论著

复方黄芪颗粒对小鼠抗疲劳的作用及其机制研究

Study on the anti-fatigue effect of compound Huangqi granules on mice and its mechanism

:509-515
 
       目的   探讨复方黄芪颗粒(CHG)的抗疲劳作用及其机制。方法  48只雄性BALB/C小鼠随机分为空白对照组、低剂量(9.1 g/kg)、中剂量(18.2 g/kg)、高剂量(27.3 g/kg)CHG 3个试验组,每组12只。试验组给予不同剂量的复方黄芪颗粒溶液灌胃,空白对照组小鼠给予等体积生理盐水。给药30 d后,检测小鼠体内相关指标变化,观察其抗疲劳作用并分析相关机制。结果   与空白对照组相比,试验组小鼠体质量差异无统计学意义(P>0.05),小鼠力竭游泳时间及转棒耐力时间均明显延长(P<0.01),血尿素氮(BUN)、乳酸脱氢酶(LDH)、丙二醛(MDA)水平明显降低P<0.01),肝糖原和肌糖原水平升高(P<0.05),超氧化物歧化酶(SOD)活性升高(P<0.01)。体外抗氧化试验表明CHG以剂量依赖性方式清除2,2-联氮-二(3-乙基-苯并噻唑-6-磺酸)二铵盐(ABTS)和1,1-二苯基-2-三硝基苯肼(DPPH)自由基。当CHG质量浓度为100.000 0 mg/mL时,CHG对DPPH自由基清除能力可达85.030 3%。当CHG质量浓度为25.000 0 mg/mL时,CHG对ABTS自由基清除能力可达96.357 2%。结论  CHG具有抗疲劳的作用,其作用机制可能与抗氧化作用相关。
      Objective  To investigate the anti-fatigue effects of compound Huangqi granules(CHG)and its mechanism.Methods  Forty-eight male BALB/C mice were randomly divided into blank control group,9.1,18.2,27.3 g/kg CHG group(test groups).The test groups received different concentrations of CHG solution by gavage,and the blank control group mice were given equal volume saline.After 30 days of administration,the mice were tested,meanwhile the anti-fatigue effect and mechanism were investigated.Results  Compared with blank control group,there was no significant difference in body weight(P>0.05).The exhaustive swimming time and rod turning endurance time of mice were significantly prolonged(P<0.01).The serum levels of blood urea nitrogen,lactate dehydrogenase and malondialdehyde were significantly decreased(P<0.01),while the liver and muscle glycogen levels(P<0.05)and superoxide dismutase activity were increased(P<0.01).In vitro antioxidant tests showed that CHG can remove (1,1-Diphenyl-2-picrylhydrazyl,ABTS) and (2,2’-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid,DPPH) free radicals in a dose-dependent manner.When the CHG concentration is 100 mg/mL,the DPPH free  radical scavenging ability of CHG can reach 85.030 3%.When the CHG concentration was 25 mg/mL,the scavenging ability of CHG to ABTS free radicals reached 96.357 2%.Conclusions  CHG has anti-fatigue effect,and its mechanism may be related to anti-oxidation effect.
论著

预防性风险管理对肌层浸润性膀胱癌根治术后的应用效果及术后生活质量影响

Effect of preventive risk management after surgery and quality of life of myometrial invasive bladder cancer patients

