전체메뉴
Search
Article Search

JoP

Research Article

Split Viewer

Related articles in JAMS

More Related Articles

Article

Research Article

J Acupunct Meridian Stud 2023; 16(3): 101-108

Published online June 30, 2023 https://doi.org/10.51507/j.jams.2023.16.3.101

Copyright © Medical Association of Pharmacopuncture Institute.

Application of Biophysical Properties of Meridians in the Visualization of Pericardium Meridian

Feng Xiong1 , Ruimin Xu2 , Tongju Li3 , Jinyu Wang1,4 , Qingchuan Hu3 , Xiaojing Song1 , Guangjun Wang1 , Huanhuan Su3 , Shuyong Jia1 , Shuyou Wang1 , Zongxiang Zhu2,5 , Weibo Zhang1,*

1Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
2Beijing Yanhuang Meridian Research Center, Beijing, China
3Ennova Institute of Life Science and Technology, ENN Group, Langfang, China
4School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine,Beijing, China
5Institute of Biophysics,Chinese Academy of Sciences, Beijing, China

Correspondence to:Weibo Zhang
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
E-mail 1507307638@qq.com

Received: October 12, 2022; Revised: February 17, 2023; Accepted: May 24, 2023

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The biophysical properties of the meridian system, an important concept of traditional Chinese medicine, include low impedance, resounding voice, and high acoustic conductance, all of which are helpful for elucidating the essence of meridians.
Objectives: To visualize the human pericardium meridian (PC) based on the resounding voice property of meridians.
Methods: Visualization of the PC was performed by injection of fluorescein sodium at the PC6 acupoint (Neiguan) on the PC. Before injection, percussion active points (PAPs) were identified by the virtue of their resounding voice properties. After injection, the trajectories of fluorescein migration throughout the body surface were recorded and analyzed. The distribution of fluorescein in the tissue was further studied using cross-sections of hind limbs of mini-pigs, in which fluorescein was injected into low impedance points.
Results: The identified PAP lines were colocalized with PC. Following intradermal fluorescein injection, 1-3 fluorescent lines, which were unrelated to the arm veins, were observed in 7 of 10 participants; 85.4% of fluorescent signals were coincident with PAPs and their intensity had a negative correlation with the body mass index (r = –0.56, p = 0.045). Cross-sections showed a Y-shaped fluorescence pattern where the two migration lines on the surface were the two vertices of the “Y.”
Conclusion: The trajectories of fluorescein in the body are suggestive of the anatomical structure of meridians. The PC is related to the deep horizontal interstitial channels that connect to the body surface through vertical interstitial spaces. These biophysical properties and techniques for meridian visualization are valuable for revealing the anatomical structure of meridians.

Keywords: Pericardium meridian, Percussion active point line, Fluorescein sodium, Interstitial channel, Meridians

INTRODUCTION

Traditional Chinese medicine (TCM) has been applied in disease prevention in China for more than 2,000 years, and more recently, has greatly reduced the occurrence and severity of coronavirus disease (COVID-19) during its epidemic in China [1-4]. However, the theory of TCM is poorly defined, especially the anatomic structure of the meridian, which remains controversial. The biophysical properties of meridians, including their electric, acoustic, thermal, optical, magnetic, and myoelectric aspects have all been intensively studied [5]. Most meridians have a lower impedance than non-meridian regions [5,6]. Meridians are also associated with low hydraulic resistance channels in the extracellular matrix [7,8]. Isotopic substances, such as 99mTcO4 and some protein dyes, can be traced as they migrate through meridians [9]. Additionally, in the 1980s, Zhu and Hao [10] at the Institute of Biophysics of the Chinese Academy of Sciences studied the biophysical features of meridians and found that they had a low impedance and resounding voice compared to the adjacent regions. The two biophysical properties were coexistent on the meridians. When tapping a point on, rather than a point outside a meridian, the resounding voice heard through a stethoscope or recorded by a machine on another location of the meridian has a higher tone and amplitude [10]. These points are called percussion active points (PAPs) and the connecting line is called a PAP line. This group also showed that PAPs are not only located on the pericardium meridian (PC) but appear on both sides of the PC meridian. In the middle of the anterior side of the forearm, PAPs form three PAP lines, including one co-aligned with the PC meridian (the main line, ML) and two branch lines (BL I and BL II) on both sides of the ML. The two branch lines are approximately 1 cm apart from the ML and have not been described in classical TCM textbooks [11,12].

