Objective To investigate whether Irisin improves islet β cells function in rats with type 2 diabetes mellitus(T2DM)by enhancing autophagy through the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)pathway,so as to provide new ideas for clinical treatment of chronic metabolic diseases such as T2DM and metabolic syndrome.Methods Thirty SD male rats were randomly divided into normal group(NC group),T2DM group,and Irisin intervention group(T2DM + Irisin group). High-fat and high-sugar diet for 5 weeks plus low-dose(35 mg/kg)streptozotocin(STZ)induced T2DM rat model. After 8 weeks of intraperitoneal injection of Irisin,rats were tested for fasting blood glucose(FBG),fasting insulin(FINS),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C). The intraperitoneal glucose tolerance test(IPGTT),intraperitoneal insulin tolerance test(IPITT)and hyperglycemic clamp test were performed to assess the islet function and insulin resistance level of rats in each group. The expression levels of PI3K/AKT/mTOR pathway proteins and autophagyrelated proteins in the pancreas were subsequently detected by Western blot. The expression levels of insulin,microtubuleassociated protein 1 light chain 3(MAP1LC3),p62,and lysosomal associated membrane protein-2(LAMP-2)in rat pancreas were detected by immunohistochemistry(IHC).Results There was an interaction between FBG and intervention time in rats(F = 11. 751,P = 0. 000),and the FBG gradually decreased in the T2DM + Irisin group with the prolongation of the intervention time. From the 4th week of intervention,the FBG in the T2DM + Irisin group decreased significantly compared with that in the T2DM group(F = 1 008. 870,P = 0. 000). Compared with NC group,the serum concentrations of TC,TG,and LDL-C concentrations in the T2DM group significantly increased(each P = 0. 000),while the HDL-C concentrations significantly decreased(P = 0. 000). After Irisin intervention,the above indexes were all improved(P = 0. 010,0. 000,0. 000 and 0. 000,respectively). Western blot results showed that compared with NC group,p62 protein expression and LC3Ⅱ/LC3Ⅰincreased significantly(P = 0. 008 and 0. 048,respectively),and LAMP-2 protein expression decreased significantly(P = 0. 000)in T2DM group. LC3Ⅱ/LC3Ⅰexpression level further increased after Irisin intervention(P =0. 000),but p62 protein level significantly decreased(P = 0. 047)and LAMP-2 protein expression increased significantly(P = 0. 000),and the IHC results were consistent with the Western blot results. The levels of p-PI3K/PI3K,p-AKT/AKT and p-mTOR/mTOR decreased significantly in the T2DM group compared with NC group(P = 0. 006,0. 031 and0. 000,respectively),and the above indicators further decreased after Irisin intervention(P = 0. 033,0. 013 and 0. 000,respectively).Conclusion Irisin can enhance autophagy through PI3K/AKT/mTOR signaling pathway to improve islet βcells function,providing a new idea for the treatment of T2DM.

Objective To introduce transforming growth factor ?(TGF ?) and the relationship between TGF ? and graft rejection. Methods Relevent articles in recent years were reviewed.Results The immunodepressive function of TGF ? could resist transplant organ rejection injury in early postoperative period ; meanwhile TGF ? also caused fibroblast migration and promoted matrix deposition by increasing collagen production and decreasing collagen breakdown via inhibition of collagenases,which resulted in transplant organ fibrosis and arteriosclerosis, gene polymorphisms of the TGF ? were associated with it. Moreover,ischemia reperfusion injury and immunodepressive drug also affected production of TGF ?.Conclusion TGF ? as a pleiotropic and multifunctional cytokine contributes to the development of acute and chronic rejection.

