Circadian responses to endotoxin treatment in mice

We tested the ability of Escherichia coli lipopolysaccharide (LPS) to phase-shift the activity circadian rhythm in C57Bl/6J mice. Intraperitoneal administration of 25 μg/kg LPS induced photic-like phase delays (−43±10 min) during the early subjective night. These delays were non-additive to those induced by light at CT 15, and were reduced by the previous administration of sulfasalazine, a NF-κB activation inhibitor. At CT 15, LPS induced c-Fos expression in the dorsal area of the suprachiasmatic nuclei (SCN). Our results suggest that the activation of the immune system should be considered an entraining signal for the murine circadian clock.     

Clinical features and management of Crohn’s disease in Chinese patients

Background An increasing incidence of Crohn‘s disease has been found in China in recent years.Our study has been focused on evaluating the diversity of the clinical manifestations of Crohn‘ s disease in order to improve early diagnostic accuracy and therapeutic efficacy.Methods Thirty patients with active Crohn‘s disease were enrolled and their clinical data, including diagnostic and therapeutic results, were analyzed. Endoscopy combined with histological examination of biopsy specimens provided characteristic features of the disease. Transabdominal bowel sonography (TABS) was used for detecting intestinal complications. Nutritional supportive therapy was given to 20 subjects with active cases of the disease.Results Most patients were young adults with a higher proportion of females to males ( ratio: 1.14:1 ). The disease affects any segment or a combination of segments along with the alimentary tract(from the mouth to the anus). In this study, the colon and small bowel were the major sites involved.Recurrent episodes of abdominal pain in the right lower quadrant and watery diarrhea were the most common symptoms. Granulomas were identifiable in nearly one-third (30. 8%) of all biopsy specimens. In moderate cases of the disease, remission was achieved more quickly through the use of oral prednisone therapy than with SASP or 5-ASA. Beneficial effects on the host‘ s nutritional status were observed. Immunosuppressives were used on an individual basis and showed variable therapeutic effects. Sixteen patients had surgery due to intestinal obstruction or failure to respond to drug therapies. Rapid improvement after surgery was reported.Conclusion Endoscopy (with biopsy) and TABS were both crucial procedures for diagnosis. SASP (or 5-ASA) and prednisone were effective as inductive therapies. Azathioprine has demonstrable benefits after induction therapy with prednisone. Surgery, as an alternative treatment, provided another effective choice in selected patients.     

中药灌肠Ⅰ号对炎性肠病大鼠血象与病理学指标的影响

目的:选择合适的大鼠炎性肠病(IBD)模型,观察中药灌肠Ⅰ号对其治疗作用,为IBD治疗寻找新途径。方法:Wistar大鼠80只,分为正常对照组、模型组、西药sulfasalazine(SASP)组和中药灌肠Ⅰ号组,每组动物20只。分别在用药后4,7,14,21 d观察外周血细胞变化与肠道病理学指标。结果:给药7 d后SASP组和中药组外周血小板数都比模型对照组明显升高。组织病理学观察显示SASP组对于IBD的远期治疗作用不甚明显,而灌肠Ⅰ号确实有减轻IBD病变,促进其修复的作用,近期与SASP相当,远期优于SASP。结论:中药灌肠Ⅰ号有较明显的抗大鼠炎性肠病效果。     

中西医结合治疗溃疡性结肠炎65例报告

目的　观察中药灌肠配合西药柳氮磺胺吡啶口服治疗溃疡性结肠炎的近期及远期疗效。方法　将纤维肠镜确诊的 10 5例溃疡性结肠炎患者随机分为中西医结合治疗组和西医治疗组。中西医结合治疗组(6 5例 )用清热解毒、活血化瘀的中药灌肠 ,益气健脾化湿的中药内服 ,配合西药柳氮磺胺吡啶口服治疗 ;西医治疗组 (4 0例)单用柳氮磺胺吡啶治疗。治疗 2个疗程后 ,观察两组的近期疗效、远期疗效。结果　中西医结合治疗组的临床治愈率为 94 6 % ,西医治疗组的临床治愈率为 82 5 % ,两组比较差异有统计学意义 (P <0 0 5 ) ;2年后的复发率中西医结合治疗组明显低于西医治疗组 (P <0 0 5 )。结论　中药内服、灌肠 ,配合柳氮磺胺吡啶口服治疗溃疡性结肠炎的疗效优于单用柳氮磺胺吡啶 ,且复发率更低     

