肌肉肌醇对HepG2 胰岛素抵抗模型葡萄糖消耗量影响的细胞实验研究

目的:研究肌肉肌醇(myo-inositol,MI)对胰岛素抵抗细胞(IR-HepG2)细胞外葡萄糖消耗量的影响。方法:采用CCK-8法观察MI、高糖对HepG2细胞活力的影响,通过高糖持续作用,胰岛素刺激诱导HepG2细胞建立胰岛素抵抗细胞模型,葡萄糖氧化酶法(GOD-POD法)鉴定模型是否成立,并用GOD-POD法检测正常HepG2细胞和MI对HepG2胰岛素抵抗细胞葡萄糖消耗量的变化。结果:在对HepG2细胞活性没有影响的情况下,MI增加了胰岛素抵抗模型的葡萄糖消耗量。与模型对照组相比,葡萄糖氧化酶法结果显示,MI可显著增加胰岛素抵抗模型葡糖糖的消耗量(P0.01)。结论:MI可明显增加IR-HepG2细胞模型葡萄糖的消耗量,对IR-HepG2细胞模型胰岛素抵抗有显著的改善作用。     

枸杞多糖对HepG2细胞胰岛素抵抗的改善作用及机制研究

目的：观察不同浓度的枸杞多糖（LBP）对HepG2细胞胰岛素抵抗的影响并探讨其机制。方法：采用高糖高胰岛素处理HepG2细胞24 h建立胰岛素抵抗细胞模型后,用台盼蓝检测活力大于95%的HepG2细胞,以10⁴/孔密度接种于96孔板内,细胞贴壁后以30 μg/ml、100 μg/ml、300 μg/ml的LBP培养48 h,200 μl/well,各组均设4个复孔。检测不同浓度的LBP对HepG2细胞活性及胰岛素抵抗的影响;细胞内丙二醛（MDA）含量和超氧化物歧化酶（SOD）的活性;各组细胞胰岛素信号转导通路中相关蛋白（IRS-2、PI3-K、Akt、GLUT2）的表达。结果：MTT显示：与正常对照组相比,IR模型组MDA含量显著升高,SOD活力明显降低,同时IRS-2、PI-3K、Akt、GLUT2蛋白表达水平明显下降;与IR模型组相比,中、高浓度LBP组MDA的含量明显降低,SOD的活力显著升高,且IRS-2、PI-3K、Akt、GLUT2蛋白表达水平明显升高;在相同的时间内,随着LBP浓度的增加,OD值逐渐降低;在同一浓度干预下,随着时间的延长,OD值也逐渐降低;葡萄糖消耗实验表明中、高浓度的LBP可显著提高胰岛素抵抗HepG2细胞的葡萄糖消耗量,而低浓度LBP对HepG2细胞葡萄糖消耗量无明显影响。结论：中、高浓度枸杞多糖能改善HepG2细胞胰岛素抵抗,其作用机制可能与降低细胞氧化应激水平及提高胰岛素信号传导通路相关蛋白表达有关。     

不同时间脂肪乳输注对大鼠葡萄糖输注率的影响

目的观察不同时间脂肪乳输注使血浆游离脂肪酸（FFA）升高对大鼠葡萄糖输注率（GIR）的影响。方法分别给大鼠输注脂肪乳2、5、7和48 h,行高胰岛素-正血糖钳夹试验评价葡萄糖输注率,测定血浆葡萄糖、FFA。结果与生理盐水输注组比较,2 h脂肪乳输注使血浆FFA升高了2倍（P〈0.01）,GIR下降27%（P〈0.05）,脂肪乳输注5 h GIR降低了52%（P〈0.01）,7 h GIR降低56%（P〈0.01）,输注48 h脂肪乳GIR降低58%（P〈0.01）,5 h组7、h组及48 h脂肪乳输注组间GIR差异没有统计学意义。结论大鼠输注脂肪乳使FFA浓度达到基础值的3倍左右,可复制出脂毒性胰岛素抵抗的模型,而且胰岛素抵抗达到一定程度后保持恒定。     

