Chinese herbal prescriptions for osteoarthritis in Taiwan: analysis of National Health Insurance dataset.

BACKGROUND: Chinese herbal medicine (CHM) has been commonly used for treating osteoarthritis in Asia for centuries. This study aimed to conduct a large-scale pharmaco-epidemiologic study and evaluate the frequency and patterns of CHM used in treating osteoarthritis in Taiwan. METHODS: A complete database (total 22,520,776 beneficiaries) of traditional Chinese medicine (TCM) outpatient claims offered by the National Health Insurance program in Taiwan for the year 2002 was employed for this research. Patients with osteoarthritis were identified according to the diagnostic code of the International Classification of Disease among claimed visiting files. Corresponding prescription files were analyzed, and an association rule was applied to evaluate the co-prescription of CHM for treating osteoarthritis. RESULTS: There were 20,059 subjects who visited TCM clinics for osteoarthritis and received a total of 32,050 CHM prescriptions. Subjects between 40 and 49 years of age comprised the largest number of those treated (19.2%), followed by 50-59 years (18.8%) and 60-69 years group (18.2%). In addition, female subjects used CHMs for osteoarthritis more frequently than male subjects (female: male = 1.89: l). There was an average of 5.2 items prescribed in the form of either an individual Chinese herb or formula in a single CHM prescription for osteoarthritis. Du-zhong (Eucommia bark) was the most commonly prescribed Chinese single herb, while Du-huo-ji-sheng-tang was the most commonly prescribed Chinese herbal formula for osteoarthritis. According to the association rule, the most commonly prescribed formula was Du-huo-ji-sheng-tang plus Shen-tong-zhu-yu-tang, and the most commonly prescribed triple-drug combination was Du-huo-ji-sheng-tang, Gu-sui-pu (Drynaria fortune (Kunze) J. Sm.), and Xu-Duan (Himalaya teasel). Nevertheless, further clinical trials are needed to evaluate the efficacy and safety of these CHMs for treating osteoarthritis. CONCLUSIONS: This study conducted a large scale pharmaco-epidemiology survey of Chinese herbal medicine use in OA patients by analyzing the NHIRD in Taiwan in year 2002.

Somatic mutations in the D-loop of mitochondrial DNA in oral squamous cell carcinoma.

We aimed to characterize somatic mutations in the D-loop of mitochondrial DNA (mtDNA) and their impact on survival in oral squamous cell carcinoma patients in an endemic betel quid chewing area. Histologically confirmed oral cancer and corresponding non-tumor tissues were obtained from 59 patients. The D-loop of mtDNA sequence in a patient's non-cancerous tissues was compared with that of paired oral cancer samples and any sequence differences were identified as somatic mutations. With a median follow-up of 16 months, somatic mutations of the D-loop were observed in 38 (64.4%) patients and most of them occurred in the poly-C tract. There was no significant difference between the mutation group and non-mutation group in age, gender, primary site, histological features, pathological stage, smoking, betel quid chewing, alcohol consumption, and postoperative radiotherapy. However, patients with D-loop mutations have better survival (2 year disease specific survival rate: 73.4 vs. 45.0%, P = 0.0374). A high rate of somatic mutations in the D-loop region of mtDNA was found in betel quid-related oral squamous cell carcinoma patients. Somatic mutation of D-loop of mtDNA was associated with better survival.

The association between surgical site infection and previous operation in oral cavity cancer patients.

We investigated the post-operative surgical site infection (SSI) rate in oral cavity cancer patients who had previous operation in the oral cavity region and compared it with that of patients without previous operation. We retrospectively reviewed over 1,000 chart records of oral cavity cancer patients from January 2004 to November 2010 and relevant data were collected. Statistical methods included descriptive statistics, bivariate analyses, and a multiple logistic regression model for investigating the relevant factors of post-operative SSI. A total of 894 patients were enrolled in the final analyses. The overall post-operative SSI rate was 20.8%. Previous history of operation was identified in 173 patients (19.4%). There was no significant difference in post-operative SSI rate between the patients with previous operation and those without (22.5 vs. 20.4%, P = 0.601). Previous operation in the oral cavity region was not associated with increased post-operative SSI rate in oral cavity cancer patients.

