Research progress on corneal nerves and substance P in viral keratitis / 国际眼科杂志(Guoji Yanke Zazhi)

Diseases like viral keratitis can harm corneal nerves, which are necessary for maintaining the health and functionality of the cornea. Recent research has shown that corneal nerve pathology affects the infected eye as well as the contralateral one, and that aberrant changes in sympathetic nerves can be seen, with the exception of sensory nerves that correspond to corneal sensation. However, apart from in vivo confocal microscopy and corneal sensation, there have been no additional prognostic indicators that allow clinicians to assess the severity of corneal nerve damage. While multiple functions of corneal nerves are mediated by neuropeptides, substance P, the first topical neuropeptide used in ocular clinical practice, was proved to regulate the process of viral infections, and it is involved in bilateral corneal pathologies through pro-inflammatory and neurotrophic functions in viral keratitis, so it may be used as a diagnostic biomarker or a therapeutic target. Therefore, this review summarized the changes and roles of corneal nerves as well as substance P in viral keratitis, which may serve as a reference for further study into associated mechanisms and clinical applications.

The anatomical variation of T3 sympathetic ganglion and its relationship with surgical outcomes in primary palmar hyperhidrosis / 中华胸心血管外科杂志

Objective:To investigate the anatomical variation of the T3 sympathetic ganglia and its relationship with surgical outcomes in primary palmar hyperhidrosis.Methods:A total of 86 patients with primary palmar hyperhidrosiswho underwent R4 sympathicotomy from November 2017 to September 2018 were prospectively enrolled. The anatomical variation of T3 sympathetic ganglia was observed by fluorescence thoracoscopy. The therapeutic effect and side effect were followed up after operation.The relationship between T3 anatomical variation and postoperative effect was analyzed.Results:82.6% of T3 ganglion had no anatomic variation, 17.4% of T3 ganglion shifted down to the surface of the fourth rib or intercostal space. After 1 month of follow-up, the therapeutic effect was: overly dry 2.1%, dry 39.4%, mild moist 57.0%, moist 1.4% innormalside, and 13.3%, 53.3%, 33.3%, 0 in the variation side respectively. Mann- Whitney U test showed statistically significant difference between the two groups( P=0.004). After 1 year of follow-up, the effect was 0, 36.5%, 56.9%, 6.6% in normal side, and 0, 33.3%, 63.0%, 3.7% in the variation side respectively. There was no significant difference between the two groups by Mann- Whitney U test( P=0.869). Conclusion:Fluorescence thoracoscopy showed that the variation rate of the position of T3 sympathetic ganglion was 17.4%. Postoperatively, patients with the downshift variation of T3 sympathetic ganglion have drier hands in short-term follow-up.

Is there neural and functional recovery after clip removal in cervical experimental sympathectomy? / Existe recuperação neural e funcional após a retirada de clipe quando da indução de simpatectomia cervical experimental?

ABSTRACT Background: The surgical treatment of hyperhidrosis by thoracic sympathectomy has brought, in addition to symptomatic relief for many, its main adverse effect: compensatory or reflex sweating. The clipping technique in place of the sympathetic nerve section gave rise to the hope of reversibility, but the positive results showed to be quite divergent, evidencing the academic deficiency regarding the study of this phenomenon. Aim: To observe micro and macroscopic damage caused by the polymer clip on sympathetic nerve of rabbits seven days after their clipping and the findings after three weeks of clip removal. Method: In this experimental study, 20 rabbits were divided into two groups of 10, group 1 (clipping) and group 2 (de-clipping). The right cervical sympathetic nerve of all animals was clamped with polymeric clip, and in group 2 the nerve was unclipped seven days later. Group 1 rabbits were induced to death on the 7th postoperative day, and group 2 on the 21st after removal of the polymer clip. Macroscopic variables were: clip appearance, presence of discontinuity lesion, infection and adhesions around the nerve. H&E was used in the evaluation of the phases and degree of the inflammatory process and presence of necrosis, and picrosirius red F3BA for quantification of collagen. Results: The cervical sympathetic nerve was intact, without necrosis or infection in all animals of the experiment; there were adhesions in both groups, being minimal in eight animals of each group and moderate or intense in two; the clip was completely closed in all animals at the 7th postoperative day; the inflammatory process shown was chronic, with monomorphonuclear predominance. There was no significant difference between groups regarding the intensity the inflammatory process, but the amount of collagen type I and type III was significantly higher in group 2. Conclusions: The injury caused by the polymer clip on the sympathetic nerve may be reversible, allowing functional return in the areas involved in the simulated cervical sympathectomy. Clipping of the cervical sympathetic nerve using a polymer clip does not cause discontinuity injury.