:494-499
 
       目的   探讨预防性风险管理在肌层浸润性膀胱癌根治术后的应用效果及对术后生活质量影响。方法   选取2020年6月—2023年10月安阳市肿瘤医院收治的66例肌层浸润性膀胱癌患者,应用抽签法分为观察组(n=33)与对照组n=33)。所有患者均采取根治性全膀胱切除术与淋巴清扫术治疗,对照组患者术后实施常规护理,观察组在对照组基础上增加预防性风险管理。对比两组术后尿量、胃肠功能恢复时间、术后住院时间,干预前后病耻感及负面情绪、术后并发症发生率,最后对比两组干预前后生活质量变化。结果   两组患者术后尿量对比差异无统计学意义(P>0.05),观察组术后胃肠功能恢复时间为(5.27±0.82)d,术后住院时间为(18.31±3.27)d,短于对照组的(7.25±1.12)(23.27±4.18)d,对比差异有统计学意义(t分别为8.194、5.369,P<0.05);干预后两组患者病耻感量表(SSCI)、抑郁自评量表(SDS)和焦虑自评量表(SAS)评分均降低,观察组分别为(35.67±7.45)(40.02±2.43)(45.36±4.17)分,低于对照组的(48.27±10.69)(54.54±3.54)(51.37±4.38)分,对比差异有统计学意义(t分别为5.555、19.426、5.709,P<0.05);观察组术后并发症发生率为9.09%,低于对照组的30.30%(χ 2 =4.690,P=0.030);干预后两组膀胱癌特异性模块、功能状况、精神状况、家庭/社会状况及躯体状况相关维度膀胱癌患者生活质量量表(FACT-BL)评分均升高,观察组分别为(34.27±3.26)(25.11±4.23)(21.51±4.23)(25.02±4.43)(20.56±3.11)分,高于对照组的(27.00±4.34)(21.11±3.24)(16.12±2.12)(21.54±5.54)(15.87±4.13)分,对比差异有统计学意义(t分别为7.694、4.313、6.544、2.818、5.211,P<0.05)。结论   预防性风险管理在肌层浸润性膀胱癌根治术后的应用效果显著,可缩短患者术后胃肠功能恢复时间及住院时间,改善患者负面情绪,有助减少术后并发症,提升患者生活质量。
       Objective  To explore the effect of preventive risk management on postoperative application and quality of life of myometrial invasive bladder cancer patients after radical surgery.Methods  A total of 66 patients with myometrial invasive bladder cancer admitted to Anyang Cancer Hospital from June 2020 to October 2023 were selected as research objects,and were divided into observation group(n=33)and control group(n=33)by lot drawing.All patients were treated with  radical total cystectomy and lymph node dissection.The control group received routine nursing care after surgery,while the observation group received preventive risk management in addition to the control group.The postoperative urine output,recovery time of gastrointestinal function,and hospitalization time between two groups were compared,as well as the shame and negative emotions before and after intervention,the incidence of postoperative complications,and the changes in quality of life between the two groups before and after intervention.Results  There was no significant difference in postoperative urine volume between the two groups of patients(P>0.05),and the postoperative gastrointestinal function recovery time(5.27±0.82)d,postoperative hospitalization time(18.31±3.27)d were shorter than the control group[(7.25±1.12)d,(23.27±4.18)d],with statistical significantce(t=8.194,5.369,P<0.05).After intervention,the Stigma Scale of Chronic Illness(SSCI),Self Rating Depression Scale(SDS),and Self-Rating Anxiety Scale(SAS)in both groups of patients decreased,and the observation group[(35.67±7.45),(40.02±2.43),(45.36±4.17)]scored lower than the control group[(48.27±10.69),(54.54±3.54),(51.37±4.38)],statistically significantt=5.555,19.426,5.709,P<0.05).The incidence of postoperative complications in the observation group was significantly lower at 9.09% compared to the control group at 30.30%(χ 2 =4.690,P=0.030,P<0.05).After intervention,the scores of bladder cancer specific module,functional status,mental status,family/social status and physical status  related dimensions of bladder cancer patients’ quality of life scale for bladder cancer patients(FACT-BL)in both groups increased,and the observation group[(34.27±3.26),(25.11±4.23),(21.51±4.23),(25.02±4.43),(20.56±3.11)] scored higher than the control group[(27.00±4.34),(21.11±3.24),(16.12±2.12),(21.54±5.54),(15.87±4.13)],the comparison was statistically significant(t=7.694,4.313,6.544,2.818,5.211,P<0.05).Conclusions  Preventive  risk management has a significant effect on the application of myometrial invasive bladder cancer after radical surgery,which can shorten the recovery time of gastrointestinal function and hospital stay,improve patients’ negative emotions,assist in preventing postoperative complications,and improve patients’ quality of life.
论著

类风湿因子、T 淋巴细胞亚群与类风湿关节炎病情程度的关系研究

Relationship between rheumatoid factor,T lymphocyte subsets and the degree of rheumatoid arthritis

