Traditional Chinese medicine treatment for benign thyroid nodules: Literature review.

Thyroid nodules (TNs) are pathological changes characterized by abnormal proliferation of thyroid gland tissue. Approximately 19% to 67% of asymptomatic individuals are diagnosed with TNs, with the majority being benign nodules and 4% to 6.5% being thyroid cancer nodules. Western medicine recommends regular examinations and surgery, while traditional Chinese medicine (TCM) provides an alternative choice to maintain thyroid function and reduce the need for surgery. However, in Taiwan, research on TCM treatment for benign TNs is primarily limited to case reports, lacking large-scale and systematic clinical studies. We conducted a search of electronic databases including PubMed, Google Scholar, Wanfang Data, and China National Knowledge Infrastructure to collect clinical trials related to TCM treatment for TNs. Our goal is to provide new treatment options, further validate the value of TCM in the treatment of TNs, and lay a foundation for future clinical research.

Heart rate variability behavior in young men after short-term carotenoid-containing supplementation.

Background: Heart rate variability can reflect the risk of developing cardiovascular disease (CVD), while carotenoids are good for CVD prevention. However, the acute effect of short-term carotenoid-containing supplementation on heart rate variability in young men is unclear. Methods: Thirty young men between 20 and 29 years of age without personal or family history of cardiovascular diseases were randomly divided into control and experimental groups. The anthropometric data, physiological parameters, and serum biochemical data were acquired, which were without significant difference between the two groups, at the beginning of trial. The participants in the experimental group consumed one pack of compound nutritional supplements in the morning (e.g., 10 AM) and another pack at night (e.g., 7 PM) each day. Heart rate variability was measured again once a month. Repeated measures analysis of variance with Roy's largest root test and Bonferroni post hoc test were applied for primary outcomes. Results: Repeated measures analysis of variance indicated a significant time interaction effect for the estimated marginal means of percussion entropy index scale (T1 versus T3, T1 versus T4, and T2 versus T4 with p = 0.009, 0.005, and 0.032, respectively). Roy's largest root test indicates there were significant differences between the means of the index after the intervention between two groups only on T3 and T4 (p = 0.007, η 2 = 0.232 and p = 0.028, η 2 = 0.162, respectively). Conclusion: Short-term carotenoid-containing supplementation could help young men by increasing heart rate variability capacity compared to controls over three months.

Calculation of an Improved Stiffness Index Using Decomposed Radial Pulse and Digital Volume Pulse Signals.

The stiffness index (SI) is used to estimate cardiovascular risk in humans. In this study, we developed a refined SI for determining arterial stiffness based on the decomposed radial pulse and digital volume pulse (DVP) waveforms. In total, 40 mature asymptomatic subjects (20 male and 20 female, 42 to 76 years of age) and 40 subjects with type 2 diabetes mellitus (T2DM) (23 male and 17 female, 35 to 78 years of age) were enrolled in this study. We measured subjects' radial pulse at the wrist and their DVP at the fingertip, and then implemented ensemble empirical mode decomposition (EEMD) to derive the orthogonal intrinsic mode functions (IMFs). An improved SI (SInew) was calculated by dividing the body height by the mean transit time between the first IMF5 peak and the IMF6 trough. Another traditional index, pulse wave velocity (PWVfinger), was also included for comparison. For the PWVfinger index, the subjects with T2DM presented significantly higher SInew values measured according to the radial pulse (SInew-RP) and DVP signals (SInew-DVP). Using a one-way analysis of variance, we found no statistically significant difference between SInew-RP and PWVfinger when applied to the same test subjects. Binary logistic regression analysis showed that a high SInew-RP value was the most significant risk factor for developing T2DM (SInew-RP odds ratio 3.17, 95% CI 1.53-6.57; SInew-DVP odds ratio 2.85, 95% CI 1.27-6.40). Our refined stiffness index could provide significant information regarding the decomposed radial pulse and digital volume pulse signals in assessments of arterial stiffness.

