破壁松花粉联合美沙拉嗪治疗溃疡性结肠炎的疗效及对免疫功能的影响

目的探讨破壁松花粉联合美沙拉嗪治疗溃疡性结肠炎(UC)患者的临床效果及对免疫功能的影响。方法回顾性分析55例溃疡性结肠炎患者的临床资料,将其分为美沙拉嗪组27例和破壁松花粉联合组28例,美沙拉嗪组给予美沙拉嗪口服,破壁松花粉联合组给予破壁松花粉联合美沙拉嗪口服。观察两组患者治疗前后疗效情况。结果与美沙拉嗪组比较,破壁松花粉联合组总有效率显著增高(P＜0.05);结肠黏膜病变、疾病活动度、免疫功能均明显改善(P＜0.05)。两组患者均未发生严重的不良反应。结论破壁松花粉联合美沙拉嗪能改善UC肠道黏膜炎症,有效控制疾病活动症状,促进机体免疫功能恢复。     

Mesalazine (5-aminosalicylic acid) induced chronic hepatitis

BACKGROUND: Treatment of ulcerative colitis or Crohn's disease with sulphasalazine causes several adverse effects, including hepatitis. Sulphasalazine is cleaved by colonic bacteria into 5-aminosalicylic acid and sulphapyridine. Received wisdom was that 5-aminosalicylic acid was topically active, whereas sulphapyridine was absorbed and caused immunoallergic side effects. Mesalazine, a slow release formulation of 5-aminosalicylic acid, was expected to be a safe alternative. However, several cases of acute hepatitis have been reported. CASE REPORT: A 65 year old man had increased liver enzymes, anti-nuclear and anti-smooth muscle autoantibodies and IgG levels, and lesions of chronic hepatitis after 21 months of mesalazine treatment. Although liver dysfunction had been identified eight months earlier, simvastatin rather than mesalazine had been withdrawn, without any improvement. In contrast, liver enzyme and IgG levels became normal and autoantibodies disappeared after discontinuation of mesalazine administration. CONCLUSION: Contrary to initial expectations, mesalazine can cause most of the sulphasalazine induced adverse effects, and hepatic side effects may be almost as frequent. When liver dysfunction occurs, mesalazine administration should be discontinued to avoid the development of chronic hepatitis and liver fibrosis.     

增塑剂及热处理对水性包衣美沙拉秦结肠靶向微丸体外释药 …

以乙基纤维素水分散体Ａｑｕａｃｏａｔ为包衣材料,制备延迟释药的美沙拉秦结肠靶向微丸,考察了４种塑塑剂（三乙酸甘油酯,癸二酯二丁酯、梅楷酸三乙酯、邻苯二甲酸二乙酯）和热处理时间对微丸释药的影响。结果显示,以枸楷酸三乙酯塑化微丸的释药最为理想,在延迟３～４ｈ后开始释药,１２内释药完全,于６０℃处理４ｈ后,释药即趋于稳定。     

Pediatric case of mesalazine‐induced interstitial nephritis with literature review

We present the case of a 14‐year‐old boy with ulcerative colitis who was diagnosed with mesalazine‐induced interstitial nephritis (M‐IIN). Improvement in renal function occurred with discontinuation of mesalazine and corticosteroid therapy. We systematically searched the literature for pediatric cases of M‐IIN. There were eight cases. Majority of the cases were boys (75%) with ulcerative colitis (75%). Average duration of mesalazine use prior to the diagnosis of interstitial nephritis was 24 ± 18 months. The median dose was 1.5 g/day. M‐IIN appears to be an idiosyncratic reaction without any relation to dose or duration of mesalazine use. Although there are no guidelines to recommend routine surveillance of renal function, monitoring of serum creatinine in patients on mesalazine remains an inexpensive and non‐invasive test that may lead to early detection and treatment of renal injury.     

Inflammatory bowel disease in subfertile men and the effect of mesalazine on fertility

Abstract

This study aimed to examine the effect of mesalazine on fertility. In this retrospective analysis of 1,225 male subfertile patients, we reviewed the cases of inflammatory bowel disease (IBD) in the medical records and evaluated the prevalence of the disease in our reproduction center. Specifically, we examined IBD patients who ceased mesalazine during male infertility treatment, and compared the seminogram of these patients before and after discontinuation of mesalazine. We also analyzed pregnancy outcome after discontinuation. The prevalence rate of Crohn’s disease and ulcerative colitis in our male infertile patients was 163 per 100,000 men and 490 per 100,000 men, respectively. Seven patients had taken mesalazine and six of them subsequently stopped the medication. The mean values of sperm concentration, sperm motility, percentage of normal formed sperm, semen volume, and total motile sperm count taken before discontinuation increased after discontinuation of mesalazine. Among these parameters, the sperm motility and total motile sperm count were significantly improved (p?<?0.05) after discontinuation. Of the six patients who stopped the drug, four achieved pregnancy with their partners, with two of the four men showing significant improvement not only in the percentage of normal shaped sperm but also sperm motility and total motile sperm count. This study provides further insight into the rarely investigated relationship between male fertility and mesalazine.     

