動機:
多囊性卵巢(Polycystic Ovary Syndrome, PCOS)及中風(stroke)所伴隨的不正常血液動力改變，可能影響心血管系統中的血管及血流特性。血壓波形的諧波分析有助於評估動脈及周邊血管特性的改變，配合微循環血流波形的時頻域分析，可能有助於偵測PCOS及stroke的所伴隨的血液動力的改變。因此，本研究的目的是想確認病患的血壓波形及血流訊號，是否有助於監測PCOS所伴隨的血管特性改變，及評估病患治療前後(stroke-針刺激; PCOS-藥物)的血管特性差異。
方法:
本研究透過心電圖、壓力感測器及雷射都卜勒血流儀來監測PCOS、stroke與正常受試者。在PCOS的實驗設計中，我們量測病患的初始生理狀態及其藥物的追蹤效果。而在stroke的實驗設計中，我們評估針刺激前後的治療效果。在資料處理上，諧波分析被應用在血壓波形訊號，而beat-to-beat的時域波形分析、變異率、複雜度以及小波分析則被應用在血流訊號。
結果:
本研究的發現如下:
1. PCOS和正常空白組的某些諧波參數呈現顯著差異。
2. 在藥物治療後，PCOS的某些諧波參數呈現顯著改變。
3. 在針刺激治療後，stroke病患患側的某些諧波參數呈現顯著改變。

結論:
本研究的結果顯示血壓波形的諧波參數可能有助於偵測由疾病所誘發的血管特性改變，並可能提供心血管調控活動的資訊。而在微循環端，血流分析可能有助於監測局部供血情況、彈性特性及微循環的調控活動程度。本研究的發現除了有助於開發非侵入且持續監測的指標，來偵測疾病如PCOS、stroke及其他疾病所伴隨的血液動力改變，也有助於評估治療如針刺激及藥物對血管特性的影響。

Motivation:
Polycystic ovary syndrome (PCOS) and stroke, are associated with abnormal hemodynamic changes, may present changes of vascular properties and blood supply in the cardiovascular system. Harmonic analysis of blood pressure waveform (BPW) provides a method to detect changes of vascular properties (such as elasticity and diameter) in the artery and the peripheral vascular beds, and hence it may help to evaluate hemodynamic changes induced by diseases and treatments. Therefore, the aim of this study is to verify the possibility harmonic indexes of the arterial blood pressure waveform (BPW) could be used to detect the induced changes of vascular properties by POCS, and evaluate the differences of vascular properties caused by treatments (stroke-acupuncture; PCOS-herbal formula).
Method:
ECG, BPW and blood flow were obtained simultaneously and noninvasively from subjects. In experimental procedure of PCOS studies, we recorded baselines of circulation conditions and medical treatment effects from PCOS patients and normal subjects. In experimental procedure of stroke studies, we measured the treatment effects from stroke patients before and after acupuncture. For the recorded BPW signals, we used harmonic analysis to calculate the amplitude proportion and variability. For the recorded LDF signal, beat-to-beat analysis, variability, complexity and wavelet transform analysis were applied to LDF pulse waveform.
Result:
There were significant differences in several harmonic indexes between PCOS and control groups. Moreover, significant changes in harmonic indexes were also noted in PCOS groups after medical treatments. In stroke subjects, there were significant changes in some specific harmonic indexes at the stroke side following acupuncture stimulation.
Conclusion:
The present results suggested that harmonic indexes of the BPW could provide detail information of arterial pulse propagation (by monitoring Cn), detect changes of vascular properties and evaluate the control activities (by monitoring CVn) in the cardiovascular system. The LDF indexes can also reveal the microcirculatory conditions in PCOS and stroke patients. These findings could help the development of an easy-to-perform, noninvasive, and continuous monitoring technique to improve the detection of hemodynamic changes induced by PCOS, stroke and other diseases. It also provides a new solution to evaluate the treatment effects such as acupuncture and herbal formula on diseases.

[1] W. h. organization. Deaths from stroke. Available: http://www.who.int/cardiovascular_diseases/resources/atlas/en/
[2] 行政院衛生署, "101年國人主要死因統計結果," 2013/6/6
[3] W. R. Milnor., Hemodynamics, 2nd ed ed. Baltimore: Williams & Wilkins, 1989.
[4] W. W. Nichols, "Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms," Am J Hypertens, vol. 18, pp. 3S-10S, Jan 2005.
