Recto-sigmoïdite induite par administration de purgatifs à propos d'un cas / Recto-sigmoiditis induced by purgative administration: a case report

Il s'agit d'un patient de 25 ans reçu pour hématochézie de grande abondance et douleurs abdominales après utilisation par voie orale et rectale d'un purgatif à base de graines de Jatropha curcas ou pignon d'Inde appelée en bambara (langue locale du Mali) « Bagani ¼ et de Scoparia dulcis appelée en bambara « timitimini ¼. La coloscopie réalisée a permis de retrouver une nécrose du colon descendant. Le patient est décédé dans un tableau de choc septique par perforation colique.

This 25-year-old patient was presented with profuse hematochezia and abdominal pain following oral and rectal use of a purgative based on Jatropha curcas or "pignon d'Inde" seeds, known in Bambara (the local language of Mali) as "Bagani", and Scoparia dulcis, known in Bambara as "timitimini". Colonoscopy revealed necrosis of the descending colon. The patient died of septic shock due to colonic perforation

Factors associated with extreme weight loss behaviors among adolescents of Northeastern Brazil: a hierarchical approach / Comportamentos extremos para perda de peso e fatores associados em adolescentes do Nordeste brasileiro: uma abordagem hierárquica

Abstract The objective of this article is to identify the prevalence and evaluate the factors associated with extreme weight loss behaviors among adolescents of Northeastern Brazil. Cross-sectional study with 2,439 adolescents from Sample 2 (2015) of the National School-based Health Survey. Extreme weight loss behaviors, such as self-induced vomiting, laxative use and use of medicines or formulas (outcome) and independent variables were evaluated using a self-administered electronic questionnaire. The statistical analysis was performed following a hierarchical conceptual model. The prevalence of extreme weight loss behaviors in the sample was 12.1%. Among the factors that showed significant association with the outcome, we emphasize the administration model of the private school (PR = 0.62; CI = 0.46-0.84), bullying related to body appearance and for other reasons (PR = 1.62; CI = 1.19-2.20), forced sexual intercourse (PR = 2.65; CI = 1.90-3.69), insomnia (PR = 1.84; CI = 1.43-2.37), and be perceived as fat or very fat (PR = 1.90; CI = 1.50-2.42). Moderate prevalence of extreme weight loss behaviors was identified among adolescents. Socioeconomic factors, exposure to violence, mental health, and body image were associated with the adoption of these behaviors.

Resumo O objetivo deste artigo é identificar a prevalência e avaliar os fatores associados aos comportamentos extremos para perda de peso em adolescentes do Nordeste brasileiro. Estudo transversal com 2.439 adolescentes da Amostra 2 (2015) da Pesquisa Nacional de Saúde do Escolar. Os comportamentos extremos para perda de peso (desfecho) e as variáveis independentes foram avaliadas por meio de um questionário eletrônico autoaplicável. A análise estatística foi realizada seguindo um modelo conceitual hierárquico. A prevalência de comportamentos extremos para perda de peso na amostra foi de 12,1%. Entre os fatores que mostraram associação significativa com o desfecho, destacam-se a situação administrativa da escola privada (RP = 0,62; IC = 0,46-0,84), ser vítima bullying relacionado à aparência corporal e pelos demais motivos (RP = 1,62; IC = 1,19-2,20), ser forçado a ter relação sexual (RP = 2,65; IC = 1,90-3,69), ter insônia (RP = 1,84; IC = 1,43-2,37) e se autoperceber como gordo ou muito gordo (RP = 1,90; IC = 1,50-2,42). Prevalência moderada de comportamentos extremos para perda de peso foi identificada entre os adolescentes. Os fatores socioeconômicos, de exposição à violência, de saúde mental e da imagem corporal se associaram à adoção de tais comportamentos.

