SPECIAL SECTION ON ADVANCED INFORMATION SENSING AND LEARNING TECHNOLOGIES

FOR DATA-CENTRIC SMART HEALTH APPLICATIONS

Received October 20, 2018, accepted November 9, 2018, date of publication November 16, 2018,
date of current version December 18, 2018.
Digital Object Identifier 10.1109/ACCESS.2018.2881535

Syndrome Differentiation and Treatment Algorithm

Model in Traditional Chinese Medicine Based on
Disease Cause, Location, Characteristics and Conditions
JU CHEN1 , DIANXING YANG1 , YUE CAO1 , YIYI MA1 , CHUANBIAO WEN1 ,
XIWEI HUANG 2 , (Member, IEEE), AND JINHONG GUO 3 , (Member, IEEE)
1 Collegeof Medical Information Engineering, Institute of Digital Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 611731, China
2 KeyLaboratory of RF Circuits and Systems, Ministry of Education, Hangzhou Dianzi University, Hangzhou 310018, China
3 Schoolof Information and Communication Engineering, Institute of Medical Equipment, University of Electronic Science and Technology
of China, Chengdu 611731, China
Corresponding authors: Chuanbiao Wen (wcb@cdutcm.edu.cn), Xiwei Huang (huangxiwei@hdu.edu.cn),
and Jinhong Guo (guojinhong@uestc.edu.cn)
This work was supported in part by the National Natural Science Foundation of China by the topic of Design of Syndrome Differentiation
and Treatment Algorithm Model in Traditional Chinese Medicine Based on Deeping Learning of ‘‘Disease Cause, Location,
Characteristics, and Conditions’’ under Grant 81804222 and by the topic of A Methodology on the Construction of the ISO-R Syndrome
Factor Differentiation System Based on the Syndrome Factor Attribution with A Digraph - An Example of Syndrome Factor Differentiation
of Lung Diseases under Grant 81804220, in part by National Social Sciences Fund by the topic of An Establishment of Medical Literatures
Database in Southwestern Ethnic Minorities under Grant 16ZDA238, in part by Sichuan Provincial Science and Technology Department
by the topic of Development of Artificial Intelligence Diagnosis and Treatment System in Traditional Chinese Medicine under Grant
2018SZ0065, in part by Sichuan Provincial Department of Education by the topic of An Application of Medical Quality Management
Informatization in Traditional Chinese Medicine under Grant SCYG2017-21, in part by Xinglin Scholarship, and in part by the Chengdu
University of Traditional Chinese Medicine by the topic of Design of Syndrome Differentiation and Treatment Algorithm Model in
Traditional Chinese Medicine Based on ‘‘Disease Cause, Location, Characteristics, and Conditions’’ under Grant QNXZ2018042.

ABSTRACT Traditional Chinese medicine (TCM) is based on a unique disease diagnosis and treatment
system that has been developed over the last 2,300 years. In the TCM, ‘‘syndrome differentiation and
treatment’’ (SDAT) is a core method for doctors to deal with diseases. This diagnostic and therapeutic
technique that infer the occurrence and the development of diseases by observing symptoms as a whole,
not only has its own uniqueness but also has been recognized by the public in oriented medical fields for
its clinical efficacy. With recent developments in computer science, the Internet, big data, and artificial
intelligence, a study based on the SDAT algorithm has aroused much attention. This paper encompasses
three stages spanning 30 years to accomplish the following: 1) the TCM data and the modern SDAT system
were collated and summarized based on 35,706 reference data on the TCM, starting from the syndrome
differentiation of four aspects, such as the cause, location, characteristics, and conditions of the disease
(CLCC), we constructed a quantitative model of the TCM SDAT regarding the CLCC of the disease,
collected the symptom information on the diagnosed subject, and transferred them to the SDAT assistant
algorithm for calculation and analysis, to determine the CLCC, Based on the therapy recommended by
the differentiation results in the knowledge base and the prescription and traditional Chinese medicines
recommended by the therapy, any stage of all diseases could determine a syndrome type by differentiating
the CLCC, we constructed the basic SDAT algorithm integrating theory, method, prescription, and medicine
and realized the calculability in the TCM diagnosis and treatment process; 2) based on the SDAT algorithm,
we developed the TCM doctor’s workstation software and introduced it to more than 80 TCM institutions
in Sichuan province, China, we collated a large-scale trove of samples of the TCM data platform that
was established with more than 2.9 million TCM electronic medical records (EMRs) and reference data,
and had the compliance tested and algorithm verified on the 9,300 EMRs of the common diseases in the
TCM; and 3) based on the dimension reduction and degree elevation optimization of the technology with
a directed graph to the basic algorithm, the algorithm complexity was reduced and the accuracy of the
algorithm was improved. It was demonstrated that the coincidence rate of the basic model was 80.47%
and the basic coincidence rate was 96.19%. After optimizing the basic algorithm (for example, for gastric
abscess), the coincidence rate increased by 7.04%. The test results demonstrated the efficacy of the model
study. This model realized a computable SDAT to specify and assist in the differentiation diagnosis and in
the treatment processes of the TCM and improve the service quality of the TCM diagnosis and treatment.
INDEX TERMS Cause, location, characteristics, conditions of diseases, syndrome differentiation and
treatment, algorithm, traditional Chinese medicine.
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I. INTRODUCTION
The two basic characteristics of TCM’s theoretical foundation
are the holistic concept and syndrome differentiation and
treatment (SDAT). With the holistic concept, a human being
is considered an organic whole; therefore, no matter which
part of the body is affected by disease, other parts of the
body shall be considered and included in the treatment. The
inductive synthesis method used in TCM is an experience-
based medical system that focuses on clinical observation,
summary, and individual differences [1], [2]. With its devel-
opment as a ‘‘system’’, TCM has been increasingly accepted
and recognized by the world [3], [4].
‘‘SDAT’’ is the basic principle of TCM in recognizing
and treating diseases. Differentiation refers to recognizing
the symptoms and signs collected by the four diagnostic
methods—inspection, auscultation-olfaction, inquisition, and
pulse-taking—after comprehensive analysis, extraction and
summarization using the TCM theories, to determine the inci-
dence cause, pathological location, characteristics of disease,
etc., and finally, reaching a conclusion about the nature of the
symptoms and signs. ‘‘Syndrome’’ refers to a pathological
summary of some stage in the development of a disease.
