Objective Evaluation of Pulse Width Using an Array Pulse Diagram.

BACKGROUND: Pulse width, which can reflect qi, blood excess, and deficiency, has been used for diagnosing diseases and determining the prognosis in traditional Chinese medicine (TCM). This study aimed to devise an objective method to measure the pulse width based on an array pulse diagram for objective diagnosis. METHODS: The channel 6, the region wherein the pulse wave signal is the strongest, is located in the middle of the pulse sensor array and at the guan position of cunkou during data collection. Therefore, the main wave (h1) time of the pulse wave was collected from the channel 6 through calculation. The left h1 time was collected from the remaining 11 channels. The amplitudes at these time points were extracted as the h1 amplitudes for each channel. However, the pulse width could not be calculated accurately at 12 points. Consequently, a bioharmonic spline interpolation algorithm was used to interpolate the h1 amplitude data obtained from the horizontal and vertical points, yielding 651 (31 × 21) h1 amplitude data. The 651 data points were converted into a heat map to intuitively calculate the pulse width. The pulse width was calculated by multiplying the number of grids on the vertical axis with the unit length of the grid. The pulse width was determined by TCM doctors to verify the pulse width measurement accuracy. Meanwhile, a color Doppler ultrasound examination of the volunteers' radial arteries was performed and the intravascular meridian widths of the radial artery compared with the calculated pulse widths to determine the reliability. RESULTS: The pulse width determined using the maximal h1 amplitude method was comparable with the radial artery intravascular meridian widths measured using color Doppler ultrasound. The h1 amplitude was higher in the high blood pressure group and the pulse width was greater. CONCLUSIONS: The pulse width determined using the maximal h1 amplitude was objective and accurate. Comparison between the pulse widths of the normal and high blood pressure groups verified the reliability of the method.

Study on the difference and regularity of tongue images in 309 patients with different pathological stages of non-small cell lung cancer.

BACKGROUND: Tongue diagnosis is a crucial traditional Chinese medicine (TCM) inspection method for TCM syndrome differentiation and treatment. OBJECTIVE: The primary research focus was on tongue image characteristic parameters of patients with non-small cell lung cancer (NSCLC). Analysis of the tongue image parameters of various pathological stages of NSCLC provides technical support for establishing an integrated Chinese and Western auxiliary diagnosis and efficacy evaluation medicine system for lung cancer that integrates tongue image features. METHODS: Tongue image characteristics of 309 patients with NSCLC and 206 controls were collected and analyzed clinically. The T-test or rank sum test and logistic regression analysis were applied to analyze the characteristics of tongue image indicators of different pathological stages of NSCLC. RESULTS: There were differences in tongue image characteristics in the NSCLC group compared to the control group. The tongue quality and brightness of the tongue coating in the NSCLC group increased, the red component was reduced, the tongue coating thickened, and the yellow component increased compared to the healthy control group. A comparison of tongue image indexes of NSCLC in different pathological stages showed that stage IV had lower TB-b and higher TB-a than stage I. In addition, stage IV had lower TB-b than stage II + III, showing an increase in the blue and red components of the tongue in stage IV and the appearance of cyanotic tongue features. CONCLUSION: The tongue image characteristics of NSCLC patients differed from those of the control group. Tongue imaging indicators can reflect the characteristics of tongue images of patients with NSCLC. The tongue image characteristics of patients with stage IV lung cancer are bluish and purple compared with those with stage I, II, and III. It is suggested that the tongue's image characteristics can be used as a reference for the pathological classification of NSCLC and judgment of the disease process.

A Study of Logistic Regression for Fatigue Classification Based on Data of Tongue and Pulse.

Methods: The Tongue and Face Diagnosis Analysis-1 instrument and Pulse Diagnosis Analysis-1 instrument were used to collect the tongue image and sphygmogram of the subhealth fatigue population (n = 252) and disease fatigue population (n = 1160), and we mainly analyzed the tongue and pulse characteristics and constructed the classification model by using the logistic regression method. Results: The results showed that subhealth fatigue people and disease fatigue people had different characteristics of tongue and pulse, and the logistic regression model based on tongue and pulse data had a good classification effect. The accuracies of models of healthy controls and subhealth fatigue, subhealth fatigue and disease fatigue, and healthy controls and disease fatigue were 68.29%, 81.18%, and 84.73%, and the AUC was 0.698, 0.882, and 0.924, respectively. Conclusion: This study provided a new noninvasive method for the fatigue diagnosis from the perspective of objective tongue and pulse data, and the modern tongue diagnosis and pulse diagnosis have good application prospects.

