A 57-year-old male patient with ulcerative colitis for more than 8 years was treated with mesalazine sustained-release granules 0.5 g thrice daily orally in the early stages of the disease, and the patient′s condition was improved. Chest CT scan showed no abnormalities in both lungs. The patient stopped taking the medication intermittently due to the remission of the condition over the course of 8 years, and due to the recurrence and worsening of symptoms, the dosage of mesalazine sustained-release granules was increased 3 times to 1 g orally, 4 times a day. At the first time, the patient experienced skin itching after taking increased dose of mesalazine for 2 days, which relieved after stopping the medication for 3 days. Afterwards, the dosage was reduced to 0.5 g thrice daily orally, and the patient′s skin itching did not recur. At the second time, the patient experienced skin itching on the trunk and limbs, chest tightness, and coughing 1 week after taking increased dose of mesalazine for 2 days, which relieved after stopping the medication for 2 days. At the third time, the patient experienced skin itching, chest tightness, and cough after taking increased dose of mesalazine for 1 day, which relieved after stopping the medication for 1 day. Laboratory tests showed no abnormalities in blood routine and C-reactive protein. High resolution CT scan of the chest revealed patchy ground glass opacities in both lungs, linear opacities in the lower lobes of both lungs, and cystic translucent opacities in the pleura of both lungs. Allergic pneumonia caused by mesalazine was considered.

A 57-year-old male patient with ulcerative colitis for more than 8 years was treated with mesalazine sustained-release granules 0.5 g thrice daily orally in the early stages of the disease, and the patient′s condition was improved. Chest CT scan showed no abnormalities in both lungs. The patient stopped taking the medication intermittently due to the remission of the condition over the course of 8 years, and due to the recurrence and worsening of symptoms, the dosage of mesalazine sustained-release granules was increased 3 times to 1 g orally, 4 times a day. At the first time, the patient experienced skin itching after taking increased dose of mesalazine for 2 days, which relieved after stopping the medication for 3 days. Afterwards, the dosage was reduced to 0.5 g thrice daily orally, and the patient′s skin itching did not recur. At the second time, the patient experienced skin itching on the trunk and limbs, chest tightness, and coughing 1 week after taking increased dose of mesalazine for 2 days, which relieved after stopping the medication for 2 days. At the third time, the patient experienced skin itching, chest tightness, and cough after taking increased dose of mesalazine for 1 day, which relieved after stopping the medication for 1 day. Laboratory tests showed no abnormalities in blood routine and C-reactive protein. High resolution CT scan of the chest revealed patchy ground glass opacities in both lungs, linear opacities in the lower lobes of both lungs, and cystic translucent opacities in the pleura of both lungs. Allergic pneumonia caused by mesalazine was considered.