It reflects the body’s ability to respond to the disease, its over-
all state, as well as the essence of the pathological changes
at the current stage. ‘‘Treatment’’ refers to the therapeutic
principles and methods determined in accordance with the
differentiation results [5], [6]. SDAT comprises the entire
process from differentiation to treatment determination.
In modern studies on the TCM method of syndrome
differentiation Bai et al. [7] and Meili et al. [8] created a
syndrome differentiation system that combines syndrome
elements with syndrome targets, i.e., a corresponding differ-
entiation between syndrome and prescription Yan et al. [9]
created a syndrome elements differentiation system.
Zhou et al. created a pathogenesis elements differentiation
system. These modern differentiation methods are the sum-
mary and development from the traditional differentiation
methods, by carrying out TCM differentiation processes
departing from symptomatic elements, symptoms, pathogen-
esis, etc. respectively and takes them as the entry points,
thus providing a theoretical basis for the quantification diag-
nostics of TCM and promoting the development of TCM
informatization. In the 1990s, computer and information
technology was introduced into TCM, marking the start of
the research on TCM information intellectualization, at the
heart of which were the TCM expert systems centered on
system modeling, knowledge acquisition, and knowledge
library construction [10]. Early 21st century witnessed a low
ebb in the intelligent study in TCM, which mainly focused on
database and knowledge engineering [11]–[16]. After 2005,
study on neural networks increased [17]–[20] and after 2010,
TCM data were accumulated mainly based on mathematical
models [21]–[26]. After four generations of TCM research on
information intellectualization, researchers are attempting to
conduct objectified, standardized, and quantified research on
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TCM using mathematics, statistics, and other methods from
different perspectives, and have made great progress, thus
serving as references for our research.
Currently, taking departure from symptomatic elements,
symptoms and pathogenesis, most of these studies focus on
the deliberation of a single expert-level issue, or is limited to a
single disease or a single purpose, lacking universality or the
integration of theory, method, prescription, and medicine in
TCM diagnosis and treatment process research. Therefore,
under the guidance of the holistic concept in TCM, we sorted
and analyzed traditional differentiation methods [27]–[30],
integrated the common points in the modern differentiation,
and arrived at four entry points of syndrome differentia-
tion, i.e. the cause, location, characteristics, and conditions
(CLCC) of a disease. As a general description of any dis-
ease, the above four aspects constitute the differential points
of the disease. Accordingly, we constructed a quantitative
model of SDAT in TCM based on the CLCC of the disease,
provided a diagnostic protocol of TCM SDAT integrating
theory, method, prescriptions, and medicines, expanded the
TCM doctor’s scope for treating disease, improved their
ability to diagnose and treat miscellaneous thorny diseases,
and shortened the time for a young TCM doctor to become
experienced.
II. CALCULABILITY OF SDAT IN TCM
A. QUANTIZATION OF SDAT IN TCM
In the TCM syndrome differentiation system, research has
focused on the key points of differentiation [8], [9], which
indicates that the essence of TCM syndrome differentiation
is a classification problem. Therefore, we have sorted out
and analyzed the methods of syndrome differentiation in
a 30-year study and extracted the core and key
points [31]–[33]. Based on the viscera syndrome differ-
entiation and eight principal syndrome differentiations as
the starting point of core differentiation, we integrated the
methods of pathogenesis and cause of disease, each attempt
at syndrome differentiation reflects the cause, location, and
characteristics of the disease, and highlights the key points of
conditions during quantification and value input. In this way,
the differentiation method that integrates the cause, location,
characteristics, and conditions of the disease [34], [35] is
finally formed. Such a method is universal and diseases
treated in various departments, such as internal medicine,
surgery, gynecology, pediatrics, exogenous diseases, and
internal injury, could be included.
The TCM differentiation method, based on the cause,
location, characteristics, and conditions of the disease,
involves 46 TCM differentiation elements in total. Thus,
we take the differentiation for the cause, location, charac-
teristics, and conditions of the disease as the key points of
classification.
Method 1: The ‘‘syndrome’’ is described according to the
following 46-bit differentiation elements that correspond to
the above CLCC of the diseases.
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J. Chen et al.: SDAT Algorithm Model in TCM Based on Disease CLCC
TABLE 1. 46-bit quantitative code for the cause, location, characteristics, and conditions of disease.
TABLE 2. 46-bit quantitative code of medicinal materials.
1) DISEASE LOCATION OF THE SYNDROME (13 BITS)
Heart, liver, gallbladder, spleen, stomach, bowel, lung, kid-
ney, bladder, bladder, uterus, thoroughfare and concept,
essence chamber and surface. It should be noted that the
disease location of the syndrome is specific to the TCM
medication rather than an exact anatomic site.
2) DISEASE CAUSE AND CHARACTERISTICS OF THE
SYNDROME (33 BITS)
Fu-organ, irregularity, heat, heat deficiency, blood heat, body
fluid deficiency, toxicity, pus, accumulation, cold, heatstroke,
deficiency of vital energy, blood deficiency, yin deficiency, qi
instability, vexation, coma (abnormal consciousness), blood
stasis, pulse obstruction, bleeding, qi stagnation, cough,
wind, stirring wind, dryness, dampness, water, sputum, diet,
and parasitosis.
3) MILD, MODERATE, AND SEVERE CONDITIONS
Take the numerical value as the basis for determining the
severity of the conditions upon assignment for the numeric
coding of each symptom.
Method 2: We propose to use quantitative code (V ) for
CLCC regarding the TCM symptoms, which is a numerical
string composed of 46 decimal numbers as shown in Table 1:
V = v1 v2 . . . . . . vn−1 vn , vn ∈ {0, 1, 2, 3}, n = 46.
Among the numbers, vn indicates the degrees of influ-
ence of current symptoms and the n-th differentiation ele-
ment, ranging from strong, medium, weak to zero. These are
expressed in the decimal numbers 3, 2, 1, and 0, respectively.
For example, ‘‘bad breath’’ has a mild effect on the stomach
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and bowel, but no effect on the heart, liver, gallbladder, etc.
As shown in Table 1, a total of 1,923 symptom codes are put
in the system knowledge base.
