Objective To investigate the clinical characteristics in nonalcoholic steatohepatitis (NASH),to provide the basis for the early clinical diagnosis.Methods 200 cases of non-alcoholic fatty liver disease(NAFLD) were divided into NAFL group(115 cases) and NASH group(85 cases).Age,gender,body mass index,blood pressure,clinical symptoms,accompany illnesses,biochemical and image index in the two groups were analyzed and compared retrospectively.Results Asthenia,accounted for 40％,which was the most common gastrointestinal symptom of NASH group.and abdominal distension,anorexia,nausea and vomiting,liver area pain and liver were all involved.There were no significant differences in mainly gastrointestinal symptoms between patients with NASH and NAFL group(P ＞ 0.05),but no symptoms incidence of the two group were higher (44.7％ vs 49.2％ ％ P ＞ 0.05) ;the incidence of obesity,hyperlipidemia,type 2 diabetes,hypertension in NASH group were significantly different compared with NAFL(45.9％ vs 20％,41.2％ vs 22.3％,28.2％ vs 15.6％ respectively P ＜ 0.05) ; In NASH group,BMI,fasting glucose(FPG),2hPPG,serum ferritin,hyaluronic acid,Ⅳ collageninsulin resistance index (HOWA-IR)increased significantly compared with NAFL[(28.68 ± 0.92)vs (22.21 ± 0.43),(9.63 ± 0.64)mmol/L vs (4.92 ± 0.78)mmol/L,(12.96 ±0.28) mmol/L vs (7.04 ±0.13) mmol/L,(243.56 ±7.95) ng/mL vs (140.03 ± 6.80)ng/mL,(130.26 ±9.i6)ng/mL vs (74.85 ±6.54)ng/mL,(130.56 ±8.16)ng/mL vs (72.68 ±7.24) ng/mL,(5.36±0.45) vs (2.63 ±0.12),respectively P＜0.05)].Conclusion Patients with NASH had no obvious gastroenterology symptoms.Obesity,type 2 diabetes,hypertension are more with NASH,and there may be multiple metabolic disorders.

AIM: To optimize the extraction process for coumarins in Angelica Dahurica by supercritical CO 2 as guided by the contents of oxyimperatorin, imperatorin and the total coumarins in the extract. METHODS: HPLC was applied to determine the contents of oxyimperatorin and imperatorin. orthogonal design was applied to optimize SFE process. Range and variance analysis as well as stepwise nonlinear regression analysis were applied to deal with experimental results. RESULTS: The optimum process was established as following: 21MPa as extracting pressure, 50℃ as extracting temperature, 3.5h as extracting time, 20 mesh as pulverized degree and 6.5MPa as separating pressure. The relative error between experimental data and calculated value was less than 5%. CONCLUSION: Changes in extracting pressure, temperature, time, pulverized degree would affect the extracting results remarkably. Some factors had interactions on the extraction of coumarins in Angelica Dahurica . Regression equation was reasonable and could forecast results precisely.

Objective To study the pathogenesis of osteoporosis in patients with liver cirrhosis following hepatitis B virus(HBV) infection(HBV-liver cirrhosis).Methods Bone mineral density(BMD) was measured by NM-300 sigle-energy X-ray acsorptiometry system for 61 patients with HBV-liver cirrhosis and 30 age-matched healthy controls.Serum levels of calcium regulatory hormones(CRH),1,25-dihydroxycholecalciferol [1,25(OH)_2D_3],parathyroid hormone(PTH),calcitonin(CT),osteocalcin(BGP),interleukin-1?(IL-1?),interleukin-6(IL-6) and tumor-necrosis factor-?(TNF-?),and urine level of crosslaps were measured in these patients and controls.Patients with HBV-liver cirrhosis were divided into two groups,osteoporotic and non-osteoporotic,based on their BMD in the ulna and radius,for comparison.Results BMD of the ulna and radius in patients with HBV-liver cirrhosis were significantly lower than those in controls.Serum levels of 1,25(OH)_2D_3 and BGP in patients with HBV-liver cirrhosis were significantly lower than those in controls,and much lower in osteoporotic group than that in non-osteoporotic one.While urine level of crosslaps increased significantly in patients with HBV-liver cirrhosis than in controls, much more increased in the those with osteoporosis than those without osteoporosis.Serum level of 1,25(OH)_2D_3 correlated with serum levels of BGP and BMD of the ulna and radius.Urine level of crosslaps correlated inversely with BMD of the ulan and radius in osteoporotic patients,but not in non-osteoporotic ones.Serum levels of IL-1?,IL-6 and(TNF-?) and urine level of crosslaps increased significantly in patients with HBV-liver cirrhosis than in controls,as well as increased significantly in those with osteoporosis than in those without osteoporosis.Serum levels of IL-1?,IL-6 and TNF-? and urine level of crosslaps correlated inversely with BMD of the ulna,particularly more significantly in those with osteoporosis than those without osteoporosis.Conclusions Two factors,less osteogenesis and more osteolysis,existed in patients with HBV-liver cirrhosis.Serum level of 1,25(OH)_2D_3 and serum levels of IL-1?,IL-6 and(TNF-?) played an important role in weakened bone formation and in increased bone resorption,respectively.Adequate supplementation of vitamin D_3 and reducing serum levels of IL-1?,IL-6 and TNF-? may be very important for prevention and treatment of hepatic bone disease.

