1.Analysis of the disease burden of hypertensive heart disease among individuals aged≥60 years globally and in China from 1990 to 2021
Jiali LI ; Chunzhen REN ; Fan LIU ; Keyan WANG ; Zhijiang BI ; Xiaoxiao ZHAO ; Lixin KE ; Haibo WANG ; Wenxi PENG ; Zhifei WANG ; Qiang ZHANG ; Peng XU ; Yingdong LI ; Xiuxiu DENG ; Xinke ZHAO ; Cuncun LU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(02):281-290
Objective To systematically analyze the characteristics of the disease burden of hypertensive heart disease (HHD) in the elderly (≥60 years) globally and in China from 1990 to 2021, and to predict its future trends from 2022 to 2040, with the aim of providing data support for optimizing comprehensive prevention and control strategies for HHD. Methods Based on the Global Burden of Disease (GBD) 2021 database, the number of prevalent cases and disability-adjusted life years (DALYs) of HHD in the elderly were extracted for the world, China, and five regions categorized by sociodemographic index (SDI). Joinpoint regression was used to analyze the temporal trends of age-standardized prevalence rate and age-standardized DALYs rate of HHD in the elderly. A three-factor decomposition method was applied to evaluate the relative contributions of aging, population growth, and epidemiological changes to the variations in the elderly HHD burden. Additionally, a Bayesian age-period-cohort model was used to predict the elderly HHD burden from 2022 to 2040. Results In 2021, the number of prevalent elderly HHD cases reached 10 283 000 globally and 3 412 400 in China, representing increases of 179.20% and 159.20% respectively, compared with 1990. The DALYs of elderly HHD were 18 812 700 person-years globally and 4 731 400 person-years in China, rising by 76.08% and 29.45% respectively from 1990. Meanwhile, the growth rates of the number of prevalent cases and DALYs of elderly HHD varied across different SDI regions. From 1990 to 2021, the age-standardized prevalence rate of elderly HHD in China, as well as the age-standardized DALYs rate of elderly HHD both globally and in China, showed significant downward trends (all average annual percentage changes<0, all P<0.001). In 2021, the 70-74 years age group accounted for the highest proportion of prevalent cases and DALYs of elderly HHD, both globally and in China. Decomposition analysis revealed that population growth was the dominant factor driving the increase in the elderly HHD burden across all regions. The prediction model results indicated that the number of prevalent cases and DALYs of elderly HHD would continue to rise globally and in China from 2022 to 2040, with the growth rate of the elderly HHD burden in China between 2021 and 2040 expected to exceed the global average. Conclusion Over the past 32 years, although the age-standardized disease rates of elderly HHD have mainly shown a downward trend globally and in China, the absolute number of the disease burden has increased substantially. The projection model indicates a continued upward trajectory, with the growth rate in China higher than the global average. Therefore, there is an urgent need to implement precise prevention and control strategies to effectively mitigate the disease burden of elderly HHD.
