Effects of Laparoscopic Pelvic Autonomic Nerve-Preserving Radical Resection of Rectal Cancer on Urinary and Sexual Function

Objective:To investigate and analyze the effect of laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer on urinary and sexual function.Methods:Cases of laparoscopic radical resection of rectal cancer in our hospital from April 2018 to April 2023 were selected,and 60 patients who met the requirements were included as research subjects.The patients were divided into an experimental group and a reference group by a double-blind mechanism,with 30 cases in each group.The experimental group underwent laparoscopic pelvic autonomic radical resection,while the reference group underwent ordinary radical resection.The voiding function,urodynamics,sexual function,and blood indexes of the patients of both groups were compared.Results:The total incidence of voiding dysfunction in the experimental group was significantly lower than in the reference group(P<0.05).Urodynamics such as abdominal leak point pressure(ALPP),maximum urethral pressure(MUP),maximum urethral closure pressure(MUCP),and functional urethral length(FUL)in the experimental group were significantly better than those in the reference group(P<0.05).The incidences of erectile dysfunction and ejaculatory dysfunction in the experimental group were significantly lower than those in the reference group(P<0.05).Before the surgery,there were no significant differences in the blood indexes such as C-reactive protein(CRP),cortisol(Cor),and pre-albumin(PA)between the two groups(P>0.05);after the operation,the blood indexes of the patients in the experimental group were significantly better than those in the reference group(P<0.05).Conclusion:Laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer has lesser effects on urinary and sexual functions.

Cardiac autonomic nerve fiber regeneration in chronic heart failure Do Akt gene-transduced mesenchymal stem cells promote repair?

BACKGROUND： Transplantation of Akt-over-expressing mesenchymal stem ceils （Akt-MSCs） has been shown to repair infarcted myocardium and improve cardiac function. However, little is known about the therapeutic effects of Akt-MSCs on cardiac autonomic neuropathy in chronic heart failure （CHF）. OBJECTIVE： The present study used adriamycin-induced CHF rat models to observe the effect of Akt-MSCs on cardiac autonomic nervous regeneration and the factors mediating this effect. DESIGN, TIME AND SETTING： A randomized, controlled animal experiment was performed at the Central Laboratory of Basic Medical College, China Medical University, between September 2008 and April 2009. MATERIALS： Rabbit anti-choline acetyltransferase （CHAT）, growth associated protein-43 （GAP-43） synaptophysin （SYN） polyclonal antibodies and the secondary antibody （goat anti-rabbit IgG） were purchased from Boster, China. Cat-A-Kit assay system was provided by Amersham, USA. METHODS： （1） Adult rat MSCs were isolated and cultured for the preparation of Akt-MSCs. （2） Forty male Wistar rats were intramyocardially administered adriamycin at 2 mg/kg over 3 days for a total of five times and once a week for additional five times thereafter to establish CHF models. At 2 weeks after final adriamycin treatment, 34 successful CHF rat models were randomized to three groups： Akt-MSCs （n = 11）, simple MSCs （s-MSCs, n =11）, and control （n = 12）. Each group was intravenously administered Akt-MSCs （2x106 cells in 100 IJL PBS）, s-MSCs （2×10^6 cells in 100 μL PBS） or equal volume of phosphate buffered saline, once a day for a total of three times. MAIN OUTCOME MEASURES： At 4 weeks after final adriamycin treatment, myocardial norepinephrine （NE） content was detected using a Cat-A-Kit assay system. Myocardial CHAT, SYN and GAP-43 were performed by immunohistochemistry and Western blot analysis. Prior to, 2 and 4 weeks after adriamycin treatment, echocardiographic examination was performed and left ventricular ejection fraction （LVEF） was determined. RESULTS： Myocardial NE content, as well as SYN-positive and GAP-43-positive nerve fiber density and expression, and LVEF, was the greatest in the Akt-MSCs group, followed by the s-MSCs group, and lastly the control group （P 〈 0.05 or P 〈 0.01）. ChAT expression was similar between Akt-MSCs and s-MSCs groups, but it was higher compared with the control group （P 〈 0.05）. NE contents were negatively correlated to LVEF （r = -0.64, P = 0.015）. CONCLUSION： Transplantation of MSCs, in particular Akt-MSCs, promotes cardiac nervous regeneration in failing heart, which might be mediated by GAP-43.

