ABSTRACT
ObjectiveTo evaluate the effectiveness and consistency of three commonly used early colorectal cancer screening models for advanced colorectal adenoma as a noninvasive means， and to assess the predictive value of traditional Chinese medicine （TCM） tongue images in the models. MethodsPatients diagnosed with colorectal adenoma who underwent colonoscopy and pathological examination were selected as the study participants. Basic clinical data and tongue image were collected. The prediction models of Asia-Pacific colorectal screening （APCS） model， its revision （M-APCS） and colorectal neoplasia predict （CNP） model were applied to compare the predictive effects of the three models on advanced stage adenomas of the colon， the differences in clinical data and traditional Chinese medicine tongue characteristics among patients with different degrees of adenomas， and the similarities and differences in tongue characteristics among the models. The discriminative ability of the three risk models was evaluated using the area under the curve （AUC） and receiver operating characteristic （ROC） curves. The calibration was assessed using the Kuder-Richardson coefficient and the Hosmer-Lemeshow test for consistency analysis. ResultsA total of 227 patients with adenoma were analyzed， including 104 patients （45.82%） with advanced adenoma. In the detection of advanced adenoma， those with greasy coating （70 cases， 67.3%） were higher than those without greasy coating （34 cases， 32.7%， P＜0.05）. After multivariate analysis， the odds ratio （OR） value of non-greasy coating was 0.371 （0.204~0.673， P＜0.01）， indicating that non-greasy coating was a protective factor for advanced adenomas. Among the three risk models， the detection rate of advanced adenoma in the high-risk group with APCS was the highest （63.3%）， which was 1.49 times and 2.04 times that of the medium-risk group （42.6%） and the low-risk group （31.1%， P＜0.01）. The detection rate of advanced adenomas in high-risk groups of M-APCS and CNP was slightly higher than that in moderate or low risk groups （P＞0.05）. The proportion of yellow and greasy coating in high-risk group was higher than that in the medium-risk or low-risk group （P＜0.05）. For the ability to distinguish advanced and non-advanced adenomas， the AUC of APCS was 0.629 （95% CI： 0.556~0.702） and was higher than that of M-APCS （0.591） and CNP （0.586）. In calibration evaluation， Cronbach's alpha was 0.919 （＞0.7）， which indicated that the three models were consistent. In the correlation matrix， the correlation coefficients between APCS model and M-APCS model， and CNP model were 0.794 and 0.717， respectively， and the correlation coefficients between M-APCS model and CNP model were 0.873， Hosmer-Lemeshow χ2 =2.552， P＞0.05， which suggested that the three models had good calibration ability. ConclusionAll three models demonstrate the efficiency to identify advanced colorectal adenoma， and their calibration ability is considered to be good. Among the three models， the APCS exhibits the highest recognition efficiency， however， the recognition accuracy of the APCS model needs improvement. The presence of a greasy coating is identified as one of the potential predictors of advanced adenoma. Consequently， it can be considered for inclusion in the risk model of advanced colorectal adenoma to enhance the accuracy.
ABSTRACT
Objective:To explore the molecular mechanism of comprehensive treatment of irritable bowel syndrome (IBS) from the perspective of alleviating gastrointestinal symptoms and neuropsychiatric symptoms by using network pharmacology and molecular docking.Methods:To retrieve the TCMSP database to obtaine the main active ingredients and the targets of Sini Powder, and the target genes of IBS were screened out through GeneCards and TTD databases. Then use STRING database and Cytoscape software to construct protein interaction network and screen the core genes, verifying the molecular docking of the core targets-drug component based on CB-Dock online molecular docking tool. Finally, used DAVID and Metascape databases respectively to conduct GO and KEGG pathways analysis. Results:There were 112 active ingredients of Sini Powder and 204 effective targets, 2 805 IBS-related genes, and 152 targets in total, which mainly concerning IL-17 signaling pathway, VEGF signaling pathway, NF-κB signaling pathway, dopaminergic synaptic pathway, serotonin synaptic pathway and calcium signaling pathway. Conclusion:Sini Powder could treat IBS by regulating neuroendocrine pathway, immune balance, improving mild intestinal inflammation and repairing intestinal barrier through multi-component, multi-path and multi-target ways.
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Objective To investigate the distribution of traditional Chinese medicine (TCM) syndrome types of functional dyspepsia (FD) in Guangzhou, and to explore their correlation with some factors such as residence time in Guangzhou, gender, age, and Helicobacter pylori (Hp) infection. Methods A total of 326 cases of FD patients from Guangzhou were investigated. Database of the related clinical data was built and analyzed. Results The commonly-seen TCM syndrome types of FD patients in Guangzhou were spleen-deficiency and qi stagnation, disharmony of liver and stomach, dampness-heat of spleen and stomach, deficiency-cold in spleen and stomach, and concurrence of cold and heat, accounting for 41.71%, 26.07%, 11.96%, 11.04% and 9.20%, respectively. There were significant differences among the TCM syndromes(P < 0.05). The differences of average age of onset, residence time in Guangzhou, FD subtypes and Hp infection were significant among each syndrome type (P < 0.05). Conclusion The distribution of TCM syndrome types of FD in Guangzhou is dominated by spleen-deficiency and qi stagnation, and the syndrome types are correlated with residence time in Guangzhou, gender, average age of onset, FD subtypes, and Hp infection.