2.Efficacy Mechanism of Xianlian Jiedu Prescription Against Colorectal Cancer Recurrence vias Regulating Angiogenesis
Yanru XU ; Lihuiping TAO ; Jingyang QIAN ; Weixing SHEN ; Jiani TAN ; Chengtao YU ; Minmin FAN ; Changliang XU ; Yueyang LAI ; Liu LI ; Dongdong SUN ; Haibo CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):79-87
ObjectiveTo explore effect of Xianlian Jiedu prescription on the recurrence of colorectal cancer (CRC) and investigate the related mechanisms. MethodsA postoperative recurrence model was established in 25 Balb/c mice by injecting CT26 cells subcutaneously into the armpit, followed by surgical removal of 99% of the subcutaneous tumor. The mice were randomly divided into model group, low-dose Xianlian Jiedu prescription (XLJDP-L) group (6.45 g·kg-1·d-1), medium-dose Xianlian Jiedu prescription (XLJDP-M) group (12.9 g·kg-1·d-1), high-dose Xianlian Jiedu prescription (XLJDP-H) group (25.8 g·kg-1·d-1), and 5-fluorouracil (5-FU) group (1×10-3 g·kg-1·d-1). The mice were euthanized after 14 days of continuous intervention, and recurrent tumor tissue was harvested. Hematoxylin and eosin (HE) staining was used to observe pathological and morphological changes in the recurrent tumor tissue. Immunohistochemistry (IHC) was employed to assess the expression of proliferating cell nuclear antigen (Ki67), vascular endothelial growth factor (VEGF), and platelet-endothelial cell adhesion molecule (CD31) in recurrent tumor tissue. The Western blot was used to detect the protein expression levels of angiopoietin-2 (ANG-2), VEGF, phosphorylated-protein kinase B (p-Akt), protein kinase B (Akt), phosphorylated-phosphatidylinositol 3-kinase (p-PI3K), and phosphatidylinositol 3-kinase (PI3K) in recurrent tumor tissue. ResultsBefore treatment, there were no statistical differences in tumor volume, tumor weight, and body mass among the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group compared to the model group, indicating model stability. After treatment, compared with those in the model group, the tumor volume and tumor weight in the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group were significantly reduced (P<0.01), showing dose dependency. Meanwhile, there were no significant differences in body weight among the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group compared to the model group. HE staining showed that compared with that in the model group, tumor tissue in the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group had loosely arranged cells, increased intercellular spaces, small and shriveled nuclei, light staining, fewer mitotic figures and atypical nuclei, and increased necrotic areas. IHC showed that compared with those of the model group, the positive rates of Ki67, VEGF, and CD31 in the recurrent tumor tissue of the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group were significantly reduced (P<0.01) in a dose-dependent manner. Western blot results showed that compared with those of the model group, the protein expression levels of ANG-2 and VEGF in the recurrent tumor tissue of the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group were significantly downregulated (P<0.05, P<0.01), and the p-Akt/Akt and p-PI3K/PI3K ratios were significantly decreased in a dose-dependent manner (P<0.05, P<0.01). ConclusionXianlian Jiedu prescription significantly inhibits the recurrence of CRC in mice after subcutaneous tumor surgery. The mechanism may involve regulating the PI3K/Akt pathway and downregulating key angiogenic proteins such as ANG-2, VEGF, and CD31.
3.Plasma Metabolomic Analysis of Colorectal Cancer Patients with Spleen-Qi Deficiency and Damp-heat Stasis-toxin Syndrome Based on UPLC-Q-Exactive-Orbitrap-MS
Siting MENG ; Lihuiping TAO ; Dong ZHANG ; Qinchang ZHANG ; Yiping FAN ; Haibo CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):130-137
ObjectiveTo observe and analyze the plasma metabolite differences among colorectal cancer patients with spleen-qi deficiency, damp-heat stasis-toxin syndrome(SRYD), non-spleen-qi deficiency, damp-heat stasis-toxin syndrome(non-SRYD), and normal human beings(Normal), aiming to identify unique metabolites specific to SRYD colorectal cancer patients and their potential biomarkers. MethodsBased on the diagnostic criteria of SRYD and non-SRYD colorectal cancer, 30 patients were included, including 10 patients with SRYD colorectal cancer and 20 patients with non-SRYD colorectal cancer, while 10 individuals were recruited for the Normal group. Metabolome sequencing of plasma from the three groups was performed by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap mass spectrometry(UPLC-Q-Exactive-Orbitrap-MS). Multivariate statistical analysis were performed by principal component analysis(PCA) and partial least squares-discriminant analysis(PLS-DA), and the intergroup differential metabolites were identified based on variable importance in the projection(VIP) value>1 and t-test P<0.05. And pathway enrichment analysis based on Kyoto Encyclopedia of Genes and Genomes(KEGG) was performed to explore the metabolites and metabolic pathways specific to SRYD colorectal cancer patients. ResultsMetabolome sequencing results showed some differences in