Bidirectional relationship between nonalcoholic fatty liver disease and sarcopenia： New insights and perspectives / 临床肝胆病杂志

‍Nonalcoholic fatty liver disease （NAFLD） is a group of highly heterogeneous diseases closely associated with metabolic dysfunction. Sarcopenia is a syndrome caused by a continuous decline in muscle mass， strength， and function， and it is often accompanied by NAFLD. Insulin resistance is the main pathological mechanism for sarcopenia and NAFLD， and in addition， factors such as changes in proteins and branched‍-‍chain amino acid， hyperammonemia， intestinal flora， and endocrine dysfunction can also lead to sarcopenia and NAFLD. With the deepening of clinical research， many published prospective studies have confirmed the existence of a bidirectional and complex pathophysiological relationship between sarcopenia and NAFLD. This article reviews the bidirectional relationship between sarcopenia and NAFLD， discusses the common pathogenesis of sarcopenia and NAFLD， summarizes the challenges faced in this field， and proposes new directions for the research on the bidirectional relationship between NAFLD and sarcopenia.

Recompensation of liver cirrhosis： Current status and challenges / 临床肝胆病杂志

‍Traditionally， the progression from compensated liver cirrhosis to decompensated liver cirrhosis has been considered an irreversible point in the natural history of the disease； however， with the suppression of underlying etiology， cure， and disease regression， this view is challenged by an increasing number of new evidence， and the idea of “recompensation of liver cirrhosis” is gradually being accepted. In recent years， scholars in China and globally have been exploring the specific definition of recompensation of liver cirrhosis and the clinical features of patients. By summarizing the recent studies on recompensation of liver cirrhosis in China and globally， integrating existing views， and analyzing related research evidence， this article points out the main challenges in the field of recompensation at this stage， including the lack of in－depth clinical and basic research， the need to define recompensation in the context of NAFLD， and related ethical issues， in order to provide new directions for future research in this field.

The advantage of polyethylene glycol electrolyte solution combined with lactulose in patients with long interval preparation-to-colonoscopy.

BACKGROUND/AIMS: The main aim of the present study was to assess the efficacy of polyethylene glycol electrolyte (PEG) solution combined with lactulose in bowel preparation to find a new method for colonoscopy preparation to improve the quality of colonoscopy in patients with long interval preparation-to-colonoscopy (P-C). MATERIALS AND METHODS: A prospective, randomized, endoscopist-blinded and placebo-controlled study was conducted. Three hundred sixty patients who were scheduled for colonoscopy were enrolled in the study. They were randomly divided into the PEG-lactulose group and the PEG-placebo group with 180 patients per arm. Two of the most common methods for estimating the quality of bowel preparation were the use of the Boston Bowel Preparation Scale and the measurement of the Bubble Scale and adenoma detection rate (ADR) as a secondary outcome of observation. RESULTS: The PEG-lactulose group had a significant improvement in the quality of bowel preparation compared with the PEG-placebo group including colon cleanliness in interval P-C at 8 and 9 h (p<0.05) and bubble elimination in interval P-C at 5, 6, 7, 8, and 9 h (p<0.05). Compared with the PEG-placebo group, the ADR (23.3% vs. 15.0%, p<0.05) and the size (≤5 mm) of the adenoma (45.2% vs. 18.5%, p<0.05) increased in the PEG-lactulose group, and there were significant differences between the two groups. CONCLUSION: PEG solution combined with lactulose can improve the quality of colonoscopy in patients with long interval P-C to allow the patients to select more flexible colonoscopy time. It is worth further popularizing in clinical practice.

Risk factors for childhood nonalcoholic fatty liver disease and related prevention and management strategies / 临床肝胆病杂志

Childhood nonalcoholic fatty liver disease (NAFLD) is one of the most common cause of chronic liver diseases in children and adolescents; its unique histopathological and clinical features may lead to its progression to liver fibrosis, liver cirrhosis, and liver cancer, and compared with adult NAFLD, it is more likely to cause other diseases and increase mortality rate. Therefore, early identification of risk factors for childhood NAFLD, effective screening of high-risk population, active prevention, and early diagnosis and treatment are key to effective clinical management of this disease. This article elaborates on the risk factors, screening methods, and preventive healthcare measures for childhood NAFLD, in order to standardize the comprehensive management of NAFLD, reduce the prevalence rate of NAFLD, delay its progression, and alleviate the economic and public health burden brought by the disease.