Assessment Parameters for Arrayed Pulse Wave Analysis and Application in Hypertensive Disorders.

Study on the objectivity of pulse diagnosis is inseparable from the instruments to obtain the pulse waves. The single-pulse diagnostic instrument is relatively mature in acquiring and analysing pulse waves, but the pulse information captured by single-pulse diagnostic instrument is limited. The sensor arrays can simulate rich sense of the doctor's fingers and catch multipoint and multiparameter array signals. How to analyse the acquired array signals is still a major problem in the objective research of pulse diagnosis. The goal of this study was to establish methods for analysing arrayed pulse waves and preliminarily apply them in hypertensive disorders. While a sensor array can be used for the real-time monitoring of twelve pulse wave channels, for each subject in this study, only the pulse wave signals of the left hand at the "guan" location were obtained. We calculated the average pulse wave (APW) per channel over a thirty-second interval. The most representative pulse wave (MRPW) and the APW were matched by their correlation coefficient (CC). The features of the MRPW and the features that corresponded to the array pulse volume (APV) parameters were identified manually. Finally, a clinical trial was conducted to detect these feature performance indicators in patients with hypertensive disorders. The independent-samples t-tests and the Mann-Whitney U-tests were performed to assess the differences in these pulse parameters between the healthy and hypertensive groups. We found that the radial passage (RP) APV h1, APV h3, APV h4, APV h3/h1 (P < 0.01), and APV h4/h1 (P < 0.05) were significantly higher in the hypertensive group than in the healthy group; the intermediate passage (IP) APV h4, APV h3/h1 (P < 0.05), and APV h4/h1 (P < 0.01) and the mean APV h3, APV h3/h1 (P < 0.05), and APV h4/h1 (P < 0.01) were significantly higher in the hypertensive group than in the healthy group, and the ulnar passage (UP) APV h4/h1 (P < 0.05) was clearly elevated in the hypertensive group. These results provide a preliminary validation of this novel approach for determining the APV by arrayed pulse wave analysis. In conclusion, we identified effective indicators of hypertensive vascular function. Traditional Chinese medicine (TCM) pulses comprise multidimensional information, and a sensor array could provide a better indication of TCM pulse characteristics. In this study, the validation of the arrayed pulse wave analysis demonstrates that the APV can reliably mirror TCM pulse characteristics.

A New Method for Syndrome Classification of Non-Small-Cell Lung Cancer Based on Data of Tongue and Pulse with Machine Learning.

OBJECTIVE: To explore the data characteristics of tongue and pulse of non-small-cell lung cancer with Qi deficiency syndrome and Yin deficiency syndrome, establish syndrome classification model based on data of tongue and pulse by using machine learning methods, and evaluate the feasibility of syndrome classification based on data of tongue and pulse. METHODS: We collected tongue and pulse of non-small-cell lung cancer patients with Qi deficiency syndrome (n = 163), patients with Yin deficiency syndrome (n = 174), and healthy controls (n = 185) using intelligent tongue diagnosis analysis instrument and pulse diagnosis analysis instrument, respectively. We described the characteristics and examined the correlation of data of tongue and pulse. Four machine learning methods, namely, random forest, logistic regression, support vector machine, and neural network, were used to establish the classification models based on symptom, tongue and pulse, and symptom and tongue and pulse, respectively. RESULTS: Significant difference indices of tongue diagnosis between Qi deficiency syndrome and Yin deficiency syndrome were TB-a, TB-S, TB-Cr, TC-a, TC-S, TC-Cr, perAll, and the tongue coating texture indices including TC-CON, TC-ASM, TC-MEAN, and TC-ENT. Significant difference indices of pulse diagnosis were t4 and t5. The classification performance of each model based on different datasets was as follows: tongue and pulse < symptom < symptom and tongue and pulse. The neural network model had a better classification performance for symptom and tongue and pulse datasets, with an area under the ROC curves and accuracy rate which were 0.9401 and 0.8806. CONCLUSIONS: It was feasible to use tongue data and pulse data as one of the objective diagnostic basis in Qi deficiency syndrome and Yin deficiency syndrome of non-small-cell lung cancer.

Acupuncture combined with western medicine for the treatment of hypertension: A protocol for an updated systematic review and meta-analysis.

