BACKGROUND:As a common complication of diabetes mellitus,male reproductive disorders have received increasing attention in recent years.Ganoderma spore have hypoglycemic,antioxidant and anti-inflammatory effects,but the regulatory mechanism for diabetic testicular tissue has not been fully elucidated. OBJECTIVE:To investigate the effect of ganoderma spore on the PTEN-induced kinase 1/E3 ubiquitin ligase pathway and cell apoptosis in testicular tissue of diabetic rats. METHODS:Forty male Sprague-Dawley rats were randomly divided into normal group,high fat and high sugar group,diabetic group and ganoderma spore group,with 10 rats in each group.The latter three groups were given high fat/high sugar diet until the end of the experiment.After 1 month of high fat/high sugar diet,the diabetic and ganoderma spore groups were given intraperitoneal injection of streptozotocin(30 mg/kg per day)to establish type 2 diabetic rat models.After successful modeling,the ganoderma spore group was intragastrically given ganoderma spore(300 mg/kg per day),and the other groups were given the same amount of normal saline for continuous 12 weeks.The sperm number and morphology were detected.The histopathological changes of the testicle were observed.Serum testosterone and oxidative stress levels in testicular tissue were measured.The levels of PTEN-induced kinase 1,E3 ubiquitin ligase,and anti-nucleoporin p62 were analyzed by immunohistochemistry and the expression of PTEN-induced kinase 1,E3 ubiquitin ligase,anti-nucleoporin p62,programmed cell death-1,microtubule-associated protein light chain 3 Ⅱ/Ⅰ,caspase 3,cleaved-caspase 3 were detected by western blot assay. RESULTS AND CONCLUSION:Compared with the normal group and the high fat and high sugar group,the diabetic group had decreased sperm number(P＜0.01),increased sperm malformation rate(P＜0.01),and decreased serum testosterone level(P＜0.01).Compared with the diabetic group,ganoderma spore intervention could increase the sperm number(P＜0.05),decrease the malformation rate(P＜0.01),and increase the serum testosterone level(P＜0.01).Compared with the normal group and the high fat and high sugar group,the malondialdehyde level in testis tissue was increased in the diabetic group(P＜0.01),while the levels of glutathione deoxidase and superoxide dismutase decreased(P＜0.01).Compared with the diabetic group,the malondialdehyde level in testis tissue was decreased in the ganoderma spore group(P＜0.01),and the levels of glutathione deoxidase and superoxide dismutase increased(P＜0.01).Immunohistochemical staining showed that compared with the normal group and the high fat and high sugar group,the positive expressions of PTEN-induced kinase 1 and E3 ubiquitin ligase in testicular tissue were decreased in the diabetic group,while the positive expressions of anti-nucleoporin p62 were increased.Compared with the diabetic group,the positive expressions of PTEN-induced kinase 1 and E3 ubiquitin ligase in testicular tissue e were increased in the ganoderma spore group,while the positive expression of anti-nucleoporin p62 was decreased.Western blot assay results indicated that compared to the normal group and the high fat and high sugar group,the expression of PTEN-induced kinase 1 and E3 ubiquitin ligase,programmed cell death-1 and the ratio of microtubule-associated protein light chain 3 Ⅱ/Ⅰ protein were decreased in the diabetic group(P＜0.05 or P＜0.01),while the expressions of anti-nucleoporin p62,caspase3 and cleaved-caspase3 were increased(P＜0.01).Compared with the diabetic group,ganoderma spore intervention could elevate the expression of PTEN-induced kinase 1 and E3 ubiquitin ligase,programmed cell death-1 and the ratio of microtubule-associated protein light chain 3 Ⅱ/Ⅰ protein(P＜0.05 or P＜0.01)as well as reduce the expressions of anti-nucleoporin p62,caspase3 and cleaved-caspase3(P＜0.05 or P＜0.01).Overall,ganoderma spores may activate the PTEN-induced kinase 1/E3 ubiquitin ligase pathway to enhance autophagy in testicular tissue and reduce apoptosis in tissue cells,so as to protect testicular tissue.

