ObjectiveTo observe the effect of Zishen Tiaogan prescription on the oxidative stress injury in the rat model of diminished ovarian reserve （DOR） and explore the role of the Kelch-like ECH-associated protein 1 （Keap1）/nuclear factor E₂-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1） signaling pathway. MethodsForty-eight female SD rats were randomly assigned into a normal group （n=12） and a modeling group （n=36）. The rats in the modeling group received subcutaneous injection of galactose （350 mg·kg^-1） combined with immobilization stress daily. After 28 days of modeling， 6 rats in the normal group and 6 rats in the modeling group were sacrificed to examine the modeling results. The successfully modeled rats were assigned into model， estradiol valerate （0.09 mg·kg^-1）， and low-， medium-， and high-dose （6.39， 12.78， 25.56 g·kg^-1， respectively） Zishen Tiaogan prescription groups. The intervention lasted for 4 weeks with 6 animals per group. Hematoxylin-eosin staining was used to observe the estrous cycle and the pathological changes in the ovarian tissue. The ovarian index was calculated. Enzyme-linked immunosorbent assay was employed to measure the serum levels of sex hormones and oxidative stress-related indexes. Western blot and real-time PCR were employed to determine the protein and mRNA levels， respectively， of Nrf2， Keap1 and HO-1 in the ovarian tissue. The positive expression of superoxide dismutase 2 （SOD2） in the ovarian tissue was detected by immunohistochemistry （IHC）. ResultsCompared with the normal group， the model group showed reduced follicles in the ovary， loose arrangement of the follicle granule layer， declined levels of anti-Mullerian hormone （AMH） and estradiol （E₂） in the serum， elevated levels of luteinizing hormone （LH） and follicle-stimulating hormone （FSH） （P<0.01）， lowered levels of superoxide dismutase （SOD）， catalase （CAT）， and glutathione （GSH） （P<0.01）， and increased accumulation of malondialdehyde （MDA） （P<0.01）. In addition， the modeling led to up-regulated protein and mRNA levels of Keap1 （P<0.01）， the expression of Nrf2 and HO-1 protein was significantly decreased （P<0.01）， the mRNA expression of Nrf2 was significantly decreased （P<0.05）， the mRNA expression of HO-1 was significantly decreased （P<0.01）， in the ovarian tissue. Compared with model group， the estradiol valerate and low-， medium-， and high-dose Zishen Tiaogan prescription groups showed increases in the ovarian index （P<0.01） and serum E₂ and AMH levels （P<0.01）， declined levels of FSH and LH （P<0.01）， increased follicles in the ovary， elevated levels of SOD， CAT， and GSH， and reduced accumulation of MDA （P<0.05， P<0.01）. Furthermore， these groups showcased down-regulated protein and mRNA levels of Keap1 （P<0.01）， the expression of Nrf2 protein was significantly increased （P<0.01）， the expression level of HO-1 protein was increased （P<0.05，P<0.01）， and increased positive expression of SOD2 （P<0.01）. ConclusionZishen Tiaogan prescription can regulate the serum levels of hormones， down-regulate the expression of Keap1， up-regulate the expression of Nrf2， HO-1， and SOD2， enhance the antioxidant capacity， and reduce the peroxidation damage in the ovarian tissue to improve the ovarian reserve function in the rat model of DOR. High-dose Zishen Tiaogan prescription demonstrated the best effect and the mechanism is associated with the regulation of the Keap1/Nrf2/HO-1 pathway.