BACKGROUND: Hypertension is a kind of cardiovascular syndrome with the main clinical manifestation of continuous increase of systemic arterial blood pressure. Hypertension coexists with other cardiovascular risk factors and is an important risk factor for cardiovascular and cerebrovascular diseases. Acupuncture is an important part of Traditional Chinese Medicine intervention. The antihypertensive effect of acupuncture on hypertension is based on the neuroendocrine system, characterized by multichannel and multitarget. This study aims to provide latest and updated proof of systematic review to assess the effectiveness and safety of acupuncture for hypertension. METHODS: We will systematically search 9 databases from their inceptions to February 2021. Only randomized controlled trials of acupuncture combined with western medicine in the treatment of hypertension will meet the inclusion criteria. The main outcome measures we focus on include clinical efficacy, syndrome efficacy, Traditional Chinese Medicine syndrome score, diastolic and systolic blood pressure changes, blood pressure variability, heart rate variability, pulse rate variability, and adverse reactions. The research screening, data extraction, and risk of bias assessment will be employed by 2 reviewers independently, and disagreement will be decided by a third senior reviewer. The Revman 5.3 software will be used for meta-analysis. The confidence of proof will be rated adopting grading of recommendations assessment, development and evaluation tool and methodological quality of this research will be assessed using assessment of multiple systematic reviews-2 and risk of bias in systematic reviews. The publication quality will be evaluated by preferred reporting items for systematic reviews and meta-analyses (PRISMA). RESULTS: This systematic review (SR) will provide evidence-based medical evidence for hypertension therapy by acupuncture combined with western medicine and we will submit the findings of this SR for peer-review publication. CONCLUSIONS: This SR will provide latest and updated summary proof for assessing the effectiveness and safety of acupuncture for hypertension. REGISTRATION NUMBER: INPLASY 202150047.

Radial Pulse Wave Signals Combined with Ba-PWV for the Risk Prediction of Hypertension and the Monitoring of Its Accompanying Metabolic Risk Factors.

Our aim was to study whether radial pulse wave signals can improve the risk prediction of incident hypertension and are associated with its concomitant metabolic risk factors beyond the traditional cardiovascular risk factor Ba-PWV. By enrolling 523 Chinese subjects in this study, linear and stepwise regression analysis was performed to assess the association of radial artery pulse wave signals and Ba-PWV with blood pressure and its related metabolic risk factors such as fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and uric acid (UA). The area under the receiver-operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated by risk assessment plot to compare the discriminative ability among models with and without radial artery pulse wave signals. After adjusting related confounding factors, radial artery pulse wave variable h 3/h 1 was selected as the sensitive influential factor for blood pressure. Moreover, a new model with h 3/h 1 had a higher AUC than the reference model without it (0.86 vs 0.84; P=0.030). And the NRI and IDI for the new model was 50.0% (P=0.017) and 3.16% (P=0.044), respectively. In addition to Ba-PWV, we found that the decrease of t 4, t 5, and h 5 might be associated with higher FPG, TC, LDL-C, and UA and lower HDL-C. This research might provide a valuable additional tool for remote wearable monitoring of radial artery pulse wave signals in hypertension risk evaluation and management.

Analysis of Pulse Signals Based on Array Pulse Volume.

OBJECTIVE: To collect and analyze multi-dimensional pulse diagram features with the array sensor of a pressure profile system (PPS) and study the characteristic parameters of the new multi-dimensional pulse diagram by pulse diagram analysis technology. METHODS: The pulse signals at the Guan position of left wrist were acquired from 105 volunteers at the Shanghai University of Traditional Chinese Medicine. We obtained the pulse data using an array sensor with 3×4 channels. Three dimensional pulse diagrams were constructed for the validated pulse data, and the array pulse volume (APV) parameter was computed by a linear interpolation algorithm. The APV differences among normal pulse (NP), wiry pulse (WP) and slippery pulse (SP) were analyzed using one-way analysis of variance. The coefficients of variation (CV) were calculated for WP, SP and NP. RESULTS: The APV difference between WP and NP in the 105 volunteers was statistically significant (6.26±0.28 vs. 6.04±0.36, P=0.048), as well as the difference between WP and SP (6.26±0.28 vs. 6.07±0.46, P=0.049). However, no statistically significant difference was found between NP and SP (P=0.75). WP showed a similar CV (4.47%) to those of NP (5.96%) and SP (7.58%). CONCLUSION: The new parameter APV could differentiate between NP or SP and WP. Accordingly, APV could be considered an useful parameter for the analysis of array pulse diagrams in Chinese medicine.

