Metabolomics characterization of Qingwei San on oral ulcer in db/db mice with stomach heat pattern

Objective:To characterize the effects of Qingwei San(QWS)on diabetic oral ulcer(OU)mice with stomach heat pattern through metabolomic analysis.Methods:A stomach heat pattern mouse model was established by treating C57BLKS/J Leprdb/db(db/db)mice with dried Zingiber officinale Rosc.rhizome(Z.officinale,Gan Jiang)decoction by gavage.All model mice had blood glucose levels of≥11.1 m M.Subsequently,OU was induced by Na OH cauterization.After 1 week of administration of QWS,non-targeted metabolomic analysis of serum was conducted using ultra high performance liquid chromatography coupled with mass spectrometry(UHPLC-MS/MS).Results:The non-targeted metabolomics results indicated that tryptophan metabolism,2-oxocarboxylic acid metabolism,serotonergic synapses,amino sugar and nucleotide sugar metabolism,and amino acid biosynthesis were involved in the therapeutic effects of QWS,with tryptophan metabolism playing a predominant role.Conclusion:QWS treatment can significantly improve the pathological status of diabetic OU mice with stomach heat pattern.QWS may regulate the release of inflammatory factors through the tryptophan metabolism pathway.

Healing property of the Piper betel phenol, allylpyrocatechol against indomethacin-induced stomach ulceration and mechanism of action

AIM：To evaluate the protective activity of allylpyrocatechol （APC）, the major antioxidant constituent of Piper betel, against the indomethacin-induced stomach ulceration in the rat model and correlates with its antioxidative and mucin protecting properties.METHODS： Male Sprague-Dawley rats were divided into five groups. Normal control rats （group Ⅰ ） were given the vehicle oral dose of gum acacia in distilled water （1 mL per rat）; ulcerated control and treated rats （groups Ⅱ-V） were given a single dose of indomethacin （30 mg/kg body wt.）; group Ⅱ rats were sacrificed 4 h after indomethacin administration; groups Ⅲ-Ⅴ rats were given the vehicle （1 mL per rat） or APC （2 mg/kg body wt.） or misoprostol （1.43 μg/kg body wt.） once daily by oral intubation for 7 d starting from 4 h after the indomethacin administration. After 7 d, the stomach tissues were excised for histological examination and biochemical analysis. RESULTS： Treatment with APC （2 mg/kg body wt per day） and misoprostol （1.43 μg/kg body wt per day） for 7 d could effectively heal the stomach ulceration as revealed from the ulcer index and histopathological studies. Compared to the zero day ulcerated group, treatment with APC and misoprostol reduced the ulcer index by 93.4% and 85.4% respectively （P 〈 0.05）. Both APC and misoprostol accelerated ulcer healing observed in natural recovery （P 〈 0.05）, their respective healing capacities not being significantly different. The healing capacities of APC and misoprostol could be attributed to their antioxidant activity as well as the ability to enhance the rnucin content of the gastric tissues. Compared to the ulcerated untreated rats, those treated with APC and rnisoprostol showed near normal MDA levels, while the protein levels were 86% and 78% of the normal value respectively （P 〈 0.05）. Likewise, both APC and rnisoprostol increased the SOD, catalase, and rnucin levels significantly （P 〈 0.05）, the effect of APC being better. CONCLUSION： APC can protect indomethacin-induced gastric ulceration due to its antioxidative and mucin protecting properties.

Feed Form Affects Growth and Stomach Ulcers in Yearling Horses

Fourteen yearling standardbred horses were used to test the hypothesis that hay and grain fed as a complete total mixed ration （TMR） cube diet （C） would result in greater average daily gain （ADG）, feed efficiency （gain to feed ratio, G/F） and apparent digestibility in horses on the TMR diet compared to horses fed the same weight and proportion of hay cubes and grain fed separately （diet HG）. Both diets consisted of 75% forage and 25% ground oats. The forage in both the plain hay cubes and the complete cubes was 80% alfalfa and 20% endophyte-free tall rescue. An additional hypothesis that stomach ulceration would not differ between horses fed either of the two diet treatments was also tested by comparing upper gastric endoscopies before and after 70 days of feeding the experimental diets. Horses fed diet C had greater ADG （P 〈 0.046） while G/F between the two treatments was not significantly different （P 〉 0.065） but showed a trend to be higher in the horses consuming diet C. Apparent digestibility of dry matter and crude protein was not different between the diet treatments, and no major gastric ulceration was found in horses consuming either diet treatment. The results of this study found that a complete cubed diet of 75% hay and 25% oats did not cause stomach ulceration while achieving an acceptable growth rate in yearling horses.

