取象比类辨证审机——简论《内经》六气病机的实质内涵

《内经》六气病机的实质内涵,是采用“取象比类”的方法,以自然界风寒暑湿燥火六种气候模式命名的六种病变类型和病变机理,与病因范畴的六淫虽然有一定的联系,但属于两类不同的概念,必须辨析清楚而不可混淆。以“中风”病为例,说明正确把握六气病机实质,对指导临床辨证论治,提高治疗效果的重要意义。     

Relationships between skin properties and environmental parameters

Background/purpose: Many authors have written about skin physiological parameters and their changes according to different environmental conditions. Nevertheless, the literature puts in evidence disagreement among different studies due to the great variability in these parameters and due to the difficulty in comparing the results obtained under different working conditions. Hence, the aim of this work is to attempt to clarify the relationship between some skin properties, such as transepidermal water loss (TEWL), skin hydration and mean skin temperature (T_sk), and the environmental parameters of ambient temperature (T_a) and relative humidity (RH), with the help of a climatic chamber to make the environment reliable. This work must be considered as the preliminary step of a wider project dealing with textile engineering: the results will be used in identifying criteria for textile design with the aim of producing more comfortable clothing. Methods: Experiments were carried out in a climatic chamber with independently controlled T_a and RH. All the combinations between three levels of T_a (20°C, 25°C and 30°C) and four levels of RH (25%, 45%, 65% and 85%) were used on a panel of six young female subjects. The assessments made were: skin surface hydration using an electrical capacitance method, TEWL using a Tewameter and T_sk using a set of thermistors. Results: The results showed a significant correlation between TEWL and T_a, while the RH had a weaker effect on TEWL in the temperature range under investigation. Also, T_sk showed a higher correlation with T_a compared with RH. Finally, skin surface hydration was found to be strongly affected by both environmental parameters. Conclusions: The analysis of experimental data resulted in the elaboration of some easy empirical models useful to evaluate the changes in TEWL, skin hydration and T_sk in different climatic conditions. These relationships must be considered to be valid only in a restricted range of T_a (20–30°C) and RH (25–85%) for young female subjects (25–35 years old).     

In vivo confocal microscopy of climatic droplet keratopathy

We describe the corneal microstructural changes in a patient with spheroidal degeneration using in vivo confocal microscopy. Multiple hypo‐ and hyper‐reflective spherical lesions were observed in the anterior corneal stroma and Bowman's layer ranging from 45 to 220 μm in size. The corneal epithelium, posterior stroma and endothelium were otherwise unaffected. In vivo confocal microscopy demonstrates good correlation with excised histological samples in climatic droplet keratopathy. It provides a non‐invasive technique to examine the living cornea for degenerative disease and acts as a bridge between clinical and laboratory observations.     

Background sodium current underlying respiratory rhythm regularity

Rhythm-generating neural circuits underlying diverse behaviors such as locomotion, sleep states, digestion and respiration play critical roles in our lives. Irregularities in these rhythmic behaviors characterize disease states – thus, it is essential that we identify the ionic and/or cellular mechanisms that are necessary for triggering these rhythmic behaviors on a regular basis. Here, we examine which ionic conductances underlie regular or ‘stable’ respiratory activities, which are proposed to underlie eupnea, or normal quiet breathing. We used a mouse in vitro medullary slice preparation containing the rhythmogenic respiratory neural circuit, called the preBötzinger complex (preBötC), that underlies inspiratory respiratory activity. We varied either [K⁺]_o or [Na⁺]_o, or blocked voltage-gated calcium channels, while recording from synaptically isolated respiratory pacemakers, and examined which of these manipulations resulted in their endogenous bursting becoming more irregular. Of these, lowering [Na⁺]_o increased the irregularity of endogenous bursting by synaptically isolated pacemakers. Lowering [Na⁺]_o also decreased the regularity of fictive eupneic activity generated by the ventral respiratory group (VRG) population and hypoglossal motor output. Voltage clamp data indicate that lowering [Na⁺]_o, in a range that results in irregular population rhythm generation, decreased persistent sodium currents, but not transient sodium currents underlying action potentials. Our data suggest that background sodium currents play a major role in determining the regularity of the fictive eupneic respiratory rhythm.     

