Nonalcoholic fatty liver disease(NAFLD)is the most common cause for elevated liver enzymes in the developed nations.The treatment should be focused on the most important risk factors,obesity and insulin resistance.As a consequence of elucidating the pathogenesis of NAFLD,the number of potential therapeutic options increased,including weight reduction,antioxidants,insulinsensitizer,lipid lowering drugs and other liver protective drugs.The drug therapy for NAFLD was reviewed in this paper.

Objective:To investigate whether miR-9 plays a role in regulating glycogen synthase kinase-3β (GSK-3β) expression, affecting Wnt/β-catenin pathway activity and the patho-genesis of Osteo-arthritis (OA).Methods:The cartilage tissue of OA patients and normal cartilage tissue after traumatic amputation were collected, and the expressions of miR-9 and GSK-3β were compared. The double luciferase gene reporting test verified whether there was a targeted regulatory relationship between miR-9 and GSK-3β. OA rat model was established and compared with sham group, enzyme-linked immuno sorbent assay (ELISA) was used to detect hydroxyproline (Hyp) content in joint fluid.A kit was used to detect caspase-3 activity, and miR-9 and GSK-3β expression differences were detected in cartilage tissue. The OA model rats were divided into 3 groups: the sham group, the OA+ antagomiR-NC group, the OA + antagomiR-9 group. ELISA was used to detect Hyp content in joint fluid, kit was used to detect caspase-3 activity, and flow cytometry was used to detect cell cartilage tissue. Apoptosis, quantitative real-time polymerase chain reaction (qRT-PCR) and western blot were used to detect the expression of miR-9, GSK-3β, β-catenin and COL2A1. The comparison of mea-surement data between the two groups was conducted by t-test. The comparison of measurement data between multiple groups was conducted by one-way Analysis of Variance (ANOVA) analysis of variance, and then Bon-ferroni method was used for comparison between the two groups. P<0.05 was considered as statistically sign-ificant. Results:The miR-9 expression of cartilage tissue were (1.09±0.25) in the control group, and (2.86±0.25) in the OA group ( t=24.30, P<0.01). The GSK-3 β mRNA expression of cartilage tissue was (0.99±0.11) in the control group, and (0.53±0.10) in the OA group ( t=15.40, P<0.01). There was a targeted regulatory relationship between miR-9 and GSK-3β. The miR-9 expression of cartilage tissue was (1.00±0.21) in the sham group, and (2.61±0.36) in the OA group (t=9.462, P<0.01). The GSK-3 β mRNA expression of cartilage tissue was (1.00±0.18) in the sham group, and (0.52±0.09) in the OA group ( t=5.842, P <0.01). The Hyp content of joint fluid was (10±3) ng/ml in the sham group, and (50±8) ng/ml in the OA group ( t=11.015, P<0.01). The Caspase-3 activity of cartilage tissue was (1.00±0.19) in the sham group, and (2.43±0.36) in the OA group ( t=8.605, P<0.01). The miR-9 expression of cartilage tissue was (2.86±0.31) in the OA+antagomir NC group, and (1.67±0.19) in the OA + antagomir-9 group ( F=105.2, P<0.01). The GSK-3β mRNA expression of cartilage tissue was (0.41±0.09) in the OA antagomir NC group, and (0.81±0.09) in the OA + antagomir-9 group ( F=49.32, P<0.01). The Hyp content of joint fluid was (52.3±6.8) ng/ml in the OA + antagomir NC group, and (30.3±3.4) ng/ml in the OA + antagomir-9 group ( F=119.7, P<0.01). The caspase-3 activity of cartilage tissue was (2.22±0.23) in the OA + antagomir NC group, and (1.43±0.14) in the OA+ antagomir NC group ( F=72.55, P<0.01). Compared with OA + antagomir NC group, the expression of β-Catenin protein in the OA + miran-tagomir-9 group wasdecreased, the expression of GSK-3 β and COL2A1 protein wasincreased, and cell apo-ptosis wasdecreased. Conclusion:The increased expression of miR-9 plays a role in reducing the expression of GSK-3β, enhancing the activity of Wnt/β-catenin pathway, promoting the degradation, destruction of cartilage matrix and the pathogenesis of OA. Inhibition of miR-9 expression can reduce the protective effect of OA.