Locating the Acupoint Baihui (GV20) Beneath the Cerebral Cortex with MRI Reconstructed 3D Neuroimages.

Baihui (GV20) is one of the most important acupoints of the Du meridian (the government vessel) and is commonly used in neurology and psychiatry and as a distal point of anorectal disorders by general practitioners. The anatomical relationship between the scalp region of the acupoint and the underlying corresponding cortex remains obscure. In this study, we first prepared the indicator for MRI scanning on a GE 1.5 T excite machine in a mode suitable for 3D reconstruction. The 3D Avizo software system (version 6.0, Mercury Computer Systems, Inc., Germany) was then used for image processing and the resulting data subsequently analyzed using descriptive statistics and analysis of variance (ANOVA). The mean distance from the Baihui anterior to the central sulcus in the adult group was greater than that in the child group (22.7 ± 2.2 and 19.7 ± 2.2 mm, resp., P = .042), whereas in the child group the distance between the Baihui anterior and the precentral sulcus was greater than in the adult group (6.8 ± 0.8 and 3.8 ± 0.8 mm, resp., P < .001). This MRI presentation demonstrates that the location of Baihui (GV20) can be identified using the distance from the central or precentral sulcus.

Prescriptions of Chinese Herbal Medicines for Insomnia in Taiwan during 2002.

Chinese herbal medicine (CHM) has been commonly used for treating insomnia in Asian countries for centuries. The aim of this study was to conduct a large-scale pharmaco-epidemiologic study and evaluate the frequency and patterns of CHM use in treating insomnia. We obtained the traditional Chinese medicine (TCM) outpatient claims from the National Health Insurance in Taiwan for the year 2002. Patients with insomnia were identified from the diagnostic code of International Classification of Disease among claimed visiting files. Corresponding prescription files were analyzed, and an association rule was applied to evaluate the co-prescription of CHM. Results showed that there were 16 134 subjects who visited TCM clinics for insomnia in Taiwan during 2002 and received a total of 29 801 CHM prescriptions. Subjects between 40 and 49 years of age comprised the largest number of those treated (25.3%). In addition, female subjects used CHMs for insomnia more frequently than male subjects (female : male = 1.94 : 1). There was an average of 4.8 items prescribed in the form of either an individual Chinese herb or formula in a single CHM prescription for insomnia. Shou-wu-teng (Polygonum multiflorum) was the most commonly prescribed single Chinese herb, while Suan-zao-ren-tang was the most commonly prescribed Chinese herbal formula. According to the association rule, the most commonly prescribed CHM drug combination was Suan-zao-ren-tang plus Long-dan-xie-gan-tang, while the most commonly prescribed triple drug combination was Suan-zao-ren-tang, Albizia julibrissin, and P. multiflorum. Nevertheless, further clinical trials are needed to evaluate the efficacy and safety of these CHMs for treating insomnia.

Radial pressure pulse and heart rate variability in heat- and cold-stressed humans.

This study aims to explore the effects of heat and cold stress on the radial pressure pulse (RPP) and heart rate variability (HRV). The subjects immersed their left hand into 45°C and 7°C water for 2 minutes. Sixty healthy subjects (age 25 ± 4 yr; 29 men and 31 women) were enrolled in this study. All subjects underwent the supine temperature measurements of the bilateral forearms, brachial arterial blood pressure, HRV and RPP with a pulse analyzer in normothermic conditions, and thermal stresses. The power spectral low-frequency (LF) and high-frequency (HF) components of HRV decreased in the heat test and increased in the cold test. The heat stress significantly reduced radial augmentation index (AIr) (P < .05), but the cold stress significantly increased AIr (P < .01). The spectral energy of RPP did not show any statistical difference in 0 ~ 10 Hz region under both conditions, but in the region of 10 ~ 50 Hz, there was a significant increase (P < .01) in the heat test and a significant decrease in the cold test (P < .01). The changes in AIr induced by heat and cold stress were significantly negatively correlated with the spectral energy in the region of 10 ~ 50 Hz (SE(10-50 Hz)) but not in the region of 0 ~ 10 Hz (SE(0-10 Hz)). The results demonstrated that the SE(10-50 Hz), which only possessed a small percentage in total pulse energy, presented more physiological characteristics than the SE(0-10 Hz) under the thermal stresses.