Method 3: We use quantitative code (D) of TCM efficacy,
which is a numerical string comprising a 46-bit decimal
number (as shown in Table 2, in which the 46-bit quantitative
code corresponding to the medicinal materials is listed).
It is assumed that the quality of the medicinal material and
the technological process of the preparation are controllable,
and the 46-bit quantitative code of TCM efficacy can be con-
structed according to the quantification for the TCM efficacy
in the known ingredients of TCM. A total of 491 quantitative
codes of medication efficacy are completed in the system
knowledge base:
D = d1 d2 . . . . . . dn−1 dn , dn ∈ {0, 1, 2, 3}, n = 46. (2)
B. MATHEMATICAL MODEL OF SDAT
Method 4: We use B = (O, S, C, T , P, G, Fj∈[1,8] ) as the
TCM doctor’s workstation, where B indicates TCM doctor’s
workstation; O indicates the patient’s chief complaint col-
lected by the application system; S indicates an assemblage
of symptom names, covering all the patient’s symptoms;
i indicates the number of symptoms; and Si ⇔ V si indicates
the unique 46-bit quantitative code (V si ) for the CLCC corre-
(1) sponding to each symptom name (Si ):
n
X
S= Si , Si ⇔ V si . (3)
i=1
C indicates the name of syndrome type, which is
comprehensively composed of several symptoms, i.e., the
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recombination of symptoms, an equivalent to the syndrome
in Western medicine. For instance, fever, aversion to cold,
headache, and floating pulse are all external symptoms and
the syndrome type is characterized by ‘‘wind–cold exterior
symptom.’’
T indicates the therapeutic method. It elects a specific
therapeutic rule after determining the syndrome and clearly
investigating the disease cause and pathogenesis. The method
of treatment is also called a basic therapeutic method, which
summarizes the common features of many specific therapeu-
tic methods, and thus has universal significance in clinical
practice. It encompasses the eight therapeutic methods: per-
spiration, vomiting, descending, moderation, warming, clear-
ing, tonifying, and digesting. The specific therapeutic method
is proposed according to the specific disease syndromes and
as a unique method, each has its own application scope, such
as clearing for heat, warming for cold (clearing heat and
removing toxicity, invigorating spleen to promote digestion).
Generally, one syndrome type corresponds to one therapeutic
method.
P indicates the prescription name and G the Chinese
medicine name. There exists the following relationship
between the two factors: j is an integer that indicates the
number of the Chinese medicines and Gi ⇔ DGi indicates
the unique 46-bit quantitative code of TCM efficacy corre-
sponding to each medicine name:
j
X due to liver-yin and kidney-yin deficiency, and the syndrome
P= Gi , Gi ⇔ DG i . (4)
i=1
F indicates an integration for the operating functions of
the syndrome differentiation algorithm in the TCM clinical
SDAT system.
F1 : Function get: O → S refers to extracting the patient’s
symptom information from results of the four diagnostic
methods by comparing the results of the four diagnostic meth-
ods with the symptom data dictionary, to extract symptom
terms which are associated with TCM disease names and
frequently used in clinical practice, e.g., get (O).
F2 : Function Refining: S → S refers to extracting the
patient’s primary symptom from the symptom information
for improvement of the accuracy of the subsequent syndrome
differentiation classification, e.g., Refining (S). This proce-
dure is manually selected by the doctor.
F3 : Function Superposition: V × V → V , D × D → D
refers to the new 46-bit primary symptom quantitative code
achieved through the superposition of the two 46-bit primary
symptom quantitative codes (possibly the primary symptom
quantitative code and drug efficacy code):
Superposition(V 1 , V 2 )
2 2 2
X j
X j
X paring the syndrome differentiation classification result and
= v1 v2 . . . . . . vjn , n = 46. (5)
j=1 j=1 j=1
F4 : Function Syndrome-diff: V → C refers to the
syndrome differentiation through quantitative code, e.g.,
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J. Chen et al.: SDAT Algorithm Model in TCM Based on Disease CLCC
TABLE 3. Total quantitative code of symptoms.
FIGURE 1. Corresponding diagram for the total quantitative code of
symptoms and differentiation elements.
Syndrome-diff (V ). V is achieved through a superposition for
all the symptom quantitative codes of the patient through the
function Superposition (V , V ). As shown in the first record
of Table 3 and Fig. 1, the heart, liver, and kidneys are the
main locations affected by disease, while the yin deficiency,
qi deficiency, blood deficiency, heat, and deficiency-heat are
the primary causes, characteristics, and conditions of the
disease syndrome. The combination can constitute a syn-
drome differentiation classification, such as the syndrome of
hyperactivity of fire due to heart-yin deficiency, the syndrome
of liver-yin deficiency, the syndrome of hyperactivity of fire
of kidney deficiency. Possible combinations are shown in
Tables 4–7: heart, liver, kidneys, yin deficiency, qi deficiency,
blood deficiency, heat and deficiency-heat. For combinations
of a single factor (Table 4) and combinations of multiple
factors (Tables 5–7), some are shown as below: ‘‘−’’ indicates
that there exists no combination of this syndrome type. The
presence of multiple words indicates that there are differ-
ent expressions for the syndrome type in different diseases,
such as liver + heat = hyperactivity of liver-yang or liver
depression of heat or liver-fire excess or hyperactivity of liver
fire. The combination results can be sequenced according
to the numerical value of the quantitative code. The top-
ranking syndromes include the syndrome of hyperactivity of
fire due to heart-yin deficiency, the syndrome of liver-yin
deficiency, the syndrome of hyperactivity of fire due to liver-
yin and kidney-yin deficiency, and the syndrome of kidney
deficiency.
F5 : Function Recommended-treatment: C → T refers
to the recommended therapy achieved by comparing the
syndrome differentiation classification result with the expert
knowledge base.
F6 : Function Recommended-prescription: C × T → P
refers to the recommended prescriptions achieved by com-
the recommended therapy with the expert knowledge base.
SDAT is the essence of TCM. As one symptom may cor-
respond to multiple syndrome types and one syndrome type
to multiple symptoms, after the syndrome type is confirmed,
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J. Chen et al.: SDAT Algorithm Model in TCM Based on Disease CLCC
TABLE 4. Combination of single factor.
TABLE 5. Combination of single–double factor 1.
TABLE 6. Combination of single–double factor 2.
