Nonalcoholic fatty liver disease(NAFLD)is a kind of metabolic and stress-related liver damage closely related with insulin resistance and inherited susceptibility. Its incidence is increasing recently in China. Liver biopsy is the gold standard for the diagnosis of NAFLD,but which is an invasive procedure with certain risks. Therefore,finding a simple and accurate diagnostic method is an eager task,and searching of non-invasive biomarkers for diagnosis of NAFLD has become a hot spot of study. This article reviewed the progress in studies on biomarkers for diagnosis of NAFLD.

OBJECTIVE To explore the pathogen distribution and their resistance in ICU of Geriatric hospital.METHODS 111 strains isolated from lower respiratory tract were collected from Sep 2006 to August 2007.The antibiotic resistance were tested.RESULTS Among 111 strains,G-strains accounted for 70.27%,in which Pseudomonas aeruginosa was the most common(20.72%).The G+bacteria were multi-resistant to most of the antibiotics except impenem.CONCLUSIONS The most common pathogens in ICU of geriatric hospital is G-bacteria with multi-resistance.The Antibiotics should be selected reasonably.

Objective To investigate the expression of insulin receptor substrate-2(IRS-2)in the liver of nonalcoholic fatty liver(NAFL)mice.Methods Ten female C57BL6J mice fed with normal diet were served as controls,while fifteen fed with high fat and sugar diet for either 8 weeks(group-A)or 16 weeks(group B)were as NAFL mice models.Abdominal fat mass,total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FBG)insulin(INS)and liver function,liver weight were measured.And the expression of IRS-2 and the content of lipid in the liver were also detected.Results The abdominal fat mass serum TC,and FBG were significantly higher in high fat and sugar diet fed mice than that in controls(P

OBJECTIVE:To study the contents changes of polysaccharide and 5-HMF in Polygonati rhizoma from different pro-ducing areas after different processing,and provide reference for the development of processing technology of Polygonati rhizoma from different producing areas and the quality standard of different processing products. METHODS:UV spectrophotometry and HPLC were conducted to respectively determine the contents of polysaccharide and 5-HMF,and compare the content differences of polysaccharide and 5-HMF in Polygonati rhizoma from different producing areas [Shaanxi Lueyang County,Shaanxi Huangling County,Yunnan Fumin County (genuine producing areas),Shaanxi Taibai County] by fresh-cutting,dry-cutting,steaming and steaming with wine. RESULTS:Polysaccharide of sample from Yunnan Fumin County showed the highest content in fresh-cut sam-ples(13.4%),no 5-HMF(0)was detected;polysaccharide contents were respectively 10.8%-13.4%,8.9%-10.8%,5.5%-6.9%, 5.6%-6.5% after fresh-cut,dry-cut,steamed and steamed with wine,5-HMF contents were 0,0,0.21%-0.50%,0.25%-0.72%. Compared with no processing samples (fresh-cut),polysaccharide contents in Polygonati rhizoma were decreased in turn after dry-cut,steamed and steamed with wine,5-HMF contents were increased in turn after steamed and steamed with wine. CONCLU-SIONS:It is suggested to consider origin factor in developing processing technology of Polygonati rhizoma from genuine and non-genuine producing areas. 5-HMF content determination index should be added into quality standard of processing products after steamed and steamed with wine.

Objective To investigate the role of nucleotide-binding oligomerization domain-containing protein 1 (NOD1) in inducing insulin resistance in differentiated human adipocytes.Methods Human preadipocytes obtained via liposuction were induced to differentiate into mature adipocytes.iE-DAP,a specific ligand for NOD1,was administered to human adipocytes in culture.NF-κB transcriptional activity and proinflammatory cytokines production were determined by luciferase assay and enzyme-linked immunosorbent assay.Glucose uptake in adipocytes was measured by 2-deoxy-D-[3 H] glucose uptake (P＜0.05).The expression of phosphatidylinositol-3-kinase p85 (PI-3K p85),insulin receptor substrate-1 (IRS-1) and Akt phosphorylations were detected by Western blotting.Results NF-κB transcriptional activity and cytokines such as interleukin (IL)-6,IL-8,and monocyte chemotactic protein 1 secretion were markedly increased after stimulation with iE-DAP (P＜0.05 or P＜0.01).Insulin-induced glucose uptake was decreased with the activation of NOD1 in a dose-and time-dependent fashion.NOD1 activation weakened insulin signal transduction as being revealed by increasing IRS-1 Ser307phosphorylation,reducing protein expression of PI-3K p85,and attenuating insulin-induced phosphorylation of Akt on Ser473 and Thr308in human adipocytes.Conclusion These results indicate that NOD1 activation induces inflammatory response and insulin resistance via IRS-1/PI3-K/Akt signaling pathway in human adipocytes.

