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.

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.

Nonalcoholic fatty liver disease (NAFLD) is associated with obesity, type 2 diabetes,dyslipidemia, hypertension, and metabolic syndrome.It likely represents hepatic manifestation of metabolic syndrome. The prevalence of NAFLD has been estimated to be 20％-30％ in the general population. However, it is much higher in type 2 diabetic patients. Several epidemiological studies indicate that NAFLD is linked to an increased risk of cardiovascular disease( CVD), which is independent of underlying cardiometabolic risk factors. This suggests that NAFLD may also be actively involved in the pathogenesis. The possible molecular mediators linking NAFLD and atherosclerosis(AS) include the release of pro-atherogenic factors by oxidative stress and inflammation as well as atherogenic dyslipidemia, abnormal adipose factors, and insulin resistance, finally aggravating progression of CVD. In this article, the relationship and possible mechanisms between NAFLD and AS are reviewed.

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.

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.

Accurate determination of hepatic fat content is essential for investigating the quantitative association between hepatic steatosis and multiple metabolic disorders,and is of great significance in determining the beginning and goal for clinical intervention.More attention has been focused on establishing a non-invasive,simple and accurate method for determining hepatic fat content.Recently,a computer-aided ultrasound quantitative method may provide a new way for single and accurate estimation of hepatic fat content.

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 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.

Nonalcoholic fatty liver disease(NAFLD)has become one of the most common liver diseases in the world.Considering the important role of insulin resistance in its pathogenic mechanisms,insulin sensitizers are becoming the promising pharmacological strategies for NAFLD.We collected and analyzed the relevant articles in recent years and found that pioglitazone,rosiglitazone and metformin could improve liver enzymes and insulin sensitivity of NAFLD.However,only pioglitazine was supported in ameliorating liver histology by envidences from randomized,double-blinded,controlled clinical trials.There were no much obvious adverse effects in NAFLD patients who received insulin senitizers.Small or medium samples and no more than 2 years of treatment course may be the major limitation of current studies.Future information derived from well-designed running trials will be useful in defining the clinical implications of insulin sensitizers in the treatment of NAFLD.