Exploring the mechanism of Buyang Huanwu decoction in the treatment of lumbar disc herniation based on network pharmacology and molecular docking

Buyang Huanwu decoction (BYHWD), as one of the traditional Chinese medicine formulas, is widely used in the clinical treatment of lumbar disc herniation (LDH) with curative effect. It has the characteristics of multi-component, multi-target, and mutual synergy, but the mechanism of action is often unclear. It needs some research to explore the molecular mechanism of BYHWD in the treatment of LDH based on network pharmacology and molecular docking. Screen the active compounds of BYHWD and predict drug-related gene/protein targets, which could determine the specific target of BYHWD in the treatment of LDH. Construct the “Drugs-Compounds-Targets” network and search for the core targets. Use Gene Ontology functional enrichment analysis, Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, and molecular docking verification to explore the possible molecular mechanism. Eighty-two effective compounds and 666 targets of BYHWD, 187 targets for LDH treatment, and 20 core candidate targets were excavated. A total of 3414 entries were identified by Gene Ontology enrichment analysis, 173 related signal pathways were identified by Kyoto Encyclopedia of Genes and Genomes enrichment analysis, and 5 core compounds were identified by molecular docking, which had a good affinity with core genes STAT3, JUN, AKT1, MAPK1, RELA, and PIK3CA. BYHWD may play the role of analgesic and improving function by synergistic anti-inflammatory and analgesic compounds, regulating cell metabolic differentiation, regulating immunity, and anticoagulation. BYHWD in the treatment of LDH may play a role in analgesia and improve function through multiple signaling pathways, including PI3K-Akt, mitogen-activated protein kinase, tumor necrosis factor, and interleukin-17. The PI3K-Akt signaling may be one of the key mechanisms.     

The intergenerational sources of the U-turn in gender segregation

In the early 1970s, the balkanization of the US labor market into “men’s occupations” and “women’s occupations” began to unravel, as women entered the professions and other male-typed sectors in record numbers. This decline in gender segregation continued on for several decades but then suddenly stalled at the turn of the century and shows no signs of resuming. Although the stall is itself undisputed, its sources remain unclear. Using nearly a half-century of data from the General Social Survey, we show that a resurgence in segregation-inducing forms of intergenerational transmission stands behind the recent stall. Far from serving as impartial conduits, fathers are now disproportionately conveying male-typed occupations to their sons, whereas mothers are effectively gender-neutral in their transmission outcomes. This segregative turn among fathers accounts for 47% of the stall in the gender segregation trend (between 2000 and 2018), while the earlier integrative turn among fathers accounts for 34% of the initial downturn in segregation (between 1972 and 1999). It follows that a U-turn in intergenerational processes lies behind the U-turn in gender segregation.

