从醒脑开窍针刺法探针刺治神之内涵

[目的] 从醒脑开窍针刺法的视角,探讨针刺治病的理论内涵,为当前针刺治神的临床实践提供思路。[方法] 以醒脑开窍针刺法为切入点,从辨证、选穴、操作、医者、患者等针刺涉及的各方面、各环节归纳其核心理念,后追本溯源分析针刺各环节与治神的关系,并就当前针刺治神的临床实践进行思考。[结果] 醒脑开窍针刺法的核心理念是治神,其将醒神、调神、养神等“治神”思想贯穿针刺始终,且将“治神”思想融合于辨证、选穴、操作、医者、患者等针刺涉及到的各方面、各环节。追本溯源发现,针刺过程由多个环节组成,且每一环节都有神的参与。经络乃神内传外使之载体,腧穴是神游行出入之处,得气乃人神被针刺调动起来的标志,补泻法是“神归其室”的关键操作。针刺治病的核心要义是对主宰人身各项机能的功能之神——人神的调动和调节,对患者意识、精神等的调节则是对这一核心要义的辅助手段。而神作为人体生命活动的总指挥,在疾病治疗过程中,都应该被视为“疾病之本”而加以治疗干预。[结论] 针刺治神是醒脑开窍针刺法的核心思想,也是针刺临床实践的理论核心,更是针刺临床疗效的保证,故明确针刺治神的重要性对针刺临床应用与发展具有重要意义。     

Ruthenium Ring‐Opening Metathesis Polymerization Catalysts Bearing o‐ Aryloxide‐N‐Heterocyclic Carbenes

A series of o‐aryloxide‐N‐heterocyclic carbene ruthenium complexes 2–4 is synthesized via sequential reactions of the o‐hydroxyaryl imidazolium proligands (2‐OH‐3,5‐^tBu₂C₆H₂)(R)(C₃H₃N₂)⁺Br^? (R = Me ( 1a ), ⁱPr ( 1b ), Mes ( 1c )) with Ag₂O and [(C₆H₆)RuCl₂]₂. All of the complexes are characterized by ¹H and ¹³C NMR spectroscopy, high‐resolution mass spectrometry (HRMS), and elemental analysis. The molecular structure of 2 is determined by single‐crystal X‐ray diffraction analysis. The ring‐opening metathesis polymerization (ROMP) of norbornene (NBE) with 2 – 4 is studied. Among them, complex 4 exhibits the highest activity and efficiency toward ROMP of NBE at 85 °C without any cocatalyst, and the resultant polymers have very high molecular weight (>10⁶ Da) and narrow molecular weight distributions. This complex can also efficiently catalyze the alternating copolymerization of NBE and cyclooctene.     

Keggin‐Type Polyoxometalate ([PMo12O40]3−) in Radical Initiating Systems: Application to Radical and Cationic Photopolymerization Reactions

New photoinitiating systems based on a polyoxometalate (POM) are proposed: phosphomolybdic acid in combination with silane, germane, or iodonium salt can be used to generate silyl, germyl, or phenyl radicals as well as silylium cations. The photochemical mechanisms are studied by steady‐state photolysis and electron spin resonance. The phosphomolybdic acid/silane/iodonium salt system can initiate either the radical photopolymerization of acrylates or the cationic photopolymerization of epoxides. The synthesis of interpenetrated polymer networks can also be carried out. The mechanical properties of the synthesized polymers are affected by the presence of POM in the matrix, as shown by their dynamic mechanical analysis (DMA).

     

Association between maximum mouth opening and area of bony fusion in simulated temporomandibular joint bony ankylosis

The aim of this study was to investigate the quantitative association between active/passive maximum mouth opening (AMMO/PMMO) and the severity of simulated temporomandibular joint (TMJ) bony ankylosis. Twenty-eight male sheep were divided randomly and equally into surgical and control groups. Surgical group animals underwent bilateral TMJ osteotomy during which left lateral pterygoid muscle function was blocked. Control animals did not undergo surgery. Body weight, AMMO/PMMO, and TMJ morphological features were evaluated preoperatively and at 12 and 24 weeks post-surgery. In the surgical group, only the right TMJ complexes with maintained lateral pterygoid muscle function developed TMJ bony ankylosis. The AMMO/PMMO and end-feel distance in the surgical group were significantly lower than those in the control group (P < 0.001, both) at 12 and 24 weeks post-surgery. Moreover, AMMO (r = −0.940 and −0.952, P < 0.001, both) and PMMO (r = −0.944 and −0.953, P < 0.001, both) were negatively correlated with the area (mm²) of bony fusion post-surgery. These findings may be useful for the clinical treatment of early mandibular condyle fracture, with the use of occlusal pads/open-mouth plates to relax the lateral pterygoid muscle and block its function. When bony ankylosis developed in the TMJ, the greater the area of bony fusion, the more limited were AMMO/PMMO.     

