星状神经节阻滞联合针刺治疗特发性面神经麻痹临床观察

目的:观察星状神经节阻滞联合针刺治疗对特发性面神经麻痹的临床疗效。方法:将62例特发性面神经麻痹患者分为两组,对照组30例采用药物治疗+针灸理疗等常规治疗,治疗组32例采用常规治疗+星状神经节阻滞(SGB)疗法,疗程30天。采用House-Brackmann面神经功能分级评定及临床疗效指标判定。结果:治疗前两组H-B面神经功能分级具有可比性。治疗后,两组H-B评分比较差异有统计学意义(P<0.05);临床疗效指标比较显示两组总有效率分别为:治疗组96.9%,对照组80.00%,治疗组优于对照组,两组差异有统计学意义(P<0.05)。结论:星状神经节阻滞联合针刺治疗对急性特发性面神经麻痹有效。     

星状神经节阻滞治疗烧伤后应激性溃疡的临床研究

目的:探讨星状神经节阻滞(stellate ganglion block,SGB)对烧伤所致应激性溃疡的临床疗效及其可能作用机制。方法:选取我院烧伤科收治的烧伤后应激性溃疡出血患者40例,将其随机分为星状神经节阻滞组(SGB组,n=20)和常规治疗组(Control组,n=20)。SGB组进行烧伤规范治疗的同时采用星状神经节阻滞治疗,隔日一次,持续治疗一周;Control组只进行常规烧伤治疗。检测和比较两组患者治疗前后血浆ET-1、NO的含量及治疗后临床症状的改善情况。结果:与Control组相比,SGB组患者治疗后血浆ET-1及NO含量均显著降低(P0.05),患者的临床总有效率明显高于Control组(P0.05)。结论:星状神经节阻滞可有效提高烧伤后应激性溃疡患者的临床疗效,可能与其调节血浆ET-1、NO的含量有关。     

星状神经节阻滞术前处理减轻脑缺血再灌注大鼠的脑梗死

目的 探讨星状神经节阻滞术(stellate ganglion block,SGB)前处理对脑缺血/再灌注(ischemia reperfusion,I/R)模型大鼠的治疗作用以及相关机制.方法 将SD大鼠随机分为3组:假手术组(Sham)、脑I/R组和I/R+SGB组.采用大脑中动脉阻塞术模拟大鼠脑I/R损伤,并在I...     

颈椎椎旁神经阻滞联合偏振光星状神经节照射治疗颈源性头痛的疗效观察

目的：观察颈椎椎旁神经阻滞联合直线偏振光红外线星状神经节照射治疗颈源性头痛的疗效。方法：120例颈源性头痛患者按照随机数字表法分为三组：颈椎椎旁神经阻滞联合偏振光星状神经节照射40例（A组）、颈椎椎旁神经阻滞40例（B组）、氨酚曲马多联合乙哌立松药物治疗组40例（C组）,三周为一疗程。治疗前后测定患者的疼痛视觉模拟评分（VAS）、颈椎活动度评分（ROM）、评定临床疗效。结果：三组治疗后疼痛视觉模拟评分（VAS）、颈椎活动度评分（ROM）均优于治疗前（P〈0．05）．A、B组治疗后VAS、ROM评分以及治愈率、有效率优于C组（P〈0．5）;A组VAS、ROM评分以及治愈率、有效率优于B组（P〈0．05）。结论：颈椎椎旁神经阻滞联合偏振光星状神经节照射和颈椎椎旁神经阻滞治疗治疗颈源性头痛疗效明显优于氨酚曲马多联合乙哌立松药物治疗组;颈椎椎旁神经阻滞联合偏振光星状神经节照射治疗颈源性头痛疗效优于颈椎椎旁神经阻滞。     

