Objective To explore the relationship between nonalcoholic fatty liver (NFALD)and apolipoprotein E (ApoE)gene polymorphism in Shanghai undergraduate students. Methods A cross-sectional survey was performed in 4 148 students from Shanghai Tongji University. Quesgionary, physical measurement, ultrasonography and biochemical parameters were used to diagnose NFALD. In patients with NAFLD and 200 healthy subjects (served as control), ApoE genotypes were determined by PCR-RFLP. Results (1)Totally 398 subjects were diagnosed as NAFLD (prevalence 9.6%). Body mass index, waist-to-hip ratio, triglycerides, total cholesterol, alanine transaminase, aspartate aminotransferase and γ-glutamyltransferase in NAFLD group were higher than those in control, which were related to the degree of NAFLD (P＜0.01). (2)ApoE genotypes distributions were significantly different between two groups (χ2=10.52, P＜0.01). In NAFLD,E4/4 genotype frequency (5.5%)increased, and E3/3 (61.8%)decreased . (3)Unconditional logistic regression showed that E4/4 were closely associated with lipid profiles. Conclusion ApoE point mutations 112 and 158 may cause different dyslipidosis. E4/4 genotype seems to be one of the genetic predisposition factors of NAFLD.

Non-alcoholic fatty liver disease(NAFLD)has become a global epidemic nowadays.Although the path-ogenesis of NAFLD remains to be uncovered,it is highly correlated with the changing of environment as other metabolic diseases.Epigenetics is the study on the differences of gene expression not caused by the changes in DNA sequencing.The epigenetics is considered to link the environment factors and the onset and development of NAFLD.As an increasing number of researches on epigenetics have emerged in recent years,our understanding of how epigenetic factors take part in the pathogenesis of NAFLD has been improved.This article reviews the recent studies on important epigenetic factors contributing to the progression of NAFLD including the DNA methylation,modification of histones and non-coding RNAs.It may give us a hint to discover novel diagnosis methods and drug targets for NAFLD.

Objective To investigate the incidence of metabolic syndrome among obese children in clinics. Methods One hundred and thirteen obese children aged 7 to 14 years were selected from clinics of nutrition(case group),and another 366 healthy students aged 7 to 14 years were served as controls.Height,body weight,waist circumference,hip circumference,blood pressure and liver ultrasound were measured,related biochemical parameters such as fasting blood glucose,fasting insulin,serum total cholesterol,triglyceride(TG),hiSh density lipoprotein and low density lipoprotein were detected,and the incidences of metabolic syndrome were obtained in two groups.Insulin resistance(IR)was evaluated by homeostasis model assessment(HOMA). Results There was no significant difference in age and gender between case group and control group(P>0.05).Body weight,body mass index(BMI),waist circumference,hip circumference,waist to hip ratio,systolic blood pressure,diastolic blood pressure,fasting blood glucose,fasting insulin,HOMA index and TG in case group were significantly higher than those in control group(P<0.01).The 75th percentile of HOMA index in control group was 3.28,and IR subgroup and non-IR subgroup were divided according to this cutpoint.In case group,body weight,BMI,waist circumference and TG in non-IR subgroup were significantly higher than those in IR subgroup (P< 0.05).Metabolic syndrome occurred in 51 cases(45.1%) in case group.The incidence of metabolic syndrome was higher in IR subgroup than that in non-IR group(50.0% vs 21.1%)(P<0.05). Conclusion The prevalence of metabolic syndrome is higher in overweight and obese children.IR has a close relationship with metabolic syndrome.

Objective To investigate the prevalence of parenteral nutrition related central venous catheter infection in elder patients with malignant tumors,and explore the risk factors. Methods The clinical data of 366 patients with malignant tumors who were managed with parenteral nutrition after operation were retrospectively analysed.The data of age,gender, body weight,diagnosis of primary disease,surgical approach,past history,volume of blood and albumin transfusion and time of fever(body temperature ≥38℃) were collected.Parenteral nutrition related parameters such as time of parenteral nutrition,total calorie,non-protein cMorie,amount of fat,protein and glucose,calorie to nitrogen ratio and carbohydrate to fat ratio were also recorded. Results The mean age of 366 patients was (71.8±6.9)years,mean time of parenteralnutrition was (10.6±6.3)d,and total time of catheterization was 3 336 days.The prevalence of parenteral nutrition related central venous catheter infection was 2.5%(9/366).Logistic regression analysis demonstrated that the relative risks of plasma albumin level before parenteral nutrition and time of high fever to catheter infection were 1.257 and 2.518,respectively(P<0.01 for both). Conclusion Plasma albumin level before parenteral nutrition and time of fever were two risk factors for parenteral nutrition related catheter infection in elder patients with malignant tumors.

