ObjectiveTo identify the active constituents of Kaixuan Jiedu core prescription （KXJD） and investigate its effective components and therapeutic targets in the treatment of common psoriasis. MethodsUltra-performance liquid chromatography-high resolution mass spectrometry （UPLC-Q-TOF MS） was used to identify and analyze the chemical components of KXJD and its blood-entering chemical components. The chemical components of the single decoction were further identified to clarify the source of the chemical components in KXJD. Then， all identified blood-entering compounds were screened for effective active ingredients through the Swiss ADME database. The active ingredient targets of KXJD were searched on the Swiss Target Prediction platform. The targets of common psoriasis were searched in OMIM， GEO， GeneCards， and DISGNET databases to obtain drug-disease intersection targets. The protein-protein interaction network of intersection targets was constructed using STRING， and then the core blood-entering component-intersection target network of KXJD was constructed. The core target proteins in the network were selected for molecular docking with the core components of KXJD. Small molecules and proteins were pretreated， and appropriate docking sites were selected. AutoDock Vina software was used for continuous local search and repeated iterations to find molecular docking conformations. PyMOL software and LigPlot+ software were used for analysis and visualization. Subsequently， the verification was carried out through animal experiments. SPF-grade male C57 mice were randomly divided into a blank group， a model group， a positive drug methotrexate group， and a KXJD group. In the model group， the methotrexate group， and the KXJD group， imiquimod was applied to the backs of the mice for modeling. The blank group and the model group were administered normal saline by gavage， while the methotrexate group and the KXJD group were respectively administered 1 mg·kg^-1 suspension and 30.42 g·kg^-1 decoction of traditional Chinese medicine by gavage. Five days after administration， the mice were sacrificed， and samples were collected. Hematoxylin-eosin （HE） staining was used to observe the skin tissue samples of mice， and the effect of KXJD on the pathological manifestations of psoriasis mice was analyzed. The expression areas of tumor necrosis factor-α （TNF-α）， cyclooxygenase 2 （PTGS2）， interleukin （IL）-1β， and IL-6 in the skin tissue of mice were detected by immunohistochemistry （IHC）. The mRNA expressions of TNF-α， IL-1β， IL-6， and PTGS2 in the skin tissue of mice were detected by real-time fluorescent quantitative polymerase chain reaction （Real-time PCR）. ResultsIn this study， 208 compounds in KXJD were identified by UPLC-Q-TOF MS， and 44 compounds were detected in serum， including 28 prototype components and 16 metabolites. 12 blood-entering active components were screened， and 1 153 active component targets and 1 076 psoriasis-related targets were identified. Eighty-five targets in the intersection set were drug-disease common targets. PPI network analysis showed that TNF-α， IL-1β， IL-6， PTGS2， and ALB were the key target proteins. The results of molecular docking showed that the binding ability of （+）-hexylphenylglycolic acid to key target proteins such as PTGS2 was stable， and PTGS2 showed high stability with a variety of core compounds. Compared with those in the blank group， the stratum corneum and epidermis in the model group mice were significantly thickened， and the pathological Baker score of the mice's skin in the model group was significantly higher than that of the blank group （P<0.01）. The expression areas of PTGS2， TNF-α， IL-1β， and IL-6 proteins in the skin tissue of the model group mice were significantly increased （P<0.01）， and the expression levels of PTGS2， TNF-α， IL-1β， and IL-6 mRNA in the skin tissue of the model group mice were significantly elevated （P<0.01）. Compared with the model group， the pathological Baker scores of the methotrexate group and the KXJD group were both decreased （P<0.01）， and the expression areas in the skin tissue of the methotrexate group and the KXJD group were significantly reduced （P<0.05， P<0.01）. The expression levels of PTGS2， TNF-α， IL-1β， and IL-6 mRNA in the skin tissue of the methotrexate group and the KXJD group were significantly decreased （P<0.01）. ConclusionKXJD can effectively improve the skin lesions of psoriasis model mice and reduce the expression of TNF-α， IL-1β， IL-6， and PTGS2 in the skin tissue of psoriasis model mice. PTGS2 has a stable binding ability with a variety of compounds in the decoction， which may be a key target for the treatment of psoriasis. The compound （+）-hexylphenylglycolic acid may play a key role.