星状神经节阻滞对非体外循环冠脉移植术病人ACTH、AT-Ⅱ及GL的影响

目的：比较单纯全麻和星状神经节阻滞术复合全麻对非体外循环冠状动脉旁路移植术（OPCABG）中应激反应的影响。方法：选择拟行OPCABG病人40例,根据实验设计随机分为星状神经节阻滞组（S组）和对照组（N组）各20例,S组在入室完成各项监测麻醉诱导前行右侧星状神经节阻滞术,两组麻醉及手术方式相同。分别于入室（T0,S组在行星状神经节阻滞前）、插气管导管（T1）、劈胸骨（T2）、和吻合前降支（T3）时记录患者的血压、脉搏并采中心静脉血测血糖,集中以放免法测促肾上腺皮质激素、血管紧张素Ⅱ和胰高血糖素。结果：与N组比较,S组患者各时点血流动力学变化更趋平稳;促肾上腺皮质激素和胰高血糖素的升高幅度明显较小（P〈0.01）。结论：星状神经节阻滞术可有效减轻OPCABG中麻醉与手术所致的过强应激反应。     

星状神经节阻滞对非体外循环冠脉移植术病人ACTH、AT-Ⅱ及GL的影响

目的:比较单纯全麻和星状神经节阻滞术复合全麻对非体外循环冠状动脉旁路移植术(OPCABG)中应激反应的影响。方法:选择拟行OPCABG病人40例,根据实验设计随机分为星状神经节阻滞组(S组)和对照组(N组)各20例,S组在入室完成各项监测麻醉诱导前行右侧星状神经节阻滞术,两组麻醉及手术方式相同。分别于入室(T0,S组在行星状神经节阻滞前)、插气管导管(T1)、劈胸骨(T2)、和吻合前降支(T3)时记录患者的血压、脉搏并采中心静脉血测血糖,集中以放免法测促肾上腺皮质激素、血管紧张素Ⅱ和胰高血糖素。结果:与N组比较,S组患者各时点血流动力学变化更趋平稳;促肾上腺皮质激素和胰高血糖素的升高幅度明显较小(P<0.01)。结论:星状神经节阻滞术可有效减轻OPCABG中麻醉与手术所致的过强应激反应。     

超声引导下星状神经节阻滞对脊柱手术患者的应用效果及对消化功能、应激反应的影响

摘要 目的：探讨超声引导下星状神经节阻滞对脊柱手术患者的应用效果及对消化功能、应激反应的影响。方法：选取我院2020年1月到2023年1月收治的60例脊柱手术患者作为研究对象,分为观察组与对照组,每组30例。对照组患者采取静脉全身麻醉,观察组患者在超声引导下行星状神经节阻滞麻醉后再行静脉全身麻醉诱导,对比两组患者术中不同时间生命体征变化,手术前后谷胱甘肽过氧化物酶（GSH-px）、超氧化物歧化酶（SOD）、丙二醛（MDA）相关应激因子变化,并对比两组患者术后2 h、术后6 h、术后12 h和术后24 h视觉模拟量表（VAS）评分,对比患者消化功能恢复时间及15项恢复质量评分量表（QoR-15）评分。结果：T₁到T₄时间观察组SPO₂、HR、MAP、DBP、SBP对比无明显差异（P＞0.05）,T₁到T₄时间对照组SPO₂、HR、MAP、DBP、SBP对比差异显著（P＜0.05）,T₂和T₃时间观察组与对照组患者SPO₂、HR、MAP、DBP、SBP对比具有显著差异（P＜0.05）;两组患者手术前GSH-px、MDA、SOD对比无明显差异（P＞0.05）,术后2h两组患者GSH-px、SOD、MDA均升高,观察组低于对照组（P＜0.05）;观察组患者术后2 h、术后6 h、术后12 h的VAS评分明显低于对照组（P＜0.05）,两组患者术后24 h的VAS评分对比无差异（P＞0.05）;观察组患者术后24 h、术后48 h、术后72h的QoR-15评分明显低于对照组（P＜0.05）,观察组患者消化功能恢复时间短于对照组（P＜0.05）。结论：超声引导下星状神经节阻滞可稳定患者生命体征,减轻患者应激反应,改善术后短期疼痛情况,促进消化功能恢复。     