Recently, Li et al. [13] injected fluorescent dyes into acupoints of the PC and observed their migration along this meridian. In addition to the main fluorescent line that ran proximately along the PC, they also observed one or two additional lines that appeared on either side of the PC. In line with this, our group has also observed multiple migration lines of fluorescein sodium (FS) following its injection into the hind limb of mini-pigs [14]. These multiple lines are comparable to the PAP lines, which reflect the biophysical properties of meridians. To confirm this, we studied the colocation of PAPs and fluorescent points following injection of FS at the PC6 acupoint (Neiguan) in humans. Moreover, to reveal the fluorescent pathway in the deep tissue beneath the skin, we studied the distribution of fluorescence in cross sections of mini-pigs, which, based on the biophysical features of meridians, further confirmed the migration of FS along the pericardium meridian.

MATERIALS AND METHODS

1. Participants

A total of ten healthy volunteers (one man and nine women) were recruited for the study, all of whom were college students in Beijing. The average age of the participants was 25.4 ± 1.26 (range: 23-27) years. The inclusion criteria were as follows: 20-30 years old; in good health with a regular lifestyle; no bad habits such as smoking or alcohol abuse; no heart, liver, brain, kidney, or other vital organ diseases; no chronic diseases; and no medication within the week before the trial. The exclusion criteria included a history of arm trauma, allergy to common allergens or iodine, coagulation disorders, and being pregnant or lactating. The study was approved by the Ethics Committee of the China Academy of Chinese Medical Sciences (approval number 2020–05–09-1-2) and was conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from all participants.

2. Localization of PAPs

The trial was conducted in a quiet room with a temperature of 20℃–25℃ and humidity of 50%-70%. The participants took the supine position with an upward medial side of the test arm. PAPs were identified by Professors Zhang and Xu, both of whom have studied PAPs for decades. Acupoints PC7 (Daling) and PC3 (Quze) were first located according to standard methods. Then, five points that equally divided the straight line between PC7 and PC3 into six segments were marked (Fig. 1). Empirically, the seven points were identified as PAPs; to confirm this, Xu tapped the test point with a special conical percussion hammer with an elastic handle, and Zhang listened to the sound transduced from the tapping site to the PC through a stethoscope placed on PC3. The PAP was confirmed when the sound from the test point was more resounding than that from the surrounding region. To locate other PAPs, the same procedure was performed on both the radial and ulnar sides of each of the five primary PAPs between PC3 and PC7. Finally, seven primary PAPs, including PC3 and PC7, with several neighbor PAPs approximately 1 cm apart from the primary PAPs were identified and marked. The primary PAPs form the ML, and the other PAPs form BL I and BL II on the ulnar and radial sides of the ML, respectively (Fig. 1B). The coincidence of the ML with PC was confirmed by Professor Zhang and Dr. Hu (a TCM physician) according to “Nomenclature and location of acupuncture points” (GB/T 12346-2006) issued by Standardization Administration of China.

Figure 1. Determination of percussion active points (PAPs) on the forearm. (A) The method for detecting PAPs using a stethoscope and a percussion hammer. The PAP is determined when it is tapped with the hammer and a resounding voice can be heard through the stethoscope. (B) PAPs (white dots) identified around the pericardium meridian (PC), formed mainline (ML, solid line), and branch lines (BL I and BL II, dashed lines). The ML is roughly identical to the PC based on classical traditional Chinese medicine theory.

