Objective To establish a 13C isotope-labeled hyperinsulinemic-euglycemic clamp model for the assessment of insulin sensitivity in mice.Methods The mouse model of insulin resistance was established by high-fat diet feeding.The phosphorylation level of downstream insulin signaling protein,Protein Kinase,also known as Akt was assessed.Glucose metabolism was evaluated using glucose tolerance test,insulin tolerance test,and pyruvate tol-erance tests and the area under the curve of the respective testes over 2 hours was calculated to quantify overall blood glucose level.Mice underwent jugular vein catheterization surgery,and a 13C isotope-labeled hyperinsulinemic-eugly-cemic clamp experiment was conducted to monitor blood glucose levels and to calculate the glucose infusion rate(GIR).Tail vein serum was collected for liquid chromatography-tandem mass spectrometry(LC-MS/MS)analysis to determine glucose disposal rate(GDR)and hepatic gluconeogenesis rate(HGP).Following the inhibition of glycog-enolysis in mice,Akt phosphorylation level was measured to evaluate insulin signaling.The clamp test was repeated to calculate GIR,and tail vein blood serum was analyzed by LC-MS/MS to determine GDR and HGP.Results After one week of high-fat diet feeding,mice exhibited significantly elevated blood glucose level(P＜0.001)accompanied by reduced p-Akt level in liver and muscle.Glucose tolerance tests,insulin tolerance tests and pyruvate tolerance test demonstrated a significant increase in blood glucose level(P＜0.05)and a higher area under curves(AUC)(P＜0.001)in high-fat-fed mice.During the 13C-labeled hyperinsulinemic-euglycemic clamp experiment,after the blood glucose levels were stable,the GIR of high-fat-fed mice was significantly reduced(P＜0.001),GDR was de-creased(P＜0.0001)and hepatic gluconeogenesis rate was increased(P＜0.01).After pharmacological inhibition of glycogenolysis,mice showed elevated blood glucose level(P＜0.001)and further reductions in p-Akt level in liver and muscle.The 13C-labeled clamp experiment revealed that in the treated group,the GIR decreased(P＜0.01)while GDR was reduced(P＜0.000 1)and HGP increased(P＜0.01).Conclusions An improved hyperinsulinemic-eugly-cemic clamp model was developed to assess insulin sensitivity in mice.

Objective:To evaluate the feasibility and safety of PT Scope (short for intelligent pressure and temperature controlled flexible ureteroscopy)combined with Thulium laser in the intracavitary treatment of upper urinary tract stones.Methods:A retrospective analysis was conducted on the clinical data of 13 patients with upper urinary tract stones who were treated with PT Scope combined with Thulium laser lithotripsy in Sun Yat-Sen Memorial Hospital from February to April 2024. There were 7 males and 6 females. The patients had a mean age of (46±10) years old, with an accumulated stone diameter of (25.8±13.3) mm. There were 7 cases of lower calyx stones (53.8%), and 3 cases of concomitant ureteral stones (23.1%).Four patients (30.8%) had positive preoperative urine cultures, and six patients (46.2%) had leukocyte counts greater than 100 cells/μl in their urine tests. The Thulium laser power was set at 45 W (1.5 J at 30 Hz, 0.3 J at 150 Hz). The renal pelvic pressure threshold was set at 30 mmHg (1 mmHg=0.133 kPa), and the temperature threshold at 43 ℃. Postoperatively, double J stents were placed for 2 to 4 weeks.Results:All 13 patients successfully completed the surgery. The median operative time was 30 (25, 90) minutes. The intraoperative average renal pelvic pressure in these 13 patients ranged from 8 mmHg to 24 mmHg, and the average renal pelvic temperature ranged from 25 ℃ to 34 ℃. Postoperatively, 1 patient experienced a fever (38.0 ℃) and 2 patients required analgesic treatment due to postoperative pain. There were no other intraoperative or postoperative complications. The median postoperative hospital stay was (1.5±0.8) days. The stone-free rate of 1 month was 84.6%(11/13).Conclusions:PT Scope combined with Thulium laser could effectively control renal pelvic pressure and temperature, achieve a high stone-free rate, and have a low complication rate. It is a safe and effective treatment for upper urinary tract stones.

