Effect and Clinical Value of Splanchnic Nerve Block of Hemodynamics in ACST

The condition of acute cholangitis of severe type (ACST) develops very rapidly and the prognosis is poor. The main clinical feature is that there is an obvious dynamic variation, which is the principal factor for the early occurrence of shock and death. In this study the Japanese long ear rabbits were used and biliary tract pressure increasing and splanchnic nervous plexus blocking experiments were conducted. Our results indicate that 0.6% of lidocaine can be used to block the right celiac plexus. It can avoid the decrease of blood pressure due to the pressure increase of the binary tract, and the decrease of blood pressure due to the pressure increase of the binary tract can be corrected by local anesthesia. 8 cases in conformity with the ACST diagnostic standards received the right renal capsule block injection for the purpose of stopping the celiac plexus, 6 cases of whom had a return of blood pressure to various extent, suggesting that the splanchnic nervous activity in the occurrence of ACST is of great significance. The technique may provide a new approach for the clinical treatment of ACST.

Effect of Increasing Biliary Tract Pressure on House Rabbit Blood Dynamics in Acute Cholangitis of Severe Type

In this study 12 Japanese long ear rabbits were used as models of acute cholangitis of severe type (ACST), and also an increasing pressure apparatus of selfmade caecus to form high pressure of the biliary tract. The animals were observed for changes in blood dynamics in an attempt to explore the effect and relation of high pressure of biliary tract and infective element in pathogenesis of ACST. It was found that when the biliary pressure was increased within 120 min in the 20 kpa group,the blood endotoxin level showed no obvious increment (P>0.05),but the decreased range of average MAP (mean artery pressure) was over 4 kpa,and the cardiac output also decreased evidently (P<0. 05) , and that when the biliary pressure was decreased,MAP and cardiac output were restored to normal gradually. Of these animals 3 didn't restore their normal condition when the blood pressure decreased to zero and died finally.Meanwhile the electric discharge frequency of the right greater splanchnic nerves increased (P<0.05),but when pressure was reduced, the frequency slowed down. From the above findings,the authors came to the conclusion that the rapid increase of the biliary tract pressure is the important factor leading to a decrease in blood pressure of ACST,and even bringing about irreversible shock , which is involved in the activity of splanchnic nerves.

Effects of Biliary Tract Pressure on Dynamics of the Oddi's Sphincter and its Nerve Mechanism

In order to explore the effect of binary tract pressure on Oddi's sphincter and the mechanism of development of high pressure of binary tract during acute obstructive and suppurative cholangitis (AOSC), house rabbits were used to establish model of high binary pressure in acute binary duct caecus. It was observed that when the pressure of the acute binary tract was increased to 8 kpa,the electric activity of Oddi's sphincter was obviously enhanced, the pressure of Oddices sphincter increased remarkably (P <0. 05), and even constant spasm appeared with accompanying increase of discharge frequency of the right greater splanchnic nerves (P <0. 05) and progressive decrease of mean arterial pressure.However, when lidocaine of 0. 6 % was used to block the right celiac plexus, no above-mentioned reaction happened when the binary tract pressure was increased again. The results indicated that the acute binary tract obstruction might induce the contraction or spasm of Oddi's sphincter and bring about a vicious cycle. Its mechanism is related to splanchnic nerves reflection and it is one of important factors in the development of AOSC course.

Deterioration in Hemodynamics Reaction, Baroreflex Sensitivity, Sympathetic Nerve Activity and Redox State of Thoracic Aorta in the Experimental Model of Nitrate Tolerance and Its Pharmacological Correction

Continuous treatment with organic nitrates causes nitrate tolerance and provides evidence for a relationship between mitochondrial complex 1 activity and mitochondrial aldehyde dehydrogenase-2 (ALDH-2) with disturbances of the hemodynamics reaction during nitroglycerin (NTG) tolerance (NTGT). The purpose of this study was the evaluation of efficacy of original oxidized form NAD-containing drug, NADCIN®, on hemodynamic reactions, baroreflex sensitivity (BRS) and reflex control of splanchnic sympathetic nerve activity (SSNA), level of redox-potential, activity of ALDH-2 and superoxide anion generation in aortic tissue in rat model of NTGT. Five groups (7 - 9 each) of male Wistar rats, including control, acute i.v. NTG (150 mcg/kg) administration, NTG tolerance NTGT treatment with NADCIN® 8 mg/kg and methylene blue (MB, 2.5 mg/kg) were used. NTGT in rats was accompanied with the greatly attenuation of hemodynamics reaction, BRS, the decreasing of the ability to reflex control of SSNA without pronounce overexpression of endothelin-1 in vessels (aorta). In NTGT rats i.v. NTG along induced less hypotensive reactions and alterations in heart period vs single NTG treated group, more expressively decreased BRS (-34%) and reflex control of SSNA (-18%). NADCIN® significantly inhibits tolerance-inducing properties of the prolonged nitroglycerin infusion (max decrease of blood pressure response to nitroglycerin injection, % of normal controls: NTGT 51.2%, NADCIN® 91.6%, MB 55.8%). NADCIN® in NTGT rats after NTG i.v. administration increased reduced BRS (+37.8%, p < 0,05), reflex control of SSNA (+29.4%, p < 0.05) and reversed the decreasing of NAD/NADH ratio, ALDH-2 activity and decreasing in superoxide generation in thoracic aortic tissue. Thus, course treatment with NADCIN® of NTGT rats restores hemodynamics changes, BRS and SSNA throughout the increasing of redox-potential NAD/NADH and cessates the NTGT developing.