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Naoxintong capsule (NXT) is a commercial medicinal product approved by the China Food and Drug Administration which is used in the treatment of stroke and coronary heart disease. However, the research on the composition and mechanism of NXT is still lacking. Our research aimed to identify the absorbable components, potential targets, and associated pathways of NXT with network pharmacology method. We explored the chemical compositions of NXT based on UPLC/Q-TOF-MS. Then, we used the five principles of drug absorption to identify absorbable ingredients. The databases of PharmMapper, Universal Protein, and the Molecule Annotation System were used to predict the main targets and related pathways. By the five principles of drug absorption as a judgment rule, we identified 63 compositions that could be absorbed in the blood in all 81 chemical compositions. Based on the constructed networks by the significant regulated 123 targets and 77 pathways, the main components that mediated the efficacy of NXT were organic acids, saponins, and tanshinones. Radix Astragali was the critical herbal medicine in NXT, which contained more active components than other herbs and regulated more targets and pathways. Our results showed that NXT had a therapeutic effect on heart diseases through the pattern “multiple components-multiple targets-multiple pathways.”

Background The systemic inflammation response index (SIRI), a novel and cost-effective serum biomarker, is associated with prognosis in patients with cancer. However, the prognostic value of the SIRI in cancer remains unclear. This study aimed to evaluate the potential role of the SIRI as a prognostic indicator in cancer. Methods Reports in which the prognostic value of the SIRI in cancer was evaluated were retrieved from electronic databases. The pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated to evaluate the prognostic significance of the SIRI. The odds ratio (OR) was also calculated to explore the association between the SIRI and clinicopathological features. Results This study included 30 retrospective studies with 38 cohorts and 10 754 cases. The meta-analysis indicated that a high SIRI was associated with short overall survival (OS) (HR = 2.04, 95% CI = 1.82–2.29, P < .001) and disease-free survival (DFS)/recurrence-free survival (RFS)/progression-free survival (PFS) (HR = 2.08, 95% CI = 1.84–2.34, P < .001). Subgroup analysis showed that the prognostic value of the SIRI was significant in all kinds of cancer included. Moreover, the SIRI was significantly correlated with sex, tumor size, T stage, N stage, TNM stage, and lymphovascular invasion. Conclusion The pretreatment SIRI could be a promising universal prognostic indicator in cancer.

Background: Pulmonary arterial hypertension (PAH) is an uncommon type of pulmonary hypertension (PH) disease characterized by progressive remodeling of distal pulmonary arteries. It could inevitably lead to pulmonary vascular resistance and even right ventricular failure. Biologists have explored the basic pathobiology of PAH, but its functional mechanism and effect in pregnant people remain unknown. This study was designed to investigate the maternal and fetal outcomes of pregnancy-related PAH.Methods: Clinical data of 59 pregnant women with PAH who were admitted to Peking Union Medical College Hospital from Jan. 2000 to Dec. 2018 were retrospectively reviewed and analyzed. Multiple parameters, including age, gestational week, the New York Heart Association (NYHA) cardiac functional classification, ultrasonic cardiogram (UCG), blood test, pregnancy complications, pulmonary arterial systolic pressure, maternal and fetal outcomes, were comprehensively investigated and analyzed.Results: According to the pulmonary arterial systolic pressure, all 59 pregnant women were divided into mild PAH (30-49 mmHg, n=18), moderate PAH (50-79 mmHg, n=17) and severe PAH (>79 mmHg, n=24).Five patients died, and the mortality rate was 8.5%. Compared with the mild and moderate groups, the mean gestational week, age of the pregnancy, and NYHA cardiac functional classification grade in the severe PAH group were dramatically different (all P<0.05). The incidence of pregnancy-related complications in the severe PAH group was significantly higher than those in the mild and moderate PAH groups (both P<0.05). Conclusions:The blood parameters, PAH, and NYHA cardiac functional classification grade were significantly changed before and after surgery. We found that the severity of PAH was a major factor of maternal and fetal outcomes. Strengthening the nursing care for pregnant women with PAH is of great clinical significance.

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Objectives: We compared the clinical efficacy of contrast-enhanced ultrasound (CEUS) to transvaginal ultrasound (TVS) for diagnosing cesarean scar pregnancy (CSP).Methods: A total of 485 cases of suspected CSP were recruited from January 2017 to March 2018. All received TVS and CEUS by two sonologists blinded to diagnosis by the other. Diagnostic features of CSP that significantly differed between modalities by univariate analysis (P < .05) were included in a logistic regression model. The sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (ÀLR), and accuracy (ACC) of CSP diagnosis by TVS and CEUS were compared according to operational and pathological outcomes as the reference standard.Results: There were 220 CSP cases (including 85 cases of type I, 93 of type II, and 42 of type III). The sensitivities of CEUS for detection of types I À III CSP were 94.1%, 92.5%, and 97.6%, respectively, and corresponding sensitivities of TVS were 82.4%, 80.6%, and 95.2%. Compared to TVS, CEUS yielded significantly better overall sensitivity (97.27% vs 88.18%), specificity (96.60% vs 75.47%), +LR (28.60 vs 3.59), ÀLR (0.03 vs 0.16), and diagnostic ACC (96.9% vs 81.23%) (all P < .001).Conclusions: CEUS is superior to TVS for detecting cesarean scar pregnancy and distinguishing among CSP types.Abbreviations: ACC = accuracy, CEUS = contrast-enhanced ultrasound, CSP = cesarean scar pregnancy, +LR = positive likelihood ratio, ÀLR = negative likelihood ratio, TVS = transvaginal ultrasound.