Objective:To explore the active components， targets， and signaling pathways responsible for Bushen Zhuyun prescription in treating the recurrent spontaneous abortion （RSA） based on network pharmacology and uncover its potential mechanism by molecular docking and in vitro cell experiments. Method:The active components of Bushen Zhuyun prescription were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）， Traditional Chinese Medicine Integrated Database （TCMID） and the published articles， followed by the prediction of drug action targets based on such platforms as DrugBank and SwissTargetPrediction. GeneCards and Online Mendelian Inheritance in Man （OMIM） were searched to obtain the RSA targets， which were then intersected with the targets of Bushen Zhuyun Decoction. Following the plotting of Bushen Zhuyun prescription-compound-target-RSA network by Cytoscape 3.7.1， the protein-protein interaction （PPI） network was then constructed with STRING for screening the core network. The resulting common targets were then subjected to Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis using R software. Autodock Vina 1.1.2 was used for molecular docking. The activation of phosphatidylinositol 3-kinase/protein kinase B （PI3K/AKT） signaling pathway by Bushen Zhuyun prescription was verified in human umbilical vein endothelial cells （HUVEC） in vitro. Result:It was found that 49 potential active components of Bushen Zhuyun prescription might act on 133 RSA targets. GO enrichment analysis yielded 470 biological processes， with angiogenesis， vascular development， cellular proliferation， and oxidative activity mainly involved. KEGG enrichment analysis revealed 103 signaling pathways （P<0.05）， and the PI3K/AKT signaling pathway， advanced glycation end product （AGE）/receptor for advanced glycation end product （RAGE） signaling pathway， and tumor necrosis factor （TNF） signaling pathway were the main ones. As indicated by molecular docking， the Vina scores of the main active component kaempferol with AKT1 and vascular endothelial growth factor A （VEGFA） were the lowest and similar. It was confirmed in vitro cell experiments that Bushen Zhuyun prescription activated the PI3K/AKT signaling pathway and up-regulated the expression of VEGFA and downstream AKT protein to promote angiogenesis. Conclusion:Bushen Zhuyun prescription promotes angiogenesis at the maternal-fetal interface by regulating angiogenesis and cellular proliferation， activating the PI3K/AKT pathway， and up-regulated the VEGFA expression， which is beneficial to the formation of placenta in early pregnancy and the maintenance of early pregnancy. This study has provided ideas for new drug development.

Adult ; Cesarean Section/statistics & numerical data* ; China/epidemiology* ; Female ; Humans ; Pregnancy ; Pregnancy Outcome/epidemiology* ; Risk Factors ; Trial of Labor ; Young Adult

Objective To explore the predictive value of baseline CD4⁺ cell counts and CD4/CD8 ratio in immune reconstitution among HIV/AIDS patients receiving highly effective antiretroviral therapy (HAART). Methods A total of 90 HIV/AIDS patients who had received over 24 months of HAART regimen and had viral road <50 copies/ml were enrolled in this study. The patients were subgrouped into immunological non-responders (INR_s) (<200 cells/μl), immunological inadequate responders (IIR_s) (200~500 cells/μl) and immunological responders (IR_s) (>500 cells/μl) according to the CD4 cell counts after two-year HAART regimen. The characteristics and dynamic CD4⁺ cell counts among the three groups were compared, and the factors of immune reconstitution were analyzed. Results The CD4⁺ cell counts in the immunological responders (IR_s) were significantly higher than those in the immunological non-responders (INR_s) and immunological inadequate responders (IIR_s) (P<0.001). The analysis of area under the ROC curve reveled that the number of CD4⁺ cells reached the highest predictive value at 1 year of HAART. Conclusion Our findings suggested that early initiation of HAART could reduce the failure of immune reconstitution. The combination of baseline CD4⁺ cell counts and baseline CD4/CD8 ratio may serve as a valid predictor of immune reconstitution prognosis after HAART.

