Beba sem moderação: motivos das denúncias dos anúncios de cerveja ao Conar / Drink it without moderation: reasons about reportings beer ad to Conar / Bébelo sin moderación: razones en quejas de la anuncios de cerveza a Conar

As propagandas de bebidas alcóolicas, além de serem mais frequentes do que outras mercadorias, também apresentam conteúdo que pode ter papel facilitador no uso dessa substância psicoativa, visto que, na maior parte delas, trazem ideias e sensações de prazer. Por isso, esta pesquisa consistiu na identificação e análise qualitativa de propagandas de cerveja que tiveram alguma denúncia feita ao ou pelo Conselho Nacional de Autorregulamentação Publicitária (Conar), nos últimos cinco anos (2015 a 2020), a partir do levantamento dessas denúncias no site do Conar e, posteriormente, foi realizada análise dos motivos condizentes com o código. Como resultado, constatou-se uma progressão nos alinhamentos entre as denúncias e as decisões, sendo encontrada maior dificuldade no alinhamento da infração em relação ao conteúdo das peças publici-tárias do que em questões técnicas.

Advertisements for alcoholic beverages, in addition to being more frequent than other goods, also present content that can play a role in facilitating the use of this psychoactive substance, since, in most of them, they bring ideas and sensations of pleasure. Therefore, this research consisted of the identification and qualitative analysis of beer advertisements that had any complaints made to or by the National Advertising Self-Regulation Council (Conar), in the last five years (2015 to 2020), based on the survey of these complaints on the website of Conar and, subsequently, an analysis of the reasons consistent with the code was carried out. As a result, there was a progression in the alignments between complaints and decisions, with greater difficulty being found in aligning the infraction in relation to the content of the advertising pieces than in technical issues.

Los anuncios de bebidas alcohólicas, además de ser más frecuentes que los de otros productos, también presentan contenidos que pueden desempeñar un papel a la hora de facilitar el consumo de esta sustan-cia psicoactiva, ya que, en la mayoría de ellos, aportan ideas y sensaciones de placer. Por lo tanto, esta investigación consistió en la identificación y análisis cualitativo de los anuncios de cerveza que tuvieron alguna denuncia realizada ante o por el Consejo Nacional de Autorregulación Publicitaria (Conar), en los últimos cinco años (2015 a 2020), a partir de la encuesta a estos. denuncias en el sitio web del Conar y, posteriormente, se realizó un análisis de los motivos compatibles con el código. Como resultado, hubo una progresión en los alineamientos entre denuncias y decisiones, encontrándose mayor dificultad en alinear la infracción con el contenido de las piezas publicitarias que en cuestiones técnicas.

Evaluación del desempeño de tres puntajes no invasivos para el diagnóstico de fibrosis avanzada en una población con hígado graso no alcohólico / Evaluation of the performance of three non-invasive scores for the diagnosis of advanced fibrosis in a population with non-alcoholic fatty liver disease

Introducción. La enfermedad hepática grasa no alcohólica (EHGNA) es la hepatopatía crónica más común en el mundo, y en aproximadamente el 10 % de los casos progresará a cirrosis o a carcinoma hepatocelular. La presencia de fibrosis hepática es el mejor predictor de esta progresión, pero su diagnóstico mediante biopsia hepática es invasivo y con riesgo de complicaciones (alrededor del 2,5 %). Existen puntajes no invasivos que se han desarrollado y validado para estadificar la fibrosis, pero no conocemos su rendimiento en la población colombiana. El objetivo de este estudio fue evaluar el desempeño de los puntajes fibrosis-4 (FIB-4), la relación AST/ALT y el índice AST/plaquetas (APRI) para la detección de fibrosis avanzada en pacientes colombianos con EHGNA. Metodología. Estudio observacional tipo transversal de pacientes con EHGNA, que entre 2008 y 2022 tuvieran disponible el resultado de una biopsia hepática. Se hizo una descripción demográfica básica y se calculó el FIB-4, la relación AST/ALT y el APRI con los laboratorios más recientes previos al procedimiento. Posteriormente se calcularon valores de sensibilidad, especificidad, valores predictivos, razones de verosimilitud y área bajo la curva-característica operativa del receptor (AUC-ROC) para los puntos de corte evaluados previamente en la literatura. Resultados. Se incluyeron 176 pacientes, de los cuales el 14,3 % tenían fibrosis avanzada. El FIB-4 presentó el mejor rendimiento con un valor AUC-ROC de 0,74 para el punto de corte de 1,30 y 2,67. En segundo lugar, estuvo la relación AST/ALT con un valor AUC-ROC de 0,68 con el punto de corte de 0,8, y finalmente el APRI con valor AUC-ROC 0,62 con el punto de corte de 1. Conclusión. En la población analizada los tres puntajes tienen menor rendimiento diagnóstico comparado a los resultados reportados en Europa y Japón. El FIB-4 es el único que alcanza una AUC-ROC con rendimiento razonable, con la limitación que 27,4 % obtuvieron un resultado indeterminado.

