Objective： Acupuncture has a definite therapeutic effect on chronic obstructive pulmonary disease （COPD）, and the cholinergic anti-inflammatory pathway （CAP） has been shown to be involved in regula- tion of infla...Objective： Acupuncture has a definite therapeutic effect on chronic obstructive pulmonary disease （COPD）, and the cholinergic anti-inflammatory pathway （CAP） has been shown to be involved in regula- tion of inflammation. In this study, we investigated whether electro-acupuncture （EA） affects the CAP in COPD,Methods： Sprague-Dawley rats were induced into COPD through exposure to cigarette smoke combined with lipopolysaccharide. EA treatment was applied at Zusanli （ST36） and Feishu （BL13） points for 30 min/d for 7 d. Seventy-two rats were randomly divided into six study groups, including normal, normal ＋ EA, normal ＋ α-bungarotoxin （α-BGT） （the antagonist of the nicotinic acetylcholine receptor α7 subunit （α7nAChR）） ＋ EA, COPD, COPD ＋ EA, and COPD ＋ α-BGT ＋ EA. Lung function, pathology and vagus nerve discharge were tested. The levels of acetylcholine （ACh）, acetylcholinesterase （ACHE）, interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-ct） in bronchoalveolar lavage fluid （BALF） and lung tissue were measured by enzyme-linked immunosorbent assay. The mRNA and protein expression and immunoreac- tivity of α7nAChR and its postreceptor inflammation signal pathway, including janus kinase 2 （JAK2）, sig- nal transducers and activators of transcription 3 （STAT3）, nuclear factor-KB （NF-KB）, were observed by quantitative reverse transcription-polymerase chain reaction, Western blot and immunohistochemistry. Results： Compared with normal rats, there were a significant decline in lung function and discharge of the vagus nerve （P 〈 0.01）, a marked sign of lung inflammation and an increase of ACh, ACHE, IL-6 and TNF-α level in BALF or lung tissue （P 〈 0.05, P 〈 0.01 ） and higher expression of 0t7nAChR, JAK2, STAT3 and NF-αB （P 〈 0.05, P 〈 0.01） in the COPD rats. In rats receiving EA, the lung function and vagal discharge were enhanced （P 〈 0.01 ）, lung inflammation was improved and the levels of ACh, ACHE, IL-展开更多
In the mechanisms of acupuncture analgesia, an important aspect often overlooked is the antiinflammatory effect of acupuncture, which is mainly attained through the self-limiting inflammatory response-inflammatory ref...In the mechanisms of acupuncture analgesia, an important aspect often overlooked is the antiinflammatory effect of acupuncture, which is mainly attained through the self-limiting inflammatory response-inflammatory reflex and its regulation of hypothalamic-pituitary-adrenal(HPA) axis and autonomic nerve system(the vagus nerve and the sympathetic postganglionic fiber). The significance of antiinflammatory effect of acupuncture in analgesia is manifested twofold: The first, inflammatory nociceptive pain is a major type of chronic pain. The second, neurogenic inflammation is the mechanism by which certain acupoints or acu-reflex points(ARPs) are formed at the body surface and have short-cut connections to the pathological focus. Selecting ARPs and applying appropriate sensory stimulation or local microtrauma(affected by different needling means or stimulation parameters), combined with lowfrequency electrical stimulation or the vagus stimulation in the concha region, are helpful to strengthen the anti-inflammatory and analgesic effect of acupuncture.展开更多
Disordered signalling between the brain and the gut are generally accepted to underlie the functional bowel disorder, irritable bowel syndrome(IBS). However, partly due to the lack of disease-defining biomarkers, unde...Disordered signalling between the brain and the gut are generally accepted to underlie the functional bowel disorder, irritable bowel syndrome(IBS). However, partly due to the lack of disease-defining biomarkers, understanding the aetiology of this complex and multifactorial disease remains elusive. This common gastrointestinal disorder is characterised by alterations in bowel habit such as diarrhoea and/or constipation, bloating and abdominal pain, and symptom exacerbation has been linked with periods of stress, both psychosocial and infection-related. Indeed, a high level of comorbidity exists between IBS and stress-related mood disorders such as anxiety and depression. Moreover, studies have observed alterations in autonomic output and neuro-endocrine signalling in IBS patients. Accumulating evidence indicates that a maladaptive stress response, probably mediated by the stress hormone, corticotropin-releasing factor contributes to the initiation, persistence and severity of symptom flares.Other risk factors for developing IBS include a positive family history, childhood trauma, dietary factors and prior gastrointestinal infection. An emerging role has been attributed to the importance of immune factors in the pathophysiology of IBS with evidence of altered cytokine profiles and increased levels of mucosal immune cells. These factors have also been shown to have direct effects on neural signalling. This review discusses how pathological changes in neural, immune and endocrine pathways, and communication between these systems, contribute to symptom flares in IBS.展开更多
