Jirui Dai

Ziwen Chen, Zhendong Wang, Chongjing Wang et al.

Dermatologic diseases impose a large and growing global burden, affecting billions and substantially reducing quality of life. While modern therapies can rapidly control acute symptoms, long-term outcomes are often limited by single-target paradigms, recurrent courses, and insufficient attention to systemic comorbidities. Traditional Chinese medicine (TCM) provides a complementary holistic approach via syndrome differentiation and individualized treatment, but practice is hindered by non-standardized knowledge, incomplete multimodal records, and poor scalability of expert reasoning. We propose DERM-3R, a resource-efficient multimodal agent framework to model TCM dermatologic diagnosis and treatment under limited data and compute. Based on real-world workflows, we reformulate decision-making into three core issues: fine-grained lesion recognition, multi-view lesion representation with specialist-level pathogenesis modeling, and holistic reasoning for syndrome differentiation and treatment planning. DERM-3R comprises three collaborative agents: DERM-Rec, DERM-Rep, and DERM-Reason, each targeting one component of this pipeline. Built on a lightweight multimodal LLM and partially fine-tuned on 103 real-world TCM psoriasis cases, DERM-3R performs strongly across dermatologic reasoning tasks. Evaluations using automatic metrics, LLM-as-a-judge, and physician assessment show that despite minimal data and parameter updates, DERM-3R matches or surpasses large general-purpose multimodal models. These results suggest structured, domain-aware multi-agent modeling can be a practical alternative to brute-force scaling for complex clinical tasks in dermatology and integrative medicine.

Chanyong Luo, Jirui Dai, Zhendong Wang et al.

Medicine is an empirical discipline refined through long-term observation and the messy, high-variance reality of clinical practice. Physicians build diagnostic and therapeutic competence through repeated cycles of application, reflection, and improvement, forming individualized methodologies. Yet outcomes vary widely, and master physicians' knowledge systems are slow to develop and hard to transmit at scale, contributing to the scarcity of high-quality clinical expertise. To address this, we propose Med-Shicheng, a general framework that enables large language models to systematically learn and transfer distinguished physicians' diagnostic-and-therapeutic philosophy and case-dependent adaptation rules in a standardized way. Built on Tianyi, Med-Shicheng consists of five stages. We target five National Masters of Chinese Medicine or distinguished TCM physicians, curate multi-source materials, and train a single model to internalize all five knowledge systems across seven tasks, including etiology-pathogenesis analysis, syndrome diagnosis, treatment principle selection, prescription generation, prescription explanation, symptom evolution with regimen adjustment, and clinical advice. Implemented on Qwen2.5-1.5B-Base, Med-Shicheng runs on resource-constrained GPUs while achieving performance comparable to DeepSeek-R1 and GPT-5. We also examine the reliability of LLM-as-a-judge versus physician evaluation: automated judging tracks overall trends but shows bias on fine-grained individualized distinctions, highlighting the need for physician involvement when ground truth is unavailable and for domain-adapted judge models.