Based on data-independent acquisition (DIA) proteomics technology, to analyze the proteomic characteristics of colorectal tubular adenoma and explore the expression changes of SLC30A10 and their potential association with the cGAS-STING pathway. A self-controlled design was adopted, collecting colorectal tubular adenoma (TA) and paired normal mucosa (NM) from 15 patients with TA. Differentially expressed proteins were screened by DIA proteomics, followed by GO and KEGG enrichment analyses. Immunohistochemistry was performed to detect the expression of SLC30A10, cGAS, STING, p-IRF3, ISG15, and β-catenin; immunofluorescence double staining was used to observe the co-localization of p-IRF3 and β-catenin; inductively coupled plasma mass spectrometry (ICP-MS) was employed to determine tissue manganese content. DIA analysis showed that SLC30A10 protein expression was significantly downregulated in TA tissues. Functional enrichment analysis indicated abnormalities in signal transduction, metabolic reprogramming, and nitrogen metabolism in TA tissues. IHC results demonstrated that, compared with NM, TA tissues exhibited reduced expression of SLC30A10, while the expression of cGAS, STING, p-IRF3, ISG15, and β-catenin was upregulated. Manganese content in TA tissues was also significantly increased. Immunofluorescence revealed enhanced nuclear signals of p-IRF3 in TA cells, with co-localization of p-IRF3 and β-catenin observed in the nucleus. Downregulation of SLC30A10 in colorectal tubular adenoma is associated with manganese accumulation and alterations in the cGAS-STING pathway, suggesting its potential role in the development and progression of adenoma, a finding with promising research implications.

Gastric cancer, recognized as one of the most lethal malignancies globally, progresses through a complex, multi-stage development. Elucidating the pathogenic mechanisms behind gastric carcinogenesis and identifying early diagnostic biomarkers are pivotal for decreasing the prevalence of gastric cancer. Using datasets on gastric cancer and its transformation from gastritis, we employed machine learning to create an early diagnostic model, identifying key genes and evaluating accuracy. We prioritized genes in the gastritis-to-cancer progression, identifying a central driver gene. Pathway analysis revealed its transformation role. Tissue microarrays and rat models validated the driver genes and networks, confirmed in cell and organoid models. We also identified cell types secreting CHI3L1 using single-cell RNA sequencing and multiplex immunohistochemistry, exploring their prognostic significance. We identified 12 driver genes potentially involved in the gastritis-to-cancer transformation, with CHI3L1, MMP12, CXCL6, IDO1, and CCL20 emerging as the top five genes via a early gastric cancer diagnostic model. CHI3L1 was pinpointed as the central driver across the gastritis-to-cancer spectrum, with its upregulation, along with CD44, β-catenin, and c-Myc, noted in gastric precancerous lesions. In vitro and organoid studies revealed CHI3L1’s role in activating the CD44-β-catenin pathway to induce malignancy. Furthermore, our findings indicate that fibroblasts and dendritic cells are the principal sources of CHI3L1 secretion, a factor that is associated with poor prognosis in gastric cancer. This study highlights CHI3L1 as a key gene driving the progression from gastritis to gastric cancer, primarily by activating the CD44-β-catenin pathway, which enhances malignant cell traits. CHI3L1 is mainly secreted by fibroblasts and dendritic cells, and its high levels are linked to poor gastric cancer prognosis.

