Neurogenic nitric oxide facilitates the central nociceptive transmission of migraine attacks

Recent studies have shown that nitric oxide （NO） can induce migraine attacks at three possible sites of action： nitroxidergic nerves, the vascular endothelium, and the central nervous system. Most previous studies have focused on the former two sites of action. Several experiments using exogenic NO donors have suggested that nitroglycerin may induce migraine via central mechanisms. However, few studies have investigated the source of the NO involved in the central mechanisms of migraine. The present study used a cat model of migraine to represent migraine attacks in humans. We performed immunochemical staining of successive frozen sections of the brainstem and upper cervical spinal cord, and then used c-Fos protein expression to label nerve cell activation. We observed the effects of N^ω-nitro-L-arginine methyl ester （L-NAME）, a non-selective nitric oxide synthase （NOS） inhibitor, and 7-nitroindozole （7-NI）, a selective neuronal NOS inhibitor, on c-Fos and nNOS expression, which were induced by electrical stimulation to the dura mater near the superior sagittal sinus. The results demonstrated that c-Fos or nNOS immunoreactive cells was concentrated in the superficial layers （laminae Ⅰ and Ⅱ） of the spinal nucleus of trigeminal nerve. L-NAME and 7-NI pre-treatment significantly decreased c-Fos and neurogenic NOS expression; and there was a significant linear correlation between c-Fos and NOS expression （r = 0.858 2, P 〈 0.01）. These findings suggest that neurogenic NO could facilitate migraine nociceptive transmission to second-order neurons of the trigeminal nerve. However, L-NAME and 7-NI may block the activation of neurons in the spinal nucleus of the trigeminal nerve by inhibiting NO synthesis, and thereby attenuate acute migraine attacks.

Low-dose dopamine reduces inflammatory factors of acute pancreatitis in rats

BACKGROUND: Acute pancreatitis, especially acute necrotizing pancreatitis (ANP), is a serious disease with a high morbidity because of multiorgan dysfunction. Recent studies have indicated that during the pathogenesis of ANP, changes of the microcirculation play an important role in the worsening of the disease. This study based on a. model of acute pancreatitis in Wistar rats was to determine the effect of treatment with low-dose dopamine on acute pancreatitis by the dynamic measurement of serum levels of inflammatory factors IL-6 and TNF-alpha. METHODS: Fifty Wistar rats were randomly divided into two groups, and a model of ANP was set up by injecting sodium taurocholate into the pancreatic duct. Rats in the dopamine group (treatment group) were given dopamine by vein and those in the acute pancreatitis group (control group) were given normal saline. To assess the effect of low-dose doparnine (5 mu g . kg(-1) . min(-1)) on induced acute pancreatitis, the antibody sandwich ELISA method was used to measure the serum levels of IL-6 and TNF-alpha at different times before and after the induction of ANP. RESULTS: The serum levels of IL-6 and TNF-alpha in the treatment and control groups before and after ANP induction were significantly different. There was a markedly significant difference in the comparison of the two groups after ANP induction (P<0.01), but no significant difference in the comparison before the induction (P>0.05). Postoperative pancreatic histopathologic changes in the treatment group were more marked than those in the control group. CONCLUSIONS: Low-dose dopamine is effective in treating ANP by alleviating inflammatory reactions. This effect may be related to the fact that low-dose doparnine not only can increase the blood flow of the pancreatic microcirculation but also reduce its permeability.

Incidence of unexplained intra-abdominal free fluid in patients with blunt abdominal trauma

