Objective:To investigate the impact of programmed death receptor-1(PD-1)and its ligand(PD-L1)on the differentiation of decidual macrophages(DMs)and embryonic development.Methods:20 patients with re-current spontaneous abortion(RSA group)and 20 patients with normal pregnancy induced artificial abortion(NP group)were selected from Sichuan Provincial People's Hospital between March 2021 and January 2024.Villous and decidual tissues were obtained from both groups.Real-time fluorescent quantitative polymerase chain reac-tion(qPCR)and Western blot techniques were used to detect the expression of PD-L1 mRNA and protein in vil-lous tissues.Flow cytometry was used to analyze the types of DMs and their PD-1 expression.Human monocytic leukemia cells(THP-1)were differentiated under different conditions,with a control group and a PD-1 blocked group established,and different reagents were added into those two groups to induce differentiation,then the pro-portion of DMs types was measured in both groups.Results:PD-L1 protein and mRNA were expressed in the vil-lous tissue of both groups of patients but the expression of PD-L1 protein and mRNA was reduced in the RSA group compared to the NP group(P<0.05).The decidual tissues of both groups contained M1 and M2 macro-phages.Compared with the NP group,the ratio of M2 to M1 DMs in the RSA group was lower(P<0.05),indica-ting a polarization towards the M1 type in DMs.There was no statistically significant difference in PD-1 expression between the two groups(P>0.05).Human THP-1 cells can be stimulated to differentiate into M1 and M2 macro-phages.Afterblocking PD-1,theratioof M2 to M1 macrophages decreased(P<0.05),indicating a polarization towards the M1 type in macrophages.Conclusions:In patients with RSA,the expression of PD-L1 in villous tis-sues is decreased,and DMs polarize towards the M1 type.Blocking the PD-1/PD-L1 pathway can further promote the polarization of macrophages towards the M1 type.The influence of PD-1/PD-L1 pathway on macrophage po-larization may provide new insights into the pathogenesis of RSA.

Objective:To investigate the impact of programmed death receptor-1(PD-1)and its ligand(PD-L1)on the differentiation of decidual macrophages(DMs)and embryonic development.Methods:20 patients with re-current spontaneous abortion(RSA group)and 20 patients with normal pregnancy induced artificial abortion(NP group)were selected from Sichuan Provincial People's Hospital between March 2021 and January 2024.Villous and decidual tissues were obtained from both groups.Real-time fluorescent quantitative polymerase chain reac-tion(qPCR)and Western blot techniques were used to detect the expression of PD-L1 mRNA and protein in vil-lous tissues.Flow cytometry was used to analyze the types of DMs and their PD-1 expression.Human monocytic leukemia cells(THP-1)were differentiated under different conditions,with a control group and a PD-1 blocked group established,and different reagents were added into those two groups to induce differentiation,then the pro-portion of DMs types was measured in both groups.Results:PD-L1 protein and mRNA were expressed in the vil-lous tissue of both groups of patients but the expression of PD-L1 protein and mRNA was reduced in the RSA group compared to the NP group(P<0.05).The decidual tissues of both groups contained M1 and M2 macro-phages.Compared with the NP group,the ratio of M2 to M1 DMs in the RSA group was lower(P<0.05),indica-ting a polarization towards the M1 type in DMs.There was no statistically significant difference in PD-1 expression between the two groups(P>0.05).Human THP-1 cells can be stimulated to differentiate into M1 and M2 macro-phages.Afterblocking PD-1,theratioof M2 to M1 macrophages decreased(P<0.05),indicating a polarization towards the M1 type in macrophages.Conclusions:In patients with RSA,the expression of PD-L1 in villous tis-sues is decreased,and DMs polarize towards the M1 type.Blocking the PD-1/PD-L1 pathway can further promote the polarization of macrophages towards the M1 type.The influence of PD-1/PD-L1 pathway on macrophage po-larization may provide new insights into the pathogenesis of RSA.