A Study of Machine-Learning Classifiers for Hypertension Based on Radial Pulse Wave.

OBJECTIVE: In this study, machine learning was utilized to classify and predict pulse wave of hypertensive group and healthy group and assess the risk of hypertension by observing the dynamic change of the pulse wave and provide an objective reference for clinical application of pulse diagnosis in traditional Chinese medicine (TCM). METHOD: The basic information from 450 hypertensive cases and 479 healthy cases was collected by self-developed H20 questionnaires and pulse wave information was acquired by self-developed pulse diagnostic instrument (PDA-1). H20 questionnaires and pulse wave information were used as input variables to obtain different machine learning classification models of hypertension. This method was aimed at analyzing the influence of pulse wave on the accuracy and stability of machine learning model, as well as the feature contribution of hypertension model after removing noise by K-means. RESULT: Compared with the classification results before removing noise, the accuracy and the area under the curve (AUC) had been improved. The accuracy rates of AdaBoost, Gradient Boosting, and Random Forest (RF) were 86.41%, 86.41%, and 85.33%, respectively. AUC were 0.86, 0.86, and 0.85, respectively. The maximum accuracy of SVM increased from 79.57% to 83.15%, and the AUC stability increased from 0.79 to 0.83. In addition, the features of importance on traditional statistics and machine learning were consistent. After removing noise, the features with large changes were h1/t1, w1/t, t, w2, h2, t1, and t5 in AdaBoost and Gradient Boosting (top10). The common variables for machine learning and traditional statistics were h1/t1, h5, t, Ad, BMI, and t2. CONCLUSION: Pulse wave-based diagnostic method of hypertension has significant value in reference. In view of the feasibility of digital-pulse-wave diagnosis and dynamically evaluating hypertension, it provides the research direction and foundation for Chinese medicine in the dynamic evaluation of modern disease diagnosis and curative effect.

Tongue Image Database Construction Based on the Expert Opinions: Assessment for Individual Agreement and Methods for Expert Selection.

This study aims at introducing a method for individual agreement evaluation to identify the discordant raters from the experts' group. We exclude those experts and decide the best experts selection method, so as to improve the reliability of the constructed tongue image database based on experts' opinions. Fifty experienced experts from the TCM diagnostic field all over China were invited to give ratings for 300 randomly selected tongue images. Gwet's AC1 (first-order agreement coefficient) was used to calculate the interrater and intrarater agreement. The optimization of the interrater agreement and the disagreement score were put forward to evaluate the external consistency for individual expert. The proposed method could successfully optimize the interrater agreement. By comparing three experts' selection methods, the interrater agreement was, respectively, increased from 0.53 [0.32-0.75] for original one to 0.64 [0.39-0.80] using method A (inclusion of experts whose intrarater agreement>0.6), 0.69 [0.63-0.81] using method B (inclusion of experts whose disagreement score="0"), and 0.76 [0.67-0.83] using method C (inclusion of experts whose intrarater agreement>0.6& disagreement score="0"). In this study, we provide an estimate of external consistency for individual expert, and the comprehensive consideration of both the internal consistency and the external consistency for each expert would be superior to either one in the tongue image construction based on expert opinions.

Pulse Wave Cycle Features Analysis of Different Blood Pressure Grades in the Elderly.

BACKGROUND AND OBJECTIVE: The same range of blood pressure values may reflect different vascular functions, especially in the elderly. Therefore, a single blood pressure value may not comprehensively reveal cardiovascular function. This study focused on identifying pulse wave features in the elderly that can be used to show functional differences when blood pressure values are in the same range. METHODS: First, pulse data were preprocessed and pulse cycles were segmented. Second, time domain, higher-order statistics, and energy features of wavelet packet decomposition coefficients were extracted. Finally, useful pulse wave features were evaluated using a feature selection and classifier design. RESULTS: A total of 6,075 pulse wave cycles were grouped into 3 types according to different blood pressure levels and each group was divided into 2 categories according to a history of hypertension. The classification accuracy of feature selection in the 3 groups was 97.91%, 95.24%, and 92.28%, respectively. CONCLUSION: Selected features could be appropriately used to analyze cardiovascular function in the elderly and can serve as the basis for research on a cardiovascular risk assessment model based on Traditional Chinese Medicine pulse diagnosis.

