Cardiac autonomic neuropathy(CAN)is a serious complication of diabetes mellitus(DM)that is strongly associated with approximately five-fold increased risk of cardiovascular mortality.CAN manifests in a spectrum of thi...Cardiac autonomic neuropathy(CAN)is a serious complication of diabetes mellitus(DM)that is strongly associated with approximately five-fold increased risk of cardiovascular mortality.CAN manifests in a spectrum of things,ranging from resting tachycardia and fixed heart rate(HR)to development of"silent"myocardial infarction.Clinical correlates or risk markers for CAN are age,DM duration,glycemic control,hypertension,and dyslipidemia(DLP),development of other microvascular complications.Established risk factors for CAN are poor glycemic control in type 1 DM and a combination of hypertension,DLP,obesity,and unsatisfactory glycemic control in type 2DM.Symptomatic manifestations of CAN include sinus tachycardia,exercise intolerance,orthostatic hypotension(OH),abnormal blood pressure(BP)regulation,dizziness,presyncope and syncope,intraoperative cardiovascular instability,asymptomatic myocardial ischemia and infarction.Methods of CAN assessment in clinical practice include assessment of symptoms and signs,cardiovascular reflex tests based on HR and BP,short-term electrocardiography(ECG),QT interval prolongation,HR variability(24 h,classic24 h Holter ECG),ambulatory BP monitoring,HR turbulence,baroreflex sensitivity,muscle sympathetic nerve activity,catecholamine assessment and cardiovascular sympathetic tests,heart sympathetic imaging.Although it is common complication,the significance of CAN has not been fully appreciated and there are no unified treatment algorithms for today.Treatment is based on early diagnosis,life style changes,optimization of glycemic control and management of cardiovascular risk factors.Pathogenetic treatment of CAN includes:Balanced diet and physical activity;optimization of glycemic control;treatment of DLP;antioxidants,first of allα-lipoic acid(ALA),aldose reductase inhibitors,acetylL-carnitine;vitamins,first of all fat-soluble vitamin B1;correction of vascular endothelial dysfunction;prevention and treatment of thrombosis;in severe cases-treatment of OH.The promising methods include prescri展开更多
A new mammalian photoreceptor was recently discovered to reside in the ganglion cell layer of the inner retina.These intrinsically photosensitive retinal ganglion cells(ipRGCs) express a photopigment,melanopsin,that c...A new mammalian photoreceptor was recently discovered to reside in the ganglion cell layer of the inner retina.These intrinsically photosensitive retinal ganglion cells(ipRGCs) express a photopigment,melanopsin,that confers upon them the ability to respond to light in the absence of all rod and cone photoreceptor input.Although relatively few in number,ipRGCs extend their dendrites across large expanses of the retina making them ideally suited to function as irradiance detectors to assess changes in ambient light levels.Phototransduction in ipRGCs appears to be mediated by transient receptor potential channels more closely resembling the phototransduction cascade of invertebrate rather than vertebrate photoreceptors.ipRGCs convey irradiance information centrally via the optic nerve to influence several functions.ipRGCs are the primary retinal input to the hypothalamic suprachiasmatic nucleus(SCN),a circadian oscillator and biological clock,and this input entrains the SCN to the day/night cycle.ipRGCs contribute irradiance signals that regulate pupil size and they also provide signals that interface with the autonomic nervous system to regulate rhythmic gene activity in major organs of the body.ipRGCs also provide excitatory drive to dopaminergic amacrine cells in the retina,providing a novel basis for the restructuring of retinal circuits by light.Here we review the ground-breaking discoveries,current progress and directions for future investigation.展开更多
