• Title/Summary/Keyword: center qi

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Sequencing Methods to Study the Microbiome with Antibiotic Resistance Genes in Patients with Pulmonary Infections

  • Tingyan Dong;Yongsi Wang;Chunxia Qi;Wentao Fan;Junting Xie;Haitao Chen;Hao Zhou;Xiaodong Han
    • Journal of Microbiology and Biotechnology
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    • v.34 no.8
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    • pp.1617-1626
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    • 2024
  • Various antibiotic-resistant bacteria (ARB) are known to induce repeated pulmonary infections and increase morbidity and mortality. A thorough knowledge of antibiotic resistance is imperative for clinical practice to treat resistant pulmonary infections. In this study, we used a reads-based method and an assembly-based method according to the metagenomic next-generation sequencing (mNGS) data to reveal the spectra of ARB and corresponding antibiotic resistance genes (ARGs) in samples from patients with pulmonary infections. A total of 151 clinical samples from 144 patients with pulmonary infections were collected for retrospective analysis. The ARB and ARGs detection performance was compared by the reads-based method and assembly-based method with the culture method and antibiotic susceptibility testing (AST), respectively. In addition, ARGs and the attribution relationship of common ARB were analyzed by the two methods. The comparison results showed that the assembly-based method could assist in determining pathogens detected by the reads-based method as true ARB and improve the predictive capabilities (46% > 13%). ARG-ARB network analysis revealed that assembly-based method could promote determining clear ARG-bacteria attribution and 101 ARGs were detected both in two methods. 25 ARB were obtained by both methods, of which the most predominant ARB and its ARGs in the samples of pulmonary infections were Acinetobacter baumannii (ade), Pseudomonas aeruginosa (mex), Klebsiella pneumoniae (emr), and Stenotrophomonas maltophilia (sme). Collectively, our findings demonstrated that the assembly-based method could be a supplement to the reads-based method and uncovered pulmonary infection-associated ARB and ARGs as potential antibiotic treatment targets.

Study on the shielding performance of bismuth oxide as a spent fuel dry storage container based on Monte Carlo simulation

  • Guo-Qiang Zeng;Shuang Qi;Peng Cheng;Sheng Lv;Fei Li;Xiao-Bo Wang;Bing-Hai Li;Qing-Ao Qin
    • Nuclear Engineering and Technology
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    • v.56 no.8
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    • pp.3307-3314
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    • 2024
  • For traditional spent fuel shielding materials, due to physical and chemical defects and cost constraints, they have been unable to meet the needs. Therefore, this paper carries out the first discussion on the application and performance of bismuth in neutron shielding by establishing Monte Carlo simulation on the neutron flux model of shielded spent fuel. Firstly, functional fillers such as bismuth oxide, lead oxide, boron oxide, gadolinium oxide and tungsten oxide are added to the matrices to compare the shielding rates of aluminum alloy matrix and silicone rubber matrix. The shielding rate of silicone rubber mixture is higher than aluminum alloy mixture, reaching more than 56%. The optimal addition proportion of bismuth oxide and lead oxide is 30%, and the neutron radiation protection efficiency reaches 60%. Then, the mass attenuation coefficients of bismuth oxide, lead oxide, boron oxide, gadolinium oxide and tungsten oxide in silicone rubber matrix are simulated with the change of functional fillers proportion and neutron energy. This simulation result shows that the mixture with functional fillers has good shielding performance for low energy neutrons, but poor shielding effect for high energy neutrons. Finally, in order to further evaluate the possibility of replacing lead oxide with bismuth oxide as shielding material, the half-value layers and various properties of bismuth oxide and lead oxide are compared. The results show that the shielding properties of bismuth oxide and lead oxide are basically the same, and the mechanical properties, heat resistance, radiation resistance and environmental protection of bismuth oxide are better than that of lead oxide. Therefore, in the case of neutron source strengths in the range of 0.01-6 MeV and secondary gamma rays produced below 2.5 MeV, bismuth can replace lead in neutron shielding applications.