Introduction. Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide, with approximately 10% of cases progressing to cirrhosis or hepatocellular carcinoma. Liver fibrosis presence is the best predictor of this progression, yet its diagnosis through liver biopsy is invasive and poses risk of complications. Although non-invasive scoring systems have been developed and validated for fibrosis staging, their performance remains unexplored in the Colombian population. This study aims to assess the efficacy of the fibrosis-4 (FIB-4) score, AST/ALT ratio, and AST to platelet ratio index (APRI) in detecting advanced fibrosis among Colombian NAFLD patients. Methods. This cross-sectional observational study included NAFLD patients with available liver biopsy results from 2008 to 2022. Basic demographic characteristics were described, and FIB-4, APRI, and AST/ALT ratio were calculated using the latest laboratory data before the procedure. Subsequently, sensitivity, specificity, predictive values, likelihood ratios, and the area under the receiver operating characteristic curve (AUC-ROC) were computed for previously assessed cutoff points. Results. A total of 176 patients were included, among whom 14.3% had advanced fibrosis. FIB-4 demonstrated superior performance with an AUC-ROC value of 0.74 for cutoff points of 1.30 and 2.67. Following was the AST/ALT ratio with an AUC-ROC value of 0.68 for cutoff point of 0.8, and finally, APRI with an AUC-ROC of 0.62 for the cutoff point of 1. Conclusion. All three scores have lower diagnostic efficacy compared to results reported in Europe and Japan. FIB-4 is the only one that achieves an acceptable AUC-ROC performance with the limitation that an indeterminate result was obtained in 27,4% of the sample.

Efecto del confinamiento por COVID-19 en la prevalencia de la enfermedad hepática esteatósica asociada a disfunción metabólica / Effect of COVID-19 lockdown on the prevalence of metabolic dysfunction-associated steatotic liver disease

Introducción. La enfermedad hepática esteatósica asociada a disfunción metabólica (MASLD) es una condición clínica frecuente, relacionada con el sobrepeso, la dislipidemia y la diabetes. Como estos factores de riesgo están a su vez asociados al sedentarismo y la ganancia de peso, se esperaría un impacto como resultado del confinamiento por COVID-19 en la prevalencia de dicha condición. Metodología. Estudio longitudinal retrospectivo en un panel de datos de 132 pacientes de 2017 a 2022, en donde fueron incluidos pacientes con una ecografía hepática y una valoración médica y paraclínica 1,5 años antes y después del periodo de confinamiento (25 de marzo de 2020 a 28 de febrero de 2021). El desenlace primario fue un cambio significativo en la prevalencia de la MASLD, y se utilizó un modelo exploratorio de regresión logística de efectos fijos con panel de datos para hallar los predictores de cambio. Resultados. En un total de 132 pacientes analizados, la prevalencia global de la MASLD antes (31 %; IC95%: 23-39) y después (35,6 %; IC95%: 27,4-43,8) del confinamiento por COVID-19 no cambió significativamente, sin embargo, en las mujeres sí hubo un aumento significativo (RR: 4; IC95%: 1,0004-16). Se encontró una marcada diferencia de prevalencia entre sexos (17 % en mujeres y 46 % en hombres; p=0,001). El confinamiento se asoció a incrementos en la masa corporal (diferencia: +1 kg; IC95%: 0,1-1,9), el colesterol LDL (diferencia: +9,7 mg/dL; IC95%: 4,9-14,4) y al diagnóstico de prediabetes (RR: 2,1; IC95%: 1,4-3,1). La MASLD se asoció positivamente a la preferencia nutricional por la comida rápida (p=0,047). Solo el índice de masa corporal resultó predictor independiente de MASLD (RR: 1,49; IC95%: 1,07-1,93). Conclusión. La prevalencia global de la MASLD no varió después del confinamiento por COVID-19, pero sí se incrementó en mujeres, y algunos de sus factores de riesgo también aumentaron significativamente. Se encontró equivalencia numérica entre la MASLD y la definición previa de la enfermedad. Se requiere un estudio local más grande para desarrollar y validar un mejor modelo predictor del cambio de la MASLD a través del tiempo.

