Wan-An Lu

Pulse Spectrum Analysis in Primary Hypertension Patients

Background and Purpose: Arterial pulse diagnosis is noninvasive and it is very popular in traditional Chinese medicine clinics. The aim of this study was to evaluate the possibility of using pulse diagnosis in patients with the primary hypertension. Methods: Noninvasive analyses of radial pulses were taken in primary hypertension patients immediately after their arrival at the physical examination room. They then underwent physical health examinations including measurement of blood pressure and heart rate, EKG, blood test, urine test, x-ray, ultrasound scanning, and recording medical history. We carried out pulse spectrum analysis on 110 patients with possible primary hypertension. We used five criteria for pulse diagnosis of blood pressure abnormalities to test for correlation. These were (1) C1≧2 (in intensity) and C4≦-3 (in intensity) or C4≦-2 (in phase), (2) C0≧4 (in intensity) and C4≦-2 (in intensity), (3) C0≧4 (in intensity) and C3≦-2 (in intensity) and C3≦-2 (in phase), (4) C0≧4 (in intensity) and C3≦-2 (in intensity) and C5≦-3 (in intensity), (5) C3≦-2 (in intensity and phase) and C6≦-2 (in intensity and phase). For the intensity, C1 (liver) every 5% above normal was given one ”+”, every 5% below normal was given one ”-”. For C3 (spleen), C4 (lung), C6 (gallbladder), every 10% above normal was given one ”+”, every 10% below normal was given one ”-”. For the phase, every 10% delay in the traveling speed of the pressure wave was given one ”-”. Results: Only the ”+”, ”N” (N = normal) and ”-” states were considered, while quantities of ”+” ”-” were not monitored. In the pulse analysis, there were 311 (from intensity) × 311 (from phase) = 177, 147 × 177, 147 possible states (3 qualitative states and 11 harmonics). We considered only five criteria for blood pressure abnormalities and the correlation was very high, p＜0.001, Kappa = 0.701. Conclusion: The results strongly suggested that each harmonic of pulse spectrum has physiological and pathological importance in the circulation and it is worth further study.

Combination of Wu Lin San and Shan Zha ameliorates substance P-induced hyperactive bladder via the inhibition of neutrophil NADPH oxidase activity.

Substance P (SP) via neurokinin type 1 receptor activates leukocytes to produce burst release of reactive oxygen species (ROS) and increases leukocytes adhesion to the vessels in the inflamed bladder. Activation of neutrophil nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity may contribute to the neutrophil ROS production. We explored the therapeutic effect of traditional Chinese formula for urinary dysfunction, Wu Lin San (WLS), and a modified formula WLS plus Shan Zha (WLSSZ) on SP-induced bladder hyperactivity. We evaluated WLS, Shan Zha, and WLSSZ effect on neutrophils NADPH oxidase activity in SP-stimulated neutrophils in vitro, and isovolumetric cystometrogram and ROS activity in vivo in anesthetized rat bladder with SP stimulation. Our results showed that WLS, Shan Zha, and WLSSZ inhibited SP-induced NADPH oxidase activity in an order WLSSZ>Shan Zha>WLS. Exogenous SP enhanced systemic vasodilation, bladder hyperactivity and bladder ROS. One week of oral administration of WLS or WLSSZ significantly reduced SP-induced bladder ROS amount and leukocyte accumulation and ameliorated the hyperactive bladder response. The therapeutic action was better in WLSSZ than in WLS. Our results indicate that a modified formula Wu Lin San plus Shan Zha can potentially ameliorate SP-induced neurogenic inflammation possibly via the inhibition of leukocyte NADPH oxidase activity.