Comparative study of purgative pharmacological effects and mechanisms of Moringa oleifera leaves and Rhei Radix et Rhizoma / 中国中药杂志

Moringa oleifera leaves are known for their "Virechana"(purgative) effect in Ayurvedic medicine in India. This study compared the purgative effects and mechanisms of M. oleifera leaves with the reference Rhei Radix et Rhizoma to establish a foundation for the further application of M. oleifera leaves in traditional Chinese medicine(TCM). Using network pharmacology and molecular docking methods, this study identified the material basis, common targets, and signaling pathways through which Rhei Radix et Rhizoma and M. oleifera leaves exerted their purgative pharmacological effects. A low-fiber diet-induced constipation mouse model was established to measure fecal parameters and small intestinal propulsion rate, and histological changes in the colon were observed using HE staining. Relative expression levels of relevant genes and target proteins were assessed using RT-qPCR and immunohistochemistry, respectively. The results showed that mapping the targets of Rhei Radix et Rhizoma and M. oleifera leaves onto the biological process network of constipation revealed close proximity, indicating that they may exert their therapeutic effects on constipation through similar biological processes. Molecular docking results indicated that compounds such as sennoside C and isoquercitrin could target serine/threonine protein kinases(AKT1) and mitogen-activated protein kinase 3(MAPK3), thereby affecting MAPK and calcium signaling pathways to promote defecation. Animal experiments demonstrated that both M. oleifera leaves and Rhei Radix et Rhizoma increased the number of fecal pellets and water content in constipated mice, improved small intestine motility, colon mucosal thickness, and muscle layer thickness, upregulated the gene expression levels of AKT1 and MAPK3 in the colon, and downregulated the expression of AQP3 protein. These findings suggest that M. oleifera leaves and Rhei Radix et Rhizoma share similarities in their therapeutic efficacy and mechanisms for treating constipation. Using Rhei Radix et Rhizoma as a reference can provide a better understanding of the characteristics of the "Virechana"(purgative) effect of M. oleifera leaves in TCM.

A rare and interesting case of Scarabiasis

Scarabiasis or Canthariasis or Beetle disease is an ectoparasitic infection of the gastrointestinal tract, in which the beetles temporarily infest the digestive tract and rarely the urinary tract. Dung beetle belongs to Scarabiaediae family.' It is mostly seen in children aged between 2 to 5 years, who play outdoor for prolonged hours without undergarments. It is a temporary infestation in which early stages of development of beetle takes place in the anus and the adult beetle flies, out of the anus while defecation. A boy aged 3 years and four months presented to the pediatric OPD with complaints of peri umbilical abdominal pain, vomiting, nausea, mucus in stool along with 'black insects' in his stool. The clinical examination revealed that the pulse rate, blood pressure and temperature were normal. Per rectal examination and ultrasound of the abdomen was normal. Routine examination of stool and urine was also found to be normal. The beetle was identified by the medical entomologist as dung beetle belonging to family Scarabidae. This report implies that the boy had an infestation with the larvae of dung beetle in the gastro intestine. The family belonged to the high range area of Mundakayam. Agriculture is the main source of income for people and main plantation being Rubber. Natives breed cattle for their livelihood and agriculture. During contact with mud or while playing outdoors naked, he would have come into contact with the eggs or the beetle, which hatched into larvae and caused canthariasis.

Study on the experimental mechanism of Warm Purgative and Strengthening Spleen therapy combined with antibiotics in the treatment of sepsis / 中国中西医结合急救杂志