RESUMO Racional: O tratamento cirúrgico da hiperidrose pela simpatectomia torácica trouxe além do alívio sintomático para muitos, também seu principal efeito adverso: o suor compensatório ou reflexo. A técnica de clipagem do nervo simpático no lugar de sua secção deu margem à esperança de reversão do procedimento; porém, os resultados mostram-se bastante divergentes e pouco conclusivos Objetivo: Observar a lesão provocada pelo clipe de polímero em nervo simpático de coelhos sete dias após sua clipagem, comparando-a com os achados após três semanas da retirada do clipe. Método: Estudo experimental, com amostra formada por 20 coelhos, divididos em dois grupos de 10, sendo o grupo 1 chamado clipagem e o 2, desclipagem. Todos foram submetidos à clipagem do nervo simpático cervical direito com clipe polimérico, e no grupo 2 realizou-se a desclipagem sete dias após. Os coelhos do grupo 1 foram submetidos à eutanásia no 7º dia de pós-operatório, e os do grupo 2 no 21º dia após a remoção do clipe. Observou-se na macroscopia o aspecto do clipe, a presença de lesão de descontinuidade, infecção e aderências ao redor do nervo. Para estudo microscópico utilizou-se a coloração H&E na avaliação das fases, grau do processo inflamatório e presença de necrose, e a de picrosirius red F3BA para quantificação de colágeno. Resultados: O nervo simpático cervical foi identificado íntegro, sem necrose ou infecção em todos os animais do experimento; havia aderências em ambos os grupos, sendo mínimas em oito de cada grupo e moderadas ou intensas em dois; em toda a amostra o clipe encontrava-se completamente fechado no 7º dia de pós-operatório; o processo inflamatório presente foi do tipo crônico, com predomínio monomorfonuclear, não se observando diferença significativa em relação ao grau do processo inflamatório entre os grupos; porém, a quantidade de colágeno tanto do tipo I quanto do tipo III foi significativamente maior no grupo 2. Conclusões: A lesão provocada pelo clipe de polímero em nervo simpático pode ser reversível possibilitando o retorno funcional nas áreas envolvidas na simpatectomia cervical simulada. A clipagem do nervo simpático cervical com uso de clipe de polímero não causa lesão de descontinuidade.

Review of the health benefits of habitual consumption of miso soup: focus on the effects on sympathetic nerve activity, blood pressure, and heart rate

High salt intake increases blood pressure, and dietary salt intake has been clearly demonstrated to be associated with hypertension incidence. Japanese people consume higher amounts of salt than Westerners. It has been reported that miso soup was one of the major sources of daily salt intake in Japanese people. Adding salt is indispensable to make miso, and therefore, in some cases, refraining from miso soup is recommended to reduce dietary salt intake. However, recent studies using salt-sensitive hypertensive models have revealed that miso lessens the effects of salt on blood pressure. In other word, the intake of miso dose not increase the blood pressure compared to the equivalent intake of salt. In addition, many clinical observational studies have demonstrated the absence of a relationship between the frequency of miso soup intake and blood pressure levels or hypertension incidence. The mechanism of this phenomenon seen in the subjects with miso soup intake has not been fully elucidated yet. However, in basic studies, it was found that the ingredients of miso attenuate sympathetic nerve activity, resulting in lowered blood pressure and heart rate. Therefore, this review focused on the differences between the effects of miso intake and those of the equivalent salt intake on sympathetic nerve activity, blood pressure, and heart rate.