A First Step towards a Comprehensive Approach to Harmonic Analysis of Synchronous Peripheral Volume Pulses: A Proof-of-Concept Study.

The harmonic analysis (HA) of arterial radial pulses in humans has been widely investigated in recent years for clinical applications of traditional Chinese medicine. This study aimed at establishing the validity of carrying out HA on synchronous peripheral volume pulses for predicting diabetes-induced subtle changes in heart energy. In this study, 141 subjects (Group 1: 63 healthy elderly subjects; Group 2: 78 diabetic subjects) were enrolled at the same hospital. After routine blood sampling, all synchronous electrocardiogram (ECG) and photoplethysmography (PPG) measurements (i.e., at the six locations) were acquired in the morning. HA of synchronous peripheral volume pulses and radial pulse waves was performed and analyzed after a short period of an ensemble averaging process based on the R-wave peak location. This study utilized HA for the peripheral volume pulses and found that the averaged total pulse energy (i.e., the C0 of the DTFS) was identical in the same subject. A logistic regression model with C0 and a waist circumference variable showed a graded association with the risk of developing type 2 diabetes. The adjusted odds ratio for C0 and the waist circumference were 0.986 (95% confidence interval: 0.977, 0.994) and 1.130 (95% confidence interval: 1.045, 1.222), respectively. C0 also showed significant negative correlations with risk factors for type 2 diabetes mellitus, including glycosylated hemoglobin and fasting plasma glucose (r = -0.438, p < 0.001; r = -0.358, p < 0.001, respectively). This study established a new application of harmonic analysis in synchronous peripheral volume pulses for clinical applications. The findings showed that the C0 could be used as a prognostic indicator of a protective factor for predicting type 2 diabetes.

Reactive Hyperemia-Triggered Wrist Pulse Analysis for Early Monitoring of Young Men with High Atherosclerotic Risk.

The high prevalence of cardiovascular disease in young adults has raised significant concern regarding the early identification of risk factors to allow for timely intervention. This study aimed to identify young males at risk of atherosclerosis using a noninvasive instrument and an initial application percussion entropy analysis of the wrist pressure pulse (WPP). In total, 49 young males aged 18 to 28, without any known history of vascular disease, were recruited. Blood samples were obtained whereby a TC/HDL cutoff value of 4 was used to divide the young men into low-risk (Group 1, TC/HDL < 4, N = 32) and high-risk (Group 2, TC/HDL ≥ 4, N = 17) groups regarding atherosclerosis. The reactive hyperemia-triggered WPPs were measured using a modified air-pressure-sensing system (MAPSS). The dilation index (DI) of the endothelial function and percussion entropy index (PEI) of the heart rate variability (HRV) assessments, calculated using pragmatic signal-processing techniques, were compared between the two groups. The nonparametric Mann-Whitney U test showed that the DI and PEI of the two groups showed statistical differences (both p < 0.05). Not only could the MAPSS assess endothelial function and HRV in young males, but the results also showed that waist circumference and PEI may serve as indicators for the early identification of young males at risk of atherosclerosis.

Percussion Entropy Analysis of Synchronized ECG and PPG Signals as a Prognostic Indicator for Future Peripheral Neuropathy in Type 2 Diabetic Subjects.

Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes. It has become an essential public health crisis, especially for care in the home. Synchronized electrocardiogram (ECG) and photoplethysmography (PPG) signals were obtained from healthy non-diabetic (n = 37) and diabetic (n = 85) subjects without peripheral neuropathy, recruited from the diabetic outpatient clinic. The conventional parameters, including low-/high-frequency power ratio (LHR), small-scale multiscale entropy index (MEISS), large-scale multiscale entropy index (MEILS), electrocardiogram-based pulse wave velocity (PWVmean), and percussion entropy index (PEI), were computed as baseline and were then followed for six years after the initial PEI measurement. Three new diabetic subgroups with different PEI values were identified for the goodness-of-fit test and Cox proportional Hazards model for relative risks analysis. Finally, Cox regression analysis showed that the PEI value was significantly and independently associated with the risk of developing DPN after adjustment for some traditional risk factors for diabetes (relative risks = 4.77, 95% confidence interval = 1.87 to 6.31, p = 0.015). These findings suggest that the PEI is an important risk parameter for new-onset DPN as a result of a chronic complication of diabetes and, thus, a smaller PEI value can provide valid information that may help identify type 2 diabetic patients at a greater risk of future DPN.