Anatomical Basis and Clinical Research of Pelvic Autonomic Nerve Preservation with Laparoscopic Radical Resection for Rectal Cancer

The clinical effect of laparoscopic rectal cancer curative excision with pelvic autonomic nerve preservation（PANP） was investigated. This study evaluated the frequency of urinary and sexual dysfunction of 149 male patients with middle and low rectal cancer who underwent laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation（PANP） from March 2011 to March 2013. Eighty-four patients were subjected to laparoscopic surgery, and 65 to open surgery respectively. The patients were followed up for 12 months, interviewed, and administered a standardized questionnaire about postoperative functional outcomes and quality of life. In the laparoscopic group, 13 patients（18.37%） presented transitory postoperative urinary dysfunction, and were medically treated. So did 12 patients（21.82%） in open group. Sexual desire was maintained by 52.86%, un-ability to engage in intercourse by 47.15%, and un-ability to achieve orgasm and ejaculation by 34.29% of the patients in the laparoscopic group. Sexual desire was maintained by 56.36%, un-ability to engage in intercourse by 43.63%, and un-ability to achieve orgasm and ejaculation by 33.73% of the patients in the open group. No significant differences in urinary and sexual dysfunction between the laparoscopic and open rectal resection groups were observed（P〉0.05）. It was concluded that laparoscopic rectal cancer radical excision with PANP did not aggravate or improve sexual and urinary dysfunction.

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.

The effect of complete and incomplete Pelvic Autonomic nerves Preservation on Urination Function in Patient With Resection of Rectal Carcinoma

Objective： To evaluate the influence of complete and incomplete pelvic autonomic nerve preservation （PANP） on urination function in patients with resection of rectal carcinoma. Methods： The changes of pre-and post-operative residual urine volume （RUV） in patient undergoing complete PANP （n = 15） and incomplete PANP （n = 17） were observed. Results： In fifteen cases with complete PANP, preoperative RUV was 4.09 ml, 14 days and 3 months after operation RUV were 8.00 ml and 7.02 ml （P 〉 0.05）. In seventeen cases with incomplete PANP, preoperative RUV was 3.90 ml, 14 days and 3 months after operation RUV were 36.55 ml and 22.64 ml （P 〈 0.001 ）. Conclusion： Complete and incomplete pelvic autonomic preservation may affect urination function in patients with resection of rectal carcinoma and RUV is an effective indicator if the pelvic autonomic nerves are preserved completely.

A comprehensive review of heart rate variability as an indicator in the regulation of the autonomic nervous system by acupuncture:a bibliometric analysis

This study sought to conduct a bibliometric analysis of acupuncture studies focusing on heart rate variability(HRV)and to investigate the correlation between various acupoints and their effects on HRV by utilizing association rule mining and network analysis.A total of 536 publications on the topic of acupuncture studies based on HRV.The disease keyword analysis revealed that HRV-related acupuncture studies were mainly related to pain,inflammation,emotional disorders,gastrointestinal function,and hypertension.A separate analysis was conducted on acupuncture prescriptions,and Neiguan(PC6)and Zusanli(ST36)were the most frequently used acupoints.The core acupoints for HRV regulation were identified as PC6,ST36,Shenmen(HT7),Hegu(LI4),Sanyinjiao(SP6),Jianshi(PC5),Taichong(LR3),Quchi(LI11),Guanyuan(CV4),Baihui(GV20),and Taixi(KI3).Additionally,the research encompassed 46 reports on acupuncture animal experiments conducted on HRV,with ST36 being the most frequently utilized acupoint.The research presented in this study offers valuable insights into the global research trend and hotspots in acupuncture-based HRV studies,as well as identifying frequently used combinations of acupoints.The findings may be helpful for further research in this field and provide valuable information about the potential use of acupuncture for improving HRV in both humans and animals.