ObjectiveTo observe the effect of Zishen Tiaogan prescription on the oxidative stress injury in the rat model of diminished ovarian reserve （DOR） and explore the role of the Kelch-like ECH-associated protein 1 （Keap1）/nuclear factor E₂-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1） signaling pathway. MethodsForty-eight female SD rats were randomly assigned into a normal group （n=12） and a modeling group （n=36）. The rats in the modeling group received subcutaneous injection of galactose （350 mg·kg^-1） combined with immobilization stress daily. After 28 days of modeling， 6 rats in the normal group and 6 rats in the modeling group were sacrificed to examine the modeling results. The successfully modeled rats were assigned into model， estradiol valerate （0.09 mg·kg^-1）， and low-， medium-， and high-dose （6.39， 12.78， 25.56 g·kg^-1， respectively） Zishen Tiaogan prescription groups. The intervention lasted for 4 weeks with 6 animals per group. Hematoxylin-eosin staining was used to observe the estrous cycle and the pathological changes in the ovarian tissue. The ovarian index was calculated. Enzyme-linked immunosorbent assay was employed to measure the serum levels of sex hormones and oxidative stress-related indexes. Western blot and real-time PCR were employed to determine the protein and mRNA levels， respectively， of Nrf2， Keap1 and HO-1 in the ovarian tissue. The positive expression of superoxide dismutase 2 （SOD2） in the ovarian tissue was detected by immunohistochemistry （IHC）. ResultsCompared with the normal group， the model group showed reduced follicles in the ovary， loose arrangement of the follicle granule layer， declined levels of anti-Mullerian hormone （AMH） and estradiol （E₂） in the serum， elevated levels of luteinizing hormone （LH） and follicle-stimulating hormone （FSH） （P<0.01）， lowered levels of superoxide dismutase （SOD）， catalase （CAT）， and glutathione （GSH） （P<0.01）， and increased accumulation of malondialdehyde （MDA） （P<0.01）. In addition， the modeling led to up-regulated protein and mRNA levels of Keap1 （P<0.01）， the expression of Nrf2 and HO-1 protein was significantly decreased （P<0.01）， the mRNA expression of Nrf2 was significantly decreased （P<0.05）， the mRNA expression of HO-1 was significantly decreased （P<0.01）， in the ovarian tissue. Compared with model group， the estradiol valerate and low-， medium-， and high-dose Zishen Tiaogan prescription groups showed increases in the ovarian index （P<0.01） and serum E₂ and AMH levels （P<0.01）， declined levels of FSH and LH （P<0.01）， increased follicles in the ovary， elevated levels of SOD， CAT， and GSH， and reduced accumulation of MDA （P<0.05， P<0.01）. Furthermore， these groups showcased down-regulated protein and mRNA levels of Keap1 （P<0.01）， the expression of Nrf2 protein was significantly increased （P<0.01）， the expression level of HO-1 protein was increased （P<0.05，P<0.01）， and increased positive expression of SOD2 （P<0.01）. ConclusionZishen Tiaogan prescription can regulate the serum levels of hormones， down-regulate the expression of Keap1， up-regulate the expression of Nrf2， HO-1， and SOD2， enhance the antioxidant capacity， and reduce the peroxidation damage in the ovarian tissue to improve the ovarian reserve function in the rat model of DOR. High-dose Zishen Tiaogan prescription demonstrated the best effect and the mechanism is associated with the regulation of the Keap1/Nrf2/HO-1 pathway.

OBJECTIVE To explore the improvement mechanism of proanthocyanidins on acute kidney injury （AKI） induced by gentamicin in rats. METHODS Gentamicin sulfate was injected intraperitoneally to construct the AKI rat model； the model rats were randomly divided into model control group， benazepril hydrochloride 5 mg/kg group （positive control）， proanthocyanidins 50 mg/kg group， proanthocyanidins 100 mg/kg group， and proanthocyanidins 200 mg/kg group， with 10 rats in each group； in addition， 10 normal rats were selected to be treated as the normal control group. The rats in each administration group were given corresponding liquid intragastrically， and the normal control group and model control group were given equal volumes of normal saline intragastrically， once a day， for 28 consecutive days. After the last administration， the levels of serum creatinine （SCr）， blood urea nitrogen （BUN）， malondialdehyde （MDA）， superoxide dismutase （SOD）， glutathione peroxidase （GSH-Px） and 24 h urinary protein （UP） were detected； the renal index was calculated； the pathological changes of renal tissue were observed and the pathological score was calculated； the apoptotic rate of cells in renal tissue and the expression levels of Caspase-3 and Bcl-2 associated X protein （Bax）， as well as the phosphorylation levels of silent information regulator of transcription 1 （SIRT1） and AMP-activated protein kinase （AMPK） were detected. RESULTS Compared with the model control group， the levels of SCr， BUN， UP and MDA， the renal index， the pathological score of renal tissue， the apoptotic rate of cells in renal tissue， the protein expression levels of Caspase-3 and Bax in renal tissue of rats in each administration group were decreased significantly； SOD and GSH-Px levels， phosphorylation levels of SIRT1 and AMPK protein were increased significantly （P＜0.05）， and the effect of proanthocyanidins was in a dose-dependent manner （P＜0.05）. There were no significant differences in the above indexes between proanthocyanidins 200 mg/kg group and benazepril hydrochloride 5 mg/kg group （P＞0.05）. CONCLUSIONS The improvement effect of proanthocyanidins on AKI rats may be related to the activation of SIRT1/AMPK signaling pathway to inhibit oxidative stress.