Introduction. Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common clinical condition, related to overweight, dyslipidemia and diabetes. As these risk factors are in turn associated with sedentary lifestyle and weight gain, an impact as a result of the COVID-19 confinement on the prevalence of MASLD would be expected. Methodology. Retrospective longitudinal study in a data panel of 132 patients from 2017 to 2022. Patients with a liver ultrasound and a medical and paraclinical assessment 1.5 years before and after the confinement period (March 25, 2020 to February 28, 2021) were included. The primary outcome was a significant change in the prevalence of MASLD, and an exploratory fixed-effects logistic regression model with panel data was used to find predictors of change. Results. In a total of 132 patients analyzed, the overall prevalence of MASLD before (31%, 95%CI: 23-39) and after (35.6%, 95%CI: 27.4-43.8) confinement by COVID-19 did not change significantly, however, in women there was a significant increase (RR: 4, 95%CI: 1.0004-16). A marked difference in prevalence was found between sexes (17% in women and 46% in men; p=0.001). Confinement was associated with increases in body mass (difference: +1 kg, 95%CI: 0.1-1.9), LDL cholesterol (difference: +9.7 mg/dL, 95%CI: 4.9-14.4) and the diagnosis of prediabetes (RR: 2.1, 95%CI: 1.4-3.1). MASLD was positively associated with nutritional preference for fast food (p=0.047). Only body mass index was an independent predictor of MASLD (RR: 1.49, 95%CI: 1.07-1.93). Conclusion. The overall prevalence of MASLD did not change after the COVID-19 lockdown, but it did increase in women, and some of its risk factors also increased significantly. Numerical equivalence was found between MASLD and the previous definition of the disease. A larger local study is required to develop and validate a better predictor model of MASLD change over time.

Chaihu Guizhi Ganjiang Decoction Improves Non-alcoholic Fatty Liver in Rats Through RIP1/RIP3/MLKL Pathways Inhibiting Necrotic Apoptosis / 广州中医药大学学报

Objective To investigate the therapeutic effect and mechanism of Chaihu Guizhi Ganjiang Decoction on non-alcoholic fatty liver disease(NAFLD)rats.Methods The experiment was conducted in five groups:normal group,model group,low-and high-dose groups of Chinese medicine(Chaihu Guizhi Ganjiang Decoction)and GSK872[receptor interacting protein kinase(RIP)3 inhibitor]group.Except for the normal group,the NAFLD rat model was constructed using high-fat chow feeding method in the remaining groups,respectively.At the end of treatment,hepatocyte apoptosis was observed by terminal transferase uridyl nick end labeling(TUNEL)method,and serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),lipids[total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],and the levels of inflammatory factors tumor necrosis factor α(TNF-α)and interleukin 1β(IL-1β)in liver tissues were measured by enzyme-linked immunosorbent assay(ELISA);and the levels of phosphorylation of RIP1,RIP3,and mixed lineage kinase structural domain-like protein(MLKL)were detected in liver tissues by Western Blot.Results Compared with the normal group,the apoptotic index of rat hepatocytes in the model group was elevated,ALT and AST in serum were significantly elevated,TC,TG and LDL-C levels were significantly elevated,and HDL-C level was significantly reduced,and the contents of TNF-α and IL-1β as well as the phosphorylated expression levels of RIP1,RIP3 and MLKL were significantly elevated in the liver tissues(P＜0.05);compared with the model group,the apoptotic index of hepatocytes in rats in the low-and high-dose groups of Chinese medicine and GSK872 group was reduced,the serum levels of ALT and AST were significantly reduced,the levels of TC,TG and LDL-C were significantly reduced,the level of HDL-C was significantly increased,and the contents of TNF-α and IL-1β and the phosphorylated expressions of RIP1,RIP3 and MLKL in the liver tissues were significantly reduced(P＜0.05);there was no significant difference in the above-mentioned indexes between the low-dose and high-dose groups of Chinese medicine and the GSK872 group(P＞0.05).Conclusion Chaihu Guizhi Ganjiang Decoction can effectively improve NAFLD in rats,and its mechanism may be related to the inhibition of RIP1/RIP3/MLKL signaling pathway activation,which in turn inhibits necrotic apoptosis.

Research progress on the role of ferroptosis in the pathogenesis of non-alcoholic fatty liver disease / 基础医学与临床

Ferroptosis is a new type of cell death proposed in recent years,and its main characteristics are iron overload and lipid peroxidation.Ferroptosis is involved in the occurrence and development of non-alcoholic fatty liv-er disease(NAFLD).Iron overload can generate a large amount of reactive oxygen species through the Fenton reac-tion.Under the action of lipoxygenase,the unsaturated fatty acids on the liver cell membrane undergo lipid peroxi-dation,which induces liver cell death and leads to the occurrence of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis.Blocking ferroptosis may provide one of the therapeutic strategies to protect liver cells.

The Association of Intestinal Flora Metabolite TMAO with Non-alcoholic Fatty Liver Disease / 昆明医科大学学报

Objective To explore the role of TMAO from gut microbiota in non-alcoholic fatty liver disease(NAFLD),we detected the serum level of TMAO and its precursor metabolites in NAFLD,as well as the expression level of Eubacterium rectum,Bacteroidetes multiforme,Lactobacillus and bifidobacterium in the intestinal flora.Methods We collected 118 subjects and divided into NAFLD group(86 cases)and healthy control group(32 cases)randomly.We also detected the serum level of TMAO and its precursor metabolites in subjects by high performance liquid chromatography tandem mass spectrometry detection(LC-MS),and the expression of target bacterial DNA was detected by qRT-PCR.Results Serum TMAO,TMA and choline levels were significantly increased in NAFLD(P<0.05),and liver fat content was positively correlated with TMAO(P<0.05).The expression level of Lactobacillus and Eubacterium rectum in NAFLD group were increased(P<0.05);the expression level of Bifidobacterium and Bacteroides multiform were decreased(P<0.05).The serum TMAO level was positively correlated with Eubacterium rectum(r=0.280,P<0.05),and negatively correlated with Bifidobacterium(r=-0.332,P<0.05).Conclusion The level of TMAO in serum shows a positive correlation with NAFLD.The structure of intestinal flora in individuals with NAFLD is altered and linked to TMAO.This suggests that the intestinal flora may have a significant impact on the development of NAFLD through TMAO.