ObjectiveTo identify the active constituents of Kaixuan Jiedu core prescription （KXJD） and investigate its effective components and therapeutic targets in the treatment of common psoriasis. MethodsUltra-performance liquid chromatography-high resolution mass spectrometry （UPLC-Q-TOF MS） was used to identify and analyze the chemical components of KXJD and its blood-entering chemical components. The chemical components of the single decoction were further identified to clarify the source of the chemical components in KXJD. Then， all identified blood-entering compounds were screened for effective active ingredients through the Swiss ADME database. The active ingredient targets of KXJD were searched on the Swiss Target Prediction platform. The targets of common psoriasis were searched in OMIM， GEO， GeneCards， and DISGNET databases to obtain drug-disease intersection targets. The protein-protein interaction network of intersection targets was constructed using STRING， and then the core blood-entering component-intersection target network of KXJD was constructed. The core target proteins in the network were selected for molecular docking with the core components of KXJD. Small molecules and proteins were pretreated， and appropriate docking sites were selected. AutoDock Vina software was used for continuous local search and repeated iterations to find molecular docking conformations. PyMOL software and LigPlot+ software were used for analysis and visualization. Subsequently， the verification was carried out through animal experiments. SPF-grade male C57 mice were randomly divided into a blank group， a model group， a positive drug methotrexate group， and a KXJD group. In the model group， the methotrexate group， and the KXJD group， imiquimod was applied to the backs of the mice for modeling. The blank group and the model group were administered normal saline by gavage， while the methotrexate group and the KXJD group were respectively administered 1 mg·kg^-1 suspension and 30.42 g·kg^-1 decoction of traditional Chinese medicine by gavage. Five days after administration， the mice were sacrificed， and samples were collected. Hematoxylin-eosin （HE） staining was used to observe the skin tissue samples of mice， and the effect of KXJD on the pathological manifestations of psoriasis mice was analyzed. The expression areas of tumor necrosis factor-α （TNF-α）， cyclooxygenase 2 （PTGS2）， interleukin （IL）-1β， and IL-6 in the skin tissue of mice were detected by immunohistochemistry （IHC）. The mRNA expressions of TNF-α， IL-1β， IL-6， and PTGS2 in the skin tissue of mice were detected by real-time fluorescent quantitative polymerase chain reaction （Real-time PCR）. ResultsIn this study， 208 compounds in KXJD were identified by UPLC-Q-TOF MS， and 44 compounds were detected in serum， including 28 prototype components and 16 metabolites. 12 blood-entering active components were screened， and 1 153 active component targets and 1 076 psoriasis-related targets were identified. Eighty-five targets in the intersection set were drug-disease common targets. PPI network analysis showed that TNF-α， IL-1β， IL-6， PTGS2， and ALB were the key target proteins. The results of molecular docking showed that the binding ability of （+）-hexylphenylglycolic acid to key target proteins such as PTGS2 was stable， and PTGS2 showed high stability with a variety of core compounds. Compared with those in the blank group， the stratum corneum and epidermis in the model group mice were significantly thickened， and the pathological Baker score of the mice's skin in the model group was significantly higher than that of the blank group （P<0.01）. The expression areas of PTGS2， TNF-α， IL-1β， and IL-6 proteins in the skin tissue of the model group mice were significantly increased （P<0.01）， and the expression levels of PTGS2， TNF-α， IL-1β， and IL-6 mRNA in the skin tissue of the model group mice were significantly elevated （P<0.01）. Compared with the model group， the pathological Baker scores of the methotrexate group and the KXJD group were both decreased （P<0.01）， and the expression areas in the skin tissue of the methotrexate group and the KXJD group were significantly reduced （P<0.05， P<0.01）. The expression levels of PTGS2， TNF-α， IL-1β， and IL-6 mRNA in the skin tissue of the methotrexate group and the KXJD group were significantly decreased （P<0.01）. ConclusionKXJD can effectively improve the skin lesions of psoriasis model mice and reduce the expression of TNF-α， IL-1β， IL-6， and PTGS2 in the skin tissue of psoriasis model mice. PTGS2 has a stable binding ability with a variety of compounds in the decoction， which may be a key target for the treatment of psoriasis. The compound （+）-hexylphenylglycolic acid may play a key role.