Current status of the research on liver injury caused by SARS-CoV-2 / 临床肝胆病杂志

The outbreak of viral pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China poses a major threat to public health. SARS-CoV-2 is highly homologous to severe acute respiratory syndrome-associated coronavirus and Middle East respiratory syndrome-associated coronavirus, all of which may cause severe respiratory symptoms. In addition to respiratory symptoms, a considerable proportion of patients with SARS and SARS-CoV-2 infection have varying degrees of liver injury, but their epidemiological features and pathogenesis remains unclear. This article summarizes the epidemiology of SARS-CoV-2 and elaborates on the current status of the research on SARS-CoV-2, possible mechanism of liver injury caused by SARS-CoV-2, and effective treatment regimens, so as to provide a reference and new research ideas for the prevention and treatment of liver injury in patients with SARS-CoV-2 infection.

From nonalcoholic fatty liver disease to metabolic fatty liver disease: An analysis based on disease heterogeneity / 临床肝胆病杂志

Nonalcoholic fatty liver disease (NAFLD) has become the most important chronic liver disease in the world, but there is still no approved drug for clinical practice. Due to the heterogeneity of NAFLD itself, although drug therapy is being developed, the response rate seems to remain low. In order to meet the needs of clinical trial design and provide accurate information for drug developers, relevant scholars have proposed to change the name of NAFLD to metabolic associated fatty liver disease This article summarizes the origin of NAFLD heterogeneity and the background of NAFLD renaming, so as to provide new ideas for accelerating the development of new therapies.

Risk factors for the coexistence of inflammatory bowel disease and nonalcoholic fatty liver disease: A Meta-analysis / 临床肝胆病杂志

ObjectiveTo investigate whether glucocorticoids, anti-tumor necrosis factor (anti-TNF) drugs, and a past history of surgical treatment of inflammatory bowel disease (IBD) are the risk factors for the coexistence of IBD and nonalcoholic fatty liver disease (NAFLD). MethodsPubMed, Embase, Cochrane Library, Wanfang Data, CNKI, and VIP were searched for clinical trials of the coexistence of IBD and NAFLD published up to October 2018. The articles included were summarized and quality assessment was performed according to inclusion and exclusion criteria. RevMan 5.2 was used for data processing; the random effects model was used for data with heterogeneity, and the fixed effect model was used for data with homogeneity. ResultsA total of 7 articles were included, with 1645 patients. The meta-analysis showed that glucocorticoids might not be a risk factor for the coexistence of IBD and NAFLD (odds ratio (OR)=1.19, 95% confidence interval (CI): 0.90-1.57, P=0.23); anti-TNF drugs were not a risk factor for the coexistence of IBD and NAFLD (OR = 0.86, 95%CI: 0.65-1.13, P=0.27); a past history of surgical treatment of IBD was a risk factor for the coexistence of IBD and NAFLD (OR=1.50, 95%CI: 1.09-2.05, P=0.01). ConclusionGlucocorticoids and anti-TNF drugs for the treatment of IBD may not increase the incidence rate of the coexistence of IBD and NAFLD, while surgical treatment for IBD may increase this incidence rate.

The economic burden and risk factors in inflammatory bowel disease with nonalcoholic fatty liver disease / 临床肝胆病杂志

Nonalcoholic fatty liver disease (NAFLD) is a disease affecting about a quarter of the general population and has become the most important chronic liver disease in China and Western countries, causing huge medical and economic burdens. The prevalence rate of NAFLD is estimated to be as high as 40% in patients with inflammatory bowel diseases (IBD) such as ulcerative colitis and Crohn’s disease. This article mainly introduces the current status, economic burden, and risk factors for NAFLD in IBD patients and summarizes the current status and prospects of such diseases, in order to lay a foundation for further research in this field.