Objective To investigate the teaching effectiveness of preventive medicine and ask the students for feedback on the curriculum in order to reform the teaching methods.Methods Questionnaire survey.Sampling survey.Results 89.2％ of students have realized the importance of preventive medicine.Respectively 16.4％ and 7.5％ of students have no interesting on the curriculum due to teachers'matter and students' idea that the course is uselessness for their major and future career.75.1％ of students are interest in Nutrition and Food Hygiene,35.2％ of students dislike Medical Statistics,and 45.3％ of students think the most tough part is Medical Statistics.78.9％ of students wish to have more practice lessons.30.5％ of students do not ask teachers questions because of no communication with teachers after class.Conclusions Preventive Medicine is still ignored by a few students.The more tough the content is,the less interest the students have. Repeatedly emphasizing the importance of Preventive Medicine in medical education,adopting and combining with the community practical cases in class lectures and frequently communicating between teachers and students after class are suggested.

Analysised the transmission routes of AIDS in hospital,preventive strategies and existing ethic problems.Putting forward the importance of respecting the proper right of AIDS patients and health care workers in the prevention of nosocomial-transmitted HIV.On the basis of scientific study,strengthening the propagating of the knowledge of AIDS in the whole society,respecting the right and statue of AIDS prevention and timely treatment among both patients and health care workers.Respecting their medical treatment right and secrets,detecting HIV of patients on the informed consent.Respecting health care workers' right,providing profession guide and preventive strategies for prevention and control of nosocomial-transmitted AIDS.

MicroRNA (miRNA)is closely related to the occurrence and development of neoplasms. miR-139 is a tumor-suppressive miRNA and its expression is decreased in a variety of tumor tissues,while over-expression of miR-139 can inhibit cancer cell proliferation,migration,invasion and induce cell apoptosis by suppressing the expression of multiple kinds of target genes.Therefore,miR-139 has potential applications in tumor diagnosis,treatment and prognosis assessment.

Objective To explore the clinical curative effect of ursodeoxycholic acid combined with reduced glutathione for non-alcoholic fatty liver disease.Methods 128 patients with non-alcoholic fatty liver disease in our hospital were selected, and they were randomly divided into control group and research group,64 cases in each group.The control group received ursodeoxycholic acid capsules, the research group received reduced glutathione tablet on the basis of ursodeoxycholic acid capsules,the two groups received treatment of two periods, each period had one and half months.The liver function and blood lipid were detected and compared between the two groups.Results The total clinical effective rate of the research group was 93.75%, which of the control group was 68.75% (x2=20.5,P=0.000),the difference was statistically significant.After treatment, liver function (ALT, AST, TBIL, GGT and ALP) and lipid levels (TG and CHO) of the two groups were improved significantly[the control group:before treatment (138.75±30.63) IU/L,(161.72±55.61) IU/L,(183.65±58.47) μmol/L,(213.65±40.35) IU/L,(82.38±23.15) IU/L,(2.85±0.77) μmol/L,(6.45±0.37) μmol/L, after treatment (66.38±26.31) IU/L,(65.39±22.15) IU/L,(92.38±36.15) μmol/L,(99.68±36.72) IU/L,(30.23±10.36) IU/L,(1.92±0.58) mol/L,(5.39±0.53) μmol/L;the research group before treatment (141.25±32.53) IU/L,(157.56±58.31) IU/L,(190.23±51.27) μmol/L,(223.72±43.18) IU/L,(80.86±21.85) IU/L,(2.92±0.73) μmol/L,(6.43±0.82) μmol/L, after treatment (37.64±11.25) IU/L,(36.25±11.83) IU/L,(47.67±8.32) μmol/L,(70.52±26.31) IU/L,(16.69±7.32) IU/L,(1.32±0.63) μmol/L,(4.31±0.63) μmol/L],the differences were statistically significant(the control group :t=14.3,12.9,10.6,16.7,16.4,7.7,13.1,all P<0.01;the research group:t=24.1,25.4,21.9,24.2,16.1,13.3,16.4,all P<0.01),but these indicators of the research group were improved significantly better than those of the control group, the differences were statistically significant(t=8.0,9.3,9.6,8.5,8.5,5.6,10.5;all P<0.01).Conclusion The clinical curative effect of research group is distinct, safe and has no obvious adverse reactions, which is worthy of clinical application.

