en Radiation Biology Radiation Biology تحقيق بديع Original Research <div style="text-align: justify;"><span style="font-size:10pt"><span style="text-justify:newspaper"><span style="text-kashida-space:50%"><span style="line-height:119%"><span style="font-family:Calibri"><span style="color:black"><span lang="en-US" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-US">Background:</span></span></span></span></span></span> <span lang="en-GB" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:black"><span style="language:en-GB">The Diminished ovarian reserve (DOR) is often linked with oxidative stress (OS) and aggravated by chemotherapy and radiation. The Keap1-Nrf2-ARE pathway regulates antioxidant defense. This study evaluated whether warming needle moxibustion alleviates OS and radiation-induced ovarian injury in DOR rats. </span></span></span></span><span lang="en-GB" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-GB">Materials and Methods: </span></span></span></span></span></span><span lang="en-GB" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:black"><span style="language:en-GB">Thirty-six female Sprague-Dawley rats were assigned to control, model, treatment, and sham groups. DOR was induced with cyclophosphamide, busulfan, and localized pelvic radiation. The treatment group received warming needle moxibustion at Guanyuan (CV4) and Sanyinjiao (SP6) for 4 weeks. Estrous cycle, oxidative stress biomarkers (SOD, GSH-Px, MDA), sex hormones (FSH, LH, E2, AMH), and Keap1-Nrf2-ARE proteins were assessed. </span></span></span></span><span lang="en-GB" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-GB">Results: </span></span></span></span></span></span><span lang="en-GB" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:black"><span style="language:en-GB">Compared with model rats, treatment significantly improved estrous cycle regularity, increased SOD and GSH-Px, reduced MDA, normalized FSH and LH, and elevated E2 and AMH (all P < 0.05). Western blot showed decreased Keap1 and increased Nrf2, HO-1, and GCLC, confirming pathway activation. </span></span></span></span><span lang="en-GB" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:#1f497d"><span style="font-style:italic"><span style="font-weight:bold"><span style="language:en-GB">Conclusion: </span></span></span></span></span></span><span lang="en-GB" style="font-size:9.0pt"><span style="font-family:Calibri"><span style="color:black"><span style="language:en-GB">Warming needle moxibustion attenuated oxidative and radiation-induced ovarian damage in DOR rats through Keap1-Nrf2-ARE modulation. These results support its potential as a fertility-preserving, non-pharmacological therapy for patients undergoing chemo-radiotherapy.</span></span></span></span></span></span></span></span></span></span></div> Warming needle moxibustion, diminished ovarian reserve, oxidative stress, radiation injury, Keap1-Nrf2-ARE pathway, fertility preservation. 435 439 http://ijrr.com/browse.php?a_code=A-10-1-1514&slc_lang=en&sid=1 H. Ma 7900319475328460033536 7900319475328460033536 No Department of Rehabilitation, Beidahuang Group General Hospital, Harbin 150088, Heilongjiang Province, China C-y. Wu wcymjs123@163.com 7900319475328460033537 7900319475328460033537 Yes Department of Nephrology, Beidahuang Group General Hospital, Harbin 150088, Heilongjiang Province, China