[Network Pharmacological Studies of Puerariae Radix in Improving Insulin Resistance].

Objective: To investigate the active components and potential mechanism of Puerariae Radix in improving insulin resistance by using network pharmacological method. Methods: Key target proteins related with insulin resistance were selected based on molecular docking technology, and then took the selected components with 31 target proteins of four pathways for docking. Meanwhile, component-target proteins network was established to network analysis by software Cytoscape 3. 2. 1. Results: 19 compounds had close interactions with four pathways such as AMPK. There were 13 compositions can verify through literature, which revealing that active ingredients and potential molecular mechanism of Puerariae Radix in improving insulin resistance, preliminarily. Conclusion: The network pharmacological method is helpful to explore the possible active components in Puerariae Radix and elucidate the mechanism.

Values of the Wells and revised Geneva scores combined with D-dimer in diagnosing elderly pulmonary embolism patients.

BACKGROUND: Pulmonary embolism (PE) can be difficult to diagnose in elderly patients because of the coexistent diseases and the combination of drugs that they have taken. We aimed to compare the clinical diagnostic values of the Wells score, the revised Geneva score and each of them combined with D-dimer for suspected PE in elderly patients. METHODS: Three hundred and thirty-six patients who were admitted for suspected PE were enrolled retrospectively and divided into two groups based on age (≥65 or <65 years old). The Wells and revised Geneva scores were applied to evaluate the clinical probability of PE, and the positive predictive values of both scores were calculated using computed tomography pulmonary arteriography as a gold standard; overall accuracy was evaluated by the area under the curve (AUC) of receiver operator characteristic curve; the negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were calculated. RESULTS: Ninety-six cases (28.6%) were definitely diagnosed as PE among 336 cases, among them 56 cases (58.3%) were ≥65 years old. The positive predictive values of Wells and revised Geneva scores were 65.8% and 32.4%, respectively (P < 0.05) in the elderly patients; the AUC for the Wells score and the revised Geneva score in elderly was 0.682 (95% confidence interval [CI]: 0.612-0.746) and 0.655 (95% CI: 0.584-0.722), respectively (P = 0.389). The negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were 93.7%, 100%, and 100% in the elderly, respectively. CONCLUSIONS: The diagnostic value of the Wells score was higher than the revised Geneva score for the elderly cases with suspected PE. The combination of either the Wells score or the revised Geneva score with a normal D-dimer concentration is a safe strategy to rule out PE.