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.

We observed in a pilot study that there was a transient elevation of brain natriuretic peptide (BNP) level shortly after the transplantation in the patient with ischemic heart failure, which is unexplainable by the simultaneous increase of the cardiac output and six-minute walk distance. Similar findings were observed in the phase I trial. We postulated on the basis of the finding of Fukuda in vitro that this transient elevation of BNP level against the improvement of cardiac function and exercise capacity might indicate cardiomyogenesis in patients after mesenchymal stem cell transplantation. Further study is warranted to verify the hypothesis.
Adult ; Aged ; Female ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; Middle Aged ; Muscle Development ; Myocytes, Cardiac ; physiology ; Natriuretic Peptide, Brain ; physiology ; Transplantation, Autologous ; Ventricular Remodeling

Objective To evaluate the efficiency of the management of medical equipment. Methods Ergonomics was applied to analyze the influence of Man-Machine-Environment System. Results Based on the actual cases, the improved procedure for equipment quality was realized and the management of purchase items were evaluated in quantification. Conclusion The efficiency of the management of medical equipment can be evaluated by using this method.

Objective To explore the clinical characteristics of myasthenia gravis(MG)in children.Methods One hundred and six children with MG in Children′s Hospital of Chongqing Medical University from Apr. 2002 to Apr. 2007 were concluded in the study.The data of laboratory examinations,including virus antibody,autoantibody test,immunity function,chest X-ray or chest CT,MRI,ECG and repetitive nerve stimulation, and treatment of cholinesterase inhibitor,glucocorticoids and high-dose immunoglobulin were reviewed.Results Among 106 children,male-to-female ratio was 1 to 1.16,male 49 cases,female 57 cases.The course of disease was 3 days to 11 years.The age of onset of all 106 children with MG varied from 10 months to 14.3 years old and the mean age was (4.74?3.32) years old.The most common age of onset was less than 3 years old(55.7%).There were 41 cases newly diagnosed children and 65 cases received irregular treatment or relapsed after treatment.The ocular muscular symptoms were mostely found at the onset(84.0%);brainstem type was involved at the onset(2.8%),generalized type was involved at the onset(13.2%);58 out of 106 cases(54.7%) had upper respiratory tract infection before the onset with MG; 41 out of 52 cases with MG had abnormal immune function or auto antibody-positive,myocardial enzymes increased in 45 cases increased in varying degrees,thymoma were not found by use of sternum or CT or MRI in 69 cases,repetitive nerve stimulation of 7 out of 11 cases were abnormal; 17 cases (16.0%) of the children received single pyridostigmine treatment,10 cases (9.4%) received co-adrenal hormone and before steroid given IVIG therapy respectively were satisfied with the efficacy,and gravis symptoms were improved;61.3% of the cases had a relapse who underwent irregular treatment or relapse after treatment,before relapse 37 cases (56.9%) received single cholinesterase inhibitor treatment, 28 cases (43.1%)for co-adrenal hormone, after adrenocortical hormone and pyridostigmine treatment.The prognosis of 72 patients(67.9%) with MG was usually good; the causes of relapse resulted from infection (30 cases, 46.2%), irregular drug use (22 cases,33.8%), and drug withdrawal and infection (13 cases, 20.0%).Conclusions As early as age of onset,the disease easily repeated,to be early co-adrenal hormone therapy group is the children′s clinical features of MG.

Objective To analyze coverage rote and quality of edible salt in Qinghai province,and to provided scientific basis for the prevention of iodine deficiency disorders.Methods According to the sampling and detection methods in the National Iodine Deficiency Disorders Monitoring Program(Trial),37 counties(cities,districts) were randomly selected in 2010.Twenty percent of the 37 counties(cities,districts),that was 6 counties (cities) were selected as key sites for monitoring of iodized salt.Quantitative determination of salt iodine was done by direct titration method(GB/T 13025.7-1999) in random monitoring,and semi-quantitative assay was used to monitor salt iodine in key sampling.Results A total of 10999 edible salt samples were tested.Among them,10525 were qualified iodized salt,269 unqualified iodized salt,and 205 non-iodized salt.The coverage rate of iodized salt was 98.14％(10794/10999),the rate of qualified iodized salt was 97.51％(10525/10794),the rate of edible qualified iodized salt was 95.69％ (10525/10999),and the rate of non-iodized salt was 1.86％ (205/10999).In the 6 key monitoring counties,salt samples of 1800 were tested.Among them,1712 were qualified iodized salt,88 non-iodized salt,and the coverage rate of iodized salt was 95.11％(1712/1800),and the rate of non-iodized salt was 4.89％(88/1800).The rates of non-iodized salt in Geermu city,Wulan county,and Jiuzhi county were 10.00％ (30/300),6.33％(19/300),5.33％(16/300),respectively.Conclusions Despite remarkable progress has been made in control of iodine deficiency disorders in Qinghai province,there are still some problems in some areas.We should establish law enforcement agencies of iodized salt and perfect sales network,perfect iodized salt network management,and strengthening health education.

Commercialization of the doctors sector and lawyers sector, and that of medical services, sharp rise of medical disputes and its impact on healthcare services have grown into major challenges for the healthcare system in the United States where litigation is the legal way out of medical disputes at large.Anglo-American law system depends heavily on precedence as the criteria and the majority of such disputes trials are held in state courts, there is also a complete system of laws and decrees on medical disputes on the federation level.In an effort to handle medical disputes that are rising sharply in a piling-up amount, American lawyers, social organizations of arbitration and medicine, and many state courts are seeking alternative dispute resolution as a better way out for medical dispute mediation and resolution.Given the gaps between China and USA in social systems, legal systems, ,economic development, cultural background, healthcare systems and heahhcare security systems, these experiences will prove their value of reference for medical disputes resolution in China.

Objective To observe the efficacy of irbesartan combined with metoprolol in the treatment of chronic congestive heart failure.Methods From April 2015 to April 2016,60 patients with chronic congestive heart failure in Central Hospital of Zhuji were randomly divided into the observation group and the control group,30 cases in each group.The two groups were given conventional treatment,the control group was treated with metoprolol,and the observation group was treated with irbesartan combined with metoprolol.The changes of left ventricular ejection fraction (LVEF),left ventricular end systolic diameter (LVESD),left ventricular end diastolic diameter (LVEDD),heart rate,systolic pressure and diastolic pressure before and after treatment in two groups were observed.And the clinical efficacy of the two groups was compared.Results After treatment,compared with the control group,the heart function index of the observation group changed obviously,LVEF increased (t=5.88,P＜0.01),LVESD and LVEDD significantly decreased (t=7.19,4.11,all P＜0.01).The heart rate of the observation group was significantly slowed down (t=2.72,P＜0.01),systolic blood pressure and diastolic blood pressure were also significantly reduced (t=2.93,3.98,all P＜0.01).The total effective rate of the observation group was 93.3％,which of the control group was 73.3％,the difference was statistically significant (χ2=4.32,P＜0.05).ConclusionIrbesartan combined with metoprolol in the treatment of chronic congestive heart failure has significant clinical efficacy,is conducive to ease the clinical symptoms and improve heart function effectively.

OBJECTIVE To evaluate the bioethical principles which should be followed in the epidemiological study of AIDS.METHODS Practicality of bioethical principles in epidemiological study of AIDS was evaluated by theoretical analysis method.RESULTS The important principles in the epidemiological study of AIDS are respect,beneficence/nonmaleficence and justice principles.CONCLUSIONS Following bioehical principle is the basis of epidemiological study of AIDS.