寸口脉分候脏腑理论的实验研究——正常人左右关脉与肝脾内在联系的探讨

寸口六脉分候脏腑理论是中医脉学的重要组成部分,为历代医家所重视。但由于六脉与脏腑的配属不一,而对其价值也褒贬不一,为古今医家所争论。肯定者认为这理论有理论依据,对临床有一定指导价值;否定者认为这理论缺乏科学依据,感性认识靠不住。但有不少学者认为六脉分候脏腑理论是中医多年传统经验。

马王堆帛书《阴阳脉死候》成书问题考论

文献证据不支持帛书《阴阳脉死候》成书参考了帛书《阴阳十一脉灸经》的意见，帛书《阴阳脉死候》当参考了类似帛书《足臂十一脉灸经》的内容。帛书《阴阳脉死候》将原本分属特定经脉的内容纂集成书，这是其主要的成书方式，这种情形也反映了对待经脉死候的一般化趋势。

马王堆帛书《脉法》《阴阳脉死候》考疑

马王堆帛书《脉法》和《阴阳脉死候》 ,主要论述经脉病证治疗及三阴五死证候 ,书中没有关于诊脉的内容 ,参阅《灵枢·经脉》篇中的经循路线、脉病主证、经病治疗及五阴死候等内容 ,初步认定二书不是脉象诊断学书籍 ,也不是独立成篇的著作 ,它们应与《阴阳十一脉灸经》是同一部书 ,即今之《灵枢·经脉》 ,只是前者成书较早 ,文理简略 ,而后者成书较晚 ,论述详尽。

中医如何诊治疑难病症

（续上期）2诊治疑难病症要把握四条原则第二是要详察脉色与形候。脉就是脉象;色就是望色,望面色,望舌色;形就是形体、形态、动态;候就是疾病现象,疾病症候。即察色,按脉,望形态,听声音,问症状,这不就是我们中医的四诊吗？《内经》说：＂能合脉色,可以万全＂,说到底就是＂望闻问切＂要详细地诊察。我们诊治疑难病人和危急病人,特别要注重详细诊察,绝对不能马虎,望闻问切缺一不可。

六经学说形成的文献基础

《伤寒论》是以六经学说为框架构筑而成的一部理论联系实际的中医典籍。以往对六经学说的研究,已经取得了长足进步。本文拟就马王堆三号汉墓帛书医经、《黄帝内经》等文献中有关三阴三阳的论述为依据,

Streamflow response to shrinking glaciers under changing climate in the Lidder Valley,Kashmir Himalayas

The study investigated the streamflow response to the shrinking cryosphere under changing climate in the Lidder valley, Upper Indus Basin(UIB), Kashmir Himalayas. We used a combination of multitemporal satellite data and topographic maps to evaluate the changes in area, length and volume of the glaciers from 1962 to 2013. A total of 37 glaciers from the Lidder valley, with an area of 39.76 km^2 in 1962 were selected for research in this study. It was observed that the glaciers in the valley have lost ~28.89 ±0.1% of the area and ~19.65 ±0.069% of the volume during the last 51 years, with variable interdecadal recession rates. Geomorphic and climatic influences on the shrinking glacier resources were studied. 30-years temperature records(1980-2010) in the study area showed a significant increasing trend in all the seasons. However, the total annual precipitation during the same period showed a nonsignificant decreasing trend except during the late summer months(July, August and September), when the increasing trend is significant. The depletion of glaciers has led to the significant depletion of the streamflows under the changing climate in the valley. Summer streamflows(1971-2012) have increased significantly till mid-nineties but decreased significantly thereafter, suggesting that the tipping point of streamflow peak, due to the enhanced glacier-melt contribution under increasing global temperatures, may have been already reached in the basin. The observed glacier recession and climate change patterns, if continued in future, would further deplete the streamflows with serious implications on water supplies for different uses in the region.

