Precancerous lesions of gastric cancer (PLGC) represent a critical stage in gastric carcinogenesis. Animal models are widely used to simulate human pathologies in the laboratory, and the establishment of PLGC animal models is essential for investigating therapeutic strategies for precancerous gastric lesions. This study describes a method for establishing a PLGC model in male Sprague-Dawley (SD) rats using a multifactorial induction approach. Rats were administered 200 µg/mL N-methyl-N'-nitro-N-nitrosoguanidine at a fixed time each day (freshly prepared and protected from light), with fasting on alternate days (1 day feeding/1 day fasting, with free access to water). On fasting days, 2% sodium salicylate was administered by gastric gavage (10 mL/kg/day). At week 32, hematoxylin and eosin (HE) staining of the gastric mucosa in the model group revealed thinning of the gastric mucosa and a reduced number of glands. Alcian blue-periodic acid-Schiff (AB-PAS) staining indicated the presence of intestinal metaplasia. Immunohistochemical analysis demonstrated increased expression of MUC2. These findings confirmed the successful establishment of the PLGC model. This model provides a valuable tool for studying the pathogenesis and treatment of precancerous lesions of gastric cancer.

Background:Current targeted therapies for gastric cancer have limited efficacy, and recently discovered markers have not significantly improved survival rates in patients with gastric cancer. Therefore, it is imperative to identify more specific genes associated with the occurrence and progression of gastric cancer to achieve prevention and treatment. The aim of this study is to discover high-risk genes for gastric cancer by integrating single-cell transcriptomics and Mendelian randomization (MR) analysis. Methods:This study integrates gastric cancer genome-wide association study (GWAS) data, single-cell transcriptomics (sc-RNA-seq), and expression quantitative trait loci (eQTL) data for analysis, and employs two-sample MR to elucidate the causal relationships between genes and gastric cancer, thereby identifying high-risk genes for gastric cancer. Subsequently, in vitro cellular experiments are conducted to validate the transcriptional expression levels of these genes. Results:After quality control of the sc-RNA-seq data, we identified 2463 markers for gastric cancer cell subtypes. Subsequently, we utilized eQTL data and GWAS data for gastric cancer to perform MR analysis, yielding 149 genes with a causal relationship with gastric cancer. By applying log2FC filtering, we ultimately identified 5 high-risk gastric cancer genes: SORBS3, RMND5A, FBXO6, LPGAT1, and EPHB4. Finally, in vitro validation confirmed the differential expression of these 5 high-risk genes between normal gastric epithelial cell lines and gastric cancer cell lines. Conclusions:Our study reveals previously unattended high-risk gastric cancer genes, potentially offering new directions and evidence for the molecular diagnosis and treatment of gastric cancer.

Aim: Precancerous lesions of gastric cancer (PLGC) represent a critical window for prevention. Developing non-invasive tools that can reliably detect these lesions is therefore a prerequisite for lowering gastric-cancer incidence. Recent work has highlighted the diagnostic promise of plasma extracellular vesicle DNAs (evDNAs) and the 5-hydroxymethylcytosine (5hmC)-Seal epigenomic platform. Here we profiled genome-wide 5hmC patterns in circulating evDNA to discover biomarkers and build a classification model. Methods: We performed whole-genome 5hmC-Seal on plasma evDNAs from 67 PLGC patients and 67 healthy individuals. By identifying trend-expressed differentially hydroxymethylated regions (DhMRs), we used machine learning algorithms to screen for diagnostic biomarkers of PLGC and established a corresponding diagnostic model. Results: We ultimately constructed a diagnostic model comprising nine DhMRs. In the test set, the area under the curve (AUC) value was 0.963, with an accuracy of 0.886, sensitivity of 95.45%, and specificity of 81.82%. These results indicate that DhMRs in evDNA can serve as diagnostic biomarkers for PLGC, with good diagnostic capability and reliability. Correlation analysis showed a strong association between the DhMRs in the diagnostic model and clinical pathological indicators of PLGC. Conclusion: We developed a non-invasive diagnostic model for PLGC by profiling 5hmC in plasma evDNA. In both accuracy and inter-batch robustness, it surpasses all previously reported assays. Our findings establish plasma-evDNA 5hmC profiling as a reliable, minimally invasive strategy for the early detection and precise diagnosis of gastric precancerous lesions, and provide a new translational and clinical framework for future work.

