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目的本研究旨在改进生殖男科领域现有的精液处理方法，特别是针对双层密度梯度法中的300 ×g 20 min处理条件，以提高受精结局。方法收集2020年7月和9月以及2022年3月和5月在中山大学附属第六医院生殖医学中心进行辅助生殖助孕的1 623例患者的精液标本进行实验。预实验中，比较四种不同的双层密度梯度方法（200 ×g 10 min、200 ×g 20 min、300 ×g 10 min和300 ×g 20 min）处理后标本的精子DNA碎片率和回收率。然后，筛选出一种最优的方法作为新方法，并与目前在用的旧方法（300 ×g 20 min双层梯度法）进行对比，检验受精率是否有统计学差异。在新方法的基础上，进一步优化为单层密度梯度法，并与双层密度梯度法进行对比，检验是否存在统计学差异。实验过程中严格控制温度、离心速度和离心时间，同时记录每组样本的数量和处理条件。结果在保证足够的精子回收率的基础上，发现四种双层密度梯度法中300 ×g 10 min的精子DNA碎片率低于300 ×g 20 min。因此，选择300 ×g 10 min作为新方法进行试验。结果表明，新方法300 ×g 10 min的总受精率、二核体（2pn）受精率均高于300 ×g 20 min，且差异有统计学意义（Pg 10 min的卵裂率也略高于300 ×g 20 min，但差异没有统计学意义（P>0.05）。单层密度梯度法的总受精率、2pn受精率均高于双层密度梯度法，但差异没有统计学意义（P>0.05）；单层密度梯度法的卵裂率高于双层密度梯度法，囊胚形成率低于双层密度梯度法，且差异均有统计学意义（Pg 20 min双层梯度法，300 ×g 10 min双层梯度法成功提高了总受精率、2pn受精率、卵裂率，缩短了精液优化处理的时间；而单层密度梯度法虽提高了卵裂率、节约了试剂成本和操作时间，但其囊胚形成率却出现了下降的情况。这些发现为生殖男科领域的精液处理方法提供了有益的指导和启示。

This paper summarized the nursing management for a patient with intertrochanteric fracture combined with pressure injuries in the left buttocks. Effective treatment plan was made based on the nursing evaluation of stage of pressure injuries. Wound dressing material and dressing change methods were carefully considered according to the different phases of wound healing. Targeted nursing interventions were carried out to improve the wound healing of the patient with pressure injuries. (本文总结1例股骨粗隆间骨折合并左臀部压力性损伤的护理经验。正确评估压力性损伤的等级, 给予有效的治疗措施, 并根据患者创面的变化, 选取适合的换药方式, 应用正确的创面敷料, 有针对性地进行护理干预, 有助于促进压力性损伤的愈合。)

目的比较单精子冷冻和常规冷冻对显微取精患者的胚胎培养及妊娠影响。方法回顾性分析自2018年1月至2021年12月于中山大学附属第六医院生殖医学研究中心行显微镜取精术患者的临床资料，行单精子冷冻共39例307枚成熟卵子为单精子冷冻组，通过SPSS统计软件倾向性评分匹配女方基本助孕信息1：1匹配选择对照组，为常规冷冻组，共410枚成熟卵子，分析单精子冷冻与常规冷冻两组的受精、胚胎培养及移植后妊娠情况。结果单精子冷冻组和常规冷冻组的年龄、体质量指数（BMI）、不孕年限、基础基础卵泡刺激素（FSH）、基础黄体生成素（LH）、基础雌二醇（E2）、抗苗勒管激素（AMH）、窦卵泡计数（AFC）、获卵数、移植胚胎数等一般资料的比较，差异均差异无统计学意义（P>0.05）；两组的受精率、可利用胚胎率、优质胚胎率比较分别为65.8% vs. 60.49%、67.82% vs. 58.87%、70.80% vs. 75.34%，差异均无统计学意义；两组的临床妊娠率为45.45% vs. 70.0%，有统计学差异（P=0.049）。结论显微取精患者若获取精子极少，为增加每颗精子利用机会以及保证后续助孕精子解冻后获取精子，单精子冷冻可为有效选择，但临床妊娠率下降，因例数限制，对后续妊娠的影响还需增加例数再观察分析。

