OBJECTIVE To explore the effect and potential mechanism of the compatibility of Astragali Radix-Puerariae Lobatae Radix on ferroptosis of liver cells in type 2 diabetes mellitus （T2DM） insulin resistance （IR） rats. METHODS Sixty male SD rats were randomly divided into control group （12 rats） and modeling group （48 rats）. The modeling group was fed with a high- fat diet for 4 consecutive weeks and then given a one-time tail vein injection of 1% streptozotocin to establish T2DM IR model. The model rats were randomly divided into model group， the compatibility of Astragali Radix-Puerariae Lobatae Radix group [QG group， 4.05 g/（kg·d）， intragastric administration]， ferroptosis inhibitor ferrostatin-1 group [Fer-1 group， 5 mg/kg by intraperitoneal injection， once every other day]， the compatibility of Astragali Radix-Puerariae Lobatae Radix+ferroptosis inducer erastin group [QG+erastin group， 4.05 g/（kg·d） by intragastric administration+erastin 10 mg/（kg·d）， intraperitoneal injection]. After 4 weeks of intervention， serum fasting blood glucose （FBG） and fasting insulin （FINS） were measured in each group of rats， and homeostasis model assessment of insulin resistance （HOMA-IR） and the natural logarithm of insulin action index（IAI） were calculated； the serum levels of total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， aspartate transaminase （AST） and alanine transaminase （ALT）， Fe2+ and Fe content， glutathione （GSH）， malondialdehyde （MDA） and superoxide dismutase （SOD） levels， NADP+/NADPH ratio and reactive oxygen species （ROS） were determined. The pathological morphology of its liver tissue was observed； the protein expressions of glutathione peroxidase 4 （GPX4）， ferritin heavy chain 1 （FTH1）， long-chain acyl-CoA synthetase 3 （ACSL3）， ACSL4， ferritin mitochondrial （FTMT）， and cystine/glutamate anti-porter （xCT） in the liver tissue of rats were detected. RESULTS Compared with control group， the liver cells in the model group of rats showed disordered arrangement， swelling， deepened nuclear staining， and more infiltration of inflammatory cells， as well as a large number of hepatocyte vacuoles and steatosis； FBG （after medication）， the levels of TC， TG， LDL-C， AST， ALT， FINS， MDA and ROS， HOMA-IR， Fe2+ and Fe content， NADP+/NADPH ratio and protein expression of ACSL4 were significantly increased or up-regulated， while the levels of HDL-C， GSH and SOD， IAI， protein expressions of GPX4， FTH1， ACSL3， FTMT and xCT were significantly reduced or down-regulated （P＜0.01）. Compared with the model group， both QG group and Fer-1 group showed varying degrees of improvement in pathological damage of liver tissue and the levels of the above indicators， the differences in the changes of most indicators were statistically significant （P＜0.01 or P＜0.05）. Compared with QG group， the improvement of the above indexes of QG+erastin group had been reversed significantly （P＜0.01）. CONCLUSIONS The compatibility decoction of Astragali Radix-Puerariae Lobatae Radix can reduce the level of FBG in T2DM IR rats， and alleviate IR degree， ion overload and pathological damage of liver tissue. The above effects are related to the inhibition of ferroptosis.

To summarize the nursing experience of 5 patients with severe ARDS complicated with hypercapnia who underwent extracorporeal carbon dioxide removal(ECCO2R).Key points of nursing care included:establishing a rapid emergency response nursing team for ECCO2R;PETCO2 real-time monitoring to grasp the timing of the machine;ensuring continuity of treatment and improving the removal efficiency;respiratory-related monitoring;prevention of complications of blood coagulation and hypothermia;and weaning from extracorporeal carbon dioxide removal.After careful treatment and care,all the 5 patients were successfully removed from ECCO2R treatment.