According to traditional Chinese medicine theory, tongue coatings reflect changes in the body. The goal of this study was to identify a metabolite or a set of metabolites capable of classifying characteristics of traditional Chinese medicine syndromes in erosive gastritis. In this study, we collected tongue coatings of patients with erosive gastritis with damp-heat syndrome (DHS), liver depression and qi stagnation syndrome (LDQSS), and healthy volunteers. Then, we analyzed the differences in metabolic characteristics between the two groups based on metabolomics. We identified 14 potential biomarkers related to the DHS group, and six metabolic pathways were enriched. The differential pathways included pyrimidine metabolism, pantothenate and CoA biosynthesis, citrate cycle (TCA cycle), pyruvate metabolism, glycolysis/gluconeogenesis, and purine metabolism. Similarly, in the LDQSS group, we identified 25 potential biomarkers and 18 metabolic pathways were enriched. The top five pathways were the TCA cycle, sphingolipid metabolism, fatty acid biosynthesis, pantothenate and CoA biosynthesis, and the pentose phosphate pathway. In conclusion, the DHS group and the LDQSS group have different characteristics.

Inflammatory bowel disease (IBD) is characterized by an inflammatory response closely related to the immune system, but the relationship between inflammation and IBD remains unclear. We performed a comprehensive 2-sample Mendelian randomization (MR) analysis to determine the causal relationship between immune cell characteristics and IBD. Using publicly available genetic data, we explored the relationship between 731 immune cell characteristics and IBD risk. Inverse-variance weighting was the primary analytical method. To test the robustness of the results, we used the weighted median-based, MR-Egger, simple mode, and mode-based methods. Finally, we performed a reverse MR analysis to assess the possibility of reverse causality. We identified suggestive associations between 2 immune cell traits and IBD risk (P = 4.18 x 10(-5) for human leukocyte antigen-DR on CD14+ monocytes, OR: 0.902; 95% CI: 0.859-0.947; for CD39+ CD4+ T cells, P = 6.24 x 10(-5); OR: 1.042; 95% CI: 1.021-1.063). Sensitivity analysis results of these immune cell traits were consistent. In reverse MR analysis, we found no statistically significant association between IBD and these 2 cell traits. Our study demonstrates the close connection between immune cells and IBD using MR, providing guidance for future clinical and basic research.

This research aims to explore the therapeutic effect and potential mechanisms of Huazhuojiedu decoction (HZJD) for alleviating precancerous lesions of gastric cancer (PLGC) both in vivo and in vitro. HZJD is a traditional Chinese herbal formula consisting of 11 herbs. Sprague-Dawley (SD) rats were randomly divided into four subgroups: control group, model group, positive drug group, and HZJD group. Hematoxylin-eosin (H&E) staining, high iron diamine-alcian blue (HID-AB) staining, alcian blue-periodic acid Schiff (AB-PAS) staining, immunohistochemistry, immunofluorescence, RT-qPCR, and Western blot assays were performed after 10 weeks of HZJD treatment. In vitro, the cell counting kit-8 (CCK-8) and 5-ethynyl-2'-deoxyuridine (EdU) assays were used to detect cell proliferation. RT-qPCR and Western blot assays were performed to evaluate mitophagy levels. The results indicated that HZJD could retard the pathological progression in PLGC rats and reduce PLGC cell proliferation. Treatment with HZJD significantly increased the mRNA and protein expression levels of Sirt3, Foxo3a, Parkin, and LC3 II/I, while decreasing the mRNA and protein expression levels of p62 and Tomm20. HZJD was found to have the ability to reverse the decline in mitophagy activity both in vivo and in vitro. In conclusion, the study assessed the impact of HZJD and provided evidence regarding its potential molecular mechanism.

