Objective Our purpose is to investigate the expression of natriuretic peptide receptor A (NPR-A) in the retina and to understand the NPR-A’ s functions during the mouse development .Methods Mice eyes were harvested from E16 ( embryonic day 16 ) to P90 ( postnatal day 90 ) . Total of 127 eyes were used in the study . Immunohistochemistries of NPR-A were carried out .Results During development , NPR-A was widely expressed in the retinal neurons .In the outer nuclear layer , NPR-A began to appear in the inner and outer projections of cone and rod cells at P7, but decreased at P14.From P30 afterward, it continued to express weakly .In the inner nuclear layer , NPR-A expressed in the dendrites of bipolar cells weakly from P 7 to adulthood , whereas no expression in horizontal cells .In the ganglion cell layer, NPR-A started highly to express in the ganglion cell bodies at E 16, and in the meantime, in the nerve fiber layer , ganglion cell axons , NPR-A was expressed highly from embryonic to adult .In the inner and outer plexiform layers, NPR-A was highly expressed at P14, but decreased gradually after P30.In addition, NPR-A also widely expressed in the inner protrusions of Müller cells.Conclusion NPR-A participates in the development of the retina , and may be the key molecule in the developing retinal neurons .Moreover, it plays an important regulatory role in the functional activity of Müller cells .

In recent years, mass spectrometry-based protein analysis has emerged as a powerful tool in clinical laboratories, offering more reliable assessments than conventional laboratory tools and providing benefits for disease diagnosis and treatment. The use of targeted protein quantitation has gained widespread acceptance, particularly in the detection of insulin-like growth factor I, thyroglobulin, and monoclonal antibody therapeutics. Meanwhile, significant advancements have been made in non-targeted protein analysis, such as the diagnosis of amyloidosis, monoclonal gammopathies, and membranous nephropathy. High-resolution mass spectrometry has enabled the identification and differentiation of pathogenic proteins in these diseases, as well as the discovery of new proteins involved in disease onset and progression. As a result, clinical diagnosis and disease differentiation have improved, as well as our understanding of these diseases.

Therapeutic drug monitoring is a good interpretation of personalized medicine, which helps to improve the safety and effectiveness of patient medication. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has gradually been widely accepted by clinical laboratories due to its characteristics of specificity, sensitivity, and flexibility in method development. This article introduces the importance and analytical techniques for therapeutic drug monitoring, describes the application and development of liquid chromatography tandem mass spectrometry for therapeutic drug monitoring, new advances in the detection of different drug types and sample types, and challenges in automation, convenience, and standardization.

Therapeutic drug monitoring is a good interpretation of personalized medicine, which helps to improve the safety and effectiveness of patient medication. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has gradually been widely accepted by clinical laboratories due to its characteristics of specificity, sensitivity, and flexibility in method development. This article introduces the importance and analytical techniques for therapeutic drug monitoring, describes the application and development of liquid chromatography tandem mass spectrometry for therapeutic drug monitoring, new advances in the detection of different drug types and sample types, and challenges in automation, convenience, and standardization.