Objective To investigate the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in Chinese patients with ischemic stroke . Methods In this multi‐center study ,2 310 continuously inpatients with ischemic stroke diagnosed in 20 stroke screening and prevention project base hospitals from June 2015 to M ay 2016 were enrolled . Carotid ultrasonography and transcranial color‐coded sonography or transcranial Doppler were performed in all patients to confirm the presence of cerebral artery stenosis or occlusion . According to the distribution of lesions ,the subjects were divided into 2 groups :the simple intracranial artery stenosis group and the simple extracranial artery stenosis group . T he difference of risk factors between the two groups was compared . Results Of the 2 310 patients with ischemic stroke ,1 516 ( 65 .6% ) had simple intracranial artery stenosis and 794 ( 34 .4% ) had simple extracranial artery stenosis . T he incidence of anterior circulation artery stenosis was higher in the group of intracranial artery stenosis than that in the extracranial artery stenosis group ( 68 .1% vs 48 .7% , P ＜0 .001) . Posterior circulation artery stenosis and combined anterior with posterior circulation artery stenosis were more common in patients with extracranial artery stenosis group than those in intracranial artery stenosis group ( 36 .4% vs 22 .1% ,14 .9% vs 9 .8% ;all P ＜0 .001) . Univariate analysis of risk factors for stroke showed that patients with intracranial arterial stenosis had a higher prevelence of hypertension , diabetes ,obesity ,and family history of stroke ,and their systolic blood pressure ,diastolic blood pressure , body mass index ( BM I) ,fasting blood‐glucose ,glycosylated hemoglobin ,triacylglycerol ,total cholesterol , and low‐density lipoprotein cholesterol were significantly higher than those in the extracranial arterial stenosis group ( all P ＜ 0 .05 ) . T he proportion of elderly ( ≥ 65 years old ) ,male and smokers in the extracranial arterial stenosis group was significantly higher than that in the intracranial arterial stenosis group ( all P ＜0 .05) . Multivariate logistic regression analysis showed that elderly ( ≥65 years old) ,male , and smoking history were independent risk factors for extracranial arterial stenosis ( OR＝ 2 .012 ,1 .637 , 1 .325 ,respectively ;all P ＜0 .05) . While hypertension ,diabetes ,less physical activity ,and high BM I levels were independent risk factors for simple intracranial arterial disease ( OR ＝ 1 .301 ,1 .252 ,1 .248 ,1 .030 , respectively ;all P ＜0 .05) . Conclusions There are significant differences in the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in patients with ischemic stroke in China .

Objective To compare the impacts of different nostril on nasotracheal intubation with video laryngoscopy.Methods Totally 120 ASA grade I maxillofacial surgery patients were equally randomized into two groups:group A(left nostril)and group B(right nostril).After rapid induction of anesthesia,the nasal intubation was completed by Tosight video laryngoscope,and the success rate of the first attempt of the tube passing through the nasal cavity was recorded and compared between these two groups.In addition,time of tube through nasal cavity,time of glottis exposure,total intubation time,intubation success rate,and nasal bleeding were recorded.Results The success rate of the first attempt of tube passing through the nasal cavity was not significantly different between groups A and B(84.7% . 81.7%;=0.202,=0.653).The time of tube passing through nasal cavity [(7.3±4.6)s .(7.5±4.1)s;=-0.223,=0.824] and the time of glottic exposure [(6.6±1.4)s .(6.7±1.4)s;=-0.348,=0.728] had no significant differences between two groups.The success rates of first intubation attempt were 100% in both groups.The total intubation time was(35.1±9.2)s in group A and(34.0±7.8)s in group B(=0.663,=0.509).Intubation-related epistaxis was found in 16 cases(27.1%)in group A and in 17 cases(28.3%)in group B( =0.022,=0.882).Conclusion Different nasal approaches have no effect on nasal intubation.
Glottis ; Humans ; Intubation, Intratracheal ; methods ; Laryngoscopes ; Laryngoscopy ; Nasal Cavity ; Oral Surgical Procedures