3. Fluorescein injection and observation on human forearms

To study whether the fluorescent dye migrates passing PAPs, after marking PAPs, 0.07 ml of 20% FS (Guangxi Wuzhou Pharmaceutical Co Ltd, China; Product batch number: 181102) was intradermally injected at PC6 (near the 2nd primary PAP from PC7) or nearby, as described by Li et al. [13]. The fluorescence of FS was observed on the forearm using a laser beam with a wavelength of 455 nm and an illumination power of approximately 0.5 mW. Photographic images were obtained with a mobile phone or a Canon 5D2 camera with a long-pass filter (LP500 nm) or a band-pass filter (BP570/40 nm) to filter out the illuminating light. Images were taken before injection and at 1, 3, 5, 10, 30, 60, and 120 min after injection. During photographing, the other light sources in the room were turned off.

4. Visualization of blood vessels

A projection vascular imager (V800p, Viencas, Shenzhen, China) was used to distinguish the superficial veins from the migration traces/points of FS [14]. The position of the veins is shown as projected red lines on the arm, and the fluorescent emission is green-yellow. These signals were recorded either separately or together to determine whether the fluorescent traces and veins coincided or overlapped.

5. Observation of the fluorescence distribution in deep tissues of animals

It was impossible to observe the distribution of fluorescence beneath the skin due to the limitation of the penetration depth of FS fluorescence. Therefore, we performed animal experiments to explore the pathways of FS in deep tissue after injection in the hind limb of two 3-month male Chinese experimental Bama pigs (Sus scrofa domestica, Liulihe Kexing Experimental Animal Breeding Center, Beijing). The mini-pigs were fed with concentrated feed (Hope Feed Co. Ltd.) in the morning and evening, and could access drinking water freely in separate cages in an animal room with a temperature of 20℃ ± 2℃ and humidity of 50% ± 10%.

To obtain cross sections of the hind limb to study the distribution of fluorescent dyes in the deep tissue, continuous processes were performed according to the methods described in our previous report [14]. Briefly, the mini-pig was first anesthetized by injection of 3% pentobarbital sodium (0.5 ml/kg, Xiyao Biotechnology Co. Ltd, Shanghai) and xylazine hydrochloride (0.1 ml/kg, Jilin Huamu Animal Health Products Co. Ltd, Changchun) in the buttock muscles. After shaving the limb, low impedance points (LIP) in the inner side of the hind limbs were located using a low impedance meridian locator (WQ6F30, Donghua Electronic Instrument Factory, Beijing). Then, 0.5 ml of 5% FS was injected into the LIPs. Ten minutes after the injection, the mini-pig was deeply anesthetized with excessive anesthetic, and the limbs were quickly frozen with dry ice for 30 min. Simultaneously, the mini-pigs were killed through bleeding the carotid artery. Then, the limbs were removed and stored at –80℃ until required to prepare cross sections with a custom-made bone-cutting knife and a moving step of 1 mm.

The fluorescence on the skin surface was photographed 10 min after the injection of FS, as described above. The fluorescence from the cross sections was imaged with a Nikon D5000 camera equipped with a 105 mm macro lens and a band-pass filter (BP570/40 nm). All of the experimental procedures were approved by the Ethics Committee of the China Academy of Chinese Medical Sciences (approval number D2022-04-14). All applicable institutional and/or national guidelines for the care and use of animals were followed.

6. Data analysis

The amount of fluorescent signal observed on the skin surface was determined as the sum of cross points in the forearm. A cross point was defined as the meet point of an observed fluorescent line (or point) and the line connecting the primary PAP and its neighboring PAPs. The cross points were also used in the evaluation of coincidence of fluorescent migration and PAPs. When one cross point was on or < 1 mm adjacent to a PAP, it was considered to be coincident with the PAP. Additionally, the difference in the body mass index (BMI) between people with and without obvious fluorescent lines was compared using the student’s t-test. The correlation between the total number of cross points and the BMI for different participants was analyzed with Pearson coefficients using SPSS Statistics for Windows (version 22.0, IBM Corp., Armonk, NY, USA). The one-tailed method was used to calculate p-values due to the obvious negative correction between BMI and cross points.