Objective:To analyze the effects of low-dose methimazole treatment on thyroid volume and calcitonin levels in patients with hyperthyroidism.Methods:A total of 100 hyperthyroidism patients who were treated at the Mianyang Central Hospital from January to June 2019 were selected and randomly divided into a control group (50 cases) and an observation group (50 cases) using a random number table method. The control group was treated with once a day and 30 mg/dose of methimazole, while the observation group was treated with twice a day and 10 mg/dose of methimazole. Thyroid volume, and thyroid function [Thyroid growth hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone receptor antibody (TRAb)] before and after treatment in two groups of patients, the changes in serum levels of calcitonin (CT), visfatin, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were compared. The clinical efficacy of two groups were also compared.Results:The total clinical effective rate of the observation group was higher than that of the control group ( P<0.05). After treatment, the thyroid volume in the observation group was significantly smaller than that in the control group, and the CT level was significantly lower than that in the control group (all P<0.05). After treatment, the TSH level in the observation group was significantly higher than that in the control group, while the levels of FT3, FT4, and TRAb were significantly lower than those in the control group (all P<0.05). After treatment, the levels of Visfatin, TNF-α, and IL-6 in the observation group were significantly lower than those in the control group (all P<0.05). Conclusions:Low dose methimazole can improve thyroid function, reduce thyroid volume, lower body CT and inflammation levels in patients with hyperthyroidism, and has a better therapeutic effect.

【Objective】 To investigate whether the blood donors' coagulation status may lead to apheresis platelet aggregation in vitro. 【Methods】 Thirty blood donors with aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times previously and occurred when the last time of apheresis donation were observed in aggregated group (referred to as the experimental group); Thirty donors without aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times were observed in the control group simultaneously. The basic platelet parameters in the two groups, including Plt, MPV, PDW, Pet, P-LCR were detected by automatic blood cell analyzer (BC-3000Plus), and thromboelastogram indexes including reaction time(R), kinetics time(K), kinetics of clot development(α), maximum amplitude (MA) and coagulation index(CI) were tested by Thrombosis elastography (TEG) before collection. With SPSS24.0 software, t test was used to compare the differences between the two groups. 【Results】 The CI value in experimental group was significantly different from that of the control group (0.48± 1.00 vs -0.99 ±1.96, P< 0.05), and there was no significant difference in all above basic platelet parameters and other TEG parameters (P>0.05 ) . 【Conclusion】 The coagulation status of blood donors may be an independent risk factor for the in vitro aggregation of apheresis platelets.

Objective To evaluate the emergency treatment strategy of acute intestinal obstruction induced by left colorectal cancer.Methods 50 patients with acute intestinal obstruction caused by left colorectal cancer were selected as the research subjects .The clinical data were retrospectively analyzed .Results Of 50 patients,6 cases of postoperative incision infection occurred in phase I excision anastomosis surgery ,no anastomotic fistula.21 cases received ileus tube decompression and phase I excision anastomosis of incision ,there were no postoperative complica-tions.50 patients recovered after surgery , no patients died in the follow-up.Conclusion For acute intestinal obstruction caused by left half colon cancer ,the method ofⅠ resection and heal surgery is the most safe ,and can be used as the preferred way to make a diagnosis and treatment ,but for patients can't tolerance emergency surgery,need the help of colonoscopy,through anal insertion catheter colon decompression and lavage and clean the dirt .

Objective To compare the clinical efficacy and safety of second -stage and one -stage extra-dissection and loose seton operation in the treatment of complex anal fistula complicated with abscess . Methods From May 2015 to December 2016 ,100 patients with complex anal fistula complicated with abscess were chosen in the First People's Hospital of Wuyi County .The patients were randomly divided into two groups , with 50 patients in each group .The control group received second -stage extra-dissection and loose seton operation ,and the observation group received one -stage extra-dissection and loose seton operation .The clinical effects ,operation time,wound healing time , hospital stay and the incidence of complications after operation of the two groups were compared.Results The total effective rates of the control group and the observation group were 94.00％,96.00％, respectively,there was no statistically significant difference between the two groups (χ2 =8.78,P >0.05).The operation time,wound healing time and hospital stay of the observation group were shorter than those of the control group,and the differences were statistically significant (t=3.72,2.96,3.40,all P<0.05).The incidence rates of urinary retention,bleeding and wound infection after operation of the control group were 2.00％,4.00％,6.00％, respectively,which of the observation group were 4.00％,2.00％,8.00％,respectively,there were no statistically significant differences between the two groups (χ2 =1.04,0.79,1.13,all P>0.05).Conclusion Second-stage and one-stage extra-dissection and loose seton operation in the treatment of complex anal fistula complicated with abscess has the same clinical effects and safety;but one -stage extra -dissection and loose seton operation can efficiently shorten the operation time and speed up the postoperative rehabilitation .