Pulse Spectrum Analysis in 205 Patients with Abnormal Liver Function Test

Background and Purpose: Pulse analysis is non-invasive and very popular in traditional Chinese medicine clinics. The aim of this study was to evaluate the possibility of pulse diagnosis. Methods: We carried out pulse spectrum analysis on 205 patients with possible liver diseases. Correlation between liver tests, which included T-Bil, D-Bil, SGOT, SGPT, ZTT, Alp, γ-GT, Cho, AIB and AIB/Glo, and ultrasound scanning were analyzed. We used six criteria for pulse diagnosis of liver abnormality to test for correlation. These were (1) C1≧3 and C1+C4≧4 or C1+C6≧4 (in intensity), (2) C1≦-3 (in intensity), (3) C6≧3 and C1+C6≧4 (in intensity. (4) C6≦-2 (in intensity) and C6≦-2 (in phase), (5) C1≧2 and C3≦-2 (in intensity) or C3≦-2 (in phase), and (6) C3≦-2 (in intensity) and C3≦-2 (in phase). For the intensity, C1 (liver) every 5% above normal was given one ”+”, every 5% below normal was given one ”-”. For C3 (spleen), C4 (lung), C6 (gallbladder), every 10% above normal was given one ”+”, every 10% below normal was given one ”-”. For the phase, every 10% delay in the traveling speed of the pressure wave was given one ”-”. Results: Only the ”+”, ”N” (N=normal) and ”-” states were considered, while quantities of ”+” ”-” were neglected. In pulse analysis, there are 311 (from intensity)×311 (from phase)=177, 147×177, 147 possible states (3 qualitative states and 11 harmonics). We considered only six criteria for liver abnormality and the correlation was very high, p＜0.001, Kappa=0.68. Conclusion: The results strongly suggest that pulse diagnosis theory has physiological and pathological importance, and is worthy of further study in the future.

The therapeutic effect of collateral meridian therapy is comparable to acupoint pressure therapy in treating myofascial pain syndrome

PURPOSE This study compared the therapeutic effects of collateral meridian therapy (CMT) with traditional acupoint pressure therapy (APT) in patients with unilateral upper back pain. MATERIAL AND METHODS Forty-nine patients with active myofascial trigger points in upper trapezius muscle were randomly allocated to the control (CTL), APT, or CMT group. Each subject in the CMT and APT groups received 2 sessions of treatment per week over 1 month. RESULTS Patients in the APT and CMT groups showed significant improvements 1 month after treatment in visual analogue scale, range of motion, pain pressure threshold, regional superficial blood flow, and physical health, as compared to the CTL group. No significant differences in outcome measures were found between APT and CMT groups 1 month after treatment. CONCLUSION Both APT and CMT have comparable therapeutic efficacy in the treatment of unilateral upper back pain with active myofascial trigger points in the upper trapezius muscle.

Reduced Room for Cardiac Vagal Modulation to Increase and Cardiac Sympathetic Modulation to Decrease by Resting in Football Players

Background: This study investigated the cardiac autonomic nervous modulation of football (soccer) players at rest, and whether resting can change it further. Methods: The stationary state spectral heart rate variability (HRV) measures at rest and 60 and 90 min after baseline measurement were compared between football players and sedentary controls. The percentages of change in HRV measures 60 and 90 min after baseline measurement were also compared between football players and sedentary controls. Results: Seventeen football players and 17 sedentary normal subjects were recruited in this study. The total power (TP), very low frequency power (VLFP), low frequency power (LFP), high-frequency power (HFP) and normalized high-frequency power (nHFP) of football players at rest were all significantly higher, while both normalized low-frequency power (nLFP) and low-/high-frequency power ratio (LHR) of football players at rest were significantly lower than those of normal controls. Sixty and 90 min after baseline measurement, though the heart rate (HR) was significantly decreased and the standard deviation of RR intervals (SDRR), root mean squared successive difference (rMSSD), TP, VLFP, and HFP were all significantly increased in the control group, there were no significant changes in the HRV measures except that the HR was slightly decreased in the football players. Conclusion: The football players have increased vagal modulation and decreased sympathetic modulation at rest as compared to sedentary non-athletes. Although vagal modulation can be increased significantly by resting in the sedentary non-athlete, it cannot be increased significantly in the football players. The football players at rest seem to be already in a relatively relaxed state which cannot be relaxed further by further resting, whereas the nonathletes are not relaxed fully at rest and more rest can lead to further relaxation. The room for cardiac vagal modulation to increase and cardiac sympathetic modulation to decrease by resting is reduced in the football players relative to that of normal subjects.