[5] C. T. Chen, S. M. Huang, H. Hsiu, W. C. Hsu, F. C. Lin, and H. W. Lin, "Using a blood pressure harmonic variability index to monitor the cerebral blood flow condition in stroke patients," Biorheology, vol. 48, pp. 219-28, 2011.
[6] M. E. Safar, B. I. Levy, and H. Struijker-Boudier, "Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases," Circulation, vol. 107, pp. 2864-9, Jun 10 2003.
[7] A. Tuttolomondo, R. Di Sciacca, D. Di Raimondo, A. Serio, G. D'Aguanno, A. Pinto, et al., "Arterial stiffness indexes in acute ischemic stroke: relationship with stroke subtype," Atherosclerosis, vol. 211, pp. 187-94, Jul 2010.
[8] T. L. Hsu, P. T. Chao, H. Hsiu, W. K. Wang, S. P. Li, and Y. Y. Wang, "Organ-specific ligation-induced changes in harmonic components of the pulse spectrum and regional vasoconstrictor selectivity in Wistar rats," Exp Physiol, vol. 91, pp. 163-70, Jan 2006.
[9] Y. Y. Wang, S. L. Chang, Y. E. Wu, T. L. Hsu, and W. K. Wang, "Resonance. The missing phenomenon in hemodynamics," Circ Res, vol. 69, pp. 246-9, Jul 1991.
[10] R. L. Farrow and R. W. Stacy, "Harmonic analysis of aortic pressure pulses in the dog," Circ Res, vol. 9, pp. 395-401, Mar 1961.
[11] S. T. Young, W. K. Wang, L. S. Chang, and T. S. Kuo, "The filter properties of the arterial beds of organs in rats," Acta Physiol Scand, vol. 145, pp. 401-6, Aug 1992.
[12] S. T. Young, W. K. Wang, L. S. Chang, and T. S. Kuo, "Specific frequency properties of renal and superior mesenteric arterial beds in rats," Cardiovasc Res, vol. 23, pp. 465-7, Jun 1989.
[13] W. A. Lu, C. H. Cheng, Y. Y. Lin Wang, and W. K. Wang, "Pulse spectrum analysis of hospital patients with possible liver problems," Am J Chin Med, vol. 24, pp. 315-20, 1996.
[14] Y. Y. L. Wang, T. L. Hsu, M. Y. Jan, and W. K. Wang, "Theory and Applications of the Harmonic Analysis of Arterial Pressure Pulse Waves," Journal of Medical and Biological Engineering, vol. 30, pp. 125-131, 2010.
[15] W. K. Wang, T. L. Hsu, J. G. Bau, and Y. Y. Wang-Lin, "Evaluation of herbal formulas by pulse analysis method," Acta Pharmacol Sin, vol. 24, pp. 145-51, Feb 2003.
[16] W. K. Wang, T. L. Hsu, and Y. Y. Wang, "Liu-wei-dihuang: a study by pulse analysis," Am J Chin Med, vol. 26, pp. 73-82, 1998.
[17] H. Hsiu, C. L. Hsu, C. T. Chen, W. C. Hsu, and F. C. Lin, "Effects of acupuncture on the harmonic components of the radial arterial blood-pressure waveform in stroke patients," Biorheology, vol. 50, pp. 69-81, 2013.
[18] B. C. Fauser, J. S. Laven, B. C. Tarlatzis, K. H. Moley, H. O. Critchley, R. N. Taylor, et al., "Sex steroid hormones and reproductive disorders: impact on women's health," Reprod Sci, vol. 18, pp. 702-12, Aug 2011.
[19] M. T. Sheehan, "Polycystic ovarian syndrome: diagnosis and management," Clin Med Res, vol. 2, pp. 13-27, Feb 2004.
[20] P. C. de Groot, O. M. Dekkers, J. A. Romijn, S. W. Dieben, and F. M. Helmerhorst, "PCOS, coronary heart disease, stroke and the influence of obesity: a systematic review and meta-analysis," Hum Reprod Update, vol. 17, pp. 495-500, Jul-Aug 2011.
[21] S. Iftikhar, M. L. Collazo-Clavell, V. L. Roger, J. St Sauver, R. D. Brown, Jr., S. Cha, et al., "Risk of cardiovascular events in patients with polycystic ovary syndrome," Neth J Med, vol. 70, pp. 74-80, Mar 2012.
[22] A. J. Cussons, B. G. Stuckey, and G. F. Watts, "Cardiovascular disease in the polycystic ovary syndrome: new insights and perspectives," Atherosclerosis, vol. 185, pp. 227-39, Apr 2006.
