1.Mutations in the epidermal growth factor receptor and targeted therapy of non-small-cell lung cancer.
Ren-Sheng LAI ; Ling XIE ; Long-Shu SHEN ; Ya-Min HE ; Chang-Le ZHU
Chinese Journal of Pathology 2005;34(11):745-746
Antineoplastic Agents
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therapeutic use
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Carcinoma, Non-Small-Cell Lung
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drug therapy
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genetics
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Drug Delivery Systems
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Erlotinib Hydrochloride
;
Female
;
Genes, erbB-1
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Humans
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Lung Neoplasms
;
drug therapy
;
genetics
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Male
;
Mutation
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Protein Kinase Inhibitors
;
therapeutic use
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Quinazolines
;
therapeutic use
;
Receptor, Epidermal Growth Factor
;
antagonists & inhibitors
;
genetics
2.Epithelial growth factor receptor (EGFR) exon double-sequencing analysis in NSClC.
Ren-sheng LAI ; Ling XIE ; Long-shu SHEN ; Chang-le ZHU ; Jun QIAN
Chinese Journal of Oncology 2006;28(8):599-602
OBJECTIVETo study the mutation patterns of epithelial growth factor receptor (EGFR) exon 18, 19 and 21 in Chinese non-small-cell lung cancers (NSCLC).
METHODSSomatic mutation in samples of 32 cases without Iressa-treatment were compared with that in 10 volunteers blood control. The mutations were identified for the forward and reverse sequence chains for the tyrosine kinase domain of the EGFR gene, followed by DNA template abstraction and Touchdown PCR.
RESULTSNine types of mutation were found in sequences of 7 cases among the 32 non-small cell lung carcinoma tissues, namely, five reported mutation within exon 19, and two new heterozygous mutations, L833V and H835L within exon 21, and two intron polymorphism. These results showed a mutation rate of 9/32 (28.1%) in Chinese with NSCLC, and of 31.6% in lung adenocarcinomas.
CONCLUSIONEGFR mutation rate in Chinese with NSCLC is consistent with those of Asian women reported in the literature but new mutation points in Chinese were presented as L833V and H835L. The mutation rate is in concordance with release rate of NSCLC obtained by Gefitinib treatment in Chinese.
Adenocarcinoma ; genetics ; Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Carcinoma, Non-Small-Cell Lung ; ethnology ; genetics ; China ; DNA Mutational Analysis ; Exons ; genetics ; Female ; Humans ; Lung Neoplasms ; ethnology ; genetics ; Male ; Middle Aged ; Mutation ; Receptor, Epidermal Growth Factor ; genetics
3.Clinical study on modified sanmiao powder in treating chronic uric acid nephropathy.
Shao-wei XIANG ; Shen-chang LAI ; Yu-hua MENG
Chinese Journal of Integrated Traditional and Western Medicine 2009;29(11):979-981
OBJECTIVETo investigate the clinical efficacy of modified Sanmiao Powder (SMP) in treating chronic uric acid nephropathy (CUAN).
METHODSNinety-four patients with CUAN were equally randomized to the treated group and the control group. Conventional treatment was given to all patients and the treated group was administered with SMP additionally for 12 weeks. Changes of symptoms were observed, and laboratory indexes, as urinary protein quantity (UPro), urinary RBC count (URBC), urinary beta2 microglobulin (beta2-M), urinary beta-N-acetylglucosaminidase (NAG), blood urea nitrogen (BUN), serum creatine (SCr) and serum uric acid (SUA), were detected before and after treatment.
RESULTSThe total effective rate in the treated group was 87.2% (41/47), and in the control group was 61.7% (21/47), showing significant difference between groups (P < 0.01); significant improvement of UPro, URBC, beta2-M, NAG, BUN, SCr and SUA were shown in the treated group (P < 0.05, P < 0.01); but in the control group, only URBC count was significantly decreased (P < 0.05), no statistically significant change of other indexes was found (P > 0.05). SUA decreased in both groups (P < 0.01), which was markedly lower in the treated group than in the control group (P < 0.05); SCr and BUN were also decreased in the treated group (P < 0.01).
CONCLUSIONSCombined therapy of SMP and conventional Western medicine shows a favorable effect in treating CUAN. It could not only reduce SUA, but also alleviate the albuminuria and hematuria, lower the urinary levels of beta2-M and NAG to improve renal function.
Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Kidney Diseases ; drug therapy ; etiology ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Phytotherapy ; Uric Acid
4.DEPTOR gene silencing promotes β-cell insulin secretion
Hong QIU ; Shu-Chang LAI ; Dao-Yan PAN ; Xiao WANG ; Jie SHEN
Chinese Journal of Tissue Engineering Research 2018;22(16):2577-2582
BACKGROUND: Mammalian target of rapamycin (mTOR) complexes are a key regulator of pancreatic beta cells mass and function. DEP-domain containing mTOR-interacting protein (DEPTOR) is a common part of mTOR complexes and whether DEPTOR loss in islet β cells affects insulin-secreting function has never been identified. OBJECTIVE: To assess the alternation of insulin secretion by silencing DEPTOR gene in pancreatic β cells NIT-1 and to explore the underlying mechanism. METHODS: Three siRNA sequences for silencing DEPTOR gene were designed and constructed, which were transfected with lipofectamine into NIT-1 cells. There were six groups: blank transfection group (NIT-1 cells plus Lipofectamin), negative control group (NC-FAM), positive control group (GAPDH), siRNA deptor 1 group (siRNA deptor385), siRNA deptor 2 group (siRNA deptor766), and siRNA deptor 3 group (siRNA deptor1275). The transfection efficiency was determined by fluorescence microscope. The relative expression level of DEPTOR mRNA was detected by quantitative-PCR. Insulin secretion in the cell conditioned medium was determined by insulin ELISA kit. The expression level of DEPTOR downstream key protein was detected by western blot assay. RESULTS AND CONCLUSION: Specific green fluorescence accumulated in a punctated pattern under fluorescence microscope, indicating that the effectiveness of transfection was eligible. Quantitative-PCR results showed two (siDEPTOR385 and siDEPTOR766) of the three siRNA sequences could significantly disrupt the expression of DEPTOR mRNA, which had significant difference with negative control group (P< 0.05). The ELISA results showed that the total amount of insulin secretion in the effective transfected groups was significantly increased (P< 0.05). Western blot assay results showed the grey levels of p-s6 and p-4EBP-1 proteins were significantly elevated, while p-AKT of those former was slightly decreased. These findings suggest that siRNA technology can effectively silence the DEPTOR gene in NIT-1 cells, which improves β-cell insulin secretion in a manner of mTORC1 activation.
5.Expression of high mobility group box-1 in the lung tissue and BALF of asthmatic mice and the influence of dexamethasone.
Chang-chun HOU ; Hai-jin ZHAO ; Shao-xi CAI ; Lai-yu LIU ; Xiang-bo SHEN ; Guan-wen MO
Journal of Southern Medical University 2010;30(9):2051-2054
OBJECTIVETo investigate the expression of high mobility group box-1 (HMGB1) in the lung tissue and bronchoalveolar lavage fluid (BALF) of asthmatic mouse models and the influence of dexamethasone (DM).
METHODSEighteen female Balb/C mice were randomly divided PBS control group, OVA group and OVA/DM group, and asthmatic mouse models were established in the latter two groups. The airway responsiveness of the mice was assessed by whole-body plethysmography, and the cells in the BALF were counted and classified, with the supernatants of the BALF collected for detection of the level of HMGB1 by ELISA. The left lung of the mice was collected for HE staining, and the expression of HMGB1 in the right lung tissue was detected by Western blotting.
RESULTSAsthmatic mouse models were successfully established. The level of HMGB1 in the BALF was significantly higher in OVA group than in the control group (6.31 ± 4.05 ng/ml vs 2.59 ± 0.73 ng/ml, P = 0.017), but no significant difference was found between OVA/DM group (3.39 ± 0.50 ng/ml) and OVA group (PP = 0.052). The expression of HMGB1 relative to tubulin was significantly higher in OVA group than in the control group (2.08 ± 0.87 vs 0.85 ± 0.30, P = 0.032), but similar between OVA/DM group (1.15 ± 0.48) and OVA group (PP = 0.133).
CONCLUSIONThe expression of HMGB1 is obviously increased in the lung and BALF of asthmatic mice and DM produces no significant effect on HMGB1 expression, suggesting that HMGB1 may serve as a new therapeutic target for asthma treatment.
