《庄子·逍遥游》“摶”、“搏”之辨

《庄子·逍遥游》中的“摶”字有的版本认为应写作“摶”，但也有的版本认为应写作“搏”?疚拇影?本、字的形音义、刻版及书法中常见的构形等方面进行分析,认为产生“摶”和“搏”分歧的原因是“摶”和“搏”形体相近,在书籍流传过程中很容易出现讹误;同时又从文献的注疏和引用等方面进行论证,从而认为在《庄子·逍遥游》中应写作“摶”。

孪生兄弟“搏”与“博”

“搏”在操场上玩够了，坐在树阴下喘着粗气。 “老是这样疯玩，也不是个办法呀!”“搏”对自己说，“我得去图书室看看书，学点知识。”

中医学“搏”的概念内涵考释

“搏”概念源于《黄帝内经》,本义多指结聚、攻击,脉学方面则反映交争之势而于脏腑取脉法、阴阳取脉法中多有应用。对“搏”的概念内涵进行考释,总结其搏击、交结、停聚、变化、相附、脉搏、病理脉象七种含义;对“搏”的病机进行考释,归纳其四种特征,即搏争从化、兼化、伏留结聚、变动化气;总结“搏”病机病位包含脏腑、经络、五体、气分、血分等多个层面,涉及开宣、托补、调衡等诸多治法。以此系统考究完善“搏”的概念内涵,以期为诸多现代难治性疾病提供新的诊疗视角与思路。

《伤寒论》《金匮要略》“搏”“搏”辨

“摶”之俗体作“(搏)”,与“搏”形近,近一个世纪来《伤寒论》《金匮要略》铅字排印本、电脑录入本凡“搏”皆讹为“搏”,而赵开美本《伤寒论》、元大德《千金翼方》或作俗体“搏”,或作繁体“摶”；元邓珍本《金匮要略》、赵开美本《金匮要略》皆作俗体“搏”,是诸善本《伤寒论》《金匮要略》无一作“搏”者。本文确证铅字排印本、电脑录入本《伤寒论》《金匮要略》之“搏”皆为讹字,当作“摶”。2005年8月人民卫生出版社白文本《伤寒论》据笔者意见已将“搏”改为“抟”。

《老子》“搏之不得”辨正

《老子·道经》十四章中"搏之不得"的"搏"在各家传本和出土文献中,大致有三种异文:或作"搏",或作"抟(摶)",或作"(扌昬)"。本文先从语境词义分析出发,得出该处动词无论是"搏"、"抟(摶)"、"(扌昬)",都应该是不表结果的触摸义。再根据训诂学原理,尽可能全面地考察了三者在辞书及前人训诂中的各个义项,发现只有"(扌昬)"具有不表结果的触摸义,与该文语境相符。该句当依帛书《老子》甲、乙本,辨正为"(扌昬)之不得"。

文化素养与运动智能提高对“搏克”运动员的影响

"搏克"是蒙古民族具有悠久历史的传统体育竞赛项目。随着体育赛事竞争性增强、科技化程度增高,对"搏克"运动员的要求也与时俱进,从有助于传承与发展蒙古族传统体育竞赛项目,有助于运动员对技、战术、规则的理解,有助于"搏克"运动科学发展,有助于运动员提升就业能力几个方面阐述了"搏克"运动员文化素养与运动智能提高的重要性,以期为"搏克"运动基层教练员、运动员提供一个新的视野,同时也希望为蒙古族"搏克"运动继承与发展提供某些借鉴。

“搏?博”教育与学校文化特色建设的实践探索

探索学校开展特色文化建设途径与方法,目的是提炼文化建设成功经验,形成学校特色的文化,为学校发展奠定基础。通过挖掘并传承学校的历史,结合实际,提炼以“搏”“博”为核心的精神和品质,将“搏?博”教育融入在学校校园文化建设中,融入学校体育教育中,融入学校德育特色建设中,融入学校学习型组织创建中,取得一定成效,我们仍需不断研究创新。

宋本《伤寒论》版本研究

校读台湾本、日本内阁文库本、中国中医科学院所藏宋本《伤寒论》,发现日本内阁文库本虽然有些讹误,但版本价值高;然在文字正确性方面,台湾本、中国中医科学院本优于日本内阁本。

A REPEATED METHOD FOR ECG DATA COMPRESSION

A new electrocardiogram(ECG) data compression method is presented.It employs a repeated coding.In this method beat templates are extracted from original signals according to the features of ECG.The data are divided into three parts:beat template,residual and position parameter.The three separate parts are first encoded with LADT,and then use the lossless entropy encoding to maintain a low level of reconstructed waveform distortion.The entropy encoding based on Huffman encoding is employed here as an example.Selections from the MIT BIH arrhythmia database,show that there is substantial improvement in compression ratio (CR) over other single and simple compression methods for comparable percent root mean square difference(PRD).