metabolic profiles between the groups. A total of 111 plasma differential metabolites were found in the SRYD group and the Normal group, of which 31 were up-regulated and 80 were down-regulated, mainly including stearoyl lysophosphatidylcholine, indole-3-acrylic acid, and dehydroepiandrosterone sulfate(P<0.05). The non-SRYD group exhibited 97 differentially expressed metabolites compared to the Normal group, with 36 up-regulated and 61 down-regulated, mainly including stearoyl lysophosphatidylcholine, sphingosine, and palmitoyl lysophosphatidylcholine(P<0.05). And the SRYD group exhibited 19 differentially expressed metabolites compared to the non-SRYD group, of which 5 were up-regulated and 14 were down-regulated, mainly including dihydrosphingosine, palmitic acid, and linoleoylethanolamide(P<0.05). The significant differential metabolites were subjected to KEGG analysis to obtain significantly enriched metabolic pathways in each group, and the results showed that 11 metabolic pathways such as primary bile acid synthesis, cholesterol metabolism and bile secretion were differential signaling pathways specific to SRYD colorectal cancer. Further retrieval of the above key signaling pathways showed that bile acids were up-regulated in both bile secretion and primary bile acid synthesis pathways, and there was a trend of up-regulation of glycochenodeoxycholic acid, taurochenodeoxycholic acid, and chenodeoxycholic acid. ConclusionPrimary bile acid synthesis, cholesterol metabolism, and bile secretion-related pathways may be differential signaling pathways specific to SRYD colorectal cancer, and bile acid is a core molecule in the metabolic pathway, which can serve as potential biomarkers closely related to the development and progression of SRYD colorectal cancer.
4.Plasma Metabolomic Analysis of Colorectal Cancer Patients with Spleen-Qi Deficiency and Damp-heat Stasis-toxin Syndrome Based on UPLC-Q-Exactive-Orbitrap-MS
Siting MENG ; Lihuiping TAO ; Dong ZHANG ; Qinchang ZHANG ; Yiping FAN ; Haibo CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):130-137
ObjectiveTo observe and analyze the plasma metabolite differences among colorectal cancer patients with spleen-qi deficiency, damp-heat stasis-toxin syndrome(SRYD), non-spleen-qi deficiency, damp-heat stasis-toxin syndrome(non-SRYD), and normal human beings(Normal), aiming to identify unique metabolites specific to SRYD colorectal cancer patients and their potential biomarkers. MethodsBased on the diagnostic criteria of SRYD and non-SRYD colorectal cancer, 30 patients were included, including 10 patients with SRYD colorectal cancer and 20 patients with non-SRYD colorectal cancer, while 10 individuals were recruited for the Normal group. Metabolome sequencing of plasma from the three groups was performed by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap mass spectrometry(UPLC-Q-Exactive-Orbitrap-MS). Multivariate statistical analysis were performed by principal component analysis(PCA) and partial least squares-discriminant analysis(PLS-DA), and the intergroup differential metabolites were identified based on variable importance in the projection(VIP) value>1 and t-test P<0.05. And pathway enrichment analysis based on Kyoto Encyclopedia of Genes and Genomes(KEGG) was performed to explore the metabolites and metabolic pathways specific to SRYD colorectal cancer patients. ResultsMetabolome sequencing results showed some differences in metabolic profiles between the groups. A total of 111 plasma differential metabolites were found in the SRYD group and the Normal group, of which 31 were up-regulated and 80 were down-regulated, mainly including stearoyl lysophosphatidylcholine, indole-3-acrylic acid, and dehydroepiandrosterone sulfate(P<0.05). The non-SRYD group exhibited 97 differentially expressed metabolites compared to the Normal group, with 36 up-regulated and 61 down-regulated, mainly including stearoyl lysophosphatidylcholine, sphingosine, and palmitoyl lysophosphatidylcholine(P<0.05). And the SRYD group exhibited 19 differentially expressed metabolites compared to the non-SRYD group, of which 5 were up-regulated and 14 were down-regulated, mainly including dihydrosphingosine, palmitic acid, and linoleoylethanolamide(P<0.05). The significant differential metabolites were subjected to KEGG analysis to obtain significantly enriched metabolic pathways in each group, and the results showed that 11 metabolic pathways such as primary bile acid synthesis, cholesterol metabolism and bile secretion were differential signaling pathways specific to SRYD colorectal cancer. Further retrieval of the above key signaling pathways showed that bile acids were up-regulated in both bile secretion and primary bile acid synthesis pathways, and there was a trend of up-regulation of glycochenodeoxycholic acid, taurochenodeoxycholic acid, and chenodeoxycholic acid. ConclusionPrimary bile acid synthesis, cholesterol metabolism, and bile secretion-related pathways may be differential signaling pathways specific to SRYD colorectal cancer, and bile acid is a core molecule in the metabolic pathway, which can serve as potential biomarkers closely related to the development and progression of SRYD colorectal cancer.