At present, the model of Internet Plus continuity of care ensures that patients receive continuous and effective care interventions in the family and community, thereby improving their quality of life and accelerating the recovery process. This paper analyzed and summarized the application of continuity of care based o Internet Plus model in patients after total hip arthroplasty, in order to provide reference for healthcare professionals to provide multifaceted care for patients after surgery. (人工髋关节置换术后患者出院后的居家康复管理是加快术后康复的关键。“互联网+延续性护理”模式可确保患者在家庭和社区中得到持续有效的护理干预, 从而提高其生活质量, 加速康复进程。本文就“互联网+延续性护理”模式在髋关节置换术后患者中的应用进行分析和总结, 旨在为髋关节置换术后患者的康复治疗提供参考。)

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目的探索人卵泡液中神经营养因子4（NT-4）及卵丘颗粒细胞中TrkB受体的表达与卵子发育潜能的关系。方法收集2020年5月至2020年11月在中山大学附属第六医院生殖中心，因男方因素行卵胞浆内单精子注射（ICSI）治疗的63例患者的卵泡液和卵丘颗粒细胞，用ELISA检测卵泡液中NT-4水平，实时荧光定量PCR检测卵丘颗粒细胞中TrkB受体两种不同亚型TrkB-fl和TrkB-t1的表达水平，分析与卵子成熟、受精和胚胎发育的关系。结果卵泡液中NT-4水平与正常受精数（rs=0.250， P=0.048）、可利用胚胎数（rs=0.320， P=0.011）、优质胚胎数（rs=0.327， P=0.009）和优质囊胚数（rs=0.303， P=0.029）呈正相关。卵丘颗粒细胞中TrkB-t1在高囊胚形成率组（≥60%）和高优质囊胚率组（≥50%）中的表达均较低［0.86 （0.60， 1.85） vs. 2.29 （1.09， 3.44） ， P=0.008； 0.84（0.64， 1.45） vs. 1.73 （0.96， 3.14） ， P=0.031］。多重线性回归分析结果示优质胚胎数受获卵数（P=0.001）、卵泡液中NT-4水平（P=0.005）和卵丘颗粒细胞TrkB-t1表达水平（P=0.049）影响。结论人卵泡液中NT-4水平与ICSI患者卵子发育潜能正相关，其可能在卵子发育过程中发挥着重要作用。卵丘颗粒细胞中TrkB-t1的高表达与卵子发育潜能受损有关。

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An expert opinion fusion method is proposed to address the problem of the inability of D-S (Dempster-Shafer) evidence theory to effectively assemble high-conflict expert opinions on the emergency decision-making results of hydraulic engineering. This method introduces improvements to D-S evidence theory by incorporating Lance distance and information entropy. Initially, the improved intuitionistic fuzzy entropy was utilized to calculate attribute weights, considering the fuzziness of decision-making information. This process resulted in Mass functions for each expert regarding the proposed solutions. Subsequently, the credibility of the evaluation evidence was determined using Lance distance to measure the conflict and discrepancy between any two experts. Information entropy was employed to describe the randomness in expert decision-making, thus obtaining the uncertainty of the evaluation evidence. These aspects were discounted to obtain the expert's comprehensive weight, ensuring accuracy and reasonableness in the revised weight. Finally, the D-S evidence combination rule was applied to compute the Mass functions of experts' revised opinions on the solutions, ultimately providing the final decision outcome. The effectiveness of the model was verified through case analysis and method comparison. The results demonstrate that the proposed method can effectively assemble highly conflicting expert opinions. In comparison with other methods, the fusion results are more accurate, and the considerations regarding the problem are more scientific and effective. This method can serve as a basis for emergency decision-making in hydraulic engineering. [ABSTRACT FROM AUTHOR]

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Effects of substituting chemical nitrogen fertilizer with organic nitrogen fertilizer on greenhouse spinach yield, quality, soil fertility and rhizosphere bacterial community were studied. The experiment adopted an equal nitrogen design with six treatments, i. e., 0 (CF), 20% (OM20), 40% (OM40), 60% (OM60), 80% (OM80), and 100% (OM100) of chemical nitrogen being replaced respectively. The results showed that 20% of chemical nitrogen replacement with organic fertilizer was most conducive to improving the yield and quality of spinach, with fresh and dry weight, vitamin C, and soluble sugar significantly higher than that of CF. In all treatments, adding organic fertilizer could significantly increase the soil pH, organic matter, nitrogen, available phosphorus, and available potassium content, and significantly reduce the bulk density. When the proportion of organic nitrogen fertilizers was 20%-80%, the content of alkaline nitrogen was significantly lower than CF. Applying organic fertilizer could significantly increase the α diversity of soil bacteria and reduce β diversity. Spinach organic acid content and soil alkaline nitrogen content significantly contributed to β diversity, which was 12. 80% and -4. 71% respectively. Application of organic fertilizer can improve the relative abundance of beneficial bacteria such as aerobic and stress tolerant, but it might also increase the relative abundance of potential pathogenic bacteria. In summary, the replacement of chemical nitrogen fertilizer with organic nitrogen fertilizers can improve the quality of spinach and improve soil fertility and resistance. [ABSTRACT FROM AUTHOR]

