Cardiac autonomic neuropathy(CAN)is an often overlooked and common complication of diabetes mellitus.CAN is associated with increased cardiovascular morbidity and mortality.The pathogenesis of CAN is complex and invol...Cardiac autonomic neuropathy(CAN)is an often overlooked and common complication of diabetes mellitus.CAN is associated with increased cardiovascular morbidity and mortality.The pathogenesis of CAN is complex and involves a cascade of pathways activated by hyperglycaemia resulting in neuronal ischaemia and cellular death.In addition,autoimmune and genetic factors are involved in the development of CAN.CAN might be subclinical for several years until the patient develops resting tachycardia,exercise intolerance,postural hypotension,cardiac dysfunction and diabetic cardiomyopathy.During its sub-clinical phase,heart rate variability that is influenced by the balance between parasympathetic and sympathetic tones can help in detecting CAN before the disease is symptomatic.Newer imaging techniques(such as scintigraphy)have allowed earlier detection of CAN in the pre-clinical phase and allowed better assessment of the sympathetic nervous system.One of the main difficulties in CAN research is the lack of a universally accepted definition of CAN;however,the Toronto Consensus Panel on Diabetic Neuropathy has recently issued guidance for the diagnosis and staging of CAN,and also proposed screening for CAN in patients with diabetes mellitus.A major challenge,however,is the lack of specific treatment to slow the progression or prevent the development of CAN.Lifestyle changes,improved metabolic control might prevent or slow the progression of CAN.Reversal will require combination of these treatments with new targeted therapeutic approaches.The aim of this article is to review the latest evidence regarding the epidemiology,pathogenesis,manifestations,diagnosis and treatment for CAN.展开更多
Objective： To investigate the frequency of parasympathetic neurogenesis and determine its association with tumor budding and prognosis in pancreatic ductal adenocarcinoma （PDAC）. Methods： Parasympathetic neurogene...Objective： To investigate the frequency of parasympathetic neurogenesis and determine its association with tumor budding and prognosis in pancreatic ductal adenocarcinoma （PDAC）. Methods： Parasympathetic neurogenesis was defined as the distribution of abnormal parasympathetic nerves in the stroma tissue. Staining of vesicular acetylcholine transporter （VAChT）, as a marker for parasympathetic neurogenesis, was performed on a representative specimen of the tumor for 59 PDAC patients with available clinical, pathologic, and follow-up information. Three specimens containing normal pancreatic tissues were stained in parallel. The number of parasympathetic nerve fibers was counted in five high-power microscopic fields （5×0.785 mm2）. Cut-offvalues were calculated by receiver operating characteristic curve analysis. Results： VAChT-positive parasympathetic nerve fibers were not seen in the stroma of 3 cases of normal pancreatic tissues. In 59 PDAC cases, the range of parasympathetic neurogenesis was 4-38 fibers/（5×0.785） mm2, with a median of 18 fibers/（5×0.785） mm2. Patients with parasympathetic neurogenesis 〉 15 fibers/（5×0.785） mm2 were defined as the high-density group （39 patients, 66.1%）, and those with parasympathetic neurogenesis 〈15 fibers/（5×0.785） mm2 as the low-density group （20 patients, 33.9%）. The high-density group had a higher occurrence of tumor budding （P=0.001） and a higher rate of early recurrence （P=0.035）. Parasympathetic neurogenesis appeared to be an independent adverse prognostic factor [hazard ratio （HR）=2.45, 95% confidence interval （95% CI）： 1.25-4.81, P=0.009], in addition to American Joint Committee on Cancer （AJCC） stage （P=0.010） and tumor budding （P=0.009）. Conclusions： Parasympathetic neurogenesis is strongly associated with tumor budding and correlates with an adverse prognosis in PDAC.展开更多
The devastating losses following traumatic spinal cord injury(SCI) encompass the motor, sensory and autonomic nervous systems. Neurogenic bowel is a slow transit colonic dysfunction marked by constipation, rectal evac...The devastating losses following traumatic spinal cord injury(SCI) encompass the motor, sensory and autonomic nervous systems. Neurogenic bowel is a slow transit colonic dysfunction marked by constipation, rectal evacuation difficulties, decreased anorectal sensation, fecal incontinence or some combination thereof. Furthermore, neurogenic bowel is one of the most prevalent comorbidities of SCI and is recognized by afflicted individuals and caregivers as a lifelong physical and psychological challenge that profoundly affects quality of life. The restoration of post-injury control of movement has received considerable scientific scrutiny yet the daily necessity of voiding the bowel and bladder remains critically under-investigated. Subsequently, physicians and caregivers are rarely presented with consistent, evidence-based