The experiment aimed to evaluate effects and mechanisms of aVNS in the IA-treated rats and performed in 4 groups of rats (36 rats):

Control group: normal rats without any IA treatment and aVNS or sham, but received balloon and wires implantation of EMG and ECG (n = 12; 6 rats were randomly picked and sacrificed for the gastric emptying test).

IA-treated group: IA-treated rats received balloon and wires implantation of EMG and ECG but not aVNS or sham (n = 12; 6 rats were randomly chosen and sacrificed for the gastric emptying test).

aVNS group: IA-treated rats received aVNS and balloon and wires implantation of EMG and ECG (6 IA-treated rats with daily aVNS).

Sham-aVNS group: IA-treated rats received sham-aVNS and balloon and wires implantation of EMG and ECG (6 IA-treated rats with daily sham-aVNS).

The experimental protocol for these animals is shown in Figure 1A (not every animal received all indicated treatments or procedures). Surgical procedures were performed at the age of 8 weeks for placement of gastric balloon and various wire electrodes. Physiological measurements, including gastric emptying and open field test (OFT), were made before (9th week) and after (11th week) the treatment (aVNS or sham-aVNS), while electromyography (EMG) was performed at the 9th week and 10th week. Various tissues were collected at the end of the study for mechanistic assessment.
In order to investigate the vagal efferent pathway involved in the ameliorating effects of aVNS in IA-treated rats, we implemented another experiment including 4 groups (24 rats): (1) the IA-treated group and IA + aVNS group were similar with above experiment (n = 6); (2) IA + Subphrenic vagotomy (SV) group (6 IA-treated rats were subjected to SV without stimulation) and (3) IA + aVNS + SV group (6 IA-treated rats were subjected to SV with aVNS). The experimental protocol for these rats was similar to the other four groups of rats (Figure 1B) except that SV was performed but no gastric balloon or EMG electrodes were implanted (this was to avoid excessive surgeries which would lead to severe complications).
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