Changyong Luo

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.

Zhi Liu, Tao Yang, Jing Wang et al.

Natural medicines, particularly Traditional Chinese Medicine (TCM), are gaining global recognition for their therapeutic potential in addressing human symptoms and diseases. TCM, with its systematic theories and extensive practical experience, provides abundant resources for healthcare. However, the effective application of TCM requires precise syndrome diagnosis, determination of treatment principles, and prescription formulation, which demand decades of clinical expertise. Despite advancements in TCM-based decision systems, machine learning, and deep learning research, limitations in data and single-objective constraints hinder their practical application. In recent years, large language models (LLMs) have demonstrated potential in complex tasks, but lack specialization in TCM and face significant challenges, such as too big model scale to deploy and issues with hallucination. To address these challenges, we introduce Tianyi with 7.6-billion-parameter LLM, a model scale proper and specifically designed for TCM, pre-trained and fine-tuned on diverse TCM corpora, including classical texts, expert treatises, clinical records, and knowledge graphs. Tianyi is designed to assimilate interconnected and systematic TCM knowledge through a progressive learning manner. Additionally, we establish TCMEval, a comprehensive evaluation benchmark, to assess LLMs in TCM examinations, clinical tasks, domain-specific question-answering, and real-world trials. The extensive evaluations demonstrate the significant potential of Tianyi as an AI assistant in TCM clinical practice and research, bridging the gap between TCM knowledge and practical application.