:361-365
 
       目的   分析类风湿因子(RF)、T淋巴细胞亚群(CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ )与类风湿关节炎病情程度的关系。方法   选取2023年1月—2024年4月收治的90例类风湿关节炎患者作为观察组,同期到院的90例健康体检者为对照组,均接受RF、CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ 检测,并按照类风湿关节炎患者病情评价(DAS28)判定观察组患者病情的严重程度,应用Pearson相关性分析RF、CD3+ 、CD4+ 、CD8+ 、CD4+ /CD8+ 与患者病情严重程度的关系。结果   与对照组比较,观察组RF及CD8+ 水平较高,CD3+ 、CD4+ 及CD4+ /CD8+ 水平较低(P<0.05);不同病情的RF及CD8+ 水平比较,重度患者最高,其次为中度、轻度,而CD3+ 、CD4+ 及CD4+ /CD8+ 水平比较,轻度患者最高,其次为中度、重度,两两比较均有差异统计学意义(P<0.05);经Pearson相关性分析,RF及CD8+ 水平与病情程度呈正相关,CD3+ 、CD4+ 及CD4+ /CD8+ 水平与病情程度呈负相关(P<0.05)。结论  RF、T淋巴细胞亚群指标与类风湿关节炎发生、发展有密切关系,可为医师准确评估患者病情严重程度提供可靠参考。
       Objective  To analyze the relationship between rheumatoid factor(RF),T lymphocyte subsets(CD3+CD4+ ,CD8+ ,CD4+ /CD8+ )and the severity of rheumatoid arthritis.Methods  A total of 90 patients with rheumatoid arthritis from January 2023 to April 2024 were selected as the observation group,and 90 healthy checkup individuals who came to the hospital during the same period were selected as the control group.All patients underwent RF,CD3+ ,CD4+ ,CD8+ ,and CD4+ /CD8+  tests,and the severity of their condition was determined based on the evaluation of rheumatoid arthritis patient condition(DAS28).Pearson Correlation analysis was used to analyze the relationship between RF,CD3+ ,CD4+ ,CD8+ ,CD4+ /CD8+  and the disease severity of the patients.Results  Compared with the control group,RF and CD8+  levels in the observation group were higher,while the levels of CD3+ ,CD4+  and CD4+ /CD8+  were low(P<0.05).Comparison of RF and CD8+  levels for different conditions,the RF and CD8+  levels of the severe patients was highest,followed by moderate and mild.However,the CD3+ ,CD4+  and CD4+ /CD8+levels were highest in mild patients,followed by the moderate and sereve patients.Statistical significance was found in both pairwise comparisons(P<0.05).After the Pearson correlation analysis,RF and CD8+  levels were positively correlated with the degree of disease,while CD3+ ,CD4+ ,and CD4+ /CD8+  levels were inversely associated with the degree of disease condition(P<0.05).Conclusions  RF and T lymphocyte subsets are closely related to the occurrence and development of rheumatoid arthritis,and can provide reliable references for physicians to accurately evaluate the severity of patients’ conditions.
论著

风险防范护理干预对控制冠状动脉造影术后患者血管并发症的影响

Effect of risk prevention nursing intervention on controlling vascular complications in patients after coronary angiography

:356-360
 
      目的   探讨在冠状动脉造影术后患者中应用风险防范护理干预对血管并发症的控制效果。方法   选择2022年1月—2023年6月于我院接受治疗的85例冠状动脉造影术后患者。按照随机数字表法分组,其中对照组42例给予常规护理干预,观察组43例给予风险防范护理干预,比较两组干预前后的心理状态、治疗依从性、血管并发症。结果   干预后,观察组正性情绪(PA)评分高于对照组PA评分(t=3.821,P<0.001),观察组负性情绪(NA)评分低于对照组NA评分(t=5.380,P<0.001)。与对照组比,观察组治疗依从性更好(Z=2.268,P=0.023)。观察组血管并发症总发生率低于对照组(9.30% vs 30.95%,χ 2 =6.224,P=0.013)。结论   采用风险防范护理干预,能够改善冠状动脉造影术后患者的心理状态,提高治疗依从性,并降低血管并发症总发生率。
       Objective  To explore the effect of  risk prevention nursing intervention on controlling vascular complications in patients after coronary angiography.Methods  Eighty-five patients after coronary angiography in our hospital were selected from January 2022 to June 2023.They were grouped according to the random number table.And 42 cases were divided into the control group for routine nursing intervention,and 43 cases in the observation group were given risk prevention nursing intervention.Psychological status,treatment compliance and vascular complications of the two groups were observed.Results  After the intervention,the postive affect score of the observation group was higher than that of the control group(t=3.821,P<0.001),and the negative affect score of the observation group(21.25±3.31)was lower than the score of the control group(25.35±3.70)t=5.380,P<0.001).Compared with the control group the compliance of observation group was higher(Z=2.268,P=0.023).The overall incidence of vascular complications in the observation group was lower than that in the control group(9.30% vs 30.95%,χ2=6.224,P=0.013).Conclusions  Risk prevention nursing intervention can improve the psychological status of patients after coronary angiography,improve treatment compliance,and reduce the overall incidence of vascular complications.
论著

