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] Through a meta-analysis to compare the effectiveness and safety of traditional Chinese medicine and western medicine in the treat-ment of chronic atrophic gastritis(CAG) with dysplasia . [Methods] Randomized clinical trials(RCTs) which compared traditional Chinese medicine and western medicine for chronic atrophic gastritis with dysplasia in PubMed, Cochrane library, WanFang and CNKI were searched. The patients which were analyzed were divided into two groups: western medicine and traditional Chinese medicine.Statistical heterogeneity between trials was evaluated by RevMan5.0. Heterogeneity of the included articles was tested and used to select proper effective model for calculation.Publication bias was investigated through visual inspection of funnel plots and Egger's regression model.[Results] 6 RCTs including 632 patients were analyzed. The total odd ratios(OR) of clinical symptoms,gastroscope symptoms,pathological symptoms by traditional Chinese medicine were higher than western medicine, the OR values were 3.40(95%CI:2.18~5.31,P<0.01),4.14(95%CI:2.37~7.20,P<0.01),2.94(95%CI:1.77~4.90,P<0.01),3.71(95%CI:2.29~6.02,P<0.01),4.41(95%CI:2.75~7.07,P<0.01),5.21 (95%CI:3.65~7.43,P<0.01). Inspection of the funnel plots for al outcome measures did not reveal evidence of publication bias( P=0.81, 0.41, 0.29, 0.88, 0.44, 0.82, respectively).[Conclusions] The treatment of chronic atrophic gastritis with dysplasia by traditional Chinese medicine can improve the excel ent response rate, overal response rate of clinical symptoms,gastroscope symptoms,pathological symptoms better than its purely western medicine treatment efficacy.

BACKGROUND: Whether bone morphogenetic protein 2 (BMP-2) can be transduced into marrow stromal cells (MSCs) and produce osteogenic effects by viral or non-viral vector remains unclear? OBJECTIVE: To observe the expression of cultured rabbit MSCs transfected with pcDNA3-hBMP2 in vitro. Simultaneously, the MSCs were transfected but not screened and then transplanted into autologous muscle to investigate the osteogenic capability by X-ray. DESIGN, TIME AND SETTING: A controlled observation experiment was performed at the Department of Orthopedics, Liaoning Medical University between November 2004 and April 2005. MATERIALS: Six adult New Zealand rabbits, of either gender, weighing 2.0-3.0 kg, were included for this study. BMP2 antibody was the product of Sanaka Company, USA. pcDNA3-hBMP2 was provided by Professor Pu Qin from the Department of Biochemistry, Fourth Military Medical University of Chinese PLA). Restriction enzyme was purchased from Takara biotechnology (Dalian) CO., LTD., China. METHODS: Super-purified plasmid pcDNA3-hBMP2 was extracted from E. coli. Bone marrow was taken from the adult rabbit femur for harvesting MSCs by density gradient separation. The MSCs were divided into the following 4 groups: Group A, cells were transfected and screened by G418; Group B, cells were transfected by pcDNA3-hBMP2; Group C, cells were transfected by empty vector pcDNA3; Group D, only transfection reagent Fugene 6 was added.MAIN OUTCOME MEASURES: Transient BMP2 expression was analyzed by immunohistochemistry. Expression of osteocalcin and collagen I was examined by immunohistochemistry and in situ hybridization, respectively. Two weeks after transfection, MSCs from the group B were autologously transplanted into the muscle. Four weeks later, X-ray assay was used to observe bone formation.RESULTS: pcDNA3-hBMP2 was successfully transduced into MSCs and transiently expressed BMP2 100%. Four weeks after gene transfection, expression levels of osteocalcin and collagen I were significantly higher in the group A than in the groups C and D. X-ray results demonstrated new bone formation four weeks after MSCs transplanted into the muscle.CONCLUSION: pcDNA3-hBMP2 can safely and efficiently transfect MSCs and induce them to differentiate towards osteoblasts by secreting BMP2.

Objective To observe the effect of angiotensin-converting enzyme inhibitors (ACEI) on anemia and erythropoietin (EPO) requirements in maintenance hemodialysis patients. Methods Ninety maintenance hemodialysis patients with hypertension and anemia were divided into 2 groups by random digits table, observation group (45 cases, using ACEI as antihypertensive treatment), control group [45 cases,using calcium channel blocker (CCB) as antihypertensive treatment]. The follow-up period after starting ACEI or CCB therapy was one year. The hemoglobin concentration, serum EPO, EPO requirements were compared after 0, 2, 4, 6, 8, 10, 12 months' treatment. Results In response to ACEI, the mean hemoglobin value in observation group decreased progressively, reaching statistical significance after 6 months, and it had significant difference compared with that in control group [6 months: (94.21±9.20) g/Lvs. (105.55±9.16) g/L,12 months: (95.90±6.75) g/L vs. (105.81±4.45) g/L,P <0.05]. The EPO requirements experienced a progressive increase in observation group and reached statistical significance after 8 months, compared with those in control group [8 months: ( 10 090.75±1918.35) U/week vs. (7010.32±1600.15) U/week, 12 months: (11 586.39±2009.76) U/week vs. (7068.48±1615.35) U/week,P<0.05].Serum erythropoietin concentration remained stable during the study in two groups. Conclusion ACEI can worsen anemia and reduce the efficacy of EPO in maintenance hemodialysis patients.