TABLE 7. Combination of double–double factor.
the therapy and prescription would be determined accord-
ingly. Therefore, the recommended therapies and prescrip-
tions used for the knowledge base were based on govern-
ment documents, such as Government Document 9 [2017]
and 18 [2016], State Administration of Traditional Chinese
Medicine of P. R. China; Memo No. 83, 114, 93, 9, 141, 147,
State Administration of Chinese Medicine and Pharmacol-
ogy, Bureau of Medical Administration [2015–2010]. The
algorithm was constructed by the ‘‘13th Five-Year’’ projected
teaching materials (10th version), including Chinese Inter-
nal Medicine, Gynecology of Traditional Chinese Medicine,
Pediatrics of Traditional Chinese Medicine, and Surgery of
Traditional Chinese Medicine.
For example, the disease name ‘‘insomnia’’ in Memo
No. 148, State Administration of Chinese Medicine and Phar-
macology, Bureau of Medical Administration [2010] was
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divided into seven syndrome types including ‘‘hyposomnia of
liver fire harassing the heart’’, ‘‘hyposomnia of phlegm-heat
harassing the heart’’, and ‘‘stomach gas estrangement’’. Addi-
tionally, the syndromes in each syndrome type are described
in detail. Take ‘‘hyposomnia of liver fire harassing the heart’’
as an example. The syndromes are sudden insomnia, short
temper, difficulty in falling asleep, and sleep easily disturbed
by dreams, fullness and distension in chest and hypochon-
drium, proneness to sighing, bitter mouth, dry throat,
dizziness and distention in the head, hot eyes and tinnitus,
constipation and scanty dark urine, red tongue with yel-
low fur and pulse string.’’ Each syndrome corresponds to a
unique therapy. Take ‘‘hyposomnia of phlegm-heat harassing
the heart’’ as an example. The therapy is ‘‘soothing liver
and purging fire. Each therapy corresponds to one or two
prescriptions. In this case, the recommended prescriptions
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 J. Chen et al.: SDAT Algorithm Model in TCM Based on Disease CLCC

are Huanglian Wendan decoction, including rhizoma pinel- TABLE 8. Units for magnetic properties.
liae preparata, Chen pi, zhu ru, Zhishi, Gardenia jasmi-
noides, goldthread, fuling, polygala root, platycladi seed, and
liquorice.
In conclusion, after determining the ‘‘syndrome type
name’’ with the differentiation results, we can pinpoint a ther-
apy in the knowledge base, with at most two recommended
prescriptions. This is why differentiation is precisely at the
core of disease diagnosis and treatment in TCM. A 46-bit
quantitative code is presented in this paper for the purpose
of differentiation, with reference data combined with clinical
medical cases being introduced later to construct a knowl-
edge base, including an introduction to the corresponding
regulations.
F7 : Function A-custom-action (Fj∈[1,6] ) refers to support
for manual intervention of the algorithm by doctors on their
own. For example, A-custom-action (Refining (S)) indicates
that doctors can extract the primary syndromes based on the
primary syndrome information automatically provided by the
system, to achieve a more accurate primary syndrome by
deleting and adding the primary syndrome information.
F8 : Function Validation:V × P uses the primary syndrome
quantitative code and prescription efficacy to compare the
quantitative code and drug, and verify the anastomosis for
the 46-bit quantitative code regarding the differentiation and
diagnosis and treatment.

C. SDAT ALGORITHM
Input: Patient’s information on four diagnostic methods (O)
Output: Patient’s syndrome type (C), therapy (T ), and
prescription (P).

III. DATA STATISTICS AND PREPROCESSING

OF DATA PLATFORM
The prototype of the basic algorithm was achieved, i.e.,
a TCM doctor’s workstation, which are currently used in
more than 80 TCM hospitals in Sichuan province, China,
and collecting EMR data (i.e., TCM clinical data) from these
hospitals monthly. The most recent data were collected on
April 10, 2018. Moreover, there are more than 2.9 million
real TCM clinical EMRs. We used the 35,706 reference
data and over 2.9 million clinical medical records to estab-
lish a TCM data platform, collected and investigated the
TCM symptom data on the disease using perfect information, minology of Traditional Chinese Medical Diagnosis and
and preprocessed the data to ensure the data quality. Treatment (Ver. 1997), we obtained 702 TCM syndrome
types, 3,273 syndrome types, 12,113 symptoms, 15,582 pre-
A. DATA STRUCTURE AND STATISTICS OF THE DATA scriptions, and 4,036 traditional Chinese medicines.
PLATFORM
1) REFERENCE DATA 2) CLINICAL DATA
From textbooks (Ver. 10) listed in the ‘‘13th Five-Year Plan’’, 18% of hospitals (5 tertiary and 15 second-class hospitals)
such as Internal Medicine of Traditional Chinese Medicine, were found to possess 74% of the TCM EMR data. Therefore,
Gynecology of Traditional Chinese Medicine, Pediatrics of we used this 74% of data, which involved 1,795 TCM doctors
Traditional Chinese Medicine, Surgery of Traditional Chi- using the system, 2.21 million TCM EMRs, 2,258 disease
nese Medicine, Classification and Coding of Diseases in entities, 6,521 syndrome types, 21,246 symptoms, 3,285 pre-
Traditional Chinese Medicine (Ver. 1995), and Clinical Ter- scriptions, and 3,891 drugs as shown in Tables 8 and 9.

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J. Chen et al.: SDAT Algorithm Model in TCM Based on Disease CLCC
TABLE 9. Collection condition for the clinical data of tertiary hospitals.
In Table 8, EMR QTY refers to the total quantity of TCM
EMRs generated during the diagnosis and treatment using
the SDAT system; proportion refers to the proportion of
TCM doctors that use the platform in a certain hospital to
all TCM doctors in this hospital. The average percentage
of doctors using the system in Tables 8 and 9 is 63.12%;
the total number of disease entities, symptoms, syndrome
types, prescriptions, and traditional Chinese medicines only
involves the five tertiary hospitals.
B. PREPROCESSING OF REFERENCES AND CLINICAL DATA
There may be input errors, deficiencies, repetitions, irregular
titles, or other problems for the data that cause a reduction of
data quality and make it difficult to carry out direct analysis.