[23] N. I. o. health. (2012/12). Available: http://prevention/workshops/2012/pcos/,
[24] E. A.-S. P. C. W. G. Rotterdam, "Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome," Fertil Steril, vol. 81, pp. 19-25, Jan 2004.
[25] A. H. Balen, G. S. Conway, G. Kaltsas, K. Techatrasak, P. J. Manning, C. West, et al., "Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients," Hum Reprod, vol. 10, pp. 2107-11, Aug 1995.
[26] C. Dessapt-Baradez, M. Reza, G. Sivakumar, M. Hernandez-Fuentes, K. Markakis, L. Gnudi, et al., "Circulating vascular progenitor cells and central arterial stiffness in polycystic ovary syndrome," PLoS One, vol. 6, p. e20317, 2011.
[27] M. Brewer, M. Pawelczak, M. Kessler, and B. Shah, "A review of polycystic ovarian syndrome in adolescents," Minerva Pediatr, vol. 62, pp. 459-73, Oct 2010.
[28] A. B. Motta, "The role of obesity in the development of polycystic ovary syndrome," Curr Pharm Des, vol. 18, pp. 2482-91, 2012.
[29] 迟贞旎, "多囊卵巢综合征的治疗方法," Journal of Shanghai J iaotong University, vol. 28, 2008.
[30] H. Lashen, "Role of metformin in the management of polycystic ovary syndrome," Ther Adv Endocrinol Metab, vol. 1, pp. 117-28, Jun 2010.
[31] R. W. Kistner, J. L. Lewis, and G. J. Steiner, "Effects of clomiphene citrate on endometrial hyperplasia in the premenopausal female," Cancer, vol. 19, pp. 115-26, Jan 1966.
[32] J. K. Williams, R. Delansorne, and J. Paris, "Estrogens, progestins, and coronary artery reactivity in atherosclerotic monkeys," J Steroid Biochem Mol Biol, vol. 65, pp. 219-24, Apr 1998.
[33] N. Agarwal, S. P. Rice, H. Bolusani, S. D. Luzio, G. Dunseath, M. Ludgate, et al., "Metformin reduces arterial stiffness and improves endothelial function in young women with polycystic ovary syndrome: a randomized, placebo-controlled, crossover trial," J Clin Endocrinol Metab, vol. 95, pp. 722-30, Feb 2010.
[34] G. Paradisi, H. O. Steinberg, A. Hempfling, J. Cronin, G. Hook, M. K. Shepard, et al., "Polycystic ovary syndrome is associated with endothelial dysfunction," Circulation, vol. 103, pp. 1410-5, Mar 13 2001.
[35] R. S. Legro, A. R. Kunselman, and A. Dunaif, "Prevalence and predictors of dyslipidemia in women with polycystic ovary syndrome," Am J Med, vol. 111, pp. 607-13, Dec 1 2001.
[36] E. Talbott, A. Clerici, S. L. Berga, L. Kuller, D. Guzick, K. Detre, et al., "Adverse lipid and coronary heart disease risk profiles in young women with polycystic ovary syndrome: results of a case-control study," J Clin Epidemiol, vol. 51, pp. 415-22, May 1998.
[37] 奚永江, 針法灸法學, 初版 ed.: 新華書局, 民國八十一年.
[38] P. Li, H. Wang, J. Gao, A. Tong, B. Wu, and L. Yu, "Needling Neiguan (P 6) for treatment of low pulse pressure syndrome--a report of 31 cases," J Tradit Chin Med, vol. 25, pp. 273-5, Dec 2005.
[39] D. C. Lee, D. S. Yoon, M. O. Lee, and D. H. Clifford, "Some effects of acupuncture at Jen Chung (Go-26) on cardiovascular dynamics in dogs," Can J Comp Med, vol. 41, pp. 446-54, Oct 1977.
[40] H. Hsiu, W. C. Hsu, C. L. Hsu, and S. M. Huang, "Assessing the effects of acupuncture by comparing needling the hegu acupoint and needling nearby nonacupoints by spectral analysis of microcirculatory laser Doppler signals," Evid Based Complement Alternat Med, vol. 2011, p. 435928, 2011.
[41] C. Y. Chang, M. J. Chen, W. S. Yang, C. Y. Yeh, H. N. Ho, S. U. Chen, et al., "Hypoadiponectinemia: a useful marker of dyslipidemia in women with polycystic ovary syndrome," Taiwan J Obstet Gynecol, vol. 51, pp. 583-90, Dec 2012.
