The use of time-domain analysis on the choice of measurement location for pulse diagnosis research: A pilot study.

BACKGROUND: Pulse diagnosis researches acquiring pulse waves from the wrist radial artery has not yet addressed the issue of whether this information is affected by differences in the hemodynamic characteristics of pressure waves derived from different locations. This study aimed to clarify whether the blood dynamic states are identical with regard to the "three positions and nine indicators" ((Equation is included in full-text article.)) listed in traditional Chinese medicine (TCM). METHODS: A total of 37 participants of CAD group and 20 participants of healthy group were recruited, and pressure pulse waves were measured at 18 locations on both hands. A multivariate analysis (MANOVA) was performed with a "randomized block design" using SPSS 22.0 and R 3.4.1 to examine the time-domain parameters that represented certain hemodynamic characteristics. RESULTS: In CAD group, the results showed significant differences (p < 0.05) among the h1, h2, h3, h1/t, and h3/h1 measurements of the pulse waves using different indicators at the same position; the h1, h2, h3, and h1/t measurements of the pulse waves at different positions using the indicator "Superficial"; and the h1, h2, h3, h1/t, and h3/h1 measurements of the pulse waves at different positions using the indicator "Medium". In healthy group, the results showed significant differences (p < 0.05) among the h1, h2, h3, and h1/t measurements of the pulse waves using different indicators at the same position; the h1, h2, and h1/t measurements of the pulse waves at different positions using the same indicator. CONCLUSION: Because of the differences in the hemodynamic characteristics among the different positions and indicators, the article might provide a new opinion for future pulse diagnosis investigations to carefully consider the measurement location to ensure the completeness of the information.

Different Harmonic Characteristics Were Found at Each Location on TCM Radial Pulse Diagnosis by Spectrum Analysis.

PURPOSE: This study aimed to clarify whether it is appropriate to choose any measurement location for pulse diagnosis research. METHODS: A total of 37 subjects were recruited and measured for pulse pressure waves at 18 locations (9 per hand of "three positions and nine indicators"). These data were Fourier-transformed to the frequency spectrum, and the harmonics of C0-C10 of each location were obtained. Box plots of the harmonics were generated using SPSS v.22.0 and R v.3.4.1. Data were compared with multivariate analysis of variance (MANOVA) with a randomized block design. RESULTS: The results showed that certain harmonics were different at different positions and different indicators; the harmonics of the same indicator at different positions (except for C8 and C10) and those of different indicators for the same position (except for C4 and C5) were significantly different (p<0.05). CONCLUSIONS: In future researches of pulse diagnosis, due to the significant differences between positions and indicators, it is recommended that the measurement position should be carefully chosen instead of choosing any measurement location to ensure the integrity of the acquired information for further analyzing physiological or pathological status.

Cool extremities, a diagnostic sign recorded in Shang Han Lun, still good prognosis index for septic patients in today's medical intensive care unit.

OBJECTIVE: To evaluate and compare the predictive value of the physical signs mentioned by ZHANG Zhong-jing in Treatise on Cold Damaged Diseases (Shang Han Lun), together with other clinically determined diagnostic scores and laboratory values in modern medicine on 28-day mortality in septic patients. METHODS: Three-year prospective observation was conducted in medical intensive care unit in two local community hospitals. In all, 126 patients with severe sepsis and/or septic shock were consecutively enrolled. Ten diagnostic signs (lack of fever, lethargy, delirium, clammy skin, mottled skin, edematous limbs, cool extremities, threadlike pulse, tachycardia, and abdominal distension), acute physiology and chronic health evaluation (APACHE) II, cardiovascular component (CV score) in multiple organ dysfunction syndrome (MODS) score and blood sampled for cytokine measurement, including tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-8, IL-10 and IL-18, were collected within 24 h after admission. Main outcome was 28-day mortality; independent predictors were determined by multivariate logistic regression analysis. RESULTS: Significant correlation between lack of fever, cool extremities, abdominal distension, plasma IL-10 level and mortality emerged. Areas under the receiver operating characteristic curves for cool extremities (0.73, 95% confidence interval: 0.64-0.82, P<0.01) and IL-10 (0.74, 95% confidence interval: 0.66-0.83, P<0.01) indicated comparable discrimination between survivors and non-survivors. CONCLUSIONS: Assessment of cool extremities in septic patients, which showed comparable discriminant ability as IL-10, proves prognostic value of diagnostic signs recorded in Treatise on Cold Damaged Diseases, and may provide a quicker, easily-observed, and non-invasive predictor of sepsis mortality.

