Objective To assess the efficacy and safety of insulin Lispro in type 1 or type 2 diabetic patients.Methods Forty diabetic patients were assigned to receive premeal insulin Lispro plus bedtime Neutral Protamine Hagedorn(NPH)insulin for 12 weeks.The following characters were compared between before and after treatment,including fasting plasma glucose(FPG),1 h and 2 h postprandial glucose(after a standardized meal),glycosylated hemoglobin(GHbA_1c)levels,total daily insulin dose and the number of hypoglycemic episodes.Results Thirty-nine subjects fulfilled the study.After 12 weeks of Lispro treatment,the levels of FPG and 1 h and 2 h postprandial glucose were decreased significantly,being 1.12 mmol/L,2.37 mmol/L and 1.92 mmol/L respectively;GHbA_1c was decreased by 1.45%(from 8.9% to 7.5%).The dose of insulin Lispro was not changed,compared with the dose of regular human insulin at baseline.The incidence of hypoglycemia was decreased from 19.5 every week at baseline to 9.8 every week with Lispro.Conclusion Insulin Lispro is an effective agent for good glucose control with fewer hypoglycemic episodes in diabetic patients.

Objective To dynamically observe and evaluate the position and movement of anterior pelvic floor organs in vaginal delivery and selective caesarean section primipara with translabial two-dimensional 2D ultrasound and discuss the short-term effect of delivery mode on the anterior compartment of pelvic floor Methods Translabial 2D ultrasound was performed on selective caesarean section and vaginal delivery primipara in 6-8 weeks The position of bladder the existence of bladder neck funneling were observed and the mobility of bladder neck and the urethral rotation angle were measured during maximum Valsalva maneuver Results The mobility of bladder neck was larger in vaginal delivery group than selective caesarean section group during maximum Valsalva maneuver The rates of bladder neck funneling cystocele and stress urinary incontinence were higher in vaginal delivery group Conclusions Translabial 2D ultrasound could dynamically observe and evaluate the position and movement of anterior pelvic floor organ which could be used to assess the effect of delivery mode on anterior compartment of pelvic floor The short-term effect of vaginal delivery on anterior compartment of pelvic floor is greater than that of selective cesarean delivery.

Purpose To evaluate the correlation among diffusion weighted imaging (DWI), tumor Cellularity and hypoxia-inducible factor-1α (HIF-1α) for the high and low grade astrocytoma. Materials and Methods DWI was applied with 33 patients with astrocytoma confirmed by pathology, and ADC value was measured. Tumor Cellularity was measured using Scion Image 4.0.3.2. The expression of HIF-1α was tested using immunohistochemisty. Results Mean ADC value was higher in the low grade astrocytoma than that in the high grade astrocytoma (t=7.300, P<0.001). The tumor Cellularity was higher in the high grade astrocytoma than that in the low grade astrocytoma (t=-3.845, P<0.01). HIF-1αexpression could be demonstrated in the low grade [(20.08±10.01)%] and high grade [(47.91±19.03)%] astrocytoma. The negative correlation was demonstrated between ADC value and HIF-1αand tumor Cellularity (r=-0.756,-0.617;P<0.001). The positive correlation was demonstrated between HIF-1αand tumor Cellularity (r=0.622, P<0.001). Conclusion ADC value can be used to discriminate the low and high grade astrocytoma, and the role of HIF-1αshould be further to study with enlarged sample.

Objective To investigate brain function alteration in early onset schizophrenia by amplitude of low-frequency fluctuation (ALFF) based on resting-state functional MRI (fMRI). Method Twenty patients with early on?set schizophrenia and 20 sex, age, education years matched healthy controls underwent resting-state functional MRI. The difference in ALFF was compared between patients and controls. Result Compared with control group, the ALFF values in patient group increased in the left frontal gyrus, precuneus, cingulate cortex, occipital lobe, parahippocampal gyrus and calcarine (P<0.05, AlphaSim revised), while decreased in the right superior temporal lobe and the posterior lobe of cerebellum (P<0.05, AlphaSim revised). Conclusion There are abnormal ALFF in multiple regions in early onset schizo?phrenia, suggesting that early onset schizophrenia may have altered in resting-state brain activity.