strategies to successfully address the consequences of dysregulated voiding reflexes. Neurogenic bowel is commonly believed to result from the interruption of the supraspinal control of the spinal autonomic circuits regulating the colon. In this mini-review, we discuss the clinical challenges presented by neurogenic bowel and emerging pre-clinical evidence that is revealing that SCI also initiates functional remodeling of the colonic wall concurrent with a decrease in local enteric neurons. Since the enteric input to the colonic smooth muscle is the final common pathway for functional contractions of the colon, changes to the neuromuscular interface must first be understood in order to maximize the efficacy of therapeutic interventions targeting colonic dysfunction following SCI.展开更多
Acupoints on the different parts of the body surface vary in regulating the autonomic nervous system(ANS),exhibiting differences in the acupoint specificity in terms of the distributing directions of sympathetic and p...Acupoints on the different parts of the body surface vary in regulating the autonomic nervous system(ANS),exhibiting differences in the acupoint specificity in terms of the distributing directions of sympathetic and parasympathetic branches.The paper introduces the rules of acupoints on the corresponding body surfaces in modulating ANS based on their location at four limbs,abdomen,sacrum,head and face,suboccipital and lateral cervical region and auricle(concha).The fundamental rule of acupoint heterogeneity in ANS regulation is that:all acupoints can induce somatic-sympathetic reflex.The regional heterogeneity of acupoints in ANS is shown:by the fact that stimulation beyond a certain intensity can induce systemic autonomic effects.The acupoints on the abdomen act on the sympathetic nervous system,those at concha on the vagal system and those on the sacral region on the sacral parasymathetic system.The heterogeneity of acupoints in regulating ANS refers to co-effects of acupoints specific effect(within segments) and its systemic effect(whole body),which embodies the specificity of acupoints structure.The acupoints on the same body surface regions display the homogeneity of modulation.Mastering the heterogeneous characteristics of acupoints in modulating ANS is particularly conductive to constructing the theoretical basis of acupoints in clinical acupuncture treatment for systemic diseases.展开更多
The aim of this study was to examine the immunomodulatory role of the unilateral ambiguous nucleus （Amb）. We performed electrical stimulation of the unilateral Amb, electrical stimulation of the left parietal cortex...The aim of this study was to examine the immunomodulatory role of the unilateral ambiguous nucleus （Amb）. We performed electrical stimulation of the unilateral Amb, electrical stimulation of the left parietal cortex and the lateral hypothalamus following unilateral Arab lesion, as well as microinjection of acetylcholine chloride and hemicholine-3 into the unilateral Amb, and electrical stimulation of the unilateral Amb after injection of atropine, mecamylamine, propranolol, and phentolamine. Results showed that the number and proliferation of peripheral blood T lymphocytes were increased after electrical stimulation of the unilateral Arab. The cholinergic neurons in the Amb released choline substances to alter cellular immunity, thus confirming that the Amb mediates the neuro-immunomodulatory process.展开更多
The way in which the Root Mean Square of the Successive Differences between adjacent RR intervals (RMSSD) recovers immediately after exercise could be a good indicator of internal training load (ITL). The aim of this ...The way in which the Root Mean Square of the Successive Differences between adjacent RR intervals (RMSSD) recovers immediately after exercise could be a good indicator of internal training load (ITL). The aim of this study is to design a recovery index based on RMSSD. Forteen healthy men took part in this study. The experiment lasted 2 weeks, with 4 separate (48 - 72 h) sessions. First session was an incremental treadmill test to determine ventilatory thresholds (VT1 and VT2) and maximal aerobic speed (MAS). Each subject ran at VT1 speed (second day), VT2 speed (third day) and a time-to-exhaustion test at MAS (fourth day). The duration of VT1 and VT2 loads was selected in such a way that the product intensity-duration (training load) was the same. HRV was measured from 10’ prior to test (Rest) to 30’ after completed (Recovery). Recovery slopes were calculated from RMSSD values at 10 and 30 minutes. Borg scale was recorded at the end of every test and the Training Impulse (TRIMP) values were calculated using Banister equations. The RMSSD values dropped substantially regardless of the intensity and the duration of exercise (average 4 ms). The RMSSD recovery was linear during the 30 min and different depending on the intensity of exercise. To propose a recovery index, we calculated the slope of RMSDD over the 30 minutes (slope-30) and also the first 10 minutes (slope-10). Given that the slopes presented an exponential behavior in relation with effort intensity, three curves were obtained (average values, plus SD and minus SD) defining a nomogram. For practical application, we propose: 1) to measure RMSSD the last 5 minutes of exercise and any period of 5 minutes during the first 30 minutes recovery;2) to calculate the slope of RMSSD between exercise and recovery;3) to compare with the nomogram.展开更多
