa - Acupuntura objetivam exercer Acupuntura de forma integrada à Medicina Convencional, o que se dá a partir de uma nova visão de mundo, tendo por referência o contexto de uma prática médica mais abrangente e com relação médico-paciente mais humanista. O tema estudado é de relevância, visto que atualmente é crescente a procura de médicos por especialização em práticas médicas não convencionais, mais freqüentemente, Acupuntura. Também porque tem aumentado o afluxo de pacientes para estas especialidades e, finalmente, porque a discussão do humanismo na medicina é bastante presente na atualidade. Neste contexto, interessa-nos estudar o médico que tem formação na medicina convencional e busca se especializar-se em Acupuntura. Dada a natureza do problema, a pesquisa realizada é quanti-qualitativa. Foram pesquisados 175 médicos do 'Curso de Desenvolvimento em Medicina Chinesa-Acupuntura' do Center-AO - Centro de Pesquisa e Estudo da Medicina Chinesa e UNIFESP - EPM, com questionários composto por perguntas abertas e fechadas. Os dados obtidos foram analisados estatisticamente com metodologia que se aplicou no caso específico do presente estudo, bem como, com técnica de coleta de material denominada do tipo temática, baseada nas respostas dos médicos. As respostas foram analisadas com a técnica de análise de conteúdo, buscando desvelar unidades de significado, e a partir daí, estabelecemos categorias gerais e específicas, que passaram a dar significado aos discursos. Dessa forma obtivemos três grupos categoriais: "Aprimoramento profissional", "Ampliar seu próprio horizonte de vida" e "Compreender o paciente em uma dimensão mais abrangente". Nossos dados revelaram que médicos de especialidades médicas cognitivas e intermediárias são mais atraídos para a especialização em Acupuntura. Também revelaram que os médicos de nosso estudo pretendem exercer Acupuntura em diversos espaços de prática como consultório e outros espaços da medicina privada, SUS, hospitais, pesquisa e docência, entre outros, de forma integrada à Medicina Convencional, no bojo da qual a Acupuntura se firma como especialidade médica. / The main goal of the thesis is to identify conceptions relating to Conventional Medicine and Acupuncture that contributes to the understanding of reasons why doctors search for or specialize in Chinese medicine, identify expectations of the doctors researched in connection with the practice of Acupuncture and reveal the meaning of speeches about medical practice and changes of medical specialization. Assuming as a hypothesis that doctors specialize in Chinese medicine aims to practice Acupuncture integrated with Conventional Medicine, which comes from a new view of the world, having as base a more broaden medical practice in view of a more humanistic doctor-patient relationship. The subject is relevant in view of the current growth in number of doctors searching for specialization in unconventional medical practices, most frequently, Acupuncture. In addition to that, the number of patients of such practices is increasing and, finally, since the discussion of humanistic values in medicine is a current matter. In view of the above, it is important to study the doctor who has as a base the conventional medicine and who searches for specialization in Acupuncture. Due to the nature of the problematic a quantitative-qualitative research was carried on. 175 doctors from 'Curso de Desenvolvimento em Medicina Chinesa-Acupuntura' of Center-AO - Centro de Pesquisa e Estudo da Medicina Chinesa e UNIFESP - EPM- São Paulo, was researched and subjected to a questionnaire of open and closed questions. The obtained data was statistically analyzed with the methodology applicable to the concrete case of the present study, in addition to the applicable collection of material denominated thematic, based on the doctor's answers. Such answers were analyzed in face of the "content analysis" method, seeking to reveal significance units, and from than on, establishing general and specific categories, which leads to the meaning of speeches. In face of that, 3 categories were established: "Professional Improvement", "Broaden self life horizon" and "Understand patients in a more broaden dimension". The data collected reveals that doctors who specialize in cognitive and intermediary medical practices are more drawn to Acupuncture specialization. The data also revealed that doctors subject to the present study aim to practice Acupuncture in several environments, such as private offices and clinics, public hospitals (SUS), academic research, among others, in an integrated way with Conventional Medicine, which establishes Acupuncture as a medical specialization.

