Evidence-based guideline of the diagnosis and treatment in the nonalcoholic fatty liver disease was formulated by Chinese Medical Association of fatty liver disease and alcoholic liver disease in order to simplify medical decision making and to help physicians make good decisions about NAFLD,which was published in 2006.Compared with some international guidelines or recommendations,Chinese guideline is more wide and complete for diagnosis and therapy of NAFLD.Meanwhile,there is significant difference in evaluation and treatment between these guidelines.

Objective To observe the therapeutic effect of anti-HBV placenta transfer factor injection to liver cirrhosis.Methods 193 cases of liver cirrhosis resulting from chronic hepatitis B are administrated anti-HBV placenta transfer factor.The main clinical symptoms and signs(weakness,hepatalgia,hepatosplenomegaly),the biochemical markers such as liver function(ALT,AST,serum total protein,albumin,total bilirubin,A/G),blood routine,fibrosis markers(HA、LN、PⅢP、PIVP),and serum protein electrophoresis before and after 24 weeks treatment were analysed.Results The main clinical symptoms and signs,liver function,blood routine,fibrosis markers,serum protein electrophoresis were significantly improved after 24 weeks of treatment.(P

Objective To investigate the clinical and pathological features of colonic polyp canceration and related risk factors of colon polyps,and explore clinicopathologic features and major risk factors of the canceration of polyps of colon polyps.Methods Totally 80 patients with colon polyps including 6 cases of cancerations and 20 patients with colon cancers were selected from Xuzhou Tumor Hospital Admissions.Those patients were divided into 74 cases of non cancer group and 26 cases of cancer group.The clinical data,the detection index and the statistical analysis were performed.Results The clinical features of patients included 51 cases of multiple polyps,30 cases of fatty liver,13 cases of fecal occult blood positive,and 30 patients with colonoscopy.There were 218 polyps,191 data intact,and 6 cases showed cancer (3.14％).Inflammatory polyps mainly occurred in rectum,cecum,and significant risk other than the colon.Tubular adenoma occurred mainly in the transverse colon.Sigmoid colon cancer colon polyps of the highest risk showed OR =2.30 (P ＜ 0.05).The cancer risk from high to low was from tubular villous adenoma to villous adenoma hair (P ＜0.01),and no difference in tubular adenoma cancer risk (P ＞0.05).There was no difference between the indexes of the canceration group and the non cancerous group (P ＞ 0.05).The single factor analysis showed pathological type,and the lesion were the main risk factors of malignant colonic polyps (P ＜ 0.05).Multi-factor regression analysis showed WBC,pathological type,and the lesion were the main risk factors of malignant colonic polyps (P ＜ 0.05).Conclusions The colonic polyps in male have higher incidence with fatty liver,hypertension and other pathological features,and are mainly tubular adenomas,inflammatory and hyperplastic polyps,with different lesions,pathological types occur and different cancer risk.

Objective To investigate the value of Helicobacter pylori (HP),blood carcinoembryonic antigen (CEA),carbohydrate antigens 72-4 (CA72-4) and CA24-2 in the screening of gastric cancer.Methods The contents of HP,blood CEA,CA72-4 and CA24-2 in 50 healthy controls,45 patients with benign gastric lesions mnd 70 patients with gastric cancer were detected.According to the number of positive cases,the positive rate of single detection and the positive rate of combined detection were calculated.Sensitivity,specificity,and accuracy of serum tumor markers were calculated according to HP single and combined detection.Results The positive rate of each individual detection and 4 joint detection in gastric cancer group was significantly different from that in the benign lesion group and the normal control group (P ＜0.01).The positive rate of 4 joint detection in gastric cancer group was 89.25％,and the difference was statistically significant (P ＜0.01).There was no significant difference in the positive rate of the single test and the 4 joint detection in benign stomach group and normal control group (P ＞ 0.05).The sensitivity,specificity and accuracy of HP,blood CEA,CA72-4,CA24-2 joint detection were significantly higher than single detection (P ＜ 0.05).Conclusions Joint detection was significandy better than single detection,and can significantly improve the detection rate of gastric cancer.

Objective To observe the therapeutic effects of Chinese traditional compound medicine on subcilincal hepatic encephalopathy(SHE).Methods 52 patients with liver cirrhosis complicated by SHE were randomly divided into treatment group and control group.The patients of control group received conventional hepatoprotection treatment,and the patients of treatment group were given conventional treatment and Chinese traditional compound medicines.Number connection test(NCT),electroencephalogram(EEG),liver function,blood ammonia were investigated after 2 weeks of treatment.Results The number connection test (NCT),electroencephalogram (EEG),liver function,blood ammonia were significantly improved in the treatment group than that in the control group(P

Objective To reveal the expression and potential mechanisms of TGF?_1 and CTGF mRNA in liver of rats with nonalcoholic fatty hepatic fibrosis induced by highly fat-enriched diet.Methods The model group(10 rats) was fed with highly fat-enriched diet while the normal control group(10 rats) was raised by standard animal feeds for 24 weeks.Hepatic histopathological changes were evaluated,and RT-PCR method was used to assay TGF?_1 and CTGF mRNA expression levels in the liver.Results The analysis indicated that liver inflammation and fibrosis were apparently present in model rats.RT-PCR analysis revealed that the expression of TGF?_1 and CTGF in hepatic tissue were inreased in the model group as compared with the normal control group.Conclusions The rats model for hepatic fibrosis can be established by feeding with highly fat-enriched diet for 24 weeks.The expression of TGF?_1 and CTGF were enhanced in hepatic liver tissue of fatty hepatic fibrosis rats,and these changes might stimulate the fatty fibrosis.