Clinical experience of Professor Xie Jingri in the deficiency-cold of spleen and stomach type of complex peptic ulcer

Objective:To summarize Professor Xie's clinical experience in treating the deficiency cold of spleen and stomach type of complex peptic ulcer.Methods:through the observation of the curative effect of the patients with the deficiency cold of spleen and stomach type of complex peptic ulcer in the outpatient department of liver,spleen and stomach department of our hospital,the dialectical application and clinical experience of Professor Xie Jingri's self-made prescription in clinical practice were summarized.Results:Professor Xie Jingri's self-made prescription can effectively improve the clinical symptoms of patients with the deficiency cold of spleen and stomach type of complex peptic ulcer,and through individual syndrome differentiation and treatment,make the self-made prescription vary from person to person,clinical addition and subtraction,so as to further improve the clinical efficacy of patients.Conclusion:Professor Xie Jingri's self-made prescription is effective in treating complex peptic ulcer of spleen stomach deficiency cold type,which is worthy of further clinical application and promotion.

Comparison of 5-hydroxytryptophan signaling pathway characteristics in diarrhea-predominant irritable bowel syndrome and ulcerative colitis

AIM: To study differences in the visceral sensitivity of the colonic mucosa between patients with diarrheapredominant irritable bowel syndrome(IBS-D) and those with ulcerative colitis(UC) in remission and to relate these differences with changes in the 5-hydroxytryptophan(5-HT) signaling pathway. METHODS: Gastrointestinal symptoms were used to determine the clinical symptom scores and rectal visceral sensitivity of patients with IBS-D and patients with UC in remission. Blood levels of 5-HT and5-hydroxyindoleacetic acid(5-HIAA) were measured using an HPLC-electrochemical detection system. The levels of 5-HT 3 receptor(3R), 4R, and 7R m RNAs in colonic biopsy samples were detected using reverse transcription-polymerase chain reaction. The protein expression of TPH1 was analyzed by Western blot and immunohistochemistry.RESULTS: Abdominal pain or discomfort, stool frequency, and the scores of these symptoms in combination with gastrointestinal symptoms were higher in the IBS-D and UC groups than in the control groups. However, no significant differences were observed between the IBS-D and UC remission groups. With respect to rectal visceral sensitivity, the UC remission and IBS-D groups showed a decrease in the initial perception threshold, defecating threshold and pain threshold. However, these groups exhibited significantly increased anorectal relaxation pressure. Tests examining the main indicators of the 5-HT signaling pathway showed that the plasma 5-HT levels, 5-HIAA concentrations, TPH1 expression in the colonic mucosa, and 5-HT3 R and 5-HT5 R expression were increased in both the IBS-D and the UC remission groups; no increases were observed with respect to 5-HT7 R expression.CONCLUSION: The IBS-D and UC groups showed similar clinical symptom scores, visceral sensitivity, and levels of serotonin signaling pathway indicators in the plasma and colonic mucosa. However, the pain threshold and 5-HT7 R expression in the colonic mucosa were significantly different between these groups. The results reveal that(1) IBS-D and UC are related to visceral sensitivity pathogenesis and the clinical manifestations of these conditions and(2) the observed differences in visceral hypersensitivity are possibly due to differences in levels of the 5-HT7 receptor, a component of the 5-HT signaling pathway.

Spices, herbal xenobiotics and the stomach: Friends or foes?