D-HyCoSy 配合宫腔水造影对不孕症患者 IUA 诊断灵敏度、特异度分析

The analysis of sensitivity and specificity of D-HyCoSy combined with uterine hydrography in the diagnosis of IUA in infertile patients

:346-349
 
       目的   探析子宫输卵管超声造影(D-HyCoSy)配合宫腔水造影对不孕症患者宫腔粘连(IUA)诊断灵敏度、特异度情况。方法   选取2021年1月—2023年2月南华大学附属长沙中心医院的110例不孕症者为研究对象,均予以宫腔水造影、D-HyCoSy,以宫腔镜病理结果为金标准,分析不同诊断方法应用的效果。结果   在110例不孕症患者中,经宫腔镜病理检查发现,宫腔粘连患者占比47.27%(52/110)。D-HyCoSy的诊断准确率为76.36%、宫腔水造影的为79.09%,均低于联合诊断的93.63%(P<0.05)。D-HyCoSy的诊断灵敏度为73.08%,宫腔水造影的为80.77%,均低于联合诊断的94.23%,差异具有统计学意义(P<0.05)。D-HyCoSy的诊断特异度为79.31%,宫腔水造影的为77.59%,与联合诊断的93.10%相比,差异无统计学意义(P>0.05)。结论   对于不孕症患者,予以宫腔水造影联合D-HyCoSy诊断,其诊断效能高于单一诊断检查率,能更准确地判定宫腔粘连,效能高。
医院管理

广东省高水平中医院建设背景下的青年中医人才岗位胜任力现状调查分析

Investigation and analysis of the job competence status of young TCM talents under the background of high level TCM hospital construction in Guangdong Province

:273-281
 
      目的   旨在通过实证了解广东省青年中医人才岗位胜任力现状,探讨青年中医人才岗位胜任力素质特征,为青年中医人才培养提供策略。方法   通过专家咨询制定《青年中医人才岗位胜任力评价框架》并开展问卷调查,采用SPSS 26.0进行数据分析。结果   构建了包含8个一级指标、76个二级指标的《青年中医人才岗位胜任力评价框架》;广东省青年中医人才岗位胜任力自评总分整体处于及格以上水平。女性在职业价值和职业素养、临床技能、交流与沟通技能、管理能力和团队合作、批判性思维与学术科研能力的评分高于男性;不同职称在其他附加维度的评分比较具有统计学差异(P<0.05)。结论   构建的评价框架能够有效评估青年中医人才岗位胜任力;广东省青年中医人才岗位胜任力整体处于及格水平,需重视补强短板;女性青年中医人才岗位胜任力多个维度的得分优于男性,着重提升各人群的弱项维度岗位胜任力;进一步建立健全职称评聘制度,以破五唯为导向构建符合不同级别职称的青年中医人才评价机制。
      Objective  To understand the current job competence status of young TCM talents in Guangdong Province through empirical research,to explore the characteristics of job competence and quality of young TCM talents,providing strategy for cultivating young talents in TCM.Methods The “Competency Evaluation Framework for Young TCM Talents” was developed through expert consultation and a questionnaire survey was conducted.SPSS 26.0 was used for data analysis.Results  “Job Competency Evaluation Framework for Young TCM Talents” was constructed,which included 8 primary indicator items and 76 secondary indicator items.The overall self-evaluation score of the overall job competence of young TCM talents in this study was above the passing level.Female score was higher than male in terms of professional value and professional ethics,clinical skills,communication and interpersonal skills,management ability and teamwork,critical thinking and academic research ability.There were statistically significant differences in the scores of different job titles in other additional dimensions(P<0.05).Conclusions  The constructed evaluation framework can effectively assess the job competence of young TCM talents.The overall competence of young TCM talents in Guangdong Province is at a passing level,and attention  should paid to  strengthening their weaknesses.Female young TCM talents have better multidimensional scores in job competence than males,and efforts should be made to focus on improving the weak dimensional job competence of various groups of people.The professional title evaluation and appointment system needs to be established and improved.A talent evaluation mechanism should be built for young TCM talents that meets different levels of professional titles,guided by the principle of breaking the five criteria.
论著