Left-right Asymmetry of Pulse Harmonics in Non-pregnant Women and Late Pregnant Women

Background: The pulses palpated on the left and right radial arteries are said to have diagnostic significances in traditional Chinese medicine. This study investigated whether the pulse waveforms recorded at bilateral index fingers are differentiable by comparing the power spectra of pulse waveform between bilateral pulses and between non-pregnant and late pregnant women. Methods: Forty seven healthy non-pregnant women and 23 women in the third trimester of pregnancy were included in this study. A train of pulse waveform recorded via a pulse oximeter was acquired and transformed into power spectrum by means of fast Fourier transformation. The power spectra of bilateral pulse waveform were compared with each other in non-pregnant and late pregnant women. Results: The total power of pulse (TPp) of right pulse and normalized powers of the 5th, 6th, 7th, 8th harmonics (nP5~nP8) of bilateral pulses in late pregnant women were significantly smaller than their counterparts in nonpregnant women, whereas the normalized powers of the 2nd harmonics (nP2) of left and right pulses in late pregnant women were significantly greater than their counterparts in non-pregnant women. The nP4 and nP5 of left pulse were significantly smaller than those of right pulse in the non-pregnant women, but this left-right asymmetry in nP4 and nP5 disappeared in late pregnant women. Conclusion: Pregnancy can lead to a decrease in the TPp of right pulse, and nP5~nP8 of bilateral pulses, but an increase in nP2 of bilateral pulses. The nP4 and nP5 of left pulse are significantly smaller than those of the right pulse in non-pregnant women, but this left-right asymmetry in nP4 and nP5 disappears during late pregnancy. The changes in bilateral pulse waveform might be associated with the aorto-caval compression during late pregnancy.

Power spectral analysis of plethysmographic pulse waveform in pregnant women

To investigate the effect of pregnancy on the pulse wave of the mother. Pulse waveforms recorded via a pulse oximeter from the left index finger of non-pregnant women and pregnant women in the three trimesters of pregnancy were Fourier transformed into power spectra. Spectral indices of the power spectra of pulse waveform were obtained and compared among non-pregnant women and pregnant women in the three trimesters of pregnancy. The power of harmonics of pulse wave decayed exponentially with respect to the order of harmonics. The exponent and initial value of exponential decay for the power of harmonics and the power of the 2nd harmonic were increased, whereas the total power of pulse and the powers of higher order harmonics were decreased during pregnancy. The power of harmonics of pulse wave can be described by an exponential decay function with respect to the order of harmonics in both non-pregnant and pregnant women. The effects of pregnancy on the pulse wave are the reduction in the total power of pulse and the power of higher order harmonics, and the increase in the power of lower order harmonics in the power spectrum of pulse wave. This effect of pregnancy on the pulse wave might be caused by the decrease in vascular resistance during pregnancy, the increase in workload on the heart due to increased demand of the growing fetus, and the aortocaval compression caused by the progressively enlarged gravid uterus and fetus.ObjectiveTo investigate the effect of pregnancy on the pulse wave of the mother.Patients and methodsPulse waveforms recorded via a pulse oximeter from the left index finger of non-pregnant women and pregnant women in the three trimesters of pregnancy were Fourier transformed into power spectra. Spectral indices of the power spectra of pulse waveform were obtained and compared among non-pregnant women and pregnant women in the three trimesters of pregnancy.ResultsThe power of harmonics of pulse wave decayed exponentially with respect to the order of harmonics. The exponent and initial value of exponential decay for the power of harmonics and the power of the 2nd harmonic were increased, whereas the total power of pulse and the powers of higher order harmonics were decreased during pregnancy.ConclusionThe power of harmonics of pulse wave can be described by an exponential decay function with respect to the order of harmonics in both non-pregnant and pregnant women. The effects of pregnancy on the pulse wave are the reduction in the total power of pulse and the power of higher order harmonics, and the increase in the power of lower order harmonics in the power spectrum of pulse wave. This effect of pregnancy on the pulse wave might be caused by the decrease in vascular resistance during pregnancy, the increase in workload on the heart due to increased demand of the growing fetus, and the aortocaval compression caused by the progressively enlarged gravid uterus and fetus.

Effect of position on the residual heart rate variability in patients after orthotopic heart transplantation

