Neuronal Organization of Mammalian Stellate Ganglion in Postnatal Ontogenesis

The paper considers the problem of peculiarities of maturation of the stellate ganglion nerve elements in mammals of different species. This process differs in precocious and altricial animals. It has been shown that in spite of some individual peculiarities, the neurons, fibers, and conducting pathways in altricial animals are not, on the whole, completely formed morphologically and functionally. In the course of postnatal ontogenesis, not only an increase of cell sizes and development of dendrite tree, but also reorganization of nerve connections with target organ occur. The postnatal ontogenesis is also accompanied by an increase of the excitation transmission rate along the fibers and by their myelination. The asymmetry of the right and left stellate ganglia (SG) by their sizes and functional peculiarities, which exists in adult animals appears as soon as at early stages of postnatal development. The neural elements of precocious animals are changed to a lesser extent in postnatal ontogenesis and are, in many aspects, similar to those of adult organisms as early as at birth.     

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。     

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。     

星状神经节阻滞对心衰大鼠心肌细胞凋亡的影响及机制研究

摘要 目的：分析星状神经节阻滞对心衰大鼠心肌细胞凋亡的影响及机制研究。方法：采用腹动脉狭窄法构建大鼠心力衰竭模型。18只SD大鼠采用随机数字表法分为正常对照组（NC组）、假手术组（SO组）和星状神经节阻滞组（SGB组）,每组6只。正常对照组大鼠不作任何处理;待模型构建成功后,SGB组大鼠皮肤暴露至星状神经节后,采用硬膜外穿刺针植入至星状神经节分布处进行星状神经节阻滞;SO组大鼠皮肤暴露至星状神经节后直接缝合。12 w后,对各组大鼠体重、心脏重量、心脏重量指数、游泳时间、游泳指数、心肌组织学、心肌细胞阳性凋亡数、肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）表达量、白细胞介素-1β（Interleukin-1β,IL-1β）表达量、磷酸肌醇3激酶（phosphatidylinositol-3 kinase,PI3K）、丝/苏氨酸激酶（serine-threoninekinase,Akt）及半胱氨酸蛋白酶-3（Caspase-3）的mRNA和蛋白表达量进行评测。结果：与NC组相比,SO组大鼠体重、心脏重量、游泳时间、游泳指数、PI3K和Akt的mRNA及蛋白质表达量均显著降低;心脏重量指数、心肌细胞平均凋亡数、TNF-α表达量、IL-1β表达量、Caspase-3 mRNA及蛋白质表达量均显著升高,差异均有显著差异（P均＜0.05）。与SO组相比,SGB组大鼠体重、心脏重量、游泳时间、游泳指数、PI3K和Akt的mRNA及蛋白质表达量显著升高;心脏重量指数、心肌细胞平均凋亡数、TNF-α表达量、IL-1β表达量、Caspase-3 mRNA及蛋白质表达量均显著降低,差异均有显著差异（P均＜0.05）。且对心衰大鼠进行星状神经节阻滞后,SGB组大鼠心肌细胞排列规则变整齐,心肌细胞空泡化、细胞间隙、炎性反应、细胞溶解现象等明显变好。结论：星状神经节阻滞能显著抑制心衰大鼠心肌细胞凋亡。这种抑制可明显保护心脏功能,与PI3K/Akt信号通路上调密切相关。     

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。     

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。     

Catheter-Based Renal Sympathetic Denervation Significantly Inhibits Atrial Fibrillation Induced by Electrical Stimulation of the Left Stellate Ganglion and Rapid Atrial Pacing

Background

Sympathetic activity involves the pathogenesis of atrial fibrillation (AF). Renal sympathetic denervation (RSD) decreases sympathetic renal afferent nerve activity, leading to decreased central sympathetic drive. The aim of this study was to identify the effects of RSD on AF inducibility induced by hyper-sympathetic activity in a canine model.

Methods

To establish a hyper-sympathetic tone canine model of AF, sixteen dogs were subjected to stimulation of left stellate ganglion (LSG) and rapid atrial pacing (RAP) for 3 hours. Then animals in the RSD group (n = 8) underwent radiofrequency ablation of the renal sympathetic nerve. The control group (n = 8) underwent the same procedure except for ablation. AF inducibility, effective refractory period (ERP), ERP dispersion, heart rate variability and plasma norepinephrine levels were measured at baseline, after stimulation and after ablation.

Results

LSG stimulation combined RAP significantly induced higher AF induction rate, shorter ERP, larger ERP dispersion at all sites examined and higher plasma norepinephrine levels (P<0.05 in all values), compared to baseline. The increased AF induction rate, shortened ERP, increased ERP dispersion and elevated plasma norepinephrine levels can be almost reversed by RSD, compared to the control group (P<0.05). LSG stimulation combined RAP markedly shortened RR-interval and standard deviation of all RR-intervals (SDNN), Low-frequency (LF), high-frequency (HF) and LF/HF ratio (P<0.05). These changes can be reversed by RSD, compared to the control group (P<0.05).

Conclusions

RSD significantly reduced AF inducibility and reversed the atrial electrophysiological changes induced by hyper-sympathetic activity.