Core prescription pattern of Chinese herbal medicine for depressive disorders in Taiwan: a nationwide population-based study.

BACKGROUND: Depressive disorders (DD) affect not only mood and behavior but also various physical functions. Traditional Chinese medicine (TCM) has been shown to have some benefits in treating DD. However, one formula or one single herb might be not show high efficacy when used to treat depression. Thus, this study aimed to examine the core prescription pattern of Chinese herbal medicine (CHM) among patients with DD in Taiwan as a reference for related research and clinical applications. METHODS: All patients, who had been diagnosed with major depressive disorder or minor depression or dysthymia without any other baseline diseases and had at least one CHM outpatient clinical visit from 2002 to 2011, were extracted from three randomly sampled cohorts, namely the 2000, 2005 and 2010 cohorts of the National Health Insurance Research Database (NHIRD) of Taiwan. The collected data was analyzed to explore the patterns of herbal products. RESULTS: There were 197,146 patients with a diagnosis of DD and of these 1806 subjects had only a diagnosis of DD and utilized CHM. The most common formula was Gan-Mai-Da-Zao-Tang (12.19%), while Suan-Zao-Ren (3.99%) was the most commonly prescribed single herb. The core pattern of prescriptions consisted of a combination of Gan-Mai-Da-Zao-Tang, Jia-Wei-Xiao-Yao-San, Chai-Hu-Jia-Long-Gu-Mu-Li-Tang, He-Huan-Pi, Yuan-Zhi and Shi-Chang-Pu. CONCLUSIONS: This study describes the CHM core prescription pattern used to treat patients in Taiwan with DD and it is a potential candidate for study in future pharmacological or clinical trials targeting DD.

Association of interleukin-18 gene polymorphisms with calcium oxalate kidney stone disease.

OBJECTIVE: The interleukin-18 (IL-18) encoding gene has three common single-nucleotide polymorphisms at -607C/A, -137G/C and +105A/C, which have been reported to be associated with several diseases. The aim of this study is to test whether IL-18 polymorphisms could act as genetic markers for renal stone disease. MATERIAL AND METHODS: A control group of 104 healthy subjects, and 272 patients with recurrent calcium oxalate stones were examined. Polymerase chain reaction-based restriction endonuclease analysis was used to detect IL-18 polymorphisms. RESULTS: The patient and control groups differed significantly in genotypic expression of the IL-18 +105A/C polymorphism. The prevalence of the A/C + C/C genotypes in the patients was higher than that in the controls. The allelic frequency of IL-18 +105A/C differed significantly between the patients and the controls. The odds ratio (OR) of the A/C heterozygote of IL-18 +105A/C associated with urolithiasis was 2.772. The OR of the A/C + C/C genotypes of IL-18 +105A/C associated with urolithiasis was 3.097. The OR per copy of the C allele of IL-18 +105A/C associated with urolithiasis was 4.143. There were also significant differences in the prevalence of genotype IL-18 -137G/C polymorphisms between the patients and controls. The distribution of the G/G homozygote in the patients was higher than that in the controls. There was no significant difference in genotype and allelic frequency at the IL-18 -607C/A polymorphism between patients and control subjects. CONCLUSION: The results indicate that IL-18 +105A/C polymorphisms may play a role in the development of urolithiasis.

The effects of a Chinese herbal medicine (VGHBPH0) on patients with benign prostatic hyperplasia: A pilot study.