Objective To investigate mutation rate and types of KRAS in colorectal carcinoma , and to analyze the relationship between KRAS mutation and clinicopathological parameters in patients with colorectal carcinoma ( CRC) .Methods Scorpions Amplification Refractory Mutation System ( ARMS) fluorescence quantitative PCR was performed to detect the mutations in codons 12 and 13 of KRAS and to correlate between clinicopathological characteristics and the presence of various KRAS mutations of colorectal carcinoma .Results KRAS mutations were identified in 518 patients ( 42.92%) , including G12D ( 197 cases, 16.32%) , G12V ( 125 cases, 10.36%),G12C(40 cases, 3.31%),G12S(29 cases, 2.40%),G12A(21cases, 1.74%),G12R(7 cases, 0.58%),13D(117 cases, 9.69%).Female patients had a higher KRAS mutation rate than male (46.21%, 238/515 vs.40.46%, 280/692, P<0.05 ) .KRAS mutation was significantly higher in right colon cancer (46.45%,131/282)and in rectal cancer(44.50%,255/573)than that in left colon cancer(37.50%,132/352) (P<0.05,P<0.05).Conclusions There are many types of KRAS mutations in colorectal cancer, and many mutation types exist simultaneously .The detection rate of KRAS mutation is higher in female CRC patients than in the males.The detection rate of KRAS mutation is significantly higher in right colon cancer and in rectal cancer than that in left colon cancer.

Objective To investigate the clinical efficacy and safety of salmeterol xinafoate/ fluticasone propionate in the treatment of chronic obstructive pulmonary disease(COPD).Methods A total of 70 patients with COPD were randomly divided into control group and treatment group,35 cases in each group.Patients in the two groups were all given regular treatment.Patients in the control group were given inhalation treatment with 18 μg tiotropium bromide powder inhalation,qd.Patients in the treatment group were given 50 μg salmeterol fluticasone propionate powder,qd.Patients in the two groups were treated for three cycles (28 days per cycle).The clinical efficacy,pre-and post-treatment of forced vital capacity (FVC),one second forced expiratory volume (FEV1),peak expiratory flow rate value(PEF),FEV1 / FVC,the predicted percentage of FEV1 and PEF value,St.George Hospital Respiratory Questionnaire (SGRQ),multi factor grading system (BODE:body mass index,airflow obstruction,dyspnea and exercise capacity) index score and the incidence of adverse reaction were compared between the two groups.Results After treatment,the total clinical effective rates in the treatment group and the control group were 91.43％ (32/35 cases) and 77.14％ (27/35 cases),respectively,with statistically significant difference (P＜0.05).After treatment,the FEV1 in the treatment group and the control group were(1.86 ± 0.19)L and (1.42 ± 0.17) L,respectively.The FEV1/FVC were (42.93 ± 4.25) ％ and (39.73 ± 3.68) ％,respectively.The PEF were (3.69 ±0.37)L and(3.11 ±0.35)L,respectively.The FEV1/Predicted value were(48.57 ±4.97)％ and (44.47 ±4.51)％,respectively.The PEF/ Predicted value were (48.92 ±5.05)％ and (41.53 ± 4.55)％,respectively.The SGBQ score were (44.97 ±4.96) and (42.01 ±4.67) points,respectively.The BODE score were (5.98 ±0.59) and (5.67 ± 0.59) points.There were statistically significant differences in all the items above between the two groups(P ＜ 0.05).The adverse drug reactions in the treatment group were headache (1 case),tremor (1 case) and palpitation (1 case),while headache(2 cases),tremor(1 case) and hoarseness(2 cases) were found in the control group.The rates of adverse drug reaction in the treatment group and the control group were 8.57％ (3/35 cases) and 14.29％ (5/35 cases) respectively,and no statistical significance was found (P ＞ 0.05).Conclusion Salmeterol xinafoate/fluticasone propionate was safe and effective in the clinical treatment of COPD.