Mu-opioid receptors in the paraventricular nucleus regulate ejaculatory behaviors via the sympathetic nerve system in male rats / 中华男科学杂志

Objective@#To explore the effects of the mu-opioid receptor (MOR) in the paraventricular nucleus (PVN) on the ejaculatory behaviors of male rats and its potential mechanisms.@*METHODS@#Male SD rats with normal ejaculation ability were mated with female ones in hormone-induced estrus. After bilateral PVN microinjection of D-Ala-2-Me-Phe-4-Gly-ol enkephalin (DAGO) or D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH2 (CTAP) with an inserted catheter, the male animals were observed for mount latency (ML), mount frequency (MF), intromission latency (IL), intromission frequency (IF), ejaculation latency (EL), ejaculation frequency (EF), post-ejaculation interval (PEI), and intromission ratio (IR). The lumbar sympathetic nerve activity (LSNA) of the rats was recorded using the PowerLab data acquisition hardware device, and the levels of norepinephrine (NE) in the peripheral plasma were measured by ELISA following microinjection of saline or different doses of DAGO or CTAP.@*RESULTS@#Neither CTAP nor DGAO significantly affected the ML of the male rats (P > 0.05). DGAO remarkably increased IF (P < 0.01) and MF (P < 0.01), prolonged IL (P < 0.01), EL (P < 0.01) and PEI (P < 0.01), and reduced EF (P <0.01) and IR (P < 0.05). On the contrary, CTAP markedly decreased IF (P < 0.01) and MF (P < 0.01), shortened IL (P < 0.01), EL (P < 0.01) and PFI (P < 0.01), and elevated EF (P < 0.01) and IR (P < 0.01). Additionally, DAGO decreased LSNA in a dose-dependent manner and reduced the NE level in the peripheral plasma. CTAP, however, not only offset the effects of DAGO on LSNA, but also significantly increased LSNA.@*CONCLUSIONS@#MOR in PVN inhibits ejaculatory behaviors in male rats by weakening LSNA, which has provided some theoretical evidence for the use of highly selective opioids in the treatment of premature ejaculation.

Effects of venous distention on the respiratory and circulatory system after moderate-intensity exercise / 体力科学

It is well known that elderly patients with heart failure have low tolerance to exercise. Heart disease increases the cardiac load and causes severe arrhythmias due to an increase in the afferent stimuli from peripheral tissues such as skeletal muscle and from the sympathetic nervous system. Managing risk during exercise from the peripheral factors is essential to improve the quality of life of this patient population. Previous research involved utilizing high-intensity exercise and invasive methods, but it is necessary to perform at a safe intensity to evaluate the tolerance to exercise during rehabilitation. Therefore, the purpose of this study was to assess the changes in ventilatory and circulatory indices caused by venous ischemia after moderate-intensity exercise. The participants comprised ten healthy men randomly assigned to either a venous blood flow shut off task (task1) or the venous blood flow task (task 2). After 2 days or more the tasks were switched. The protocol was performed using a moderate intensity of rest for a while and performing a 4-min cycling exercise at 200 mmHg while occluding venous outflow of the left leg. Immediately after the termination, both groups took 5 min of rest. Task 1 involved occlusion of the venous outflow using 90 mmHg applied to the left thigh. The result showed that in normal subjects, shutting off the venous blood flow did not change the ventilatory response after moderate-intensity exercise but it changed the circulation index.

Peripheral Nerve Blocks in Patients with Diabetic Neuropathy and other Neuropathies: A Narrative Review.

Neuropathy, arising from different etiologies, can be a majordebilitating condition that leads to pain,reduces physicalmovement and amputation. Among all known neuropathyetiologies, diabetes mellitus is one of the significant causesthat results in peripheral and other type of neuropathies thatresult in physiological discomfort and mortality. Prolongedhyperglycemia-induced oxidative stress causes damage toneuron resulting in a range of symptoms to pain and internalorgan failure. Although treatment strategies exist to alleviatethe pain symptoms, there is no existing therapy to eliminatethe root cause of neuropathy. Presently, peripheral nerveblock by several anesthetic agents shows great promise inmanaging diabetes-induced neuropathy and neuropathiesof other etiologies. This article discusses different types ofneuropathies and their classifications with special emphasison diabetic neuropathy. The following section discusses theextent of severity of the condition in terms of its epidemiologyand associated complications. The article provides an elaborateidea on different anesthetic agents used in peripheral nerveblock in diabetic neuropathy and other neuropathic conditions.Peripheral nerve block shows a potential efficiency whensingle and combination doses of anesthetics are used. Differentadjuvants are also used in combination with anesthetics toprolong and enhance the effect of analgesia. Looking at theseverity, physiological, psychosocial and economic burden ofthe neuropathic disease, more in-depth studies and discussionshould be initiated to strengthen the use of peripheral nerveblock in the management of diabetic and other neuropathies.