广东高本底辐射地区老年居民淋巴细胞永生化细胞系的建立

目的 建立辐射高本底地区老年居民外周血永生化细胞系,以保存高本底居民特有的基因组资源,为进一步开展天然本底辐射的遗传学和分子生物学研究提供材料。方法 在知情同意的情况下收集20例高本底地区老年男性居民的外周血样品,采用EB病毒转化技术,把外周血B淋巴细胞转化成永生化淋巴母细胞系,冻存复苏后,进行细胞活性检测和排除细菌、支原体污染,并用遗传学方法检测其建系前后的遗传稳定性。结果 成功建立20例40株细胞株,所有建成的细胞株冻存后复苏成功率为100%。活性细胞大于90%,无细菌和支原体污染,G显带分析结果为转化后第20代细胞的染色体核型未发生改变。结论 本研究建立的高本底地区老年居民永生细胞系在遗传学特性上是稳定的,可用于进一步的天然本底辐射的遗传学和分子生物学研究。     

Racial background is a determinant of average warfarin dose required to maintain the INR between 2.0 and 3.0

Warfarin is a commonly used prophylactic agent for the prevention of thromboembolic disease. We hypothesized that racial background influenced warfarin dosage, and tested this by recording the international normalized ratio (INR) in 867 patients aged 40-90 routinely passing through our Anticoagulation Service whose target INR was 2-3. Mean (95% confidence interval) dose was 4.1 (4.0-4.2) mg/d in 737 Caucasians, 5.5 (4.9-6.1) mg/d in 72 Asians, and 6.7 (5. 8-7.6) mg/d in 58 Afro-Caribbeans (P < 0.05) between each group). In a subgroup of 302 (41 Asians, 22 Afro-Caribbeans, 239 Caucasians), body mass index did not influence warfarin use. Despite small numbers, we conclude that racial background, but not body mass index, is a determinant of warfarin dosage. The reasons for this could be genetic, cultural (diet related), or both.     

东北地区春季军事基础训练最佳天气分析

以中国东北４７个台站的６年逐日气象资料，分析了体感指数气候特征；找出了春季军事基础训练最佳日期、不同强度舒适训练的天数的分布，并作了区划；研究绘制出了东北地区体感指数气候分布图，对克服不良天气影响，减少训练伤，提高训练效率，具有实际意义     

Background suppression using magnetization preparation for contrast-enhanced MR projection angiography.

In contrast-enhanced MR projection angiography, vessel conspicuity is determined by the T(1)-weighted signal difference between blood and surrounding tissues. For slice-selective excitation pulses, the excitation angle varies across the slice, leading to poor saturation of the background signal at the slice edge and reducing the blood-background signal difference. This work reports on the use of magnetization preparation to enhance the T(1)-weighted contrast between blood and background tissue. Applying the prepulse nonselectively reduces the influence of the slice profile imperfections of the excitation pulse by keeping the background tissue at the slice edge saturated. Analytical calculations and in vitro experiments show that a prepulse angle of 110 degrees -130 degrees and a delay time of 20-25 ms enhance the contrast between contrast-enhanced blood (T(1) < 50 ms) and background tissues (T(1) > 200 ms), and improve the slice weighting profile. Magnetization preparation is shown to effectively suppress signal from background tissue, resulting in a threefold increase of the vessel-to-background signal ratio. Magnetization preparation eliminates the need for subtraction at the cost of a slight increase in scan time. Possible applications, such as projection MRA, detection of contrast arrival, and test-bolus tracking are demonstrated in a pig model. Magn Reson Med 46:78-87, 2001.     

影响成年癫痫患者生活质量因素的研究

目的对影响成年癫痫患者生活质量的各种因素进行分析和探讨。方法采用美国癫痫患者生活质量量表（QOLIE-31）对110例患者进行调查，分析各种因素对生活质量的影响程度，用SPSS11．5统计软件进行处理。结果不同性别间除了对发作的担忧外，其他各项均无统计学意义（P〉0．05）；不同婚姻状况比较除了认知功能外，其他各项差异较明显（P〈0．01）；病程〈10年与≥10年的患者在对发作的担忧、认知功能、社会功能方面有统计学意义（P〈0．05）；单药组和多药组患者在对发作的担忧、药物影响、社会功能方面差异有统计学意义（P〈0．01）；不同的发作类型间除了总体健康水平外，其他各项均有统计学意义（P〈0．01），不同学历在对发作的担忧、综合生活质量、情绪健康、精力／疲乏、认知功能、社会功能方面有统计学意义（P〈0．01）。结论可以认为性别对癫痫患者生活质量无明显影响，病程和用药种类对患者生活质量有一定的影响，学历、婚姻状况和发作类型对患者生活质量影响较显著。