Objective To investigate the correlation between cytomegalovirus infection and heart rate variability (HRV) in elderly patients with atherosclerosis.Methods 160 patients with coronary heart disease who met World Health Organization diagnostic criteria for coronary heart disease in 1979 were collected.According to the IMTHCMV PP65 antigen test results,patients were divided into positive group (observation group,n=103) and negative group (control group,n=57).We detected the levels of of HRV,metalloprotease-9 (MMP 9) and tumor necrosis factor α (TNF-α) in the two groups in order to access the plaque stability.Results The all sinus standard deviation of RR interval (SDNN),standard deviation of the average NN interval (SDANNI),mean value of sinus standard deviation of RR interval (SDNNI) were lower in observation group than in control group (P ＜0.05).There were no significant differences in square root of the mean squared differences of successive NN intervals (RMSSD) level and percentage of differences exceeding 50ms between adjacent normal number of intervals (PNN50) between the two groups (P＞0.05).The levels of total cholesterol and low density lipoprotein were higher and the levels of MMP 9 AND TNF α were lower in observation group than in the control group (all P＜0.05).Compared with control group,the plaque stability was decreased in observation group [20.4％ (21/103) vs.61.4％ (35/57),x2=4.273,P=0.015].Conclusions Patients with atherosclerosis combined with cytomegalovirus infection have a greater heart rate variability and poorer plaque stability.

Objective To compare different dose of remifentanil combined with propofol for painless abortion and approach to an appropriate dose of remifentanil.Methods Ninety pregnant women with ASA 1 were randomly divided into three groups(n=30)before administrating remifetanil,a bolus midazolam 1 mg was injected inminutes later.These two drugs did not stop administration until three minutes before the end of negative suction.MAP,HR,SpO2,BIS,RR,VT,PET CO2 were monitored.The onset,operation and recovery time,sedation score and adverse reaction were recorded.Results Sedation scores were significantly different between group A and C [(3.90±0.97)and(4.90±0.85),t=4.24,P＜0.01].Three cases in group A were found moving.MAP,HR,BIS decreased as compared witll baseline.HR reduced significantly in group C(P＜0.05,P＜0.01).Respiratory movement was lower and shallower.RR,VT decreased compared to preoperative one.PET C02 increased gradually (P＜0.05,P＜0.01).There were two cases of respiratory depressing in group A,four cases in group B and ten cases in group C(five cases apnea more than three minutes).All patients used oxygen mask to maintain SpO2＞95%.Incidence of adverse reactions such as chest titanic,nausea and vomiting,itching were of no difference among three groups(P＞0.05).All patients were satisfied with anesthesia.Conclusion The appropriate infusing dose of remifetory devices such as oxygen mask and monitoring life signs are very important to prevent respiratory depress and bradycardia during operation.

