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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.
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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.
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Objective:To explore the effect of problem-based learning (PBL) combined with case teaching method in the three-year probationary teaching of clinical urology in three-year higher vocational colleges.Methods:A total of 45 students from Class 1, Grade 2015, and 37 students from Class 2, Grade 2016 of Ningxia Medical University were selected as study subjects. They were divided into experimental group and control group. Forty-two students in experimental group were taught with PBL combined with case teaching method. 40 students in control group were taught with traditional clinical probation teaching method. Besides, a questionnaire survey was conducted among two groups of students in the Department of urology.Results:There was no significant difference in the scores of theoretical examination between the experimental group and the control group ( P>0.05). The scores of medical history collection, physical examination, practical skills and total scores were much higher in the experimental group than in the control group. The results of the questionnaire survey showed that the teaching of the experimental group could significantly motivate students' enthusiasm and participation, as well as enhance ability of self-study, information acquisition, innovation, analysis and problem-solving and team consciousness ( P<0.05). Conclusion:The new model of PBL combined with case teaching is helpful in improving students' academic performance, probation effect and comprehensive practical ability in urology internship teaching, which is worth being popularized in clinical teaching.
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Objective: To investigate the effect of carcinoma-associated fibroblasts (CAFs) conditioned medium on the expression of survivin gene in human intrahepatic cholangiocarcinoma HCCC-9810 cells. Methods: The effect of CAFs conditioned medium on the proliferation of HCCC-9810 cells was detected by MTT assay. The effect of CAFs conditioned medium on the cell cycle distribution of HCCC-9810 cells was detected by FCM. The effects of CAFs conditioned medium on the expression levels of survivin mRNA and protein were detected by realtime fluorescent quantitative PCR and Western blotting, respectively. Results: CAFs conditioned medium significantly promoted the proliferation of HCCC-9810 cells (P 0.05). The expression levels of survivin mRNA and protein in HCCC-9810 cells were up-regulated by CAFs conditioned medium (both P < 0.05). Conclusion: CAFs conditioned medium can promote the proliferation and cell cycle progression of HCCC-9810 cells. This effect is related to the up-regulaion of survivin mRNA and protein expressions.
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Objective To discuss the diagnostic value of contrast-enhanced ultrasonography in differentiating benign and malignant tumor of pelvic cavity.Methods From October 2014 to January 2016,abdominal ultrasonography or trans-vaginal ultrasonography were performed among outpatients and inpatients in the First Affiliated Hospital of Kunming Medical University.We found 62 cases with pelvic cavity tumors with 64 lumps,which were detected at cystic mass,cystic-solid mass,and solid mass in conventional ultrasonography.We made the diagnosis of all the lumps by performing contrast-enhanced ultrasonography,observing the infusion process and analyzing perfusion pattern,the intensity of perfusion and time intensity curve.By contrasting the diagnosis and the pathologic and long-term follow-up results,we classified the tumors into two groups,benign and malignant.Then we analyzed the time intensity curve and imaging parameters of the two groups.Restlts Among the total 64 lumps,43 was found in the group of benign tumor and 21 in the group of malignant tumor.Sixty-two were proved by pathologic results and 2 were proved by long-term follow-up results.Benign tumors showed that the infusion flowed from the peripheral to the center and enhanced equably and the vessels were regularly shaped.Malignant tumor showed that the infusion infiltrated from the center to the peripheral and enhanced quickly and unequally,and vessels were distorted.In the time intensity curve,group of benign tumors presented a gently slow raise and fall type,and group of malignant tumors showed a quickly raise and fall type.Rise time (RT) of malignant group (7.70 ± 2.56s) was shorter than benign group (11.40 ± 6.77s) (P＜0.05).Peak intensity (PI) of malignant group (16.30 ± 7.41dB) was higher than benign group (12.12 ± 6.70dB) (P＜0.05).Area Under the Curve (AUC) of malignant group (981.65 ± 548.04 dB s) was bigger than benign group (715.22 ± 651.04dB s) (P＜ 0.05).No difference was found between two groups in Time to Peak (TP) and Mean Transit Time (MTF) (P＞ 0.05).The sensitivity,specificity,positive and negative predictive value of contrast-enhanced ultrasonography were 95.2％,93.0％,86.9％,and 97.5％ respectively.Conclusion Contrast-enhanced ultrasonography ean show an eligible blood perfusion and vascularity of lumps.Analyzing perfusion pattern,time intensity curve,and other parameters can improve capacity of diagnosing and differentiating benign tumor and malignant tumor of pelvic cavity.
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Objective To study the changes of cardiac structure,heart function and pulmonary arterial pressure of the Han Chinese back to the plain after living long time on Tibetan Plateau. Methods Randomly choose 67 cases out of the Han people who have moved to the Tibetan Plateau many years , and been examined to make sure they have no disease caused by other factors. Examine their cardiac structure, heart function, pulmonary arterial pressure and valve flow velocity in Tibetan Plateau and about 60 days later back in plains respectively. Then make statistical analysis of high altitude cardiopulmonary adaptation and de-adaptation reaction according to the differences. Results Only were the values of pulmonary artery systolic pressure (PASP) and tricuspid regurgitation (TR) from the group back to plains lower than those from the group migrated to plateau (P = 0.045; P = 0.041). Other indicators of cardiac structure, heart function, pulmonary arterial pressure and valve flow velocity did not change significantly between the group back to plains and the group migrated to plateau (P > 0.05). Conclusions To Han people who returned to plains about 60 days later after long time staying on plateau , only the values of PASP and TR significantly reduce , which have not recovered to normal levels. This may be correlated with the ageing factor and long time migrating.