冯军枢机针法临床运用发微

[目的]介绍冯军教授创立的枢机针法的基本理论内容、临床应用法则及技术操作规范,探讨天人相应视角下躯体“三阴三阳”横向分域与针灸效应的关联性规律。[方法]从《伤寒论》的六经针灸学思想入手,以阴阳脉之海——任督二脉为中心,基于《素问·阴阳离合论》中的六气太极时相图模型,并根据《黄帝内经》“气位相关”理论,立足于临床实践,对躯体进行“三阴三阳”横向的空间区域划分,并列举验案一则加以佐证。[结果]人体太极图模型构建了人体前后方向气机运行与六部气化相对应的关系,枢机针法是针刺颈项区域少阳枢机和腰臀区域少阴枢机的穴结,以斡旋人体阴阳之气化的新针刺疗法,其临床运用法则主要包括通痹开结,调和枢机,燮理阴阳;审守颈项少阳之枢,主风,知调四海和脏腑精气;温扶腰臀少阴之枢,主寒,尽消阴翳。其技术操作特点是运用系统化的针刺手法体系——通痹开结调气针法和开结烧山火热补手法,辨结开结,以调枢机。所举验案属素体阳虚、复感寒邪,邪犯少阴、少阳所致,故用枢机针法温扶少阴、通达少阳,以复阴阳之气化,遂三刺而愈。[结论]人体六气(六经)太极运行模型图作为探索躯体“三阴三阳”横向分域的研究先导,为针灸理论与六经辨证的有机结合奠定了基础,据此提出的枢机针法不仅突破了经络理论作为针灸主体理论的局限性,而且弥补了全息、解剖、体表投影等针法治疗和调节之力偏弱的问题,使人体六气的运行和气化恢复正常。     

Folate-modified poly(2-ethyl-2-oxazoline) as hydrophilic corona in polymeric micelles for enhanced intracellular doxorubicin delivery

The transmembrane transport of drug loaded micelles to intracellular compartment is quite crucial for efficient drug delivery. In the current study, we investigated the cellular internalization and anticancer activity of doxorubicin loaded micelles with folate modified stealthy PEOz corona. Folate-decorated micelles incorporating doxorubicin were characterized for particle size, degree of folate decoration, drug loading content and encapsulation efficiency, morphology, and surface charge. The targeting capability and cell viability were assessed using HeLa, KB, A549 and MCF-7/ADR cell lines. In vitro study clearly illustrated the folate receptor (FR) mediated targeting of FA modified micelles to FR-positive human HeLa, KB and MCF-7/ADR cells, while specific delivery to FR-negative A549 cells was not apparently increased at the same experimental conditions. Cytotoxicity assay showed 60% and 58% decrease in IC₅₀ values for HeLa and KB cells, while only a slight decrease for A549 cells, following treatment with folate modified formulations. The enhanced intracellular delivery of FA modified micelles in MCF-7/ADR cells was also observed. In vivo antitumor tests revealed DOX entrapped FA-PEOz-PCL micelles effectively inhibited the tumor growth and reduced the toxicity to mice compared with free DOX. The current study showed that the targeted nano-vector improved cytotoxicity of DOX and suggested that this novel PEOz endowed stealthy micelle system held great promise in tumor targeted therapy.     

Interconversion of Alternating Poly(ester amide)s and Cyclic Ester Amides from Adipic Anhydride and α,ω‐Amino Alcohols

Poly(esters amide)s from adipic anhydride and α,ω‐amino alcohols were obtained by polycondensation of α‐carboxyl‐ω‐hydroxyl amides under mild conditions in solution or by bulk polycondensation at elevated temperatures. For the polycondensation in bulk the influence of catalyst and of temperature on the number‐average molecular weight was studied. At a temperature of 170 °C the polycondensation process is followed by a ring‐closing depolymerisation and the formation of cyclic ester amides. Ten‐ to fourteen‐membered cyclic ester amides were obtained and characterized. The ring‐opening polymerisation of these cyclic ester amides leads, in a controlled mode, to poly(ester amide)s. The interconversion of poly(ester amide)s and cyclic ester amides by ring‐closing depolymerisation and ring‐opening polymerisation is possible. The poly(ester amide)s from adipic anhydride and homologous α,ω‐amino alcohols H₂N? (CH₂)_x? OH (x = 2–6) are semicrystalline materials, their melting points show the odd/even effect observed for [n]‐polyamides and [n]‐polyurethanes.

Synthesis of alternating poly(ester amide)s.     

Opening of the blood-brain barrier by acute elevation of intracarotid pressure

A method for local opening of the blood-brain barrier in the territory of one internal carotid artery in the rat is described. A local hypertensive insult is induced by rapid infusion of blood into the internal carotid via the external carotid. The hemodynamic changes caused by the infusion, in particular relation to the threshold and extent of barrier opening, are analyzed. This mode of hypertensive barrier opening may be advantageous to those in which the insult is induced systemically, especially when studying the cerebrovascular effects of neurotransmitter catecholamines, since all the latter methods interfere with adrenergic mechanisms. Further, unilateral intracarotid infusion may allow the territory of the contralateral middle cerebral artery to be used as internal control.     