Animals ; Asthma ; drug therapy ; metabolism ; Bronchoalveolar Lavage Fluid ; chemistry ; Dexamethasone ; therapeutic use ; Female ; HMGB1 Protein ; genetics ; metabolism ; Lung ; metabolism ; Mice ; Mice, Inbred BALB C
6.Effects of mild hypothermia on the ROS and expression of caspase-3 mRNA and LC3 of hippocampus nerve cells in rats after cardiopulmonary resuscitation
Jian LU ; Yi SHEN ; Hui-Yin QIAN ; Li-Jun LIU ; Bao-Chun ZHOU ; Yan XIAO ; Jin-Ning MAO ; Guo-Yin AN ; Ming-Zhong RUI ; Tao WANG ; Chang-Lai ZHU
World Journal of Emergency Medicine 2014;5(4):298-305
BACKGROUND: Cardiac arrest (CA) is a common and serious event in emergency medicine. Despite recent improvements in resuscitation techniques, the survival rate of patients with CA is unchanged. The present study was undertaken to observe the effect of mild hypothermia (MH) on the reactive oxygen species (ROS) and the effect of neurological function and related mechanisms. METHODS: Sixty-five healthy male Sprague Dawley (SD) adult rats were randomly (random number) divided into 2 groups: blank control group (n=5) and CPR group (n=60). CA was induced by asphyxia. The surviving rats were randomly (random number) divided into two groups: normothermia CPR group (NT) and hypothermia CPR group (HT). Normothermia of 37 °C was maintained in the NT group after return of spontaneous circulation (ROSC), hypothermal intervention of 32 °C was carried out in the HT group for 4 hours immediately after ROSC. Both the NT and HT groups were then randomly divided into 2 subgroups 12 hours and 24 hours after ROSC (NT-12, NT-24, HT-12, HT-24 subgroups). During observation, the neurological deficit scores (NDSs) was recorded, then the bilateral hippocampi were obtained from rats' head, and monoplast suspension of fresh hippocampus tissue was made immediately to determine the level of intracellular ROS by flow cytometry. Transmission electron microscope was used to observe the ultramicro changes of cellular nucleus and mitochondria. Reverse transcription-polymerase chain reaction (RT-PCR) was used to determine the expression of caspase-3 mRNA, and western-blotting (WB) was used to determine the level of LC3 in frozen hippocampus tissue. Measured data were analyzed with paired sample t test and One-Way ANOVA. RESULTS: Of 60 rats with CA, 44 (73%) were successfully resuscitated and 33 (55%) survived until the end of the experiment. The NDSs of rats in the NT and HT groups were more significantly reduced than those in the BC group (F=8.107, P<0.05), whereas the NDSs of rats in the HT-12 and HT-24 subgroups were significantly increased in comparison with those NDSs of rats in the NT-12 and NT-24 subgroups, respectively (t=9.692, P<0.001; t=14.374, P<0.001). The ROS in hippocampus nerve cells in the NT and HT groups significantly increased compared to the BC group (F=16.824, P<0.05), whereas the ROS in the HT-12 and HT-24 subgroups significantly reduced compared with that ROS in the NT-12 and NT-24 subgroups, respectively (t=9.836, P<0.001;t=7.499, P<0.001). The expression of caspase-3 mRNA in hippocampus nerve cells in the NT and HT groups were significantly increased compared to the BC group (F=24.527, P<0.05), whereas the expression of caspase-3 mRNA in rats of the HT-12 and HT-24 subgroups was significantly reduced compared to the NT-12 and NT-24 subgroups, respectively (t=6.935, P<0.001; t=4.317, P<0.001). The expression of LC3B-II/I in hippocampus nerve cells of rats in the NT and HT groups significantly increased compared to the BC group (F=6.584, P<0.05), whereas the expression of LC3B-II/I in rats of the HT-12 and HT-24 subgroups significantly reduced compared to the NT-12 and NT-24 subgroups, respectively (t=10.836, P<0.001; t=2.653, P=0.02). Ultrastructure damage of nucleus and mitochondria in the NT group was more evident than in the BC group, and eumorphism of nucleus and mitochondria were maintained in rats of the HT group compared with the NT group. CONCLUSION: Mild hypothermia lessened the injury of nerve cells and improved the neurological function of rats that survived from cardiac arrest by reducing the ROS production of nerve cells and inhibiting the expression of caspase-3 mRNA and LC3, leading to cellular apoptosis and massive autophagy in rats that survived from cardiac arrest after CPR.
7.Effectiveness and security of anisodine hydrobromide tablets in treating nonarteritic anterior ischemic optic neuropathy: a Chinese multicenter nonrandomized controlled study
Mo YANG ; Honglu SONG ; Huanfen ZHOU ; Mengying LAI ; Quangang XU ; Mingming SUN ; Ke FAN ; Hongpei CUI ; Haiyan WANG ; Xin JIN ; Chuanbin SUN ; Qing XIAO ; Ying WANG ; Zide ZHAO ; Minglian ZHANG ; Yongye CHANG ; Mengping CHEN ; Zhanxing SHEN ; Hui YANG ; Xiaoyu XU ; Zhiqing LI ; Dongjun XING ; Yu DONG ; Jinrun YANG ; Qian REN ; Li LI ; Wenfang ZHANG ; Li SUN ; Zhengpei ZHANG ; Suyan LI ; Danyan LIU ; Nalei ZHOU ; Nali LUO ; Yadong LIU ; Shihui WEI
Chinese Journal of Experimental Ophthalmology 2023;41(7):646-653
Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.
