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.

This study explored the ideas and methods of acupuncture for Guillain-Barré Syndrome （GBS） with the core principle of “to treat flaccidity， select the yangming （阳明） channel only”. The main pathological mechanism of GBS is deficiency of qi and blood in the yangming channel， malnutrition of all sinews， diminished spleen and stomach function leading to the production of pathogenic damp-heat qi， which obstructs the meridians， and gradually affects the liver and kidneys， consuming essence and damaging blood. Concurrently， dysfunction of the dumai （督脉） pivotal mechanism and lack of moisture in sinews and vessels result in symptoms such as skin numbness， paralysis， and muscle wastage. In clinical diagnosis and treatment， a combination of syndrome and channel differentiation is taken. Treatment primarily focuses on acupoints of yangming channel， aiming to supplement qi and blood， and acupoints of du mai are combined to open the vessel and fill the marrow. Specific acupoints are selected based on syndrome differentiation， providing comprehensive regulation to promote harmonization of qi and blood， relieve meridians， and the smooth generation and circulation of whole body fluids. This， in turn， enhances the strength of muscles and bones， and fosters a robust and freely moving body.

Objective This study investigated the impact of occupational mercury(Hg)exposure on human gene transcription and expression,and its potential biological mechanisms. Methods Differentially expressed genes related to Hg exposure were identified and validated using gene expression microarray analysis and extended validation.Hg-exposed cell models and PTEN low-expression models were established in vitro using 293T cells.PTEN gene expression was assessed using qRT-PCR,and Western blotting was used to measure PTEN,AKT,and PI3K protein levels.IL-6 expression was determined by ELISA. Results Combined findings from gene expression microarray analysis,bioinformatics,and population expansion validation indicated significant downregulation of the PTEN gene in the high-concentration Hg exposure group.In the Hg-exposed cell model(25 and 10 μmol/L),a significant decrease in PTEN expression was observed,accompanied by a significant increase in PI3K,AKT,and IL-6 expression.Similarly,a low-expression cell model demonstrated that PTEN gene knockdown led to a significant decrease in PTEN protein expression and a substantial increase in PI3K,AKT,and IL-6 levels. Conclusion This is the first study to report that Hg exposure downregulates the PTEN gene,activates the PI3K/AKT regulatory pathway,and increases the expression of inflammatory factors,ultimately resulting in kidney inflammation.

Objective To explore the correlation between coronary fat attenuation index of perivascular adipose tissue(FAIPVAT),as well as volumetric perivascular characterization index(VPCI),and coronary heart disease(CHD).Methods A total of 112 patients who underwent coronary computed tomography angiography(CCTA)and coronary angiography(CAG)examinations within 2 weeks were selected.The patients were divided into CHD group and control group according to the degree of coronary artery stenosis,and were divided into calcified plaque group,non-calcified plaque group and mixed plaque group according to the nature of plaque.The correlation between FAIPVAT,VPCI and CHD were evaluated.Results Of the 112 patients,71 patients in the CHD group and 41 patients in the control group.There were significant differences in gender,age,FAIPVAT and VPCI between the two groups.FAIPVAT and VPCI were positively correlated with CHD(r=0.445,P＜0.01;r=0.669,P＜0.01).FAIPVAT and VPCI were analyzed by receiver operating characteristic(ROC)curve,the area under the curve(AUC)of FAIPVAT was 0.770,the cut-off value was-81.659 HU,the sensitiv-ity was 0.592,and the specificity was 0.878,while the AUC of VPCI was 0.892,the cut-off value was 8.056,the sensitivity was 0.887,and the specificity was 0.805.There were significant differences in FAIPVAT and VPCI between non-calcified plaque group and calci-fied plaque group.FAIPVAT and VPCI of mixed plaque group and calcified plaque group were significantly different.Conclusion FAIPVAT and VPCI have some certain correlation with CHD.FAIPVAT and VPCI can accurately evaluate the risk level of CHD and coronary artery inflammation,and the value of individualized VPCI is higher.

