The effect of adrenomedullin (AM) on insulin sensitivity in normal Wistar rats was investigated by hyperinsulinemic-euglycemic clamp in combination with isotope dilution technique. The infusion rates of AM during the clamp were 0, 0.05, 0.2, 1 ?g?kg~(-1)?min~(-1), rspectively. The glucose disposal rate (GDR) and hepatic glucose output (HGO) were calculated by the plasma 3-~(3)H-glucose specific activity. After AM infusion, the insulin-mediated glucose disposal was reduced in a dose-dependant manner. It indicated that high dose of AM could induce a marked state of insulin resistance, which was mainly characterized by inhibition of the effect of insulin to stimulate peripheral glucose metabolism.

This article reviews a recently d is covered new peptide-growth hormone-releasing peptide: ghrelin. Ghrelin is secr eted by various tissues of body, mainly by gastric tissue. Ghrelin regulates GH release from pituitary, participates in the regulation of energy metabolism, inh ibits the proliferation of tumor cells and influences the cardiovascular functio n and the release of other hormones. The study of ghrelin in many fields is prel iminary and needs further investigation.

Clinical studies remain the corresponding risk, during the study period can sometimes cause pa-tients/subjects health damage directly or even life safety;also some at the end of the study after a certain period or in the offspring can reflect the long-term adverse effects. Clinical research project risk classification method is dis-cussed, according to the influencing factors of risk can be divided into two categories, their sexual and artificially, and from their sexual risk, the researchers risk, the sponsor problems and subjects of the four aspects of risk identi-fication and evaluation is discussed in detail. Based on this, advances the tactics of risk aversion: construction of clinical research and regulation of ethical management platform,To strengthen the external supervision of research project risk, The sponsor or researchers do their job, To strengthen the construction of institutional ethics committee ability, Give full play to the institutional ethics committee functions,Risk transfer and reduce the risk.

Objective To study the manual control respiratory rhythm trigger acquisition (MCRRTA)technology in improving image quality and shortening acquisition time of the low-field MRCP scan.Methods 40 patients underwent MRCP scans using both automatic respiratory rhythm trigger acquisition (ARRTA)and MCRRTA,and the acquisition time and image quality were also ana-lyzed.Results The acquisition time of MRCP using ARRTA and MCRRTA were 675.13 ± 35.89 s and 546.38 ± 30.61 s respec-tively,exhibiting significant differences using the paired sample t-test (t=13.85,P=0.000).In ARRTA group,the scores of the image quality were 4 in 11 cases (11/40,27.5%);3 in 18 cases (18/40,45.0%);2 in 10 cases (10/40,25.0%);and 1 in only 1 case (1/40,2.5%),respectively.In MCRRTA group,the scores of the image quality were 4 in 25 cases (25/40,65.5%);3 in 10 cases (10/40,25.0%);2 in 5 cases (5/40,12.5%);and no case with 1 score (0/40,0%),respectively.The differences in image quality between two groups were statistically significant using the wilcoxon rank sum test (Z=-3.036,P=0.002).Conclusion MCRRTA technology in low-field MRCP scans can improve significantly image quality and shorten examination time.

In recent years , with dramatic increase of the number of clinical studies , researchers and ethical committees face with the new challenge of ethical issues about protection of subjects .Based on the experience of previous ethical review , this article summed up a few typical cases of clinical research , involving the practical ethi-cal issues, such as the goal of research , informed consent, and compensation for damage caused by research .And then it analyzed the ethical issues in these cases , and proposed some suggestions for the reference of clinical re-searchers , ethical committees and policy makers .

Objective:To investigate the reasons of the tension of doctor-patient relationship and the medical violence from the perspective of the doctors, in order to provide a reference for finding a viable solution. Methods:Questionnaires survey were conducted about doctors' working conditions in 45 hospitals of 9 provinces. Results:On-ly 3. 6% medical staff had a harmonious doctor-patient relationship, the causes for the tense doctor-patient rela-tionship were poor communication with patients (75%), medical limitations (46. 2%);From the patients perspec-tive, the patients 'unpleasant caused by overtreatment due to complex illness accounted for 54. 2%;Institutional health-related reasons accounted for 82 . 6%. Conclusions:In the past five years after the new health care re-form, the tense doctor-patient relationship has not been released. So, should focus on training to enhance the com-munication skills of medical personnel and medical humanities education while the implementation of the national health care reform, in order to reduce iatrogenic conflicts.

Duck enteritis virus (DEV) is a herpesvirus that causes an acute, contagious and fatal disease. In the present article, the DEV UL4 gene was cloned and sequenced from a vaccine virus. A degenerate oligonucleotide primer for the consensus site of herpesvirus UL3 gene and a specific primer located in UL5 were used in the polymerase chain reaction (PCR) to amplify a DNA product 2 086 bp in size. DNA sequence analysis revealed that a 714 bp open reading frame (ORF) of DEV encoding a 237 amino acid polypeptide is homologous to the family of herpesvirus UL4 proteins and therefore has been characterized as a DEV UL4 gene. Alignment of the DEV UL4 protein sequence with those of other alphaherpesviruses showed that 10 amino acid residues are completely conserved. Phylogenetic tree analysis showed that the seventeen alphaherpesviruses viruses analyzed were classified into four large groups, and the duck enteritis virus branched separately, closely related to the Mardiviruses group comprising Gallid herpesvirus 2 (GaHV-2), Gallid herpesvirus 3 (GaHV-3) and Meleagrid herpesvirus 1 (MeHV-1). The present study showed that the evolutionary relationship of the UL4 protein could be used for classification of alphaherpesviruses.