Therefore, it is necessary to preprocess the data. We retained
the patient information, such as patient ID, admission date,
symptoms, syndrome type, disease entities, disease loca-
tion, disease characteristics, therapeutic method, and pre-
scription. Additionally, the information is normalized and
unified in accordance with Basic Theory Nomenclature of
Traditional Chinese Medicine (GB/T20348-2006) and Clin-
ical Diagnosis and Treatment of Traditional Chinese
Medicine–Syndromes (GB/T16751.2-1997) issued by the
State Administration of Traditional Chinese Medicine of the
P. R. China, and data falling short of the national TCM
terminology standards were dealt with by means of amend-
ment, splitting, combination, and removal of repetitions.
After pretreatment, 422 disease entities, 318 syndrome types,
15,105 symptoms, 2,896 prescriptions, and 2,914 drugs were
achieved.
IV. TEST ON COMMON CLINICAL DISEASES
Five common TCM diseases (epigastric pain, dysmenor-
rhea, diabetes, pneumonia, and eczema) were selected for
testing. Five-star EMR (referring to all contents of the-
ory, method, prescription, and medicine, i.e., chief com-
plaint, symptom, diagnosis, therapeutic method, prescription
name, and TCM name and dosage) were collected from
the platform as test data between December 2015 and
January 2018. There were 9,300 medical cases: 2,252 cases
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for epigastric pain, 2,096 cases for dysmenorrhea, 2,639 cases
for diabetes, 1,793 cases for pneumonia, and 520 cases for
eczema. The test was conducted according to the following
test standards of differentiation:
1) The result will be accepted if the first two items at
the disease location are fully consistent. In the case of
deficiency of heart and spleen, it is accepted if there are
heart and spleen for the first two superimposed numer-
ical values (achieved from Function Superposition) at
the primary syndrome site. It is basically accepted if
there are heart and spleen in the first four bits. It is
unaccepted if either heart or spleen is absent from the
disease location.
2) It is accepted if the first three are consistent in the
cause, characteristics, and conditions of the disease.
In the case of deficiency of heart and spleen, it is
accepted if there are qi deficiency and blood deficiency
in the first three bits according to the superimposed
numerical values (achieved from Function Superposi-
tion) of the cause, characteristics, and conditions of the
disease. It is basically accepted if there are qi defi-
ciency and blood deficiency in the individual cause,
characteristics, and conditions of the disease. It is unac-
cepted if either qi deficiency or blood deficiency is
absent.
3) It is accepted if the name of the syndrome type is
consistent. In the case of deficiency of heart and spleen,
it is accepted. It is basically accepted if the name of the
syndrome type is not the deficiency of heart and spleen,
but the features of the syndrome are consistent accord-
ing to CLCC (i.e., there are heart and spleen in the
first two bits of disease location, and qi deficiency and
blood deficiency in the first three bits of the CLCC).
It is unaccepted if the syndrome and the CLCC are
inconsistent.
4) It is accepted if the prescription name (such as gui-
pi decoction) is consistent. It is basically accepted if
the TCM compositions are consistent but prescription
name is inconsistent. It is unaccepted if the TCM com-
positions and prescription name are inconsistent.
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TABLE 10. Collection condition for the clinical data of second-class hospitals.

FIGURE 2. Data process diagram of data platform.

According to a comprehensive assessment, it is accepted unaccepted if there is any inconsistency in the above four
if the above four assessments are completely consistent. items.
It is basically accepted if there is no inconsistent item and With the test on the five disease entities data, we achieved
any is basically consistent in the above four items. It is the coincidence rate and basic coincidence rate as shown

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J. Chen et al.: SDAT Algorithm Model in TCM Based on Disease CLCC
FIGURE 3. Standard procedures for differentiation test.
in Fig. 4. Figure 4(a) shows the coincidence rate and
basic coincidence rate of the system in differentiating the
disease location. Figure 4(b) shows the coincidence rate
and basic coincidence rate of the system in differentiat-
ing the cause, characteristics, and conditions of the disease.
Figure 4(c) shows the coincidence rate and basic coincidence
rate recommended by the name of the system syndrome type.
Figure 4(e) shows the coincidence rate and basic coincidence
rate of the comprehensive assessment on the system SDAT.
The coincidence rate and basic coincidence rate of the whole
system can reach 80.47% and 96.19%, respectively.
Currently, there are expert systems established as per the
single and veteran expert knowledge and the SDAT system
established by neural networks and various data statisti-
cal methods in the TCM SDAT system, with accuracy
reaching 80–90%. However, the methods more often than not
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use existing algorithms and models, and their data, usually
derived from the references and the veteran expert’s knowl-
edge, are basically devoid of or rarely include clinical data.
Therefore, regardless of the rules and training, the data alone
fail to fully reflect the pathogenesis of the disease, thus it is
difficult to determine some syndrome types in practical appli-
cation as a great number of achievements are confined to the
laboratory stage. Therefore, no comparison was conducted
with other algorithms in this paper.
V. DIMENSION REDUCTION AND DEGREE ELEVATION
FOR ALGORITHM OPTIMIZATION
A. DIMENSION REDUCTION OF DIFFERENTIATION
ELEMENTS
Three hundred and four dominant diseases in TCM were
identified by Memo No. 103, State Administration of Chinese
71809

FIGURE 4. 2,252 cases for stomach ache, 2,096 cases for dysmenorrhea, 2,630 cases for diabetes, 2,651 cases for pneumonia, and 520 cases for
eczema were taken as the disease entities for test and analysis in Fig. 5, and have the coincidence rate and basic coincidence rate calculated
according to the rules for differential test and assessment.
Medicine and Pharmacology, Bureau of Medical Adminis-
tration [2012] and Memo No. 119, State Administration of
Chinese Medicine and Pharmacology, Bureau of Medical
Administration [2012] via issuance; recognized by Memo
No. 130, State Administration of Chinese Medicine and
Pharmacology, Bureau of Medical Administration [2012]
via issuance, the data platform possessed 205 dominant
disease data in TCM. The basic algorithm has universal-
ity and the differentiation element is considered compre-
hensively, with a coincidence rate of 80.47%. If further
adaptation to clinical data is required, then the basic algo-
rithm shall be optimized. Therefore, we attempted to analyze
the large sample data of the data platform taking the
disease entities as units and applied the differentiation
elements of the CLCC that have a potential variable
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J. Chen et al.: SDAT Algorithm Model in TCM Based on Disease CLCC
model [39] for a dimension reduction of disease entities to
reduce the complexity of the algorithm and the effect of
the uncorrelated differentiation elements of the syndrome
type.
