Lipid rafts are microdomains in the cell membrane that are involved in cell signal transduction,metabolism,and intercellu-lar interactions.In recent years,studies have shown that lipid rafts play an important role in the pathogenesis of diabetes.Cholesterol and sphingolipids are the main lipid components in lipid rafts,and the protein components in lipid rafts include caveolin,flotillin,pal-mitoylated proteins,and glycosylphosphatidylinositol-anchored proteins.Changes in these components affect the structure and function of lipid rafts,which in turn may affect insulin signal transduction,leading to the occurrence of diabetes-related diseases.Lipid rafts are closely related to the occurrence and development of diabetes in different tissues.Pancreatic lipid rafts are closely related to insulin se-cretion,and their structural changes affect insulin synthesis and release.Changes in lipid rafts in adipose tissue are related to insulin resistance and disorders of glycolipid metabolism.Changes in lipid rafts in the liver can affect gluconeogenesis and glycogen synthesis.Lipid rafts in the kidney play a regulatory role in the progression of diabetic nephropathy.This article aims to provide a comprehensive overview of the role of lipid rafts in the pathogenesis of diabetes,offering insights into the identification of new targets for the prevention and treatment of diabetes in the future,as well as presenting a new perspective for the development of therapeutic agents for diabetes.

Objective To investigate the correlation between lung Point-of-Care ultrasound score and clinical indicators by analyzing the features of Point-of-Care ultrasound in acute COVID-19.Methods 30 COVID-19 patients admitted to the Affili-ated Hospital of North Sichuan Medical College were selected,lung Point-of-Care ultrasound sequential scan was conducted in pa-tients with the BLUE-PLUS regimen and the lung Point-of-Care ultrasound semi-quantitative scoring was performed.The clinical indicators of partial pressure of carbon dioxide,anion gap,PH value,standard bicarbonate,oxygen partial pressure,oxygen satu-ration,the lymphocyte percentage(LYM% ),the lymphocytic absolute value(LYM#),the clinical typing,hospital stay,etc were collected.The lung Point-of-Care ultrasound score of acute COVID-19 patients in different clinical typing was compared and the features of Point-of-Care ultrasound in acute COVID-19 were analyzed.The ROC curve was constructed to analyze the effec-tiveness of lung Point-of-Care ultrasound score for the typing of normal type and(critical)severe type.Results In 30 cases of COVID-19 patients during the acute period,there were 29 patients with at least one lung point involvement on both sides(96.7% ),1 case with at least one lung point involvement on one side(3.3% )and 15 cases showed Lung consolidation＞1cm at least one lung point.Comparison of the same lung point between the left and right lung was performed and there was statistical-ly significant difference in the total scores between the left and right lung(P＜0.05).Comparison of total scores of different lung points in patients with different clinical types showed there was statistically significant difference in the total scores of left lung,the total scores of right lung,the total scores of whole lung between normal type and critical type(P＜0.05).The area under the curve(AUC)for the diagnosis of normal and(critical)severe types based on the total lung scores is 0.870.The total scores of the left lung,right lung,and whole lung were not correlated with LYM% ,LYM#,and anion gap(P＞0.05)were positively cor-related with clinical typing and hospital stay,and negatively correlated with standard bicarbonate(P＜0.05).The total scores of the left lung and whole lung were negatively correlated with PH value,oxygen partial pressure,and oxygen saturation,but posi-tively correlated with partial pressure of carbon dioxide(P＜0.05).The total scores of the right lung was not correlated with PH value,partial pressure of carbon dioxide,oxygen partial pressure,and oxygen saturation(P＞0.05).Conclusion There were differences in Point-of-Care ultrasound features among patients with different clinical types of acute COVID-19,Lung Point-of-Care ultrasound semi-quantitative scoring is correlated with pH value,partial pressure of carbon dioxide,standard bicarbonate,ox-ygen partial pressure,oxygen saturation,clinical typing and hospital stay.The patients of critical type have higher scores,lung Point-of-Care ultrasound is expected to be used for clinical typing and condition evaluation of acute COVID-19 patients.