Background Based on the hypothesis that pulmonary vein isolation could result in the damage of the epicardial fat pads, this study aimed to investigated the impact of right upper pulmonary vein （RUPV） isolation on v...Background Based on the hypothesis that pulmonary vein isolation could result in the damage of the epicardial fat pads, this study aimed to investigated the impact of right upper pulmonary vein （RUPV） isolation on vagal innervation to atria. Methods Bilateral cervical sympathovagal trunks were decentralized in 6 dogs. Metoprolol was given to block sympathetic effects. Multipolar catheters were placed into the right atrium （R.A） and coronary sinus （CS）. RUPV isolation was performed via transseptal procedure. Atrial effective refractory period （ERP）, vulnerability window （VW） of atrial fibrillation （AF）, and sinus rhythm cycle length （SCL） were measured at RA and distal coronary sinus （CSd） at baseline and vagal stimulation before and after RUPV isolation. Serial sections of underlying tissues before and after ablation were stained with haematoxylin and eosin. Results SCL decreased significantly during vagal stimulation before RUPV isolation （197±21 vs 13±32 beats per minute, P〈0.001）, but remained unchanged after RUPV isolation （162±29 vs 140±39 beats per minute, P〉0.05）. ERP increased significantly before RUPV isolation compared with that during vagal stimulation [（85.00±24.29） ms vs （21.67±9.83） ms at RA, P〈0.001; （90.00± 15.49） ms vs （33.33±25.03） ms at CSd P〈0.005], but ERP at baseline hardly changed after RUPV isolation compared with that during vagal stimulation [（103.33 ± 22.50） vs （95.00± 16.43） ms at RA, P = 0.09; （98.33±24.83） vs （75.00±29.50） ms at CSd, P=0.009]. The ERP shortening during vagal stimulation after RUPV isolation decreased significantly [（63.33 ±22.51） ms vs （8.33 ± 9.83） ms at RA, P〈0.005; （56.67±20.66） ms vs （23.33± 13.66） ms at CSd, P〈0.05]. AF was rarely induced at baseline before and after RUPV isolation （VW close to 0）, while VW of AF to vagal stimulation significantly decreased after RUPV isolation [（40.00± 10.95） vs 0 ms at RA, P〈0.001; （45.00±32.09） v展开更多
Whether in the West or the East,the connection between the ear and the rest of the body has been explored for a long time.Especially in the past century or more,the relevant theoretical and applied research on the ear...Whether in the West or the East,the connection between the ear and the rest of the body has been explored for a long time.Especially in the past century or more,the relevant theoretical and applied research on the ear has greatly promoted the development of ear therapy,and finally the concept of transcutaneous auricular vagus nerve stimulation(taVNS)has been proposed.The purpose of taVNS is to treat a disease non-invasively by applying electrical current to the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear.In the past two decades,taVNS has been a topic of basic,clinical,and transformation research.It has been applied as an alternative to drug treatment for a variety of diseases.Based on the rapid understanding of the application of taVNS to human health and disease,some limitations in the development of this field have also been gradually exposed.Here,we comprehensively review the origin and research status of the field.展开更多
The hippocampus is involved in the regulation of the autonomic nervous system,together with the hypothalamus and brainstem nuclei,such as the paraventricular nucleus and nucleus tractus solitarius.The vagus nerve-nucl...The hippocampus is involved in the regulation of the autonomic nervous system,together with the hypothalamus and brainstem nuclei,such as the paraventricular nucleus and nucleus tractus solitarius.The vagus nerve-nucleus tractus solitarius pathway has an important role in cardiovascular reflex regulation.Myocardial ischemia has been shown to cause changes in the autonomic nervous system,affecting the dynamic equilibrium of the sympathetic and vagal nerves.However,it remains poorly understood how the hippocampus communicates with brainstem nuclei to regulate the autonomic nervous system and alleviate myocardial ischemic tissue damage.A rat model of acute myocardial ischemia（AMI） was made by ligating the left anterior descending branch of the coronary artery.Three days before ischemia,the hippocampal CA1 region was damaged.Then,3 days after ischemia,electroacupuncture（EA） at Shenmen（HT7）-Tongli（HT5） was performed（continuous wave,1 m A,2 Hz,duration of 30 minutes）.Cluster analysis of firing patterns showed that one type of neuron was found in rats in the sham and AMI groups.Three types of neurons were observed in the AMI ＋ EA group.Six types of neurons were found in the AMI ＋ EA ＋ Lesion group.Correlation analysis showed that the frequency of vagus nerve discharge in each group was negatively correlated with heart rate（HR）（P 〈 0.05,r =-0.424）,and positively correlated with mean arterial pressure（MAP）（P 〈 0.05,r = 0.40987） and the rate-pressure product（RPP）（P 〈 0.05,r = 0.4252）.The total frequency of the nucleus tractus solitarius discharge in each group was positively correlated with vagus nerve discharge（P 〈 0.01,r = 0.7021）,but not with hemodynamic index（HR： P 〉 0.05,r =-0.03263; MAP： P 〉 0.05,r =-0.08993; RPP： P 〉 0.05,r =-0.03263）.Some neurons（Neuron C） were negatively correlated with vagus nerve discharge,HR,MAP and RPP in the AMI ＋ EA group（vagus nerve discharge： P 〈 0.05,r =-0.87749; HR： P 〈 0.01,r =-0.91902; MAP： 展开更多
Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （...Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （PRE） have been treated with VNS in China's Mainland.The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.Methods：We retrospectively assessed the clinical outcome of 94 patients with PRE,who were treated with VNS at Beijing Fengtai Hospital and Beij ing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients.The clinical data analysis was retrospectively examined.Results：Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve.At last follow-up,we found McHugh classifications of Class Ⅰ in 33 patients （35.1％）,Class Ⅱ in 27 patients （28.7％）,Class Ⅲ in 20 patients （21.3％）,Class Ⅳ in 3 patients （3.2％）,and Class Ⅴ in 11 patients （l 1.7％）.Notably,8 （8.5％） patients were seizure-free while ≥50％ seizure frequency reduction occurred in as many as 60 patients （63.8％）.Furthermore,with regard to the modified Engel classification,12 patients （12.8％） were classified as Class Ⅰ,l l patients （11.7％） were classified as Class Ⅱ,37 patients （39.4％） were classified as Class Ⅲ,34 patients （36.2％） were classified as Class Ⅳ.We also found that the factors of gender or age are not associated with clinical outcome.Conclusions：This comparative study confirmed that VNS is a safe,well-tolerated,and effective treatment for Chinese PRE patients.VNS reduced the seizure frequency regardless of age or gender of studied patients.展开更多
Objective:To explore the effect and its possible mechanism of the intervention of transcutaneous auricular vagus nerve stimulation(taVNS)for the functional dyspepsia(FD)model rats.Methods:Of the 25 male SD rats,6 rats...Objective:To explore the effect and its possible mechanism of the intervention of transcutaneous auricular vagus nerve stimulation(taVNS)for the functional dyspepsia(FD)model rats.Methods:Of the 25 male SD rats,6 rats were set as blank group,the other 19 rats were established to be the functional dyspepsia(FD)model by iodoacetamide intragastric administration,and 18 FD models were successfully established.The 18 model rats were randomly divided into a model group,a shamtaVNS group,and taVNS group,with 6 rats in each group.There was no intervention applied to the rats in the blank and model groups.Whereas,the rats in sham-taVNS group received stimulation to the rim of auricular concha of both sides,and those in taVNS group received stimulation to the cavity of auricular concha of both sides,for 30 min each time,once a day,7 days in succession.After the intervention,the gastric sensitivity of the rats in each group under different pressure conditions in the stomach,the expressions of serum brain-gut peptide motilin(MTL),cholecystokinin(CCK),glucagon-likepeptidel(GLP-1),and inflammatory factors IL-4,IL-10,and IL-1βwere detected.Results:(1)Gastric sensitivity:compared with the blank group,the gastric sensitivity of the model group was higher(P<0.05).Compared with the model group,the gastric sensitivity of the taVNS group was lower(P<0.05).Compared with the sham-taVNS group,the gastric sensitivity of the taVNS group was lower(P<0.05).(2)Expression of brain-gut peptide:compared with the blank group,MTL was lower,CCK and GLP-1 were higher in the model group(all P<0.05).Compared with the model group,MTL was higher,CCK and GLP-1 were lower in the taVNS group(all P<0.05).Compared with the shamtaVNS group,CCK and GLP-1 were lower in the taVNS group(both P<0.05).(3)Expression of inflammatory factors:compared with the blank group,IL-4 and IL-10 were lower and was higher in the model group(all P<0.05).Compared with the model group,IL-10 was higher and IL-1βwas lower in the shamtaVNS group(all P<0.05),while IL-4 and IL-10 wer展开更多
Postoperative ileus is a frequently occurring surgical complication, leading to increased morbidity and hospital stay. Abdominal surgical interventions are known to result in a protracted cessation of bowel movement. ...Postoperative ileus is a frequently occurring surgical complication, leading to increased morbidity and hospital stay. Abdominal surgical interventions are known to result in a protracted cessation of bowel movement. Activation of inhibitory neural pathways by nociceptive stimuli leads to an inhibition of propulsive activity, which resolves shortly after closure of the abdomen. The subsequent formation of an inflammatory infiltrate in the muscular layers of the intestine results in a more prolonged phase of ileus. Over the last decade, clinical strategies focusing on reduction of surgical stress and promoting postoperative recovery have improved the course of postoperative ileus. Additionally, recent experimental evidence implicated antiinflammatory interventions, such as vagal stimulation, as potential targets to treat postoperative ileus and reduce the period of intestinal hypomotility. Activation of nicotinic receptors on inflammatory cells by vagal input attenuates inflammation and promotes gastrointestinal motility in experimental models of ileus. A novel physiologicalintervention to activate this neuroimmune pathway is enteral administration of lipid-rich nutrition. Perioperative administration of lipid-rich nutrition reduced manipulation-induced local inflammation of the intestine and accelerated recovery of bowel movement. The application of safe and easy to use antiinflammatory interventions, together with the current multimodal approach, could reduce postoperative ileus to an absolute minimum and shorten hospital stay.展开更多
