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.

【Objective】To investigate the relationship of plasma renin activity(PRA),angiotensin Ⅱ(Ang Ⅱ) and aldosterone(ALD) activities with syndrome patterns in patients with ventricular remodeling following myocardial infarction,and to supply neuroendocrine evidence for syndrome differentiation of ventricular remodeling following myocardial infarction.【Methods】Sixty patients with ventricular remodeling following myocardial infarction were classified as Qi stagnation and blood stasis(pattern 1,n=16),phlegm-turbidity blockage(pattern 2,n=15),yangQi deficiency(pattern 3,n=16) and yin-blood deficiency(pattern 4,n=13).Radioimmunoassay(RIA) was used to measure plasma renin,Ang Ⅱ and ALD levels in acute myocardial infarction patients 7 days after onset,and cardiac color ultrasound was used to examine left ventricular function.【Results】In patients with ventricular remodeling following myocardial infarction,left ventricular end diastolic diameter(LVEDD),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),and left ventricular ejection fraction(EF) increased as compared with those in the healthy.LVEDD,LVESV and LVEDV became larger in patients with pattern 3 and pattern 1 than those in patients with pattern 2 and pattern 4(P

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.

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] Summing up the specific application of the three stages therapy of Professor XU Li in the treatment of cancer.[Methods]By copying the prescription and consulting the medical books of Professor XU, learning his clinical experience in treatment of cancer,summing up the core thinking of the three stages therapy and the experience of Chinese medicinal plant. [Result]By summing up the three stages therapy(assisting ,maintaining and palliative treatment),the special herb and attaching importance to develop the XIAN TIAN and HOU TIAN in the treatment of cancer ,it can improve radiation and chemotherapy therapeutic efficacy and resistance to transfer the maintenance treatment of recurrence ,improve the quality of life and prolong survival time of palliative care.By the guidance of the three stages therapy,smoothly finish the postoperative radiotherapy of nasopharyngeal carcinoma,successfully reverse the precancerous lesions of chronic atrophic gastritis with intestinal metaplasia,the two typical medical cases have significant curative effect. [Conclusion] Taking the three stages therapy in the process of the treatment of the tumor and precancerous lesions ,it can get good clinical effect,it is worth spreading in clinic.

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.