Objective: To retrospectively analyze the prognostic value of platelet count recovery in the early stage post burn for patients with extremely severe burn, so as to evaluate their severity. Methods: A study involving 244 adult patients with extremely severe burn admitted to our hospital from January 2006 to December 2015, conforming to the inclusion criteria, was conducted. Data of their demography, injury, transmission, disease change in hospital, and platelet count from post injury day (PID) 1 to 10 were collected. (1) Patients were divided into survival group (n=212) and non-survival group (n=32) according to whether death or not. The dynamic change characteristic of platelet count in patients of two groups from PID 1 to 10 was analyzed and compared. (2) Patients were divided into return to normal group (RN, n=163) and non-return to normal group (NRN, n=81) according to whether platelet count returned to normal within one week post burn. The proportion of patients who received mechanical ventilation and mortality in groups RN and NRN, and length of stay in ICU between patients with platelet count that returned to normal and that did not return to normal in the early stage post burn in survival group were compared. Data were processed with independent samples t test , analysis of variance of repeated measurement, chi-square test, and binomial distribution test. Correlation was analyzed between data of sex, age, weight, total burn area, full-thickness burn area, inhalation injury, length of hospital stay, receiving mechanical ventilation, platelet count recovery condition within one week post burn and death of patients using the univariate and multivariate Cox regression analysis. Receiver operating characteristic (ROC) curve of platelet count on PID 8 was drawn to evaluate predicting value for death of 244 patients. Results: (1) The platelet count kept declining from PID 1 to 4, declined to below the normal low limit on PID 2, and reached its lowest level on PID 4 both in survival group and non-survival group. The platelet count both in survival group and non-survival group rose gradually from PID 4 to 10, and returned to normal on PID 8 and 10, respectively. There was no significant difference in platelet count of patients in two groups on PID 1 (t=1.01, P>0.05), while platelet count of patients in non-survival group was obviously lower than that in survival group from PID 2 to 10 (with t values from 2.64 to 7.17, P values below 0.01). The daily increment of platelet count in survival group from PID 4 to 10 was (26±13)×10⁹/L, obviously higher than that in non-survival group [(19±11)×10⁹/L, t=2.76, P<0.01]. (2) The proportion of patients who received mechanical ventilation was obviously lower than that of patients who did not receive mechanical ventilation in group RN (P<0.01), while the proportion of patients who received mechanical ventilation was obviously higher than that of patients who did not receive mechanical ventilation in group NRN (P<0.05). The proportion of patients who received mechanical ventilation in group NRN was obviously higher than that in group RN (χ²=32.93, P<0.01). The mortality of patients in group NRN was obviously higher than that in group RN (χ²=20.99, P<0.01). The length of stay in ICU of patients whose platelet count did not return to normal in the early stage was significantly longer than that of patients whose platelet count returned to normal in the early stage in survival group (t=4.20, P<0.01). (3) Total burn area, receiving mechanical ventilation, and platelet count did not return to normal within one week post burn were independent risk factors for death of patients with extremely severe burn (with hazard ratio respectively 1.073, 16.552, and 2.249, 95% confidence interval respectively 1.033-1.115, 2.147-127.580, and 0.993-5.096, P<0.05 or P<0.01). (4) The area under the ROC curve of platelet count on PID 8 to predict death of 244 patients with extremely severe burn was 0.745 (with 95% confidence interval 0.645-0.845, P<0.01), and 150×10⁹/L was chosen as the optimal threshold value, with sensitivity of 71.4% and specificity of 71.0%. Conclusions Platelet count recovery in the early stage post burn of patients with extremely severe burn was significantly associated with their prognosis and could be used as an important indicator to evaluate the severity of illness.

