The incidence rate of nonalcoholic fatty liver disease (NAFLD) is continuously increasing in the world, and NAFLD is a major cause of chronic liver disease in developed countries such as the United States and may become the most common chronic liver disease in China in the future. NAFLD is often observed in the obese population; however, it is also commonly seen in lean individuals. This article summarizes the latest studies on lean NAFLD and elaborates on the following pathogeneses of this disease: the change in single nucleotide polymorphism is one of the predisposing factors for NAFLD in the lean population; the change of gut microbiota and sarcopenia may induce a variety of metabolic disorders including hyperlipidemia, hyperuricemia, insulin resistance, and iron metabolic disorders, and such metabolic disorders may promote the development of NAFLD; in addition, unhealthy dietary habits and lifestyle may contribute to the accumulation of fat and increase the burden of the liver. The combined effect of these factors eventually lead to the development of NAFLD, but further studies are still needed to clarify the pathogenesis of lean NAFLD.

An in vitro synthesized random ssDNA library was subjected to 12 rounds of selection against anti-screening cells and sieving cells by SELEX. Normal and inflammatory cervical exfoliation cells were selected as anti-screening cells, and the cervical exfoliation cells of low-grade squamous intraepithelial lesion (CIN1), high-grade squamous intraepithelial lesion (CIN2, CIN3) and cervical carcinoma were selected as sieving cells during the screening process. Then, the highly specific aptamer CIN-Ap4 was established by the analysis of the specificity, affinity and cell immunofluorescence, which can be used as biomarker for Cervical Intraepithelial Neoplasia. Prime Premier 5.0 was applied to design a random ssDNA library. According to the fixed sequence at both ends of the library, a pair of primers were designed and synthesized. At the same time, the optimal annealing temperature, cycle times and primer concentration ratio of PCR procedure were selected. The results under the optimal condition are shown as follows. In the 50 μL reaction system, the optimum reaction conditions of symmetry PCR are as follows: annealing temperature is 49.5 ℃, number of cycles is 15. The optimal reaction conditions of indirect asymmetric PCR are as follows: the primer concentration ratio is 80:1, and the number of cycles is 35. The experiment proves that the oligonucleotide library is constructed successfully, and the highly specific dsDNA and ssDNA can be obtained under optimal PCR conditions with good repeatability, which establishes the foundation for the further exploration and experimentation.

Objective To investigate the effects and underlying mechanism of the scavenger receptor CD36 in high glucose-induced rat glomerular mesangial cells apoptosis.Methods The mesangial cells of rats were divided into 4 groups:control group (5.6 mmol/L glucose),mannitol group (24.2 mmol/L mannitol+5.6 mmo]/L glucose),high glucose group (30 mmol/L glucose),CD36 monoantibody group (30 mmol/L glucose+CD36 mono-antibody).The intracellular ROS level was detected by confocal microscopy with fluorescent probe CM-H2DCFDA.MDA,GSH-PX,8-OHDGA in cell supernatant were detected.Apoptosis was determined by flow cytometry followed by Annexin V-FITC/PI double stains.The expression of CD36,Bax and Bcl-2 were detected by RT-PCR and Western blotting.Results The expression of CD36 was detected in glomerular mesangial cells.The highest level was found in high glucose group in 24 hours.There was no significant difference found between control group and mannitol group with respect to intracellular ROS generation,MDA,8-OHDG,GSH-PX level,apoptosis rate,expression of CD36,Bax and Bcl-2 (all P ＞ 0.05).There was no significant difference in the expression of CD36 between CD36 mono-antibody group and high glucose group (P ＞ 0.05).Compared to control group,the intracellular ROS generation,MDA and 8-OHDG levels,apoptosis rate,the expression of CD36 and Bax were significantly increased,the GSH-PX level and the expression of Bcl-2 were significantly lower in high glucose group (all P ＜ 0.05).Compared to the high glucose group,the intracellular ROS generation,MDA and 8-OHDG levels,apoptosis rate,the expression of Bax were suppressed but the GSH-PX level and the expression of Bcl-2 increased in CD36 mono-antibody group (all P ＜ 0.05).The intracellular ROS level was positively correlated with apoptosis rate,protein expression of CD36 and Bax gene,was negatively correlated with Bcl-2 protein expression.Conclusions CD36 was involved in the high glucose induced apoptosis of mesangial cells which was potentially mediated by an increased level of oxidative stress.

