黄帝新经（3）——称出你的生命力

《黄帝内经》以人为本、提挈天地、神出鬼没、博大精深,是中国传统文化中的瑰宝.现代中医人要排除西医的干扰,要坚定自己的信念,要在《黄帝内经》这一伟大基础上不畏艰难地开拓向前,要不断推出具有民族特色的、通俗易懂的理论成果奉献给世界.本文依托《黄帝内经》,力求让每个人简单、明确地称出自己的生命力,让人们找到不断增强生命力的正确方向,让有志者迈入人生的康庄大道.     

Symptomatic Atrioventricular Dual Pathway Double Responses: A Role for Slow Pathway Ablation

Two patients with symptomatic fast/slow pathway double responses were evaluated with electrophysiology studies. Chronic palpitations were resistant or worsened by medical therapy. No reentry tachycardias were induced. A nonreentrant paroxysmal supraventricular tachycardia was documented, Radiofrequency ablation of the slow pathway was safely and successfully performed. Patients remain asymptomatic for 16-18 months. Ablation of the slow pathway for this substrate is a viable option.     

Modulation of the cellular immune response during Plasmodium falciparum infections in sickle cell trait individuals.

Plasma and peripheral blood mononuclear cells (PBMC) were obtained from P. falciparum-infected individuals with and without the sickle cell trait at diagnosis and 7 days after treatment. HbAA and HbAS patients were compared for levels of plasma soluble IL-2 receptors (IL-2R) and the in vitro cellular reactivity to affinity-purified soluble P. falciparum antigens (SPAg), PPD and phytohaemagglutinin (PHA). At diagnosis, HbAS patients with clinical disease had lower plasma-soluble IL-2R levels and parasite counts than the corresponding HbAA patients, whereas HbAS and HbAA patients with asymptomatic infections had comparable soluble IL-2R levels and parasite counts. PBMC from HbAS patients had higher proliferation and IFN-gamma production in response to SPAg than PBMC from HbAA patients. The difference in the lymphoproliferative responses to SPAg between the two groups was evident in patients with asymptomatic infections. In all patients, the clinical severity, the soluble IL-2R levels and the parasite counts were directly related. The former two were inversely related to the proliferative responses to SPAg. After treatment, all the studied parameters were comparable in the two groups. The study indicates that during P. falciparum infection, HbAS compared with HbAA patients had lower in vivo cellular activation and higher in vitro cellular reactivity in response to soluble malaria antigens.     

下丘脑对血糖的调节

下丘脑腹内侧核(VMH)中存在的血糖感受神经元参与全身血糖稳定状态的调节。其中分为两种不同功能的血糖感受神经元:葡萄糖兴奋神经元——当细胞外周环境中葡萄糖浓度升高时能降低其代谢率;葡萄糖抑制神经元——当外周葡萄糖浓度升高时能提高其代谢率。除VMH外,脑中还有更高级的血糖调节中枢,能和VMH部位通过促肾上腺皮质激素释放因子(CRF)、尿皮质醇及促肾上腺皮质激素释放因子受体(CRFRs)相互作用。1型糖尿病患者对低血糖的负调节反应(CRRs)存在缺陷,导致在胰岛素治疗的过程中发生低血糖事件。研究VMH部位对血糖调节的机制能为其治疗提供新的线索。     

利多卡因表面麻醉减轻术前置胃管对心血管的影响

将安置胃管的择期手术患者80例随机分为实验组（A）和对照组（B）。A组用2％利多卡因5ml行咽喉部表面麻醉后再安置胃管，比较两组置管前、置管即刻及置管后1、3、5min时心率、收缩压、心率值。结果显示：A组置管即刻和置管后上述各测定值稳定（P＞0．05），而B组则显著升高（P＜0．05或P＜0．01）。提示：2％利多卡因咽喉部表面麻醉能有效的预防安置胃管时的心血管反应。     

浓止喘消咳液对小鼠免疫力及应激性的影响

目的：观察浓止喘消咳液对小鼠免疫力和应激性的影响。方法：采用比色法测量小鼠碳粒廓清指数和血清溶血素含量。用常压耐缺氧和抗疲劳游泳实验测小鼠存活时间。结果：浓止喘消咳液能明显增加碳粒廓清指数和血清溶血素的含量,提高小鼠抗缺氧能力,延长游泳时间。结论：浓止喘消咳液可提高机体免疫力和抗应激能力。     

Long-term survival following aortic valve replacement.