Research progress in the treatment of AMPK regulating lipid accumulation in the treatment of nonalcoholic fatty liver disease / 实用医学杂志

Non-alcoholic fatty liver disease(NAFLD)is the leading cause of chronic liver disease and has posed significant challenges to global public health and medical care.Due to the unclear pathogenesis of NAFLD,lipid accumulation plays a key role in its development.AMPK,as a crucial molecule in lipid metabolism regulation,can improve lipid accumulation caused by NAFLD.This article describes the specific mechanisms of AMPK-related molecules in improving lipid accumulation and treating NAFLD,and lists the current experimental and therapeutic drugs related to AMPK.The potential of AMPK-related drugs in improving lipid accumulation and treating NAFLD is demonstrated,providing ideas and references for future research on AMPK-related drugs for treating NAFLD.

MiRNA-122 contributes to the effect of exercise on non-alcoholic fatty liver / 中国组织工程研究

BACKGROUND:In recent years,with the improvement of living standards,non-alcoholic fatty liver disease has a gradually increasing trend.miRNA-122 is one of the most abundant microRNAs in the liver,which plays an important role in maintaining the environmental stability and differentiation of the liver.Exercise training is a non-drug treatment for non-alcoholic fatty liver disease,which may improve liver lipid metabolism by regulating the expression of miRNA-122. OBJECTIVE:To review the effects of miRNA-122 on the pathological factors related to non-alcoholic fatty liver disease as well as the effects of exercise on the expression of miRNA-122 and the occurrence and development of nonalcoholic fatty liver disease. METHODS:The first author searched the databases of CNKI,WanFang,VIP,PubMed,Geenmedical,EBSCO,Medline,Web of Science,and Elsevier using"non-alcoholic fatty liver disease,microRNA,microRNA-122,lipid metabolism,inflammatory response,insulin resistance,exercise,physical exercise,exercise training"as the English and Chinese search terms for all relevant literature published before June 5,2022.All included documents were screened,summarized,and analyzed.Finally,68 documents were included for review. RESULTS AND CONCLUSION:Compared with the healthy control group,the expression of circulating miRNA-122 is increased in patients with non-alcoholic fatty liver disease.The level of miRNA-122 may show different expression levels at different stages of non-alcoholic fatty liver disease.miRNA-122 can regulate the expression of downstream-related proteins,influence lipid metabolism,inflammatory response,insulin resistance and other pathogenic factors in non-alcoholic fatty liver disease by targeting base complementary pairing sites on mRNA or directly acting as physiological ligands of some RNA receptors.Different exercise modes can improve non-alcoholic fatty liver disease.Therefore,patients with non-alcoholic fatty liver disease need to complete at least 120 minutes of moderate-intensity exercise every week to have a positive effect.For patients who can tolerate various exercises,priority should be given to the combination of aerobic and resistance exercises 4-5 times a week.The exercise intensity should be 50%-70%of the maximum heart rate and the exercise should last for>3 months.For patients with poor tolerance,resistance exercise may be more feasible than aerobic exercise.In addition,patients with non-alcoholic fatty liver disease can also choose proper exercise modes according to their own disease conditions(such as liver enzymes and lipid levels).Exercise can be used as a feasible strategy to prevent non-alcoholic fatty liver disease,reduce liver steatosis,and alleviate liver inflammatory response and insulin resistance.Exercise training can regulate the expression of miRNA-122,but in patients with non-alcoholic fatty liver disease,the effect of exercise on miRNA-122 and its related signal pathways remains to be studied.

Hepatic lipidomics study in chronic cadmium-exposed mice / 局解手术学杂志

Objective To study the change of lipidomics in chronic cadmium-exposed mice,thereby screening out lipid subclasses,lipid molecules and enriched metabolic pathways with significant differences.Methods Twelve SPF male C57BL/6J mice(8 weeks old)were randomly divided into the control group(normal water feeding)and the experimental group[cadmium water(0.6 mg/L of CdCl2)feeding],with 6 mice in each group.Mice were sacrificed after 6 months of cadmium exposure,and fresh liver tissues were collected immediately.Lipid oil red O staining and lipidomics analysis were performed on liver tissue.Results Compared with the control group,the liver tissue of mice in the experimental group did not appear red after lipid oil red O staining.Seventeen lipid subclasses with significant differences and 144 lipid molecules with significant differences were screened out by lipidomics.These lipid molecules with significant differences were enriched in glycerophospholipid metabolism,linoleic acid metabolism,alpha-linolenic acid metabolism,glycosylphosphati-dylinositol biosynthesis,glycerolipid metabolism and arachidonic acid metabolism by KEGG.Conclusion This study reveals that chronic cadmium exposure can induce the disorder of lipid subclasses and lipid metabolites in the liver of mice,which provides a basis for understanding the non-alcoholic fatty liver disease caused by chronic cadmium exposure.