Ambulatory blood-pressure monitoring, antihypertensive therapy and the risk of fall injuries in elderly hypertensive patients

Background Fall injuries are common among the elderly. The aim of this study was to investigate whether blood-pressure patterns, as measured by 24-h ambulatory blood pressure monitoring （ABPM）, or intensification of antihypertensive therapy following the 24-h ABPM, may be associated with fall injuries in hypertensive elderly patients. Methods In a retrospective study, community-based elderly patients （age ≥ 70 years） who were referred to 24-h ABPM were evaluated for fall injuries within one-year post-ABPM. We compared the clinical characteristics, 24-h ABPM patterns and the intensification of hypertensive therapy following 24-h ABPM, between patients with and without a fall injury. Results Overall 1032 hypertensive elderly patients were evaluated. Fifty-five （5.3%） had a fall injury episode in the year following ABPM. Patients with a fall injury were significantly older, and with higher rates of previous falls. Lower 24-h diastolic blood-pressure （67.3 ± 7.6 vs. 70.7 ± 8.8 mmHg; P 〈 0.005） and increased pulse-pressure （74.7 ± 14.3 vs. 68.3 ± 13.7 mmHg; P 〈 0.005）, were found in the patients with a fall injury, compared to those without a fall injury. After adjustment for age, gender, diabetes mellitus and previous falls, lower diastolic blood-pressure and increased pulse-pressure were independent predictors of fall injury. Intensification of antihypertensive treatment following the 24-h ABPM was not associated with an increased rate of fall injury. Conclusions Low diastolic blood-pressure and increased pulse-pressure in 24-h ABPM were associated with an increased risk of fall injury in elderly hypertensive patients. Intensification of antihypertensive treatment following 24-h ABPM was not associated with an increased risk of fall injury.

Idiopathic ventricular fibrillation with fragmented QRS complex and J wave in resting electrocardiogram

Objective To describe the clinical characteristics of idiopathic ventricular fibrillation （IVF） with fragmented QRS complex （f-QRS） and J wave in resting electrocardiogram. Methods We reviewed data from 21 case subjects in our hospital who were resuscitated after cardiac arrest due to IVF and assessed the prevalence of f-QRS and J wave in resting electrocardiogram （ECG）. All the case subjects were classified among three groups based on the electrocardiographic morphology： group I, both f-QRS and J wave were observed （n = 6）, group II, only J wave was observed （n = 9）, group III, neither f-QRS nor J wave was observed （n = 6）. Population characteristics, history of syncope or sudden cardiac arrest, incidence of ventricular fibrillation （VF）, and circumstance of VF were evaluated among the three groups. Results The incidence of index events （syncope, survived cardiac arrest and VF episodes recorded in implantable cardioverter defibrillator （ICD） or pacemakers） was 13.4 ~ 5.6 per-year in group I, 10.8 ~ 3.9 per-year in group II, and 9.8 -4- 4.2 per-year in group HI. There were significant differences in incidences among the three groups, the most frequent index events were observed in group I. The hazard ratio for incidence was 3.2 （95%CI, 1.1-7.9; P = 0.01）. The history and circumstance of the index events were different among the groups. In group I, all the index events occurred during sleep in early morning. In group II, four subjects suffered VF during strenuous physical activities or agitation state, two during sleep in early morning, three in usual activity. In group III, one subject suffered VF during sleep in early morning, one in agitation state, four in usual activity. Conclusions This study suggests that the IVF patients with the combined appearance of f-QRS and J wave in the resting ECG suffer an increased risk of VF, this subgroup of IVF patients has a unique clinical feature.