Hepatic angiosarcoma with clinical and histological features of Kasabach-Merritt syndrome

Hepatic angiosarcoma is a mesenchymal tumor originating from liver sinusoidal endothelial cells. It is an extremely rare malignant neoplasm accounting for less than 1% of primary malignant liver tumors. The deregulated coagulopathy that can be seen in hepatic angiosarcoma fulfills the clinical diagnostic criteria of disseminated intravascular coagulation. However, the mechanism that governs this coagulopathy has been poorly understood. This case report provides histological evidence of the consumption of coagulation factors along with trapped platelets occurring within the tumor, which is the foundation for the concept of Kasabach-Merritt syndrome(KMS). KMS is characterized by thrombocytopenia and hyperconsumption of coagulation factors within a vascular tumor. However, KMS associated with angiosarcoma has not been well recognized. This case report describes, for the first time, the histological evidence of KMS that occurred in an extremely rare mesenchymal malignant tumor of the liver.

马王堆医书与饮食疗法

马王堆医书与饮食疗法喻燕姣马王堆医书是指１９７２－１９７３年在湖南长沙马王堆汉墓出土的医药书籍。它包括帛书《足臂十一脉灸经》、《阴阳十一脉灸经》、《脉法》、《阴阳脉死候》、《五十二病方》、《杂疗方》、胎产书》、《养生方》、《却谷食气》、《导引图》，竹...

Effect of Aspect on Climate Variation in Mountain Ranges of Shennongjia Massif, Central China

The aim of this study was to better understand the mechanisms of regional climate variation in mountain ranges with contrasting aspects as mediated by changes in global climate. It may help predict trends of vegetation variations in native ecosystems in natural reserves. As measures of climate response, temperature and precipitation data from the north, east, and south-facing mountain ranges of Shennongjia Massif in the coldest and hottest months(January and July), different seasons(spring, summer, autumn, and winter) and each year were analyzed from a long-term dataset(1960 to 2003) to tested variations characteristics, temporal and spatial quantitative relationships of climates. The results showed that the average seasonal temperatures and precipitation in the north, east, and south aspects of the mountain ranges changed at different rates. The average seasonal temperatures change rate ranges in the north, east, and south-facing mountain ranges were from –0.0210℃/yr to 0.0143℃/yr, –0.0166℃/yr to 0.0311℃/yr, and –0.0290 ℃/yr to 0.0084℃/yr, respectively, and seasonal precipitation variation magnitude were from –1.4940 mm/yr to 0.6217 mm/yr, –1.6833 mm/yr to 2.6182 mm/yr, and –0.8567 mm/yr to 1.4077 mm/yr, respectively. The climates variation trend among the three mountain ranges were different in magnitude and direction, showing a complicated change of the climates in mountain ranges and some inconsistency with general trends in global climate change. The climate variations were significantly different and positively correlated cross mountain ranges, revealing that aspects significantly affected on climate variations and these variations resulted from a larger air circulation system, which were sensitive to global climate change. We conclude that location and terrain of aspect are the main factors affecting differences in climate variation among the mountain ranges with contrasting aspects.

Synedra ulna var.repanda,a new variety of Synedra (Bacillariophyta) from Xinjiang,China

Synedra ulna var, repanda Q. X. Wang ＆ Q. M. You, a new variety of Synedra （Bacillariophyta） from Xinjiang, China, is described and illustrated, and the characteristic of the variety： includes undulate-linear valves and straight pseudoraphe, differs from other species of Synedra.

How to select the appropriate candidate of pulmonary arterial hypertension： specific therapy in elderly patients with pulmonary hypertension

Recent reports from pulmonary arterial hypertension （PAH） registries suggest that the mean age at diagnosis is increasing in a growing proportion of elderly patients. The combination of several reasons such as aging popula- tion, increase in life expectancy, growing PAH awareness of physicians and patients, and availability of more treatment options could explain the changing picture of PAH. PAH should be considered as an emerging entity in the elderly.