INTRODUCTION:Chronic erosive gastritis (CEG) is closely related to gastric cancer, which requires early diagnosis and intervention. The invasiveness and discomfort of electronic gastroscope have limited its application in the large-scale screening of CEG. Therefore, a simple and noninvasive screening method is needed in the clinic.OBJECTIVES:The aim of this study is to screen potential biomarkers that can identify diseases from the saliva samples of CEG patients using metabolomics.METHODS:Saliva samples from 64 CEG patients and 30 healthy volunteers were collected, and metabolomic analysis was performed using UHPLC-Q-TOF/MS in the positive and negative ion modes. Statistical analysis was performed using both univariate (Student's t-test) and multivariate (orthogonal partial least squares discriminant analysis) tests. Receiver operating characteristic (ROC) analysis was conducted to determine significant predictors in the saliva of CEG patients.RESULTS:By comparing the saliva samples from CEG patients and healthy volunteers, 45 differentially expressed metabolites were identified, of which 37 were up-regulated and 8 were down-regulated. These differential metabolites were related to amino acid, lipid, phenylalanine metabolism, protein digestion and absorption, and mTOR signaling pathway. In the ROC analysis, the AUC values of 7 metabolites were greater than 0.8, among which the AUC values of 1,2-dioleoyl-sn-glycoro-3-phosphodylcholine and 1-stearoyl-2-oleoyl-sn-glycoro-3-phospholine (SOPC) were greater than 0.9.CONCLUSIONS:In summary, a total of 45 metabolites were identified in the saliva of CEG patients. Among them, 1,2-dioleoyl-sn-glycoro-3-phosphorylcholine and 1-stearoyl-2-oleoyl-sn-glycoro-3-phosphorine (SOPC) might have potential clinical application value.

Abstract Backgroud：Huazhuojiedu decoction (HZJD) has been demonstrated to be effective in the treatment of precancerous lesions of gastric cancer (PLGC). We aimed to explore the potential mechanisms of HZJD for alleviating PLGC in vivo and in vitro. Methods: The PLGC rat model was established by administrating 1-Methyl-3-nitro-1-nitrosoguanidine (MNNG) and sodium for 24 weeks, followed by 10 weeks of HZJD decoction or vitamin B12 therapy. The PLGC cell model (MC) was prepared by inducing human gastric mucosal epithelial cells (GES-1) with MNNG. HZJD decoction and vitamin B12 drug-containing serum were given to treat MC cells, meanwhile sirt3 siRNA was transfected into MC cells. The CCK-8 assay and the EdU assay were used to detect cell proliferation. The histopathological changes of gastric tissues were observed by H&E staining, HID/AB staining and AB/PAS staining. The mRNA and protein expressions of on mitophagy-related molecules were detected by RT-qPCR and Western blot. Immunohistochemistry was used to test the differential expressions of sirt3/foxo3a/parkin pathway. Immunofluorescence was used to evaluate mitophagic level. Transmission electron microscopy was used to monitor the degree of mitochondrial damage and the occurrence of mitophagy. Results: The results indicated that HZJD could retard the pathological progress of gastric mucosa in PLGC rats and reduce the elevated cell proliferation in MC cells. The treatment of HZJD could significantly increase the gene and protein expressions of sirt3, foxo3a, parkin, LC3Ⅱ/Ⅰ, meanwhile decrease the mRNA and protein expressions of p62, tomm20. The colocalization of LC3 and COX Ⅳ was inhibited in PLGC rats, besides the fluorescent intensity of mitophagy was weakened in MC cells. This downtrend of mitophagic level in vivo and in vitro could be reversed by HZJD. More importantly, the improvement of mitophagy by HZJD was associated with sirt3/foxo3a/parkin pathway. Conclusions: Our results suggested that HZJD decoction could ameliorate PLGC in vivo and in vitro, and its therapeutic effect might be related to regulating mitophagy via sirt3/foxo3a/parkin pathway.

王彦刚教授认为胃食管反流病的核心病机为郁热阴伤,此核心病机在疾病的发生发展过程中起着主导作用.本病病位涉及肝、肺及脾胃,由此将其分为肝胃郁热阴伤与肺胃郁热阴伤两大基本类型,使辨证论治更富有针对性.而在疾病发展过程中,可能兼夹湿热、瘀血等病机,因此,以清宣郁热,养阴护津为疾病的核心治法;清热祛湿,活血化瘀为针对兼夹病机的主要治法,临床疗效满意.临证王彦刚教授注重四诊合参,辨证加减,疗效确切.