Nanotechnology-enabled diagnostics for the correlation between serum APN, Cystatin C and MMP-9 levels in patients with hypertension during pregnancy

  • Hui Deng;Yu-Lan Fan;Yu-Qi Wang;Yin Yang;Da-Yong Jiang
    • Advances in nano research
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    • v.17 no.3
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    • pp.213-219
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    • 2024
  • Nanotechnology is one of the critical factors involved in enhancing the sensitivity of serum biomarker detection. To explore the relationship between serum APN, Cystatin C and MMP-9 levels in patients with hypertension during pregnancy and the severity and prognosis of the disease. A total of 75 cases of hypertensive disorder complicating pregnancy (HDCP) patients who were admitted to the hospital from February 5, 2023 to May 9, 2024, were selected as the study group, and 70 healthy pregnant women who were in the same gestational week were selected as the control group. The serum APN, MMP-9 and Cys C levels of pregnant women and HDCP patients with different disease severity were compared between the two groups, and the receiver characteristic curve (ROC) was used to analyze its diagnostic value. The serum APN, MMP-9 and Cys C levels of HDCP patients with different prognosis were compared, and the factors affecting the prognosis of patients were analyzed by Logistic regression. Nanoparticles could aslo enable the sensitive detection and quantification of APN, Cystatin C, and MMP-9 in serum samples, thus increasing the accuracy of the study. The serum MMP-9 and Cys C levels of pregnant women in the study group were significantly increased, and the APN level was significantly decreased (P<0.05). Serum MMP-9 and Cys C levels in patients with pregnancy-induced hypertension, mild preeclampsia, and severe preeclampsia gradually increased (r=0.768, 0.766; P<0.001), and APN levels gradually decreased (r=-0.748, P< 0.001). In the diagnosis of patients with HDCP, the sensitivity, specificity and AUC of APN single diagnosis were 70.00%, 82.67% and 9.848 respectively. The sensitivity, specificity and AUC of MMP-9 single diagnosis were 82.86%, 74.67% and 298.300 respectively. The sensitivity, specificity and AUC of Cys C single diagnosis were 80.00%, 74.67% and 1.301 respectively. There were significant differences in age, BMI, parity, dysthymia, disease severity, APN, MMP-9 and Cys between patients with poor prognosis of HDCP and patients with good prognosis of HDCP (P<0.001). The patient's age, BMI, disease severity, APN, MMP-9 and Cys Cwere all related to HDCP. They were related risk factors of HDCP (P<0.05).

Ginsenoside compound K protects against cerebral ischemia/ reperfusion injury via Mul1/Mfn2-mediated mitochondrial dynamics and bioenergy

  • Qingxia Huang;Jing Li;Jinjin Chen;Zepeng Zhang;Peng Xu;Hongyu Qi;Zhaoqiang Chen;Jiaqi Liu;Jing Lu;Mengqi Shi;Yibin Zhang;Ying Ma;Daqing Zhao;Xiangyan Li
    • Journal of Ginseng Research
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    • v.47 no.3
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    • pp.408-419
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    • 2023
  • Background: Ginsenoside compound K (CK), the main active metabolite in Panax ginseng, has shown good safety and bioavailability in clinical trials and exerts neuroprotective effects in cerebral ischemic stroke. However, its potential role in the prevention of cerebral ischemia/reperfusion (I/R) injury remains unclear. Our study aimed to investigate the molecular mechanism of ginsenoside CK against cerebral I/R injury. Methods: We used a combination of in vitro and in vivo models, including oxygen and glucose deprivation/reperfusion induced PC12 cell model and middle cerebral artery occlusion/reperfusion induced rat model, to mimic I/R injury. Intracellular oxygen consumption and extracellular acidification rate were analyzed by Seahorse multifunctional energy metabolism system; ATP production was detected by luciferase method. The number and size of mitochondria were analyzed by transmission electron microscopy and MitoTracker probe combined with confocal laser microscopy. The potential mechanisms of ginsenoside CK on mitochondrial dynamics and bioenergy were evaluated by RNA interference, pharmacological antagonism combined with co-immunoprecipitation analysis and phenotypic analysis. Results: Ginsenoside CK pretreatment could attenuate mitochondrial translocation of DRP1, mitophagy, mitochondrial apoptosis, and neuronal bioenergy imbalance against cerebral I/R injury in both in vitro and in vivo models. Our data also confirmed that ginsenoside CK administration could reduce the binding affinity of Mul1 and Mfn2 to inhibit the ubiquitination and degradation of Mfn2, thereby elevating the protein level of Mfn2 in cerebral I/R injury. Conclusion: These data provide evidence that ginsenoside CK may be a promising therapeutic agent against cerebral I/R injury via Mul1/Mfn2 mediated mitochondrial dynamics and bioenergy.

