title: Quantization and diagnosis of Shanghuo (Heatiness) in Chinese medicine using a diagnostic scoring scheme and salivary biochemical parameters.
abstract: BACKGROUND
  This study aims to establish a diagnostic scoring scheme for Shanghuo (Heatiness) and to evaluate whether Shanghuo is associated with biochemical parameters of salivary lysozyme (LYZ), salivary secreted immunoglobulin (S-IgA), salivary amylase (AMS), and saliva flow rate (SFR).
  
  
  METHODS
  We collected 121 Shanghuo patients at the Affiliated Hospitals of Guangzhou University of Traditional Chinese Medicine in Guangdong Province, 60 cases as a Shanghuo recovered group, and 60 healthy cases as a healthy control group. The diagnostic scoring scheme was established by probability theory and maximum likelihood discriminatory analysis on the basis of epidemiology with the design of self-controlled clinical trial. Subsequently, we used the same methods to collect 120 Shanghuo patients, 60 Shanghuo recovered cases, and 60 healthy cases in both Hunan Province and Henan Province. The levels of LYZ, S-IgA, AMS, and SFR were tested when the patients suffered from Shanghuo or recovered, respectively.
  
  
  RESULTS
  The diagnostic score table for Shanghuo syndrome was established first. In the retrospective tests, the sensitivity, specificity, accuracy, and positive likelihood ratio of the diagnostic score table were 98.9%, 93.5%, 97.5%, and 14.34%, respectively. In the prospective tests, the corresponding values were 94.9%, 85.7%, 91.7%, and 6.64%, respectively. Shanghuo was classified into three degrees based on the diagnostic scores, common Shanghuo: 63-120; serious Shanghuo: 121-150; very serious Shanghuo: >150. A negative correlation was found between Shanghuo and S-IgA (R = -0.428; P = 0.000). The level of S-IgA was also affected by seasonal and regional factors. No significant correlations were found between Shanghuo and the levels of LYZ, AMS, and SFR.
  
  
  CONCLUSIONS
  In this study, Shanghuo could be diagnosed by the combination of the diagnostic score table and S-lgA level.
authors.forename: Sijun
authors.initials: S
authors.lastname: Liu
authors.affiliation: Guangzhou University of Traditional Chinese Medicine, 12 Jichang Road, Guangzhou 510405, China. vip.hzs@gzhtcm.edu.cn.
authors.forename: Zhaosheng
authors.initials: Z
authors.lastname: Huang
authors.forename: Qingguang
authors.initials: Q
authors.lastname: Wu
authors.forename: Zhangjie
authors.initials: Z
authors.lastname: Huang
authors.forename: Lirong
authors.initials: L
authors.lastname: Wu
authors.forename: Wenli
authors.initials: W
authors.lastname: Yan
authors.forename: David Lungpao
authors.initials: DL
authors.lastname: Chang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Yang
authors.forename: Zongwei
authors.initials: Z
authors.lastname: Wang