Objective The embryonic development is usually observed for 5-6 days during the process of embryo culture in most embryonic laboratories.The article aimed to explore the application of D 6+D7 frozen-thawed blastocyst transfer in patients with di -minished ovarian reserve(DOR). Methods Retrospective analysis was conducted on 285 patients with DOR who were treated with in-vitro fertilization and embryo transfer (IVF-ET) in our center from 2015 to 2017.Frozen embryos were harvested from the natural cycle , mini-stimulation protocol, ovulation induction during the luteal phase , followed by frozen-thawed embryo transfer with a total of 442 cycles. The frozen embryos were divided into cleavage embryo group and blas -tocyst group according to different life stages , and comparison was made in general data and pregnancy outcome between the two groups .The blastocyst transfer group was subdivided into Day 5 group and Day6+Day7 group followed by the comparison of different pregnancy outcome between the two groups . Results Patients with DOR were treated with frozen-thawed blastocyst transfer with 291 cycles in cleavage embryo group and 151 cycles in blastocyst group.The implantation rate, clinical pregnancy rate, and ongoing pregnancy rate of blastocyst group were significantly higher than those of cleavage embryo group ( 44.62％ vs 22.46％, 50.33％ vs 33.33％, 37.75％ vs 21.65％, P<0.05) and the abortion rate of blastocyst group was significantly lower than that of cleavage embryo group (35.05％ vs 25％, P<0.05).As to the frozen blastocyst transplantation cycle , the number of D5 blastocysts was 69, and D6+D7 blastocyst was 76. The embryo planting rate, clinical pregnancy rate, continued pregnancy rate and abortion rate of D 6+D7 group were higher than those of D5 group(39.74％ vs 50％, 44.93％ vs 55.26％, 34.78％ vs 39.47％, 22.58％ vs 28.57％), but the difference was of no statistical significance(P>0.05). Conclusion In patients with DOR, the transplanted blastocyst can significantly improve the pregnancy out -come, increase the clinical pregnancy rate and reduce the abortion rate .The embryo planting rate and clinical pregnancy rate of the transplanted D6+D7 blastocyst were higher than those of D 5 blastocyst, but the difference was not statistically significant .The abortion rate was also increased.Therefore, when the number of embryos is limited, patients with DOR may consider transplanting D 6+D7 high-quality blastocysts in order to get a certain clinical pregnancy rate .

To discuss the repair mechanism of Qinbai Qingfei concentrated pellets to AEC-Ⅱ of rats infected by mycoplasma through the observation of the changes and distribution of TGF-β and SP-A in lungs, totally 60 Wistar rats that weighing 80-100 g were collected, with male and female in half. The rats were divided into six groups randomly, with 10 rats each group, namely blank group, model group, positive group and Qinbai Qingfei concentrated pellets high, middle and low dose groups. Rats were infected through nasal intubation drip of MP. After 10 days of administration, serum and bronchoalveolar lavage fluid (BALF) were collected to detect the concentration of surface activity related protein A (SP-A) by ELISA, left pulmonary tissues of rats were collected to observe the expression and distribution of transforming growth factor-beta (TGF-β) and SP-A by immunohistochemistry, and right pulmonary tissues were taken to detect TGF-β and SP-A mRNA expression level by real-time quantitative PCR (RT-PCR). Qinbai Qingfei concentrated pellets can reduce the expression of TGF-β and increase the expression of SP-A in the lung tissues of rats infected by mycoplasma. Specifically, TGF-β was mainly distributed among the lung interstitium, while SPAs were mainly distributed in AEC-II and parts of alveolar macrophage. The level of SP-A was reduced in serum and increased in BALF in rats in Qinbai Qingfei concentrated pellets groups. It was proved that Qinbai Qingfei concentrated pellets can restore the normal morphology and function of the lung by reducing the content of TGF-β to inhibit epithelial-mesenchymal transition (EMT) of alveolar type II epithelial cells and increasing the expression of SP-A. Qinbai Qingfei concentrated pellets have the repairing ability to capillary vessel damage caused by MP in lung tissues of rats.

Wnt5a is a representative Wnt ligand that regulates multiple cellular functions through the Wnt5a non-classical pathway. Although Wnt5a has been implicated in various pathological conditions, its role in cancer is ambiguous and might involve methyl modifications, distinct mRNA isoforms, as well as different downstream pathways. Therefore, it is an essential factor in cancers' progression (invasion, migration, proliferation, and epithelial-mesenchymal transition), and a potential biomarker for prognosis and treatment.