[42] M. Rajkhowa, R. H. Neary, P. Kumpatla, F. L. Game, P. W. Jones, M. S. Obhrai, et al., "Altered composition of high density lipoproteins in women with the polycystic ovary syndrome," J Clin Endocrinol Metab, vol. 82, pp. 3389-94, Oct 1997.
[43] M. R. Adams, J. K. Williams, and J. R. Kaplan, "Effects of androgens on coronary artery atherosclerosis and atherosclerosis-related impairment of vascular responsiveness," Arterioscler Thromb Vasc Biol, vol. 15, pp. 562-70, May 1995.
[44] G. P. Bernini, A. Moretti, M. Sgro, G. F. Argenio, C. O. Barlascini, R. Cristofani, et al., "Influence of endogenous androgens on carotid wall in postmenopausal women," Menopause, vol. 8, pp. 43-50, Jan-Feb 2001.
[45] P. Y. Liu, A. K. Death, and D. J. Handelsman, "Androgens and cardiovascular disease," Endocr Rev, vol. 24, pp. 313-40, Jun 2003.
[46] A. Galluzzo, M. C. Amato, and C. Giordano, "Insulin resistance and polycystic ovary syndrome," Nutr Metab Cardiovasc Dis, vol. 18, pp. 511-8, Sep 2008.
[47] 吳菁洳、楊雅雯. (中華民國九十八年六月出版) 多囊性卵巢症候群與胰島素增敏劑的治療. 臨床藥學. 72-77.
[48] G. E. Nilsson, T. Tenland, and P. A. Oberg, "Evaluation of a laser Doppler flowmeter for measurement of tissue blood flow," IEEE Trans Biomed Eng, vol. 27, pp. 597-604, Oct 1980.
[49] A. D. Hughes, C. Park, J. Davies, D. Francis, G. T. S. A. Mc, J. Mayet, et al., "Limitations of augmentation index in the assessment of wave reflection in normotensive healthy individuals," PLoS One, vol. 8, p. e59371, 2013.
[50] J. A. Chirinos, J. G. Kips, D. R. Jacobs, Jr., L. Brumback, D. A. Duprez, R. Kronmal, et al., "Arterial wave reflections and incident cardiovascular events and heart failure: MESA (Multiethnic Study of Atherosclerosis)," J Am Coll Cardiol, vol. 60, pp. 2170-7, Nov 20 2012.
[51] H. Hsiu, P. T. Chao, W. R. Chiang, R. Y. Hsu, M. Y. Jan, T. L. Hsu, et al., "Evaluation of stationarity of laser Doppler signal in the pulse-based synchronized-averaging analysis," Conf Proc IEEE Eng Med Biol Soc, vol. 2007, pp. 982-4, 2007.
[52] C. J. Kelly, A. Speirs, G. W. Gould, J. R. Petrie, H. Lyall, and J. M. Connell, "Altered vascular function in young women with polycystic ovary syndrome," J Clin Endocrinol Metab, vol. 87, pp. 742-6, Feb 2002.
[53] D. Romualdi, B. Costantini, L. Selvaggi, M. Giuliani, F. Cristello, F. Macri, et al., "Metformin improves endothelial function in normoinsulinemic PCOS patients: a new prospective," Hum Reprod, vol. 23, pp. 2127-33, Sep 2008.
[54] R. D. Latham, N. Westerhof, P. Sipkema, B. J. Rubal, P. Reuderink, and J. P. Murgo, "Regional wave travel and reflections along the human aorta: a study with six simultaneous micromanometric pressures," Circulation, vol. 72, pp. 1257-69, Dec 1985.
[55] H. Hsiu, S. M. Huang, C. L. Hsu, S. F. Hu, and H. W. Lin, "Effects of cold stimulation on the harmonic structure of the blood pressure and photoplethysmography waveforms," Photomed Laser Surg, vol. 30, pp. 77-84, Feb 2012.
[56] K. Lakhani, A. M. Seifalian, and P. Hardiman, "Impaired carotid viscoelastic properties in women with polycystic ovaries," Circulation, vol. 106, pp. 81-5, Jul 2 2002.
[57] R. Shroff, A. Kerchner, M. Maifeld, E. J. Van Beek, D. Jagasia, and A. Dokras, "Young obese women with polycystic ovary syndrome have evidence of early coronary atherosclerosis," J Clin Endocrinol Metab, vol. 92, pp. 4609-14, Dec 2007.
[58] W. A. Lu, Y. Y. Wang, and W. K. Wang, "Pulse analysis of patients with severe liver problems. Studying pulse spectrums to determine the effects on other organs," IEEE Eng Med Biol Mag, vol. 18, pp. 73-5, Jan-Feb 1999.
