AIM:To study the effect of Exendin-4 on the glucose tolerance and serum glucose level in normal animals. METHODS: The fasting blood glucose concentration was tested at 0,1,2,3,4 h and 2,4 week after the first administration of Exendin-4 (0.1, 0.3, 0.9 g/kg, 4 weeks, qd) in Wistar rats ,taking insulin as positive control. Before intragastric administration 2.5 g/kg glucose, Exendin-4 (0.2, 0.6, 1.8 g/kg) were subcutaneously injected, then the fasting blood glucose concentration was tested at 0.5, 1, 2 h after the glucose loading. After hypodermic administration of Exendin-4 (0.2, 0.6, 1.8 g/kg), half of the mice were subcutaneously administrated 2.5 g/kg glucose 15 min later, and the insulin was tested at the end of the experiment. RESULTS:Exendin-4 could not significantly change the fasting blood glucose concentration at different times. The fasting blood glucose concentration was significantly decreased after glucose loading by administration Exendin-4. Exendin-4 could increase the serum insulin concentration remarkably after glucose loading and could not change much without glucose loading. CONCLUSION: The results suggest that the blood glucose regulation of Exendin-4 was related to the concentration of glucose.

Objective To design a portable vital signs monitoring system to monitor and analyze severe patient vital signs in field conditions.Methods The communication protocols of all medical devices were analyzed.The information on the vital signs were acquired periodically from medical devices with the signal transducer based on embedded technique,and then sent to the computer for analysis.The abnormalities were displayed on the portable terminal.Results The system met the desired requirements,and facilitated the medical personnel dedicated to treatment.Conclusion The system contributes to information sharing for the changes of vital signs in field conditions,so that the doctor can take measures in time to enhance the efficiency and reliability of the treatment.

Objective To evaluate the safety of modified sputum induction in moderate to very severe COPD during exacerbation. Methods Ninety patients with moderate, severe or very severe COPD during exacerbation (27 with type Ⅰ and Ⅱ respiratory failure,18 with coronary heart disease, 38 with tachycardia) were chosen as research subjects. All the patients underwent induced sputum. During induction , all patients were given electrocardiographic monitoring and pulmonary function check every 5 minutes and FEV1, HR, SpO2 in the process of testing were recorded. Results Ninety patients underwent 224 sputum inductions progress, 222 were safety. Qualified sputum samples were collected for 216 times, sputum induction was successful in 96.43% of occasions. Heart rate rising and SpO2 reducing during sputum induction mainly occurred in the beginning 5 minutes, FEV1 did not change in the whole process. Conclusion Modified sputum induction can be safe through closely monitoring in patients with moderate-to-very severe COPD with exacerbation, even with type Ⅰ or typeⅡ respiratory failure. But the risk of sputum induction will increase if patients with coronary heart disease and tachyarrhythmia, especially within beginning 5 minutes of sputum induction.

Objective To evaluate the effect of cisplatin on analgesia with morphine in rats with incisional pain.Methods Forty-two adult male Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 6 groups (n =7 each) using a random number table:normal saline group (group C),normal saline + Pglycoprotein inhibitor LY335979 group (group CL),normal saline + morphine group (group CM),cisplatin group (group S),cisplatin + morphine group (group SM) and cisplatin + morphine + LY335979 group (group SML).Cisplatin 2 mg/kg was injected intraperitoneally once every two days for 5 times in S,SM and SML groups,while the equal volume of normal saline was injected intraperitoneally in C,CL and CM groups.At 2 days after the end of administration,the incisional pain models were established.At 10 min after establishing the model,normal saline 2 ml was injected subcutaneously in C and S groups; LY335979 20 mg/kg was injected via the caudal vein and normal saline 2 ml was injected subcutaneously in group CL; morphine 2 mg/kg was injected subcutaneously in CM and SM groups; LY335979 20 mg/kg was injected via the caudal vein and morphine 2 mg/kg was injected subcutaneously in group SML.Cumulative pain score was used to evaluate analgesia.Results Compared with group C,cumulative pain scores were significantly decreased in group CM,and no significant change was found in cumulative pain scores in CL and S groups.Compared with group CM,cumulative pain scores were significantly increased in group SM,and no significant change was found in cumulative pain scores in group SML.Cumulative pain scores were significantly lower in group SML than in group SM.Conclusion Cisplatin can weaken analgesia induced by morphine in rats with incisional pain through enhancing P-glycoprotein function in the blood-brain barrier.