老年慢性心力衰竭患者血清 SCD-1 和 sVEGFR-2 表达水平及其与预后的评估价值研究

Expression levels of serum SCD-1 and sVEGFR-2 in elderly patients with chronic heart failure and their prognostic value

:241-246
 
       目的   探究血清多配体蛋白聚糖-1(SCD-1)与可溶性血管内皮生长因子受体-2(sVEGFR-2)表达水平在老年慢性心力衰竭患者预后评估的判定价值。方法   选取2023年1月—2024年3月珠海市第五人民医院检验科收治的110例老年慢性心力衰竭患者,检测其血清SCD-1和sVEGFR-2水平,对患者进行随访调查,了解其再次由于心力衰竭住院、心源性死亡的情况。运用多因素Logistic回归分析,探究老年慢性心力衰竭患者预后影响因素。结果  Logistic回归分析显示,心功能分级(OR=3.433,95%CI:0.934~6.431)、B型脑钠肽升高(OR=2.462,95%CI:0.861~4.765)、血清SCD-1升高OR=3.795,95%CI:0.972~6.894)、血清sVEGFR-2升高(OR=3.842,95%CI:0.942~6.912)为影响老年慢性心力衰竭患者预后不良的重要因素(P<0.05);联合血清SCD-1和sVEGFR-2曲线下面积0.962与B型脑肽钠曲线下面积0.844,相较于单一SCD-1曲线下面积0.658、sVEGFR-2曲线下面积0.712明显偏高(P<0.05)。结论   经研究证实,老年慢性心力衰竭患者预后效果不理想,其血清SCD-1和sVEGFR-2监测水平异常升高,和老年慢性心力衰竭预后不佳存在关联性,可视为老年慢性心力衰竭患者判定预后效果的主要标志物。
      Objective  To investigate the prognostic value of serum syndecan-1(SCD-1)and soluble vascular endothelial growth factor receptor-2(sVEGFR-2)expression levels in elderly patients with chronic heart failure.Methods  A total of 110 elderly patients with chronic heart failure admitted to our hospital were selected,with a time interval of January 2023 to March 2024.Serum SCD-1 and sVEGFR-2 levels were detected and follow-up investigations were conducted to understand their re hospitalization and cardiogenic death due to heart failure.Multiple logistic  regression analysis was used to explore the prognostic factors affecting elderly patients with chronic heart failure.Results  According to logistic retrospective analysis,heart function grading(OR=3.433,95%CI:0.934-6.431),elevated B-type brain natriuretic peptide(OR=2.462,95%CI:0.861-4.765),elevated serum SCD-1(OR=3.795,95%CI:0.972-6.894),and elevated serum sVEGFR-2(OR=3.842,95%CI:0.942-6.912)were important factors affecting the poor prognosis of elderly patients with chronic heart failure,with differences P<0.05.The area under the curve of combined serum SCD-1 and sVEGFR-2 was 0.962,and the area under the curve of B-type brain peptide sodium was 0.844,which was significantly higher than that of a single SCD-1 curve of 0.658 and sVEGFR-2 curve of 0.712,with a difference of P<0.05.Conclusions  Research has confirmed that the prognosis of elderly patients with chronic heart failure is not satisfied,and their serum SCD-1 and sVEGFR-2 monitoring levels are abnormally elevated,which is related to the poor prognosis of elderly patients with chronic heart failure.It can be regarded as the main biomarker for defining the prognosis of elderly patients with chronic heart failure.
论著

以 IMB 模型为基础延续护理平台在帕金森病患者中的应用

Application of continuous care platform based on IMB model in Parkinson’s patients

