香砂六君子汤联合瑞巴派特对胃溃疡疗效及胃黏膜蛋白的影响

目的 探讨香砂六君子汤联合瑞巴派特治疗脾胃不和型胃溃疡及对胃黏膜蛋白水平影响。方法 选取2022年1—12月收治的130例脾胃不和型胃溃疡患者为研究对象,按随机数字表法将其分为对照组与研究组,每组65例。对照组采用瑞巴派特治疗,研究组在对照组基础上予以香砂六君子汤治疗。2组患者均持续治疗6周。评估2组临床疗效及安全性。比较2组治疗前后中医证候评分及溃疡愈合情况。比较2组治疗前后胃泌素-17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)及PGⅠ与PGⅡ的比值(PGⅠ/PGⅡ)。结果 研究组患者幽门螺杆菌根除率及治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,2组患者症状积分、溃疡愈合组织学观察评分以及G-17、PGⅠ、PGⅡ水平和PGⅠ/PGⅡ低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组头晕2例,对照组头晕1例,2组不良反应发生率比较,差异无统计学意义(P=0.559)。结论 香砂六君子汤联合瑞巴派特治疗脾胃不和型胃溃疡疗效及安全性均较高,可有效改善患者中医证候,调节胃黏膜蛋白水平,加速胃黏膜愈合。

清化饮对慢性胃炎脾胃湿热证胃黏膜蛋白的影响

目的观察清化饮对慢性胃炎脾胃湿热证患者的临床疗效和胃黏膜蛋白质表达的影响,为识别鉴定清化饮治疗慢性胃炎脾胃湿热证相关蛋白质奠定基础。方法选择符合纳入、排除标准的慢性胃炎脾胃湿热证患者30例(治疗组),给予清化饮治疗1个月后观察临床疗效,并利用双向凝胶电泳技术分离健康对照组及治疗组治疗前后的胃黏膜总蛋白,获得双向凝胶电泳图谱,经GS710扫描仪扫描后使用PDQuest 8.0软件分析获得差异蛋白质点。结果治疗组中医证候疗效总有效率为96.67%,胃镜下疗效总有效率为93.33%,病理疗效总有效率80%。健康对照组、治疗组治疗前、治疗后胃黏膜蛋白质点数依次为(510±22)个、(527±49)个、(526±30)个。经图像分析统计后发现:治疗组与健康对照组比较有21个蛋白表达上调,10个蛋白表达下调;治疗组治疗前后比较,表达上调21个蛋白质中治疗后有18个表达降低,而表达下调10个蛋白质中有9个表达增强。结论清化饮能有效减轻临床症状,改善慢性胃炎脾胃湿热证患者胃镜下及病理表现,清化饮治疗慢性胃炎脾胃湿热证可能是通过调节胃黏膜蛋白质的表达而实现的。

复萎抗异汤对胃癌前病变患者胃黏膜P16、bcl-2、cox-2、survivin蛋白表达影响的研究

目的:探讨复萎抗异汤对胃癌前病变患者胃黏膜P16、bcl-2、cox-2、survivin蛋白表达影响。方法:选择2019年5月—2022年1月收治的120例胃癌前病变患者作为研究对象,按随机数表法分为3组,每组40例。中药组采取复萎抗异汤治疗,西药组采取维酶素治疗,联合组采取中西医联合治疗,对3组治疗效果进行比较。结果:中药组治疗总有效率为85.00%(34/40),西药组为77.50%(31/40),联合组为97.50%(39/40),差异有统计学意义(P<0.05);联合组胃镜下充血、糜烂、黏膜白相、颗粒增生、血管透见、胆汁反流等内镜征象改善率与中药组、西药组比较差异有统计学意义(P<0.05);3组治疗前的腺体萎缩、肠上皮化生、不典型增生等病理征象积分差异无统计学意义(P>0.05),治疗后3组积分比较差异有统计学意义(P<0.05);3组治疗前的胃黏膜P16、bcl-2、cox-2、survivin蛋白表达差异无统计学意义(P>0.05);经治疗后3组胃黏膜P16、bcl-2、cox-2、survivin蛋白表达比较差异有统计学意义(P<0.05)。结论:复萎抗异汤联合西药治疗胃癌前病变的效果最佳,能有效提高内镜征象改善率,降低病理征象积分,也能调节胃黏膜P16、bcl-2、cox-2、survivin蛋白表达,值得推广。

