Light adaptation enables the vertebrate visual system to operate over a wide range of ambient illumination. Regulation of phototransduction in photoreceptors is considered a major mechanism underlying light adaptation. However, various types of neurons and glial cells exist in the retina, and whether and how all retinal cells interact to adapt to light/dark conditions at the cellular and molecular levels requires systematic investigation. Therefore, we utilized single-cell RNA sequencing to dissect retinal cell-type-specific transcriptomes during light/dark adaptation in mice. The results demonstrated that, in addition to photoreceptors, other retinal cell types also showed dynamic molecular changes and specifically enriched signaling pathways under light/dark adaptation. Importantly, Müller glial cells (MGs) were identified as hub cells for intercellular interactions, displaying complex cell‒cell communication with other retinal cells. Furthermore, light increased the transcription of the deiodinase Dio2 in MGs, which converted thyroxine (T4) to active triiodothyronine (T3). Subsequently, light increased T3 levels and regulated mitochondrial respiration in retinal cells in response to light conditions. As cones specifically express the thyroid hormone receptor Thrb, they responded to the increase in T3 by adjusting light responsiveness. Loss of the expression of Dio2 specifically in MGs decreased the light responsive ability of cones. These results suggest that retinal cells display global transcriptional changes under light/dark adaptation and that MGs coordinate intercellular communication during light/dark adaptation via thyroid hormone signaling.
Animals ; Mice ; Dark Adaptation ; Light ; Retina ; Retinal Cone Photoreceptor Cells/metabolism* ; Adaptation, Ocular ; Neuroglia/physiology* ; Cell Communication ; Thyroid Hormones

Objective To explore the humidification effects between the humidifiers Venturi high-flow oxygen therapy(HVHF)and the high-flow humidified oxygen therapy in the treatment of patients with tracheotomy after the withdrawal of ventilator,and analyse the humidification performance and effect of airway humidification on the two oxygen therapies hence to provide an objective basis for selection of a humidified oxygen therapy.Methods A total of 146 ICU patients who had tracheotomy and completely withdrawal of ventilator in a general hospital in Shenzhen from July 2020 to December 2021 were randomly divided into trial group(n=73)and control group(n=73).With identical speed of airflow,patients in the trial groups were treated with HVHF and the patients of control group were offered with high-flow humidified oxygen therapy via AIRVOTM2.Data of the two groups were compared at the time points of days 0,2,7 and 14 in terms of absolute humidity(AH),relative humidity(RH),temperature(T)),sputum viscosity,arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),oxygenation index(PaO2/FIO2)and the incidence of pulmonary infection.Results In the study,total of 61 patients in the control group and 72 patients in the trial group completed the high-flow humidified oxygen therapies,due to tubing detachments in 12 and 1 patients in the two groups,respectively.Repeated-Measures ANOVA analysis showed that,in both groups,there was a time effect(P<0.05)between the absolute humidity,relative humidity,temperature of the gas,PaO2,PaCO2,and PaO2/FiO2 at different time points.PaO2 and PaO2/FiO2 in both groups showed interactions at different time points(P<0.05).PaO2 and PaO2/FiO2 in the trial group were better than those in the control group at the time points of days 2,7 and 14(P<0.05).On days 2,7 and 14,the viscosity of sputum in the intervention group was better than that in the control group,and the incidence of pulmonary infection in the trial group was significantly lower than that in the control group(P<0.05).Conclusions HVHF and AIRVOTM2 both exhibit no obvious difference in gas humidification via high-flow humidification oxygen therapy in the patients with tracheotomy after withdrawal of ventilator.However,HVHF is superior to AIRVOTM2 in terms of improving airway humidification and oxygenation as well as reducing lung infection.Therefore,it is suggested that an HVHF is preferable for high-flow humidified oxygen therapy in treating the patients with tracheotomy after the withdrawal of ventilator.

