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Objective To evaluate the efficacy of lumbar sympathetic ganglion pulsed radiofrequency (PRF) in treatment of diabetic neuropathic pain.Methods Forty-eight patients of both sexes with diabetic neuropathic pain,aged 45-75 yr,with the course of disease 4-7 yr,were divided into 2 groups (n =24 each) using a random number table method:control group (C group) and PRF group (P group).Group C was treated with conventional drugs.Bilateral lumbar sympathetic ganglion PRF was performed on the basis of conventional drug therapy in group P.The serum concentrations of tumor necrosis factor-alpha and interleukin-6 were measured by enzyme-linked immunosorbent assay.The visual analogue scale score was recorded before treatment and at 1,2 and 4 weeks of treatment.The degree of efficacy was recorded at 4 weeks of treatment,and the total effective rate was calculated.Results Compared with group C,the visual analogue scale score and serum concentrations of tumor necrosis factor-alpha and interleukin-6 were significantly decreased,and the total effective rate and degree of curative efficacy were increased in group P (P＜0.05).No pulsed radiofrequency-related complications or drugs-related adverse reactions were found in two groups.Conclusion Lumbar sympathetic ganglion PRF can effectively relieve diabetic neuropathic pain in the patients.
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Objective To evaluate the effect of pulsed radiofrequency (PRF) on the phenotypic transformation of the lumbar sympathetic ganglion (LSG) in the rats with diabetic neuropathic pain (PDN).Methods Twenty-four clean-grade healthy adult male Sprague-Dawley rats,aged 2 months,weighing 180-220 g,were divided into 4 groups (n =6 each) according to the method of random number table:control group (group C),group PDN,group PRF,and PRF control group (group PC).The PDN model was established by intraperitoneal injection of streptozotocin 60 mg/kg in anesthetized rats.Citrate-sodium citrate buffer 6 ml/kg was intraperitoneally injected in group C.Group PC only received radiofrequency needle puncture.PRF was performed on the right L3 LSG in group PRF.The mechanical paw withdrawal threshold (MWT) to yon Frey filament stimulation was measured before intraperitoneal injection (baseline,T0),before PRF and at 1,3,5,7 and 14 days after PRF.The rats were then sacrificed,and ipsilateral L3 LSGs were removed for determination of the expression of tyrosine hydroxylase (TH) and vesicle glutamate transporter2 (VGLUT2) in LSGs (by double immunofluorescent staining) and for examination of pathological changes (with a light microscope).The number of neurons expressing VGLUT2 was counted.Results Compared with group C,the MWT was significantly decreased at T1-6,and the number of neurons expressing VGLUT2 was increased at T6 in PDN,PC and PRF groups (P＜0.05).Compared with PDN and PC groups,the MWT was significantly increased at T2-6,and the number of neurons expressing VGLUT2 was decreased at T6 in group PRF (P＜0.05).TH expression in LSGs was found,and no VGLUT2 expression in LSGs was observed in group C,the expression of TH and VGLUT2 in LSGs was found in the other three groups,especially in PDN and PC groups,and most of the neurons expressing VGLUT2 expressed TH simultaneously.Conclusion The mechanism by which PRF mitigates PDN is related to inhibiting the phenotypic transformation of LSGs in the rats.
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Objective To evaluate the clinical efficacy of “Shamrock” ultrasound images?guided lumbar sympathetic ganglion blockade ( LSGB) . Methods Sixty patients of both sexes, aged 18-60 yr, weighing 50-70 kg, of American Society of Anesthesiologists physical statusⅠorⅡ, undergoing unilater?al LSGB, were divided into groupⅠ ( n=30) and group Ⅱ ( n=30) using a random number table. In group Ⅰ, unilateral LSGB was performed at the L2 level under ultrasound guidance with paramedian trans?verse scanning. In groupⅡ, unilateral LSGB was performed at the L2 level under ultrasound guidance with“Shamrock” ultrasound images. After final needle position was confirmed, 2% lidocaine 6?0 ml was ad?ministered in each patient. At 20 min before and after LSGB, the visual analogue scale scores and skin temperature of the big toe of the affected foot were recorded, and the successful blockade and visibility of important paravertebral structures on ultrasound images were recorded during puncture. Results The visu?al analogue scale scores were significantly lower, and the skin temperature on the affected side was signifi?cantly higher after LSGB than before LSGB in both groups ( P<0?05) . The important paravertebral struc?tures such as erector spinae, quadratus lumborum, psoas major, transverse process of L2 vertebrae, and the curved edge of L2 vertebrae were visible in both groups. The visibility rate of the inferior vena cava or ab?dominal aorta on ultrasound images and the success rate of blockade were significantly lower in group Ⅰthan in group Ⅱ (P<0?01). Conclusion Compared with paramedian transverse scanning, LSGB has some advantages such as real?time monitoring, higher success rate of blockade, better efficacy and avoiding damage to great vessels when performed under “Shamrock” ultrasound image guidance.
