Objective:To investigate the effect of p38MAPK signaling pathway mediating progesterone regulation on IL-8 protein secretion by decidual stromal cells(DSCs)on early spontaneous miscarriage.Methods:IHC and Western blot were applied to detect protein expressions of p38MAPK and p-p38MAPK in decidual tissues of miscarriage group and control group.Human DSCs in early pregnancy were isolated in vitro and cultured to be treated with different concentrations of progesterone(0.01 μmol/L,0.1 μmol/L,1 μmol/L and 10 μmol/L),with ELISA measuring IL-8 protein secretion from DSCs and Western blot measuring protein expressions of p38MAPK and p-p38MAPK in DSCs.After treatment with p38MAPK inhibitor SB203580,IL-8 protein secretion was detected by ELISA in progesterone+inhibitor group,progesterone group and control group.Results:Protein expression of p-p38MAPK in decidual tissues of miscarriage group was significantly higher than that of control group(P=0.002 3).Protein secretion of IL-8 in DSCs of 0.01 μmol/L progesterone group was lower than that of control group(P=0.027 6),protein expression of p-p38MAPK in DSCs of 0.1 μmol/L proges-terone group was lower than that of control group(P=0.025 3),IL-8 protein expression was significantly lower than that in control group(P=0.007 0),and protein expressions of both IL-8 and p-p38MAPK from DSCs in 1 μmol/L and 10 μmol/L progesterone groups were significantly lower than those in control group(P=0.003 2,P=0.001 9;P=0.002 2,P=0.001 3).IL-8 protein secretion in proges-terone+p38MAPK inhibitor group was further reduced compared to progesterone group(P=0.046 6).Conclusion:Abnormal activation of p38MAPK signaling pathway is involved in early spontaneous miscarriage,and progesterone may down-regulate IL-8 expression in DSCs by inhibiting p38MAPK phosphorylation to correct early spontaneous miscarriage caused by Th1/Th2 cytokine imbalance.

Occult hepatitis B virus (HBV) infection (OBI) refers to the presence of replicable viral DNA in the liver of individuals with negative hepatitis B surface antigen (HBsAg), while HBV DNA can be detectable or undetectable in the serum, which is a special form of HBV DNA infection. In OBI carriers, the negative HBsAg in blood and the extremely low or fluctuating content of HBV DNA make it difficult in clinical detection. There is a risk for developing into occult cirrhosis and liver cancer, and it increases the potential danger of hepatitis B virus transmission during blood transfusion, hemodialysis and organ transplantation. Therefore, deep study of the pathogenic mechanism of OBI and searching for specific and sensitive detection markers are crucial for more timely and standardized diagnosis, treatment and prevention. This paper reviews the current situation of occult hepatitis B virus infection and the development of laboratory detection techniques in recent years, and discusses more efficient laboratory diagnostic techniques and markers based on its potential pathogenic mechanism.

Objective To explore the integration value of mobile virtual reality devices in the classroom teaching of human anatomy,and to evaluate their potential impact on the in-depth construction of human anatomy knowledge,the cultivation of spatial cognitive ability,and the transformation of teaching paradigms from the perspectives of cognitive load theory and situated learning.Methods The undergraduate students majoring in clinical medicine in Peking University were selected as the research objects.Among them,students in grade 2019 were the control group,and students in grade 2022 were the experimental group,introducing movable virtual anatomy equipment and other teaching auxiliary method in theory and practice courses.The final exam scores of the two groups of students were compared,and a questionnaire survey was conducted for the experimental group after the course,and the survey result were statistically analyzed.Results The final examination result showed that the average score of the experimental group was 82.47±10.19,and the average score of the control group was 74.82±16.56,which was significantly higher in the experimental group than in the control group,with statistical significance(P＜0.05).The questionnaire survey result showed that compared with traditional classroom teaching,94.62％of students preferred the new auxiliary teaching mode such as VR,96.77％of students believed that VR assisted teaching could achieve the traditional teaching effect or better,95.7％of them think that it improved students' interest in learning human anatomy,and 98.92％thought that it improved students' knowledge of anatomy.Conclusion The application of mobile virtual reality devices in anatomy classroom teaching provides immersive and interactive 3D visualization teaching scenarios,effectively reducing students' cognitive load on abstract and complex anatomical structures,promoting spatial understanding and knowledge internalization,significantly improving teaching effectiveness and self-learning ability,thus changing the traditional anatomy teaching mode and laying a solid foundation for the development of future medical education and the cultivation of medical talents.