Objective To explore the synergism efficacy and mechanism of Warm Purgative and Strengthening Spleen (WPSS) therapy combined with antibiotics in the treatment of sepsis. Methods Thirty-two SPF Spargue-Dawley (SD) rats were used to replicate the rat sepsis model by cecum ligation perforation (CLP) method and equally divided into model control (MC) group, ceftriaxone group, Chinese herbal medicine (CHM) group and ceftriaxone +CHM group. Eight SD rats underwent sham surgery were used as a sham operation (Sham) group. Rats in Sham and MC groups were administered with 0.9% normal saline (NS) by intraperitoneal injection and gavage. Rats in CHM group were administered with modified Dahuang Fuzi Decoction (DFD, 8 mg/kg) by gavage + 0.9% NS by intraperitoneal injection, Bid. Rats in ceftriaxone group were administered with 0.9% NS by gavage and ceftriaxone (120 mg/kg) by intraperitoneal injection, Bid. Rats in ceftriaxone + CHM group were administered with modified DFD (8 mg/kg) by gavage and ceftriaxone (120 mg/kg) intraperitoneal injection, Bid. The drugs were given for 2 days. The mortality of rats in each group was observed after treatment. The intestinal flora changes and intestinal permeability [intestinal mucosa injury index (IMII), intestinal mucosa secretory immunoglobulin (sIgA), serum D-lactic acid, diamine oxidase (DAO) and sIgA] were detected. Meanwhile, the levels of serum inflammation indexes [lipopolysaccharide (LPS), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)] were detected. Results ① Mortality: ceftriaxone+CHM group (25.0%) < CHM group (37.5%) and ceftriaxone group (37.5%) < MC group (50.0%), the differences between groups were statistically significant (all P < 0.05). ② 16S rDNA sequencing analysis: the ratio of Bacteroidetesin in MC group was lower than that in the Sham group [(24.36±7.15)% vs. (45.20±6.05)%], and the ratio of Proteobacteria in MC group was higher than that in Sham group [(10.03±7.55)% vs. (0.41±0.21)%]. The diversity of intestinal flora in ceftriaxone group was significantly lower than that in Sham and CHM groups (404.60±17.09 vs. 470.80±16.97, 469.20±14.59), the differences between groups were statistically significant (all P < 0.05). The principal component analysis (PCA) suggested that the composition of CHM group was closer to that of Sham group, which indicated that WPSS therapy could reduce intestinal flora disorders in rats with sepsis. ③The pathological changes of intestinal mucosa: light microscope showed the intestinal mucosa of Sham group was intact; the intestinal mucosa became thinner, and local inflammatory cells had infiltration in MC group. The thickness of intestinal mucosa in CHM, ceftriaxone and CHM+ceftriaxone groups was slightly thicker, and the infiltration of local inflammatory cells was less than that in MC group. The thickness of intestinal mucosa in CHM group and ceftriaxone+CHM group was slightly thicker than that in the ceftriaxone group, and the arrangement was more regular than that in MC group and ceftriaxone group.④Intestinal mucosa permeability and inflammatory state: IMII, D-lactic acid, DAO, LPS, TNF-α and IL-6 of rats in MC group were higher than those of rats in Sham group [IMII: 4.37±0.56 vs. 0.26±0.29, D-lactic acid (mg/L):12.35±0.83 vs. 7.30±1.29, DAO (kU/L): 2.16±0.43 vs. 0.32±0.06, LPS (kU/L): 0.663±0.012 vs. 0.095±0.003, TNF-α (μg/L): 251.03±82.69 vs. 52.15±6.25, IL-6 (μg/L): 160.50±4.77 vs. 54.30±3.36], while sIgA in MC group was lower than that in Sham group (mg/L: 11.57±0.17 vs. 26.76±1.99). IMII, D-lactic acid, DAO, LPS, TNF-α and IL-6 of rats in CHM, ceftriaxone and CHM+ ceftriaxone groups were significantly lower than those of rats in MC group, while sIgA in CHM, ceftriaxone and CHM+ceftriaxone groups were significantly higher than that of rats in MC group. The change of CHM+ceftriaxone group was more significant than those of CHM group and ceftriaxone group [IMII:1.78±0.23 vs. 1.96±0.62, 3.39±0.43, D-lactic acid (mg/L): 8.56±0.37 vs. 9.62±0.57,11.42±0.39, DAO (kU/L):1.14±0.12 vs. 1.72±0.24, 2.01±0.32, sIgA (mg/L): 25.34±1.49 vs. 23.99±7.85, 17.46±1.20, LPS (kU/L):0.302±0.007 vs. 0.387±0.004, 0.715±0.013, TNF-α (μg/L): 57.10±3.98 vs. 101.49±21.49, 141.91±20.20, IL-6 (μg/L): 93.71±2.39 vs. 87.12±7.31, 104.27±1.84]. Conclusion WPSS therapy may improve the efficacy of antibiotics in the treatment of sepsis by regulating the intestinal flora and reducing the intestinal mucosa permeability and inflammation level.

