objectiveTo investigate the differences in clinical indices and lipid metabolism between the patients with nonalcoholic fatty liver disease （NAFLD） and healthy individuals in the overweight population. MethodsIn this study， body mass index （BMI）>23 kg/m² was defined as overweight. A total of 62 overweight patients with NAFLD who were admitted to Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2020 to April 2021 were enrolled as overweight NAFLD group， and 50 overweight individuals who underwent physical examination during the same period of time were enrolled as control group. Clinical information and blood biochemical parameters were recorded for all subjects. Ultra-performance liquid chromatography-tandem mass spectrometry was used to analyze serum lipidomic profile， and principal component analysis and orthogonal partial least squares-discriminant analysis were used to perform the multivariate statistical analysis of lipidomic data. The chi-square test was used for comparison of categorical data between two groups， and the independent-samples t test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups. ResultsThe overweight NAFLD group had a significantly higher BMI than the overweight control group （Z=-2.365， P=0.018）. As for serological markers， compared with the overweight control group， the overweight NAFLD group had significantly higher levels of red blood cells， hemoglobin， hematocrit， uric acid， total protein， globulin， alkaline phosphatase， gamma-glutamyl transpeptidase， alanine aminotransferase， aspartate aminotransferase， cholinesterase， low-density lipoprotein， total cholesterol， triglyceride， apolipoprotein B， and blood glucose （all P<0.05）. The lipidomic analysis showed that there was a significant difference in lipid metabolism between the two groups， and a total of 493 differentially expressed lipids were identified （VIP value>1， P<0.05）， among which 143 lipids were significantly upregulated and 350 lipids were significantly downregulated in the overweight NAFLD group. The mean total fatty acid content in the overweight NAFLD group was 3.6 times that in the overweight control group. Compared with the overweight control group， the overweight NAFLD group had a significant reduction in the content of triglyceride with>3 unsaturated bonds （P<0.001） and a significant increase in the content of triglyceride with ≤3 unsaturated bonds （P<0.001）. ConclusionCompared with healthy overweight individuals， overweight NAFLD patients tend to have significant abnormalities in some biochemical parameters and lipid metabolites， with significant increases in the content of fatty acid in blood and the types of saturated fat chains in triglycerides.

The prevalence rate of nonalcoholic fatty liver disease (NAFLD) is increasing year by year, which poses a heavy burden on global public health. The pathogenesis of NAFLD is closely associated with the factors including obesity, insulin resistance, and diet, among which diet is the core and cornerstone of the prevention and treatment of NAFLD. In view of the fact that previous studies focused on the association of different dietary components, structures, and plans with NAFLD and seldom explored the impact of overall dietary behavior on NAFLD, this article reviews the effect of dietary behavior on NAFLD, in order to provide a reference for the prevention and treatment of NAFLD and the guidance on rational dietary behaviors and habits for patients.

Objective To collect the serum samples of patients with nonalcoholic fatty liver disease (NAFLD), and to investigate the changes in serum metabolic biomarkers before and after lifestyle intervention. Methods A total of 23 patients who were diagnosed with NAFLD in Department of Gastroenterology and Inpatient Department, Putuo District Central Hospital of Shanghai, from January 2019 to January 2020 were enrolled, and all patients received the intervention with aerobic exercise and equicaloric low-carbohydrate high-protein diet. A total of 13 healthy volunteers who underwent physical examination in Physical Examination Center were enrolled as control group. For the patients with NAFLD, basic information was collected before and after intervention, blood samples were collected twice to measure liver function, blood glucose, and blood lipids, and part of serum was used for serum metabolomics analysis. The serum samples were analyzed by ultra-performance liquid chromatography/tandem high-resolution mass spectrometry. The data collected were processed in Compound Discover, and then principal component analysis (PCA) and orthogonal partial least squares discriminant analysis were used to establish the profile of differentially expressed blood metabolites between patients and healthy people and perform the enrichment analysis of differentially expressed metabolic pathways. The independent samples t -test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon non-parametric test was used for comparison of non-normally distributed continuous data between two groups. Results After lifestyle intervention, the patients had significant reductions in body mass index ( P < 0.01), body weight ( P < 0.01), and serum biochemical parameters alkaline phosphatase, albumin, gamma-glutamyl transpeptidase, and alanine aminotransferase (all P < 0.05), as well as a significant reduction in total protein ( P < 0.01), while there were no significant improvements in cholinesterase, aspartate aminotransferase, and glucose. As for the four items for blood lipids, there was a significant reduction in triglyceride ( P < 0.01), while there were no significant improvements in high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol. The metabolomics analysis showed that 33 serum metabolites changed significantly after lifestyle intervention. In addition, PCA results showed that after intervention, the level of metabolites in patients tended to be normal. The signaling pathway analysis showed that exercise and diet mainly affected the pathways of bile acid, unsaturated fatty acid synthesis, and phenylalanine metabolism. Conclusion Lifestyle intervention can achieve varying degrees of reduction in the body weight of patients with NAFLD, improve serum biochemical parameters, and regulate the abnormal metabolic pathway in patients with NAFLD, which has important clinical value and significance for guiding clinicians to formulate reasonable diet and exercise strategies for patients with NAFLD and prevent the progression of NAFLD.