Objective:The clinical characteristics of pregnant women with HELLP syndrome before and after delivery and the risk factors of pregnancy outcomes were analyzed.Methods:A retrospective analysis was con-ducted on 126 cases of HELLP syndrome admitted to The Affiliated Suzhou Hospital of Nanjing Medical University from January 2010 to May 2021,divided into prenatal HELLP group[n=108,98 cases with severe preeclampsia(SPE)]and postpartum HELLP group(n=18,15 cases with SPE),to compare the differences in clinical charac-teristics and pregnancy outcomes between the two groups with the different onset time and whether they were complicated with SPE.Results:①Compared with the postpartum HELLP group,the prenatal HELLP group had higher systolic blood pressure in the third trimester of pregnancy,shorter time from preeclampsia to HELLP syn-drome,higher liver function abnormalities,lower platelet counts,and lower 24-hour urinary protein,with statistically significant differences(P＜0.05).There was no statistically significant differences in adverse pregnancy outcomes and neonatal prognosis between the two groups(P＞0.05).②When combined with SPE,the antenatal HELLP group had a shorter interval from preeclampsia to HELLP syndrome,lower platelet counts,and higher liver en-zymes than the postpartum HELLP group,with statistically significant differences(P＜0.05).③There was no sig-nificant difference in clinical features between the antenatal HELLP group and the postpartum HELLP group when not complicated with SPE(P＞0.05).Conclusions:There is only one difference between prenatal and postnatal HELLP syndrome in terms of the speed of disease progression,the time taken from preeclampsia to HELLP syn-drome,and both can lead to serious maternal and neonatal complications,which should be identified early in clini-cal practice.

Objective:The clinical characteristics of pregnant women with HELLP syndrome before and after delivery and the risk factors of pregnancy outcomes were analyzed.Methods:A retrospective analysis was con-ducted on 126 cases of HELLP syndrome admitted to The Affiliated Suzhou Hospital of Nanjing Medical University from January 2010 to May 2021,divided into prenatal HELLP group[n=108,98 cases with severe preeclampsia(SPE)]and postpartum HELLP group(n=18,15 cases with SPE),to compare the differences in clinical charac-teristics and pregnancy outcomes between the two groups with the different onset time and whether they were complicated with SPE.Results:①Compared with the postpartum HELLP group,the prenatal HELLP group had higher systolic blood pressure in the third trimester of pregnancy,shorter time from preeclampsia to HELLP syn-drome,higher liver function abnormalities,lower platelet counts,and lower 24-hour urinary protein,with statistically significant differences(P＜0.05).There was no statistically significant differences in adverse pregnancy outcomes and neonatal prognosis between the two groups(P＞0.05).②When combined with SPE,the antenatal HELLP group had a shorter interval from preeclampsia to HELLP syndrome,lower platelet counts,and higher liver en-zymes than the postpartum HELLP group,with statistically significant differences(P＜0.05).③There was no sig-nificant difference in clinical features between the antenatal HELLP group and the postpartum HELLP group when not complicated with SPE(P＞0.05).Conclusions:There is only one difference between prenatal and postnatal HELLP syndrome in terms of the speed of disease progression,the time taken from preeclampsia to HELLP syn-drome,and both can lead to serious maternal and neonatal complications,which should be identified early in clini-cal practice.

Objective:The clinical characteristics of pregnant women with HELLP syndrome before and after delivery and the risk factors of pregnancy outcomes were analyzed.Methods:A retrospective analysis was con-ducted on 126 cases of HELLP syndrome admitted to The Affiliated Suzhou Hospital of Nanjing Medical University from January 2010 to May 2021,divided into prenatal HELLP group[n=108,98 cases with severe preeclampsia(SPE)]and postpartum HELLP group(n=18,15 cases with SPE),to compare the differences in clinical charac-teristics and pregnancy outcomes between the two groups with the different onset time and whether they were complicated with SPE.Results:①Compared with the postpartum HELLP group,the prenatal HELLP group had higher systolic blood pressure in the third trimester of pregnancy,shorter time from preeclampsia to HELLP syn-drome,higher liver function abnormalities,lower platelet counts,and lower 24-hour urinary protein,with statistically significant differences(P＜0.05).There was no statistically significant differences in adverse pregnancy outcomes and neonatal prognosis between the two groups(P＞0.05).②When combined with SPE,the antenatal HELLP group had a shorter interval from preeclampsia to HELLP syndrome,lower platelet counts,and higher liver en-zymes than the postpartum HELLP group,with statistically significant differences(P＜0.05).③There was no sig-nificant difference in clinical features between the antenatal HELLP group and the postpartum HELLP group when not complicated with SPE(P＞0.05).Conclusions:There is only one difference between prenatal and postnatal HELLP syndrome in terms of the speed of disease progression,the time taken from preeclampsia to HELLP syn-drome,and both can lead to serious maternal and neonatal complications,which should be identified early in clini-cal practice.