[59] T. C. Rodrigues, J. Ehrlich, C. M. Hunter, G. L. Kinney, M. Rewers, and J. K. Snell-Bergeon, "Reduced heart rate variability predicts progression of coronary artery calcification in adults with type 1 diabetes and controls without diabetes," Diabetes Technol Ther, vol. 12, pp. 963-9, Dec 2010.
[60] J. F. Thayer, S. S. Yamamoto, and J. F. Brosschot, "The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors," Int J Cardiol, vol. 141, pp. 122-31, May 28 2010.
[61] H. Fakhrzadeh, A. Yamini-Sharif, F. Sharifi, Y. Tajalizadekhoob, M. Mirarefin, M. Mohammadzadeh, et al., "Cardiac autonomic neuropathy measured by heart rate variability and markers of subclinical atherosclerosis in early type 2 diabetes," ISRN Endocrinol, vol. 2012, p. 168264, 2012.
[62] A. J. Seely and P. T. Macklem, "Complex systems and the technology of variability analysis," Crit Care, vol. 8, pp. R367-84, Dec 2004.
[63] H. M. Stauss, "Identification of blood pressure control mechanisms by power spectral analysis," Clin Exp Pharmacol Physiol, vol. 34, pp. 362-8, Apr 2007.
[64] H. Kai, H. Kudo, N. Takayama, S. Yasuoka, H. Kajimoto, and T. Imaizumi, "Large blood pressure variability and hypertensive cardiac remodeling--role of cardiac inflammation," Circ J, vol. 73, pp. 2198-203, Dec 2009.
[65] G. Parati, J. E. Ochoa, and G. Bilo, "Blood pressure variability, cardiovascular risk, and risk for renal disease progression," Curr Hypertens Rep, vol. 14, pp. 421-31, Oct 2012.
[66] K. Lakhani, P. Hardiman, and A. M. Seifalian, "Intima-media thickness of elastic and muscular arteries of young women with polycystic ovaries," Atherosclerosis, vol. 175, pp. 353-9, Aug 2004.
[67] A. Eke, P. Herman, and M. Hajnal, "Fractal and noisy CBV dynamics in humans: influence of age and gender," J Cereb Blood Flow Metab, vol. 26, pp. 891-8, Jul 2006.
[68] A. Virdis, L. Ghiadoni, A. A. Qasem, G. Lorenzini, E. Duranti, G. Cartoni, et al., "Effect of aliskiren treatment on endothelium-dependent vasodilation and aortic stiffness in essential hypertensive patients," Eur Heart J, vol. 33, pp. 1530-8, Jun 2012.
[69] G. W. Zhong, M. J. Chen, Y. H. Luo, L. L. Xiang, Q. Y. Xie, Y. H. Li, et al., "Effect of Chinese herbal medicine for calming Gan () and suppressing hyperactive yang on arterial elasticity function and circadian rhythm of blood pressure in patients with essential hypertension," Chin J Integr Med, vol. 17, pp. 414-20, Jun 2011.
[70] M. A. Creager and M. A. Roddy, "Effect of captopril and enalapril on endothelial function in hypertensive patients," Hypertension, vol. 24, pp. 499-505, Oct 1994.
[71] S. U. Park, W. S. Jung, S. K. Moon, C. N. Ko, K. H. Cho, Y. S. Kim, et al., "Chunghyul-dan (Qingxie-dan) improves arterial stiffness in patients with increased baPWV," Am J Chin Med, vol. 34, pp. 553-63, 2006.
[72] S. H. Wang, M. Y. Jan, W. K. Wang, and Y. Y. Wang, "Effects of antihypertensive drugs on specific harmonic indices of the pulse waveform in normotensive Wistar Kyoto rats," Clin Exp Hypertens, vol. 34, pp. 74-8, 2012.
[73] N. Sekiya, M. Kainuma, H. Hikiami, T. Nakagawa, K. Kouta, N. Shibahara, et al., "Oren-gedoku-to and Keishi-bukuryo-gan-ryo inhibit the progression of atherosclerosis in diet-induced hypercholesterolemic rabbits," Biol Pharm Bull, vol. 28, pp. 294-8, Feb 2005.
[74] K. Nozaki, H. Goto, T. Nakagawa, H. Hikiami, K. Koizumi, N. Shibahara, et al., "Effects of keishibukuryogan on vascular function in adjuvant-induced arthritis rats," Biol Pharm Bull, vol. 30, pp. 1042-7, Jun 2007.