Objective:To investigate the application value of auricular point pressing with beans combined with Chinese medicine for rehabilitation in older adults after total hip arthroplasty.Methods:This is a prospective case-control study. A total of 80 older adult patients with femoral neck fractures who underwent total hip arthroplasty at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from September 2020 to January 2022 were included in this study. These patients were randomly divided into a control group and an observation group, with 40 patients per group. The control group underwent conventional interventions, while the observation group underwent auricular point pressing with beans combined with Chinese medicine. Clinical efficacy was compared between the two groups.Results:The overall response rate in the observation group was 85.00% (34/40), which was significantly higher than 65.0% (26/40) in the control group ( χ2 = 4.27, P = 0.036). Before surgery, there were no significant differences in various indicators between the two groups (all P > 0.05). At 2 weeks after surgery, the hemoglobin level and Harris scores in the observation group were higher than those in the control group ( t = -7.11, -5.81, both P < 0.05). At 1 and 3 days and 2 weeks after surgery, the D-dimer level, prothrombin time, activated partial thrombin time, thrombin time, Visual Analogue Scale score, and Pittsburgh Sleep Quality Index (PSQI) in the observation group were significantly lower than those in the control group (all P < 0.05). At 3 days and 2 weeks after surgery, C-reactive protein, thigh and calf circumference of the affected limb in the observation group were significantly lower than those in the control group ( t = 2.34, 6.85, 4.47, 3.89, 6.63, 4.35, all P < 0.05). After surgery, the time to get off the bed and the length of hospital stay in the observation group were (3.58 ± 2.43) days and (7.14 ± 2.18) days, respectively, which were significantly shorter than (5.47 ± 2.35) days and (9.13 ± 2.14) days in the control group ( t = 3.54, 4.12, both P < 0.001). The incidence of postoperative deep vein thrombosis in the observation group was 5.00% (2/40), which was significantly lower than 10.00% (4/40) in the control group ( χ2 = 0.72, P = 0.396). Conclusion:Auricular point pressing with beans combined with Chinese medicine can promote rapid rehabilitation of older adult patients with femoral neck fractures after total hip arthroplasty.

Bipolar androgen therapy (BAT), as a new therapy, can effectively reduce the serum prostate specific antigen (PSA) level of a part of patients with castration resistant prostate cancer (CRPC), delay tumor progression, improve their quality of life and restore the sensitivity to drug therapy. This paper will review the background, possible mechanism, clinical research progress and development prospect of BAT.

Objective:To retrieve and summarize evidence for prevention of hypothermia at birth in newborn.Methods:Databases such as Up To Date, BMJ Best Practice, National Institute for Health and Care Excellence(NICE), Joanna Briggs Institute (JBI), Cochrane Library, Registered Nurses′Association of Ontario (RNAO), American Heart Association(AHA), Web of Science, PubMed, Chinese Biology Medical Literature database, Wanfang Med Online were searched to collect relevant evidence for prevention of hypothermia at birth in newborn, including guidelines, systematic reviews, evidence summaries and expert consensus. Two researchers independently evaluated the quality of the literature and extracted the data of the literature which met the criteria.Results:Six articles were selected, including 1 clinical decision support system, 2 guidelines, 1 systematic review and 2 expert consensuses. Nineteen pieces of best evidence were summarized.Conclusions:This study summarized the best evidence for the prevention of hypothermia at birth in newborn, and provided evidence-based support for clinical practice.