Objective Using Nutrition Risk Screening (NRS 2002),to assess the nutritional risk of inpatients with digestive diseases and evaluate its clinical significance.Methods The information of 274 patients med the inclusion criteria were collected in our department from August to October 2011.Nutrition status was assessed according to NRS 2002 by trained nurses.Results The prevalence of nutritional risk was 22.99 ％ (63/274).The rate of nutritional risk of the elderly inpatients (≥ 65y) with digestive diseases was significant higher the younger ones (＜ 65y)(32.95％ vs 18.28％,P ＜ 0.05).74.6％ inpatients with nutritional risk and 52.13％ with no risks were given enteral or parenteral nutritional support during the hospitalized period.Conclusion There was higher nutritional risk rate in inpatients with digestive diseases,especially the elderly ones.For deferent patients,the nutritional support should be on the basis of patient' s nutritional state.

Objective To investigate the clinical significance of serum pepsinogen (PG) in gastric cancer screening. Methods The clinical data of 930 patients underwent colonoscopy were retrospectively analyzed. Among them, non chronic atrophic gastritis was in 550 cases (chronic atrophic gastritis group), chronic atrophic gastritis in 300 cases (chronic atrophic gastritis group), gastric cancer in 80 cases (gastric cancer group). The patients in chronic atrophic gastritis group were divided into mild chronic atrophic gastritis subgroup (100 cases), moderate chronic atrophic gastritis subgroup (120 cases) and severe chronic atrophic gastritis subgroup (80 cases) according to the severity of the atrophy. The levels of serum PGⅠand PGⅡwere detected by enzyme linked immunosorbent assay (ELISA) method, and the ratio of PGⅠand PGⅡ(PGR) was calculated. Results There was no statistical difference in PGⅡ among the 3 groups (F = 1.226, P>0.05). The PG Ⅰand PGR in gastric cancer group were significantly lower than those in chronic atrophic gastritis and non chronic atrophic gastritis:(70.41 ± 39.42)μg/L vs. (83.10 ± 30.08) and (165.5 ± 41.40)μg/L, 3.76 ± 2.03 vs. 5.08 ± 1.82 and 6.84 ± 1.88, those in chronic atrophic gastritis were significantly lower than those in non chronic atrophic gastritis group, there were statistical differences (P<0.05). The PG Ⅰand PGR in mild and moderate chronic atrophic gastritis subgroup were significantly higher than those in severe chronic atrophic gastritis subgroup and gastric cancer group:(95.50 ± 30.80) and (82.10 ± 31.42)μg/L vs. (70.12 ± 20.12) and (70.41 ± 39.42) μg/L, 5.84 ± 2.88 and 5.08 ± 1.89 vs. 3.90 ± 2.78 and 3.76 ± 2.03, there were statistical differences (P<0.05), but there was no statistical difference between severe chronic atrophic gastritis subgroup and gastric cancer group (P>0.05), and there was no statistical difference between mild chronic atrophic gastritis subgroup and moderate chronic atrophic gastritis subgroup (P>0.05). The receiver operating characteristic (ROC) curve was used, the optimal critical value of PG Ⅰ was 74.8μg/L, the area under curve (AUC) was 0.842, the sensitivity was 90%, specificity was 75%;the optimal critical value of PGR was 4.46, AUC was 0.837, the sensitivity was 75%, specificity was 82%;the AUC of combined detection of PG Ⅰ and PGR was 0.906, the sensitivity was 88%, specificity was 85%. Conclusions Detection of PG Ⅰ combined with PGR can be used as gastric cancer screening, the recommended level of PGⅠ≤74.80μg/L and PGR≤4.46.