Objective: To observe the clinical efficacy of Chinese herb tea on intervention of non-alcoholic fatty liver disease（NAFLD） with damp-heat accumulation type. Methods: A total of 72 NAFLD with damp-heat accumulation type patients were randomly divided into control group and treatment group, with 36 patients in each group. The control group received diet and exercise intervention, and the treatment group added Chinese herb tea on the basis of the control group. The course of treatment of both groups was 12 weeks. The two groups were observed traditional Chinese medicine（TCM） symptom score, controlled attenuation parameter（CAP）, serum alanine aminotransferase（ALT）, aspartate aminotransferase（AST）, total cholesterol（TC）,triglyceride（TG） and traditional Chinese medicine syndrome before and after treatment, and the adverse reactions of the two groups. Results: There was a significant difference in overall response rate between the treatment group and the control group 96.9%（31/32） vs 92.9%（26/28）（P＜0.05）. After treatment, both groups had significant reductions in TCM symptom score,CAP, ALT, AST, TC（P＜0.05） and the treatment group also had significant reductions in TG（P＜0.05）. Compared with the control group, the treatment group had significantly greater reductions in TCM symptom score, CAP（P＜0.05）. No adverse effects were seen in either group during the treatment period. Conclusion: Chinese herb tea can effectively improve the clinical symptoms and liver function of NAFLD with damp-heat accumulation type, reduce the hepatic fat content and blood lipid level,and have high safety.

目的 研究大肠黑变病(melanosis coli,MC)伴发息肉的内镜特点.方法 回顾性分析2014年1月至2021年2月在北京中医药大学东方医院行肠镜检查的患者,根据疾病诊断纳入MC、MC伴息肉、息肉患者,收集三组患者的年龄、黑变部位、息肉大小、息肉部位、息肉类型、息肉病理类型等资料进行统计学分析.结果 研究分别纳入MC组302例、MC+息肉组246例、息肉组333例患者.年龄:MC+息肉组年龄高于MC组和息肉组(P<0.05),MC+息肉组发病人群以60～74岁居多(61.0％)(P<0.05).黑变部位:MC+息肉组黑变累及3个部位以上的发生频率高于MC组(P<0.05).息肉大小:MC+息肉组直径>1 cm的息肉检出率高于息肉组(P<0.05).息肉部位:MC+息肉组右半结肠和盲肠的息肉检出率高于息肉组,病变≥3个部位的频率高于息肉组(P<0.05).息肉类型:MC+息肉组绒毛管状腺瘤、腺瘤样增生的检出率高于息肉组,管状腺瘤、增生性息肉、炎性息肉的检出率低于息肉组(P<0.05).病理类型:MC+息肉组和息肉组的息肉病理类型分布及检出率比较,差异无统计学意义(P>0.05).结论 MC伴发息肉发病年龄较高,黑变范围更广,息肉部位也较多,息肉恶变倾向更明显.

刘景源教授主要从事温病教学和研究,在内科杂病治疗方面亦有丰富经验,尤对脾胃病有独到认识.他根据脾胃的生理病理特点,提出治疗脾胃病三法:建中固本补益中气,健脾益胃升阳降气,升清降浊调畅气机.临床用方有以下特色:建中固本擅用黄芪建中汤,辛开苦降习用五味制酸方.五味制酸方由海螵蛸、浙贝母、黄连、吴茱萸、煅瓦楞子共5味药组成,该方标本兼顾,治疗胃酸过多,临床有良好疗效.

目的 基于文献探究中医体质类型分布与慢性萎缩性胃炎(Chronic atrophic gastritis,CAG)的相关性与规律性,为中医药防治慢性萎缩性胃炎提供循证医学证据.方法 检索中国知网数据库(CNKI)、重庆维普中文科技期刊数据库(VIP)、万方数据(Wanfang Database)、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library、Embase、Webof Science 8个数据库,纳入所有评价中医体质类型与慢性萎缩性胃炎相关性的临床研究文献.采用R语言(version 4.0.5)与Review Manager 5.4进行Meta分析,以随机效应模型合并数据,运用漏斗图、Egger's test、Begg's test评估偏倚风险.结果 共18项研究符合纳入标准,样本量总计3172例.气虚质、阳虚质和阴虚质占慢性萎缩性胃炎患者的比例分别为18％[95％CI(13％,23％),Q=221.84,P<0.01]、17％[95％CI(13％,24％),Q=278.14,P<0.01]、16％[95％CI(12％,20％),Q=138.08,P<0.01].华东地区与华北地区阳虚质比例相当,华东地区气虚质较多,华北地区阴虚质较多.女性气虚质、气郁质比例高于男性,而男性湿热质、痰湿质比例高于女性.痰湿质在伴有幽门螺杆菌感染的CAG患者中分布较多.轻中度萎缩性胃炎患者气虚质、阳虚质、湿热质较多,而重度萎缩性胃炎患者阳虚质、阴虚质、血瘀质较多.结论 气虚质、阳虚质和阴虚质是慢性萎缩性胃炎患者的主要体质类型,也是导致慢性萎缩性胃炎发病的重要危险因素.