Objective:To explore the effect of Kangfuxin solution combined with triamcinolone and Econazole cream in elderly patients with hip fracture complicated with incontinence dermatitis, and to provide reference for clinical nursing.Methods:A randomized controlled trial was conducted to select 80 elderly patients with hip fracture complicated with incontinence dermatitis who were hospitalized in the Orthopedics Department of the First Medical Center of the PLA General Hospital from February 2023 to March 2024 by convenient sampling method. They were divided into the experimental group and the control group with 40 cases in each group according to random number table method. The experimental group was treated with Kangfuxin solution combined with triamcinolone and econazole cream for incontinence dermatitis. Intervention was stopped after 2 weeks of intervention or the incontinence dermatitis reached the clinical healing standard. In the control group, 3M spray was used to care the affected area of incontinence dermatitis, intervention was stopped after 2 weeks or the incontinence dermatitis reached the clinical healing standard. Incontinence dermatitis Skin Injury Assessment Scale (IADS) and perineal skin assessment tool PAT were used to evaluate the skin status of the two groups, and the healing time and treatment effectiveness of the two groups were compared.Results:In the control group, there were 11 males and 29 females, with age of (76.53 ± 8.67)years. There were 9 males and 31 females in the experimental group, with age of (76.56 ± 8.69)years, and there was no significant differences in baseline data between the two groups (all P>0.05). After intervention, the IADS and PAT scores of the control group were (27.13±5.22) points and (5.11 ± 0.94) points respectively, which were significantly higher than those of the experimental group (25.43 ± 4.15) points and (3.73 ± 1.21) points, and the differences were statistically significant ( t=7.22, 8.21, both P<0.05). The effective treatment in the experiment group was 97.5% (39/40), which was significant higher than 72.5% (29/40) in the control group ( χ2=13.25, P<0.05). The healing time of experimental group was (4.57 ± 3.44) d, which was significantly shorter than that of control group (9.23 ± 4.19) d, with statistical significance ( t=11.61, P<0.05). Conclusions:The combined application of Kangfuxin solution and triamcinolone and Econazole cream has a significant effect on improving incontinence dermatitis and perineal health in elderly patients with hip fracture, can effectively reduce symptoms and accelerate skin healing, and has certain clinical application value.

Objective To observe the clinical efficacy of"hegu needling"combined with"joint needling"in the treatment of chronic lumbar muscle strain.Methods A total of 64 patients with chronic lumbar muscle strain were randomly divided into observation group and control group,32 cases in each group.The control group was treated with routine acupuncture,and the observation group was treated with"hegu needling"combined with"joint needling"on the basis of the control group.One week for a course of treatment,a total of two courses of treatment.After two weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes of Visual Analogue Scale(VAS)of pain score and simplified Oswestry Dysfunction Index questionnaire(simplified ODI)score were observed before and after treatment.The changes of spinal mobility were compared before and after treatment between the two groups.Results(1)The total effective rate was 93.75%(30/32)in the observation group and 78.13%(25/32)in the control group.The curative effect of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the simplified ODI score and spinal activity score of the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the simplified ODI score and spinal activity score,the differences were statistically significant(P＜0.05).(3)After two weeks of treatment,the VAS scores of the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the VAS score,the difference was statistically significant(P＜0.05).After one month of treatment,there was no significant difference in VAS score of the observation group when compared with that after two weeks of treatment(P＞0.05).Conclusion"Hegu needling"combined with"joint needling"in the treatment of chronic lumbar muscle strain can significantly improve the patients'pain symptoms,enhance the patient's waist function,and improve the patients'spinal mobility.