Objective To investigate the diagnostic value of serum homocysteine in the diagnosis of colon cancer.Methods The performance rate method was used to detect the level of serum homocysteine(Hcy) in colon cancer group(50 cases) who were treated in Beijing Tiantan Hospital Affiliated to Capital Medical University from March 2011 to June 2016 and control group(50 cases).The expression of independent samples t test was used to analysis of the difference of the Hcy levels between the two groups.The ROC curve was used to evaluate the value of Hcy in diagnosis of colon cancer.Results The serum Hcy level in colon cancer group was (18.6±8.9) μmol/L,in healthy control group was (10.7±4.3) μmol/L,colon cancer group serum Hcy levels were significantly higher than those of healthy control group,there was significant difference(t=5.627,P<0.01).AUC of ROC curve was 0.775,cut-off value of 18.5 μmol/L,sensitivity was 0.50,specificity was 0.94,95%CI was 0.682-0.868(P<0.01).Conclusion Serum Hcy can be used as a reference index of the diagnosis of colon cancer.

Objective To study the clinical features,diagnosis and treatment of polycystic liver disease (PLD)complicated with portal hypertension (PHT).Methods The clinical data of one patient with PLD and PHT was retrospectively analyzed,and relevant literature was reviewed.Results The patient presented fatigue,dyspepsia, abdominal distension and lower limb edema.Laboratory examination showed mild liver dysfunction(Alkaline phospha-tase 291.2U/L,gamma glutamyl transpeptidase 168.1U/L,59.9g/L,total protein,albumin 32.2g/L,21.0μmol /L, total bilirubin,direct bilirubin 11.5μmol /L).Abdominal ultrasound (US)and computerized tomography (CT) showed multiple noncommunicating cysts of varying size in both liver and kidney.Antioxidant supplements and diuretic were introduced,and the therapy was approved to be effective.Conclusion The case in this report illustrates that PLD could occasionally present with PHT.Physician should be alert to prevent misdiagnosis.

Objective To prepare mouse model with heat stress and determine its pathological changes of the lung and brain during heat stress. Methods BALB/c mouse were randomly (random number) divided into two groups, control group and heat stress group. The animals in the control group were sham- heated at a temperature of ( 25 ± 0.5) ℃ and humidity of (35 ± 5 ) %. The animals of heat stress group were placed in a prewarmed incubator maintained at (35.5 ± 0.5) ℃ and relative humidity of (60 ± 5) %. Rectal temperature (Tc) was monitored, and when Tc respectively reached 39 ℃, 40 ℃ , 41 ℃ and 42 ℃, those study animals were killed. The other animals were removed from the incubator and allowed to cool at an ambient temperature of (25 ±0. 5)℃ and humidity of (35 ±5)% , respectirvely for 12 and 24 hrs when Tc reached 41 ℃ , and for 6 hrs when Tc reached 42 ℃. The lung and brain of all the animals were isolated. Hematoxylin and eosin stain and light microscope were used to detect their pathological changes. Results All the animals displayed uniform response to the heat stress. Low degree of heat stress could induced obviously pathological changes of the lung, progressively greater damage to lung with further congestion of lung matrix, asystematic hemorrhage of alveolar space, abscission of alveolar epithelial cell and disappear of pulmonary alveolus tissue structure were detected with the rise of Tc to 42 ℃. However, absorption of congestion and hemorrhage and recovery of pulmonary alveolus tissue structure could also be seen with cooling at ambient temperature. With low degree of heat stress, the brain only showed moderate edema. Neuronal denaturation and necrosis were detected when Tc reached to 42 ℃. Interestingly, the lesions of brain further aggravated even through cooling treatment after Tc reached to 42 ℃ , but recovery could been observed after cooling treatment followed with Tc of 41 ℃. Conclusions The pathological changes of the lung and brain showed distinctive lesions to heat stress and cooling treatment, and these changes were correlated with the timing and time of cooling treatment, which provide the experimental basis to further study the mechanisms between the heatstroke and multiple organ dysfunction syndrome (MODS).

At present, traditional imaging techniques for the diagnosis of early-stage pancreatic cancer lack enough sensitivity, and therefore, early diagnosis of pancreatic cancer is still the biggest challenge in precision medicine around the world. Based on a large amount of clinical practice and the development of related techniques, endoscopic ultrasonography (EUS) gradually shows its advantages in the diagnosis of pancreatic cancer, especially early diagnosis. This article reviews the application of EUS in the early diagnosis of pancreatic cancer and related research advances.