Clinical Evaluation of Color Doppler Ultrasound in Selecting the Optimal Treatment Modality for Infantile Hemangioma

Objective We investigated the efficacy and safety of 1064 nm Nd： YAG laser, intense pulsed light （IPL）, and lauromacrogol injection in the treatment of hemangioma, in order to evaluate the value of color Doppler ultrasound guidance in choosing the optimal treatment modality. Methods Infantile patients who were clinical diagnosed as hemangiomas were randomly divided into group A, who had color Doppler ultrasound examinations before the treatment, and group B who had the treatment without ultrasound evaluation. Patients in the group A were assigned into subgroups according to the depth of lesion by sonography： group A-1 for those who had a lesion depth 〈1.2 mm, and took intense pulsed light therapy; group A-2 for those who had a lesion depth ≥1.2mm and 〈 3 mm, and took long pulse 1064 nm Nd：YAG laser therapy; group A-3 for those who had a lesion depth ≥3mm and 〈5 mm, and were treated by IPL combined with long pulse 1064 nm Nd：YAG laser treatment; Group A-4 for those who had a lesion depth ≥5 mm, and took lauromacrogol injection therapy. Patients in the group B took long pulse 1064 nm Nd：YAG laser treatment without preoperative ultrasound evaluation. The efficacy and adverse reactions of the treatments between the groups were evaluated and compared statistically. Results Totally 113 patients with 128 skin lesions were enrolled in this study, 85 in the group A （mean age 6.8±7.9 months） and 28 in the group B （mean age 6.9±9.9 months）. The mean depth of hemangioma was 3.3±1.1 mm in the group A, ranging from 0.5-7.8 mm, with 0.8±0.4 mm, 2.2±0.4 mm, 4.2±0.6 mm and 6.2±0.7 mm in group A1, A2, A3 and A4, respectively. The cure rates and effective rates in the group A were significantly higher than those in the group B （cure rates： 64.5% vs 56.3%, U=3.378, P=0.045; effective rates： 89.5% vs 78.1%, U=4.163, P=0.041）. The adverse effect rates of the group A （vesicle 20.0%, pigmentation 46.9%, scarring 17.7%） were lower than those of the group B （vesicle 21.9%, pigmentation 60.4%, scarring 25.0%）. Incidences of pigmentation and scarring were statistically significantly different （U=3.884, P=0.034, and U=4.016, P=0.032 respectively） between the two groups. Conclusion With the guidance of color Doppler ultrasound, the efficacy and safety of long pulse 1064 nmNd：YAG laser, intense pulsed light, and lauromacrogol injection in the treatment of infantile hemangioma have better outcomes compared to laser treatment alone without preoperative ultrasound examination.

Dual antiplatelet therapy increases pocket hematoma complications in Chinese patients with pacemaker implantation

Objective To assess the prevalence of the bleeding complications in pacemaker implanted patients receiving different antiplatelet regimens, and the influence of each regimen on hospital stays after device implantation. Methods We prospectively enrolled 364 patients receiving the cardiac rhythm device implantations in Fuwai Hospital from July 2012 to December 2013. Bleeding complications including pocket hematoma, hemothorax, cardiac tamponade and blood transfusion requirement were measured as endpoints. Post operation hospital stay was also included in the endpoints. Results Bleeding complications were detected in 15 patients （14 with hematoma, one with hemothorax） out of all 364 patients （4.12%）. Dual antiplatelet therapy （DAT） significantly increased hematoma （19.3%） compared with aspi- fin treatment （ASA） （3.2%, P = 0.001） and no antiplatelet therapy （1.9%, P 〈 0.001）. There was no significant difference in incidence of pocket hematoma between the ASA group and the control group （P = 0.45）. The post procedure hospital stay was longer in DAT group （5.45 ± 2.01 days） compared to those in the ASA group （3.65 ± 1.37 days, P 〈 0.05） or control group （3.99 ± 2.27 days, P 〈 0.05）. Pocket hema- toma was considered an independent predictor of hospital stay prolongation （OR： 5.26; 95% CI： 1.56-16.64; P = 0.007）. Conclusions Among the Chinese patients undergoing device implantation in this study, the use of dual antiplatelet agents significantly increased the risk of pocket hematoma complications and led to a longer hospital stay. Use of aspirin alone did not increase the risk.

