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.
目的 提示临床在使用解郁化痰安神颗粒过程中,予以关注其发生的药物不良反应,同时进一步重视中成药及中药制剂带来的药物不良反应,并与中医药当中的瞑眩反应予以区分。方法 通过分析1例解郁化痰安神颗粒致失眠不良反应,基于中国知网、万方数据知识服务平台等国内数据库,对不良反应发生机制予以分析、讨论。结果 本次解郁化痰安神颗粒致失眠不良反应1例,不良反应相关性评价为“可能”,根据临床观察,可能为中药中典型的“瞑眩反应”。结论 临床当发现基于中成药的不良反应,应予以分析辨别,及时处置药物不良反应,进一步观察研究瞑眩反应。
Objective To suggest that during the clinical use of Jieyu Huatan Anshen Granules,attention should be paid to its adverse drug reactions,and further attention should be paid to the adverse drug reactions caused by traditional Chinese patent medicines and simple preparations and traditional Chinese medicine preparations,and it should be distinguished from the insomnia and dizziness reactions in traditional Chinese medicine.Methods A case of insomnia adverse reaction caused by Jieyu Huatan Anshen Granules was analyzed based on domestic databases such as CNKI and Wanfang data to investigate and discuss the mechanism of adverse reactions.Results One case of insomnia adverse reaction caused by Jieyu Huatan Anshen Granules was reported,and the correlation evaluation of the adverse reaction was “possible”.According to clinical observations,it may be a typical “dizziness reaction” in traditional Chinese medicine.Conclusions When adverse reactions based on traditional Chinese medicine decoction,traditional Chinese patent medicines and simple preparations and other traditional Chinese medicine preparations are found in clinical practice,they should be analyzed and identified,and the adverse reactions should be handled in time and be further observed and studied.
目的 分析现代文献中穴位贴敷疗法干预矮小症研究现状,为临床治疗该病提供依据。方法 整理近2018年1月—2023年12月6年间国内医学期刊上公开发表的关于穴位贴敷疗法治疗矮小症的中文文献,对文献年代分布、发表期刊、研究内容、贴敷穴位、贴敷药物、贴敷的时间、频次、治疗时间、观察指标、中西医结合治疗矮小症、不良反应等进行统计分析。结果 最终纳入的文献共10篇,近6年间均有相关文献发表;发表期刊《中医儿科杂志》《新中医》《中国现代医生》《中医外治杂志》《中国中西医结合儿科学》;研究内容涉及矮小症分型、穴位贴敷联合重组人生长激素法、畲医法、中药内服法、拉伸操法、营养干预指导、推拿等方法治疗矮小症。结论 穴位贴敷疗法联合其他疗法在临床上对儿童矮小症的改善效果显著,不良反应轻微,相信随着矮小症成因的进一步明确,穴位贴敷疗法治疗矮小症的机制会更加清晰,为改善矮小症提供科学理论依据,同时,为矮小症等相关疾病的治疗提供新思路。
Objective To analyze the research status of acupoint application therapy in short stature from January 2018 to December 2023,and to provide basis for clinical treatment of the disease.Methods To review the Chinese literature published in domestic medical journals in recent 6 years on the treatment of short stature by acupoint application therapy,including the distribution of time and journals,the research contents,the acupoint application,the drug application,the application time,the treatment frequency and duration,the observation index,treatment of short stature with integrated traditional,Chinese and Western medicine and adverse reactions were statistically analyzed.Results There were 10 articles in this review,and all of them were published in the past 6 years,published journal were Pediatrics of Traditional Chinese medicine,new Traditional Chinese medicine,modern Chinese doctor,Journal of external treatment of traditional Chinese medicine,Pediatrics of integrated traditional Chinese and Western medicine in China.The research content involved the short stature classification,acupoint application combined with recombinant human growth hormone therapy,the She medical therapy,traditional Chinese medicine,stretching manipulation,nutrition intervention guidance,massage and other methods.Conclusions The combination of acupoint application therapy and other therapies has a significant clinical effect on the improvement of short stature in children,with slight adverse reactions.It is believed that with the further clarification of the causes of short stature,the mechanism of point application therapy for short stature will be more clear and provide scientific basis for improving short stature.At the same time,it may provide a new idea for the treatment of dwarfism and other related diseases.