Angiotensin-Converting Enzyme 2 in the Rostral Ventrolateral Medulla Regulates Cholinergic Signaling and Cardiovascular and Sympathetic Responses in Hypertensive Rats / 神经科学通报·英文版

The rostral ventrolateral medulla (RVLM) is a key region in cardiovascular regulation. It has been demonstrated that cholinergic synaptic transmission in the RVLM is enhanced in hypertensive rats. Angiotensin-converting enzyme 2 (ACE2) in the brain plays beneficial roles in cardiovascular function in hypertension. The purpose of this study was to determine the effect of ACE2 overexpression in the RVLM on cholinergic synaptic transmission in spontaneously hypertensive rats (SHRs). Four weeks after injecting lentiviral particles containing enhanced green fluorescent protein and ACE2 bilaterally into the RVLM, the blood pressure and heart rate were notably decreased. ACE2 overexpression significantly reduced the concentration of acetylcholine in microdialysis fluid from the RVLM and blunted the decrease in blood pressure evoked by bilateral injection of atropine into the RVLM in SHRs. In conclusion, we suggest that ACE2 overexpression in the RVLM attenuates the enhanced cholinergic synaptic transmission in SHRs.

Chronic Intermittent Hypobaric Hypoxia Ameliorates Renal Vascular Hypertension Through Up-regulating NOS in Nucleus Tractus Solitarii / 神经科学通报·英文版

Chronic intermittent hypobaric hypoxia (CIHH) is known to have an anti-hypertensive effect, which might be related to modulation of the baroreflex in rats with renal vascular hypertension (RVH). In this study, RVH was induced by the 2-kidney-1-clip method (2K1C) in adult male Sprague-Dawley rats. The rats were then treated with hypobaric hypoxia simulating 5000 m altitude for 6 h/day for 28 days. The arterial blood pressure (ABP), heart rate (HR), and renal sympathetic nerve activity (RSNA) were measured before and after microinjection of L-arginine into the nucleus tractus solitarii (NTS) in anesthetized rats. Evoked excitatory postsynaptic currents (eEPSCs) and spontaneous EPSCs (sEPSCs) were recorded in anterogradely-labeled NTS neurons receiving baroreceptor afferents. We measured the protein expression of neuronal nitric oxide synthase (nNOS) and endothelial NOS (eNOS) in the NTS. The results showed that the ABP in RVH rats was significantly lower after CIHH treatment. The inhibition of ABP, HR, and RSNA induced by L-arginine was less in RVH rats than in sham rats, and greater in the CIHH-treated RVH rats than the untreated RVH rats. The eEPSC amplitude in NTS neurons receiving baroreceptor afferents was lower in the RVH rats than in the sham rats and recovered after CIHH. The protein expression of nNOS and eNOS in the NTS was lower in the RVH rats than in the sham rats and this decrease was reversed by CIHH. In short, CIHH treatment decreases ABP in RVH rats via up-regulating NOS expression in the NTS.

Ultrasound-guided lumbar sympathetic block for flap repair of lower limb defects / 中华创伤骨科杂志

Objective To evaluate the efficacy of ultrasound-guided lumbar sympathetic block (LSB) used for flap repair of lower limb defects.Methods A retrospective study was conducted of the 27 patients who had received flap repair of lower limb defects at Department of Anesthesiology,Central People's Hospital of Zhanjiang surgery from June 2017 to December 2018.Of them,14 had conventional flap repair (conventional group) and 13 additional ultrasound-guided LSB (LSB group).The 2 groups were compared at 12,24,48 and 72 hours after operation in terms of color,texture,skin temperature and survival of the flaps and visual analogue scale (VAS) pain scores.Functional recovery of flap sensation after one month follow-up was also observed and compared.Results The 2 groups were comparable because there were no significant differences between them in the preoperative general data(P ＞ 0.05).All the patients were followed up for an average of 3.1 months (from 2 to 6 months).At 12 and 24 hours after operation,the LSB group had significantly more patients with normal flap color (84.6％ and 92.3％) than the conventional group (35.7％ and 50.0％) (P ＜ 0.05).At 12,24,48 and 72 hours after operation,the LSB group had significantly higher skin temperature (36.7 ± 0.2 ℃,36.8±0.3 ℃,36.9±0.2 ℃ and 36.9±0.1 ℃) than the conventional group(35.4±0.4 ℃,35.7 ± 0.6 ℃,35.9 ± 0.3 ℃ and 36.2 ± 0.2 ℃) (P ＜ 0.05).At 12 and 24 hours after operation,the LSB group had significantly lower VAS pain scores (2.1 ± 1.0 and 2.3 ± 0.9) than the conventional group(4.6 ± 0.9 and 4.4 ±0.8) (P ＜0.05).All the flaps in the LSB group obtained primary survival after operation while infection occurred in one case in the conventional group.One month follow-up showed that 12 patients in the LSB group (92.3％) obtained sensory recovery of flaps while 6 ones (42.9％) did in the conventional group,showing a significant difference (P ＜ 0.05).Conclusion As an auxiliary treatment for flap repair of lower limb defects,SLB can improve the blood supply to the transplanted flap and facilitate the recovery of nerve function in the graft flap.