Objective:The clinical characteristics of pregnant women with HELLP syndrome before and after delivery and the risk factors of pregnancy outcomes were analyzed.Methods:A retrospective analysis was con-ducted on 126 cases of HELLP syndrome admitted to The Affiliated Suzhou Hospital of Nanjing Medical University from January 2010 to May 2021,divided into prenatal HELLP group[n=108,98 cases with severe preeclampsia(SPE)]and postpartum HELLP group(n=18,15 cases with SPE),to compare the differences in clinical charac-teristics and pregnancy outcomes between the two groups with the different onset time and whether they were complicated with SPE.Results:①Compared with the postpartum HELLP group,the prenatal HELLP group had higher systolic blood pressure in the third trimester of pregnancy,shorter time from preeclampsia to HELLP syn-drome,higher liver function abnormalities,lower platelet counts,and lower 24-hour urinary protein,with statistically significant differences(P＜0.05).There was no statistically significant differences in adverse pregnancy outcomes and neonatal prognosis between the two groups(P＞0.05).②When combined with SPE,the antenatal HELLP group had a shorter interval from preeclampsia to HELLP syndrome,lower platelet counts,and higher liver en-zymes than the postpartum HELLP group,with statistically significant differences(P＜0.05).③There was no sig-nificant difference in clinical features between the antenatal HELLP group and the postpartum HELLP group when not complicated with SPE(P＞0.05).Conclusions:There is only one difference between prenatal and postnatal HELLP syndrome in terms of the speed of disease progression,the time taken from preeclampsia to HELLP syn-drome,and both can lead to serious maternal and neonatal complications,which should be identified early in clini-cal practice.

Objective:The clinical characteristics of pregnant women with HELLP syndrome before and after delivery and the risk factors of pregnancy outcomes were analyzed.Methods:A retrospective analysis was con-ducted on 126 cases of HELLP syndrome admitted to The Affiliated Suzhou Hospital of Nanjing Medical University from January 2010 to May 2021,divided into prenatal HELLP group[n=108,98 cases with severe preeclampsia(SPE)]and postpartum HELLP group(n=18,15 cases with SPE),to compare the differences in clinical charac-teristics and pregnancy outcomes between the two groups with the different onset time and whether they were complicated with SPE.Results:①Compared with the postpartum HELLP group,the prenatal HELLP group had higher systolic blood pressure in the third trimester of pregnancy,shorter time from preeclampsia to HELLP syn-drome,higher liver function abnormalities,lower platelet counts,and lower 24-hour urinary protein,with statistically significant differences(P＜0.05).There was no statistically significant differences in adverse pregnancy outcomes and neonatal prognosis between the two groups(P＞0.05).②When combined with SPE,the antenatal HELLP group had a shorter interval from preeclampsia to HELLP syndrome,lower platelet counts,and higher liver en-zymes than the postpartum HELLP group,with statistically significant differences(P＜0.05).③There was no sig-nificant difference in clinical features between the antenatal HELLP group and the postpartum HELLP group when not complicated with SPE(P＞0.05).Conclusions:There is only one difference between prenatal and postnatal HELLP syndrome in terms of the speed of disease progression,the time taken from preeclampsia to HELLP syn-drome,and both can lead to serious maternal and neonatal complications,which should be identified early in clini-cal practice.

