Geographic differences in psychological symptoms, sleep quality, and quality of life in patients with inflammatory bowel disease: A multicenter study in China.

OBJECTIVE: We aimed to explore the geographic differences in psychological symptoms, sleep quality, and quality of life (QoL) among adult patients with inflammatory bowel disease (IBD). METHODS: A unified questionnaire was developed to collect data on psychological status and QoL of IBD patients from 42 hospitals across 22 provinces, municipalities, and autonomous regions in China's mainland from September 2021 to May 2022. RESULTS: A total of 2478 patients with IBD were surveyed. The proportions of patients with anxiety (28.5% vs 23.1%), depression (32.3% vs 27.8%), and poor QoL (44.8% vs 32.2%) were significantly higher in patients from the northern region compared to the southern region (all P < 0.05). In the western region, the proportions of patients with anxiety (31.9% vs 23.0%), depression (37.7% vs 26.7%), sleep disturbances (64.5% vs 58.5%), and poor QoL (44.9% vs 34.8%) were significantly higher than in the eastern and central regions (all P < 0.01). Patients from inland regions had significantly higher rates of anxiety (27.1% vs 23.3%), depression (32.5% vs 26.0%), sleep disturbance (62.0% vs 57.7%), and poor QoL (43.5% vs 29.9%) compared to those from coastal regions (all P < 0.05). In economically underdeveloped areas, the proportions of patients with depression (33.1% vs 28.5%) and poor QoL (52.0% vs 32.4%) were significantly higher than in economically (relatively) developed areas (both P < 0.05). CONCLUSION: There are significant geographic differences in psychological symptoms, sleep quality, and QoL among Chinese patients with IBD, which might provide valuable insights for global IBD research and clinical practice.

[Structural development of root and their relationship to accumulation of triterpenoid saponins in Achyranthes bidentata Bl].

A study concerning the relationship of dynamic accumulation of triterpenoid saponins and anatomical characteristics of Achyranthes bidentata Bl roots was undertaken by anatomical, histochemical and phytochemical method respectively. Results revealed that the primary and secondary structures of the root resembled those of usual dicots. The continual thickening growth of root principally resulted from the differentiation and development of the tertiary structure. The first ring of supernumerary cambium originated from the parenchyma and vascular ray cells of secondary phloem and each of the followed rings initiated in the outmost foundamental parenchyma cells which were derived from the immediate preceding ring. In the supernumerary cambiums, there had not distinction between the fusiform initial and the ray initial. Its cells present stratifide arranged from a longitudinal section through root. Regular and concentric rings of tertiary vascular bundles who differentiate centrifugally were enclosed by the connective parenchyma. The number of the rings continually increase with the development of the root itself. Triterpenoid saponins accumulated mainly in pericycle, primary phloem and parenchyma between primary phloem and xylem in the primary structure of root but came into existence in cells of secondary phloem and phelloderm with secondary structure development of root, and as well as in supernumerary cambium and phloem of tertiary vascular bundle after the tertiary structure maturated gradually in the roots. The investigation provides indications that the tertiary structure were not only main parts in the roots of Achyranthes bidentata Bl, but also important storage region of triterpenoid saponins in its growth and development. In addition, the analysis of using the HPLC showed that dynamic increasing trend oleanolic acid was as "S" curve during the roots growth and development and up to the highest content of triterpenoid saponins after plants grew 120 days. Meanwhile, the number of the rings of tertiary vascular bundles, length and diameter of the roots were the same as the triterpenoid saponins increasing trend. It should be optimal season for harvest.