Electroacupuncture modulates the activity of the hippocampus-nucleus tractus solitarius-vagus nerve pathway to reduce myocardial ischemic injury

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： P 〈 0.05,r =-0.85691; RPP： P 〈 0.01,r =-0.91902）.Some neurons（Neurons C,D and E） were positively correlated with vagus nerve discharge,HR,MAP and RPP in the AMI ＋ EA ＋ Lesion group（vagus nerve discharge： P 〈 0.01,r = 0.8905,P 〈 0.01,r = 0.9725,P 〈 0.01,r = 0.9054; HR： P 〈 0.01,r = 0.9347,P 〈 0.01,r = 0.9089,P 〈 0.05,r = 0.8247; MAP： P 〈 0.05,r = 0.8474,P 〈 0.01,r = 0.9691,P 〈 0.01,r = 0.9027; RPP： P 〈 0.05,r = 0.8637,P 〈 0.01,r = 0.9407,P 〈 0.01,r = 0.9027）.These findings show that the hippocampus-nucleus tractus solitarius-vagus nerve pathway is involved in the cardioprotective effect of EA at the heart meridian.Some interneurons in the nucleus tractus solitarius may play a particularly important role in the cardiomodulatory process.

Positive effects of music therapist's selected auditory stimulation on the autonomic nervous system of patients with disorder of consciousness: a randomized controlled trial

The current randomized controlled trial was performed at the China Rehabilitation Science Institute, China to test the hypothesis that musical auditory stimulation has positive effects on the autonomic nervous system of patients with disorder of consciousness.Although past studies have recommended that patients with disorder of consciousness listen to patient-preferred music, this practice is not universally accepted by researchers.Twenty patients with severe disorder of consciousness listened to either therapist-selected(n = 10, 6 males and 4 females;43.33 ± 18.76 years old) or patient-preferred(n = 10, 5 males and 5 females, 48.83 ± 18.79 years old) musical therapy, 30 minutes/day, 5 times/week for 6 weeks.The results showed no obvious differences in heart rate variability-related parameters including heart rate, standard deviation of normal-to-normal R-R intervals, and the root-mean-square of successive heartbeat interval differences of successive heartbeat intervals between the two groups of patients.However, percentage of differences exceeding 50 ms between adjacent normal number of intervals, low-frequency power/high-frequency power, high-frequency power norm, low-frequency power norm, and total power were higher in patients receiving therapist-selected music than in patients receiving their own preferred music.In contrast, this relationship was reversed for the high-frequency power and very-low-frequency band.These results suggest that compared with preferred musical stimulation, therapist-selected musical stimulation resulted in higher interactive activity of the autonomic nervous system.Therefore, therapist-selected musical stimulation should be used to arouse the autonomic nervous system of patients with disorder of consciousness.This study was approved by the Institutional Ethics Committee of China Rehabilitation Research Center, China(approval No.2018-022-1) on March 12, 2018 and registered with the Chinese Clinical Trial Registry(registration number Chi CTR1800017809) on August 15, 2018.

Vitamin C ameliorated cardiac autonomic neuropathy in type 2 diabetic rats

BACKGROUND Vitamin C(VC)is a common antioxidant with cell protection potentials.However,its possible protective effect on cardiac autonomic nerves from diabetic induced insults is yet to be explored.AIM To investigate the effects of VC on diabetic cardiac autonomic neuropathy.METHODS Thirty male Wistar rats were equally grouped into control,diabetic and diabetic+VC.Type 2 diabetes was induced with fructose diet and alloxan.VC(1 g/kg)was administered for 4 wk via oral canula.Blood pressure and heart rate were measured non-invasively using tail flick blood pressure monitor.Spectral analysis of heart rate variability(HRV)was used to assess cardiac autonomic neuropathy.Blood was collected from the ocular sinus for biochemical analysis.Urethane(1 g/kg-ip)was used for anaesthesia prior to HRV and cervical dislocation to harvest hearts.Intracardiac autonomic nerve was assessed using tyrosine hydroxylase immunohistochemistry on fixed heart sections.RESULTS Results were analysed using ANOVA atα0.05.Unlike VC and control groups,diabetic rats showed significantly(P<0.0001)reduced HRV,increased heart-rate and blood pressure,initial increase in cardiac tyrosine hydroxylase activities at week-2 and sparse activity at week-4 of diabetes.Furthermore,apolipoprotein B,Oxidative stress and inflammatory markers were significantly(P<0.01)reduced in VC treated rats.CONCLUSION VC possesses cardio-autonomic nerve protective potential and ameliorates the symptoms of cardiac autonomic neuropathy in type 2 diabetes.The possible mechanisms via which VC exert these effects may be via downregulation of oxidative stress,inflammation and apolipoprotein B.

