Ascites of cirrhosis is one of the most common complications in patients with decompensated cirrhosis.Branch of Gastrointestinal Diseases,China Association of Chinese Medicine Published Expert consensus on Traditional Chinese Medicine diagnosis and treatment of ascites due to cirrhosis in 2012 and 2017.With the development of Traditional Chinese Medicine research on cirrhosis ascites,it is necessary to update the expert consensus on diagnosis and treatment.This consensus combines the research of Traditional Chinese Medicine and Western medicine in the diagnosis,treatment and prevention of ascites in cirrhosis,highlights the clinical practicability and reflects the latest research progress.
Ulcerative colitis is a chronic nonspecific intestinal inflammatory disease characterized by continuous and diffuse inflammation of the colorectal mucosa. In recent years, the incidence and prevalence of ulcerative colitis have been increasing rapidly, and it has become a common clinical disease. The syndrome differentiation and treatment system of the six channels and classic prescriptions established by ZHANG Zhongjing in Shanghan Zabing Lun have been widely used in the clinical diagnosis and treatment of ulcerative colitis and have achieved good curative effect. This paper discusses the clinical thinking and experience of the treatment of ulcerative colitis with Jingfang from the evolution of disease names, pathological mechanism, common prescriptions and application points.
Objective: To investigate the mechanism of ursolic acid（UA） suppresses colorectal cancer progression based on proteomics. Methods: HCT-116 was selected as the study target, and the CCK-8 assay was used to detect the inhibition rates on HCT-116 after the treatment with different concentrations of UA. Extracted proteins from UA-treated and control cells were analyzed by proteomic analysis. Differential expression proteins（DEPs） were screened and then analyzed by GO and KEGG enrichment analysis. The target pathway was further verified by GSEA pathway enrichment analysis. Ingenuity pathway analysis（IPA） focused on key signaling pathways, and the results of IPA were verified by Western blot, measurement of intracellular total cholesterol level, and flow cytometry. Results: UA inhibited HCT-116 cell proliferation in a dose-dependent manner. The IC 50 , IC 20 and IC 10 of UA on HCT-116 were 7.733 μg/mL, 5.926 μg/mL and 5.072 μg/mL, respectively. Next, 1.6 μg/mL and 3.2 μg/mL UA were selected for follow-up experiments. UA inhibited HCT-116 cell proliferation in a time-and dose-dependent manner at non-toxic concentrations. Proteomics identified 468 DEPs between the control group and the UA-treated group. GO and KEGG enrichment analysis showed that the DEPs were associated with many biological processes such as cholesterol metabolism, autophagy, and ferroptosis. GSEA enrichment analysis further confirmed that the cholesterol metabolic pathway was related to the DEPs（NES=1.76, P＜0.001）. IPA showed that UA significantly activated the LXR/RXR signaling(Z-score=3.00,-log 10 （P）=9.49). The verification experiment results showed that UA up-regulated the expression of LXR/RXR target proteins MYLIP, ABCG1, and apolipoprotein E（APOE）. In addition, UA decreased the total cholesterol level and induced apoptosis in HCT-116 cells. Furthermore, cholesterol supplementation could antagonize UA-induced apoptosis. Conclusion: UA activates LXR/RXR signaling and increases the expression of target proteins MYLIP, ABCG1 and APOE, which results in the decrease of cholesterol level, inhibition of proliferation, and increase of apoptosis in colorectal cancer cells.
Objective: To study the distribution of TCM syndromes of gastric mucosal dysplasia and its correlation with pathological changes. Methods: Using a cross-sectional research method and using unified diagnostic criteria, the pathological diagnosis of 480 patients with low-grade/uncertain dysplasia of gastric mucosal was collected, and the four diagnosis information of Traditional Chinese Medicine, such as primary and secondary symptoms, tongue and pulse, were collected to clarify their TCM syndrome types and pathological tissue classification. The database was established, and the data analysis was carried out by using IBM-SPSS 26.0 software. Results: A total of 480 cases were included in this study, there were 261 patients with low grade dysplasia and 219 patients with uncertain dysplasia. The total frequency of single syndrome and complex syndrome in all patients was 706 times, there were 276 patients with single syndrome, 182 patients with two syndromes and 22 patients with three syndromes. The frequency of syndromes was: liver-stomach stagnation-heat syndrome＞spleen and stomach qi deficiency＞blood stasis of stomach collaterals＞damp-heat in spleen-stomach＞spleen and stomach deficiency and cold＞stagnation of qi in liver-stomach＞deficiency of yin in stomach. The age of spleen and stomach qi deficiency syndrome is higher than that of non spleen and stomach qi deficiency syndrome（P＜0.05）. There is a negative correlation between spleen and stomach deficiency and cold syndrome and atrophy range and atrophy degree（P＜0.05）. There was a positive correlation between spleen and stomach qi deficiency and the extent of dysplasia, atrophy, and intestinal chemosis lesions（P＜0.05）. Conclusion: Liver-stomach stagnation-heat syndrome, spleen and stomach qi deficiency, blood stasis of stomach collaterals are common syndromes of dysplasia; spleen and stomach deficiency and cold syndrome is mostly distributed in the early stage of the disease with less atrophy degree and smaller atrophy range; the spleen and stomach qi deficiency is an important link in the pathogenesis of dysplasia, and it is also a key syndrome in the development of lesions and even canceration. It is often accompanied by qi stagnation, blood stasis, stagnant heat, damp heat, etc.
Gastric cancer is a major challenge when it comes to preventing and controlling malignant tumors in China. The existence of atrophic gastritis and precancerous lesions provides the possibility for early diagnosis and treatment, and is the focus of secondary prevention of gastric cancer. During the past 40 years, Chinese Medicine research has made some significant achievements regarding the diagnosis, treatment, and prevention of atrophic gastritis and gastric precancerous lesions; however, deficiencies still exsit. This article reviews the history of Traditional Chinese Medicine research on atrophic gastritis and precancerous lesions, puts forward the strategies to deal with the existent problems and points out the future development, in order to provide reference for the construction of the secondary prevention and treatment system of gastric cancer with Chinese characteristics.