Comparison of Purgative Manna Drop and Phototherapy with Phototherapy Treatment of Neonatal Jaundice: A Randomized Double-Blind Clinical Trial

OBJECTIVES: Herbal remedies such as purgative manna are used to treat neonatal jaundice. In this study Bilineaster drop (purgative manna) and phototherapy, and phototherapy treatment alone were compared by assessing phototherapy duration and number of days in hospital. METHODS: There were 150 consecutive term neonates with jaundice, weighting from 2,500 g to 4,000 g enrolled in this randomized double blind clinical trial. The neonates were randomly assigned to intervention and control groups. The control patients received only phototherapy and the intervention group underwent phototherapy treatment and purgative manna drop (5 drops per kg of body weight, 3 times a day). Direct and total measurements of bilirubin concentration in the serum were measured and the reduction in concentration of bilirubin was calculated. RESULTS: There were 28% of patients whose hospital duration following phototherapy was 2 days, for Bilineaster and phototherapy treatment this was 49.3% of patients. At 48 hours and 72 hours the reduction in the concentration of total bilirubin in the serum was statistically significantly different across groups (p 0.05). The reduction in direct bilirubin concentration in the serum was significantly different between groups at 72 hours and 96 hours (p > 0.001). CONCLUSION: Purgative manna and phototherapy, can statistically significantly reduce total bilirubin concentration at 48 hours and 72 hours compared with phototherapy alone, and reduce the length of hospital stay for jaundiced neonates at 2 days compared with phototherapy treatment.

Design and evaluation of rhubarb total free anthraquinones oral colon-specific drug delivery granules to improve the purgative effect

Rhubarb is commonly used as a cathartic in Asian countries. However, researchers have devotedextensive concerns to the quality control and safety of rhubarb and traditional Chinese preparations composed of rhubarb due to the instable purgative effect and potential nephrotoxicity of anthraquinones. In this study, we aimed to prepare rhubarb total free anthraquinones (RTFA) oral colon-specific drug delivery granules (RTFA-OCDD-GN) to delivery anthraquinones to colon to produce purgative effect. RTFA-OCDD-GN were prepared using chitosan and Eudragit S100 through a double-layer coating process and the formulation was optimized. Continuous release studies were performed in a simulated gastric fluid (pH 1.2), followed by a small-intestinal fluid (pH 6.8) and a colonic fluid (pH 7.4, containing rat cecal contents). The purgative effect test was performed in rats. The dissolution profile of RTFA-OCDD-GN showed that the accumulative dissolution rate of RTFA was about 83.0% in the simulated colonic fluid containing rat cecal contents and only about 9.0% in the simulated gastrointestinal fluids. And the RTFA-OCDD-GN could produce the comparative purgative activity as rhubarb, suggesting it could deliver the free AQs to the colon. The RTFA-OCDD-GN was a useful media to enhance the purgative activity of free anthraquinones after administered orally.

Optimizatoin of extraction technology of compound purgative Moringa Oleifera based on central composite design and response surface method / 国际中医中药杂志

Objective To optimize the extraction technology of Compound purgative Moringa Oleifera by central composite design-response surface method. Methods The content of isoquercetin and astragalin, the yield of dry extract and overall desirability (OD) were used as the evaluation indexes; the factors such as water addition, extraction times and time for extraction were employed to optimize extraction technology of central composite design-response surface method. Results Optimal extraction technology was as follows: 3 times extracted with 10-fold the amount of water for 1 h each time. Conclusions Central composite design-response surface method was suitable for optimizing extraction technology of compound purgative Moringa Oleifera.