超声引导下星状神经节阻滞联合前锯肌平面阻滞对乳腺癌根治术患者术后急性疼痛及睡眠时间的影响

摘要 目的：探讨超声引导下星状神经节阻滞（U-SGB）联合前锯肌平面滞（U-SAPB）对乳腺癌根治术患者术后急性疼痛及睡眠时间的影响。方法：乳腺癌根治术女性患者120例随机均分为对照组、U-SAPB组和联合组（U-SGB联合U-SAPB）,每组40例。对照组患者仅行全身麻醉,U-SAPB组患者行U-SAPB,联合组患者行U-SGB联合U-SAPB,术后均给予患者自控静脉镇痛（PCIA）。比较三组患者术后不同时间点的疼痛强度视觉模拟评分 (VAS) 、术后3天内夜间睡眠持续时间、术后首次按压镇痛泵时间及有效按压次数。结果：与对照组相比,联合组患者术后各个时间点VAS评分显著降低 (P<0.05)、首次按压镇痛泵时间明显推迟、术后镇痛泵有效按压次数减少、术后3天内夜间睡眠持续时间更长(P<0.05);与U-SAPB组相比,联合组患者VAS评分在术后8 h及之后更优、术后首次按压镇痛泵时间更晚 (P<0.05)。结论：与单纯全身麻醉、前锯肌平面阻滞相比,超声引导下星状神经节阻滞联合前锯肌平面阻滞能有效缓解乳腺癌患者的术后急性疼痛,延长术后早期夜间睡眠持续时间。     

星状神经节电刺激建立交感神经介导的急性房颤犬模型

目的建立交感神经张力异常介导的急性房颤动物模型的方法学。方法将16只随意来源犬分为三组：对照组（n=4）,右侧星状神经节（aSG）组（n=6）和左侧星状神经节（LSG）组（n=6）,测定心房和肺静脉不同部位的房颤诱发率、房颤持续时间。结果RSG刺激显著增加右心房（RA）的房颤诱发率和持续时间（P〈0．05）,LSG刺激显著增加左心房（LA）、左上肺静脉（LSPV）、左下肺静脉（LIPV）的房颤诱发率和持续时间（P〈0．05）;与刺激时相比,RSG切除显著降低RA的房颤诱发率和持续时间（P〈0．05）;LSG切除显著降低LA、LSPV、LIPV的房颤诱发率和持续时间（P〈0．05）。结论星状神经节电刺激同时快速心房起搏6h可成功建立交感神经介导的急性房颤犬模型,星状神经节电刺激使心房和肺静脉部位的房颤诱发率显著升高,房颤持续时间显著延长,去星状神经节支配可减少房颤的发生和维持。     

选择性雌激素受体调节剂在绝经后女性中的应用研究进展

雷洛昔芬和泰莫西芬是人工合成雌激素受体调节剂,具有与雌激素受体的高亲和力,并且拥有在不同的靶组织可分别表现为雌激素激动剂和拮抗剂的特性,因此又被称为选择性雌激素受体调节剂,这类药物的出现为患绝经后综合征的女性病人提供了新的用药选择。着重综述雷洛昔芬和泰莫西芬等具代表性的选择性雌激素受体调节剂在绝经后女性中的应用研究进展。     

Morphometric study of the superior cervical and stellate ganglia of spontaneously hypertensive rats during the prehypertensive stage

To compare the functional state of the superior cervical (SCG) and stellate sympathetic ganglia (SG) of spontaneously hypertensive rats (SHR) with those of age-matched normotensive Wistar Kyoto rats (WKY), ganglion cell volume and area occupied by ganglion cells relative to each whole ganglionic area were morphometrically examined using the Texture Analyse System (TAS) in rats at 0, 10 and 30 days of age. The weight of each ganglion relative to animal weight was also measured. The ganglion cell volume and the relative area of ganglionic cells in both ganglia of SHR were significantly larger (P<0.05) than those of age-matched WKY at ages 0 and 10 days after birth. The relative ganglionic weights of SHR were significantly larger (P<0.01) compared with those of WKY at all ages examined, except for SG at 0 days after birth. These results show that the relative volume of sympathetic ganglion cells is greater in both SCG and SG of SHR than that of WKY, suggesting that hyperfunction of sympathetic ganglia occurs at the prehypertensive stage as a primary factor in the development of hypertension in SHR.     