Traditional chinese medicine diagnosis "yang-xu zheng": significant prognostic predictor for patients with severe sepsis and septic shock.

Pathogenesis of sepsis includes complex interaction between pathogen activities and host response, manifesting highly variable signs and symptoms, possibly delaying diagnosis and timely life-saving interventions. This study applies traditional Chinese medicine (TCM) Zheng diagnosis in patients with severe sepsis and septic shock to evaluate its adaptability and use as an early predictor of sepsis mortality. Three-year prospective observational study enrolled 126 septic patients. TCM Zheng diagnosis, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and blood samples for host response cytokines measurement (tumor necrosis factor- α , Interleukin-6, Interleukin-8, Interleukin-10, Interleukin-18) were collected within 24 hours after admission to Intensive Care Unit. Main outcome was 28-day mortality; multivariate logistic regression analysis served to determine predictive variables of the sepsis mortality. APACHE II score, frequency of Nutrient-phase heat, and Qi-Xu and Yang-Xu Zhengs were significantly higher in nonsurvivors. The multivariate logistic regression analysis identified Yang-Xu Zheng as the outcome predictor. APACHE II score and levels of five host response cytokines between patients with and without Yang-Xu Zheng revealed significant differences. Furthermore, cool extremities and weak pulse, both diagnostic signs of Yang-Xu Zheng, were also proven independent predictors of sepsis mortality. TCM diagnosis "Yang-Xu Zheng" may provide a new mortality predictor for septic patients.

Nodal regulates energy metabolism in glioma cells by inducing expression of hypoxia-inducible factor 1α.

BACKGROUND: A shift in glucose metabolism from oxidative phosphorylation to anaerobic glycolysis is the biochemical hallmark of malignant cancer cells. METHODS: In the present study, we demonstrated that Nodal stimulated the expression of glycolytic enzymes and decreased reliance on mitochondrial oxidative phosphorylation in human glioma cancer cells. The shift in glucose metabolism was mediated by induction of the hypoxia-inducible factor (HIF). RESULTS: Nodal protein expression was shown to be correlated with expression levels of glucose transporter (Glut)-1, hexokinase (HK)-II, pyruvate dehydrogenase kinase (PDK)-1, the phosphorylation level of pyruvate dehydrogenase (PDH), glucose uptake, and lactate accumulation in human glioma cells. These effects were inversely correlated with mitochondrial oxygen consumption and ATP production. Knockdown of Nodal expression with specific small hairpin RNA reduced Glut-1, HK-II, and PDK-1 expressions and PDH phosphorylation. Nodal knockdown also reduced glucose uptake and lactate generation, which in turn increased mitochondrial membrane potential (Ψ), O2 utilization, and ATP synthesis. The ectopic expression of Nodal in low-expressing Nodal glioma cells resulted in the opposite results compared with those of Nodal knockdown glioma cells. Treatment of cells with recombinant Nodal increased HIF-1 expression, and this effect was regulated at the transcriptional level. Blockage of the Nodal receptor by a pharmacological inhibitor or Nodal knockdown in U87MG cells decreased HIF-1α expression. Furthermore, HIF-1α knockdown in U87MG cells decreased Glut-1, HK-II, and PDK-1 expressions and PDH phosphorylation, which were similar to results in Nodal knockdown cells. CONCLUSION: Taken together, these results suggest that Nodal affects energy metabolism through HIF-1α.

The therapeutic effects of acupuncture on patients with chronic neck myofascial pain syndrome: a single-blind randomized controlled trial.

Chronic neck myofascial pain syndrome (MPS) is a common disorder seen in clinics. There is no gold standard method to treat myofascial pain. We investigated the effects of acupuncture on patients with chronic neck MPS by a single-blind randomized controlled trial. A total of 35 patients were randomly allocated to an acupuncture group (AG) or a sham acupuncture group (SG). Each subject received acupuncture treatment twice per week for three consecutive weeks. The primary outcome measure was quality of life as assessed with Short Form-36, and secondary outcome measures were neck range of motion (ROM), motion-related pain, and Short-Form McGill Pain Questionnaire (SF-MPQ), as determined by a blinded investigator. The clinical assessments were made before treatment (BT) and after six acupuncture treatments (AT), as well as four weeks (F1) and 12 weeks (F2) after the end of the treatment. A total of 34 patients completed the trial. The results indicated that there is no significant difference in the ROM, motion-related pain, and SF-MPQ scores between AG and SG at AT, F1 and F2 (all p > 0.05). However, AG has greater improvement in physical functioning and role emotional of Short Form-36 quality of life at F2. The results indicate that acupuncture may be used to improve the quality of life in patients with chronic neck MPS.