急性胰腺炎(AP)是一种常见的消化系统急症。随着生活水平的提高,其重症发病率也逐年增加。中西医结合治疗急性胰腺炎在临床实践中展现出优势。近年来,大柴胡汤合大承气汤在治疗急性胰腺炎方面药理机制的研究不断延伸,同时对方药中的药理活性成分也在不断深入研究。该文旨在整理相关研究,综述大柴胡汤合大承气汤治疗急性胰腺炎的理论基础、临床应用、药物活性成分、药理机制等,以期为临床实践和进一步深入研究提供参考。
Acute pancreatitis(AP)is a common gastrointestinal emergency.With the improvement of living standards,the incidence of severe AP has been increasing year by year.The combined treatment of traditional Chinese and Western medicine has shown advantages in the clinical practice of acute pancreatitis.In recent years,the pharmacological mechanism of Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis has been continuously studied,and the pharmacological active components in the prescription are also being explored.This article aims to summarize relevant research on the theoretical basis,clinical application,active ingredients and pharmacological mechanism of Dachaihu Decoction combined with Dachengqi Decoction in the treatment of acute pancreatitis,providing reference for clinical practice and further research.
胰源性门静脉高压(PSPH)是由脾静脉(SV)流通受阻引起的一种临床综合征,在临床较为罕见且对患者造成生命威胁,但却为门静脉高压唯一可治愈的类型。其主要发病诱因是胰腺原发疾病,通常为胰腺急(慢)性炎症、胰腺占位性病变和胰腺手术操作导致。1型孤立性食管胃底静脉曲张、脾大、脾功能亢进是PSPH的主要临床表现特征,其中食管胃底曲张静脉破裂出血是PSPH最为严重的并发症;患者若表现为肝功能正常但出现原因不明脾肿大并伴有消化道出血症状,应考虑可能出现了PSPH。PSPH的治疗可分为胰腺原发病、门静脉高压及并发症的综合性诊治。本文旨在回顾PSPH的相关文献,对其有关临床诊断与治疗现状进行综述,以期指导医务工作者在临床中尽早发现PSPH并对患者及时有效治疗。
Pancreatic segmental portal hypertension(PSPH)is a clinical syndrome caused by spleen vein(SV)occlusion or stenosis.It is a rare and life-threatening hemorrhagic disease of the upper digestive tract,but it is the only curable type of portal hypertension.The main cause is primary pancreatic disease,which is usually due to acute or chronic pancreatic inflammation,pancreatic space-occupying lesions and pancreatic surgery.Type 1 isolated esophagogastric varices,splenomegaly and hypersplenism are the main clinical features of PSPH,and esophagogastric variceal bleeding is the most serious complication of PSPH.PSPH should be considered in patients with normal liver function but unexplained splenomegaly accompanied by gastrointestinal bleeding.The treatment of PSPH can be divided into a comprehensive diagnosis and treatment of primary pancreatic disease,portal hypertension and complications.Therefore,the purpose of this paper is to review relevant literature of PSPH,the relevant clinical diagnosis and treatment status quo were summerized,in order to guide the medical workers in clinical PSPH,early detection and timely and effective treatment for patients.
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.
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.
目的 探讨转录因子E盒结合锌指蛋白1(ZEB1)、溶酶体相关膜蛋白5(LAMP5)在结直肠癌组织中的表达水平分析及预后预测价值。方法 选取驻马店市中心医院2018年1月—2020年1月收治的120例结直肠癌患者,分别采取所有患者的结直肠癌组织及癌旁组织进行免疫组化染色,对比ZEB1、LAMP5阳性率。对比不同病理特征结直肠癌患者ZEB1、LAMP5表达水平差异。对所有患者进行4年随访,依照随访结果将患者分为2个亚组,即预后不良组(n=35)和预后良好组(n=85),对比两组患者一般临床特征及ZEB1、LAMP5表达水平,应用Logistic回归分析ZEB1、LAMP5对结直肠癌预后的预测价值。结果 结直肠癌组织ZEB1、LAMP5相对表达量(38.26±5.49、26.77±3.85)与ZEB1、LAMP5阳性率(86.67%、72.22%)高于癌旁组织(15.46±2.54、8.04±1.59、23.33%、15.56%],对比差异有统计学意义(t=41.280,χ2=25.437;t=49.255,χ 2 =16.071;P<0.05)。不同TNM分期[Ⅰ~Ⅱ期(35.55±4.13)、Ⅲ~Ⅳ期(42.32±4.75)]、淋巴结转移患者[是(44.37±4.28)、否(35.84±3.77)]、肿瘤分化程度[低分化(35.27±4.57)、中高分化(41.34±4.60)]ZEB1相对表达量对比差异有统计学意义(t=-8.281,P<0.001;t=10.746,P<0.001;t=-7.253,P<0.001);不同TNM分期[Ⅱ期(24.88±3.37)、Ⅲ~Ⅳ期(29.61±2.57)]、淋巴结转移[是(30.72±2.19)、否(25.21±3.19)]、肿瘤分化程度[低分化(24.57±3.62)、中高分化(29.04±2.55)]患者LAMP5相对表达量对比差异有统计学意义(t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,P<0.001);预后良好组与预后不良组患者性别、年龄、大体类型、肿瘤大小对比差异无统计学意义(P>0.05),预后良好组与预后不良组患者TNM分期、淋巴结转移、肿瘤分化程度、ZEB1、LAMP5阳性比例对比差异有统计学意义(P<0.05);Logistic回归分析显示:淋巴结转移、ZEB1阳性、LAMP5阳性为结直肠癌预后不良独立预测因素(P<0.05)。结论 ZEB1、LAMP5在结直肠癌组织中呈现高表达状态,且与结直肠癌的发生有关,同时ZEB1、LAMP5是结直肠癌预后的独立预测因素,两者有希望成为结直肠癌的治疗靶点。