BACKGROUND: The current Western medicine treatment options for benign prostatic hyperplasia (BPH) have various degrees of documented effectiveness. However, the uses of these interventions are limited to specific patient populations or have certain side effects that interfere with patient quality of life. This study evaluated the clinical effects of a Chinese herbal medicine (CHM) on patients with BPH. METHODS: This was a single-arm pilot study. Twenty BPH patients were enrolled, and they were required to take the investigated CHM three times a day for 8 weeks, along with their Western medicine. Patients returned to clinics as scheduled and completing international prostate symptoms scores (IPSS), aging male symptoms score, international index of erectile function, and body constitution questionnaire of traditional Chinese medicine. Uroflowmetry and sonography were also applied to evaluate the changes in urinary velocity and post-voiding residual urine volume from the baseline to the end of the study. RESULTS: The mean IPSS total score was significantly decreased by 2.5 points after 8 weeks of treatment with the CHM (from 17.5 to 15.0, p = 0.03). The mean IPSS voiding subscore was decreased by 1.7 points (from 10.1 to 8.4, p = 0.02), and the mean incomplete emptying subscore was decreased by 0.8 points (from 2.9 to 2.1, p = 0.02), with both decreases being statistically significant. A descending trend in the post-voiding residual urine volume was also observed (from 52.9 to 30.8 mL, p = 0.07). CONCLUSION: This trial indicated that the add-on CHM treatment (VGHBPH0) might be a potential treatment for improving the lower urinary tract symptoms of BPH patients.

Frequency and pattern of Chinese herbal medicine prescriptions for chronic hepatitis in Taiwan.

ETHNOPHARMACOLOGICAL RELEVANCE: Chinese herbal medicine (CHM) has been commonly used in treating liver diseases in Asian countries. AIM OF STUDY: To conduct a large-scale pharmacoepidemiological study and evaluate the frequency and pattern of CHM prescriptions in treating chronic hepatitis. MATERIALS AND METHODS: We obtained the database of traditional Chinese medicine outpatient claims from the national health insurance in Taiwan for the whole 2002. Patients with chronic hepatitis were identified by the corresponding diagnosis of International Classification of Disease among claimed visiting files. Corresponding prescription files were analyzed, and association rule were applied to evaluate the co-prescription of CHM in treating chronic hepatitis. RESULTS: Among the 91,080 subjects treated by CHM for chronic hepatitis, the peak age was in the 40 s, followed by 30 s and 50 s. Male/female ratio was 2.07:1. Long-dan-xie-gan-tang and Saliva miltiorrhiza (Dan-shen) were the most commonly prescribed Chinese herbal formula and single herbal drug, respectively. The most common two-drug prescription was Jia-wei-xia-yao-san plus Saliva miltiorrhiza, and the most common three-drug prescription was Jia-wei-xia-yao-san plus Saliva miltiorrhiza and Artemisia capillaries (Yin-chen-hao). CONCLUSIONS: This study showed the utilization pattern of Chinese herbal drugs or formulae in treating chronic hepatitis. Further researches and clinical trials are needed to evaluate the efficacy of these Chinese herbs or its ingredients in treating chronic hepatitis.

A clinical study of integrating acupuncture and Western medicine in treating patients with Parkinson's disease.

Complementary therapy with acupuncture for Parkinson's disease (PD) has been studied for quite a long time, but the effectiveness of the treatment still remains unclear. The aim of this study is to evaluate the integrated effects of acupuncture treatment in PD patients who received western medicine. In the short-term acupuncture treatment study, 20 patients received acupuncture therapy twice a week in acupoints DU 20, GB 20, LI 11, LI 10, LI 4, GB 31, ST 32, GB 34 and GB 38 along with western medicine for 18 weeks, and 20 controlled patients received western medicine only. In the long-term acupuncture treatment, 13 patients received acupuncture treatment twice a week for 36 weeks. The outcome parameters include Unified Parkinson's disease rating scale (UPDRS), Beck Anxiety Inventory (BAI), Beck Depression Inventory-Version 2 (BDI-II), and WHO quality of life (WHOQOL). In the short-term clinical trial, a higher percentage of patients in the acupuncture group had score improvement in UPDRS total scores (55% vs. 15%, p = 0.019), sub-score of mind, behavior and mood (85% vs. 25%, p < 0.001), activity of daily living (65% vs. 15%, p = 0.003), mobility (40% vs. 15%, p = 0.155) and complication of treatment (75% vs. 15%, p < 0.001), BDI-II score (85% vs. 35%, p = 0.003), and WHOQOL score (65% vs. 15%, p = 0.003) when compared to control group at the end of the 18 weeks' follow up. After 36 weeks of long-term acupuncture treatment, the mean UPDRS total scores and sub-score of mentation, behavior and mood, sub-score of complications of therapy and BDI-II score decreased significantly when compared to the pretreatment baseline. In conclusion, acupuncture treatment had integrated effects in reducing symptoms and signs of mind, behavior, mood, complications of therapy and depression in PD patients who received Western medicine.