Orexins, produced in the lateral hypothalamus, are important neuropeptides that participate in the sleep/wake cycle, and their expres- sion coincides with the projection area of the vagus nerve in the brain. Vagus ner...Orexins, produced in the lateral hypothalamus, are important neuropeptides that participate in the sleep/wake cycle, and their expres- sion coincides with the projection area of the vagus nerve in the brain. Vagus nerve stimulation has been shown to decrease the amounts of daytime sleep and rapid eye movement in epilepsy patients with traumatic brain injury. In the present study, we investigated whether vagus nerve stimulation promotes wakefulness and affects orexin expression. A rat model of traumatic brain injury was established using the free fall drop method. In the stimulated group, rats with traumatic brain injury received vagus nerve stimulation （frequency, 30 Hz, current, 1.0 mA; pulse width, 0.5 ms; total stimulation time, 15 minutes）. In the antagonist group, rats with traumatic brain injury were intracerebroventricularly injected with the orexin receptor type 1 （OXIR） antagonist SB334867 and received vagus nerve stimulation. Changes in consciousness were observed after stimulation in each group. Enzyme-linked immunosorbent assay, western blot assay and immunohistochemistry were used to assess the levels of orexin-A and OX1R expression in the prefrontal cortex. In the stimulated group, consciousness was substantially improved, orexin-A protein expression gradually increased within 24 hours after injury and OX1R expres- sion reached a peak at 12 hours, compared with rats subjected to traumatic brain injury only. In the antagonist group, the wake-promoting effect of vagus nerve stimulation was diminished, and orexin-A and OX1R expression were decreased, compared with that of the stim- ulated group. Taken together, our findings suggest that vagus nerve stimulation promotes the recovery of consciousness in comatose rats after traumatic brain injury. The upregulation of orexin-A and OXIR expression in the prefrontal cortex might be involved in the wake-promoting effects of vagus nerve stimulation.展开更多
Objective: To investigate the relationship between basal ganglia cerebral infarction and paroxysmal atrial fibrillation(PAF) caused by abnormal vagus nerve tension.Methods: A total of 1 483 cases of elder patients wit...Objective: To investigate the relationship between basal ganglia cerebral infarction and paroxysmal atrial fibrillation(PAF) caused by abnormal vagus nerve tension.Methods: A total of 1 483 cases of elder patients with cerebral infarction who received head CT or MRI examination during the period were enrolled, including 830 male and613 female, with the average age as 78 years. These cases were divided into basal infarction ganglia group(n = 1 045) and non-basal ganglia infarction group(n = 438)according to the anatomic site of cerebral infarction. The differences of the incidence of PAF, left atrial diameter and heart rate variability were compared between the two groups.Results: In basal ganglia infarction group, the incidence rate of PAF was significantly higher than that of non-basal ganglia infarction group(P < 0.05). The incidence trend of cerebral infarction in basal ganglia was age-related, in the >79 years basal ganglia cerebral infarction group, the incidence of PAF was significantly higher than that of nonbasal ganglia infarction group(P < 0.05). There was no significant difference in the left atrial diameter between the basal ganglia infarction group and non-basal ganglia infarction group. Basal ganglia cerebral infarction patients with high PAF had higher heart rate variability than non-basal ganglia infarction group.Conclusion: Elderly patients with basal ganglia infarction have high incidence of PAF.Sympathetic nerve damage in cerebral basal ganglia, increased vagal tension and cardiac vagal tension are the direct causes of PAF. The results indicates that the increased central vagal nerve tension mediated PAF probably is an indication of supplying sympathetic neurotransmitter or cardiac vagal denervation treatment.展开更多
Vagus nerve stimulation exerts protective effects against ischemic brain injury; however, the underlying mechanisms remain unclear. In this study, a rat model of focal cerebral ischemia was established using the occlu...Vagus nerve stimulation exerts protective effects against ischemic brain injury; however, the underlying mechanisms remain unclear. In this study, a rat model of focal cerebral ischemia was established using the occlusion method, and the right vagus nerve was given electrical stimula-tion （constant current of 0.5 mA; pulse width, 0.5 ms; frequency, 20 Hz; duration, 30 seconds; every 5 minutes for a total of 60 minutes） 30 minutes, 12 hours, and 1, 2, 3, 7 and 14 days after surgery. Electrical stimulation of the vagus nerve substantially reduced infarct volume, improved neurological function, and decreased the expression levels of tumor necrosis factor-α and in-terleukin-6 in rats with focal cerebral ischemia. The experimental findings indicate that the neuroprotective effect of vagus nerve stimulation following cerebral ischemia may be associated with the inhibition of tumor necrosis factor-α and interleukin-6 expression.展开更多