中药对脾胃湿热证患者胃黏膜水通道蛋白3、4基因表达的影响

目的探讨脾胃湿热证与胃黏膜水通道蛋白 (AQP) 3、4基因表达的关系及中药清热化湿方对其影响。方法选择慢性浅表性胃炎患者 6 8例 ,属脾胃湿热证者 5 3例 (其中湿重于热 19例 ,热重于湿 14例 ,湿热并重 2 0例 ) ,脾虚证者 15例。脾胃湿热证患者予中药清热化湿方治疗。采用荧光定量PCR方法检测胃黏膜AQP 3、4的基因表达。结果脾胃湿热证组患者AQP 3基因表达的水平高于健康人组 (10名 )和脾虚证组 ,但 3者比较 ,差异无显著性 ;AQP 4基因表达的水平则显著高于健康人组和脾虚证组 (P <0 .0 5或P <0 .0 1) ;脾虚证组与健康人组比较差异无显著性 ;脾胃湿热证各亚型之间比较呈湿重于热 >湿热并重 >热重于湿的趋势 ;治疗后脾胃湿热证患者及湿重于热亚型AQP 3、4的基因表达水平显著下降 (P <0 0 1) ,接近健康人组及脾虚证组水平。结论AQP 3、4的异常表达可能是脾胃湿热证的发生机制之一 ,中药可能通过影响AQP 3。

健胃愈疡颗粒对复发胃溃疡大鼠胃黏膜黏蛋白5AC mRNA 的影响

目的:观察不同药物干预对胃溃疡大鼠胃黏膜组织中黏蛋白5AC(Mucin5AC,MUC5AC)mRNA 表达的影响及其抗溃疡复发作用的影响。方法:采用 Okabe 改良法制做大鼠胃溃疡模型,应用 Watanabe 法复制胃溃疡复发模型。采用逆转录聚合酶链反应(RT-PCR)技术,检测胃黏膜组织 MUC5AC mRNA 的表达。结果:(1)在灌胃后第10天健胃愈疡组、正常组、假手术组、雷尼替丁组、中西药结合组 MUC5AC mRNA 表达显著高于模型组(P<0.05或 P<0.01);(2)在第92天诱发溃疡复发,健胃愈疡组、正常组、假手术组、模型未复发组、雷尼替丁组、中西药结合组 MUC5AC mRNA 表达显著高于模型复发组(P<0.05或 P<0.01),健胃愈疡组、中西药结合组 MUC5AC mRNA 表达显著高于雷尼替丁组(P<0.01);(3)健胃愈疡组溃疡复发率、溃疡指数均显著低于模型复发组(P<0.01)。结论:健胃愈疡颗粒可显著提高胃溃疡大鼠胃黏膜组织中 MUC5ACmRNA 的表达水平,起到保护胃黏膜的作用,参与胃溃疡的修复及抗溃疡复发的病理生理过程。