Spices and herbal remedies have been used since ancient times to treat a variety of disorders. It has been experimentally demonstrated that spices, herbs, and their extracts possess antimicrobial, anti-inflammatory, antirheumatic, lipid-lowering, hepatoprotective, nephroprotective, antimutagenic and anticancer activities, besides their gastroprotective and anti-ulcer activities. Despite a number of reports on the toxicity of herbs and spices, they are generally accepted as safer alternatives to conventional therapy against gastric ulcers. To this end, it is also believed, that excessive consumption of spices may favor the pathogenesis of gastric and duodenal ulcer and some studies have substantiated this common perception. Based on various in vivo experiments and clinical studies, on the effects of spices and herbs on gastric ulcers, it has indeed been shown that certain spices do possess remarkable anti-ulcer properties mediated by antisecretory, cytoprotective, antioxidant, and anti-Helicobacter pylori effects and mechanisms regulated by nitric oxide, prostaglandins, non-protein sulfhydryl molecules and epidermal growth factor expression. Accordingly, their consumption may attenuate and help prevent peptic ulcer disease. In the present review, the beneficial effects of spices and herbal nutritive components on the gastric mucosa are discussed against the paradigm of their deleterious potential.

Effect of resveratrol on Treg/Th17 signaling and ulcerative colitis treatment in mice

AIM: To determine the therapeutic efficacy of resveratrol on ulcerative colitis (UC) and its underlying mechanisms. METHODS: The mouse UC model was developed using 5% dextran sulfate sodium. Mice were randomly divided into four groups: normal control, UC model group, resveratrol low-dose group (RLD; 50 mg/kg per day), and resveratrol high-dose group (RHD; 100 mg/kg per day). RESULTS: The results showed that RLD regulates Treg/Th17 balance mainly through reducing the number of Th17 cells, whereas RHD regulates Treg/Th17 balance through both downregulating the number of Th17 cells and upregulating the number of Treg cells. Resveratrol can also regulate the level of plasma and intestinal mucosal cytokines including interleukin (IL)-10, transforming growth factor-beta 1, IL-6, and IL-17. The expressions of hypoxia inducible factor (HIF)-1 alpha, mammalian target of rapamycin (mTOR), and signal transducer and activator of transcription 3 were significantly decreased in the intestinal tissues of mice treated with resveratrol. CONCLUSION: The therapeutic efficacy of resveratrol in UC is dose dependent and closely associated with the regulation of Treg/Th17 balance and the HIF-1 alpha/mTOR signaling pathway.

The role of adhesion molecules in gastri c ulcer healing

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Association of CagA and VacA presence with ulcer and non-ulcer dyspepsia in a Turkish population

AIM:The mostly known genotypic virulence features,of H.pylori are cytotoxin associated gene A (cagA) and Vacuolating cytotoxin gene A (VacA).We investigated the association of these major virulence factors with ulcer and non-ulcer dyspepsia in our region. METHODS:One hundred and forty two dyspeptic patients were studied (average age 44.8±15.9 years,range 15-87 years,64 males and 78 females).Antral and corpus biopsies were taken for detecting and genotyping of H.pylori.107 patients who were H.pylori positive by histological assessment were divided into three groups according to endoscopic findings:Duodenal ulcer (DU),gastric ulcer (GU) and non-ulcer dyspepsia (NUD).The polymerase chain reaction (PCR) was used to detect CagA and VacA genes of H.pylori using specific primers. RESULTS:H.pyloriwas isolated from 75.4% (107/142) of the patients.Of the 107 patients,66 (61.7%) were cagA- positive and 82 (76.6%) were VacA-positive.CagA gene was positively associated with DU and GU (P<0.01,P<0.02), but not with NUD (P>0.05).Although VacA positivity in ulcer patients was higher than that in NUD group,the difference was not statistically significant (P>0.05). CONCLUSION:There is a significantly positive association between CagA genes and DU and GU.The presence of VacA is not a predictive marker for DU,GU,and NUD in our patients.

Helicobacter pylori: the primary cause of duodenal ulceration or a secondary infection?

