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

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.

Phase Ⅱ metabolic enzymes play pivotal role in the biotransform and metabolism of exogenous substances, which might influence its ability of metabolism and detoxification to exogenous carcinogens.Polymorphism have been demonstrated in various phase Ⅱ metabolic enzymes and etiology studies showed that individuals exposed to the same environment could develop different susceptibility to tumorigenesis due to different metabolic enzyme polymorphism. Here, we summarized the effects of phase Ⅱ metabolic enzyme polymorphism on the risk of cancer.

Objective To summarize the management and diagnosis of testicular tumors in children.Methods The clinical characteristics, diagnosis, treatment and outcome of patients with pediatric testicular tumors, who were referred to Department of Pediatric Surgery, Shengjing Hospital of China Medical University from January 2003 to December 2013 ,were analyzed retrospectively.Results All of the 76 prepubertal patients were diagnosed initially with a painless scrotal mass.The mean age of the patients at diagnosis ranged from 1 to 156 months[mean(32.3 ±4.4) months].There were 39 cases(51.3％) with ages of0-1 years,18 cases (23.7％) with ages of 1-3 years,10 cases (13.2％) with ages of ＞ 3-7 years,9 cases(11.8％) with ages of ＞ 7-14 years.There were 37 cases in left side and 39 cases in right.And there were 59 cases (77.6％)of benign tumors and 17 cases(22.4％)of malignant tumors.Of the benign tumors,42 cases(55.2％)were teratomas, including 34 cases of mature teratoma and 8 cases of immature teratoma;11 cases were epidermoid cyst;11 cases were other benign tumors as lymphangioma.Among the 17 cases of malignant tumors, 16 cases (21.1％) were yolk sac tumors, which were I stage;1 case was embryoma.Thirty-three patients had abnormal alpha fetoprotein (AFP)concentrations before surgery,including 9 patients with mature teratoma,7 patients with immature teratoma, 16 patients with yolk sac tumors, 1 patient with embryonal carcinoma of testis.Of the 59 cases of benign tumors,testis-sparing surgery was done in 50 tumors, the other 9 patients underwent testis-excising because of tumor severely oppressing testis.All the 17 cases of malignant tumors underwent testis-excising.There were 76 cases in the follow-up.One patient with yolk sac tumor died for pulmonary metastasis during the follow-up.Others were alive and free of tumor recurrence.Conclusions The age range of the prepubertal testicular onset was 1 year or younger, most of the tumors were benign, and the most common subtype was teratoma.AFP highly expressed in yolk sac tumors, it was help to diagnosis.Testis-sparing surgery should be performed for the benign tumors and testis-excising for the malignant tumors.

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.

Green tea is a drink made from the steamed and dried leaves of the Camellia sinensis plants.Green tea contains a number of bioactive chemicals,including polyphenols that exert anticancer and antioxidant properties.Many studied have shown that green tea polyphenols have neuroprotective effect in cerebral ischemia through the mechanisms of antioxidant,antiapoptosis,and reducing brain edema.

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.