B. DEGREE ELEVATION FOR THE DIRECTED GRAPH
ANALYSIS ON THE DIFFERENTIATION ELEMENTS
The degree elevation herein refers to the differentiation ele-
ments constituting a syndrome type under the guidance of
TCM theory. We attempted to use the directed graph to
describe the relationship among ‘‘symptom - disease cause -
disease characteristics’’ in order to form a knowledge graph
to assist in combination of differentiation elements and to
promote the coincidence rate for the degree elevation of the
basic algorithm.
VOLUME 6, 2018
J. Chen et al.: SDAT Algorithm Model in TCM Based on Disease CLCC
FIGURE 5. Structure for the directed graph of the differentiation elements.
TABLE 11. Comparison table before and after dimension reduction of differentiation elements.
Taking epigastric pain as an example, based on the
2,252 data points achieved from the data platform between
December 2015 and January 2018, the syndrome type
elements of epigastric pain were extracted and 19-bit new
differentiation elements were achieved by using the CLCC
differentiation elements of dimension reduction in the poten-
tial variable model shown in Table 10. One hundred forty-two
clinical data points on epigastric pain were used to carry out
a repeatability demonstration test on the basic algorithm and
the basic algorithm after ‘‘dimension reduction and degree
elevation.’’ After dimension reduction, the coincidence rate
of the basic algorithm increased by 7.04%, to some extent
demonstrating the feasibility of the algorithm optimization,
which provided an idea for further optimization of other
disease entities. The specific optimization procedure will be
introduced in a subsequent paper after further verification.
VI. CONCLUSIONS
By studying traditional and modern SDAT systems in TCM,
starting from the syndrome differentiation of four aspects
(the cause, location, characteristics, and conditions) of the
VOLUME 6, 2018
disease, this paper constructed a quantitative model of TCM
SDAT regarding the cause, location, characteristics, and con-
ditions of the disease, and collected symptom information
on the diagnosed subject and enter it into the SDAT assis-
tant algorithm for calculation and analysis to determine the
cause, location, characteristics, and conditions of the disease.
Based on the therapy recommended by the differentiation
results in the knowledge base and the prescription and tradi-
tional Chinese medicines recommended by the therapy, any
stage of all diseases could be determined by syndrome type
by differentiating the disease cause, disease location, dis-
ease characteristics, and disease conditions (i.e., cause, loca-
tion, characteristics, and conditions of the disease). Unlike
other differentiation methods concentrating on certain med-
ical records, this system, as a universal model, deals with
various diseases seen in internal medicine, surgery, gyne-
cology, pediatrics, exogenous and internal injuries. In this
model, a computable SDAT was achieved to specify and assist
in the differentiation, diagnosis, and treatment processes of
TCM, to improve the service quality of TCM diagnosis and
treatment, and to shorten the time for a TCM doctors to
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gather clinical experience. The trial was conducted with real
medical records collected by the system. The data demon-
strated that the algorithm could reach a coincidence rate
of 80.47%, with a basic coincidence rate of 96.49%, which
could benefit the diagnosis and treatment at TCM medi-
cal institutions. At the same time, algorithm optimization
was discussed for preliminary verification, which provides
a further work program in promoting the coincidence rate
of the algorithm. More importantly, we collected the clinical
medical records and further collection would be conducted
to provide valuable first-hand data for further study on the
algorithm.
REFERENCES
[1] J. Zhu and H. X. Zhu, ‘‘Discussion of TCM ‘syndrome’ and ‘treatment
based on syndrome differentiation,’’’ China J. Traditional Chin. Med.
Pharmacy, no. 1, pp. 21–24, 2017.
[2] W. Xu, L. Zhang, Y. Huang, Q. Yang, H. Xiao, and D. Zhang, ‘‘Discrim-
ination of type 2 diabetes mellitus corresponding to different traditional
Chinese medicine syndromes based on plasma fatty acid profiles and
chemometric methods,’’ J. Ethnopharmacol., vol. 143, no. 2, pp. 463–468,
2012.
[3] P. Wang, H. Sun, P. Wang, Y. Han, and X. Wang, ‘‘Future perspectives of
personalized medicine in traditional Chinese medicine: A systems biology
approach,’’ Complementary Therapies Med., vol. 20, nos. 1–2, pp. 93–99,
2012.
[4] T. Ma, C. Tan, H. Zhang, M. Wang, W. Ding, and S. Li, ‘‘Bridging
the gap between traditional Chinese medicine and systems biology: The
connection of Cold Syndrome and NEI network,’’ Mol. Biosyst., vol. 6,
no. 4, pp. 613–619, 2010.
[5] M. Jiang et al., ‘‘Syndrome differentiation in modern research of traditional
Chinese medicine,’’ J. Ethnopharmacol., vol. 140, no. 3, pp. 634–642,
2012.
[6] M. F. Mei, ‘‘A systematic analysis of the theory and practice of syn-
drome differentiation,’’ Chin. J. Integr. Med., vol. 17, no. 11, pp. 803–810,
2011.
[7] X.-H. Bai et al., ‘‘Development and application of microcosmic syndrome
differentiation in the modern TCM syndrome differentiation system,’’
China J. Traditional Chin. Med. Pharmacy, vol. 30, no. 3, pp. 649–651,
2015.
[8] Y. U. Meili et al., ‘‘Historical evolution and modern development of
Chinese medicine syndrome differentiation system,’’ J. Traditional Chin.
Med., vol. 57, no. 12, pp. 991–995, 2016.
[9] E. Yan, J. Song, C. Liu, and W. Hong, ‘‘A research on syndrome element
differentiation based on phenomenology and mathematical method,’’ Chin.
Med., vol. 12, no. 1, p. 19, 2017.
[10] G. J. Yu et al., ‘‘Exploitation means and techniques of traditional Chinese
medicine expert system in pocket computer,’’ Discovery Nature, vol. 12,
no. 3, pp. 80–85, 1993.
[11] W. Chen and S. He, ‘‘Application of data mining technology in TCM
diagnosis and treatment,’’ in Proc. IEEE Int. Conf. Bioinformatics Biomed.