美沙拉秦缓释片治疗溃疡性结肠炎临床研究

目的观察美沙拉秦缓释片在溃疡性结肠炎治疗中的疗效,副作用及半年复发率。方法随机将溃疡性结肠炎患者分为治疗组40例,给美沙拉秦缓释片1 g,3次/d,复方谷胺酰氨0.2 g,3次/d餐后服用。对照组35例,给予柳氮磺胺吡啶1 g,4次/d,复方谷胺酰氨0.2g,3次/d餐后服用,均治疗至4周。而后复查肝肾功能,免疫球蛋白,血尿常规及肠镜,并继续治疗及随访半年。结果治疗组显效率为52.5.0%,总有效率为92.5%,半年复发12.5%,无明显副反应。对照组显效率为25.7%,总有效率为71.4%,半年复发率31.4%;副反应表现白细胞轻度减少4例(11.4%),胃肠道反应8例(22.8%)。结论美沙拉秦缓释片能有效治疗溃疡性结肠炎,副作用少,半年复发低。     

Spectroscopic assessment of dermal melanin using blue vitiligo as an in vivo model

BACKGROUND: Spectroscopic methods have been used to analyze in vivo melanin in the past but the specific effect of melanin depth on autofluorescence and reflectance spectroscopy has not been determined. In patients with blue vitiligo, three distinctive clinicopathologic patterns are present: (1) normal skin with normal epidermal melanin pigmentation (2), skin of blue vitiligo with dermal melanin pigmentation, and (3) tissue of regular vitiligo with no melanin pigmentation. Blue vitiligo may thus serve as an in vivo model to assess dermal pigment using spectroscopic techniques. OBJECTIVES: To evaluate the reflectance and autofluorescence spectra of a patient with blue vitiligo in order to assess the effect of melanin pigmentation and its localization on the optical properties of the skin. METHODS: The blue-gray, normal and depigmented lesions of a patient with blue vitiligo were analyzed using reflectance and fluorescent spectroscopy. The condition was likely induced by a phototoxic reaction in a patient with pre-existing vitiligo. These data were then correlated to the histologic and electron microscopic findings present in the various types of lesions. RESULTS: Reflectance spectroscopy detected little difference in spectral shape between skin sites affected by blue vitiligo vs. vitiligo. Autofluorescence spectroscopy detected an apparent difference between the two types of lesions, with the blue-gray lesions (blue vitiligo) showing lower fluorescence intensity and spectral maximum position red-shifted compared with regular vitiligo, whereas regular vitiligo showed more intense hemoglobin absorption than the blue vitiligo. CONCLUSIONS: Dermal melanin present in blue vitiligo can be well characterized by autofluorescence spectroscopy, while little difference in reflectance spectral shape exists between vitiligo and blue vitiligo. Thus, autofluorescence spectroscopy may better identify deeper structures in skin tissue, such as melanin, than reflectance spectroscopy.     

双歧杆菌三联活菌胶囊联合美沙拉嗪栓剂治疗UC的临床观察

目的：探讨双歧杆菌三联活菌胶囊联合美沙拉嗪栓剂治疗溃疡性结肠炎（UC）的临床疗效及安全性。方法将收治的60例UC患者按随机数字表分为观察组和对照组,每组30例。2组均予美沙拉嗪栓剂治疗,1 g/次,2次/d,塞肛,在此基础上,观察组加用双歧杆菌三联活菌胶囊,0.42g/次,3次/d,饭后半小时温水服用。2组疗程均为4周。观察治疗前后的临床疗效、改良Mayo评分及不良反应发生率,进行对比分析。结果观察组的总有效率为93.33%,与对照组比较,差异有统计学意义（P＜0.05）。2组治疗后的改良Mayo评分分别为（1.19±1.72）分、（3.21±1.36）分,组间比较,观察组的改善优于对照组（P＜0.05）,而2组不良反应发生率分别为6.67%。13.33%,组间比较无统计学意义。结论培菲康联合美沙拉嗪栓剂治疗溃疡性结肠炎疗效显著。     

抗结肠炎药美沙拉嗪的合成及结构鉴定

报告了抗溃疡性结肠炎药美沙拉嗪的合成工艺及结构鉴定。工艺过程包括重氮化反应、重氮耦合反应和还原反应 ,总收率 6 0 % ,产品含量≥ 99.0 %。通过元素分析、紫外吸收光谱、红外吸收光谱、1 H-核磁共振谱、1 3 C-核磁共振谱和质谱确证了结构     

美沙拉嗪栓联合穴位贴治疗溃疡性结肠炎中期效果探讨

目的:探讨美沙拉嗪栓联合穴位贴治疗溃疡性结肠炎中期临床效果。方法:将溃疡性结肠炎中期患者86例随机分为2组,各43例,其中对照组在常规治疗的基础上使用美沙拉嗪栓每日1~2次治疗,1枚/次,观察组在对照组治疗的基础上使用穴位贴,以中脘、足三里、大肠俞及上巨虚四穴进行贴敷,1贴/d,连续治疗3个月为1个疗程,治疗1个疗程后比较2组患者临床症状积分,临床症状缓解时间及1年后随访患者临床症状复发情况。结果:治疗后1周开始观察组临床症状积分显著低于治疗前及同期对照组(P0.05),治疗后观察组腹泻、腹痛腹胀及黏液脓血便消失时间均短于对照组(P0.05),治疗后1年观察组中发生腹痛、腹泻及脓血便的比率低于对照组(P0.05)。结论:美沙拉嗪栓联合穴位贴治疗溃疡性结肠炎,能较快改善临床症状,且维持时间长。