[75] Y. Nagata, H. Goto, H. Hikiami, T. Nogami, M. Fujimoto, N. Shibahara, et al., "Effect of keishibukuryogan on endothelial function in patients with at least one component of the diagnostic criteria for metabolic syndrome: a controlled clinical trial with crossover design," Evid Based Complement Alternat Med, vol. 2012, p. 359282, 2012.
[76] K. Fujita, T. Yamamoto, T. Kamezaki, and A. Matsumura, "Efficacy of keishibukuryogan, a traditional Japanese herbal medicine, in treating cold sensation and numbness after stroke: clinical improvement and skin temperature normalization in 22 stroke patients," Neurol Med Chir (Tokyo), vol. 50, pp. 1-5; discussion 5-6, Jan 2010.
[77] T. Ushiroyama, A. Ikeda, K. Sakuma, and M. Ueki, "Comparing the effects of estrogen and an herbal medicine on peripheral blood flow in post-menopausal women with hot flashes: hormone replacement therapy and gui-zhi-fu-ling-wan, a Kampo medicine," Am J Chin Med, vol. 33, pp. 259-67, 2005.
[78] W. K. Wang, H. L. Chen, T. L. Hsu, and Y. Y. Wang, "Alteration of pulse in human subjects by three Chinese herbs," Am J Chin Med, vol. 22, pp. 197-203, 1994.
[79] F. Lombardi, D. Torzillo, G. Sandrone, L. Dalla Vecchia, M. L. Finocchiaro, R. Bernasconi, et al., "Beta-blocking effect of propafenone based on spectral analysis of heart rate variability," Am J Cardiol, vol. 70, pp. 1028-34, Oct 15 1992.
[80] G. Zuanetti, R. Latini, J. M. Neilson, P. J. Schwartz, and D. J. Ewing, "Heart rate variability in patients with ventricular arrhythmias: effect of antiarrhythmic drugs. Antiarrhythmic Drug Evaluation Group (ADEG)," J Am Coll Cardiol, vol. 17, pp. 604-12, Mar 1 1991.
[81] W. Jiang, S. Ladd, C. Martsberger, M. Feinglos, S. E. Spratt, M. Kuchibhatla, et al., "Effects of pregabalin on heart rate variability in patients with painful diabetic neuropathy," J Clin Psychopharmacol, vol. 31, pp. 207-13, Apr 2011.
[82] J. Wang, F. M. Shen, M. W. Wang, and D. F. Su, "Effects of nine antihypertensive drugs on blood pressure variability in sinoaortic-denervated rats," Acta Pharmacol Sin, vol. 27, pp. 1013-7, Aug 2006.
[83] D. F. Su and C. Y. Miao, "Reduction of blood pressure variability: a new strategy for the treatment of hypertension," Trends Pharmacol Sci, vol. 26, pp. 388-90, Aug 2005.
[84] H. Hsiu, S. M. Huang, and T. L. Hsu, "Evaluation of the function of arteriolar opening by variability in microcirculatory blood flow following angiotensin II administration in rats," Biorheology, vol. 47, pp. 239-53, 2010.
[85] P. C. Williams, M. D. Stern, P. D. Bowen, R. A. Brooks, M. K. Hammock, R. L. Bowman, et al., "Mapping of cerebral cortical strokes in Rhesus monkeys by laser Doppler spectroscopy," Med Res Eng, vol. 13, pp. 3-5, 1980.
[86] G. P. Rodgers, A. N. Schechter, C. T. Noguchi, H. G. Klein, A. W. Nienhuis, and R. F. Bonner, "Periodic microcirculatory flow in patients with sickle-cell disease," N Engl J Med, vol. 311, pp. 1534-8, Dec 13 1984.
[87] U. Dirnagl, B. Kaplan, M. Jacewicz, and W. Pulsinelli, "Continuous measurement of cerebral cortical blood flow by laser-Doppler flowmetry in a rat stroke model," J Cereb Blood Flow Metab, vol. 9, pp. 589-96, Oct 1989.
[88] D. Tsantilas, A. I. Hatzitolios, K. Tziomalos, D. Karamitsos, and D. Papadimitriou, "Effects of buflomedil on skin blood flow in patients with type 2 diabetes mellitus without overt micro- or macroangiopathy," Int Angiol, vol. 30, pp. 164-71, Apr 2011.