Survival analysis of patients with oral squamous cell carcinoma with simultaneous second primary tumors.

BACKGROUND: The purpose of this study was to investigate the rate of simultaneous second primary tumor (SPT) in patients with oral squamous cell carcinoma. The survival of patients with simultaneous SPT was also compared with patients without. METHODS: The presence of SPT was documented along with the patients' demographic data, tumor-related features, and survival status. Kaplan-Meier method was used for survival analysis. Relevant factors influencing the survival were examined by the Cox proportional hazard model. RESULTS: A total of 897 patients' medical records were obtained. Among them, 43 patients (4.8%) had simultaneous SPT and their prognosis was poorer than that of patients without. The Cox proportional hazard model revealed that patients with simultaneous SPT tended to have a higher probability of death (relative risk [RR], 1.694; p = .015). CONCLUSIONS: Simultaneous SPT is an independent prognostic factor for patients with oral squamous cell carcinoma. Those with simultaneous SPT have poorer survival when compared to those without.

Pulse analysis in bipolar disordered and nonpsychotic human subjects.

The research literature indicates that patients with bipolar disorder (BPD) differ from healthy individuals in various ways that are also recognized in traditional Chinese medicine. The purpose of the current study was to analyze the pulse spectra in BPD patients to determine any differences from nonpsychotic healthy individuals. Sphygmography was used to measure the radial arterial pulse waves in all subjects. We analyzed the original waveforms and then transformed them into frequency spectra via Fourier transformation. The relative strength of each harmonic, believed to be connected to meridians in Chinese medicine, was identified from the frequency, and we compared the differences among the harmonics. A total of sixty individuals, thirty with BPD and thirty nonpsychotic healthy controls, participated in the study. The harmonic values of C4 (Lung Meridian) on the right hand, 401.33 ± 50.10 vs. 762.44 ± 125.17, were significantly different (p < 0.05) between the BPD group and the nonpsychotic healthy group. The harmonic percentage of C3 (Spleen Meridian) on the right hand, 7.85 ± 0.59% vs. 10.79 ± 1.01%, and C4 (Lung Meridian), 1.80 ± 0.15 vs. 3.24 ± 0.43, was significantly different (p < 0.05) between the two groups. The results were similar for the right and left hands. In this study, we objectively detected constitutional differences between BPD patients and healthy controls through arterial pulse analysis. The pulse spectrum analyzer is a non-invasive diagnostic tool that can be used to integrate scientific technology with traditional Chinese medicine. We plan further study in this field to improve the accuracy of diagnosis in Chinese medicine.

Shrinkage of head and neck cancer specimens after formalin fixation.

BACKGROUND: We conducted this study to investigate whether formalin fixation is associated with the shrinkage of head and neck cancer specimens. METHODS: Patients scheduled to undergo operation were eligible for enrollment. Fresh specimens were measured immediately in the operating room, and the measurements were repeated after formalin fixation. RESULTS: A total of 100 specimens were collected. Nearly half of them were obtained from the oral cavity (n=49), and a large majority were squamous cell carcinoma (n=69). The average decreases in length, width, and depth after formalin fixation were 1.50mm (4.40%), 1.52 mm (6.18%), and 0.67 mm (4.10%), respectively. There was no significant difference in the shrinkage percentage associated with gender, age, tumor site, tumor size, or histology. CONCLUSION: We found that head and neck cancer specimens shrink after formalin fixation. Therefore, we recommend that the specimen be measured immediately in order to avoid the underestimation of tumor size.