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ObjectiveTo investigate the role and mechanism of cervical sympathetic ganglia block in alleviation of cerebrovascular spasm (CVS) of rabbits after subarachnoid hemorrhage ( SAH ).Methods A total of 18 healthy male white rabbits whose cervical sympathetic ganglia were successfully blocked were randomly divided into three groups:sham operation group (Group A),SAH group (Group B) and SAH with cervical sympathetic ganglia block group (Group C).Venous blood (2 ml) and cerebrospinal fluid (2 ml) were obtained before the first blood injection ( T1 ),at 30 minutes after injection ( T2 ) and at day 7 after injection ( T3 ),respectively,and conserved in a low temperature refrigerator for spare use.Basilar artery value at T1,T2 and T3 was measured via cerebral angiography.The degree of damage to nervous system at T3 was recorded.ResultsThere was no significant difference in diameter of basilar artery at T1 among three groups.At T2 and T3,the diameters of basilar artery of Groups B and C were shorter than that of Group A,with Group B shorter than Group C,with statistical differences ( P ＜0.01 ).There were no significant differences in NO and NOS in plasma and cerebrospinal fluid at T1 among three groups (P＞0.05).NO and NOS contents at T2 and T3 were lower than those at T1,with Group A lower than Groups B and C,with statistical differences (P＜0.01 ).At T3,the nerve function of Groups B and C were better than that of Group A,with Group C better than Group B ( P ＜0.01 ).Conclusion Cervical sympathetic ganglia block relieves CVS,increases NO content and NOS activity in plasma and cerebrospinal fluid and promotes neural functional recovery after SAH.
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Objective To establish a method for acute isolation of rat superior cervical ganglion (SCG) cells and identify the electrophysiological properties.Methods Sprague-Dawley rats of both sexes,aged 5-12 days,were decapitated.The SCGs were removed quickly,and the single SCG cell was enzymatically isolated from the SCGs.When the holding potential was - 60 mV,100 μmol/L acetylcholine was applied and the nicotinic acetylcholine receptor currents were recorded by whole-cell patch-clamp technique.When the holding potential was 760 mV,65 mmol/L KCl was applied and quantal release of catecholamines was detected by using carbon fiber electrodes.Results SCG cells with normal electrophysiological properties were isolated.Typical nicotinic acetylcholine receptor currents and quantal release of catecholamines were recorded successfully.Conclusion The cells suitable for patch-clamp experiments can be obtained by using the method for acute isolation of rat SCG cells.
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ObjectiveTo investigate the effect of ketamine on nicotine-induced current in rat superior cervical ganglion neurons.MethodsNewborn Wistar rats were used in this study.Neurons were isolated enzymatically from superior cervical ganglia of newborn rats in an aseptic condition and cultured in 90％ DMEM/F12,10％ horse serum containing penicillin 100 μg/ml for 5-7 d.Nicotine-induced current was measured and recorded using whole-cell patch clamp technique.A mixture of nicotine 50 μmol/L and different concentrations of ketamine ( 10,25,50,100 μmol/L) was added to the isolated neurons.The effect of ketamine on nicotine-induced current was evaluated.ResultsNicotine-induced peak current was inhibited by ketamine in a concentration-dependent manner.The time constant of fast and slow desensitizing phase of the nicotine acetylcholine receptor was shortened after being exposed to the mixture of nicotine 50 μmol/L + 50 or 100 μmol/L ketamine as compared to nicotine 50 μmol/L-induced current.The median effective concentration of ketamine inhibiting nicotine-induced current was less than 20 μmol/L.ConclusionKetamine can decrease nicotine-induced current in rat superior cervical ganglion neurons in a concentration-dependent manner indicating that inhibition of sympathetic activity is involved in the mechanism of decrease in BP by ketamine in specific condition.
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Objective To study the value of CT in confirming the diagnosis of schwannoma of the cervical sympathetic nerve ( SSN) or vagus nerve (SVN) before operation.Methods From October 1988 to March 2001,45 SSNs and 14 SVNs confirmed by surgery and pathology were analyzed to discover the rules of displacement of common carotid artery (A),internal carotid artery (I) and internal jugular vein (V). Results 43 SSNs located at the level of common carotid bifurcation or/and upper neck with A or/and I abutting against and displacing to the lateral periphery of the tumor.In 35 SSNs with enhanced CT,the V was also abutted against and displaced to the lateral periphery of the tumor.The rest two SSNs located at the root of the neck with A and V anterolateral to but not abutting against the tumor.The growth of 12 SVNs all resulted in separation between the A or I and the V.The A or I was displaced to the medial periphery of SVN and the V to the lateral periphery.Their distance was 90? to 180?. Conclusion During the growth of SSN or SVN,the CT axial scan can still accurately reflect the anatomical positional relationships among A,I,and V with the cervical sympathetic nerve or vagus nerve.So CT is a very valuable tool in confirming the diagnosis of SSN or SVN preoperatively.
