基于营卫学说探讨肺痿、肺痈、肺胀的准确辨识

肺痿、肺痈、肺胀三病在临床上较为常见,受病情轻重及转归的影响,准确辨识和诊治三病难度较大。本文结合《金匮要略》《伤寒论》《黄帝内经》《难经》等典籍的营卫理论,通过对营卫化源、循行、阴阳属性、对人体生理病理的影响等内容的简要概括,将古今医家对三病的正邪虚实、脏腑三焦、五行制化等不同看法统一于营卫之中,阐述肺痿偏于营损,以复营生津为主、肺痈偏于营滞,以利气排脓为主、肺胀偏于卫滞,以宣卫化饮为主的诊治观点,以及强调在营卫合阴的基础上肺痈、肺胀可相互转化,并根据病机进一步细化肺痿、肺痈早期的症状鉴别,更着重分析《金匮要略》诸方的组方思路、主治差异以及临床疗效,完善三病起于营卫,治于营卫的论述过程。本文从营卫理论出发重新探讨肺痿、肺痈、肺胀,不仅为临床诊治三病提供理论指导,更是借对张仲景营卫观的挖掘拓展,为临床内外伤杂病的辨证论治提供新的切入点。

Characterizing Spatial Patterns of Precipitation Based on Corrected TRMM_3B_(43) Data over the Mid Tianshan Mountains of China

The poor distribution of meteorological stations results in a limited understanding of the precipitation pattern in the Tianshan Mountains. The spatial patterns of precipitation over the mid Tianshan Mountains were characterized based on the TRMM 3B43 monthly precipitation data. By comparing satellite estimates with observed data, it shows that TRMM 3B43 data underestimate the precipitation in mountain region. Regression models were developed to improve the TRMM 3B43 data, using geographic location and topographic variables extracted from DEM using GIS technology. The explained variance in observed precipitation was improved from 64% (from TRMM 3B43 products alone) to over 82% and the bias reduced by over 30% when location and topographic variables were added. We recalculated all the TRMM 3B43 monthly precipitation grids for the period 1998 to 2009 using the best regression models, and then studied the variation patterns of precipitation over the mid Tianshan Mountains. The results are well explained by a general understanding of the patterns of precipitation and orographic effects. This indicated that the Tianshan Mountains strongly influences the amount and distribution of precipitation in the region. This is highlighted by the confinement of the precipitation maxima to the windward (northern slope). And complex vertical changes in the provenance and distribution of precipitation, like that a negative increasing rate of precipitation in the vertical direction exists in the north but does not in south. The results have also revealed large gradients and different patterns in seasonal precipitation that are not simply related to elevation, the distribution of precipitation may also be affected by other seasonal factors such as the sources of moist air, wind direction and temperature.

Comparison of CloudSat Cloud Liquid Water Paths in Arctic Summer Using Ground-Based Microwave Radiometer

Arctic clouds strongly influence the regional radiation balance, temperature, melting of sea ice, and freezing of sea water. Despite their importance, there is a lack of systematic and reliabie observations of Arctic clouds. The CloudSat satellite launched in 2006 with a 94GHz Cloud Profiling Radar （CPR） may contribute to close this gap. Here we compare one of the key parameters, the cloud liquid water path （LWP） retrieved from CloudSat observations and from microwave radiometer （MWR） data taken during the ASCOS （Arctic Summer Cloud Ocean Study） cruise of the research vessel Oden from August to September 2008. Over the 45 days of the ASCOS cruise, collocations closer than 3 h and 100 km were found in only 9 d, and collocations closer than 1 h and 30 km in only 2 d. The poor correlations in the scatter plots of the two LWP retrievals can be explained by the patchiness of the cloud cover in these two days （August 5th and September 7th）, as confirmed by coincident MODIS （Moderate-resolution Imaging Spectroradiome- ter） images. The averages of Oden-observed LWP values are systematically higher （40-70 g m-2） than the corresponding CloudSat observations （0-50 g m2）. These are cases of generally low LWP with presumably small droplets, and may be explained by the little sensitivity of the CPR to small droplets or by the surface clutter.

