Objective To explore the mechanism of action of Xiao chengqitang in the treatment of ulcerative colitis (UC) by network pharmacology. Methods From January 17th to January 20th, 2022, the active components and action targets of Xiao chengqitang (Radix Rhei Et Rhizome, Magnolia Officinalis Rehd Et Wils and Aurantii Fructus Immaturus) were obtained from Traditional Chinese Medicine System Pharmacology Database and Analysis Platform. “Ulcerative Colitis” was used as a search term to retrieve related targets of UC from GeneCards database, to obtain the targets for the treatment of UC using Xiao chengqitang. Then, Cytoscape 3.7.2 software was used for further topological analysis and the Chinese medicine compound-target network of genes was constructed. At the same time, protein-protein interaction network of Xiao chengqitang for the treatment of UC was constructed by STRING database. In addition, targets of Xiao chengqitang for the treatment of UC were applied for gene ontology (GO) analysis, as well as Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Results A total of 26 major active ingredients of Xiao chengqitang were obtained after screening, corresponding to 122 drug targets, 4837 disease targets for UC and 86 drug-disease common targets. According to protein-protein interaction network topology analysis parameters, 10 key therapeutic targets were screened, namely RAC-alpha serine/threonine-protein kinase, cellular tumor antigen p53, tumor necrosis factor-α, interleukin-6, caspase-3, prostaglandin-endoperoxidesynthases 2, transcription factor AP-1, vascular endothelial growth factor A, myc proto-oncogene protein and interleukin-1β. The results of GO and KEGG analysis indicated that the therapeutic targets of Xiao chengqitang for UC were mainly enriched in phosphatidylinositol 3-kinase-protein kinase B signaling pathway, inflammatory bowel disease, nuclear factor κB signaling pathway, calcium signaling pathway and peroxisome proliferators-activated receptor signaling pathway. Conclusions The potential mechanism of Xiao chengqitang in the treatment of UC may be that Xiao chengqitang acts on key therapeutic targets such as RAC-alpha serine/threonine-protein kinase, cellular tumor antigen p53, tumor necrosis factor-α, interleukin-6, prostaglandin-endoperoxidesynthases 2, vascular endothelial growth factor A and interleukin-1β, and participates in the regulation of phosphatidylinositol 3-kinase-protein kinase B signaling pathway, nuclear factor κB signaling pathway and calcium signaling pathway.
ObjectiveTo systematically review the methodological quality of clinical practice guidelines (CPGs) on the management of acute gastroenteritis/diarrhea in children, then to compare differences and similarities of drug recommendations, in order to provide references for clinical practice. MethodsGuidelines concerning acute gastroenteritis/diarrhea in children were searched in CNKI, VIP, WanFang Data, CBM, PubMed and EMbase databases from inception to April 2015. The websites of GIN (Guidelines International Network), CGC (China Guideline Clearinghouse), NGC (National Guideline Clearinghouse), APP (American Academy of Pediatrics), NICE (National Institute for Health and Clinical Excellence) and the WHO (World Health Organization) were also searched for additional guidelines. The methodological quality of included guidelines were evaluated according to the AGREE Ⅱ instrument, and the differences between recommendations of included guidelines were compared. ResultsA total of 9 guidelines on acute gastroenteritis/diarrhea in children were included. Among them, 3 guidelines were developed by USA, 1 by Malaysia, 1 by EU, 1 by UK, 1 by South Wales, 1 by Australia and 1 by South Africa. Five guidelines were evidence-based guidelines, and the other 4 were non-evidence-based guidelines. The average scores of guidelines in six domains of AGREE Ⅱ were 79% (clarity of presentations), 74% (scope and purpose), 44% (stakeholder involvement), 35% (rigor of development), 32% (applicability), and 30% (editorial independence), respectively. The recommendations of management and treatment were almost consistent. ConclusionThe overall quality of included guidelines was not high. The domain scores of "clarity of presentations" and "scope and purpose" were higher, but the domain scores of "stakeholder involvement", "rigor of development", "applicability" and "editorial independence" needed to be improved. There is still no local guideline of acute gastroenteritis/diarrhea in children in China, so it's urgent to develop guideline that should be suite able for Chinese condition.
ObjectiveTo summarize the significance of laboratory examinations in diagnosis of ulcerative colitis (UC). MethodsLiteratures at home and abroad were searched to review the clinical significance of laboratory examinations indexes in diagnosis of UC. ResultsAnti-neutrophilcytoplasmicantibodies (ANCA) had some value in diagnosis of UC, but it was limited in evaluation of UC in active patients. The positive rate of anti-intestinal goblet cell antibody (GAB) in patients with UC was higher than that of patients with Crohn's disease (CD), so it could be used as identification indexes of the two diseases, but it could not reflect the severity of the disease. Anti-saccharomyces cerevisiae antibodies (ASCA) and anti-pancreatic antibody (PAB) were mainly used in the differential diagnosis of UC and CD, but they had no significant advantages in diagnosis of UC. Fecal calprotectin (FCP) played a positive role in evaluation of recurrence and activity in UC. Although lactoferrin, M2-pyruvate kinase (M2-PK), and S100A12 were not as effective as FCP, but if combined with related indicators, they were also important. ConclusionsOf the relevant indexes of laboratory examination in the diagnosis of UC, FCP plays an importent role in the evaluation of recurrence and activity of UC.
ObjectiveTo summarize the clinical features and experience of Methicillin-resistant Staphylococcus aureus (MRSA)-associated enteritis. MethodsClinical data of 21 patients with MRSA-associated enteritis who were treated in our hospital from Jan. 2003 to May. 2015 were analyzed retrospectively. ResultsAfter diagnosed or suspected of MRSA-associated enteritis, the 21 patients received a drug therapy with vancomycin instead of other antibiotic, 3 patients (14.3%) who failed to get satisfactory symptom relief received a plus therapy with biapenem; 13 patients (61.9%) received treatment which plus drugs such as Bacillus licheniformis capsules or combining Bifidobacterium to regulate intestinal microflora. Severe complications, such as intestinal fistula (8 patients, 38.1%）, toxic shock (16 patients, 76.2%）, organ system failure (14 patients, 66.7%) occurred in 17 patients (80.9%) of the 21 patients when 2-7 days (mean of 4.7 days) after diarrhea. Among 21 patients received therapy, 7 patients (33.3%) were cured and 2 patients (9.5%) were improved, whereas 11 patients died, with a total mortality of 52.4%, another 1 patient was lost to follow up (4.8%). There were 8 patients who were followed-up for 1-12 months (the median time was 3.1-month). During the followed-up period, 2 of them died and others stayed alive without occurrence. ConclusionAlthough uncommon, MRSA-associated enteritis progressed rapidly, with many complications and high mortality rate. Early diagnosis and timely targeted treatment restoring the balance of gastrointestinal microecology are the key to decrease its mortality.