3.Neuroendocrine dysfunction in sepsis and its therapeutic strategy.
Qing-hong ZHANG ; Yong-ming YAO
Chinese Journal of Burns 2010;26(2):87-89
Severe sepsis provokes significant abnormalities in host neuroendocrine system, and they are hallmarked by the glucocorticoid and growth hormone resistance, vasopressin deficiency, and compromised vagal activity. As a consequence, the increased stress hormones result in a hyperdynamic circulation, hypermetabolic state, and the hyperglycemia/insulin resistance in sepsis. The cardiac autonomic dysfunction also occurs as a consequence of depressed vagal activity. Current therapeutic strategies include insulin therapy to control hyperglycemia, physiologic doses of corticosteroids to improve immunity, growth hormone to reverse negative nitrogen balance, and vasopressin to raise blood pressure. Non-specific beta-adrenergic blockade has also been attempted to either attenuate the hypermetabolism or to reduce the inflammatory response. Future therapy may be directed at both central and peripheral immune system so as to alleviate the hyperdynamic inflammatory state and possibly encephalopathy in severe sepsis.
Autonomic Nervous System
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physiopathology
;
Humans
;
Neurosecretory Systems
;
physiopathology
;
Sepsis
;
physiopathology
;
therapy
4.Research advances of autonomic nervous system in the regulation of cardiac inflammation.
Ye-Nan FENG ; Han XIAO ; You-Yi ZHANG
Acta Physiologica Sinica 2019;71(2):225-234
The autonomic nervous system consists of the sympathetic nervous system and the parasympathetic nervous system. These two systems control the heart and work in a reciprocal fashion to modulate myocardial energy metabolism, heart rate as well as blood pressure. Multiple cardiac pathological conditions are accompanied by autonomic imbalance, characterized by sympathetic overactivation and parasympathetic inhibition. Studies have shown that overactive sympathetic nervous system leads to increased cardiac inflammatory reaction. Orchestrated inflammatory response serves to clear dead cardiac tissue and activate reparative process, whereas excessive inflammation may result in pathological cardiac remodeling. Since the discovery of the α7 nicotinic acetylcholine receptor (α7nAChR)-mediated cholinergic anti-inflammatory pathway (CAP), the protective effects of the parasympathetic nervous system in cardiac inflammation have attracted more attention recently. In this review, we summarized the role and underlying mechanisms of the sympathetic and parasympathetic nervous systems in cardiac inflammation, in order to provide new insight into cardiac inflammatory response in cardiovascular diseases.
Autonomic Nervous System
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physiology
;
Heart
;
physiopathology
;
Humans
;
Inflammation
;
physiopathology
;
Parasympathetic Nervous System
;
physiology
;
alpha7 Nicotinic Acetylcholine Receptor
;
physiology
5.Assessment of Autonomic Nervous System with Analysis of Heart Rate Variability in Children with Spastic Cerebral Palsy.
Eun Sook PARK ; Chang Il PARK ; Sung Rae CHO ; Jeong Whan LEE ; Eun Joo KIM
Yonsei Medical Journal 2002;43(1):65-72
The purpose of this study was to investigate the function of the autonomic nervous system in children with spastic cerebral palsy (CP) through an analysis of heart rate variability (HRV) occurring with orthostatic stress. Twelve children with spastic CP and twelve normal children participated in this study. The echocardiogram (ECG) signals were recorded for 3 minutes in both the supine and 70 degrees C head-up tilt positions, and then the HRV signals underwent power spectrum analysis at each position. Two components were measured; a low- frequency (LF) component (0.05 - 0.15Hz) primarily reflecting sympathetic activity during orthostatic stress and a high-frequency (HF) component (0.15 - 0.4Hz) reflecting parasympathetic activity. In the supine position, there was no significant difference between any of the HRV components of the two groups. In the head-up tilt position, absolute and normalized LF were significantly increased and absolute HF was significantly decreased in the normal children (p < 0.05), but not in the children with spastic CP. The results of this study suggest that cardiac autonomic functions, such as vagal withdrawal and sympathetic activation which occur during head-up tilt position, are not sufficient to overcome the orthostatic stress arising in spastic CP children.
Autonomic Nervous System/*physiopathology
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Cerebral Palsy/*physiopathology
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Child
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Female
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*Heart Rate
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Human
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Male
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Posture
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Supine Position
7.Schrimer test in Parkinson's disease.
Oh Young KWON ; Seung Hyun KIM ; Ju Han KIM ; Myung Ho KIM ; Myung Kyoo KO
Journal of Korean Medical Science 1994;9(3):239-242
We carried out the Schirmer test to measure objectively the amount of lacrimation among 51 clinically diagnosed parkinsonian patients (33 men and 18 women aged 50 to 79 years, mean 64) and 75 age-matched controls (42 men and 33 women aged 50 to 76, mean 62). Whatman No. 2 paper, prepared in precut strips 5mm by 35mm, was placed in the cul-de-sac for five minutes, after which the wetted length of the strip was studied. It was noted that the lacrimation amount decreased in patients with Parkinson's disease compared with controls: the average amount of lacrimation was 3.4 +/- 2.3mm in the former group and 8.1 +/- 6.5mm in the latter group (p < 0.01). We believe that the decrease in the amount of lacrimation is associated with emotional disturbance and autonomic dysfunction, and presume that the lacrimation may be under the control of the basal ganglia which has a connection with the superior salivatory nucleus downward and the limbic system upward.
Aged
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Autonomic Nervous System/physiopathology
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Female
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Human
;
Limbic System/physiopathology
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Male
;
Middle Age
;
Parkinson Disease/*physiopathology
;
Tears/*secretion
8.Autonomic Disturbances in Acute Cerebrovascular Disease.
Jun MO ; Lei HUANG ; Jianhua PENG ; Umut OCAK ; Jianmin ZHANG ; John H ZHANG
Neuroscience Bulletin 2019;35(1):133-144
Autonomic disturbances often occur in patients with acute cerebrovascular disease due to damage of the central autonomic network. We summarize the structures of the central autonomic network and the clinical tests used to evaluate the functions of the autonomic nervous system. We review the clinical and experimental findings as well as management strategies of post-stroke autonomic disturbances including electrocardiographic changes, cardiac arrhythmias, myocardial damage, thermoregulatory dysfunction, gastrointestinal dysfunction, urinary incontinence, sexual disorders, and hyperglycemia. The occurrence of autonomic disturbances has been associated with poor outcomes in stroke patients. Autonomic nervous system modulation appears to be an emerging therapeutic strategy for stroke management in addition to treatments for sensorimotor dysfunction.
Acute Disease
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Animals
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Autonomic Nervous System
;
physiopathology
;
Cerebrovascular Disorders
;
complications
;
physiopathology
;
Humans
;
Nerve Net
;
injuries
;
Sensorimotor Cortex
;
physiopathology
;
Stroke
;
physiopathology
10.Liver biopsy complicated by vaso-vagal episodes.
Ruidan ZHENG ; Richun RAO ; Bifen CHEN
Chinese Journal of Hepatology 2002;10(6):458-458