Objective To establish a quality control method for monitoring the blood concentrations of cyclosporin A and tacrolimus by HPLC-MS/MS,and to evaluate the quality control samples using the Westgard multi-rule theory.Methods HPLC-MS/MS was used to determine the concentration of cyclosporin A and tacrolimus in human whole blood.The quality control samples of low,medium and high concentration levels in the therapeutic drug monitoring process were statistically analyzed,Levery-Jennings and Z-score quality control charts were drawn,and the Westgard multi-rule theory was applied for in-house quality control evaluation.Results The established method was fully validated with linear ranges of 10.40-1 040.00 ng·mL-1 and 0.50-49.50 ng·mL-1,the quantification limits were 10.40 and 0.50 ng·mL-1,respectively.The extraction recoveries were 108.61％-113.24％and 101.99％-109.37％,respectively.The matrix factors normalized by internal standard were 106.68％-111.27％and 95.70％-97.81％for cyclosporin A and tacrolimus,respectively.The intra-day and inter-day accuracy and precision were less than 15.0％.Other parameters were also validated and met the acceptance criteria.Levery-Jennings and Z-score quality control charts showed that there were 4 warnings(violation of the 12s rule)in the results of the 26 groups of quality control samples in the third quarter of 2022,and no phenomenon was observed to be out of control.Conclusion The established in-house quality control system for therapeutic drug monitoring of cyclosporin A and tacrolimus can effectively ensure the accuracy of blood drug concentration detection.

Transradial access(TRA)for performing interventional diagnosis and treatment can reduce access site complications.However,TRA can still cause complications in the operated limb,including radial artery spasm,radial artery perforation,hemorrhage,hematoma,radial artery dissection,osteofascial compartment syndrome,nerve injury,pseudoaneurysm,arteriovenous fistula,and radial artery occlusion,among which radial artery spasm is the most commonly seen.At present,the clinical recognition,prevention and treatment of complications of surgical limbs are still insufficient.Therefore,this consensus aims to make a detailed introduction about the identification,prevention and nursing of nine major types of complications of the surgical limb in interventional diagnosis and treatment procedures via radial artery access,to propose 24 recommendations which may provide a reference for medical institutions in carrying out the nursing care for complications of the surgical limb in interventional diagnosis and treatment procedures via radial artery access,and to reduce the occurrence of complications in patients.(J Intervent Radiol,2024,33:465-471)

Objective:To study the clinical application of hanging moxibustion in intervention of deep venous thrombosis (DVT) of lower extremity after intertrochanteric fracture of femur, in order to provide theoretical basis for the clinical application of suspension moxibustion.Methods:By adopting a controlled clinical trial method, a total of 100 patients with femoral intertrochanteric fracture who came to Keqiao District Hospital of Traditional Chinese Medicine, Shaoxing City, Zhejiang Province for orthopaedic surgery from January 2021 to September 2022 were selected by convenient sampling method and randomly divided into the control group and the observation group, 50 cases in each group. The control group was given routine nursing intervention, and the observation group was given the traditional Chinese medicine nursing intervention of hanging moxibustion on the basis of the control group. The changes of coagulation function indexes, hemorheology indexes, hemodynamics, the swelling degree score of the affected limb, and the Visual Analogue Scale (VAS) of the affected limb pain in the two groups of patients with intertrochanteric fracture before and 14 days after the intervention, and the incidence of lower extremity deep venous thrombosis (DVT) in the two groups after 1 d, 3 d, 7 d, and 14 d of intervention were observed and recorded.Results:After 14 days of intervention, D-dimer, fibrinogen and prothrombin time in the observation group were (380.64 ± 41.78) μg/L, (4.51 ± 0.49) g/L and (10.46 ± 1.04) s, respectively, which were better than those in the control group (464.91 ± 46.81) μg/L, (4.82 ± 0.56) g/L and (12.85 ± 1.12) s with statistical difference ( t=9.50, 2.95, 11.06, all P<0.05). After 14 days of intervention, the whole blood low tangential viscosity, whole blood high tangential viscosity and plasma viscosity in the observation group were (8.34 ± 0.42), (3.72 ± 0.28) and (1.21 ± 0.18) mPa/s, respectively, which were significantly lower than (8.90 ± 0.46), (4.13 ± 0.26) and (1.53 ± 0.22) mPa/s in the control group ( t=6.36, 7.59, 7.96, all P<0.05). After 14 days of intervention, the postoperative blood flow, maximum blood flow velocity and average blood flow velocity in the observation group were (1.89 ± 0.26) L/min, (31.57 ± 3.29) cm/s, (34.41 ± 3.62) cm/s, which were significantly higher than (1.45 ± 0.21) L/min, (24.18 ± 2.85) cm/s, (27.96 ± 3.15) cm/s in the control group ( t=9.31, 12.01, 9.50, all P<0.05). After 14 days of intervention, the total incidence of lower limb DVT in the observation group was 2.00%(1/50) , lower than 24.00%(12/50) in the control group, the difference between the two groups was significant ( χ2=10.70, P<0.05). Conclusions:Suspended moxibustion can significantly improve the coagulation function, hemorheology, hemodynamics, swelling and pain of the affected limb in patients with postoperative intertrochanteric fracture of the femur, and reduce the occurrence of DVT in the lower extremity. It is recommended to be widely used in clinical practice.