A critical review on Nepal Dock (Rumex nepalensis): A tropical herb with immense medicinal importance

Rumex nepalensis Spreng. (Polygonaceae) commonly known as Nepal Dock has wide-spectrum therapeutic potencies and is extensively used for centuries in traditional medicine systems. The leaves of this plant are edible and a rich source of natural antioxidants. They act as a possible food supplement and are largely used in pharmaceutical industry. Extracts and metabolites from this plant exhibits pharmacological activities including anti-inflammatory, antioxidant, antibacterial, antifungal, antiviral, insecticidal, purgative, analgesic, antipyretic, anti-algal, central nervous system depressant, genotoxic, wound healing and skeletal muscle relaxant activity. Due to its remarkable biological activities, it has the potential to act as a rich source of drug against life threatening diseases. However, more studies are needed to scientifically validate the traditional uses of this plant, beside isolating and identifying their active principles and characterizing the mechanisms of action. We present herein a critical account of its botany, ecology, traditional uses, phytoconstituent profile and major pharmacological activities reported in recent years and therefore will provide a source of information on this plant for further studies.

Absence seizure associated with coloprep consumption in colonoscopy / Convulsão de ausência com o uso de Coloprep em colonoscopia

Coloprep is a bowel preparatory solution given before endoscopic procedures to get a unobscured internal vision. It has among its constituent's sodium sulphate, potassium sulphate and magnesium sulphate which produce an osmotic effect in the bowel. However, the use of such agents in hyponatremic and patients predisposed to seizures can have adverse ramifications. The current case outlines manifestation of absence seizure in a 52-year-old male patient who was administered Coloprep for colonoscopy. There was absence of other predisposing factors and the symptoms were ameliorated using timely identification and rectification of the underlying derangements.

Coloprep é uma solução preparatória intestinal administrada antes de procedimentos endoscópicos, com o objetivo de se ter uma visão interna não obscurecida. Entre os constituintes de Coloprep, observa-se sulfato de sódio, sulfato de potássio e sulfato de magnésio, que provocam efeito osmótico no intestino. Mas o uso de tais agentes em pacientes hiponatrêmicos e com predisposição para convulsões pode ter ramificações adversas. O caso em tela delineia uma manifestação de convulsão de ausência em paciente do gênero masculino com 52 anos e que recebeu Coloprep para colonoscopia. Não havia outros fatores predisponentes e os sintomas melhoraram graças à oportuna identificação e correção dos transtornos subjacentes.

Comparative study on expelling water retention with drastic purgative of crude and vinegar stir-baked Kansui Radix in cancerous ascites rats / 中草药

Objective: To compare the function of expelling water retention with drastic purgative of crude and vinegar stir-baked Kansui Radix in cancerous ascites model rats. Methods: Furosemide was taken as positive control drug, and the cancerous ascites model rats were respectively orally administered with powder of crude and vinegar stir-baked Kansui Radix and their alcohol and water extract for 7 d. The amounts of urine and ascites, the levels of urinary sodium, potassium, chlorideion, and pH value, and the contents of PRA, Ang II, ALD, and ADH in serum were investigated. Results: Compared with model group, the amount of urine of each medication administration group significantly increased (P < 0.05, 0.01), the amount of ascites, the levels of urinary sodium, potassium, chlorideion, and pH value (P < 0.01), and the contents of PRA, Ang II, ALD, and ADH in serum all showed a significant decrease (P < 0.05, 0.01). Among them, the groups which were administered with powder of crude and vinegar stir-baked Kansui Radix were the most significant, and there was no significant difference between the two groups. Conclusion: The powders of crude and vinegar stir-baked Kansui Radix have a remarkable effect on expelling water retention with drastic purgative, and they could improve the symptom of cancerous ascites model rats.