Snake bite induced cellulitis leading to infected open dislocation of the first metacarpophalangeal joint – A rare complication

Non-traumatic open dislocation of the first metacarpophalangeal joint is a rare phenomenon. We present a rare such occurrence secondary to snake bite induced cellulitis. A 22-year-old girl presented with pain and instability of her right thumb two months. She had snake bite two months back following which she developed cellulitis which gradually became infected. She presented with raw area over her dorsal aspect of the thumb with active infection. Radiographs revealed metacarpophalangeal joint dislocation. She underwent debridement, stabilisation and soft tissue coverage. At final follow up, she was pain free and the wound healed completely.     

Balance and Strength—Estimating the Maximum Prey‐Lifting Potential of the Large Predatory Dinosaur Carcharodontosaurus saharicus

Motivated by the work of palaeo‐art “Double Death (2011),” a biomechanical analysis using three‐dimensional digital models was conducted to assess the potential of a pair of the large, Late Cretaceous theropod dinosaur Carcharodontosaurus saharicus to successfully lift a medium‐sized sauropod and not lose balance. Limaysaurus tessonei from the Late Cretaceous of South America was chosen as the sauropod as it is more completely known, but closely related to the rebbachisaurid sauropods found in the same deposits with C. saharicus. The body models incorporate the details of the low‐density regions associated with lungs, systems of air sacs, and pneumatized axial skeletal regions. These details, along with the surface meshes of the models, were used to estimate the body masses and centers of mass of the two animals. It was found that a 6 t C. saharicus could successfully lift a mass of 2.5 t and not lose balance as the combined center of mass of the body and the load in the jaws would still be over the feet. However, the neck muscles were found to only be capable of producing enough force to hold up the head with an added mass of 424 kg held at the midpoint of the maxillary tooth row. The jaw adductor muscles were more powerful, and could have held a load of 512 kg. The more limiting neck constraint leads to the conclusion that two, adult C. saharicus could successfully lift a L. tessonei with a maximum body mass of 850 kg and a body length of 8.3 m. Anat Rec, 298:1367–1375, 2015. © 2015 Wiley Periodicals, Inc.     

Shear Performance of Reinforced Concrete Beams with Small Circular Openings Strengthened Using Rectangular and Octagonal-Shaped Reinforcement

An experimental case study was carried out to investigate the shear performance of reinforced concrete beams with small circular openings under a cyclic anti-symmetric bending moment. The openings were strengthened by using a newly developed reinforcement continuously bent into rectangular and octagonal shapes, which was convenient for installation and effective for crack control. The presence of web opening reinforcement, the reinforcing method, and the web opening spacing were employed as main variables in the design of five specimens. The cyclic performance of all specimens was evaluated in terms of failure mode, crack pattern, strength and stiffness degradation, and strain distribution. Experimental results were discussed to assess the suitability of the proposed web opening reinforcement in RC web opening beams. It was confirmed that the proposed web opening reinforcement exhibited outstanding crack control and served as a shear resistance component in place of the concrete cross-section lost due to web openings. Finally, the shear strength of all specimens, obtained from the cyclic loading tests, were compared with those obtained from the equation proposed by Mansur (1998) and the Architectural Institute of Japan standard 2010.     

Nonsurgical and nonprosthetic camouflage treatment of skeletal Class II open bite with bilaterally missing lower first molars

This report illustrates the successful nonsurgical and nonprosthetic camouflage treatment of a skeletal Class II open bite malocclusion combined with missing mandibular first molars bilaterally. In the mandible, the second and third molars were uprighted and protracted, substituting for the missing first molars. In the maxilla, anterior bodily retraction and full-arch intrusion were achieved following premolar and second molar extraction, which also induced autorotation of the mandible. The treatment outcome and prognosis were confirmed with three-dimensional superimposition techniques, along with long-term stability.     

心理干预在下颌升支矢状劈开截骨术后肌功能康复训练中的作用

目的:探讨心理干预在下颌升支矢状劈开截骨术(sagittal split ramus osteotomy,SSRO)矫治下颌前突畸形术后肌功能康复训练中的作用。方法:60例接受下颌升支矢状劈开术的患者随机分为实验组和对照组,2组均接受系统治疗和肌功能康复训练,实验组在此基础上增加心理干预,测量术前、术后2、4周的张口度;术前、术后4、8周的焦虑自评评分和力。结果:实验组术后4周时张口度已接近术前水平,术后8周时力接近术前水平,焦虑情绪改善,实验组各方面参数相比对照组都有明显提高。结论:系统地心理干预能有效地提高患者健康知识水平,改善认知态度,使焦虑情绪得以改善,医患配合度提高,从而提高治疗有效率。