RESULTS

1. Migration of FS along the meridian

After injection of FS into PC6, one or more linear proximal trajectories were observed in seven of the ten cases. The migration lines were coincident with the PAP lines along the PC, indicated as passing pre-marked PAPs (Fig. 2A-2G). In most cases, the lines were not continuous and switched from the mainline to a branch line (Fig. 2C) and vice versa (Fig. 2A and 2B). The migration distance varied between cases, and the migrations shown in Fig. 2F and 2G were short and did not pass the elbow region (PC3). Moreover, no fluorescent lines were observed in three participants, but fluorescent points near PC3 were obvious (Fig. 2H-2J). Two of the three participants were women with a BMI of > 22 kg/m2 and the other woman had stout arms, which may have contributed to the difference in the number of fluorescent lines with other people. In most cases, the migration was proximal, and only one case exhibited fluorescent points at the distal sites (between PC7 and PC8) (Fig. 2J).

Figure 2. Percussion active points (PAP) and traces of FS sodium. Fluorescent signals are shown as yellow-green, PAPs are marked in white (in the main line) or in green (in the branch lines) over the original pink markers for clarity. PC6 (blue dots) indicates the main injection points.

These results clearly show migration beneath the skin, regardless of whether the lines are observed on the skin or not. To clarify whether the migration occurs through blood vessels, co-visualization of blood vessels and fluorescent traces was performed after the FS path from the injection point was fully developed. As seen in Fig. 3, the veins depicted as red did not overlap or coincide with the main fluorescence line shown in yellow-green.

Figure 3. Co-visualization of blood vessels and fluorescent paths. (A) Fluorescence imaging only. (B) Overlay of both fluorescent lines and vein imaging. (C) Vein imaging only.

2. Coincidence of PAPs and fluorescent traces

As the fluorescence signals on the skin are intermittent, the cross point (a fluorescent point on the line connecting one primary PAP and its two adjacent neighbor PAPs) was introduced to quantify the fluorescence intensity. A coincident ratio of cross points overlapping PAPs to total cross points was calculated to evaluate the preference for migration to PAPs. According to Fig. 2 for cases A to J, the coincident ratios were 4:4, 3:5, 6:7, 6:8, 6:7, 4:4, 3:3, 1:1, 1:1, and 1:1 respectively. The total coincident ratio was 35:41, i.e., the possibility of FS passing through PAPs was approximately 85.4%.

3. Correlation of fluorescent traces and BMI

In this study and our previous studies, we noticed that fluorescent signals were more easily observed in people with slim bodies. In this study, seven people with an average BMI of 19.0 ± 2.6 kg/m2 showed 1-3 fluorescent lines, while no obvious fluorescent line was observed in the other three people, who had a BMI of 21.4 ± 1.3 kg/m2 (p = 0.086, one-tailed t-test). Additionally, there was an obvious correlation between BMI and the total number of cross points of all ten participants (r = –0.56, p = 0.045, one-tailed test; Fig. 4). Considering that the number of cross points reflects the abundance of the fluorescent signals, these data clearly show that the appearance of fluorescent traces on the skin is influenced by the state of obesity.

Figure 4. Correlation of body mass index (BMI) and total number of cross points. The negative correlation between the BMI and number of cross points is demonstrated by the trendline (dashed line) and the negative Pearson correlation coefficient (r).

4. Distribution of FS in mini-pig limbs

After injection at LIPs in the hind limb of miniature pigs, 2-3 roughly paralleled long-distance fluorescence migration lines could be observed on the surface (Fig. 5A). Cross sections showed a Y-form fluorescence pattern and clarified that the two migration lines were actually the two vertices of the “Y” (Fig. 5B). The lines on the surface were actually connected to one fluorescent line in a deep position beneath the skin. The third fluorescent line on the surface resulted from the upward penetration of FS along myofascial chains in the top-middle of the “Y” (Fig. 5C). These data suggest that the surface fluorescent lines are connected to the myofascial chains. Moreover, when the brightness of the image shown in Fig. 5C is reduced, the fluorescence is clearly shown between muscles and should originate from the FS that remained on the fasciae during its migration upward to the skin surface.