Objective To evaluate the clinical value of contrast-enhanced ultrasound (CEUS) in preoperative diagnosis of anal fistula. Methods Forty-five patients with fistula in ano were evaluated by physical examination, then CEUS were peformed by injecting SonoVue through the external opening to enhance the detection of the fistulous track and the internal opening. The results of CEUS were matched with surgical features to establish their accuracy in preoperative assessment of anal fistula. Results Simple typing fistula was found in 19 of 45 patients and 26 patients had complex fistulas. The accurate diagnostic rates by conventional ultrasound of simple typing fistula and complex fistulas were 89. 5% and 61.5%,respectively,the accurate diagnostic rates by CEUS of simple typing fistula and complex fistulas were 94. 7% and 92.3%, respectively, there was no significant difference between conventional ultrasound and CEUS about simple typing fistula( P ＞0.05), and there was significant difference about complex fistulas ( P ＜0. 05). Conclusions CEUS has a good visibility and accurate rate for diagnosis of anal fistula,It plays an important role for operation.

Objective To investigate the correlations between miRNA and mRNA ( the regulatory effects of miRNA) in a rat model of trinitro-benzene-sulfonic acid (TNBS)/ethanol induced ulcerative colitis ( UC) .Methods TNBS and ethanol were used to induce the development of UC in rats .After the modeling procedure and oral administration of normal saline ( NS) for 14 days, rats from the control and model groups were dissected to collect the samples of colonic mucosa .General and histological evaluations were performed to validate the modeling of UC .The expression of miRNA was profiled using miRNA microarray .The target miRNAs that were closely related to the pathogenesis of UC were selected out according to the results of mi -croarray and related literatures .RT-PCR was performed to verify the differentially expressed miRNAs .The mirWalk database was used to predict the target genes of miRNAs .In order to verify whether the predicted results were in accordance with the actual results , the microarray technology was used for mRNA expression profiling .The genes that showed interactions with those miRNAs were screened out .The David database was used for gene annotation .An interaction net between miRNA and mRNA was formed .Results General and histological manifestation of colon tissue samples from the model group were in accordance with the features of UC.Sixty-eight miRNAs were identified to be differentially expressed in rats from the model group and the control group (fold change>2, P<0.05, expression mean>7).Six candidate miRNAs were selected as hav-ing close relations to the pathogenesis of UC referring to reported literatures , the expression of which was checked and verified by real-time polymerase chain reaction (PCR).Compared with the control group, 4 miRNAs (miR-146a-5p, miR-146b-5p, miR-126a-3p and miR-21-5p) were up-regulated (P<0.01, P<0.05) and 2 miRNAs (miR-200b-3p and miR-145-5p) were down-regulated (P<0.01) in rats with TNBS/ethanol induced UC.Four mRNAs (IL-6, Ccl5, Mapk3 and Smad7) that interacted with the 6 miRNAs were identified based on the results of target gene prediction of the above 6 miRNAs and gene expression pro-filing.The David database was used to annotate the interactions for elucidating their significance in the path -ogenesis of UC .Conclusion A miRNA can regulate many signaling pathways and a signaling pathway can also be regulated by many miRNAs .Therefore , simply inhibiting certain pathways may not radically stop the process of inflammation .Studying the functions of miRNAs and elucidating the correlations between miRNA and mRNA might fundamentally inhibit the development of UC .

Objective:To screen inflammatory factors of ulcerative colitis(UC).Methods:Three sets of human GeneChip datasets were included from Gene Expression Omnibus(GEO).Differentially expressed genes(DEGs)from two of datasets were analyzed with R software,and intersection and combination of top 20 DEGs of UC rat GeneChip were screened to identify core genes of UC.ROC curve was used to evaluate sensitivity and specificity of core genes in another human microarray data set.CIBERSORT was used to analyze relationship between core genes and immune cells,proteins co-expressed with core gene were identified using protein-protein interaction(PPI)network diagram and analyzed for functional enrichment.Molecular docking of core genes with anti-inflamma-tory herbal medicines for treatment of UC was performed.Correlation between core genes and inflammation and effect of anti-inflamma-tory traditional Chinese medicine on core genes were verified by in vitro experiments.Results:S100A8 was screened out as core gene of UC with high sensitivity and specificity(AUC=0.953).S100A8 was positively correlated with immune inflammatory cells such as neutrophils,activated mast cells and monocytes.PPI and enrichment analysis revealed that S100A8 was related to inflammatory path-ways such as RAS signaling pathway,PI3K-AKT signaling pathway and mTOR signaling pathway.Anti-inflammatory Chinese medi-cines triptolide,baicalin and berberine had good binding force with S100A8.In vitro experiments suggest that S100A8 played an im-portant role in inflammation,triptolide,baicalin and berberine could reduce expression of S100A8.Conclusion:S100A8 may be an inflammatory core gene of UC,and it is expected to become a new therapeutic target.