8.Effect of Xianlian Jiedu Prescription on Proliferation and Glycolysis of Human Colorectal Cancer HCT-116 Cells and Mechanism
Li-huiping TAO ; Yue-yang LAI ; Hai-bo CHENG ; Wei-xing SHEN ; Jia-ni TAN ; Chang-liang XU ; Cheng-tao YU ; Min-min FAN ; Liu LI ; Zheng-jie SHEN
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(8):72-78
ObjectiveTo explore the effect of Xianlian Jiedu prescription (XLJDP) on the proliferation and glycolysis of human colorectal cancer HCT-116 cells and the underlying mechanism. MethodHCT-116 cells were cultured with XLJDP and then the survival rate was examined by methyl thiazolyl tetrazolium (MTT) assay. The effect on the HCT116 cell proliferation was detected by colony formation assay and 5-ethynyl-2′-deoxyuridine (EDU) incorporation assay. The amount of glucose consumed by HCT-116 cells was measured by glucose test kit, and the amount of produced lactic acid was determined by lactic acid test kit 48 h after the treatment with XLJDP. The expression of glycolysis-related proteins mammalian target of rapamycin (mTOR), phosphorylated mTOR (p-mTOR), glucose transporter 1 (GLUT1), and lactate dehydrogenase (LDHA) was detected by Western blot. ResultThe half-maximal inhibitory concentration (IC50) of XLJDP against HCT-116 cells was 6.82 g·L-1. Compared with the blank group, XLJDP (1.625, 3.25, 6.50 g·L-1) inhibited the proliferation of HCT-116 cells (P<0.05, P<0.01). Moreover, compared with the blank group, XLJDP (1.625, 3.25, 6.50 g·L-1) suppressed glucose uptake and lactic acid production in a dose-dependent manner (P<0.05, P<0.01). The expression of p-mTOR/mTOR, LDHA, and GLUT1 was down-regulated by XLJDP (P<0.05, P<0.01). ConclusionXLJDP can significantly inhibit the proliferation and the Warburg effect of glycolysis in colorectal cancer cells by regulating the mTOR signaling pathway and the down-regulating the expression of LDHA, GLUT1, and other key proteins and enzymes in glycolysis.
9.Shenbai Jiedu Fang inhibits AOM/DSS-induced colorectal adenoma formation and carcinogenesis in mice via miRNA-22-mediated regulation of the PTEN/PI3K/AKT signaling pathway.
Jian Rong LIU ; Wei Xing SHEN ; Hai Bo CHENG ; Min Min FAN ; Jun XIAO ; Chang Liang XU ; Jia Ni TAN ; Yue Yang LAI ; Cheng Tao YU ; Dong Dong SUN ; Liu LI
Journal of Southern Medical University 2022;42(10):1452-1461
OBJECTIVE:
To observe the inhibitory effect of Shenbai Jiedu Fang (SBJDF, a compound recipe of traditional Chinese herbal drugs) on chemically induced carcinogenesis of colorectal adenoma in mice and explore the role of PTEN/PI3K/AKT signaling pathway in mediating this effect.
METHODS:
Four-week-old male C57BL/6 mice were randomly divided into control group (n=10), AOM/DSS model group (n=20), low-dose (14 g/kg) SBJDF group (n=10) and high-dose (42 g/kg) SBJDF group (n= 10). In the latter 3 groups, the mice were treated with azoxymethane (AOM) and dextran sodium sulphate (DSS) to induce carcinogenesis of colorectal adenoma. In the two SBJDF treatment groups, SBJDF was administered daily by gavage during the modeling. The survival rate, body weight, general condition of the mice, and intestinal adenoma formation and carcinogenesis were observed. The expressions of proteins associated with the PTEN/PI3K/AKT signaling pathway in the intestinal tissue were detected using immunohistochemistry.