p-Coumaric-Acid-Containing Adenostemma lavenia Ameliorates Acute Lung Injury by Activating AMPK/Nrf2/HO-1 Signaling and Improving the Anti-oxidant Response.

Adenostemma lavenia is a perennial herb belonging to the Compositae family and is widely distributed in the tropical parts of Asia. It has been widely used as medicine in Taiwan with the whole plant used to treat pulmonary congestion, pneumonia, bacterial infections of the respiratory tract, edema, and inflammation. This study sought to investigate the anti-inflammatory effects of A. lavenia in vitro and in animal models. The anti-inflammatory effects of ethyl acetate fractions of A. lavenia (EAAL) were stimulated with lipopolysaccharide (LPS) murine macrophages (RAW 264.7) and lung injury in mice. EAAL reduced proinflammatory cytokine responses. Preoral EAAL alleviated LPS-induced histological alterations in lung tissue and inhibited the infiltration of inflammatory cells and protein concentrations in bronchoalveolar lavage fluid (BALF). EAAL prevented protein expression of inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2); phosphorylation of IκB-α, MAPKs, and AMP-activated protein kinase (AMPK); and activated anti-oxidant enzymes (catalase, SOD, and GPx), heme oxygenase-1 (HO-1), and nuclear factor E2-related factor 2 (Nrf2) in LPS-stimulated cells and lung tissues. Fingerprinting of EAAL was performed with HPLC to control its quality, and p-coumaric acid was found to be a major constituent. This study suggests that EAAL is a potential therapeutic agent to treat inflammatory disorders.

The Association Between Different Patterns of Traditional Chinese Medicine Treatment and All-Cause Mortality Among Cancer Patients.

BACKGROUND: Cancer patients receiving Western medical treatment, frequently seek Traditional Chinese Medicine (TCM) to alleviate adverse effects and prolong survival. OBJECTIVE: This study evaluated the association between the use of TCM and cancer survival rate. Research into the effect of TCM on patient survival is limited, this analysis focused on 3 patterns of TCM use. METHODS: Three retrospective cohorts with different patterns of TCM use were selected from the National Health Insurance Research Database of Taiwan and analyzed. Patients with newly diagnosed cancer between 1997 and 2012 were classified into groups of prediagnosis, postdiagnosis, and continuous TCM use associated with awareness of cancer diagnosis. All demographic and clinical data were analyzed. RESULTS: After propensity score matching, longevity of the postdiagnosis and continuous TCM user was significantly longer than the non-TCM user. The adjusted hazard ratios of death in postdiagnosis and continuous TCM use groups (0.59 and 0.61, respectively) were lower than the non-TCM use group. CONCLUSION: The analysis suggests that cancer patients using TCM in conjunction with Western medical treatment exhibited a higher survival rate than patients not using TCM treatment.

Asatone Prevents Acute Lung Injury by Reducing Expressions of NF-[Formula: see text]B, MAPK and Inflammatory Cytokines.

