| ObjectivePolyps and chronic atrophic gastritis,gastric stump lesion is equivalent to gastric precancerous disease.At present,gastric polyp is often divided into hyperplastic,adenomatous and hyperplastic polyps who can be developed into adenomatous polyp,adenomatous polyps is cancerous.Because the two polyps were malignant tendency or gastric cancer and coexist,much attention has been paid to it.This study is divided into two parts: clinical research and experimental study of proteomics.Under the guidance of syndrome differentiation in TCM on the treatment.Analysis hyperplasia of gastric polyps common TCM syndrome type distribution,after the endoscopic resection in the treatment of patients were followed up to understand the relationship between hyperplasia of gastric polyp recurrence and syndrome,to guide the clinical treatment of Chinese medicine,to provide a scientific basis for the prevention and treatment of hyperplastic polyps;combined with proteomics method,screening of different TCM Syndromes of type specific protein,so as to clarify its unique mass peak,for the formation of gastric polyps and gastric cancer proteome informatics lay the foundation to promote the traditional Chinese and western medicine the intersection and fusion.MethodsPart I :clinical researchDesigning and making hyperplastic gastric polyps questionnaire and collecting the hospital confirmed for hyperplastic gastric polyps patients as case group.The one who came to the hospital for physical examination and determine for healthy persons as control group,collecting the information of four diagnostic methods and general information;groups of case of illness in the hospital underwent endoscopic resection were followed up to understand postoperative recurrence.To determine the distribution of common TCM Syndromes of hyperplastic gastric polyps according to the collected data,and the correlation between different syndromes and syndrome recurrence.Part II: experimental studyExtraction conforms to the inclusion criteria patients in each case group and control group serum samples,after centrifugation supernatant,and removal of high abundance proteins by 2-D PAGE combined with MALDI-TOF mass spectrometry screening and characterization of differences in protein and for increasing nature of gastric polyps in different TCM Syndromes of specific protein,to explore the relationship between hyperplastic gastric polyps and gastric cancer.ResultsPart I :clinical research1.the clinical study of a total of 150 cases of patients with hyperplastic gastric polyps,46 cases of healthy control group,of which the proportion of men and women in the case group was 1:1.27,which suggested that the prevalence rate of female was higher than that of male.Healthy control group of male and female ratio 1.09:1.There was no significant difference in the sex ratio of thecase group and the control group(P>0.05).2.150 cases of hyperplastic gastric polyps in patients is divided into three layers.In the overall age distribution,the minimum age is 25 years,the maximum age is 74 years old,the average age is(58.7±7.2)years old.Age composition ratio: middle-aged(52.67%)> elderly(38.0%)> young people(9.33%).The incidence rate of the elderly was higher than that of the young people.3.Correlation analysis of hyperplastic polyps of TCM syndrome type and age: the test showed between TCM Syndromes of different ages have significant difference(P<0.05).The middle-aged man with spleen deficiency and qi stagnation phlegm stasis,phlegm and blood stasis in the elderly.4.The average age,average weight and average BMI of the control group were not significantly different(P>0.05)between the two groups.5.Hyperplasia of gastric polyps common TCM syndrome type distribution:60 patients of spleen deficiency syndrome(40%),48 cases of qi stagnation and phlegm obstruction syndrome(32%),phlegm and blood stasis syndrome in 42cases(28%),syndrome type of order: spleen and stomach deficiency cold >qi stagnation of phlegm > phlegm stasis stasis syndrome.6.Hyperplastic gastric polyps in different TCM syndrome type and relapse frequency correlation: cases of hyperplasia of gastric polyps group 150 cases,after endoscopic resection,after the return of 9 months,a total of 23 cases of recurrence is 15.3%,of which recurrence 1 in 14 cases(9.33%)recurrence 2times for the 5 cases(3.33%),relapse 3 times in 4 cases(2.67%).It was suggested that the patients with hyperplastic gastric polyps recurred 1 times.There was no significant difference between the different types of traditional Chinese medicine(TCM)and the number of recurrence in hyperplastic gastric polyps(P>0.05).Part II: experimental study1.case group respectively and health control group comparison,spleen deficiency syndrome and healthy control group compared,a total of 42 protein spots were,9 proteins were identified,including up-regulated protein spots in 7,the number of protein down regulated 1.Stagnation of Qi and phlegm syndrome and healthy control group in comparison,a total of 39 differentially expressed protein spots,nine proteins were identified,the upregulation of protein points to4,the number of protein down regulated 2.Phlegm and blood stasis syndrome and healthy as compared to control group,a total of 34 different protein spots,eight kinds of proteins were identified,the up-regulated protein spots in 3,occurred down regulated protein spots in May;in spleen deficiency syndrome in most significantly upregulated,and qi stagnation and phlegm syndrome and phlegm and blood stasis in each node card in the upregulation and downregulation of the basic balance.2.case of the overall group and health control group comparison,two protein spots were raised at the same time,respectively Creatinekinase B-type and complement C3;1 protein spots were cut down at the same time,TRFE;prompt Creatinekinase B-type,complement C3,TRFE may hyperplastic gastric polyps specific protein.3.Creatinekinase B-type,complement C3,ighm,Transthyretin in spleen deficiency in the expression of the significant changes;haptoglobin,hemopexin,Serotransferrin,complment C4-A,Iglambda chain V-I region Wah in Qi stagnation and phlegm obstruction in the expression of the significant changes;RET4,apolipoprotein A-I in phlegm and blood stasis was the most significant may suggest different TCM syndrome of gastric hyperplastic polyp candidate objective index.ConclusionsPart I :clinical researchAccording to the inclusion between the standard of the case group and the healthy control group sex,age distribution,weight,height,BMI significantly,cases of hyperplastic gastric polyps hair whims of female is higher than male,middle-aged patients,the incidence rate was higher than that in other age groups can,rate of spleen deficiency and qi stagnation and phlegm resistance group of middle-aged patients was higher than that in other age groups,phlegm and blood stasis each node syndrome incidence of elderly patients is higher than that of the young and middle-aged.Hyperplastic polyps after endoscopic treatment has certain recurrence rate,but there are no significant differences between different TCM syndromes and recurrence times,mainly recurred 1times.Part II: experimental study1.The serum samples of three different kinds of traditional Chinese medicine syndromes and healthy control group were studied by proteomics method.The 27 differential protein spots were found,and 13 proteins were found.There was a significant difference in the expression of these 13 proteins in the different traditional Chinese medicine syndromes(P<0.05).Creatinekinase B-type protein and TRF gray value increased,the gastric hyperplastic polyps specific protein;Creatinekinase B-type,complement C3,ighm,Transthyretin in spleen deficiency in expression of the significant changes were found;haptoglobin,hemopexin,Serotransferrin,complment C4-A,Iglambda chain V-I region Wah in Qi stagnation and phlegm obstruction in the expression of the significant changes;RET4,apolipoprotein A-I in phlegm and blood stasis was the most significant may these proteins can be as hyperplastic gastric polyps in different TCM syndrome differentiation,treatment of candidate objectiveindicators.2.According to the foreign literature which TRF protein and digestive system neoplasms in the literature is to definite,TRF in three groups of patients serum were decreased,decreased binding ability of free iron ions,a lack of iron in the body,oxygen carrying capacity decreased anoxic stress DNA damage-cancer,this process can reflects digestive tract tumor occurrence and development process by the TRF.Phlegm and blood stasis type may be more prone to gastric cancer,should increase the degree of attention,regular follow-up. |
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