:235-240
 
       目的   分析以信息-动机-行为技巧(IMB)模型为基础延续护理平台在帕金森病患者中的应用效果。方法   纳入河南省人民医院在2019年1月至2022年1月期收治的帕金森病患者96例进行研究,将其依据随机数表法分为对照组和观察组,均为48例,对照组均给予常规护理干预,观察组均给予以IMB模型为基础延续护理平台干预。比较两组主要照顾者干预前24 h(T0)和完成干预24 h(T1)内的心理状态评分、自我效能、希望水平、运动能力、肌张力、认知功能,并评估T1时刻的Barthel指数。结果   观察组患者T1时的汉密尔顿焦虑量表(HAMA)(16.64±2.57)分、汉密尔顿抑郁量表(HAMD)(16.38±1.69)分均低于对照组(20.65±1.68)(19.57±2.65)分(t=10.116、5.407,P<0.001),观察组患者T1时的自我效能(7.24±1.48)分、希望水平(44.51±4.07分)均高于对照组(6.02±1.74)(38.95±4.54)分(t=3.357、3.311,P<0.001),观察组患者T1时的运动能力评分(43.62±4.01)分高于对照组(39.17±5.25)分(t=4.715,P<0.001),肌张力评分(0.72±0.21)分低于对照组(1.13±0.52)分(t=5.118,P<0.001),观察组患者T1时刻的Barthel指数评估依靠帮助完成率(6.25%)、部分完成率(10.42%)低于对照组(25.00%)、(27.08%)(χ 2 =6.353、5.263,P<0.05),观察组患者T1时刻的命名能力(3.46±0.51)、延迟回忆(3.78±0.21)分、语言能力(3.29±0.48)分、注意力评分(3.95±0.10)分均高于对照组(2.91±0.98 )(3.21±0.96)(2.87±0.82)(3.76±0.05)分(t=3.698、3.675、3.846、4.305,P<0.001)。结论   以IMB模型为基础延续护理平台干预能够改善帕金森病患者的负性情绪,提升自我效能、希望水平,改善运动能力、肌张力、日常生活能力、认知水平。
       Objective  To analyze the application effect of the information motivation behavioral skills(IMB)model as a continuous care platform in Parkinson’s patients.Methods  A study was conducted on 96 Parkinson’s patients enrolled in our hospital from January 2019 to January 2022.They were divided into a control group and an observation group based on a  random number table method,with 48 patients in each group.The control group received routine nursing intervention,while the observation group received continuous nursing platform intervention based on the IMB model.The psychological state scores,self-efficacy,hope level,motor ability,muscle tone,cognitive function of the two main caregivers 24 hours before intervention(T0)and 24 hours after completion of intervention(T1),and evaluate the Barthel index at T1 time were compared.Results  The Hamilton Anxiety Scale(HAMA)[(16.64±2.57)points] and Hamilton Depression Scale(HAMD)[(16.38±1.69 points)scores]of patients in the observation group at T1 were lower than those in the control group [(20.65±1.68)points,(19.57±2.65)points](t=10.116,5.407,P<0.001).The self-efficacy of patients in the observation group at T1 was(7.24±1.48)points.The hope level [(44.51±4.07)points] was higher than that of the control group [(6.02±1.74)points,(38.95±4.54)points](t=3.357,3.311,P<0.001).The motor ability score at T1 time in the observation group [(43.62±4.01)points] was higher than that in the control group [(39.17±5.25)points](t=4.715,P<0.001),and the muscle tone score [(0.72±0.21)points] was lower than that in the control group [(1.13±0.52)points](t=5.118,P<0.001).The Barthel index evaluation of patients in the observation group at T1 time relied on help completion rate(6.25%)and partial completion rate(10.42%),which were lower than those in the control group(25.00%)and(27.08%)(χ 2 =6.353,5.263,P=0.012,0.022).The naming ability [(3.46±0.51)points],delayed recall [(3.78±0.21)points],language ability [(3.29±0.48)points],attention scores [(3.95±0.10)points] were higher than the control group [(2.91±0.98)points,(3.21±0.96)points,(2.87±0.82)points,(3.76±0.05)points](t=3.698,3.675,3.846,4.305,P=<0.001,<0.001,<0.001).Conclusions  Continuing nursing platform intervention based on the IMB model can improve the negative emotions,self-efficacy,hope level,motor ability,muscle tone,daily living ability,and cognitive level of Parkinson’s patients.
论著

基于网络药理学与分子对接技术研究白头翁汤治疗细菌性痢疾的潜在活性成分及作用机制

Research on potential active ingredients and mechanisms of Baitouweng Decoction in the treatment of bacterial dysentery through network pharmacology and molecular docking