OBJECTIVE:To establish HPLC fingerprints of Yigan yiqi jieyu granules. METHODS:HPLC method was adopted. The determination was performed on Diamonsil C18column with mobile phase consisted of water-acetonitrile(gradient elution)at flow rate of 1.0 mL/min. The detection wavelength was set at 230 nm,and column temperature was 30 ℃. The sample size was 10 μL. Using paeoniflorin as control,HPLC chromatograms of 10 batches of samples were determined.The similarity was evaluated by using TCM Chromatogram Fingerprint Similarity Evaluation System(2004 A version)to determine common peak. RESULTS:There were 34 common peaks in HPLC fingerprints of 10 batches of samples,with the similarities>0.98. After validation,HPLC chromatograms of 10 batches of were in good agreement with control fingerprint. CONCLUSIONS:Established fingerprint can provide reference for identification and quality evaluation of Yigan yiqi jieyu granules.

Objective: To investigate the distribution of gross α and gross β radioactive levels in drinking raw water from different regions of Guangdong province, and to establish the radioactive level base line value in raw water. Methods: The samples from 191 drinking water sources in use in Guangdong province were collected in rainy season and dry season, respectively, and determined and analyzed under the standard examination method for drinking water-radiological parameters (GB/T 5750.13-2006). The levels of gross α and gross β radioactivity were evaluated under the standard for drinking water quality (GB 5749-2006). Results: A total of 377 raw water samples were taken, including 189 samples in rainy season and 188 samples in dry season, in which 186 samples were matched between rainy season and dry season. In dry season, the gross α levels ranged from 0.008 Bq/L to 0.582 Bq/L, averaged at (0.034±0.060) Bq/L, while the gross β levels ranged from 0.014 Bq/L to 0.637 Bq/L, averaged at (0.108±0.091) Bq/L. In rainy season, the gross α levels ranged from 0.008 Bq/L to 0.402 Bq/L, averaged at (0.045±0.064) Bq/L, while the gross β levels ranged from 0.014 Bq/Lto 0.848 Bq/L, averaged at (0.125±0.128) Bq/L. The gross α and gross β radioactivity levels of other samples were much lower than the guidance values in the national radioactivity standards on drinking water radioactivity, except for a sample from Shanwei area. The gross α and gross β radioactivity levels in the rainy season were higher than in the dry water season, and the gross α radioactivity levels in the rainy season were significantly higher than in the dry water season. There were significant differences in gross α and gross β radioactivity levels in rainy(F_{rainy season}=1.819, 2.709, P<0.05) and dry season (F_{dry season}=1.985, 8.461, P<0.05)in different water systems, and the levels of gross α and gross β radioactivity in the rivers in western Guangdong were the highest. The gross α and gross β radioactivity levels of groundwater in rainy season were higher than in river water and lake water, and the gross α and gross β radioactivity levels in river water were higher than in lake and reservoir water, with the statistically significant differences(F_{total α}=39.323, F_{total β}=25.911, P<0.05), the gross α and gross β radioactivity levels in dry season were higher than in river water and lake water, with the statistically significant difference(F_{total α}=11.520, F_{total β}=28.435, P<0.05). The highest radioactivity levels is in groundwater, followed by river water, and the lowest is in lake and reservoir water. Conclusions The natural radioactivity background levels in drinking raw water in Guangdong province is lower than the limit value on drinking water stipulated by our country. The radioactivity levels in raw water in western Guangdong is significantly higher than in other water systems, and the radioactivity level in river water is also significantly higher than in lake and reservoir water.

Objective To survey the basic situation of diagnosis and treatment in clinical nuclear medicine across Guangdong province,evaluate the risks of exposure to the radiation workers and public and explore the countermeasures to control radiation exposre.Methods A survey team was set up to survey,by filling questionnaires,the basic information on nuclear medicine practices for workers,equipment,radionuclide,frequency and dose to workers and radiation protection measures.Results A total of 71 nuclear medicine institutions was involved in the survey with 733 radiation workers in 2016 in Guangdong.The average annual effective dose to nuclear medicine workers was (0.55±0.66) mSv per year.The total pieces of nuclear medical equipment was up to 189 in 2016 including 59 SPECT/CT scanners (5 SPECT),28 PET/CT scanners and 54 thyroid scanners.Total activity of 1.15× 10s MBq in radiopharmaceuticals was used in 325 903 examinations and treatments with the number of frequency of 2.97 examinations per 1 000 population.Concluions There have been a rapid progress in practice of nuclear medicine over the past 20 years in Guangdong province with departments of nuclear medicine set up in 18 of 21 cities.Compared with 1998,the activity in radiopharmaceuticals used has increased by 414％ in 2016 and the number of frequency of examination and treatment has increased by 111％.The rapid expansion of nuclear medicine practice has also caused potential risks of radiation to the public and environment.