BACKGROUND: Intra-abdominal free fluid is commonly caused by injuries of solid or hollow organs in patients suffering from blunt abdominal trauma (BAT). However, it presents a diagnostic dilemma for surgeons when free fluid is unexplained, especially in stable BAT patients. This study was to analyze the incidence of such unexplained free fluid in BAT patients and its diagnostic value in abdominal organ injury. METHODS: Altogether 597 patients with BAT who had been treated at our trauma center over a 10-year period were reviewed. Stable patients with free fluid but without free air or definite organ injury on abdominal computed tomography were studied. Clinical management and operative findings were analyzed. RESULTS: Thirty-four (5.70%) of the 597 patients met the inclusion criteria: 24 (4.02%) underwent therapeutic exploratory laparotomy: bowel injuries were found in 13, hepatic rupture in 3, colon rupture in 3, duodenal rupture in 2, spleen rupture in 1, pancreas rupture in 1, and gallbladder perforation in 1. In 2 patients, laparotomy was nontherapeutic. Those with moderate or large amounts of free fluid were more likely to suffer from a hollow viscus injury and have a therapeutic procedure. The mean time of hospital stay for the delayed laparotomy group was longer than that for the emergency group (19 5.12 vs. 12 2.24 days; t=2.73, P<0.01). CONCLUSIONS: There was a positive correlation between the amount of unexplained free fluid and the determination of intra-abdominal organ injury. The proportion of BAT patients who required surgical intervention was high, particularly those with a moderate or large amount of free fluid, and most of them suffered from a hollow organ injury. Emergency laparotomy is recommended for these patients.

Evaluation of the performance of InnowaveDX MTB/RIF for the detection of Mycobacterium tuberculosis complex and rifampicin resistance

Objective To evaluate the performance of Mycobacterium tuberculosis and rifampicin resistance mutation detection kit(InnowaveDX MTB/RIF,referred to as"InnowaveDX")in diagnosing tuberculosis and rifampicin resistance using sputum samples.Methods From June 19,2020 to May 16,2022,patients with suspected tuberculosis were prospectively and consecutively enrolled in Hunan Provincial Tuberculosis Prevention and Control Institute,Henan Provincial Hospital of Infectious Diseases and Wuhan Jinyintan Hospital.A total of 1328 patients with suspected tuberculosis were finally included.

Differential expression of MicroRNA in the exosomes of unstable angina patients with Qi deficiency and blood stasis syndrome

Objective To analyze differential expression of MicroRNA(miRNA)in serum exosomes of unstable angina(UA)patients.Methods Peripheral blood of 115UA patients,including 59 patients with qi deficiency and blood stasis syndrome(QDBSS)and 56 patients without QDBSS,and 36 healthy volunteers were recruited,and the exosomes in the supernatant were extracted.

Effect of artesunate on reducing renal and intestinal injury after cardiopulmonary resuscitation in porcine

Objective To investigate the effect of artesunate(ART)on renal and intestinal injury aftercardiopulmonary resuscitation(CPR)in porcine,and to explore its mechanism.Methods A total of 24 healthy male white porcines were randomly divided into 3groups:Sham group(n=6),CPR group(n=10)and ART group(n=8).Sham group was only prepared for the experiment.

Safety and efficacy ofthe early administration of levosimendan in patients with acute non-ST-segment elevation myocardial infarction and elevated NT-proBNP levels: An Early Management Strategy of Acute Heart Failure (EMS-AHF)

Objective To investigate the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction(NSTEMI)and elevated levels of N-terminal pro-hormone B-type natriuretic peptide(NTproBNP)with levosimendan within 24 hours of first medical contact(FMC).

Comparison of Charlson＇s weighted index of comorbidities with the chronic health score for the prediction of mortality in septic patients