Greater fluctuations in office blood pressure increase the risk of stroke and blood pressure volatility is an important risk factor for cardiovascular events. Effects of sympathetic and parasympathetic nerve on blood ...Greater fluctuations in office blood pressure increase the risk of stroke and blood pressure volatility is an important risk factor for cardiovascular events. Effects of sympathetic and parasympathetic nerve on blood pressure regulation are well known, however, those on visit-to visit variation remains unclear. Aim of this study is to clarify the contribution of sympathetic and parasympathetic balance on blood pressure fluctuation. Methods: We enrolled 23 outpatients with essential hypertension. We measured blood pressure, and pulse rate at clinic 14 times in a row and calculated coefficient of variance (CV) as visit-to-visit variability. The velocity of pupil contraction, miosis (VC) and dilation, mydriasis (VD) was determined from pupillary function test. Results: Systolic blood pressure and diastolic blood pressure were not significantly correlated with VC, VD and VD/VC. Heart rate was not correlated with VC and VD, but significantly correlated with VD/VC. CV of systolic blood pressure, diastolic blood pressure and heart rate were not significantly correlated with VC or VD. Ratio of VD to VC significantly negative correlated with CV of blood pressure, diastolic blood pressure, and heart. Value of VD was significantly correlated with value of VC. Conclusion: Visit-to-visit variability of blood pressure and heart rate is not related with sympathetic or parasympathetic tone independently but augmented by the impaired sympathetic and parasympathetic balance.展开更多
Excessive reactive oxygen species(ROS)(such as the superoxide radical) are commonly associated with cardiac autonomic dysfunctions. Though superoxide dismutase 1(SOD1) overexpression may protect against ROS damage to ...Excessive reactive oxygen species(ROS)(such as the superoxide radical) are commonly associated with cardiac autonomic dysfunctions. Though superoxide dismutase 1(SOD1) overexpression may protect against ROS damage to the autonomic nervous system, superoxide radical reduction may change normal physiological functions. Previously, we demonstrated that human SOD1(hSOD1) overexpression does not change baroreflex bradycardia and tachycardia but rather increases aortic depressor nerve activity in response to arterial pressure changes in C57 B6 SJL-Tg(SOD1)2 Gur/J mice. Since the baroreflex arc includes afferent, central, and efferent components, the objective of this study was to determine whether hSOD1 overexpression alters the central and vagal efferent mediation of heart rate(HR) responses. Our data indicate that SOD1 overexpression decreased the HR responses to vagal efferent nerve stimulation but did not change the HR responses to aortic depressor nerve(ADN)stimulation. Along with the previous study, we suggest that SOD1 overexpression preserves normal baroreflex function but may differentially alter the functions of the ADN, vagal efferents, and central components. While SOD1 overexpression likely enhanced ADN function and the central mediation of bradycardia, it decreased vagal efferent control of HR.展开更多
BACKGROUND： Dysfunctional autonomic cardiac regulation is thought to be associated with high mortality in epileptic patients. OBJECTIVE： To explore changes in sympathetic and parasympathetic activities in epileptic ...BACKGROUND： Dysfunctional autonomic cardiac regulation is thought to be associated with high mortality in epileptic patients. OBJECTIVE： To explore changes in sympathetic and parasympathetic activities in epileptic patients with repetitive generalized tonic-clonic seizures by observing interictal heart rate. DESIGN, TIME AND SEI-I＇ING： A case-control study was performed at the Buddhist Tzu Chi General Hospital from July 2006 to May 2009. PARTICIPANTS： A total of 30 patients, comprising 15 males and 15 females, who presented with chronic epilepsy and repetitive generalized tonic-clonic seizures according to International League Against Epilepsy guidelines （ILAE, 1989）, were selected. In addition, 30 matched, healthy volunteers were selected as controls. METHODS： Lead I electrocardiogram was performed in the epilepsy and control groups for 5 minutes during a daytime interictal period. Frequency-domain analysis of heart rate variability was performed using fast Fourier transformation. MAIN OUTCOME MEASURES： Heart rate interval, high frequency （HF; 0.15-0.45 Hz） power, low frequency （LF; 0.04-0.15 Hz） power, and LF/（HF ＋ LF） expressed in normalized units （LF%）. RESULTS： Compared with the control group, the epilepsy group exhibited a significantly lower mean heart rate interval and HF power, but a significantly greater LF% （P〈 0.01）. There was no significant difference in LF power between the groups （P = 0.17）. CONCLUSION： Patients with chronic epilepsy exhibited faster heart rates during interictal periods, which could contribute to hiclher sympathetic and lower parasympathetic activities.展开更多