Normalizing the eating pattern with virtual reality for bulimia nervosa: a case report / Normalización de la ingesta con realidad virtual en la bulimia nerviosa: un caso clínico

The aim of the present study was to analyze the effects of a virtual reality (VR) component as a therapeutic tool to normalize eating patterns, as part of the cognitive-behavioral treatment of a bulimia nervosa (BN) patient. Results indicated that the patient made significant progress with her eating habits; binges and vomits were eliminated completely. Moreover, when the VR started the patient avoided food, especially meat (5 over 5), and it was reduction of this avoidance in the lasts sessions (2 and 3 over 5). It was also observed a reduction in the avoidance and the fear of eating (from 10 and 9 to 6 and 5 respectively) and increased the impulse control (from 2 to 7). The patient felt that the VR experience seemed real and similar to reality (mean score of 8.3 over 10). Before and after the seven VR sessions, there was a decrease in the drive for thinness, bulimia, ineffectiveness, and BITE symptoms and severity, and in the general psychopathology. Moreover, the patient improved her motivation to change. Results suggest that VR is a relevant and effective complement to traditional treatment in a BN patient. Further studies should continue this line of research by using larger sample sizes with different diagnoses and subtypes and control groups.

El objetivo del presente estudio fue analizar el efecto de un componente de realidad virtual (RV) como una herramienta de terapia para la normalización de la ingesta, como parte de un tratamiento cognitivo conductual para la bulimia nerviosa (BN). Después de un módulo de 7 sesiones de RV, la paciente tuvo un progreso significativo en sus hábitos alimentarios. Los atracones y vómitos se eliminaron completamente. Además, al inicio de las sesiones, la paciente evitaba la comida, especialmente la carne (5 sobre 5), observándose una reducción de la evitación en las últimas sesiones (2 y 3 sobre 5). También se redujeron la evitación y el miedo a comer (de 10 y 9 a 6 y 5, respectivamente) y aumentó el control del impulso (de 2 a 7). La paciente sintió como real la experiencia virtual y fue evaluada como similar a lo que experimenta en la vida real (puntuación media de 8,3 sobre 10). Después de las 7 sesiones de RV, hubo una reducción en el impulso por adelgazar, bulimia, ineficacia, en los síntomas y la gravedad del BITE, y en la psicopatología general. Además, la motivación al cambio mejoró en la paciente. Los resultados indican que la RV es un complemento relevante y efectivo en el tratamiento tradicional en una paciente con BN. Se requieren futuros estudios en esta línea muestras más amplias con diferentes diagnósticos y subtipos y grupo control.

Methanol extract of Tephrosia vogelii leaves potentiates the contractile action of acetylcholine on isolated rabbit jejunum

To investigate the modulating role of methanol extract of Tephrosia vogelii leaves on acetylcholine (ACh)-induced contraction of isolated rabbit jejunum. Methods: Rabbit jejunum segment was removed and placed in an organ bath containing Tyrode’s solution, and its contractions were recorded isometrically. Results: ACh (2.0 × 10-10 g/mL) and the extract (2.0 × 10-4 g/mL) individually increased the frequency of contraction (mean ± SEM) of the isolated smooth muscle tissue by 47.6% ± 9.5%and 77.8% ± 66.5%, respectively. When ACh and the extract were combined, the frequency of contraction of the tissue was increased by 222.2% ± 25.9%, representing a 366.7% increase (P < 0.001) over the effect of ACh alone. Similarly, ACh (2.0 × 10-9 g/mL) and the extract individually increased significantly (P < 0.001) the amplitude of contraction of the tissue by 685.7% ± 61.1% and 455.2% ± 38.1%, respectively. When ACh and the extract were combined, the amplitude of contraction of the tissue rose by 1263.8% ± 69.0%, representing 84.3% increase over the effect of ACh alone. Conclusions: The findings demonstrate that methanol extract of Tephrosia vogelii leaves potentiates the contractile effect of ACh on intestinal smooth muscle, supporting the traditional claim that the plant is purgative.