Objective To assess the prognostic value of tumor burden measured by 18F-fluorodeoxy glucose-positron emission tomography ( FDG PET) imaging for stage Ⅲ NSCLC). Methods Fifty-six patients with lung cancer were analyzed, to whom staging PET-CT scans before treatment concurrent chemoradiotherapy and 2-year follow-up were performed. , Relationship between overall survival (OS) and metabolic tumor volume (MTV) and maximum standardized uptake value (SUVmax) were determined.Results The estimated median OS for the cohort were 14. 5 months. Kaplan-Meier analysis showed that MTV had a significant effect on OS (x2 =5.42 ,P =0. 014). No significant relationship was found between SUVmax and OS ( x2 = 0. 74, P = 0. 391 ). According to multivariate Cox regression analysis, MTV and SUVmax wereassociatedwithincreaseddeath ( x2 = 5.54, P = 0.019; x2 = 4.47, P = 0.031 ). Conclusions This study shows that higher tumor burden assessed by PET MTV is an independent unfavorable prognostic factor in lung cancer, MTV is valuable for predicting overall survival and could be a prognostic factor.

Objective:To investigate whether chemokine like factor (CKLF)-like myelin and lympho-cyte and related proteins for vesicle trafficking and membrane link (MARVEL)transmembrane domain-containing protein 2 (CMTM2)is involved in spermatogenesis in varicocele induced sub-fertility rats and to discuss the possible mechanisms.Methods:Forty male SD rats (body weight:220 -330 g,age:6 -7 weeks)were randomly divided into 4 groups:varicocele for 4 weeks,varicocele for 12 weeks,sham operation for 4 weeks and sham operation for 12 weeks,with 10 rats in each group.These rats were intro-duced by partially ligating left kidney veins for the experimental groups,and the sham surgery groups as controls were executed with exactly the same surgery as in the experimental groups except for the ligation. The rats in control and experimental groups for 4 and 12 weeks were killed after laparotomy at the end of 4 and 12 weeks,respectively,the left testes and epididymis were taken out for counting the sperm,ob-serving the seminiferous tubule change and immunochemistry for CMTM2.The changes included sperm density and motility,the outer diameter and inner diameter change and the changes of epithelium and the CMTM2 expression in immunochemistry.Results:Compared with the control groups,the sperm density [(63.9 ±7.1)×106 /mL vs.(74.3 ±5.0)×106 /mL]and motility[(58.7% ±7.9%)vs.(66.1% ± 4.3%)]were reduced slightly in group of varicoele for 4 weeks,respectively (t =1.432,1.563;P =0.076,0.059,respectively ).Varicocele significantly caused a decrease in sperm concentration [(40.5 ±7.2)×106 /mL vs.(71.1 ±4.5)×106 /mL]and motility [(35.2% ±8.5%)vs.(63.4% ± 4.1%)]at 12 weeks,compared with the related sham groups (t =3.754,3.933;P =0.004,0.002, respectively).Additionally,testis CMTM2 exhibited the same disparity,that is,the CMTM2 protein ex-pression in varicocele group was significantly reduced,with the ratio of sham group to varicocele group at the end of 12 weeks 2.3 ±0.4 (t =1.978;P =0.039).In the evaluation of seminiferous tubules diame-ter,the external [(198.2 ±10.2)μm vs.(255.8 ±12.7)μm,t =2.125,P =0.003]and epithelium diameter [(54.1 ±1.5)μm vs.(75.5 ±4.1)μm,t =2.246,P =0.021]were decreased compared with the sham-related groups and previous varicocele groups.In all the varicocele groups,all types of sperm motility decreased compared with the related sham-operated group (P <0.05).Conclusion:This study suggests varicocele has a detrimental effect on CMTM2 levels and decreases spermatogonia cell number,seminiferous tubules diameter,and sperm indices.CMTM2 is associated with sperm changes in rats with varicocele,and further studies are needed to study the mechanism.

Objective To explore the effectiveness of health risk assessment-based self-health management in individuals at high risk for diabetes.Methods From January 2016 to December 2017,we selected 1200 individuals at high risk for diabetes and divided them into a regular group(n=600)and a management group(n =600)using random number table sampling.The regular group was given regular health education and management,while the management group received intervention targeting high-risk factors.Both groups were under observation for six months and intervention effects in the two groups were compared.Results After intervention,fasting blood glucose,postprandial blood glucose,and glycosylated hemoglobin in the management group were significantly lower than in the regular group (P ＜0.05);Patients in the management group had better self-management than those in the regular group at strict diet control (90.0％ vs.76.3％),strict medication compliance (86.7％ vs.71.7％),weekly exercise time ＞ 1 h (92.5％ vs.70.0％),and weekly blood glucose measurements ＞3 (89.5％ vs.76.7％) (P ＜0.05);scores on patient satisfaction with intervention were higher in the management group than in the regular group(94.77±4.26 vs.84.65±t7.77,P＜ 0.05).Conclusions Health risk assessment-based self-health management proves to be effective for individuals at high risk for diabetes,with effective control over blood sugar levels as well as improvement in self-management efficacy and patient satisfaction.