Ultrasonic quantitative measurement of hepatorenal index for diagnosing non-alcoholic fatty liver disease in children / 中国介入影像与治疗学

Objective To explore the value of ultrasonic quantitative measurement of hepatorenal index(HRI)for diagnosing non-alcoholic fatty liver disease(NAFLD)in children.Methods Abdominal ultrasound and upper abdominal MRI data of 70 obese children were retrospectively analyzed.ROI with different sizes and shapes of liver and right kidney were delineated on longitudinal and transverse ultrasound images,respectively,and the echo intensity of ROIs were measured to obtain HRIsmall ROI on longitudinal section,HRIsmall ROI on transverse section,HRIlarge ROI on longitudinal section and HRIlarge ROI on transverse section,i.e.HRI1,HRI2,HRI3,HRI4,while the gray,skewness and kurtosis of liver ultrasound image were recorded.Liver proton density fat fraction(PDFF)were measured based on MRI,and NAFLD was diagnoses taken PDFF≥6%as standard.The correlations of HRI with PDFF and liver ultrasound image related parameters were analyzed.Taken MRI as the standard,receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of HRI for NAFLD.Multivariate logistic regression analysis was performed taken age,sex,body mass index(BMI)percentile,HRI3 and liver ultrasound image related parameters as independent variables and MRI diagnosis of NAFLD as dependent variable to screen the predictors of MRI diagnosis of NAFLD.Results HRI1,HRI2,HRI3 and HRI4 obtained with ultrasound was 1.89±0.52,1.88±0.55,1.97±0.51 and 1.92±0.55,respectively.PDFF obtained with MRI was(12.53±3.14)%,and diagnosed NAFLD in 34 cases.HRI and PDFF had moderate positive correlation(r=0.51-0.61,all P＜0.01).The correlation between HRI3 and PDFF was the strongest(r=0.61),and HRI3 was weakly correlated with liver gray3(r=-0.270,P=0.020),with area under the curve(AUC)for diagnosing NAFLD of 0.93(P＜0.01).BMI percentile(OR=1.06),HRI3(OR=34.20)and liver gray3(OR=0.79)were all predictive factors for MRI diagnosis of NAFLD.Conclusion Ultrasonic quantitative measurement of HRI had high clinical value for diagnosing NAFLD in children.

Effects of different formulations of high-fat diet on establishment of a non-alcoholic fatty liver model in rats / 中国临床药理学与治疗学

AIM:To improve the success rate of experimental modeling of non-alcoholic fatty liver(NAFLD)in rats by high-fat diet through comparing three different formulations of high-fat diets in con-structing non-alcoholic fatty liver rats model,so as to provide a reliable animal model for the study of non-alcoholic fatty liver disease.METHODS:SPF-grade male SD rats were divided into four groups randomly:control group,high-fat diet group1(HFD1),high-fat diet group2(HFD2),high-fat diet group3(HFD3).Each group was given the corre-sponding feed for 8 weeks while modeling.The da-ta on general observation,body weight changes,and ingestion of the rats were recorded during the modeling period.After 8 weeks'feeding,liver ultra-sound,CT and MRI examination were performed for the rats of each group to check the status.Blood and liver samples were collected.Changes in liver function(ALT,AST),blood lipids(TC,TG,HDL-C,LDL-C),and inflammatory indexes(IL-1β,IL-6,TNF-α)were detected.The morphology of the liv-ers was observed with the naked eyes,and the liv-er index and Lee's index were calculated at the end of 8 weeks.The effects of different high-fat diets on the establishment of NAFLD model in SD rats were comprehensively evaluated by comparing the difference of above indexes among the groups.RE-SULTS:Compared with the control group,rats in the HFD1,HFD2 and HFD3 groups showed poor mental deterioration,decreased activity,severe hair loss,decreased food intake,increased body weights,and significantly increased liver index and Lee's in-dex,along with increased liver volume,blunt edge,steatosis and lipid deposition,and the trend was even more pronounced in the HFD3 group.Com-pared with the control group,the serum levels of ALT,AST,TC,TG,LDL-C,IL-1β,IL-6 and TNF-α were significantly increased,while the contents of HDL-C was significantly decreased in the HFD1,HFD2 and HFD3 group,especially in the HFD3 group.Com-pared with the control group,the B ultrasonogra-phy showed an enlarged liver with enhanced paren-chymal echo and pipe unsharpness,CT showed that the liver and spleen CT ratio decreased obvi-ously,and the MRI images showed obvious differ-ence of liver signal intensity between in/out of phase image in the HFD1,HFD2 and HFD3 group,and the most significant imaging changes was ob-served in the HFD3 group.CONCLUSION:The above three kinds of high-fat diets can establish NAFLD model in SD rats after 8 weeks'feeding,the models induced by HFD3 was better than those in-duced by the other two groups.NAFLD lesion is rel-atively serious and expected to last longer in HFD3 group,which are more suitable for investigating the underlying mechanisms of non-alcoholic fatty liver disease and development of lipid-lowering drugs.