Objective　To evaluate the effects of lipid emulsion on parenteral nutrition associated liver dis ease (PNALD) in old tumor patients. Methods　A retrospective study was performed with 402 patients in Renji Hospital from January 2003 to December 2008. Patients were retrieved according to the following criteria: (1)age ≥60 years; (2) confirmed diagnosis of tumor, had no evidence of metastasis, and tumor was completely resected before receiving parenteral nutrition; (3) liver and kidney function was in normal range before receiving parenteral nutrition; (4) parenteral nutrition days ≥7; and (5) parenteral nutrition was infused in "all in one" bag via central venous. Patients with history of viral hepatitis or died in parenteral nutrition episode were excluded. These 402 patients aged (71.7 ±6.8) years and the average parenteral nutrition time was (10. 2 ±5.9) (range, 7-61 )days. In 311 patients (77.4％), non-protein calorie was obtained from carbohydrate and lipid and 91 patients (22. 6％ ) just obtained non-protein calorie from carbohydrate.　Results　The total prevalence of PNALD was 15.2％ (61/402). The prevalence of PNALD was 8.8％ (8/91) in patients receiving parenteral regiment without lipid and 17.0％ (53/311) in patients receiving parenteral nutrition with lipid, and there was no significant difference in prevalence of PNALD between two groups (χ2 = 3.72, P = 0.07 ). Lipid type and amount showed no significant effects on PNALD ( P ＞ 0.05 ). The fever days ( P ＜ 0. 001 ), baseline level of alanine transaminase (P ＜0. 001 ) and γ-glutamyltransferase (P ＜0. 001 ) were risk factors for liver injury by logistic regression. Conclusion　Lipid emulsion can be safely used in old tumor patients without affecting the occurrence of PNALD.

Objective To investigate the distribution of homeostasis model assessment-insulin resistance(HOMA-IR)index and its relationship with metabolic syndrome and inflammatory cytokines in students aged 7 to 14 years. Methods The data of 366 students(n=163 for boys and n=203 for girls) aged 7 to 14 years were collected,including anthropometric parameters (height,body weight,body mass index,waist circumference,hip circumference and waist-hip ratio),blood pressure,total fat mass,fat proportion,fasting blood lipid,fasting blood glucose,fasting insulin and serum levels of inflammatory cytokines such as tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6),and insulin resistance was evaluated by HOMA-IR index. Results The 75 th percentile of HOMA-IR index for boys and girls was 3.62 and 2.88,respectively.Body weight,height,body mass index,waist circumference,hip circumference,total fat mass and fat proportion were positively related to HOMA-IR index(P<0.01).When HOMA-IR index surpassed 75th percentile,age,anthropometric parameters,total fat mass,fat proportion and systolic blood pressure significantly increased in boy and girl students(P<0.05),no significant change occurred in diastolic blood pressure in boy and girl students,the levels of serum TNF-α and IL-6 significantly increased in boy students(P<0.05),while there was no significant change in level of CRP in boy students and levels of CRP.TNF-α and IL-6 in girl students. Conclusion The increase of HOMA-IR index leads to a dramatic increase of anthropometrie parameters,total fat mass,fat proportion and serum TNF-α and IL-6 in boy students,while that results in the increase of anthropometric parameters,total fat mass and fat proportion in sid students,with no significant change in serum inflammatory cytokines.

Objective To explore the prevalence of parenteral nutrition-associated liver disease (PNALD) and its risk factors in elderly people after gastrointestinal operation. Methods Seventy-five patients received parenteral nutrition (PN) after gastrointestinal operation were retrospectively analyzed. Age, height, body mass index, suftering diseases, history of diseases, time of therapy, total calorie, nonprotein calorie, the kind and amount of fat emulsion and amino acid, the amount of glucose, non-protein energy to nitrogen ratio, ratio of glucose to lipid, liver function, renal function and blood routine were collected. Results The prevalence of PNALD was 25.3% (19/75). The total calorie, nonprotein calorie, the amount of protein, the amount of glucose and ratio of glucose to lipid were obviously higher in PNALD group than in non-PNALD group [(24.0±6.5) vs. (20.7±5.4)kcal·kg-1·d-1, (20.5±5.5)vs. (17.2±4.8)kcal·kg-1·d-1, (1.0±0.3)vs. (0.9±0.2)g ·kg-1·d-1, (2.9±0.9)vs.(2.3±0.9)g·kg-1·d-1, 1.5±0.7 vs. 1.1±0.5; all P<0.05], while the hemoglobin was lower in PNALD group [(97.4±15.1)vs. (110.1±19.1)g/L, P<0.05]. The kind of fat emulsion and amino acid, gender, history of diseases, suftering diseases, body mass index, serum albumin, leukocyte levels and renal function were comparable between the two groups (χ2=0.114,0.843,0.116,0.531,0.344,1.588,0.006,0.063 and 0.549, all P>0.05). Conclusions The prevalence of PNALD is 25.3% in 75 elderly patients after gastrointestinal operation. Total calorie, the amount of glucose and the ratio of glucose to lipid should be reduced in these patients for preventing PNALD.