肠道菌群与绝经综合征的研究前景

绝经综合征是指女性绝经前后因雌激素水平波动或下降所引起的一系列生理及心理的短期、中期和长期的临床症状,严重影响老年女性的生活质量。目前激素替代治疗（HRT）被认为是治疗绝经综合征最有效的方法。但是,由于HRT相关的健康风险以及人群对HRT的担忧,很多女性不能或者不选择HRT治疗。因此,随着全球老龄化社会的到来,以绝经期女性为中心的综合治疗,包括共同决策替代药物成为当务之急。本文旨在阐述肠道菌群与绝经综合征临床症状的关系并分析治疗效果,探讨肠道菌群在绝经综合征治疗中的研究前景。

     

Immunocytochemical properties of stellate ganglion neurons during early postnatal development

Neurotransmitter features in sympathetic neurons are subject to change during development. To better understand the neuroplasticity of sympathetic neurons during early postnatal ontogenesis, this study was set up to immunocytochemically investigate the development of the catecholaminergic, cholinergic, and peptidergic phenotypes in the stellate ganglion of mice and rats. The present study was performed on Wistar rats and Swiss mice of different ages (newborn, 10-day-old, 20-day-old, 30-day-old, and 60-day-old). To this end, double labeling for tyrosine hydroxylase (TH), choline acetyltransferase (ChAT), vasoactive intestinal (poly)peptide (VIP), neuropeptide Y (NPY), galanin (GAL), and somatostatin (SOM) was applied. The results obtained indicate that the majority of the neurons in the stellate ganglion of both species were TH-positive from birth onward and that a large part of these neurons also contained NPY. The percentage of neurons containing TH and NPY invariably increased with age up to 60 days postnatally. A smaller portion of the stellate ganglion neurons contained other types of neuropeptides and showed a distinct chronological pattern. The proportion of VIP- and ChAT-positive neurons was maximal in 10-day-old animals and then decreased up to 60 days of age, whereas the number of SOM-positive cells in rats significantly decreased from birth onward. In newborn rats, VIP-, ChAT- and SOM-positive neurons were largely TH-positive, while their proportions decreased in 10-day-old and older rats. Accordingly, the largest part of VIP-positive neurons also expressed SOM immunoreactivity at birth, after which the number of neurons containing both peptides diminished. The VIP- and SOM-positive cells did not contain NPY in any of the age groups studied. In rats up to 10 days of life, GAL-immunoreactive (-IR) neurons were scarce, after which their number increased to reach a maximal value in 30-day-old animals and then declined again. The SOM-reactive cells had the smallest size in all rats, while the largest neurons were those containing ChAT. In the mouse stellate ganglion, VIP- and ChAT-IR neurons were larger in comparison to NPY- and TH-IR cells. Our study further revealed some species differences: compared to mice the proportion of neurons containing TH and NPY was higher in rats at all ages under study. Furthermore, no GAL-immunostained neurons were found in mice and the number of SOM-positive cells in mice was limited compared to that observed in rats. In conclusion, the development of neurotransmitter composition is complete in rats and mice by their second month of life. At this age, the percentages of immunopositive cells have become similar to those reported in adult animals.     

Regeneration of Cholinesterases in the Stellate and Normal and Denervated Superior Cervical Ganglia of the Cat Following Inactivation by Sarin

Abstract: Experiments were designed to test the hypothesis that ganglionic butyrylcholinesterase (BuChE) is derived from acetylcholinesterase (AChE). At 5 to 8 days following preganglionic denervation of the right superior cervical ganglion (SCG), cats were given sarin, 2.0 μmol/kg, i.v. At intervals of 1 h and 1, 2, 3, 6, 11, and 22 days later, they were killed, and the AChE and BuChE contents of both SCG and both stellate ganglia (StG) were assayed. The regeneration of AChE in the normal ganglia occurred in two phases: an initial rapid phase, to 25-40% of control activity in 1 day, and a slow phase, to approximately 70% of control activity in 22 days. BuChE reached approximately 85% of control activity in normal SCG and StG at 22 days. In the denervated SCG, AChE activity reached a maximum of approximately 17% of normal at 1 day, the value prior to the administration of sarin, and did not increase appreciably above this subsequently. BuChE activity in the denervated SCG reached approximately 50% of normal ganglia at 22 days. At each interval, its activity approached 55% of that of the contralateral normal SCG, the value found in the denervated SCG prior to the administration of sarin. Hence, the regeneration of BuChE appears to be independent of the presence of AChE in the neuropil. The origin of ganglionic BuChE remains obscure.     