Chronic pelvic pain (CPP) is defined as constant or intermittent lower, cyclical or non-cyclical abdominal pain of at least six months’ duration. In the United Kingdom, over 1 million women suffer from CPP, with an estimated annual healthcare cost above £150 million. The aetiology of CPP is unknown in up to 50% of women, and in the remainder, the symptoms of CPP is associated with endometriosis, pelvic adhesions, irritable bowel syndrome or painful bladder syndrome. CPP is often accompanied by painful periods, pain during sexual intercourse and defaecation. Fatigue, sleep disturbances and depression are also common among this group of women. CPP asserts a heavy emotional, social and economic burden. Standard treatments such as hormonal and analgesic regimens are often associated with unacceptable side effects, even if helpful for the pain, underlining an urgent need for a satisfactory treatment. The meridian balanced method (BM) electro-acupuncture (EA) treatment (acupuncture needling + traditional Chinese medicine health consultation [TCM HC]) may be effective in managing CPP symptoms. Thus, I have completed a pilot study comprising of a three-armed randomised controlled trial (RCT), using a mixed methods research (MMR) approach, to assess the feasibility of a future large-scale RCT to determine the effectiveness of the meridian BMEA treatment on CPP in women. My hypothesis is that it is feasible to conduct such a large-scale RCT for CPP in women. The primary objectives were to determine recruitment and retention rates. The secondary objectives were to evaluate the, acceptability of the methods of recruitment, randomisation, interventions and assessment tools and any signals of effectiveness of the interventions. Thirty (30) women with CPP were randomised into three groups: BMEA treatment, TCM HC, or National Health Service standard care (NHS SC) group. The effects of my interventions were assessed by validated pain, physical and emotional functioning questionnaires, completed at weeks 0, 4, 8 and 12 of the study. Semi-structured telephone interviews and focus group discussions to explore participants’ experience of the study were conducted. Of the 59 women who were referred to the study, 30 women (51%) were randomised. There was a statistically significant difference in retention rates between the three groups. The retention rates were 80% (95% CI 74-96), in the BMEA treatment group, 53 % (95% CI 36- 70) in the TCM HC group and 87% (95% CI 63-90) in the NHS SC group. (Chi-square test, p=0.08) The attendance rates of the BMEA treatment group were 90% compared to 56% in the TCM HC group. There was a statistically significant difference (Mann-Whitney test, p=0.023) in attendance between the two intervention groups. Telephone interviews regarding the acceptability of the methods of recruitment, randomisation, assessment tools and interventions were positive. No adverse effects that were directly related to BMEA treatments were reported or observed. A higher proportion of the BMEA treatment group achieved clinical significance in the VAS-pain, BPI-pain severity, interference, and sleep scores, when compared to the other two groups. Due to small sample sizes, there was insufficient power to show statistically significant difference. (Fishers Exact Test, p=1.0) Analyses of the questionnaire data per group showed statistically significant differences in the following: the BMEA treatment group experienced less in pain at weeks 4 (p=0.01) and 8 (p=0.005); less helplessness (p=0.03) and their anxiety and depression scores declined at week 4 (p=0.04). The NHS SC group also reported less pain at week 4 (p=0.04). However, this group scored higher in anxiety and depression at weeks 8 and 12 (p=0.04). No statistically significant differences were achieved between the three groups at baseline, weeks 4, 8 and 12 in all scores. The therapeutic benefits gained by the TCM HC group were less compared to those of the BMEA treatment group, but better when compared to the NHS SC group. The BMEA treatment and TCM HC groups showed lower scores in anxiety and depression while the NHS SC group showed higher scores in anxiety and depression. The NHS SC group also tended to ruminate and magnify their problems as well as feeling more helpless than the other two groups. The three key themes that emerged from thematic analysis of focus group discussions were the “whole person effects” where participants reported an improvement in pain, sleep and a general sense of wellbeing in the two intervention groups; the “experience of standard care” and “impact of living with CPP”. In conclusion, the results of my pilot study are supportive of the feasibility of a future large-scale study. There were signals of effectiveness of interventions but the sample size was too small to make a definitive conclusion.

Seventeen Cree anti-diabetic herbal medicines and eight Traditional Chinese Medicines have been examined for their potential to cause interactions with drugs, which is considered as a major reason for adverse drug effects. Specifically, the effect of these natural health products was examined on major Phase I drug metabolism enzymes including cytochrome P450, human carboxylesterase-1 and flavin-containing monooxygenases. Several of these natural health products have the potential to cause adverse drug effect through the inhibition of major drug metabolism enzymes. The results indicated that 7 Cree medicines plant extracts inhibited CYP3A4 activity, and 3 of them have been proven to cause potent mechanism-based inactivation of CYP3A4. Seven of eight Traditional Chinese Medicines have been identified as strong CYP3A4 inhibitors; the ethanol extract of Goji has identified as a potent inhibitor for CYP2C9 and 2C19. Goji juice showed universal inhibitory effects on most of the tested enzymes except flavin-containing monooxygenases 3.

Seventeen Cree anti-diabetic herbal medicines and eight Traditional Chinese Medicines have been examined for their potential to cause interactions with drugs, which is considered as a major reason for adverse drug effects. Specifically, the effect of these natural health products was examined on major Phase I drug metabolism enzymes including cytochrome P450, human carboxylesterase-1 and flavin-containing monooxygenases. Several of these natural health products have the potential to cause adverse drug effect through the inhibition of major drug metabolism enzymes. The results indicated that 7 Cree medicines plant extracts inhibited CYP3A4 activity, and 3 of them have been proven to cause potent mechanism-based inactivation of CYP3A4. Seven of eight Traditional Chinese Medicines have been identified as strong CYP3A4 inhibitors; the ethanol extract of Goji has identified as a potent inhibitor for CYP2C9 and 2C19. Goji juice showed universal inhibitory effects on most of the tested enzymes except flavin-containing monooxygenases 3.