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.

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.

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.

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

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 investigate the clinical value of Holter monitor(DCG) in the diagnosis and treatment of dilated cardiomyopathy (DCM).Methods According to NT-proBNP ＞ 2 000pg/mL,left ventricular ejection fraction (LVEF) ≤40％,New York Heart Association (NYHA) rated Ⅲ-Ⅳ,67 patients with DCM were divided into the high risk group and nonhigh risk group.All kinds of arrhythmia patients proportion was compared between the two groups,in order to understand the risk factors of DCM and arrhythmias.Results In high risk group,18 cases had ventricular tachycardia,the incidence rate was 66.7％,which was significantly higher than that of non high risk group (2 cases,5.0％) (x2 =29.271,P ＜ 0.01).While other arrhythmia,atrial premature beats,single premature ventricular contraction,atrial fibrillation and so on,had no statistical difference (P ＞ 0.05).Conclusion The DCM patients with various types of arrhythmia,ventricular tachycardia in patients directly influence the severity and prognosis,Holter monitor has an irreplaceable role.

Objective To analyze the correlation of discomfort experience and factual recollection (FR) in patients of intensive care unit (ICU). Methods Fifty-five ICU patients and 63 ward patients par-ticipated in the study. Standardized questionnaires were used to evaluate all patients" FR and the results underwent analysis. Results The prevalence of recollection of any type of discomfort in the ICU patients was 64%. The presence of an endotracheal tube, pain and hallucinations were identified as sources of dis-comfort.The median score for FR in the ICU patients was 7.25. The median score for FR in the ward pa-tients was 13.50. The difference between them was highly significant (t =3.34, P < 0.01 ). Logistic analysis revealed that discomfort, especially discomfort caused by the presence of an endotracheal tube, pain and hallucinations, was positively related to FR, 0R95%CI (1.2～2.1), P < 0.01. Conclusions The presence of an endotracheal tube, pain and hallucinations were most frequently reported as sources of discomfort in ICU patients and their memory was often impaired. FR and recollection of discomfort appear to be related significantly in ICU patients.

Objective To explore the before taking finasteride on transurethral plasmakinetic resection of prostate(TUPKVP)patients about IPSS,QOL,Qmax,PVR and other indicators.Methods 180 cases with benign prostatic hyperplasia were randomly divided into observation group and control group,90 cases in each group.Observation group and control group were given conventional therapy and the observed patients took 5 mg of finasteride everyday one week before surgery,all patients were followed up for 1 month.The two groups of TUPKVP patients were compared about IPSS,QOL,Qmax and PVR,intraoperative blood loss,operation time,irrigation fluid volume indicators.Results 180 patients were given successfully TUPKVP surgery.IPSS,QOL,Qmax and PVR contrast were significantly improved after treatment(t=5.11,7.01,3.06,6.17,11.82,4.13,4.52,5.17,all P＜0.05).IPSS,Qmax,PVR of the observation group after treatment was significantly better than that of the control group(t=11.35,5.26,3.12,all P＜0.05),the QOL difference between the two groups after treatment was not statistically significant(P＞0.05).The cure rate of the observation group was 87.8％,which was significantly higher than 63.33％ in the control group(x2=14.56,P＜0.05).Intraoperative flushing fluid volume,intraoperative blood loss,duration of surgery in the observation group were significantly different compared with the control group,(t=21.15、43.12,5.33,all P＜0.05).Conclusion The preoperative taking finasteride can reduce TUPKVP blood loss and flushing fluid volume,shorten operation time and effectively improve the security of the operation.

Objective In Caucasian populations, the tumor cells of Epstein Barr virus (EBV)-positive classical Hodgkin lymphoma (cHL) patients more frequently express HLA class Ⅰ and HLA class Ⅱ molecules compared to EBV-negative cHL patients. HLA expression (in relation to EBV) in Asian cHL patients has not been previously investigated. Methods 145 cHL patients with formalin-fixed, paraffin embedded tissue blocks available from Beijing, China were randomly selected. Hematoxylin & Eosin-stained slides were used to reclassify the histological subtypes according to the WHO classification. EBV status was determined by visualization of EBER in tumor cells using in situ hybridization. Membranous expression of HLA molecules was detected by immunohistochemistry using antibodies HC-10 (class Ⅰ heavy chain) and antiβ2-microglobulin for HLA class Ⅰ, and CR3/43 for HLA class Ⅱ. Results EBV (+) tumor cells were observed in 40 % (58/145) of the cHL patients. As expected, the percentage of EBV(+) cases was much higher in the mixed cellularity subtype (71%) than that in the nodular sclerosis subtype (16 %) (P ＜0.001). The expression of HLA class Ⅰ was observed in 79 % of the EBV (+) cHL cases and in 30 % of the EBV (-) cases (P ＜0.001). For HLA class Ⅱ, 52 % of EBV(+) cHL cases were positive, compared to 43 % in EBV(-) cases (P =0.277). Conclusion The results in China population were similar to that in the Caucasian population for HLA class Ⅰ, but not for HLA class Ⅱ.

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.