Effect of Shensong Yangxin on the Progression of Paroxysmal Atrial Fibrillation is Correlated with Regulation of Autonomic Nerve Activity

Background： Shensong Yangxin （SSYX）, a traditional Chinese herbal medicine, has long been used clinically to treat arrhythmias in China. However, the mechanism of SSYX on atrial fibrillation （AF） is unknown. In this study, we tested the hypothesis that the effect of SSYX on the progression of paroxysmal AF is correlated with the regulation of autonomic nerve activity. Methods： Eighteen mongrel dogs were randomly divided into control group （n = 6）, pacing group （n = 6）, and pacing ＋ SSYX group （n = 6）. The control group was implanted with pacemakers without pacing; the pacing group was implanted with pacemakers with long-term intermittent atrial pacing; the pacing ＋ SSYX group underwent long-term intermittent atrial pacing and SSYX oral administration. Results： Compared to the pacing group, the parameters of heart rate variability were lower after 8 weeks in the pacing ＋ SSYX group （low-frequency [LF] component： 20.85± 3.14 vs. 15.3±1.89 ms2, P =0.004; LF component/high-frequency component： 1.34 ± 0.33 vs. 0.77± 0.15, P 〈 0.001 ）. The atrial effective refractory period （AERP） was shorter and the dispersion of the AERP was higher after 8 weeks in the pacing group, while the changes were suppressed by SSYX intake. The dogs in the pacing group had more episodes and longer durations of AF than that in the pacing ＋ SSYX group. SSYX markedly inhibited the increase in sympathetic nerves and upregulation of tumor necrosis factor-alpha and interleukin-6 expression in the pacing ＋ SSYX group. Furthermore, SSYX suppressed the decrease of acetylcholine and α7 nicotinic acetylcholine receptor protein induced by long-term intermittent atrial pacing. Conclusions： SSYX substantially prevents atrial electrical remodeling and the progression of AF. These effects of SSYX may have association with regulating the imbalance of autonomic nerve activity and the cholinergic anti-inflammatory pathway.

Olfactory ensheathing cell transplantation improves sympathetic skin responses in chronic spinal cord injury

Forty-three patients with chronic spinal cord injury for over 6 months were transplanted with bryonic olfactory ensheathing cells, 2-4 × 106, into multiple sites in the injured area under the sur-gical microscope. The sympathetic skin response in patients was measured with an electromyo-graphy/evoked potential instrument 1 day before transplantation and 3-8 weeks after trans-tion. Spinal nerve function of patients was assessed using the American Spinal Injury Association impairment scale. The sympathetic skin response was elicited in 32 cases before olfactory en-sheathing celltransplantation, while it was observed in 34 cases after transplantation. tantly, sympathetic skin response latency decreased significantly and amplitude increased cantly after transplantation. Transplantation of olfactory ensheathing cells also improved American Spinal Injury Association scores for movement, pain and light touch. Our findings indicate that factory ensheathing celltransplantation improves motor, sensory and autonomic nerve functions in patients with chronic spinal cord injury.

Association of auricular pressing and heart rate variability in pre-exam anxiety students

A total of 30 students scoring between 12 and 20 on the Test Anxiety Scale who had been exhibiting an anxious state 〉 24 hours, and 30 normal control students were recruited. Indices of heart rate variability were recorded using an Actiheart electrocardiogram recorder at 10 minutes before auricular pressing, in the first half of stimulation and in the second half of stimulation. The results revealed that the standard deviation of all normal to normal intervals and the root mean square of standard deviation of normal to normal intervals were significantly increased after stimulation. The heart rate variability triangular index, very-low-frequency power, low-frequency power, and the ratio of low-frequency to high-frequency power were increased to different degrees after stimulation. Compared with normal controls, the root mean square of standard deviation of normal to normal intervals was significantly increased in anxious students following auricular pressing. These results indicated that auricular pressing can elevate heart rate variability, especially the root mean square of standard deviation of normal to normal intervals in students with pre-exam anxiety.