Advances in epidemiology and serum markers for the noninvasive diagnosis of nonalcoholic fatty liver disease / 中华肝脏病杂志

The global prevalence rate of nonalcoholic fatty liver disease (NAFLD) has increased year by year, and it has become the number one cause for chronic liver disease in China. In addition, the trend of NAFLD has become more pronounced and evident in female gender and younger age group. The long-term persistence of fatty liver disease may cause serious consequences. There are no accepted diagnostic criteria for diagnosing noninvasive diagnosis of NAFLD. Alpha-ketoglutarate is a newly discovered serological marker of high diagnostic value and considered the most valuable potential biomarker along with cytokeratine-18 (CK-18).

Photothermal effects of metallic carbon nanotubes on human breast cancer cells / 药学学报

SWNTs are a mixture of 1/3 metallic SWNTs (m-SWNTs) and 2/3 semiconducting SWNTs (s-SWNTs). It is desirable to separate the metallic SWNTs from the semi-conducting ones. In this study m-SWNTs was separated by using a poly[(m-phenylenevinylene)-alt-(p-phenylenevinylene)] (PmPV) derivative and used as photo-thermal media instead of SWNTs. The separation effects of m-SWNTs were evaluated by Raman spectra, molecular modeling and TEM images. The effects of m-SWNTs on MCF-7 cell proliferation and apoptosis were evaluated with MTT assay and flow cytometry, respectively. m-SWNTs were separated with high purity. A strong inhibition of MCF-7 cell growth was observed with the m-SWNTs under near-infrared (NIR) light irradiation. Our results will be helpful for the potential applications of m-SWNTs in clinical photothermal cancer therapy.

Photothermal effects of metallic carbon nanotubes on human breast cancer cells / 药学学报

SWNTs are a mixture of 1/3 metallic SWNTs (m-SWNTs) and 2/3 semiconducting SWNTs (s-SWNTs). It is desirable to separate the metallic SWNTs from the semi-conducting ones. In this study m-SWNTs was separated by using a poly[(m-phenylenevinylene)-alt-(p-phenylenevinylene)] (PmPV) derivative and used as photo-thermal media instead of SWNTs. The separation effects of m-SWNTs were evaluated by Raman spectra, molecular modeling and TEM images. The effects of m-SWNTs on MCF-7 cell proliferation and apoptosis were evaluated with MTT assay and flow cytometry, respectively. m-SWNTs were separated with high purity. A strong inhibition of MCF-7 cell growth was observed with the m-SWNTs under near-infrared (NIR) light irradiation. Our results will be helpful for the potential applications of m-SWNTs in clinical photothermal cancer therapy.

School-based EMP competence development of excellent doctors characterized by formative assessment / 中华医学教育探索杂志

In accordance with students' learning needs and future professional development, individualized practices of formative assessment are analyzed in terms of diverse evaluators, accumula-tive learning contents, after-class tutoring, thus to maximize student's learning potentials, to be capa-bility-oriented, to make students highly qualified and competent for their future clinical position and academically developed. Additionally, the assessing competence of teachers is vital to the successful implementation of formative assessment. Importantly, each medical university can explore further into the practice of formative evaluation, based on the orientation of itself.

"On the teaching mode of specialized English in the class of""excellent physicians"" based on the educational structure theory" / 中华医学教育探索杂志

Based on the educational structure theory, the difference between mass education and elite education is probed at the macroscopic level to make it clear that the essence of Physician education and training program of excellence is elite education for occupational purposes; at the mi-croscopic level the orientation of English teaching for the class ofexcellent physicians is determined as English for occupational purposes. Moreover, the curriculum system of medical English is designed, and teaching materials associated with clinical medicine are selected, the language laboratory simulat-ing hospital scenes is constructed, and the transboundary team of teachers is built comprising university teachers and doctors in hospitals. At the level of individual, the competency model of English forexcellent physicianshas been developed, English competence requirements in medical industry being clearly established . In a word , the study of macrostructure points out the direction and target of English teaching for excellent physicians; the study of microstructure perfects the mode of English teaching forexcellent physicians;and the study of individual structure indicates the ultimate foothold of English education forexcellent physicians. Three aspects are integrated into an organic whole.

