Professor Tang Xudong's Research On The Correlation Between H.pylori And TLR4/CDX2 In The Context Of CAG Experience Mining And Gastric Mucosal Atrophy

Helicobacter pylori(H.pylori)is an important pathogenic factor of Chronic Atrophic Gastritis(CAG)and gastric cancer.Spleen deficiency is one of the major pathogenesis of CAG,which is closely related to H.pylori infection.The main content of this study is divided into two parts:the first part is Professor Tang Xudong’s experience mining for CAG The second part is the study of the correlation between H.pylori infection and TLR4/CDX2 in the background of atrophic gastric mucosa.1.Professor Tang Xudong’s experience in treating CAGObjective:Through the data mining method to analyze the clinical experience of Professor Tang Xudong for the treatment of CAG,to extract the common prescriptions,drugs and drug pairs for the treatment of CAG On this basis,combining theoretical analysis and follow-up experience to explore the clinical experience of professor Tang Xudong on the treatment of CAG.Methods:This paper collects the medical records of Professor Tang Xudong for the treatment of CAG,collects the basic date,symptoms,diagnosis and prescriptions,and uses the cloud platform of ancient and modern medical cases to carry out frequency statistics,correlation analysis,cluster analysis and complex network analysis.Combined with the follow-up experience of professor Tang Xudong,this paper summarizes his thinking mode of the treatment of CAG and the experience of drug use.Results:121 cases diagnosed with CAG were screened.Through data mining analysis,the symptoms of distention and fullness(72 cases,59.50%),stomachache(62 cases,51.24%),and belching(57 cases,47.11%)were most obvious.The tongue nature was characterized by pink tongue(62 cases,41.89%),dark tongue(27 cases,18.24%),and the tongue coating mainly covered with thin fur(75 cases,44.91%),The main pulse is thready pulse(107 cases,76.98%).The diagnosis of Chinese medicine was mainly distention and fullness(73 cases,52.52%).TCM syndrome was mainly Spleen-stomach deficiency syndrome(73 frequency,30.58%).The rule of treatment was mainly liver soothing and spleen strengthening(41 frequency,29.75%).The main prescriptions were Xiang Su Decoction(55 frequency,39.57%)and Si Jun Zi Decoction(44 times,31.65%).Traditional chinese medicine has the highest frequency of Sha Ren,Zhi Gan Cao,Chen Pi and Dang Shen.The action of traditional chinese medicine has the highest frequency of dampness and phlegm.Cluster analysis and correlation analysis show that there are common use drug pairs of Chai Hu-Bai Shao-Dang Gui,Shu Di Huang-Shan Yu Rou,Cu Xiang Fu-Zi Su Geng,Sha Ren-Dan Shen-Dou Kou,Sheng Pu Huang-Wu Ling Zhi,Fa Ban Xia-Huang Qin,Zi Su Geng-Chen Pi,Ku Xin Ren-Tao Ren,Xiang Yuan-Fo Shou,Chao Cang Zhu-Fa Ban Xia,Pao Jiang-Fu Ling,Chao Cang Zhu-Dang Shen,Huang Qin-Gan Jiang,Fa Ban Xia-He Ye,Fa Ban Xia-Zi Su Ye,Shu Di Huang-Dang Gui,Ju Ye-Ju He,Mo Han Lian-Nv Zhen Zi,Chai Hu-Huang Qin,Chuan Xiong-Li Zhi He,Zi Su Geng-Fa Ban Xia,Gan Jiang-Dang Shen,Pei Lan-Fa Ban Xia,Huang Qin-Fa Ban Xia,Dan Pi-Shan Zhi,Huang Lian-Wu Yu,Long Dan Cao-Huang Lian,Huang Lian-Pao Jiang,Sheng Huang Qi-Dang Shen,Pei Lan-Cang Zhu,Cang Zhu-Fa Ban Xia,Sha Ren-Dan Shen-Dou Kou,Long Dan Cao-Huang Lian-Wu Yu,Huang Lian-Wu Yu-Pu Gong Ying,Huang Lian-Huang Qin-Gan Jiang(small amount of Huang Lian),Huang Lian-Huang Qin-Pao Jiang(small amount of Huang Lian),Cang Zhu-Fa Ban Xia-Pei Lan,et al.The Si Qi of Chinese medicine are mainly warm,and the Wu Wei are mainly bitter,and the channel troprism are mainly spleen channel and stomach channel.Conclusion:Spleen deficiency is one of the main pathogenesis of CAG.Professor Tang Xudong’s treatment of CAG in the treatment of syndrome differentiation embodies the main method of invigorating the spleen,regulating the stomach from the spleen,regulating Qi and blood from the spleen,and restoring the normal rhythmic movement of the gastrointestinal itself.2.The correlation