王彦刚教授认为慢性疲劳综合征与脾胃密切相关,对于从脾胃治疗有独到的经验和体会.王教授认为浊毒内蕴脾胃为本病根本病机,治疗以化浊解毒为根本大法,结合患者舌苔、脉象以及胃镜检查等选择化浊解毒基础方,具体施以疏肝理气、健脾补气、活血化瘀、滋阴增液之法,疗效显著.

Abstract Background Disturbance of the intestinal flora is a pathogenic factor for chronic atrophic gastritis (CAG). Hua-Zhuo-Jie-Du (HZJD) has been shown to be an effective Chinese herbal preparation for treating CAG. However, the effects of HZJD on the intestinal flora of CAG is unclear. In this study, we probed the regulating effects of HZJD on intestinal microbes in CAG rats using 16S rRNA gene sequencing. Methods High-performance liquid chromatography (HPLC) analysis was used to perform quality control of HZJD preparations. We then administered 1-methyl-3-nitro-1-nitrosoguanidine (200 μg/ml) to Sprague–Dawley rats to establish a CAG model. HZJD and vitacoenzyme were administered orally to these rats over a 10 week period. Hematoxylin and eosin (H&E) staining was performed to observe the histopathology of CAG rats. A rarefaction curve, species accumulation curve, Chao1 index, and ACE index were calculated to assess the alpha diversity. Principal component analysis (PCA), non-metric multi-dimensional scaling (NMDS), and unweighted pair group method with arithmetic mean (UPGMA) were conducted to examine the beta diversity. The LEfSe method was used to identify differential bacteria. Differential function analysis used PCA based on KEGG function prediction. Results HPLC showed that our HZJD preparation method was feasible. H&E staining showed that HZJD significantly improved the pathological state of the gastric mucosa in CAG rats. The rarefaction curve and species accumulation curve showed that the sequencing data were reasonable. The Chao1 and ACE indices were significantly increased in CAG rats compared to the N group. Following HZJD and vitacoenzyme treatment, the Chao1 and ACE indices were decreased. PCA, NMDS, and UPGMA results showed that the M group was separated from the N, HZJD, and V groups, and LEfSe results showed that the relative abundance of Akkermansia, Oscillospira, Prevotella, and CF231 were significantly higher in the N group. Proteobacteria and Escherichia were significantly enriched in the M group, Allobaculum, Bacteroides, Jeotgalicoccus, Corynebacterium, and Sporosarcina were significantly enriched in the V group, and Firmicutes, Lactobacillus, and Turicibacter were significantly enriched in the HZJD group. Conclusion HZJD exhibited a therapeutic effect on the intestinal flora of CAG rats.

OBJECTIVE:To identify specific Chinese medicines (CMs) that may benefit patients with gastroesophageal reflux disease (GERD), and explore the action mechanism.METHODS:Domestic and foreign literature on the treatment of GERD with CMs was searched and selected from China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and PubMed from October 1, 2011 to October 1, 2021. Data from all eligible articles were extracted to establish the database of CMs for GERD. Apriori algorithm of data mining techniques was used to analyze the rules of herbs selection and core Chinese medicine formulas were identified. A system pharmacology approach was used to explore the action mechanism of these medicines.RESULTS:A total of 278 prescriptions for GERD were analyzed, including 192 CMs. Results of Apriori algorithm indicated that Evodiae Fructus and Coptidis Rhizoma were the highest confidence combination. A total of 32 active ingredients and 66 targets were screened for the treatment of GERD. Enrichment analysis showed that the mechanisms of action mainly involved pathways in cancer, fluid shear stress and atherosclerosis, advanced glycation end product (AGE), the receptor for AGE signaling pathway in diabetic complications, bladder cancer, and rheumatoid arthritis.CONCLUSION:Evodiae Fructus and Coptidis Rhizoma are the core drugs in the treatment of GERD and the potential mechanism of action of these medicines includes potential target and pathways.

