Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder, affecting 10%-24% of the general population, and the incidence is much higher (70% -80% ) in type 2 diabetic patients. Recent studies indicate that fatty liver is an emerging problem in the Asia-Pacific region and China. The community prevalence of NAFLD in Shanghai is 15%. A large body of evidences suggests that NAFLD is the hepatic manifestation of the metabolic syndrome. NAFLD is not only associated with the metabolic syndrome, it also predicts the development of type 2 diabetes and cardiovascular disease (CVD). The liver is a central organ for controlling and regulating glucose and lipids metabolism; intrahepatocellular lipid accumulation plays a key role in the development of metabolic-ally related disorders. It is crucial that specialists, especially endocrinologists, and practising clinicians should be aware of the strong association between NAFLD and increased risks of diabetes and CVD, NAFLD should be diagnosed correctly and defined timely in regarding its role as risk factors of underlying diabetes and CVD.

Researches in type 2 diabetes and non-alcoholic fatty liver disease have been made in recent years.The intimate connection between these two diseases has been analysed and explored.Whether non-alcoholic fatty liver disease is a hepatic complication of type 2 diabetes remains to be elucidated.The poor outcome of liver disease in patients with type 2 diabetes should be emphasized.

The progress in nonalcoholic fatty liver disease(NAFLD) research has shown an important role of hepatic steatosis in triggering insulin resistance and glucose/lipid metabolic disorders.As an early reversible therapeutic target for metabolic diseases,NAFLD has attracted increasing attention from endocrinologists and gastroenterologists,as well as deeping the studies in this field.Based on the recent progress in NAFLD research,this review mainly presents the new understanding and concept of NAFLD,discusses the features of the new guidelines and concensus for NAFLD treatment,and introduces some updated developments in NAFLD diagnosis and therapy.Furthermore,future directions of NAFLD research are also predicted in the article.

Objective To study the effect of caveolin-1 on renal injury and the expression of tight junction proteins in MRL/lpr mice kidney.Methods The mice were divided into 4 groups:5 mice in the normal control group (BALB/c mice);the MRL/lpr lupus mice (n=18) were randomly divided into the MRL/lpr group in which 6 mice were included;the negative control group in which 6 mice were included;the caveolin1 transfection group in which 6 mice were included.The changes of urine protein,the levels of urea (BUN) and creatinine (Cr) were detected.The expressions of claudin-5,occludin,ZO-1 and caveolin-1 protein were determined by western bloting.Analysis of variance was used to determine statistical significant differences between the two groups.A significance level of 0.05 was considered as signigicant.Results Compared with the control group,24 h urine protein [(2 894±437) mg,(412±72) mg],BUN [(8.7±1.5) mmol/L,(6.9±0.4) mmol/L],Cr [(106±22) μmol/L,(85±4) μmol/L] were significantly increased,level of caveolin-1 protein increased (265±17,61±6),the level of occludin (114±12,190±12),claudin-5 (60±5,80±6) and ZO-1 (98±11,206±15) protein decreased in the MRL/lpr group (P＜0.05).After caveolin-1 transfection,the levels of urinary protein [(1 253±249) mg,(2 894±437) mg],BUN [(6.5±1.3) mmol/L,(8.7±1.5) mmol/L],Cr [(78±17) μmol/L,(106±22)μmol/L] were significantly decreased,and the levels of occludin (218±16,114±12),claudin-5 (87±6,60±5)ZO-1 (313±17,98±11) were increased (P＜0.05).Conclusion The expression of caveolin-1 protein in the renal tissues of lupus nephritis increases.Caveolin-1 can reduce the expression of tight junction proteins and contribute to progres-sion of lupus nephritis.

Objective To observe the effect and safety of modified Yishen Zhuyang Huoxue Huazhuo Formula for polycystic ovarian syndrome (PCOS) in the TCM pattern of deficiency of spleen and kidney with phlegm-dampness. Methods Totally 123 cases were recruited into this study and randomized to two groups by central random approach, 64 cases in the observation group and 59 cases in the control group. Patients in the observation group were given the modified Yishen Zhuyang Huoxue Huazhuo Formula, while those in the control group were given compound cyproterone acetate tablet, for two treatment courses, three months for one course. The changes of ovarian volume and the number of follicles before and after treatment were observed. Adverse reactions were also evaluated. Results Bilateral ovarian volumes in both groups decreased after treatment (P<0.05, P<0.01), while the control group showed a significant better improvement (P<0.05). The number of follicles in the two groups decreased, but no significant difference were observed between the two groups (P>0.05). The rate of adverse reaction in the observation group was lower than the control group. Conclusion Modified Yishen Zhuyang Huoxue Huazhuo Formula is effective for PCOS patient by reducing the ovarian volume with a low incidence of side effect.

Objective To study the effect of hydroxychloroquine (HCQ) on the suppressors of cytokine signaling (SOCS) in the kidney of MRL/lpr mice and evaluate the protection of HCQ on lupus nephritis.Methods Twenty-six rats were randomly divided into 3 groups:the control group which was consisted of 6 mice; the MRL/lpr group which was consisted of 10 mice; and the HCQ group which was consisted of 10.24-hour urinary protein level and anti dsDNA levels were tested.The expressions of SOCS-1 and SOCS-3 protein were determined by western blot.Analysis of variance was used to determine statistically significant differences between the two groups.A P value less than 0.05 was considered to be statistically significant.Results Compared with the control group,the levels of 24-hour urinary protein [(2 356.6±509.3) mg vs (440.3±90.1)mg] and anti ds-DNA (128.7±32.3 vs 14.9±1.4) were significantly increased in the MRL/lpr group,the expression levels of SOCS-1 and SOCS-3 protein were increased.After treated with HCQ,the levels of 24-hour urinary protein [(70.8±11.1) mg vs (2 356.6±509.3) mg] and anti-dsDNA (111.8±330.1 vs 128.7±32.3)were significantly decreased,the expression level of SOCS-1 and SOCS-3 protein decreased significantly (P＜ 0.05).Conclusion HCQ can inhibit SOCS expression in the kidney of lupus mice,reduce proteinuria and delay progression of immune disorders and lupus nephritis.

An early diagnosis of nonalcoholic fatty liver disease ( NAFLD) is meaningful to the prevention and cure of diabetes and cardiovascular disease ( CVD). The sensitivity and specificity of qualitative methods vary greatly, and these methods do not quantify liver fat content. Pathological diagnosis is a quantitative method, but it is invasive and inappropriate for clinical application. The establishment of H Magnetic Resonance Spectrum (1H MRS) opened up a brand-new era for noninvasive liver fat quantification. This review systemically introduces the new progress in noninvasive diagnosis of NAFLD.

Diabetes Mellitus, Type 2 ; complications ; Humans ; Non-alcoholic Fatty Liver Disease ; complications

Microsomal triglyceride transfer protein (MTP) is a key transfer protein in lipid metabolism and is mainly expressed in the hepatocytes and enterocytes.It plays an important role in transferring triglyceride as well as in assembly and secretion of very low density lipoprotein.Recent studies have shown that MTP is closely related to the onset and development of non-alcoholic fatty liver disease.

Three cellulose derivatives were synthesized and used as chiral stationary phases based on silica gel.The effects of adsorbances on the column numbers and stabilities have been investigated.These stationary phases exhibited high chiral recognition for various racemates.At the same time,the on-line curves of polarimeter were obtained by high performance liquid chromatography with polarimeter as on-line detector.