Objective:The clinical characteristics of pregnant women with HELLP syndrome before and after delivery and the risk factors of pregnancy outcomes were analyzed.Methods:A retrospective analysis was con-ducted on 126 cases of HELLP syndrome admitted to The Affiliated Suzhou Hospital of Nanjing Medical University from January 2010 to May 2021,divided into prenatal HELLP group[n=108,98 cases with severe preeclampsia(SPE)]and postpartum HELLP group(n=18,15 cases with SPE),to compare the differences in clinical charac-teristics and pregnancy outcomes between the two groups with the different onset time and whether they were complicated with SPE.Results:①Compared with the postpartum HELLP group,the prenatal HELLP group had higher systolic blood pressure in the third trimester of pregnancy,shorter time from preeclampsia to HELLP syn-drome,higher liver function abnormalities,lower platelet counts,and lower 24-hour urinary protein,with statistically significant differences(P＜0.05).There was no statistically significant differences in adverse pregnancy outcomes and neonatal prognosis between the two groups(P＞0.05).②When combined with SPE,the antenatal HELLP group had a shorter interval from preeclampsia to HELLP syndrome,lower platelet counts,and higher liver en-zymes than the postpartum HELLP group,with statistically significant differences(P＜0.05).③There was no sig-nificant difference in clinical features between the antenatal HELLP group and the postpartum HELLP group when not complicated with SPE(P＞0.05).Conclusions:There is only one difference between prenatal and postnatal HELLP syndrome in terms of the speed of disease progression,the time taken from preeclampsia to HELLP syn-drome,and both can lead to serious maternal and neonatal complications,which should be identified early in clini-cal practice.

Objective:The clinical characteristics of pregnant women with HELLP syndrome before and after delivery and the risk factors of pregnancy outcomes were analyzed.Methods:A retrospective analysis was con-ducted on 126 cases of HELLP syndrome admitted to The Affiliated Suzhou Hospital of Nanjing Medical University from January 2010 to May 2021,divided into prenatal HELLP group[n=108,98 cases with severe preeclampsia(SPE)]and postpartum HELLP group(n=18,15 cases with SPE),to compare the differences in clinical charac-teristics and pregnancy outcomes between the two groups with the different onset time and whether they were complicated with SPE.Results:①Compared with the postpartum HELLP group,the prenatal HELLP group had higher systolic blood pressure in the third trimester of pregnancy,shorter time from preeclampsia to HELLP syn-drome,higher liver function abnormalities,lower platelet counts,and lower 24-hour urinary protein,with statistically significant differences(P＜0.05).There was no statistically significant differences in adverse pregnancy outcomes and neonatal prognosis between the two groups(P＞0.05).②When combined with SPE,the antenatal HELLP group had a shorter interval from preeclampsia to HELLP syndrome,lower platelet counts,and higher liver en-zymes than the postpartum HELLP group,with statistically significant differences(P＜0.05).③There was no sig-nificant difference in clinical features between the antenatal HELLP group and the postpartum HELLP group when not complicated with SPE(P＞0.05).Conclusions:There is only one difference between prenatal and postnatal HELLP syndrome in terms of the speed of disease progression,the time taken from preeclampsia to HELLP syn-drome,and both can lead to serious maternal and neonatal complications,which should be identified early in clini-cal practice.

Objective:The clinical characteristics of pregnant women with HELLP syndrome before and after delivery and the risk factors of pregnancy outcomes were analyzed.Methods:A retrospective analysis was con-ducted on 126 cases of HELLP syndrome admitted to The Affiliated Suzhou Hospital of Nanjing Medical University from January 2010 to May 2021,divided into prenatal HELLP group[n=108,98 cases with severe preeclampsia(SPE)]and postpartum HELLP group(n=18,15 cases with SPE),to compare the differences in clinical charac-teristics and pregnancy outcomes between the two groups with the different onset time and whether they were complicated with SPE.Results:①Compared with the postpartum HELLP group,the prenatal HELLP group had higher systolic blood pressure in the third trimester of pregnancy,shorter time from preeclampsia to HELLP syn-drome,higher liver function abnormalities,lower platelet counts,and lower 24-hour urinary protein,with statistically significant differences(P＜0.05).There was no statistically significant differences in adverse pregnancy outcomes and neonatal prognosis between the two groups(P＞0.05).②When combined with SPE,the antenatal HELLP group had a shorter interval from preeclampsia to HELLP syndrome,lower platelet counts,and higher liver en-zymes than the postpartum HELLP group,with statistically significant differences(P＜0.05).③There was no sig-nificant difference in clinical features between the antenatal HELLP group and the postpartum HELLP group when not complicated with SPE(P＞0.05).Conclusions:There is only one difference between prenatal and postnatal HELLP syndrome in terms of the speed of disease progression,the time taken from preeclampsia to HELLP syn-drome,and both can lead to serious maternal and neonatal complications,which should be identified early in clini-cal practice.