Polyene phosphatidylcholine injection in the treatment of alcoholic liver disease:a systematic review and Meta-analysis / 中国药师

Objective To evaluate the efficacy and safety of polyene phosphatidylcholine injection in the treatment of liver disease.Methods Pubmed,Embase,The Cochrane Library,ClinicalTrial.gov,CNKI,SinoMed,VIP,and WanFang Data were electronically searched to collect randomized controlled trials(RCTs)of polyene phosphatidylcholine injection in the treatment of liver disease from inception to December 31st,2022.Two researchers independently screened literature,extracted data and assessed the risk of bias of the included studies.The Meta-analysis was performed using Stata 17.0 software.Results A total of 10 RCTs were included,including 809 patients.Meta-analysis showed that the effective rate in the polyene phosphatidylcholine injection group was higher than that in the control group(RR=1.12,95％CI 1.04 to 1.20,P=0.003 8).Compared with the control group,polyene phosphatidylcholine injection could decrease ALT level(MD=-18.92 U/L,95％CI-27.75 to-10.09,P＜0.001),AST level(MD=-31.19 U/L,95％CI-46.27 to-16.11,P=0.000 1),TBiL level(MD=-7.31 μmol/L,95％CI-10.75 to-3.88,P＜0.001),and GGT levels(MD=-48.93 U/L,95％CI-54.64 to-43.21,P＜0.001).Only one study reported mild adverse events,and six studies reported no severe adverse events in patients.Conclusion Current evidence shows that polyene phosphatidylcholine injection in the treatment of alcoholic liver disease can increase the effective rate,improve the levels of liver function indicators(ALT,AST,TBiL,and GGT),and has less adverse events.Due to the limited number and quality of included studies,the above conclusions need to be verified by more high-quality studies.

Application of non-invasive inflammation diagnosis model in the diagnosis of non-alcoholic fatty liver disease and liver fibrosis in patients with combined hepatitis B virus infection / 中国医师杂志

Objective:To analyze the application value of non-invasive inflammation diagnosis model in the diagnosis of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) combined with hepatitis B virus (HBV) infection.Methods:A total of 98 patients with NAFLD complicated with HBV infection admitted to some coastal China Coast Guard Hospital of People′s Armed Police from June 2019 to October 2021 were selected. Their liver stiffness (LSM), aspartate aminotransferase to platelet ratio (APRI), γ-glutamyltranspeptidase to platelet ratio (GPR), and fibrosis index based on factor 4 (FIB-4) were measured, The receiver operating characteristic (ROC) curve was used to analyze its clinical diagnostic efficacy for liver fibrosis caused by NAFLD combined with HBV infection.Results:Among 98 patients, there were 7 cases in S0 stage, 47 cases in S1 stage, 21 cases in S2 stage, 14 cases in S3 stage, and 9 cases in S4 stage; Including 35 cases of obvious liver fibrosis and 9 cases of cirrhosis. There was no statistically significant difference in gender and body mass index (BMI) among patients in different stages (all P>0.05). Age: the S0 group<the S1 group<the S2 group<the S3 group<the S4 group ( P<0.05); LSM, APRI, FIB-4: S0 group<S1 group<S2 group<S3 group<S4 group (all P<0.05); The GPR of the S0 and S1 groups was significantly lower than the other groups ( P<0.05), and the S2 group<the S3 group<the S4 group ( P<0.05). The sensitivity and specificity of LSM in diagnosing obvious liver fibrosis were 71.6% and 83.1%, respectively; The sensitivity and specificity of APRI were 61.4% and 80.9%, respectively; The sensitivity and specificity of GPR were 82.3% and 66.8%, respectively; The sensitivity and specificity of FIB-4 were 66.2% and 69.5%, respectively. The sensitivity and specificity of LSM in diagnosing liver cirrhosis were 86.1% and 67.5%, respectively; The sensitivity and specificity of APRI were 77.4% and 75.2%, respectively; The sensitivity and specificity of GPR were 79.6% and 75.3%, respectively; The sensitivity and specificity of FIB-4 were 81.2% and 60.4%, respectively. Conclusions:Patients with NAFLD combined with HBV infection show a significant increase in LSM, APRI, GPR, and FIB-4 as liver fibrosis worsens. These non-invasive inflammatory diagnostic models have certain diagnostic value for liver fibrosis, with LSM and GPR having higher diagnostic efficacy.

