Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China

BACKGROUND/AIMS: Patients with active ulcerative colitis (UC) have elevated levels of activated myeloid-derived leukocytes as a source of inflammatory cytokines. The selective depletion of these leukocytes by adsorptive granulocyte/monocyte apheresis (GMA) with an Adacolumn should alleviate inflammation, promote remission and enhance drug efficacy. However, studies have reported contrasting efficacy outcomes based on patients’ baseline demographic variables. This study was undertaken to understand the demographic features of GMA responders and nonresponders. METHODS: This was a multicenter study in China involving four institutions and 34 patients with active UC. Baseline conventional medications were continued without changing the dosage. The treatment efficacy was evaluated based on the endoscopic activity index and the Mayo score. RESULTS: Thirty of the 34 patients completed all 10 GMA treatment sessions. The overall efficacy rate was 70.59%. The receiver operating characteristic analysis showed that the area under the curve was approximately 0.766 for a Mayo score of ≤5.5 with 0.273 specificity and 0.857 sensitivity (Youden index, 0.584) for GMA responders. No GMA-related serious adverse events were observed. CONCLUSIONS: The overall efficacy of GMA in patients with active UC who were taking first-line medications or were corticosteroid refractory was encouraging. Additionally, GMA was well tolerated and had a good safety profile.

Stady of the nitric oxide,oxygen free radical in serun and intestine mucosal in rats / 中国基层医药

Objective To explore the changes of nitric oxide(NO) and superoxide dismutase(SOD) in the serun and intestine mucosal and the treatment of ulcerative colitis(UC) with tanshinon in rats,Methods 30 mg of trinitro-benzene-sulfonic acid (TNBS) dissolved in 0.85ml of 50% ethanol was administrated intrarectally in Sprague-Dawley female rats to induce experimental colitis.After 7 days,the rats were divided into normal control, 0.9% saline and treatment group tanshinon 2ml?kg~(-1)?d~(-1) were intravenously.The therapeutic effect was evaluated by measuring the ponderal index,the surface area of the ulcers,macroscopical and histological score,activity of NO and SOD were measured in colonic tissue and serum all rats.Results Compared with the saline group,the ponderal index,the surface area of the ulcers,macroscopical and histological score,activity of NO level in the serum and intes- tine mucosal was decreased and the SOD increased of significantly in the treatment group(P

Effect of changji' an oral liquid on activated signal alterative intensity in algesthesia domain in patients with diarrhea type irritable bowel syndrome due to gan-pi disharmony / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Changji' an (CJA) oral liquid on the activated signal alterative intensity (ASAI) in intracranial algesthesia domain in patients with diarrhea type irritable bowel syndrome (IBS) due to Gan-Pi disharmony.</p><p><b>METHODS</b>Twenty-four patients were randomly divided into 2 groups, 14 in the treated group and 10 in the control group, they were administrated with CJA and placebo respectively. The sensory threshold and score in the two groups recorded by rectal inflation test were compared and analyzed. The change of ASAI in intracranial algesthesia domain was analyzed by functional magnetic resonance imagine (fM-RI) during rectum being inflated with 30 ml, 60 ml, 90 ml and 120 ml of gas respectively.</p><p><b>RESULTS</b>The initial sensory thresholds in the two groups were insignificantly different, but significant difference did show between the two groups in urgent defecation threshold and pain threshold after treatment (P < 0.05). Comparison in visual simulative scores between the two groups after treatment at rectal inflated for 30 ml showed no significant difference, but it showed significant difference when the inflation was over 30 ml (P < 0.05). In the treated group, the ASAI in insula cortex when rectal inflation being 90 ml or 120 ml and that in thalamus when rectal inflation being 120 ml were significantly decreased (P < 0.05). But in the control group, it changed insignificantly after treatment.</p><p><b>CONCLUSION</b>The treatment of CJA on Gan-Pi disharmony caused diarrhea type IBS might be effected by regulating the ASAI in intracranial insula cortex and thalamus.</p>

A randomized controlled Multi-center clinical trial on mosapride in the treatment of functional dyspepsia / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the effectiveness and safety of mosapride on treatment of functional dyspepsia.</p><p><b>METHODS</b>Randomized controlled clinical trial was conducted and patients suffered from functional dyspepsia were included. 5 mg mosapride was given three times daily for 4 weeks in the treatment group. 10 mg domperidone was given three times daily for 4 weeks as control. Changes on symptom score, gastric empty or new occurring events were included as outcomes.</p><p><b>RESULTS</b>231 patients suffered from functional dyspepsia were selected by inclusion and exclusion criteria from August 15 to Oct 22, 1999. Of these, 108 (46.8%) were males, versus 123 (53.2%) females and 118 (51.2%) in the treatment group and 113 (48.9%) as controls. 222 (96.1%) patients were followed up. Results showed that the total efficacy rates in early satiety and abdominal distension were 84.5% and 90.1% in mosapride after the 2 weeks of treatment. Mosapride seemed to be more effective in improving symptoms of belching and heartburn than that in controls (P < 0.05). In 4 weeks, the total efficacy in improving symptoms of abdominal distention and belching showed more effective in mosapride than that in controls (P < 0.05). Decrease of symptoms score was more in mosapride than that in controls (P < 0.05). Mosapride was less effective in controls in improving the gastric empty in terms of proportion (46.2% vs. 25.9%, P = 0.020) and range (46.2% vs. 24.0%, P = 0.003). Side effects would include diarrhea, constipation, headache, dizziness, insomnia, skin scare and the like. There was no significant difference between the two groups (9.6% in mosapride vs. 14.0% in controls).</p><p><b>CONCLUSION</b>Mosapride was safe and effective in improving the symptoms and gastric empty of functional dyspepsia.</p>