Polycystic ovary syndrome(PCOS)is one of the main causes of ovulatory dysfunction-induced female infertility.The dysfunction of the hypothalamic-pituitary-ovarian axis(HPOA)is a key factor promoting reproductive damage and metabolic abnormalities in PCOS.This article explored the correlation between HPOA dysfunction and the pathogenesis of heart-kidney disharmony in TCM based on Ye Tianshi's theory of"simultaneous upper and lower diseases,treating the middle energizer".It is believed that the treatment of PCOS should aim at restoring the ascending and descending of qi in the middle energizer,with the main therapeutic approach being soothing the liver and strengthening the spleen,which can provide ideas for the clinical treatment of PCOS.

Polycystic ovary syndrome(PCOS)is a complex disease that significantly impacts women's reproductive and metabolic health.The reprogramming of glucose metabolism points to fundamental changes in energy metabolism,which are central to the imbalance in energy metabolism,hormonal abnormalities,increasing insulin resistance,and chronic inflammatory states observed in PCOS.This represents a core pathological link in the pathogenesis of PCOS.The theory of"Spleen Qi to Dispersing Essence"provides a comprehensive overview of spleen function,essential for ensuring the normal operation of organs and the distribution of Qi,blood,and bodily fluids.It serves as a crucial theoretical support for the treatment of PCOS with traditional Chinese medicine.This article explores the role of regulating PCOS based on the theory of"Spleen Qi to Dispersing Essence"with a focus on the reprogramming of glucose metabolism.The mechanism of traditional Chinese medicinal treatments that assist Spleen Qi to Dispersing Essence is closely related to regulating glucose metabolism reprogramming,offering a novel research direction for the treatment of PCOS with TCM.

Polycystic ovary syndrome(PCOS)is one of the main causes of ovulatory dysfunction-induced female infertility.The dysfunction of the hypothalamic-pituitary-ovarian axis(HPOA)is a key factor promoting reproductive damage and metabolic abnormalities in PCOS.This article explored the correlation between HPOA dysfunction and the pathogenesis of heart-kidney disharmony in TCM based on Ye Tianshi's theory of"simultaneous upper and lower diseases,treating the middle energizer".It is believed that the treatment of PCOS should aim at restoring the ascending and descending of qi in the middle energizer,with the main therapeutic approach being soothing the liver and strengthening the spleen,which can provide ideas for the clinical treatment of PCOS.

Polycystic ovary syndrome(PCOS)is a complex disease that significantly impacts women's reproductive and metabolic health.The reprogramming of glucose metabolism points to fundamental changes in energy metabolism,which are central to the imbalance in energy metabolism,hormonal abnormalities,increasing insulin resistance,and chronic inflammatory states observed in PCOS.This represents a core pathological link in the pathogenesis of PCOS.The theory of"Spleen Qi to Dispersing Essence"provides a comprehensive overview of spleen function,essential for ensuring the normal operation of organs and the distribution of Qi,blood,and bodily fluids.It serves as a crucial theoretical support for the treatment of PCOS with traditional Chinese medicine.This article explores the role of regulating PCOS based on the theory of"Spleen Qi to Dispersing Essence"with a focus on the reprogramming of glucose metabolism.The mechanism of traditional Chinese medicinal treatments that assist Spleen Qi to Dispersing Essence is closely related to regulating glucose metabolism reprogramming,offering a novel research direction for the treatment of PCOS with TCM.

Objective:To explore the clinical efficacy of immunoadsorption in highly sensitized kidney transplant (KT) candidates.Methods:From September 2019 to April 2023, the relevant clinical data were retrospectively reviewed for 26 highly sensitized KT recipients. Protein A immunoadsorption desensitization therapy was offered after KT. The effect of immunosorbent on reducing anti-human leukocyte antigen (HLA) antibodies was summarized. And operative success rate and postoperative complication incidence were calculated.Results:The mean number of treatment session was (10.76±5.53). The highest level of HLA-Ⅰ antibody mean fluorescence intensity (MFI) dropped from (17 921±4 442) to (7 333±6 434) with a decline of 59% and HLA-Ⅱ antibody MFI decreased from (21 135±5 245) to (10 989±7 627) with a decline of 48%. The differences were statistically significant (both P<0.001). All kidneys were harvested from cadavers. The complications were acute antibody mediated rejection (7 cases), perioperative pulmonary infection (3 cases) and myelosuppression (2 cases). The average follow-up period was (30.8±12.6) month. The graft survival rate was 88.5% (23/26) and the recipient survival rate 100% (26/26) . Conclusions:Immunoadsorption therapy can effectively reduce HLA antibody in highly sensitized KT candidates, thereby increasing the probability of successful KT. In terms of safety, immunosorbent therapy may boost the potential risks of infection and myelosuppression. It requires heightened attention.