荞麦黄酮复合物对2型糖尿病大鼠胰岛素抵抗的影响

本实验是在前期研究的基础上,采用灌胃脂肪乳和腹腔注射小剂量四氧嘧啶成功建立Wistar大鼠2型糖尿病胰岛素抵抗动物模型。结果提示:荞麦黄酮复合物能够明显的降低2型糖尿病大鼠的血糖、血脂水平,改善糖耐量、提高胰岛素敏感性。进一步探讨荞麦黄酮复合物的降血糖改善胰岛素抵抗的作用及其机制。     

胰岛素耐受的HepG2细胞模型建立

采用高胰岛素体外诱导培养HepG2细胞,建立胰岛素耐受的细胞模型。将HepG2细胞置于5×10-7mol/L胰岛素培养液中24h,采用3H-D-葡萄糖掺入试验及残余125I-胰岛素结合率测定等方法观察高胰岛素对HepG2细胞葡萄糖摄取率及其胰岛素受体数目和功能的影响。高胰岛素诱导培养的HepG2细胞葡萄糖掺入率及残余125I-胰岛素结合率明显低于未用高胰岛素诱导的HepG2细胞(对照细胞)。将高胰岛素诱导培养的HepG2细胞置于不含胰岛素的培养液中60h,其细胞葡萄糖摄取率仍明显低于对照细胞。将HepG2细胞置于5×10-7mol/L胰岛素环境中24h,该细胞对胰岛素的生物学效应产生抵抗,其胰岛素抵抗状态可维持60h。     

GK糖尿病大鼠生物学特性观察

目的了解2型糖尿病模型GK大鼠生长曲线、主要脏器重量、糖代谢等生物学特性,评价GK大鼠葡萄糖刺激的胰岛素分泌能力。方法采用51只雄性GK大鼠及15只年龄性别匹配的Wistar大鼠作为研究对象。测定13周龄GK、Wistar大鼠空腹血糖、23周龄GK大鼠空腹及随机血糖。随访GK及Wistar大鼠生长曲线,34～46周龄期间血糖、糖化血红蛋白。46周龄时行腹腔葡萄糖耐量实验（IPGTT）,计算相关参数评价β细胞葡萄糖刺激的胰岛素分泌能力;之后处死大鼠,脏器称重。比较GK及Wistar大鼠间上述各指标差异。结果13周龄GK大鼠空腹血糖4．74±0．41mmol／L,对照Wistar大鼠1．85±0．44mmol／L（P〈0．001）。23周龄GK大鼠空腹血糖7．88±1．96mmol／L,随机血糖9．91±3．52～13．46±4．13mmol／L。7～20及34～45周龄期间GK大鼠体重高于对照Wistar大鼠（P〈0．05）,46周龄时无显著性差异。34～45周龄期间GK大鼠空腹血糖、进食后血糖、HbAlc均高于对照Wistar大鼠（P〈0．05）。IPGTT曲线下面积分析示GK大鼠胰岛素曲线下面积（AUCi）、葡萄糖曲线下面积（AUCg）高于对照Wistar大鼠,胰岛素与葡萄糖曲线下面积比值（AUCi／AUCg）低于对照Wistar大鼠,差异均有显著性（P〈0．05）。GK大鼠肾脏重量高于对照Wistar大鼠（P〈0．05）,余主要脏器重量差异无显著性。结论GK大鼠空腹血糖、进食后血糖、HbAlc水平升高,葡萄糖刺激的胰岛素分泌能力（GSIS）减退,葡萄糖刺激后胰岛素分泌早期相消失,晚期相代偿性增加,具有2型糖尿病特点;体重、血糖等生物学特性稳定。     

高脂饮食对动物生理行为影响的实验研究

给予大鼠高脂饮食,观察对大鼠体重、日饮水量、血糖、血脂水平的影响。结果发现,给予高脂饮食后,大鼠的血糖和TG、TC、LDL、HDL 分别升高了140.89%和25.77%、275.52%、105.54%、31.25%,与实验前比,差异有显著性意义（P<0.01）;给予实验组大鼠二苯乙烯20 d,大鼠日饮水量显著减少（P<0.05～0.001）,体重明显增加（P<0.05～0.001）,血糖和血脂水平比给药前显著降低（P<0.05-0.01）。     