Asatone is an active component extracted from the Chinese herb Radix et Rhizoma Asari. Our preliminary studies have indicated that asatone has an anti-inflammatory effect on RAW 264.7 culture cells challenged with lipopolysaccharide (LPS). Acute lung injury (ALI) has high morbidity and mortality rates due to the onset of serious lung inflammation and edema. Whether asatone prevents ALI LPS-induced requires further investigation. In vitro studies revealed that asatone at concentrations of 2.5-20[Formula: see text][Formula: see text]g/mL drastically prevented cytotoxicity and concentration-dependently reduced NO production in the LPS-challenged macrophages. In an in vivo study, the intratracheal administration of LPS increased the lung wet/dry ratio, myeloperoxidase activity, total cell counts, white blood cell counts, NO, iNOS, COX, TNF-[Formula: see text], IL-1[Formula: see text], and IL-6 in the bronchoalveolar lavage fluid as well as mitogen-activated protein kinases in the lung tissues. Pretreatment with asatone could reverse all of these effects. Asatone markedly reduced the levels of TNF-[Formula: see text] and IL-6 in the lung and liver, but not in the kidney of mice. By contrast, LPS reduced anti-oxidative enzymes and inhibited NF-[Formula: see text]B activations, whereas asatone increased anti-oxidative enzymes in the bronchoalveolar lavage fluid and NF-[Formula: see text]B activations in the lung tissues. Conclusively, asatone can prevent ALI through various anti-inflammatory modalities, including the major anti-inflammatory pathways of NF-[Formula: see text]B and mitogen-activated protein kinases. These findings suggest that asatone can be applied in the treatment of ALI.

Effects of Combined Far-Infrared Radiation and Acupuncture at ST36 on Peripheral Blood Perfusion and Autonomic Activities.

Using four-channel photoplethysmography (PPG) for acquiring peripheral arterial waveforms, this study investigated vascular and autonomic impacts of combined acupuncture-far infrared radiation (FIR) in improving peripheral circulation. Twenty healthy young adults aged 25.5 ± 4.6 were enrolled for 30-minute measurement. Each subject underwent four treatment strategies, including acupuncture at ST36 (Zusanli), pseudoacupuncture, FIR, and combined acupuncture-FIR at different time points. Response was assessed at 5-minute intervals. Area under arterial waveform at baseline was defined as AreaBaseline, whereas AreaStim referred to area at each 5-minute substage during and after treatment. AreaStim/AreaBaseline was compared at different stages and among different strategies. Autonomic activity at different stages was assessed using low-to-high frequency power ratio (LHR). The results demonstrated increased perfusion for each therapeutic strategy from stage 1 to stage 2 (all p < 0.02). Elevated perfusion was noted for all treatment strategies at stage 3 compared to stage 1 except pseudoacupuncture. Increased LHR was noted only in subjects undergoing pseudoacupuncture at stage 3 compared to stage 1 (p = 0.045). Reduced LHR at stage 2 compared to stage 1 was found only in combined treatment group (p = 0.041). In conclusion, the results support clinical benefits of combined acupuncture-FIR treatment in enhancing peripheral perfusion and parasympathetic activity.

Scutellaria baicalensis Ameliorates Acute Lung Injury by Suppressing Inflammation In Vitro and In Vivo.

Scutellaria baicalensis has been widely used as both a dietary ingredient and traditional herbal medicine in Taiwan to treat inflammation, cancer, and bacterial and viral infections of the respiratory tract and gastrointestinal tract. This paper aims to investigate the in vitro and in vivo anti-inflammatory effects of S. baicalensis. In HPLC analysis, the fingerprint chromatogram of the water extract of S. baicalensis (WSB) was established. The anti-inflammatory effects of WSB were inverstigated using lipopolysaccharide (LPS)-stimulated mouse macrophage (RAW264.7) in vitro and LPS-induced lung injury in vivo. WSB attenuated the production of LPS-induced nitric oxide (NO), tumor necrosis factor-alpha (TNF-[Formula: see text], interleukin-[Formula: see text] (IL-1[Formula: see text], and IL-6 in vitro and in vivo. Pretreatment with WSB markedly reduced the LPS-induced histological alterations in lung tissues. Furthermore, WSB significantly reduced the number of total cells and the protein concentration levels in the BALF. WSB blocked protein expression of inducible NO synthase (iNOS), cyclooxygenase-2 (COX-2), phosphorylation of I[Formula: see text]B-[Formula: see text] protein and MAPKs in LPS-stimulated RAW 264.7 cells and LPS-induce lung injury was also blocked. This study suggests that WSB possesses anti-inflammatory effects in vitro and in vivo, and the results suggested that WSB may be a potential therapeutic candidate for the treatment of inflammatory diseases.