介绍王彦刚教授运用化浊解毒法从脾胃辨治干燥综合征的临证经验,王彦刚教授从"核心病机观"出发,认为干燥综合征与脾胃关系密切,浊毒侵犯中焦脾胃,气机升降失常,津液输布失司,机体失养是干燥综合征的核心病机,贯穿疾病始末.在治疗上以化浊解毒为基本大法,遵循疾病发展之规律,抓住每一阶段主要病机,不忘核心病机,以虚实为纲,着眼于脾胃,佐以解毒、行气、祛湿、清热、祛瘀、滋阴等法,病证结合,辨证施治,治疗效果显著.文末以典型案例佐证,供同道参考借鉴.

Ethnopharmacological relevance: Huazhuojiedu decoction, a Chinese herbal preparation, has been proven to be clinically effective in treating precancerous lesions in gastric cancer (PLGC). This formula is optimized from a classic formula called "Ganluxiaodu Dan." Although some experiments have shown that Huazhuojiedu decoction is effective against PLGC, the mechanism remains unclear. Aim of the study: To investigate the treatment of PLGC with Huazhuojiedu decoction from the perspective of lncRNA in vitro and in vivo. Materials and methods: A PLGC rat model was prepared and randomly divided into a Huazhuojiedu decoction group (HG), a vitacoenzyme group (VG), a model group (MG), and a normal group (CG). Each group was given a corresponding concentration of medicine and distilled water for 10 weeks. The pathological changes in the gastric mucosa were observed by hematoxylin-eosin staining (HE). High-throughput sequencing was performed to detect the differentially expressed lncRNAs in the HG, MG, and CG. Quantitative real-time reverse transcription-polymerase chain reaction (RT-qPCR) was used to verify differentially expressed lncRNAs, and rat-human homology information was obtained from the University of California, Santa Cruz (UCSC) Genome Database. Human gastric mucosal epithelial cells (GES-1) were used to prepare precancerous lesions of gastric cancer cells (MC). A Huazhuojiedu decoction drug-containing serum was prepared to treat the MC cells. The effects of the Huazhuojiedu decoction and the lncRNA ENST00000517368 (lnc 517368) knockdown or over-expression on PLGC cell proliferation and apoptosis were evaluated in vitro using CCK-8, flow cytometry, and RT-qPCR. Results: The HE results showed that gastric mucosal pathology was significantly improved in the HG. High-throughput sequencing results showed that compared with the CG, 91 lncRNAs upregulated in the MG were restored and downregulated in the HG (P < 0.05), and 115 lncRNAs downregulated in the MG were restored and upregulated in the HG (P < 0.05). The results of RT-qPCR were consistent with the sequencing results. The differentially expressed genomic rat lncRNA ENSRNOT00000079699 is homologous to human lnc 517368. In cell experiments, high expression of lnc 517368 promoted proliferation and reduced apoptosis in PLGC cells, while the Huazhuojiedu decoction reduced the expression of lnc 517368 and improved cell morphology. Conclusions: Huazhuojiedu decoction inhibited cell proliferation and promoted apoptosis in PLGC cells, and its effect may be partially dependent on the downregulation of lnc 517368.

Chinese medicine theory believes that tongue coatings demonstration is a window of body change. Metabonomics technology is one of its commonly used methods, and extensive research has been carried out on tongue coating. To further explore the variations of the metabolome in erosive gastritis patients with different tongue features, we carried out this study. In this study, we collected the tongue coatings of erosive gastritis with Shirezhongzu (SR) syndrome, Ganyuqizhi (GY) syndrome and healthy volunteers. Then based on OPLS-DA to analyze the differences in metabolic characteristics between the three groups.The results show that erosive gastritis of SR syndrome and GY syndrome do have different characteristics. Unfortunately, although the SR group and the GY group show significant differences, the model is not robust enough. To solve this problem, we followed up with further machine learning analysis. Finally, we discovered potential biomarkers that can be used for the differential diagnosis of the two. They are Stearoylcarnitine, Lumichrome, Urocanic acid, and Pyridoxine..