The Association of Radial Artery Pulse Wave Variables with the Pulse Wave Velocity and Echocardiographic Parameters in Hypertension.

This study aims at exploring the cardiovascular pathophysiological mechanism of TCM (traditional Chinese medicine) pulse by detecting the correlation between radial artery pulse wave variables and pulse wave velocity/echocardiographic parameters. Two hundred Chinese subjects were enrolled in this study, which were grouped into health control group, hypertension group, and hypertensive heart disease group. Physical data obtained in this study contained TCM pulse images at "Guan" position of the left hand, pulse wave velocity, and echocardiographic parameters. Linear and stepwise regression analysis was performed to assess the association of radial artery pulse wave variables with pulse wave velocity and echocardiographic parameters in the total population and in each different group. After adjusting for related confounding factors, decrease of t1, t5 and increase of h1, h3/h1 were statistically associated with arterial stiffness in the total population (P<0.05). Moreover, the correlation study in each group showed that the decrease of both t3 and h5 was also related to arterial stiffness (P<0.05). In terms of echocardiographic parameters, the height of dicrotic wave indicated by h5 was the most relevant pulse wave variable. For the health control, h5 was negatively associated with interventricular septal thickness (VST) and left ventricular posterior wall thickness (PWT) (P<0.05), while for the hypertension population and those with target-organ damage to heart, increase of h5 might be associated with decrease of ejection fraction (EF) and increase of all the remaining echocardiographic parameters especially for left ventricular end-systolic diameter (LVDs) and Left ventricular end-diastolic diameter (LVDd) (P<0.05). In conclusion, we found radial artery pulse wave variables were in association with the arterial stiffness and echocardiographic changes in hypertension, which would provide an experimental basis for cardiovascular pathophysiological mechanism of radial artery pulse wave variables.

The Classification of Tongue Colors with Standardized Acquisition and ICC Profile Correction in Traditional Chinese Medicine.

Background and Goal. The application of digital image processing techniques and machine learning methods in tongue image classification in Traditional Chinese Medicine (TCM) has been widely studied nowadays. However, it is difficult for the outcomes to generalize because of lack of color reproducibility and image standardization. Our study aims at the exploration of tongue colors classification with a standardized tongue image acquisition process and color correction. Methods. Three traditional Chinese medical experts are chosen to identify the selected tongue pictures taken by the TDA-1 tongue imaging device in TIFF format through ICC profile correction. Then we compare the mean value of L*a*b* of different tongue colors and evaluate the effect of the tongue color classification by machine learning methods. Results. The L*a*b* values of the five tongue colors are statistically different. Random forest method has a better performance than SVM in classification. SMOTE algorithm can increase classification accuracy by solving the imbalance of the varied color samples. Conclusions. At the premise of standardized tongue acquisition and color reproduction, preliminary objectification of tongue color classification in Traditional Chinese Medicine (TCM) is feasible.

Syndrome Differentiation Analysis on Mars500 Data of Traditional Chinese Medicine.

Mars500 study was a psychological and physiological isolation experiment conducted by Russia, the European Space Agency, and China, in preparation for an unspecified future manned spaceflight to the planet Mars. Its intention was to yield valuable psychological and medical data on the effects of the planned long-term deep space mission. In this paper, we present data mining methods to mine medical data collected from the crew consisting of six spaceman volunteers. The synthesis of the four diagnostic methods of TCM, inspection, listening, inquiry, and palpation, is used in our syndrome differentiation. We adopt statistics method to describe the syndrome factor regular pattern of spaceman volunteers. Hybrid optimization based multilabel (HOML) is used as feature selection method and multilabel k-nearest neighbors (ML-KNN) is applied. According to the syndrome factor statistical result, we find that qi deficiency is a base syndrome pattern throughout the entire experiment process and, at the same time, there are different associated syndromes such as liver depression, spleen deficiency, dampness stagnancy, and yin deficiency, due to differences of individual situation. With feature selection, we screen out ten key factors which are essential to syndrome differentiation in TCM. The average precision of multilabel classification model reaches 80%.

[Analysis on pulse diagram characteristics of subjects with subhealth state].