Figure 5. Fluorescent traces after injection of fluorescein sodium at a low-impedance point in a mini-pig hind limb. (A) Multiple migration lines (yellow lines) on the limb surface. (B) Transection of the hind limb showing a Y-shaped fluorescence pattern. The “X” and the green line in (A) and (B) represent the injection point and section line, respectively. (C) Aggregated fluorescein sodium (green) along the myofasciae. The two white arrows point to the vertices of the myofascial “Y,” and the red arrows show the prolongation of fluorescein sodium from a deeper position to the skin surface along the myofasciae. (D) Part of (C) with reduced brightness. This phenomenon has been reported in detail in our previous study [14].

DISCUSSION

Biophysical features, such as low impedance and resounding voices, are important for the localization of meridians and have been previously used to prove their existence [13-15]. However, not all meridians have low impedance [16-18]. Quantitative analysis with an automatic percussion machine and frequency analyzer showed that the resounding voice on the pericardium had a higher amplitude at 100-200 Hz compared to the sounds outside meridians [10]. The results of our previous studies have shown that meridians are actually low hydraulic resistance interstitial fluid channels in the interstitium [7,8,19,20]. FS is a small hydrophilic molecule, which, when injected into the body, can move together with interstitial fluids along a meridian or converge toward a meridian according to Darcy’s law and Fick’s law of diffusion [14]. This type of movement is not influenced by external factors and has strong objectivity. Weibo Zhang’s team first used FS to trace a meridian after injection at acupoints of rats [15]. Later, using the same method, migration of FS passing through LIPs in mini-pigs was observed [14]. In humans, clear FS trajectories appear on the skin along the PC, which was localized according to the standard TCM method and was confirmed low impedance [13]. These results suggest that the presence of FS pathways along the PC in the body is consistent with low-impedance channels. In the present study, for the first time, we found that FS injected at or near PC6 could migrate along the pre-marked PAPs on human skin, further confirming the resounding voice property of the PC. Thus, the FS trajectory, the low-resistance channel, and the PAP line is coincident with the PC. Fluorescein tracing, low-impedance determination, and resounding voice detection may all be effective methods to verify the presence of meridians.

The migration paths of FS along meridians observed on the skin surface are often discontinuous and vary in length and intensity [13,14]. Sometimes no fluorescent lines are observed, and only fluorescent dots appear at PC3. In this study, we found that BMI was negatively correlated with the appearance of migration lines on the body surface, which is probably related to the actual migration path of fluorescent dye in vivo. However, as we cannot perform an autopsy to study how FS migrates deep in the human body, we repeated the experiment with mini-pigs [14] and observed three fluorescent lines on the skin after FS injection in the LIPs on the inner side of their hind limbs (Fig. 5A). We further studied the cross-section of FS migration in the extremities of mini-pigs and found that the fluorescence lines appeared in a Y-shaped pattern (Fig. 5B and 5C). Even when the fluorescent signal was no longer observed on the surface of the body, a FS line could still be found in a deeper section [14]. These findings strongly indicate that the migration of the dye was first and mostly in the deep subcutaneous parts before forming the fluorescent spots or lines on the skin surface; this is consistent with the yellow-green color of the urine often preceding the appearance of fluorescent lines on the body surface and may also explain the frequent fluorescent dots at PC3, a site far from the injection site [13]. Around PC3, the skin is thin, fat cells are reduced, and the elbow fossa is relatively loose, thereby facilitating the diffusion of deep FS to the body surface; this also explains the negative correlation between BMI and body surface fluorescence, in that when the BMI is high, the increased penetration distance and the amount of adipose tissue are not conducive to the movement of the water-soluble dye.

The phenomenon of directed running in deep and rising toward the skin surface may also explain the multiple fluorescent lines observed. Cross-section studies revealed that the surface lines were connected with different penetration pathways from the deep channel (Fig. 5B). Therefore, multiple parallel migration lines on the skin surface are not necessarily indicative of multiple meridians in the deep layers but could be the result of different penetration pathways originating from the same meridian. The different surface pathways may also collectively reflect the state and position of lower meridians. In this study, seven of ten subjects showed 1-3 migration trajectories along the pericardium meridian. Even in the cases where only one line was formed, the line sometimes interchangeably passed through PAPs in both the mainline and branch lines. It is likely that all acupoints or PAPs have a unique structure or composition that promotes the transport of unique substances including FS, which explains the observation of solitary fluorescent points, especially at PC3 [13].

