OBJECTIVE:To provide an objective experimental basis for the gastric mucosa pathological evolution and the transformation of different Traditional Chinese Medicine(TCM)syndromes in helicobacter pylori(H.pylori)-relate...OBJECTIVE:To provide an objective experimental basis for the gastric mucosa pathological evolution and the transformation of different Traditional Chinese Medicine(TCM)syndromes in helicobacter pylori(H.pylori)-related gastric diseases(HPGD)patients,based on the combination of TCM syndrome differentiation,molecular biology and histopathology.METHODS:A total of 203 participants were enrolled in this study.The expressions of miR-499/miR-149 and H.pylori infection in the gastric tissues from all participants were detected.The genotyping for miR-499 rs3746444 and miR-149 rs2292832 was performed.RESULTS:In H.pylori positive subjects,the proportion of precancerous gastric lesions(PGL)in liver-stomach disharmony syndrome(LSDS)group was higher than in spleen Qi deficiency syndrome(SQDS)group(P<0.001);The proportion of gastric cancer(GC)in SQDS group was higher than in spleen-stomach damp-heat syndrome(SSDHS)group and LSDS group(all P<0.001).We also found C allele of miR-149 rs2292832 was linked to lower risk of gastric atrophy[miR-149 rs2292832 C vs T:adjusted odds ratio=0.207;95%confidence interval(0.043-0.989);P=0.048].Compared with healthy control(HC)group,the expression of miR-499 was significantly increased in GC group,while the expression of miR-149was significantly decreased in chronic inflammation group,PGL group and GC group(all P<0.05).Test for trend showed that GC risk was on a rising trend with the increasing expression of miR-499 and decreasing expression of miR-149(both P for trend<0.05).CONCLUSION:The C allele of miR-149 rs2292832 may be a protective factor for gastric mucosal atrophy.H.pylori may participate in the evolution of benign to malignant gastric mucosa lesions by inducing the overexpression of miR-499 and down regulation of miR-149.In addition,patients with H.pylori infection combined SQDS or LSDS may have higher risk of gastric mucosal malignant lesions.展开更多
文摘目的对润肠方药治疗便秘型肠易激综合征(IBS-C)的临床疗效及安全性进行系统性评价。方法计算机检索包括Pub Med、Springer Link、EMBASE、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库和维普网(VIP)7个数据库,时限为建库至2017年9月10日。文献质量采用Cochrane手册中Cochrane风险偏倚工具进行评估;质量评价及数据提取均由两名评价员独立完成。纳入研究的数据分析应用Rev Man 5.3软件。结果最终纳入14篇文献共计1114例患者,其中,润肠方药治疗(治疗组)588例,常规西药治疗(西药组)526例。Meta分析结果显示:治疗组临床疗效优于西药组,差异有统计学意义(OR=4.49;95%CI:3.22,6.26;P<0.00001);治疗组中医症候积分较西药组明显下降,差异有统计学意义(OR=-4.64;95%CI:-7.36,-1.91;P=0.0008),且排便及大便性状的改善也均优于西药组,差异有统计学意义(OR=3.61;95%CI:1.25,10.39.P=0.02;OR=3.74;95%CI:1.49,9.39;P=0.005);但针对腹痛则两组疗效相当,差异无统计学意义(OR=1.03;95%CI:0.24,4.51;P=0.97);从远期疗效来看,治疗组优于西药组,差异有统计学意义(OR=3.67;95%CI:1.73,7.78;P=0.0007)。结论润肠方药治疗IBS-C疗效优于常规西药,且安全性较高,远期疗效较好,不良反应少;但仍有待于开展更多大样本、多中心、长期随访高质量临床研究以获得更佳的循证医学证据,从而更好地指导临床。
基金the National Natural Science Foundation of China:the Exploration of the Traditional Chinese Medicine Syndrome Characteristics During Benign and Malignant Pathological Evolution in Hp-Related Gastric Diseases from Wnt/β-catenin Signaling Pathway based on the Theory of"Evil Poison Lead to Change"(No.81774238)the Exploration of the Traditional Chinese Medicine Syndrome Characteristics During Benign and Malignant Pathological Evolution in Hp-Related Gastric Diseases based on the Theory of"Latent Toxin"and the Polymorphism and Expression of Mucosal Barrier Related Genes(No.82174298)。
文摘OBJECTIVE:To provide an objective experimental basis for the gastric mucosa pathological evolution and the transformation of different Traditional Chinese Medicine(TCM)syndromes in helicobacter pylori(H.pylori)-related gastric diseases(HPGD)patients,based on the combination of TCM syndrome differentiation,molecular biology and histopathology.METHODS:A total of 203 participants were enrolled in this study.The expressions of miR-499/miR-149 and H.pylori infection in the gastric tissues from all participants were detected.The genotyping for miR-499 rs3746444 and miR-149 rs2292832 was performed.RESULTS:In H.pylori positive subjects,the proportion of precancerous gastric lesions(PGL)in liver-stomach disharmony syndrome(LSDS)group was higher than in spleen Qi deficiency syndrome(SQDS)group(P<0.001);The proportion of gastric cancer(GC)in SQDS group was higher than in spleen-stomach damp-heat syndrome(SSDHS)group and LSDS group(all P<0.001).We also found C allele of miR-149 rs2292832 was linked to lower risk of gastric atrophy[miR-149 rs2292832 C vs T:adjusted odds ratio=0.207;95%confidence interval(0.043-0.989);P=0.048].Compared with healthy control(HC)group,the expression of miR-499 was significantly increased in GC group,while the expression of miR-149was significantly decreased in chronic inflammation group,PGL group and GC group(all P<0.05).Test for trend showed that GC risk was on a rising trend with the increasing expression of miR-499 and decreasing expression of miR-149(both P for trend<0.05).CONCLUSION:The C allele of miR-149 rs2292832 may be a protective factor for gastric mucosal atrophy.H.pylori may participate in the evolution of benign to malignant gastric mucosa lesions by inducing the overexpression of miR-499 and down regulation of miR-149.In addition,patients with H.pylori infection combined SQDS or LSDS may have higher risk of gastric mucosal malignant lesions.