Objective To observe the differential expression level of CD4+CD25+Foxp3+regulatory T cells (Treg) in liver of arsenic-exposed rats, explore the regulatory mechanisms on immunological of hepatic injury induced by arsenic, and provide a basis for prevention and treatment of the disease. Methods Thirty-two healthy Wistar rats were selected and randomly divided into control,low,medium and high arsenic dose groups by weight,8 rats per group. Rats in control group were given oral gavage of deionized water, while the other groups were given oral gavage doses of 2.00 g/L sodium arsenite(NaAsO2) according to their body weight for 6 days every week, the concentrations were 1.25, 2.50 and 5.00 ml/kg. After 4 months, liver tissue samples of rats were collected, the content of arsenic in liver was detected by inductively coupled plasma mass spectrometry (ICP-MS);the expression of Treg cells in liver was detected by immunohistochemistry; enzyme-linked immunosorbent assay (ELISA) was applied to detect the levels of interloukin-10 (IL-10),transforming growth factor beta 1 (TGF-β1), IL-6, IL-17 and IL-2. Results Compared with the control group [28.57 (17.64 - 35.64)μg/g], the content of arsenic in liver in low,medium and high arsenic exposed groups[M(P25-P75):638.30(527.91-802.58),591.64(513.82-723.16),792.55 (695.93 - 1 074.41) μg/g] increased, the differences were statistically significant(P < 0.05). Compared with low arsenic group, the content of arsenic in liver in high arsenic group increased, the difference was statistically significant (P < 0.05). Numerical density on area (NA) of positive Treg cells in medium,high arsenic exposed groups [(2.25 ± 0.50),(4.00 ± 2.16)A/cm2]was higher than that of the control group[(0.60 ± 0.54)A/cm2,P<0.05];NA of positive Treg cells in high arsenic exposed group was higher than that of the low arsenic exposed group[(1.50 ± 0.58) A/cm2, P < 0.05]. The expressions of the IL-10 in low, medium and high arsenic exposed groups [(5.58 ± 1.70), (6.78 ± 1.09),(7.18 ± 0.53)μg/L]were higher than that of the control group[(2.32 ± 0.83) μg/L,P<0.05];compared with low arsenic group, the expression of IL-10 in high arsenic group increased (P < 0.05); compared with control group [(1.46 ± 0.65) μg/L], the expression of TGF-β1 in high arsenic exposed group increased[(9.06 ± 3.60)μg/L, P<0.05];compared with control group [(2.33 ± 0.66)μg/L], the expression of IL-6 in high arsenic exposed group increased [(5.03 ± 1.39) μg/L, P < 0.05], compared with low arsenic exposed group [(2.46 ± 1.71) μg/L], the expressions of IL-6 in high arsenic exposed group increased, the difference was statistically significant (P < 0.05);the expression of IL-17 among control, low, medium and high arsenic exposed groups[(4.87 ± 1.64),(7.50 ± 2.74), (6.21 ± 1.47),(7.23 ± 2.68)μg/L]were not statistically significant (F = 1.429, P > 0.05); compared with control group [(16.30 ± 3.98) μg/L], the expression of IL-2 in high arsenic exposed group decreased[(9.93 ± 2.65) μg/L, P <0.05]. The content of arsenic in liver was positively correlated with the expression of IL-10, TGF-β1, IL-17, IL-6 (rs=0.696,0.463,0.632,0.502,P<0.05),and negatively correlated with the expression of IL-2(rs=-0.522,P<0.05). Conclusion With increasing of arsenic exposure level, the content of arsenic in liver and the expression of CD4+CD25+Foxp3+Treg have increased,the cytokines are secreted abnormally,liver immunological micro environment is disordered,immune tolerance is formed,and immune clearance is inhibited,which may play an important role in the occur and development of immunological liver damage induced by arsenic in rat.