Background Vagus nerve stimulation （VNS） is an alternative treatment for drug-resistant epilepsy （DRE）. The study aimed to explore the potential factors of prognosis, safety and effect of VNS treatment in patients...Background Vagus nerve stimulation （VNS） is an alternative treatment for drug-resistant epilepsy （DRE）. The study aimed to explore the potential factors of prognosis, safety and effect of VNS treatment in patients with DRE. Methods We retrospectively examined 45 cases of DRE that received VNS treatment in our center from June 2004 to June 2010 and analyzed the parameters （age of patient receiving VNS, seizure frequency before and after VNS as well as treatment duration） by Student＇s t test, Fisher＇s exact and Mann-Whitney U tests, and multivariate Logistic regression. Results The overall response rate was 64% （29/45）, 67% （6/9） for adults and 64% （23/36） for children, with no significant difference （P=0.28）. Twenty-two cases had been in VNS therapy for over 1 year with a treatment efficacy of 73% （16/22）, whereas 23 cases had been in VNS therapy no more than 1 year with a treatment effecacy of 57% （13/23）, and has statistically significant difference （P=0.03）. The main side effect included hoarseness of voice and cough. One patient＇s device was removed due to infection. One patient＇s VNS was half-way terminated due to seizure aggravation. One patient died due to status epilepticus. Conclusions VNS is a safe and effective treatment for DRE. Duration of VNS therapy may be a crucial factor on prognosis.展开更多
基金supported by grants from the National Natural Science Foundation of China(No. 81373743)Outstanding Young Talents Support Program of Anhui(No. 20140181)
文摘Objective： Acupuncture has a definite therapeutic effect on chronic obstructive pulmonary disease （COPD）, and the cholinergic anti-inflammatory pathway （CAP） has been shown to be involved in regula- tion of inflammation. In this study, we investigated whether electro-acupuncture （EA） affects the CAP in COPD,Methods： Sprague-Dawley rats were induced into COPD through exposure to cigarette smoke combined with lipopolysaccharide. EA treatment was applied at Zusanli （ST36） and Feishu （BL13） points for 30 min/d for 7 d. Seventy-two rats were randomly divided into six study groups, including normal, normal ＋ EA, normal ＋ α-bungarotoxin （α-BGT） （the antagonist of the nicotinic acetylcholine receptor α7 subunit （α7nAChR）） ＋ EA, COPD, COPD ＋ EA, and COPD ＋ α-BGT ＋ EA. Lung function, pathology and vagus nerve discharge were tested. The levels of acetylcholine （ACh）, acetylcholinesterase （ACHE）, interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-ct） in bronchoalveolar lavage fluid （BALF） and lung tissue were measured by enzyme-linked immunosorbent assay. The mRNA and protein expression and immunoreac- tivity of α7nAChR and its postreceptor inflammation signal pathway, including janus kinase 2 （JAK2）, sig- nal transducers and activators of transcription 3 （STAT3）, nuclear factor-KB （NF-KB）, were observed by quantitative reverse transcription-polymerase chain reaction, Western blot and immunohistochemistry. Results： Compared with normal rats, there were a significant decline in lung function and discharge of the vagus nerve （P 〈 0.01）, a marked sign of lung inflammation and an increase of ACh, ACHE, IL-6 and TNF-α level in BALF or lung tissue （P 〈 0.05, P 〈 0.01 ） and higher expression of 0t7nAChR, JAK2, STAT3 and NF-αB （P 〈 0.05, P 〈 0.01） in the COPD rats. In rats receiving EA, the lung function and vagal discharge were enhanced （P 〈 0.01 ）, lung inflammation was improved and the levels of ACh, ACHE, IL-
文摘In the mechanisms of acupuncture analgesia, an important aspect often overlooked is the antiinflammatory effect of acupuncture, which is mainly attained through the self-limiting inflammatory response-inflammatory reflex and its regulation of hypothalamic-pituitary-adrenal(HPA) axis and autonomic nerve system(the vagus nerve and the sympathetic postganglionic fiber). The significance of antiinflammatory effect of acupuncture in analgesia is manifested twofold: The first, inflammatory nociceptive pain is a major type of chronic pain. The second, neurogenic inflammation is the mechanism by which certain acupoints or acu-reflex points(ARPs) are formed at the body surface and have short-cut connections to the pathological focus. Selecting ARPs and applying appropriate sensory stimulation or local microtrauma(affected by different needling means or stimulation parameters), combined with lowfrequency electrical stimulation or the vagus stimulation in the concha region, are helpful to strengthen the anti-inflammatory and analgesic effect of acupuncture.
文摘Disordered signalling between the brain and the gut are generally accepted to underlie the functional bowel disorder, irritable bowel syndrome(IBS). However, partly due to the lack of disease-defining biomarkers, understanding the aetiology of this complex and multifactorial disease remains elusive. This common gastrointestinal disorder is characterised by alterations in bowel habit such as diarrhoea and/or constipation, bloating and abdominal pain, and symptom exacerbation has been linked with periods of stress, both psychosocial and infection-related. Indeed, a high level of comorbidity exists between IBS and stress-related mood disorders such as anxiety and depression. Moreover, studies have observed alterations in autonomic output and neuro-endocrine signalling in IBS patients. Accumulating evidence indicates that a maladaptive stress response, probably mediated by the stress hormone, corticotropin-releasing factor contributes to the initiation, persistence and severity of symptom flares.Other risk factors for developing IBS include a positive family history, childhood trauma, dietary factors and prior gastrointestinal infection. An emerging role has been attributed to the importance of immune factors in the pathophysiology of IBS with evidence of altered cytokine profiles and increased levels of mucosal immune cells. These factors have also been shown to have direct effects on neural signalling. This review discusses how pathological changes in neural, immune and endocrine pathways, and communication between these systems, contribute to symptom flares in IBS.