Objective To investigate the effect of glycine N-methyl transferase (GNMT)on intrauterine adhesion (IUA)fibrosis and its related mechanism.Methods In vivo experiment:A total of 36 healthy female SD rats (SPF grade,6～8 weeks old and weighing from 180～220 g)were subjected in this study.IUA model of SD rats and IUA model of GNMT overexpressed rats were established.RT-qPCR and immunofluorescence assay were applied to detect GNMT expression level in normal uterus and model group.RT-qPCR and Western blotting were used to detect the mRNA and protein levels of fibrosis-related molecules and the activation of TGF-β1/Smad3 signaling pathway in each group.The number of endometrial glands in each group was observed by HE staining.Masson staining was used to analyze the severity of endometrial fibrosis in each group.In vitro experiment:transformed human endometrial stromal cells (THESCs)fibrotic phenotype model was constructed using TGF-β1,and THESCs stably transfected with GNMT overexpression lentvirus were treated with TGF-β1.RT-qPCR and Western blotting were used to detect the mRNA and protein expression of fibrosis-related molecules.The expression of TGF-β1/Smad3 signaling pathway was detected by Western blotting.TGF-β1/Smad3 signaling pathway was activated by TGF-β1/Smad signaling pathway activator (SRI-011381),and the expression of TGF-β1/Smad3 signaling pathway and key molecular proteins of fibrosis phenotype was measured with Western blotting.Results In vivo experiment,the mRNA and protein expression levels of GNMT were significantly decreased in the IUA rats than the control rats (P<0.05).Overexpression of GNMT decreased the mRNA and protein levels of fibrosis related molecules,Collagen Ⅰ,Collagen Ⅲ and FN in the IUA rats (P<0.05),and decreased the phosphorylation levels of TGF-β1 and its downstream Smad3 protein (P<0.05).HE and Masson staining showed that overexpression of GNMT could increase the number of endometrial glands and reduce the severity of fibrosis in the IUA rats (P<0.05).In vitro experiments:overexpression of GNMT decreased the mRNA and protein levels of Collagen Ⅰ,Collagen Ⅲ and FN associated with fibrotic phenotype of THESCs (P<0.05),and reduced the phosphorylation level of Smad3 protein,downstream of TGF-β1 (P<0.05).After activation of TGF-β1/Smad3 signaling pathway,the protein levels of TGF-β1/Smad3 signaling pathway and downstream fibrosis phenotype molecules,Collagen Ⅲ and FN,were significantly decreased in the LV-GNMT+SRI-011381 group.Conclusion Overexpression of GNMT can inhibit endometrial fibrosis by regulating TGF-β1/Smad3 signaling pathway,thus achieving therapeutic effect on IUA.

There are limited reports available regarding the treatment of amputated noses. This article presented a case of an incompletely amputated nose in a 47-year-old male who was admitted to Dalian University Affiliated Xinhua Hospital in July 2023. He was characterized by an amputated right nasal tip and alar region, with an avulsion area of approximately 4 cm×4 cm. The broad pedicle was connected to the nasal base, approximately 5 mm below the remaining nasal column, and only the nasal column retained a satisfactory arterial blood supply. During the operation, the amputated tissue was implanted in situ, and clindamycin was employed to prevent infection after the operation by intravenous infusion. Bloodletting with flaps, wet application of heparin saline, and massage were employed and all the amputated tissue survived. The appearance of the nose was deemed acceptable. By reviewing relevant literature, the author discussed and summarized the methods of nasal blood supply and treatment for nasal amputated injuries, thereby providing a reference for the management of similar cases.

There are limited reports available regarding the treatment of amputated noses. This article presented a case of an incompletely amputated nose in a 47-year-old male who was admitted to Dalian University Affiliated Xinhua Hospital in July 2023. He was characterized by an amputated right nasal tip and alar region, with an avulsion area of approximately 4 cm×4 cm. The broad pedicle was connected to the nasal base, approximately 5 mm below the remaining nasal column, and only the nasal column retained a satisfactory arterial blood supply. During the operation, the amputated tissue was implanted in situ, and clindamycin was employed to prevent infection after the operation by intravenous infusion. Bloodletting with flaps, wet application of heparin saline, and massage were employed and all the amputated tissue survived. The appearance of the nose was deemed acceptable. By reviewing relevant literature, the author discussed and summarized the methods of nasal blood supply and treatment for nasal amputated injuries, thereby providing a reference for the management of similar cases.