The instrument is com posed of such components as SCM,pressure sensor,electric pump,magnetic valve and sleeve-type gasbag.It can control the hemostatic pressure,hemostatic time and slack time automatically.So the ischemic necrosis can be avoided thoroughly thr ough it.With the small volume,light weight,low power consumption and convenient operation,the instrument is fit for emergency treatment of mass casualties.

OBJECTIVE: To provide reference for the improvement of management quality of high-alert medications in ward area. METHODS: Risk management was used to estimate risk factor of commonly used high-alert medications in ward area. Then the homologous management measures were formulated based on potential risk. RESULTS: With enforcement of risk management, risk awareness of relevant responsible person was strengthened. They knew more knowledge about high-alert medications and its rate increased from 60% to 96%. The phenomena such as nonstandard storage and placement of drugs, unclear identification had never happened again. CONCLUSION: The application of risk management in high-alert medications contributes to improve anti-distress awareness of relevant responsible person, guarantee safety of drug use and enhance the quality of care.

To explore the law and characteristics of adverse events of medical devices and to provide research methods and basis for reducing the recurrence of similar adverse events, we collect medical devices safety information from five representative countries in the world, and make statistics and analysis on the types of events, the types of management and the causes of events. The results show that among 136 serious adverse events, the top three causes of recall are product design factors, software factors, and component defects. In order to reduce the application risk of medical devices, it is suggested that product designers, operating users and medical institutions should correctly implement the monitoring and evaluation system of medical devices.
Equipment Safety ; Equipment and Supplies/adverse effects* ; Product Surveillance, Postmarketing ; Software

Dysfunction of the Hippo pathway enables cells to evade contact inhibition and provides advantages for cancerous overgrowth. However, for a significant portion of human cancer, how Hippo signaling is perturbed remains unknown. To answer this question, we performed a genome-wide screening for genes that affect the Hippo pathway in Drosophila and cross-referenced the hit genes with human cancer genome. In our screen, Prosap was identified as a novel regulator of the Hippo pathway that potently affects tissue growth. Interestingly, a mammalian homolog of Prosap, SHANK2, is the most frequently amplified gene on 11q13, a major tumor amplicon in human cancer. Gene amplification profile in this 11q13 amplicon clearly indicates selective pressure for SHANK2 amplification. More importantly, across the human cancer genome, SHANK2 is the most frequently amplified gene that is not located within the Myc amplicon. Further studies in multiple human cell lines confirmed that SHANK2 overexpression causes deregulation of Hippo signaling through competitive binding for a LATS1 activator, and as a potential oncogene, SHANK2 promotes cellular transformation and tumor formation in vivo. In cancer cell lines with deregulated Hippo pathway, depletion of SHANK2 restores Hippo signaling and ceases cellular proliferation. Taken together, these results suggest that SHANK2 is an evolutionarily conserved Hippo pathway regulator, commonly amplified in human cancer and potently promotes cancer. Our study for the first time illustrated oncogenic function of SHANK2, one of the most frequently amplified gene in human cancer. Furthermore, given that in normal adult tissues, SHANK2's expression is largely restricted to the nervous system, SHANK2 may represent an interesting target for anticancer therapy.