:216-227
 
       目的  采用网络药理学方法与分子对接技术分析白头翁汤治疗细菌性痢疾(BD)的潜在活性成分与作用机制。方法  借助中药系统药理学数据库与分析平台(TCMSP)及PubChem数据库检索筛选白头翁汤方的化学成分和作用靶点,通过Uniprot数据库校正基因名,同时通过比较毒物基因组学数据库(CTD)、药物靶标数据库(TTD)、GeneCards数据库和药物和药物靶标数据库(DRUGBANK)获得BD相关疾病靶点。经在线绘图平台微生信分析“活性成分-疾病”交集靶点,使用Cyoscape 3.7.2软件构建可视化的中药-活性成分-靶点网络、蛋白质互作网络,筛选潜在的关键活性成分与核心靶点;通过Metascape数据库对进行靶点的基因本体(GO)功能分析和京都百科全书基因和基因组通路数据库(KEGG)通路富集分析,同时使用Cyoscape 3.7.2软件构建基因-通路网络,筛选潜在的通路及其作用机制。同时采用分子对接技术对白头翁汤中关键活性成分和BD核心靶点进行分析。结果  白头翁汤共筛选出266个潜在活性成分,其中,槲皮素、β-谷甾醇、异鼠李素、异延胡索单酚碱、小檗红碱、豆甾醇等66个关键活性成分可通过肿瘤坏死因子(TNF)、白细胞介素-6(IL-6)、前列腺素内过氧化物合酶2(PTGS2)、丝氨酸/苏氨酸蛋白激酶1(AKT1)、血管内皮生长因子A(VEGFA)、V-rel网状内皮细胞病毒癌基因同源物A(RELA)、半胱氨酸天冬氨酸蛋白酶3(CASP3)、白细胞介素-8(CXCL8)、白细胞介素-1B(IL-1B)、丝裂原活化蛋白激酶1(MAPK1)、白细胞介素-10(IL-10)等33个潜在交集靶点作用于BD。GO基因功能分析共得到生物过程(BP)条目20个、细胞组成(CC)条目6个、分子功能(MF)条目9个(P<0.01),主要涉及外部凋亡过程、细胞迁移正向调控、细胞因子受体结合、蛋白同源二聚活性、TNF受体超家族结合等生物进程。KEGG通路富集分析确定13条信号通路(P<0.01),主要涉及癌症信号通路、白细胞介素-17(IL-17)信号通路等关键通路。分子对接结果显示槲皮素、β-谷甾醇、异鼠李素、异延胡索单酚碱等核心活性成分与TNF、IL-6、PTGS2核心靶点具有良好的结合效应(结合能<-5 kJ/mol)。结论  白头翁汤主要通过槲皮素、β-谷甾醇等潜在的多种活性成分作用于TNF、IL-6、IL-1B、PTGS2、AKT1、VEGFA等潜在的关键靶点调控IL-17等信号通路,从而发挥治疗细菌性痢疾的作用,符合中药复方多成分、多靶标、多途径起效的显著特征。
      Objective To analyze the potential active ingredients and mechanism of Baitouweng Decoction in the treatment of bacillary dysentery(BD)by means of network pharmacology and molecular docking technology.Methods With the help of the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(Traditional Chinese Medicine Systems Pharmacology Database,TCMSP)and PubChem database to search and screen the chemical composition and target of Baitouweng Decoction,the gene name was corrected through the Uniprot database,and the CTD database,TTD database,GeneCards database and DRUGBANK database obtain BD-related disease targets.The intersection target was obtained through the online  drawing platform,and Cytoscape 3.7.2 was used to construct a network of Pulsatilla active ingredient-component disease intersection target.The protein-protein interaction analysis of the intersection target was performed through the String database,and the Cytoscape 3.7.2 software was used for visualization.The Metascape database platform performed GO function analysis and KEGG pathway enrichment analysis on the target to predict its mechanism of action.The  key active ingredient compounds in Baitouweng Decoction were molecularly docked with the core protein in the intersection target.Results A total of 266 potential active ingredients in Baitouweng Decoction were screened,of which 66 key active ingredients such as quercetin,β-sitosterol,isorhamnetin,Isocorypalmine,berberine,stigmasterol,etc.It acts on BD through 33 potential intersection targets such as TNF,IL-6,PTGS2,AKT1,VEGFA,RELA,CASP3,CXCL8,IL-1B,MAPK1,IL-10.GO gene function analysis yielded a total of 20 biological process(BP)entries,6 cell composition(CC)entries,and 9 molecular function(MF)entries(P<0.01),which mainly involve external apoptosis process and positive regulation of cell migration,Cytokine receptor binding,protein homodimerization activity,tumor necrosis factor receptor superfamily binding and other biological processes.KEGG pathway enrichment analysis identified 13 signal pathways(P<0.01),mainly related to key pathways such as cancer signal pathway and IL-17 signal pathway.The results of molecular docking showed that the core active ingredients such as quercetin,β-sitosterol,isorhamnetin,Isocorypalmine and TNF,IL-6,PTGS2 core targets have good binding effects(binding energy <-5 KJ /mol).Conclusions Baitouweng Decoction modulated signaling pathways involving IL-17 through its active constituents like quercetin and β-sitosterol,targeting key molecules such as TNF,IL-6,IL-1β,PTGS2,AKT1,and VEGFA,reflecting the multi-target therapeutic approach of traditional Chinese medicine.
论著

