Clinicopathological features and expression of regulatory mechanism of the Wnt signaling pathway in colorectal sessile serrated adenomas/polyps with different syndrome types

BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide,with the fourth highest mortality among all cancers.Reportedly,in addition to adenomas,serrated polyps,which account for 15%-30%of CRCs,can also develop into CRCs through the serrated pathway.Sessile serrated adenomas/polyps(SSAs/Ps),a type of serrated polyps,are easily misdiagnosed during endoscopy.AIM To observe the difference in the Wnt signaling pathway expression in SSAs/Ps patients with different syndrome types.METHODS From January 2021 to December 2021,patients with SSAs/Ps were recruited from the Endoscopy Room of Shanghai Traditional Chinese Medicine-Integrated Hospital,affiliated with Shanghai University of Traditional Chinese Medicine.Thirty cases each of large intestine damp-heat(Da-Chang-Shi-Re,DCSR)syndrome and spleen-stomach weakness(Pi-Wei-Xu-Ruo)syndrome were reported.Baseline comparison of the general data,typical tongue coating,colonoscopy findings,and hematoxylin and eosin findings was performed in each group.The expression of the Wnt pathway-related proteins,namelyβ-catenin,adenomatous polyposis coli,and mutated in colorectal cancer,were analyzed using immunohistochemistry.RESULTS Significant differences were observed with respect to the SSAs/Ps size between the two groups of patients with different syndrome types(P=0.001).The other aspects did not differ between the two groups.The Wnt signaling pathway was activated in patients with SSAs/Ps belonging to both groups,which was manifested asβ-catenin protein translocation into the nucleus.However,SSAs/Ps patients with DCSR syndrome had more nucleation,higherβ-catenin expression,and negative regulatory factor(adenomatous polyposis coli and mutated in colorectal cancer)expression(P<0.0001)than SSA/P patients with Pi-Wei-Xu-Ruo syndrome.In addition,the SSA/P size was linearly correlated with the related protein expression.CONCLUSION Patients with DCSR syndrome had a more obvious Wnt signaling pathway activation and a higher risk of carcinogenesis.A high-quality colonoscopic diagnosis was essential.The thorough assessment of clinical diseases can be improved by combining the diseases of Western medicine with the syndromes of traditional Chinese medicine.

Efficacy of Gastrosis No.1 Compound on Functional Dyspepsia of Spleen and Stomach Deficiency-Cold Syndrome:A Multi-Center,Double-Blind,Placebo-Controlled Clinical Trial

To assess the efficacy and safety of Gastrosis No.1 compound in the treatment of functional dyspepsia with Spleen （Pi） and Stomach （Wei） deficiency-cold syndrome. Methods： A randomized, double-blind, placebo-controlled trial was performed in 5 centers. Patients with functional dyspepsia （FD） of Spleen-deficiency and qi-stagnation syndrome （162 cases） were randomly assigned to groups given Chinese herbal medicine （CHM） Gastrosis No.1 compound or placebo in a 2：1 ratio. This trial included a 4-week treatment period and a 4-week follow-up period. The outcomes were the dyspepsia symptom scores （measured by total dyspepsia symptom scale and single dyspepsia symptom scale） and syndromes of traditional Chinese medicine score （measured by traditional Chinese medicine syndrome scale）. The outcomes were noted at weeks 0, 4 and 8. Results： Compared with patients in the placebo group, patients in the CHM group showed significant improvement in the dyspepsia symptom scores as rated by patients and investigators （P〈0.01）, and also showed improvement in syndromes of traditional Chinese medicine score （P〈0.01）. No serious adverse event was reported. Safety tests obtained after 4 weeks of treatment showed no abnormal values. Conclusion： CHM Gastrosis No.1 compound was effective and safe in the treatment of functional dyspepsia with Spleen and Stomach deficiency-cold syndrome.

Effects of Plasma Cortisol and Its Receplor on Patients with Deficiency－Cold and Deficiency－Heat Syndromes

lasma cortisol levels and leukocyte glucocorticosteroid receptor (GCR) contents were assayed in 10 patients with Deficiency-Cold Syndrome, 10 patients with Deficiency-Heat Syndrome, and 10healthy subjects as normal control. The results showed practically normal plasma cortisol levels in the De-ticiency-Cold Group, but the leukocyte GCR contents were markedly lowered. In the Deficiency-Heatgroup, plasma cortisol levels were remarkably elevated and the leukocyte GCR contents also tended to behigher than normal. The quantity of plasma cortisol concentrations multiplied by leukocyte GCR contentscan be taken as a sensitive index for the differentiation of Cold and Heat natures in Deficiency Syndromes.