ObjectiveTo investigate the effects of Jiaohong pills （JHP） and its prescription， Pericarpium Zanthoxyli （PZ） and Rehmanniae Radix （RR） cognitive dysfunction in scopolamine-induced Alzheimer's disease （AD） mice and its mechanism through pharmacodynamic and metabolomics study. MethodThe animal model of AD induced by scopolamine was established and treated with PZ， RG and JHP， respectively. The effects of JHP and its formulations were investigated by open field test， water maze test， object recognition test， avoidance test， cholinergic system and oxidative stress related biochemical test. Untargeted metabolomics analysis of cerebral cortex was performed by ultra-performance liquid chromatography-Quadrupole/Orbitrap high resolution mass spectrometry （UPLC Q-Exactive Orbitrap MS）. ResultThe behavioral data showed that， compared with the model group， the discrimination indexes of the high dose of JHP， PZ and RR groups was significantly increased （P<0.05）. The staging rate of Morris water maze test in the PZ， RR， high and low dose groups of JHP was significantly increased （P<0.05， P<0.01）， the crossing numbers in the PZ， JHP high and low dose groups were significantly increased （P<0.05， P<0.01）； the number of errors in the avoidance test were significantly reduced in the PZ and high-dose JHP groups （P<0.01）， and the error latencies were significantly increased in the JHP and its prescription drug groups （P<0.01）. Compared with the model group， the activities of acetylcholinesterase in the cerebral cortex of the two doses of JHP group and the PZ group were significantly increased （P<0.05， P<0.01）， and the activity of acetylcholinesterase in the high-dose JHP group was significantly decreased （P<0.05）， and the level of acetylcholine was significantly increased （P<0.01）. At the same time， the contents of malondialdehyde in the serum of the two dose groups of JHP decreased significantly （P<0.05， P<0.01）. The results of metabolomics study of cerebral cortex showed that 149 differential metabolites were identified between the JHP group and the model group， which were involved in neurotransmitter metabolism， energy metabolism， oxidative stress and amino acid metabolism. ConclusionJHP and its prescription can antagonize scopolamine-induced cognitive dysfunction， regulate cholinergic system， and reduce oxidative stress damage. The mechanism of its therapeutic effect on AD is related to the regulation of neurotransmitter， energy， amino acid metabolism， and improvement of oxidative stress.

Objective:To explore the effects of participatory interactive teaching in the clinical internship course of pediatric infectious diseases.Methods:217 undergraduate students of grade 2018 majoring in pediatrics were selected as the experimental group, and 208 undergraduate students of grade 2017 majoring in pediatrics were selected as the control group. The experimental group used the teaching method of BOPPPS combined with case-based learning and team-based learning, while the control group adopted the traditional teaching method. Evaluate the learning effectiveness by comparing the formative evaluation and theoretical exam scores of the two groups , and a questionnaire survey was conducted for the students in the experimental group to investigate teaching feedback. SPSS 19.0 was used to perform the t test for data analysis. Results:The experimental group had significantly better scores than the control group in final theoretical examination [(75.04±9.12) vs. (71.03±9.51), P<0.05] and formative evaluation [(81.03±6.13) vs. (70.02±10.32), P<0.05]. According to the results of the questionnaire survey on teaching satisfaction, the students were satisfied with the interactive participatory teaching method in the four aspects of improving learning interest, improving learning ability, classroom satisfaction level, and course acceptance level. Conclusions:The pragmatic teaching reform in the internship of pediatric infectious diseases is highly accepted by students and beneficial to improving students' clinical thinking ability and comprehensive quality, which is worth further application and promotion.

OBJECTIVE To explore the mechanism of Baihe Dihuang decoction in the treatment of Alzheimer's disease(AD) based on network pharmacology, molecular docking and animal experiment. METHODS TCMSP were used to predict the active components and targets of Baihe Dihuang decoction and disease-related targets were collected from GeneCards, OMIM and DRUGBANK databases, respectively. Target protein interactions were analyzed with STRING database and biological function and pathway were analyzed with Metascape database. Lastly relevant results were analyzed with Cytoscape 3.8.0. AutoDock vina software was used for molecular docking to analyze the binding energy of the active components and key targets of Baihe Dihuang decoction. PyMOL software were used to visualize the optimal docking results. ICR male mice were randomly divided into control group, model group, Rolipram group, low, medium and high dose group of Baihe Dihuang decoction. After 14 days of administration, the neurobehavioral scores of mice in each group were collected, and the expression of related proteins in brain tissue was detected, ELISA and Western blotting were used to detect the expression of the key protein cAMP, PKA, p-CREB and BDNF. At last, the adverse reaction of Baihe Dihuang decoction was observed by vomiting experiment. RESULTS A total of 13 active components and 39 key targets were collected from network pharmacology. The docking results showed that the first 10 core targets all performed well and their effects were closely related to PRKACA. Compared with the control group, the model group mice's recognition rate of new objects and the spontaneous alternation reaction rate were significantly reduced, the escape latency was significantly prolonged, and the target quadrant stay time, the number of crossing platforms were significantly reduced; cAMP, PKA, p-CREB and BDNF in the hippocampus of mice was significantly decreased. Baihe Dihuang decoction could reverse the behavior of AD mice and the expression of cAMP, PKA, p-CREB and BDNF. In the vomiting experiment, the anesthesia recovery time of the Rolipram group was significantly prolonged, while that of the Baihe Dihuang decoction group was not significantly affected. CONCLUSION The mechanism of Baihe Dihuang decoction in the treatment of AD may be related to its influence on cAMP-PKA and regulation of cAMP-PKA-CREB-BDNF signal pathway, and the adverse reactions are milder than those of clopramide.

