Objective To investigate the inhibitory effect of erianin on T cell proliferation and its underlying mechanism.Methods Peripheral blood mononuclear cells(PBMCs)were isolated using density gradient centrifugation,and T cells were purified by magnetic-activated cell sorting(MACS)with immunomagnetic beads,followed by being activated with anti-human CD3 antibodies and anti-human CD28 antibodies.The activated T cells were labeled with carboxyfluorescein succinimidyl ester(CFSE),and the effects of erianin(0.05～0.20 μmol/L)on the proliferation,apoptosis,expression of activation marker cluster of differentiation 25(CD25),cell cycle distribution of activated T cells,as well as the survival rate of resting T cells were assessed using flow cytometry.Enzyme-linked immunosorbent assay(ELISA)was applied to determine the secretion levels of IL-2 and IL-17 in the culture supernatant of erianin-treated activated T cells.Western blotting was employed to examine the impact of erianin on the protein expression of cell division cycle protein 2(CDC2),phosphorylated CDC2(p-CDC2),and Cyclin B1.The differences were observed between the erianin-treated group and the positive control group(activation with CD3/CD28 antibodies).Results CFSE proliferation assay demonstrated that the proliferative rate of activated T cells was in a concentration-dependent decline after 0.05～0.20 μmol/L erianin treatment(P<0.0001),with a half-maximal inhibitory concentration(IC50)of 0.09±0.10 μmol/L.No significant differences were observed in apoptotic rates or survival rates among the erianin-treated groups(activated and resting T cells)and the positive control cells.Analysis of T cell activation markers revealed that erianin had no impact on CD25 expression or IL-2 secretion.However,ELISA results indicated erianin exerted a significant suppression on the secretion of pro-inflammatory cytokine IL-17(P<0.0001).Cell cycle analysis showed that erianin arrested activated T cells at the G2/M phase(P<0.05).Further mechanistic investigations demonstrated that while erianin did not alter CDC2 phosphorylation or total CDC2 expression,but it markedly down-regulated CyclinB1 expression(P<0.01).Conclusion Erianin exhibits potent immunomodulatory activity by suppressing activated T cell proliferation through down-regulating Cyclin B1.

The establishment of standardized statistical analysis strategies is of great significance to ensuring scientific value and promoting high-quality development in pharmacoepidemiology research.Based on the Guide on Methodological Standards in Pharmacoepidemiology(2nd edition),this article interprets the statistical analysis content within it section of the Guidelines.The first part outlines the importance and specific content of statistical analysis strategies in pharmacoepidemiology studies,introduces the variable definitions and sample size estimation and elaborates on data preprocessing and statistical methods.It also briefly discusses bias control and sensitivity analysis.The second part focuses on considerations for developing statistical analysis strategies,with further clarification on subgroup analysis,interim analysis,and the preparation of the statistical analysis reports.

The establishment of standardized statistical analysis strategies is of great significance to ensuring scientific value and promoting high-quality development in pharmacoepidemiology research.Based on the Guide on Methodological Standards in Pharmacoepidemiology(2nd edition),this article interprets the statistical analysis content within it section of the Guidelines.The first part outlines the importance and specific content of statistical analysis strategies in pharmacoepidemiology studies,introduces the variable definitions and sample size estimation and elaborates on data preprocessing and statistical methods.It also briefly discusses bias control and sensitivity analysis.The second part focuses on considerations for developing statistical analysis strategies,with further clarification on subgroup analysis,interim analysis,and the preparation of the statistical analysis reports.

Teaching clinics represent a unique form of outpatient training of resident physicians and serve as a crucial instrument and core component of standardized training of general practice residents. This article reviews the common model and innovations of teaching clinics of general practice in China, and analyzes their reported effectiveness in enhancing the capabilities of consultation of resident physicians, the teaching capabilities of general practice trainers, as well as satisfaction levels of involved participants. It outlines the challenges encountered in implementing teaching clinics, including inadequate teaching facilities and equipment, incomplete incentive system for teaching, difficulties in patient recruitment, and weaknesses in the teaching capabilities of trainers. To address these challenges, this article proposes corresponding strategies based on realistic needs, including the improvement of facilities and equipment in teaching clinics, the establishment of incentive systems for teaching clinics, the expansion of patient recruitment channels for teaching clinics, and the enhancement of training for trainers' teaching capabilities. This is envisaged to provide both theoretical bases and practical guidance for the effective execution and standardized development of teaching clinics in general practice residency training bases.