Self-assembly refers to the spontaneous process where basic units such as molecules and nanostructured materials form a stable and compact structure. Peptides can self-assemble by non-covalent driving forces to form various morphologies such as nanofibers, nano layered structures, and micelles. Peptide self-assembly technology has become a hot research topic in recent years due to the advantages of definite amino acid sequences, easy synthesis and design of peptides. It has been shown that the self-assembly design of certain peptide drugs or the use of self-assembled peptide materials as carriers for drug delivery can solve the problems such as short half-life, poor water solubility and poor penetration due to physiological barrier. This review summarizes the formation mechanism of self-assembled peptides, self-assembly morphology, influencing factors, self-assembly design methods and major applications in biomedical field, providing a reference for the efficient use of peptides.
Pharmaceutical Preparations ; Peptides/chemistry* ; Amino Acid Sequence ; Nanostructures/chemistry* ; Drug Delivery Systems

Arrhythmogenic cardiomyopathy (ACM), a fatal heart disease characterized by fibroadipocytic replacement of cardiac myocytes, accounts for 20% of sudden cardiac death and lacks effective treatment. It is often caused by mutations in desmosome proteins, with Desmoglein-2 (DSG2) mutations as a common etiology. However, the mechanism underlying the accumulation of fibrofatty in ACM remains unknown, which impedes the development of curative treatment. Here we investigated the fat accumulation and the underlying mechanism in a mouse model of ACM induced by cardiac-specific knockout of Dsg2 (CS-Dsg2 ^-/-). Heart failure and cardiac lipid accumulation were observed in CS-Dsg2 ^-/- mice. We demonstrated that these phenotypes were caused by decline of fatty acid (FA) β-oxidation resulted from impaired mammalian target of rapamycin (mTOR) signaling. Rapamycin worsened while overexpression of mTOR and 4EBP1 rescued the FA β-oxidation pathway in CS-Dsg2 ^-/- mice. Reactivation of PPARα by fenofibrate or AAV9-Pparα significantly alleviated the lipid accumulation and restored cardiac function. Our results suggest that impaired mTOR-4EBP1-PPARα-dependent FA β-oxidation contributes to myocardial lipid accumulation in ACM and PPARα may be a potential target for curative treatment of ACM.

Objective:To explore the effect of different post-processing parameters of digital radiography (DR) on the quality of chest X-ray for pneumoconiosis diagnosis, and to provide suggestions on parameter setting suitable for this kind of DR machine.Methods:From January 1, 2022 to June 30, 2022, the chest films of 35 workers in the department of radiology of Hangzhou occupational disease prevention and treatment hospital were randomly selected and printed after setting different image post-processing parameters. The quality of chest film was evaluated by the measurement of optical densitometer and the combination of subjective and objective by professional physicians.Results:When the density is set to 2 and the contrast/detail contrast is 4.5, the optical density of each area of DR chest film meets the requirements of chest X-ray quality, and the qualified rate of physician quality evaluation is the highest.Conclusion:Reasonable setting of image post-processing parameters can improve the quality of chest radiograph.

