Objective To investigate the clinical characteristics in nonalcoholic steatohepatitis (NASH),to provide the basis for the early clinical diagnosis.Methods 200 cases of non-alcoholic fatty liver disease(NAFLD) were divided into NAFL group(115 cases) and NASH group(85 cases).Age,gender,body mass index,blood pressure,clinical symptoms,accompany illnesses,biochemical and image index in the two groups were analyzed and compared retrospectively.Results Asthenia,accounted for 40％,which was the most common gastrointestinal symptom of NASH group.and abdominal distension,anorexia,nausea and vomiting,liver area pain and liver were all involved.There were no significant differences in mainly gastrointestinal symptoms between patients with NASH and NAFL group(P ＞ 0.05),but no symptoms incidence of the two group were higher (44.7％ vs 49.2％ ％ P ＞ 0.05) ;the incidence of obesity,hyperlipidemia,type 2 diabetes,hypertension in NASH group were significantly different compared with NAFL(45.9％ vs 20％,41.2％ vs 22.3％,28.2％ vs 15.6％ respectively P ＜ 0.05) ; In NASH group,BMI,fasting glucose(FPG),2hPPG,serum ferritin,hyaluronic acid,Ⅳ collageninsulin resistance index (HOWA-IR)increased significantly compared with NAFL[(28.68 ± 0.92)vs (22.21 ± 0.43),(9.63 ± 0.64)mmol/L vs (4.92 ± 0.78)mmol/L,(12.96 ±0.28) mmol/L vs (7.04 ±0.13) mmol/L,(243.56 ±7.95) ng/mL vs (140.03 ± 6.80)ng/mL,(130.26 ±9.i6)ng/mL vs (74.85 ±6.54)ng/mL,(130.56 ±8.16)ng/mL vs (72.68 ±7.24) ng/mL,(5.36±0.45) vs (2.63 ±0.12),respectively P＜0.05)].Conclusion Patients with NASH had no obvious gastroenterology symptoms.Obesity,type 2 diabetes,hypertension are more with NASH,and there may be multiple metabolic disorders.

Objective To investigate the diagnostic values of color ultrasound to the stenosis of extracranial carotid arteries.Methods Color ultrasound examination and digital subtraction angiography(DSA)were performed in 145 patients with ischemic cerebravascular disease.The sensitivity and specificity of color ultrasound for the stenosis of extracranial carotid arteries were analyzed according to the golden standard of DSA results.Results The sensitivity and specificity of color ultrasound for stenosis of carotid bifurcation,subclavicular artery and vertebral artery were 96.8%,80.6%,60.0% and 98.7%,33.3%,89.0%.The accuracy of color ultrasound for stenosis of carotid bifurcation,subclavicular artery and vertebral artery were 93.0%,92.8% and 82.1%.Conclusion Color ultrasound examination are effective for the diagnosis of carotid bifurcation sterosis,and less effective for the diagnosis of the subclavicular and vertebral artery stenosis because of the poor sensitivity.

Objective To study the pathogenesis of osteoporosis in patients with liver cirrhosis following hepatitis B virus(HBV) infection(HBV-liver cirrhosis).Methods Bone mineral density(BMD) was measured by NM-300 sigle-energy X-ray acsorptiometry system for 61 patients with HBV-liver cirrhosis and 30 age-matched healthy controls.Serum levels of calcium regulatory hormones(CRH),1,25-dihydroxycholecalciferol [1,25(OH)_2D_3],parathyroid hormone(PTH),calcitonin(CT),osteocalcin(BGP),interleukin-1?(IL-1?),interleukin-6(IL-6) and tumor-necrosis factor-?(TNF-?),and urine level of crosslaps were measured in these patients and controls.Patients with HBV-liver cirrhosis were divided into two groups,osteoporotic and non-osteoporotic,based on their BMD in the ulna and radius,for comparison.Results BMD of the ulna and radius in patients with HBV-liver cirrhosis were significantly lower than those in controls.Serum levels of 1,25(OH)_2D_3 and BGP in patients with HBV-liver cirrhosis were significantly lower than those in controls,and much lower in osteoporotic group than that in non-osteoporotic one.While urine level of crosslaps increased significantly in patients with HBV-liver cirrhosis than in controls, much more increased in the those with osteoporosis than those without osteoporosis.Serum level of 1,25(OH)_2D_3 correlated with serum levels of BGP and BMD of the ulna and radius.Urine level of crosslaps correlated inversely with BMD of the ulan and radius in osteoporotic patients,but not in non-osteoporotic ones.Serum levels of IL-1?,IL-6 and(TNF-?) and urine level of crosslaps increased significantly in patients with HBV-liver cirrhosis than in controls,as well as increased significantly in those with osteoporosis than in those without osteoporosis.Serum levels of IL-1?,IL-6 and TNF-? and urine level of crosslaps correlated inversely with BMD of the ulna,particularly more significantly in those with osteoporosis than those without osteoporosis.Conclusions Two factors,less osteogenesis and more osteolysis,existed in patients with HBV-liver cirrhosis.Serum level of 1,25(OH)_2D_3 and serum levels of IL-1?,IL-6 and(TNF-?) played an important role in weakened bone formation and in increased bone resorption,respectively.Adequate supplementation of vitamin D_3 and reducing serum levels of IL-1?,IL-6 and TNF-? may be very important for prevention and treatment of hepatic bone disease.

