中枢神经系统的容积传递及其不同形式

Volume transmission (VT) is a widespread mode of intercellular communication that occurs in the extracellular fluid (ECF) and in the cerebrospinal fluid (CSF) of the brain with VT signals moving from source to target cells via energy gradients leading to diffusion and convection (flow). The VT channels are diffuse forming a plexus in the extracellular space, while in wiring transmission (WT) the channels (axons, terminals) are private. The speed is slow (seconds-minutes) in VT while rapid in the millisecond range in WT. The extracellular space is the substrate for VT, which is modulated by the extracellular matrix. Extrasynaptic VT is linked to synaptic transmission and likely often takes place due to incomplete diffusion barriers with the synaptic transmitter reaching extrasynaptic domains of the pre-and post-synaptic membrane of the synapse, the astroglia, and even adjacent synapses. Indications exist for the existence of striatal D2-like receptor-mediated extrasynaptic form of dopamine (DA) VT at the local circuit level in vivo in the human striatum. Synaptic glutamate via extrasynaptic VT can act on extrasynaptic metabotropic glutamate receptors located on the astroglia leading to Ca²⁺ mediated astrocytic glutamate release into the extracellular space (ECS). Long distance peptide VT and CSF VT is the major long distance VT with distances more than 1 mm and flow in the CSF. Indications for long distance VT of beta-endorphin and oxytocin are obtained. We propose that monogamy in the female prairie vole may take place through an increase in oxytocin VT, especially in nucleus accumbens. Release of extracellular vesicles containing receptors, proteins, RNAs and mtDNA from cellular networks in the central nervous system (CNS) into the ECF and CSF may be a fundamental communication in the CNS. It represents a special form of volume transmission, the Roamer subtype of VT. It may greatly contribute to dynamic events of synaptic plasticity but also to spread of pathological proteins in protein conformational disorders. VT also occurs in the peripheral nervous system and associated cells. Short and long distance VT may take place in meridian channels via diffusion and flow in the interstitial fluid. Acupuncture can produce VT signals by releasing transmitters and modulators from nerve terminals and mast cells.     

青少年循经感传现象影响因素的探讨

为观察青少年循经感传现象的影响因素。选择97例近视患者。以四肢远部取穴为主，采用针刺激发循控感传。结果发现感传显著程度随着激发次数的增加而增加；受试者低年龄段的感传效果优于高年龄段，单纯“麻”的针感比“酸、麻、胀、痛”的复合针感的感传效果佳；远部加局部取穴的感传显著程度优于单纯远部取穴。说明青少年循控感传显著程度与针刺激发次数、年龄、针感性质、远近配穴因素密切相关。     

心脑血管病患者的循经感传规律初探

目的：探讨循经感传现象与心脑血管病之间的规律性关系。方法：对５６例循经感传阳性的心脑血管病患者进行观察。结果：心脑血管病同时罹患者,其循经感传现象的阳性率比分别患病者高;高血压能明显提高循经感传的阳性率;单灶脑梗塞多呈单经感传,多灶脑梗塞则呈泛经感传。结论：循经感传现象与疾病间存在一定的规律性联系,并可依此进行病灶穴位诊断。     

Understanding Qi Running in the Meridians as Interstitial Fluid Flowing via Interstitial Space of Low Hydraulic Resistance

Qi, blood and the meridians are fundamental concepts in Chinese medicine (CM), which are components of the human body and maintain physiological function. Pathological changes of qi, blood and meridians may lead to discomfort and disease. Treatment with acupuncture or herbal medicine aims to regulate qi and blood so as to recover normal function of the meridians. This paper explores the nature of qi as well as compares and correlates them with the structures of the human body. We propose a conceptualization of qi as being similar to the interstitial fluid, and the meridians as being similar to interstitial space of low hydraulic resistance in the body. Hence, qi running in the meridians can be understood as interstitial fluid flowing via interstitial space of low hydraulic resistance.     

循经感传皮肤温度的观测

本文通过30例循经感传者右侧前臂段,循经皮肤温度360次对照观测,发现观测部位皮肤温度有伴随感传出现而变化的循经性.提示,循经感传在外周似有实质性生理功能活动的存在,影响局部皮肤微循环状态.联系我们既往的研究,认为循经感传的形成是“中枢”和“外周”共同综合作用的结果.     