Abstract Background Hua-Zhuo-Jie-Du (HZJD), a Chinese herbal prescription consisting of 11 herbs, is commonly used in China to treat chronic atrophic gastritis (CAG). We aimed to determine the effect of HZJD on the microbiome-associated metabolic changes in CAG rats. Methods The CAG rat models were induced by 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) combined with irregular fasting and 2% sodium salicylate, which was intragastrically administrated in fasted animals for 24 weeks. The CAG rats in the Chinese medicine (CM) group were administered a daily dose of 14.81 g/kg/day HZJD, and the vitacoenzyme (V) group were administered a daily dose of 0.08 g/kg/day vitacoenzyme. All animals were treated for 10 consecutive weeks, consecutively. Hematoxylin and eosin (H&E) staining was used to assess the histopathological changes in the gastric tissues. An integrated approach based on liquid chromatograph mass spectrometer (LC-MS) metabolic profiling combined with 16S rRNA gene sequencing was carried out to assess the effects of HZJD on CAG rats. Spearman analysis was used to calculate the correlation coefficient between the different intestinal microbiota and the metabolites. Results The H&E results indicated that HZJD could improve the pathological condition of CAG rats. The LC–MS results indicated that HZJD could significantly improve 21 gastric mucosal tissue perturbed metabolites in CAG rats; the affected metabolites were found to be involved in multiple metabolic pathways, such as the central carbon metabolism in cancer. The results of 16S rRNA gene sequencing indicated that HZJD could regulate the diversity, microbial composition, and abundance of the intestinal microbiota of CAG rats. Following HZJD treatment, the relative abundance of Turicibacter was increased, and the relative abundance of Desulfococcus and Escherichia were decreased in the CM group when compared with the M group. Spearman analysis revealed that perturbed intestinal microbes had a strong correlation with differential metabolites, Escherichia exhibited a negative correlation with l-Leucine, Turicibacter was negatively correlated with urea, and Desulfococcus exhibited a positive correlation with trimethylamine, and a negative correlation with choline. Conclusions HZJD could protect CAG by regulating intestinal microbiota and its metabolites.

BackgroundTo investigate the intestinal dysfunction after acute myocardial infarction (AMI) and discuss the underlying mechanism.MethodsRats were divided into three groups randomly, including AMI group, Sham group and Normal (N) group. An AMI model was established with ligating the left anterior descending artery (LAD) without ventilator assisted. The body surface electrocardiogram (ECG), HE staining of myocardial tissues and echocardiogram were used to evaluate whether the model was established successfully. The HE staining for ileum tissue was applied to evaluate the structure of the ileum, the intestinal propulsive rate were conducted to investigate the intestinal dysfunction, and laser speckle technique was developed in order to measure the mesenteric blood flow. immunohistochemical method was used to determined the expression of Indoleamine 2, 3-dioxygenase (IDO) in ileum, high-performance liquid chromatography was used to detected 5-hydroxytryptamine(5-HT) metabolism in rats plasma and ileum.ResultsAfter AMI in rats, the ECG shows ST segment elevation in lead Ⅱ for more than 30 minutes and pathological Q wave appeared at 4 weeks after surgery. HE staining showed at 4 weeks after AMI, the ventricular wall of the infarcted area of the rats became thin and white. Echocardiogram showed Left ventricular internal diameters of systole(LVIDs) and Left ventricular internal diameters of diastole(LVIDd) in the AMI group increased significantly, and Interventricular septal thickness at end diastole(IVSd) decreased significantly. Left ventricular ejection fraction(LVEF) and Fractional shortening(FS) values in the AMI group were significantly decreased. HE staining showed intestinal mucosa was hyperemia, edema, and it was infiltrated by a large number of neutrophils. The intestinal propulsive rate was increased in AMI group. Laser speckle technique shows the mesenteric blood flow was decreased in AMI group. Immunohistochemistry showed the expression of IDO was increased in AMI group. High-performance liquid chromatography showed the 5-HT content in the plasma was increased, and the content of 5-HT and 5-hydroxy indole acetic acid (5-HIAA) in the ileum was increased in AMI group.ConclusionIntestinal dysfunction after AMI may be achieved by decreased intestinal blood perfusion, IDO-related inflammation and the dysfunction of 5-HT metabolic pathway.

