Chronic Hepatitis B Patients with Nonalcoholic Fatty Liver Disease R.D. Zheng 1 , C.R. Xu 1 , J. Chen 1 , B.F. Chen 1 1 Southeast Hospital Background: To investigate clinical pathological characteristic in HBeAg negative Chronic hepatitis B (CHB) patients with nonalcoholic fatty liver disease (NAFLD). Methods: We measured fasting blood glucose, insulin, triglyceride, cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST) in HBeAg negative chronic hepatitis B (CHB) patients with nonalcoholic fatty liver disease (NAFLD). And we detected Hepatitis B Virus marker, HBV-DNA, counted body mass index, insulin resistance index and observed pathological characteristic. All these patients with diagnosis were confirmed by clinical and pathological evidence. Result : The body mass index, homeostatic model assessment (HOMA) of insulin resistance, fasting blood glucose, insulin, triglycerides, cholesterol, were significantly higher in HBeAg negative chronic hepatitis B (CHB) patients with nonalcoholic fatty liver disease (NAFLD) than HBeAg negative chronic hepatitis B patients. But the alanine aminotransferase (ALT), aspartate aminotransferase (AST), HBV DNA levels were significantly lower in HBeAg negative CHB patients with NAFLD than in HBeAg negative chronic hepatitis B patients. Histologic features in HBeAg negative chronic hepatitis B(CHB) patients with nonalcoholic fatty liver disease (NAFLD) are in zone 3 predominate macrovesicular steatosis and mild inflammatory infiltrate in portal region. Conclusion: The HBeAg negative chronic hepatitis B (CHB) patients with nonalcoholic fatty liver disease, whose hepatic steatosis changes are mainly caused by the metabolic factors. To carry out liver biopsy selectively for the patients with HBeAg negative chronic hepatitis B having metabolic factors, which is helpful for early diagnosis in HBeAg negative chronic hepatitis B (CHB) patients with nonalcoholic fatty liver disease (NAFLD). Aims: To investigate the preventive effect of Cordyceps sinensis and its possible mechanism on apoptosis of NAFLD. Methods: Rats were randomly divided into basic diet group (B group), pathologic group (NASH group) and cordyceps sinensis group(CS group).The latter two groups were administered with high-fat diet to establish NAFLD animal models. CS group were treated with CS at the 9th week after high fat diet. Rats were sacrificed at the end of the 18th week. Biochemical examination were used to detect superoxide dismutase (SOD) of liver tissue. Hepatocyte apoptosis was assessed in each group using the TUNEL assay and immunohistochemistry for activated Bax Bcl-2 Caspase-3 and NF-kB P65. Results: (1) Compated with the B group, severe hepatosteatosis, inflammative necrosis and local fibrigenisis were showed in liver of NFSH group. SOD lever was significantly decreased (P<0.01) and TUNEL-positive cells were significantly increased (P<0.01). Immuunohistochemistry test demonstrated active Bax Caspase-3was increased (P<0.01) while no apparent change was observed in Bcl-2. (2) In CS group, only diffusive steatosis but not inflammation or fibrosis was found. SOD lever was increased than that of NASH group (P<0.05). TUNEL-positive cells and active Bax Caspase-3 were significantly decreased (P<0.05 P<0.01) that those of NASH group. Bcl-2 and NF-kB P65 were increased (P<0.01) than those of NASH group. Conclusions: Hepatocyte apoptosis is a prominent feature of NAFLD. Cordyceps sinensis may be useful as an antiapoptosis theraphy in this syndrome through increasing activity of SOD, decreasing express of Bax and increasing express of Bcl-2 and NF-kB P65. Background: Non-alcoholic steatohepatitis (NASH) is a leading cause of chronic liver disease. Insulin-sensitizing , anti-inflammatory and anti-fibrotic effect of thiazolidinediones support their use in the treatment of NASH. We aimed to evaluate the efficacy of thiazolidinediones in the treatment of NASH. Methods: We have identified randomised clinical trials, evaluating the efficacy of thiazolidinediones versus placebo in NASH, through MEDLINE, EMBASE, AMI, Cochrane Central Register of Controlled trials. Data were abstracted from each study and disagreements were resolved by consensus. Dichotomous outcomes were reported as relative risk with 95% confidence interval based on fixed-effects model. Results: We included three trials, two evaluating pioglitazone and another rosiglitazone. A total of 171 patients were involved in the analysis. Thiazolidinediones was noted to improve liver function tests. It was effective in the reduction of steatosis among patients with NASH (RR 0.67, 95% CI 0.52-0.87). It was found to be beneficial in improving ballooning necrosis (RR 0.79, 95% CI 0.66-0.95). It was also found to improve lobular inflammation (RR 0.72, Background: It is well known that the weight reduction is effective for ALT normalization in patients with non-alcoholic fatty liver disease (NAFLD). The necessary condition for ALT normalization is still unclear. To clarify the necessary and sufficient condition for ALT normalization, we investigated the effects of body fat decrease in NAFLD patients by body composition analyzer. Methods: Forty-six NAFLD patients (23 male, 23 female, mean age 49.8±12.9 years old) with abnormal ALT levels were evaluated. The volume of skeletal muscle, body fat and BMR were examined by using the body composition analyzer (In Body 720; Biospace Co. Ltd., Tokyo Japan). All patients were received an individualized diet consultation by dietician every 4 weeks for 6 months. Daily energy was BMR (basal metabolic rate) x1.2 kcal and protein was 1.0-1.2g per ideal body weight. Result: Twenty-eight of 46 patients (60.9%) were achieved normal ALT level. In ALT normalized group, the body weight and fat loss were 3.6±2.3 kg, 3.0±1.5kg (2.8±1.7 %body fat) respectively. On the other hand, in cases with ALT remained abnormal level, the body weight and fat loss were 0.5±1.5kg, 0.4±1.6kg (0.5±1.6 %body fat). Conclusion: Our results demonstrate that the fat loss of 3 kilograms or more was necessary to normalize ALT level in NAFLD patients.