Objective To evaluate the clinical efficacy and safety of Shaohuang laxative mixture in the treatment of intestinal gas stagnation constipation.Methods A total of 144 patients with intestinal gas stagnation constipation were randomly divided into treatment group and control group,each group 72 cases.Patients in treatment group were orally administration Shaohuang laxative mixture,20 mL each time,tid.Patients in control group were orally given Muxiang Binlang pill 6 g each time,tid.Once the defecate free,stopping the medication,and followed up for 7 d to observe the defecating awareness,frequency,stool shape (according to Bristol stool from scale),time,amount,accompanying symptoms (including defecation pain,abdominal distension,defecation difficulties,exhaust,etc.),the main related signs,physical and chemical indicators.Besides,the adverse drug reactions were recorded during the treatment.Results After treatment,the total effective rate in treatment group was 91.94％ (57/62 cases),had no significant difference with that in control group,which was 90.16％ (55/61 cases,P ＞ 0.05).After treatment,the scores of desire to defecate,defecation frequency,defecation quality,defecation time,defecation volume,defecation difficulty level,abdominal distension and pain,belching,Xiongxie fullness and borborygrmi in treatment group were 4.81 ±0.80,4.19 ±0.78,4.91 ±0.76,5.11 ±0.92,4.25 ±0.61,4.20 ±0.77,5.11 ±0.68,5.06 ±0.79,3.73 ±0.61,4.40 ±0.64 in treatment group,had no significant difference with those in control group,which were 4.65 ± 0.74,4.26 ± 0.84,4.81 ± 0.88,5.02 ± 0.99,4.12 ± 0.54,4.19 ± 0.81,5.02 ±0.76,5.00 ±0.75,3.87 ±0.66,4.33 ±0.51 (P ＞0.05),but had significant difference with those before treatment (P ＜ 0.05).The adverse reactions in treatment group and control group were nausea and diarrhea,and the incidences of adverse drug reactions in treatment group and control group were 3.23％ (2/62 cases) and 4.92％ (3/61 cases),with no significant difference (P ＞ 0.05).Conclusion Shaohuang laxative mixture and aplotaxis auriculata compound pill have similar efficacy in treatment of intestinal gas stagnation constipation.Shaohuang laxative mixture is safe and effective in the treatment of intestinal gas stagnation.

Objective: To explore the mechanism of intestinal tissue damage induced by macrophages activated by WNT2B high-expressed fibroblasts. Methods: This study involved biological information analysis, pathological tissue research and cell experimental research. The biological information of the colon tissue from the children with inflammatory bowel disease in previous study was analyzed again with single-cell sequencing. The pathological tissues were collected by colonoscopy from 10 children with Crohn's disease treated in the Department of Gastroenterology of Guangzhou Women and Children's Medical Center from July 2022 to September 2022. According to the findings of colonoscopy, tissues with obvious inflammation or ulceration were classified as the inflammatory group, while tissues with slight inflammation and no ulceration were classified as the non-inflammatory group. HE staining was performed to observe the pathological changes of the colon tissues. Macrophage infiltration and CXCL12 expression were detected by immunofluorescence. In terms of cell experiments, fibroblasts transfected with WNT2B plasmid or empty plasmid were co-cultured with salinomycin treated or non-treated macrophages, respectively; the expression of proteins through Wnt classical pathway were detected by western blotting. Macrophages treated with SKL2001 were used as the experimental group, and those with phosphate buffer as the control group. The expression and secretion of CXCL12 in macrophages were detected by quantitative Real-time PCR and enzyme-linked immunosorbent assay (ELISA). T-test or rank sum test were used for the comparison between groups. Results: Single-cell sequencing analysis suggested that macrophages were the main cells in inflammatory bowel disease colon tissue, and there was interaction between WNT2B high-expressed fibroblasts and macrophages. HE staining of the 10 patients ((9.3±3.8) years old, 7 males and 3 females) showed that the pathological score of colon tissue in the inflammatory group was higher than that in the non-inflammatory group (4 (3, 4) vs. 2 (1, 2) points, Z=3.05, P=0.002). Tissue immunofluorescence indicated that the number of infiltrating macrophages in the inflammatory group was significantly higher than that in the non-inflammatory group under high power field of view (72.8±10.4 vs.8.4±3.5, t=25.10, P<0.001), as well as the number of cells expressing CXCL12 (14.0±3.5 vs. 4.7±1.9, t=14.68, P<0.001). In cell experiments, western blotting suggested an elevated level of glycogen synthase kinase-3β phosphorylation in macrophages co-cultured with fibroblast transfected with WNT2B plasmid, and salinmycin could reverse this change. Real-time PCR suggested that the transcription level of CXCL12 in the experimental group was higher than that in the control group (6.42±0.04 vs. 1.00±0.03, t=183.00, P<0.001), as well as the expression and secretion of CXCL12 by ELISA ((465±34) vs. (77±9) ng/L, t=13.21, P=0.006). Conclusion: WNT2B high-expressed fibroblasts can secrete WNT2B protein and activate the Wnt classical signaling pathway thus enhancing the expression and secretion of CXCL12 in macrophages, inducing the development of intestinal inflammation of Crohn's disease.
Child ; Male ; Humans ; Female ; Child, Preschool ; Adolescent ; Crohn Disease ; Inflammatory Bowel Diseases ; Colon ; Inflammation ; Colonoscopy ; Glycoproteins ; Wnt Proteins