Objective To investigate the effects of Chaihuang Yishen Granules on renal fibrosis in unilateral ureteral obstruction(UUO)mice and its underlying mechanisms.Methods Twenty-four 8-week-old male C57BL/6 mice were randomly divided into control group,model group,and low and high dose groups of Chaihuang Yishen Granules(6 in each group).In control group,only right kidney ureter was exposed and dissected.In model group,the UUO animal model was established by UUO.In low and high dose groups,mice were administered intragastrically at doses of 3.8 and 7.6 g/kg of Chaihuang Yishen Granules respectively,following the model group's method to establish the UUO model.After 7 days,the mice were euthanized and renal samples were collected.HE and Masson staining were used to observe pathological changes and fibrosis degree of the kidneys in each group,Sirius red staining was used to observe collagen deposition.The expression levels of α-smooth muscle actin(α-SMA),fibronectin(FN),type Ⅰ collagen(Col-Ⅰ),glycogen synthase kinase 3β(GSK-3β),and β-catenin related proteins were detected using Western blotting.Changes in A33 and GSK-3β,β-catenin mRNA levels were measured by RT-PCR.Additionally,a normal transformed C3H mouse kidney-1(TCMK1)was used as control(normal group);an in vitro fibrosis model was established using TCMK1 stimulated with Transforming Growth Factor-β(TGF-β);and an in vitro drug model was established using TCMK1 treated with serum containing Chaihuang Yishen Granules.A33 was overexpressed in TCMK1 cells using a transfection with an A33 overexpression plasmid,and changes in fibrosis-related indicators and the expression of A33 and GSK-3β,β-catenin mRNA were observed.Results RT-PCR results showed that,compared with control group,A33 level was significantly increased in model group,while it was significantly reduced in both low and high dose groups of Chaihuang Yishen Granules(P＜0.05).Western blotting showed that the expression levels of fibrosis-related factors such as α-SMA,FN,Col-Ⅰ in model group were significantly higher than those in control group(P＜0.05);while compared with model group,the expression levels of α-SMA,FN,Col-Ⅰ in low and high dose groups of Chaihuang Yishen Granules were significantly lower(P＜0.05).HE,Masson,immunohistochemical staining results showed that model group had severe kidney structural damage,significant increase in collagen deposition,and significantly higher expression levels of GSK-3β and β-catenin proteins compared with those in control group(P＜0.01).In contrast,low and high dose groups of Chaihuang Yishen Granules had good kidney structure,significant improvement in kidney damage and fibrosis,and significantly lower expression levels of GSK-3β and β-catenin proteins compared with those in model group(P＜0.05).In vitro experiment results confirmed that,compared with normal group,A33 overexpression promoted the upregulation of fibrosis-related factors in TCMK1 cells,significantly increase the expression of downstream target genes GSK-3β and β-catenin mRNA in the Wnt/β-catenin signaling pathway(P＜0.05),and A33 overexpression reversed the cellular fibrosis changes downregulated by the serum containing Chaihuang Yishen Granules(P＜0.01).Conclusion Chaihuang Yishen Granules significantly improve renal fibrosis in UUO mice by downregulating the A33/Wnt/β-catenin signaling pathway,suggesting that A33 may be a potential therapeutic target for renal fibrosis.

Solid dispersion technology is an advanced technology to improve the solubility and bioavailability of poorly soluble drugs.Inhibition of the recrystallization and amorphous phase separation of amorphous solid dispersion (ASD) active pharmaceutical ingredients are important to ensure product stability,so the characterization of ASD phase separation is essential.Based on the principle of phase separation,this paper analyzed and summarized the advantages,disadvantages and applicability of the various characterization techniques,in order to provide an efficient reference for the characterization and stability study of ASD.