5.Analysis of reoperation causes in unilateral biportal endoscopy for treating lumbar degenerative diseases
Yuquan LIU ; Guangpeng LI ; Xiang LI ; Bin ZHU ; Weiyang ZUO ; Haining TAN ; Ning LIU ; Qi FEI ; Haibo SUN ; Tianqi FAN ; Yong YANG ; Lingjia YU
International Journal of Surgery 2025;52(2):108-113
Objective:To analyze the reoperation rate and causes during the early adoption phase of unilateral biportal endoscopy (UBE).Methods:The clinical data of 180 patients who underwent UBE performed by a single surgeon at Beijing Friendship Hospital, Capital Medical University from October 2021 to June 2023 were retrospectively analyzed. Clinical and imaging data of patients who underwent reoperation were collected to analyze the causes of reoperation, and the clinical efficacy of the reoperations was also followed up. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used before and after treatment. Results:A total of 180 patients who underwent UBE were included in this study, of which 6 patients underwent reoperation, and the reoperation rate was 3.33%. Among them, 3 cases occurred in the first 90 surgeries and the other 3 occurred in the subsequent 90 surgeries. The causes of reoperation were as follows: recurrent lumbar disc herniation at the same segment postoperatively in 2 cases, insufficient decompression in 2 cases, disc herniation following isolated decompression in 1 case, and immediate postoperative perianal numbness in 1 case. The time between the initial surgery and reoperation ranged from 0 to 187 days, with an average of 63.3 days. The average follow-up time after reoperation was 18.3 months. The visual analogue scale (VAS) and Oswestry disability index (ODI) scores of the patients at the last follow-up were significantly improved compared with those before operation (VAS score of low back pain: 5.2 ± 1.7 before operation, 1.2 ± 0.8 at the last follow-up, P<0.001; VAS score of leg pain: 7.2 ± 1.5 before operation, 1.2 ± 1.2 at the last follow-up, P<0.001; ODI score: 67.3 ± 5.7 before operation, 20.2 ± 8.2 at the last follow-up, P<0.001). The postoperative modified MacNab scores were generally satisfactory (4 cases were rated as excellent, accounting for 66.7%; 2 cases were rated as good, accounting for 33.3%). Except for one patient who experienced dural injury during open revision surgery, there were no serious complications such as nerve damage. Conclusions:In the early stages of UBE surgery, recurrent lumbar disc herniation and inadequate decompression are the primary reasons for reoperation, typically occurring within the first three months postoperatively. Reoperation does not significantly increase the risk of nerve injury. Enhanced early postoperative follow-up is recommended. For symptomatic patients, a second surgery with thorough decompression can yield satisfactory treatment outcomes.