OBJECTIVE: To develop a radioactive sewage purification device that can effectively filter the nuclides in low-level nuclide-contaminated wastewater. METHODS: The radioactive sewage purification device was composed of lifting pump, stack filter, multi-medium filter, security filter, tubular ultrafiltration membrane, high-pressure pump and reverse osmotic membrane. The combined process of adsorption-ultrafiltration-reverse osmosis was used to separate radioactive elements from wastewater by reverse osmosis membrane separation system. Through two-stage multi-medium filter circulation system circulation treatment, radioactive sewage was purified. The flow rate of water treatment is 20 L/min. The filtration efficiency and purification efficiency of the device were tested by filtration experiments on elements containing radionuclide and purification experiments on radionuclide.RESULTS: The filtration efficiency on iodine, potassium, strontium and cesium, that are the common elements in radioactive sewage samples were 97.88%, 98.38%, 99.99% and 99.80%, respectively. The single purification efficiency of radionuclide ~(40)K in low-level radioactive sewage was over 90.00%. CONCLUSION: The device has high filtering efficiency for common elements such as iodine, potassium, strontium and cesium in sewage and high removal rate of radioactive activity for sewage containing ~(40)K. It can be further optimized and transformed into a suitable radioactive sewage water purifier.

OBJECTIVETo summarize the treatment status of gastric gastrointestinal stromal tumor (GIST) in Shandong province,by analyzing the clinicopathological features and prognostic factors.

METHODSClinicopathological and follow-up data of 1 165 patients with gastric GIST between January 2000 and December 2013 from 23 tertiary referral hospitals in Shandong Province were collected to establish a database. The risk stratification of all cases was performed according to the National Institutes of Health(NIH) criteria proposed in 2008. Kaplan-Meier method was used to calculate the survival rate. Log-rank test and Cox regression model were used for univariate and multivariate prognostic analyses.

RESULTSAmong 1 165 cases of gastric GIST, 557 were male and 608 were female. The median age of onset was 60 (range 15-89) years. Primary tumors were located in the gastric fundus and cardia in 623 cases(53.5%), gastric body in 346 cases(29.7%), gastric antrum in 196 cases(16.8%). All the cases underwent resection of tumors, including endoscopic resection (n=106), local resection (n=589), subtotal gastrectomy(n=399), and total gastrectomy(n=72). Based on the NIH risk stratification, there were 256 cases (22.0%) at very low risk, 435 (37.3%) at low risk, 251 cases (21.5%) at intermediate risk, and 223 cases (19.1%) at high risk. A total of 1 116 cases(95.8%) were followed up and the median follow-up period was 40 (range, 1-60) months. During the period, 337 patients relapsed and the median time to recurrence was 34 (range 1-60) months. The 1-, 3-, and 5-year survival rates were 98.6%, 86.1% and 73.4%, respectively. The 5-year survival rates of patients at very low, low, intermediate, and high risk were 93.1%, 85.8%, 63.0% and 42.3% respectively, with a statistically significant difference (P=0.000). Multivariate analysis showed that primary tumor site (RR=0.580, 95%CI:0.402-0.835), tumor size (RR=0.450, 95%CI:0.266-0.760), intraoperative tumor rupture(RR=0.557, 95%CI:0.336-0.924), risk classification (RR=0.309, 95%CI:0.164-0.580) and the use of imatinib after surgery (RR=1.993, 95%CI:1.350-2.922) were independent prognostic factors.

CONCLUSIONSThe choice of surgical procedure for gastric GIST patients should be based on tumor size. All the routine procedures including endoscopic resection, local excision, subtotal gastrectomy and total gastrectomy can obtain satisfactory curative outcomes. NIH classification has a high value for the prediction of prognosis. Primary tumor site, tumor size, intraoperative tumor rupture, risk stratification and postoperative use of imatinib are independent prognostic factors in gastric GIST patients.