Effect of xy2004, a centchroman derivative, on proliferation of MCF-7 cells in vitro and the mechanism / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of xy2004, a centchroman derivative, on the proliferation of MCF-7 cells and the mechanisms.</p><p><b>METHODS</b>The effects of xy2004 on MCF-7 cell proliferation and apoptosis were evaluated with MTT assay and flow cytometry, respectively. The expressions of the apoptosis-related proteins were examined with Western blotting. Competitive estrogen-receptor binding assay was used to investigate the affinity of xy2004 to estrogen receptors (ER).</p><p><b>RESULTS</b>xy2004 induced proliferation of MCF-7 cells at low concentrations but inhibited cell proliferation at high concentrations. The application of tamoxifen inhibited xy2004-induced proliferation of MCF-7 cells. The relative binding affinity of xy9906 to ERα and ERβ, presented as the IC50 value, was 7.38 × 10⁻³ mol/L and 4.12 × 10⁻⁷ mol/L, respectively. Treatment of MCF-7 cells with high-concentration xy2004 reduced the cellular expression of Bcl-2 protein and increased Bax protein expression.</p><p><b>CONCLUSION</b>At low concentrations, xy2004 directly stimulates the proliferation of MCF -7 cells through ligand-receptor binding, and at high concentrations, it inhibits the cell proliferation by regulating the expression levels of the apoptosis-related proteins.</p>

Changes of cholinergic nerves and tumor necrosis factor-α in doxorubicin-induced rat failing heart / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the changes of cholinergic nerves in doxorubicin (DOX)-induced rat failing heart and tumor necrosis factor-α (TNF-α) in the heart tissue and serum.</p><p><b>METHODS</b>Adult Sprague-Dawley rats were randomized into control (n=10) and DOX-induced chronic heart failure (CHF) groups (n=15), and in the latter group, the rats were given intraperitoneal injections of 2.5 mg/kg DOX once a week for 6 weeks, with a total cumulative dose of 15 mg/kg. The control rats were injected with normal saline (1 ml/week). Karnovsky-Roots histochemical staining combined with point counting was used to demonstrate the distribution of cholinergic nerves in the heart. The expression levels of TNF-α in the heart tissue and serum were determined with ELISA.</p><p><b>RESULTS</b>Positively stained cholinergic nerves were found in all the rat hearts in the two groups, but in CHF group, the point counts of cholinergic nerves were significantly lower than that of the control group (P<0.01). Compared with the control rats, those with DOX-induced CHF showed elevated levels of TNF-α both in the heart tissue and in the serum (P<0.01).</p><p><b>CONCLUSION</b>In rats with DOX-induced CHF, the parasympathetic nervous system is down-regulated in the failing heart, and the diminished cholinergic anti-inflammatory pathway may play an important role in the progression of CHF.</p>

Isolation and purification of lily polysaccharide and its anti-tumor activity / 西安交通大学学报(医学版)

Objective To isolate and purify crude lily polysaccharide and observe anti-tumor activity of the isolated and purified polysaccharide.Methods Crude lily polysaccharide was extracted from lily by water extraction and ethanol precipitation.After dialyzing,de-proteining and freeze-drying,preliminary purification of crude lily polysaccharide was obtained.After being separated by anion-exchange chromatography,preliminary purification was further isolated and purified.Purified lily polysaccharide was given to the H22-bearing mice.The effects of purified lily polysaccharide on tumor weight and immune function were evaluated.Results Crude lily polysaccharide was isolated and purified successfully.After a Sephadex chromatography,the purified polysaccharide showed as a single peak,demonstrating its homogenicity.The purified lily polysaccharide showed an inhibitory effect on H22-bearing mice tumor growth.It significantly increased the weight of immune organs and improved the immune function of the mice.Conclusion The purified lily polysaccharide was homogeneous.It could inhibit H22 tumor growth and enhance non-specific immune functions in H22-bearing mice.This research has laid the foundation for further pharmacological study on lily polysaccharide.