6.Exploring the Components and Mechanism of Shenbai Jiedu Decoction in Treating CRA Carcinogenesis Based on LC-MS and Network Pharmacology
Li LIU ; Qiuying YAN ; Xiaoxuan FAN ; Minmin FAN ; Liu LI ; Huiping TAO-LI ; Shuchen CHANG ; Haibo CHENG ; Dongdong SUN
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(8):771-784
OBJECTIVE To identify the chemical components of Shenbai Jiedu Decoction(SBJDD),a traditional Chinese medi-cine(TCM)prescription clinically used for the treatment of colorectal adenoma(CRA),and explore the potential mechanism of SBJDD preventing and treating CRA carcinogenesis.METHODS An ultra-high performance liquid chromatography-time of flight-mass spectrometry(UPLC-Q-TOF-MS)method was established to detect the chemical components in the decoction of SBJDD and the plas-ma samples of rats after administration with SBJDD.Based on the network pharmacological method,SBJDD was screened for the poten-tial active ingredients at different stages of CRA carcinogenesis,and the mechanism of the anti-cancer effect of SBJDD was explored.In vitro experiments were also carried out to verify the mechanism of anti-colorectal cancer(CRC)action of SBJDD.RE-SULTS The detection data of UPLC-Q-TOF-MS showed that 152 components were found from SBJDD water extraction.41 chemical compounds were identified in plasma samples from rats administrated with SBJDD.Network pharmacology analysis indicated that during the CREI stage,the potential active ingredients in SBJDD,including epiberberine,and kushenol H,might affect target proteins such as PIK3CA,MAPK3 and PIK3CB.This,in turn,can influence signaling pathways like PI3K-AKT and Ras signaling pathways,and regulate biological processes like protein phosphorylation,and signal transduction.During the CRA stage,the potential active ingredi-ents from SBJDD,such as 3,7-dihydroxycoumarin,palmatine,and kushenol A,might affect target proteins such as AKT and EGFR.This can regulate the negative regulation of apoptotic process,and positive regulation of cell proliferation,and modify HIF-1,and Rap1 signaling pathways.During the progression of CRA carcinogenesis,potential active ingredients such as 3,7-dihydroxycouma-rin may interact with TP53,and impact the PI3K-AKT,and Thyroid hormone signaling pathways to regulate biological processes,in-cluding positive regulation of transcription from RNA polymerase Ⅱ promoter,and negative regulation of apoptotic process.In the CRC stage,core ingredients like p-coumaric acid may bind with proteins such as PRKCB.This binding may impact the signaling pathways that negatively affect EGFR tyrosine kinase inhibitor resistance,and PI3K-AKT signaling pathways.Additionally,it may regulate bio-logical processes,including negative regulation of apoptotic process,signal transduction,and protein phosphorylation.In vitro experi-ment results indicated that SBJDD inhibited the proliferation of HT29 cells and suppressed the expression of EGFR and PKC proteins.CONCLUSION The UPLC-Q-TOF-MS method is established to effectively separate the chemical constituents in SBJDD,which are mainly composed of alkaloids,organic acids and flavonoids components.Components from SBJDD dock with different targets during the carcinogenesis process of CRA and regulate cancer-related signaling pathways to exert therapeutic effects.
7.The effects of treadmill training with different intensities on tendon-bone healing in rats after anterior cruciate ligament reconstruction
Ting LIANG ; Liang ZHU ; Xuliang ZHAO ; Haibo ZHAO ; Fan JIANG ; Tengbo YU
Chinese Journal of Orthopaedic Trauma 2024;26(10):890-898
Objective:To investigate the effects of treadmill training with different intensities on tendon-bone healing in rats after anterior cruciate ligament (ACL) reconstruction.Methods:Of the 99 adult male Sprague-Dawley (SD) rats used for this study, 90 were randomly selected to undergo ACL reconstruction with autologous caudal tendon. Two weeks after the surgical reconstruction, the 90 SD rats were randomized into a low-intensity group (group L, n=30) subjected to treadmill training at a speed of 12 m/min, a moderate-intensity group (group M, n=30) subjected to treadmill training at a speed of 18 m/min, and a free group (group C, n=30) subjected to free activities in the cage as a model control. The other 9 rats were set as a blank control (group N, n=9) subjected to no treatment at all. The treadmill training started at the end of 2 weeks after surgical reconstruction. Hematoxylin-eosin (HE), micro-CT analysis, mechanical testing, real-time quantitative polymerase chain reaction (qPCR) and western blot analysis were used to evaluate the quality of tendon-bone healing. Results:There were no significant differences in the areas of femoral and tibial lateral bone tunnels or the total bone volume ratio (BV/TV) between the 3 groups 2 weeks after surgery ( P > 0.05). At 4 weeks and 8 weeks after surgery, the areas of lateral tibial bone tunnel and lateral femoral tunnel in groups C, M and L showed a decreasing trend ( P < 0.05) while the BV/TV of lateral femoral tunnel and the BV/TV of lateral tibial tunnel in groups C, M and L showed an increasing trend ( P < 0.05). At 8 weeks after surgery, HE staining showed that the tendon-bone healing was the most mature in group L, followed by group M, and the least mature in group C, showing statistically significant differences ( P < 0.05). The stiffness and maximum failure load showed an increasing trend from group C to group M to group L to group N. The stiffness in group M and the stiffness and maximum failure load in groups N and L were significantly higher than those in group C ( P < 0.05). The relative mRNA expression levels of osteopontin (OPN) and collagen type Ⅱ alpha 1 chain gene (COL2 α 1), as well as the protein expression levels of osteocalcin, OPN, and COL2 α 1, showed an increasing trend from group C to group M to group L, showing significant differences between pairwise comparisons ( P < 0.05). Conclusions:Treadmill training starting at the end of 2 weeks after surgery is beneficial to tendon-bone healing and improves the biomechanical strength of the tendon-bone complex. Low-intensity mechanical stimulation is more conducive to new bone formation and collagen fiber remodeling in the tendon-bone complex.
