This paper summarizes Professor WANG Xiuxia's clinical experience in treating hyperprolactinemia using the liver soothing therapy. Professor WANG identifies liver qi stagnation and rebellious chong qi （冲气） as the core pathomechanisms of hyperprolactinemia. Furthermore， liver qi stagnation may transform into fire or lead to pathological changes such as spleen deficiency with phlegm obstruction or kidney deficiency with essence depletion. The treatment strategy centers on soothing the liver， with a modified version of Qinggan Jieyu Decoction （清肝解郁汤） as the base formula. Depending on different syndrome patterns such as liver stagnation transforming into fire， liver stagnation with spleen deficiency， or liver stagnation with kidney deficiency， heat clearing， spleen strengthening， or kidney tonifying herbs are added accordingly. In addition， three paired herb combinations are commonly used for symptom specific treatment， Danggui （Angelica sinensis） with Chuanxiong （Ligusticum chuanxiong）， Zelan （Lycopus lucidus） with Yimucao （Leonurus japonicus） ， and Jiegeng （Platycodon grandiflorus） with Zisu （Perilla frutescens）.

BACKGROUND:LncRNA-TNFRSF13C,an important factor in B cell development and function,is expressed in periodontal tissues of patients with periodontitis,but the specific mechanism is still unclear. OBJECTIVE:To investigate the mechanism of lncRNA-TNFRSF13C regulating miR-1246 on hypoxia-inducible factor 1α in periodontal cells. METHODS:Human periodontal ligament cells(hPDLCs)were treated with lipopolysaccharide and divided into group A(hPDLCs cell lines without transfection),group B(hPDLCs cell lines transfected with TNFRSF13C NC-siRNA),group C(hPDLCs cell lines transfected with TNFRSF13C-siRNA),group D(hPDLCs cell line transfected with miR-1246 mimics),group E(hPDLCs cell line transfected with miR-1246 siRNA),group F(hPDLCs cell line transfected with TNFRSF13C-siRNA+miR-1246 mimics),and group G(hPDLCs cell line transfected with TNFRSF13C-siRNA+miR-1246 siRNA).The relative expression of lncRNA-TNFRSF13C and miR-1246 in each group was detected by qRT-PCR.Cell counting kit-8 assay was used to detect cell viability.Apoptosis was detected by flow cytometry.Expression of hypoxia-inducible factor 1α and vascular endothelial growth factor proteins was detected by western blot.The correlation between lncRNA-TNFRSF13C and miR-1246 was analyzed by Pearson,and the targeting relationship was analyzed by dual-luciferase reporter assay. RESULTS AND CONCLUSION:There was no significant difference in human periodontal ligament cell activity,apoptosis rate and protein indexes between groups A and B(P>0.05).Compared with group B,hPDLCS cell activity in group C was increased,and apoptosis rate and the expression of hypoxia-inducible factor 1α and vascular endothelial growth factor proteins were decreased(P<0.05).Compared with group C,hPDLCS cell activity in group D was decreased,and apoptosis rate and the expression of hypoxia-inducible factor 1α and vascular endothelial growth factor proteins were increased(P<0.05).Compared with group D,the cell activity of group E was increased(P<0.05).The cell activity in group F was lower than that in group E,and the apoptosis rate was reduced in both groups E and F(P<0.05).Compared with group F,the cell activity of group G was increased,and the apoptosis rate and the expression of hypoxia-inducible factor 1α and vascular endothelial growth factor were decreased(P<0.05).LncRNA-TNFRSF13C was positively correlated with miR-1246(P<0.05).Compared with the TNFRSF13C-siRNA group,the fluorescence activity of miR-1246-wt in the TNFRSF13C-NC group was reduced(P>0.05);compared with the miR-1246-NC group,the fluorescence activities of hypoxia-inducible factor 1α-wt and vascular endothelial growth factor-wt in the miR-1246 mimics group were increased(P<0.05).To conclude,down-regulation of lncRNA-TNFRSF13C can promote the activity of periodontal cells treated with lipopolysaccharide,reduce apoptosis,and inhibit hypoxia-inducible factor 1α and vascular endothelial growth factor.The mechanism is related to the regulation of miR-1246 activity.