OBJECTIVE： To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia. DATA RETRIEVAL： A computer-based retriev...OBJECTIVE： To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia. DATA RETRIEVAL： A computer-based retrieval was performed for papers examining the distribution of cardiac autonomic nerves, using “heart, autonomic nerve, sympathetic nerve, vagus nerve, nerve distribution, rhythm and atrial fibrillation” as the key words. SELECTION CRITERIA： A total of 165 studies examining the distribution of cardiac autonomic nerve were screened, and 46 of them were eventually included. MAIN OUTCOME MEASURES： The distribution and characteristics of cardiac autonomic nerves were observed, and immunohistochemical staining was applied to determine the levels of tyrosine hydroxylase and acetylcholine transferase （main markers of cardiac autonomic nerve distribution）. In addition, the correlation between cardiac autonomic nerve distribution and cardiac arrhythmia was investigated. RESULTS： Cardiac autonomic nerves were reported to exhibit a disordered distribution in different sites, mainly at the surface of the cardiac atrium and pulmonary vein, forming a ganglia plexus. The distribution of the pulmonary vein autonomic nerve was prominent at the proximal end rather than the distal end, at the upper left rather than the lower right, at the epicardial membrane rather than the endocardial membrane, at the left atrium rather than the right atrium, and at the posterior wall rather than the anterior wall. The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution, and the distribution density of autonomic nerves was determined using a computer-aided morphometric analysis system. CONCLUSION： The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the occurrence, maintenance,展开更多
Parasympathetic function can be assessed by the deep breathing test (DB) as a simple and reproducible cardiovascular reflex. The aim of this study is to use this test to compare the vagal response of a young footballe...Parasympathetic function can be assessed by the deep breathing test (DB) as a simple and reproducible cardiovascular reflex. The aim of this study is to use this test to compare the vagal response of a young footballers group to of age-matched untrained normal subjects. Deep breathing test was performed in 2 groups: one of 20 adult young footballers (average age of 19.3 ± 0.6 years), and a second age-matched group of 20 untrained subjects (average age of 19.6 ± 0.6 years). Subjects underwent the DB test after 30 min resting in supine position, and responses were expressed as a percentage of variation of heart rate during the stimulation. Student’s t-test was used to evaluate statistical differences among the two groups for all parameters (vagal response, heart rate, VO2max….) and considering p < 0.05 as a significant difference. The results showed that vagal response to deep breathing test was significantly higher in the young footballers when compared to the untrained controls (72.6% ± 16.2% vs 55.0% ± 12.8%, respectively, p = 0.03). The basal heart rate was significantly lower in footballers than in the controls group (52.1 ± 7.4 bat/min vs 69.8 ± 14.3 bat/min, p < 0.01). The use of the simple test of deep breathing allowed us to demonstrate that adult young footballers have a significantly lower basal HR and higher parasympathetic response in comparison to untrained subjects.展开更多
The TCM philosophy of a meridian and associated channels pertains to the specific function of one or more organs. We define the <span style="font-family:Verdana;">Lung Primary Meridian (LUM) together w...The TCM philosophy of a meridian and associated channels pertains to the specific function of one or more organs. We define the <span style="font-family:Verdana;">Lung Primary Meridian (LUM) together with the </span><span style="font-family:Verdana;">Lung Sinew (LUSC), Divergent (LUDC), Luo-connecting (LULCC) Channels as a system of routes plus some parts of the body (such as muscles) to fulfil respiration, as a main function under different situations. There is very limited information about the Lung associated channels in classical literature of TCM. With a clear focus on the function of respiration, we have carried out a detailed analysis of the biomedical consequence of stimulating the LUM, analysed the roles played by LUSC, LUDC, and LULCC. The updated LUM and LUDC include acupoints of other meridians, serving the same purpose of