循经感传和模拟循经感传时大脑皮层体觉诱发反应地形图的比较

目的 观察外加刺激对针刺穴位时大脑皮层第一体觉区(SI)功能活动的影响,探讨循经感传和模拟循经感传时皮层体觉诱发电位(SEP)地形图的不同.方法 应用脑诱发电位地形图技术观察16名感传显著者和11名无感传受试者,以脑电信号采集处理系统自颅外记录SI的体觉诱发反应地形图:模拟感传是以柔软的画笔沿胆经路线模拟感传的速度轻轻刷动.结果 ①感传显著者当感传沿胆经路线上传至头面部时,大脑皮层体觉诱发反应地形图除了在靠近中线的下肢代表显示1个红色高电位反应外,越过了上肢代表区,在外侧端的面部代表区又出现1个红色的高电位反应区,而对于无感传受试者来说,在同样的条件下,只能在下肢代表区出现1个红色高电位反应;②模拟循经感传时,大脑皮层第一体觉区SEP地形图的表现是:11名受试者中有6名受试者SEp地形图的下肢和面部代表部位同时出现了2个反应,5名受试者SEP地形图只在下肢代表区出现1个反应.结论 循经感传和模拟循经感传时,SEP地形图的表现类似,再次证实外周动因激发是产生循经感传现象的决定因素.     

当前经络实质研究中存在的问题--从针刺麻醉机制的研究来看当前经络实质的研究

在对经络的实质及经络研究方法分析的基础上,通过和针刺麻醉机制研究比较,认为循经感传的研究无法揭示经络的实质,经络显示研究缺乏科学依据。目前还不具备进行经络显示研究的条件,经络研究首先要解决的问题是针刺穴位是怎样作用于内脏器官以及作用途径。     

以甲皱微循环指标对循经感传现象的观察

本文以甲皱微循环指标,对循经感传现象进行了观察.结果发现,循经感传到达经络所属指端后,甲皱微循环管袢数增多、长度及袢顶宽度增加、微血流速度加快,与循经感传出现前相比差异有显著性和非常显著性意义,p值分别小于0.05,0.05,0.01,0.001,提示,循经感传的形成,在外周必有其固定的生理过程.本研究为建立循经感传现象客观显示新方法及揭示经络实质提供了实验依据。     

经络气血理论的生物物理论证

目的：用现代生物物理原理论证中医经络气血理论。方法：应用多电极电生理技术记录生物电传导。结果：针刺引起生物电循古典经脉线路传导。结论：中医数千年最神秘的＂气＂即是现代的生物电;红细胞在血液循环中不断消耗氧气、营养物质和二氧化碳来产生生物电,红细胞是类似燃料电池功能的集群流动发电机;毛细动脉管、毛细静脉管、毛细淋巴管、细胞间隙组织液电解质网络和细胞群的复式微循环构成了古典中医经络三维解剖结构的最小单位,是所有组织和器官解剖结构的共性;十二正经和奇经八脉是由复式微循环最小单位形成的有着特殊结构的生物电主干天然通道;在特定的穴位,多条毛细动脉管生物电路、毛细静脉管生物电路、毛细淋巴管生物电路、细胞间隙组织液生物电路以及细胞群分别携带独立生物电流,经捻转提插行针刺激放大后多条电路并联,受刺者就会因电流的加强而感到酸麻胀痛的电刺激作用,这就是古典针灸＂得气＂术语的实质意义,也是针灸通过调动、激发人体自身能量治疗病痛的原理。     

婴儿马尔尼菲青霉病并多器官功能损害1例

目的：探讨婴儿马尔尼菲青霉病（PSM）并多器官功能损害临床特点。方法：分析我院2010年10月发现的1例婴儿马尔尼菲青霉病并多器官功能损害患者临床特点,同时复习20例本病的文献资料。结果：给予患儿吸氧、抗感染、液体疗法、纠正贫血、对症支持治疗等,但病情未见明显改善,治疗1周后患者自动要求出院。结论：马尔尼菲青霉病较少见,临床上可分为局限型和播散型,病情凶险、死亡率高,应用外周血液及骨髓涂片检查进行早期诊断,将大大提高本病的预后。