Succession Features and Dynamic Simulation of Subalpine Forest in the Gongga Mountain, China

The Gongga Mountain of eastern Tibet Plateau is a representative of the alpine regions with high peaks and deep valleys. Climate change over the last thousand years has controlled the dynamics of glacier and debris flow occurrence, which resulted in substantial changes in the mountainous environment. The authors surveyed the community structure of primary forests in Gongga Mountain and forest succession processes in woodland plots. The changing features in the subalpine environment are discussed in this paper. Tree species and sizes between the glacier shrinking areas and debris flow fans in Hailuogou Valley are compared. The pioneer species that settle in debris flow fans and the glacier shrinking areas are Salix spp. and Populus purdomii. Abies fabri and Picea brachytyla are the climax tree species. The succession process of primary vegetation in Hailuogou (2700 ~ 3200 m) can be divided into four stages: Slash surface (20~ 200 yr) Salix-Populus seeding community (10 ~ 30 yr) Populus-Salix sapling community (30 ~ 100 yr) Populus-Abies mixed community (50 ~ 100 yr) Abies-Picea climax In a natural and undisturbed environment, trees compete for light, water and nutrients. Disaster disturbance in mountains is a very important driving factor for regeneration of woody plants. Repeated destruction of forests by glacier movement or debris flows generated additional forest gaps that allow young plants to grow. In this study the Gongga Forest Succession Model (GFSM) was developed for simulation of forest community succession processes on different scales in Gongga Mountain. A soil succession module was added to the GFSM model to simulate soil formation and chemical element change of woodland. In order to represent major features of forests in Southwestern China, many field works has been done to identify ecological parameters of various trees in the subalpine region. On the basis of simulation of tree life history, the GFSM combines forest succession with soil change in both material components and nutrition content. The Monte-Carlo method was applied to simulate random weather fluctuation and the uncertainty of tree death. These modeled processes agreed with the field investigation results in this region. The elevation distribution of different tree species was also simulated; and the results are consistent with field observations of ecological features of tree species. The modeling approach reflects well the succession dynamics of primary forests in Southwestern China. These results are very useful for improving the management policies and prediction technology for restoration and conservation of primary forests in Southwestern China.

Particular evolution in a 72-year-old diabetic patient with acute coronary syndrome

Diabetes mellitus is an important risk factor for coronary atherosclerosis and many patients present extensive coronary stenosis at coronarography. However, in patients with diabetes, endothelial and microvascular dysfunction also participate in chronic and acute myocardial ischemia. Although the majority of diabetic patients with myocardial infarction have angiographic evidence of significant coronary artery disease.

Spatial distribution of morphometric parameters of glacial cirques in the Central Pyrenees(Aran and Boí valleys)

Glacial cirques are typical landscape features of mid-latitude mountain environments like the Central Pyrenees. Their morphology as well as their spatial distribution provides insights about past glaciers and climates. In this study, we examine the distribution, morphometrical and topographical characteristics of glacial cirques in two U-shaped glacial valleys located in the Central Pyrenees – the Aran and the Boí valleys. They are located in different aspects of this mountain range(north vs south) under different climatic influences that promoted distinct glaciation patterns during the late Pleistocene. The spatial mapping of these landforms was carried out using high-resolution imagery and field observations. We analysed the data of the morphometrical and topographical variables of the glacial cirques by using different statistical and geospatial methods in order tounveil the factors controlling their formation and development. A total of 186 glacial cirques were mapped in the study area, including 119 in the Aran and 67 in the Boí valleys. The local topography and microclimate conditions lead to substantial differences in both areas in terms of the morphology and dimensions of the cirques. Glacial cirques in Boí are distributed at slightly higher elevations than in Aran and they are also larger, though their dimensions decrease with elevation in both valleys. Aran cirques are mostly oriented NE, while Boí landforms do not show any prevailing aspect. Even though lithology does not control the distribution of the glacial cirques, some specific lithological settings may favour the development of larger cirques. In general, glacial cirques in the Aran and the Boí valleys show morphometrical properties similar to those reported in other mid-latitude mountain ranges.