Objective To compare the effects of dapagliflozin and sitagliptin combined with metformin on glucose and lipid metabolism and inflammatory reaction in obese type 2 diabetes patients.Methods A total of 120 obese type 2 diabetes patients treated in Danzhou People's Hospital from January 2019 to January 2022 were divided into observation group(dapagliflozin+metformin)and control group(sitagliptin+metformin).The indexes of glucose and lipid metabolism and serum inflammatory factors were recorded before and after treatment.The curative effect was compared between the two groups.Results The curative effect of the observation group was significantly higher than that of the control group(96.67%vs.83.33%,P<0.05).There were no significant differences in the indexes of glucose and lipid metabolism or the levels of serum inflammatory factors between the two groups before treatment(all P>0.05).Fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPBG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),interleukin-6(IL-6),tumor necrosis factor α(TNF-α)and C-reactive protein(CRP)were significantly decreased after treatment in both groups,and high-density lipoprotein cholesterol(HDL-C)was significantly increased(all P<0.05).The observation group had lower levels of FBG,2 hPBG,HbA1c,TC,TG,LDL-C,IL-6,TNF-α and CRP and higher level of HDL-C than control group after treatment(all P<0.05).Conclusion Both dapagliflozin and sitagliptin combined with metformin are effective for the treatment of obese type 2 diabetes.But the combined use of dapagliflozin and metformin is more effective;it can effectively improve the glucose and lipid metabolism and reduce the level of inflammatory factors,making it worthy of clinical promotion.

Long-term care is a long-term guarantee mechanism to meet the care needs of the old adults and ensure the quality of life. Among them, the professionalism and stability of the care team is a key factor to ensure the development of long-term care work. This paper analyzes the possible reasons for slow development of time bank with volunteers as the main body in the process of localization, and constructs a new model of diversified caring bank from the construction of care team, so as to promote the high-quality and sustainable development of long-term care in China.

Objective:To investigate whether the cyclosporin A (CsA) can improve the blastocyst implantation with mild impaired of trophoblast cells of mice.Methods:1) Totally 30 ICR mice were intraperitoneally injected with 5 mg/kg CsA, then the blood concentrations of CsA in mice were detected at 1 h, 3 h, 4 h, 6 h, 8 h, 10 h, 13 h, 14 h, 16 h and 20 h after administration using chemiluminescence method. 2) A total of 36 mice were randomly divided into control group and experimental group (CsA group); the experimental group was intraperitoneally injected with 5 mg/kg CsA and control group was injected with the equivalent dose olive oil of the same body weight. Embryos were classified into A, B, C types according to the guidelines of Gardner and experimental needs. Embryos were transferred to the uterus in the two groups. The embryo implantation rate was calculated and the leukemia inhibitory factor (LIF) mRNA level was measured by real time fluorescence quantitative PCR in 5.5 d postcoitum (dpc).Results:1) The blood concentration of CsA in mice reached a peak at 6-10 h after administration. 2) The embryo implantation rate of B type [73.9% (34/46)] had significantly improved in experimental group [50.0% (23/46), P=0.018]. 3) The expression of LIF mRNA level was not significantly different between the two groups ( P>0.05). Conclusion:When CsA was administered at a dose of 5 mg/kg, CsA can improve the embryo implantation rate with mild impaired trophoblast cells. CsA might become a potential drug to increase the success rates of the in vitro fertilization.

Objective:To investigate whether the cyclosporin A (CsA) can improve the blastocyst implantation with mild impaired of trophoblast cells of mice.Methods:1) Totally 30 ICR mice were intraperitoneally injected with 5 mg/kg CsA, then the blood concentrations of CsA in mice were detected at 1 h, 3 h, 4 h, 6 h, 8 h, 10 h, 13 h, 14 h, 16 h and 20 h after administration using chemiluminescence method. 2) A total of 36 mice were randomly divided into control group and experimental group (CsA group); the experimental group was intraperitoneally injected with 5 mg/kg CsA and control group was injected with the equivalent dose olive oil of the same body weight. Embryos were classified into A, B, C types according to the guidelines of Gardner and experimental needs. Embryos were transferred to the uterus in the two groups. The embryo implantation rate was calculated and the leukemia inhibitory factor (LIF) mRNA level was measured by real time fluorescence quantitative PCR in 5.5 d postcoitum (dpc).Results:1) The blood concentration of CsA in mice reached a peak at 6-10 h after administration. 2) The embryo implantation rate of B type [73.9% (34/46)] had significantly improved in experimental group [50.0% (23/46), P=0.018]. 3) The expression of LIF mRNA level was not significantly different between the two groups ( P>0.05). Conclusion:When CsA was administered at a dose of 5 mg/kg, CsA can improve the embryo implantation rate with mild impaired trophoblast cells. CsA might become a potential drug to increase the success rates of the in vitro fertilization.