中医综合疗法治疗类风湿性关节炎疗效观察

[目的]观察中医方法治疗类风湿性关节炎的疗效。[方法]将87例随机分为治疗组44例和对照组43例,治疗组予温针灸配合口服中药汤剂,对照组予口服甲氨喋呤,柳氮磺吡啶及扶他林,治疗90d后观察两组疗效及不良反应。[结果]治疗组有效率84.09%,对照组为81.40%(P>0.05)无明显差异。不良反应:治疗组22.73%明显小于对照组的53.49%。[结论]采用中医方法治疗类风湿性关节炎能取得较好的疗效,且不良反应少,费用低。     

Current medical therapy of inflammatory bowel disease

The 1990's have brought a significant promise and the hope for a better and brighter future in the new millennium for patients with inflammatory bowel disease (I3D). A better understanding of the pathophysiology of IBD symptoms has led to newer treatnent modalities and streamlining of therapy for specific subsets of patients. ULCERATIVE COUTISThe treatnent for ulcerative colitis (UC) is aimed at modulating the inflammatory response. The drugs which are found to be effective are sulfasalazine (Azulfidine, Salazopyrin) and its 5ASA derivatives, glucocorticosteroids, immunomodulators/immunosuppressants, and other new potential drugs (Table 1).     

Abnormal semen quality and low serum testosterone in men with inflammatory bowel disease treated for a long time with sulfasalazine

Our purpose was to study the effects of long-term salazopyrine treatment on male fertility. Seven patients, 21-37 years old, who had been treated for ulcerative colitis with 3 g/day of salazopyrine for more than 6 months, were examined. All their semen samples showed abnormal sperm motility (17% +/- 9.3) and abnormal morphology (36.3% +/- 14.4) with the predominance of large-headed spermatozoa. The endocrine picture and pituitary reserve were evaluated by GnRH and TRH tests. The basal values of testosterone were lower than the normal in our laboratory (greater than 3 ng/ml) and significantly lower (2.4 +/- 0.7 ng/ml, p less than 0.025) than in the control group (fertile men). LH was significantly higher (9 +/- 2 mIU/ml, p less than 0.005) but still within the limits of normal. The responses of FSH and LH to GnRH and of PRL to TRH were normal. The mechanisms by which salazopyrine may affect fertility are discussed.     

金双歧联合柳氮磺胺吡啶治疗溃疡性结肠炎疗效观察

目的评价微生态制剂金双歧联合柳氮磺胺吡啶治疗溃疡性结肠炎的临床疗效。方法52例内镜确诊为病变在直肠、乙状结肠的轻、中度溃疡性结肠炎患者随机分为对照组（25例）及治疗组（27例）。对照组予柳氮磺胺吡啶（SASP）1．0g，口服，4次／d；治疗组予金双歧4，0g，灌肠，1次／晚，并予柳氮磺胺吡啶1．0g，口服，4次／d，疗程均为6周。治疗后进行症状评分，对药物疗效进行评价，同时复查肠镜取病理观察组织学的变化。结果在临床症状、肠镜下表现、组织学进步方面（总有效率分别为88．0％和63．0％，80．0％和51．9％，76.0％和48．1％）。经X^2检验差异均有显著意义（P〈0．05）。结论金双歧联合柳氮磺胺吡啶治疗溃疡性结肠炎（UC）疗效满意。较单用柳氮磺胺吡啶好。     

Successful treatment of recalcitrant necrotizing eosinophilic folliculitis using indomethacin and cephalexin

A 56-year-old man presented with a 4-month history of a painful and pruritic eruption consisting of crusted plaques and blisters on his face, scalp and chest. The patient suffered from headaches and malaise but was afebrile. Two skin biopsies revealed an epidermis which was eroded and covered by locules of serum and neutrophils. In the underlying dermis, there was a marked mixed inflammatory reaction including lymphocytes, neutrophils and numerous eosinophils. There was exocytosis of eosinophils into several follicles with areas of follicular mucinosis. A diagnosis of necrotizing eosinophilic folliculitis was made based upon the clinical and histopathological findings. The diagnosis was supported by the rapid response to a combination of indomethacin and cephalexin. The patient has taken continuous indomethacin (with rabeprazole and misoprostol cover) and cephalexin for 2 years. If treatment is withdrawn he experiences a flare of his disease within 2 weeks. This case highlights the potentially chronic nature of this disease.