文摘Background Based on the hypothesis that pulmonary vein isolation could result in the damage of the epicardial fat pads, this study aimed to investigated the impact of right upper pulmonary vein （RUPV） isolation on vagal innervation to atria. Methods Bilateral cervical sympathovagal trunks were decentralized in 6 dogs. Metoprolol was given to block sympathetic effects. Multipolar catheters were placed into the right atrium （R.A） and coronary sinus （CS）. RUPV isolation was performed via transseptal procedure. Atrial effective refractory period （ERP）, vulnerability window （VW） of atrial fibrillation （AF）, and sinus rhythm cycle length （SCL） were measured at RA and distal coronary sinus （CSd） at baseline and vagal stimulation before and after RUPV isolation. Serial sections of underlying tissues before and after ablation were stained with haematoxylin and eosin. Results SCL decreased significantly during vagal stimulation before RUPV isolation （197±21 vs 13±32 beats per minute, P〈0.001）, but remained unchanged after RUPV isolation （162±29 vs 140±39 beats per minute, P〉0.05）. ERP increased significantly before RUPV isolation compared with that during vagal stimulation [（85.00±24.29） ms vs （21.67±9.83） ms at RA, P〈0.001; （90.00± 15.49） ms vs （33.33±25.03） ms at CSd P〈0.005], but ERP at baseline hardly changed after RUPV isolation compared with that during vagal stimulation [（103.33 ± 22.50） vs （95.00± 16.43） ms at RA, P = 0.09; （98.33±24.83） vs （75.00±29.50） ms at CSd, P=0.009]. The ERP shortening during vagal stimulation after RUPV isolation decreased significantly [（63.33 ±22.51） ms vs （8.33 ± 9.83） ms at RA, P〈0.005; （56.67±20.66） ms vs （23.33± 13.66） ms at CSd, P〈0.05]. AF was rarely induced at baseline before and after RUPV isolation （VW close to 0）, while VW of AF to vagal stimulation significantly decreased after RUPV isolation [（40.00± 10.95） vs 0 ms at RA, P〈0.001; （45.00±32.09） v
基金This review was supported by the National Key R&D Program of China(2018YFC1705800)the National Natural Science Foundation of China(81803872,81674072)+1 种基金the Joint Sino-German Research Project(GZ1236)the Fundamental Research Funds for the Central Public Welfare Research Institutes(ZZ201813006).
文摘Whether in the West or the East,the connection between the ear and the rest of the body has been explored for a long time.Especially in the past century or more,the relevant theoretical and applied research on the ear has greatly promoted the development of ear therapy,and finally the concept of transcutaneous auricular vagus nerve stimulation(taVNS)has been proposed.The purpose of taVNS is to treat a disease non-invasively by applying electrical current to the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear.In the past two decades,taVNS has been a topic of basic,clinical,and transformation research.It has been applied as an alternative to drug treatment for a variety of diseases.Based on the rapid understanding of the application of taVNS to human health and disease,some limitations in the development of this field have also been gradually exposed.Here,we comprehensively review the origin and research status of the field.
基金supported by the National Natural Science Foundation of China,No.81273858a grant from the Anhui University Research and Innovation Platform Team Construction Project in China,No.2015TD033
文摘The hippocampus is involved in the regulation of the autonomic nervous system,together with the hypothalamus and brainstem nuclei,such as the paraventricular nucleus and nucleus tractus solitarius.The vagus nerve-nucleus tractus solitarius pathway has an important role in cardiovascular reflex regulation.Myocardial ischemia has been shown to cause changes in the autonomic nervous system,affecting the dynamic equilibrium of the sympathetic and vagal nerves.However,it remains poorly understood how the hippocampus communicates with brainstem nuclei to regulate the autonomic nervous system and alleviate myocardial ischemic tissue damage.A rat model of acute myocardial ischemia（AMI） was made by ligating the left anterior descending branch of the coronary artery.Three days before ischemia,the hippocampal CA1 region was damaged.Then,3 days after ischemia,electroacupuncture（EA） at Shenmen（HT7）-Tongli（HT5） was performed（continuous wave,1 m A,2 Hz,duration of 30 minutes）.Cluster analysis of firing patterns showed that one type of neuron was found in rats in the sham and AMI groups.Three types of neurons were observed in the AMI ＋ EA group.Six types of neurons were found in the AMI ＋ EA ＋ Lesion group.Correlation analysis showed that the frequency of vagus nerve discharge in each group was negatively correlated with heart rate（HR）（P 〈 0.05,r =-0.424）,and positively correlated with mean arterial pressure（MAP）（P 〈 0.05,r = 0.40987） and the rate-pressure product（RPP）（P 〈 0.05,r = 0.4252）.The total frequency of the nucleus tractus solitarius discharge in each group was positively correlated with vagus nerve discharge（P 〈 0.01,r = 0.7021）,but not with hemodynamic index（HR： P 〉 0.05,r =-0.03263; MAP： P 〉 0.05,r =-0.08993; RPP： P 〉 0.05,r =-0.03263）.Some neurons（Neuron C） were negatively correlated with vagus nerve discharge,HR,MAP and RPP in the AMI ＋ EA group（vagus nerve discharge： P 〈 0.05,r =-0.87749; HR： P 〈 0.01,r =-0.91902; MAP：
文摘Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （PRE） have been treated with VNS in China's Mainland.The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.Methods：We retrospectively assessed the clinical outcome of 94 patients with PRE,who were treated with VNS at Beijing Fengtai Hospital and Beij ing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients.The clinical data analysis was retrospectively examined.Results：Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve.At last follow-up,we found McHugh classifications of Class Ⅰ in 33 patients （35.1％）,Class Ⅱ in 27 patients （28.7％）,Class Ⅲ in 20 patients （21.3％）,Class Ⅳ in 3 patients （3.2％）,and Class Ⅴ in 11 patients （l 1.7％）.Notably,8 （8.5％） patients were seizure-free while ≥50％ seizure frequency reduction occurred in as many as 60 patients （63.8％）.Furthermore,with regard to the modified Engel classification,12 patients （12.8％） were classified as Class Ⅰ,l l patients （11.7％） were classified as Class Ⅱ,37 patients （39.4％） were classified as Class Ⅲ,34 patients （36.2％） were classified as Class Ⅳ.We also found that the factors of gender or age are not associated with clinical outcome.Conclusions：This comparative study confirmed that VNS is a safe,well-tolerated,and effective treatment for Chinese PRE patients.VNS reduced the seizure frequency regardless of age or gender of studied patients.