Androgen insensitivity syndrome (AIS) is a recessive single gene disease of X chromosome, which is rare clinically and has a very low incidence in newborn boys. This is mainly due to the abnormal pathway in which androgens play a role, resulting in sexual differentiation disorder in patients. A pair of identical twins were admitted to our hospital, and a new pathogenic mutation site of the androgen receptor gene was found, resulting in an androgen insensitivity phenotype.

Objective To understand the genetic variations of neuraminidase (NA) genes of avian influenza virus H9N2 in Weining,Guizhou Province,and to provide the scientific evidence for the prevention and control of avian influenza virus.Methods Ribonucleic acids (RNA) were extracted and NA genes were amplified and sequenced from 13 randomly selected H9N2 positive samples from the live poultry market (LPM)environments in north of Weining Yi and Hui and Miao autonomous county (Weining),Guizhou Province during 2015 to 2017.Then the homology,genetic evolution,and sites of stalk deletion areas,potential N-glycosylation,receptor binding regions and drug resistance of H9N2 subtype avian influenza viruses were analyzed by a series of bioinformation software.Results Homology analysis revealed that there were 93.0％-100.0％ and 92.1％-100.0％ similarity among 13 strains H9N2 avian influenza viruses in nucleotide and amino acid of the NA gene,respectively.All strains belonged to DK/HK/Y280/97 sub-lineage,but their genetic sources were complex and diverse.Thirteen strains had a stalk deletion of 3 amino acid residues TEI at positions 63-65 and 3 isolates had mutation QN to QK at positions 39-40.The potential N-glycosylation sites at amino acid residues 86,146,200,and 234 of the NA protein of all strains were highly conserved,while other N-glycosylation sites had quantity and site mutations.There were different mutation types at the three sialic acid binding site areas,especially at 399-404 area.All NA protease activity sites and key sites of the 13 strains had no mutations associated with resistance to the neuraminidase inhibitor drugs.Conclusions All 13 strains H9N2 viruses belongs to DK/HK/Y280/97 sub-lineage in Weining,Guizhou Province during 2015-2017,and their genetic sources are complex and diverse.The mutations on sites of stalk areas,potential N-glycosylation and sialic acid binding site areas are presented at different degrees.Hence,enhancing surveillance and controlling H9N2 avian influenza virus is necessary.

Objective: To investigate the molecular characteristics and tracing of the hemagglutinin (HA) gene, and to analyze the risk of human infection with influenza virus A (H7N9) in Guizhou Province, so that to provide evidence for the prevention and control of highly pathogenic avian influenza A (H7N9). Methods: Nucleic acids of 5 strains of H7N9 including 1 sample of the patient′s nasopharyngeal swab and 4 samples of the live poultry market (LPM) environment were extracted and HA genes were amplified and sequenced. Then the homology, genetic evolution and the pivotal sites related to receptor binding regions, pathogenicity and potential glycosylation of the avian influenza A (H7N9) viruses were analyzed by a series of bioinformatics softwares. Results: Homology analysis revealed that the homologies of nucleotide and amino-acid of the HA gene of H7N9 strains from the patient and LPM in Weining County, Guizhou Province were 99.8% and 99.6%, respectively, while those of 4 strains from LPM were both 100%. The homologies of nucleotide and amino-acid of the HA gene of H7N9 strains were the highest with the strain of A/Guangxi/5/2017 isolated from a Guangxi infected patient (99.7%-99.9% and 99.4%-99.8%, respectively), while those with the strain isolated from LPMs environment at the end of 2016 (A/Environment/Guangdong/C16283222/2016) were 99.0%-99.2% and 98.9%-99.2%, respectively. However, the homologies of nucleotide and amino-acid of the HA gene of H7N9 strains with A/Shanghai/2/2013 recommended by world health organization and the candidate vaccine strain A/Anhui/1/2013 were 96.8%-97.0% and 95.8%-96.2%, respectively. Phylogenetic analysis showed that the 5 strains had the nearest genetic distance to the strain A/Guangxi/5/2017. All the 5 strains cleavage site sequences of HA protein showed mutation of PEVPKRKRTAR↓GLF, and they were highly pathogenic avian influenza viruses mutant strains, which all had mutation of G186V at the receptor binding sites of HA gene, while no Q226L mutation was found. All 5 strains had new mutation of A363S, and new mutations of R56K and I297V were only found in the strain isolated from the patient. Among the five potential glycosylation motifs in the HA, only 421NWT and 493NNT had variation of the position post shift. Conclusions All the 5 H7N9 strains isolated in Weining County, Guizhou Province are highly pathogenic avian influenza mutative viruses. The current candidate vaccine may not provide a very good protection. The mutations of cleavage site of HA protein, G186V as well as other new mutation sites of HA may enhance the susceptibility and pathogenicity to human beings.