BACKGROUND Electroacupuncture(EA) at ST36 can significantly improve gastrointestinal symptoms, especially in promoting gastrointestinal motility. The automatic nervous system plays a main role in EA, but few studies e...BACKGROUND Electroacupuncture(EA) at ST36 can significantly improve gastrointestinal symptoms, especially in promoting gastrointestinal motility. The automatic nervous system plays a main role in EA, but few studies exist on how vagovagal and sympathetic reflexes affect EA to regulate gastrointestinal motility.AIM To study the role of vagovagal and sympathetic reflexes in EA at ST36, as well as the associated receptor subtypes that are involved.METHODS Gastric motility was measured with a manometric balloon placed in the gastric antrum area in anesthetized animals. The peripheral nervous discharge was measured using a platinum electrode hooking the vagus or greater splanchnic nerve, and the central nervous discharge was measured with a glass microelectrode in the dorsal motor nucleus of the vagus(DMV). The effects and mechanisms of EA at ST36 were explored in male Sprague-Dawley rats which were divided in to a control group, vagotomy group, sympathectomy group, and microinjection group [including an artificial cerebrospinal fluid group, glutamate(L-Glu) group, and γ-aminobutyric acid(GABA) group] and in genetically modified male mice [β1β2 receptor-knockout(β1β2^(-/-)) mice, M2M3 receptorknockout(M2M3^(-/-)) mice, and wild-type control mice].RESULTS EA at ST36 promoted gastric motility during 30-120 s. During EA, both vagus and sympathetic nerve discharges increased, with a much higher frequency of vagus nerve discharge than sympathetic discharge. The gastric motility mediated by EA at ST36 was interdicted by vagotomy. However, gastric motility mediated by EA at ST36 was increased during 0-120 s by sympathectomy, which eliminated the delay effect of EA during 0-30 s, but it was lower than the control group during 30-120 s. Using gene knockout mice and their wild-type controls to explore the receptor mechanisms, we found that EA at ST36 decreased gastric motility in M2/3^(-/-) mice, and promoted gastric motility in β1/2^(-/-) mice. Extracellular recordings showed that EA at ST36 increased spikes of the DMV. 展开更多
AIM： To analyze the prevalence of gastroesophageal reflux disease （GERD） related symptoms in patients with diabetes mellitus （DM） and to find out the relationship between diabetic neuropathy and the prevalence of...AIM： To analyze the prevalence of gastroesophageal reflux disease （GERD） related symptoms in patients with diabetes mellitus （DM） and to find out the relationship between diabetic neuropathy and the prevalence of GERD symptoms. METHODS： In this prospective questionnaire study, 150 consecutive type 2 diabetic patients attending the endocrine clinic were enrolled. A junior physician helped the patients to understand the questions. Patients were asked about the presence of five most frequent symptoms of GERD that included heartburn （at least 1/wk）, regurgitation, chest pain, hoarseness of voice and chronic cough. Patients with past medical history of angina, COPD, asthma, cough due to ACEI or preexisting GERD prior to onset of diabetes and apparent psychiatric disorders were excluded from the survey. We further divided the patients into two groups based on presence or absence of peripheral neuropathy. Out of 150 patients, 46 had neuropathy, whereas 104 patients did not have neuropathy. Data are expressed as mean ± SD, and number of patients in each category and percentage of total patients in that group. Normal distributions between groups were compared with Student t test and the prevalence rates between groups were compared with Chi-square tests for significance. RESULTS： The average duration of diabetes were 12 ± 9.2 years and the average HbAlc level of this group was 7.7% ± 2.0%. The mean weight and BMI were 198 ± 54 Ibs. and 32 ± 7.2 kg/m^2. Forty percent （61/150） patients reported having at least one of the symptoms of GERD and thirty percent （45/150） reported having heartburn at least once a week. The prevalence of GERD symptoms is higher in patients with neuropathy than patients without neuropathy （58.7% vs 32.7%, P 〈 0.01）. The prevalence of heartburn, chest pain and chronic cough are also higher in patients with neuropathy than in patients without neuropathy （43.5% vs 24%; 10.9% vs 4.8% and 17.8% vs 6.7% respectively, P 〈 0.05）. CONCLUSION： The prevalence of GER展开更多