Objective:To investigate whether hsa_circ_0054595(circRTN4)is involved in glomerulosclerosis of lupus nephri-tis(LN)by regulating monocyte-derived TNF-α.Methods:RT-qPCR and immunofluorescence were used to detect the expression of TNF-α in monocytes of LN patients,and fluorescence in situ hybridization(FISH)was used to detect the expression of circRTN4.THP1 cells were transfected with circRTN4-siRNA and negative control NC-siRNA,respectively.RT-qPCR and Western blot were used to detect the expression of TNF-α in THP1cell,and ELISA was used to detect the expression of TNF-α in THP1 culture superna-tant.THP1 cells were transfected with mircoRNA mimics,and the expression of TNF-α was detected by Western blot.The direct bind-ing of miR-486-3p to TNF-α and circRTN4 were verified by reversion experiment and dual luciferase reporter gene experiment.MRL/lpr mice were injected with circRTN4 recombinant adeno-associated virus via tail vein,and the expression of circRTN4 in peripheral blood mononuclear cells of the mice was detected by RT-qPCR.ELISA was used to detect the expression of serum TNF-α.HE staining and PAS staining were used to observe the pathological changes,and immunofluorescence was used to detect the expression of FN.Results:The expressions of TNF-α and circRTN4 were increased in monocytes of LN patients(P<0.05).The expression of TNF-α in THP1 was significantly increased in the LN group(P<0.01).Knockdown of circRTN4 inhibited the expression and secretion of TNF-α(P<0.05),and this effect was achieved by binding to miR-486-3p(P<0.01).In vivo,knockdown of circRTN4 in peripheral blood monocytes of MRL/lpr mice reduced the expression of TNF-α in serum(P<0.05),and improved glomerular cell proliferation and FN deposition.Conclusion:Highly expressed circRTN4 in monocytes promotes the expression of TNF-α by binding to miR-486-3p,and participates in the occurrence and development of glomerulosclerosis in LN.

OBJECTIVE To retrospectively summarize the CT and enhanced MRI imaging characteristics of common unilateral benign nasal and sinus lesions and to outline key points for differentiation from malignant lesions.METHODS A total of 134 cases of unilateral benign nasal and sinus lesions were included in this study,with preoperative sinus CT and enhanced MRI examinations performed.The imaging characteristics of CT and MRI,the extent of the lesions,and the involvement and destruction of surrounding bone and structures were recorded and summarized for each type of lesion.RESULTS Unilateral lesions on CT appeared as generally homogeneous soft tissue density shadows.The affected sinus bones showed internal calcification,localized bone hyperplasia of the sinus wall,extensive uniform centripetal bone hyperplasia and thickening of the sinus wall,expansive destruction of the sinus wall bone,and worm-eaten destruction of the sinus wall bone in 33,13,29,9,and 5 cases,respectively.On MRI T1WI,the lesions appeared as generally homogeneous isointense shadows.Enhanced T1 images showed mild,moderate,and significant enhancement in 3,10,and 108 cases,respectively,with 55 cases presenting as mixed signals.CONCLUSION The imaging manifestations of unilateral benign lesions vary.CT can clearly present high-density shadows such as calcifications within unilateral lesions and changes in surrounding bone.Enhanced MRI of the sinuses provides richer information about the different components within the lesions.Careful differentiation of unilateral lesions should be performed by combining the imaging characteristics of sinus CT and enhanced MRI.