[89] H. Hsiu, S. M. Huang, C. T. Chen, C. L. Hsu, and W. C. Hsu, "Acupuncture stimulation causes bilaterally different microcirculatory effects in stroke patients," Microvasc Res, vol. 81, pp. 289-94, May 2011.
[90] H. Hsiu, W. C. Hsu, C. L. Hsu, C. Y. Chen, and Y. F. Wu, "Effects of oral ingestion of two herbal formulas (Qi-Gong Wan and Gui-Zhi-Fu-Ling Wan) on the skin-surface laser-Doppler signals in polycystic-ovary subjects," under review.
[91] H. Hsiu, W. C. Hsu, Y. F. Wu, C. L. Hsu, and C. Y. Chen, "Differences in the skin-surface laser-Doppler signals between polycystic-ovary-syndrome and normal subjects," Microcirculation, Oct 1 2013.
[92] H. Hsiu, W. C. Hsu, C. L. Hsu, J. G. Bau, C. T. Chen, and Y. S. Liu, "Complexity analysis of the microcirculatory-blood-flow response following acupuncture stimulation," Microvasc Res, vol. 89, pp. 34-9, Sep 2013.
[93] H. Hsiu, C. L. Hsu, and M. Y. Jan, "Relations between beat-to-beat microcirculatory blood flow and variations therein," Photomed Laser Surg, vol. 28, pp. 785-92, Dec 2010.
[94] L. Bernardi, M. Rossi, P. Fratino, G. Finardi, E. Mevio, and C. Orlandi, "Relationship between phasic changes in human skin blood flow and autonomic tone," Microvasc Res, vol. 37, pp. 16-27, Jan 1989.
[95] P. Kvandal, S. A. Landsverk, A. Bernjak, A. Stefanovska, H. D. Kvernmo, and K. A. Kirkeboen, "Low-frequency oscillations of the laser Doppler perfusion signal in human skin," Microvasc Res, vol. 72, pp. 120-7, Nov 2006.
[96] B. J. West, Fractal Physiology. New York: Oxford University Press, 1994.
[97] H. T. Wu, C. Y. Lee, C. C. Liu, and A. B. Liu, "Multiscale cross-approximate entropy analysis as a measurement of complexity between ECG R-R interval and PPG pulse amplitude series among the normal and diabetic subjects," Comput Math Methods Med, vol. 2013, p. 231762, 2013.
[98] G. M. Lee, S. Fattinger, A. L. Mouthon, Q. Noirhomme, and R. Huber, "Electroencephalogram approximate entropy influenced by both age and sleep," Front Neuroinform, vol. 7, p. 33, 2013.
[99] R. Sun, R. Song, and K. Y. Tong, "Complexity Analysis of EMG Signals for Patients After Stroke During Robot-Aided Rehabilitation Training Using Fuzzy Approximate Entropy," IEEE Trans Neural Syst Rehabil Eng, Nov 13 2013.
[100] F. Liao, D. W. Garrison, and Y. K. Jan, "Relationship between nonlinear properties of sacral skin blood flow oscillations and vasodilatory function in people at risk for pressure ulcers," Microvasc Res, vol. 80, pp. 44-53, Jul 2010.
[101] F. Liao, W. D. O'Brien, Jr., and Y. K. Jan, "Assessing complexity of skin blood flow oscillations in response to locally applied heating and pressure in rats: implications for pressure ulcer risk," Physica A, vol. 392, Oct 15 2013.
[102] F. Esen, S. Caglar, N. Ata, T. Ulus, A. Birdane, and H. Esen, "Fractal scaling of laser Doppler flowmetry time series in patients with essential hypertension," Microvasc Res, vol. 82, pp. 291-5, Nov 2011.
[103] R. B. Panerai, "Complexity of the human cerebral circulation," Philos Trans A Math Phys Eng Sci, vol. 367, pp. 1319-36, Apr 13 2009.
[104] A. V. Tankanag, I. V. Tikhonova, and N. K. Chemeris, "[Age-dependent characteristics of the skin peripheral blood flow oscillations by nonlinear dynamics methods in humans]," Ross Fiziol Zh Im I M Sechenova, vol. 94, pp. 260-6, Mar 2008.
[105] H. T. Wu, C. C. Liu, M. T. Lo, P. C. Hsu, A. B. Liu, K. Y. Chang, et al., "Multiscale cross-approximate entropy analysis as a measure of complexity among the aged and diabetic," Comput Math Methods Med, vol. 2013, p. 324325, 2013.
[106] J. H. Zhang, D. Wang, and M. Liu, "Overview of systematic reviews and meta-analyses of acupuncture for stroke," Neuroepidemiology, vol. 42, pp. 50-8, 2014.