A multiple-legged robot is traditionally controlled by using its dynamic model.But the dynamic-model-based approach fails to acquire satisfactory performances when the robot faces rough terrains and unknown environmen...A multiple-legged robot is traditionally controlled by using its dynamic model.But the dynamic-model-based approach fails to acquire satisfactory performances when the robot faces rough terrains and unknown environments.Referring animals＇ neural control mechanisms,a control model is built for a quadruped robot walking adaptively.The basic rhythmic motion of the robot is controlled by a well-designed rhythmic motion controller（RMC） comprising a central pattern generator（CPG） for hip joints and a rhythmic coupler（RC） for knee joints.CPG and RC have relationships of motion-mapping and rhythmic couple.Multiple sensory-motor models,abstracted from the neural reflexes of a cat,are employed.These reflex models are organized and thus interact with the CPG in three layers,to meet different requirements of complexity and response time to the tasks.On the basis of the RMC and layered biological reflexes,a quadruped robot is constructed,which can clear obstacles and walk uphill and downhill autonomously,and make a turn voluntarily in uncertain environments,interacting with the environment in a way similar to that of an animal.The paper provides a biologically inspired architecture,with which a robot can walk adaptively in uncertain environments in a simple and effective way,and achieve better performances.展开更多
Objective：To observe the clinical effect of acupuncture plus rehabilitation training in treating early-stage shoulder-hand syndrome due to ischemic stroke.Methods：Sixty patients were randomized into an observation g...Objective：To observe the clinical effect of acupuncture plus rehabilitation training in treating early-stage shoulder-hand syndrome due to ischemic stroke.Methods：Sixty patients were randomized into an observation group and a control group,30 in each.The observation group was intervened by acupuncture plus rehabilitation training,and the control group only received rehabilitation training.After 3 treatment courses,the scores of visual analogue scale （VAS） and Fugl-Meyer assessment scale （FMA）,and the clinical effect were compared between the two groups.Results：The two groups both obtained significant improvements in VAS and FMA scores after treatment （P〈0.05 or P〈0.01）.After treatment,it showed marked differences in comparing VAS and FMA scores between the observation group and the control group （P〈0.05）.The total effective rate was 86.7% in the observation group,versus 63.3% in the control group,and the difference was statistically significant （P〈0.05）.Conclusion：The result of acupuncture plus rehabilitation training in treating early-stage shoulder-hand syndrome due to ischemic stroke is superior to rehabilitation training alone.展开更多
This work concerns biped adaptive walking control on slope terrains with online trajectory generation. In terms of the lack of satis- factory performances of the traditional simplified single-layered Central Pattern G...This work concerns biped adaptive walking control on slope terrains with online trajectory generation. In terms of the lack of satis- factory performances of the traditional simplified single-layered Central Pattern Generator （CPG） model in engineering applications where robots face unknown environments and access feedback, this paper presents a Multi-Layered CPG （ML-CPG） model based on a half-center CPG model. The proposed ML-CPG model is used as the underlying low-level controller for a quadruped robot to generate adaptive walking patterns. Rhythm-generation and pattern formation interneurons are modeled to promptly generate motion rhythm and patterns for motion sequence control, while motoneurons are modeled to control the output strength of the joint in real time according to feedback. Referring to the motion control mechanisms of animals, a control structure is built for a quadruped robot. Multi-sensor models abstracted from the neural reflexes of animals are involved in all the layers of neurons through various feedback paths to achieve adaptability as well as the coordinated motion control of a robot＇s limbs. The simulation experiments verify the effectiveness of the pre- sented ML-CPG and multi-layered reflexes strategy.展开更多
Previous studies have demonstrated the effects of different afferent fibers on electroacupuncture （EA）- induced analgesia. However, contributions of functional receptors expressed on afferent fibers to the EA analge...Previous studies have demonstrated the effects of different afferent fibers on electroacupuncture （EA）- induced analgesia. However, contributions of functional receptors expressed on afferent fibers to the EA analgesia remain unclear. This study investigates the roles of acid-sensing ion channel 3 （ASIC3） and transient receptor potential vanifioid 1 （TRPV1） receptors in EA-induced segmental and systemic analgesia. Effects of EA at acupoint ST36 with different intensities on