Objective To establish the reference intervals for test indicators of thyroid function,namely thyroid stimulating hormone(TSH),free thyroxine(FT4),and free triiodothyronine(FT3),in the children aged 0 to 15 years old in Nanning,China.Methods A total of 1 289 healthy children aged 0 to 15 years old who attended the Guangxi International Zhuang Medicine Hospital Affiliated with Guangxi University of Chinese Medicine from October 2018 to August 2023 were selected.The concentrations in serum TSH,FT4,and FT3 were measured by chemiluminescent microparticle immunoassay(CMIA).According to the Clinical and Laboratory Standards Institute(CLSI)EP28-A3c guideline,the nonparametric percentile method was used to establish the reference intervals for TSH,FT4,and FT3 in the children aged 0 to 15 years old in Nanning area.Results The established reference intervals were as follows:TSH(male):0 to＜1 month:0.88-7.81 μIU/mL,1 month to 15 years:0.59-5.06 μIU/mL;TSH(female):0 to＜1 month:0.93-8.42μIU/mL,1 month to 15 years:0.60-4.30 μIU/mL.FT4(male):0 to＜1 month:0.99-1.92 pg/mL,1 month to 15 years:0.86-1.33 pg/mL;FT4(female):0 to＜1 month:1.05-2.06 pg/mL,1 month to 15 years:0.85-1.37 pg/mL;FT3:0 to＜1 month:2.16-4.24 pmol/L,1 month to＜11 years:2.75-4.49 pmol/L,11 to 15 years:2.45-4.34 pmol/L.Significant differences were observed among different gender and age groups for TSH,FT4,and FT3 levels(P＜0.05).Conclusion This study successfully established the refer-ence intervals of TSH,FT4,and FT3 in the children aged 0 to 15 years old in Nanning area,which were significantly different among various gender and age groups.

Objective To study the distribution and drug resistance characteristics of pathogenic bacteria in the elderly population of China by collecting and analyzing the standardized case data on the pathogens of infections in elderly patients,and to facilitate the establishment of a standardized layered surveillance system for pathogenic bacteria in China.Methods We collected the case data of elderly patients(≥65 years old)from 62 sentinel hospitals across the country in 2021.Then,we statistically analyzed the data by patient age,their geographical region,the distribution of pathogenic bacteria,and the drug resistance characteristics of main pathogens.Results A total of 3468 cases from across the country were included in the study.The top three sources of patients were the intensive care unit(13.2%),the department of respiratory medicine(11.2%),and the department of general surgery(8.4%).The top three types of specimens were urine(25.5%),sputum(20.6%),and blood(18.7%).A total of 3468 strains of pathogens were isolated,among which,78.9%were gram-negative bacteria and 21.1%were gram-positive bacteria.The top five types of bacteria were Escherichia coli(20.9%),Klebsiella pneumoniae(18.3%),Pseudomonas aeruginosa(11.2%),Staphylococcus aureus(9.0%),and Acinetobacter baumannii(7.0%).The isolation rates of common important drug-resistant bacteria were 38.0%for methicillin-resistant Staphylococcus aureus(MRSA),68.7%for carbapenem-resistant Acinetobacter baumannii(CRAB),and 38.2%for carbapenem-resistant Pseudomonas aeruginosa(CRPA),20.1%for carbapenem-resistant Klebsiella pneumoniae(CRKP),5.2%for carbapenem-resistant Escherichia coli(CRECO),and 2.1%for vancomycin-resistant Enterococcus(VRE).There were differences in the isolation rates of CRAB and CRKP in clinical care in the elderly population in seven geographical regions of China(P＜0.05).Klebsiella pneumoniae is the most important pathogen in the elderly population≥85 years old,and the isolation rates of CRKP showed significant differences in different age groups(P＜0.05).Conclusion There are significant differences in the drug resistance of pathogenic bacteria in the elderly populations of different regions and age groups in China.Therefore,monitoring the distribution and drug resistance of pathogenic bacteria in the elderly population and formulating targeted treatment plans according to the characteristics of the specific regions and age groups are of great significance to the improvement in the treatment outcomes and prognosis of the elderly population.