Objective:To investigate the impact of programmed death receptor-1(PD-1)and its ligand(PD-L1)on the differentiation of decidual macrophages(DMs)and embryonic development.Methods:20 patients with re-current spontaneous abortion(RSA group)and 20 patients with normal pregnancy induced artificial abortion(NP group)were selected from Sichuan Provincial People's Hospital between March 2021 and January 2024.Villous and decidual tissues were obtained from both groups.Real-time fluorescent quantitative polymerase chain reac-tion(qPCR)and Western blot techniques were used to detect the expression of PD-L1 mRNA and protein in vil-lous tissues.Flow cytometry was used to analyze the types of DMs and their PD-1 expression.Human monocytic leukemia cells(THP-1)were differentiated under different conditions,with a control group and a PD-1 blocked group established,and different reagents were added into those two groups to induce differentiation,then the pro-portion of DMs types was measured in both groups.Results:PD-L1 protein and mRNA were expressed in the vil-lous tissue of both groups of patients but the expression of PD-L1 protein and mRNA was reduced in the RSA group compared to the NP group(P<0.05).The decidual tissues of both groups contained M1 and M2 macro-phages.Compared with the NP group,the ratio of M2 to M1 DMs in the RSA group was lower(P<0.05),indica-ting a polarization towards the M1 type in DMs.There was no statistically significant difference in PD-1 expression between the two groups(P>0.05).Human THP-1 cells can be stimulated to differentiate into M1 and M2 macro-phages.Afterblocking PD-1,theratioof M2 to M1 macrophages decreased(P<0.05),indicating a polarization towards the M1 type in macrophages.Conclusions:In patients with RSA,the expression of PD-L1 in villous tis-sues is decreased,and DMs polarize towards the M1 type.Blocking the PD-1/PD-L1 pathway can further promote the polarization of macrophages towards the M1 type.The influence of PD-1/PD-L1 pathway on macrophage po-larization may provide new insights into the pathogenesis of RSA.

Objective:To investigate the impact of programmed death receptor-1(PD-1)and its ligand(PD-L1)on the differentiation of decidual macrophages(DMs)and embryonic development.Methods:20 patients with re-current spontaneous abortion(RSA group)and 20 patients with normal pregnancy induced artificial abortion(NP group)were selected from Sichuan Provincial People's Hospital between March 2021 and January 2024.Villous and decidual tissues were obtained from both groups.Real-time fluorescent quantitative polymerase chain reac-tion(qPCR)and Western blot techniques were used to detect the expression of PD-L1 mRNA and protein in vil-lous tissues.Flow cytometry was used to analyze the types of DMs and their PD-1 expression.Human monocytic leukemia cells(THP-1)were differentiated under different conditions,with a control group and a PD-1 blocked group established,and different reagents were added into those two groups to induce differentiation,then the pro-portion of DMs types was measured in both groups.Results:PD-L1 protein and mRNA were expressed in the vil-lous tissue of both groups of patients but the expression of PD-L1 protein and mRNA was reduced in the RSA group compared to the NP group(P<0.05).The decidual tissues of both groups contained M1 and M2 macro-phages.Compared with the NP group,the ratio of M2 to M1 DMs in the RSA group was lower(P<0.05),indica-ting a polarization towards the M1 type in DMs.There was no statistically significant difference in PD-1 expression between the two groups(P>0.05).Human THP-1 cells can be stimulated to differentiate into M1 and M2 macro-phages.Afterblocking PD-1,theratioof M2 to M1 macrophages decreased(P<0.05),indicating a polarization towards the M1 type in macrophages.Conclusions:In patients with RSA,the expression of PD-L1 in villous tis-sues is decreased,and DMs polarize towards the M1 type.Blocking the PD-1/PD-L1 pathway can further promote the polarization of macrophages towards the M1 type.The influence of PD-1/PD-L1 pathway on macrophage po-larization may provide new insights into the pathogenesis of RSA.

Objective:To investigate the impact of programmed death receptor-1(PD-1)and its ligand(PD-L1)on the differentiation of decidual macrophages(DMs)and embryonic development.Methods:20 patients with re-current spontaneous abortion(RSA group)and 20 patients with normal pregnancy induced artificial abortion(NP group)were selected from Sichuan Provincial People's Hospital between March 2021 and January 2024.Villous and decidual tissues were obtained from both groups.Real-time fluorescent quantitative polymerase chain reac-tion(qPCR)and Western blot techniques were used to detect the expression of PD-L1 mRNA and protein in vil-lous tissues.Flow cytometry was used to analyze the types of DMs and their PD-1 expression.Human monocytic leukemia cells(THP-1)were differentiated under different conditions,with a control group and a PD-1 blocked group established,and different reagents were added into those two groups to induce differentiation,then the pro-portion of DMs types was measured in both groups.Results:PD-L1 protein and mRNA were expressed in the vil-lous tissue of both groups of patients but the expression of PD-L1 protein and mRNA was reduced in the RSA group compared to the NP group(P<0.05).The decidual tissues of both groups contained M1 and M2 macro-phages.Compared with the NP group,the ratio of M2 to M1 DMs in the RSA group was lower(P<0.05),indica-ting a polarization towards the M1 type in DMs.There was no statistically significant difference in PD-1 expression between the two groups(P>0.05).Human THP-1 cells can be stimulated to differentiate into M1 and M2 macro-phages.Afterblocking PD-1,theratioof M2 to M1 macrophages decreased(P<0.05),indicating a polarization towards the M1 type in macrophages.Conclusions:In patients with RSA,the expression of PD-L1 in villous tis-sues is decreased,and DMs polarize towards the M1 type.Blocking the PD-1/PD-L1 pathway can further promote the polarization of macrophages towards the M1 type.The influence of PD-1/PD-L1 pathway on macrophage po-larization may provide new insights into the pathogenesis of RSA.