performing satisfactory respiration starting from checking the quality of the inflow through the nose. The LUSC includes the respiratory muscles (plus the associated connective tissues) extending to various parts of the body. The muscles of the limb (as part of the LUSC) embrace the nerves that provide routes for somatosensory reflexes and play the role of locomotion, providing voluntary respiration via the pectoralis muscles. The muscles of LUSC are bounded by stiff connective tissue layers, forming compartments, and are part of the pulley system for various body locomotions. Within a compartment, the interstitial fluid, blood, lymph flows must be potent to protect the associated nerves related to LUM;the healthy state of the LUSC also provides freedom of various types of locomotion. The LULCC exists because the vagus nerve has a part of it passing through the spinal cords all the way down to the sacrum domain, with exiting nerve innervating two-third of the large intestine. The crucial steps of our deductions </span><span style="font-family:Verdana;">are supported by experimental evidence based on modern neurophysiology and kinesiology. We discover that all the four channels state展开更多
文摘Cardiac autonomic neuropathy(CAN)is an often overlooked and common complication of diabetes mellitus.CAN is associated with increased cardiovascular morbidity and mortality.The pathogenesis of CAN is complex and involves a cascade of pathways activated by hyperglycaemia resulting in neuronal ischaemia and cellular death.In addition,autoimmune and genetic factors are involved in the development of CAN.CAN might be subclinical for several years until the patient develops resting tachycardia,exercise intolerance,postural hypotension,cardiac dysfunction and diabetic cardiomyopathy.During its sub-clinical phase,heart rate variability that is influenced by the balance between parasympathetic and sympathetic tones can help in detecting CAN before the disease is symptomatic.Newer imaging techniques(such as scintigraphy)have allowed earlier detection of CAN in the pre-clinical phase and allowed better assessment of the sympathetic nervous system.One of the main difficulties in CAN research is the lack of a universally accepted definition of CAN;however,the Toronto Consensus Panel on Diabetic Neuropathy has recently issued guidance for the diagnosis and staging of CAN,and also proposed screening for CAN in patients with diabetes mellitus.A major challenge,however,is the lack of specific treatment to slow the progression or prevent the development of CAN.Lifestyle changes,improved metabolic control might prevent or slow the progression of CAN.Reversal will require combination of these treatments with new targeted therapeutic approaches.The aim of this article is to review the latest evidence regarding the epidemiology,pathogenesis,manifestations,diagnosis and treatment for CAN.
基金supported by grants from China Cancer Research Foundation Y-N2013-008the Doctoral Program of the Ministry of Education 20130001110089 to DR Xiu+1 种基金the National Natural Science Foundation of China 81272709 to W FuPeking University Third Hospital Grant Y81524-01 to LF Zhang
文摘Objective： To investigate the frequency of parasympathetic neurogenesis and determine its association with tumor budding and prognosis in pancreatic ductal adenocarcinoma （PDAC）. Methods： Parasympathetic neurogenesis was defined as the distribution of abnormal parasympathetic nerves in the stroma tissue. Staining of vesicular acetylcholine transporter （VAChT）, as a marker for parasympathetic neurogenesis, was performed on a representative specimen of the tumor for 59 PDAC patients with available clinical, pathologic, and follow-up information. Three specimens containing normal pancreatic tissues were stained in parallel. The number of parasympathetic nerve fibers was counted in five high-power microscopic fields （5×0.785 mm2）. Cut-offvalues were calculated by receiver operating characteristic curve analysis. Results： VAChT-positive parasympathetic nerve fibers were not seen in the stroma of 3 cases of normal pancreatic tissues. In 59 PDAC cases, the range of parasympathetic neurogenesis was 4-38 fibers/（5×0.785） mm2, with a median of 18 fibers/（5×0.785） mm2. Patients with parasympathetic neurogenesis 〉 15 fibers/（5×0.785） mm2 were defined as the high-density group （39 patients, 66.1%）, and those with parasympathetic neurogenesis 〈15 fibers/（5×0.785） mm2 as the low-density group （20 patients, 33.9%）. The high-density group had a higher occurrence of tumor budding （P=0.001） and a higher rate of early recurrence （P=0.035）. Parasympathetic neurogenesis appeared to be an independent adverse prognostic factor [hazard ratio （HR）=2.45, 95% confidence interval （95% CI）： 1.25-4.81, P=0.009], in addition to American Joint Committee on Cancer （AJCC） stage （P=0.010） and tumor budding （P=0.009）. Conclusions： Parasympathetic neurogenesis is strongly associated with tumor budding and correlates with an adverse prognosis in PDAC.