Objective:To investigate the safety and efficacy of low molecular weight heparin (LMWH) bridging program in the perioperative period of mini-percutaneous nephrolithotomy (mPCNL) for long-term antithrombotic patients.Methods:The clinical data of 50 patients who received long-term antithrombotic therapy with mPCNL in Sun Yat-sen Memorial Hospital from January 2013 to December 2017 were retrospectively analyzed. Perioperative anticoagulation plans were drawn up after discussion with an internist. Patients with high thrombosis risk were bridged with LMWH during the perioperative period. Resumed LMWH anticoagulation within 48 hours after surgery. Patients with low or medium thrombosis risk directly discontinued anticoagulation one week before surgery. Preoperative anticoagulation was resumed within 48 hours after removing the nephrostomy tube in all patients. We analyzed the general information before surgery, data during surgery, postoperative hemoglobin changes and stone-free rate (SRF) of all cases. 21 patients were treated with LMWH bridging (bridging group), and 29 patients were directly discontinued with anticoagulant drugs (non-bridging group). There was no statistical difference between the two groups in age [(59.7±7.1) vs. (52.4±10.4)years] , gender [(male/female), 14/7 vs. 19/10], BMI [ (24.3±3.9) kg/m 2 vs. (24.7±5.1) kg/m 2], S. T.O.N.E. score (7.4±1.1 vs. 6.9±1.0), stone surface area [ 314.0(31.4-1 130.4) mm 2 vs. 282.5(64.7-866.0) mm 2], the number of calculi involved in calyces (6/15 vs. 13/16) and stone-related surgical history [ 34% (7/21) vs. 24% (7/29) ]. Results:In the bridging group, 18 patients (86%) performed single-channel mPCNL, 3 patients (14%) underwent dual-channel mPCNL, and the operation time was 80 (35-180) min. In the non-bridging group, 27 patients (93%) underwent single-channel mPCNL, 2 patients (7%) performed dual-channel mPCNL, and the operation time was 80 (30-60) min. The mean changes in hemoglobin in the bridging group and the non-bridging group was 18 (-2 -66) g/L and 14 (-25-64) g/L, respectively ( P = 0.073). The average postoperative hospital stay in the bridging group was (8.6 ± 3.5) days, and the non-bridging group was (7.1 ± 2.3) days ( P= 0.057). Two patients in each group received blood transfusion, and no patients received interventional embolization. The SRF of bridging group and non-bridging group was 81.0% (17/21) vs. 75.9% (22/29) ( P = 0.67) 1 month after the operation. During the perioperative period, no patients had thrombotic complications. Conclusions:When mPCNL was required for long-term antithrombotic treatment patients, the use of LWMH alternatives during the perioperative period did not increase bleeding related complications.

Objective:To investigate whether coxsackievirus A 16 (CVA16) infection would affect the expression of N6-methyladenosine (m 6A) methylation-related proteins in human bronchial epithelial cells (16HBE), ICR suckling mice and SCRBA2 humanized mice and influence their subcellular localization. Methods:CVA16 was used to infect 16HBE cells at a multiplicity of infection (MOI) of 0.1 and mice at 10 7 CCID 50/ml. Changes in the expression of methyltransferases, demethylases and methylated reading proteins were analyzed by Western blot. Cellular localization of these proteins was observed using immunofluorescence. Results:The expression of m 6A methylation-related proteins was gradually reduced in CVA16-infected cells with time, but showed no obvious change in ICR suckling mice or SCRBA2 humanized mice. After infection, m 6A methylation-related proteins were redistributed in both the nucleus and cytoplasm and even degraded. Conclusions:CVA16 replication in host cells altered the expression and cellular localization of m 6A methylation-related proteins, which indicated that m 6A modification might be a new potential target for enterovirus therapy.

