Objective To investigate the value of high density lipoprotein-cholesterol (HDL-C) in the diagnosis and risk assessment of non-alcoholic fatty liver disease (NAFLD).Methods A cross-sectional study and multistage stratified random sampling method were performed in epidemiological survey.According to inclusion and exclusion criteria,a total of 3 312 individuals were enrolled and divided into NAFLD group (913 cases) and non-NAFLD group (2 399 cases).The serum lipid levels were compared between the two groups.Receiver operating characteristic (ROC) curve was performed to evaluate the value of HDL-C in the diagnosis of NAFLD.The binary logistic regression models were established based on HDL-C level.The differences in liver function indexes were compared among the research objects with different HDL-C levels.T test and MannWhitney U test were performed for statistical analysis.Results The serum levels of total cholesterol,triglyceride and low density lipoprotein-cholesterol (LDL-C) of NAFLD group were all higher than those of non-NAFLD group ((5.24 ±0.92) mmol/L vs.(4.98 ±0.92) mmol/L,(1.95 ± 1.41) mmol/L vs.(1.13 ± 0.68) mmol/L,(3.31 ± 0.84) mmol/L vs.(3.09 ± 0.84) mmol/L),and the differences were statistically significant (t =-7.29,-22.38 and-6.84,all P ＜ 0.01).However the serum HDL-C level of NAFLD group was lower than that of non-NAFLD group((1.30 ±0.33) mmol/L vs.(1.64 ±0.40) mmol/L),and the difference was statistically significant (t =24.93,P ＜0.01).The incidence of hypercholesterolemia,hypertriglyceridemia,hypo-high-density lipoprotein cholesterolemia and hyper-low-density lipoprotein cholesterolemia of NAFLD group was 48.0％ (438/913),44.8％ (409/913),31.0％ (283/913) and 82.8％ (756/913),respectively,which were significantly higher than that of non-NAFLD group (36.8％,882/2 399;13.2％,317/2 399;10.5％,251/2 399;71.8％,1 723/2 399),and the differences were statistically significant (x2 =34.65,385.43,206.18 and 42.37,all P ＜ 0.01).Using the cut-off values of HDL-C ≤ 1.66 mmol/L in female and ≤ 1.33 mmol/L in male,the area under curve (AUC) values for NAFLD diagnosis were 0.720 (95％ confidence interval (CI) 0.693 to 0.747) and 0.708 (95％ CI 0.679 to 0.737),respectively,the sensitivity was 79.1％ and 76.6％,and the specificity was 55.0％ and 54.6％.The results of binary logistic regression models based on HDL-C level indicated that prevalence of NAFLD in female with low HDL-C was 4.584 times (95％ CI 3.530 to 5.940,P ＜0.01) higher than that in female with high HDL-C;the prevalence of NAFLD in male with low HDL-C was 3.898 times (95％ CI 3.020 to 5.030,P ＜0.01) higher than that of male with high HDL-C.The alanine aminotransferase (ALT),aspartate transaminase (AST),gamma glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP) levels of low HDL-C group were all higher than those of high HDL-C group (20.10 U/L,14.40 U/L to 29.40 U/L vs.16.80 U/L,12.70 U/L to 23.00U/L;19.20 U/L,16.00 U/Lto23.70 U/Lvs.19.00 U/L,16.00 U/Lto22.17 U/L;22.00 U/L,14.00 U/L to34.00 U/L vs.15.00 U/L,11.00 U/L to 23.00 U/L and 71.00 U/L,59.00 U/L to 85.00 U/L vs.66.00 U/L,55.00 U/L to 82.00 U/L),and the differences were statistically significant (Z =-10.53,-2.20,-14.19 and-5.87,all P＜0.05).Conclusion The serum HDL-C level is negatively correlated with the risk of NAFLD level,and the NAFLD risk of individuals with low HDL-C level is significantly higher than individuals with high HDL-C level.

To investigate the correlation between the number of peripheral blood circulating tumor cells (CTCs) and clinicopathological features of early breast cancer. 
 Methods: The clinical and pathological data from 100 patients with early breast cancer treated by a breast cancer treatment team in the Department of Breast Surgery, Second Xiangya Hospital, Central South University, were collected from January 2017 to December 2018. For these patients, their peripheral blood CTCs were detected, enumerated and typed by CanpatrolTM CTC assay.
 Results: The positive rate of CTCs was 90% in peripheral blood of patients with early breast cancer, and the majority of molecular phenotypes was hybrid CTCs (55.6%). The positive rate of CTCs was only related to the pathological type of tumor (P<0.05), but not to other clinicopathological features. No correlation between clinicopathological features and the total number of CTCs, the number of epithelial CTCs or the number of hybrid CTCs was found. However, the number of mesenchymal CTCs was significantly correlated with the expression of hormone receptors and Ki-67 (r=0.200, P<0.05), and there was a significant correlation between the proportion of mesenchymal CTCs and the expression level of Ki-67 (r=0.213, P<0.05).
 Conclusion: The number of CTCs is not correlated with all clinicopathological features, but patients with negative hormone receptor and high expression of Ki-67 probably have more hybrid CTCs.
Biomarkers, Tumor ; Breast Neoplasms ; Epithelial-Mesenchymal Transition ; Humans ; Neoplastic Cells, Circulating