Anticoagulation therapy in intra-aortic balloon counterpulsation： Does IABP really need anti-coagulation ？

Objective: To investigate if intra-aortic balloon pump(IABP) is contraindicated without anticoag-ulation therapy. Methods: Some 153 IABP patients in the King Abdulaziz Cardiac Center(KSA) were random-ly assigned into two groups. Anticoagulation group( Group A) consisted of 71 patients who were given heparin intravenously with target aPTT 50 - 70 seconds. Non-anticoagulation group( Group B) consisted of 82 patients without intravenous heparin during balloon pumping. Hematological parameters including platelet count, D-dimer, Plasminogen activator inhibitor-1 (PAI-1) and fibrinogen degradation products(FDP) were checked respectively at the point of baseline, 24 hours, 48 hours and 24 hours post IABP counterpulsation. Clot deposits on balloon surface, vascular complications from IABP including bleeding and limb ischemia were recorded.Results: Platelet count and PAI-1 level decreased at 24 hours and 48 hours in both groups ( P < 0.05) . D-dimer and FDP level increased at 24 hours and 48 hours in both groups( P < 0.05), but returned to the baseline level 24 hours post IABP removal( P > 0.05) . Three patients in Group A and 2 patients in Group B developed minor limb ischemia( P > 0.05). No major limb ischemia in either group. Two patients in Group A suffered major bleeding and required blood transfusion or surgical intervention, whereas no patient had major bleeding in Group B. Eight patients had minor bleeding in Group A, but only 2 patients in Group B ( P <0.05). No clot deposit developed on IABP surface in either group. Conclusion: IABP is safe without routine anticoagulation therapy. Selecting appropriate artery approach and early detection intervention are key methods for preventing complications.

汉代丧服决狱对传统礼俗的破坏与“法律儒家化”之重估

瞿同祖提出"法律儒家化"命题时,以晋律"准五服以制罪"为标志。这包含两层基本意义:一是晋泰始律之前的秦汉律令条文与决狱定谳是非儒学性的,尤其是未曾引入五服制;二是泰始律"准五服以制罪"才将刑无等级的法家律令改造为维护等级的儒家律令。通过对东汉时期典型案例"何侍搏姑案"的细致分析,可证汉代已存在以丧服决狱,并且,这一决狱方式颠覆了传统礼俗,使丧服由亲疏程度的表征,被异化为行为规范。于是,礼所原有的双向性原则被摧毁,代之以法的单向性原则。对于以服制入律的准确评价,不是欺骗性的"法律儒家化",而是"儒学暴力化"。

A novel approach for extracting pulse rate,respiratory rate and heart rate from photoplethysmogram

Photoplethysmogram(PPG)is a noninvasive method for detecting human cardiovascular pulse wave using optical technology.The PPG containing a lot of physiological information is from the MIMIC database.This paper proposes a combinatorial method of ensemble empirical mode decomposition(EEMD),cepstrum,fast Fourier transform(FFT)and zero-crossing detection to improve the robustness of the estimation of pulse rate(PR),heart rate(HR)and respiratory rate(RR)from the PPG.First,the PPG signal was decomposed into finite intrinsic mode functions(IMF)by EEMD.Because of its adaptive filtering property,the different signals were reconstructed using different IMFs when estimating different physiological parameters.Second,the PR was obtained by zero-crossing detection after rejecting low frequency IMFs containing artifacts.Third,IMFs with frequency between 1.00 Hz to 1.67 Hz(60 beats/min to 100 beats/min)were selected for estimating HR.Then,the frequency band that reflects the heart activity was analyzed by the cepstrum method.Finally,the respiratory signal can be extracted from PPG signal by IMFs with frequency between 0.05 Hz to 0.75 Hz(3 breahts/min to 45 breaths/min).Then the spectrum of signal was obtained by FFT analysis and the RR was estimated by detecting the maximum frequency peak.The algorithm has been tested on MIMIC database obtained from 53 adults.The experiment results show that the physiological parameters extracted by this integrated signal processing method are consistent with the real physiological parameters.And the computation load of this method is small and the precision is high(not larger than 1.17%in error).

Investigation of blood pulse PPG signal regulation on toe effect of body posture and lower limb height

Objective: To study the regulation of blood pulse volume via photoplethysmography (PPG) signal detected from toe, while the lower limb is passively raised in different height positions. Methods: Use a modified non-invasive PPG technique to detect the blood pulse signal on toe with infrared (IR) photo sensor. A protocol consisting of two postures, i.e., supine and 45° reclining, was designed to conduct laboratory trial in this study. During the period of performing the protocol of these postures, the lower limb was passively raised from the heights of 10 cm to 60 cm randomly and individually with sponge blocks underneath the foot. Results: In the supine posture, the higher the foot was passively raised, the more the blood PPG signal decreased. In the 45° reclining posture, the blood PPG signal increased at the beginning and then decreased in the foot height position from 10 cm to 60 cm. In both postures the normalized AC signal changes significantly while the normalized DC signal changes little. Conclusion: The toe PPG signals can obviously indicate the regulated blood volume change with the designated postural procedures due to the heart level position.