Effects of Chinese herbal medicine in combination with mitomycin C on gastric cancer cells.

Chinese herbal medicine (CHM) is frequently used by cancer patients in Chinese community. It remains largely unknown about the interaction between CHM and chemotherapeutic agents. Herein, we evaluated 3 commonly used CHM formulas for cancer patients: Bu-Zhong-Yi-Qi-Tang (BZYQT), Bao-Yuan-Tang (BYT), and Ju-Yuan-Jian (JYJ). We examined the effects of these 3 formulas in human gastric cancer cells MKN-74, in terms of cytotoxicity and apoptosis induction when used alone or in combination with mitomycin C (MMC). Cytotoxicity was determined by tetrazolium dye colorimetric assay. The 10% inhibitory concentration of CHM was used in this study. Cells were first exposed to CHM or phosphate buffered saline (as control) for 48 h. Then MMC at final concentration of 0.25 µg/ml was added to media for another 24-h. Among these 3 CHM formulas, BZYQT showed the most pronounced effect in augmenting MMC-induced cytotoxicity. The viability of MKN-74 cells was decreased to 43.1% when treated with BZYQT and MMC, compared to 94.9% with MMC alone. We subsequently examined apoptosis induction by quantitative florescent microscopy and single-strand DNA enzyme-linked immunosorbent assay, and found BZYQT did not enhance MMC-induced apoptosis. Our findings indicate BZYQT in combination with MMC induces cell death in gastric cancer cells via non-apoptotic mechanism. Our results provide a rationale for further investigation in the interaction of CHM and anti-cancer treatment.

Hispolon from Phellinus linteus induces G0/G1 cell cycle arrest and apoptosis in NB4 human leukaemia cells.

Hispolon (a phenolic compound isolated from Phellinus linteus) has been shown to possess strong antioxidant, anti-inflammatory, anticancer, and antidiabetic properties. In this study, we investigated the antiproliferative effect of hispolon on human hepatocellular carcinoma NB4 cells using the MTT assay, DNA fragmentation, DAPI (4, 6-diamidino-2-phenylindole dihydrochloride) staining, and flow cytometric analysis. Hispolon inhibited the cellular growth of NB4 cells in a dose-dependent manner through the induction of cell cycle arrest at G0/G1 phase measured using flow cytometric analysis and apoptotic cell death, as demonstrated by DNA laddering. Exposure of NB4 cells to hispolon-induced apoptosis-related protein expressions, such as the cleavage form of caspase 3, caspase 8, caspase 9, poly (ADP ribose) polymerase, and the proapoptotic Bax protein. Western blot analysis showed that the protein levels of extrinsic apoptotic proteins (Fas and FasL), intrinsic related proteins (cytochrome c), and the ratio of Bax/Bcl-2 were increased in NB4 cells after hispolon treatment. Hispolon-induced G0/G1-phase arrest was associated with a marked decrease in the protein expression of p53, cyclins D1, and cyclins E, and cyclin-dependent kinases (CDKs) 2, and 4, with concomitant induction of p21waf1/Cip1 and p27Kip1. We conclude that hispolon induces both of extrinsic and intrinsic apoptotic pathways in NB4 human leukemia cells in vitro.

Novel application of a multiscale entropy index as a sensitive tool for detecting subtle vascular abnormalities in the aged and diabetic.