Objective To explore how to organically integrate the human anatomy curriculum with medical imaging,thereby enhancing medical students' spatial understanding and 3D reconstruction skills,and strengthening their anatomical foundation and clinical competence.This approach aims to bridge the gap between basic science and clinical practice while cultivating clinical thinking abilities.Methods In this study,the medical imaging knowledge was introduced into the anatomy curriculum in Peking University,enabling students to better understand the human body structure and its relationship to the clinical practice with aid of the ultrasound and MRI method.After the course concluded,we evaluated the examination result and learning satisfaction data from the anatomy course.Results The result showed that students provided positive feedback,showing increased interest in learning,enhanced initiative,significant improvement in their anatomy grades(P＜0.01),and a notable enhancement in their ability to apply basic knowledge to solve clinical problems(P＜0.05).Conclusion The integrated teaching approach of medical imaging and human anatomy courses provides innovative ideas and practical method for medical students to learn the basic medical course and enhance their clinical skills in the future.

Objective:To investigate the effect of p38MAPK signaling pathway mediating progesterone regulation on IL-8 protein secretion by decidual stromal cells(DSCs)on early spontaneous miscarriage.Methods:IHC and Western blot were applied to detect protein expressions of p38MAPK and p-p38MAPK in decidual tissues of miscarriage group and control group.Human DSCs in early pregnancy were isolated in vitro and cultured to be treated with different concentrations of progesterone(0.01 μmol/L,0.1 μmol/L,1 μmol/L and 10 μmol/L),with ELISA measuring IL-8 protein secretion from DSCs and Western blot measuring protein expressions of p38MAPK and p-p38MAPK in DSCs.After treatment with p38MAPK inhibitor SB203580,IL-8 protein secretion was detected by ELISA in progesterone+inhibitor group,progesterone group and control group.Results:Protein expression of p-p38MAPK in decidual tissues of miscarriage group was significantly higher than that of control group(P=0.002 3).Protein secretion of IL-8 in DSCs of 0.01 μmol/L progesterone group was lower than that of control group(P=0.027 6),protein expression of p-p38MAPK in DSCs of 0.1 μmol/L proges-terone group was lower than that of control group(P=0.025 3),IL-8 protein expression was significantly lower than that in control group(P=0.007 0),and protein expressions of both IL-8 and p-p38MAPK from DSCs in 1 μmol/L and 10 μmol/L progesterone groups were significantly lower than those in control group(P=0.003 2,P=0.001 9;P=0.002 2,P=0.001 3).IL-8 protein secretion in proges-terone+p38MAPK inhibitor group was further reduced compared to progesterone group(P=0.046 6).Conclusion:Abnormal activation of p38MAPK signaling pathway is involved in early spontaneous miscarriage,and progesterone may down-regulate IL-8 expression in DSCs by inhibiting p38MAPK phosphorylation to correct early spontaneous miscarriage caused by Th1/Th2 cytokine imbalance.

The treatment landscape for metastatic renal cell carcinoma(mRCC)has evolved rapidly over the past two decades with the introduction of targeted therapies and novel immune checkpoint inhibitors.Among these developments,cytoreductive nephrectomy(CN)remains a controversial and unresolved issue,with its survival benefits being questioned compared to systemic therapy(ST).The role and optimal timing of CN in the context of modern systemic treatment for mRCC remain unclear.Additionally,there is still no well-defined consensus on patient selection for CN.Therefore,this article provides a concise review of current evidence regarding CN in mRCC,incor-porating the latest renal cancer management guidelines.We focus particularly on optimal surgical timing,candidate patient selection,and the therapeutic value of metastasectomy.Furthermore,we examine the current role of CN in metastatic non-clear cell renal cell carcinoma and explore its evolving clinical applications and future prospects in mRCC treatment.