The prevalence rate of nonalcoholic fatty liver disease (NAFLD) is increasing year by year and it has become one of the most common chronic liver diseases in the world. Studies have shown that circular RNA (circRNA) is closely associated with NAFLD and is considered a potential diagnostic biomarker and therapeutic target for NAFLD. This article summarizes the regulatory role of circRNA in the pathogenesis of NAFLD and its value in diagnosis and treatment and points out that circRNA plays an important role in the development and progression of NAFLD and may have important clinical significance in the diagnosis and treatment of NAFLD.

ObjectiveTo investigate the association between serum interleukin (IL) and liver pathological changes in patients with chronic hepatitis B (CHB). MethodsA total of 59 patients with CHB who were treated in Putuo District Central Hospital of Shanghai from February 2018 to February 2019 were enrolled as subjects, and liver biopsy was performed for all patients. According to the degree of liver inflammation, the patients were divided into mild inflammation (G1-G2) group and severe inflammation (G3-G4) group, and according to the degree of liver fibrosis, the patients were divided into mild fibrosis (S0-S2) group and severe fibrosis (S3-S4) group. Serum liver function parameters, blood lipids, interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), and interleukin-10 (IL-10) were measured for all patients. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon non-parametric test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between groups. A Spearman correlation analysis was also performed. ResultsThe degree of liver fibrosis increased with the increase in liver inflammation (rs=0.538, P＜0.001). Compared with the mild inflammation group, the severe inflammation group had significantly higher serum levels of alanine aminotransferase ［95.00 (45.00-16925) U/L vs 51.00 (29.00-88.00) U/L, Z=-2.625, P=0.009］, aspartate aminotransferase ［54.50 (34.75-84.50) U/L vs 38.00 (30.00-49.00) U/L, Z=-2.014, P=0.044］, and gamma-glutamyl transpeptidase ［91.00 (56.72-192.25) U/L vs 44.00 (24.00-100.00) U/L, Z=-2.400, P=0.016］. The severe fibrosis group had a significantly higher serum level of high-density lipoprotein than the mild fibrosis group ［0.97 (0.32-1.08) mmol/L vs 1.23 (0.36-1.38) mmol/L, Z=-1.300, P=0.008］. The severe inflammation group had a significantly higher serum level of IL-2 receptor than the mild inflammation group ［704.00(418.00-103800) U/ml vs 436.00(335.00-555.00) U/ml, Z=-3.405, P=0.001］, and the severe fibrosis group had a significantly higher serum level of IL-2 receptor than the mild fibrosis group ［735.00(523.00-890.50) U/ml vs 447.00 (351.50-624.50) U/ml, Z=-5.358, P=0.001］. ConclusionThe degree of liver inflammation is positively correlated with that of liver fibrosis, while the serum level of IL-2 receptor increases with the increase in the degrees of liver inflammation and fibrosis, indicating that IL-2 receptor can reflect the degrees of liver inflammation and fibrosis to some extent.