Effect of electroacupuncture on myocardial infarct size and expression of inflammatory cytokines and sympathetic-active substances in the myocardial ischemic tissue of rats / 针刺研究

OBJECTIVE: To investigate the effect of electroacupuncture (EA) on the expression of interleukin-8 (IL-8), interleukin-10 (IL-10), tyrosine hydroxylase (TH), β3-adrenergic receptor (β3AR), and endothelial nitric oxide synthase (eNOS) in myocardial tissue in ischemic myocardial injury rats, so as to reveal its underlying mechanisms in myocardial protection via anti-inflammation and sympathetic nerve remodeling. METHODS: A total of 48 male Sprague-Dawley rats were randomly divided into sham-operation (sham, n＝9), sham ＋EA (n＝9), model (n＝15) and EA (n＝15) groups. The myocardial ischemia (MI) model was established by ligation of the left anterior descending branch of the left coronary artery. EA (2 Hz/15 Hz，1.5－2 mA) was applied to bilateral "Neiguan" (PC6) for 30 min, once daily for 4 days. The myocardial infarct size was detected by 2, 3, 5 triphenyltetrazolium chloride (TTC) staining, myocardial histopathological changes and inflammatory infiltration were assessed by H．E. staining, and the expression of IL-8, IL-10, TH, β3AR, and eNOS in the myocardium was determined by using Western blot. RESULTS: Compared with the sham group, a marked myocardial infarction was found in the left ventricle tissue, accompanied with disordered arrangement of myocardial fibers and higher degree of inflammatory cell infiltration, and increased expression of IL-8, TH, β3AR and eNOS in the myocardium in the model group (P0.05). After EA intervention and in comparison with the model group, the myocardial infarct size was significantly reduced (P<0.01), the severity of inflammatory cell infiltration and disordered arrangement of myocardial fibers were relieved, and the expression of IL-10 and eNOS proteins were significantly up-regulated (P<0.05), and the markedly up-regulated expression of IL-8, TH, and β3AR were significantly suppressed in the EA group (P<0.01)．. CONCLUSION: EA intervention can reduce the myocardial infarct size (protective effect) in MI rats possibly by reducing inflammatory reaction and sympathetic nerve remodeling.

Consideration of a New Category of Patients for Whom Ryokeijutsukanto is Effective at a Different Stage Then was Previously Reported / 日本東洋医学雑誌

Ryokeijutsukanto consists of four crude drugs, Hoelen, Cinnamonmi Cortex, Atractylodis Rhizoma, and Glycyrrhizae Radix. In Kampo medicine, it is used for the yang stage, fluid disturbances, and qi counterflow. It is also used for orthostatic disturbance, which does not change smoothly from parasympathetic nerve dominance to sympathetic nerve dominance. This time, we report that ryokeijutsukanto is also effective for disturbance with function regulation of autonomic nervous system. Case 1: a patient who had headache after exercise and working. Case 2: a patient who had dizziness and cold sweat that appeared in the evening. Case 3: a patient who had headache after working or on holidays. In these cases, ryokeijutsukanto was effective for symptoms that appeared when the patient could not change smoothly from sympathetic nerve dominance to parasympathetic nerve dominance. Furthermore, we found that ryokeijutsukanto was effective, even if there was no sign of fluid disturbance in conjunction with the yang stage and qi counterflow. We identified a new category of patients for whom ryokeijutsukanto is effective.