Objective:To explore the effect of different post-processing parameters of digital radiography (DR) on the quality of chest X-ray for pneumoconiosis diagnosis, and to provide suggestions on parameter setting suitable for this kind of DR machine.Methods:From January 1, 2022 to June 30, 2022, the chest films of 35 workers in the department of radiology of Hangzhou occupational disease prevention and treatment hospital were randomly selected and printed after setting different image post-processing parameters. The quality of chest film was evaluated by the measurement of optical densitometer and the combination of subjective and objective by professional physicians.Results:When the density is set to 2 and the contrast/detail contrast is 4.5, the optical density of each area of DR chest film meets the requirements of chest X-ray quality, and the qualified rate of physician quality evaluation is the highest.Conclusion:Reasonable setting of image post-processing parameters can improve the quality of chest radiograph.

OBJECTIVE: To explore the genetic basis for a child with succinate semialdehyde dehydrogenase deficiency. METHODS: Peripheral blood samples of the proband and his parents were collected and subjected to Sanger sequencing. High-throughput sequencing was used to verify the gene variants. Bioinformatic software was used to analyze the pathogenicity of the variant sites. RESULTS: Sanger sequencing showed that the proband carried a homozygous c.1529C>T (p.S510F) variant of the ALDH5A1 gene, for which his mother was a carrier. The same variant was not detected in his father. However, high-throughput sequencing revealed that the child and his father both had a deletion of ALDH5A1 gene fragment (chr6: 24 403 265-24 566 986). CONCLUSION The c.1529C>T variant of the ALDH5A1 gene and deletion of ALDH5A1 gene fragment probably underlay the disease in the child. High-throughput sequencing can detect site variation as well as deletion of gene fragment, which has enabled genetic diagnosis and counseling for the family.
Amino Acid Metabolism, Inborn Errors/genetics* ; Child ; Developmental Disabilities ; Humans ; Infant ; Mutation ; Succinate-Semialdehyde Dehydrogenase/genetics*

Objective:To study the effect of baicalein on the expression of glutamate receptor related protein in PC12 cells injured by Aβ 25-35. Methods:PC12 cells were divided into control group, model group, estradiol group and baicalein group with different concentrations. The survival condition of PC12 cells in each group were detected by thiazole blue (MTT). PC12 cells were divided into control group, model group, estradiol group and baicalein group. The control group and model group were cultured with DMEM medium, and the estradiol group was added with 1×10 -3 μmol/L estradiol DMEM medium, baicalein group was added with 1 μmol/L baicalein DMEM medium. After 2 hours of intervention, 20 μmol/L Aβ 25-35 was added to the model group, estradiol group and baicalein group with induced PC12 cell injury. After 22 hours of intervention, flow cytometry was used to detect the apoptosis of PC12 cells. The expression of estrogen receptor β (ER β), phosphorylated c-Jun N-terminal kinase (p-JNK/JNK) and ionic receptor N-methyl-D-aspartate receptor 1 (NMDAR1), glutamate receptor 2 (GluR2) and calcium/calmodulin dependent protein kinase Ⅱ (CaMK Ⅱ) were detected by Western blot. Results:Compared with model group, 1 μmol/L baicalein significantly increased the proliferation rate [(95.80±2.47)% vs. (64.34±3.84)%]. The apoptosis rate of PC12 cells[(7.83±0.67)% vs. (12.84±0.91)%] was significantly decreased in baicalein group ( P<0.01). The expression of NMDAR1 (0.582±0.012 vs. 0.352±0.012), GluR2(0.538±0.017 vs. 0.355±0.006), ER β (0.362±0.015 vs. 0.262±0.018) in baicalein group were significantly increased ( P<0.01), the expression of p-JNK/JNK (0.476±0.013 vs. 0.752±0.014) and CaMK Ⅱ(0.499±0.019 vs. 0.670±0.016) in baicalein group were significantly decreased ( P<0.01). Conclusions:Baicalein has a protective effect on PC12 cells injured by Aβ 25-35. Its mechanism may be related to the inhibition of p-JNK/JNK activity by activating ERβ and regulating the expression of glutamate receptor related protein.

Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.