成纤维细胞生长因子(FGF)-21改善胰岛素抵抗肝细胞对葡萄糖的吸收和肝糖原的合成

在体外建立胰岛素抵抗肝细胞模型,探讨在胰岛素抵抗状态下成纤维细胞生长因子(FGF)-21对模型细胞糖代谢的影响及机制．将HepG2细胞置于10^-7 mol/L 的胰岛素培养基中培养24 h,建立胰岛素抵抗细胞模型．分别用不同浓度的胰岛素和FGF-21处理模型细胞,采用葡萄糖氧化酶-过氧化物酶(GOD-POD)法检测细胞对葡萄糖的摄取情况,并检查胰岛素与FGF-21的协同作用．利用实时荧光定量PCR检测FGF-21对模型细胞葡萄糖转运蛋白1(GLUT1)mRNA表达的影响,蒽酮法检测模型细胞糖原合成量,探讨FGF-21对胰岛素抵抗细胞模型葡萄糖摄取的影响及机制．结果发现,用高浓度胰岛素处理HepG2细胞24 h后,细胞对胰岛素的敏感性显著降低,说明成功建立了胰岛素抵抗细胞模型,抵抗状态可维持48 h,未发现细胞形态学变化．FGF-21能改善胰岛素抵抗模型细胞的葡萄糖摄取,参与肝糖原的合成,并与胰岛素产生协同作用．实时荧光定量PCR结果发现,FGF-21作用模型细胞后,细胞的GLUT1 mRNA表达量显著增加,说明FGF-21促进模型细胞摄取葡萄糖的作用机制与其增加GLUT1的表达有关．     

槟榔碱对2型糖尿病大鼠肝脏胰岛素抵抗的作用

目的：探讨槟榔碱对2型糖尿病大鼠肝脏胰岛素抵抗的影响及其机制。方法：采用高果糖饲料饲养Wistar大鼠12周制备2型糖尿病大鼠模型,实验动物随机分为5组（n=8）：对照组、模型组、模型＋不同浓度的槟榔碱（0,0．5,1,5mg／kg）组。4周后通过检测血糖、血脂、胰岛素、RT-PCR检测肝脏组成型雄甾烷受体（CAR）、孕甾烷x受体（PXR）、糖代谢相关基因：葡萄糖-6-磷酸酶（G6Pase）、磷酸烯醇式丙酮酸羧激酶（PEPCK）和炎症相关因子：白细胞介素-6（IL-6）、肿瘤坏死因子α（TNF-α）mRNA表达,Western blot检测大鼠肝内p-AKT和葡萄糖转运体4（GLUT4）蛋白表达。结果：1,5mg／kg槟榔碱显著降低糖尿病大鼠体重、空腹血糖、空腹胰岛素、血脂和糖代谢相关基因及炎症相关因子mRNA水平,提高CAR、PXR mRNA水平及p-AKT、GLUT4蛋白水平。结论：槟榔碱可能通过提高CAR和PXR的表达,导致肝脏糖代谢关键酶PEPCK、G6Pase基因表达或者炎性因子肿瘤坏死因子-α（TNF-α）、白介素-6（n-6）表达降低,改善2型糖尿病大鼠肝脏胰岛素抵抗。     

罗格列酮对胰岛素抵抗人肝细胞Angpil3和LXRce基因表达的影响

研究罗格列酮对胰岛素抵抗人肝L02细胞Angptl3基因及与脂代谢相关的LXRα基因的影响。采用高胰岛素诱导法建立胰岛素抵抗模型（IR-L02）,分别加入含有和不含罗格列酮的不同葡萄糖浓度培养液培养,用葡萄糖氧化酶-过氧化物酶法（GOD—POD法）检测培养液残存葡萄糖量,并用RT-PCR方法检测基因Angptl3、LXRαmRNA表达水平的变化。结果表明相同葡萄糖浓度下罗格列酮作用组（IR—R组）的培养液残存葡萄糖量比无罗格列酮作用组（IR组）减少;IR—R组的Angptl3、LXRαmRNA表达水平较IR组显著升高（P〈0．05）。     

Effect of ethanolic extracts of Ananas comosus L. leaves on insulin sensitivity in rats and HepG2