Background: Systemic sclerosis (SSc) is 1 of the most complex systemic autoimmune diseases.Accumulating evidence suggests that gut microbiota affect the development and function of the immune system and may play a role in the pathogenesis of autoimmune diseases. This new paradigm raises the possibility that many diseases result, at least partially, from microbiota-related dysfunction. This understanding invites the investigation of fecal microbiota transplantation (FMT) in the treatment of SSc. However, no study has specifically and systematically investigated the efficacy and safety of FMT in the treatment of SSc. Thus, this study will systematically and comprehensively appraise the efficacy and safety of FMT in the treatment of SSc. Methods: We will search the following sources without restrictions for date, language, or publication status: PubMed, Web of Science,Cochrane Central Register of Controlled Trials (CENTRAL) Cochrane Library, EMBASE and China National Knowledge Infrastructure. We will apply a combination of Medical Subject Heading (MeSH) and free-text terms incorporating database-specific controlled vocabularies and text words to implement search strategies. We will also search the ongoing trials registered in the World Health Organization's International Clinical Trials Registry Platform. Besides, the previous relevant reviews conducted on FMT for SSc and reference lists of included studies will also be searched. Results: This study will provide a reliable basis for the treatment of SSc with FMT. Conclusions: The findings will be an available reference to evaluate the efficacy and safety of FMT in the treatment of SSc. Registration number: INPLASY202060019.

Abstract Background: Systemic sclerosis (SSc) is 1 of the most complex systemic autoimmune diseases.Accumulating evidence suggests that gut microbiota affect the development and function of the immune system and may play a role in the pathogenesis of autoimmune diseases. This new paradigm raises the possibility that many diseases result, at least partially, from microbiota-related dysfunction. This understanding invites the investigation of fecal microbiota transplantation (FMT) in the treatment of SSc. However, no study has specifically and systematically investigated the efficacy and safety of FMT in the treatment of SSc. Thus, this study will systematically and comprehensively appraise the efficacy and safety of FMT in the treatment of SSc. Methods: We will search the following sources without restrictions for date, language, or publication status: PubMed, Web of Science,Cochrane Central Register of Controlled Trials (CENTRAL) Cochrane Library, EMBASE and China National Knowledge Infrastructure. We will apply a combination of Medical Subject Heading (MeSH) and free-text terms incorporating database-specific controlled vocabularies and text words to implement search strategies. We will also search the ongoing trials registered in the World Health Organization's International Clinical Trials Registry Platform. Besides, the previous relevant reviews conducted on FMT for SSc and reference lists of included studies will also be searched. Results: This study will provide a reliable basis for the treatment of SSc with FMT. Conclusions: The findings will be an available reference to evaluate the efficacy and safety of FMT in the treatment of SSc. Registration number: INPLASY202060019.

目的:观察化浊解毒方治疗慢性糜烂性胃炎(Chronic erosive gastritis,CEG)浊毒内蕴证患者的临床疗效及上皮细胞间质化(Epithelial-Mesenchymal-transition,EMT)相关蛋白:钙黏附蛋白E(E-cadherin,E-cad)、Snail1、Twist的表达水平,探讨化浊解毒方治疗慢性糜烂性胃炎浊毒内蕴证的作用机制,为浊毒理论的临床应用提供理论依据.方法:将68例CEG浊毒内蕴证患者随机分为治疗组和对照组各34例,治疗组给予口服化浊解毒方,对照组口服阿拉坦五味丸,3个月为一个疗程,两组均连续服用2个疗程.观察两组治疗前后症状积分、中医证候疗效、胃镜及病理疗效及胃粘膜EMT相关蛋白E-cad、Snail1、Twist表达水平变化.结果:治疗组症状积分、中医证候疗效、胃镜疗效、病理疗效均优于对照组.与对照组比较,治疗组胃粘膜E-cad蛋白表达水平明显上调.胃粘膜Snail1蛋白、Twist蛋白表达明显下调.结论:化浊解毒方能明显改善CEG浊毒内蕴证患者的临床症状、胃镜及病理情况,其作用机制可能与上调E-cad蛋白,下调Snail1、Twist蛋白,阻止上皮细胞向间质细胞转化有关.