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Objective To examine characteristics of patients with blood urea nitrogen (BUN) levels higher and lower than the normal limit.Methods During January 2012 to January 2015,116 patients with upper gastrointestinal diseases were selected to study,according to the patient's blood urea nitrogen level,all the patients were divided into high BUN group and low BUN group,and there were 76 patients in the high BUN group,and 40 patients in low BUN group,compared the biochemical indices,gastrointestinal bleeding forrest grading and disease severity of the two groups,and univariate logistic regression analysis.Results The serum white blood cell count,blood urea nitrogen,creatinine and glycated hemoglobin levels in patients of high BUN group [(9 593±5 012)× 102/μl,368.1±162.3 mg/L,11.2±3.7 mg/L and 6.38±1.08％] were significantly higher than that of low BUN patients [(6 804 ± 2 087) × 102/μl,121.0 ± 39.3 mg/L,8.1 ± 3.2 mg/L and 5.51 ± 0.42 ％] (t =3.645～12.659,all P＜0.05),and the hemoglobin levels (87.3±35.1 g/L) of the patients in high BUN group was significantly lower than that of the low BUN patients (108.0 ± 31.2 g/L) (t=3.252,P=0.032).Logistic regression analysis showed the presence of hemoglobin and glycosylated hemoglobin levelst of wo groups of patients was significantly different (P＜0.05),and showed that showed the highest correlation with BUN.Gastrointestinal bleeding forrest hierarchical data of the two groups of patients showed no significant difference (P＞0.05).The proportion of patients with gastric ulcers of high BUN patients was significantly higher than that of the low BUN patients (x2 =39.655,P=0.000).Conclusion Patients with high expression of serum urea nitrogen had more severe upper gastrointestinal bleeding,and it is worthy of attention in the process of clinical diagnostic.
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Objective To investigate infection status and antimicrobial resistance mechanism of methicillin-resistant Staphylococcusaureus(MRSA),and provide reference for the rational antimicrobial use in clinic. Methods Staphylococcusaureus (SA)isolated from various specimens in Xuzhou area in 2012-2015 were collected,MR-SA strains were preliminarily screened by cefoxitin disk diffusion method,and confirmed by amplification of mecA gene,antimicrobial resistance of MRSA was determined by Kirby-Bauer method,minimal inhibitory concentration (MIC)was measured by E-test method,genotypes of staphylococcal chromosomal cassette mec(SCCmec)were de-termined by multiplex PCR. Results A total of 116 strains of MRSA were identified among 210 SA strains in 2012-2015,114 of which were positive for mecA gene,the total detection rate of MRSA was 55.24% . Susceptibility rates of MRSA to vancomycin,quinupristin/dalfopristin,and linezolid were all 100% ,resistance rates of MRSA to chloramphenicol and furantoin were both low,which were 15.52% and 1.72% respectively,resistance rates of MR-SA to 10 kinds of antimicrobial agents were all>80% ;resistance rates of MRSA to penicillins,aminoglycosides, macrolides,quinolones,sulfanilamide,rifampicin,tetracycline,and clindamycin were all higher than methicillin-sensitive Staphylococcusaureus(MSSA). MICs of vancomycin to MRSA in 2012-2015 were all 1.0μg/mL,MIC90 were all 1.5μg/mL,one MRSA isolate was with a vancomycin MIC of 2.0μg/mL in 2015. MRSA typing results of 116 MRSA isolates showed that SCCmec II,SCCmec III,and SCCmec IV accounted for 9.48% (n= 11),73.28% (n= 85),and 1.72% (Iva,n= 2;IVb,n= 2)respectively,13.79% (n= 16)of MRSA isolates were nontypeable, SCCmec I and SCCmec V type strains were not found. Conclusion MRSA is seriously multidrug-resistant,the drift has not been discovered in MIC value of vancomycin against MRSA,the major SCCmec genotype of MRSA is SCCmec III,infection control measures should be taken to control MRSA infection.