The incidence rate of nonalcoholic fatty liver disease (NAFLD) is increasing year by year and NAFLD has become one of the most common liver diseases in the world. Metabolomics follows the research thoughts of genomics and proteomics and conducts a quantitative analysis of all metabolites in organisms to explore the association between metabolites and physiological and pathological changes, which provides a new way for studying the traditional Chinese medicine diagnosis and treatment of NAFLD. This article summarizes the research advances in metabolomics and traditional Chinese medicine syndromes in NAFLD, so as to provide new thoughts and methods for further exploration of NAFLD.

Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease around the world, and its incidence rate is increasing year by year. Oxidative stress is the second hit in the classic “two-hit” pathogenesis of NAFLD, which is currently recognized as one of the pathogeneses of NAFLD. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a group of positive regulators that protect hepatocytes against oxidative stress. It is a key factor for cellular anti-oxidative stress and a key transcription factor that antagonizes liver oxidative stress. It plays an important role in the development and progression of NAFLD and may be a potential treatment target for improving NAFLD. This article reviews the role of oxidative stress and the Nrf2 pathway in the pathogenesis of NAFLD.

The incidence rate of nonalcoholic fatty liver disease (NAFLD) keeps increasing year by year, making NAFLD one of the most common liver diseases in the world. Reasonable diet and exercise are currently recognized as the most crucial step in the treatment of NAFLD and are the cornerstone of the management of NAFLD patients. However, diet and exercise regimens vary across countries, regions, and societies due to various objective reasons. This article reviews the diet and exercise regimens for NAFLD patients reported in different countries, regions, and literatures in recent years, in order to provide a basis for clinicians to guide NAFLD patients to develop reasonable diet and exercise strategies.

Objective:To analyze the characteristics of plasmids in KPC-2-producing Serratia marcescens ( S. marcescens) isolates. Methods:Four carbapenem-resistant S. marcescens strains were isolated from four patients admitted to the hepatobiliary ward of Affiliated Cancer Hospital of Zhengzhou University in 2016. BD Phenix-100 was used to identify the strains and detect the minimum inhibitory concentrations (MICs). Homology analysis was performed using pulsed-field gel electrophoresis (PFGE). The modified Hodge test was used to detect the phenotypes of carbapenemase. PCR and gene sequencing were used to detect the types of carbapenem resistance genes. The transferability of plasmids was detected by conjugation test. The characteristics of plasmids were analyzed by genomic alignment method after whole genome sequencing. DNAMAN V9 software was used to compare the amino acid sequences of the replication initiation proteins. A phylogenetic tree was constructed with neighbor-joining method using MEGA7.0. Results:All of the four S. marcescens strains were resistant to carbapenem antibiotics. They were highly homologous according to PFGE. Hodge test results were all positive and the carbapenemase genotype was blaKPC-2. Conjugation test results were positive. The plasmid was a circular DNA of 42 742 bp in length. It had the similar skeleton of incX6 plasmid and the similar amino acid sequence of replication initiation protein. Moreover, it and incX6 plasmid were at the same node in the phylogenetic tree. The blaKPC-2 was located in the core of drug resistance, which was composed of insertion elements including Tn3 family transposons, recombinant enzyme genes, △ISKpn6 and ISKpn27. Conclusions:The plasmid was incX6-like. The blaKPC-2 gene was located in the transposon of △Tn6296. More attention should be paid to the bacteria carrying KPC-2 in incX plasmids.

Ovarian cancer(OC)is an aggressive and fatal cancer. A growing number of studies have shown that the tumor mi-croenvironment(TME)is involved in the promotion and development of ovarian cancer,immunosuppression and inflammatory response through various mechanisms. TME includes tumor blood vessels and lymphatic vessels,as well as cancer cells,mesenchymal cells,im-mune cells,and extracellular matrix(ECM). Based on recent literature reports,this paper reviews the commonly used three-dimen-sional(3D)cell culture model of ovarian tumor microenvironment,and summarizes many 3D models that do not contain primitive stro-mal cells,aiming to find new approaches for ovarian cancer treatment.