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 construct the human Alzheimer's disease (AD) specific single chain anti‐bodies (scFv) library for sceening human AD scFv to Aβ1‐42 oligomers .Methods RNA was isola‐ted from 40 ml peripheral blood taken from 18 AD patients .Variable heavy (V H ) and variable light (VL ) genes were amplified by RT‐PCR and linked to the scFv fragments that were then cloned into the phage vector pCANTAB5E .The scFv library was constructed by electroporating E .coli TG1 cells into the pCANTAB5E and rescuing the assistant phage M13K07 .Results The total RNA was extracted .The VH and VL genes were amplified .Electropharesis showed that the length of VH and VL genes was 360bp and 300bp respectively and the length of linked scFv was 750bp .The 2 .4 × 109 scFv library was thus constructed and identified by BstN I digestion .Elec‐tropharesis showed that the length of BstN I‐digested scFv fragments varied ,indicating that the library is of a good diversity .Conclusion The human AD phage scFv library we constructed lays a foundation for screening the antibodies to Aβ1‐42 oligomers and the treatment of AD .

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.

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.

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.