Parasympathetic neurogenesis is strongly associated with tumor budding and correlates with an adverse prognosis in pancreatic ductal adenocarcinoma

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.

Visit-to-Visit Blood Pressure Variability Are Associated with an Imbalance between Sympathetic and Parasympathetic Tone in Hypertensive Patients

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.

Excessive parasympathetic responses to sympathetic challenges: a treatable, hidden, dynamic autonomic imbalance

Background:A common assumption with autonomic assessment is that one branch opposes the other.With independent measures of parasympathetic (P) and sympathetic (S) ac tivity,based on concurrent time-frequency analysis of respiratory activity and heart rate variability,this assumption has been challenged.Clinical observations of unprovoked P-excess during S-stimulation have been associated with treatable,abnormal responses.Method:Serial autonomic profiling of 12,967 patients was performed using the P&S method (ANX-3.0 Autonomic Monitor by ANSAR Medical Technologies,Inc.,Philadelphia,PA) over a five-year period.Treatment protocols are very low-dose and depend on patient history.For cardiovascular disease patients,Carvedilol was prescribed.For non-CVD patients,Nortriptyline was prescribed.In some cases where end-organ effects were not yet presented or relieved,patients were weaned of therapy once PE was relieved.Alternative therapies included Specific Chiropractic Adjustment,better known in the literature as Chiropractic Manipulative Therapy and intensive zero-impact,cardiovascular exercise.Results:PE patients present with normal HR and BP and no other apparent symptoms at rest.However,they reported symptoms of:sleep difficulties,palpitations,poor peripheral circulation,general malaise,depression (often with anxiety or ADD-like symptoms),frequent headache or migraines,menopause difficulties in women,hypothyroidism,cognitive difficulties,gastrointestinal upset,persistent weight-gain,and dizziness after standing.Conclusion:Normalizing PE,regardless of method,stabilizes the patient,relieves symptoms,improves quality of life,and improves patient outcomes.

Parasympathetic Dysfunction in Black African Patients with Heart Failure:A Cross-Sectional Study in Sub-Saharan Africa

Background: Heart Failure (HF) is a major public health problem worldwide. Neurohormonal changes associated with HF are current therapeutic targets. The parasympathetic system in HF has not been well studied especially in black Africans. Aim: This study aimed to report on the prevalence and determinants of parasympathetic dysfunction in patients with heart failure in sub-Saharan Africa. Methods: We conducted a cross-sectional study between December 2017 and April 2018 in the outpatient and inpatient departments in two teaching hospitals in Yaounde-Cameroon. Cases were patients with HF matched with controls without HF according to age, sex, and risk factors (hypertension, diabetes, and obesity). We assessed the parasympathetic function via the Deep Breathing Test using an electrocardiograph. Results: We recruited 35 patients in each group. The mean age was 57 ± 11.68 years. Vagal dysfunction was seen in 51.4% of cases and 11.4% of controls (aOR: 10.1 [95% CI: 2.7 - 38.3], p = 0.001). This risk increased with the severity of HF-aOR: 11.8, [95% CI: 1.8 - 77.9], p = 0.01 for dyspnea stage III-IV, and aOR: 9.27, [95% CI: 1.3 - 65.3], p = 0.025) for HF with reduced Ejection fraction. This risk was not associated with the classic cardiovascular risk factors. Conclusion: Parasympathetic dysfunction as assessed with the Deep Breathing Test was seen in over half of the patients with HF and this was associated with the severity and type of HF.

The underlying mechanism of prodromal PD:insights from the parasympathetic nervous system and the olfactory system

Neurodegeneration of Parkinson’s disease(PD)starts in an insidious manner,30–50%of dopaminergic neurons have been lost in the substantia nigra before clinical diagnosis.Prodromal stage of the disease,during which the disease pathology has started but is insufficient to result in clinical manifestations,offers a valuable window for disease-modifying therapies.The most focused underlying mechanisms linking the pathological pattern and clinical characteristics of prodromal PD are the prion hypothesis of alpha-synuclein and the selective vulnerability of neurons.In this review,we consider the two potential portals,the vagus nerve and the olfactory bulb,through which abnormal alpha-synuclein can access the brain.We review the clinical,pathological and neuroimaging evidence of the parasympathetic nervous system and the olfactory system in the neurodegenerative process and using the two systems as models to discuss the internal homogeneity and heterogeneity of the prodromal stage of PD,including both the clustering and subtyping of symptoms and signs.Finally,we offer some suggestions on future directions for imaging studies in prodromal Parkinson’s disease.

Cardiac autonomic neuropathy in patients with diabetes mellitus

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.

Investigating neurogenic bowel in experimental spinal cord injury: where to begin?

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.

Ambiguous nucleus regulates the proliferation and percentage of T lymphocytes in peripheral blood

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.

Effects of chronic epilepsy on heart rate variability A case-control study

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.

Cardiac autonomic nerve distribution and arrhythmia

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, and symptoms of arrhythmia.

Recovery Slope of Heart Rate Variability as an Indicator of Internal Training Load

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.