Effect of oxidized regenerated cellulose on the healing of pharyngeal wound: an experimental animal study.

BACKGROUND: This study aimed to investigate the relationship between oxidized regenerated cellulose (ORC) and mucosa healing in an experimental animal model. METHODS: Fifteen adult Sprague-Dawley rats were randomly divided into three groups that underwent different wound treatments. In Group 1, no pharyngeal wound was created. In Group 2, the pharyngeal wound was sutured with Prolene only. In Group 3, the pharyngeal wound was sutured with Prolene, and covered with one layer of ORC before closure of the skin wound. The animals were euthanized either 5 or 10 days after operation, and wound conditions were inspected and recorded. Specimens including sections of larynx and pharynx/upper esophagus were taken for microscopic and molecular biological examination. RESULTS: The pharyngotomy/esophagotomy wounds achieved good healing outcomes 10 days after operation. Wounds treated with ORC had significantly diminished inflammatory cell infiltration in microscopic examination when compared with that of those without ORC 5 days after operation. The matrix metalloproteinases (MMP) expression level was higher in wounds of Group 2 and Group 3, when compared with that of group 1. In addition, the MMP expression level was lower in the ORC-treated wounds when compared with that of those without ORC. There was no significant difference in fibroblast proliferation, collagen deposition, endothelin-1, alpha-smooth muscle actin, and transforming growth factor beta 1 expression level between wounds treated with ORC and those without ORC. CONCLUSION: Reduced inflammatory response and decreased MMP expression level was observed in ORC-treated wounds. Whether ORC facilitates mucosa healing requires further investigation.

The pulse spectrum analysis at three stages of pregnancy.

OBJECTIVES: This study is the first to detect the radial pulses of the three diagnosis positions (inch, bar, and cubit) in both wrists (six positions) by pulse spectrum analysis. The purpose of this study was to identify the difference among pulses of the six positions at three stages of pregnancy and to examine whether the results of this study agree with the theory of Traditional Chinese Medicine (TCM), which states that the cubit pulse shows unique changes for an expectant woman and that the pulse changes coincide with the progression of gestation. SUBJECTS AND METHODS: One hundred and fifty (150) healthy pregnant women were divided into three groups according to gestational age (9-14 weeks, 20-28 weeks, and 32-37 weeks of gestation) and 50 healthy nonpregnant women were used as controls. A pulse analyzer was used to detect the six positions of the radial pulses and to calculate the 10 relative energy values of the spectrum's harmonics of the six positions. RESULTS: Results show that most of the 10 relative spectral energy values of the right and left cubits are statistically (p<0.01) higher than those of the inch for the pregnant women as compared with the nonpregnant women. In addition, the 10 relative spectral energy values of the six positions are not identical at the three stages of pregnancy. CONCLUSIONS: The cubit pulse is unique for pregnant women, which is consistent with the theory of TCM. In addition, the pulse conditions at the three stages of pregnancy are dissimilar.

Comparison between free flap and pectoralis major pedicled flap for reconstruction in oral cavity cancer patients--a quality of life analysis.

We aimed to compare the differences between free flap and pectoralis major myocutaneous flap (PMMF) for reconstruction in oral cavity cancer patients. Patients who received free flap or PMMF reconstruction after ablation surgeries were eligible for the current study. The patients' demographic data, medical history, and quality of life scores were collected and analyzed. A total of 491 patients' records were obtained. Among them, 100 patients completed a quality of life questionnaire. No significant differences could be found in age, morbidity, stage, and hospitalization between the free flap and PMMF groups. However, there were significant differences between both groups in gender, primary site, peri-operative blood loss, and operation duration. Patients reconstructed with free flap had better speech and shoulder functions as well as better mood status. Data from this study provide useful information for physicians and patients during their discussion of treatment modalities for oral cancers.