Effects of electroacupuncture on sympathetic nerve-related substance in myocardial tissue in mice with myocardial ischemia / 中国针灸

OBJECTIVE@#To observe the effects of electroacupuncture (EA) on sympathetic nerve-related substance in myocardial tissue in mice with myocardial ischemia (MI), and to explore its possible mechanism.@*METHODS@#Thirty adult male C57BL/6 mice were randomly divided into a sham operation group, a model group and an EA group, 10 mice in each one. The model of MI was established in the model group and EA group by ligating the left anterior descending branch of coronary artery. The mice in the sham operation group were not treated with ligating at left anterior descending branch of coronary artery, but the remaining procedure was similar with the model group. The mice in the EA group were treated with EA at "Neiguan" (PC 6) with 2 Hz/100 Hz of frequency and 2 mA of intensity, 20 min per treatment, once a day for totally 5 days. No EA was given for model group and sham operation group. The electrocardiogram was recorded and △ST value was calculated to evaluate the model. TTC staining was applied to evaluate the infarct size. Immunohistochemical (IHC) method was applied to evaluate the positive nerve fiber density in myocardial tissue. Western blot method was applied to test the protein expression levels of neuregulin-1 (NRG-1), tyrosine hydroxylase (TH), growth associated protein-43 (GAP-43).@*RESULTS@#The electrocardiogram (lead II) results indicated compared with the sham operation group, the S-T segments in the model group and EA group were increased obviously (both <0.01), indicating the MI model was established successfully. The TTC staining results indicated compared with sham operation group, the infarction size was significantly increased in the model group (<0.01); compared with the model group, the infarction size in the EA group was significantly reduced (<0.01). The IHC results indicated compared with the sham operation group, the positive nerve fiber density in myocardial was increased in the model group (<0.01); compared with the model group, the positive nerve fiber density in myocardial was reduced in the EA group (<0.05). The Western blot results indicated compared with the sham operation group, the expression levels of TH, NRG-1 and GAP-43 were significantly increased in the model group (<0.01); compared with the model group, the expression level of TH and GAP-43 were significantly reduced (<0.01) and that of NRG-1 was increased in the EA group (<0.05).@*CONCLUSION@#EA could increase the expression of NRG-1 and reduce the expression of TH and GAP-43 in myocardial tissues in MI mice, which could suppress sympathetic nerve hyperexcitability after infarction to achieve myocardial protection effect.

Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity / 영남의대학술지

BACKGROUND: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB.METHODS: Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient's hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups.RESULTS: The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures (0.50±0.38℃ and 1.41±0.68℃ at C6 and C7, respectively; p < 0.05). Significantly increased post-SGB temperatures (difference >1℃) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p < 0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05).CONCLUSION: The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6.

Effect of carotid sympathetic nerve net stripping operation in treating children patients with spastic unilateral cerebral palsy and its effect on motor function / 重庆医学

Objective To investigate the effect of carotid sympathetic nerve net stripping operation in treating children patients with spastic unilateral cerebral palsy and its effect on motor function.Methods Seventy-six children cases of spastic unilateral cerebral palsy were divided into the control group and observation group.On the basis of routine therapy,the former was treated with type A botulinum toxin,while the latter used the carotid sympathetic nerve netting operation for the treatment.After 6-month treatment,the improvement degree of the Comprehensive Functional Rating Scale of Cerebral Palsy Children,Gross Motor Function Measure(GMFM) score and Ashworth spasm grade were compared between the two groups.Results after 6-month treatment,the improvement degrees of the Comprehensive Functional Rating Scale of Cerebral Palsy Children,GMFM scores and Ashworth spasm grade in the observation group were significantly greater than those in the control group,the difference was statistically significant (P＜0.05).Conclusion The carotid sympathetic nerve net stripping operation in treating children patients with spastic unilateral cerebral palsy has significant effect and is worthy to be popularized in clinic.

Clinical characteristics and treatment of radiation-induced sympathetic nerve injury / 实用医学杂志

Objective To investigate the characteristics,treatment and prognosis of radiation-induced sympathetic chain injury.Methods We observed 6 cases with radiation-induced sympathetic chain injury and re-viewed the clinical features,treatment and prognosis of these patients. Results The median age of these 6 cases was 50 and the interval between radiotherapy to onset was 7.7 years.Dizziness was the first and most common symp-tom and dramatic fluctuation of blood pressure was the most common physical sign.Steroids might be considered for the treatment of radiation-induced sympathetic nerve injury. However,the therapeutic effect still needs to be proved.Conclusions Sympathetic nerve injury is an uncommon but dramatic symptom in NPC patients after radio-therapy.