Objective: To investigate the diagnosis and treatment effect of early inflammatory bowel obstruction after operation. Methods: The clinical data of 20 patients with early inflammatory bowel obstruction were analyzed.The therapeutic effect was analyzed. Results: 20 patients were treated with significant improvement in abdominal pain and abdominal distention, and gastrointestinal decompression volume was (221.6±138.6)mL/d.Patients with abdominal flat tablet showed that the intestinal canal was significantly reduced or disappeared, and all patients were cured and discharged. Conclusion For the patients with early inflammatory intestinal obstruction after operation, we should pay close attention to the clinical response of patients, adopt comprehensive treatment to relieve patients' pain.

Objective To observe the effects of acupuncture combined with traditional Chinese medicine on scores of TCM syndrome and Neck Pain Questionnaire (NPQ) in patients of cervical spondylosis with syndrome of cold locking the collaterals. Methods Ninety cases of patients were randomly divided into acupuncture combined with TCM group, TCM group, and acupuncture group, 30 cases in each group. The acupuncture combined with TCM group was given modified Guizhi plus Gegen decoction and electro acupuncture;the TCM group was given modified Guizhi plus Gegen decoction only;the acupuncture group was given electro acupuncture only. The scores of TCM syndrome and NPQ of the three groups were observed and analyzed comparatively. Results The deviation scores of TCM syndrome and NPQ before and after treatment of the acupuncture combined with TCM group were higher than the acupuncture group and the TCM group (P<0.05), but there was no statistical difference between the acupuncture group and the TCM group (P>0.05). Conclusion Acupuncture combined with traditional Chinese medicine can relieve clinical symptoms of patients with cervical spondylosis with syndrome of cold locking the collaterals, ease their cervical pain, and improve their cervical function.

Objective To establish the pyrogen removing effect of activated carbon in the technics of traditional Chinese medicine (TCM) injections. Methods The content of bacterial endotoxin concentration was detected by kinetic turdimetric assay to evaluate the effect of removing pyrogen before and after using activated carbon in concentrated solution of TCM injection. Results The activated carbon adsorption rate of Shuanghuanglian concentrated solution≥70%and the activated carbon adsorption rate of Danshen concentrated solution>95%. Conclusion Pyrogen manufacturing process is scientific and rational by adding activated carbon adsorption in powder injection of TCM. The bacterial endotoxin of large doses can't be removed fully by activated carbon adsorption.

Objective To summary the experience of microsurgery of meningioma in skull base treatment. Methods To study the clinical data of 10 cases patients of meningioma in skull base who were subjected to microsurgery by using retrospective analysis. Among the 10 patients, there were 3 cases of meningioma of the olfactory groove. There were 2 cases of sphenoid ridge meningioma, meningioma in the middle cranial fossa, meningioma in the cerebellopontine angle respectively.There was 1 case of meningioma of velarium in temporal lobe. Results In 7 cases, the meningioma was completely removed. And in another 3 cases, the meningioma got subtotal resection. During and after the operation, there were no severe complications observed or death occurrence in all the 10 cases of meningioma patients. Two months post of operation,all patients got a significant amelioration in their symptoms. A total of 9 cases were followed up. There was 1 case of IIa type meningioma recurred. Conclusion To elevate the whole shearing rate of meningioma in skull base and reduce the mortality of it,it is most important for appropriate operative route selection and well mircosugical technique application.