基金supported by grants from the National Institutes of Health,No.NINDS 49177(to GMH)Craig H.Neilsen Foundation Senior Research award,No.295319(to GMH)
文摘The devastating losses following traumatic spinal cord injury(SCI) encompass the motor, sensory and autonomic nervous systems. Neurogenic bowel is a slow transit colonic dysfunction marked by constipation, rectal evacuation difficulties, decreased anorectal sensation, fecal incontinence or some combination thereof. Furthermore, neurogenic bowel is one of the most prevalent comorbidities of SCI and is recognized by afflicted individuals and caregivers as a lifelong physical and psychological challenge that profoundly affects quality of life. The restoration of post-injury control of movement has received considerable scientific scrutiny yet the daily necessity of voiding the bowel and bladder remains critically under-investigated. Subsequently, physicians and caregivers are rarely presented with consistent, evidence-based strategies to successfully address the consequences of dysregulated voiding reflexes. Neurogenic bowel is commonly believed to result from the interruption of the supraspinal control of the spinal autonomic circuits regulating the colon. In this mini-review, we discuss the clinical challenges presented by neurogenic bowel and emerging pre-clinical evidence that is revealing that SCI also initiates functional remodeling of the colonic wall concurrent with a decrease in local enteric neurons. Since the enteric input to the colonic smooth muscle is the final common pathway for functional contractions of the colon, changes to the neuromuscular interface must first be understood in order to maximize the efficacy of therapeutic interventions targeting colonic dysfunction following SCI.
基金Supported by National Natural Science Foundation of China:No.82374284Jiangsu Natural Science Foundation:No.BK20221350。
文摘Acupoints on the different parts of the body surface vary in regulating the autonomic nervous system(ANS),exhibiting differences in the acupoint specificity in terms of the distributing directions of sympathetic and parasympathetic branches.The paper introduces the rules of acupoints on the corresponding body surfaces in modulating ANS based on their location at four limbs,abdomen,sacrum,head and face,suboccipital and lateral cervical region and auricle(concha).The fundamental rule of acupoint heterogeneity in ANS regulation is that:all acupoints can induce somatic-sympathetic reflex.The regional heterogeneity of acupoints in ANS is shown:by the fact that stimulation beyond a certain intensity can induce systemic autonomic effects.The acupoints on the abdomen act on the sympathetic nervous system,those at concha on the vagal system and those on the sacral region on the sacral parasymathetic system.The heterogeneity of acupoints in regulating ANS refers to co-effects of acupoints specific effect(within segments) and its systemic effect(whole body),which embodies the specificity of acupoints structure.The acupoints on the same body surface regions display the homogeneity of modulation.Mastering the heterogeneous characteristics of acupoints in modulating ANS is particularly conductive to constructing the theoretical basis of acupoints in clinical acupuncture treatment for systemic diseases.
基金the National Natural Science Foundation of China,No. 30901057,30871840,31072100Graduate Innovation Fund of Jilin University,No.20101057
文摘The aim of this study was to examine the immunomodulatory role of the unilateral ambiguous nucleus （Amb）. We performed electrical stimulation of the unilateral Amb, electrical stimulation of the left parietal cortex and the lateral hypothalamus following unilateral Arab lesion, as well as microinjection of acetylcholine chloride and hemicholine-3 into the unilateral Amb, and electrical stimulation of the unilateral Amb after injection of atropine, mecamylamine, propranolol, and phentolamine. Results showed that the number and proliferation of peripheral blood T lymphocytes were increased after electrical stimulation of the unilateral Arab. The cholinergic neurons in the Amb released choline substances to alter cellular immunity, thus confirming that the Amb mediates the neuro-immunomodulatory process.
文摘The way in which the Root Mean Square of the Successive Differences between adjacent RR intervals (RMSSD) recovers immediately after exercise could be a good indicator of internal training load (ITL). The aim of this study is to design a recovery index based on RMSSD. Forteen healthy men took part in this study. The experiment lasted 2 weeks, with 4 separate (48 - 72 h) sessions. First session was an incremental treadmill test to determine ventilatory thresholds (VT1 and VT2) and maximal aerobic speed (MAS). Each subject ran at VT1 speed (second day), VT2 speed (third day) and a time-to-exhaustion test at MAS (fourth day). The duration of VT1 and VT2 loads was selected in such a way that the product intensity-duration (training load) was the same. HRV was measured from 10’ prior to test (Rest) to 30’ after completed (Recovery). Recovery slopes were calculated from RMSSD values at 10 and 30 minutes. Borg scale was recorded at the end of every test and the Training Impulse (TRIMP) values were calculated using Banister equations. The RMSSD values dropped substantially regardless of the intensity and the duration of exercise (average 4 ms). The RMSSD recovery was linear during the 30 min and different depending on the intensity of exercise. To propose a recovery index, we calculated the slope of RMSDD over the 30 minutes (slope-30) and also the first 10 minutes (slope-10). Given that the slopes presented an exponential behavior in relation with effort intensity, three curves were obtained (average values, plus SD and minus SD) defining a nomogram. For practical application, we propose: 1) to measure RMSSD the last 5 minutes of exercise and any period of 5 minutes during the first 30 minutes recovery;2) to calculate the slope of RMSSD between exercise and recovery;3) to compare with the nomogram.