Objective: To analyze the influencing factors and clinical significance of severe hypocalcemia in patients with extremely severe burns in early stage. Methods: Clinical data of 142 patients with extremely severe burns admitted to our wards from January 2010 to July 2015, conforming to the study criteria, were retrospectively analyzed. (1) The incidence of hypocalcemia and severe hypocalcemia on admission were calculated. (2) Patients were divided into the male group (n=113) and the female group (n=29) according to gender. The levels of serum calcium of patients whose age more than 55 years old and less than or equal to 55 years old in the two groups were compared with t test. (3) Patients were divided into severe hypocalcemia group (n=52) and non-severe hypocalcemia group (n=90) according to the level of serum calcium on admission. The data including gender, age, flame burn, total burn area, inhalation injury, admission time, the pH value, and the albumin level of patients on admission between two groups were compared with chi-square test or t test. Indexes with P<0.1 between two groups were selected, and multivariate logistic regression analysis was conducted to screen the influencing factors of severe hypocalcemia in patients with extremely severe burns in early stage. (4) According to the prognosis, patients were divided into survival group (n=112) and non-survival group (n=30). The data including gender, age, flame burn, total burn area, inhalation injury, admission time, the level of serum calcium, the pH value, and the albumin level of patients on admission between two groups were compared with chi-square test or t test. Indexes with P<0.1 between two groups were selected, and multivariate Cox regression analysis was conducted to screen the influencing factors of prognosis of patients with extremely severe burns. Results: (1) The incidence of hypocalcemia on admission was 97.2% (138/142), and patients diagnosed as severe hypocalcemia accounted for 36.6% (52/142). (2) In the male group, the level of serum calcium of patients with age more than 55 years old was (1.84±0.19) mmol/L, which was close to (1.88±0.21) mmol/L of patients with age less than or equal to 55 years old within the same group and (1.96±0.13) mmol/L of patients with age more than 55 years old in the female group (t=0.833, 1.560, P>0.05). In the female group, the level of serum calcium of patients with age less than or equal to 55 years old was (1.78±0.19) mmol/L, which was significantly lower than that of patients with age less than or equal to 55 years old in the male group and that of patients with age more than 55 years old in the female group (t=-2.197, -2.472, P<0.05). (3) Compared with those of patients in severe hypocalcemia group, the total burn area and the proportion of inhalation injury of patients in non-severe hypocalcemia group were obviously smaller (t=2.379, χ² =13.410, P<0.05 or P<0.01), and the admission time was obviously earlier (t=2.675, P<0.01), while the albumin level was obviously higher (t=-6.163, P<0.01). There were no statistically significant differences between patients of the two groups in gender, flame burn, age, and the pH value on admission (χ²=1.869, 2.850, t=-0.578, 0.645, P>0.05). Multivariate logistic regression analysis showed that only the albumin level on admission was the independent influencing factor of severe hypocalcemia in patients with extremely severe burns (with odds ratio 1.179, 95% confidence interval 1.092-1.273, P<0.01). (4) Compared with those of patients in non-survival group, the total burn area and the proportion of inhalation injury in survival group were smaller (t=-5.515, χ²=27.573, P<0.05 or P<0.01), while the pH value and the albumin level on admission were higher (t=2.208, 3.321, P<0.05 or P<0.01). There were no statistically significant differences between patients of the two groups in gender, flame burn, age, admission time, and the level of serum calcium on admission (χ²=0.198, 2.545, t=-1.316, -1.397, 1.857, P>0.05). Multivariate Cox regression analysis showed that total burn area and inhalation injury were the independent risk factors to predict prognosis of patients with extremely severe burns (with relative risk 1.066 and 4.081, 95% confidence interval 1.023-1.110 and 1.144-14.559, P<0.05 or P<0.01), but the pH value and levels of albumin and serum calcium were not independent risk factors to predict prognosis of patients with extremely severe burns (with relative risk 0.003, 1.025, and 0.634, 95% confidence interval <0.001-1.183, 0.956-1.099, and 0.055-7.321, P>0.05). Conclusions The level of serum calcium of the majority of patients with extremely severe burns on admission is decreasing significantly, especially the female patients less than or equal to 55 years old. Compared with non-severe hypocalcemia patients, patients with severe hypocalcemia are with larger total burn area, higher proportion of inhalation injury, later admission time, and lower albumin level on admission. However, only the albumin level on admission is the independent influencing factor of severe hypocalcemia in patients with extremely severe burns. And the level of serum calcium on admission can not predict the prognosis of patients with extremely severe burns.

To examine the feasibility of using a computer tool for stratifying the severity of Coronavirus Disease 2019 (COVID-19) based on computed tomography (CT) images. We retrospectively examined 44 confirmed COVID-19 cases. All cases were evaluated separately by radiologists (visually) and through an in-house computer software. The degree of lesions was visually scored by the radiologist, as follows, for each of the 5 lung lobes:0, no lesion present;1,<1/3 involvement;2,>1/3 and<2/3 involvement;and 3,>2/3 involvement. Lesion density was assessed based on the proportion of ground-glass opacity (GGO), consolidation and fibrosis of the lesions. The parameters obtained using the computer tool included lung volume (mL), lesion volume (mL), lesion percentage (％), and mean lesion density (HU) of the whole lung, right lung, left lung, and each lobe. The scores obtained by the radiologists and quantitative results generated by the computer software were tested for correlation. A Chi-square test was used to test the consistency of radiologist- and computer-derived lesion percentage in the right/left lung, upper/lower lobe, and each of the 5 lobes. The results showed a strong to moderate correlation between lesion percentage scores obtained by radiologists and the computer software (r ranged from 0.7679 to 0.8373, P < 0.05), and a moderate correlation between the proportion of GGO and mean lesion density (r=-0.5894, P<0.05), and proportion of consolidation and mean lesion density (r=0.6282, P<0.05). Computer-aided quantification showed a statistical significant higher lesion percentage for lower lobes than that assessed by the radiologists (x2 = 8.160, P = 0.004). Our experiments demonstrated that the computer tool could reliably and accurately assess the severity and distribution of pneumonia on CT scans.