内镜下窄带成像以及胃黏膜血红蛋白的指数技术在慢性萎缩性胃炎诊断中的应用

目的探讨内镜下窄带成像(NBI)以及胃黏膜血红蛋白的指数(IHb)技术在诊断慢性萎缩性胃炎的价值。方法 312例胃炎患者随机分为普通白光内镜组(n=107)、NBI+放大内镜组(n=102)和NBI+放大内镜+IHb组(n=103),所有患者均取病理活检和CD34免疫组化,依次在普通白光内镜、NBI、IHb和放大内镜下观察病灶病变轮廓、胃小凹及微血管形态,测量病灶IHb值,结合病理活检及微血管密度(MVD)计数情况,评价各种诊断方法的清晰度,结果比较以病理检查结果为中心进行综合分析。评估不同内镜技术诊断胃黏膜萎缩的准确率。结果 NBI联合IHb技术在诊断慢性萎缩性胃炎的符合率优于普通白光内镜(P<0.05)。而与病理活检及通过CD34标记微血管染色的方法 MVD计数诊断慢性萎缩性胃炎符合率差异无统计学意义(P>0.05)。结论内镜下窄带成像和胃黏膜血红蛋白的指数技术有助于内镜下直接慢性萎缩性胃炎的诊断准确率,能指导有针对性活检,提高活检的检出率。

Association of high expression in rat gastric mucosal heat shock protein 70 induced by moxibustion pretreatment with protection against stress injury

AIM:To study the effect of moxibustion on Zusanli or Liangmeng point on gastric mucosa injury in stress-induced ulcer rats and its correlation with the expression of heat shock protein 70 (HSP70). METHODS:Sixty healthy SD rats (30 males,30 females) were divided into control group,injury model group,Zushanli point group,Liangmeng point group. Stress gastric ulcer model was induced by binding cold stress method. Gastric mucosa ulcer injury (UI) index was calculated by Guth method. Gastric mucosa blood flow (GMBF) was recorded with a biological signal analyzer. Protein content and gene expression in gastric mucosal HSP70 were detected by immunohistochemistry (IHC) and reverse transcription polymerase chain reaction (RT-PCR). Thiobarbital method was used to determine malondialdehyde (MDA) content. Gastric mucosal endothelin (ET) and prostaglandin E2 (PGE2) were analyzed by radioimmunoassay. RESULTS:High gastric mucosal UI index,high HSP70 expression,low GMBF and PGF2,elevated MDA and ET were observed in gastric mucosa of rats subjected to cold stress. Moxibustion on Zusanli or Liangmeng point decreased rat gastric mucosal UI index,MDA and ET. Conversely,the expression of HSP70,GMBF,and PGE2 was elevated in gastric mucosa after pretreatment with moxibustion on Zusanli or Liangmeng point. The observed parameters were significantly different between Zusanli and Liangmeng points. CONCLUSION:Pretreatment with moxibustion on Zusanli or Liangmeng point protects gastric mucosa against stress injury. This protection is associated with the higher expression of HSP70 mRNA and protein,leading to release of PGE2 and inhibition of MDA and ET,impairment of gastric mucosal index.

Loss of FHIT expression in gastric mucosa of patients with family histories of gastric cancer and Helicobacter pylori infection

AIM: To answer the question whether FHIT gene expression is affected by the family history of gastric carcinoma and the presence of Helicobacter pylori (Hpylori) in the gastric mucosa of patients with dyspepsia.METHODS: FHIT gene expression in two different topographic sites of the gastric mucosa of twenty-one patients with dyspepsia and with or without familial gastric carcinoma, infected or not infected with H pylori, was evaluated by reverse transcription-PCR (RT-PCR) and IMAGE QUANT methods. A rapid urease test and histopathological examination were used to determine H pylori colonization.RESULTS: In the gastric mucosa of patients with family histories of gastric carcinoma, the amount of FHIT protein mRNA was reduced down to 32%, and for patients with H pylori colonization, to 24% in comparison to controls with dyspepsia and without cancer in the family. FHIT expression was independent of the topography of specimens (corpus vsantrum), and for the control patients it was less sensitive to infection with H pylori. A considerable statistical difference in FHIT levels was observed in the gastric mucosa from the corpus of patients with family histories of gastric carcinoma in respect to H pylori colonization (P = 0.06). Macroscopic evaluation of the gastric mucosa demonstrated that pathologic changes classified according to the Sydney system had no significant influence on FHIT expression within each tested group of patients.CONCLUSION: Loss of FHIT expression was observed in patients with dyspepsia and family histories of gastric carcinoma, especially those infected with H pylori. Such results may constitute an early indication of the development of gastric carcinoma, which is associated with family factors including heredity and H pylori infection. The loss of the FHIT gene may serve as a marker for early diagnosis and prevention of gastric carcinoma, especially in context of early monitoring of H pylori infection in individuals with a record of familial stomach cancer.