Ethanolic extracts of Ananas comosus L. leaves (AC) enriched with phenols have hypoglycemic activity in diabetic rats. Here, we investigated the effect of AC on insulin sensitivity in rats and HepG2. In high-fat diet-fed and low-dose streptozotozin-treated diabetic Wistar rats subjected to challenge with exogenous human insulin, AC treatment at an oral dose of 0.40 g/kg could significantly improve sensitivity to exogenous insulin. After a sub-acute treatment, AC also could inhibit the development of insulin resistance in high-fat diet-fed and low-dose streptozotozin-treated diabetic rats following the test of loss of tolbutamide-induced blood glucose lowering action. For intravenous insulin/glucose infusion test, high-fat diet-fed and low-dose alloxan-treated Wistar rats were associated with insulin resistance, which was improved after AC or fenofibrate treatment. AC application inhibited the development of insulin resistance in HepG2 cells. The above animal models were well developed to simulate type 2 diabetes. Taken together, our results suggest that AC may improve insulin sensitivity in type 2 diabetes and could be developed into a new potential natural product for handling of insulin resistance in diabetic patients.     

Salsalate and Adiponectin Improve Palmitate-Induced Insulin Resistance via Inhibition of Selenoprotein P through the AMPK-FOXO1α Pathway

Selenoprotein P (SeP) was recently identified as a hepatokine that induces insulin resistance (IR) in rodents and humans. Recent clinical trials have shown that salsalate, a prodrug of salicylate, significantly lowers blood glucose levels and increases adiponectin concentrations. We examined the effects of salsalate and full length-adiponectin (fAd) on the expression of SeP under hyperlipidemic conditions and explored their regulatory mechanism on SeP. In palmitate-treated HepG2 cells as well as high fat diet (HFD)-fed male Spraque Dawley (SD) rats and male db/db mice, SeP expression and its regulatory pathway, including AMPK-FOXO1α, were evaluated after administration of salsalate and salicylate. Palmitate treatment significantly increased SeP expression and aggravated IR, while knock-down of SeP by siRNA restored these changes in HepG2 cells. Palmitate-induced SeP expression was inhibited by both salsalate and salicylate, which was mediated by AMPK activation, and was blocked by AMPK siRNA or an inhibitor of AMPK. Chromatin immunoprecipitation (ChIP) and electrophoretic mobility shift (EMSA) assay showed that salsalate suppressed SeP expression by AMPK-mediated phosphorylation of FOXO1α. Moreover, fAd also reduced palmitate-induced SeP expression through the activation of AMPK, which results in improved IR. Both salsalate and salicylate treatment significantly improved glucose intolerance and insulin sensitivity, accompanied by reduced SeP mRNA and protein expression in HFD-fed rats and db/db mice, respectively. Taken together, we found that salsalate and adiponectin ameliorated palmitate-induced IR in hepatocytes via SeP inhibition through the AMPK-FOXO1α pathway. The regulation of SeP might be a novel mechanism mediating the anti-diabetic effects of salsalate and adiponectin.     

Impaired insulin-receptor autophosphorylation is an early defect in fat-fed, insulin-resistant rats.

High-fat feeding results in impaired insulin signaling in skeletal muscle, but the role of the insulin receptor (IR) remains controversial. In the present study, female Fischer 344 rats were fed diets either low in fat [low fat, complex carbohydrate (LFCC)] or high in fat and sucrose (HFS). Insulin-stimulated skeletal muscle glucose transport, measured in purified sarcolemmal vesicles, was lower in rats consuming the HFS diet for 2 and 8 wk compared with LFCC controls (72.9 +/- 3.5, 67.6 +/- 3.5, and 86.1 +/- 3.5 pmol x mg(-1) x 15 s(-1), respectively; P < 0.05). Muscle IR content was unchanged in 2-wk HFS animals but was 50% lower in the 8-wk HFS group (P < 0.001). However, compared with LFCC, insulin-stimulated IR autophosphorylation was 26% lower in 2-wk HFS and 40% lower in 8-wk HFS animals (P < 0.005). Total muscle content of the proposed IR inhibitors cytokine tumor necrosis factor-alpha and membrane glycoprotein PC-1 was not significantly changed in HFS animals at either 2 or 8 wk. These results demonstrate that high-fat feeding induces insulin resistance in muscle concomitant with a diminished IR signaling capacity, although the mechanism remains unknown.     