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ObjectiveTo investigate the changes in serum levels of M30, M65, and interleukin-17 (IL-17) and their clinical significance in patients with acute pancreatitis. MethodsA total of 126 patients with acute pancreatitis who were admitted to our hospital from December 2009 to December 2013 were selected, and according to clinical diagnosis, they were divided into mild acute pancreatitis group (82 patients) and severe acute pancreatitis group (44 patients). A total of 107 healthy subjects who underwent physical examination during the same period of time were enrolled as the control group. On days 1, 2, and 4, the serum levels of M30, M65, and IL-17 were measured, and M30/M65 ratio was calculated. Comparison of coutinous data between multiple groups was made by ANOVA and pairwise comparison between any two groups was made by SNK-q test, comparison between two groups was made by independent-sample t test, while comparison of categorical data by chisquare test. ResultsOn days 1, 2, and 4, the severe acute pancreatitis group and mild acute pancreatitis group had significantly higher serum levels of M30, M65, and IL-17 (P＜0.05), and a significantly lower M30/M65 ratio (P＜0001), as compared with the healthy controls. On days 1, 2, and 4, the severe acute pancreatitis group had significantly higher serum levels of M30 and M65 than the mild acute pancreatitis group (P＜0.001); on day 1, the severe acute pancreatitis group had a significantly lower M30/M65 ratio than the mild acute pancreatitis group (P＜0.001); the serum level of IL-17 showed no significant difference between the two groups (P＞0.05). M65 and IL-17 had high sensitivity and specificity in the diagnosis of acute pancreatitis. ConclusionThe serum levels of M65 and IL-17 and M30/M65 ratio at 24 hours after the attack of acute pancreatitis can be used as the serological biomarkers for early evaluation of the severity of acute pancreatitis.
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Objective To review the clinical features of chronic daily headache (CDH).Methods The clinical data of 128 patients with chronic daily headache,including general condition,characteristics of headache,concomitant symptom and disability were analyzed retrospectively.The features of primary chronic daily headache (PCDH) and medication over-dose headache (MOH) were compared.Results Among 128 cases females accounted for 79.7％ with an average age of 45.2 years and 88 patients were associated with drug overdose.The symptoms included nausea (68/128),photophobia (75/128),phonophobia (102/ 128),depression (77/128) and irritability (93/128),sleep disorders (94/128),dizziness (75/128),emotional irritability(58/128) and depression(21/128).The migraine disability assessment questionnaire and headache impact test-6 scores showed that disability was resulted from the severe degree of headache in 62.2％ (51/82) and 73.2％ (82/112) of CDH patients respectively.Compared with PCDH patients,the MOH patients had older age (t =2.59,P =0.011),longer duration (t =2.48,P =0.015) and severer degree of headache(t =5.58,P =0.018),and chronic migraine (t =11.95.P =0.001) was the most common primary headache type.Conclusions Most CDH patients are middle-aged women,with moderate to severe pain,usually complicated with depression,dysphoria and asomnia.Chronic daily headache patients are commonly associated with drug overdose.
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Objective To observe the influence of rizatriptan on the behavior and pain-related cytokines in peripheral blood of the migraine model rats, and to investigate the theraputic effect of rizatriptan on migraine.Methods A total of 24 rats were randomly divided into:control group,migraine group,rizatriptan control group and rizatriptan treatment group.The rats in rizatriptan control and rizatriptan treatment groups were intragastrically perfused with rizatriptan,1 mg·kg-1 per day (according to the adult daily dose),and the rats in control and migraine groups were perfused with normal saline,1 mL per day. After 7 d, nitroglycerin was subcutaneously inj ected into the buttocks of the rats in rizatriptan treatment and migraine groups to induce migraine.Normal saline was injected into the rats in control and rizatriptan control groups.At 60-90 min following nitroglycerin injection,the total number of behavioral symptoms was measured.The serum calcitonin gene-related peptide(CGRP),5-hydroxytryptamine (5-HT ), interleukin-1β(IL-1β), and tumor necrosis factor-α(TNF-α) levels were determined using ELISA. Results Compared with migraine group, the behavioral score of the rats in rizatriptan treatment group was significantly decreased (P0.05 );the serum 5-HT level in rizatriptan control group was significantly increased(P0.05).Conclusion Rizatriptan can relieve the behavior symptoms in nitroglycerin-induced migraine model rats, increase the serum 5-HT level, improve the vasomotor disturbance,and relieve the angiectasis.