Objective:To investigate the impact of programmed death receptor-1(PD-1)and its ligand(PD-L1)on the differentiation of decidual macrophages(DMs)and embryonic development.Methods:20 patients with re-current spontaneous abortion(RSA group)and 20 patients with normal pregnancy induced artificial abortion(NP group)were selected from Sichuan Provincial People's Hospital between March 2021 and January 2024.Villous and decidual tissues were obtained from both groups.Real-time fluorescent quantitative polymerase chain reac-tion(qPCR)and Western blot techniques were used to detect the expression of PD-L1 mRNA and protein in vil-lous tissues.Flow cytometry was used to analyze the types of DMs and their PD-1 expression.Human monocytic leukemia cells(THP-1)were differentiated under different conditions,with a control group and a PD-1 blocked group established,and different reagents were added into those two groups to induce differentiation,then the pro-portion of DMs types was measured in both groups.Results:PD-L1 protein and mRNA were expressed in the vil-lous tissue of both groups of patients but the expression of PD-L1 protein and mRNA was reduced in the RSA group compared to the NP group(P<0.05).The decidual tissues of both groups contained M1 and M2 macro-phages.Compared with the NP group,the ratio of M2 to M1 DMs in the RSA group was lower(P<0.05),indica-ting a polarization towards the M1 type in DMs.There was no statistically significant difference in PD-1 expression between the two groups(P>0.05).Human THP-1 cells can be stimulated to differentiate into M1 and M2 macro-phages.Afterblocking PD-1,theratioof M2 to M1 macrophages decreased(P<0.05),indicating a polarization towards the M1 type in macrophages.Conclusions:In patients with RSA,the expression of PD-L1 in villous tis-sues is decreased,and DMs polarize towards the M1 type.Blocking the PD-1/PD-L1 pathway can further promote the polarization of macrophages towards the M1 type.The influence of PD-1/PD-L1 pathway on macrophage po-larization may provide new insights into the pathogenesis of RSA.

Objective:To investigate the impact of programmed death receptor-1(PD-1)and its ligand(PD-L1)on the differentiation of decidual macrophages(DMs)and embryonic development.Methods:20 patients with re-current spontaneous abortion(RSA group)and 20 patients with normal pregnancy induced artificial abortion(NP group)were selected from Sichuan Provincial People's Hospital between March 2021 and January 2024.Villous and decidual tissues were obtained from both groups.Real-time fluorescent quantitative polymerase chain reac-tion(qPCR)and Western blot techniques were used to detect the expression of PD-L1 mRNA and protein in vil-lous tissues.Flow cytometry was used to analyze the types of DMs and their PD-1 expression.Human monocytic leukemia cells(THP-1)were differentiated under different conditions,with a control group and a PD-1 blocked group established,and different reagents were added into those two groups to induce differentiation,then the pro-portion of DMs types was measured in both groups.Results:PD-L1 protein and mRNA were expressed in the vil-lous tissue of both groups of patients but the expression of PD-L1 protein and mRNA was reduced in the RSA group compared to the NP group(P<0.05).The decidual tissues of both groups contained M1 and M2 macro-phages.Compared with the NP group,the ratio of M2 to M1 DMs in the RSA group was lower(P<0.05),indica-ting a polarization towards the M1 type in DMs.There was no statistically significant difference in PD-1 expression between the two groups(P>0.05).Human THP-1 cells can be stimulated to differentiate into M1 and M2 macro-phages.Afterblocking PD-1,theratioof M2 to M1 macrophages decreased(P<0.05),indicating a polarization towards the M1 type in macrophages.Conclusions:In patients with RSA,the expression of PD-L1 in villous tis-sues is decreased,and DMs polarize towards the M1 type.Blocking the PD-1/PD-L1 pathway can further promote the polarization of macrophages towards the M1 type.The influence of PD-1/PD-L1 pathway on macrophage po-larization may provide new insights into the pathogenesis of RSA.