地塞米松诱发的大鼠胰岛素抵抗模型

目的：建立一种简便可靠的大鼠胰岛素抵抗模型。方法：对大鼠进行不同剂量地塞米松腹腔注射,观察不同时间各组大鼠糖代谢相关变化。结果：大鼠空腹葡萄糖、胰岛素、胰岛素抵抗程度呈地塞米松给药时间及剂量依赖性,后两者改变先于前者改变。结论：一定剂量的地塞米松空腹注射将诱发大鼠胰岛素抵抗,这种模型简便、可靠,可用于相关课题的研究。     

Abrogation of oxidative stress improves insulin sensitivity in the Ren-2 rat model of tissue angiotensin II overexpression

To evaluate the role of renin-angiotensin system (RAS)-mediated oxidative stress in insulin resistance (IR), we compared the effects of the angiotensin II (ANG II) receptor blocker (ARB) valsartan and a superoxide dismutase (SOD) mimetic, tempol, on whole body glucose tolerance and soleus muscle insulin-stimulated glucose uptake in transgenic hypertensive TG(mREN-2)27 (Ren-2) rats. Ren-2 rats and Sprague-Dawley (SD) controls were given valsartan (30 mg/kg) or tempol (1 mmol/l) in their drinking water for 21 days. IR was measured by glucose tolerance testing (1 g/kg glucose ip). IR index (AUC(glucose) x AUC(insulin)) was significantly higher in the Ren-2 animals compared with SD controls (30.5 +/- 7.0 x 10(6) arbitrary units in Ren-2 vs. 10.2 +/- 2.4 x 10(6) in SD, P < 0.01). Both valsartan and tempol treatment normalized Ren-2 IR index. Compared with SD controls (100%), there was a significant increase in superoxide anion production (measured by lucigenin-enhanced chemiluminescence) in soleus muscles of Ren-2 rats (133 +/- 15%). However, superoxide production was reduced in both valsartan- and tempol-treated (85 +/- 22% and 59 +/- 12%, respectively) Ren-2 rats. Insulin (INS)-mediated 2-deoxyglucose (2-DG) uptake (%SD basal levels) was substantially lower in Ren-2 rat soleus muscle compared with SD (Ren-2 + INS = 110 +/- 3% vs. SD + INS = 206 +/- 12%, P < 0.05). However, Ren-2 rats treated with valsartan or tempol exhibited a significant increase in insulin-mediated 2-DG uptake compared with untreated transgenic animals. Improvements in skeletal muscle insulin-dependent glucose uptake and whole body IR in rats overexpressing ANG II by ARB or SOD mimetic indicate that oxidative stress plays an important role in ANG II-mediated insulin resistance.     

Adrenomedullin protects against fructose-induced insulin resistance and myocardial hypertrophy in rats

Adrenomedullin (ADM) has been recognized as a multipotent multifunctional peptide. To explore the pathophysiological roles of ADM in insulin resistance (IR), we studied the changes in ADM mRNA level in the myocardium and vessels and the effect of ADM supplementation on rats with IR induced by fructose feeding. Rats were fed 4% fructose in drinking water for 8 weeks, and ADM was administered subcutaneously in pure water through an Alzet Mini-osmotic Pump at 300 ng/kg/h for the last 4 weeks. Compared with controls, rats with IR showed increased levels of fasting blood sugar and serum insulin, by 95% and 67%, respectively (all P < 0.01), and glycogen synthesis and glucose transport activity of the soleus decreased by 54% and 55% (all P < 0.01). mRNA level and content of brain natriuretic peptide (BNP) in myocardial were all increased significantly. Fructose-fed rats showed increased immunoreactive-ADM content in plasma by 110% and in myocardia by 55% and increased mRNA level in myocardia and vessels (all P < 0.01). ADM administration ameliorated the induced IR and myocardial hypertrophy. The glycogen synthesis and glucose transport activity of the soleus muscle increased by 41% (P < 0.01) and 32% (P < 0.05). ADM therapy attenuated myocardial and soleus lipid peroxidation injury and enhanced the antioxidant ability. Our results showed upregulation of endogenous ADM during fructose-induced IR and the protective effect of ADM on fructose-induced IR and concomitant cardiovascular hypertrophy probably by its antioxidant effect, which suggests that ADM could be an endogenous protective factor in IR.     