目的 分析经结肠镜检查确诊的6410例结直肠病患者临床资料,为疾病防治提供依据.方法 对6410例结直肠病患者的临床资料作回顾性分析.结果 6410例结直肠病患者均经结肠镜检查确诊,其中结直肠息肉患者5412例、结直肠憩室患者393例、结直肠炎患者356例、溃疡性结肠炎患者294例、结直肠癌患者255例、大肠黑变病患者252例.临床表现主要为腹痛、腹泻、便秘及便血等,其中结直肠息肉、结直肠炎、结直肠憩室患者的临床表现主要为腹痛,结直肠癌患者的临床表现主要为便血,大肠黑变病患者的临床表现主要为便秘,溃疡性结肠炎患者的临床表现主要为便血、黏液脓血便.溃疡性结肠炎患者中男性占比显著高于女性(P<0.05);≤40岁的结直肠病患者中溃疡性结肠炎占比最高,60～70岁间为结直肠息肉、大肠黑变病、结直肠憩室的检出高峰,≥71岁患者中以结直肠癌占比最高.结直肠癌发病部位以直肠为主,溃疡性结肠炎发病部位以直乙状结肠为主,结直肠憩室发病部位以结肠为主,结直肠息肉发病部位以左半结肠为主.结直肠息肉病理类型以管状腺瘤为主,形态以山田Ⅰ型、Ⅱ型为主.5412例结直肠息肉患者中,息肉癌变130例,癌变部位以直肠、乙状结肠为主.结论 结直肠病以结直肠息肉多见,临床表现主要为腹痛、腹泻、便秘及便血,其中≤40岁男性患者中溃疡性结肠炎占比较高,≥71岁患者中结直肠癌占比最高.部分结直肠息肉患者出现息肉癌变,癌变部位以直肠、乙状结肠为主.

目的 系统评价中国儿童及超重肥胖儿童非酒精性脂肪性肝病(NAFLD)患病率,为儿童及超重肥胖儿童NAFLD的流行病学研究和临床防治提供数据基础.方法 计算机检索中国知网、维普网、万方数据知识平台、中国生物医学文献数据库、PubMed、The Cochrane Library、EMbase、Web of Science,收集2000-2021年之间的关于中国儿童及超重肥胖儿童NAFLD患病率的中英文研究.采用R语言(version 4.0.5)对提取数据进行Meta分析,以随机效应模型合并数据,运用漏斗图、Egger's test、Begg's test评估偏倚风险.结果 共纳入25项研究,其中8项研究为儿童NAFLD患病率,17项研究为超重肥胖儿童NAFLD患病率,研究样本量总计35 300例,其中肥胖儿童样本量为7 649例.Meta分析结果显示,中国儿童NAFLD患病率为6.3％(95％CI:4.6％～7.9％),超重肥胖儿童NAFLD患病率为40.4％(95％CI:31.5％～49.9％).亚组分析结果显示,不同性别、研究地区、研究时间的儿童及超重肥胖儿童NAFLD患病率存在差异.结论 我国儿童及超重肥胖儿童NAFLD患病率较高,儿童NAFLD正逐渐成为我国重大公共卫生问题之一.