ObjectiveTo investigate the correlation between serum CA125 level and the severity of liver dysfunction in patients with liver cirrhosis. MethodsWanfang Data, CNKI, CBM, and VIP were searched for Chinese articles on the correlation between serum CA125 level and the severity of liver dysfunction in patients with liver cirrhosis published from January, 2008 to October, 2018, with a liver cirrhosis group and a normal control group in each article. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used for quality assessment. The mean and standard deviation of CA125 in liver cirrhosis group, healthy control group, and liver cirrhosis groups with different Child-Pugh classes were analyzed. Meta-Analyst software was used to calculate the standardized mean deviation (SMD) of CA125 in each group and perform the meta-analysis. A heterogeneity analysis was performed for the studies included in this study; a random effects model was used in case of significant heterogeneity, while a fixed effect model was used in case of insignificant heterogeneity. A one-way analysis of variance was used for comparison of continuous data between multiple groups. ResultsA total of 15 articles were included in this study. The meta-analysis showed that the liver cirrhosis group had a significantly higher serum CA125 level than the healthy control group (181.18±110.76 U/ml vs 15.10±7.15 U/ml, SMD=2.28, 95% confidence interval: 1.81-2.76, P＜0.001). The level of CA125 increased significantly with the increase in Child-Pugh class (F=15.704, P＜0.001). ConclusionSerum CA125 level is correlated with the severity of liver dysfunction in patients with liver cirrhosis and thus has a certain value in evaluating the severity of liver dysfunction and predicting prognosis.

OBJECTIVETo determine whether Toll-like receptor 4 (TLR4) is involved in development of gut leakiness in alcoholic steatohepatitis using an in vivo animal model and an in vitro cell culture system.

METHODSMice were fed an alcohol (ethanol group, EtOH) or isocaloric liquid diet (control group, Ctrl). Successful establishment of the alcoholic steatohepatitis model was assessed at week 6 by measuring serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities and evaluating the liver pathology using hematoxylin and eosin (HandE) staining of liver tissues. Gut permeability was assessed by measuring serum endotoxin and urine lactulose/mannitol (L/M) levels and evaluating HandE-stained colon tissues. Intestinal and colon tissue expression levels of TLR4 were assessed by immunohistochemistry. Cultured Caco-2 cells were exposed to 25 - 400 mmol/L EtOH and changes in TLR4 were assessed by enzyme-linked immunoassay and in permeability were assessed by intracellular uptake of FD4.

RESULTSThe mice in the EtOH group had significantly higher levels of serum ALT (46.5 +/- 6.9 U/L vs. Ctrl: 30.9 +/- 4.4 U/L, P less than 0.01), serum AST (53.3 +/- 7.9 U/L vs. Ctrl: 29.3 +/- 3.8 U/L, P less than 0.01), serum endotoxin (0.33 +/- 0.05 Eu/L vs. Ctrl: 0.27 +/- 0.04 Eu/L, P less than 0.01), and urine L/M (2.59 +/- 0.44% vs. Ctrl: 2.17 +/- 0.31%, P less than 0.05). The mice in the EtOH group also had significantly higher expression levels of TLR4 in intestinal tissues (13.1 +/- 2.0 ng/ml vs. Ctrl: 7.4 +/- 1.2 ng/L, P less than 0.01) and in colonic tissues (18.5 +/- 2.7 ng/ml vs. Ctrl: 9.1 +/- 1.6 ng/ml, P less than 0.01). The intestinal histopathology of the two groups was not different. Immunohistochemical staining of colonic tissues showed brown particles distributed in the endochylema and membrane of the EtOH group, which was almost completely absent in the Ctrl group. EtOH treatment of Caco-2 cells led to a dose-dependent increase in TLR4 expression and in cellular permeability.

CONCLUSIONChronic alcohol exposure induced TLR4 expression and cellular permeability in gut tissues. Activation of TLR4 may be involved in development of gut leakiness in alcoholic liver disease.

Animals ; Disease Models, Animal ; Gastrointestinal Tract ; metabolism ; Liver Diseases, Alcoholic ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred C57BL ; Toll-Like Receptor 4 ; metabolism