(BIBM), Kansas City, MO, USA, Nov. 2017, pp. 1350–1353.
[12] X. U. Ming and L. U. Jia-Hui, ‘‘Discussion of TCM clinical data mining
based on the real world study,’’ China J. Traditional Chin. Med. Pharmacy,
vol. 32, no. 4, pp. 1640–1643, 2017.
[13] J. Y. Ren, X. U. Ming, and L. U. Jia-Hui, ‘‘Research progress on clinical
medication regularity and syndrome type based on data mining,’’ China J.
Traditional Chin. Med. Pharmacy, vol. 32, no. 10, pp. 4579–4582, 2017.
[14] X.-Y. Xu, G.-Q. Han, and H.-Q. Min, ‘‘Construct concise and accurate
classifier by atomic association rules,’’ in Proc. IEEE Int. Conf. Mach.
Learn., vol. 3, Aug. 2004, pp. 1604–1609.
[15] L. Y. Zhao et al., ‘‘Establishment of the associated model between turbid
phlegm syndrome and clinical indicators in the patients of diabetes type 2
based on decision tree method,’’ World J. Integr. Traditional Western Med.,
vol. 9, no. 3, pp. 297–299, 2014.
[16] S. Yu et al., ‘‘Research on dietetic therapy of TCM by computer-
aided design,’’ in Proc. IEEE Int. Symp. IT Med. Educ., Aug. 2009,
pp. 1085–1090.
71812
J. Chen et al.: SDAT Algorithm Model in TCM Based on Disease CLCC
[17] Q.-Y. Jiang, X.-J. Yang, and X.-S. Sun, ‘‘An aided diagnosis model of
sub-health based on rough set and fuzzy mathematics: A case of TCM,’’
J. Intell. Fuzzy Syst., vol. 32, no. 6, pp. 4135–4143, 2017.
[18] H.-Y. Wang, ‘‘A novel method for quantitative diagnosis based on decision
tree in traditional Chinese medicine,’’ in Proc. 8th Int. Conf. Mach. Learn.,
vol. 1, 2009, pp. 344–349.
[19] Z.-X. Xu et al., ‘‘Recognition of TCM syndrome types of cardiovascular
diseases based on support vector machine and artificial neural networks,’’
J. Beijing Univ. Traditional Chin. Med., vol. 34, no. 8, pp. 539–543, 2011.
[20] X. M. Yang et al., ‘‘Data mining-based detection of acupuncture treatment
on juvenile myopia,’’ J. Traditional Chin. Med., vol. 32, no. 3, pp. 372–376,
2012.
[21] C. Zou et al., ‘‘Establishment of clinical research model of traditional
Chinese medicine based on big data of the real world,’’ China J. Traditional
Chin. Med. Pharmacy, no. 10, pp. 4113–4116, 2016.
[22] L. U. Peng et al., ‘‘Development and application of traditional Chinese
medicine inheritance support system,’’ Chin. J. Experim. Traditional Med.
Formulae, vol. 18, no. 9, pp. 1–4, 2012.
[23] Z. Yan et al., ‘‘Analysis on composition principles of prescriptions for
TCM therapy of GERD by using TCM inheritance support platform sys-
tem,’’ Liaoning J. Traditional Chin. Med., vol. 44, no. 3, pp. 456–459,
2017.
[24] J. He, X. Cao, and Y. Hu, ‘‘Development of the Cardiac failure expert
system for Chinese medicine diagnosis based on database,’’ in Proc. IEEE
Int. Conf. Bioinform. Biomed., Dec. 2014, pp. 61–66.
[25] L. I. Feng-Gang, N. I. Zhi-Wei, and L. Gao, ‘‘TCM recipe automatic
composing based on CBR and multi-strategies similarity retrieval,’’ Appl.
Res. Comput., vol. 27, no. 2, pp. 544–547, 2010.
[26] J.-J. Xia et al., ‘‘The effect of TCM characteristic therapy on rehabilita-
tion in patients with chronic kidney disease based on information shar-
ing system,’’ in Proc. IEEE Int. Conf. Bioinform. Biomed., Nov. 2015,
pp. 173–178.
[27] P. Constantinou and A. P. Dawid, ‘‘Extended conditional independence
and applications in causal inference,’’ J. Artif. Intell. Res., vol. 5, no. 1,
pp. 301–328, 2015.
[28] H. Wang et al., ‘‘Development of syndrome differentiation of pathogeny in
Chinese medicine syndrome differentiation system,’’ J. Traditional Chin.
Med., vol. 58, no. 7, pp. 541–544, 2017.
[29] Y. U. Meili et al., ‘‘Historical evolution and modern development of
Chinese medicine syndrome differentiation system,’’ J. Traditional Chin.
Med., vol. 57, no. 12, pp. 991–995, 2016.
[30] X. U. Weiming et al., ‘‘Systematic retrospection and research prospects
of contemporary Chinese medicine syndrome differentiation methods,’’
J. Traditional Chin. Med., vol. 57, no. 18, pp. 1531–1539, 2016.
[31] Z. B. Zhang, Y. Y. Wang, A. P. Lv, L. Guo, and Y. Wang, ‘‘On combined
syndrome differentiation of essential elements of syndrome and syndrome
target point corresponding syndromes,’’ J. Traditional Chin. Med., vol. 47,
no. 7, pp. 483–485, 2006.
[32] X. Sun et al., ‘‘Research on basic path and inherent law in the process of
Chinese medicine treatment based on syndrome differentiation,’’ J. Tradi-
tional Chin. Med., vol. 57, no. 4, pp. 289–294, 2016.
[33] X. U. Wen-Jie and Y. Q. Wang, ‘‘Application of modern methodology in the
research of TCM syndrome differentiation based on Bayesian network,’’
China J. Traditional Chin. Med. Pharmacy, vol. 27, no. 12, pp. 3168–3171,
2012.
[34] Q. Wang, ‘‘Classification and diagnosis basis of nine basic constitutions in
Chinese medicine,’’ J. Beijing Univ. Traditional Chin. Med., vol. 28, no. 4,
pp. 1–8, 2005.
[35] J. Chen et al., ‘‘Development of clinical assistant diagnosis and treatment
system based on traditional Chinese medicine syndrome differentiation and
treatment,’’ Modernization Traditional Chin. Med. Materia Medica-World
Sci. Technol., vol. 17, no. 12, pp. 2436–2442, 2015.