INTRODUCTIONIt is generally accepted that Helicobacter pylori ( H.pylori) infection has a role in duodenal ulceration .Eradicaton of H .pylori accelerates healing compared with placebo in the absence of control of gastric secretion and reduces ulcer recurrence .There is increasing evidence ,however ,that is may not be the primary cause of duodenal ulceration ,but that is may be a secondary factor in a nnmber of cases .This possibility is supported by four sets of observations : 1 Geographical distribution:

CLINICOPATHOLOGICAL STUDY ON 3441 CASES OF BENIGN AND MALIGNANT ULCERS——The National Cooperative Group for Pathological Study on the Canceration of Gastric Ulcer

Resected specimens of benign and malignant gastric ulcers from 3441 cases were studied and compared clinically and pathologically. Among them, 421 cases of malignant ulcer were found. The malignant ulcers differed notably from the ulcerated gastric carcinoma and showed many similarities to the benign chronic gastric ulcer (CGU). The most distinct feature of malignant ulcer was lack of cancerous infiltration and muscular residue in the scar tissue of ulcer base. The existence of this type of ulcer clinically and pathomophologically supports the viewpoint that CGU can undergo malignant change. The rate of malignant change of CGU in this study was 3. 48%.

Treatment of Peptic Ulcer with Xiao Jianzhong Tang—A Report of 80 Cases

With Xiao Jianzhong Tang (小建中汤), the author has successfully treated 80 cases of peptic ulcer. The therapeutic effects obtained were compared with that of the Western medicine. A report follows.

Mechanism of Th17/Treg immune axis regulating the intestinal microflora of ulcerative colitis

Ulcerative colitis(UC)is a type of chronic inflammatory recurrent disease.At present,the etiology and pathogenesis are still unclear,and immune factors are usually considered to be the final link in the pathogenesis of UC.Due to the increasing incidence of this disease,longer course of disease,and difficult to heal,related research has gradually deepened,and related researches on intestinal flora,immunity,genetics,etc.have become hotspots.A large amount of evidence indicates that regulatory T cells(Treg),helper T cell 17(Th17),Th17/Treg immune axis and intestinal microbiota in UC patients play an important role in regulating the occurrence and development of diseases.In recent years,the intestine has been gradually discovered There is also a certain correlation between the tract microbiota and the Th17/Treg immune axis.Therefore,this article examines a large number of relevant Chinese and English materials at home and abroad in recent years to analyze the Th17/Treg cells,intestinal microbiota and the relationship between the two in UC patients.The existing relevance and other issues are briefly discussed and summarized in order to provide more practical basis for clinical targeted therapy.

Mechanism of Liancao-Xieli capsule in the treatment of ulcerative colitis through the differentiation of Th17 and Treg cells

Objective:To observe the effect of Liancao-Xieli Capsule on STAT signal pathway and T cell differentiation in mouse model of ulcerative colitis;Methods:Forty BALB/c mice were randomly divided into the control group,model group,mesalazine group and Liancao-Xieli capsule group.Except the control group,the other three groups were treated with 3%dextran sodium sulfate free drinking water to construct the model of ulcerative colitis.During the modeling period,each group was given corresponding drugs for intervention,while the control group and the model group were given the same volume of distilled water by gavage as the control.After treatment,HE staining was used to observe the pathological changes of colon tissue,flow cytometry was used to detect the proportion of Th17 and Treg cells in spleen and mesenteric lymph nodes,and ELISA was used to detect TGF-β,IL-6 and IL-17A in colon tissue.Western blot was used to detect the expression levels of related proteins in STAT3/ROR-γt and STAT5/Foxp3 signaling pathways.Results:Compared with the model group,the body weight,colon length and the content of TGF-βin the colon tissue of the mice in the Liancao-Xieli capsule group increased significantly after the experiment,while the DAI score,colon histopathology score,and the contents of IL-6 and IL-17A in the colon tissue were significantly reduced,and the difference was statistically significant(P<0.01).At the same time,Liancao-Xieli capsule can reduce the ratio of Th17 cells and the ratio of Th17/Treg in the spleen and mesenteric lymph node tissues of UC mice,and increase the ratio of Treg cells,and the difference is statistically significant when compared with the model group(P<0.01).In addition,compared with the model group,the expression levels of p-STAT3 and RORγt protein in the colon tissue of the Liancao-Xieli capsule group were significantly reduced,and the expression levels of p-STAT5 and Foxp3 protein were significantly increased after treatment,and the differences are statistically significant(P<0.01),while the expression levels of STAT3 and STAT5 proteins in colon tissue did not change significantly,and the difference was not statistically significant(P>0.05);Conclusion:Liancao-Xieli Capsule can regulate the immune balance of Treg/Th17 and improve the intestinal inflammation of UC.Its mechanism of action is mainly through inhibiting STAT3/ROR-γt and promoting the activation of STAT5/Foxp3 signaling pathway.

