论暴盲

暴盲是指眼外观端好、视力急剧下降的眼病,最早见于<证治准绳·杂病·七窍门>.暴盲包含现代医学多种眼底疾病.彭清华于1989年明确提出对暴盲病名进行分化,分为视衣脱落暴盲、目衄暴盲、脉络阻滞暴盲、目系炎性暴盲和目系外伤暴盲5种病名;1999年又将其分为络阻暴盲、目衄暴盲、络损暴盲、火郁暴盲、视衣脱离5种;2003年出版的全国高等中医院校规划教材<中医眼科学>在彭清华对暴盲分类的基础上,将其分为络阻暴盲、络损暴盲、目系暴盲和视衣脱离4种.就古今医家对暴盲的病因及治疗进行阐述.     

中医“阴阳-五行-六气-经络-脏腑体系”构建探源

中医认为人体与自然是相互感应的有机系统,人体小宇宙与自然大宇宙具有同源、同构和同律性,由此而提出了天人相应的理论。文章将五行、六气、脏腑、十二经络及二十四节气等中医基础理论的内容进行了系统地探讨,阐释了天人相应理论的框架体系。     

手十二井穴刺络放血对一氧化碳中毒昏迷小鼠促醒作用及其机制的初步研究

[目的]观察手十二井穴刺络放血对煤气中毒小鼠的促醒作用,并探讨其部分作用机制。[方法]选用成年雄性昆明小鼠共54只,随机分为正常组、模型组和治疗组,每组18只。模型组和治疗组小鼠分批在罐内静式吸入含一氧化碳(CO)浓度为4 300 ppm的空气60~70 min,正常组小鼠不给予CO气体,置于空罐中,时长同模型组。小鼠从罐中取出后,治疗组进行手十二井血刺络放血。观察染毒后即刻、1 h和4 h小鼠意识状态和静脉血中碳氧血红蛋白浓度变化。[结果]治疗组与模型组相比,小鼠昏迷时间明显缩短;染毒后1 h和4 h,治疗组小鼠静脉血中碳氧血红蛋白浓度明显低于模型组。[结论]手十二井穴刺络放血对急性CO中毒小鼠具有促醒作用,可以缩短昏迷时间,其机制可能与手十二井穴刺络放血可以降低小鼠血液中碳氧血红蛋白含量有关。     

Alternating low frequency stimulation of medial septal and commissural fibers induces NMDA-dependent, long-lasting potentiation of hippocampal synapses in urethane-anesthetized rats

Recent evidence indicates that some synapses exhibit long-lasting synaptic potentiation in response to low frequency (1 Hz) stimulation, similar to long-term potentiation (LTP) following high frequency induction protocols. Here, the authors characterize a form of long-lasting synaptic potentiation in the hippocampal CA1 area following alternating, single pulse stimulation of the medial septum (MS) and hippocampal CA3 commissural fibers (MS-H LTP). In urethane-anesthetized rats, alternating single pulse stimulation of the MS and CA3 (50 pulses each at 0.5 Hz, 1,000 ms interstimulus interval [ISI]) produced gradual increases of field excitatory postsynaptic potential (fEPSP) amplitude in CA1 ( approximately 123% of baseline), while MS or CA3 stimulation alone was ineffective. The fEPSP enhancement was long-lasting (>4h) and repeated episodes of alternating MS-CA3 stimulation tended to result in greater levels of potentiation than those elicited by a single episode. Surprisingly, ISIs of 500, 750, and 1,500 ms did not result in significant changes in fEPSP amplitude, while an ISI of 100 ms produced synaptic depression. MS-H LTP was resistant to systemic administration of nicotinic and muscarinic receptor antagonists (scopolamine, mecamylamine), but abolished by systemic MK-801 (0.5 mg/kg, i.p.) or local CA1 application of AP-V (10 mM), indicative of a critical role of hippocampal NMDA receptors in this effect. Paired-pulse facilitation experiments revealed a gradually developing, significant inverse correlation between fEPSP enhancement and decrease in paired-pulse facilitation ratio, suggesting a role of changes in presynaptic transmitter release. Together, these data demonstrate a novel form of long-lasting synaptic enhancement in CA1 neurons in response to low frequency activity in separate afferent systems, an activity that might mimic some aspects of natural discharge patterns during the acquisition or consolidation of memory processes in hippocampal circuits.     