Background and purpose: Oxymatrine, which is the main effective component of Sopkora flavescens Ait, has anti-fibrosis and antiviral activities, and also has a good effect on leukopenia after either chemotherapy or radiotherapy. Recent studies showed that oxymatrine has the abilities of anti-invasion and killing tumor cells in some degree, and as a supplementary anticancer drug in chemical therapy. In this study, we investigated the antitumor mechanism of oxymatrine by observing cell proliferation and VEGF expression in human gastric cancer SGC-7901 cell line. Methods: Human gastric cancer SGC-7901 cells was cultured in vitro and treated with oxymatrine, then cell proliferation was examined by the method of MTT. Immunohistochemistry was applied to examine the protein expression of VEGE The transcriptions of VEGF mRNA were demonstrated by RT-PCR technique.Results: Low-dose (0.5 mg/mL) oxymatrine has a mild inhibitory effect on cellular proliferation of SGC-7901 cells (P>0.05). When concentration exceeded 1 mg/mL, oxymatrine significantly inhibited cellular proliferation in a time-and concentration-dependent manner, and down-regulated the mRNA and protein expression of VEGF (P<0.05).Conclusion: Within a certain drug concentration, oxymatrine can inhibit the proliferation of SGC-7901 cells and play a potential role in inhibiting angiogenesis by down-regulating the expression of VEGF.

BACKGROUND: Electro-acupuncture therapy shows good central and peripheral analgesic effects. Several studies have shown that transforming growth factor β (TGF-β) plays an important role in the pathogenesis of knee osteoarthritis. OBJECTIVE: To investigate the mechanism underlying electro-acupuncture treatment of knee osteoarthritis. METHODS: A total of 80 healthy male 3-month-old Sprague Dawley rats were randomly and evenly divided into normal, model, electro-acupuncture and drug groups. Rat models of knee osteoarthris were estbalished by ligating the femoral veins and forcing rats to do activies. At 1 month after knee osteoarthris induction, the electro-acupuncture group rats received electro-acupuncture therapy at two acupoints Neixiyan (EX-LE4) and Dubi (ST 35) with a depth of 0.1 cun (pulse 2 Hz, 20 minutes, once a day). The drug group rats were intraarticularly administerd sodium hyaluronate (0.1 mL/administration, once a week). After 2-week treatment, synovial tissue of the knee joint was harvested to determine the exprssion of TGF-β1, TGF-β1 receptor Ⅰand TGF-β1 receptor Ⅱ. RESULTS AND CONCLUSION: TGF-β1 expression in synovial tissue of the knee joint was significantly increased after knee osteoarthris (P < 0.05), but after electro-accupuncture therepy or sodium hyaluronate treatment, TGF-β1 expression was significantly decreased (P < 0.05), moreover, TGF-β1 receptor Ⅰ, Ⅱ expression was signficantly decreased (P < 0.05). These findings suggest that electro-acupuncture for treatment of knee osteoartheis improves the symptoms of osteoarthris by downregulating TGF-β1 expression, and reduction in TGF-β1 receptor Ⅰ, Ⅱ expression promotes the recovery of knee osteoarthris.

Objective To investigate the selection and efficacy of operative medality for pancreatic transec-tion with major duct injury. Methods The clinical data were retrospectively analyzed in 21 patients with pancreatic disruption. They were treated in our hospital from Jan. 1995 to Feb. 2009. There were 14 males and 7 females in these cases with a mean age of 26 years (range 9-53 years). The trauma causes of them were blunt injuries in 13 and patent injuries in 8 cases. The injury grade (according to American Association for the Surgery of Trauma) distribution for these patients was grade Ⅲin 8 cases, grade Ⅳ in 8 cases, and grade V in 3. The early emergency operation was performed in eighteen within 12 hours, and delayed opera-tion was in three cases. Of these operative medalities, Roux-en-Y distal panereatojejunostomy was in 10 ca-ses, pancreatoduodenectomy was in 3, modified duodenal diverticulizatian was in 2, distal pancreatectomy was in 3, tube installing in major duct and external drainage, and suture of pancreatic section was in 2, su-ture of two broken sides in 1 (Roux-en-Y distal pancreatojejunostomy in second time). Results Twenty patients were cured, and one was died after a procedure of pancreatoduodenectomy. The postoperative pan-creatic fistula happened in 3 cases and recovered well with conservative line of management. Conclusions For improving the outcome of pancreatic transection, the earlier exploratory laparotomy and carrying out concept of "Damage Control Surgery" are critical. The individual operative modality based on the grade should be a-dopted in the surgical procedure.