Hydrography and Circulation in the Eastern Tropical Indian Ocean during April-May 2011

The distribution of hydrography and circulation in the eastern tropical Indian Ocean(ETIO) during April-May 2011 were analyzed using cruise observations,satellite observations,and historic hydrographic data.It was observed that warm water(>28℃) occupies the upper 50-m layer in the ETIO.Low-salinity surface water was observed at the mouth of the Bay of Bengal(BOB),which further extends to the Arabian Sea and off Sumatra via the Sri Lanka coast and the eastern bay mouth.Arabian Sea high-salinity water(ASHSW) is carried eastward along the equator to around 90°E by the equatorial undercurrent(EUC).It also runs south of Sri Lanka(north to 3°N) and in the western bay mouth(west to 87°E) but is much shallower than its counterpart at the equator.It is suggested to be the residual of the ASHSW,which intrudes into the BOB during the preceding southwest monsoon.Our results also show that,in the south of Sri Lanka,just below this subsurface high-salinity water,very-low-salinity water(about 34.8) occurs at depths of 100-200 m.Further analysis suggests that this low-salinity water comes from the BOB.

Preliminary Evaluation of Cloud Fraction Simulations by GAMIL2 Using COSP

The Cloud Feedback Model Intercomparisons Project (CFMIP) Observation Simulator Package (COSP) is adopted in the Grid-point Atmospheric Model of IAP LASG (GAMIL2) during CFMIP at Phase II to evaluate the model cloud fractions in a consistent way with satellite observations. The cloud simulation results embedded in the Atmospheric Model Intercomparison Project (AMIP) control experiment are presented using three satellite simulators: International Satellite Cloud Climatology Project (ISCCP), Moderate Resolution Imaging Spectroradiometer (MODIS), and Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) lidar onboard the Cloud- Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO). Overall, GAMIL2 can produce horizontal distributions of the low cloud fraction that are similar to the satellite observations, and its similarities to the observations on different levels are shown in Taylor diagrams. The discrepancies among satellite observations are also shown, which should be considered during evaluation.

Influence of urbanization on the thermal environment of meteorological station:Satellite-observed evidence

In this paper, five national meteorological stations in Anhui province are taken as typical examples to explore the effects of local urbanization on their thermal environment by using Landsat data from 1990 to 2010. Satellite-based land use/land cover(LULC), land surface temperature(LST), normalized difference vegetation index(NDVI) are used to investigate the effects. The study shows that LULC around meteorological stations changed significantly due to urban expansion. Fast urbanization is the main factor that affects the spatial-temporal distribution of thermal environment around meteorological stations. Moreover, the normalized LST and NDVI exhibit strong inverse correlations around meteorological stations, so the variability of LST can be monitored through evaluating the variability of NDVI. In addition, station-relocation plays an important role in improving representativeness of thermal environment. Notably, the environment representativeness was improved, but when using the data from the station to study climate change, the relocation-induced inhomogeneous data should be considered and adjusted. Consequently,controlling the scale and layout of the urban buildings and constructions around meteorological stations is an effective method to ameliorate observational thermal environment and to improve regional representativeness of station observation. The present work provides observational evidences that high resolution Landsat images can be used to evaluate the thermal environment of meteorological stations.

MODIS BRIGHTNESS TEMPERATURE DATA ASSIMILATION UNDER CLOUDY CONDITIONS Ⅱ: IMPACTS ON RAINSTORM FORECASTING

Satellite observations provide large amount of information of clouds and precipitation and play an important role in the forecast of heavy rainfall.However,we have not fully taken advantage of satellite observations in the data assimilation of numerical weather predictions,especially those in infrared channels. It is common to only assimilate radiances under clear-sky conditions since it is extremely difficult to simulate infrared transmittance in cloudy sky.On the basis of the Global and Regional Assimilation and Prediction Enhanced System 3-dimensional variance(GRAPES-3DVar),cloud liquid water content, ice-water content and cloud cover are employed as governing variables in the assimilation system.This scheme can improve the simulation of infrared transmittance by a fast radiative transfer model for TOVS (RTTOV)and adjust the atmospheric and cloud parameters based on infrared radiance observations.In this paper,we investigate a heavy rainfall over Guangdong province on May 26,2007,which is right after the onset of a South China Sea monsoon.In this case,channels of the Moderate Resolution Imaging Spectroradiometer(MODIS)for observing water vapor(Channel 27)and cloud top altitude(Channel 36)are selected for the assimilation.The process of heavy rainfall is simulated by the Weather Research and Forecasting(WRF)model.Our results show that the assimilated MODIS data can improve the distribution of water vapor and temperature in the first guess field and indirectly adjust the upper-level wind field.The tendency of adjustment agrees well with the satellite observations.The assimilation scheme has positive impacts on the short-range forecasting of rainstorm.