Objective To investigate the infiltration of T helper 17 (Th17) and regulatory T cells (Treg) in the liver of rats exposed to arsenic,and to investigate the roles of Th17 and Treg in infiltration of liver injury induced by arsenic.Methods Thirty-two Wistar rats,half male and half female,were randomly divided into control,low,medium and high arsenic dose groups by body weight via the random number table method,8 rats per group.Rats in control group were given oral garage of deionized water,while other groups were given oral gavage doses of 2.00 g/L sodium arsenite (NaAsO2) according to their body weight for 6 days every week,the concentrations of NaAsO2 were 1.25,2.50 and 5.00 ml/kg,respectively.After 4 months,liver tissue samples of rats were collected,the content of arsenic in liver was determined by inductively coupled plasma mass spectrometry (ICP-MS);Hematoxylin-eosin staining (HE) method was used to observe the morphological changes of liver tissue in rats;the protein expressions of interleukin-17A (IL-17A,the imflammatory factor secreted by Th17 cells) and Forkhead Box P3 (Foxp3,the lineage-specific transcription factor of Treg cells) were measured with immunohistochemistry.Results ① Arsenic content in liver of low,medium,and high arsenic exposed groups [63.83 (52.79-80.26),59.16 (51.38-76.58),79.26 (69.59-107.44) μg/g] were higher than those of the control group [2.86 (1.76-3.56)μg/g,P ＜ 0.05],and the high arsenic dose group was higher than the medium arsenic dose group (P ＜ 0.05).② With increasing doses of arsenic,the numbers of inflammatory cells in the liver tissue of rats were increased,and the liver tissue of the high arsenic dose group showed vacuolar degeneration and pathological changes in some areas.③ Compared with the control group,low and medium arsenic dose groups (0.001 + 0.001,0.010 ± 0.020,0.030 ± 0.080),the expression of IL-17A protein in the liver in high arsenic dose group were significantly increased (0.220 ± 0.130,P ＜ 0.05),the differences were statistically significant between groups (F =14.776,P ＜0.05).The expressions of Foxp3 protein in the liver in low,medium,and high arsenic dose groups were significantly higher (0.270 ± 0.050,0.330 ± 0.040,0.320 ± 0.070) than that in the control group (0.070 ± 0.020),the differences were statistically significant between groups (F =56.990,P ＜ 0.05).④ There was a positive correlation between hepatic arsenic levels and protein levels of IL-17A and Foxp3 in liver (r =0.48,0.81,P ＜ 0.05).Conclusion Arsenic exposure can increase the content of arsenic in liver tissue of rats,which causes the changes of infiltration of Th17 and Treg cells,leading to the change of immune status,suggesting that Thl7 and Treg cells play an important role in the development of arsenic-induced immune injury.

Objective To explore the influence of high flux hemodialysis (HFHD) and hemodialysis filtration (HDF) on the dialysis effect and patients mortality in the patients with end-stage renal disease(ESRD).Methods One hundred and twenty-two patients with ESRD in our hospitals were selected and respectively adopted HFHD (HFHD group,62 cases) and HDF (HDF group,60 cases) for conducting the dialysis therapy.The serum indexes before and after treatment were detected and compared between the two groups.Results Compared with before treatment,the level of blood urea nitrogen (BUN),blood uric acid (BUA),serum creatinine (Scr),blood phosphorus (P),parathyroid hormone (PTH),β2 microglobulin (β2-MG) and cysteine protease inhibitors (Cys-C) after treatment in the two groups were significantly decreased(P＜0.05).The clearance rates of P,PTH and Cys-C in the HFHD group were significantly higher than those in the HDF group(t=2.479,t=1.834,t=1.512,P＜0.05).The mortality after an average follow-up of (12.2 ± 3.7) months had statistical difference between the two groups,the mortality rate in the HDF group was significantly higher than that in the HFHD group (P＜ 0.05).The multivariate Cox regression analysis results showed that the HFHD was an important factor affecting death in ESRD patient (HR =0.50,95 ％ CI:0.33-0.84,P =0.009).Conclusion HFHD has more significant effect for clearing P,PTH,β2-MG and Cys-C than HDF in ESRD patients,moreover can reduces their mortality.