阴道分娩后尿失禁患者疾病应对方式及其相关影响因素分析

Analysis of disease coping strategies and related influencing factors in patients with urinary incontinence after vaginal delivery

:211-215
 
       目的   探讨阴道分娩后尿失禁患者疾病应对方式的影响因素。方法   选取2022年1月—2023年1月医院收治的阴道分娩后尿失禁患者78例,评估所有患者的应对方式,根据结果分为积极应对组与消极应对组,设计基线资料调查表,详细统计两组患者的基线资料并比较,重点分析阴道分娩后尿失禁患者疾病应对方式的影响因素。结果   经评估,78例阴道分娩后尿失禁患者疾病消极应对有40例,占比51.28%;积极应对组与消极应对组患者的产次(χ 2 =4.110,P=0.043)、文化水平(Z=2.094,P=0.036)、家庭关怀度(Z=2.069,P=0.040)与自我效能(Z=2.249,P=0.025)比较差异有统计学意义,组间年龄(t=0.096,P=0.924)、孕次(t=1.257,P=0.212)、体质指数(BMI)(t=0.125,P=0.901)、工作(χ 2 =0.778,P=0.378)、家庭月人均收入(χ 2 =0.044,P=0.834)、漏尿(χ 2 =0.040,P=0.842)比较差异无统计学意义;经回归分析发现,家庭关怀度低(OR=1.799,P=0.041)、自我效能低(OR=1.942,P=0.026)、经产妇(OR=2.554,P=0.045)及文化水平低(OR=1.837,P=0.038)均是阴道分娩后尿失禁患者疾病应对方式的影响因素。结论   阴道分娩后尿失禁患者疾病消极应对风险高,可能与产次、文化水平、家庭关怀度及自我效能有关。
       Objective To explore the influencing factors of disease coping strategies in patients with urinary incontinence after vaginal delivery.Methods A total of 78 patients with urinary incontinence after vaginal delivery admitted to the hospital from January 2022 to January 2023 were selected.The coping strategies of all patients were evaluated,and they were divided into a positive coping group and a negative coping group based on the results.A baseline data questionnaire was designed,and the baseline data of the two groups of patients were compared in detail.The focus was on analyzing the factors influencing the disease coping strategies of patients with urinary incontinence after vaginal delivery.Results After evaluation,40 out of 78 patients with urinary incontinence after vaginal delivery had negative coping strategies,accounting for 51.28%.The parity of patients in the positive and negative coping groups(χ 2 =4.110,P=0.043),educational level(Z=2.094,P=0.036),family care(Z=2.069,P=0.040),and self-efficacy(Z=2.249,P=0.025)among the groups were different.Age between groups(t=0.096,P=0.924),gestational age(t=1.257,P=0.212),body mass index(t=0.125,P=0.901),and work experience(χ 2 =0.778,P=0.378),monthly per capita income of households(χ 2 =0.044,P=0.834),urinary leakage(χ 2 =0.040,P=0.842)had no statistically significant difference in comparison.Through regression analysis,it was found that low family care(OR=1.799,P=0.041),low self-efficacy(OR=1.942,P=0.026),postpartum women(OR=2.554,P=0.045),and low educational level(OR=1.837,P=0.038)were all influencing factors on the disease coping strategies of patients with urinary incontinence after vaginal delivery.Conclusions  Patients with urinary incontinence after vaginal delivery have a higher risk of negative coping with the disease,which may be related to parity,educational level,family care and self-efficacy.
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