Severe Disease Activity Based on the Paris Classification Is Associated with the Development of Extraintestinal Manifestations in Korean Children and Adolescents with Ulcerative Colitis

BackgroundThere are limited data regarding the extraintestinal manifestations (EIMs) associated with pediatric inflammatory bowel disease (IBD) in Korea. We aimed to investigate the clinical features and factors associated with the development of EIMs in Korean children and adolescents with IBD.MethodsThis multicenter, retrospective study was conducted from 2010 to 2017. Baseline clinicodemographic, laboratory findings, disease activity, disease phenotypes, and EIMs were investigated.ResultsA total of 172 patients were included. One-hundred thirty-seven (79.7%) had Crohn''s disease (CD), and 35 (20.3%) had ulcerative colitis (UC). EIMs occurred in 42 patients (24.4%). EIMs developed in 34/137 diagnosed with CD (24.8%), and in 8/35 diagnosed with UC (22.9%), during a median follow-up duration of 3.2 (interquartile range, 1.9–5.4) years for CD and 3.0 (1.0–4.0) years for UC, respectively. Arthritis/arthralgia was most commonly observed (n = 15, 35.7%), followed by stomatitis/oral ulcer (n = 10, 23.8%), hepatitis (n = 5, 11.9%), nephritis (n = 4, 9.5%), pancreatitis (n = 2, 4.8%), erythema nodosum (n = 2, 4.8%), pyoderma gangrenosum (n = 1, 2.4%), primary sclerosing cholangitis (n = 1, 2.4%), uveitis (n = 1, 2.4%), and ankylosing spondylitis (n = 1, 2.4%). A significant difference in disease severity based on the Paris classification (P = 0.011) and ESR at diagnosis (P = 0.043) was observed between the EIM positive and negative group in patients with UC. According to logistic regression analyses, S1 disease severity based on the Paris classification was the only factor that was significantly associated with the development of EIMs (odds ratio, 16.57; 95% confidence interval, 2.18–287.39; P = 0.017).ConclusionSevere disease activity based on the Paris classification in pediatric patients with UC was significantly associated with EIM development. As disease severity in the Paris classification is a dynamic parameter, treatment should be focused on disease control to minimize the occurrence of EIMs in Korean children and adolescents with UC.     

五指莲重楼的黄酮和甾体类化学成分研究

目的:研究五指莲重楼根茎中的化学成分。方法:采用溶剂法提取,利用正相硅胶色谱、葡聚糖凝胶SephadexLH-20、反相制备色谱等手段进行分离纯化,并通过现代波谱技术进行结构鉴定。结果:从乙酸乙酯层和正丁醇层中分离得到14个化合物,分别鉴定为胡萝卜苷(1),豆甾醇-3-O-β-D-吡喃葡萄糖苷(2),β-蜕皮激素(3),偏诺皂苷元-3-O-α-L-呋喃阿拉伯糖基(1→4)-[α-L-吡喃鼠李糖基(1→2)]-β-D-吡喃葡萄糖苷(4),薯蓣皂苷元-3-O-α-L-吡喃鼠李糖基(1→4)-α-L-吡喃鼠李糖基(1→4)-[α-L-吡喃鼠李糖基(1→2)]-β-D-吡喃葡萄糖苷(5),山柰酚(6),芦丁(7),杨梅素(8),4,2′,4′-trihydroxychalcone(9),异鼠李素-3-O-β-D-吡喃葡萄糖苷(10),异鼠李素-3-O-芸香糖苷(11),异鼠李素-3-O-龙胆双糖苷(12),5,5′,7-三羟基-4′,4,7″-三甲氧基-[3′-8″]双黄酮(13),5,5′,7,4′,4,7″-六羟基-[3′-8″]双黄酮(14)。结论:化合物1~3,6~14为首次从该种植物中分离得到,其中化合物7~9,13和14为首次从该属植物中分离得到。     

根际促生菌剂对滇重楼生理特性及无机元素的影响

目的:研究接种不同根际促生菌剂(PGPR)对滇重楼幼苗的生长发育和入药品质的影响,为培育优质滇重楼药材提供参考.方法:通过室温盆栽接种试验方法,采用单因素完全随机设计,研究了5种不同PGPR对滇重楼生理特性及无机元素的影响.结果:接种外源不同PGPR可以不同程度地促进滇重楼的生长发育,延缓叶片的衰老,提高新根茎和老根茎...     

滇重楼丛枝菌根与次生代谢产物甾体皂苷的关系初探

目的:考察滇重楼根际丛枝菌根真菌的侵染率、孢子密度与其次生代谢产物甾体皂苷含量的相关性。方法:采用Phillips和Hayman染色法挑选滇重楼丛枝菌根,采用Gendemann湿筛倾析法获得AMF孢子并进行计数。同时,采用HPLC测定滇重楼中4种甾体皂苷(重楼皂苷Ⅰ,Ⅱ,Ⅵ,Ⅶ)的含量。结果:滇重楼根际丛枝菌根真菌侵染率与其孢子密度呈显著的正相关,而侵染率、孢子密度与其根茎总甾体皂苷含量呈一定的正相关。结论:丛枝菌根真菌是影响滇重楼活性成分含量的重要因素。     

彝药“麻补”的资源调查及生药学研究

目的：对凉山彝族自治州彝族民间习用药材“麻补”进行系统的资源调查和生药学研究。方法：通过野外资源普查结合文献标本查考,采用原植物鉴定、药材性状鉴定及显微鉴定。结果：摸清了彝药“麻补”在凉山彝族自治州的资源分布,明确了其基源为狭叶重楼Paris．polyphylla Smith var．stenophylla f.atifolia（Wang et Tang）H．Li,详细描述了彝药“麻补”的原植物形态特征、根茎横切面组织构造和药材粉末特征。结论：所得结果可以为彝药“麻补”的鉴定及资源开发利用提供依据。     

蚤休总皂甙与半边莲生物碱对内皮素及内皮型一氧化氮合酶表达的对比研究

目的:探讨蚤休总皂甙与半边莲生物碱对内皮素和内皮型一氧化氮合酶表达的影响,并比较两种制剂的药效差别。方法:提取蚤休总皂甙与半边莲生物碱,观察两种制剂对高脂血症大鼠主动脉内皮细胞内皮素(ET)合成、血浆ET浓度和血浆内皮型一氧化氮合酶(ecNOS)浓度的影响。结果:高脂喂养大鼠动脉内皮细胞ET-1的合成与释放明显增高,而ecNOS明显降低;应用蚤休总皂甙60d后,动脉内皮细胞ET的合成与释放显著低于高脂对照组(P<0.05),但血浆ecNOS含量无明显变化;应用半边莲生物碱60d后,动脉内皮细胞ET的合成、释放减少(P<0.05)的同时,血浆ecNOS含量较高脂对照组显著升高。结论:蚤休总皂甙与半边莲生物碱均能抑制ET的合成和释放,半边莲生物碱同时还能够促进ecNOS合成和释放,其药效优于蚤休总皂甙。