Detection of serum IDO and its correlation with Treg/Th17, Th1/Th2 immune balance in patients with ulcerative colitis

Objective: To investigate the relationship between serum IDO levels and Treg/Th17, Th1/Th2 immune balance in patients with ulcerative colitis (UC). Methods: 78 cases of UC patients in our hospital during September 2015 to January 2018 were divided into Light UC group (n=42) and Severe UC group (n=36) according to severity of diarrhea. 50 cases of healthy volunteers underwent physical examination at the same time were selected as Normal control group. Serum contents of IDO, Treg, Th17, Th1, Th2-related cytokines were measured between three groups, the relationship between IDO and Treg/Th17, Th1/Th2 immune balance in UC patients was evaluated. Results: There were significant differences in serum contents of IDO, Treg, Th17, Th1, Th2 related cytokines among three groups (P<0.05). As aggravation of UC, serum content of IDO increased, contents of Treg cytokines IL-10, TGF-β decreased, contents of Th17 cytokines IL-17, IL-21 increased, contents of Th1 cytokines IL-2, IFN-γ increased, contents of Th2 cytokines IL-4, IL-13 decreased (P<0.05). Correlation analysis showed that serum IDO level was negatively correlated with Treg cytokines and positively correlated with Th17 cytokines, positively correlated with Th1 cytokines and negatively correlated with Th2 cytokines (P<0.05). Conclusion: Serum content of IDO in UC patients increases abnormally and is directly related to the immune balance of Treg/Th17 and Th1/Th2. It can be used as an effective index to evaluate the immune status of UC patients.

Effects of nutritional support and intervention on intestinal flora, Th cellular immune response and inflammatory response in patients with severe ulcerative colitis

Objective: To explore the effects of nutritional support and intervention on intestinal flora, Th cellular immune response and inflammatory response in patients with severe ulcerative colitis. Methods: A total of 90 UC patients who were diagnosed and treated in the hospital between August 2014 and January 2017 were divided into the control group (n=45) and the nutritional intervention group (n=45) by random number table. Control group received clinical routine therapy for UC, and nutritional intervention group received routine therapy as well as nutritional support and intervention. The differences in the intestinal flora distribution, Th1/Th2 cytokine contents and inflammatory mediator contents were compared between the two groups. Results: Before intervention, there was no statistically significant difference in the intestinal flora distribution, Th1/Th2 cytokine contents and inflammatory mediator contents between the two groups. After intervention, the number of enterobacter and enterococcus in nutritional intervention group were lower than those in control group whereas the number of lactobacilli, Bifidobacterium and clostridium butyricum were higher than those in control group;serum IL-2 and IFN-γ contents were lower than those of control group whereas IL-4 and IL-10 contents were higher than those of control group;serum MCP-1, MIP-1a and HMGB-1 contents were lower than those of control group. Conclusion: Nutritional support and intervention can further balance the intestinal flora distribution and Th1/Th2 immune response and suppress the systemic inflammatory response in patients with severe ulcerative colitis.

65例胃早癌脉管侵犯的相关因素分析

目的探讨胃早癌脉管侵犯的相关因素。方法回顾性分析江苏省扬州市江都人民医院2018年1月—2023年6月收治的65例胃早癌内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)患者资料。根据术后病理结果将患者分为脉管侵犯组与非侵犯组,分别为31例和34例。分析各组病例的临床特征、胃镜表现及病理特点,通过logistic回归分析探讨胃癌发生脉管浸润的独立危险因素。结果病灶>2 cm(OR=4.959,95%CI1.490~16.500)、合并溃疡(OR=3.667,95%CI 1.429~21.950)、Kit-67指数>30%(OR=9.601,95%CI2.530~36.373)、病理分化差(OR=6.440,95%CI1.822~22.760)及浸润深度T1b(tumour infiltration depth 1b,T1b)(OR=6.301,95%CI1.913~20.802)对胃早癌脉管侵犯有影响(P<0.05)。Kit-67指数>30%是脉管转移独立高危因素(P<0.05)。结论脉管侵犯与多种因素有关,Kit-67指数对评估是否合并脉管侵犯有重要临床意义。