Along with the fast development of medical technology,the theory of holistic medical care is infiltrated into every aspect of clinical medical practices.In this paper,though the treatment of surgical hepatobiliary diseases under the direction of holistic medical care ,we emphasize the significance of holistic medical care in diagnosis and treatment ,recommend and canonize the usage of holistic medical care into the clinical practices.

Objective To investigate analgesia of dezocine in abdominal anesthesia postoperative.Methods 80 cases (ASA I ~II)abdominal surgery under general anesthesia patients required postoperative analgesia,according to different postoperative analgesia drug,patients were randomly divided into 2 groups:dezocine group (group D),dezocine 0.6 mg/kg+ondansetron 4mg plus 0.9% sodium chloride to 100 mL,loading dose of intravenous patient controlled analgesia (PCIA);fentanyl group (group F),fentanyl 12 g/kg+ondansetron 4mg plus 0.9% sodium chloride to 100 mL,loading dose plus PCIA,recorded after 2,4,8,12,24,48 h visual analog scale (VAS)and Ramsay sedation score.Results The 2 groups were not statistically significant differences in VAS score and Ramsay score,and the incidence of adverse reaction of fentanyl group was significantly higher than that of dezocine group (P<0.01).Conclusion Dezocine group could provide analgesia safe and comfortable for patients after abdominal operation under general anesthesia.

Objective To observe the clinical efficacy of cluster needling at the anterior oblique line of vertex-temporal plus speech training in treating motor aphasia after cerebral infarction.Method Forty patients with motor aphasia after cerebral infarction were randomized into a treatment group and a control group, 20 in each group. Both groups were given basic neurological treatment. In addition, the treatment group was intervened by cluster needling at the anterior oblique line of vertex-temporal plus speech training, while the control group was by speech training alone. After 4-week treatments, the speech function and communication ability were observed and the clinical efficacies were compared.Result The total effective rate was 90.0% in the treatment group versus 80.0% in the control group, and the difference was statistically significant (P<0.05). After treatment, the speech function score and Chinese Functional Communication Profile (CFCP) score were changed significantly in both groups (P<0.01). There were significant differences in comparing the speech function and CFCP scores between the two groups (P<0.01,P<0.05).Conclusion Cluster needling at the anterior oblique line of vertex-temporal plus speech training is an effective approach in treating motor aphasia after cerebral infarction.

Objective To investigate the efficacy of paroxetine hydrochloride on elderly ulcerative colitis with anxiety /depression as adjuvant treatment. Methods The total of 80 cases of elderly ulcerative colitis with anxiety / depression were randomly assigned to the treatment and control groups ( n= 40 cases) . The mild or moderate UC patients in the control group were treated with mesalazine enteric coated tablets 1 g,tid,po or 1 g,qid,po, respectively;upon the complete treatment for 2 weeks, the patients with lower response were added with prednisone acetate tablets 10 mg,qid,po;and the patients in the treatment group were treated with paroxetine hydrochloride tablets starting from 10 mg·d-1 to 20 mg·d-1 3 days later, for 2 months in addition to the basic treatment as those in the control group. No alcohol, no coffee and no irritated foods were allowed during the treatment;regular reexamination was taken once for every 2 weeks. The clinical manifestations and colonoscopy Mayo composite score and Hamilton anxiety / depression ( HAMA/HAMD) score test were assessed for every patient before and after treatment, to detect the improvement after treatment. Results After treatment, the Mayo scores of the treatment group decreased significantly in comparison to the control group,with the total efficiency was markedly higher than that of the control group ( P<0. 05);HAMA and HAMD in treatment group were obviously lower than those before treatment ( both P<0. 01);HAMA and HAMD scores in the control group displayed no variation after treatment. Conclusion The adjuvant therapy of paroxetine hydrochloride remarkably improves the clinical and endoscopic manifestations of elderly patients with ulcerative colitis with anxiety/depression.