文摘Greater fluctuations in office blood pressure increase the risk of stroke and blood pressure volatility is an important risk factor for cardiovascular events. Effects of sympathetic and parasympathetic nerve on blood pressure regulation are well known, however, those on visit-to visit variation remains unclear. Aim of this study is to clarify the contribution of sympathetic and parasympathetic balance on blood pressure fluctuation. Methods: We enrolled 23 outpatients with essential hypertension. We measured blood pressure, and pulse rate at clinic 14 times in a row and calculated coefficient of variance (CV) as visit-to-visit variability. The velocity of pupil contraction, miosis (VC) and dilation, mydriasis (VD) was determined from pupillary function test. Results: Systolic blood pressure and diastolic blood pressure were not significantly correlated with VC, VD and VD/VC. Heart rate was not correlated with VC and VD, but significantly correlated with VD/VC. CV of systolic blood pressure, diastolic blood pressure and heart rate were not significantly correlated with VC or VD. Ratio of VD to VC significantly negative correlated with CV of blood pressure, diastolic blood pressure, and heart. Value of VD was significantly correlated with value of VC. Conclusion: Visit-to-visit variability of blood pressure and heart rate is not related with sympathetic or parasympathetic tone independently but augmented by the impaired sympathetic and parasympathetic balance.
基金supported by National Institutes of Health grant HL-75034by Institutional Funds of the University of Central Florida
文摘Excessive reactive oxygen species(ROS)(such as the superoxide radical) are commonly associated with cardiac autonomic dysfunctions. Though superoxide dismutase 1(SOD1) overexpression may protect against ROS damage to the autonomic nervous system, superoxide radical reduction may change normal physiological functions. Previously, we demonstrated that human SOD1(hSOD1) overexpression does not change baroreflex bradycardia and tachycardia but rather increases aortic depressor nerve activity in response to arterial pressure changes in C57 B6 SJL-Tg(SOD1)2 Gur/J mice. Since the baroreflex arc includes afferent, central, and efferent components, the objective of this study was to determine whether hSOD1 overexpression alters the central and vagal efferent mediation of heart rate(HR) responses. Our data indicate that SOD1 overexpression decreased the HR responses to vagal efferent nerve stimulation but did not change the HR responses to aortic depressor nerve(ADN)stimulation. Along with the previous study, we suggest that SOD1 overexpression preserves normal baroreflex function but may differentially alter the functions of the ADN, vagal efferents, and central components. While SOD1 overexpression likely enhanced ADN function and the central mediation of bradycardia, it decreased vagal efferent control of HR.
基金a Grant from the Buddhist Tzu Chi General Hospital,Hualien,Taiwan
文摘BACKGROUND： Dysfunctional autonomic cardiac regulation is thought to be associated with high mortality in epileptic patients. OBJECTIVE： To explore changes in sympathetic and parasympathetic activities in epileptic patients with repetitive generalized tonic-clonic seizures by observing interictal heart rate. DESIGN, TIME AND SEI-I＇ING： A case-control study was performed at the Buddhist Tzu Chi General Hospital from July 2006 to May 2009. PARTICIPANTS： A total of 30 patients, comprising 15 males and 15 females, who presented with chronic epilepsy and repetitive generalized tonic-clonic seizures according to International League Against Epilepsy guidelines （ILAE, 1989）, were selected. In addition, 30 matched, healthy volunteers were selected as controls. METHODS： Lead I electrocardiogram was performed in the epilepsy and control groups for 5 minutes during a daytime interictal period. Frequency-domain analysis of heart rate variability was performed using fast Fourier transformation. MAIN OUTCOME MEASURES： Heart rate interval, high frequency （HF; 0.15-0.45 Hz） power, low frequency （LF; 0.04-0.15 Hz） power, and LF/（HF ＋ LF） expressed in normalized units （LF%）. RESULTS： Compared with the control group, the epilepsy group exhibited a significantly lower mean heart rate interval and HF power, but a significantly greater LF% （P〈 0.01）. There was no significant difference in LF power between the groups （P = 0.17）. CONCLUSION： Patients with chronic epilepsy exhibited faster heart rates during interictal periods, which could contribute to hiclher sympathetic and lower parasympathetic activities.