Background Comorbidity is one of the most important determinants ot short-term and long-term outcomes in septic patients. Charlson＇s weighted index of comorbidities （WIC） and the chronic health score （CHS）, which is a component of the acute physiology and chronic health evaluation （APACHE） II, are two frequently-used measures of comorbidity. In this study, we assess the performance of WIC and CHS in predicting the hospital mortality of intensive care unit （ICU） patients with sepsis. Methods A total of 338 adult patients with sepsis were admitted to a multisystem ICU between October 2010 and August 2012. Clinical data were collected, including age, gender, underlying diseases, key predisposing causes, severity-of- sepsis, and hospital mortality. The APACHE II, CHS, acute physiology score （APS）, sequential organ failure assessment （SOFA） and WIC scores were assessed within the first 24 hours of admission. Univariate and multiple Logistic regression analyses were used to compare the performance of WlC and CHS. The area under the receiver operating characteristic curve （AUC） was used to predict hospital mortality over classes of risk. Results Of all the enrolled patients, 224 patients survived and 114 patients died. The surviving patients had significantly lower WlC, CHS, APACHE II, and SOFA scores than the non-surviving patients （P 〈0.05）. Combining WIC or CHS with other administrative data showed that the hospital mortality was significantly associated with age, severe sepsis, key predisposing causes such as pneumonia, a history of underlying diseases such as hypertension and congestive cardiac failure, and WlC, CHS and APS scores （P 〈0.05）. The AUC for the hospital mortality were 0.564 （95% confidence interval （CO 0.496-0.631） of CHS, 0.663 （95% CI 0.599-0.727） of WIC, 0.770 （95% CI 0.718-0.822） of APACHE II, 0.856 （95% Cl 0.815-0.897） of the CHS combined with other administrative data, and 0.857 （95% CI 0.817-0.897） of the WlC combined with other administrative data. The diagnostic value of WIC was better than that of CHS （P=0.0015）. Conclusions The WlC and CHS scores might be independent determinants for hospital mortality among ICU patients with sepsis. WlC might be an even better predictor of the mortality of septic patients with comorbidities than CHS. Chin Med J 2014;127 （14）： 2623-2627

Distinct properties and metabolic mechanisms of postresuscitation myocardial injuries in ventricular fibrillation cardiac arrest versus asphyxiation cardiac arrest in a porcine model

Background The two most prevalent causes of sudden cardiac death are ventricular fibrillation cardiac arrest （VFCA） and asphyxiation cardiac arrest （ACA）. Profound postresuscitation myocardial dysfunction has been demonstrated in both VFCA and ACA animal models. Our study aimed to characterize the two porcine models of cardiac arrest and postresuscitation myocardial metabolism dysfunction. Methods Thirty-two pigs were randomized into two groups. The VFCA group （n=16） were subject to programmed electrical stimulation and the ACA group （n=16） underwent endotracheal tube clamping to induce cardiac arrest （CA）. Once induced, CA remained untreated for a period of 8 minutes. Two minutes following initiation of cardiopulmonary resuscitation （CPR）, defibrillation was attempted until return of spontaneous circulation （ROSC） was achieved or animals died. To assess myocardial metabolism, 18F-FluoroDeoxyGlucose Positron Emission Tomography was performed at baseline and 4 hours after ROSC. Results ROSC was 100% successful in VFCA and 50% successful in ACA. VFCA had better mean arterial pressure and cardiac output after ROSC than ACA. Arterial blood gas analysis indicated more detrimental metabolic disturbances in ACA compared with VFCA after ROSC （ROSC 0.5 hours, pH： 7.01±0.06 vs. 7.21±0.03, P〈0.01; HCO3： （15.83±2.31 vs. 20.11±1.83） mmol/L, P〈0.01; lactate： （16.22±1.76 vs. 5.84±1.44） mmol/L, P〈0.01）. Myocardial metabolism imaging using Positron Emission Tomography demonstrated that myocardial injuries after ACA were more severe and widespread than after VFCA at 4 hours after ROSC （the maximum standardized uptake value of the whole left ventricular： 1.00±0.17 vs. 1.93±0.27, P〈0.01）. Lower contents of myocardial energy metabolism enzymes （Na＊-K＊-ATPase enzyme activity, Ca2＊- ATPase enzyme activity, superoxide dismutase and phosphodiesterase） were found in ACA relative to VFCA. Conclusions Compared with VFCA, ACA causes more severe myocardium injury and metabolism hindrance, therefore they should be treated as different pathological entities.

Propylthiouracil induced antineutrophil cytoplasmic antibodies-associated vasculitis

To the editor： Antineutrophil cytoplasmic antibodies （ANCA） are a group of autoantibodies associated with various diseases andcan be detected in drug-induced vasculitides. Here, we report two patients of drug-induced vasculitides combind with kidney damage （one is followed-up 10 years, the other is followed-up 3 years） and review the literature for the occurrence of this complication, share the common phenomenon with our peers.