基金Supported by International Cooperation and Exchange of the National Natural Science Foundation of China:NO.8182010803381473780The Fundamental Research Funds for the Central public welfare research institutes:NO.ZZ201915009.
文摘Objective:To explore the effect and its possible mechanism of the intervention of transcutaneous auricular vagus nerve stimulation(taVNS)for the functional dyspepsia(FD)model rats.Methods:Of the 25 male SD rats,6 rats were set as blank group,the other 19 rats were established to be the functional dyspepsia(FD)model by iodoacetamide intragastric administration,and 18 FD models were successfully established.The 18 model rats were randomly divided into a model group,a shamtaVNS group,and taVNS group,with 6 rats in each group.There was no intervention applied to the rats in the blank and model groups.Whereas,the rats in sham-taVNS group received stimulation to the rim of auricular concha of both sides,and those in taVNS group received stimulation to the cavity of auricular concha of both sides,for 30 min each time,once a day,7 days in succession.After the intervention,the gastric sensitivity of the rats in each group under different pressure conditions in the stomach,the expressions of serum brain-gut peptide motilin(MTL),cholecystokinin(CCK),glucagon-likepeptidel(GLP-1),and inflammatory factors IL-4,IL-10,and IL-1βwere detected.Results:(1)Gastric sensitivity:compared with the blank group,the gastric sensitivity of the model group was higher(P<0.05).Compared with the model group,the gastric sensitivity of the taVNS group was lower(P<0.05).Compared with the sham-taVNS group,the gastric sensitivity of the taVNS group was lower(P<0.05).(2)Expression of brain-gut peptide:compared with the blank group,MTL was lower,CCK and GLP-1 were higher in the model group(all P<0.05).Compared with the model group,MTL was higher,CCK and GLP-1 were lower in the taVNS group(all P<0.05).Compared with the shamtaVNS group,CCK and GLP-1 were lower in the taVNS group(both P<0.05).(3)Expression of inflammatory factors:compared with the blank group,IL-4 and IL-10 were lower and was higher in the model group(all P<0.05).Compared with the model group,IL-10 was higher and IL-1βwas lower in the shamtaVNS group(all P<0.05),while IL-4 and IL-10 wer
基金Supported by DANONE Research Centre for Specialised Nutrition, Wageningen, the Netherlandsby AGIKO-stipendia 920-03-522 (to Lubbers T) and 920-03-271 (to Luyer M) from the Netherlands Organization for Health Research and Development
文摘Postoperative ileus is a frequently occurring surgical complication, leading to increased morbidity and hospital stay. Abdominal surgical interventions are known to result in a protracted cessation of bowel movement. Activation of inhibitory neural pathways by nociceptive stimuli leads to an inhibition of propulsive activity, which resolves shortly after closure of the abdomen. The subsequent formation of an inflammatory infiltrate in the muscular layers of the intestine results in a more prolonged phase of ileus. Over the last decade, clinical strategies focusing on reduction of surgical stress and promoting postoperative recovery have improved the course of postoperative ileus. Additionally, recent experimental evidence implicated antiinflammatory interventions, such as vagal stimulation, as potential targets to treat postoperative ileus and reduce the period of intestinal hypomotility. Activation of nicotinic receptors on inflammatory cells by vagal input attenuates inflammation and promotes gastrointestinal motility in experimental models of ileus. A novel physiologicalintervention to activate this neuroimmune pathway is enteral administration of lipid-rich nutrition. Perioperative administration of lipid-rich nutrition reduced manipulation-induced local inflammation of the intestine and accelerated recovery of bowel movement. The application of safe and easy to use antiinflammatory interventions, together with the current multimodal approach, could reduce postoperative ileus to an absolute minimum and shorten hospital stay.