8.Biological Foundation of Colorectal Adenoma Carcinogenesis in Damp-heat Accumulation Syndrome Based on Transcriptome Sequencing and Mechanism of Shenbai Jiedu Prescription
Yuquan TAO ; Haibo CHENG ; Minmin FAN ; Chengtao YU ; Liu LI ; Ye ZHANG ; Mingxin NI ; Meng SHEN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(19):48-54
ObjectiveTo explore the biological foundation of colorectal adenoma in damp-heat accumulation syndrome and the possible anti-tumor mechanism of Shenbai Jiedu prescription. MethodEight patients with colorectal adenoma in damp-heat accumulation syndrome, 11 patients with non-damp-heat accumulation syndrome, and 10 patients with colorectal cancer recruited by Jiangsu Provincial Hospital of Traditional Chinese Medicine from February 2019 to December 2020 meeting the inclusion criteria were clinically obtained, and the tissue of the three groups of patients was subjected to transcriptome sequencing to screen for the differentially expressed genes between the syndrome and the diseases. The intersection of the differentially expressed genes between the syndrome and the disease was taken for further screening of the differentially expressed genes sequentially increasing or sequentially decreasing in patients with non-damp-heat accumulation syndrome, damp-heat accumulation syndrome, and colorectal cancer, and functional enrichment analysis and signaling pathway enrichment analysis were carried out. Real-time polymerase chain reaction (Real-time PCR) was used to detect the effect of Shenbai Jiedu prescription on the expression of the above key differential genes. ResultBy comparing the damp-heat accumulation syndrome and non-damp-heat accumulation syndrome, a total of 384 differentially expressed genes were screened, of which 203 were up-regulated genes, and 181 were down-regulated genes. By comparing the colorectal adenoma of colorectal cancer and damp-heat accumulation syndrome, a total of 2 965 differentially expressed genes were screened, of which 2 460 were up-regulated genes, and 505 were down-regulated genes. The intersection of differentially expressed genes of the two groups was taken, and a total of 58 differentially expressed genes with the same changes were screened. The gene ontology functions were mainly enriched in UDP-galactose: β-N-acetylglucosamine beta-1,3-galactosyltransferase activity, N-acetyllactosaminide beta-1,3-N-acetylglucosaminyltransferase activity, and poly-N-acetyllactosamine biosynthetic process. Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathways were mainly enriched in glycosphingolipid biosynthesis-globo and isoglobo series, glycosphingolipid biosynthesis-lacto and neolacto series, and IL-17 signaling pathway. Shenbai Jiedu prescription significantly inhibited the expression of key genes involved in the enrichment, such as FOSB and B3GALT5, in a dose-dependent manner (P<0.05). ConclusionGlycolipid metabolism may be the biological foundation of colorectal adenoma in damp-heat accumulation syndrome, and Shenbai Jiedu prescription may inhibit colorectal adenoma carcinogenesis by down-regulating the expression of FOSB and B3GALT5.