左旋氨氯地平联合综合性心理干预治疗高血压伴围绝经综合征患者的临床观察

目的:探讨左旋氨氯地平联合综合性心理干预治疗高血压伴围绝经综合征患者的临床治疗效果,为临床治疗提供参考。方法:按照随机数字表法将2014年7月-2015年7月三峡大学仁和医院收治的113例高血压伴围绝经综合征患者分为两组,观察组(n=57例)采用左旋氨氯地平联合综合性心理干预,对照组(n=56例)仅予以左旋氨氯地平治疗。治疗1个月后,采用汉密尔顿焦虑量表(HAMA)和抑郁量表(HAMD)评分对两组患者的主要症状改善进行评估,测量两组治疗前后卵巢功能指标促黄体生成素(Luteinizing hormone,LH)、血清促卵泡成熟激素(Follicle stimulating hormone,FSH)以及雌激素(Estrogen,E2),并比较两组患者治疗后的临床疗效。结果:两组患者治疗后的LH、FSH以及E2水平均较治疗前明显改善,且观察组改善的幅度明显优于对照组,差异有统计学意义(P0.05)。两组治疗后的HAMA、HAMD评分均较治疗前降低,且观察组降低的幅度明显优于对照组,差异有统计学意义(P0.05)。观察组治疗后的临床疗效优于对照组,差异有统计学意义(P0.05)。结论:左旋氨氯地平联合综合性心理干预可明显改善患者的负性情绪和提高临床治疗效果,有较高的临床推广价值。     

更年期潮热与体温调节

由于潮热是更年期女性的最常见和最特异的症状,也是最痛苦的症状之一。潮热主要发生在更年期过渡期的妇女,主要表现为忽冷忽热,其发生严重的影响了更年期妇女的情绪、睡眠及生活质量。但是其发病的病理学机制仍然不清楚。研究表明,潮热的发生与体温调节的异常有关,大多数学者认为潮热发生的机制是体温调节中枢的异常,并通过改变外周和中心体温而实现。因此,本文对潮热时体温调定点,其外周和中心体温的变化情况,作出综述。     

Immunohistochemical evidence for different pathways immunoreactive to substance P and calcitonin gene-related peptide (CGRP) in the guinea-pig stellate ganglion

The colocalization of immunoreactivities to substance P and calcitonin gene-related peptide (CGRP) in nervous structures and their correlation with other peptidergic structures were studied in the stellate ganglion of the guinea pig by the application of double-labelling immunofluorescence. Three types of fibre were distinguished. (1) Substance P⁺/CGRP⁺ fibres, which sometimes displayed additional immunoreactivity for enkephalin, constituted a small fibre population of sensory origin, as deduced from retrograde labelling of substance P⁺/CGRP⁺ dorsal root ganglion cells. (2) Substance P⁺/CGRP^– fibres were more frequent; some formed baskets around non-catecholaminergic perikarya that were immunoreactive to vasoactive intestinal polypeptide (VIP). (3) CGRP⁺/substance P^– fibres were most frequent and were mainly distributed among tyrosine hydroxylase (TH)-immunoreactive cell bodies. The peptide content of fibre populations (2) and (3) did not correspond to that of sensory ganglion cells retrogradely labelled by tracer injection into the stellate ganglion. Therefore, these fibres are throught to arise from retrogradely labelled preganglionic sympathetic neurons of the spinal cord, in which transmitter levels may have been too low for immunohistochemical detection of substance P or CGRP. CGRP-immunoreactivity but no substance P-immunolabelling was observed in VIP-immunoreactive postganglionic neurons. Such cell bodies were TH-negative and were spared by substance P-immunolabelled fibre baskets. Retrograde tracing with Fast Blue indicated that the sweat glands in the glabrous skin of the forepaw were the targets of these neurons. The streptavidin-biotin-peroxidase method at the electron-microscope level demonstrated that immunoreactivity to substance P and CGRP was present in dense-cored vesicles of 50–130 nm diameter in varicosities of non-myelinated nerve fibres in the stellate ganglion. No statistically significant difference in size was observed between vesicles immunolabelled for substance P and CGRP. Immunoreactive varicosities formed axodendritic and axosomatic synaptic contacts, and unspecialized appositions to non-reactive neuronal dendrites, somata, and axon terminals. Many varicosities were partly exposed to the interstitial space. The findings provide evidence for different pathways utilizing substance P and/or CGRP in the guinea-pig stellate ganglion.