Research progress on serological markers of non-alcoholic fatty liver disease / 中国综合临床

The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing year by year, and it has become a serious public health problem that threatens human health.NAFLD patients can progress from simple steatosis to non-alcoholic steatohepatitis (NASH), liver fibrosis, and even cirrhosis without intervention. Therefore, early diagnosis and treatment are particularly important.Liver biopsy is the gold standard for diagnosing NAFLD, but its limitations such as invasion, bleeding, and high cost limit its widespread clinical application. There is an urgent need for sensitive and convenient non-invasive diagnostic methods to achieve early diagnosis and treatment of NAFLD.This article provides a review of the progress in serological diagnostic methods for NAFLD both domestically and internationally in recent years.

Effects of Jianpi Liqi Huashi Prescription on Hepatocellular Damage,Oxidative Stress and Nitrative Stress in Mice with Non-alcoholic Steatohepatitis / 中国中医药信息杂志

Objective To observe the effects of Jianpi Liqi Huashi Prescription on hepatocyte injury,oxidative stress and nitrative stress in mice with non-alcoholic steatohepatitis(NASH);To explore its mechanism in the treatment of NASH.Methods Totally 32 male C57BL/6J mice were randomly divided into control group,model group and TCM low-and high-dosage groups,with 8 mice in each group.The control group was fed with ordinary diet,and the other groups were fed with high-fat diet,for consecutive 16 weeks.Starting from the 13th week,the control group and model group were given 0.4%CMC-Na solution by intragastric administration and the TCM groups were given corresponding doses of drugs by intragastric administration,respectively.Biochemical instrument was used to detect serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)contents,HE staining and oil red O staining were used to detect liver histopathology,triglyceride(TG)content and myeloperoxidase(MPO)activity in liver tissue were detected through test kit.immunofluorescence staining was used to detect positive expression of CD11b in liver tissue,the mRNA expressions of NOX1 and NCF1 were detected by RT-PCR,and the protein expressions of inducible nitric oxide synthase(iNOS)and 3-nitrotyrosine(3-NT)in liver tissue were detected by Western blot.Results Compared with the control group,the hepatocytes in the model group showed diffuse steatosis,hepatocyte swelling and inflammatory cell infiltration;a large number of fat droplets were formed by oil red O staining;serum ALT and AST contents significantly increased(P<0.05),the TG content and MPO activity in liver tissue significantly increased(P<0.05);the positive expression of CD11b in liver tissue increased;the mRNA expressions of NOX1 and NCF1 in liver tissue significantly increased(P<0.05);the expressions of iNOS and 3-NT protein in liver tissue significantly increased(P<0.05).Compared with the model group,the degree of liver steatosis,the level of inflammatory cell infiltration and the number of lipid droplets in TCM groups decreased significantly;serum ALT and AST contents significantly decreased(P<0.05);the TG contents and MPO activity in liver tissue significantly decreased(P<0.05);the positive expression of CD11b in liver tissue decreased;the mRNA expressions of NOX1 and NCF1 in liver tissue significantly decreased(P<0.05);the expression of 3-NT protein in liver tissue significantly decreased(P<0.05);the expression of iNOS protein in liver tissue of mice in TCM high-dosage group significantly decreased(P<0.05).Conclusion Jianpi Liqi Huashi Prescription may relieve liver cell damage,lipid deposition and inflammation in NASH mice by alleviating oxidative stress and nitrative stress in the liver,and play a role in the treatment of NASH.

Pathological diagnosis of alcoholic liver disease / 临床肝胆病杂志

Alcoholic liver disease （ALD） is a liver disease caused by long-term heavy drinking. With the improvement in the living standard of Chinese people， the incidence rate of ALD tends to increase significantly. The typical pathological patterns of ALD include alcoholic steatosis， alcoholic steatohepatitis， liver fibrosis， and alcoholic cirrhosis. The diverse and complex pathological morphology of ALD and its similarities with other liver diseases pose a great challenge to pathologists. This article reviews the histopathological morphology， grading and staging systems， and differential diagnosis of ALD.

Population distribution of non-alcoholic fatty liver disease before and after renaming and risk factors for liver fibrosis in metabolic dysfunction-associated steatotic liver disease / 临床肝胆病杂志

