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 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 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.

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.

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.

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 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.

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.