Internet Addiction in Adolescents and its Relation to Sleep and Depression (청소년의 인터넷 중독 : 수면, 우울과의 관련성)

  • Song, Ho-Kwang;Jeong, Mi-Hyang;Sung, Da-Jung;Jung, Jung-Kyung;Choi, Jin-Sook;Jang, Yong-Lee;Lee, Jin-Seong
    • Sleep Medicine and Psychophysiology
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    • v.17 no.2
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    • pp.100-108
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    • 2010
  • Objectives: "Internet-addiction" came into common use not only in clinical setting but also in everyday life. But, pathophysiology and diagnostic criteria of the internet addiction remain unknown. Because adolescents are in developing period, they might be vulnerable to the internet addiction, depression and sleep-related problem. The objectives of this study were to investigate the characteristics of internet addiction and its association with sleep pattern and depression in Korean adolescence. Methods: Subjects were 799 middle and high school students in Seoul, Korea. We administered a self-reported questionnaire including socio-demographic data, Korean versions of Young's Internet Addiction Scale (YIAS), Pittsburgh Sleep Quality Index (PS-QI), the Center for Epidemiologic Studies for Depression Scale (CES-D) and questions about internet using patterns. Data of 696 subjects were included in analysis. Chi-square tests were used to analyze proportional differences, and ANOVA with post-hoc tests were used to analyze differences among groups. Partial correlation analyses were performed to analyze the correlation of internet addiction with other variables (two-tailed, p<0.05). Results: Of the 696 participants (grade 2 of middle school; M2 135 vs. grade 1 of high school; H1 238 vs. grade 2 of high school; H2 323), 2.0% (n=14) were internet-addicted (IA), 27.7% (n=193) were over-using (OU) and 70.3% (n=489) were not-addicted (NA). The mean scores of YIAS, PSQI and CES-D scores were 35.24${\pm}$12.78, 5.53${\pm}$3.04 and 16.72${\pm}$8.69, respectively. In higher grade students, average total sleep time was shorter (M2 426.20${\pm}$67.68 min. vs. H1 380.47${\pm}$62.57 min. vs. H2 354.67${\pm}$73.37 min., F=51.909, p<0.001), and PSQI (4.69${\pm}$3.14 vs. 5.42${\pm}$3.15 vs. 5.97${\pm}$2.83, F=8.871, p<0.001) CES-D (13.53${\pm}$8.37 vs. 16.96${\pm}$8.24 vs. 17.87${\pm}$8.84, F=12.373, p<0.001) scores were higher than those of lower grade students. Comparing variables among IA, OU and NA groups, computer using time not for study (96.36${\pm}$63.31 min. vs. 134.92${\pm}$86.79 min. vs. 213.57${\pm}$136.87 min., F=34.287, p<0.001) and portable device using time not for study (84.22${\pm}$79.11 min. vs. 96.97${\pm}$91.89 min. vs. 152.31${\pm}$93.64 min., F= 5.400, p=0.005) were different among groups. PSQI (5.26${\pm}$2.97 vs. 6.08${\pm}$2.97 vs. 7.50${\pm}$4.41, F=8.218, p<0.001) and CES-D scores (15.40${\pm}$8.08 vs. 19.05${\pm}$8.42 vs. 30.43${\pm}$13.69, F=32.692, p<0.001) were also different among groups. YIAS score were correlated with computer using time not for study (r=0.356, p<0.001) and portable device using time not for study (r= 0.136, p<0.001). PSQI score (r=0.237, p<0.001) and CES-D score (r=0.332, p<0.001). YIAS score and PSQI score (r=0.131, p= 0.001), YIAS and CES-D score (r=0.265, p<0.001), PSQI score and CES-D score (r=0.357, p<0.001) were correlated each other. Conclusion: These results suggested that adolescents' internet-addiction was correlated with not only computer and portable device using time not for study but also depression and sleep-related problems. We should pay attention to depression and sleep-related problems, when evaluating internet-addiction in adolescents.

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Analysis of the Issues received by Quality Improvement Department and their Management in a Medical Center (일 의료원의 통합 고충처리센터 접수 내용과 이에 대한 해결방안 분석)

  • Tark, Kwan-Chul;Park, Hyun-Ju;Chun, Ja-Hae;Kang, Eun-Sook;Moon, Ju-Young;Choi, Mi-Young;Kim, Hyun-Ju;Kang, Jin-Kyung
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.118-131
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    • 2000
  • Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

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Changes in Feed Value, Forage Productivity, and Grazing Intensity at Native Pasture Grazed by Growing Korean Native Female Goat(Capra hircus coreanae) (육성 암컷 흑염소 방목 야초지에서 사료가치, 사초 건물 수량 및 방목 강도의 계절별 변화에 관한 연구)