OBJECTIVE: To study the pulse diagram parameters of subjects with subhealth state and to find the pulse parameters for subhealth state evaluation. METHODS: A total of 1 275 subjects without diagnosed diseases were recruited and their health conditions were assessed with Health Evaluating Questionnaire H20 V2009. The subjects were assigned to health group or subhealth group according to the scale score. Subjects' syndrome in the subhealth group was differentiated using score of "subhealth state of syndrome differentiation V2010". Another 121 patients with cardiovascular diseases were enrolled as a control. The pulse information was collected with YJJ-101 subhealth pulse monitoring system and the parameters include amplitude of main wave (h1), amplitude of repeat wave (h5) and its front wave (h3), 1/3 or 1/5 width of main wave (w1) or (w2), time of rapid ejection phase (t2), period of pulse (t), pulse pressure (Pp), square (S), area in systole (As) and area in diastole (Ad) of pulse diagram and ratios of h3/h1, h5/h1, w1/t, w2/t and h1/t1. RESULTS: Pulse diagram analysis showed significant differences among health, subhealth and disease group in Pp, h1, S and As and ratios of h5/h1 and w2/t. Compared with the health group, the values of w1/t and w2/t of the subhealth group increased (P<0.05), and Pp, h1, h5, h5/h1, S, As and Ad decreased (P<0.05). Compared with health group, the parameters of pulse of the subhealth group were increased in Pp and h5/h1 (P<0.05) and decreased in h1, w2/t, S and As (P<0.05). Compared with health group, pulse parameters h3/h1, w1, w1/t, w2/t of excess and deficiency syndrome group increased, and h1, h5, h1/t 1and h5/h1 decreased. Among different syndromes of subhealth state, pulse diagram parameters h1, h5, h3/h1, h5/h1 and w1/t of yin deficiency, qi deficiency, liver stagnation and excess heat group were significantly different (P<0.05) from the health group, for example, pulse parameters h1 and h5 of stagnation, yin deficiency, qi deficiency and excess heat group declined in order, and pulse parameters h3/h1 and w1/t of liver stagnation, excess heat, yin deficiency and qi deficiency group increased in order. Pulse index h1 in the kidney deficiency group was higher than that in the health group and the other syndrome groups. CONCLUSION: Results of analyzing sphygmogram parameters showed different characteristics among different health status and the subhealth state due to different syndromes. Sphygmogram parameters may be used for objective evaluation of health status or subhealth syndrome differentiation.

[Facial spectrum and color characteristics of five viscera reflecting on the face in sub-health status].

OBJECTIVE: To observe the facial spectrum and color of different points, the positions of heart, liver, spleen, lung and kidney of traditional Chinese medicine reflecting on the face, in healthy participants and those with a sub-health status, so as to provide an objective basis for health evaluation. METHODS: The health condition of 470 subjects without acute and chronic conditions was assessed using the Health Evaluating Questionnaire H20 V2009. The subjects were diagnosed with health (more than 80 score) or sub-health (score between 60 and 80) status according to the questionnaire score. The subjects with a subhealth status were also analyzed using the five-viscera syndrome differentiation of traditional Chinese medicine using the form for collecting information according to the four examinations. Then for gathering the facial color information, CIE L*a*b and C values and reflections of wavelengths ranged from 400 to 700 nm were measured using a CM-2600D spectrophotometer on 8 points of the face, including the frontal part, glabella, nose, mandible, two cheeks and eyelids. RESULTS: L value of the sub-health group was higher than that of the health group (P<0.05), and a, b and C values were lower than those of the health group (P<0.05), suggesting that the facial complexion of the sub-health group was pale/whiter than the health group. The reflectance rates of wavelengths (from 400 to 550 nm) of the sub-health group were higher than those of the health group (P<0.05), which suggested that the facial complexion of the sub-health group was partially green. The a, b and C values of the forehead, glabella and nose of subjects in the sub-health group were apparently different from the health subjects. L values of five-viscera types were significantly different from people of a health status (P<0.05). There were some differences in color values among the five-viscera groups: lung group's color values were significantly different from the others in terms of a, b and C values. The spectral reflectance of different viscera groups of the sub-health group also showed certain differences: reflectance of wavelengths at 400 to 490 nm in the lung group and at 520 to 580 nm in the spleen group showed significant difference from the other groups, and the lung group was lower and the spleen group was higher than the others. CONCLUSION: There are some differences in facial spectrum and color in different sites of the face in sub-health status of different viscera syndrome types, which can provide an objective basis for health evaluation.

Objectified study on tongue images of patients with lung cancer of different syndromes.