Objective:To explore the risk factors for 30-day death in emergency department patients, and then construct a prediction model and validate it using nomogram.Methods:A retrospective cohort study was conducted. The clinical data of 1 091 patients admitted to the emergency department of the First People's Hospital of Changde from January 1 to June 30, 2021 was collected, including 741 patients from January 1 to March 31 in the development group and 350 patients from April 1 to June 30 in the validation group. General information, first vital signs admitted to the emergency department, and laboratory results were collected, the modified early warning score (MEWS) was calculated, and 30-day outcomes were recorded. Univariate and multivariate Logistic regression analysis was used to screen out the risk factors of 30-day death. According to the results of multivariate analysis, the nomogram was used to construct a 30-day death prediction model. The receiver operator characteristic curve (ROC curve) was used to evaluate the consistency of the prediction model, the calibration of the prediction model was evaluated by the Hosmer-Lemeshow goodness of fit test.Results:A total of 1 091 patients were enrolled. There were 741 patients in the development group, including 356 males and 385 females, aged (51.42±17.33) years old, and the 30-day mortality was 28.88%. There were 350 patients in the validation group, including 188 males and 162 females, aged (52.88±16.11) years old, and the 30-day mortality was 24.00%. The results of the univariate analysis showed that age, primary diagnosis on admission, consciousness, respiratory rate (RR), systolic blood pressure (SBP), heart rate (HR), pulse oxygen saturation (SpO 2), MEWS score, erythrocyte sedimentation rate (ESR), procalcitonin (PCT) and body mass index (BMI) might be the risk factors for 30-day death in patients in the emergency department. The results of the multivariate analysis showed that the MEWS score [odds ratio ( OR) = 14.22, 95% confidence interval (95% CI) was 1.46-138.12], ESR ( OR = 46.71, 95% CI was 20.48-106.53), PCT ( OR = 4.97, 95% CI was 2.46-10.02), BMI (24.0-27.9 kg/m 2: OR = 37.82, 95% CI was 14.69-97.36; ≥28.0 kg/m 2: OR = 62.11, 95% CI was 25.77-149.72) were independent risk factors for 30-day death in the emergency department (all P < 0.05). Using the four variables with the results of multivariate analysis to construct a nomogram prediction model, the area under the ROC curve (AUC) was 0.974 (95% CI was 0.753-0.983) for the development group, and the AUC was 0.963 (95% CI was 0.740-0.975) for the validation group. The Hosmer-Lemeshow test showed no statistically significant difference between the predicted outcome of the nomogram prediction model and the actual occurrence ( χ2 = 1.216, P = 1.270). Conclusion:The prediction model developed by the MEWS score combined with BMI, ESR and PCT can scientifically and effectively predict the 30-day outcome of emergency department patients.

Objective:To investigate the correlation between inositol level and glycolipid metabolism in gravidas with gestational diabetes mellitus (GDM).Methods:A cross-sectional study was conducted on 80 GDM cases undergoing routine examination at Fujian Provincial Maternity and Children's Hospital from November 2018 to August 2019, who were selected as GDM groups. Another 50 women with uncomplicated pregnancies during the same period were selected as the control group. Blood and urine inositol level and serum glycolipid profiles were compared between the two groups, and their association was analyzed. Independent or paired-sample t test, Mann-Whitney test, Chi-square (or Fisher's exact) test, and Pearson correlation test were performed for statistical analysis. Results:The serum inositol concentration and high-density lipoprotein (HDL) cholesterol in the GDM group were significantly lower [322.1 ng/ml (279.1-364.1 ng/ml) vs 403.8 ng/ml (391.8-425.3 ng/ml), Z=-7.879; 1.8 mmol/L (1.5-2.0 mmol/L) vs 2.0 mmol/L (1.7-2.2 mmol/L), Z=-2.419; both P<0.05], while the concentration of urine inositol, lipoprotein-a (lipo-a), 0 h-, 1 h-, 2 h-oral glucose tolerance test (OGTT) glucose, fasting insulin, and glycosylated hemoglobin (HbA1c) were significantly higher when comparing to the control group [192.2 ng/ml (171.0-219.9 ng/ml) vs 143.8 ng/ml (121.1-158.6 ng/ml), Z=-6.834; 253.2 mg/L (65.0-349.0 mg/L) vs 148.5 mg/L(46.5-159.3 mg/L), Z=-0.187; 5.0 mmol/L (5.1-5.6 mmol/L) vs 4.4 mmol/L (4.2-4.6 mmol/L), Z=-5.547; 10.0 mmol/L (9.1-11.3 mmol/L) vs 7.8 mmol/L (7.0-8.4 mmol/L), Z=-6.987; 8.6 mmol/L(7.6-9.4 mmol/L) and 6.6 mmol/L (5.7-7.1 mmol/L), Z=-7.100; 18.2 mU/L(10.6-25.9 mU/L) vs 11.0 mU/L (6.3-12.7 mU/L), Z=-4.537; 5.4%(4.5%-5.5%) vs 5.1%(4.9%-5.4%), Z=-3.468; all P<0.05]. (2) Serum inositol concentration was negatively correlated with fasting insulin and 0 h-, 1 h-, 2 h- OGTT glucose level ( r=-0.386, -0.416, -0.350 and -0.407, respectively); urinary inositol concentration was positively correlated with 0 h-, 1 h-, 2 h-OGTT glucose levels ( r=0.402, 0.389 and 0.429, respectively) (all P<0.05). Conclusions:Serum inositol concentration was decreased, and urinary inositol excretion was increased in women with GDM. Measurement of changes in inositol levels during the second trimester may be helpful to assess the metabolic status of pregnant women.