Imprint of the ENSO on Rainfall and Latent Heating Variability over the Southern South China Sea from TRMM Observations

Analyses of the Tropical Rainfall Measuring Mission （TRMM） datasets revealed a prominent interannual variation in the convective-stratiform rainfall and latent heating over the southern South China Sea （SCS） during the winter monsoon between 1998 and 2010. Although the height of maximum latent heating remained nearly constant at around 7km in all of the years, the year-to- year changes in the magnitudes of maximum latent heating over the region were noticeable. The interannual variations of the convee- tive-stratiform rainfall and latent heating over the southern SCS were highly anti-correlated with the Nifio-3 index, with more （less） rainfall and latent heating during La Nifia （El Nifio） years. Analysis of the large-scale environment revealed that years of active rain- fall and latent heating corresponded to years of large deep convergence and relative humidity at 600hPa. The moisture budget diag- nosis indicated that the interarmual variation of humidity at 600hPa was largely modulated by the vertical moisture advection. The year-to-year changes in rainfall over the southern SCS were mainly caused by the interannual variations of the dynamic component associated with anomalous upward motions in the middle troposphere, while the interannual variations of the thermodynamic com- ponent associated with changes in surface specific humidity played a minor role. Larger latent heating over the southern SCS during La Nifia years may possibly further enhance the local Hadley circulation over the SCS in the wintertime.

论《伤寒论》脉诊

脉见大、浮、数、动、滑,为阳脉,而脉见沉、涩、弱、弦、微,为阴脉,阳主生,阴主死。阴病见阳脉提示阴气虽盛,但阳气来复,故曰生;阳病见阴脉提示阳浮而阴气内盛,故曰死。故从脉诊中来区别阴阳,综合全身证候以进行辨证,了解阴阳的消长,可以判断邪正的盛衰,从而决定病机的发展趋势以及疾病的预后。以脉测证,脉证合参,可知疾病的病理机转。阴平阳秘、正气强胜、胃气充盛、营卫和谐、人体与外界自然以及脏腑内外升降平衡协调则身体强健无病,即使患病也易治愈,反之则病进预后不良。

Effects of penehyclidine hydrochloride on rat intestinal barrier function during cardiopulmonary bypass

AIM:To test the ability of penehyclidine hydrochloride (PHC) to attenuate intestinal injury in a rat cardiopulmonary bypass (CPB) model.METHODS:Male Sprague-Dawley rats were randomly divided into six groups (eight each):sham-operated control;sham-operated low-dose PHC control (0.6 mg/kg);sham-operated high-dose PHC control (2.0 mg/kg);CPB vehicle control;CPB low-dose PHC (0.6 mg/kg);and CPB high-dose PHC (2.0 mg/kg).Blood samples were collected from the femoral artery 2 h after CPB for determination of plasma diamine oxidase (DAO),D-lactate and endotoxin levels.Spleen,liver,mesenteric lymph nodes and lung were removed for biochemical analyses.Intestinal tissue ultrastructure was examined by electron microscopy.RESULTS:In the sham-operated groups,high-and low-dose-PHC had no significant impact on the levels of DAO,D-lactate and endotoxin,or the incidence of intestinal bacterial translocation (BT).Serum levels of DAO,D-lactate,endotoxin and the incidence of intestinal BT were significantly increased in the surgical groups,compared with the sham-operated groups (0.543 ± 0.061,5.697 ± 0.272,14.75 ± 2.46,and 0/40 vs 1.038 ± 0.252,9.377 ± 0.769,60.37 ± 5.63,and 30/40,respectively,all P < 0.05).PHC alleviated the biochemical and histopathological changes in a dosedependent manner.Serum levels of DAO,D-lactate,and endotoxin and the incidence of intestinal BT in the high-dose PHC group were significantly lower than in the low-dose PHC group (0.637 ± 0.064,6.972 ± 0.349,29.64 ± 5.49,and 14/40 vs 0.998 ± 0.062,7.835 ± 0.330,38.56 ± 4.28,and 6/40,respectively,all P < 0.05).CONCLUSION:PHC protects the structure and function of the intestinal mucosa from injury after CPB in rats.

