Objective To evaluate the application of “expert-guided network tracking system” in training community general practitioner for hypertension management.Methods Total 855 general practitioners (GPs) from 20 community health service centers in Hangzhou,Jiaxing and Shaoxing of Zhejiang province were divided into two groups: 430 GPs from 10 community health centers received training for hypertension management using “ expert-guided networking tracking system” (intervention group) in December 2008 and 425 GPs from another 10 health centers received conventional training (control group).Questionnaire surveys about the knowledge and skill of hypertension management were conducted before and 3 y after training.Results The awareness rates of knowledge about hypertension prevention and control,non-drug therapy and drug therapy increased from 37.0％ (159/430),45.6％ (196/430),42.8％ (184/430) to 66.8％ (284/425),81.4％ (346/425),77.6％ (330/425),respectively and the accuracy of case analysis increased from 38.4％ (490/1290) to 73.3％ (946/1290) (P ＜0.01) after training in intervention group.Meanwhile the knowledge and case management abilities in control group were also improved after conventional training,but the degree was significantly lower than that in the intervention group.Conclusions “Expert-guided networking tracking system” can significantly improve the knowledge and skills for hypertension management in community general practitioners.

Adiponectin is an adipocyte-derived secretory protein. It was found to be associated with insulin resistance, inflammation and arteriosclerosis. To further study the biological function and expression of adiponection in vivo, adipoenctin gene knock-out and LacZ gene knock-in mouse model was constructed. Gene targeting strategy was designed to replace part of exon 2 and exon 3 of adiponectin gene with full length LacZ gene in frame with remaining upstream ATG and signal peptide sequence of exon 2. The targeting vector (Adipo-LacZ-XpPNT) was constructed and verified by restriction enzyme digestion and sequencing. CJ7 ES cells were transfected with targeting vector linearized by NotⅠ digestion, selected in the medium containing both G418 and ganciclovoir. Resistant clones were screened by PCR and further confirmed by Southern blot for correct homologous recombinants. Chimera mice were obtained by routing microinjection of homologous recombined ES cells into blastocysts. After mating, mice heterozygous and further homozygous for adiponectin knockout and LacZ gene knock-in were established. Expression of both endogenous adiponectin and exogenous LacZ gene in mouse tissues and sera were detected by RT-PCR, Northern-blot, Western blot and ELISA. The results show that adiponectin was disrupted at both mRNA and protein levels. LacZ gene is expressed exclusively in adipose tissue of mutant mice. Its expression profile is identical to endogenous adiponection. Unexpectedly, LacZ activity could not be detected in both adipose tissue and serum although LacZ protein can be detected in adipose tissue but not in serum of mutant mice. In conclusion, mice homozygous for adiponectin knockout and LacZ gene knock-in have been successfully constructed. Mutant mice display LacZ expression profile identical to endogenous adiponectin albeit neither LacZ activity nor protein can be detected in serum of mutant mice.

Objective To investigate the efficacy and safety of endovascular recanalization 6-24 h after onset in patients with acute basilar artery occlusion,and explore the related factors for their prognoses.Methods Clinical data of 37 patients with acute basilar artery occlusion,received endovascular recanalization in our hospital from January 2016 to July 2019,were retrospectively collected;23 patients were into group of onset-to-puncture time (OPT)＞6 h (6-24 h),and 14 patients were into group of OPT ≤ 6 h (0-6 h).Statistical methods were used to compare the postoperative symptomatic intracranial hemorrhage rate,good prognosis rate (modified Rankin scale [mRS] scores ≤ 3) and mortality 3 months after onset between the two groups;clinical data between the subgroups with good and poor prognoses in patients of group of OPT＞6 h were compared.Results The postoperative symptomatic intracranial hemorrhage rate,and good prognosis rate and mortality of patients from group of OPT＞6 h were 30.4％,47.8％ and 43.5％,respectively;and there were no statistically significant differences as compared with those in patients from group of OPT≤6 h (35.7％,35.7％,and 42.9％,P＞0.05).Scores of scales based on preoperative CTA images (posterior circulation-Alberta stroke program early CT scale [pc-ASPECTS],scale of posterior circulation on CTA [pc-CTA],and scale of basilar artery on CTA [BATMAN]) showed significant differences between the good prognosis subgroup and poor prognosis subgroup in patients fiom group of OPT＞6 h (P＜0.05).Conclusion Endovascular recanalization 6-24 h after onset is effective in patients with acute basilar artery occlusion,and the safety does not obviously decrease;scores of pc-ASPECTS,pc-CTA and BATMAN may be related to the clinical prognoses.