Objective:To investigate the relationship between carotid atherosclerosis(CAS)and subclinical left ventricular(LV)dysfunction in type 2 diabetes mellitus patients with preserved LV ejection fraction(LVEF).Methods:A total of 120 patients with type 2 diabetes mellitus who had LVEF≥50% were selected in the Department of Endocrinology, the First Affiliated Hospital of Air Force Medical University from June 2021 to October 2021. The global longitudinal strain(GLS)was obtained by two-dimensional speckle tracking echocardiography(STE)to assess subclinical LV systolic function. The mitral ratio of peak early to late diastolic filling velocity(E/A), and mitral velocity to early diastolic velocity of the mitral annulus(E/E′)ratio were obtained by pulsed tissue Doppler echocardiography to assess LV diastolic function. Acrroding to bilateral carotid ultrasound examination, the subjects were divided into normal carotid arteries group( n=46) and CAS group( n=74). Demographics and biochemical parameters were compared between two groups. Binary logistic regression and Pearson correlation analysis were used to evaluate the relationship between CAS and subclinical LV dysfunction. Results:The CAS group had a higher proportion of men, older age, and a longer duration of diabetes than the normal carotid arteries group(all P<0.05). There was no difference in LVEF and GLS between the two groups [normal carotid arteries group vs CAS group, LVEF: (60.72±4.73)% vs(60.07±4.28)%; GLS: (18.24±3.72)% vs(17.81±3.47)%, respectively; both P>0.05]. However, compared with normal carotid arteries group, E/A ratio was decreased and E/E′ ratio was significantly increased in CAS group(both P<0.01). Pearson correlation analysis showed that GLS was not correlated with carotid plaque thickness and carotid intima-media thickness(CIMT; both P>0.05). By contrast, E/E′ ratio was positively correlated with carotid plaque thickness and CIMT(both P<0.05). Binary logistic regression analysis showed that GLS and E/E′ ratio were not associated with CAS( both P>0.05). However, decreased E/A ratio was significantly associated with the existence of CAS( OR=0.09, 95% CI 0.01-0.67, P=0.018). Conclusions:In type 2 diabetes mellitus patients without overt heart failure and with preserved LVEF, the occurrence of CAS is not associated with subclinical LV systolic impairment assessed by GLS, but is significantly associated with LV diastolic dysfunction, and is independent of traditional cardiovascular risk factors.

The high-content image-based assay is commonly leveraged for identifying the pheno-typic impact of genetic perturbations in biology field.However,a persistent issue remains unsolved during experiments:the interferential technical noises caused by systematic errors(e.g.,tempera-ture,reagent concentration,and well location)are always mixed up with the real biological signals,leading to misinterpretation of any conclusion drawn.Here,we reported a mean teacher-based deep learning model(DeepNoise)that can disentangle biological signals from the experimental noises.Specifically,we aimed to classify the phenotypic impact of 1108 different genetic perturbations screened from 125,510 fluorescent microscopy images,which were totally unrecognizable by the human eye.We validated our model by participating in the Recursion Cellular Image Classification Challenge,and DeepNoise achieved an extremely high classification score(accuracy:99.596％),ranking the 2nd place among 866 participating groups.This promising result indicates the success-ful separation of biological and technical factors,which might help decrease the cost of treatment development and expedite the drug discovery process.The source code of DeepNoise is available at https://github.com/Scu-sen/Recursion-Cellular-Image-Classification-Challenge.

Hemorrhage/etiology* ; Humans ; Image-Guided Biopsy ; Lung/diagnostic imaging* ; Lung Diseases/etiology* ; Lung Neoplasms ; Retrospective Studies ; Risk Factors ; Ultrasonography, Interventional