OBJECTIVETo investigate effects of systemic red light therapy on wound repair of burned patients and discuss its possible mechanisms of wound healing promotion.

METHODS138 burned patients were randomly divided into systemic red light treatment group (n = 69) and control group (n = 69). Patients in control group received routine therapy, while those in test group were given systemic red light therapy once a day, 30 minutes at a time until the wounds were recovered. The clinical findings and variables indicating wound repair were assessed on the 7th, 10th, 14th day, 21st day post-burn and the day when the wounds were healed.

RESULTSMean time of wound recovery were 19.86 +/- 2.43 days and 21.02 +/- 2.97 days respectively of those deep-thickness wounds in test group and control group, with statistically significance (P < 0.05). For the severity of the pain, VAS during time of dressing change on the 10th, 14th day post burn was lower in test group than that in control group which indicated less painful in test group (P < 0.05), suggesting pain relief effect of systemic red light therapy.

CONCLUSIONSystemic red light therapy was effective to promote wound healing of deep-thickness burn wounds and other similar acute wounds. Simultaneously, it is efficacious in pain relief and safe for those patients.

Adolescent ; Adult ; Aged ; Burns ; therapy ; Female ; Humans ; Light ; Male ; Middle Aged ; Pain Management ; Phototherapy ; Treatment Outcome ; Wound Healing ; Young Adult

Objective To explore the classification of collateral blood compensation pathways and collateral blood compensation characteristics in patients with common carotid artery occlusive disease.Methods The hemodynamie and imaging data of 20 patients with common carotid artery occlusive disease,admitted to our hospital from May 2016 to September 2018,were collected.The patients were classified according to whether they had internal carotid artery stealing and collateral circulation compensating for collateral flow.Results Internal carotid artery hematoma was found in 11 of the 20 patients;there was collateral circulation in 17 patients,including 10 branches of the anterior communicating artery,9 branches of the posterior communicating artery,11 branches of the posterior cerebral artery-middle cerebral arterial pia anastomosis,and 8 branches of the ocular artery.There were three types of collateral blood compensation pathways to be discovered in the 20 patients with common carotid artery occlusive disease;type Ⅰ (n=3) was the collateral blood compensation pathway with simple internal carotid artery stealing,type Ⅱ (n=8) was the collateral blood compensation pathway with internal carotid artery stealing and collateral circulation,and type Ⅲ (n=9) was the collateral blood compensation pathways with simple collateral circulation.Conclusion In some patients with common carotid artery occlusion,the internal carotid artery stealing route exists in the collateral flow compensation.

Objective:To investigate the clinical effect of self-designed modified rhomboid flap in repairing rhomboid, round, and teardrop-shaped wounds on the face.Methods:A retrospective observational study was conducted. From August 2018 to April 2020, 30 patients with facial lesions admitted into Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the People's Hospital of Jianchuan County in Yunnan province met the inclusion criteria, including 16 males and 14 females, aged 23 to 88 years. The wound area ranged from 1.0 cm×1.0 cm to 7.0 cm×5.0 cm, with 10 cases of rhomboid wounds, 12 cases of round wounds, and 8 cases of teardrop-shaped wounds. The self-designed modified rhomboid flaps were applied to repair the wounds and after that, the patients were followed up for 1 to 18 months to record the survival of flaps, wound tension, scar formation and complications after surgery.Results:No necrosis or blackening was observed at the tip of the flaps after surgery. All the flaps survived and the wounds healed well with little tension, minimal scars, and no complications.Conclusions:The self-designed modified rhomboid flap is especially suitable for facial wounds with multiple important organs, multiple anatomical subunits, and areas with large changes in soft tissue tension, which can reduce not only the rotation of the flap, but also unnecessary excision of normal skin and soft tissue.