经脉学说与扁鹊脉法的血缘

完整的经脉学说由循行、病候、诊法、治则、治疗五部分构成,其核心为经脉病候。基于多重证据证明:经脉病候"是动"病以及渗透于病候之中或附于之下的"脉死候"皆出于扁鹊色脉诊;对于脉候,汉以前曾出现过种种不同的、基于四时阴阳学说的解释,扁鹊脉法"标本诊法"的诞生及其在临床上的广泛应用,促进了一种全新的理论解释的诞生——用脉的联系直接解释脉候;又伴随着扁鹊医学血脉理论的新发展,经脉学说也发生了革命——其理论范式从"树型"变为"环型"。换言之,扁鹊医学不仅孕育了经脉学说,而且决定了她的归宿。

Impact of meteorological conditions and PM2.5 on the onset of acute aortic dissection in monsoonal climate

Objective To investigate the impact of meteorological conditions and PM2.5 on the onset of acute aortic dissection in monsoonal climate. Methods A linear regression analysis was performed in monsoonal climate epidemiological survey for a period of four years on the impact of meteorological factors （minimal temperature, mean temperature, maximal temperature, average daily surface temperature, day temperature range, relative humidity, mean wind speed, and atmospheric pressure） and PM2.5 concentration on the daily incidences of acute aortic dissections. Meteorological variables and PM2.5 concentration were retrieved on a daily basis from Beijing Regional Climate Center and the Ministry of Environmental Protection of the People’s Republic of China’s website, and the daily incidences of acute aortic dissections were retrieved from the Clinical Data Analysis and Reporting System in the Emergency and Critical Care Center of Beijing Anzhen Hospital. Results During the study period （from January 2011 to December 2014）, 1164 patients were identified as having acute aortic dissections. The corresponding incidences in spring and autumn were 0.96 and 1.00, respectively, which significantly higher than that in summer and winter. The incidences of acute aortic dissection in a day could be predicted by diurnal temperature range （DTR） using the following linear multiple regression models： incidences of acute aortic dissection = 0.543 ＋ 0.025 × DTR. Conclusion This is the first study to show an attributable effect of DTR on acute aortic events in monsoonal climate. Our study confirms that meteorological variables were important factors influencing the incidence of acute aortic dissection.

Changes of Temperature and Precipitation Extremes in Hengduan Mountains,Qinghai-Tibet Plateau in 1961-2008

Variations and trends in extreme climate events are more sensitive to climate change than the mean values, and so have received much attention. In this study, twelve indices of temperature extremes and 11 indices of precipita- tion extremes at 32 meteorological stations in Hengduan Mountains were examined for the period 1961-2008. The re- suits reveal statistically significant increases in the temperature of the warmest and coldest nights and in the frequen- cies of extreme warm days and nights. Decreases of the diurnal temperature range and the numbers of frost days and ice days are statistically significant. Regional averages of growing season length also display the trends consistent and significant with warming. At a large proportion of the stations, patterns of temperature extremes are consistent with warming since 1961： warming trends in minimum temperature indices are greater than those relating to maximum temperature. As the center of the Shaluli Mountain, the warming magnitudes decrease from inner to outer. Changes in precipitation extremes is low： trends are difficult to detect against the larger inter-annual and decadal-scale variability of precipitation, and only the wet day precipitation and the regional trend in consecutive dry days are significant at the 0.05 level. It can be concluded that the variation of extreme precipitation events is not obvious in the Hengduan Mountains, however, the regional trends generally decrease from the south to the north. Overall, the spatial distribution of temporal changes of all extreme climate indices in the Hengduan Mountains illustrated here reflects the climatic complexity in mountainous regions.