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Objective To investigate the effects of ropivacaine on the whole cell sodium currents in rat sympathetic ganglion neurons in order to determine whether sympathetic ganglion is involved in the ropivacaine cardiotoxity. Methods The sympathetic neurons were enzymatically isolated from the superior cervical ganglion. The effects of ropivacaine on the whole cell sodium channel currents were assessed using patch clamp technique. Results Ropivacaine blocked the whole cell sodium channel currents dose dependently. When the holding potential (Vh) was -80mV and Vt Omv , 0.01?mol/L ropivacaine reduced peak currents by 30.02% with a mean IC50 of 2.68?mol/L. The blockade was also potential dependent. When Vh was -60mv, the mean IC50 was 1.55?mol/l. 1.0?mol/L ropivacaine reduced the peak value of I V curve by 30.66% but did not affect the shape of I V curve and caused 2.56mv shift of voltage dependence activation curve to depolarized potentials and 3.56mv shift of steady state inactivation curve to more hyperdepolarized potentials.The conditioning pulse potential at which half maximal channels were activated (V1/2), changed from -52.99mv to -56.44mv and the test potential at which half maximal channels were activated (V1/2), changed from -25.2mv to -22.64mv. Conclusions Subconvulsive concentration of ropivacaine significantly inhibits sympathetic ganglion neurons in a dose dependent and potential dependent way through the inactivation of sodium channel,indicating that sympathetic ganglion neurons may contribute to the cardiotoxity of ropivacaine.
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Objective To study the effects of propofol on the whole-cell sodium currents in rat sympathetic neurons in order to investigate the mechanisms of propofol-mediated peripheral vasodilation.Methods Whole-cell patch-clamp recordings were made from enzymatically isolated rat superior cervical sympathetic neurons.Results Propofol dose-dependently blocked the whole-cell sodium currents evoked by a voltage step from a holding potential of -- 80mV to 0mV with a mean IC50 value of 32. 19?mol/L (r = 0. 982, P
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75%), effective (VAS reduced by 74%-50%), partially effective (by 49%-25% ) and ineffective (
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Objective To investigate the ablative effect of high intensity focused ultrasound (HIFU) on the celiac ganglion (CG) and the subsequent change in gastro-intestinal (GI) function. Methods Thirty-three New Zealand white rabbits of both sexes aged 5-10 months weighing 1.6-2.7 kg were randomly divided into 3 groups (n=11 each) according to the dose of HIFU (intensity?time) : group A 50 W?cm-2?10 sec; group B 10 W?cm-2 ?10 sec and group C no HIFU. Upper abdomen was opened through median incision under general anesthesia. CG was exposed to HIFU. One animal was killed in each group at 4h after operation and CG was obtained for microscopic examination. The GI function was observed for 3 days in the rest 10 animals in each group. The motor function of the hind limbs and the appearance of skin were observed for 30 days after operation. One animal in each group was killed 30 days after HIFU and CG was obtained for microscopic examination. Results Stroma edema was observed in group A and B 4 hours after HIFU. The neurons became smaller and the nuclei condensed, and fiber hyperplasia and satellite cells were observed in CG 30 days after HIFU in group A and B. The incidence of diarrhea was significantly increased in group A as compared with group B and C (P
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ve To investigate the effects of clinical relevant concentrations of midazolam on whole-cell N-type calcium currents of sympathetic ganglion neurons trying to assess the involvement of sympathetic ganglion in circulation depression produced by midazolam. Methods 7-10 d SD rats were decapitated and bilateral superior cervical ganglions were rapidly removed and kept in 4℃, oxygen saturated incubation solution. TTX 1?mol/L and nifedipine 10 ?mol/L were added to the solution to block the Na+ and L-type calcium currents. Midazolam was also added to the solution. The final concentration of midazolam were 0.1, 0.3, 3, 10, 50, 100?mol/L.The effects of different concentration of midazolam on the whole-cell N-type calcium channel currents were assessed by patch-clamp technique. Results When the holding potential (Vh) was - 80mV and stimulating votage(Vt) was between - 30mV and 10mV midazolam inhibited the whole-cell N-type calcium currents dose-dependently ( r = 0.964, P
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Microdialysis probes were implanted into the rabbit cerebral cortex and caudate nucleus followed by perfusion with Ringer solution at a flow rate of 3.0?l/min. Cerebral ischemia was induced by electrical stimulation of the unilateral superior cervical ganglion for 1h. Dialysate samples were analyzed by high performance liquid chromatography (HPLC). Following ischemia, extracelluar (EC) contents of adenosine (Ado) and its metabolites were significantly increased upto 6 ～ lOfold(Ado), 5 ～ 6fold(Inosine, Ino) and 2 ～ 3fold(Hypoxanthine, Hyp) in both the cerebral cortex and caudate nucleus(P