The incidence of prostate cancer is increasing year by year in China. People with BRCA mutation are at high risk of prostate cancer. However, there is no clear and effective treatment for mHSPC with high metastatic load carrying BRCA mutation. In this study, we report a mHSPC patient with high metastatic burden and germline BRCA1 gene mutation who rapidly progressed to mCRPC after traditional CAB therapy and then received ADT combined with abiraterone and achieved significant PSA response, suggesting that ADT combined with abiraterone may be an effective therapy for mHSPC patients with BRCA1 germline mutation.

The outbreak of COVID-19 around the world has made more than two millions of confirmed patients and serious shortages of healthcare resources and medical staff in many countries. In the battle of fighting COVID-19 in Wuhan, many microsurgery staff across China were sent to Wuhan and put on duty in the treatment of COVID-19 patients. The purpose of this article is to review the personal experiences of microsurgery staff in fighting against COVID-19 as well as to analyse how to act professionally when facing the challenges and change of roles and meanwhile having to give full play to the professional advantages subject to make contributions to the battle of COVID-19. A reference is hereby provided for the microsurgery staff in dealing with a sudden and major epidemic outbreak in the future.

Objective To investigate the role of transient receptor potential vanilloid tpye 1 (TRPV1) in the pathological process of detrusor overactivity (DO) induced by partial bladder outlet obstruction (BOO).Methods Between June 2014 and December 2014,40 female Wistar rats received partial urethral ligation and urodynamic analysis 6 weeks after.Urinary bladder and dorsal root ganglion (DRG) were removed and RT-PCR,Western Blot and IHC were performed to investigate the expression and location of TRPV1 in control and DO rats.Effect of different concentrations of TRPV1 agonist,as well as TRPV1 antagonist,was also evaluated with isolated detrusor strips.Results 40 female Wistar rats received BOO surgery and 26 of them developed DO.Immunohistochemistry observed linear TRPV1-reactive staining mainly in sub-urothelial and muscular layer.Expression of TRPV1 mRNA and protein in urinary bladder [(0.18±0.02) vs.(0.36 ±0.03),P＜0.05] and dorsal root ganglia (DRG) [(0.41 ±0.05) vs.(0.66 ±0.04),P ＜ 0.05] significantly increased in BOO induced OAB rats.In isolated detrusor strips studies,the amplitude [(0.26 ±0.05)g vs.(0.69 ±0.11)g,P ＜0.05] and frequency [(5.91 ±0.59) Hz vs.(8.75 ± 0.54) Hz,P ＜ 0.05] of contractions of DO tissues were significantly higher than that of control ones.Capsaicin significantly increased the amplitude but not frequency of detrusor intrinsic contractility and this effect was enhanced in OAB conditions.All changes induced by capsaicin were blocked by capsazepine pre-incubated.Conclusions In BOO induced DO rats,over-expressed TRPV1 was involved in DO pathological process by directly sensitizing bladder afferent fibers or indirectly enhancing detrusor intrinsic properties.