To bridge the gap between curriculum content and clinical needs,as well as address the insufficient quality of online educational resources in current postgraduate anesthesiology education,this study proposes a“libra...To bridge the gap between curriculum content and clinical needs,as well as address the insufficient quality of online educational resources in current postgraduate anesthesiology education,this study proposes a“library-style”network resource platform for anesthesia graduate students,grounded in the competency-based medical education framework.The platform’s primary focus is“classical knowledge module”,which covers six core domains in anesthesiology,such as clinical anesthesia management,anesthesia technical operation,and anesthesia pharmacology.The platform also integrates‘Internet+’technology,creating a multifunctional network resource to support comprehensive learning.The platform is characterized by modularized knowledge,diversified resources,dynamic updates,and universal accessibility,enabling postgraduate students to engage in independent and lifelong learning.This flexibility fosters the innovation of hybrid teaching models,combining both online and offline components.The study aims to strengthen the competency-oriented anesthesia training system,providing robust support for both clinical practice and academic research.展开更多
Vascular calcification(VC)is a common characteristic of aging,diabetes,chronic renal failure,and atherosclerosis.The basic component of VC is hydroxyapatite(HAp).Nano-sized HAp(nHAp)has been identified to play an esse...Vascular calcification(VC)is a common characteristic of aging,diabetes,chronic renal failure,and atherosclerosis.The basic component of VC is hydroxyapatite(HAp).Nano-sized HAp(nHAp)has been identified to play an essential role in the development of pathological calcification of vasculature.However,whether nHAp can induce calcification in vivo and the mechanism of nHAp in the progression of VC remains unclear.We discovered that nHAp existed both in vascular smooth muscle cells(VSMCs)and their extracellular matrix(ECM)in the calcified arteries from patients.Synthetic nHAp had similar morphological and chemical properties as natural nHAp recovered from calcified artery.nHAp stimulated osteogenic differentiation and accelerated mineralization of VSMCs in vitro.Synthetic nHAp could also directly induce VC in vivo.Mechanistically,nHAp was internalized into lysosome,which impaired lysosome vacuolar H+-ATPase for its acidification,therefore blocked autophagic flux in VSMCs.Lysosomal re-acidification by cyclic-3′,5′-adenosine monophosphate(cAMP)significantly enhanced autophagic degradation and attenuated nHAp-induced calcification.The accumulated autophagosomes and autolysosomes were converted into calcium-containing exosomes which were secreted into ECM and accelerated vascular calcium deposit.Inhibition of exosome release in VSMCs decreased calcium deposition.Altogether,our results demonstrated a repressive effect of nHAp on lysosomal acidification,which inhibited autophagic degradation and promoted a conversion of the accumulated autophagic vacuoles into exosomes that were loaded with undissolved nHAp,Ca^(2+),Pi and ALP.These exosomes bud off the plasma membrane,deposit within ECM,and form calcium nodules.Vascular calcification was thus accelerated by nHAP through blockage of autophagic flux in VSMCs.展开更多
It’s often the case that the supplier will provide the retailer with a permissible delay period in payments, during which the supplier charges the retailer no interest and the retailer accumulates interest earned fro...It’s often the case that the supplier will provide the retailer with a permissible delay period in payments, during which the supplier charges the retailer no interest and the retailer accumulates interest earned from investment return. As a type of price reduction and an alternative to price discount,trade credit helps the supplier encourage the retailer’s ordering. This paper develops an inventory replenishment model for a deteriorating item with time-varying demand and shortages, taking account of trade credit and time value of money under inflation over a finite time horizon. This model is an extension and development of the existing studies related to the inventory system considering trade credit and time value of money and offers a more general model with more flexibility and resilience to handle the situation where demand of the end market is non-decreasing with regard to time.展开更多
基金supported by Planning Project of Shanghai Higher Education Association(2QYB24158)Collaborative Education Project of the Ministry of Education of China(250101414020206).
文摘To bridge the gap between curriculum content and clinical needs,as well as address the insufficient quality of online educational resources in current postgraduate anesthesiology education,this study proposes a“library-style”network resource platform for anesthesia graduate students,grounded in the competency-based medical education framework.The platform’s primary focus is“classical knowledge module”,which covers six core domains in anesthesiology,such as clinical anesthesia management,anesthesia technical operation,and anesthesia pharmacology.The platform also integrates‘Internet+’technology,creating a multifunctional network resource to support comprehensive learning.The platform is characterized by modularized knowledge,diversified resources,dynamic updates,and universal accessibility,enabling postgraduate students to engage in independent and lifelong learning.This flexibility fosters the innovation of hybrid teaching models,combining both online and offline components.The study aims to strengthen the competency-oriented anesthesia training system,providing robust support for both clinical practice and academic research.
基金supported by the National Natural Science Foundation of China Grant(No.81570251 and NO.82070448 to HY).
文摘Vascular calcification(VC)is a common characteristic of aging,diabetes,chronic renal failure,and atherosclerosis.The basic component of VC is hydroxyapatite(HAp).Nano-sized HAp(nHAp)has been identified to play an essential role in the development of pathological calcification of vasculature.However,whether nHAp can induce calcification in vivo and the mechanism of nHAp in the progression of VC remains unclear.We discovered that nHAp existed both in vascular smooth muscle cells(VSMCs)and their extracellular matrix(ECM)in the calcified arteries from patients.Synthetic nHAp had similar morphological and chemical properties as natural nHAp recovered from calcified artery.nHAp stimulated osteogenic differentiation and accelerated mineralization of VSMCs in vitro.Synthetic nHAp could also directly induce VC in vivo.Mechanistically,nHAp was internalized into lysosome,which impaired lysosome vacuolar H+-ATPase for its acidification,therefore blocked autophagic flux in VSMCs.Lysosomal re-acidification by cyclic-3′,5′-adenosine monophosphate(cAMP)significantly enhanced autophagic degradation and attenuated nHAp-induced calcification.The accumulated autophagosomes and autolysosomes were converted into calcium-containing exosomes which were secreted into ECM and accelerated vascular calcium deposit.Inhibition of exosome release in VSMCs decreased calcium deposition.Altogether,our results demonstrated a repressive effect of nHAp on lysosomal acidification,which inhibited autophagic degradation and promoted a conversion of the accumulated autophagic vacuoles into exosomes that were loaded with undissolved nHAp,Ca^(2+),Pi and ALP.These exosomes bud off the plasma membrane,deposit within ECM,and form calcium nodules.Vascular calcification was thus accelerated by nHAP through blockage of autophagic flux in VSMCs.
文摘It’s often the case that the supplier will provide the retailer with a permissible delay period in payments, during which the supplier charges the retailer no interest and the retailer accumulates interest earned from investment return. As a type of price reduction and an alternative to price discount,trade credit helps the supplier encourage the retailer’s ordering. This paper develops an inventory replenishment model for a deteriorating item with time-varying demand and shortages, taking account of trade credit and time value of money under inflation over a finite time horizon. This model is an extension and development of the existing studies related to the inventory system considering trade credit and time value of money and offers a more general model with more flexibility and resilience to handle the situation where demand of the end market is non-decreasing with regard to time.
