Evaluation of exercise-inducedperiodicbreathing (PB) in cardiopulmonary exercise testing (CPET) is one of important diagnostic evidences to judge the prognosis of chronic heart failure cases. In this study, we propose a method for the quantitative analysis of measured ventilation signals from an exercise test. We used an autoregressive (AR) model to filter the breath-by-breath measurements of ventilation from exercise tests. Then, the signals before reaching the most ventilation were decomposed into intrinsic mode functions (IMF) by using the Hilbert-Huangtransform (HHT). An IMF represents a simple oscillatory pattern which catches a part of original ventilation signal in different frequency band. For each component of IMF, we computed the number of peaks as the feature of its oscillatory pattern denoted by Δ i . In our experiment, 61 chronic heart failure patients with or without PB pattern were studied. The computed peaks of the third and fourth IMF components, Δ3 and Δ4, were statistically significant for the two groups (both p values < 0.02). In summary, our study shows a close link between the HHT analysis and level of intrinsic energy for pulmonary ventilation. The third and fourth IMF components are highly potential to indicate the prognosis of chronic heart failure.
Pancreaticcancer is a difficult-to-treat cancer with a late presentation and poor prognosis. Some patients seek traditional Chinesemedicine (TCM) consultation. We aimed to investigate the benefits of complementaryChineseherbalmedicine (CHM) among patients with pancreaticcancer in Taiwan.
We included all patients with pancreaticcancer who were registered in the Taiwanese Registry for Catastrophic Illness Patients Database between 1997 and 2010. We used 1:1 frequency matching by age, sex, the initial diagnostic year of pancreaticcancer, and index year to enroll 386 CHM users and 386 non-CHM users. A Cox regression model was used to compare the hazard ratios (HRs) of the risk of mortality. The Kaplan-Meier curve was used to compare the difference in survival time.
According to the Cox hazard ratio model mutually adjusted for CHM use, age, sex, urbanization level, comorbidity, and treatments, we found that CHM users had a lower hazard ratio of mortality risk (adjusted HR = 0.67, 95% CI = 0.56-0.79). Those who received CHM therapy for more than 90 days had significantly lower hazard ratios of mortality risk than non-CHM users (90- to 180-day group: adjusted HR = 0.56, 95% CI = 0.42-0.75; >180-day group: HR = 0.33, 95% CI = 0.24-0.45). The survival probability was higher for patients in the CHM group. Bai-hua-she-she-cao (Herba Oldenlandiae; Hedyotis diffusa Spreng) and Xiang-sha-liu-jun-zi-tang (Costus and Chinese Amomum Combination) were the most commonly used single herb and Chineseherbal formula, respectively.
ComplementaryChineseherbaltherapy might be associated with reduced mortality among patients with pancreaticcancer. Further prospective clinical trial is warranted.
Chineseherbalmedicine; National Health Insurance Research Database; complementary and alternative medicine; pancreaticcancer; traditional Chinesemedicine