Objective To study the radiation dose distribution in the X-ray room,and provide the strategy of radiation protection for the medical staff and the patient’s nursing who had to enter the room while the X-ray was exposing.Methods The thermolumi-nescent dosemeters(TLDs)was placed around the center of the X-ray tube with the same level of the bed.Then,exposure parame-ters,including the X-ray tube voltage value and the field of view,were changed for different groups while exposing.All of the TLDs were taken back to the lab for analysis.Results The differences between the two groups which had the same distance in different di-rections were statistically significant (P <0.01).With the same radiographic condition and direction,the radiation dose on the site of 10 cm from X-ray tube center was the maximum,while the site of 120 cm was the minimum.With the same radiographic condition and distance,the radiation dose on the anode side of the X-ray tube in the room was relative lower,while the site behind the X-ray tube was relative higher.With the same voltage value,distance and direction,the same sites that had the smaller FOV(34 cm×34 cm) received lower radiation dose than those with larger FOV(52.6 cm× 52.6 cm).Meanwhile,the sites with the voltage of 70 kV re-ceived the lower radiation dose than that with the voltage value of 120 kV.Conclusion In the X-ray room,the medical staff and the patient’s nursing can choose the area on the right side(anode side),keep far away from the X-ray tube center,avoid the rear of the X-ray tube and the cathodic direction of the X-ray tube to reduce the radiation dose.

Banksia is a significant element in vegetation of southwestern Australia, a biodiversity hotspot with global significance. In particular, Banksia hookeriana represents a species with signif-icant economic and ecological importance in the region. For better conservation and management, we reported an overview of transcriptome of B. hookeriana using RNA-seq and de novo assembly. We have generated a total of 202.7 million reads (18.91 billion of nucleotides) from four leaf sam-ples in four plants of B. hookeriana, and assembled 59,063 unigenes (average size=1098 bp) through de novo transcriptome assembly. Among them, 39,686 unigenes were annotated against the Swiss-Prot, Clusters of Orthologous Groups (COG), and NCBI non-redundant (NR) protein databases. We showed that there was approximately one single nucleotide polymorphism (SNP) per 5.6–7.1 kb in the transcriptome, and the ratio of transitional to transversional polymorphisms was approximately 1.82. We compared unigenes of B. hookeriana to those of Arabidopsis thaliana and Nelumbo nucifera through sequence homology, Gene Ontology (GO) annotation, and KEGG pathway analyses. The comparative analysis revealed that unigenes of B. hookeriana were closely related to those of N. nucifera. B. hookeriana, N. nucifera, and A. thaliana shared similar GO anno-tations but different distributions in KEGG pathways, indicating that B. hookeriana has adapted to dry-Mediterranean type shrublands via regulating expression of specific genes. In total 1927 poten-tial simple sequence repeat (SSR) markers were discovered, which could be used in the genotype and genetic diversity studies of the Banksia genus. Our results provide valuable sequence resource for further study in Banksia.