Smoking, alcohol, and betel quid and oral cancer: a prospective cohort study.

We aimed to investigate the association between smoking, alcoholic consumption, and betel quid chewing with oral cancer in a prospective manner. All male patients age ≥18 years who visited our clinic received an oral mucosa inspection. Basic data including personal habits were also obtained. A multivariate logistic regression model was utilized to determine relevant risk factors for developing oral cavity cancer. A total of 10,657 participants were enrolled in this study. Abnormal findings were found in 514 participants (4.8%). Three hundred forty-four participants received biopsy, and 230 patients were proven to have oral cancer. The results of multivariate logistic regression found that those who smoked, consumed alcohol, and chewed betel quid on a regular basis were most likely to develop cancer (odds ratio: 46.87, 95% confidence interval: 31.84-69.00). Therefore, habitual cigarette smokers, alcohol consumers, and betel quid chewers have a higher risk of contracting oral cancer and should receive oral screening regularly so potential oral cancer can be detected as early as possible.

Visual screening of oral cavity cancer in a male population: experience from a medical center.

BACKGROUND: We aimed to evaluate the effectiveness of an oral cavity cancer visual screening program conducted in a tertiary academic medical center. We also wanted to determine which group of participants was at greater risk of contracting oral cavity cancer. METHODS: Participants were first asked to relate their personal habits during the past 6 months. Visual screening of the oral cavity was then performed under adequate lighting and with proper instruments. RESULTS: From March 2005 to January 2010, 13,878 participants were enrolled in this study. The average age was 54.6 years. Positive lesions were identified in 726 participants (5.2%), and 282 of those participants (2.1%) had oral cavity cancers confirmed. The sensitivity and specificity of this study were 98.9% and 98.7%, respectively. Those participants who were habitual smokers, alcohol consumers, and betel quid chewers had the highest risk of developing oral cavity cancer when compared with those who did not have these habits (odds ratio=46.90, 95% confidence interval=33.15-66.35, p<0.001). CONCLUSION: The oral screening program conducted in a tertiary medical center was effective. We suggest that individuals aged ≥40 years or who are habitual cigarette smokers, alcohol consumers, and betel quid chewers should receive oral screening regularly so that potential oral cancer can be detected as early as possible.

Radial pressure pulse and heart rate variability in normotensive and hypertensive subjects.

OBJECTIVES: The characteristics of the right/left radial pressure pulse (RPP) at the six diagnosis positions in Chinese medicine are not well documented. The purpose of this study is to investigate the spectral energy and augmentation index (AI) of bilateral RPP at the six diagnosis positions and heart rate variability (HRV) in the normotensives, hypertensives without heart dysfunction (HTN-N), and hypertensives with mild diastolic dysfunction (HTN-A). DESIGN: One hundred and thirty-eight (138) subjects were enrolled in this study. All subjects underwent measurements of brachial arterial blood pressure and RPP of both wrists while seated, and the supine measurement of HRV. AI and spectral energy of RPP as well as HRV were analyzed. RESULTS: The low-frequency component, the spectral HRV parameter, was significantly reduced in HTN-A compared with that in the normotensive group. Radial AI of the six diagnosis positions in HTN-N was significantly higher compared with that in the normotensive group or HTN-A. At the six diagnosis positions, the spectral energy of 0-10 Hz (SE(0-10 Hz)) in both hypertensive groups and 10-50 Hz (SE(10-50 Hz)) in the HTN-A group were significantly higher compared with those in the normotensive group. SE(10-50 Hz) at right Chy, left Chun, and left Guan in the HTN-N group were higher than those in the normotensive group. Within each group, there was a significant difference in the energy proportion, 10-50 Hz% (EP(10-50 Hz%)), between the six positions and a significant reduction only at the left Chun position in both hypertensive groups compared to that in the normotensive group. CONCLUSIONS: It is concluded that the EP(10-50 Hz%) revealed the specific characteristics of RPP and significantly varied at the six positions, and the left Chun position, the position to detect the heart diseases in Chinese medicine, is qualified to discriminate the differences between the normotensive and hypertensive patients.