Ischemic stroke is a common acute cerebrovascular disease in clinical practice, which poses a severe threat to human health. In recent years, with deepening understanding of ischemic stroke, significant progress has been made in the diagnosis and treatment. However, current treatments for ischemic stroke are partially limited due to extremely complex pathological mechanisms. Studies have shown that mitochondrial dysfunction plays an important role in the pathogenesis of ischemic stroke. Therefore, modulation of mitochondrial function through mitochondrial dynamics is essential to ameliorate the damage of cerebral ischemic neuronal cells. In this article, the molecular mechanism of mitochondrial dynamics and its role in ischemic stroke were reviewed, aiming to provide useful reference for the treatment of ischemic stroke. [ABSTRACT FROM AUTHOR]

Fe3O4 Nanospheres with good dispersibility were synthesized by hydrothermal method, and mesoporous silica (MSN) was coated on their outer layer. Chitosan (CS) and hyaluronic acid (HA) were further modified to form highly dispersed nanospheres Fe3O4@SiO2@MSN@CS@HA. The structure, morphology, particle size, and dispersibility of several nanospheres were characterized by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The outer layer content, specific surface area, and pore size were measured using a thermogravimetric analyzer (TGA) and a specific surface area analyzer (BET). The performance of the Fenton reaction was measured using a UV visible spectroscopy analyzer and its reaction rate was calculated. The results indicate that nanospheres have good dispersibility and drug loading ability, and the divalent iron ions(Fe2+) they contain can further realize the potential of chemodynamic therapy (CDT) for tumors. [ABSTRACT FROM AUTHOR]

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目的探讨体外受精（IVF）周期获卵≤3枚胚胎移植策略。方法回顾性分析2017年1月至2019年4月于中山大学附属第六医院生殖医学研究中心行IVF/ICSI助孕患者共1 600个周期，分为3组：1组：新鲜周期D3移植（615例），2组：复苏周期D3移植（525例），3组：复苏周期囊胚移植（460例），收集3组患者助孕资料，多因素回归分析比较3组间的生化妊娠、临床妊娠及活产情况。结果3组患者年龄、基础FSH、AMH无明显差别，t检验结果均P>0.05，即两组数据总体一般资料无差异。1组与2组相比，1组有更高的生化妊娠率、临床妊娠率及活产率（38.2% vs. 29.3%，34.5% vs. 25.9%，18.2% vs. 11.2%）,差异有统计学意义。若患者因各种原因取消移植，复苏周期的囊胚移植（3组），生化妊娠率、临床妊娠率及活产率明显高于2组（36.7% vs. 29.3%，33.4% vs. 25.9%，13.7% vs. 11.2%）, 差异有统计学意义。通过多因素回归分析，在控制了年龄、AMH、胚胎移植等级等潜在混杂因素后，1组的活产率仍显著高于2组[OR=1.906 (1.272-2.857)，P=0.002]，3组的活产率仍显著高于2组[OR=3.388 (1.876-6.118)，P=0.000]。结论IVF周期中，若患者获卵≤3枚，争取新鲜周期D3移植；若取消移植，全胚冷冻建议囊胚冷冻。