Objective To explore the effects of different hemodialysis ways on insulin resistance (IR) in non-diabetic renal disease patients with maintenance hemodialysis.Methods A total of 101 cases of non-diabetic renal disease patients with maintenance hemodialysis in Xuzhou Central Hospital from January 2014 to January 2015 were selected and divided into three groups:high-flux hemodialysis (HFHD) group,low-flux hemodialysis (LFHD) group and hemodialysis filtration (HDF) group.Patients in the three study groups were treated with HFHD,LFHD and HDF,respectively.After 6 months of hemodialysis treatment,clinical data and biochemical indicators were compared among the three groups,and Pearson correlation analysis and multivariate logistic regression analysis were used to explore the correlated factors of homeostasis model insulin resistance index (HOMA-IR).Results The levels of parathyroid hormone (PTH) in the HDF group and HFHD group were significantly lower than that in the LFHD group (P＜0.05),while the urea clearance index (Kt/V) values were significantly higher than that in the LFHD group (P＜ 0.05).The β2-microglobulin (β2-MG),fasting insulin (FINS) levels and HOMR-IR in the HDL group were significantly lower than those in the HFHD group and LFHD group (P＜0.05),and β2-MG clearance rate (β2-MGCR) in the HDF group was significantly higher than that in the HFHD group and LFHD group (P＜0.001).Pearson correlation analysis showed that HOMA-IR was positively correlated with BMI (r=0.346,P=0.014),and was negatively correlated with β2-MGCR and HDL-C (r=-0.412,P=0.002;r=-0.204,P=0.042).Multivariate logistic regression analysis showed that BMI and HDF were independent factors affecting HOMA-IR values (OR=1.538,95％CI 1.364-1.759,P=0.021;OR=0.137,95％CI 0.045-0.632,P=0.012).Conclusion Compared with HFHD and LFHD,HDF can alleviate IR in non-diabetic renal disease patients with maintenance hemodialysis,which is of great significance for clinical treatment.

Objective To investigate the differential expression levels and significance of regulatory T cell (Treg) and T helper 17 (Th17) related immunologic factors in peripheral blood of arsenic-exposed rats.Methods Thirty-two Wistar rats were numbered by weight,randomly divided into four groups [control,low (1.25 ml/kg),medium (2.50 ml/kg),and high (5.00 ml/kg)],8 rats per group.Rats in control group were given oral gavage of deionized water,and low,medium and high arsenic exposed groups were given oral gavage doses of 2.00 g/L sodium arsenite (NaAsO2) according to their body weight for 6 days every week.After 4 months,the urine and peripheral blood samples of rats were collected,urinary arsenic (uAs) was detected by inductively coupled plasma-mass spectrometry (ICP-MS),the results were shown in [median (minimum and maximum)],uAs was corrected by urinary creatinine (uCr),the unit was μg/g Cr;enzyme-linked immune-sorbent assay (ELISA) was applied to detect the levels of Treg,Th17,T lymphocytes activation related immunologic factors [interleukin-10 (IL-10),transforming growth factor beta1 (TGF-31),IL-17,IL-6,IL-2],the results were shown in (x) ± s.Results The uAs of the rats was compared between control,low,medium,and high arsenic exposed groups [7.50 (3.16-9.81),72.34 (62.34-106.63),209.15 (154.41-232.20),369.73 (289.50-516.55) μg/g Cr],the differences were statistically significant (F =337.55,P ＜ 0.05).IL-10 [(85.03 ± 7.11),(93.96 ± 8.14),(97.48 ± 6.23),(93.47 ± 4.41) ng/L],TGF-β1 [(72.88 ± 2.96),(81.45 ± 8.15),(86.08 ± 7.55),(90.29 ± 5.35) ng/L],IL-17 [(18.15 ± 3.66),(25.54 ± 5.59),(31.48 ± 5.74),(37.25 ± 7.36) ng/L],IL-6 [(83.68 ± 8.48),(85.14 ± 7.11),(89.78 ± 5.36),(93.48 ± 5.77) ng/L],and IL-2 [(80.65 ± 6.90),(73.86 ± 8.00),(69.93 ± 7.77),(62.06 ± 9.82) ng/L] of the rats were compared between control,low,medium,and high arsenic exposed groups,the differences were statistically significant (F =5.094,11.054,16.249,3.474,5.119,all P ＜ 0.05).There were positive correlations between uAs and TGF-β1,IL-17 concentration (r =0.723,0.605,all P ＜ 0.01),while IL-2 showed a negative correlation (r =-0.484,P ＜ 0.05).Concltsion Arsenic exposure could affect the secretion of Treg and Th17 related immunologic factors,so as to the imbalance of anti-inflammatory and pro-inflammatory,which may play a role in the formation and development of arsenic-related immune injury.