Influence on Serum Inflammatory Factors Level and Efficacy of Octreotide Combined with Potent Purga-tive Decoction with Additions in Patients with Early Postoperative Inflammatory Bowel Obstruction ( EPIS-BO) after Abdominal Operation / 中国药师

Objective:To discuss the influence and curative effect of octreotide combined with potent purgative decoction with ad-ditions on serum inflammatory factors level in the patients with early postoperative inflammatory bowel obstruction ( EPISBO) after ab-dominal operation. Methods: Totally 78 cases of patients with EPISBO after abdominal operation were divided into the observation group and the control group with 39 ones in each. The patients in the two groups were given the basic medical treatment, such as fast-ing, water deprivation, gastrointestinal decompression, maintenance of water, electrolyte and acid-base balance, infection prevention, parenteral nutrition support and etc. The patients in the control group were given 0. 1mg octreotide via hypodermic injection, q8h, while the patients in the observation group were additionally given potent purgative decoction with additions, one dose per day comple-ted by twice or three times through mouth or nasogastric tube. The course of treatment was 1 week. The changes of serum hs-CRP and TNF-α levels in the two groups before the treatment and after the medical treatment were observed and compared, and the curative effect and adverse drug reactions ( ADR) were evaluated as well. Results: After the one-week medical treatment, the serum hs-CRP and TNF-α levels in the two groups were obviously declined (P0. 05). Conclusion:Octreotide combined with potent purgative decoction with additions has significant curative effect in the patients with EPISBO after abdominal operation with high security, and the mechanisms are related with such effects as reducing serum hs-CRP and TNF-α levels and inhibiting local inflammatory response in intestinal tract.

Comparative effects of different extracts of Kansui Radix stir-baked with vinegar on function of expelling water retention with drastic purgative in cancerous ascites model rats / 中草药

Objective: To study the effects of different extracts of Kansui Radix stir-baked with vinegar (KRV) on the function of expelling water retention with drastic purgative in cancerous ascites model rats. Methods: The cancerous ascites model rats were respectively ig administered with KRV powder, ethanol extract, aqueous extract, and ehanol and aqueous extract of KRV (340 mg/kg) for 7 d. The amounts of urine and ascites, the levels of urinary sodium, potassium, chloride ion, and pH value, and the contents of PRA, Ang II, and ALD in serum were investigated. UPLC-QTOF MS technology was used to explore the components differences in various extracts of KRV. Results: Compared with the control group, the amount of urine in model group was significantly reduced (P<0.05), the ascites generated, and the urinary sodium, potassium, chloride ion, pH value, and the contents of PRA, Ang II, and ALD in serum were all significantly increased (P<0.01). Compared with the model groups, the treatment groups showed decreasing trend in ascites; The amounts of urine in positive groups, powder groups, ethanol and aqueous extract groups showed a significant increase (P<0.05); The level of urinary sodium of water extraction groups showed significant decrease (P<0.05); The levels of urinary sodium, potassium, chloride ion, pH value, and the contents of PRA, Ang II, and ALD in serum of positive groups, powder groups, ethanol extract groups, and ethanol and aqueous extract groups all showed a significant decrease (P<0.05, 0.01). Diterpenes were inspected in the alcohol extract and alcohol and aqueous extract, fewer in the aqueous extract. Conclusion: Powder groups and ethanol and aqueous extract groups of KRV have remarkable effect on expelling water retention with drastic purgative, and there is no significant difference between the two groups, which could provide the basis for clinical medication of KRV that is made into the pill and powder. Diterpenes in KRV may be the active components on the function of expelling water retention with drastic purgative.

Methanol extract of Tephrosia vogelii leaves potentiates the contractile action of acetylcholine on isolated rabbit jejunum

Objective: To investigate the modulating role of methanol extract of Tephrosia vogelii leaves on acetylcholine (ACh)-induced contraction of isolated rabbit jejunum. Methods: Rabbit jejunum segment was removed and placed in an organ bath containing Tyrode's solution, and its contractions were recorded isometrically. Results: ACh (2.0 × 10