The involvement of deep channels most likely occurs in the visualization of other meridians [21]. Indocyanine green (ICG) is another medical fluorescent dye, and its fluorescence can penetrate deeper than FS. Indeed, after co-injection of FS and ICG into PC, the ICG fluorescent signal appears earlier and migrates farther than that of FS. The visualization of meridians using ICG demonstrate longer migration lines along the PC than those along other meridians; this difference may lie in the different meridian complexity, including the depth of the meridians and channels.

Furthermore, the coincidence of PAPs and the fluorescence pathway implies a biological basis of the acoustic properties of meridians. Although the existence of PAP lines along meridians has been verified by tens of thousands of people [10-12,22,23], the conclusions were not universally accepted due to technical limitations at that time. Zhu et al. [24] found relatively transparent rhomboid or triangular connective tissues among the muscles below the stomach meridian and PAP lines. Here we report the distribution of FS or its fluorescence at/near the PAPs (Fig. 2) and in channels formed by surrounding muscles and connective tissue (Fig. 5). The fascia of loose connective tissue sandwiched between two solid tissues can form a cavity-like resonance structure, which, after being hit, will release a resounding voice, forming the morphological basis of the acoustic property. This structure also has the characteristics of low hydraulic resistance and can be the channels of water and small molecules. Similar to the connection of the surface fluorescent lines with the subcutaneous myofascia (Fig. 5), the 2-3 PAP lines along the human PC are also connected with the fasciae. The fascia network has been considered as the anatomic basis of the meridian [25]. Fasciae are soft connective tissues whose unique biophysical properties may enable resonant sound propagation; however, further studies are needed to characterize their electrical and fluid conductance.

CONCLUSIONS

In this study, we demonstrate the migration of FS channels passing through PAPs that were previously demarcated, further confirming the objectivity of early biophysical studies on meridians. The trajectories of FS in the body are suggestive of the anatomical structure of meridians. The PC is related to the deep horizontal interstitial channels that connect to the body surface through vertical interstitial spaces. The visualization of the PC based on its acoustic properties further elucidates the importance of these biophysical properties and confirms the consistency of multiple methods to verify the existence of meridians.

ACKNOWLEDGEMENTS

The authors are grateful to Dr. Glen Rein for his great help in language editing. The authors also thank all the participants of this study.

FUNDING

This work was supported by the Scientific and technological innovation project of China Academy of Chinese Medical Sciences (No. CI2021A03406); the Fundamental Research Funds for the Central Public Welfare Research Institutes (No. ZZ 20191606); and Special Funds of the National Natural Science Foundation of China (No. 82050006).

AUTHORS' CONTRIBUTIONS

Weibo Zhang and Tongju Li contributed to the study concept and design. Feng Xiong and Tongju Li contributed to experimental operation, main statistical analysis and drafting the report. Ruimin Xu, Jingyu Wang, Xiaojing Song, Qingchuan Hu and Huanhuan Su contributed to the experiment. Guangjun Wang, Shuyong Jia and Shuyou Wang contributed to the literature review and interpretation of the data. Zongxiang Zhu and Weibo Zhang provided administrative, technical, and material support and supervised the study. All authors revised the text for intellectual content and have read and approved the final version of the manuscript.

CONFLICT OF INTEREST

The authors declare no conflict of interest.

Fig 1.

Figure 1.Determination of percussion active points (PAPs) on the forearm. (A) The method for detecting PAPs using a stethoscope and a percussion hammer. The PAP is determined when it is tapped with the hammer and a resounding voice can be heard through the stethoscope. (B) PAPs (white dots) identified around the pericardium meridian (PC), formed mainline (ML, solid line), and branch lines (BL I and BL II, dashed lines). The ML is roughly identical to the PC based on classical traditional Chinese medicine theory.
Journal of Acupuncture and Meridian Studies 2023; 16: 101-108https://doi.org/10.51507/j.jams.2023.16.3.101

Fig 2.