Although previous studies have shown the successful use of pressure-induced reactive hyperemia as a tool for the assessment of endothelial function, its sensitivity remains questionable. This study aims to investigate the feasibility and sensitivity of a novel multiscale entropy index (MEI) in detecting subtle vascular abnormalities in healthy and diabetic subjects. Basic anthropometric and hemodynamic parameters, serum lipid profiles, and glycosylated hemoglobin levels were recorded. Arterial pulse wave signals were acquired from the wrist with an air pressure sensing system (APSS), followed by MEI and dilatation index (DI) analyses. MEI succeeded in detecting significant differences among the four groups of subjects: healthy young individuals, healthy middle-aged or elderly individuals, well-controlled diabetic individuals, and poorly controlled diabetic individuals. A reduction in multiscale entropy reflected age- and diabetes-related vascular changes and may serve as a more sensitive indicator of subtle vascular abnormalities compared with DI in the setting of diabetes.

Effects of hot and cold foods on signals of heart rate variability and nail fold microcirculation of healthy young humans: a pilot study.

In traditional Chinese medicine, hot- and cold-attribute of food ingredients are a major part of dietary therapy. The aim of this study was to establish a suitable scientific methodology to define the attributes of food ingredients by investigating the relationship between food attributes and the physiological signals produced in healthy young subjects with different constitutions. Thirty subjects were grouped into hot and cold constitutions by Chinese medical doctors. Every subject took water, aged ginger tea and coconut water, which are well recognized as having neutral-, hot- and cold-attribute, respectively, on different visits. The different physiological signals induced by the samples were observed using skin and axillary temperature sensors, a heart rate variability analyzer and a laser Doppler anemometer. We found that the capillary red blood cell (RBC) velocity in nail fold microcirculation (NFM) of the subjects with hot constitution accelerated significantly after taking the hot-attribute aged ginger tea, which might be the result of elevated vagal activity leading to arteriole dilation in these subjects. In contrast, in subjects with cold constitution, capillary RBC velocity decelerated significantly and skin temperature decreased markedly after taking the cold-attribute coconut water, which might have been induced by sympathetic nerve activation causing the arteriole to be constricted. Accordingly, the use of capillary RBC velocity of NFM measured by laser Doppler anemometer may be a promising way to classify attributes of food ingredients commonly used in Chinese medicine dietary therapy in accordance with different personal constitutions.

Effect of hot-attribute aged ginger tea on chinese medical pulse condition of healthy young humans.

Young individuals typically have a dry-heat ( zào rè) constitution and feel overly stimulated. This study observes specialties on the right-bar ( yòu guan) section of the radial-arterial pulse of healthy young subjects, and investigates pulse variations induced by different attribute foods. Chinese medical doctors grouped thirty subjects into heat and non-heat constitutions. Each subject took water, aged ginger tea, and coconut water, well recognized as neutral, hot, and cold drinks, on different visits. The current study observed physiological signals induced by the samples using novel noninvasive sphygmography and a blood pressure monitor. As the baseline bigger percussion wave, dicrotic wave, and area in the sphygmogram of the non-heat constitution subjects, this work suggests that blood vessels of these subjects may be more relaxed than that of the heat constitution ones. Stroke volume increased and pulse pressure decreased in the non-heat constitution subjects after taking aged ginger tea, which may elevate arterial compliance corresponding to maintaining an estimated radial-arterial diameter in our study. However, the percussion wave widened and the valley increased in the heat constitution subjects after taking aged ginger tea. This corresponds to the markedly reduced radial-arterial diameter, indicating tighter blood vessels than the baseline status. Accordingly, this study confirms that selecting foods with attributes opposite to personal constitutions is important for reestablishing a healthy cold-heat balance within the human body. Moreover, novel noninvasive sphygmography may be a useful instrument to classify scientifically the heat personal constitution and the responses to different attribute foods.

An empirical comparison of the WHOQOL-BREF and the SGRQ among patients with COPD.

