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南方医科大学学报JSOUTHMEDUNIV5732007275FROMMERIDIANSANDACUPOINTSTOSELFSUPERVISIONANDCONTROLSYSTEMAHYPOTHESISOFTHE10THFUNCTIONALSYSTEMBASEDONANATOMICALSTUDIESOFDIGITIZEDVIRTUALHUMANWANGJUN1,DONGWEIREN2,WANGCHUNLEI1,YAODAWEI3,ZHAOBINGLEI2,SHENBAOLIN1,YANGLINLIN1,YUANLIN11DEPARTMENTOFANATOMY,2DEPARTMENTOFEMBRYOLOGYANDHISTOLOGY,SOUTHERNMEDICALUNIVERSITY,GUANGZHOU510515,CHINA3DEPARTMENTOFANATOMY,CHINESEUNIVERSITYOFHONGKONG,HONGKONGABSTRACTCHINESEACUPUNCTUREANDMOXIBUSTIONHASBEENWIDELYACCEPTEDASAUSEFULTHERAPEUTICSALLOVERTHEWORLD,BUTITSMECHANISMHASNOTBEENFULLYDEFINEDFORTHISPURPOSE,ARETICULARFRAMEWORKOFWHOLEBODYFASCIAANDCONNECTIVETISSUESHASBEENESTABLISHEDBYMEANSOFDIGITIZEDVIRTUALHUMANTECHNIQUETHEVIRTUALACUPOINTSREPRESENTEDTHREEDIMENSIONALLYWERECOMPAREDWITHTHESITESFORSTIMULATIONINPRACTICEOFTRADITIONALCHINESEMEDICINETCMACUPUNCTURETHERAPYTHERESULTSSHOWEDTHATTHEFASCIALNETWORKCONSTITUTEDBYTHECONNECTIVETISSUESMAYBETHEANATOMICALBASISFORACUPUNCTURETHERAPYWEFOUNDTHATTHEACUPOINTSWEREMAINLYLOCATEDWHERETHICKCONNECTIVETISSUESWEREPRESENTINTHISFASCIALNETWORK,SENSITIVENERVEENDINGS,ACTIVECELLSANDLYMPHATICVESSELSABOUNDEDINTHESITESWITHTHICKCONNECTIVETISSUE,ANDNEEDLINGATTHESESITESINDUCEDDEFINITEBIOLOGICALEFFECTSINLIGHTOFBIOLOGICALPHYLOGENYANDEMBRYODEVELOPMENT,WEBELIEVETHATTHECONNECTIVETISSUENETWORKMAYCONSTITUTEANEWFUNCTIONALSYSTEMINTHEHUMANBODY,THESELFSUPERVISIONANDCONTROLSYSTEMFASCIOLOGY,WHICHPROVIDESATHEORETICALBASEFORACUPUNCTURETHERAPYKEYWORDSDIGITIZEDVIRTUALHUMAN/ANATOMYCONNECTIVETISSUESELFSUPERVISIONANDCONTROLSYSTEMFASCIOLOGY/MECHANISMTHEMERIDIANSANDACUPOINTSARETHEFUNDAMENTALCONCEPTSINACUPUNCTURETHERAPYINTRADITIONALCHINESEMEDICINETCM,ANDHAVEBEENSTUDIEDWIDELYFORSEVERALDECADES13THESEACUPOINTSARELINKEDTOGETHERINANETWORKOF“MERIDIANS”RUNNINGLONGITUDINALLYALONGTHEBODYCHENG4FOUNDTHATDISRUPTIONOFTHEMERIDIANCHANNELNETWORKWASASSOCIATEDWITHDISEASECONDITIONS,ANDNEEDLINGATTHEACUPUNCTUREPOINTSMAYINSOMEWAYMODULATETHEFUNCTIONALSTATEOFTHISSYSTEMATTACHMENTS79ANDVARIOUSTYPESOFSENSORYNERVEENDINGS10HAVEBEENDESCRIBEDATTHEACUPUNCTUREPOINTSATTEMPTSWEREALSOMADETOIDENTIFYTHEPHYSIOLOGICALDIFFERENCESSUCHASSKINCONDUCTANCE,PRESSURE,MOISTUREANDSKINABRASIONBETWEENTHEACUPOINTSANDTHESURROUNDINGTISSUES11,BUTTHESEEFFORTSSELDOMYIELDSOLIDCONCLUSIONSWITHREGARDTOTHEANATOMICALAND/ORPHYSIOLOGICALCHARACTERISTICSOFTHEACUPUNCTUREPOINTSINFACT,ANCIENTDOCUMENTSOFACUPUNCTUREHAVEALREADYMADESEVERALREFERENCESTO“FAT,GREASYMEMBRANES,FASCIAEANDSYSTEMSOFCONNECTINGMEMBRANES”12,WHICHECHOEDTHESUGGESTIONBYAFEWSCHOLARSINRECENTYEARSTHATAPROBABLECORRESPONDENCEMIGHTEXISTBETWEENTHEHOWEVER,THEACUPUNCTUREMERIDIANSANDACUPOINTSHAVENOTBEENSHOWNTOHAVEPHYSIOLOGICALEQUIVALENTSINCURRENTUNDERSTANDINGOFMODERNMEDICALSCIENCE5UNIQUETERMS,SUCHASINTERCELLULARCOMMUNICATION,CELLMOVEMENTANDMIGRATION,ANDENERGYTRANSFORMATIONANDEXCHANGE,ANDSOON,AREUSEDINTHEACUPUNCTUREDOCUMENTATIONSTODESCRIBESUCHDYNAMICPROCESSESINTHEMEANTIME,SEVERALRESEARCHERSHAVEFOUNDDISTINCTHISTOLOGICALFEATURESTHATMIGHTDIFFERENTIATETHEACUPUNCTUREPOINTSFROMTHEIRSURROUNDINGTISSUES,ANDSUCHSTRUCTURESASTHENEUROVASCULARBUNDLES6,NEUROMUSCULARACUPUNCTUREMERIDIANSANDCONNECTIVETISSUES13TOSUPPORTTHISHYPOTHESIS,HELENEETALPROVIDEDEXPERIMENTALEVIDENCEBYCHARACTERIZINGACONNECTIVETISSUERESPONSETOACUPUNCTURENEEDLINGTHATWASQUANTITATIVELYDIFFERENTATTHEACUPUNCTUREPOINTSFROMTHATATTHECONTROLPOINTSTHISMIGHTGIVEIMPORTANTCLUESTOTHENATUREOFTHEACUPUNCTUREPOINTSANDMERIDIANS14HOWEVER,IFTHECONNECTIVETISSUESAREINDEEDTHEVERYANATOMICALBASISOFMERIDIANSANDACUPOINTS,WHATISTHENTHEPHYSIOLOGICALBASISOFTHEM,ANDWHATFUNCTIONWILLCONNECTIVETISSUESPLAYINTHEACUPUNCTURETHERAPYCANWEUSEDIGITALTECHNOLOGYTORECONSTRUCTTHERECEIVED20061220SUPPORTEDBYHITECHDEVELOPMENTPROGRAMOFCHINA2001AA231031,2002AA231021ANDKEYSCITECHRESEARCHPROJECTOFGUANGDONGPROVINCE2002B30611WANGJUN1970,PHD,SPECIALIZEDINDIGITALANATOMYRESEARCH,TEL02062842308,EMAILWHMZYQFIMMUCOMCORRESPONDINGAUTHORYUANLIN,TEL02061648637,FAX“CONNECTIVELINESANDPOINTS”,WHICHAREIDENTICALTOTHETHESEQUESTIONS,WECONSTRUCTEDAVIRTUALMODELOFTHEHUMANCONNECTIVETISSUENETWORKBYEXPLOITINGTHEPREVIOUSLYESTABLISHEDDIGITIZEDVIRTUALCHINESEMALERECONSTRUCTIONOFTHECONNECTIVETISSUENETWORKMODELTHEIMAGESOFTHECONNECTIVETISSUESFROMTHEDIGITIZEDVIRTUALCHINESEMALEDATASETWERESEPARATEDFROMTHOSEOFOTHERTISSUESFORTHREEDIMENSIONALRECONSTRUCTIONOFTHECONNECTIVETISSUENETWORKMODELOFHUMANBODYRECONSTRUCTIONOFTHEEXTREMITIESANDTHETRUNKWITHLABELEDTHICKCONNECTIVETISSUEONEHUNDREDIMAGESOFTHETRUNKWITH4MMSPACING,100OFTHEUPPEREXTREMITYAND100OFTHELOWEREXTREMITYWITH5MMSPACING,ALLINTAGGEDIMAGEDATABASEBYLABELINGTHEPOINTSOFTHICKCONNECTIVETISSUES,WERECONSTRUCTEDTHREEDIMENSIONALIMAGESOFTHESEPOINTS,WHICHWERETHENCOMPAREDWITHTHEACUPOINTSANDMERIDIANSUSEDINTRADITIONALACUPUNCTURETHERAPYINLIGHTOFDEVELOPMENTALBIOLOGY,WEKNOWTHATINMULTICELLULARORGANISMS,MESENCHYMEISDERIVEDFROMJELLYLIKEEXTRACELLULARFLUIDECFANDFURTHERDIFFERENTIATESINTOMANYCELLTYPES,TISSUES,EVENORGANSINHIGHERCREATURESLIKEHUMANBEINGS,MESENCHYMEGIVESRISETOALLTHEFASCIALTISSUETHROUGHOUTTHEBODYTHEFASCIAEFORMAFRAMEWORKOFCONNECTIVETISSUESTOSUPPORTTHEGROWTHOFCELLSOFALLFUNCT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EDERMALDENSECONNECTIVETISSUE,SUBCUTANEOUSLOOSECONNECTIVETISSUE,INTERMUSCULARLOOSECONNECTIVETISSUE,LOOSECONNECTIVETISSUEAROUNDTHENERVESANDBLOODVESSELS,ANDTHEHILUSANDCOATINGLOOSECONNECTIVETISSUEOFORGANSFIG3POSITIONINGOFTHETHICKCONNECTIVETHEVISCERALTISSUEANDCABFDEFIG4COMPARISONBETWEENTHEREBUILTIMAGESANDTHETRADITIONALRECORDSAREBUILDINGOFTHERENANDDUCHANNELSBDISTRIBUTIONOFTHEDUCHANNELCREBUILDINGOFTHEUPPEREXTREMITYFASCIAESHOWINGTHELARGEINTESTINECHANNELOFHANDYANGMINGLIANDTHETRIPLEWARMERCHANNELOFHANDSHAOYANGSJDDISTRIBUTIONOFTWOCHANNELSINTHEUPPEREXTREMITYEREBUILDINGOFTHELOWEREXTREMITYFASCIAESHOWINGTHESPLEENCHANNELOFFOOTTAIYINSPANDTHEURINARYBLADDERCHANNELOFFOOTTAIYANGBLFDISTRIBUTIONOFTWOCHANNELSINTHELOWEREXTREMITYTAB1FASCIALSTRUCTUREOFACUPOINTSSTIMULATEDINTHE14INTERNATIONALCHANNELSINTERNATIONALCHANNELSABBREVIATIONNUMBEROFACUPOINTS12345THELUNGCHANNELOFHANDTAIYINLUTHELARGEINTESTINECHANNELOFHANDYANGMINGLITHESTOMACKCHANNELOFFOOTYANGMINGSTTHESPLEENCHANNELOFFOOTTAIYINSPTHEHEARTCHANNELOFHANDSHAOYINHTTHESMALLINTESTINECHANNELOFHANDTAIYANGSITHEURINARYBLADDERCHANNELOFFOOTTAIYANGBLTHEKIDNEYCHANNELOFFOOTTAIYINKITHEPERICARDIUMCHANNELOFHANGJUEYINPCTHETRIPLEWARMERCHANNELOFHANDSHAOYANGSJTHEGALLBLADDERCHANNELOFFOOTSHAOYANGGBTHELIVERCHANNELOFFOOTJUEYINLRTHEDUCHANNELDUTHERENMERIDIANRNTOTAL11204521919672792344142824361122012022191102481223105104512413225231220402230170101221125221504441105336314148258232610191DERMALDENSECONNECTIVETISSUE2SUBCUTANEOUSLOOSECONNECTIVETISSUE3LOOSECONNECTIVETISSUEINTHEINTERMUSCULARSEPTUM4LOOSECONNECTIVETISSUEAROUNDNEUROVASCULARTRACT5LOOSECONNECTIVETISSUEOFTHEHILUSOFTHEVISCERALORGANWANGJUN,ETALFROMMERIDIANSANDACUPOINTSTOSELFSUPERVISIONANDCONTROLSYSTEMAHYPOTHESISOFTHE10THFUNCTIONALSYSTEMBASEDONANATOMICALSTUDIESOFDIGITIZEDVIRTUALHUMAN第5期577SEPTUMSTIMULATEDMOSTOFTHEACUPOINTSWHICHARETOBETOTHEDEPTHSOFTHEDERMALDENSEANDMERIDIANSANDACUPOINTSDEVELOPMENTALBIOLOGYOFTHECONNECTIVETISSUETHEDEVELOPMENTALBIOLOGYOFFASCIAECANREVEALTHEFUNCTIONOFTHEFASCIALNETWORKASISKNOWN,INTHESUBCUTANEOUSLOOSECONNECTIVETISSUESARELOCATEDINTHEHEADTHEACUPOINTSONTHELIMBSAREUSUALLYSTIMULATEDTOTHEDEPTHSOFTHELOOSECONNECTIVETISSUEINTHEINTERMUSCULARSEPTUMANDTHATAROUNDTHENEUROVASCULARPROCESSOFPHYLOGENICEVOLUTION,FASCIAEORIGINALLYEVOLVEFROMTHEMESENCHYMEOFTHEMETAZOANPHYLAANDTHENFROMECFINTHEMULTICELLULARORGANISMINASENSE,THEFASCIALNETWORK,THEMESENCHYMEANDTHEECFAREHOMOLOGOUSTHEIRCOMMONFUNCTIONISTOSUSTAINTHESTABILITYOFTHEINTERNALENVIRONMENTOFTHEBODYFIG5TRACTTHEACUPOINTSFORNEEDLINGONTHEBACKANDABDOMENARELOCATED,INGENERAL,INTHELOOSECONNECTIVETISSUEINTHEINTERMUSCULARSEPTUM,BUTPARTOFTHEACUPOINTSONTHEABDOMENAREINTHELOOSECONNECTIVETISSUEOFTHEHILUSOFTHEVISCERALORGANSDISCUSSIONVARIOUSACUPUNCTURETHERAPIESANDTHECONNECTIVETISSUESINTHISSTUDY,WECONFIRMEDTHECORRESPONDENCEBETWEENTHEACUPOINTSANDTHECOURSESOFFASCIAEREPRESENTEDBYTHREEDIMENSIONALRECONSTRUCTIONWEHAVEALSONOTEDTHATTHEPRACTICEOFVARIOUSOTHERTRADITIONALCHINESETHERAPIESINVOLVESTHESTIMULATIONINVARYINGMANNERSOFDIFFERENTLAYERSOFCONNECTIVETISSUESFOREXAMPLE,THESCALINGTHERAPY,PERCUSSOPUNCTATORTHERAPY,MEDICATEDPLASTERTHERAPYANDTHECOMMONLYUSEDMODERNSKINSTIMULATINGTHERAPYINVOLVETHESTIMULATIONOFTHEDERMALDENSECONNECTIVETISSUETHESUPERFICIALNEEDLETHERAPYANDSUBCUTANEOUSNEEDLETHERAPYSTIMULATETHESUBCUTANEOUSLOOSECONNECTIVETISSUEACCORDINGTOTHEPREVIOUSSTUDIES,THESITESFORSTIMULATIONINVARIOUSSTIMULATIONTHERAPIESHAVEONECOMMONFEATUREPRESENCEOFABUNDANTSENSORYNERVEENDINGSANDLYMPHATICCAPILLARIESTHISMIGHTBETHEREASONWHYTHESETRADITIONALTHERAPIESWORKWHENAFIG5ORIGINATIONOFTHECONNECTIVETISSUEOFHUMANBODYTHEABOVEDIAGRAMILLUSTRATESTHATTHEMESODERMFURTHERGIVESRISETOORGANSANDSYSTEMSWITHSPECIFICFUNCTIONS,NAMELYTHELOCOMOTOR,IMMUNE,URINARY,REPRODUCTIVEANDCIRCULATORYSYSTEMSHOWEVER,THERESIDUEMESENCHYMEISDIFFERENTIATEDINTOCONNECTIVETISSUETHATISDISTRIBUTEDTHROUGHOUTTHEBODYOFHIGHERNEEDLEISINSERTEDINTOTHE“POINT”WHERETHICKCONNECTIVETISSUEISPRESENT,TWIRLINGANDROTATINGTHENEEDLEMAYINCREASETHEAMOUNTOFCONNECTIVETISSUESUNDERSTIMULATION,THUSPRODUCINGSTRONGERBIOLOGICALEFFECTSNOWBYWAYOFDIGITALANATOMICRECONSTRUCTION,SCIENTISTSCANCONSTRUCTTHEFRAMEWORKMODELOFTHEANIMALSTHECONNECTIVETISSUENETWORKPROVIDESSUPPORTFORALLTHECELLSOFTHEFUNCTIONALTISSUESOTHERTHANTHECENTRALNERVESYSTEM,ANDSERVESASTHEMATRIXFORTHEGROWTHOFTISSUECELLS,SUCHASTHEBASEMENTMEMBRANEOFTHEEPIDERMISANDGASTROINTESTINALTRACTENDOTHELIUM,ASWELLASTHECAPSULESCOATINGAROUNDANDEXTENDINGINTOTHEMUSCLES,VISCERALORGANS,BONEANDMERIDIANSANDACUPOINTSINHUMAN,ORINANIMALSDIGITALANATOMICTHREEDIMENSIONALRECONSTRUCTIONHASENABLEDTHEEXPLORATIONOFNEWACUPOINTSINTHETHORACICCAVITY,ABDOMINALCAVITY,PELVICCAVITY,ANDBASEOFTHESKULLMOREOVER,THISTECHNIQUEPROVIDESVERYUSEFULANATOMICALMODELTOFACILITATETHERESEARCHONTHETHEIRINTERSTITIALSPACEINFACT,ASANESSENTIALCONSTITUTIVEELEMENTOFTHEINTERNALENVIRONMENTFORTHEGROWTHOFVARIOUSFUNCTIONALTISSUECELLS,THECONNECTIVETISSUESSTILLRETAINTHEIRORIGINALFUNCTIONSANDTHEMESENCHYME,ORTHEADULTMESENCHYME,FORMSANADDITIONALFUNCTIONALSYSTEMINHUMANWITHTHECOOPERATIONOFTHEPERIPHERALNERVOUSSYSTEMANDIMMUNESYSTEMTHELYMPHATICVESSELSWEHEREREFERTOTHISSYSTEMASTHEAUTOSURVEILLANCESYSTEM,BECAUSEWEBELIEVETHATBESIDESIMMOBILIZATION,PARTITIONANDSUPPORTTHATAREGENERALLYRECOGNIZEDASTHEFUNCTIONSOFTHECONNECTIVETISSUE,THEFASCIAEALSOHELPMAINTAINHOMEOSTASISOFTHEORGANISM,REPAIRTHETISSUEORCELLINJURIESANDAUTONOMOUSLYREGULATETISSUEMETABOLISMSIMILARLY,THEBONESNOTONLYPROVIDEATTACHMENTFORTHEINCLUDINGCELLMETABOLISM,REPAIRANDREGENERATION,WHILETHEPARASYMPATHETICNERVEREGULATESTHEFUNCTIONALACTIVITIESOFTHEINTERNALORGANS,SUCHASSECRETIONANDPERISTALSISTHESECRETEDHORMONESBYTHEHYPOTHALAMUSNERVEREGULATETHESYSTEMICSTATEOFTHEBODY3AUTOIMMUNEREGULATIONOFTHELYMPHATICSYSTEMCELLDEBRISANDLARGEMOLECULARMASSSUBSTANCESENTERTHELYMPHATICCAPILLARIESINTHECONNECTIVETISSUEANDTHENTHECENTRALLYMPHOIDORGANSTHROUGHTHELYMPHATICVESSELSTOACTIVATESPECIFICIMMUNERESPONSESDEGENERATEDCELLSARECLEAREDTHROUGHTHEBODYFLUIDSANDIMMUNERESPONSESOFTHECELLSTHEAUTOSURVEILLANCESYSTEMCANBECLASSIFIEDINTOMUSCLESANDSUPPORTTHEBODYWEIGHT,IMPORTANTROLESINHEMATOPOIESISANEONATEHASGREATERABUNDANCEBUTALSOPLAYOFCONNECTIVETISSUESTHATGRADUALLYDECREASEWITHGROWTH,ANDINOLDAGE,THESKINBECOMESRATHERTHINASTHEFAT,FASCIAEORCONNECTIVETISSUESDIMINISHTHISFACTSEEMSTOSUGGESTTHATTHECONNECTIVETISSUESALSOSERVEASTHERESERVOIROFSOMESORTOFHUMANENERGYANDPLAYANINDISPENSABLEROLEINTHEAGEINGPROCESS3TYPES,REACTINGWITHFAST,MODERATEANDSLOWRESPONSES,RESPECTIVELYREGULATIONOFTHENEURALREFLEXVIATHESENSORYNERVESTOTHESPINALCORD,THALAMUS,ANDLIMBICSYSTEMISEXECUTEDTHROUGHFASTRESPONSENEUROENDOCRINEREGULATIONFIRSTVIATHESENSORYNERVESANDTHENVIATHALAMUS,LIMBICSYSTEMANDHYPOTHALAMUSTOTHENEUROENDOCRINESYSTEMRELIESONMODERATERESPONSEANDAUTOIMMUNEREGULATIONTHATSTARTSFROMTHELYMPHTOTHECENTRALLYMPHOIDORGANSANDTHENTOTHEIMMUNEAGENTSISACCOMPLISHEDTHROUGHSLOWRESPONSETHEAUTOSURVEILLANCESYSTEMHASTWOMAINCONCEPTANDMECHANISMSYSTEMOFTHEAUTOSURVEILLANCEINHUMAN,THEAUTOSURVEILLANCESYSTEMISCOMPOSEDOFTHECONNECTIVETISSUENETWORKWHICHMONITORSANDREGULATESLIVINGANDFUNCTIONALCONDITIONSOFTISSUECELLSITSAUTOREGULATINGMECHANISMSMAYBEDESCRIBEDINTHEFOLLOWINGASPECTS1NEURALREFLEXREGULATIONTHESENSORYNERVEIMPULSESENTERTHEPOSTERIORHORNOFTHESPINALCORDVIATHEDORSALROOTGANGLION,ANDTHENDIRECTLY,ORTHROUGHFUNCTIONSONEISTOREGULATETHEFUNCTIONALSTATEMETABOLICACTIVITYANDEXCITATION,SUCHASNEURALREFLEXREGULATIONANDNEUROENDOCRINEREGULATIONTHEOTHERISTOREGULATETHESTATEOFLIFEACTIVITYCELLDIVISION,GROWTHTHEINTERMEDIATENERVE,ACTONTHEMOTONEURONANDANDAPOPTOSIS,INCLUDINGCELLDIVISIONANDGROWTHINTERNEURONOFTHESPINALCORDANTERIORHORNTORAISETHETHRESHOLDOFEXCITATIONOFTHESETWOKINDSOFNEURONS,RESULTINGSUBSEQUENTLYINSPASMRELIEFANDANALGESIA2NEUROENDOCRINEREGULATIONTHESENSORYNERVEIMPULSESVIATHESPINALCORTEXBUNDLEREACHTHETHALAMUSANDARETRANSMITTEDTHROUGHTHERELAYNEURONSTOTHECEREBRALCORTEX,LIMBICSYSTEMANDSUBCORTICALSTRUCTURESINTURNTHESESTRUCTURESSENDTHEIMPULSESBACKTOTHETHALAMUSTOBLOCKTHETRANSMISSIONOFINCOMINGSTIMULATIONTOTHECORTEX,ANDALSOSENDTHEIMPULSESTOTHEHYPOTHALAMUSWHICHUNDERSTIMULATIONCANSECRETEVARIOUSHORMONESTOREGULATETHEEXCITATIONOFTHESYMPATHETICNERVEANDTHEPARASYMPATHETICNERVEINTHISMANNER,ANAL
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