Discussion on Gynecological Recipe Cases of Contrary Treatment / 浙江中医药大学学报

[Objective] To dicuss the application of contraray treatment from“Yel ow Emperor’s Internal Classics”in gynecological diseases, hoping to guide the clinic. [Method] By reviewing the articles concerning contrary treatment in “True Large Theory.Yel ow Emperor’s Internal Classics”, take clinical recipe cases as examples, such as stimulating the menstrual flow and water circulation for long menstruation; dispel ing wind to relieve exterior syndrome for night sweat in menstruation;dismounting for morbid leucorrhea;reinforcing spleen for pregnant digestion;tonifying Qi for pregnant constipation;warm drugs for sore throat, etc. Meanwhile, it sums up the application rules of the contrary treatment in gynecological diseases. [Result] The gynecological dis-eases can be cured by contrary therapy based on differentiation of signs, i.e.treating diarrhea with purgative,treating obstruction with tonics, treating heat with warm, al with good cure effect proved by practice.[Conclusion] To treat gynecological diseases with contrary therapy is the demonstration of search-ing for primary cause in treatment;we shal further dig out, inherit and develop it and make it better serve the clinic.

A Case of Adhesive Ileus Successfully Treated with Shojokito / 日本東洋医学雑誌

We report a case of recurring adhesive ileus that was successfully treated with shojokito (decoction) without inserting a nasogastric tube. The patient was a 75-year-old male who had been treated for abdominal symptoms in our department after a laparotomy. He visited our hospital mainly for complaints of abdominal pain and distention, was diagnosed with adhesive ileus because of a niveau image upon abdominal X-ray, and was hospitalized the same day. We diagnosed him as Yang syndrome and excess syndrome because he had thick yellow fur of the tongue, and administered shojokito. He broke wind at 40 minutes after administration of shojokito, and had bowel movement two hours later. Furthermore, he had mass diarrhea after another administration of this formula, and the niveau image disappeared the next day. It is often considered that an ileus develops with Cold, for which daikenchuto is prescribed frequently. However, in some cases cold purgative formulas such as jokito group may be effective, if such cases are Yang syndrome and excess syndrome, and present with yellow fur of the tongue.

Influence of Ethyl Alcohol on Purgative Action of Rhubarb / 中药新药与临床药理

Experimental studies showed that the water extract of rhubarb had low content of anthraquinone and a strong purgative while the alcohol extract a high content of anthraquinone and was free of purgative action,even tannin was eliminated.The purgative action of the water extract was also last when mixed with alcohol extract. The experimental results coincide with the traditional experience in Chinese medicinal theory:"the fresh Rhubarb has a purgative action while rhubarb prepared with wine can promote blood circulation and remove blood stasis."However, from the angle of anthraquinone and tannin, the explanation is unreasonable. It is indicated that the purgative action of rhubarb is greatly influenced, even disappears when prepared with alcohol. So, attention should be paid in the preparation process of Chinese patent drugs containing rhubarb.

The actions of Xiaochengqi Decoction,Houpusanwu Decoction and Houpudah uang Decoction / 中成药

AIM: To observe the difference of actions among three traditional compl ex prescriptions with the same composition but the different dosage, including X iaochengqi Decoction, Houpudahuang Decoction and Houpusanwu Decoction, so as to provide evidence for their different clinical applications. METHODS: A series of experiments were performed, including carbon p rop ellance in small intestine, black stool excretion, cough induced by ammonia liqu or and phenol red secretion from trachea. RESULTS: Three prescriptions all enhanced carbon propellance in sma ll intestine at the high dosage, while at the low dosage only Houpusanwu Decoct ion showed the significant effect. They all shortened the latency of black stool a nd increased their total amounts in 6 hours at the high dosage, while at the low dosage Xiaochengqi Decoction and Houpudahuang Decoction had the significant p urgative action. Houpudahuang Decoction remarkably prolonged cough latency, dec reased cough times and enhanced phenol red secretion from trachea, while other t wo prescriptions had no obvious effects. CONCLUSION: Such results showed that Xiaochengqi Decoction had the better purgative action, while Houpusanwu Decoction regulated Qi strongerly, a nd Houpudanghuang Decoction showed the marked actions of relieving cough and re solving phlegm.