Objective:To observe effects of Huanglian Jiedu Decoction on expression of insulin receptor substrate 1(IRS-1)and the level of tyrosine phosphorylation in skeletal muscles to explore the molecular mechanism in improving insulin resistance.Methods:Wistar system insulin resistance model rats were developed with injection of small dose of streptozotocin into the caudal vein plus feeding by forage with high sugar and high lipids,and they were treated with Huanglian Jiedu Decoction for 10 weeks.Then blood sugar and serum insulin level were determined,and the changes of IRS-1 protein expression and tyrosine phosphorylation level in the skeletal muscles of the rat with insulin resistence after treatment of Huanglian Jiedu Decoction were detected with immuno- precipitation and Western Blot methods.Results:After treatment with Huanlian Jiedu Decoction,IRS-1 expression and IRS-1 tyrosine phosphorylation level in the muscular tissue increased as compared with those of the model group.Conclusion Huanglian Jiedu Decoction improves IRS-1 protein expression and tyrosine phosphorylation level in the skeletal muscle tissue of the rats with insulin resistance,which is possibly one of the mechanisms of decreasing blood sugar and improving sensitivity of insulin in tissues.

Objective To compare the effect of different flow rate of oxygen inhalation on relieving scapuledynia after laparoscopic cholecystectomy(LC) with carbon dioxide pneumoperitoneum. Methods 100 patients adopted LC were divided into the 2 L/min group (n=50), the 4 Ldmin group (n=50), both re-ceived oxygen inhalation 6 hours after LC. The incidence and degree of scapulodynia and the blood- gas analysis were analyzed. Results The incidence of scapulodynia after LC in the 4 L/min group was signifi-cantly lower than that of 2 L/min group. PaCO2,PaO2 and pH in the 4 L/min group were different from those of the 2 L/min group. Conclusions Increasing flow rate of oxygen inhalation can relieve incidence and degree of scapulodynia after laparoscopic cholecystectomy.

Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.