[36] B. Zhang and M. Wu, Internal Medicine of Traditional Chinese Medicine.
Beijing, China: China Press of Traditional Chinese Medicine, 2016,
pp. 39–389.
[37] Y. Tan, Gynecology of Traditional Chinese Medicine. Beijing, China:
China Press of Traditional Chinese Medicine, 2016, pp. 56–282.
[38] R. Ma, Pediatrics of Traditional Chinese Medicine. Beijing, China: China
Press of Traditional Chinese Medicine, 2016, pp. 55–249.
[39] H. Chen, Surgery of Traditional Chinese Medicine. China Press of Tradi-
tional Chinese Medicine, 2016, pp. 50–354.
[40] Classification and Coding of Diseases in Traditional Chinese Medicine,
document GBT 15657-1995, 1995.
[41] Clinical Terminology of Traditional Chinese Medical Diagnosis and Treat-
ment, document GB/T 16751.1-1997, 1997.
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J. Chen et al.: SDAT Algorithm Model in TCM Based on Disease CLCC
JU CHEN received the M.E. degree from Sichuan
Normal University in 2012. She is currently the
Executive Deputy Director of the Digital Med-
ical Research Institute, Chengdu University of
Traditional Chinese Medicine (TCM), a Research
Assistant and a member of the Cloud Health
Branch, China Information Association for Tra-
ditional Chinese Medicine and Pharmacy. She is
principally engaged in the study of artificial intel-
ligence of the TCM. She received the Third Prize
in Sichuan Provincial Excellent Teaching Achievements in 2014, the First
Prize of the Chengdu City Science and Technology Progress in 2015, the First
Prize of Science and Technology Progress from the China Association for
Acupuncture and Moxibustion in 2016, and the First Prize of the Science
and Technology Progress Award from the China Association for Research
and Advancement of Chinese Traditional Medicine in 2017.
DIANXING YANG has cultivated over 20 master’s
and doctoral students. He is currently a Professor
and the Ph.D. Supervisor of the Chengdu Uni-
versity of Traditional Chinese Medicine (TCM),
China, the Vice President of the China Asso-
ciation of Chinese Medicine, and the President
of the Sichuan Association of Chinese Medicine.
He has published more than 10 monographs as
lead author, including Entering The New Era of
the TCM-Rules of Syndrome Differentiation and
Treatment in the TCM. He has been engaged in teaching, scientific research,
and the clinical practices of the TCM, oriented in clinical application, and
the rules of syndrome differentiation, treatment, and research on the TCM
digitization. He received many prizes, such as the Second Prize from the
National Excellent Teaching Achievements and the First and Second Prizes
in Sichuan Provincial Scientific and Technological Progress.
YUE CAO received the degree from the Acupunc-
ture and the Massage College, Chengdu University
of Traditional Chinese Medicine, China, in 2017,
where she is currently pursuing the master’s degree
in acupuncture and massage.
YIYI MA received the bachelor’s degree in
medicine from the Chengdu University of Tradi-
tional Chinese Medicine (TCM), Chengdu, China,
in 2016. She is currently pursuing the master’s
degree in TCM information alization with the
Chengdu University of TCM.
VOLUME 6, 2018
CHUANBIAO WEN is currently pursuing the
master’s degree in software engineering from the
University of Electronic Science and Technology
of China. He is currently the Director of the Digital
Medical Research Institute, Chengdu University of
Traditional Chinese Medicine (TCM). He is also
an Academic Leader of discipline focused on TCM
informatics in the state administration of TCM and
the President of the TCM and Pharmacy, Cloud
Health Branch, China Information Association. He
is principally engaged in the studies such as digital TCM science, big data
analytics, cloud health platform, and artificial intelligence of the TCM. He
received the First Prize of the effects of education reform regarding the
stimulation of practical training system by the thinking of the TCM in
Sichuan, in 2011, the First and the Second Prize of the Chengdu City Science
and Technology Progress Award in the platform based on the syndrome
differentiation and treatment in the TCM and the digitization system based on
the TCM from 2013 to 2015, the First Prize of the Sichuan Provincial Science
and Technology Progress Award in clinical decision supporting platform
on big data evidence-based acupuncture and moxibustion in 2016, and the
First Prize of the Science and Technology Progress Award from the China
Association for Research and Advancement of the TCM in the big data
platform of syndrome differentiation and treatment in 2017.
XIWEI HUANG (M’15) received the B.Eng.
degree in information engineering from the
Beijing Institute of Technology, China, in 2009,
and the Ph.D. degree in circuits and sys-
tems from Nanyang Technological University,
Singapore, in 2015. From 2011 to 2014, he was
a joint Ph.D. Student with the Institute of Micro-
electronics, Agency for Science, Technology and
Research, Singapore. In 2015, he joined the School
of Electronics and Information, Hangzhou Dianzi
University, China, where he has been an Associate Professor since 2016. His
research interest includes CMOS multimodal sensors and systems design for
biomedical diagnostics.
JINHONG GUO received the bachelor’s degree in
electronic engineering from the University of Elec-
tronic Science and Technology of China, Chengdu,
China, in 2010, and the Ph.D. degree in biomedical
engineering from Nanyang Technological Univer-
sity in 2014. After his doctoral studies, he was a
Post-Doctoral Fellow of the pillar of engineering
design with MIT, SUTD, Singapore, from 2014 to
2015. He then worked as a Visiting Professor with
the School of Mechanical Engineering, University
of Michigan, Ann Arbor, from 2016 to 2016. He is currently a Full Professor
with the School of Information and Communication Engineering, University
of Electronic Science and Technology of China, and the Chengdu University
of Traditional Chinese Medicine, Chengdu. He has published over 70 pub-
lication in top journal, such as the IEEE TII, TBME, TBioCAS, Analytical
Chemistry, and Biosensors and bioelectronics. His current research interests
focus on electrochemical sensors and lab-on-a-chip devices for point of care
test toward clinical use. He was a recipient of the China Sichuan Thousand
Talents Plan for Scholars Award (2015) and the Chengdu Expert in Science
and Technology Award (2015). He served as a Lead Guest Editor and a Guest
Editor for the IEEE TBioCAS, Micromachine, Electrophoresis, and Sensors.
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