ObjectiveTo investigate the value of transient elastography (TE) in the staging of hepatic fibrosis in patients with autoimmune liver disease (ALD). MethodsPubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, and VIP databases were searched for English and Chinese articles on TE in the staging of hepatic fibrosis in ALD published from January 2000 to January 2021. Two reviewers independently performed data extraction for the articles included, and QUADAS2 was used for quality assessment. The bivariate mixed effects model in Stata 15.0 software was used to perform the Meta-analysis. ResultsA total of 11 articles were included, with 1041 patients in total. In the diagnosis of significant hepatic fibrosis (F≥2), TE had a pooled sensitivity of 0.81 (95% CI: 0.75-0.86), a specificity of 0.87(95%CI: 0.79-0.92), and an area under the receiver operating characteristic curve (AUC) of 0.91(95%CI: 0.88-0.93); in the diagnosis of advanced hepatic fibrosis (F≥3), TE had a pooled sensitivity of 0.81(95%CI: 0.74-0.87), a sensitivity of 0.90(95%CI: 0.85-0.93), and an AUC of 0.92(95%CI: 0.90-0.94); in the diagnosis of early-stage liver cirrhosis (F4), TE had a pooled sensitivity of 0.87(95%CI: 0.74-0.93), a specificity of 0.93(95%CI: 0.87-0.97), and an AUC of 0.96(95%CI: 0.94-0.97). ConclusionTE has a good diagnostic value in evaluating significant liver fibrosis, advanced liver fibrosis, and early-stage liver cirrhosis in patients with ALD, especially with a relatively high diagnostic accuracy for early-stage liver cirrhosis.

Objectives:Conventional approaches for patients with nonerosive gastroesophageal reflux disease (NERD) were not satisfactory. This study aimed to evaluate the effectiveness and mechanisms of Chinese herbal medicine Hewei Jiangni Decoction (HWJND) as a novel and promising regimen for NERD.Methods:A total of 128 patients with NERD were randomly assigned to the Treatment group and Control group. The patients from the Treatment group were administered HWJND (81 g) plus dummy omeprazole (20 mg) daily for 8 weeks, and the others were given dummy HWJND granules (81 g) plus omeprazole (20 mg). The clinical efficacy was assessed using the gastroesophageal reflux disease questionnaire (GERD-Q) scale, patient reported outcomes (PRO) scale, and short form health survey 36 (SF-36) scale at week 4. Moreover, its pharmacological and molecular mechanisms were elucidated based on network pharmacology and molecular docking.Results:Due to case shedding and other reasons, 109 patients, including 56 in the Treatment group and 53 in the Control group completed this study. Our results showed that HWJND significantly improved heartburn, regurgitation, epigastric pain, nausea, and sleep disturbance, which led to a significant reduction of GERD-Q scores in NERD patients. In addition, PRO scores of NERD patients with HWJND administration were improved, and sufficient relief of physical role, body pain, general health, social function, and mental health on the SF-36 scale was also observed in patients after HWJND treatment. We further showed that the curative effect of HWJND was close to that of omeprazole, except for the better improvement of general health and social function. What's more, the main active ingredients of HWJND included quercetin, beta-sitosterol, naringenin, baicalein, and kaempferol were retrieved, and the protective effects of HWJND against NERD may be closely related to targets such as TNF, IL6, IL1B, MMP9, CXCL8, and EGFR, which were mainly enriched in IL-17 signaling pathway and TNF signaling pathway.Conclusion:Our findings demonstrate that HWJND is noninferior to oral omeprazole for the treatment of patients with NERD, plays a therapeutic role through multiple targets and diverse pathways, and holds promise for complementary and alternative therapy for the treatment of NERD. This trial is registered with http://www.chictr.org.cn, Chinese Clinical Trials Registry [ChiCTR2200055960].