Factors that affect heart rate variability following acute resistance exercise:A systematic review and meta-analysis

Background:There is controversial evidence regarding the effect of acute resistance exercise(ARE) on heart rate variability(HRV) parameters,which indicates the activities of the cardiac autonomic nervous system.The aim of this study was to perform a systematic review and meta-analysis of the literature on the effect of ARE on HRV parameters and identify its possible moderating factors.Methods:The PubMed-Medline,Web of Science,SPORTDiscus,and Cochrane Library databases were searched.The Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) declaration was followed,and the methodological quality of the studies was evaluated.The level of significance was set at p≤0.05.Twenty-six studies met the inclusion criteria.Main effect analyses between pre-and post-test interventions demonstrated an increase in normalized units low frequency(p <0.001;standardized mean difference(SMD)=0.78;95% confidence interval(95%CI):0.46-1.11) and low frequency/high frequency ratio(p <0.001;SMD=0.82;95%CI:0.64-0.99) and a decrease in standard deviation of the normal-to-normal(NN)interval(p <0.001;SMD=-0.58;95%CI:-0.85 to-0.30),root mean square of the successive differences(p <0.001;SMD=-1.01;95%CI:-1.29 to-0.74),and normalized units high frequency(p <0.001;SMD:-1.08;95%CI:-1.43 to-0.73) following ARE in healthy individuals range:15 ± 1 to 48 ± 2 years;mean ± SD).Results:There were differences between the subgroups in the number of sets used in an exercise(p=0.05) for root mean square of the successive differences,as well as for exercise intensity(p=0.01) and rest between sets(p=0.05) for normalized units high frequency.Interestingly,there were differences between the subgroups in training volume for root mean square of the successive differences(p=0.01),normalized units high frequency(p=0.003) and normalized units low frequency(p=0.02).Conclusion:Overall,there was a withdrawal of cardiac parasympathetic and activation of cardiac sympathetic modulations following ARE,and these changes were greater with higher training volume ~30 min after ARE in healthy individuals.Furthermore,the number of sets,intensity,and rest between sets affected HRV parameters.However,gender,body mass index,and training status did not influence the changes in HRV parameters as a response to ARE.

Morphologic Relationship between the Pontine Micturition Center and the Sympathetic Center in the Spinal Cord of the Rat

To study whether the sympathetic nerves coordinate with the parasympathetic nerves during micturition in the rat. We used antegrade neural tracing with biotinylated dextran amine (BDA) injected into the pontine micturition center (PMC) to label the terminals in the L6-S1 cord. Preganglionic parasympathetic neurons (PPNs) in the L6-S1 segment were labelled by retrograde transport of Fluorogold (FG) from the major pelvic ganglion (MPG).We detected retrograde neurons in L6-S1 using retrograde transport of horseradish peroxidase (HRP) from the intermediolateral cell column (IML) of the L1-L2 segment where sympathetic preganglionic neurons (SPNs) are located. Immunohistochemical methods showed that PPNs were identified to be choline acetyltransferase-immunoreactive (ChAT-IR). HRP-labelled neurons were not ChAT-IR and located dorsal to PPNs. BDA-labelled terminals were located mainly in the bilateral IML of L6-S1, some of which had synaptic contact with the HRP-labelled neurons. In addition, there were some wheat germ agglutinin-horseradish peroxidase (WGA-HRP) labelled terminals in the ipsilateral IML of the L1-L2 segment after WGA-HRP was microinjected into SPN. We conclude that PMC may control the preganglionic neurons of sympathetic nerves through the interneurons located dorsal to PPNs.

Young footballers, assessed by deep breathing test, have a higher vagal response

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.

A Novel Apprehension of the Primary Lung Meridian, Sinew Channel, Divergent Channel, Luo-Connecting Channel Acting as a Single Unit System to Serve Respiration Function Based on Modern Neurophysiology and Kinesiology

The TCM philosophy of a meridian and associated channels pertains to the specific function of one or more organs. We define the Lung Primary Meridian (LUM) together with the 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 are supported by experimental evidence based on modern neurophysiology and kinesiology. We discover that all the four channels stated above work as a unit system to allow respiration to be possible under various postures/conditions. The complexity of structures and processes is eased off by providing 29 figures and 13 tables for the relevant muscles and nerves. In addition to respiration, the Lung system in TCM context includes interaction of this system with the sweat gland and neuroendocrine system;such aspects will be left to another study.

Analyzing ECS for Perinatal Pregnant and Fetus

Objective:Analyzing digital characteristics (chaotic and spectral features) of fetal and pregnant womans Heart Period Signal (HPS) can assess the autonomic function. Methods:Extracting and analyzing HPS of fetal and pregnant woman in perinatal period were realized by the method called visual programming. The hardware consists of electrode, amplifier, analog to digital converter (ADC) with 12bit, printer and microcomputer. Low level I/O operation for the ADC was finished by means of assembler in-line in Delphi (language) under Windows operating system. The software package was designed by Object Oriented Programming technique. So, all the system is a multi-media one and established under Windows. The subjects are in supine,electrocardiosignal (ECS) from the leads placed at symphysis pubica to inferior border of abdominal wall was acquired. ECS was preprocessed by wavelet filter. The sophisticated technique developed by our laboratory was used to accomplish analyzing digital characteristic of HPS. Results: The system could be used to assess fetal and pregnant womans autonomic function, furthermore, sympathetic and parasympathetic nervous function can be evaluated respectively and quantificationally.Discussions:(1) The system could be used to prognosis fetal distress. (2) Digital characteristic of fetal and other age segments HPS that vary with age could approve the viewpoint that there is a characteristic curve to suggest the physiological process of development, mature and senility, based on it, we could find the way of anti-senility. (3) Some digital parameters of fetal HPS locate between those of newborn and adult, which may imply that fetal autonomic nervous regulation is influenced by mothers nerve and endocrine.

穴位刺激调控自主神经系统的区域异质性

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.

Baroreflex Control of Heart Rate in Mice Overexpressing Human SOD1: Functional Changes in Central and Vagal Efferent Components

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.