Anemia after gastrectomy for early gastric cancer:Long-term follow-up observational study

AIM:To identify the incidence and etiology of anemia after gastrectomy in patients with long-term follow-up after gastrectomy for early gastric cancer.METHODS:The medical records of those patients with early gastric adenocarcinoma who underwent curative gastrectomy between January 2006 and October 2007 were reviewed.Patients with anemia in the preoperative workup,cancer recurrence,undergoing systemic chemotherapy,with other medical conditions that can cause anemia,or treated during follow up with red cell transfusions or supplements for anemia were excluded.Anemia was defined by World Health Organization criteria(Hb < 12 g/dL in women and < 13 g/dL in men).Iron deficiency was defined as serum ferritin < 20 g/dL.Vitamin B12 deficiency was defined as serum vitamin B 12 < 200 pg/mL.Iron deficiency anemia was defined as anemia with concomitant iron deficiency.Anemia from vitamin B 12 deficiency was defined as megaloblastic anemia(mean cell volume > 100 fL) with vitamin B 12 deficiency.The profile of anemia over 48 mo of follow-up was analyzed.RESULTS:One hundred sixty-one patients with gastrectomy for early gastric cancer were analyzed.The incidence of anemia was 24.5% at 3 mo after surgery and increased up to 37.1% at 48 mo after surgery.The incidence of iron deficiency anemia increased during the follow up and became the major cause of anemia at 48 mo after surgery.Anemia of chronic disease and megaloblastic anemia were uncommon.The incidence of anemia in female patients was significantly higher than in male patients at 12(40.0% vs 22.0%,P = 0.033),24(45.0% vs 25.0%,P = 0.023),36(55.0% vs 28.0%,P = 0.004),and 48 mo(52.0% vs 31.0%,P = 0.022) after surgery.Patients with total gastrectomy showed significantly higher incidence of anemia than patients with subtotal gastrectomy at 48 mo after surgery(60.7% vs 31.3%,P = 0.008).The incidence of iron deficiency was significantly higher in female patients than in male patients at 6(35.4% vs 13.3%,P = 0.002),12(45.8% vs 16.8%,P < 0.001),18(52.1% vs 22.3%,P < 0.001),24(60.4% vs 20.9%,P < 0.001),36(62.5% vs 29.2%,P < 0.001),and 48 mo(66.7% vs 34.7%,P = 0.001) after surgery.CONCLUSION:Anemia was frequent after gastrectomy for early gastric cancer,with iron deficiency being the major cause.Evaluation for anemia including iron status should be performed after gastrectomy and appropriate iron replacement should be considered.

贾充与司马攸之死

作为西晋的开国元勋和太子司马衷、齐王司马攸的岳父,贾充对司马衷和司马攸的态度与晋武帝立嗣过程密切相关。贾充在其出镇一事、夏侯和事件和卫瓘进言事件中都没有明确表示过自己的态度,正因如此,晋武帝在司马攸的问题上才比较谨慎,直到贾充死后才开始着手处理,可以说,司马攸之死与贾充之死直接相关。

Real-data assimilation experiment with a joint data assimilation system: assimilating carbon dioxide mole fraction measurements from the Greenhouse gases Observing Satellite