Objective To evaluate the effects of autophagy on oxidative stress induced by contrast media in podocytes.Methods The differentiated mouse podocytes were exposed to contrast media (Iopromide,50 mg/L)、rapamycin (Rap,autophagy enhancer,1 ng/L),3-methyladenine (3-MA,autophagy inhibitor,2 mmol/L) for 2 hours.The expression of autophagy protein LC3-Ⅱ and Beclin-1 as well as oxidative stress-related proteins Catalase,MnSOD were detected by Western blot.The formations of autophagy were observed by MDC staining,and the levels of reactive oxygen species (ROS) by CM-H2DCFDA staining.Cell activity was evaluated by CCK8 assay.Results Both the levels of oxidative stress and autophagy in podocytes increased when stimulated by contrast media,the expression of LC3-Ⅱ and Beclin-1 were enhanced,Catalase and MnSOD were inhibited (all P ＜ 0.05).Rapamycin increased the expression of Catalase,MnSOD and cell activity of podocytes,reduced the generation of ROS (all P ＜ 0.05),but in Rap group,cell activity showed no significant difference (P ＞ 0.05).3-MA decreased the expression of Catalase 、MnSOD and inhibited the cell activity of podocyte,increased the generation of ROS (all P ＜ 0.05).Conclusion Autophagy protects podocyte from contrast media by the means of reducing oxidative stress.

Objective To investigate the renoprotective effect of erythropoietin(EPO) in streptozotocin-induced diabetic rats and to explore the possible mechanism.Methods The SD rats were randomly divided into there groups: normal control rats, diabetic, diabetic treated with EPO(NC, DM, DE groups).The rats were sacrificed after 8 weeks treatment.Renal morphology was observed by light microscopy.The expression of erythropoietin receptor(EPOR) in kidney was detected by immunofluorescence and Western blotting.The expression of p47phox, transforming growthfactor (TGF)β1andfibronectin (FN)proteininkidneywasdetectedby immunohistochemistry and Western blotting.The activity of antioxidants including total antioxidant capacity (T-AOC), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and the level of malondialdehyde(MDA) in kidney were also measured.Results EPO treatment notably attenuated renal pathologic and functional changes.The expression of EPOR was found in kidney,but there was no difference among groups(P＞0.05).Compared with normal rats, diabetic rats showed an elevated expression of p47phox, TGF-β1, FN proteins and MDA levels in kidney as well as reduced activities of SOD, GSH-Px and T-AOC (all P＜0.01).Compared with diabetic rats, EPO could decrease the protein expression of p47phox,TGF-β1and FN in kidney (all P＜0.05).Meanwhile, elevated MDA level in the kidney was decreased as well as decreased SOD, GSH-Px,T-AOC activities were significantly remitted in DE group(all P＜0.01).Conclusion EPO can amelioraterenaldamagevia theinhibition of oxidativestressandTGF-β1andFNprotein expression in streptozotocin-induced diabetic rats.

Objective To observe the release of inflammation-related factors after angiotensin Ⅱ (Ang Ⅱ ) stimulation in rat tubular epithelial cells (NRK-52E), to analyze whether these effects were mediated by TLR4-MyD88 pathway, and to reveal the novel mechanism of injury by Ang Ⅱ on NRK-52E cells. Methods After synchronization, cells incubated with AngⅡ (10-7 mmol/L) were used as the stimulation group, cells without stimulation were as normal control. To determine the role of TLR4 and the adaptor MyD88, equal number of NRK-52E cells was added with 10-5 mmol/L candesartan or 20 mg/L TLR4 blocking peptide for 1 h and then incubated with Ang Ⅱ (10-7 mmol/L) respectively. RT-PCR was used to analyze TLR4 mRNA and MyD88 mRNA expression. Immunofluorescence and confocal microscopy were used to observe TLR4 protein expression. ELISA was used to detect the concentration of tumor necrosis factor-alpha (TNF-α) and heat shock protein 47(HSP47) in cell supernatant respectively. Results TLR4 and MyD88 were highly expressed in Ang Ⅱ-induced NRK-52E cells (P＜0.01), and the TNF-α and HSP47 levels were also increased markedly compared with control group (P＜0.01). In NRK-52E cells that were pre-incubated with candesartan, TLR4 and MyD88 expression were obviously inhibited,subsequently, HSP47 and TNF-α production decreased remarkably compared with Ang Ⅱ group (P＜0.01). TLR4 blocking peptide had the similar effect in a dose-dependent manner, in which its effect was dependent on inhibiting TLR4-MyD88 expression. Conclusion The mechanism of Ang Ⅱ -induced injury effect on NRK-52E cells is related to the increase of TLR4-MyD88 activity,which is followed by the enhance of TNF-α and HSP47 expression. This process is inhibited by candesartan via modulation of innate immune pathway.