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Objective To assess the influence of Rizatriptan on the cholecystokinin( CCK) expression in periaqueductal gray( PAG) of migraine model rat to investigate the possible mechanism by which Triptans treat mi?graine. Methods A total of 24 rats were randomly divided into four groups:normal control groups(A),migraine model groups(B),Rizatriptan control groups(C) and Rizatriptan treatment groups(D).C and D groups were intra?gastrically perfused with Rizatriptan,1 mg/kg per day. After 7 days,nitroglycerin was subcutaneously injected into the buttocks of the B and D group to induce migraine. Two hours after nitroglycerin injection,the trigeminal ganglia were isolated.CGRP expression in periaqueductal gray were determined using SYBR Green I real?time quantitative PCR and Immunohistochemistry. Results CCK mRNA levels ( target gene mRNA copies per 250 ng total RNA,× 106) in the rat midbrain of A,B,C,D groups were 1.25±0.41,1.71±0.93,0.17±0.12,0.22±0.07 respectively. CCK?8?immunoreactive positive cells in the rat PAG of each group were 37.17±12.62,40.17±11.09,27.33±7.71, 20.67±7.66 respectively. CCK mRNA expression in group C was significantly lower than that of group A(P<0.05) while the CCK mRNA expression in group D was lower than that of group B(P<0.05).The CCK?8?positive cells of the rat PAG in group D were lower than that in group B(P<0.05) . Conclusion Rizatriptan can down regulate the expression of CCK?8 in the PAG of the migraine rats and weaken the CCK?8 induced inhibition of the analgesic effects of opioid peptides.
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Objective This study assesses the influence of rizatriptan on calcitonin gene-related peptide (CGRP),proenkephalin (PENK) and cholecystokinin (CCK) mRNA expressions in the trigeminal ganglia of a rat migraine model and investigates the possible mechanisms by which triptans treat migraine.Methods A total of 24 rats were randomly divided into four groups:normal control group (A),migraine model group(B),rizatriptan control group (C) and rizatriptan treatment group(D).Groups C and D were intragastrically perfused with rizatriptan,1 mg/kg per day.After 7 days,nitroglycerin was subcutaneously injected into the buttocks of the groups B and D to induce migraine.Two hours after nitroglycerin injection,the trigeminal ganglia was isolated.CGRP,PENK and CCK mRNA expressions in the trigeminal ganglia were determined using SYBR Green Ⅰ real-time quantitative PCR.Results The copy number of CGRP mRNA (× 107) in 200 ng total RNA of each group was 0.05 ±0.01,1.30 ±0.52,0.23 ±0.12,0.43 ±0.33 ; The copy number of PENK mRNA (× 103) in 200 ng total RNA of each group was 3.30 ± 1.65,0.34 ±0.14,3.91 ± 2.44,0.71 ± 0.13.The copy number of CGRP mRNA in the trigeminal ganglia of group B was significantly higher than that of group A (q =7.854,P ＜ 0.05) ; CGRP mRNA expressions were significantly lower in the trigeminal ganglia of rats in group D compared with group B (q =5.458,P ＜0.05).Compared with group A,PENK mRNA expressions in the trigeminal ganglia of rats were significantly lower in group B (q =4.478,P ＜ 0.05).PENK mRNA expressions were significantly higher in trigeminal ganglia of rats in group C compared with group D (q =4.838,P ＜ 0.05).CCK mRNA expression in trigeminal ganglia of rats was similar among groups.Conelusions Rizatriptan can decrease the expressions of CGRP in the trigeminal ganglia of the migraine rats and exhibits neurogenic inflammation triggered by CGRP.PENK expressions decrease in the trigeminal ganglia of the migraine rats,weaken the analgesic effects of enkephalin.