This study analyzed the practical experience of the World Health Organization,the European Union,the United States,and Japan,to reveal the characteristics of health emergency drills in terms of institutional construction,technological integration,and international collaboration.The health emergency drills present three major development trends:paradigm shift driven by social demand,efficiency improvement empowered by intelligent technology,and deepening international cooperation under the global governance framework.In response to the construction needs of China's public health emergency system,policy recommendations were proposed to establish a hierarchical classification system,a full-cycle training strategy for major infectious diseases,a dual wheel drive mechanism by both techniques and qualified personnel,and a path for global governance participation.

Surgical complications,as a key focus and challenge in hospital quality management,serve as important indicators for medical quality monitoring and hospital performance evaluation.From the perspective of hospital performance evaluation,it reviews relevant indicators related to surgical complications in domestic and international hospital performance evaluation systems.lt analyzes the definition and assessment methods of surgical complications,the calculation and evaluation methods of surgical complication incidence rates,and the association between surgical complications and medical insurance payments.The aim is to provide reference guidelines for further improving China's monitoring and evaluation system for surgical complications,thereby enhancing the accuracy,scientific rigor,and fairness of performance evaluations

Objective To explore the effectiveness of"near peer learning"(NPL)in the electromyo-graphy(EMG)teaching module for neurology residents.Methods The Department of Neurology,Peking Union Medical College Hospital implemented an NPL instructional design for a course on EMG for residents from November 2020 to March 2024.This teaching session was held annually,in which senior residents in-structed juniors who were 1 or 2 years earlier in their training.The residents participated in the pre-course/post-course tests and completed a feedback survey at the end of the session.This evaluation method was used to un-derstand the effectiveness of the NPL intervention in EMG teaching.Results Over four years,a total of 83 residents participated.Among them,there were 24 postdoctoral students,52 postgraduates and 7 junior resi-dents.The results showed that the post-course test scores were significantly improved compared with pre-course test scores(74.33±2.43 vs.70.11±2.49,P=0.005),with the most remarkable improvements seen for"tu-tees"(73.84±20.53 vs.70.29±21.46,P=0.020),postgraduates(74.04±22.51 vs.68.97±21.40,P=0.009),first-year residents(70.19±4.02 vs.63.59±3.59,P=0.040)and first-time participating resi-dents(65.23±3.24 vs.60.97±3.21,P=0.030).The post-program feedback showed that both tutors and tu-tees thought highly of NPL,believing that it enabled them to gain knowledge and helped them to improve teaching skills.Conclusions The NPL intervention is suitable for the teaching of EMG,because of its contri-bution to knowledge acquisition and basic clinical skills improvement.The NPL is worth replicating in other teaching and learning programs.

Surgical complications,as a key focus and challenge in hospital quality management,serve as important indicators for medical quality monitoring and hospital performance evaluation.From the perspective of hospital performance evaluation,it reviews relevant indicators related to surgical complications in domestic and international hospital performance evaluation systems.lt analyzes the definition and assessment methods of surgical complications,the calculation and evaluation methods of surgical complication incidence rates,and the association between surgical complications and medical insurance payments.The aim is to provide reference guidelines for further improving China's monitoring and evaluation system for surgical complications,thereby enhancing the accuracy,scientific rigor,and fairness of performance evaluations

To improve the understanding of the special imaging features of pulmonary cryptococcosis in immunocompetent individuals and reduce misdiagnosis and missed diagnosis through the analysis of rare clinical cases and literature review. We reported a case of normal immunocompetent pulmonary cryptococcosis with pulmonary hypertension and COVID-19 weak positive nucleic acid during convalescence, CT scan of the lungs revealed rare features similar to pulmonary interstitial changes. Literature was reviewed to further discuss pulmonary cryptococcosis's clinical symptoms, imaging manifestations, diagnosis, and treatment outcome. The patient with severe aortic stenosis needed to be treated by surgery as soon as possible. Secondary pulmonary infection, subacute onset, and clinical manifestations were nonspecific, and empirical anti-infection treatment at the beginning of the disease was not effective. The timely revision of the examination confirmed that the predominant causative agent was Cryptococcus neoformans, and prompt administration of antifungal treatment facilitated surgical intervention and yielded favorable therapeutic outcomes. Literature review revealed that it is rare for pulmonary cryptococcosis in immunocompetent patients to present with pulmonary interstitial changes on CT findings.Pulmonary cryptococcosis presents with non-specific clinical symptoms and diverse imaging features, making it prone to mixed infection and requiring high vigilance. In this case, the immunocompetent patient's pulmonary CT findings exhibited changes resembling those in immunodeficient patients with pulmonary cryptococcosis. The underlying pathogenic mechanism needs to be further explored.