Objective To better mobilize the work motivation of the majority of medical staff and to explore the optimization strategy of the remuneration distribution mechanism in public hospitals.Methods A semi-structured interview was conducted on employees of a large public hospital in Henan Province using purposive sampling method in March 2024.Sort out,code,and integrate interview data based on grounded theory.Results Based on 40 interview materials,44 initial concepts,14 basic categories,6 main categories,and 3 core categories were summarized.A model of pay distribution mechanism in public hospitals based on pay distribution principle,pay distribution structure and pay management system was constructed.Conclusion It is recommended that hospitals ensure the fairness and competitiveness of salary distribution,implement diversified salary policies,and continuously improve the salary distribution structure and supervision and management system.

Objective To better mobilize the work motivation of the majority of medical staff and to explore the optimization strategy of the remuneration distribution mechanism in public hospitals.Methods A semi-structured interview was conducted on employees of a large public hospital in Henan Province using purposive sampling method in March 2024.Sort out,code,and integrate interview data based on grounded theory.Results Based on 40 interview materials,44 initial concepts,14 basic categories,6 main categories,and 3 core categories were summarized.A model of pay distribution mechanism in public hospitals based on pay distribution principle,pay distribution structure and pay management system was constructed.Conclusion It is recommended that hospitals ensure the fairness and competitiveness of salary distribution,implement diversified salary policies,and continuously improve the salary distribution structure and supervision and management system.

Objective To better mobilize the work motivation of the majority of medical staff and to explore the optimization strategy of the remuneration distribution mechanism in public hospitals.Methods A semi-structured interview was conducted on employees of a large public hospital in Henan Province using purposive sampling method in March 2024.Sort out,code,and integrate interview data based on grounded theory.Results Based on 40 interview materials,44 initial concepts,14 basic categories,6 main categories,and 3 core categories were summarized.A model of pay distribution mechanism in public hospitals based on pay distribution principle,pay distribution structure and pay management system was constructed.Conclusion It is recommended that hospitals ensure the fairness and competitiveness of salary distribution,implement diversified salary policies,and continuously improve the salary distribution structure and supervision and management system.

Objective To better mobilize the work motivation of the majority of medical staff and to explore the optimization strategy of the remuneration distribution mechanism in public hospitals.Methods A semi-structured interview was conducted on employees of a large public hospital in Henan Province using purposive sampling method in March 2024.Sort out,code,and integrate interview data based on grounded theory.Results Based on 40 interview materials,44 initial concepts,14 basic categories,6 main categories,and 3 core categories were summarized.A model of pay distribution mechanism in public hospitals based on pay distribution principle,pay distribution structure and pay management system was constructed.Conclusion It is recommended that hospitals ensure the fairness and competitiveness of salary distribution,implement diversified salary policies,and continuously improve the salary distribution structure and supervision and management system.

Objective To better mobilize the work motivation of the majority of medical staff and to explore the optimization strategy of the remuneration distribution mechanism in public hospitals.Methods A semi-structured interview was conducted on employees of a large public hospital in Henan Province using purposive sampling method in March 2024.Sort out,code,and integrate interview data based on grounded theory.Results Based on 40 interview materials,44 initial concepts,14 basic categories,6 main categories,and 3 core categories were summarized.A model of pay distribution mechanism in public hospitals based on pay distribution principle,pay distribution structure and pay management system was constructed.Conclusion It is recommended that hospitals ensure the fairness and competitiveness of salary distribution,implement diversified salary policies,and continuously improve the salary distribution structure and supervision and management system.

Objective To better mobilize the work motivation of the majority of medical staff and to explore the optimization strategy of the remuneration distribution mechanism in public hospitals.Methods A semi-structured interview was conducted on employees of a large public hospital in Henan Province using purposive sampling method in March 2024.Sort out,code,and integrate interview data based on grounded theory.Results Based on 40 interview materials,44 initial concepts,14 basic categories,6 main categories,and 3 core categories were summarized.A model of pay distribution mechanism in public hospitals based on pay distribution principle,pay distribution structure and pay management system was constructed.Conclusion It is recommended that hospitals ensure the fairness and competitiveness of salary distribution,implement diversified salary policies,and continuously improve the salary distribution structure and supervision and management system.