Building a professional clinical research team inside hospitals is in favor improving their research abilities,accelerating the clinical discipline construction,improving their comprehensive influence.Also it fits the objective of general hospital development under gate-keeping system.Now in domestic,the percentage of professional research staff in large hospitals accounts was much less than the international level.The main reasons included the misunderstanding of constructing the research-oriented hospitals,insufficient human resources enrollment,less attractive environment to the highlevel researchers and the absence of relevant degree training programs.To enhance the construction of research-oriented hospitals,it's of key importance to build the professional research team in hospitals.Besides,the hospital has to update management conception,broaden the channels of talent cultivation,grasp the development of the subject accurately and interact with the basic medicine and public health subject,increase the financial investment and perfect the relevant management regulations.

OBJECTIVE: To investigate the features of nasal septum cellule in computed tomographic (CT) images and its clinical significance. METHOD: CT scans data of nasal septum in 173 patients were randomly obtained from January 2001 to June 2005. Prevalence and clinical features were summarized in the data of 19 patients with nasal septum cellule retrospectively. RESULT: (1) Nineteen cases with nasal septum cellule were found in 173 patients. (2) All nasal septum cellule of 19 cases located in perpendicular plate of the ethmoid bone, in which 8 cases located in upper part of nasal septum and 11 located in middle. (3) There were totally seven patients with nasal diseases related to nasal septum cellule, in which 3 cases with inflammation, 2 cases with bone fracture, 1 case with cholesterol granuloma, 1 case with mucocele. CONCLUSION Nasal septum cellule is an anatomic variation of nasal septum bone, and its features can provide further understanding of some diseases related to nasal septum cellule.
Adolescent ; Adult ; Aged ; Ethmoid Bone ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Nasal Bone ; diagnostic imaging ; Nasal Septum ; diagnostic imaging ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND:Our previous studies have confirmed that H2O2 and ginsenoside Rg1 can cause changes in reactive oxygen species levels in human periodontal ligament cells,but the correlation of reactive oxygen species with apoptosis and autophagy remains unclear. OBJECTIVE:To explore the effect and mechanism of ginsenoside Rg1 on H2O2-induced apoptosis and autophagy of human periodontal ligament cells. METHODS:Human periodontal ligament cells were divided into control group,H2O2 group and H2O2+Rg1 group.Ginsenoside Rg1(50 μmol/L)was pre-incubated for 24 hours and H2O2 was treated for 2 hours(500 μmol/L).CCK-8 assay was used to detect the proliferation ability of the cells.A fluorescent probe DCFH-DA was used to detect the reactive oxygen species level of the cells.qRT-PCR and western blot assay were used to detect heme oxygenase 1,apoptosis-related factor Caspase-3,Bax,anti-apoptotic factor Bcl-2,autophagy Beclin-1,P62,LC3,pathway-related factors phosphatidylinositol-3-kinase(PI3K),protein kinase B(AKT),mammalian target of rapamycin(mTOR)mRNA and protein expression. RESULTS AND CONCLUSION:(1)Compared with the control group,the proliferation activity of human periodontal ligament cells in the H2O2 group decreased.Compared with the H2O2 group,the proliferation activity of human periodontal ligament cells increased in the H2O2+Rg1 group.(2)Compared with the control group,the expression of reactive oxygen species and heme oxygenase-1 increased in the H2O2 group.Compared with the H2O2 group,the expression of reactive oxygen species and heme oxygenase-1 decreased in the H2O2+Rg1 group.(3)Compared with the control group,the expression of Caspase-3,Bax,Beclin-1 and LC3 increased,while the expression of Bcl-2 and P62 decreased in human periodontal ligament cells of the H2O2 group.Compared with the H2O2 group,the expressions of Caspase-3,Bax,Beclin-1 and LC3 decreased,and the expressions of Bcl-2 and P62 increased in the H2O2+Rg1 group.(4)Compared with the control group,the expressions of PI3K,AKT and mTOR decreased in human periodontal ligament cells of the H2O2 group.Compared with the H2O2 group,the expressions of PI3K,AKT and mTOR increased in human periodontal ligament cells of the H2O2+Rg1 group.(5)These results suggest that ginsenoside Rg1 can inhibit H2O2-induced apoptosis and autophagy in human periodontal ligament cells by reducing the content of reactive oxygen species and down-regulating the related factor expression of the PI3K/AKT/mTOR pathway.