Figure 2.Percussion active points (PAP) and traces of FS sodium. Fluorescent signals are shown as yellow-green, PAPs are marked in white (in the main line) or in green (in the branch lines) over the original pink markers for clarity. PC6 (blue dots) indicates the main injection points.
Journal of Acupuncture and Meridian Studies 2023; 16: 101-108https://doi.org/10.51507/j.jams.2023.16.3.101

Fig 3.

Figure 3.Co-visualization of blood vessels and fluorescent paths. (A) Fluorescence imaging only. (B) Overlay of both fluorescent lines and vein imaging. (C) Vein imaging only.
Journal of Acupuncture and Meridian Studies 2023; 16: 101-108https://doi.org/10.51507/j.jams.2023.16.3.101

Fig 4.

Figure 4.Correlation of body mass index (BMI) and total number of cross points. The negative correlation between the BMI and number of cross points is demonstrated by the trendline (dashed line) and the negative Pearson correlation coefficient (r).
Journal of Acupuncture and Meridian Studies 2023; 16: 101-108https://doi.org/10.51507/j.jams.2023.16.3.101

Fig 5.

Figure 5.Fluorescent traces after injection of fluorescein sodium at a low-impedance point in a mini-pig hind limb. (A) Multiple migration lines (yellow lines) on the limb surface. (B) Transection of the hind limb showing a Y-shaped fluorescence pattern. The “X” and the green line in (A) and (B) represent the injection point and section line, respectively. (C) Aggregated fluorescein sodium (green) along the myofasciae. The two white arrows point to the vertices of the myofascial “Y,” and the red arrows show the prolongation of fluorescein sodium from a deeper position to the skin surface along the myofasciae. (D) Part of (C) with reduced brightness. This phenomenon has been reported in detail in our previous study [14].
Journal of Acupuncture and Meridian Studies 2023; 16: 101-108https://doi.org/10.51507/j.jams.2023.16.3.101

There is no Table.

