Objective To inveatigate the effect of 15-HETE, a metabolite of arachidonic acid, on isolated hypoxic pulmonary arterial ringa ( PARs) , trying to find appropriate treatment for pulmonary hypertension and its complications during anesthesia in order to avoid hypoxemia. Methods Sixteen healthy Wistar rats of either sex weighing (230 ? 10) g were randomly divided into two groups : A control group breathing fresh air (FiO2 =21%) and B hypoxia group breathing hypoxic air (N2 = 90% , O2 = 10% ) in a hypoxic box. After breathing hypoxic air for 9 days the animals were anesthetized. Heart and lungs were immediately removed and PARs (0.5-1.0 mm in diameter and 3 mm in length) were prepared. Four PARs were prepared from each animal. The PARs were suspended in baths filled with Krebs-Hensleit (K-H) solution maintained at 37℃ and aerated with 95% O2 and 5% CO2. Preload was gradually increased to 0.3 g in 30 min. The isometric tension was measured using a four-channel force-displacement transducer. 15-HETE was added to K-H solution and the concentration was gradually increased from 10-8 to 10-6 mol?L-1 at 5 min intervals. Contractility of PARs was analyzed by a software of Medlab 6.0. Concentration-tension curve was drawn and contraction rates were calculated. 2 mmol?L-1 4-AP, 10-2 mol?L-1 TEA and 10-6 mol?L-1 GLYB were added to separate K-H solution baths and 40 min later 15-HETE was added in order to detennine the effect of difierent potassium channel blockers on contraction response of PARs to 15-HETE. Results With increasing concentration from 10-8 to 10-6 mol?L-1 , 15-HETE increased PARs tension gradually in a dose-dependent manner from 106% ?6% to 139% ? 4% in group A and from 113% ?6% to 163% ?6% in group B. The difference in PARs tension between group A and B was statistically significant (P

The regional education platform is important in the training and continuing education for general practitioners,which provides clinical training program to upgrade the competence of general practitioner,but it is still in the initial stage.This article introduces the construction and development of inservice training and education platform for general practitioners in Shanghai Jiading district,and introduces the specific function and main features of the platform.

From April 2017 to September 2019, the START (standardized reception, teaching, analysis, research, training) method was adopted to train 50 general practitioners at the community general practice teaching clinic of Shanghai Huangdu Community Health Service Center. After 3 months of training, the progress of clinical competence and teaching ability were assessed. After training, the scores of clinical skills and communication skills were significantly higher than those before training (P<0.01). The scores of medical history taking, clinical thinking and health education were higher than before (all P<0.01). But there was no significant difference in record writing and reception time management between those before and after training (all P>0.05). The scores of the ability for building physician-patient relationship, collecting information and providing feedback, understanding complaints from patients′ perspective, sharing information and obtaining informed consents were higher than that before training (all P<0.01). The teaching ability of plan design and teaching method were significantly improved compared with that before training (all P<0.01). The satisfaction rate of START method was 96.0%(48/50). The START method applied in community teaching clinic can significantly improve the clinical competency and teaching ability of general practitioners.

BACKGROUNDInsulin resistance (IR) plays an important pathophysiological role in the development of diabetes, dyslipidemia, hypertension, and cardiovascular disease. Moreover, IR can occur even in non-obese people without diabetes. However, direct detection of IR is complicated. In order to find a simple surrogate marker of IR early in non-obese people, we investigate the association of commonly-used biochemical markers (liver enzymes and lipid profiles) with IR in urban middle-aged and older non-obese Chinese without diabetes.

METHODSThis cross-sectional study included 1 987 subjects (1 473 women). Fasting blood samples were collected for measurement of glucose, insulin, liver enzymes, lipid profiles and creatinine. Subjects whose homeostasis model of assessment-IR (HOMA-IR) index values exceeded the 75th percentile (2.67 for women and 2.48 for men) of the population were considered to have IR. The area under the receiver operating characteristic curve (ROC) was used to compare the power of potential markers in identifying IR.

RESULTSTriglycerides (TG) and ratio of TG to high-density lipoprotein cholesterol (TG/HDL-C) discriminated IR better than other indexes for both sexes; areas under the receiver operating characteristic (ROC) curves (AUC) values were 0.770 (95% confidence interval 0.733-0.807) and 0.772 (0.736-0.809), respectively, for women and 0.754 (0.664-0.844) and 0.756 (0.672-0.840), respectively, for men. To identify IR, the optimal cut-offs for TG and TG/HDL-C ratio were 1.315 mmol/L (sensitivity 74.3%, specificity 71.0%) and 0.873 (sensitivity 70.1%, specificity 73.4%), respectively, for women, and 1.275 mmol/L (sensitivity 66.7%, specificity 74.4%) and 0.812 (sensitivity 75.8%, specificity 69.2%), respectively, for men.

CONCLUSIONTG and TG/HDL-C ratio could be used to identify IR in urban middle-aged and older non-obese Chinese without diabetes.

Aged ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Cholesterol, HDL ; blood ; Cross-Sectional Studies ; Diabetes Mellitus ; blood ; Female ; Humans ; Insulin Resistance ; physiology ; Liver ; enzymology ; Male ; Middle Aged ; Triglycerides ; blood