Objective To explore the best time window of intake and output volume observation after partial nephrectomy and its predictive value for acute renal injury. Methods The information of totally 134 renal cancer patients with regular subsequent visits after partial nephrectomy in Peking Union Medical College Hospital from December 2014 to December 2015 were collected. The intake and urine volume per hour was recorded. The receiver operating characteristic (ROC) curve was used to explore the best time wind of intake and output volume observation and its predictive value for acute renal injury in patients with partial nephrectomy. Results Acute renal injury was found in 19.4% of the 134 patients. The differences between intake and output volumes 10, 14, 16 and 18 h postoperatively in the acute renal injury group were bigger than those in the non acute renal injury group (P＜0.05). According to the multiple regression analysis, the intake and output volume 10 h postoperatively and the time of warm ischemia were the independent risk factors to postoperative renal injury (P＜0.05). The intake and output volume 10 h postoperatively had predictive power to acute renal injury, whose area under the ROC was 0.747 (95%CI:0.592-0.903, P＜0.05). Conclusions The intake and output volume 10 h postoperatively may be the best time window for observing the intake and output volume in patients with acute renal injury after partial nephrectomy.

Objective:To compare the therapeutic effect of polysaccharide iron complex capsule and Shengxuening tablet on renal anemia in maintenance hemodialysis (MHD) patients.Methods:Patients who received MHD treatment from April to June 2016 in our dialysis center and met the criteria for iron deficiency anemia were block-randomly divided into two groups: the polysaccharide-iron complex group and the Shengxuening group. Blood routine, iron metabolism biomarkers and biochemical exams were measured before treatment and at the 1st, 2nd and 3rd months after treatment, and the incidence of adverse reactions were recorded. The compliance rate of the two groups was observed and compared, and the block-randomized-statistical methods were used to compare the clinical data of the two groups before and after treatment, and cost-benefit analysis was also conducted.Results:Thirty patients in each group completed follow-up. After three months of treatment, the blood routine and iron metabolism indicators of the two groups were improved. Compared with the Shengxuening group, the polysaccharide iron complex group had higher therapeutic efficiency, and the levels of hemoglobin, transferrin saturation and serum ferritin were higher, and lower use of recombinant human erythropoietin ( P<0.05). The other indexes such as red blood cell (RBC), hematocrit (HCT) levels and the effective rate of anemia correction, the effective rate of iron therapy, the effective rate of iron therapy between the two groups were similar. Cost-benefit analysis suggested that the use of polysaccharide iron complexes to treat anemia has lower costs and higher benefits ( P<0.05). Conclusions:Polysaccharide iron complex capsule can better correct anemia and improve iron metabolism, and has low cost-effectiveness, which can effectively reduce medical insurance expenditure. It is a good iron supplementing method in addition to intravenous iron supplement.

Cryptogenic multifocal ulcerous stenosing enteritis（CMUSE） is a rare and difficult disease characte-rized by chronic recurrent intestinal obstruction and gastrointestinal bleeding caused by multiple ulcers and strictures of the small intestine. There is still a lack of mature and systematic guidance for the treatment of the disease. This paper reported a case of CMUSE mainly manifested as fatigue， abdominal distention， and edema of both lower limbs ， who is treated by integrated traditional Chinese and western medicine. In western medicine treatment， hormone and symptomatic treatment are mainly used. In traditional Chinese medicine treatment， the method of fortifying spleen and reinforcing healthy qi is taken as the basis； during the active stage of the disease， the method of moving qi and removing stagnation， clearing and removing dampness and heat， astringing and engendering flesh should be combined with， while during the remission stage， it is advised to unite with the method of diffusing lung and moving water， regulating and harmonizing zang-fu （脏腑） organs； simultaneously， replenishing qi and invigorating blood can be used throughout the treatment， and attach importance to the maintenance therapy of the traditional Chinese medicine immunomo-dulatory agent Tripterygium glycosides. After more than 2 years of treatment， the patient's clinical symptoms were significantly relieved， and all indicators basically restored to normal， having a stable condition.