BACKGROUND: Skeletal muscle insulin resistance is the key pathological link of type 2 diabetes. Static exercise can effectively improve skeletal muscle insulin resistance, but the mechanism remains unclear. OBJECTIVE: To explore the mechanism of static exercise on insulin resistance in the skeletal muscle of type 2 diabetic mice based on the phosphatidyl inositol 3-kinase (PI3K)/protein kinase B (AKT)/glucose transporter (GLUT4) signaling pathway. METHODS: After 1 week of adaptive feeding, 7 out of 40 C57BL/6 mice were randomly selected as blank group and fed common diet, while the other mice were fed high-fat diet and taken to prepare type 2 diabetes models through the low-dose streptozotocin intraperitoneal injection. Twenty-four mice were successfully modeled and they were randomly divided into model group (n=8), metformin group (n=8) and static exercise group (n=8), which continued to be fed high-fat diet. The metformin group was given 200 mg/kg metformin dissolved in normal saline (2 ml/kg) by gavage, once a day, for 6 weeks. The static exercise group was given normal saline daily by gavage and carried out static exercise, 30 minutes a day, 6 days per week. The model group was given the same dose of normal saline daily by gavage without exercise intervention. After the intervention, the fasting blood glucose of each group was detected, the intraperitoneal glucose tolerance test was performed, and the area under the glycemic curve was calculated. Glycosylated hemoglobin, serum insulin, insulin resistance index were detected by ELISA. Total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein were detected using biochemical methods. The mRNA expression levels of PI3K, AKT and GLUT4 in the gastrocnemius of mice were detected by real-time quantitative PCR. Morphological changes of the gastrocnemius were observed by hematoxylin-eosin staining, and the cross-sectional area of muscle fibers was calculated. RESULTS AND CONCLUSION: Compared with the blank group, fasting blood glucose, glycosylated hemoglobin, area under the glycemic curve, insulin resistance index, total cholesterol, triglyceride and low-density lipoprotein levels were significantly increased in the model group (P < 0.01, P < 0.05). Whereas, these indicators were significantly lower in the static exercise and metformin group than the model group (P < 0.01, P < 0.05). Compared with the blank group, serum insulin and high-density lipoprotein levels were significantly declined in the model group (P < 0.01) and the mRNA expression of PI3K, AKT and GLUT4 in the gastrocnemius of mice were also significantly reduced (P < 0.01). These indicators were significantly elevated in the metformin group and static exercise group compared with the blank group (P < 0.01). Compared with the blank group, the muscle fibers in the model group were disordered, and the muscle cells atrophied and the muscle fiber gap widened. The cross-sectional area of muscle fibers was significantly decreased in the model group compared with the blank group (P < 0.01). Compared with the model group, atrophy of the gastrocnemius fibers and muscle fiber space were improved in the static exercise group and the metformin group, and the cross-sectional area of muscle fiber was significantly increased in both groups (P < 0.01). These findings indicate that static resistance training may promote glucose uptake and utilization by up-regulating the expression of PI3K, AKT and GLUT4 mRNA in skeletal muscle tissue, thereby improving the morphology and function of skeletal muscle tissue, alleviating insulin resistance and regulating glucose homeostasis. [ABSTRACT FROM AUTHOR]

[Objective]To clarify the improvement effect of polyacrylamide (PAM) on sandy gravel beach in coastal difficult sites. [Method] Rhizophora stylosa was used as the research material to explore the effects of different PAM application rates (0. 25%, 0. 50%, 0. 75%, 1. 00%, 1. 25%, respectively recorded as P1, P2, P3, P4, P5 ) mixed with silt and compound biological inoculants on plant growth and soil nutrients through tidal-simulation test. [Result]Compared with CK treatment, in different PAM application rates treatments, the tree heights and number of leaves increased to 18. 75%-48. 82% and 5. 0%-55. 0%, respectively;the ground diameters significantly increased to 43. 16% -71. 43%;the roots and stems biomass increased to 16. 41%-87. 26% and 14. 91%-72. 75%, respectively;the leaves biomass significantly increased to 64. 36%-156. 93%, and the root-shoot ratio significantly decreased to 15. 62%-26. 98%. The application of PAM had a greater impact on soil organic matter, the total and available nutrients of soil phosphorus and potassium, and the soil organic matter, total phosphorus and total potassium significantly increased to 623. 47%-794. 78%, 114. 49%-142. 03% and 145. 90%-167. 24%, respectively;the available phosphorus and available potassium significantly increased to 146. 55%-268. 12%, 24. 69%-61. 74%, respectively. [Conclusion]The mixed application of PAM with silt and compound biological inoculants can promote the growth of Rhizophora stylosa seedlings and improve soil nutrients. It can be used as soil conditioner for sandy gravel beach in coastal difficult sites and the recommended application rate of PAM is 0. 75%. [ABSTRACT FROM AUTHOR]

Household electric vehicle charging in residential areas has a strong centrality. Large-scale electric vehicle charging load causes large peak valley load difference and other problems in the distribution network system. This study proposes a user charging selection control strategy based on Multi Objective Particle Swarm Optimization (MPSO) algorithm. Through the analysis and prediction of electric vehicle charging load, a multi-objective optimization model is established with the minimum variance of the total system load and scheduling cost as the objective function. Meanwhile, considering the constraints of electric vehicle battery and system power, the MPSO algorithm is used to solve the optimal initial charging time of electric vehicles. The simulation results show that compared with unordered charging of EVs in residential areas, the EV charging strategy proposed in this study can effectively reduce load peak and dispatch cost. [ABSTRACT FROM AUTHOR]

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