Objective:To explore the effects of Changtong Recipe on levels of intestinal neurotransmitters and inflammatory cytokines in the elderly with functional constipation (FC).Methods:A total of 90 elderly patients with FC meeting the inclusion criteria in the hospital were enrolled between June 2020 and October 2021. According to the principle of random allocation, they were divided into control group (45 cases, treated with oral polyethylene glycol electrolyte powder) and treatment group (45 cases, Changtong Recipe). All were treated for 3 months and followed up for 30 d. Before and after treatment, TCM symptoms were scored. The levels of vasoactive intestinal peptide (VIP) and substance P (SP) were detected by radioimmunoassay. The levels of IL-17A and IL-18 were detected by ELISA. The constipation severity and quality of life were evaluated by clinical constipation scale (CCS) and Patient Assessment of Constipation Quality of Life scale (PAC-QOL). The adverse events during treatment and recurrence during follow-up were recorded. The clinical responsive effect was evaluated.Results:After treatment, there were 44 cases in treatment group and 43 cases in control group included into the statistics. The differences in total response rate between treatment group and control group were statistically significant [97.7% (43/44) vs. 81.4% (35/43); χ2=6.25, P=0.012]. After treatment, scores of TCM symptoms (mental fatigue, shortness of breath and abdominal distension, foreign body sensation in the throat, palpitation, cold extremities) and total score in the treatment group were significantly lower than those in the control group ( t=3.71, 10.25, 2.87, 2.87, 5.68, 26.94, all Ps<0.01), and scores of CCS and PAC-QOL were significantly lower than those in the control group ( t=11.71, 18.84, all Ps<0.001). After treatment, levels of serum VIP [(41.86±1.16) ng/L vs. (35.71±1.97) ng/L, t=17.79] and SP [(42.15±1.90) ng/L vs. (39.53±2.13) ng/L, t=6.06] in treatment group were higher than those in the control group ( P<0.01), while levels of IL-17A [(35.71±5.97 ) pg/L vs. (41.86±5.16) pg/L, t=5.14] and IL-18 [(22.15±3.90) pg/L vs. (26.53±4.13) pg/L, t=5.09] in treatment group were significantly lower than those in the control group ( P<0.01). During treatment, difference in incidence of adverse events between treatment group and control group was not statistically significant [9.1% (4/44) vs. 14.0% (6/43); χ2=0.13, P=0.716]. During the 30d of follow-up, differences in recurrence rate between treatment group and control group were statistically significant [2.3% (1/44) vs. 16.3% (7/43); χ2=5.11, P=0.024]. Conclusion:The Changtong Recipe can improve levels of intestinal neurotransmitters (VIP, SP) and quality of life in elderly patients with FC, reduce levels of inflammatory cytokines (IL-17A, IL-18) and improve clinical curative effect safely.

BACKGROUND: Procyanidins is a kind of polyphenol compounds in regnum vegetable, which is composed of different quantities of catechin and epicatechin. Studies show that procyanidins plays a role on protecting vascular endothelium, scavenging free radicals, resisting platelet aggregation, and reducing capillary permeability. Thus, procyanidins has obviously functions of reducing blood pressure, anti-oxidant activity, anti-edema, preventing coronary heart disease and atherosclerosis.
OBJECTIVE: To study the vasorelaxant effect of procyanidins on pulmonic rings and its mechanisms.
METHODS: Rabbit thoracic pulmonary arteries were isolated. Pre-contracted with noradrenalin (1×10-6 mol/L) and their responses to different concentrations of procyanidins (0.625, 1.25, 2.5 mg/L) were investigated. After removal of the endothelium of pulmonary artery smooth muscle, the effects of different signaling pathway inhibitors on procyanidins-induced relaxation, including nitric oxide synthase inhibitor Nω-Nitro-L-arginine (1×10-4 mol/L), methylene blue (1×10-5 mol/L), prostaglandin synthase inhibitor indomethacin (1×10-5 mol/L) and blockage of the adrenergicβ-receptor propranolol (1×10-5 mol/L), were also assessed.
RESULTS AND CONCLUSION: (1) Procyanidins did not change the resting tension of rabbit’s pulmonic rings, but caused an obvious dose-dependent relaxation in 1×10-6 mol/L noradrenalin-precontracted pulmonic rings (r=0.69, P < 0.001). (2) The relaxant effect of procyanidins was significantly reduced by removal of endothelium or by treatment with either Nω-Nitro-L-arginine or methylene blue, but not by treatment with prostaglandin synthase inhibitor or blockage of the adrenergic β-receptor. (3) Procyanidins (20 mg/L) dropped the dose-effect curves of noradrenalin, KCl and on pulmonic rings denuded endothelium. Moreover, affinity index of noradrenalin, KCl and CaCl2 decreased (P < 0.01). (4) Procyanidins also inhibited the vasoconstriction caused by noradrenalin in the first phase, but had no impact on the constriction induced by CaCl2 in the second phase. (5) Procyanidins has an endothelium-dependent vasorelaxation on isolated rabbit’s pulmonic rings, which is possibly mediated by nitric oxide/cyclic guanosine monophosphate pathways. Procyanidins blocked receptor-operated and voltage-dependent calcium channels to reduce intracel ular Ca2+, and induced vasorelaxation.