In all late-industrial countries, women and men continue to occupy very different types of jobs, with women concentrated in service and nurturing occupations (e.g., sales clerk and nurse) and men concentrated in manual and analytic occupations (e.g., laborer and computer scientists). The standard sociological account of such segregation treats it as a premodern relic that should gradually disappear as educational opportunities are equalized, egalitarian gender attitudes diffuse, overt and covert forms of employer discrimination are rooted out, and family-friendly workplaces and related labor market reforms are instituted (1, 2). Between 1970 and 1990, these types of institutional reforms indeed seemed to be bearing fruit, with most late-industrial countries experiencing sharp declines in segregation (3).This egalitarian turn proved to be short-lived. By the end of the 20th century, the decline in gender segregation had stalled in many late-industrial countries, including the United States (4–7). In Fig. 1, we present the US trend using the General Social Survey (GSS), the main data source for our analyses (8). The trend lines in Fig. 1 reveal that the downturn stalled well before integration was achieved (and Fig. 1B additionally suggests a resegregative uptick off this already high baseline). To completely eliminate segregation, ∼60% of US workers would have to shift to a different occupation, a stark result given the stated commitment to gender equality and equal opportunity in the United States. This hypersegregation translates into profound gender gaps in pay, authority, working conditions, and much more (9–12). Because occupational segregation generates such a wide range of unequal outcomes, it has become a conventional policy target among those who seek to reduce gender inequality.Open in a separate windowFig. 1.The U-turn in occupational gender segregation shown by (A) the index of dissimilarity and (B) a margin-free measure of the gender-by-occupation association. Analysis is based on the 1972 to 2018 GSS using women and men in the labor force, ages 25 to 64 (inclusive), with nonmissing data on age, gender, and occupation. n = 44,640. Occupations are coded with 1970 Census Occupational Classification (see SI Appendix, Appendixes B and D, for details). Trend is smoothed with locally smoothed regression (LOESS) with the span set at 0.75. For the definition of D and A, see Materials and Methods.The long line of research on the sources of the stall proceeds in part from this widely shared (albeit not universal) commitment to reduce gender inequality. Although far from conclusive or exhaustive, the available research suggests that 1) the persisting double burden of domestic work erodes the willingness or capacity of women to hold jobs that entail long hours or overwork (12–14); 2) the persistence of norms against women outearning their partners (in marriages between women and men) leads to settling and underachievement (15); 3) the persistence of essentialist beliefs about the types of occupations that women and men are qualified to undertake locks in a conventional division of labor (1, 16, 17); and 4) the continuing tendency of employers to discriminate against mothers (18) and those who participate intermittently in the labor force (19, 20) makes it difficult for women to break into male-typed occupations.^* Across these assorted supply-side and demand-side accounts, a common theme is that the easy desegregative gains have been creamed off, that a new equilibrium or natural rate (22) has been reached, and that puncturing this equilibrium may require different or more aggressive countermeasures.This interpretation rests on a distinction between 1) overt and easy-to-attack inequalities and 2) covert and difficult-to-attack inequalities. It is often argued, for example, that overt forms of hiring discrimination against women can be reduced through antidiscrimination law and open hiring practices, whereas subtler or covert forms are not as easy to address, at least with legal remedies. Likewise, the extreme essentialist view that women are utterly lacking in rational faculties was an early casualty of the gender revolution, whereas it has proven more difficult to root out a subtler form of essentialism that presumes that men are more likely than women to be “brilliant” or “geniuses” (23). By this logic, the gender revolution will only be reenergized by developing new interventions that are fine-tuned for the subtler, albeit still very consequential, mechanisms that lie behind gender inequality.This conclusion may well be warranted. It would, however, be premature to adopt this interpretation without a fuller understanding of the institutional sources of the stalling out. It is striking in this regard that none of the foregoing accounts directly features the role of intergenerational processes. To be sure, conventional accounts routinely invoke the segregative effects of gender-biased training, norms, and culture, but the social processes through which gender-biased training is delivered or gender-biased norms and culture are instilled are left unclear and thus may or may not have intergenerational sources. This is an unfortunate omission because it undermines our capacity to remediate well. As it stands, most currently popular interventions do not target intergenerational processes (24), an understandable state of affairs given that relatively little is now known about their role in the stalling out.There is, then, a worrying omission in our research on the gender U-turn. Although this omission might seem surprising, it has to be remembered that the contemporary family is often seen as a prime carrier of new forms of gender egalitarianism and accordingly an unlikely source of the stalling out. The new gender-egalitarian family features mothers who are increasingly likely to work, to commit to bona fide careers, and to espouse liberal attitudes (25). In this conventional characterization of familial change, it is notable that mothers are represented as a main force for change, whereas fathers remain in the background largely carrying on. This raises the possibility that fathers may not always be unfettered agents of egalitarian change and may, to the contrary, be implicated in the stalling out. The purpose of our paper is to explore this segregative-father hypothesis by melding models of segregation and intergenerational transmission.The results will show that the U-turn in the segregation trend is indeed linked to a U-turn in intergenerational processes. As we will discuss, a variety of mechanisms may lie behind the rise of segregative reproduction, yet most of them involve familial processes in some fashion. It follows that insofar as desegregation is a policy objective, it may be strategic to build interventions that address contemporary family processes.The two streams of mobility research upon which our analysis will capitalize are those examining 1) the net effects of mothers and fathers on outcomes and 2) the effects of intragenerational mobility on segregation. The first of these two streams is of course especially relevant when examining the intergenerational sources of segregation (26, 27). In recent decades, there has been a backlash against treating the father’s or “family head’s” occupation as a satisfactory measure of class origins (28), a long-overdue development given that a rising share of children are now growing up in more complicated families with many potential role models (29, 30). This newer line of multiple-parent mobility research has, however, focused mainly on examining the relative size of the effects of mothers and fathers, a type of “horse race” analysis that comes naturally when one seeks to rectify decades of scholarship that ignored mothers altogether. As important and influential as this research is, it cannot directly answer the research question that we are taking on, given that the implications of this horse race for occupational segregation depend on the extent to which class and gender-typing reproduction come together. To understand how intergenerational transmission contributes to gender segregation, we need to know 1) whether mothers are passing on female-typed occupations disproportionately to daughters and 2) whether fathers are passing on male-typed occupations disproportionately to sons. Although the intergenerational transmission of gender-typed aspirations is well understood (31, 32), our research takes the next step of building gendered mobility models that uncover whether actual reproductive practices are affected by the gender of the parent, the gender typing of the occupation, and the gender of the offspring (33).The second stream of mobility research relevant to our analysis examines the effects of intragenerational mobility on gender segregation (34). This line of research, which has a long history (35), examines how women and men move in and out of the labor force over their career, how women and men move in and out of gender-typed occupations over their career, and how such mobility has gendered sources (e.g., sexual harassment, gender discrimination, and the “second shift”). Within this literature, many scholars (36) have examined whether the gender of managers affects hiring and promotion decisions (and hence downstream segregation), a line of questioning that is formally similar to our own interest in whether the gender of the parent affects occupational outcomes. Because parents are engaged in ongoing socialization, aspiration development, human capital investment, and network provisioning, their effects on segregation may well be more consequential than the pinpoint hiring and firing decisions of managers. This is the core rationale for building intergenerational processes into a segregation trend analysis.     

