| Background Stellate ganglion block is a method of reversible sympathetic nervous system block by injecting appropriate amount of Local anesthetic into the Loose connective tissue of stellate ganglion,it is a commonly used ganglionic block in anesthesia and pain treatment.Acute peritonitis is one of the most common surgical acute abdomen,which is caused by bacterial infection,chemical stimulation and physical injury.At present,anti-infection therapy is often used in clinic,and surgical treatment will be adopted in severe cases.Stellate ganglion block can reduce the level of inflammatory factors and reduce the inflammatory reaction to a certain extent,but its therapeutic effect and mechanism are not clear.In this study,the rat model of acute peritonitis was established by stellate ganglion block followed by administration of specific drugs or normal saline,to observe the effect of stellate ganglion block on acute peritonitis in rats,and to explore the anti-inflammatory mechanism of stellate ganglion block.Objective 1.It is proved that stellate ganglion block can inhibit the inflammatory reaction of acute peritonitis and is beneficial to the treatment of peritonitis.2.To investigate whether the anti-inflammatory mechanism of stellate ganglion block is related to the cholinergic anti-inflammatory pathway mediated by the activation of α7nAChR receptors.Methods In this project,40 male rats(200-250g)were randomly divided into four groups: blank group,acute peritonitis group(AP group),acute peritonitis + stellate ganglion block group(AP+SGB group),α7nAChR inhibitor methyl bovine pentine + acute peritonitis+ stellate ganglion block group(MLA+AP+SGB group).The blank group was injected with0.2ml of normal saline every 6 hours after the right stellate ganglion block;the other three groups were established by intraperitoneal injection of 2% acetic acid,and then the right side of the neck was blinded by posterior path puncture,the right stellate ganglion block was performed and the specified drug was given,and the right stellate ganglion block was repeated every 6 hours.The AP group was injected with 0.2ml normal saline,and the AP+SGB group was injected with 0.2ml of local anesthetic 0.5% ropivacaine.The MLA+AP+SGB group was injected intraperitoneally with α7nAChR inhibitor MLA 0.24ug/g1 h in advance,and then the same method was used to establish an acute peritonitis model,and the right stellate ganglion block was performed and 0.2ml of local anesthetic 0.5%ropivacaine was injected.The behavioral changes of each group of rats were observed,and the heart rate of rats was measured and recorded.After 24 hours of molding,each group of rats was sacrificed,and blood was taken for the detection of complete blood white blood cell count;ELISA method to detect the concentration level of IL-18 and TNF-α in serum;The abdominal cavity of rats was observed,a small amount of peritoneal tissue was used for HE staining,and the pathology was observed under light microscopy.The ELISA method detected the levels of IL-18 and TNF-α in peritoneal tissue;The expression of α7nAChR protein and α7nAChR mRNA in peritoneal tissues was detected by PCR.Results(1)Heart rate of rats: Compared with the blank group,the heart rate of the other three groups increased(P<0.05).(2)White blood cell count: Compared with the blank group,the values of AP Group and MLA + AP + SGB Group were significantly higher(P<0.05),compared with the AP Group,the values of Ap + SGB Group were lower(P<0.05),compared with the AP + SGB Group,the values of AP + SGB Group were significantly lower(P<0.05),MLA + AP + SGB Group had higher values(P<0.05).(3)The serum levels of inflammatory factors: Compared with the blank group,the levels of Il-18 and TNF-α in the other three groups increased(P<0.05),while the levels of Il-18 and TNF-α in AP + SGB Group decreased(P<0.05).The serum levels of Il-18 and TNF-α in MLA+ AP + SGB Group were higher than those in AP + SGB Group(P<0.05).(4)Inflammatory factors in peritoneal tissue: Compared with the blank group,the serum levels of Il-18 and TNF-α in the other three groups were increased(P<0.05),while compared with the AP group,the serum levels of Il-18 and TNF-α in the AP + SGB Group were decreased(P<0.05),the serum levels of Il-18 and TNF-α in MLA + AP + SGB Group were higher than those in AP + SGB Group(P<0.05).(5)Abdominal conditions: Compared with the blank group,the peritoneal and intestinal hyperemia and edema in AP Group and MLA + AP + SGB Group were more obvious,and the bloody ascites exudation was more obvious,and the peritoneal and intestinal hyperemia and edema were less in the SGB + AP Group than in the AP Group,compared with SGB + AP Group,MLA + AP + SGB Group had more serious hyperemia and edema of peritoneal and intestinal wall.(6)Local peritoneal histopathological changes: The structure of the peritoneum in the blank group was basically intact,there were a lot of inflammatory cells in the AP group,a little inflammatory cells in the AP + SGB Group,and there were more inflammatory cells in the MLA + AP + SGB Group.(7)Peritoneal tissue α7nAChR protein expression: Compared with the blank group,the expression level of α7nAChR protein was higher in the other three groups(P<0.05),compared with the AP Group,the expression level of α7nAChR protein was higher in AP +SGB Group and MLA + AP + SGB Group(P<0.05);compared with AP + SGB Group,MLA+ AP + SGB Group had lower histone expression level(P<0.05).(8)Peritoneal tissue α7nAChR mRNA expression levels: Compared with the blank group,the expression levels of α7nAChR mRNA in the other three groups were higher(P<0.05),compared with the AP Group,the expression levels of α7nAChR mRNA in AP + SGB Group and MLA + AP + SGB Group were higher(P<0.05).Conclusions 1.Acute peritonitis will increase the levels of IL-18 and TNF-α in rat serum and peritoneal tissue,and stellate ganglion block treatment can reduce the production of these two inflammatory factors,inhibit the inflammatory response of acute peritonitis,and facilitate the treatment of peritonitis.2.The anti-inflammatory mechanism of stellate ganglion block is prabably related to the activation of cholinergic anti-inflammatory pathway mediated byα7nachr receptor. |
