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Aim To investigate the pharmacological mechanism of the couplet medicines " Cangzhu-Yiy-iren" in treating adenoid hypertrophy (AH) of children based on network pharmacology. Methods To screen the active ingredient and relevant targets of the couplet medicines "Cangzhu-Yiyiren", a visual network map of " Drug-Component-Target " was constructed; related targets of AH were retrieved and standardized, and A PPI network to treat AH of children by " Cangzhu-Yiyiren" was constructed. Enrichment analysis was performed for the core targets, and a " targets -pathways" network was constructed. The expression of target proteins from spleen tissues of different groups was determined by Western blot to verify that atractylone regulated the expression of inflammatory factors by HIF-1 α-SUMOylation. Results A total of 71 drug-related targets and 337 disease-related targets for AH in children were obtained, and there were 30 " Drug-Disease " intersection targets. The main active components of the couplet medicines "Cangzhu-Yiyiren" were stigmaster-ol, atractylone and so on. The biological processes mainly involved in were tube morphogenesis, response to hormone, the main cellular components involved in were membrane raft, transcription regulator complex, and the molecular function of related targets were mainly enriched in the transcription factor binding, protein domain specific binding, etc. The enrichment analysis indicated that it was associated with apoptosis-multiple species, VEGF signaling pathway, and HIF-1 signaling pathway ,etc. The results of animal experiments showed that SUMO-1,HIF-1α,VEGF and VEGF-R protein expression were all down-regulated compared with the model group ( P < 0. 05 ). Conclusions The treatment of pediatric AH which takes the " Activating Spleen Treatment of Nasa" as the guiding ideology, is realized through multi-components, multi-target, multi-pathways, and mainly from the anti-inflammatory, immune regulation, antioxidant and other aspects to play its role in the treatment of children with AH.
ABSTRACT
OBJECTIVE@#To investigate the use of antibiotics in children with community-acquired pneumonia (CAP) in multiple regions of China, and to provide a reference for CAP standard treatment and rational antibiotic use in children.@*METHODS@#The medical data of 1 383 children with CAP who were hospitalized in the department of pediatrics in 10 grade A tertiary hospitals from 9 cities between April 14, 2014 and January 1, 2016 were reviewed, to analyze the status of antibiotic use in hospitalized children in North China, Northeast China, East China, and South China.@*RESULTS@#The overall rate of antibiotic use in children with CAP was 89.08%, with 88.7% in North China, 95.5% in Northeast China, 83.3% in East China, and 86.6% in South China. The main types of antibiotics used were cephalosporins, macrolides, compound preparations of β-lactam antibiotics, polyphosphoric broad-spectrum antibiotics and other β-lactam antibiotics. The selection of antibiotics was generally rational, but antibiotics were still used in some patients with viral infection alone or a combined use of ≥2 kinds of antibiotics were noted in some patients with infection caused by one kind of pathogen. Irrational antibiotic use was observed in 131 children (10.63%).@*CONCLUSIONS@#There are high rates of antibiotic use and irrational use of antibiotics among children with CAP. Standard management of antibiotic use in children with CAP should be strengthened.