补益脾胃溃结方对脾胃虚弱型溃疡性结肠炎患者的临床疗效

目的 探讨补益脾胃溃结方对脾胃虚弱型溃疡性结肠炎患者的临床疗效。方法 132例患者随机分为对照组和观察组,每组66例,对照组给予常规治疗,观察组在对照组基础上加用补益脾胃溃结方,疗程4周。检测临床疗效、Mayo评分、SF-36评分、中医证候评分、5-HT、IL-6、TNF-α、IL-4、CD4^(+)/CD8^(+)、LPS、TGF-β1、DAO变化。结果 观察组总有效率高于对照组(P<0.05)。治疗后,2组Mayo评分、中医证候评分、TNF-α、LPS、5-HT、IL-6、CD4^(+)/CD8^(+)、DAO降低(P<0.05),SF-36评分、TGF-β1、IL-4升高(P<0.05),以观察组更明显(P<0.05)。结论 补益脾胃溃结方可减轻脾胃虚弱型溃疡性结肠炎患者炎症反应,调节免疫功能,抑制疼痛介质分泌,促进肠黏膜修复,提高临床疗效。

胃冠状静脉TH胶栓塞加脾切除术治疗门静脉高压症食管胃底曲张静脉破裂出血

目的 探讨胃冠状静脉TH胶栓塞加脾切除术治疗门静脉高压症食管胃底曲张静脉破裂出血的效果。方法 采用α 氰基丙烯酸正辛脂 (含显影剂的TH胶 )对 10 6例门静脉高压症引起食管胃底静脉曲张的患者行胃冠状静脉栓塞加脾切除术。结果 急诊栓塞 15例 ,出血立即停止 ,止血率 10 0 %。异位栓塞 3例 ( 2 .83 % )。手术死亡 2例 ( 1.89% )。术后胃黏膜糜烂、溃疡出血4例 ( 3 .77% ) ,经保守治疗治愈。随访 92例 ( 86.79% ) ,术前有出血史者 5 4例 ,其中 6例 ( 11.11% )再出血 ,预防性手术 3 8例中有 2例 ( 5 .2 6% )出血。 92例无一例肝性脑病。结论 该术式较分流术简便、创伤小、止血效果好 ,再出血率低 ,适应证宽。

芍药汤对胃肠湿热型溃疡性结肠炎大鼠Th17相关细胞因子的影响

目的研究芍药汤对胃肠湿热型溃疡性结肠炎大鼠Th17相关因子的影响,探讨芍药汤治疗胃肠湿热型溃疡性结肠炎的机制。方法将40只清洁级大鼠随机分为空白组、模型组、芍药汤组及柳氮磺吡啶(SASP)组;除空白组外,其他三组大鼠制成胃肠湿热型模型后,再用三硝基苯磺酸(TNBS)造模成溃疡性结肠炎模型;灌胃治疗14 d后,处死大鼠前对其进行疾病活动指数(DAI)评分,完毕后麻醉大鼠,腔静脉取血,采用酶联免疫吸附测定(ELISA)检测血清中细胞因子白细胞介素17(IL-17)、γ干扰素(IFN-γ)及白细胞介素27(IL-27),并取病变结肠进行结肠大体形态损伤指数(CMDI)评分。结果 DAI评分及CMDI评分方面,与空白组比较,模型组明显升高,差异有高度统计学意义(P<0.01),治疗后芍药汤组评分低于模型组,差异有高度统计学意义(P<0.01);血清IL-17方面,模型组明显高于空白组,芍药汤组明显低于模型组,差异均有高度统计学意义(P<0.01);大鼠血清IFN-γ及IL-27方面,模型组明显低于空白组,差异有高度统计学意义(P<0.01),芍药汤组高于模型组,差异有统计学意义(P<0.05)。结论芍药汤能明显降低胃肠湿热型溃疡性结肠炎大鼠血清中IL-17水平,并可相应升高其血清中IFN-γ及IL-27水平,其可能为治疗溃疡性结肠炎的有效机制之一。