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.

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.

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.

Diabetes Mellitus, Type 2 ; complications ; Humans ; Non-alcoholic Fatty Liver Disease ; complications

Objective To observe the effect and safety of modified Yishen Zhuyang Huoxue Huazhuo Formula for polycystic ovarian syndrome (PCOS) in the TCM pattern of deficiency of spleen and kidney with phlegm-dampness. Methods Totally 123 cases were recruited into this study and randomized to two groups by central random approach, 64 cases in the observation group and 59 cases in the control group. Patients in the observation group were given the modified Yishen Zhuyang Huoxue Huazhuo Formula, while those in the control group were given compound cyproterone acetate tablet, for two treatment courses, three months for one course. The changes of ovarian volume and the number of follicles before and after treatment were observed. Adverse reactions were also evaluated. Results Bilateral ovarian volumes in both groups decreased after treatment (P<0.05, P<0.01), while the control group showed a significant better improvement (P<0.05). The number of follicles in the two groups decreased, but no significant difference were observed between the two groups (P>0.05). The rate of adverse reaction in the observation group was lower than the control group. Conclusion Modified Yishen Zhuyang Huoxue Huazhuo Formula is effective for PCOS patient by reducing the ovarian volume with a low incidence of side effect.

Objective To study the effect of hydroxychloroquine (HCQ) on the suppressors of cytokine signaling (SOCS) in the kidney of MRL/lpr mice and evaluate the protection of HCQ on lupus nephritis.Methods Twenty-six rats were randomly divided into 3 groups:the control group which was consisted of 6 mice; the MRL/lpr group which was consisted of 10 mice; and the HCQ group which was consisted of 10.24-hour urinary protein level and anti dsDNA levels were tested.The expressions of SOCS-1 and SOCS-3 protein were determined by western blot.Analysis of variance was used to determine statistically significant differences between the two groups.A P value less than 0.05 was considered to be statistically significant.Results Compared with the control group,the levels of 24-hour urinary protein [(2 356.6±509.3) mg vs (440.3±90.1)mg] and anti ds-DNA (128.7±32.3 vs 14.9±1.4) were significantly increased in the MRL/lpr group,the expression levels of SOCS-1 and SOCS-3 protein were increased.After treated with HCQ,the levels of 24-hour urinary protein [(70.8±11.1) mg vs (2 356.6±509.3) mg] and anti-dsDNA (111.8±330.1 vs 128.7±32.3)were significantly decreased,the expression level of SOCS-1 and SOCS-3 protein decreased significantly (P＜ 0.05).Conclusion HCQ can inhibit SOCS expression in the kidney of lupus mice,reduce proteinuria and delay progression of immune disorders and 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.

Objective In Caucasian populations, the tumor cells of Epstein Barr virus (EBV)-positive classical Hodgkin lymphoma (cHL) patients more frequently express HLA class Ⅰ and HLA class Ⅱ molecules compared to EBV-negative cHL patients. HLA expression (in relation to EBV) in Asian cHL patients has not been previously investigated. Methods 145 cHL patients with formalin-fixed, paraffin embedded tissue blocks available from Beijing, China were randomly selected. Hematoxylin & Eosin-stained slides were used to reclassify the histological subtypes according to the WHO classification. EBV status was determined by visualization of EBER in tumor cells using in situ hybridization. Membranous expression of HLA molecules was detected by immunohistochemistry using antibodies HC-10 (class Ⅰ heavy chain) and antiβ2-microglobulin for HLA class Ⅰ, and CR3/43 for HLA class Ⅱ. Results EBV (+) tumor cells were observed in 40 % (58/145) of the cHL patients. As expected, the percentage of EBV(+) cases was much higher in the mixed cellularity subtype (71%) than that in the nodular sclerosis subtype (16 %) (P ＜0.001). The expression of HLA class Ⅰ was observed in 79 % of the EBV (+) cHL cases and in 30 % of the EBV (-) cases (P ＜0.001). For HLA class Ⅱ, 52 % of EBV(+) cHL cases were positive, compared to 43 % in EBV(-) cases (P =0.277). Conclusion The results in China population were similar to that in the Caucasian population for HLA class Ⅰ, but not for HLA class Ⅱ.

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 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.