文摘OBJECTIVE： To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia. DATA RETRIEVAL： A computer-based retrieval was performed for papers examining the distribution of cardiac autonomic nerves, using “heart, autonomic nerve, sympathetic nerve, vagus nerve, nerve distribution, rhythm and atrial fibrillation” as the key words. SELECTION CRITERIA： A total of 165 studies examining the distribution of cardiac autonomic nerve were screened, and 46 of them were eventually included. MAIN OUTCOME MEASURES： The distribution and characteristics of cardiac autonomic nerves were observed, and immunohistochemical staining was applied to determine the levels of tyrosine hydroxylase and acetylcholine transferase （main markers of cardiac autonomic nerve distribution）. In addition, the correlation between cardiac autonomic nerve distribution and cardiac arrhythmia was investigated. RESULTS： Cardiac autonomic nerves were reported to exhibit a disordered distribution in different sites, mainly at the surface of the cardiac atrium and pulmonary vein, forming a ganglia plexus. The distribution of the pulmonary vein autonomic nerve was prominent at the proximal end rather than the distal end, at the upper left rather than the lower right, at the epicardial membrane rather than the endocardial membrane, at the left atrium rather than the right atrium, and at the posterior wall rather than the anterior wall. The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution, and the distribution density of autonomic nerves was determined using a computer-aided morphometric analysis system. CONCLUSION： The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the occurrence, maintenance,
文摘Parasympathetic function can be assessed by the deep breathing test (DB) as a simple and reproducible cardiovascular reflex. The aim of this study is to use this test to compare the vagal response of a young footballers group to of age-matched untrained normal subjects. Deep breathing test was performed in 2 groups: one of 20 adult young footballers (average age of 19.3 ± 0.6 years), and a second age-matched group of 20 untrained subjects (average age of 19.6 ± 0.6 years). Subjects underwent the DB test after 30 min resting in supine position, and responses were expressed as a percentage of variation of heart rate during the stimulation. Student’s t-test was used to evaluate statistical differences among the two groups for all parameters (vagal response, heart rate, VO2max….) and considering p < 0.05 as a significant difference. The results showed that vagal response to deep breathing test was significantly higher in the young footballers when compared to the untrained controls (72.6% ± 16.2% vs 55.0% ± 12.8%, respectively, p = 0.03). The basal heart rate was significantly lower in footballers than in the controls group (52.1 ± 7.4 bat/min vs 69.8 ± 14.3 bat/min, p < 0.01). The use of the simple test of deep breathing allowed us to demonstrate that adult young footballers have a significantly lower basal HR and higher parasympathetic response in comparison to untrained subjects.
文摘The TCM philosophy of a meridian and associated channels pertains to the specific function of one or more organs. We define the <span style="font-family:Verdana;">Lung Primary Meridian (LUM) together with the </span><span style="font-family:Verdana;">Lung Sinew (LUSC), Divergent (LUDC), Luo-connecting (LULCC) Channels as a system of routes plus some parts of the body (such as muscles) to fulfil respiration, as a main function under different situations. There is very limited information about the Lung associated channels in classical literature of TCM. With a clear focus on the function of respiration, we have carried out a detailed analysis of the biomedical consequence of stimulating the LUM, analysed the roles played by LUSC, LUDC, and LULCC. The updated LUM and LUDC include acupoints of other meridians, serving the same purpose of performing satisfactory respiration starting from checking the quality of the inflow through the nose. The LUSC includes the respiratory muscles (plus the associated connective tissues) extending to various parts of the body. The muscles of the limb (as part of the LUSC) embrace the nerves that provide routes for somatosensory reflexes and play the role of locomotion, providing voluntary respiration via the pectoralis muscles. The muscles of LUSC are bounded by stiff connective tissue layers, forming compartments, and are part of the pulley system for various body locomotions. Within a compartment, the interstitial fluid, blood, lymph flows must be potent to protect the associated nerves related to LUM;the healthy state of the LUSC also provides freedom of various types of locomotion. The LULCC exists because the vagus nerve has a part of it passing through the spinal cords all the way down to the sacrum domain, with exiting nerve innervating two-third of the large intestine. The crucial steps of our deductions </span><span style="font-family:Verdana;">are supported by experimental evidence based on modern neurophysiology and kinesiology. We discover that all the four channels state