EXPERIMENTAL STUDY ON MOXIBUSTION AT ZUSANLI(ST 36) AND LIANGMEN (ST 21) INDUCING HEAT SHOCK PROTEIN 70 (HSP70) EXPRESSION TO RESIST OXIDATIVE INJURY OF GASTRIC MUCOSA

To observe effect of moxibustion at Zusanli （足三里 ST 36） and Liangmen （梁门 ST 21 ） on expression of heat shock protein 70 （HSP70） in gastric mucosa of the rat of stress ulcer （SU） to explore the mechanism of moxibustion in resisting oxidative injury of the gastric mucosa. Methods： Sixty SD rats were evenly randomized into 4 groups, a blank group, a model group, an acupoint moxibustion group and a non-acupoint moxibustion group. Water restraint stress （WRS） method was used to make stress gastric ulcer rat model. The ulcerative index （Ul） of gastric mucosa was evaluated by using GUTH method, the gastric mu- cosa blood flux （GMBF） was detected by a laser Doppler bloodflow monitor, and HSP70 expression and malondialdehyde （MDA） content in the gastric mucosa were determined respectively with immunohistochemical and thiobarbiturate methods. Results： Moxibustion at Zusanli （ST 36） and Liangmen （ST 21 ） significantly de- creased Ul, up-regulated HSP70 expression, increased GMBF, and decreased MDA content in the gastric mucosa in the rat of stress gastric ulcer, with significant differences as compared with the model group and the non-acupoint moxibustion group （P 〈 0.05 or P 〈 0.01 ）. Conclusion： Moxibustion at Zusanli （ST 36） and Liangmen （ST 21 ） can induce high expression of HSP70 and decrease MDA content in the gastric mucosa, so as to resist oxidative injury, with relative acupoint specificity.

Research progress on Helicobacter pyloriouter membrane protein

Helicobacter pylori (H pylori), one of the most common bacterial pathogens on human beings, colonizes the gastric mucosa. In its 95 paralogous gene families, there is a large outer membrane protein (OMP) family. It includes 32 members. These OMP are important for the diagnosis, protective immunity, pathogenicity of H pylori and so on. They are significantly associated with high H pylori density,the damage of gastric mucosa, high mucosal IL-8 levels and severe neutrophil infiltration. We introduce their research progress on pathogenicity.

Cellular stress and redox activity proteins are involved in gastric carcinogenesis associated with Helicobacter pylori infection expressing high levels of thioredoxin-1

Heficobacterpylori infection is related to the development of gastric diseases. Our previous studies showed that high thioredoxin-1 （Trxl） expression in H. pylori can promote gastric carcinogenesis. To explore the underlying molecular mechanisms, we performed an isobaric tags for relative and absolute quantitation （iTRAQ）-based quantitative proteomic analysis of stomach tissues from Mongolian gerbil infected with H. pylori expressing high and low Trxl Differences in the profiles of the expressed proteins were analyzed by bioinformatics and verified using Western blot analysis. We found three candidate proteins, 14-3-3α/β, glutathione-S-transferase （GST）, and heat shock protein 70 （HSP70）, in high Trxl tissues compared with low Trxl tissues and concluded that cellular stress and redox activity- related proteins were involved in the pathogenesis of gastric cancer associated with H. pylori Trxl.