References

  1. Qu J, Zheng Y, Ni F, Yu Y, Guo H, Yu R. Discussion on the advantages and characteristics of TCM in the prevention and treatment of pneumonia caused by COVID-19. J Liaoning Univ Tradit Chin Med 2020;22:102-5.
  2. Ren W, Du J, Xia N. Literature analysis of TCM prevention and treatment of COVID-19 based on CNKI network. Chin Manip Rehabil Med 2021;33:129-36.
  3. Li Y, Wang Z, Lin J, Zhang G, Xu Y. Progress on the role of traditional Chinese medicine in inflammatory injury of COVID-19. Chin Sci Bull 2021;66:3377-84.
    CrossRef
  4. Zheng Q, Huang H, Zeng M, You P. Clinical effects of integrated treatnent of traditional Chinese medicine and Western medicine on COVID-19: a systematic review. Strait Pharm J 2021;33:129-36.
  5. Li J, Wang Q, Liang H, Dong H, Li Y, Ng EH, et al. Biophysical characteristics of meridians and acupoints: a systematic review. Evid Based Complement Alternat Med 2012;2012:793841.
    Pubmed KoreaMed CrossRef
  6. Ahn AC, Martinsen OG. Electrical characterization of acupuncture points: technical issues and challenges. J Altern Com. plement Med 2007;13:817-24.
    CrossRef
  7. Zhang WB, Tian YY, Li H, Tian JH, Luo MF, Xu FL, et al. A discovery of low hydraulic resistance channel along meridians. J Acupunct Meridian Stud 2008;1:20-8.
    Pubmed CrossRef
  8. Zhang WB, Wang GJ, Fuxe K. Classic and modern meridian studies: a review of low hydraulic resistance channels along meridians and their relevance for therapeutic effects in traditional Chinese medicine. Evid Based Complement Alternat Med 2015;2015:410979. https://doi.org/10.1155/2015/410979.
    Pubmed KoreaMed CrossRef
  9. de Vernejoul P, Albarède P, Darras JC. Nuclear medicine and acupuncture message transmission. J Nucl Med 1992;33:409-12.
    Pubmed
  10. Zhu Z, Hao J. [Biophysics in Acupuncture & Meridian-Scientific Verification of Chinese First Great Invention]. 2nd ed. Beijing: Peking Publishing House, 1998. Chinese.
  11. Xu R, Li M, Zhu Z, Hao J. Holographic location of three yin meridians of hand in skin region with biophysical methods. Chin J Basic Med Tradit Chin Med 1998;12:43-5.
  12. Xu R, Zhang R, Tymowsky JC, Zhu Z. [Study on body surface location of pericardial meridians of Hand JueYin]. China J Tradit Chin Med Pharm 1987;5:21-2.
  13. Li T, Tang BQ, Zhang WB, Zhao M, Hu Q, Ahn A. In vivo visualization of the pericardium meridian with fluorescent dyes. Evid Based Complement Alternat Med 2021;2021:5581227. https://doi.org/10.1155/2021/5581227.
    Pubmed KoreaMed CrossRef
  14. Xiong F, Song X, Jia S, Wang G, Li H, Gu X, et al. Preliminary observation of the migration of sodium fluorescein along meridians in the limbs of mini-pigs. Sci China C 2020;50:1453-63. https://doi.org/10.1360/SSV-2020-0144.
    CrossRef
  15. Gu X, Wang YP, Wang GJ, Song XJ, Jia SY, Li HY, et al. [Display of low hydraulic resistance channels along Conception Vessel by in vivo fluorography in rats]. Zhen Ci Yan Jiu 2020;45:227-32. Chinese.
    Pubmed CrossRef
  16. Kramer S, Winterhalter K, Schober G, Becker U, Wiegele B, Kutz DF, et al. Characteristics of electrical skin resistance at acupuncture points in healthy humans. J Altern Complement Med 2009;15:495-500. https://doi.org/10.1089/acm.2008.0331.
    Pubmed CrossRef
  17. Wei J, Mao H, Zhou Y, Wang L, Liu S, Shen X. Research on nonlinear feature of electrical resistance of acupuncture points. Evid Based Complement Alternat Med 2012;2012:179657.
    Pubmed KoreaMed CrossRef
  18. Ahn AC, Park M, Shaw JR, McManus CA, Kaptchuk TJ, Langevin HM. Electrical impedance of acupuncture meridians: the relevance of subcutaneous collagenous bands. PLoS One 2010;5:e11907. https://doi.org/10.1371/journal.pone.0011907.
    Pubmed KoreaMed CrossRef
  19. Zhang WB, Tian YY, Li H, Zeng YJ, Zhuang FY. [A method to measure hydraulic resistance of subcuitis continuously and the study of low hydraulic resistance points]. Acta Biophysica Sinica 1998;14:373-9. Chinese.
  20. Song X, Xiong F, Jia S, Wang G, Wang S, Wang J, et al. Observation of microstructure of midline interstitial channels of the inner abdominal wall in rat for in vivo confocal laser imaging. Acta Laser Biol Sin 2021;30:435-40.
  21. Hu Q, Li T, Zhang WB, Tang BQ. In vivo visualization of meridians with fluorescent dyes. Asian J Surg 2023;46:2599-600. https://doi.org/10.1016/j.asjsur.2022.12.129.
    Pubmed CrossRef
  22. Zhu Z, Xie J, Ding Z, Huang S, Yu S, Hao J, et al. Study on the specific percussion sound of the line of latent propagated sensation along the channel of large intestine. Zhen Ci Yan Jiu 1982;04:299-302.
  23. Xie J, Xu R, Zhu Z, Yu S, Huang S. An experimental study of locating the line of latent propagated sensation along stomach meridian and its low impedance characteristic. Zi Ran Za Zhi 1989;11:840-4.
  24. Zhu ZX, Xu RM, Zhang JC, Li MS, Wu YZ, Hao JK. [Preliminary report on approaches of the essence of meridian sound]. Zhen Ci Yan Jiu 1988;13:260-1. Chinese.
    Pubmed
  25. Yuan L, Bai Y, Huang Y, Wu J, Wang C, Wang J, et al. Anatomical discovery of meridians and collaterals and the theory of fasciaology. Shanghai J Acupunct Moxibustion 2011;30:1-5.
    CrossRef