儿外科监护室血流感染的病原菌分布及耐药性分析

目的 了解儿外科重症监护病房血流感染的病原菌分布及药物敏感情况,以利于临床合理选用抗生素.方法 收集2011年1月至2015年12月我院儿外科重症监护病房确诊为血流感染的138例患儿的临床资料,对病原菌分布及耐药情况进行分析.结果 5年中血流感染的发生率为3.88‰(138/35524),且以1岁以下婴儿发生最多,最终死亡19例(13.77%).138例血流感染患儿共获得179株病原菌,革兰阳性菌、革兰阴性菌和真菌感染分别占60.89%(109/179)、22.91%(41/179)和16.20%(29/179).革兰阳性菌中凝固酶阴性葡萄球菌检出率最高(84/179,46.93%);革兰阴性菌中前3位的是鲍曼不动杆菌(15/179,8.38%)、肺炎克雷白杆菌(12/179,6.70%)和大肠埃希菌(6/179,3.35%),其中耐碳青霉烯类鲍曼不动杆菌的检出呈逐年上升趋势;真菌中以非白色念珠菌为主(14/179,7.82%).检出的多重耐药菌株对碳青霉烯类的耐药率明显上升.结论 儿外科重症监护病房患儿的血流感染率逐年增高,且低龄儿童的病死率亦高,需要临床上注重病原学检测,以指导合理使用抗菌药物,减少耐药菌株的产生.     

Moorfields回归分析及多变量区别分析诊断开角型青光眼

目的研究Moorfields回归分析(MRA)及多变量区别分析(MDA)的2个指标FSM和RB诊断开角型青光眼的能力,及MRA在视盘整体和视盘分区间的差异。方法对23例正常人(26眼)、26例可疑开角型青光眼患者(32眼)和21例开角型青光眼患者(21眼)进行HRT-Ⅱ和OCTOPUS视野计G2-TOP程序两项检查。结果视盘整体MRA、FSM、RB与视野缺损指数间相关系数分别为0.537、-0.565、-0.716(P<0.01),且3个组间差异均有统计学意义(P<0.01),随着视盘面积增大,MRA、FSM和RB特异性均下降。可疑组中视盘分区MRA与视野检查一致率均高于整体,一致率最高分区为颞下(78.13%)。各分区中MRA敏感性、特异性最高的分区为颞上和颞下。结论MRA和MDA检测开角型青光眼能力较强,且与视野检查间存在较好的相关性,但应用于大视盘分析时须谨慎下结论。     

透明角膜小切口白内障手术后角膜散光变化

目的　评价透明角膜小切口超声乳化白内障吸除折叠式人工晶状体植入术后角膜散光的变化。方法　将62例(78只眼)白内障患者,按照切口位置位于颞上方及鼻上方或角膜曲率最大子午线轴位分为A、B两组,行透明角膜小切口超声乳化白内障吸除折叠式人工晶状体植入术,比较术后角膜散光的变化情况。结果　A、B两组术后3个月平均手术性角膜散光度分别为（0.83±0.65）D和（0.72±0.55）D,差异无显著性(P>0.05);平均角膜散光度分别较术前减少0.11D和0.39D,两者比较差异有显著性（P<0.05）。结论　以透明角膜小切口行超声乳化白内障吸除折叠式人工晶状体植入术,术后角膜散光度小;结合散光轴位选择切口位置,术后可明显减小角膜散光度。     