Reperfusion injury occurs after return of spontaneous circulation (ROSC) in patients with cardiac arrest (CA), which leads to multiple organ dysfunction, called post-cardiac arrest syndrome (PCAS). PCAS is closely related to the prognosis of CA patients, and is an independent risk factor of survival. Integrated traditional Chinese and Western medicine diagnosis and treatment is critical for improving prognosis of PCAS. In order to guide and standardize integrated traditional Chinese and Western medicine diagnosis and treatment in PCAS among clinicians, nurses and research personnel in China, the Emergency Medicine Professional Committee of the Chinese Society of Integrated Chinese and Western Medicine has established an expert group to determine 14 clinical issues related to the diagnosis and treatment of PCAS with integrated traditional Chinese and Western medicine through clinical survey. The working group formulates a search strategy for each clinical issue according to the PICO principle. Chinese and English literature were searched from CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, and Cochrane Library. The grade of recommendations assessment, development and evaluation (GRADE) were used to form the level of evidence and recommendation. When the literature evidence was insufficient, the recommendations and level of recommendation were formed after expert discussion. Combined with the aspects of generalizability, suitability, and resource utilization, the expert consensus developed 28 recommendations around the 14 aspects of three stages of PCAS, including early circulation, respiratory support and reversible cause relief, mid-term neuroprotection, improvement of coagulation, prevention and treatment of infection, kidney and gastrointestinal protection and blood sugar control, post rehabilitation treatment, providing references for the integrated traditional Chinese and Western medicine of the diagnosis and treatment for PCAS.

This investigation with questionnaires is about the recognition of ethical issues involved in therapeutic cloning and human embryo managemeat, and its aim is to provide basis for working out ethical guidelines of therapeutic cloning and human embryo management. The investigation has been carried out among professionals in the field of obstetrics, gynecology, and reproductive medicine in the east and west parts of our country including 12 third grade hospitals in Shanghai and Xi'an and 20 maternal and child health stations at the district and county levels with randomized sampling and voluntarily billing the questionnaires without name. A total of 400 feedbacks have been received. The results show that 91. 25% of the investigated persons admit researches on therapeutic cloning, and that majority of them recognize that moral status of embryos develops and changes in accordance with the different stages of embryo development, and put forward some recommendations to strengthen the researches on therapentic cloning and the management of human embryos in order to protect the human dignity and support the researches on therapeutic cloning.

The instrument is com posed of such components as SCM,pressure sensor,electric pump,magnetic valve and sleeve-type gasbag.It can control the hemostatic pressure,hemostatic time and slack time automatically.So the ischemic necrosis can be avoided thoroughly thr ough it.With the small volume,light weight,low power consumption and convenient operation,the instrument is fit for emergency treatment of mass casualties.

Dysfunction of the Hippo pathway enables cells to evade contact inhibition and provides advantages for cancerous overgrowth. However, for a significant portion of human cancer, how Hippo signaling is perturbed remains unknown. To answer this question, we performed a genome-wide screening for genes that affect the Hippo pathway in Drosophila and cross-referenced the hit genes with human cancer genome. In our screen, Prosap was identified as a novel regulator of the Hippo pathway that potently affects tissue growth. Interestingly, a mammalian homolog of Prosap, SHANK2, is the most frequently amplified gene on 11q13, a major tumor amplicon in human cancer. Gene amplification profile in this 11q13 amplicon clearly indicates selective pressure for SHANK2 amplification. More importantly, across the human cancer genome, SHANK2 is the most frequently amplified gene that is not located within the Myc amplicon. Further studies in multiple human cell lines confirmed that SHANK2 overexpression causes deregulation of Hippo signaling through competitive binding for a LATS1 activator, and as a potential oncogene, SHANK2 promotes cellular transformation and tumor formation in vivo. In cancer cell lines with deregulated Hippo pathway, depletion of SHANK2 restores Hippo signaling and ceases cellular proliferation. Taken together, these results suggest that SHANK2 is an evolutionarily conserved Hippo pathway regulator, commonly amplified in human cancer and potently promotes cancer. Our study for the first time illustrated oncogenic function of SHANK2, one of the most frequently amplified gene in human cancer. Furthermore, given that in normal adult tissues, SHANK2's expression is largely restricted to the nervous system, SHANK2 may represent an interesting target for anticancer therapy.