Objective Use of silencing information regulatory factor 1(SIRT1)/high mobility group protein B1(HMGB1)/nuclear transcription factor-KB(NF-κB)to investigate the inhibitory effect and mechanism of Salvia miltiorrhiza Bunge gynostemma pentaphyllum tea on hepatocyte inflammatory apoptosis in mice with carbon tetrachloride(CC14)-induced acute liver injury.Methods C57BL/6 mice were randomly divided into a control group;model group;resveratrol group;Salvia miltiorrhiza Bunge gynostemma pentaphyllum tea low-,medium-,and high-dose groups;and a positive drug group.The mice were given continuous intragastric administration of the treatments for 14 days.An acute liver injury model was established by intraperitoneal injection of 0.5％CC14 olive oil solution(5 mL/kg).The levels of alanine transferase(ALT),aspartate transferase(AST),lactate dehydrogenase(LDH)in serum and hydroxyproline(Hyp),malondialdehyde(MDA),and superoxide dismutase(SOD)in the liver were determined by biochemical method.Serum levels of inflammatory tumor necrosis factor-α(TNF-α),interleukin(IL)-6,and IL-1 β were determined by enzyme-linked immunosorbent assay.Eosin-hematoxylin and terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick end labeling(TUNEL)staining were used to examine the pathological morphology and apoptosis in liver tissues.The protein expression of SIRT1,HMGB1,and NF-κB were detected by Western Blot.Results Compared with those of the control group,the model group's serum ALT,AST,and LDH levels and liver tissue Hyp activity were significantly increased;MDA and SOD activities in liver tissue were significantly decreased;the levels of inflammatory factors TNF-α,IL-6,and IL-1 β in liver tissue were significantly increased;and there were obvious signs of pathological injury and hepatocyte apoptosis in the liver tissue.The expression of SIRT1 protein decreased significantly,while the expression of HMGB1 and NF-κB proteins increased,in liver tissue.Compared with those of the model group,the Salvia miltiorrhiza Bunge gynostemma pentaphyllum tea high group and resveratrol group serum levels of ALT,AST,and LDH and liver tissue Hyp activity were significantly decreased;MDA and SOD activities in liver tissue were significantly increased;the levels of serum inflammatory factors TNF-α,IL-6,and IL-1β were decreased;and pathological injury to liver tissue and the apoptosis of liver cells were significantly improved.The expression of SIRT1 protein in liver tissue was increased,while the expression of HMGB1 and NF-κB protein were decreased in the Salvia miltiorrhiza Bunge gynostemma pentaphyllum tea high-dose group and resveratrol group(P＜0.05 or P＜0.01).Conclusions Salvia miltiorrhiza Bunge gynostemma pentaphyllum tea effectively protects against acute liver injury,and its mechanisms may be related to the regulation of the SIRT1/HMGB1/NF-κB signaling pathway and the alleviation hepatocyte inflammatory apoptosis.

To explore the effectiveness of "near peer learning" (NPL) in the electromyography(EMG)teaching module for neurology residents.

Sterilization is one of the key links in the production of traditional Chinese medicine,and it is also an important factor to ensure the safety,effectiveness and quality control of traditional Chinese medicine.Traditional sterilization techniques such as moist heat sterilization are limited in many cases due to their inherent shortcomings.In contrast,irradiation sterilization has attracted more and more attention due to its advantages of fast,efficient,strong sterilization and low cost.However,the chemical composition of traditional Chinese medicine is complex,due to the radioactivity and strong penetration of irradiation,after a certain dose of irradiation,its chemical composition and pharmacological activity may change.At present,there is still a lack of systematic research on the changes of chemical composition,effectiveness and safety of traditional Chinese medicine after irradiation sterilization.Based on the research status of 60Co-γ ray and electron beam irradiation sterilization in the sterilization of traditional Chinese medicine in recent years,this paper reviews the effects of irradiation on the effectiveness of traditional Chinese medicine,the detection methods of irradiation and the safety evaluation,in order to provide some reference for the subsequent application of irradiation sterilization of traditional Chinese medicine.