the C-fiber reflex and mechanical and thermal pain thresholds were measured among the ASIC3-/-, TRPV1-/-, and C57BL/6 mice. Compared with C57BL/6 mice, the ipsilateral inhibition of EA with 0.8 C-fiber threshold （0.8Tc） intensity on C-fiber reflex was markedly reduced in ASIC3-/- mice, whereas the bilateral inhibition of 1.0 and 2.0Tc EA was significantly decreased in TRPV1-/- mice. The segmental increase in pain thresholds induced by 0.3 mA EA was significantly reduced in ASIC3-/- mice, whereas the systemic enhancement of 1.0 mA EA was markedly decreased in TRPV1-/- mice. Thus, segmental analgesia of EA with lower intensity is partially mediated by ASIC3 receptor on Aβ-fiber, whereas systemic analgesia induced by EA with higher intensity is more likely induced by TRPV1 receptor on Aδ- and C-fibers.展开更多
文摘Cardiac autonomic neuropathy(CAN)is a serious complication of diabetes mellitus(DM)that is strongly associated with approximately five-fold increased risk of cardiovascular mortality.CAN manifests in a spectrum of things,ranging from resting tachycardia and fixed heart rate(HR)to development of"silent"myocardial infarction.Clinical correlates or risk markers for CAN are age,DM duration,glycemic control,hypertension,and dyslipidemia(DLP),development of other microvascular complications.Established risk factors for CAN are poor glycemic control in type 1 DM and a combination of hypertension,DLP,obesity,and unsatisfactory glycemic control in type 2DM.Symptomatic manifestations of CAN include sinus tachycardia,exercise intolerance,orthostatic hypotension(OH),abnormal blood pressure(BP)regulation,dizziness,presyncope and syncope,intraoperative cardiovascular instability,asymptomatic myocardial ischemia and infarction.Methods of CAN assessment in clinical practice include assessment of symptoms and signs,cardiovascular reflex tests based on HR and BP,short-term electrocardiography(ECG),QT interval prolongation,HR variability(24 h,classic24 h Holter ECG),ambulatory BP monitoring,HR turbulence,baroreflex sensitivity,muscle sympathetic nerve activity,catecholamine assessment and cardiovascular sympathetic tests,heart sympathetic imaging.Although it is common complication,the significance of CAN has not been fully appreciated and there are no unified treatment algorithms for today.Treatment is based on early diagnosis,life style changes,optimization of glycemic control and management of cardiovascular risk factors.Pathogenetic treatment of CAN includes:Balanced diet and physical activity;optimization of glycemic control;treatment of DLP;antioxidants,first of allα-lipoic acid(ALA),aldose reductase inhibitors,acetylL-carnitine;vitamins,first of all fat-soluble vitamin B1;correction of vascular endothelial dysfunction;prevention and treatment of thrombosis;in severe cases-treatment of OH.The promising methods include prescri
基金supported by grants from the National Institutes of Health, the National Institute of Neurological Disorders and Stroke R01 NS035615the National Eye Institute R01 EY017809
文摘A new mammalian photoreceptor was recently discovered to reside in the ganglion cell layer of the inner retina.These intrinsically photosensitive retinal ganglion cells(ipRGCs) express a photopigment,melanopsin,that confers upon them the ability to respond to light in the absence of all rod and cone photoreceptor input.Although relatively few in number,ipRGCs extend their dendrites across large expanses of the retina making them ideally suited to function as irradiance detectors to assess changes in ambient light levels.Phototransduction in ipRGCs appears to be mediated by transient receptor potential channels more closely resembling the phototransduction cascade of invertebrate rather than vertebrate photoreceptors.ipRGCs convey irradiance information centrally via the optic nerve to influence several functions.ipRGCs are the primary retinal input to the hypothalamic suprachiasmatic nucleus(SCN),a circadian oscillator and biological clock,and this input entrains the SCN to the day/night cycle.ipRGCs contribute irradiance signals that regulate pupil size and they also provide signals that interface with the autonomic nervous system to regulate rhythmic gene activity in major organs of the body.ipRGCs also provide excitatory drive to dopaminergic amacrine cells in the retina,providing a novel basis for the restructuring of retinal circuits by light.Here we review the ground-breaking discoveries,current progress and directions for future investigation.