Study was made of 95 survivors of aortic valve replacement during the early years of this procedure (1964 to 1970). The average follow-up time was 50.2 months. Survival was not related to hemodynamic parameters, such as cardiac index or left ventricular pressure, and did not appear to be influenced by the type of preoperative valve lesion. A history of angina pectoris and a New York Heart Association Class IV grouping were associated with shorter survival. Associated coronary artery disease was a leading cause of death in those patients surviving less than 2 years and angina pectoris the leading cause of morbidity in the long-term survivors. Sudden death occurred in five patients. Once a patient survived 36 months after the operation, the prognosis was excellent.     

Transient effects of quick changes in myocardial metabolism and perfusion pressure on coronary vasomotor responses

Summary The effects of transient changes in coronary transmural pressure on the coronary vasomotor tone was studied in 23 anesthetized dogs. Increases and decreases of the coronary transmural pressure were obtained by constrictions of various duration (2 to 20 s) of the descending thoracic aorta.The maneuvers were performed in animals with intact cardiac innervation, with the vagi sectioned and with vagal section together with -blockade. In the absence of -blockade the increase in the transmural pressure caused a transient increase in the coronary vasomotor tone attributable to a myogenic contractile response and the extravascular compression. This contractile response was not observed when the transmural pressure was increased in the presence of high vasomotor tone after -blockade. In all animals a transient hyperemia was seen with its peak 8 to 12 s after the release of the aortic constriction. Since its timing and amplitude were independent of the duration of the constriction, the metabolic effect of the increased ventricular afterload, although it may have contributed to the decrease of the coronary resistance, cannot be considered entirely responsible for the hyperemia, which was otherwise compatible with a myogenic vasodilatory response triggered by the sudden fall of the transmural pressure at the release of the constriction.It is concluded that, in the coronary circulation of the intact dog, transient changes in transmural pressure can induce vasomotor responses in which myogenic and metabolic mechanisms combine together in regulating the coronary flow. Changes in extravascular compression can also affect the flow when the experimental maneuver implies changes in the diastolic left ventricular pressure and volume. With the present experimental procedure the myogenic responses have been evidenced when the metabolic factors would have been expected to produce opposite changes in the vasomotor tone.The experiments were conducted according to the ethic protocol indicated by the Italian Government Act DL n. 116 of January 27, 1992 on the protection of animals used in scientific experiments.     

Competition between T cells maintains clonal dominance during memory inflation induced by MCMV

Both human cytomegalovirus (HCMV) and murine cytomegalovirus (MCMV) establish persistent infections that induce the accumulation of virus‐specific T cells over time in a process called memory inflation. It has been proposed that T cells expressing T‐cell receptors (TCRs) with high affinity for HCMV‐derived peptides are preferentially selected after acute HCMV infection. To test this in the murine model, small numbers of OT‐I transgenic T cells, which express a TCR with high affinity for the SIINFEKL peptide, were transferred into congenic mice and recipients were challenged with recombinant MCMV expressing SIINFEKL. OT‐I T cells were selectively enriched during the first 3 weeks of infection. Similarly, in the absence of OT‐I T cells, the functional avidity of SIINFEKL‐specific T cells increased from early to late times postinfection. However, even when exceedingly small numbers of OT‐I T cells were transferred, their inflation limited the inflation of host‐derived T cells specific for SIINFEKL. Importantly, subtle minor histocompatibility differences led to late rejection of the transferred OT‐I T cells in some mice, which allowed host‐derived T cells to inflate substantially. Thus, T cells with a high functional avidity are selected shortly after MCMV infection and continuously sustain their clonal dominance in a competitive manner.     

The future of immunoimaging — Deeper,bigger, more precise,and definitively more colorful

Immune cells are thoroughbreds, moving farther and faster and surveying more diverse tissue space than their nonhematopoietic brethren. Intravital 2‐photon microscopy has provided insights into the movements and interactions of many immune cell types in diverse tissues, but more information is needed to link such analyses of dynamic cell behavior to function. Here, we describe additional methods whose application promises to extend our vision, allowing more complete, multiscale dissection of how immune cell positioning and movement are linked to system state, host defense, and disease.