The performance of a joint data assimilation system（Tan-Tracker）,which is based on the PODEn4 Dvar assimilation method,in assimilating Greenhouse gases Observing SATellite（GOSAT） carbon dioxide（CO2） data,was evaluated.Atmospheric 3D CO2 concentrations and CO2 surface fluxes（CFs） from2010 were simulated using a global chemistry transport model（GEOS-Chem）.TheTan-Tracker system used the simulated CO2 concentrations and fluxes as a background field and assimilated the GOSAT column average dry-air mole fraction of CO2（X（CO2）） data to optimize CO2 concentrations and CFs in the same assimilation window.Monthly simulated X（CO2）（X（CO2）Sim）） and assimilated X（CO2）（X（CO2）,TT） data retrieved at different satellite scan positions were compared with GOSAT-observed X（CO2）（X（CO2）,obs）data.The average RMSE between the monthly X（CO2）,TT and X（CO2）,Obs data was significantly（30%） lower than the average RMSE between X（CO2）,Sim and X（CO2）,Obs）.Specifically,reductions in error were found for the positions of northern Africa（the Sahara）,the Indian peninsula,southern Africa,southern North America,and western Australia.The difference between the correlation coefficients of the X（CO2）,Sim）and X（CO2）,Obs and those of the X（CO2）Π）,TT and X（CO2）,Obs was only small.In general,the Tan-Tracker system performed very well after assimilating the GOSAT data.

CLIMATOLOGICAL CHARACTERISTICS FOR THE ONSET OF ASIAN SUMMER MONSOON AS REVEALED BY HIRS-Tb12 AND DROUGHT AND FLOODS IN EASTERN CHINA

As shown in comparison and study of the HIRS-Tb12 data and conventional data, temperature, humidity and vertical motion are structured differently in the Southern and Northern Hemispheres, which are well depicted with the HIRS-Tb12 data. When high pressures rapidly decrease over the regions of South China Sea and Arabian Sea with the HIRS-Tb12 less than 200 W/m2, monsoons will set off in the South China Sea, Arabian Sea and Bay of Bengal, respectively. From a year of significant drought to one of significant floods, the trend of evolution is significantly different in the downdraft areas of the subtropical highs between the two hemispheres.

The Impact of "Bad" Argo Profiles on Ocean Data Assimilation

Recent studies have found cold biases in a fraction of Argo profiles (hereinafter referred to as bad Array for Real-time Geostrophic Oceanography (Argo) profiles) due to the pressure drifts during 2003 and 2006. These bad Argo profiles have had an important impact on in situ observation-based global ocean heat content esti- mates. This study investigated the impact of bad Argo profiles on ocean data assimilation results that were based on observations from diverse ocean observation systems, such as in situ profiles (e.g., Argo, expendable bathy- thermograph (XBT), and Tropical Atmosphere Ocean (TAO), remote-sensing sea surface temperature products and satellite altimetry between 2004 and 2006. Results from this work show that the upper ocean heat content analysis is vulnerable to bad Argo profiles and demon- strate a cooling trend in the studied period despite the multiple independent data types that were assimilated. When the bad Argo profiles were excluded from the as- similation, the decreased heat content disappeared and a warming occurred. Combination of satellite altimetry and mass variation data from gravity satellite demonstrated an increase, which agrees well with the increased heat con- tent. Additionally, when an additional Argo profile quality control procedure was utilized that simply removed the profiles that presented static unstable water columns, the results were very similar to those obtained when the bad Argo profiles were excluded from the assimilation. This indicates that an ocean data assimilation that uses multiple data sources with improved quality control could be less vulnerable to a major observation system failure, such as a bad Argo event.

Assessment of Dust Aerosol Optical Depth and Shortwave Radiative Forcing over the Northwest Pacific Ocean in Spring Based on Satellite Observations

Dust aerosol optical depth (AOD) and its ac-companying shortwave radiative forcing (RF) are usually simulated by numerical models.Here,by using 9 months of Moderate Resolution Imaging Spectroradiometer (MODIS) aerosol product data in combination with Clouds and the Earth's Radiant Energy System Single Scanner Footprint (CERES/SSF) data,dust AOD and its shortwave RF were estimated over the cloud-free north-west (NW) Pacific Ocean in the springs of 2004,2005,and 2006.The results showed that in this region,the mean dust AOD and its shortwave RF were 0.10 and 5.51 W m 2,respectively.In order to validate the dust AOD de-rived by MODIS,results from the Goddard Global Ozone Chemistry Aerosol Radiation and Transport (GOCART) model were also used here.The correlation coefficient between the monthly averaged dust AOD derived by MODIS measurements and the model simulation results was approximately 0.53.Since the estimates of the dust AOD and its shortwave RF obtained in this study are based mainly on satellite data,they offer a good reference for numerical models.