In vitro growth inhibition of human colonic tumor cells by Verapamil

AIM: To investigate the effects and mechanisms of Verapamil on cultured human colonic tumor (HCT) cells.METHODS: HCT cells were treated with different concentrations of Verapamil, and their proliferation was examined by MTT assay. The areas of sub-diploid peak were measured by flow cytometry, and the DNA ladder was found by agarose gel electrophoresis. The characteristic changes in morphology were observed under light microscopy. The cell nuclei (propidium iodide labeled, PI-labeled) and cellular distribution and concentration of calcium (Fluo-3-labeled) were studied by using laser confocal scanning microscope.RESULTS: The proliferation of HCT cells was inhibited by different concentrations of Verapamil. With the increase in concentration of Verapamil, the percent of G0-G1 phase cells in HCT cells increased and that of S phase cells decreased. After treating with different concentrations of Verapamil, flow cytometry showed that HCT cells were enlarged in areas of sub-diploid in a dose-dependent manner. Gel electrophoresis results displayed a typical DNA ladder. On staining with Wrights-Giemsa, the typical cellular apoptosis morphologic changes were also observed. PI-labeled cell nuclei were found markedly changed. In addition, we inspected that the 100 μmol/L Verapamil could increase the intracellular calcium ion concentration [Ca2+]i in HCT cells.CONCLUSION: Verapamil can inhibit proliferation of HCT cells via inducing cell apoptosis.

Structure and design method for pulse-triggered flip-flops at switch level

A kind of structure and a design method using transmission voltage-switch theory for pulse-triggered flip-flops were proposed,which are suitable for all kinds of pulse-triggered flip-flops and no extra techniques are needed to eliminate the switching activities of internal nodes.Based on the proposed structure and design technique,two pulsed flip-flops were implemented and simulated.The proposed pulsed flip-flops have simple circuit structures.HSPICE simulation shows that the proposed pulsed D flip-flop outperforms the conventional pulsed D flip-flop by 17.2% in delay and 30.1% in power-delay-product(PDP) and the proposed pulsed JK flip-flop has low power and small PDP compared with pulsed D pulsed flip-flops,confirming that the proposed structure and design technique are simple and practical.

Left univentricular pacing for cardiac resynchronization therapy using rate-adaptive atrioventricular delay

Objective To evaluate left univentricular （LUV） pacing for cardiac resynchronization therapy （CRT） using a rate-adaptive atrioven- tricular delay （RAAVD） algorithm to track physiological atrioventricular delay （AVD）. Methods A total of 72 patients with congestive heart failure （CHF） were randomized to RAAVD LUV pacing versus standard biventricular （BiV） pacing in a 1 ： 1 ratio. Echocardiography was used to optimize AVD for both groups. The effects of sequential BiV pacing and LUV pacing with optimized A-V （right atrio-LV） delay using an RAAVD algorithm were compared. The standard deviation （SD） of the S/R ratio in lead VI at five heart rate （HR） segments （Rs/R-SD5）, defined as the ＂tracking index,＂ was used to evaluate the accuracy of the RAAVD algorithm for tracking physiological AVD. Results TheQRS complex duration （132 ± 9.8 vs. 138± 10ms, P 〈 0.05）, the time required for optimization （21 ±5 vs. 50±8min, P〈 0.001）, the mitral regurgitant area （1.9 ± 1.1 vs. 2.5 ± 1.3 em2, P 〈 0.05）, the interventricular mechanical delay time （60.7 ± 13.3 ms vs. 68.3 ± 14.2 ms, P 〈 0.05）, and the average annual cost （13,200 ± 1000 vs. 21,600 ± 2000 RMB, P 〈 0.001） in the RAAVD LUV pacing group were significantly less than those in the standard BiV pacing group. The aortic valve velocity-time integral in the RAAVD LUV pacing group was greater than that in the standard BiV pacing group （22.7 ± 2.2 vs. 21.4 ± 2.1 cm, P 〈 0.05）. The Rs/R-SD5 was 4.08 ± 1.91 in the RAAVD LUV pacing group, and was significantly negatively correlated with improved left ventricular ejection fraction （LVEF） （ALVEF, Pearson＇s r = -0.427, P = 0.009）, and positively correlated with New York Heart Association class （Spearman＇s r - 0.348, P 0.037）. Conclusions RAAVD LUV pacing is as effective as standard BiV pacing, can be more physiological than standard BiV pacing, and can de- crease the average annual cost of CRT.