基金Supported by the National Natural Science Foundation of China,No.81373749No.81574071,and No.81673883
文摘BACKGROUND Electroacupuncture(EA) at ST36 can significantly improve gastrointestinal symptoms, especially in promoting gastrointestinal motility. The automatic nervous system plays a main role in EA, but few studies exist on how vagovagal and sympathetic reflexes affect EA to regulate gastrointestinal motility.AIM To study the role of vagovagal and sympathetic reflexes in EA at ST36, as well as the associated receptor subtypes that are involved.METHODS Gastric motility was measured with a manometric balloon placed in the gastric antrum area in anesthetized animals. The peripheral nervous discharge was measured using a platinum electrode hooking the vagus or greater splanchnic nerve, and the central nervous discharge was measured with a glass microelectrode in the dorsal motor nucleus of the vagus(DMV). The effects and mechanisms of EA at ST36 were explored in male Sprague-Dawley rats which were divided in to a control group, vagotomy group, sympathectomy group, and microinjection group [including an artificial cerebrospinal fluid group, glutamate(L-Glu) group, and γ-aminobutyric acid(GABA) group] and in genetically modified male mice [β1β2 receptor-knockout(β1β2^(-/-)) mice, M2M3 receptorknockout(M2M3^(-/-)) mice, and wild-type control mice].RESULTS EA at ST36 promoted gastric motility during 30-120 s. During EA, both vagus and sympathetic nerve discharges increased, with a much higher frequency of vagus nerve discharge than sympathetic discharge. The gastric motility mediated by EA at ST36 was interdicted by vagotomy. However, gastric motility mediated by EA at ST36 was increased during 0-120 s by sympathectomy, which eliminated the delay effect of EA during 0-30 s, but it was lower than the control group during 30-120 s. Using gene knockout mice and their wild-type controls to explore the receptor mechanisms, we found that EA at ST36 decreased gastric motility in M2/3^(-/-) mice, and promoted gastric motility in β1/2^(-/-) mice. Extracellular recordings showed that EA at ST36 increased spikes of the DMV.
文摘AIM： To analyze the prevalence of gastroesophageal reflux disease （GERD） related symptoms in patients with diabetes mellitus （DM） and to find out the relationship between diabetic neuropathy and the prevalence of GERD symptoms. METHODS： In this prospective questionnaire study, 150 consecutive type 2 diabetic patients attending the endocrine clinic were enrolled. A junior physician helped the patients to understand the questions. Patients were asked about the presence of five most frequent symptoms of GERD that included heartburn （at least 1/wk）, regurgitation, chest pain, hoarseness of voice and chronic cough. Patients with past medical history of angina, COPD, asthma, cough due to ACEI or preexisting GERD prior to onset of diabetes and apparent psychiatric disorders were excluded from the survey. We further divided the patients into two groups based on presence or absence of peripheral neuropathy. Out of 150 patients, 46 had neuropathy, whereas 104 patients did not have neuropathy. Data are expressed as mean ± SD, and number of patients in each category and percentage of total patients in that group. Normal distributions between groups were compared with Student t test and the prevalence rates between groups were compared with Chi-square tests for significance. RESULTS： The average duration of diabetes were 12 ± 9.2 years and the average HbAlc level of this group was 7.7% ± 2.0%. The mean weight and BMI were 198 ± 54 Ibs. and 32 ± 7.2 kg/m^2. Forty percent （61/150） patients reported having at least one of the symptoms of GERD and thirty percent （45/150） reported having heartburn at least once a week. The prevalence of GERD symptoms is higher in patients with neuropathy than patients without neuropathy （58.7% vs 32.7%, P 〈 0.01）. The prevalence of heartburn, chest pain and chronic cough are also higher in patients with neuropathy than in patients without neuropathy （43.5% vs 24%; 10.9% vs 4.8% and 17.8% vs 6.7% respectively, P 〈 0.05）. CONCLUSION： The prevalence of GER
基金supported by National Natural Science Foundation of China (Grant No. 50905012)the Fundamental Research Funds for the Central Universities of China (Grant No. 2012JBM088)
文摘A multiple-legged robot is traditionally controlled by using its dynamic model.But the dynamic-model-based approach fails to acquire satisfactory performances when the robot faces rough terrains and unknown environments.Referring animals＇ neural control mechanisms,a control model is built for a quadruped robot walking adaptively.The basic rhythmic motion of the robot is controlled by a well-designed rhythmic motion controller（RMC） comprising a central pattern generator（CPG） for hip joints and a rhythmic coupler（RC） for knee joints.CPG and RC have relationships of motion-mapping and rhythmic couple.Multiple sensory-motor models,abstracted from the neural reflexes of a cat,are employed.These reflex models are organized and thus interact with the CPG in three layers,to meet different requirements of complexity and response time to the tasks.On the basis of the RMC and layered biological reflexes,a quadruped robot is constructed,which can clear obstacles and walk uphill and downhill autonomously,and make a turn voluntarily in uncertain environments,interacting with the environment in a way similar to that of an animal.The paper provides a biologically inspired architecture,with which a robot can walk adaptively in uncertain environments in a simple and effective way,and achieve better performances.