Efficacy analysis of intravenous thrombolysis after cardiopulmonary resuscitation for patients with acute myocardial infarction and cardiac arrest

Objective To explore the clinical value of intravenous thrombolysis in the treatment of patients with acute myocardial infarction(AMI)and cardiac arrest after cardiopulmonary resuscitation.Methods 120 patients with AMI and cardiac arrest admitted in our hospital from Mar2009 to Mar 2013 were divided into thrombolytic group(n=50)and control group(n=70)according to

The clinical application of non-biotype artificial liver support system to acute liver failure of children

Objective To explore the therapeutic effect of non-biotype artificial liver support system(NBALSS)in acute liver failure(ALF)of children by analyzing the data of16 children with ALF treated with plasma exchange(PE)and continuous venovenous hemodiafiltration(CVVHDF)in the past 2 years.Methods A total of 16 children with ALF in PICU

Predictive factors predicting inadequate ST-segment resolution in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention

Objective To survey ST-segment resolution in STEMI patients undergoing emergency percutaneous coronary intervention(PCI)and to find the specific clinical features of patients with inadequate ST-segment resolution.Methods A total of 198 patients were divided into two groups according to the ratio of ST-segment resolution:relatively adequate ST-segment resolution group(】50%)and inadequate ST-segment resolution group(【50%).

Effect of β-sodium aescinate on hypoxia-inducible factor-1α expression in rat brain neurons after cardiopulmonary resuscitation

Objective To investigate the expression of the hypoxia-inducible factor(HIF)-1α in rat brain neuronsand the intervention of β-sodium aescinate after restoration of spontaneous circulation(ROSC).Methods

The analysis of correlation between serum procalcitonin concentration and microbial infectionsin patients with sepsis

Objective To investigate the diagnostic and predict value of procalcitonin (PCT) in ICU patients with sepsis and the correlation between PCT concentration and positive results of bacterial culture.Methods A total of 278patients with sepsis were admitted into emergency ICU,general ICU and respiratory ICU from October 2011 to September 2012.Of them,193 patients had definite microbial infection evidence.Serum PCT levels among groups of different pathogens were compared.The analysis of correlation between the PCT concentration of

Comparison of point-of-care testing and laboratory testing of myocardial damage markers in the diagnosis and prognosis of acute coronary syndrome

Objective To compare the point-of-care testing(POCT) and laboratory testing of myocardial damage markers in the diagnosis and prognosis of acute coronary syndrome (ACS). Methods A total of 3467 patients with ACS who were treated in the Emergency Department of

Expression of fractalkine in acute lung injury induced by paraquat in rats

Objective To observe the expression of fractalkine(FKN or CX3CL1)in serum and lung tissue in early phases after paraquat(PQ)poisoning in rats,and to analyze the effect of FKN on acute lung injury induced by PQ.Methods A total of 66 SD rats were randomly(random number)divided into two groups,namely PQ

Survey of tele-consultation on Internet for care of myocardial infarction carried out by the chest pain center

Objective To study the efficiency of tele-consultation on Internet with transmitting realtime 12-lead ECG carried out by the Chest Pain Center evaluated by the length of time required for the emergency percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction (STEMI) .Methods A total of 435 STEMI patients treated by emergency PCI were divided into group A (n=98,admitted in 2010) 。

Clopidogrel metabolism related gene polymorphisms in Chinese patients with acute coronary syndrome

Objective To detect the single nucleotide polymorphisms of clopidogrel metabolism related genes(CYP2C19,ABCB1 and PON1) in Chinese patients with acute coronary syndrome(ACS) by genotype analysis. Methods Genetic analysis was performed in patients admitted

A study of inhibitory effect of ulinastatin on hyper-permeability of endothelium induced by TNF-α

Objective To investigate the influence of Ulinastatin(UTI)on the hyper-permeahility of vascular endothelial cells induced by tumor necrosis factor alpha(TNF-α).Methods Inflammation model was induced by TNF-αin human umbilical vein endothelial cell line(EA.hy926).The experiment was designed into 4 groups:normal group,TNF-αgroup,UTI group and TNF-αwith