between H.pylori and TLR4/CDX2 in the background of atrophy of gastric mucosaObjective:To observe the differences in the expression of TLR4 and CDX2 in gastric mucosa with chronic superficial gastritis,CAG with intestinal metaplasia and CAG with dysplasia,and to analyze the correlation with H.pylori infection,MUC5AC,MUC6,MUC2,CD10,TNF alpha.To explore the correlation between H.pylori,TLR4,CDX2,MUC5AC,MUC6,MUC2,CD 10,TNF alpha and precancerous lesions in the background of gastric atrophy,and to provide a molecular biological tool for the clinical monitoring of precancerous lesions.Methods:Case sources:outpatients and publicly recruited patients in Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences;Cross sectional clinical study design;Experimental methods:HE staining,immunohistochemical staining,rapid urease test;Detection indexes:TLR4,CDX2,MUC5AC,MUC6,MUC2,CD10,TNF alpha and H.pylori infection.Results:there were 69 patients in the group,including 10 cases(14.5%)of chronic superficial gastritis,30 cases of CAG with intestinal metaplasia(43.5%),and 29 cases of dysplasia(42%)with CAG The positive rate of TLR4 in CSG group was 80%,the positive rate in group IM was 86.7%,and the positive rate in group Dys was 100%.The expression of TLR4 in the three groups showed an upward trend,and the difference between the three groups was statistically significant(P<0.05).The expression rate of TLR4 in H.pylori positive group was lower than that in H.pylori negative group,but there was no significant difference between the two groups(p>0.05).The positive rate of CDX2 in CSG group was 40%,the positive rate in group IM was 83.3%,and the positive rate in group Dys was 65.5%.The difference of CDX2 positive rate between the three groups was statistically significant(P<0.05).The positive rate of CDX2 in H.pylori positive group was higher than that in H.pylori negative group,but there was no significant difference in CDX2 positive rate between the two groups(p>0.05).The positive rate of MUC2 in group IM and group Dys was significantly higher than that in group CSG,and the positive rate of MUC2 in the three groups was statistically significant(P<0.05).The expression rate of MUC2 in H.pylori positive group was lower than that in H.pylori negative group,but there was no significant difference between the two groups(p>0.05).The positive rate of MUC5AC and MUC6 in group Dys was lower than that in group CSG and IM,but there was no significant difference in the three groups(P>0.05),and there was no statistical significance between the two and the positive rates of H.pylori(P>0.05).The positive rate of TNF alpha in the three groups was 100%.With the development of CSG,IM and Dys,the positive expression intensity of TNF alpha was on the rise,and the difference in the expression intensity of TNF alpha in the three groups was statistically significant(p<0.05).CDX2 is closely related to MUC2(p<0.01),CDX2 is closely related to CD10(p<0.01),TLR4 is closely related to TNF alpha(p<0.01).Conclusion:1.The expression intensity of TLR4 is rising in the development of CSG,CAG with IM,CAG with Dys,and is positively correlated with the expression intensity of TNF-alpha,and TLR4 promoted the expression of the inflammatory factor TNF alpha.2.The expression rate of CDX2 in intestinal metaplasia was the highest,and CDX2 was positively correlated with CD 10 and MUC2.The combined detection of CDX2,CD 10 and MUC2 was helpful for the diagnosis and identification of intestinal metaplasia.3.In the development process of CSG,CAG and IM,CAG and Dys,MUC5AC and MUC6 expression decreased,MUC2 expression increased,and gastric mucosal barrier function weakened.4.H.pylori recognizes and colonizes gastric mucosa through TLR4,resulting in impaired gastric mucosal barrier function and promoting the development of intestinal metaplasia and dysplasia.Combined detection of H.pylori infection,TLR4,CDX2,MUC5AC,MUC6,MUC2,CD 10 and TNF alpha are helpful for monitoring the risk of precancerous lesions.