目的 探讨复查胃镜的中年人群上消化道疾病的内镜及病理学特征,为临床诊治提供依据.方法 回顾性分析2015年1月1日至2020年12月31日在北京中医药大学东方医院胃镜中心复查电子胃镜的中年人群,收集其性别、胃镜诊断、病理结果及H.pylori结果等数据,对首查及复查结果进行分析比较.结果 共有397例年龄为35～55岁复查胃镜的受检者,首次检查中慢性萎缩性胃炎、胃溃疡、胃息肉、十二指肠溃疡、食管溃疡、胃癌例数分别为:86例(21.66％)、49例(12.34％)、73例(18.38％)、41例(10.33％)、5例(1.26％)、2例(0.50％),复查例数分别为:93例(23.43％)、19例(4.79％)、89例(22.42％)、20例(5.04％)、1例(0.25％)、1例(0.25％),其中复查胃溃疡、十二指肠溃疡检出率低于首查,差异有统计学意义(P<0.05).十二指肠溃疡、胃息肉的例数在性别分布上差异有统计学意义(P<0.05),H.pylori阳性例数首查、复查分别为:264例(88.29％)、161例(78.92％),差异有统计学意义(P<0.05).慢性萎缩性胃炎、胃溃疡、胃息肉中H.pylori阳性例数高于阴性例数,差异有统计学意义(P<0.05).胃癌前病变首查例数为215例,复查为250例,其中首查胃黏膜萎缩、肠上皮化生、异型增生、上皮内瘤变检出例数分别为:86例(21.66％)、205例(51.64％)、45例(11.34％)、42例(10.58％),复查分别为:93例(23.43％)、226例(56.93％)、89例(22.42％)、37例(9.32％),复查异型增生检出率高于首查(P<0.05).癌前病变发病部位在胃窦、胃角、胃体、贲门、幽门的分布,差异有统计学意义(P<0.05),以胃窦、胃角最为常见.两次检查癌前病变的H.pylori阳性例数高于H.pylori阴性例数,差异有统计学意义(P<0.05).结论 复查胃镜的中年人群中慢性萎缩性胃炎、胃息肉及H.pylori阳性检出率较高;癌前病变中肠上皮化生检出率最高,而异型增生例数复查增加最多;癌前病变部位以胃窦、胃角最为常见.

目的 系统评价低碳水化合物饮食干预对非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)的治疗效果.方法 检索中国知网、万方、维普、PubMed、Embase和Cochrane Library数据库自建库到2019年3月低碳水化合物饮食干预治疗NAFLD相关文献,运用Cochrane偏倚风险评估工具进行文献质量评价,应用RevMan 5.3软件对提取的数据参数进行Meta分析,Stata15.0软件进行敏感性分析和发表偏倚检测.结果 纳入的5篇随机对照研究符合标准,病例总数220例,Meta分析结果显示:低碳水化合物饮食与低脂饮食相比,可降低NAFLD患者低密度脂蛋白(LDL)和甘油三酯(TG)水平,但对体质指数(BMI)、高密度脂蛋白(HDL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)并未产生明显影响.敏感性分析和发表偏倚检测结果显示,单个研究对合并结果稳定性影响不显著且不存在明显发表偏倚.结论 与低脂饮食相比,低碳水化合物饮食可显著改善患者部分血脂水平,但对BMI和肝酶改善作用有限.

睡觉时流口水,鼻翼发红有口气,眼睛易疲劳……这些都是脾胃功能失调的表现.中药学讲,脾胃乃后天之本,负责全身营养物质的运输和吸收.五官尤其是面部也要靠脾胃滋养.脾胃不好,通过“察言观色”就能看出来. 一看面色健康的面色是明润光泽的,如果脾胃虚弱,运化出了问题,面部就会发黄或发白,缺少光泽.如果面色发黄,枯槁无光,称为萎黄,多为脾胃气虚,气血不足;面色黄而虚浮,称为黄胖,为脾虚湿蕴;面色淡白无华,唇舌色淡,多为脾胃气血亏虚.当然,面色因人而异,有的人皮肤较白,有的人皮肤较黑,关键是看有没有滋润的光泽.