Objective:To investigate the impact of programmed death receptor-1(PD-1)and its ligand(PD-L1)on the differentiation of decidual macrophages(DMs)and embryonic development.Methods:20 patients with re-current spontaneous abortion(RSA group)and 20 patients with normal pregnancy induced artificial abortion(NP group)were selected from Sichuan Provincial People's Hospital between March 2021 and January 2024.Villous and decidual tissues were obtained from both groups.Real-time fluorescent quantitative polymerase chain reac-tion(qPCR)and Western blot techniques were used to detect the expression of PD-L1 mRNA and protein in vil-lous tissues.Flow cytometry was used to analyze the types of DMs and their PD-1 expression.Human monocytic leukemia cells(THP-1)were differentiated under different conditions,with a control group and a PD-1 blocked group established,and different reagents were added into those two groups to induce differentiation,then the pro-portion of DMs types was measured in both groups.Results:PD-L1 protein and mRNA were expressed in the vil-lous tissue of both groups of patients but the expression of PD-L1 protein and mRNA was reduced in the RSA group compared to the NP group(P<0.05).The decidual tissues of both groups contained M1 and M2 macro-phages.Compared with the NP group,the ratio of M2 to M1 DMs in the RSA group was lower(P<0.05),indica-ting a polarization towards the M1 type in DMs.There was no statistically significant difference in PD-1 expression between the two groups(P>0.05).Human THP-1 cells can be stimulated to differentiate into M1 and M2 macro-phages.Afterblocking PD-1,theratioof M2 to M1 macrophages decreased(P<0.05),indicating a polarization towards the M1 type in macrophages.Conclusions:In patients with RSA,the expression of PD-L1 in villous tis-sues is decreased,and DMs polarize towards the M1 type.Blocking the PD-1/PD-L1 pathway can further promote the polarization of macrophages towards the M1 type.The influence of PD-1/PD-L1 pathway on macrophage po-larization may provide new insights into the pathogenesis of RSA.

Objective:To investigate the application of case-based learning (CBL) combined with evidence-based learning (EBL) teaching in clinical teaching of oncology.Methods:Totally 57 resident doctors were divided into experimental group and control group. The experimental group received CBL and EBL teaching, and the control one received lecture-based learning (LBL) teaching. The teaching effect was evaluated by examination and questionnaire, and the data were analyzed by SPSS 20.0.Results:The examination scores of the experimental group and the control group were (85.393±7.213) and (81.276±8.035), and the ones of case analysis were (34.393±2.485) and (32.379±3.005) respectively. Meanwhile, questionnaire survey showed that the evaluations of experimental group were significantly better than those of the control one in promoting learning interest and initiative, retrieval ability, self-learning ability, clinical thinking and learning efficiency ( P<0.05). Conclusion:The teaching effect of integration of CBL and EBL is better than LBL.

Objective To explore the effects of high phosphate and low calcium on the secretion function and cell proliferation in normal rat parathyroid tissues.Methods The rat parathyroid tissues resected by surgical operation under dissection microscope were incubated in vitro for 5 days and were treated with high phosphate or low calcium medium on the second day and the third day after incubation.The cell apoptosis at different time points was measured by flow cytometry.The levels of intact parathyroid hormone (iPTH) in the supernatant at different time points were detected by ELISA.The mRNA levels of prepro-PTH and proliferating cell nuclear antigen (PCNA) were measured by real-time PCR,while the protein levels of PCNA after the 24-hour treatment with high phosphate or low calcium medium were measured by Western blotting.Results Flow cytometric analysis showed that the percentage of normal living cells on the first day and the second day after incubation was significantly higher than that on the third day to the fifth day after incubation in the rat parathyroid tissues (all P ＜ 0.05),and there was no statistical difference among that on the third day to the fifth day after incubation.There was no significant difference in cell survival rates on the first day to the fifth day after incubation (all ＞ 85％) under normal or high phosphate medium.There was no significant difference in the daily iPTH level on the first day to the fifth day after incubation under normal medium.Compared with normal medium,the iPTH level in the supernatant under high phosphate medium increased (P ＜ 0.05),and the expressions of preproPTH mRNA and PCNA in parathyroid tissues were significantly up-regulated (both P ＜ 0.05) after the 24-hour treatment with high phosphate medium.Compared with normal medium,the iPTH level in the supernatant under low calcium medium increased (P ＜ 0.05),and the expression of preproPTH mRNA in parathyroid tissues was significantly up-regulated after the 24-hour treatment with low calcium medium (P ＜ 0.05).Conclusions It is feasible to incubate the parathyroid issues from rats in vitro,and the best incubation time should be within 2 days.Low calcium and high phosphate stimulation could increase the synthesis and secretion of PTH,while high phosphate can also promote the cell proliferation,which is an important factor for the regulation of parathyroid function in physiological state.