  • Yun, Yeong Sik;Seong, Hye Jin;Zhang, Qi Man;Chung, Sang Uk;Lee, Ga Eul;Park, Jae Hyun;Jang, Se Young;Lee, Jin wook;Kim, Kwan woo;Moon, Sang Ho
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.38 no.2
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    • pp.120-125
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    • 2018
  • The study was conducted to determine effects on forage productivity, feed value, grazing intensity and livestock productivity in growing Korean native female goat grazing in native pasture. Its with average initial body weight of $14.10{\pm}3.6kg$ and an average age of 4 months were used in this study. Dry matter content of native pasture was the highest at $33.48{\pm}2.56%$ in June, and the content was significantly increased from spring to autumn (p<0.05). Crude protein was maintained between 11% and 12% on average. Nutrient content was maintained at a certain level in native pasture, but there were differences due to the different types of wild grasses produced in each season. The productivity of forage crops increased from June, but decreased after August and showed a characteristic of grassland where productivity decreased rapidly in spring and autumn. The average grazing intensity are 39 head/ha. Black goat average daily gain was 80.2g/d. The stable weight gain in grazing is that the nutrient requirement of the black goat was met by supplementing the concentrated feed during grazing. study, can be expected that the productivity of livestock can be increased through the proper feeding of supplementary feed and maintenance of grazing intensity.

A Pilot Study of Evaluating the Reliability and Validity of Pattern Identification Tool for Insomnia and Analyzing Correlation with Psychological Tests (불면증 변증도구 신뢰도와 타당도 평가 및 심리검사와의 상관성에 대한 초기연구)

  • Jeong, Jin-Hyung;Lee, Ji-Yoon;Kim, Ju-Yeon;Kim, Si-Yeon;Kang, Wee-Chang;Lim, Jung Hwa;Kim, Bo Kyung;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.1
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    • pp.1-12
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    • 2020
  • Objectives: The purpose of this study was to evaluate the reliability and validity of the instrument on pattern identification for insomnia (PIT-Insomnia) and verify the correlation between PIT-Insomnia and psychological tests. Methods: Two evaluators examined the pattern identification of the participants who met insomnia disorder diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) and took the Insomnia Severity Index (ISI) score over 15 once manually and twice using the PIT-Insomnia to measure the inter-rater and test-retest reliability. We also conducted the following surveys: the Pittsburgh Sleep Quality Index (PSQI), the Korean version of Beck's depression inventory (K-BDI), the Korean version of the State-Trait Anxiety Inventory (STAI-K), the Korean Symptom checklist-95 (KSCL-95), and the EuroQol-5 dimension (EQ-5D), to measure concurrent validity and correlation between the PTI-Insomnia and psychological tests. Results: 1. The test-retest reliability analysis of the pattern identification results showed moderate agreement, and test-retest reliability analysis of each pattern identification score showed agreements from poor to moderate. 2. The inter-rater reliability analysis of the pattern identification results via manual showed slight agreement, when analysis was performed with calibration, the inter-rater reliability analysis of the pattern identification results via manual showed fair agreement. 3. The concordance analysis between results via manual and the PIT-Insomnia showed poor agreement, when the analysis was performed with calibration, concordance analysis showed fair agreement. 4. The concordance analysis between the PIT-Insomnia and the PSQI showed positive linear correlation. 5. The concordance analysis between the PIT-Insomnia and the PSQI, K-BDI, STAI-K, KSCL-95, and EQ-5D showed that non-interaction between the heart and kidney have positive linear correlation with the K-BDI, anxiety item of KSCL-95, dual deficiency of the heart-spleen have positive linear correlation with somatization item of KSCL-95, paranoia item of KSCL-95, heart deficiency with timidity have positive linear correlation with stress vulnerability item of KSCL-95, parania item of KSCL-95, phlegm-fire harassing the heart have positive linear correlation with K-BDI, paranoia item of KSCL-95, depressed liver qi transforming into fire have positive linear correlation with the anxiety item of KSCL-95, parania item of KSCL-95, all pattern identification have negative linear correlation with EQ-5D. Conclusions: The PIT-Insomnia has moderate agreement of reliability and reflects the severity of insomnia since it has some concurrent validity with the PSQI. There are some correlations between the PTI-Insomnia with specific psychological tests, so we could suggest it can be used appropriately in the clinical situation.