Objective To investigate whether erythropoietin (EPO) can inhibit the proapoptotic effect of high glucose on rat proximal tubular epithelial cells, and the possible mechanisms in which EPO exerts its anti-apoptotic role. Methods Rat proximal tubular epithelial cells (NRK-52E) were divided into 5 groups: normal control group, osmolarity control group, high glucose group, high glucose with EPO (50 U/ml) group and high glucose with EPO (100 U/ml) group. The expression of EPO receptor (EPOR) in NRK-52E cells was examined by immunocytochemistry. The effect of high glucose on the expression of EPOR was detected by Western blotting. The rate of apoptosis was evaluated by flow cytometry Annexin V-FITC/PI double stains. The intracellular ROS was detected using fluorescent probe CM-H2DCFDA. The expression of bcl-2, bax and caspase-3 mRNA were examined by RT-PCR. Results The expression of EPOR was demonstrated in NRK-52E cells, and high glucose could up-regulate the expression of EPOR. High glucose could induce oxidative stress in NRK-52E cells, and up-regulate the mRNA expression of bax and caspase-3, down-regulate the mRNA expression of bcl-2. These effects of high glucose on NRK-52E cells could be reversed by EPO. Conclusion EPO inhibits NRK-52E cells apoptosis induced by high glucose through attenuating oxidative stress,up-regulating theexpression of bcl-2 mRNA and down-regulating the expression of bax and caspase-3 mRNA, which may be mediated by EPOR.

Clinical data of 116 patients with implanted permanent dual catheters for hemodialysis,including 18 with infection and 98 non-infection, during January 2006 and July 2009 were retrospectively analyzed to study risk factors for catheter-related bacteremia (CRB). Duration of catheter implantation,primary disease, routine blood examinations and blood biochemical examination of the patients were analyzed between the two groups. COX proportional hazard regression analysis was performed for all predictor variables. Results showed that overall incidence of bacteremic episodes was 0. 314 per 1000 catheter-day.Compared to that in infection group, levels of hemoglobin, plasma albumin, peripheral lymphocyte count and ratio of CD4/CD8 in non-infection group were significantly higher ( all P ＜ 0. 05 ), and OR of CRB were 4. 011 (P =0. 0213) for diabetes mellitus and 7. 181 for hemoglobin level less than 80g/L (P = 0. 0020),respectively. It is suggested that improving nutrition status and correcting anemia for patients with hemodialysis are necessary to reduce CRB.

Objective To determine the effects of practicing a simplified 24 movement form of Tai chi on the level of inflammatory cytokines and the quality of life of type 2 diabetes patients. Methods A group of type 2 diabetes patients practiced a simplified 24 movement Tai chi routine 60 min/d, 3 d/week for 6 months. Plasma glu-cose and insulin concentration were monitored. The plasma level of IL-6, IL-18, sCD40L, hsCRP and HBAc1 were measured. Changes in the patients' quality of life were also measured by using the SF-36. Results Serum IL-6,IL-18, hsCRP and sCD40L levels were all significantly lower compared with a control group. Significant quality of life improvements were seen in the Tai chi group compared with the controls. Significant reductions were seen in blood pressure, glycated haemoglobin, glucose, insulin resistance and urinary albumin. Conclusions These results sug-gest that regular Tai chi practice can prevent complications and improve the quality of life of diabetes sufferers through glyeaemic control and down-regulating inflammatory cytokine levels.

Objective To explore the expression and significance of nestin in renal tubular epithelial cells in hypercholesterolemic rats. Methods Dietary-induced hyperlipidemia were induced in female SD rats by given 4% cholesterol and 1% cholic acid diet for 16 weeks. Changes of serum lipid, urinary albumin, serum creatinine and renal interstitial pathological changes were assessed. The expression of nestin and a-smooth muscle actin (α-SMA) were detected by immunohistochemical stain. Results The serum levels of total cholesterol, low density lipoprotein, urinary albumin and serum creatinine were significantly increased in hyperlipidemia group, accompanied with renal interstitial injury and fibrosis. As time extended, the expression of nestin and a-SMA in renal tubular epithelial cells were increased significantly. There was positive correlation among the expression of nestin and total cholesterol, low density lipoprotein, urinary albumin and serum creatinine( r =0.963,0.830,0.944,0.706, P <0.01). Nestin also had a positive correlation with tubular-interstitial index ( r = 0. 974, P < 0. 01) and α-SMA ( r = 0. 804, P < 0. 01). Conclusion The increased expression of nestin may be associated with renal tubular-interstitial fibrosis and tubular epithelial myofibroblast transdifferentiation in hypercholesterolemic rats.