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Guidelines for the diagnosis and management of nonalcoholic fatty liver disease: update 2010: (published in Chinese on Chinese Journal of Hepatology 2010; 18:163-166).

*Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine and Department of Gastroenterology, Shanghai First People’s Hospital, Shanghai, Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, Department of Gastroenterology, First Affiliated Hospital, College of Medicine, Zhejiang University, **Department of Hepatology, Hangzhou Sixth People’s Hospital, Hangzhou, Zhejiang Province, Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province. and Department of Internal Medicine, Prince of Wales Hospital, Shatin, The Chinese University of Hong Kong, Hong Kong SAR, China

Guidelines for the diagnosis and treatment of nonalcoholic fatty liver diseases

Nonalcoholic fatty liver disease (NAFLD) is a clinical and pathological syndrome. The main characteristic is diffuse ballooning fatty degeneration of hepatocytes induced by pathologic factors except alcohol and other known factors that injure liver. NAFLD includes simple fatty liver and nonalcoholic steatohepatitis (NASH) with or without liver cirrhosis. Insulin resistance and genetic susceptibility are closely correlated with NAFLD. Following the greatly increased incidence of obesity and diabetes, NAFLD has become one of the common chronic diseases in our country, severely harming the people’s health. For standardizing the diagnosis, treatment and therapeutic effect evaluation of NAFLD, the Fatty Liver and Alcoholic Liver Disease Study Group of the Chinese Society of Hepatology organized experts in this field to work out guidelines for the diagnosis and treatment of nonalcoholic fatty liver diseases (abbreviated to ‘guidelines’) with reference to the latest worldwide research data and in accordance with the principles of evidence-based medicine. The evidence base categorized into three grades and five levels (Table 1), presented as italicized Rome digits in parentheses. 1

Assessment of fibrosis in chronic liver diseases

The assessment of liver fibrosis provides useful information not only for diagnosis but also for therapeutic decisions. Although liver biopsy is the current gold standard for fibrosis assessment, it has some risks and limitations, including intra‐observer and inter‐observer variation, sampling error and variability. In recent years, many studies and great interest have been dedicated to the development of non‐invasive tests to substitute a liver biopsy for fibrosis assessment and follow up. Advances in serological and radiological tests such as serum marker panels, transient elastography and their combinations can assess fibrosis accurately and reduce the need for a liver biopsy. But at present, all have failed to completely replace a liver biopsy because of their respective limitations and an imperfect gold standard used in current researches. The searching for an ideal surrogate is still in progress.

Guidelines for the diagnosis and management of alcoholic liver disease: Update 2010

*Department of Gastroenterology, First Affiliated Hospital, College of Medicine, Zhejiang University and Department of Hepatology, Hangzhou Sixth People’s Hospital, Hangzhou, Zhejiang Province, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine and Department of Gastroenterology, Shanghai First People’s Hospital, Shanghai, Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, **Department of Hepatology, First Affiliated Hospital, College of Medicine, Jilin University, Changchun, Jilin Province, and Department of Gastroenterology, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China

Guidelines for the diagnosis and treatment of alcoholic liver disease.

Blackwell Publishing Asia Melbourne, Australia CDD hines Journal of Digestive Diseases 1443-9611 573

18α‐glycyrrhetinic acid extracted from Glycyrrhiza radix inhibits proliferation and promotes apoptosis of the hepatic stellate cell line

To evaluate the effect of 18α‐glycyrrhetinic acid (18α‐GA) on the proliferation and apoptosis of hepatic stellate cells (HSCs) and its underlying mechanisms.

Preliminary experimental research on the mechanism of liver bile secretion stimulated by peppermint oil.

OBJECTIVE:  To investigate the choleretic effect and molecular mechanisms of action of peppermint oil (PO), the main component of Danshu capsules (Sichuan Jishengtang Pharmaceutical Co., Ltd., Pengzhou, Sichuan Province, China).

Changes of serum biochemical parameters and liver pathology in 18 patients with 1,1,2,2-tetrachloroethane-induced hepatotoxicity

OBJECTIVE:  To evaluate the changes of serum biochemical parameters and liver pathology in patients with 1,1,2,2‐tetrachloroethane (TTCE)‐induced hepatotoxicity.

MicroRNA profile analysis in the liver fibrotic tissues of chronic hepatitis B patients

We aimed to identify the features of microRNA (miRNA) at different fibrotic stages in patients with hepatitis B virus (HBV)‐related liver fibrosis.

Advances in noninvasive methods for diagnosing nonalcoholic fatty liver disease.

The prevalence of nonalcoholic fatty liver disease (NAFLD), one of the most common chronic liver diseases worldwide, has been increasing. In terms of pathological changes, NAFLD can be divided into simple steatosis, nonalcoholic steatohepatitis (NASH) and liver cirrhosis. Hepatocyte damage and inflammatory activity are the main characteristics for evaluating the progress of liver disease. Early and effective diagnosis of the disease is quite important. Pathological findings based on liver biopsy or resected specimens are considered the gold standard for diagnosing and staging steatosis, fibrosis and cirrhosis; however, it is invasive and may lead to related complications. Non‐imaging methods such as clinical features and biochemical tests, and imaging methods such as ultrasonography, FibroScan, computed tomography and magnetic resonance imaging are the commonly used noninvasive alternatives, being relatively novel, safe and reliable. In this review, we summarized the benefits and shortcomings of these non‐invasive methods for the evaluation of NAFLD.