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Although many Chinese and international guidelines offer recommendations for the treatment of nonalcoholic fatty liver disease (NAFLD), there are also confusions in clinical practice, including the differences in drug indications, drug selection, the basic principles of lifestyle intervention, and key points in individual regimens between Chinese and international guidelines. In addition, there are also differences in many aspects including medical model and medical insurance system between the East and the West. These differences are great challenges for clinical practice, and the hepatologists in China have to face the challenges of localization when following the guidelines for the treatment of NAFLD.
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Objective To investigate the association of serum uric acid level with glomerular filtration rate and explore the predictive value of the physiological uric acid levels for reduced renal function.Methods A total of 6 532 subjects from Karemary community and 2 402 subjects from the First Affiliated Hospital of Xinjiang Medical University were enrolled.All subjects were surveyed with questionnaire and their serum biochemical indices and liver functions were measured.Meanwhile,a cohort study was conducted,752 subjects with normal renal function were selected from young and middle-aged healthy people in 2008.During the 3-year follow-up,the incidence of reduced renal function and the risk factors of estimated glomerular filtration rate (eGFR) were analyzed.Results Serum uric acid (SUA) was the independent risk factor of reduced GFR in cross-sectional analysis.The 2 groups were stratified by sex and age,except for female population over 45 years old in the first group,the level of physiological serum uric acid was the risk factor for decreased eGFR in the rest of groups.During 3-year follow-up,the incidence of reduced renal function was 15.40％ and SUA was the independent risk factor of decreased eGFR.Conclusions The concentration of physiological serum uric acid was closely related with renal function,and the increase in SUA whthin normal range had an important early predictive value for decreased GFR.
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Objective To explore the association of serum uric acid level with non-alcoholic fatty liver disease(NAFLD) in Han and Uyghur ethnic groups.Methods A cross-sectional study was performed in the population in 2011 in the First Affiliated Hospital of Xinjiang Medical University.The study included 2439 Uyghurs and 2285 Hans with a questionnaire survey,and body mass index (BMI),waist circumference,blood pressure,blood glucose,blood lipid,and serum uric acid (SUA) level were measured.The participants were divided into 4 groups according to the quartiles of the SUA levels within the normal range,and those with SUA levels above the normal range served as hyperuricemia group.The associations between serum uric acid level and prevalence of non-alcoholic fatty liver,hyperuricemia,and metabolic syndrome (MS,including each component of MS) were analyzed.Results Among Uyghurs and Hans,the detection rates of NAFLD were 26.7％ and 23.6％ respectively,the detection rates of hyperuricemia were 7.8％ and 18.2％,and the level of serum uric acid in Uyghur group was lower than that in Han group (P＜0.01).The detection rate of NAFLD in the hyperuricemia patients was significantly higher than that in nonhyperuricemia group.Among the Uyghurs and Hans,the detection rates of NAFLD in the hyperuricenia patients were 24.0％ and 19.9％.The detection rate of NAFLD was positively associated with concentration of serum acid even that within the normal range.Conclusion The relationship between the level of serum uric acid and the prevalence of NAFLD is more evident in Uyghur than that in Han.
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We produced high pathogenic avian influenza H5N1 haemagglutinin protein HA1 in recombinant Pichia pastoris in a 10 L fermentor, to establish a high-density cell fermentation method. We studied the effects of different factors such as culture temperature, induced temperature, methanol feeding methods, trace elements on the growth of Pichia pastoris, the yield and the biologic activity of recombinant HA1 protein. The culture temperature in pre-induced and induced stage were optimized at 25 degrees C to adapt cell growth and recombinant protein expression, and induced temperature at 25 degrees C also resulted in higher biologic activity of rHA1 than at 30 degrees C. The binding activity of rHA1 against a wide-spectrum neutralizing antibody was susceptible to the presence of any trace elements, although trace elements would essentially benefit for the cell fermentation. As a conclusion, the expression level of rHA1 produced with optimized fermentation process reached 120 mg/L, which was 10.5 times higher than the one produced in regular shaking flask. The resultant high-density cell fermentation can likely produce rHA1 of H5N1 in large scale.