AIMS: To compare the psychometric properties of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) instrument and the St. George's Respiratory Questionnaire (SGRQ), and to examine the association between pulmonary function and domains and items of these questionnaires in patients with chronic obstructive pulmonary disease (COPD). METHODS: The WHOQOL-BREF and the SGRQ were administered to 211 patients. The reliability and validity of, and correlations among, the domain scores were examined. Multiple regression analyses were performed to identify which items were independently associated with subjects' lung functions. RESULTS: Both questionnaires showed good internal consistency (alpha > 0.8), except the SGRQ symptoms domain (alpha = 0.66), minimal ceiling and floor effects, and good item convergent and item discriminant validity. There were moderate correlations between physical domain of the WHOQOL-BREF and activity, impacts and total domains of the SGRQ, and between psychological domain of the WHOQOL-BREF and impacts and total domains of the SGRQ. Eighteen items were significantly associated with lung function, particularly those items relating to mobility/walking and activities of daily living (ADL). CONCLUSION: Both the WHOQOL-BREF and the SGRQ showed comparable reliability and validity. Items related to mobility/walking and ADL may be useful in clinical screening for lung function impairment.

A novel noninvasive measurement technique for analyzing the pressure pulse waveform of the radial artery.

Previous noninvasive measurements of the pulse waveform of the radial artery have not employed standard positioning procedures. Here, we propose a new noninvasive measuring apparatus that has a two-axis mechanism and employs a standard positioning procedure for detecting the optimal site for accurately measuring the pressure pulse waveform (PPW). A modified sensor was designed to simultaneously measure the arterial diameter changed waveform (ADCW) and PPW. Considering the artery as a cylinder, the measured waveform would be distorted if the sensor were not at the middle of arterial width. Moreover, a blood vessel is elastic, and its compliance changes with the transmural pressure, being maximal when the transmural pressure is equal to zero. The sensor should detect the PPW with the lowest possible distortion and, hence, an analysis of the vascular geometry and an arterial model were used to design a standard positioning procedure based on the ADCW for the X and Z axes. In order to verify the resolution of the X axis scanning procedure, the echo method was used to measure the radial artery outer diameter in ten healthy subjects. The difference between the scanning width and the actual arterial diameter was 0.36 +/- 0.23 mm (mean +/- SD). Finally, the PPW as measured at the optimal position was used to diagnose myocardial ischemia symptoms in 60 elderly subjects whose chief complaint was chest pain, with the exercise electrocardiogram being used as a reference to compare between individuals with and without myocardial ischemia. The PPW analysis used the harmonic components in the frequency domain. We found that the fourth harmonic of the Fourier series differed significantly between the groups (p = 0.0039), which is consistent with previous studies. The results indicate that our noninvasive measurement apparatus is very suitable for analyzing the PPW of the radial artery.

How to standardize 3 finger positions of examiner for palpating radial pulses at wrist in traditional Chinese medicine.

This study was to provide a standardized definition of the positioning method of finger placement on the radial artery for pulse diagnosis in traditional Chinese medicine (TCM); that is, to define the locations of Cun, Guan and Chi in TCM. A total of 200 subjects (100 males and 100 females, 18-40 years of age) were recruited from the general population. According to ancient TCM records, the "6% of the elbow length" (ELx6%) is used as the standard method of establishing the length of Cun. We hypothesized that the highest point of "prominent bone" (PB) is the lower limit of Cun, so "the distance between the distal wrist crease and the highest point of the PB" (DWP) is considered the length of Cun. If this hypothesis holds, then we can define the locations of Cun, Guan and Chi by using the ratio 6:6:7 from the ancient TCM records. The distribution of relative bias and paired t-test were used to verify the findings. The mean value of relative bias of DWP compared with ELx6% was close to 0% (males = 2.1%, SD = 12.2%; females = 0.2%, SD = 12.6%). The paired t-test confirmed that there was no significant difference (p > 0.05) between the mean values of the DWP and ELx6%. Therefore, it is reasonable to assume that the length of the Cun is equal to the length of the DWP. Our findings confirm that the location of Cun is from the distal wrist crease to the highest point of PB.