OBJECTIVES:Although many studies have examined changes in gut microbiota composition in gastric carcinogenesis to clarify the mechanism of action of anticancer drugs, it is unclear whether animal models of gastric carcinogenesis adequately reflect the disease in humans.METHODS:To address this issue, the present study investigated changes in the gut microbiome profile of a rat model of gastric carcinogenesis established using a combination of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), sodium salicylate, irregular fasting, and ranitidine. The rats were divided into control (Normal), chronic non-atrophic gastritis (CNAG), chronic atrophic gastritis (CAG), precancerous lesion of gastric cancer (PLGC), and gastric cancer (GC) groups according to histopathological features. Gut microbiome in gastric carcinogenesis profiling was performed by 16S rRNA gene sequencing of rat feces samples.RESULTS:We found that gut bacterial species richness increased whereas species diversity decreased during gastric carcinogenesis, with the most significant changes detected in the PLGC group. Gut microbiota community composition differed across groups, with the greatest similarities observed between CNAG and CAG groups and between PLGC and GC groups. There were significant differences in taxonomic representation at the phylum level: the PLGC group had the highest ratio of Firmicutes/Bacteroidetes whereas the GC group had the highest abundance of Proteobacteria and Actinobacteria.CONCLUSIONS:These results indicate that changes in the gut microbiome in a rat model of MNNG-induced gastric carcinogenesis are similar to those observed in humans, thus providing a useful tool for evaluating the efficacy and mechanism of action of novel monotherapies or drug combinations for the treatment of gastric carcinogenesis.

[目的]以痰浊内阻、湿热瘀结型非酒精性脂肪性肝炎(NASH)患者为观察对象,从超声衰减参数(CAP值)、肝功能、血脂水平、中医证候评分、腹部B超等指标来对比茵陈苓桂剂与易善复的临床疗效,探讨温运清利法治疗NASH的作用机理.[方法]收集来源于北京中医药大学东方医院符合诊断标准与纳入标准的痰浊内阻、湿热瘀结型NASH患者72例,随机分为治疗组与对照组,各36例.治疗组给予口服茵陈苓桂剂,每日1剂,早晚饭后1h口服;对照组给予口服易善复,每次2粒(456 mg),每日3次,2组均服用3个月.治疗期间2组均进行饮食、运动干预.观察2组患者治疗前后临床症状、CAP值、腹部B超、肝功能、血脂等的变化情况.[结果]①治疗组改善NASH患者的CAP值优于对照组(P＜0.01),提示茵陈苓桂剂对降低肝脏脂肪含量有明显的效果.②治疗组改善NASH患者的ALT优于对照组(P＜0.01),2组治疗后AST比较差异无统计学意义,二者无明显差别.③治疗组临床症候疗效总有效率为93.1％,优于对照组的84.4％ (P＜0.05).④治疗组在改善右胁胀痛、右胁下痞块、口干口苦的方面优于对照组(P＜0.05);在体态丰腴、身目发黄、上腹胀满、大便不爽、恶心欲吐的改善方面与对照组差异无统计学意义.⑤血脂方面,2组治疗效果差异无统计学意义.⑥腹部B超方面,2组疗效差异无统计学意义.[结论]茵陈苓桂剂能够有效治疗痰浊内阻、湿热瘀结型NASH患者的临床症状、降低CAP值、改善肝脏影像学变化、改善肝功能、纠正脂质代谢紊乱,明确了温运清利法既能温化痰浊、清利肝胆,又能改善肝功能及肝脏脂肪含量,恢复整体功能以治其本.