The development of Hainan traditional Chinese medicated diet therapy was surveyed and analyzed. The related suggestions are supplied for the development of traditional Chinese medicated diet therapy in Hainan. The designed questionnaires are set up for the surveys that include the respondents’ awareness of the medicated diet therapy and the current status of the medicated diet therapy markets. A total of 450 questionnaires have been sent and 363 respondents (80.67%) were reveiced and analyzed. The result showed that 49.59% (180/363) of the respondents knew the TCM diet therapy well, 43.80% (159/363) favored TCM diet. More than half of the respondents keep in the beauty maintain, the weight-loss and qi and blood maintain by TCM diet. The respondents showed their own favour when they consumed TCM diet. 44.63% (162/363) of the respondents regarded the effectiveness of the TCM diet as important, and 31.40% (114/363) regarded the flavour or taste of the diet as important. The highest consumption of TCM diet that can be accepted was 160 yuan per person. The reputation of a medicinal restaurant is the most important factor for consumers. To cultivate the professionals for the medicated diet’s services and management is an urgent undertaking. To utilize the specific medicines and foods of Hainan for developing the TCM diet is a positive motives. It is necessary to adopt international standards to strengthen the government’s control over the entirely industrial chain of the TCM diet therapy. It will be prosperous to utilize the characteristic culture to establish the medicinal restaurants in Hainan. They will become the new engines for improving economic, social and cultural development of Hainan free trade.

Objective To investigate the effect of adjusting tube current time product (mAs) according to head circumference index on head CT image quality and organ-specific-dose level based on Monte Carlo analysis platform.Methods A total of 92 patients including children and adolescents with different clinical symptoms undergoing head CT scan were prospectively selected between September 2017 and June 2018 in the First Hospital of Jilin University.Without limiting the size of the head circumference,there were 22 patients were selected as conventional group by random number table,whose head circumference was 48.1-59.2 cm.Low dose group was divided into following three subgroups according to different head circumferences:A group 54.1-57.0 cm (n=22);B group 51.1-54.0 cm (n=26) and C group 48.1-51.0 cm (n=22).Tube current time product was 250 mAs for conventional group,200 mAs for A group,150 mAs for B group and 100 mAs for C group,respectively.The organ-specific-radiation doses (brain,eye lens and salivary gland) were recorded by Monte Carlo analysis platform and the subjective and objective image quality score was evaluated.Analyses of the differences between four groups were compared with image quality score as well as organ-specific-radiation dose by single factor variance.Results Radiation dose to brain was conventional group (34.37±3.62),A group (25.91±0.99),B group (23.18±6.11) and C group (17.38 ± 3.23) mSv,respectively.The difference was of statistical significance in the four groups (F=54.51,P＜0.05).Dose to eye lens was conventional group (41.54± 1.04),A group (33.03±0.35),B group (26.18±2.72) and C group (20.88±4.45) mSv,with statistical significance in difference between the four groups (F=189.75,P＜0.05).Dose to salivary gland was conventional group (35.04 ± 4.94),A group (25.92 ± 0.99),B group (22.93 ± 6.54) and C (14.96±2.67) mSv,respectively,with statistical significance in difference between the four groups (F=65.74,P＜0.05).Image quality scores were respectively conventional group (4.97±0.13),A group (4.77 ± 0.49),B group (4.60 ± 0.49) and C group (3.98 ± 0.61),respectively,with statistical significance between them (F=3.89,P＜0.05),but without statistical significance in difference between the four groups (P ＞ 0.05).The signal-to-noise ratios of gray matter in A,B and C groups were conventional group (18.69 ± 3.55),A group (16.76 ± 2.87),B group (15.05 ± 2.80) and C group (13.65±2.53),respectively,without statistical significance in difference between the four groups (P＞ 0.05);The signal-to-noise ratios of white matter in conventional group (17.46±3.72),A group (15.54± 2.81),B group (13.71±2.43) and C group (11.77±2.18),respectively,without statistical significance in difference between the four groups (P＞0.05).Conclusions Adjusting the tube current time product (mAs) according to head circumference index of children and adolescents can make scanning program more personalized and reduce organ-specific-radiation doses to sensitive organs without compromise of image quality.