RESULTS:
Compared with those in the model group, the mice treated with SBJDF, especially at the high dose, showed a significantly lower incidence of intestinal carcinogenesis and had fewer intestinal tumors with smaller tumor volume. Pathological examination showed the occurrence of adenocarcinoma in the model group, while only low-grade and high-grade neoplasia were found in low-dose SBJDF group; the mice treated with high-dose SBJDF showed mainly normal mucosal tissues in the intestines with only a few lesions of low-grade neoplasia of adenoma. Compared with those in the control group, the mice in the model group had significantly elevated plasma miRNA-222 level (P < 0.05), which was obviously lowered in the two SBJDF groups (P < 0.01). The results of immunohistochemistry revealed that compared with the model group, the two SBJDF groups, especially the high-dose group, had significantly up-regulated expressions of PTEN, P-PTEN and GSK-3β and down-regulated expressions of p-GSK-3 β, PI3K, AKT, P-AKT, β-catenin, c-myc, cyclinD1 and survivin in the intestinal tissues.
CONCLUSION
SBJDF can significantly inhibit colorectal adenoma formation and carcino-genesis in mice possibly through regulating miRNA-222 and affecting PTEN/PI3K/AKT signaling pathway.
Animals
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Male
;
Mice
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Adenoma/prevention & control*
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Azoxymethane/adverse effects*
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Carcinogenesis/drug effects*
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Colorectal Neoplasms/prevention & control*
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Dextran Sulfate/adverse effects*
;
Disease Models, Animal
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Glycogen Synthase Kinase 3 beta/metabolism*
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Mice, Inbred C57BL
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MicroRNAs/metabolism*
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Phosphatidylinositol 3-Kinases/metabolism*
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Proto-Oncogene Proteins c-akt/metabolism*
;
Signal Transduction
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Drugs, Chinese Herbal/therapeutic use*
10.Transcriptome Analysis of Xianlian Jiedu Prescription in Intervention of Colorectal Carcinoma Due to Dampness, Heat, Stasis, and Toxin in Mice
Tong-qing CHEN ; Cheng-tao YU ; Hui-qin XU ; Hai-bo CHENG ; Wei-xing SHEN ; Jia-ni TAN ; Chang-liang XU ; Yue-yang LAI ; Min-min FAN
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(8):63-71
ObjectiveTo analyze the transcriptome characteristics of Xianlian Jiedu prescription (XLJDP) in the intervention of colorectal carcinoma by high-throughput cDNA-sequencing (RNA-seq). MethodNinety male C57BL/6 mice were randomly divided into the control group, colorectal carcinoma due to dampness, heat, stasis, and toxin model group, and XLJDP group, with 30 mice in each group. Mice in the model group and XLJDP group were fed a high-fat diet and provided with azoxymethane and dextran sodium sulfate (AOM/DSS) for inducing colorectal carcinoma. Those in the XLJDP group were further treated with intragastric administration of 12.9 g·kg-1 XLJDP since the day of modeling for 112 days. The colorectal tissues were collected from each group 4 h after the last drug treatment and stained with hematoxylin-eosin (HE) and methylene blue for observing the pathological changes. The total RNA was extracted from colorectal tissues for RNA-Seq-based transcriptome profiling, followed by gene oncology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis and the screening and verification of differentially expressed genes. ResultCompared with the model group, XLJDP significantly relieved the colorectal congestion and edema and decreased tumor number and volume in mouse colorectal tissues. The methylene blue staining results indicated that XLJDP significantly suppressed the development of aberrant crypt foci (ACF,P<0.01). As revealed by HE staining, XLJDP significantly alleviated the injury and dysplasia of colorectal tissues. Transcriptome analysis identified 615 differentially expressed genes (446 up-regulated and 169 down-regulated) between the model group and the blank group and 54 differentially expressed genes (29 up-regulated and 25 down-regulated) between the XLJDP group and model group. XLJDP mainly affected the expression of NIMA-related protein kinase 7 gene (Nek7, P<0.01), Mucin 16 (Muc16, P<0.01), SiahE3 ubiquitin protein ligase family member 3 (Siah3, P<0.01), regenerating islet-derived protein 3-gamma (Reg3g, P<0.01), RNA polymerase Ⅱ elongation factor-associated factor 2 (Eaf2, P<0.01), transforming growth factor‐alfa gene (TGF-α, P<0.05), secretoglobin family 1A member 1 (Scgb1a1, P<0.05), family with sequence similarity 227 member B (Fam227B, P<0.05), cytochrome P450 family 2 subfamily c polypeptide 40 (Cyp2c40, P<0.01), and ankyrin repeat and EF-hand domain containing protein 1 (Ankef1, P<0.05). Enrichment analysis showed that intestinal epithelial cell proliferation, metabolism of xenobiotics by cytochrome P450, and arachidonic acid metabolism signaling pathway were significantly enriched. ConclusionXLJDP is able to interfere with colorectal tumorigenesis and development due to dampness, heat, stasis, and toxin in mice, which has been proved by transcriptome analysis to be related to the regulation of metabolism-related pathways.