Alternative Surgical Methods in Patients with Recurrent Palmar Hyperhidrosis and Compensatory Hyperhidrosis

Recurrent hyperhidrosis after thoracic sympathectomy is an uncomfortable condition, and compensatory hyperhidrosis (CH) is one of the most troublesome side effects. Here, we describe two patients with recurrent palmar hyperhidrosis (PH) and CH over the whole body simultaneously. They were treated with bilateral T4 sympathetic clipping and reconstruction of the sympathetic nerve from a T5 to T8 sympathetic nerve graft, which was transferred to the resected T3 sympathetic bed site. They reported improvements in sweating and were fully satisfied with the results. Our method can be considered as an alternative approach for patients with recurrent PH and CH.

Anatomy and Physiology of the Autonomic Nervous System / 대한평형의학회지

The autonomic nervous system (ANS) integrates the function of the internal organs for the homeostasis against various external environmental changes. The efferent components of the ANS are regulated by sensory signals arising from the viscera as well as non-visceral organs. The central neural networks that integrate these sensory signals and modify visceral motor output are complex, and synaptic reflexes formed in the brainstem and spinal cord integrate behavioral responses and visceral responses through the central neural networks. A detailed understanding of the neural network presented above may explain the role of the vestibular system on the homeostasis more extensively.

Evaluation of left ventricular systolic function after renal sympathetic denervation in beagles with heart failure by layer-specific two-dimensional speckle tracking imaging / 中华超声影像学杂志

Objective To assess the left ventricular systolic function after renal sympathetic denervation(RSD) in beagles with heart failure by layer-specific two-dimensional speckle tracking imaging.Methods Twenty-three beagles were randomly divided into control group (8 dogs),URSD group (8 dogs)and RSD group (7 dogs).Control group was implanted with pacemakers without pacing,URSD group was implanted with pacemakers and underwent 3 weeks of rapid right ventricular pacing,and RSD group underwent catheter-based RSD bilaterally and was simultaneously implanted with pacemakers.All standard measurements were obtained from the left ventricular short-axis views at the levels of mitral annulus,papillary muscle and apex,and apical four-chamber,two-chamber,and long-axis views.The peak systolic longitudinal strain and circumferential strain of each layer of the left ventricle were measured by layerspecific two-dimensional speckle tracking imaging.Results After 3 weeks,all of the dogs in both the URSD and RSD groups showed lower left ventricular diastolic and systolic function compared with those in the control group,however,the dogs in the RSD group had a higher LV ejection fraction (LVEF) than the dogs in the URSD group(P ＜ 0.05).Compared with the control group,the global longitudinal strain,circumferential strain and radial strain all decreased significantly in URSD and RSD groups.The longitudinal strain of endo-and mid-cardium and the circumferential strain in endo-cardium were significantly higher in RSD group than those in URSD group(P ＜0.05).Conclusions Myocardial systolicfunction is impaired in dogs with heart failure,layer-specific two-dimensional speckle tracking imaging can provide effective tools to assess the left ventricular systolic function.Renal sympathetic denervation can improve the myocardial systolic function in dogs with heart failure.

Analysis Regarding Effect of Sympathetic Nerves on Body Regulation and Acupuncture Efficacy by Alpha1-adrenoreceptor Mediation / 现代生物医学进展

To clarify the effect of the sympathetic nerves on the body's physiopathological changes and acupuncture effect by the alphal-AR mediation in the past 30 years.The paper has referred to the database of CNKI and Pubmed,and systematically reviewed the publications in the past 30 years about the research of the alphal-AR mediation of the sympathetic nerves to the body's physiological andpathological changes and acupuncture effect.Alphal-AR not only mediated the sympathetic nerves on the inotropic change of the heart,and the contraction of the vascular smooth muscles,bladder sphincter,and uterine smooth muscles and other physiological effect,but also mediated cardiac arrhythmia,myocardial hypertrophy and other pathological process.In addition,Alphal-AR also mediated the acupuncture signal transmission,and acupuncture was able to adjust the sympathetic nervous tension.The body's physiopathological changes are closely related to alpha1-AR and subtype alteration.The in-depth study of alphal-AR helps to explain physiopathological mechanism of the body,as well as provide theoretical basis and the corresponding pharmacological models for better selective drugs.Studying Alpha1-AR on meridians contributes to the discovery of meridian essence and the substantial basis of acupuncture effects.