OBJECTIVE: To describe the characteristic of tongue images of patients with lung cancer of different Chinese medicine (CM) syndromes and to reveal the elemental rule on the changes of the tongue images. METHODS: A total of 207 patients with lung cancer were divided into four syndrome groups according to the theory of CM: Fei and Shen deficiency syndrome (Group A, 72 cases), Pi deficiency and phlegm deficiency and phlegm) and Shen (deficiency and phlegm) deficiency syndrome (Group A, 72 cases), Pi (deficiency and phlegm) deficiency and phlegm dampness syndrome (Group B, 57 cases), phlegm-heat retention in Fei (Group C, 36 cases) and yin asthenia generating intrinsic heat syndrome (Group D, 42 cases). The tongue parameters were detected by tongue image digital analysis instrument, and the tongue images were described with qualitative, tongue color and quantitative analysis, respectively. The International Commission on Illumination (CIE) L·a·b (CIELAB) color model was used for the quantitative classification. RESULTS: There was a significant statistical difference between different syndrome groups of lung cancer on tongue color, coating color, and thickness of tongue coating (P<0.01), and there was significant statistical difference between the four syndrome groups on Lab values of the tongue and coating (P<0.05). The correct identification rate of discriminant function on the raw data was 65.7%, including 72.2% for Group C, 69.4% for Group A, 69.0% for Group D and 54.4% for Group B. CONCLUSIONS: A tongue image digital analysis instrument can objectively describe the tongue features of patients with different syndromes of lung cancer. The tongue diagnosis is very important to syndrome differentiation in CM. Tongue diagnosis should be combined with some important characteristics of syndromes in the future to establish a "combination of four examination methods, including inspection, auscultation, interrogation, and pulse-feeling and palpation" in the tongue diagnostic system.

[Determination methods for inspection of the complexion in traditional Chinese medicine: a review].

Inspection of the complexion is one of the characteristics of traditional Chinese medical diagnosis. Traditional Chinese medicine puts high emphasis on inspection of the complexion and there exists detailed discussion on inspection of facial expression in Neijing. The so-called inspection of facial expression is a method to diagnose diseases according to the theory of five Zang-organs matching five elements and five colors by distinguishing various changes of facial color, such as green, red, yellow, white and black based on yin and yang doctrine and five elements theory. Nowadays, more and more experts have introduced color optical theory and modern devices into the modern research field of traditional Chinese medical diagnosis with the development of color optical theory and the renewal of determining devices, such as digital camera, color differentiation meter and spectrophotometer, to make the research more scientific and objective and avoid the deviations caused by human factors. The modern study of traditional Chinese medicine diagnosis has made fare progress, consequently enriching the contents of its facial color observation and giving a more scientific explanation of it. However, the devices being used now are still disunited; the data may be unilateral and cannot contain the whole information. So the most important task is to invent and use scientific devices conforming better with the theory of five colors observation in traditional Chinese medicine.

[Analysis of tongue color under natural daylight based on chromatic aberration correction].

OBJECTIVE: To establish an analytical method for tongue image acquisition under natural daylight based on L*a*b* error correction, and to observe the classification rules of tongue color using color error correction. METHODS: The tongue images in 413 cases were collected under natural indoor daylight by using Nikon D70 digital SLR camera, and then the color error was adjusted by using Nikon Capture NX software correction according to Kodak Q-13 grey card. The classification and quantitative analysis of the tongue color after software correction was carried out depending on L*a*b* color space. RESULTS: The software correction method had good effects in adjusting the tongue color image error. The L* values of light red, deep red and cyanosis tongues decreased as compared with that of light white tongue (P<0.01), while the a* values of light red, deep red and cyanosis tongues increased as compared with light white tongue (P<0.01). There was no significant difference in L* value between deep red tongue and cyanosis tongue, and there was also no significant difference in a* value between light red tongue and cyanosis tongue. The b* values of light red and deep red tongues increased as compared with that of light white tongue (P<0.01), while the b* value of cyanosis tongue decreased as compared with light red and deep red tongues (P<0.01). There was no significant difference in b* value between light white tongue and cyanosis tongue, and there was also no significant difference in b* value between light red tongue and deep red tongue. The a* value of white fur was higher than that of yellow fur (P<0.01), while the b* value of white fur was lower than that of yellow fur (P<0.01). There was no significant difference in L* value between white fur and yellow fur. CONCLUSION: The analytical method for tongue image acquisition under natural daylight based on L*a*b* error correction is accurate in color restoration and feasible to operate.