OBJECTIVE To compare the effect on umbilical care of the neonates between the natural dying method and the traditional ethanol disinfection method so as to provide a better method of umbilical nursing for the neo-nates.METHODS A total of 212 healthy neonates who were given birth in the First Medical Center of Chinese PLA General Hospital from Aug.2024 to Nov.2024 were recruited as the research subjects and were randomly divided into the natural drying method with 103 cases and the traditional ethanol disinfection method with 109 cases ac-cording to the method of umbilical care.The time of umbilical cord separation,rate of umbilical bleeding and inci-dence of umbilical secretions were observed and compared between the two groups of neonates.RESULTS There were 16 neonates with the healing time of umbilical cord separation no more than 7 days under the treatment of natural drying method,with 5 cases more than the neonates under the treatment of traditional ethanol disinfection method.The average healing time of umbilical cord separation was 11.69 days under the natural drying method,1.43 days shorter than 13.12 days under the traditional ethanol disinfection method,and there was significant difference(P＜0.05).The rate of umbilical bleeding was 5.82％under the natural drying method,a reduction of 0.60％as compared with 6.42％under the traditional ethanol disinfection method;the incidence of umbilical se-cretions was 0.97％under the national drying method,a reduction of 1.78％as compared with 2.75％under the traditional ethanol disinfection method,but there were no significant differences.CONCLUSIONS As compared with the traditional ethanol disinfection method,the natural drying method can shorten the time of umbilical cord separation,reduce the risk of umbilical infection,and reduce the stress from the neonatal nursing.It is worthy to be promoted.

OBJECTIVE To compare the effect on umbilical care of the neonates between the natural dying method and the traditional ethanol disinfection method so as to provide a better method of umbilical nursing for the neo-nates.METHODS A total of 212 healthy neonates who were given birth in the First Medical Center of Chinese PLA General Hospital from Aug.2024 to Nov.2024 were recruited as the research subjects and were randomly divided into the natural drying method with 103 cases and the traditional ethanol disinfection method with 109 cases ac-cording to the method of umbilical care.The time of umbilical cord separation,rate of umbilical bleeding and inci-dence of umbilical secretions were observed and compared between the two groups of neonates.RESULTS There were 16 neonates with the healing time of umbilical cord separation no more than 7 days under the treatment of natural drying method,with 5 cases more than the neonates under the treatment of traditional ethanol disinfection method.The average healing time of umbilical cord separation was 11.69 days under the natural drying method,1.43 days shorter than 13.12 days under the traditional ethanol disinfection method,and there was significant difference(P＜0.05).The rate of umbilical bleeding was 5.82％under the natural drying method,a reduction of 0.60％as compared with 6.42％under the traditional ethanol disinfection method;the incidence of umbilical se-cretions was 0.97％under the national drying method,a reduction of 1.78％as compared with 2.75％under the traditional ethanol disinfection method,but there were no significant differences.CONCLUSIONS As compared with the traditional ethanol disinfection method,the natural drying method can shorten the time of umbilical cord separation,reduce the risk of umbilical infection,and reduce the stress from the neonatal nursing.It is worthy to be promoted.

The treatment landscape for metastatic renal cell carcinoma(mRCC)has evolved rapidly over the past two decades with the introduction of targeted therapies and novel immune checkpoint inhibitors.Among these developments,cytoreductive nephrectomy(CN)remains a controversial and unresolved issue,with its survival benefits being questioned compared to systemic therapy(ST).The role and optimal timing of CN in the context of modern systemic treatment for mRCC remain unclear.Additionally,there is still no well-defined consensus on patient selection for CN.Therefore,this article provides a concise review of current evidence regarding CN in mRCC,incor-porating the latest renal cancer management guidelines.We focus particularly on optimal surgical timing,candidate patient selection,and the therapeutic value of metastasectomy.Furthermore,we examine the current role of CN in metastatic non-clear cell renal cell carcinoma and explore its evolving clinical applications and future prospects in mRCC treatment.

Occult hepatitis B virus (HBV) infection (OBI) refers to the presence of replicable viral DNA in the liver of individuals with negative hepatitis B surface antigen (HBsAg), while HBV DNA can be detectable or undetectable in the serum, which is a special form of HBV DNA infection. In OBI carriers, the negative HBsAg in blood and the extremely low or fluctuating content of HBV DNA make it difficult in clinical detection. There is a risk for developing into occult cirrhosis and liver cancer, and it increases the potential danger of hepatitis B virus transmission during blood transfusion, hemodialysis and organ transplantation. Therefore, deep study of the pathogenic mechanism of OBI and searching for specific and sensitive detection markers are crucial for more timely and standardized diagnosis, treatment and prevention. This paper reviews the current situation of occult hepatitis B virus infection and the development of laboratory detection techniques in recent years, and discusses more efficient laboratory diagnostic techniques and markers based on its potential pathogenic mechanism.