[107] W. Zhou and J. C. Longhurst, "Neuroendocrine mechanisms of acupuncture in the treatment of hypertension," Evid Based Complement Alternat Med, vol. 2012, p. 878673, 2012.
[108] K. Linde, G. Allais, B. Brinkhaus, E. Manheimer, A. Vickers, and A. R. White, "Acupuncture for tension-type headache," Cochrane Database Syst Rev, p. CD007587, 2009.
[109] T. Huang, L. J. Yang, W. B. Zhang, S. Y. Jia, Y. Y. Tian, G. J. Wang, et al., "Observation of Microvascular Perfusion in the Hegu (LI4) Acupoint Area after Deqi Acupuncture at Quchi (LI11) Acupoint Using Speckle Laser Blood Flow Scanning Technology," Evid Based Complement Alternat Med, vol. 2012, p. 604590, 2012.
[110] J. M. Park, A. S. Shin, S. U. Park, I. S. Sohn, W. S. Jung, and S. K. Moon, "The acute effect of acupuncture on endothelial dysfunction in patients with hypertension: a pilot, randomized, double-blind, placebo-controlled crossover trial," J Altern Complement Med, vol. 16, pp. 883-8, Aug 2010.
[111] J. S. Lee and Y. C. Fung, "Flow in nonuniform small blood vessels," Microvasc Res, vol. 3, pp. 272-87, Jul 1971.
[112] G. B. Moody. (2012). Approximate Entropy (Apen).
[113] R. J. Storella, H. W. Wood, K. M. Mills, J. K. Kanters, M. V. Hojgaard, and N. H. Holstein-Rathlou, "Approximate entropy and point correlation dimension of heart rate variability in healthy subjects," Integr Physiol Behav Sci, vol. 33, pp. 315-20, Oct-Dec 1998.
[114] J. S. Richman and J. R. Moorman, "Physiological time-series analysis using approximate entropy and sample entropy," Am J Physiol Heart Circ Physiol, vol. 278, pp. H2039-49, Jun 2000.
[115] E. Hori, K. Takamoto, S. Urakawa, T. Ono, and H. Nishijo, "Effects of acupuncture on the brain hemodynamics," Auton Neurosci, vol. 157, pp. 74-80, Oct 28 2010.
[116] M. Sandberg, L. G. Lindberg, and B. Gerdle, "Peripheral effects of needle stimulation (acupuncture) on skin and muscle blood flow in fibromyalgia," Eur J Pain, vol. 8, pp. 163-71, Apr 2004.
[117] M. Rossi, A. Bradbury, A. Magagna, M. Pesce, S. Taddei, and A. Stefanovska, "Investigation of skin vasoreactivity and blood flow oscillations in hypertensive patients: effect of short-term antihypertensive treatment," J Hypertens, vol. 29, pp. 1569-76, Aug 2011.
[118] H. Hsiu, W. C. Hsu, C. L. Hsu, S. M. Huang, and Y. Y. Lin, "Microcirculatory changes by laser Doppler after infrared heating over acupuncture points--relevance to moxibustion," Photomed Laser Surg, vol. 27, pp. 855-61, Dec 2009.
[119] H. Hsiu, W. C. Hsu, C. L. Hsu, S. M. Huang, T. L. Hsu, and Y. Y. Wang, "Spectral analysis on the microcirculatory laser Doppler signal of the acupuncture effect," Conf Proc IEEE Eng Med Biol Soc, vol. 2008, pp. 2916-9, 2008.
[120] T. Soderstrom, A. Stefanovska, M. Veber, and H. Svensson, "Involvement of sympathetic nerve activity in skin blood flow oscillations in humans," Am J Physiol Heart Circ Physiol, vol. 284, pp. H1638-46, May 2003.
[121] D. Thomas, S. Collins, and S. Strauss, "Somatic sympathetic vasomotor changes documented by medical thermographic imaging during acupuncture analgesia," Clin Rheumatol, vol. 11, pp. 55-9, Mar 1992.
[122] S. Knardahl, M. Elam, B. Olausson, and B. G. Wallin, "Sympathetic nerve activity after acupuncture in humans," Pain, vol. 75, pp. 19-25, Mar 1998.
[123] B. Anderson, A. Nielsen, D. McKee, A. Jeffres, and B. Kligler, "Acupuncture and heart rate variability: a systems level approach to understanding mechanism," Explore (NY), vol. 8, pp. 99-106, Mar-Apr 2012.