Objective To investigate the expression levels and prognostic value of transcription factor E-box binding to zinc finger protein 1(ZEB1)and lysosomal associated membrane protein 5(LAMP5)in colorectal cancer tissues.Methods A total of 120 colorectal cancer patients admitted to a hospital from January 2018 to January 2020 were selected.Immunohistochemical staining was performed on the colorectal cancer tissues and adjacent tissues of all patients,and the positivity rates of ZEB1 and LAMP5 were compared.The expression levels of ZEB1 and LAMP5 in colorectal cancer patients with different pathological characteristics were compared.All patients were followed up for 4 years and divided into two subgroups based on the follow-up results,namely the poor prognosis group(n=35)and the good prognosis group(n=85).The general clinical characteristics and expression levels of ZEB1 and LAMP5 were compared between the two groups.Logistic regression analysis was used to evaluate the predictive value of ZEB1 and LAMP5 for the prognosis of colorectal cancer.Results The relative expression level of ZEB 1 and LAMP 5 in colorectal cancer tissues [(38.26±5.49),(26.77±3.85)] and the positive rate of ZEB 1 and LAMP 5(86.67%,72.22%)were significantly higher than that of adjacent tissues [(15.46±2.54),(8.04±1.59),23.33%,15.56%],the contrast difference was statistically significant(t=41.280,χ2=25.437;t=49.255,χ 2 =16.071;P<0.05).Relative ZEBI expression levels in different TNM stages [I-Ⅱstage(35.55±4.13),Ⅲ-Ⅳstage(42.32±4.75)],lymph node metastasis[Yes(44.37±4.28),No(35.84±3.77)],degree of tumor differentiation [hypodifferentiated(35.27±4.57),and middle or high differentiated (29.04±2.55)],those differences were statistically significant(t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,P<0.001).The relative expression of LAMP 5 between different TNM stages [I-Ⅱstage(24.88±3.37),Ⅲ-Ⅳstage(29.61±2.57)],lymph node metastasis [yes(30.72±2.19),no(25.21±3.19)],degree of tumor differentiation [hypodifferentiated(24.57±3.62),and middle or high differentiated(29.04±2.55)],the contrast was statistically significant(t=-8.254,P<0.001;t=9.227,P<0.001;t=-7.797,P<0.001).There were no differences in gender,age,gross type,and tumor size between the good prognosis group and the poor prognosis group(P>0.05),while there were differences in TNM stages,lymph node metastasis,tumor differentiation degrees,ratio of ZEB 1 and LAMP 5(P<0.05).Logistic regression analysis showed that TNM stage,lymph node metastasis,ZEB 1 positive,and LAMP 5 positive were independent predictive factors of poor prognosis in colorectal cancer(P<0.05).Conclusions ZEB1 and LAMP5 are highly expressed in colorectal cancer tissues and closely related to the occurrence and development of colorectal cancer.ZEB1 and LAMP5 are independent prognostic factors for colorectal cancer,and they have the potential to become therapeutic targets for colorectal cancer.
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.
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.