Relationship between syndrome elements and anterior communicating artery opening in patients with smptomatic severe carotid artery stenosis/occlusion

Objective To study the relationship between syndrome elements and anterior communicating artery(ACoA)opening in patients with symptomatic severe carotid artery stenosis/occlusion.Methods Thirty-six patients with symptomatic severe carotid stenosis/occlusion were collected,including 26 patients with cerebral infarction and 10 patients with transient ischemic attack(TIA).Syndrome elements at five time points were collected.Computer tomography angiography(CTA)combined with magenic resonance angiograp(MRA)was used to evaluate the primary collateral circulation,and the prognosis and syndrome elements were statistically analyzed according to whether the ACoA was open or not.Results The ACoA was open more in the primary collateral circulation among patients with symptomatic severe carotid stenosis/occlusion.There was a statistically significant difference in national institute of health stroke scale(NIHSS)score improvement and good prognosis[the modified rankin scale(mRS)≤2]between the ACoA open group and the ACoA nonopen group on the 90th day(P<0.05).The proportion of patients with internal wind syndrome,blood stasis syndrome,Qi deficiency syndrome,and Yin deficiency syndrome in the ACoA non-open group was higher than that in the open group.Conclusion In the patients with severe carotid artery stenosis/occlusion,the group with presence of anterior communicating artery had better prognosis.The syndrome elements are more complex in the group without the presence of anterior communicating artery.The proportion of Qi deficiency syndrome was positively correlated with the non-opening of anterior communicating artery.The imaging evaluation of collateral circulation can provide guidance for syndrome differentiation and treatment.

Projections of the impacts of climate change on the water deficit and on the precipitation erosive indexes in Mantaro River Basin, Peru

Projections of climate change are essential to guide sustainable development plans in the tropical Andean countries such as Peru. This study assessed the projections of precipitation and potential evaporation, rain erosive potential, and precipitation concentration in the Mantaro River Basin, in the Peruvian Andes, which is important for agriculture and energy production in Peru. We assumed the Intergovernmental Panel on Climate Change （IPCC） AIB greenhouse gas emission scenario and simulated the global climate change by the HadCM3 global climate model. Due to the steepness of the mountain slopes and the narrowness of the river valley, this study uses the downscaling of the global model simulations by the regional Eta model down to 2o-km resolution. The downscaling projections show decrease in the monthly precipitation with respect to the baseline period, especially during the rainy season, between February and April, until the end of the 21st century. Meanwhile, a progressive increase in the monthly evaporation from the baseline period is projected. The Modified Fournier Index （MFI） shows a statistically significant downward trend in the Mantaro River Basin, whieh suggests a possible reduction in the rain erosive potential. The Precipitation Concentration Index （PCI） shows a statistically significant increasing trend, which indicates increasingly more irregular temporal distribution of precipitation towards the end of the century. The results of this study allow us to conclude that there should be a gradual increase in water deficit and precipitation concentration. Both changes can be negative for agriculture, power generation, and water supply in the Mantaro River Basin in Peru.

The Role of Chilean Mountain Areas in Time of Drought and Energy Crisis:New Pressures and Challenges for Vulnerable Ecosystems

In the summer of 2010/2011 Chile suffered the third most severe energy and water supply crisis in only one decade. This may be surprising as the Andes which accompany the country along 4,200 km are a water tower and could provide more electricity and water than needed. On top of that, it has to be mentioned that Chile also counts with sunny and windy climates and with excellent geothermal energy resources and thus has a huge potential as far as renewable energies are concerned. After analyzing the existing natural conditions, the infrastructure and the present challenges of climate change, it has to be asked in which way Chile can make use of this potential in the near future, considering the legal and political situation and the technological opportunities. It seems that the resources are still hidden in the Andes, and only the key is missing to realize the country＇s natural potential. This research has been based on the analysis of existing literature, media, quantitative data from government institutions and other antecedents obtained by the authors in field work done in the South of Chile in 2OLO. The added value of this compilation lies in the comprehensive perspective, linking the knowledge of climatologists, hydrologists, mountain researchers and energy experts in order to support a sustainable energy and water supply for the future in Chile. From this present research, it can be concluded that Chile necessarilyhas to adopt new energy-related strategies, particularly those aimed at diminishing the strong dependence on traditional sources of energy and establishing new techniques and technologies for generating electrieity and utilizing the vast potential that the country is ready to offer, such as that provided by the Andes along 4,200 kilometers.