Objective We aimed to compare the efficacy and prognosis of percutaneous coronary intervention(PCI)in complex and high-risk patients with coronary heart disease(CHD)treated with extracorporeal membrane oxygenation(ECMO)combined with intra-aortic balloon pump(IABP)assistance,and explore the application value of combined use of mechanical circulatory support(MCS)devices in complex PCI.Methods A total of patients who met the inclusion criteria and underwent selective PCI supported by MCS at the Department of Cardiology,the First Affiliated Hospital of the Air Force Medical University from January 2018 to December 2022 were continuously enrolled.According to the mechanical circulatory support method,the patients were divided into ECMO+IABP group and IABP group.Clinical characteristics,angiographic features,in-hospital outcomes,and complications were collected.The intra-hospital outcomes and major adverse cardiovascular events(MACE)at one month and one year after the procedure were observed.The differences and independent risk factors between the two groups in the above indicators were analyzed.Results A total of 218 patients undergoing elective PCI were included,of which 66 patients were in the ECMO+IABP group and 152 patients were in the IABP group.The baseline characteristics of the two groups of patients were generally comparable,but the ECMO+IABP group had more complex lesion characteristics.The proportion of patients with atrial fibrillation(6.1％vs.0.7％,P=0.030),left main disease(43.9％vs.27.0％,P=0.018),triple vessel disease(90.9％vs.75.5％,P=0.009),and RCA chronic total occlusion disease(60.6％vs.35.5％,P＜0.001)was higher in the ECMO+IABP group compared to the IABP group.The proportion of patients with previous PCI history was higher in the IABP group(32.9％vs.16.7％,P=0.014).There was no statistically significant difference in the incidence of in-hospital complications between the two groups(P=0.176),but the incidence of hypotension after PCI was higher in the ECMO+IABP group(19.7％vs.9.2％,P=0.031).The rates of 1-month MACE(4.5％vs.2.6％,P=0.435)and 1-year MACE(7.6％vs.7.9％,P=0.936)were comparable between the two groups.Multivariate analysis showed that in-hospital cardiac arrest(OR 7.17,95％CI 1.27-40.38,P=0.025)and after procedure hypotension(OR 3.60,95％CI 1.10-11.83,P=0.035)were independent risk factors for the occurrence of 1-year MACE.Conclusions Combination use of ECMO+IABP support can provide complex and high-risk coronary heart disease patients with an opportunity to achieve coronary artery revascularization through PCI,and achieve satisfactory long-term prognosis.

Objective To explore the improving effect of eicosapentaenoic acid(EPA)on the skeletal muscle insulin resistance in obese rats by regulating the p38 MAPK signaling pathway.Methods Fifty male Wistar rats were randomly divided into the control group,model group,inhibitor group,EPA group and inhibi-tor+EPA group,10 cases in each group.The intervention lasted for 6 weeks.The inhibitor group was given 1 mg/kg p38 MAPK inhibitor SB203580 by gavage.The EPA group was given 70 mg/kg EPA by gavage,the in-hibitor+EPA group was given SB203580+EPA by gavage,and the model group and control group were given equal volume of saline.The levels of fasting blood-glucose,fasting serum insulin,glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)and malondialdehyde(MDA)in the skeletal muscles were deter-mined.The rat insulin resistance degree was evaluated by using the intraperitoneal glucose tolerance test(IPGTT)and insulin tolerance test(ITT).The protein and mRNA expression levels of phosphorylation p38 in the rat skeletal muscle tissues were detected by Western blot and qRT-PCR.Results Compared with the control group,the body weight,epididymal fat wet weight,fasting blood-glucose and insulin levels,IPGTT and ITT blood glucose levels,and MDA content in the model group were significantly increased,the GSH-Px and SOD activities were significantly decreased,and the relative expression levels of p-p38 protein and p38 mRNA expression in skeletal muscle tissues were significantly increased(P＜0.05).Compared with the model group,the body weight and epididymal fat wet weight in the EPA group and inhibitor+EPA group were sig-nificantly decreased,while the fasting blood-glucose,fasting serum insulin,IPGTT and ITT blood glucose lev-els and MDA contents in the inhibitor group and EPA group were significantly decreased,the activities of GSH-Px and SOD were significantly increased,and the relative expression level of p-p38 protein in skeletal muscle tissues was significantly decreased(P＜0.05).However,the expression of p38 mRNA in skeletal muscle tissues had no significant change(P＞0.05).Conclusion EPA alleviates the oxidative stress possibly by inhibiting p38 MAPK signaling pathway,thus improves the skeletal muscle insulin resistance of obese rats.