Cortical infarction of the right parietal lobe and neurogenic heart disease A report of three cases

Three male patients were diagnosed with new cortical infarctions of the right parietal lobe on the basis of head magnetic resonance imaging; high-intensity signals indicating lesions in the right parietal lobe were noted on diffusion-weighted images at admission. Two of them presented with left hand weakness, and one exhibited left upper limb weakness. Treatment for improving blood supply to the brain was administered. One patient died suddenly because of ventricular fibrillation 3 days after admission. The other two patients had increased troponin levels and abnormal electrocardiograms, and were diagnosed with acute myocardial infarction half a month after admission. When lesions exist in field 7 of the parietal cortex （resulting in paralysis of the contralateral hand）, the sympathetic center of the posterior lateral nucleus of the hypothalamus demonstrates compensatory excitement, which easily causes tachyarrhythmia and sudden death. Our experimental findings indicate that close electrocardiograph monitoring and cerebral infarction treatment should be standard procedures to predict and help prevent heart disease in patients with cerebral infarction in the right parietal lobe and left upper limb weakness as the main complaint.

Sympathetic skin response in patients with myasthenia gravis: A comparative analysis

BACKGROUND： The examination of sympathetic skin response is an important index for assessing the autonomic nerve function, and patients with myasthenia gravis are always accompanied by dysautonomia. Therefore, it will be important to know whether sympathetic skin response can be used as the index for the clinical evaluation of myasthenia gravis. OBJECTIVE： To investigate the diagnostic value of sympathetic skin response in the damage of autonomic nerve function of patients with myasthenia gravis. DESIGN： A case-controlled comparative observation. SETTING： Department of Neurology and Room of Nerve Electromyogram, the Affiliated Hospital of North Sichuan Medical College. PARTICIPANTS： Thirty outpatients or inpatients with myasthenia gravis were selected from the Department of Neurology, the Affiliated Hospital of North Sichuan Medical College from May 2006 to May 2007, including 9 males and 21 females, aged 8 - 72 years with a mean age of （28 ± 5） years old. They were all accorded with the diagnostic standards of myasthenia gravis, accompanied by different severity of autonomic nerve symptoms, including poor skin nutrition, sweating of hands and feet, pyknocardia, persistent hypotension, abdominal pain, constipation, etc. They all had not taken any drug affecting the autonomic nerve function before the examination. Informed consents were obtained from all the patients. Meanwhile, 30 healthy physical examinees were enrolled as the normal control group, including 10 males and 20 females, aged 10 - 75 years with a mean age of （31 ±5） years old. Approval was obtained from the hospital ethic committee. METHODS： After admission, the patients were examined with sympathetic skin response using DANTEC keypoint 2.0 electromyography evoked potential apparatus （Danmark）. The changes of the latency and wave amplitude of sympathetic skin response were observed. The subjects in the normal control group were examined with the same methods at physical examination. Abnormality was judged by the disappearance of wave form, latency longer than that in the normal control group by Mean＋2.5SD, or wave amplitude lower than the average value in the normal control group by 50%. MAIN OUTCOME MEASURES： The results of the latency and wave amplitude of sympathetic skin response were compared between the patients with myasthenia gravis and normal controls. RESULTS： All the 30 patients with myasthenia gravis and 30 healthy physical examinees were involved in the final analysis of results. There were no significant differences between the left and right upper and lower limbs in both the myasthenia gravis group and normal control group （P 〉 0.05）. In the myasthenia gravis group, the abnormal rate of sympathetic skin response was 37% （11/30）, the latency was prolonged and the wave amplitude was decreased as compared with those in the normal control group, and there were significant differences （P 〈 0.01）. CONCLUSION： Sympathetic skin response can be used as an electrophysiological index for judging the damages of autonomic nerve function in patients with myasthenia gravis.

The Value of HRV Analysis and Multiple Correlations for Study of Child Virus Myocarditis

Objectives To evaluate thevalue of HRV analysis and multiple correlations forstudy of child virus myocarditis. Methods HRVanalysis was performed on 41 myocarditis and 40 nor-mal children. The HRV changes in waking and sleep-ing time were observed as well. Multiple correlationand regression were carried out with the depth of ST-T depression as dependent variable and all HRV timeand frequency domain indexes including those inwaking and sleeping time as independent variables.Results HRV abnormality was found in virus my-ocarditis children .Their HRV indexes were decreasedno matter waking time or sleeping time and the differ-ences hetween waking and sleeping time were muchless than those in the controls. In multiple correlationand regression analysis, the ST depression correlatedwith VLF, LFN, LF. Conclusions HRV abnormali-ties existed in children with virus myocarditis whichindicates the sympathetic tense were increased per-manently. The ST depression correlates with VLF,LFN, LF. HRV analysis is helpful with the study andits diagnosis of autonomic function in children withvirus myocarditis.