兔视网膜中央静脉阻塞模型中小胶质细胞CD40和铁蛋白的表达

目的　分析兔视网膜中央静脉阻塞模型中小胶质细胞ＣＤ４０和铁蛋白表达的变化,探讨其发生机制。方法　将３０只有色兔随机分为空白组、模型组,以激光动力学方法造模,行眼底照相和眼底荧光血管造影法检查,分别于１ｄ、３ｄ、７ｄ、１４ｄ和２８ｄ对两组兔视网膜及视神经标本采用免疫组织化学方法检测ＣＤ４０和铁蛋白表达水平。４０倍光镜照相,测定灰度值和积分光密度（ＩＯＤ）,对测得数据进行统计学分析。结果　小胶质细胞ＣＤ４０的表达结果:３ｄ时空白组和模型组视网膜标本灰度值分别为１９３．４２±９．７２和８６.０３±５．１２,差异有统计学意义（Ｐ＜０．０５）;３ｄ时空白组和模型组视神经标本灰度值分别为１９６．２６±１０．７８和８５．９１±５．０１,差异有统计学意义（Ｐ＜０．０５）;３ｄ时空白组和模型组视网膜标本ＩＯＤ分别为１０５．３６±７．５８和４４７９．３２±３０７．２２,差异有统计学意义（Ｐ＜０.０５）;３ｄ时空白组和模型组视神经标本ＩＯＤ分别为５４．６３±８．７９和１０４３６．４２±１３０６.８３,差异有统计学意义（Ｐ＜０．０５）。小胶质细胞铁蛋白的表达结果:３ｄ时空白组和模型组视网膜标本的ＩＯＤ分别为１６１．９６±３５．３７和１２９５．５９±１２４．７１,差异有统计学意义（Ｐ＜０．０５）。结论　视网膜中央静脉阻塞可以引起视网膜及视神经小胶质细胞的活化,免疫组织化学染色显示小胶质细胞ＣＤ４０和铁蛋白表达均为阳性结果。     

Hypertension and diabetes synergistically strengthen the association with cataracts among Chinese

AIM: To examine the relationship between age-related cataracts (ARC) and comorbid hypertension and diabetes. METHODS: We analyzed the administrative records of 6,467 patients aged 50 years and older admitted to the ophthalmological department of a tertiary hospital from January 1st, 2011 to May 20th, 2017. With either eye considered, an ARC (n=3,343) was defined as the presence of lens opacity or previous cataract surgery without evidence of trauma, congenital anomalies or using certain medications. Patients admitted to the same department during the same period due to ocular traumas without clinical evidence of cataracts (n=379) were recruited as the cataract-free controls. Unconditional logistic regressions were obtained the odds ratio (OR) of hypertension and diabetes among ARC patients adjusted for age, sex and health care accessibility. RESULTS: Hypertension was diagnosed in 29.54% of men with any type of cataracts, in 30.12% of men with an ARC, and 10.82% of men of cataract-free controls. Diabetes was diagnosed in 16.64% of men with any type of cataracts, in 16.48% of men with ARC and 4.22% of men of cataract-free controls. Similar patterns were observed among women. After adjusting for age, sex, and health care accessibility, hypertension was weakly [OR=1.83 (95%CI: 1.23, 2.74)] and diabetes was strongly [3.38 (1.86, 6.15)] associated with ARCs. The adjusted OR of comorbid hypertension and diabetes among adults with ARC was 18.20 (4.38, 75.59). CONCLUSION: Hypertension and diabetes were independently associated with ARC. Hypertension and diabetes, if co-existing, multiplicatively strengthened the association with ARC.     

视神经损伤再生中血小板源生长因子的表达

目的:检测PDGF-BB在视神经损伤和修复过程中表达的变化。方法:建立大鼠视神经再生模型,免疫组化法检测PDGF-BB在正常视神经和视神经-坐骨神经吻合后不同时段在各组织部位的表达。结果:在大鼠正常视神经,PDGF-BB阴性表达,在视神经-坐骨神经吻合后,视神经PDGF-BB阳性表达,其表达量随病程的发展而变化。结论:坐骨神经移植能够促进视神经的再生,在此过程中PDGF-BB发挥着一定的作用。     

眼部血管平滑肌瘤与平滑肌瘤

报告眼部血管平滑肌瘤１２例，平滑肌瘤２例，并作临床病理分析。本病临床特点是：①ＣＴ显示为圆或椭圆形边界清楚包块，部分病例有钙化斑存在。②手术时所见为一个圆或椭圆形、有包膜、紫红色肿块，与周围组织粘连及易出血。按组织病理学分类，血管平滑肌瘤可分为三个类型（海绵状型、静脉型、实体型），在部分病例标本中，三种类型可同时存在。     

高度近视全阈值静态视野形态改变及相关因素分析

目的:研究高度近视眼全阈值静态视野形态的改变。方法:应用Dicon TKS-5000型自动视野分析仪检查高度近视65例(130眼)的全阈值静态视野,并观察其后极部眼底改变。结果:视野异常115眼(88.5%),其中生理盲点扩大86眼(66.2%),出现黄斑中心相对暗点75眼(57.7%),弥漫性损害39眼(30.0%)。发现黄斑中心相对暗点75眼中仅有51眼在眼底镜下发现黄斑部病变(χ2=22.042,P<0.01)。结论:高度近视眼的视野改变与患者的屈光度及后极部眼底病变有关。视野改变的形态,程度与眼底后极部改变的形态不完全对应。高度近视患者视野改变早于眼底镜下眼底改变,对于早期诊断及治疗具有指导意义。