从络病学说论治胆石症内镜下逆行胰胆管造影术后患者临床症状改善的经验

胆胰疾病是临床常见多发消化系统疾病,其中胆总管结石好发,目前内镜下逆行胰胆管造影术(endoscopic retrograde cholangiopancreatograph,ERCP)已成为治疗该病的有效手段.ERCP以其创伤小、手术时间短、患者耐受度好、术后恢复快等优点被广泛应用[1-2].由于术后可能出现炎症瘢痕...     

艾灸的特点及温通效应

分析艾灸在施灸部位所造成的温热刺激以及炎性化脓现象,指出由于艾火的刺激,才造就了灸法疏通气血的效应特征.认为“温通”是对灸法效应的高度概括,灸法散寒通络、透热泄毒、扶助正气、防病保健等作用都离不开艾火疏通气血的效应特征,因此“温通”是艾灸与生俱来的本质与灵魂.     

刺络拔罐治疗带状疱疹后遗神经痛的临床研究

目的:观察刺络拔罐法治疗带状疱疹后遗神经痛的临床疗效.方法:对43例患者痛点局部施行刺络拔罐方法,隔日治疗一次.采用视觉模拟评分法(VAS)进行治疗前后自身对照.结果:痊愈23例(53.596),显效12例(27.9%),有效5例(11.6%),无效3例(6.9%),总有效率93.0%,治疗前后VAS比较,P<0.01.结论:刺络拔罐治疗带状疱疹后遗神经痛简便、有效、安全.     

叶天士络病理论研究

叶天士<临证指南医案>集中体现了叶天士目的络病思想.从<临证指南医案>中可以看到,叶天士将其广泛应用于中医各种病证目的辨治过程中.<临证指南医案>中目的络病病位广,病程长短不一,病因病机多种多样,具有独到目的治疗用药特色.可见,叶天士已总结出比较完善目的络病理论.叶天士对中医学目的发展作出了不可磨灭目的贡献.     

Convergence of entorhinal and CA3 inputs onto pyramidal neurons and interneurons in hippocampal area CA1--an anatomical study in the rat

The entorhinal cortex (EC) conveys information to hippocampal field CA1 either directly by way of projections from principal neurons in layer III, or indirectly by axons from layer II via the dentate gyrus, CA3, and Schaffer collaterals. These two pathways differentially influence activity in CA1, yet conclusive evidence is lacking whether and to what extent they converge onto single CA1 neurons. Presently we studied such convergence. Different neuroanatomical tracers injected into layer III of EC and into CA3, respectively, tagged simultaneously the direct entorhino-hippocampal fibers and the indirect innervation of CA1 neurons by Schaffer collaterals. In slices of fixed brains we intracellularly filled CA1 pyramidal cells and interneurons in stratum lacunosum-moleculare (LM) and stratum radiatum (SR). Sections of these slices were scanned in a confocal laser scanning microscope. 3D-reconstruction was used to determine whether boutons of the labeled input fibers were in contact with the intracellularly filled neurons. We analyzed 12 pyramidal neurons and 21 interneurons. Perforant path innervation to pyramidal neurons in our material was observed to be denser than that from CA3. All pyramidal neurons and 17 of the interneurons received contacts of both perforant pathway and Schaffer input on their dendrites and cell bodies. Four interneurons, which were completely embedded in LM, received only labeled perforant pathway input. Thus, we found convergence of both projection systems on single CA1 pyramidal and interneurons with dendrites that access the layers where perforant pathway fibers and Schaffer collaterals end.     

通络法在老年中风后痉挛性偏瘫的辨证应用

临床上有多种治疗方法应用于中风后痉挛性偏瘫，通络法是针对络脉不畅引起病变的治疗大法。笔者结合老年人的生理特点论述运用通络法治疗不同证型的中风后痉挛性偏瘫。