DCDC2 gene polymorphisms are associated with developmental dyslexia in Chinese Uyghur children

Developmental dyslexia is a complex reading and writing disorder with strong genetic components. In previous genetic studies about dyslexia, a number of candidate genes have been identified. These include DCDC2, which has repeatedly been associated with developmental dyslexia in various European and American populations. However, data regarding this relationship are varied according to population. The Uyghur people of China represent a Eurasian population with an interesting genetic profile. Thus, this group may provide useful information about the association between DCDC2 gene polymorphisms and dyslexia. In the current study, we examined genetic data from 392 Uyghur children aged 8–12 years old from the Xinjiang Uyghur Autonomous Region of China. Participants included 196 children with dyslexia and 196 grade-, age-, and gender-matched controls. DNA was isolated from oral mucosal cell samples and fourteen single nucleotide polymorphisms（rs6456593, rs1419228, rs34647318, rs9467075, rs793862, rs9295619, rs807701, rs807724, rs2274305, rs7765678, rs4599626, rs6922023, rs3765502, and rs1087266） in DCDC2 were screened via the SNPscan method. We compared SNP frequencies in five models（Codominant, Dominant, Recessive, Heterozygote advantage, and Allele） between the two groups by means of the chi-squared test. A single-locus analysis indicated that, with regard to the allele frequency of these polymorphisms, three SNPs（rs807724, rs2274305, and rs4599626） were associated with dyslexia. rs9467075 and rs2274305 displayed significant associations with developmental dyslexia under the dominant model. rs6456593 and rs6922023 were significantly associated with developmental dyslexia under the dominant model and in the heterozygous genotype. Additionally, we discovered that the T-G-C-T of the four-marker haplotype（rs9295619-rs807701-rs807724-rs2274305） and the T-A of the two-marker haplotype（rs3765502-1087266） were significantly different between cases and controls. Thus, we conclude that DCDC2 gene polymorphisms are associated with developmental dyslexia in Chinese Uyghur children.

Nerve plane-sparing radical hysterectomy： a simplified technique of nerve-sparing radical hysterectomy for invasive cervical cancer

Background In order to simplify the complicated procedure of nerve-sparing radical hysterectomy, a novel technique characterized by integral preservation of the autonomic nerve plane has been employed for invasive cervical cancer. The objective of this study was to introduce the nerve plane-sparing radical hysterectomy technique and compare its efficacy and safety with that of nerve-sparing radical hysterectomy. Methods From September 2006 to August 2010, 73 consecutive patients with International Federation of Gynecology and Obstetrics stage IB to IIA cervical cancer underwent radical hysterectomy with two different nerve-sparing approaches. Nerve-sparing radical hysterectomy was performed for the first 16 patients （nerve-sparing radical hysterectomy group）. The detailed autenomic nerve structures were identified and separated by meticulous dissection during this procedure. After January 2008, the nerve plane-sparing radical hysterectomy procedure was developed and performed for the next 57 patients （nerve plane-sparing radical hysterectomy group）. During this modified procedure, the nerve plane （meso-ureter and its extens;ion） containing most of the autonomic nerve structures was integrally preserved. The patients＇ clinicopathologic characteristics, surgical parameters, and outcomes of postoperative bladder function were compared between the two groups. Results There were no significant differences between the nerve plane-sparing radical hysterectomy and nerve-sparing radical hysterectomy groups regarding age, International Federation of Gynecology and Obstetrics stage, pathological type, preoperative treatment, or need for intraoperative blood transfusion. The nerve plane-sparing radical hysterectomy group had a higher body mass index than that of the nerve-sparing radical hysterectomy group （P=0.028）. The mean surgical duration in the nerve plane-sparing radical hysterectomy and nerve-sparing radical hysterectomy groups were （262_＋46） minutes and （341＋36） minutes （P 〈0.01）. On the 8th postoperative day, 41 （71.9%） patients in the nerve plane-sparing radical hysterectomy group and nine （56.3%） patients in the nerve-sparing radical hysterectomy group had a postvoid residual urine volume of 〈100 ml （P=0.233）. The median duration of catheterization was eight days （range 8-23 days） for the nerve plane-sparing radical hysterectomy group and eight days （range 8-22 days） for the nerve-sparing radical hysterectomy group （P=-0.509）. Neither surgery-related injury nor pathologically positive margins were reported in either group. Conclusion Nerve plane-sparing radical hysterectomy is a reproducible and simplified modification of nerve-sparing radical hysterectomy, and may be preferable to nerve-sparing radical hysterectomy for treatment of early-stage invasive cervical cancer.

Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems,levels and targets and is not limited to“driving the vagus-adrenal axis”

In October 2021,an international collaborative study on the use of electroacupuncture(EA)to treat inflammation was published in the journal Nature by Dr.Qiufu Ma’s team.Based on the results of EA on inflammation in the mouse model of lipopolysaccharide inflammatory storm,the study showed that the distal effect of acupuncture can be achieved by“driving the vagus-adrenal axis(through the adrenal medulla,by releasing catecholamines).”PROKR2Cre-marked sensory neurons,which innervate the deep hindlimb fascia but not the abdominal fascia,are crucial for driving this axis.The study suggests the existence of specificity distribution of acupoints,that different EA stimulation intensities or different needle penetration depths have different therapeutic effects,that photosensitive stimulation may be a substitute for needle acupuncture,and that massage,stretching and body movements may also activate PROKR2Cremarkable dorsal root ganglion sensory neurons and elicit anti-inflammatory effects.However,results of some other studies are contrary to the conclusions of Ma’s team.For examples:low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation,which is more relevant to the real daily acupuncture practice,and this effect was partly related to the adrenal cortex and associated with the stimulation of corticosterone and adrenocorticotropic hormone;manual acupuncture(similar to the low-intensity EA)at KI3,Zhichuan point(an extra point),etc.was effective in a severe COVID-19 patient with sepsis;stimulating ST25 with low-intensity EA or manual acupuncture was effective against gastrointestinal inflammations;the above mentioned points are not in an area enriched with PROKR2Cre-marked sensory nerve endings.Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems,multi-levels and multi-targets,which does not limit to“driving the vagus-adrenal axis.”

Identification of the surgical indication line for the Denonvilliers’fascia and its anatomy in patients with rectal cancer

Background:The high rate of urogenital dysfunction after traditional total mesorectal excision(TME)has caused doubts among scholars on the standard fashion of dissection.We have proposed the necessity to preserve the Denonvilliers’fascia in patients with rectal cancer.However,how to accurately locate the Denonvilliers’fascia is unclear.This study aimed to explore anatomical features of the Denonvilliers’fascia by comparing autopsy findings and observations of surgical videos so as to propose a dissection method for the preservation of pelvic autonomic nerves during rectal cancer surgery.Methods:Five adult male cadaver specimens were dissected,and surgical videos of 135 patients who underwent TME for mid-low rectal cancer between January 2009 and February 2019 were reviewed to identify and compare the structure of the Denonvilliers’fascia.Results:The monolayer structure of the Denonvilliers’fascia was observed in 5 male cadaver specimens,and it was located between the rectum,the bottom of the bladder,the seminal vesicles,the vas deferens,and the prostate.The Denonvilliers’fascia was originated from the rectovesical pouch(or rectum-uterus pouch),down to fuse caudally with the rectourethral muscle at the apex of the prostate,and fused to the lateral ligaments on both sides.The fascia was thinner on the midline with a thickness of 1.06±0.10 mm.The crown shape of the Denonvilliers’fascia was slightly triangular,with a height of approximately 5.42±0.16 cm at midline.Nerves were more densely distributed in front of the Denonvilliers’fascia than behind,especially on both sides of it.Under laparoscopic view,the Denonvilliers’fascia was originated at the lowest point of the rectovesical pouch(or rectum-uterus pouch),with a thickened white line which was a good mark for identifying the Denonvilliers’fascia.Conclusion:Identification of the surgical indication line for the Denonvilliers’fascia could help us identify the Denonvilliers’fascia,and it would improve our ability to protect the pelvic autonomic function of patients undergoing TME for rectal cancer.