Effect of moxibustion treatment on cell apoptosis and expressions of heat shock protein and second mitochondrial activator of caspase in acute gastric mucosal lesion of rats

OBJECTIVE:To investigate the effect of moxibustion-acupoint treatment with acupoints of Zusanli(ST 36) and Zhongwan(RN 12) on cell apoptosis and the expressions of heat shock protein(HSP) 60,HSP70 and second mitochondrial activator of caspase(Smac) in rat models of acute gastric mucosal lesion(AGML),and explore the mechanisms underlying protection of gastric mucosal lesion.METHODS:Twenty-four Sprague Dawley rats were divided into 3 groups,blank controlled group(group A),controlled-point group(group B) and acupoint group(group C),8 for each.After 8-day moxibustion treatment in group B and C,gastric lavage of anhydrous ethanol was used to created AGML in all three groups.The Guth method was employed to measure the ulcer index(UI) of gastric mucosal lesion and immunohistochemistry used to measure apoptosis with apoptosis index(AI) and examinetheexpressionsofHSP60,HSP70and Smac.RESULTS:Compared with group A,the expressions of UI,AI,Smac and HSP60 were markedly elevated in group B(P<0.05 or P<0.01).However the expression of HSP70 showed no obvious change(P>0.05);the expressions of UI,HSP60 and HSP70 were markedly elevated in group C(P<0.01) while those of AI and Smac became obviously suppressed(P<0.01).Compared with group B,the expressions of UI,AI and Smac decreased significantly in group C(P< 0.01) while those of HSP60 and HSP70 increased markedly(P<0.01),and the expressions of HSP60 and HSP70 were considerably up-regulated(P< 0.01).CONCLUSION:The moxibustion treatment could alleviate the gastric mucosal lesion caused by anhydrous ethanol,induce the over-expressions of HSP60 and HSP70,and down-regulate the expression of Smac,which could suppress cell apoptosis.

Effect of Moxibustion on Expression of HSP70 and Apoptosisrelated Factors in Rats with Acute Gastric Mucosal Damage

Objective： To observe the effect of preventively used moxibustion on the expression of apoptosis-related factors in rats with acute gastric mucosal damage （GMD）, and analyze the relationship between those factors and heat shock protein 70 （HSP70）, for discovering the mechanism of moxibustion for protecting gastric mucosa from the aspect of mitochondria signal transduction of apoptosis. Methods： Thirty-two Wistar rats were randomly divided into binding, model, acupoint-moxibustion and non-acupoint-moxibustion groups, 8 in each group. Moxibustion was applied preventively to acupoint-moxibustion and non-acupointmoxibustion groups respectively for 8 d. Rats in binding and model groups were served with restraint without moxibustion. The GMD models were induced in groups except for A group, and the expression of cytochrome c （Cyt-c） in gastric mucosa was measured by Western-blot analysis, the expression of HSP70, cell apoptosis index （AI）, apoptotic protease activating factor 1 （Apaf-1）, Caspase-9, Caspase-3, Bcl-2 and Bax in gastric mucosal cells were studied by immunohistochemical detection. Results： Compared with binding group, the expressions of HSP70, AI, Cyt-c, Apaf-1, Caspase-9, Caspase-3, Bcl-2 and Bax of gastric mucosa in model group were significantly higher （P〈0.05 or P〈0.01）. Compared with model group, the expressions of HSP70 and Bcl-2 were significantly higher （P〈0.01）, while AI, Cyt-c, Apaf-1, Caspase-9, Caspase-3, Bax were significantly lower （P〈0.01） in acupoint-moxibustion group.Compared with the acupoint-moxibustion group, the expressions of HSP70 and Bcl-2 were significantly lower （P〈0.01）, while AI, Cyt-c, Apaf-1, Caspase-9, Caspase-3, Bax were significantly higher （P〈0.05 or P〈0.01） in non-acupoint-moxibustion group. Conclusion： Moxibustion inhibits the apoptosis of rats＇ gastric mucosal cells and protect them from damage, through up-regulating the expression of HSP70, and modulating the expressions of Cyt-c, Apaf-1, Caspase-9, Caspase-3, Bcl-2 and Bax which were related to the mitochondria signal transduction of apoptosis.