ObjectiveTo investigate the population distribution of non-alcoholic fatty liver disease before and after renaming and the association between the types of metabolic risk factors （MRF） for metabolic dysfunction-associated steatotic liver disease （MASLD） and advanced liver fibrosis. MethodsThis study was conducted among 515 patients who were admitted to The Affiliated Hospital of Xuzhou Medical University and Wuxi Fifth People’s Hospital from January 2019 to January 2022 and had hepatocyte steatosis ≥5% by liver biopsy. Among these patients， 2 patients did not meet the diagnostic criteria for nonalcoholic fatty liver disease （NAFLD） and metabolic associated fatty liver disease （MAFLD）， respectively， and were classified as steatotic liver disease （SLD） with other specific causes， and the other 513 patients were divided into MASLD group with 275 patients， comorbid group with 216 patients （MASLD comorbid with other liver diseases）， and cryptogenic SLD group with 22 patients. The above groups were compared in terms of clinical features， laboratory markers， and advanced liver fibrosis. The MASLD patients with different types of MRF were compared in terms of clinical features， laboratory markers， and advanced liver fibrosis， and the risk factors for advanced liver fibrosis in patients with MASLD were analyzed. The Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups and further comparison between two groups； the chi-square test was used for comparison of categorical data between multiple groups， and Bonferroni correction was used for further comparison between two groups. The logistic regression analysis was used to identify the risk factors for liver fibrosis. ResultsAmong the 515 patients with SLD， 297 patients （57.7%） met the diagnostic criteria for NAFLD， among whom 22 were classified as cryptogenic SLD and 275 met the diagnostic criteria for MASLD， and 467 （90.7%） were diagnosed with MAFLD. There were significant differences between the three groups in sex， body mass index （BMI）， gamma-glutamyl transpeptidase， triglyceride， cholesterol， low-density lipoprotein cholesterol， high-density lipoprotein cholesterol， fasting plasma glucose， NAFLD fibrosis score （NFS）， fibrosis-4 （FIB-4）， and F3-4 （all P<0.05）. Compared with the MASLD group and the cryptogenic SLD group， the comorbid group had the highest proportion of patients with advanced liver fibrosis （P<0.001）. With the increase in the type of MRF， the patients tended to have an older age， a significantly higher proportion of female patients， a higher possibility of hypertension and diabetes， and higher levels of metabolic parameters including BMI， blood lipids， and blood glucose （all P<0.05）. With the increase in the types of MRF in MASLD patients， they tended to have significantly higher noninvasive fibrosis scores （NFS and FIB-4） and a significantly higher proportion of patients with advanced liver fibrosis （P<0.05）. The multivariate logistic regression analysis showed that age ≥50 years （odds ratio ［OR］=2.622， 95% confidence interval ［CI］： 1.091‍ ‍—‍ ‍6.300， P=0.031） and the increase in the type of MRF （OR=1.876， 95%CI： 1.194‍ ‍—‍ ‍2.947， P=0.006） were independent risk factors for MASLD with severe liver fibrosis. ConclusionThe new definition of MASLD is based on the positive identification of MRF， and the reclassified population of MASLD is smaller than that of MAFLD， with little difference from that of NAFLD. In addition， age ≥50 years and the increase in the type of MRF are independent risk factors for MASLD with advanced liver fibrosis.

Advances in the multi-omics research on nonalcoholic fatty liver disease / 临床肝胆病杂志

The prevalence rate of nonalcoholic fatty liver disease （NAFLD） reaches up to 30% around the world， and the disease has a serious impact on human health and constitutes a public health burden. Due to difficulties in the diagnosis and monitoring of NAFLD， it is important to identify potential drug targets and biomarkers， and multi-omics techniques hold great promise in the search for early diagnostic markers， therapeutic targets， and outcome and prognostic assessment of NAFLD. This article reviews the research advances in multi-omics techniques in the field of NAFLD in recent years， in order to provide a richer theoretical basis and new strategies for the prevention and treatment of NAFLD.

Exercise intervention prescription for postmenopausal women with nonalcoholic fatty liver disease and related comorbidities / 临床肝胆病杂志

The prevalence rate of nonalcoholic fatty liver disease （NAFLD） in postmenopausal women is significantly higher than that in premenopausal women and even exceeds that in men of the same age group， and exercise intervention remains an effective method for the prevention and treatment of NAFLD in postmenopausal women. In addition， postmenopausal women with NAFLD often have comorbidities such as sarcopenia， osteoporosis， cardiovascular diseases， and diabetes， which requires targeted exercise prescriptions and proactive intervention for potential comorbidities. Through a literature review， this article provides targeted recommendations for exercise intervention prescriptions in postmenopausal women with NAFLD and related comorbidities.

Application study of non-alcoholic steatohepatitis based on radiomics of computed tomography / 中国现代医生

Objective To construct and validate a whole liver radiomics model based on computed tomography(CT)to identify patients with non-alcoholic steatohepatitis(NASH).Methods A total of 122 patients with nonalcoholic fatty liver disease treated in Zhejiang Provincial People's Hospital from June 2018 to December 2022 were retrospectively selected,including 52 patients with NASH.They were randomly divided into training group(n=85)and test group(n=37)according to a ratio of 7:3,and the liver plain scan images of each patient were selected to extract the radiomics features.The extracted features of the training group were dimensioned down and the radiomics signature was established.After that,a joint model was constructed with relevant clinical features to identify NASH patients,and the diagnostic effectiveness of the model was evaluated using receiver operating characteristic curve and test group data.Results The joint model was constructed based on age and radiomics labels.The diagnostic efficiency of the model for identifying NASH patients in training group and test group were 0.899 and 0.880,the specificity were 91.2%and 88.1%,and the sensitivity were 86.7%and 88.2%,respectively.In addition,the calibration curve also showed good calibration performance in training group and test group.Conclusion The joint model based on liver CT can quantitatively evaluate NASH,and is expected to provide a non-invasive evaluation tool for clinical use.