9.Effect of Shenbai Jiedu Prescription on Fecal Metabolomics and Intestinal Flora Distribution in Patients with Colorectal Adenoma
Ye ZHANG ; Mingxin NI ; Meng SHEN ; Yuquan TAO ; Liu LI ; Minmin FAN ; Haibo CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(19):55-63
ObjectiveTo observe the effects of Shenbai Jiedu prescription on fecal metabolomics and intestinal flora diversity distribution in patients with colorectal adenoma and explore its potential targets. MethodA total of 21 patients diagnosed with colorectal adenoma were enrolled in this study. Following a four-week administration of Shenbai Jiedu prescription, their clinical symptoms were observed, and fecal samples of patients before and after treatment were collected. Untargeted metabolomics and metagenomic analysis based on liquid chromatography-mass spectrometry (LC-MS) were employed to investigate the possible metabolic pathway of Shenbai Jiedu prescription and its influence on the distribution of intestinal flora in patients. ResultThe total scores of traditional Chinese medicine (TCM) syndromes of patients after drug administration decreased significantly (P<0.01). The results of untargeted metabolomics showed that the distribution of metabolites exhibited aggregation before and after drug administration, and a total of 106 differential metabolites were screened out (P<0.05). The Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis revealed that arginine-proline metabolism, ferroptosis, glycine, and serine and threonine metabolism were significantly enriched metabolic pathways (P<0.05). Notably, L-4-hydroxyglutamate semialdehyde, glutathione, isopentenyl pyrophosphate, creatinine, 4-acetamido-2-aminobutanoic acid, and guanidoacetic acid were found to be involved in these aforementioned metabolic pathways. Furthermore, the association between these metabolites and different intestinal flora was analyzed, and the results showed that Shenbai Jiedu prescription could interfere with metabolic pathways such as amino acid and ferroptosis in patients with colorectal adenoma by regulating intestinal flora such as Lachnoclostridium, Eggerthella, and Dialister (P<0.05). ConclusionShenbai Jiedu prescription may improve the clinical symptoms of patients by increasing the abundance of intestinal beneficial bacteria, reducing the abundance of harmful bacteria, and regulating metabolic pathways such as amino acid and ferroptosis in patients with colorectal adenoma. This study may provide some research ideas and directions for Shenbai Jiedu prescription to interfere with colorectal adenoma recurrence and carcinogenesis.
10.Research Progress of Traditional Chinese Medicine Compounds in Prevention and Treatment of Colorectal Adenoma: A Review
Meng SHEN ; Ye ZHANG ; Kai CHEN ; Yuquan TAO ; Minmin FAN ; Mingxin NI ; Liu LI ; Haibo CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(19):64-72
Colorectal adenoma is a benign tumor originating from the mucosal glandular epithelium of the colorectum and belongs to the category of intraepithelial neoplasia. Its etiology and pathogenesis are not completely clear, and some patients have genetic factors. In recent years, with the improvement in living standards, the incidence of colorectal adenoma has gradually increased due to high-fat diets, intestinal flora disorder, and emotional disturbance. As one of the precancerous lesions of colorectal cancer, colorectal adenoma is increasingly threatening human health. Surgical resection is the most direct and effective method for the treatment of colorectal adenoma, but some patients with colorectal adenoma have the possibility of recurrence after resection. At present, there is still a lack of effective prevention and treatment measures for the recurrence of colorectal adenoma. Traditional Chinese medicine (TCM) plays a unique advantage in improving the clinical symptoms of patients with colorectal adenoma and preventing postoperative recurrence and carcinogenesis. Therefore, this review summarized the clinical research and mechanism of TCM compounds in the prevention and treatment of colorectal adenoma in recent years. The clinical study on the prevention and treatment of colorectal adenoma by TCM compounds can be divided into internal treatment, external treatment, and internal and external combined treatment. The internal treatment mainly focuses on strengthening the spleen, and the external treatment includes retention enema, acupoint application, and other methods. The internal and external combined treatment is mainly based on the internal administration of TCM compounds combined with acupuncture, retention enema, and acupoint stimulation. The study on the mechanism of TCM compounds in preventing and treating colorectal adenoma was mainly explored from the aspects of regulating intestinal flora, regulating cell proliferation immune function, and achieving anti-inflammation. This review summarized the research progress of TCM compounds in the prevention and treatment of colorectal adenoma in recent years and provided a reference for future treatment with TCM.

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