Background This study investigated the effects of position on heart rate variability (HRV) in patients some years after orthotopic heart transplantation (OHT) surgery. Methods Spectral HRV analysis was performed on 15 patients after OHT and 16 patients with coronary artery disease (CAD). HRV measures were compared between OHT and CAD patients in four randomly ordered positions [supine, right lateral decubitus (RLD), left lateral decubitus (LLD), and upright]. Multivariable linear regression analysis was used to identify the factors associated with cardiac function and HRV of OHT patients in supine position, and the factors associated with the outcome (OHT or CAD) of the patients. Results The powers in all frequency ranges were significantly decreased in all four positions in OHT patients about 9 years after OHT surgery, as compared with those of CAD patients. Both RLD and LLD positions can lead to a significantly higher normalized high‐frequency power in OHT patients than the supine position, as compared with the CAD patients. The LLD position seemed to be better than the other recumbent positions in terms of vagal enhancement in the OHT patients. Multivariable linear regression analysis showed that the left ventricular ejection fraction of OHT patients can be predicted from a linear combination of the OHT to HRV interval, and normalized very low‐frequency power in the supine position. Furthermore, better cardiac function and the presence of cardiomyopathy would increase the necessity of OHT surgery, while the use of nitrates would decrease the necessity of OHT surgery. Conclusion Both the RLD and LLD positions, especially the LLD position, can lead to a higher vagal modulation in OHT patients about 9 years after OHT surgery, provided that the HRV measures can still be regarded as indicators of autonomic nervous modulation in such patients. Moreover, left ventricular ejection fraction, cardiomyopathy, and the use of nitrates were all associated with the necessity of OHT surgery.

Increased first and second pulse harmonics in Tai Chi Chuan practitioners

BackgroundTai Chi Chuan (TCC) is known to be a good calisthenics for people. This study examined the relationship between pulse harmonics and autonomic nervous modulation in TCC practitioners.MethodsPower spectral measures of right pulse wave and heart rate variability (HRV) measures were compared between TCC practitioners and control subjects. Correlation analyses between pulse harmonics and HRV measures were performed using linear regression analysis.ResultsAt baseline, the total power of pulse (TPp), powers of all individual pulse harmonics, normalized power of the 1st harmonics (nPh1) of TCC practitioners were greater, while the normalized power of the 4th pulse harmonics (nPh4) of TCC practitioners was smaller, than those of the controls. Similarly, the baseline standard deviation (SDRR), coefficient of variation (CVRR), and normalized high-frequency power (nHFP) of RR intervals were smaller, while the normalized very low-frequency power (nVLFP) and low-/high- frequency power ratio (LHR) were larger in the TCC practitioners. The TCC age correlated significantly and negatively with nPh1, and nearly significantly and negatively with nPh2 in the TCC practitioners. Thirty min after TCC exercise, the percentage changes in mRRI, SDRR, TP, VLFP were decreased, while the percentage changes in HR, ULFP, nLFP, and Ph2 were increased, relative to the controls. Correlation analysis shows that the %Ph2 correlates significantly and negatively with %mRRI and significantly and positively with %HR.ConclusionThe TCC practitioners had increased baseline total power of pulse and the 1st and 2nd pulse harmonics, and decreased power of the 4th pulse harmonics, along with decreased vagal modulation and increased sympathetic modulation. After TCC exercise, the power of the 2nd harmonics of TCC practitioners was increased which might be related to the increase in HR due to decreased vascular resistance after TCC exercise.

The Changes in Serum Insulin, Aldosterone and Endothelin-1 Levels After 3 Months of Tai Chi Chuan Training in the Adults

Introduction: This study investigated the effects of 3 months of Yang?s Tai Chi Chuan (TCC) training on the hemodynamics, fasting blood sugar (FBS), blood lipids, serum insulin, serum aldosterone, and serum endothelin-1 (ET-1) in the adults. Methods: Twenty normal controls and 22 TCC trainees were recruited to participate in this study. The hemodynamics, FBS, blood lipid, serum insulin, aldosterone, ET-1, HOMA-IR, log(HOMA), QUICKI, and TG/HDL-C before and after 3 months of TCC were compared between the 2 groups of subjects. Results: After 3 months of TCC training, the HDL-C, QUICKI, ET-1, and aldosterone were significantly increased, whereas the serum insulin, HOMA, and log(HOMA) were significantly decreased in the TCC group, as compared with the control group. Intra-group comparison shows that the HDL-C, QUICKI and aldosterone were significantly increased, while the serum insulin, HOMA-IR, log(HOMA), and ET-1 were significantly decreased after 3 months of TCC in the TCC group. The %FBS correlated significantly and negatively with the %TG/HDL-C, %QUICKI, and %ET- 1. The %Insulin correlated significantly and positively with %HOMA, and significantly and negatively with %QUICKI. Conclusion: TCC training for 3 months can increase the serum levels of ET-1 and aldosterone, and decrease serum insulin level and insulin resistance in the TCC trainees. TCC might improve the cardiovascular function and insulin sensitivity of its practitioners through regulation of lipid and glucose metabolism, and the interplay among insulin, aldosterone, and ET-1.