Objective To study the preventive and therapeutic effects and the mechanism of Chinese traditional compound medicine to subcilincal hepatic encephalopathy(SHE)induced by endotoxin in liver cirrhotic rats.Methods The liver cirrhosis model of rats were made in subcutaneous injection of 40% carbon tetrachloride,the SHE model was made by infused with endotoxin into the tail vein.Treatment group was given low dose or moderate dose or high dose of Chinese traditional compound medicine,Control group was treated with lactulose.The morbidity of SHE,hepatic function,blood ammonium(BA),endotoxin,liver tissue pathology were observed.Results Above indexes were improved by every group of Chinese traditional compound medicine.The curative effect of moderate and high group of Chinese traditional compound medicine to the hepatic function,BA,endotoxin,liver tissue pathology were better than that of lactulose.Conclusions The effects of the Chinese traditional compound medicines(compose of Polygonum cuspidatum,raw hawthornfruit,seed of Zizyphus jujuba Mill,Mongolian Dandelion Herb and Rhizoma Acoori Graminei)in SHE prevention and treatment is significant.Its mechanism might be as follows:① recovering liver function,decreasing inflammatory changes of liver tissue;② preventing the absorption of BA,lowering the content of BA;③ reducing the sensitivity of the body to endotoxin.

Objective To investigate the effect of LF on blood biochemistry,cytokines in rats with NASH in order to approach possible mechanism of LF against NASH.Methods 50 male SD rats were randomly divided into the normal control group(10 rats),the model group(10 rats),the Essentinale group(10 rats)、the LF high dose group(10 rats)and the LF low dose group(10 rats).Except for the normal control group which was raised by standard animal feeds,others were all raised by high fat feeds to make NASH model and administered by Essentinale,high dose LF and low dose LF for 12 weeks.Hepatic lipid contents,plasma TG,CHO,HDL-C,LDL-C,ALT,AST and TNF-?,FFA,Leptin concentrations were evaluated,as were histopathological changes in the liver.Results In this NASH model,the liver FZ(liver weight /body weight),plasma CHO,LDL-C,ALT,AST and TNF-?,FFA,Leptin concentrations were higher than that in normal control group,but the levels of serum HDL-C and TG were reduced.In addition,the histopathological showed increased fatty droplets within hepatocytes and liver inflammation.The levels of serum ALT,AST,HDL-C,TNF-?,Leptin,FFA and hepatic CHO,TG contents in the LF high dose group and LF low dose group were reduced compared with that in the model group,while the levels of serum TG,HDL-C were enhanced remarkably.In addition,liver inflammation was improved evidently.Conclusions Treatment with LF might improve non-alcholic steatohepatitis,because LF inhibits the elevation in the level of plasma cytokine.

Objective:To investigate the utilization of total parenteral nutrition ( TPN) in a hospital to provide reference for the clinical rational drug use. Methods:The utilization and trend of TPN in the surgical inpatients during August 2012 to July 2013 in the hospital were analyzed statistically. Results:Totally 116 patients received TPN with 1 013 times, and the patients with gastrointestinal malignant tumor accounted for 48. 3%. The average use day was (8. 7 ± 3. 2) d and the total energy was within the range of 900-1 500 kcal. The number of prescription with glycolipid ratio below 1 was 878 (86. 7%), that with hot nitrogen ratio of 100-150 was 689 (68. 0%), that with monovalent cation concentration below 150 mmol·L-1 was 1 008 (99. 5%), that with divalent cation concentra-tion below 5 mmol·L-1 was 879 (86. 8%), that with glutamine was 765 (75. 5%) and that with sugar and insulin ratio (g:u) be-low 3 was 42 (4. 1%). Conclusion:The maln problem in the TPN application in the hospital is that glycolipid ratio in the majority of prescriptions is low, and irrational hot nitrogen ratio, excessive cation concentration and insulin dosage appeared in the minority of pre-scriptions. Clinicians should strengthen the learning of parenteral nutrition knowledge and clinical pharmacists should actively perform reasonable intervention in the TPN prescriptions to promote the reasonable TNP therapy and improve the therapeutic effect.

Objective To evaluate the association of Smad2/3,Smad4 and P-Smad3 protein expressions in tissue with liver fibrosis in patients with chronic HBV infections.Methods Liver biopsy was performed to determine the liver fibrosis grades in 131 cases of chronic HBV infections.Immunohistochemistry and semiquantitative analysis were applied to detect the expression of Smad2/3,Smad4 and P-Smad3 proteins in liver tissues.Results Smad2/3,Smad4 and P-Smad3 were detected mainly in fibrous septum,portal areas,myofibroblasts,sinus and cytoplasm in the liver tissue.The expression of Smad2/3,Smad4 and P-Smad3 was increased with the development of fibrosis ( r =0.81,0.58and 0.68,P =0.000),and a strong positive correlation was observed among three proteins (r =0.75,0.87and 0.84,P =0.000).Conclusion The expression of Smad2/3,Smad4 and P-Smad3 is correlated with liver fibrosis in chronic HBV infection,which suggests that the up-regulation of Smad proteins may be involved in the progression of liver fibrosis.