Objective To investigate the map and pattern of blood oxygen level dependent(BOLD)signal changes correlated to interictal epileptiform discharges(IEDs)with EEG-fMRI in patients with partial epilepsy and then to explore the pathophysiological mechanisms of epileptic discharges and their effect on brain function in partial epilepsy.Methods Through the method of EEG-fMRI,2 patients with parial epilepsy were studied.The relationship between the regions of BOLD signal changes linked to IEDs and the electroelinical localization of epileptogenic zone in patients with partial epilepsy were investigated.Results The epileptogenic areas localized by electroclinical findings in the 2 patients all showed maximal activation and 2 sites of significant activation were found in 1 of the 2 patients;Weak activation were also manifested in the opposite side corresponding to lesions.Conclusions IED-linked BOLD response in patients with partial epilepsy is mainly in epileptogenic zones and weak activation can also be seen in the corresponding contralateral areas of epileptogenic zoiles.Activation areas ale well concordant with epileptogenie areas localized by electroclinical findings.

Objective To comparatively evaluate the clinical efficacy and adverse events of chemoradiotherapy combined with/without radioactive iodine-125 ( 125-I) implantation for locally advanced non-small cell lung cancer. Methods With locally advanced non-small cell lung cancer admitted to Department of Radiotherapy of Jianhu County People's Hospital and Yancheng Third People's Hospital from March 2014 to March 2015 of 38 patients were enrolled and randomly divided into the observation ( chemoradiotherapy+ radioactive 125-I implantation, n=20) and control groups ( chemoradiotherapy, n=18) . All patients underwent conventional three-dimensional conformal radiotherapy and TC chemotherapy. In the observation group, 125-I implantation was performed at 3 months after chemoradiotherapy. The short-term clinical efficacy, progression-free survival, overall survival and adverse events were statistically compared between two groups. Results The total effective rate in the observation group was 85%, significantly higher than 56% in the control group ( P=0.046) . Until May, 2018, the progression-free survival rates in the observation and control groups were 65% and 61% ( P=0.457) , the overall survival rates were 32% and 26%, and the median survival time was 22.8( 95%CI: 20.5-23.5) and 21.3( 95%CI: 15.9-26.0) months ( P=0.633) . The incidence rates of adverse events in the observation and control groups were 45% and 78% ( P>0.05) . Conclusions Concurrent chemoradiotherapy combined with radioactive 125-I implantation yields high short-term efficacy in the treatment of locally advanced non-small cell lung cancer. It can prolong the long-term survival to certain extent and yield a low incidence rate of severe adverse events, which deserves to be validated by large sample-size investigations.

Objective To investigate the effects of epinephrine on the pharmacokinetics and pharmacodynamics of 150 mg levobupivacaine in patients with lower extremity surgery under ischial-femoral nerve block. Methods Forty patients with ASA I - Ⅱ undergoing elective ankle arthroplasty were randomLy divided into two groups including levobupivacaine group (L group), levobupivacaine combined with 1:200000 epinephrine group (LE group ), with 20 cases in each group. Under the guidance of ultrasound, the L group was treated with the sciatic nerve block and femoral nerve block by 15 mL 0. 5％ levobupivacaine (total 30 mL, 150 mg). The LE group was treated with the sciatic nerve block and femoral nerve block by 0. 5％ levobupivacaine combined with 1: 200000 epinephrine of 15mL (total 30 mL, 150 mg). 5 mL venous blood was collected immediately after the end of administration in the femoral nerve block and at 5, 15, 30, 45, 60, 120, 180, 360, 720 min after the end of administration. The concentration of levobupivacaine in plasma at each time point was detected by gas chromatography -mass spectrometry (GC-MS). Pharmacokinetic parameters were calculated using Kinetica 4. 4. 1 drug and statistical software. The onset and duration of nerve block was evaluated. Results At 15 and 30 minutes, the levobupivacaine concentration in LE group was lower than that in L group(P＜0. 05). The peak plasma concentration of levobupivacaine in LE group was lower than that in L group (P＜0. 01). There was no significant difference in the other pharmacokinetic parameters between the two groups (P＞0. 05). There was no significant difference in the onset time and the maintenance time of nerve block between the two groups (尸＞0. 05). Conclusion Epinephrine can reduce Cmax of plasma levobupivacaine in 150 mg levobupivacaine -induced ischial -femoral nerve block, but has no effect on the onset and maintenance of nerve block.

Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.