房室交界区三角的观察和测量

在110例人心(成人70,儿童40)上,观察了由冠状窦口、Todaro腱及三尖瓣隔瓣附着缘围成的房室交界区三角,对上述各边界及室间隔膜部进行了测量。三角的三个角各有不同结构占据,前上角为房室结,顶角有冠状窦和心最小静脉开口,后下角深面为右冠状动脉“U”形袢。就上述特点结合临床进行了讨论。     

Functionalization of Shortened Single‐Walled Carbon Nanotubes with Poly(p‐dioxanone) by “Grafting‐From” Approach

Summary: It has been a real challenge to form carbon nanotube (CNT)/polymer composites where CNTs are well‐dispersed in the polymer matrix and the interactions between CNTs and polymers are effectively strong. In this paper, we applied surface‐initiated, ring‐opening polymerization (SI‐ROP) of p‐dioxanone (PDX) to shortened single‐walled carbon nanotubes (s‐SWCNTs) and successfully formed s‐SWCNT/PPDX composites (see Figure). Due to intimate interactions between s‐SWCNTs and PPDX, we observed dramatic changes in PPDX properties upon the formation of the composites: 10%‐weight‐loss‐temperature of PPDX increased by 20 °C (measured by thermogravimetric analysis) and the patterns of T_g and T_m were greatly altered. We did not observe any noticeable peaks from the composite up to 120 °C in differential scanning calorimetry (DSC), while DSC data of PPDX itself showed T_g and T_m at ?13.4 and 103 °C respectively.

Schematic representation of the procedure for formation of s‐SWCNT/PPDX composites.     

Hydrolytic and Thermal Degradation of Random Copolyesters of ε‐Caprolactone and 2‐Oxepane‐1,5‐dione

The hydrolytic and thermal stability of random copolyesters of ε‐caprolactone (ε‐CL) and ca. 30 mol‐% 2‐oxepane‐1,5‐dione (OPD) have been investigated. Compared with poly(ε‐caprolactone) (PCL) of a comparable molecular weight, the hydrolytic degradation of the copolyester is faster in a phosphate buffer (pH = 7.4) at 37 °C as confirmed by the time dependence of water absorption, weight loss, melting temperature, and molecular weight. This difference is a result of the higher hydrophilicity imparted to the copolyester by the ketone of the OPD units. The thermal degradation has been studied by thermogravimetric analysis (TGA), ¹H NMR spectroscopy, and size exclusion chromatography (SEC). The activation energy of the thermal degradation under nitrogen has been found to be lower for the copolyesters than for PCL, which indicates that the OPD co‐units have a deleterious effect on the thermal stability of PCL. The thermal degradation primarily occurs by pyrolysis of the ester functions.

Pyrolysis of the ester function of the ε‐CL/OPD diad.     

Transition Metal‐Catalyzed Ring‐Opening Polymerization of Silicon‐Bridged [1]Ferrocenophanes in the Presence of Functional Silanes: Molecular Weight Control and Synthesis of Telechelic Poly(ferrocenylsilanes)

The transition metal‐catalyzed ring‐opening polymerization of dimethyl[1]silaferrocenophane (fcSiMe₂) ( 1 ), fc = Fe(η‐C₅H₄)₂), in the presence of MePhSiH₂, or the chlorosilanes ClMe₂SiH, ClMePhSiH, or ClPh₂SiH has been shown to allow access to poly(ferrocenylsilane)s R¹R²R³Si? [fcSiMe₂]_n? H ( 4 , 6 – 8 ), and R¹? [Me₂Sifc]_m? SiR²R³? [fcSiMe₂]_n? H ( 5 ) with controlled molecular weights and which are capped by the corresponding R¹R²R³Si and Si? H groups ( 4 , 5 : R¹ = H, R² = Me, R³ = Ph, 6 : R¹ = Cl, R² = R³ = Me, 7 : R¹ = Cl, R² = Me, R³ = Ph, 8 : R¹ = Cl, R² = R³ = Ph). Materials with molecular weights in the range M _n of 3.5 × 10³ to 2.5 × 10⁴ and polydispersities of 1.3–2.2 were prepared. All of the silanes examined in this study were found to be more reactive as capping agents than the previously studied Et₃SiH; the order of reactivity for molecular weight control was determined to be MePhSiH₂ ≈ ClMe₂SiH ≈ ClMePhSiH ≈ ClPh₂SiH > Et₃SiH. In addition, the reactivity of the resulting Si? Cl end‐functionalities of poly(ferrocenylsilane)s 6 and 7 was explored, and reactions with commercial poly(ethylene glycol) methyl ether yielded poly(ethylene oxide)–block–poly(ferrocenylsilane) diblock copolymers, 10 and 11 . The Si? H end group, however, was much less reactive and attempts to utilize this functionality for hydrosilylation of divinyl‐terminated poly(dimethylsiloxane) to form block copolymers was ineffective.

     

Chain Extension and Cyclization of Telechelic Polysarcosines

Summary: Sarcosine N‐carboxyanhydride (Sar‐NCA) was polymerized with 1,12‐diaminododecane (DAD) or 1,13‐diamino‐4,7,10‐trioxatridecane (DATT) as initiators, and telechelic blocks having two secondary amino endgroups were obtained. Their structure was proven by ¹H NMR and MALDI‐TOF mass spectrometry. The SEC measurements indicated narrow molecular weight distribution with polydispersity indices in the range of 1.1–1.2. These difunctional polysarcosines were reacted with three different coupling agents: 4,4′‐diisocyanatodiphenylmethane (MDI), N‐hydroxysuccinimide sebacate, and sebacoyl bisimidazolide. Although the ¹H NMR spectra proved high conversions, only a moderate chain extension was observed. The MALDI‐TOF mass spectra indicated a high extent of cyclization, which limited the chain growth.

MALDI‐TOF mass spectrum of a DATT‐initiated polysarcosine after reaction with sebacoyl bisimidazolide.