实验性2型糖尿病恒河猴模型的构建及其部分临床特征分析

目的构建2型糖尿病（T2DM）恒河猴模型,使之成为研究人类T2DM的有效替身。方法以高糖高脂饮食为基础,在出现高脂血症和肥胖状态后注射35mg／kg的链脲佐菌素（STZ）,测定体重指数、血脂、空腹血糖、胰岛素、胰岛素抵抗指数、尿糖和口服葡萄糖耐量试验等,分析其部分临床特征。结果T2DM模型组体重指数（BMI）大于35达到重度肥胖,有高脂血症的特点,空腹血糖、胰岛素和胰岛素抵抗指数显著增高（P〈0．01）,尿糖检测呈阳性,葡萄糖耐量受损并且空腹血糖高于7mmol／L、2h的血糖水平高于11．Immol／L,胰岛有轻度损伤和病变。结论通过部分临床特征分析,T2DM模型组具有典型的T2DM临床特征,可成为T2DM研究的有效模型。     

Development and characterization of a novel rat model of type 2 diabetes mellitus: the UC Davis type 2 diabetes mellitus UCD-T2DM rat

The prevalence of type 2 diabetes (T2DM) is increasing, creating a need for T2DM animal models for the study of disease pathogenesis, prevention, and treatment. The purpose of this project was to develop a rat model of T2DM that more closely models the pathophysiology of T2DM in humans. The model was created by crossing obese Sprague-Dawley rats with insulin resistance resulting from polygenic adult-onset obesity with Zucker diabetic fatty-lean rats that have a defect in pancreatic beta-cell function but normal leptin signaling. We have characterized the model with respect to diabetes incidence; age of onset; longitudinal measurements of glucose, insulin, and lipids; and glucose tolerance. Longitudinal fasting glucose and insulin data demonstrated progressive hyperglycemia (with fasting and fed glucose concentrations >250 and >450 mg/dl, respectively) after onset along with hyperinsulinemia resulting from insulin resistance at onset followed by a progressive decline in circulating insulin concentrations, indicative of beta-cell decompensation. The incidence of diabetes in male and female rats was 92 and 43%, respectively, with an average age of onset of 6 mo in males and 9.5 mo in females. Results from intravenous glucose tolerance tests, pancreas immunohistochemistry, and islet insulin content further support a role for beta-cell dysfunction in the pathophysiology of T2DM in this model. Diabetic animals also exhibit glycosuria, polyuria, and hyperphagia. Thus diabetes in the UC Davis-T2DM rat is more similar to clinical T2DM in humans than in other existing rat models and provides a useful model for future studies of the pathophysiology, treatment, and prevention of T2DM.     

Modulation of insulin resistance and hypertension by voluntary exercise training in the TG(mREN2)27 rat.

Hypertension is often accompanied by insulin resistance of skeletal muscle glucose transport. The male heterozygous TG(mREN2)27 rat, which harbors a mouse transgene for renin, displays local elevations in the renin-angiotensin system and exhibits markedly elevated systolic blood pressure (SBP). The present study was undertaken to characterize insulin-stimulated skeletal muscle glucose transport in male heterozygous TG(mREN2)27 rats and to evaluate the effect of voluntary exercise training on SBP and skeletal muscle glucose transport. Compared with normotensive Sprague-Dawley rats, TG(mREN2)27 rats displayed a 53% elevation (P < 0.05) in SBP, a twofold increase in plasma free fatty acid levels, and an exaggerated insulin response during an oral glucose tolerance test. Moreover, insulin-mediated glucose transport (2-deoxyglucose uptake) in isolated epitrochlearis and soleus muscles of TG(mREN2)27 animals was 33 and 43% less, respectively, than in Sprague-Dawley controls. TG(mREN2)27 rats ran voluntarily for 6 wk and achieved daily running distances of 6-7 km over the final 3 wk. Training caused a 36% increase in peak aerobic capacity and a 16% reduction in resting SBP. Fasting plasma insulin (21%) and free fatty acid (34%) levels were reduced in the trained TG(mREN2)27 rats. Whole body glucose tolerance was improved in the trained TG(mREN2)27 rats and was associated with increases of 39 and 50% in insulin-mediated glucose transport in epitrochlearis and soleus muscles, respectively. Whole muscle GLUT-4 protein was increased in the soleus (23%), but not in the epitrochlearis, of trained TG(mREN2)27 rats. These data indicate that the male heterozygous TG(mREN2)27 rat is a model of both hypertension and insulin resistance. Importantly, both of these defects can be beneficially modified by voluntary exercise training.