AIMTo test the hypothesis that K8/K18 variants predispose humans to non-alcoholic fatty liver disease (NAFLD) progression and its metabolic phenotypes.METHODSWe selected a total of 373 unrelated adult subjects from our Physical Examination Department, including 200 unrelated NAFLD patients and 173 controls of both genders and different ages. Diagnoses of NAFLD were established according to ultrasonic signs of fatty liver. All subjects were tested for population characteristics, lipid profile, liver tests, as well as glucose tests. Genomic DNA was obtained from peripheral blood with a DNeasy Tissue Kit. K8/K18 coding regions were analyzed, including 15 exons and exon-intron boundaries.RESULTSAmong 200 NAFLD patients, 10 (5%) heterozygous carriers of keratin variants were identified. There were 5 amino-acid-altering heterozygous variants and 6 non-coding heterozygous variants. One novel amino-acid-altering heterozygous variant (K18 N193S) and three novel non-coding variants were observed (K8 IVS5-9A→G, K8 IVS6+19G→A, K18 T195T). A total of 9 patients had a single variant and 1 patient had compound variants (K18 N193S+K8 IVS3-15C→G). Only one R341H variant was found in the control group (1 of 173, 0.58%). The frequency of keratin variants in NAFLD patients was significantly higher than that in the control group (5% vs 0.58%, P = 0.015). Notably, the keratin variants were significantly associated with insulin resistance (IR) in NAFLD patients (8.86% in NAFLD patients with IR vs 2.5% in NAFLD patients without IR, P = 0.043).CONCLUSIONK8/K18 variants are overrepresented in Chinese NAFLD patients and might accelerate liver fat storage through IR.

Background Insulin resistance (IR) related metabolic disorders are associated with a worse prognosis of chronic hepatitis B virus (CHB) infection or nonalcoholic fatty liver disease (NAFLD). However, the relationships among CHB, steatosis, IR and metabolic factors remain controversial. The study aims to evaluate the impact of insulin resistance severity on metabolic profiles in patients with CHB, NAFLD and the coincidence of the two. Methods We conducted a cross-sectional study between January 2011 and December 2018 that included 2768 consecutive Chinese subjects (healthy controls: 667, CHB: 970, NAFLD: 878, CHB with NAFLD: 253). IR was determined with the homeostasis model assessment for insulin resistance (HOMA-IR). Metabolic measures included fasting serum insulin, glucose, lipid profiles and uric acid. Results The prevalence of IR was increased in CHB with NAFLD subjects compared with that in control subjects or subjects with CHB or NAFLD alone (41.5% vs 2.9%/11.9%/36.9%, respectively; P < 0.001). Within NAFLD and CHB with NAFLD group, the frequency of metabolic syndrome, hypertension and hyperuricemia increased as the HOMA-IR category increased ( P for trend < 0.05). A higher risk for total cholesterol, low-density lipoprotein cholesterol and elevated alanine transaminase was observed with IR in the CHB with NAFLD group compared with that in the other groups, while no stepwise increase in hypertriglyceridemia was found in HOMA-IR in the CHB with NAFLD group. Conclusion Insulin resistance is highly prevalent in patients with CHB combined with NAFLD, and the increased metabolic risk, rather than hypertriglyceridemia, is driven by IR in CHB combined with NAFLD.

Objective: To study the clinical effects of emergency surgery in treating patients with acute abdominal pain. Methods: 60 patients admitted to our hospital between January 2019 and December 2019 were randomly selected as subjects, and the incidence of complications and mortality of the patients were observed. Results: Among the 60 patients, definitive diagnosis was obtained during the operation and there was no mortality. After the operation, they were transferred to other relevant departments for continued treatment. Among the 60 patients, 4 cases had complications, accounted for incidence of 6.67%. Conclusion: The diagnosis of emergency surgical treatment based on acute abdominal pain avoided misdiagnosis and realized non-invasive diagnosis, and provided a valid reference for avoiding overtreatment.