The Food Safety of Superfine Powder (Phellinus linteus) Processed by Nanomill in C57BL/6 Mice (C57BL/6 마우스에서 나노밀 가공된 초미세분말(상황버섯)의 식이 안전성 연구)

  • Kim, Dong-Heui;Teng, Yung-Chien;Yoon, Yang-Sook;Qi, Xu-Feng;Jeong, Hyun-Seok;Joo, Kyung-Bok;Lee, Kyu-Jae
    • Applied Microscopy
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    • v.39 no.2
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    • pp.133-139
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    • 2009
  • A officinal mushroom, Phellinus linteus (PL) has been known to exhibit potent biological activities including antioxidative and anticancer effect. PL is consumed as a type of powder or extract for the purpose of health promotion and disease treatment. Recently superfine PL products was commercialized according to the development of pulverizing technology such as nanomill, so the evaluation of food safety is suggested. This study was conducted to evaluate the food safety of superfine PL (SPL) through hematological, biochemical and histological examination in mice as compared with fine PL (FPL). In the particle size distribution in volume after nanomill processing, the mean diameter of SPL and FPL particles was 11.78 ${\mu}m$ and 216.1 ${\mu}m$, and d (0.5), the particle diameter measured at 50% of distribution was 5.5 ${\mu}m$ and 147.9 ${\mu}m$, respectively. As the result of body weight, food intake and the weight of organs, SPL group didn't show any statistical difference compared with FPL group and normal group (N). Hematological and biochemical values were also involved in the normal range, although ALT (N vs. FPL, P<0.001) and BUN (N vs. FPL, P<0.01; N vs. SPL, P<0.01) showed significance compared with N group but there are no significance between FPL and SPL group. In the result of histological examination with liver, kidney, spleen, and small and large intestine, abnormal findings such as inflammatory reaction and histological changes were not observed. Our results suggest that the oral intake of SPL diet is not harmful to the animal in the hematological, biochemical and histological aspects although particle size was reduced to the level of superfine. However, further study will be necessary to confirm the histological safety in relation to the gastrointestinal contact of superfine particles in the case of large amount and long-term intake.

The E-mail Survey on the Neck Pain for Acupuncture and Moxibustion Clinical Guideline (경항통에 관한 침구임상 진료지침 개발을 위한 전자우편 설문조사)

  • Kim, Hyun-Wook;Kim, Sung-Soo;Nam, Dong-Woo;Kim, Eun-Jung;Hong, Kwon-Eui;Kim, Sung-Chul;Kim, Sun-Woong;Lee, Jae-Dong;Kim, Kap-Sung;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.26 no.3
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    • pp.67-80
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    • 2009
  • Objectives : The purpose of this survey is the development on the neck pain for acupuncture and moxibustion clinical guideline. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results and Conclusions : 1. The first selected pattern identification on the neck pain This study shows that the meridian pattern identification was selected 35 times(61.4%), the pattern identification based on cause of disease was selected 8 times(14.0%), the visceral pattern identification was selected 7 times(12.3%), the other pattern identification was selected 4 times(7.0%), Qi blood yin yang pattern identification was selected 2 times(3.5%), according to symptoms was selected 1 time(2.4%). 2. Meridian pattern identification Small intestine meridian of hand Taeyang was used 39 times(18.1%), Large intestine meridian of hand Yangmyeong and Bladder meridian of foot Taeyang was used 34 times(15.7%), Gall-bladder meridian of foot Soyang was 32 times(14.8%), Tripple energizer meridian of hand Soyang was used 31 times(14.4%), Governor meridian was used 30 times(13.9%), Lung meridian of hand Taeeum was used 8 times(3.7%), Heart meridian of hand Soeum and Pericarduim meridian of hand Gworeum was used 4 times(1.9%). 3. Pattern identification based on cause of disease Wind-Cold-Dampness was used 31 times(17.5%), Accumulation of the collateral by Phelgm-Dampness was used 16 times(14.0%), affection by exopathogen Wind-Cold(stiff neck, sprain of cervical) was used 13 times (11.4%), Defecient-Cold was used 10 times(8.8%), affection by exopathogen Wind-Dampness was used 9 times(7.9%), Deep Invasion by Wind-Cold was used 8 times(7.0%), Wind-Cold was used 7 times (6.1%), Wind-Cold was used 6 times(5.3%), Accumulation in the Center by Phelgm-Dampness, Imparement of bou fluid by Pathogenic Heat, Wind-Heat with Dampness was used 5 times(4.4%), affection by exopathogen Wind-Dampness and Accumulation of the collateral by Wind-Cold was used 4 times(3.5%), Invasion of Dampness-Heat was used 2 times(1.8%). 4. Visceral pattern identification Rising of the Liver yang was used 16 times(41%), Yin deficiency of Liver and Kidney+pathogens was used 15 times(38.5%), Yin deficiency of Liver and Kidney was used 8 times(20.5%) on this survey.

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