基金supported by the Natural Science Foundation of China,No.81260295the Graduate Student Innovation Fund of Jiangxi Province of China,No.YC2015-S090
文摘Orexins, produced in the lateral hypothalamus, are important neuropeptides that participate in the sleep/wake cycle, and their expres- sion coincides with the projection area of the vagus nerve in the brain. Vagus nerve stimulation has been shown to decrease the amounts of daytime sleep and rapid eye movement in epilepsy patients with traumatic brain injury. In the present study, we investigated whether vagus nerve stimulation promotes wakefulness and affects orexin expression. A rat model of traumatic brain injury was established using the free fall drop method. In the stimulated group, rats with traumatic brain injury received vagus nerve stimulation （frequency, 30 Hz, current, 1.0 mA; pulse width, 0.5 ms; total stimulation time, 15 minutes）. In the antagonist group, rats with traumatic brain injury were intracerebroventricularly injected with the orexin receptor type 1 （OXIR） antagonist SB334867 and received vagus nerve stimulation. Changes in consciousness were observed after stimulation in each group. Enzyme-linked immunosorbent assay, western blot assay and immunohistochemistry were used to assess the levels of orexin-A and OX1R expression in the prefrontal cortex. In the stimulated group, consciousness was substantially improved, orexin-A protein expression gradually increased within 24 hours after injury and OX1R expres- sion reached a peak at 12 hours, compared with rats subjected to traumatic brain injury only. In the antagonist group, the wake-promoting effect of vagus nerve stimulation was diminished, and orexin-A and OX1R expression were decreased, compared with that of the stim- ulated group. Taken together, our findings suggest that vagus nerve stimulation promotes the recovery of consciousness in comatose rats after traumatic brain injury. The upregulation of orexin-A and OXIR expression in the prefrontal cortex might be involved in the wake-promoting effects of vagus nerve stimulation.
基金funded by Shanghai Health and Family Planning Commission Youth Found to Wenbo Cheng(20144Y0116)
文摘Objective: To investigate the relationship between basal ganglia cerebral infarction and paroxysmal atrial fibrillation(PAF) caused by abnormal vagus nerve tension.Methods: A total of 1 483 cases of elder patients with cerebral infarction who received head CT or MRI examination during the period were enrolled, including 830 male and613 female, with the average age as 78 years. These cases were divided into basal infarction ganglia group(n = 1 045) and non-basal ganglia infarction group(n = 438)according to the anatomic site of cerebral infarction. The differences of the incidence of PAF, left atrial diameter and heart rate variability were compared between the two groups.Results: In basal ganglia infarction group, the incidence rate of PAF was significantly higher than that of non-basal ganglia infarction group(P < 0.05). The incidence trend of cerebral infarction in basal ganglia was age-related, in the >79 years basal ganglia cerebral infarction group, the incidence of PAF was significantly higher than that of nonbasal ganglia infarction group(P < 0.05). There was no significant difference in the left atrial diameter between the basal ganglia infarction group and non-basal ganglia infarction group. Basal ganglia cerebral infarction patients with high PAF had higher heart rate variability than non-basal ganglia infarction group.Conclusion: Elderly patients with basal ganglia infarction have high incidence of PAF.Sympathetic nerve damage in cerebral basal ganglia, increased vagal tension and cardiac vagal tension are the direct causes of PAF. The results indicates that the increased central vagal nerve tension mediated PAF probably is an indication of supplying sympathetic neurotransmitter or cardiac vagal denervation treatment.
基金supported by the Beijing Natural Science Foundation of China,No.7122164
文摘Vagus nerve stimulation exerts protective effects against ischemic brain injury; however, the underlying mechanisms remain unclear. In this study, a rat model of focal cerebral ischemia was established using the occlusion method, and the right vagus nerve was given electrical stimula-tion （constant current of 0.5 mA; pulse width, 0.5 ms; frequency, 20 Hz; duration, 30 seconds; every 5 minutes for a total of 60 minutes） 30 minutes, 12 hours, and 1, 2, 3, 7 and 14 days after surgery. Electrical stimulation of the vagus nerve substantially reduced infarct volume, improved neurological function, and decreased the expression levels of tumor necrosis factor-α and in-terleukin-6 in rats with focal cerebral ischemia. The experimental findings indicate that the neuroprotective effect of vagus nerve stimulation following cerebral ischemia may be associated with the inhibition of tumor necrosis factor-α and interleukin-6 expression.
文摘Background Vagus nerve stimulation （VNS） is an alternative treatment for drug-resistant epilepsy （DRE）. The study aimed to explore the potential factors of prognosis, safety and effect of VNS treatment in patients with DRE. Methods We retrospectively examined 45 cases of DRE that received VNS treatment in our center from June 2004 to June 2010 and analyzed the parameters （age of patient receiving VNS, seizure frequency before and after VNS as well as treatment duration） by Student＇s t test, Fisher＇s exact and Mann-Whitney U tests, and multivariate Logistic regression. Results The overall response rate was 64% （29/45）, 67% （6/9） for adults and 64% （23/36） for children, with no significant difference （P=0.28）. Twenty-two cases had been in VNS therapy for over 1 year with a treatment efficacy of 73% （16/22）, whereas 23 cases had been in VNS therapy no more than 1 year with a treatment effecacy of 57% （13/23）, and has statistically significant difference （P=0.03）. The main side effect included hoarseness of voice and cough. One patient＇s device was removed due to infection. One patient＇s VNS was half-way terminated due to seizure aggravation. One patient died due to status epilepticus. Conclusions VNS is a safe and effective treatment for DRE. Duration of VNS therapy may be a crucial factor on prognosis.