文摘Objective：To observe the clinical effect of acupuncture plus rehabilitation training in treating early-stage shoulder-hand syndrome due to ischemic stroke.Methods：Sixty patients were randomized into an observation group and a control group,30 in each.The observation group was intervened by acupuncture plus rehabilitation training,and the control group only received rehabilitation training.After 3 treatment courses,the scores of visual analogue scale （VAS） and Fugl-Meyer assessment scale （FMA）,and the clinical effect were compared between the two groups.Results：The two groups both obtained significant improvements in VAS and FMA scores after treatment （P〈0.05 or P〈0.01）.After treatment,it showed marked differences in comparing VAS and FMA scores between the observation group and the control group （P〈0.05）.The total effective rate was 86.7% in the observation group,versus 63.3% in the control group,and the difference was statistically significant （P〈0.05）.Conclusion：The result of acupuncture plus rehabilitation training in treating early-stage shoulder-hand syndrome due to ischemic stroke is superior to rehabilitation training alone.
基金Acknowledgment This work was supported by the National Natural Science Foundation of China （Grant Nos. U1713211 and 61673300））.
文摘This work concerns biped adaptive walking control on slope terrains with online trajectory generation. In terms of the lack of satis- factory performances of the traditional simplified single-layered Central Pattern Generator （CPG） model in engineering applications where robots face unknown environments and access feedback, this paper presents a Multi-Layered CPG （ML-CPG） model based on a half-center CPG model. The proposed ML-CPG model is used as the underlying low-level controller for a quadruped robot to generate adaptive walking patterns. Rhythm-generation and pattern formation interneurons are modeled to promptly generate motion rhythm and patterns for motion sequence control, while motoneurons are modeled to control the output strength of the joint in real time according to feedback. Referring to the motion control mechanisms of animals, a control structure is built for a quadruped robot. Multi-sensor models abstracted from the neural reflexes of animals are involved in all the layers of neurons through various feedback paths to achieve adaptability as well as the coordinated motion control of a robot＇s limbs. The simulation experiments verify the effectiveness of the pre- sented ML-CPG and multi-layered reflexes strategy.
基金This work was supported by National Natural Science Foundation of China （Nos. 81330087 and 81503668） and Beijing Natural Science Foundation （No. 7132148）.
文摘Previous studies have demonstrated the effects of different afferent fibers on electroacupuncture （EA）- induced analgesia. However, contributions of functional receptors expressed on afferent fibers to the EA analgesia remain unclear. This study investigates the roles of acid-sensing ion channel 3 （ASIC3） and transient receptor potential vanifioid 1 （TRPV1） receptors in EA-induced segmental and systemic analgesia. Effects of EA at acupoint ST36 with different intensities on the C-fiber reflex and mechanical and thermal pain thresholds were measured among the ASIC3-/-, TRPV1-/-, and C57BL/6 mice. Compared with C57BL/6 mice, the ipsilateral inhibition of EA with 0.8 C-fiber threshold （0.8Tc） intensity on C-fiber reflex was markedly reduced in ASIC3-/- mice, whereas the bilateral inhibition of 1.0 and 2.0Tc EA was significantly decreased in TRPV1-/- mice. The segmental increase in pain thresholds induced by 0.3 mA EA was significantly reduced in ASIC3-/- mice, whereas the systemic enhancement of 1.0 mA EA was markedly decreased in TRPV1-/- mice. Thus, segmental analgesia of EA with lower intensity is partially mediated by ASIC3 receptor on Aβ-fiber, whereas systemic analgesia induced by EA with higher intensity is more likely induced by TRPV1 receptor on Aδ- and C-fibers.