Objective:To evaluate the clinical effect of the position pillows for neuraxial anesthesia.Methods:This was a prospective randomized controlled trial. Four hundred and twelve patients regardless of gender, aged ≥18 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, who underwent elective surgery under neuraxial anesthesia at Peking University Third Hospital from February to October 2023, were selected and divided into 2 groups ( n=206 each) using a random number table method: pillow group (P group) and control group (C group). Group C underwent the conventional procedure for neuraxial anesthesia. The patients were placed in a position using the position pillow on the basis of oral education before routine anesthesia in group P. The success rate of puncture at first attempt, puncture time and position placement time were recorded. The adjustment of position, body movement and occurrence of discomfort during the puncture were also recorded. The visual analogue scale score was used to evaluate the level of anxiety before positioning, after positioning and after anesthesia. The visual analogue scale score was used to evaluate the patient′s comfort and the operator′s satisfaction with position after the anesthesia was completed. Results:Compared with group C, the time for positioning was significantly shortened, the anxiety level was decreased after positioning and after anesthesia, the rate of improvement in anxiety was increased, the scores for the patient′s comfort and the operator′s satisfaction with position were increased ( P<0.05), and no significant changes were found in the success rate of puncture at first attempt, puncture time and incidence of body movement during the puncture and incidence of the adjustment of position ( P>0.05). No discomfort was observed in either group during the puncture. Conclusions:This new type of position pillows for the neuraxial anesthesia can not only optimize the effect of position placement, but also improve the patients′ comfort.

Pregnancy with solid pseudopapillary tumor of the pancreas (SPTP) is rare. Because pregnancy hormones may cause tumor progression, the management and treatment of SPTP need to balance the safety of pregnant women and fetuses with surgical treatment. We reported a case of a giant pancreatic tumor diagnosed during pregnancy that was considered to be SPTP. Examinations also showed hepatitis B virus infection and severe decompensation of liver cirrhosis. Medical termination of pregnancy was performed. The patient has lived with the tumor until now without surgery. We retrieved the published case reports, summarized the clinical characteristics of pregnancy with SPTP, and explored its management during the perinatal period. Most patients with SPTP have a good prognosis with good maternal and fetal outcomes, and it is important to choose an appropriate treatment method and timing. However, pregnancy combined with decompensated liver cirrhosis needs to be terminated in a timely manner because of its high-risk status.

Pregnancy with solid pseudopapillary tumor of the pancreas (SPTP) is rare. Because pregnancy hormones may cause tumor progression, the management and treatment of SPTP need to balance the safety of pregnant women and fetuses with surgical treatment. We reported a case of a giant pancreatic tumor diagnosed during pregnancy that was considered to be SPTP. Examinations also showed hepatitis B virus infection and severe decompensation of liver cirrhosis. Medical termination of pregnancy was performed. The patient has lived with the tumor until now without surgery. We retrieved the published case reports, summarized the clinical characteristics of pregnancy with SPTP, and explored its management during the perinatal period. Most patients with SPTP have a good prognosis with good maternal and fetal outcomes, and it is important to choose an appropriate treatment method and timing. However, pregnancy combined with decompensated liver cirrhosis needs to be terminated in a timely manner because of its high-risk status.

Objective:To evaluate the development of hypothermia after spinal anesthesia and risk factors.Methods:Patients undergoing spinal anesthesia in the anesthesia preparation room of our hospital from April 2020 to April 2021 were included. The temperature of the tympanic membrane was measured before spinal anesthesia and immediately after anesthesia and at 5, 10 and 15 min after anesthesia. Patients with tympanic membrane temperature<36 ℃ at any time point were considered as having hypothermia and included in hypothermia group and patients with membrane temperature ≥ 36 ℃ were considered as having no hypothermia and included in non-hypothermia group. The patients′ demographic data, highest anesthesia plane, puncture space of spinal anesthesia, types of anesthetics, preoperative fasting time, and surgical sites were recorded. The multivariate logistic regression analysis was performed to identify the risk factors for hypothermia.Results:A total of 196 patients were finally enrolled. The body temperature was significantly decreased at 5 and 10 min after anesthesia compared with the baseline body temperature before anesthesia and immediately after anesthesia ( P<0.001), and the incidence of hypothermia was 10.2%. The multivariate logistic regression analysis showed that female and high anesthesia plane were independent risk factors for hypothermia, and higher baseline body temperature was an independent protective factor for hypothermia ( P<0.05). Conclusions:Body temperature decreases at 5-10 min after spinal anesthesia, and the occurrence of hypothermia is not a small probability event in the patients undergoing spinal anesthesia; female and higher anesthesia plane are risk factors and higher baseline body temperature is the protective factor.