[目的]探讨茵陈二陈汤对非酒精性脂肪性肝炎(NASH)模型细胞内IRS-1ser307、PKBser473蛋白表达的影响;[方法]采用游离脂肪酸500 umol/L(棕榈酸:油酸摩尔比例为1∶2)刺激干预HepG2细胞,干预24 h建立细胞模型,采用茵陈二陈汤含药血清干预模型细胞,干预治疗24 h;选用罗格列酮、多烯磷脂酰胆碱含药血清作为治疗观察对照;Western Blot检测茵陈二陈汤对模型细胞内IRS-per307、PKBser473蛋白表达及IRS-1ser307/IRS-1、PKBser473/PKB的影响.与空白组相比,游离脂肪酸刺激24 h后,模型细胞内IRS-1ser307蛋白表达及IRS-1ser307/IRS-1水平明显升高,PKBser473蛋白及PKBser473/PKB水平显著下降;与模型组相比,茵陈二陈汤干预24 h后,模型细胞内IRS-1ser307蛋白表达(P＜0.01)及IRS-1ser307/IRS-1水平(P＜0.01)显著降低,PKBser473蛋白(P＜0.05)及PKBser473/PKB水平(P＜0.05)明显升高,且差异具有统计学意义.[结论]①茵陈二陈汤可通过调节IRS-1ser307、PKBser473蛋白表达,降低肝细胞IRS-1蛋白活化水平,促进PKB磷酸化,从而达到干预治疗作用;②茵陈二陈汤对IRS-1ser307、PKBser473蛋白的影响作用与罗格列酮及多烯磷脂酰胆碱效果相近.

Introduction The transition from chronic non-atrophic gastritis (CNAG) to chronic atrophic gastritis (CAG) and gastric carcinoma (GC) is regarded as a representative disease model of gastric mucosa malignant transformation led by uncontrolled inflammation. Traditional Chinese medicine (TCM) syndrome-targeted therapies have been applied in treating chronic gastritis (CG) malignant transformation in China with satisfying efficacy. This study aims to validate TCM syndrome features in each stage of CG malignant transformation. The findings may shed light on the TCM hypothesis of CG malignant transformation, and thus optimise syndrome-targeted treatment strategies of CNAG, CAG and GC, respectively. Methods and analysis The present study is a cross-sectional study conducted in China. A total of 2000 eligible patients, including 500 CNAG cases, 1000 CAG cases and 500 GC cases, will be recruited from four TCM hospitals. Primary outcome measures include the prevalence of TCM syndrome patterns in varied stages of CG malignant transformation. Secondary outcome measures include prevalence and severity of all the presenting signs and symptoms collected by using TCM four diagnostic methods. Descriptive analysis, comparative analysis and correlation analysis of all the measurement data will be performed by biostatisticians. Unsupervised data mining analyses, including exploratory factor analysis, association rule analysis, hierarchical clustering analysis, complex system entropy clustering analysis, and so on, will also be performed by data scientists respectively for in-depth analyses of TCM syndrome-related indicators. Ethics and dissemination The protocol has been approved by the Ethical Review Board of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine (No ECPJ-BDY-2014-02). All the study outcomes will be disseminated through national conference reports and in the meantime published on peer-reviewed journals. Trial registration number NCT03314038; Pre-results.

流行病学研究调查显示非酒精性脂肪性肝炎 (NAFLD) 近年来发病率呈上升趋势[1], 目前不少西药在临床中已观察到可以改善NAFLD, 但治疗NAFLD疗效并不理想, 并且长期服用安全性等问题仍处于探索阶段[2-4].而中医对于NAFLD的治疗具有独特的理论和雄厚的临床基础, 在NAFLD的临床治疗中具有丰富的临床经验.随着西医对NAFLD的认识的深入, 中医学对NAFLD病因和治疗也不断有新的认识.目前, 中医界对NAFLD病因病机的认识已渐趋一致, 但具体的治疗则依学者经验不同, 呈现出多样化的特点.中医在改善肝功能、调节脂质代谢上具有比较明显的疗效和优势, 尤其是在"整体观念"和"辨证论治"的指导下, 在改善患者的生存质量上具有较为明显的优势.