Assessing satellite-derived net surface radiative flux in the Arctic

Satellite-derived surface radiative fluxes have been recently improved and extended.However,the accuracy of recent satellite-derived surface radiative fluxes in the Arctic is not well characterized.Here,the authors assess the accuracy of the net surface radiative flux （NETSRF） in the Arctic,focusing on the ice-covered ocean,for three satellite products against four in situ measurements collected from different areas in the Arctic.The three satellite products are the Surface Radiation Budget project （SRB）,the International Satellite Cloud Climatology Project （ISCCP）,and the Extended AVHRR Polar Pathfinder version-2 （APP-x）.Our comparisons suggest that：（1） in terms of the overall bias,root-mean-square error,and correlation,the NETSRF of ISCCP is closer to in situ observations than that of SRB and APP-x;（2） in terms of the diurnal variation of the biases,it is not very clear which satellite product is superior to the others;and （3） in terms of the interannual variability of the bias,the NETSRF of ISCCP is more accurate than that of SRB and APP-x.This comparison may provide useful guidance to the community as to which data-set may provide the smallest bias in NETSRF

Genomic and genetic alterations influence the progression of gastric cancer

Gastric cancer is one of the leading causes of cancerrelated deaths worldwide, although the incidence has gradually decreased in many Western countries. Two main gastric cancer histotypes, intestinal and diffuse, are recognised. Although most of the described genetic alterations have been observed in both types, different genetic pathways have been hypothesized. Genetic and epigenetic events, including 1q loss of heterozygosity (LOH), microsatellite instability and hypermethylation, have mostly been reported in intestinal-type gastric carcinoma and its precursor lesions, whereas 17p LOH, mutation or loss of E-cadherin are more often implicated in the development of diffuse-type gastric cancer.In this review, we summarize the sometimes contradictory findings regarding those markers which influence the progression of gastric adenocarcinoma.

Slip-Rate on the Middle Altyn Tagh Fault since the Holocene Period

By analyzing high-resolution SPOT images and in combination with fieldwork and chronometry, three typical fault-offset sites on the south-middle Altyn Tagh strike-slip fault were studied to obtain the sinistral horizontal slip rate of the fault. At Annanba, the left-lateral strike-slip rate on a branch of the south Altyn Tagh fault is 7.5±1.7 mm/a since 9.36±0.73ka BP. At Seven Spring, the fault has four branches and the left-lateral strike-slip rate on one of them is 2.3±0.5mm/a since 13.86±1.07ka BP, and it is deduced that the total slip-rate of all the four branches is 6.9±1.5～ 9.2±2.0 mm/a since Holocene. At Yuemakeqi, the left-lateral strike-slip rate of the fault is 10.6±3.0mm/a since 4.73±0.38 ka BP. A slip-rate of 7～11mm/a on the middle segment of the Altyn Tagh fault (between 88°30’E and 93°05’E) since Holocene can be deduced from the three sites mentioned above and the result is similar to the latest GPS observation.

Regional Tectonic Deformation Background and Medium- and Short-Term Precursors to the Minle-Shandan Earthquakes1

Using GPS observations of horizontal movement from 2001 to 2003 and the cross-fault mobile short-levelling data of 1988～2003, and with the aid of the improved negative dislocation model and the time-varying curve of strain intensity ratio of fault deformation, the regional tectonic deformation background and medium- and short-term precursors related to the preparation of the Minle-Shandan earthquakes of M S6.1 and M S5.8 on October 25, 2003 are investigated. The results reveal that, under the background of the wide-range deformation adjustment, short-term relaxation and recovery caused by the Kunlun Mountains earthquake of M S8.1, the hypocenters of the earthquakes are located on the north edge of the shear stress enhancement zone between the compressional locked segments of block boundary fault, a place which may represent an accelerated strain accumulation. An obvious anomaly of strain intensity ratio appeared in short-levelling measurements crossing over the fault at the Shihuiyaokou site, the closest to the epicenters, 3 months before the occurrence of the earthquakes. In addition, the variation in number of anomalies from 10-odd days to months before the earthquakes in the entire monitoring area and the anomaly concentration and local enhancement relative to near source in the 3 months before the earthquakes are regarded to be precursors to the two events.