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, Volume 47 Issue 4 Previous Issue    Next Issue
Key anatomies of DeLancey's three levels of vaginal support theory: an observation in laparoscopic surgery
ZHAO Xiaofeng,CHEN Gongli,LEI Ling,WU Xiaomei,LIU Shikai,WANG Juntao,HU Bin,LYU Weiguo
J Zhejiang Univ (Med Sci), 2018, 47(4): 329-337.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.01
Abstract( 353 )   HTML( 23 )     PDF(1321KB)( 90 )

Objective: To observe and verify the key anatomies of DeLancey's three levels of vaginal support theory through laparoscopic surgery by space dissection technique. Methods: The features and stress performance of related anatomies were observed and analyzed in laparoscopic type C hysterectomy and pelvic lymphadenectomy for cervical cancer by natural space exposures. Results: The main ligament-like structure at level Ⅰ was the uterosacral ligament, which acted as the main apical fixation in the sacral direction, while the cardinal ligament was mainly composed of vascular system, lymph-vessels and loose connective tissue around them, lacking the tough connective tissue structures, which was connected to the internal iliac vascular system. There were no strong ligaments connected to the tendinous arch of pelvic fascia (ATFP) at the lateral side of vaginal wall at level Ⅱ. ATFP was the edge of the superior fascia of pelvic diaphragm, which was bounded by the fascia of the obturator. Its surface was smooth and close to the levator ani muscle and fuses with the vaginal fascia in about one thirds of middle lower segments of the vagina. When the ureter tunnel is separated, dense connective structures can be found in both anterior and posterior walls near the intersection of the ureter across uterine artery, fixing the bilateral angle of the bladder triangle, starting from the cervix and vagina and ending in the tunica muscularis vesicae urinariae. Conclusion: Based on the laparoscopic anatomy, the pelvic floor fascia ligament support above the levator ani muscle can be considered mainly around the vagina, and fascial ligament above the levator ani muscle can be simply considered as two parallel planes forming a "double hammock" structure, which may provide more anatomic data for pelvic floor reconstruction.

Precision screening and treatment of human papilloma virus related cervical cancer
HU Zheng,MA Ding
J Zhejiang Univ (Med Sci), 2018, 47(4): 338-343.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.02
Abstract( 289 )   HTML( 12 )     PDF(1018KB)( 95 )

Cervical cancer is a complex disease caused by both genetic susceptibility and environmental factors. Inherited genomic variance, high-risk human papilloma virus (HPV) infection/integration, genome methylation and somatic mutation could all constitute one machine learning model, laying the ground for molecular classification and the precision medicine of cervical cancer. Therefore, for cervical screening, next generation sequencing (NGS)-based HPV DNA and other molecular tests as well as dynamic machine learning models would accurately predict patients with potential to develop the cancer, thereby reducing the burden of repeated screening. Meantime, genome-editing tools targeting HPV would emerge as the next generation gene therapy for HPV-related cervical lesions. In this article, we review the substantial progress on molecular mechanism of cervical cancer development and suggest the future for precise prevention and early treatment of cervical cancer.

Value of combined detection of claudin 4 and high-risk human papilloma virus in high-grade squamous intraepithelial lesion and cervix squamous cell carcinoma
DI Chenhong,JIN Fan
J Zhejiang Univ (Med Sci), 2018, 47(4): 344-350.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.03
Abstract( 205 )   HTML( 6 )     PDF(1028KB)( 32 )

Objective: To investigate the expression of claudin 4 (CLDN4) in cervical tissues from patients with different cervical lesions, and to explore the value of combined detection of CLDN4 and high risk human papilloma virus (HR-HPV). Methods: The cervical tissue specimens of low-grade squamous intraepithelial lesion (LSIL, n=30), high-grade squamous intraepithelial lesion (HSIL, n=30), squamous cell carcinoma (SCC, n=30) as well as chronic cervicitis (control, n=30) were collected from the Sir Run Run Shaw Hospital of Zhejiang University during June 2015 and December 2016. The expression of CLDN4 protein in tissue specimens was detected by immunohistochemistry, HR-HPV was detected by real-time quantitative PCR, and the cervical exfoliated cells were examined by thinprep cytologic test (TCT). The ROC curve was applied to analyze the diagnostic value of TCT combined with HR-HPV and CLDN4 combined with HR-HPV tests for HSIL and SCC of the cervix. Results: With the increase of the severity of cervical lesions, the positive rate of CLDN4 expression rose (r=0.832, P < 0.05). Positivity of both HR-HPV infection and CLDN4 expression was found mainly in the HSIL and SCC groups. The areas under curve (AUC) of TCT combined with HR-HPV and CLDN4 combined with HR-HPV tests for diagnosis of HSIL and SCC were 0.683 and 0.633, respectively; the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TCT combined with HR-HPV test for diagnosis of HSIL and SCC were 100.0%, 36.7%, 61.2%, 100.0% and 46.7% respectively; those of CLDN4 combined with HR-HPV test were 96.7%, 30.0%, 58.0%, 90.0% and 55.0%, respectively. Conclusions: CLDN4 expression may be related to the occurrence and development of cervical carcinoma and precancerous lesions. CLDN4 combined with HR-HPV test may be used for diagnosis of HSIL and SCC of the cervix clinically.

Establishment of a prognostic model for preterm delivery in women after cervical conization
LOU Yelin,ZHOU Yimin,LU Hong,LYU Weiguo
J Zhejiang Univ (Med Sci), 2018, 47(4): 351-356.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.04
Abstract( 184 )   HTML( 4 )     PDF(978KB)( 40 )

Objective: To establish a prognostic model for preterm birth in women after cervical conization, and to evaluate its effectiveness. Methods: Seventy three women after cervical conization in Women's Hospital of Zhejiang University were included for this retrospective study. The influencing factors of preterm delivery were analyzed by Logistic regression analysis and a prognostic model was created. Receiver operating characteristic (ROC) curve was used for evaluation of the predictive ability of the model. Forty five women who underwent cervical conization were included for testing the validity of the model. Results: For women after cervical conization, mother's age (OR=1.20, 95%CI:1.01-1.43, P < 0.05) and cervical length during middle pregnancy (OR=0.06, 95%CI:0.01-0.21, P < 0.01) were independent predictors for preterm birth. The regression model was Logit (P)=1.408-2.903×cervical length+0.186×age. The areas under the ROC curve (AUC) of the training dataset was 0.93 (95%CI:0.87-0.99). The sensitivity, specificity, Youden index, positive predictive value (PPV), negative predictive value (NPV) and accuracy with the cutoff value of -1.512 were 91.7%, 81.5%, 0.732, 68.8%, 95.7% and 84.5% respectively. The AUC of the testing dataset was 0.94 (95%CI:0.86-1.00). The sensitivity, specificity, Youden index, PPV, NPV and accuracy with the cutoff value of -0.099 were 92.9%, 90.3%, 0.832, 81.3%, 96.5% and 91.1%, respectively. Conclusion: The model based on the age and cervical length during middle pregnancy can effectively predict preterm delivery in pregnant women after cervical conization.

Clinical features and prognosis of cervical adenocarcinoma and adenosquamous carcinoma: an analysis of 237 cases
CHEN Qian,LIU Lu,ZHANG Jingjing,HAN Sai,CUI Baoxia,ZHANG Youzhong,KONG Beihua
J Zhejiang Univ (Med Sci), 2018, 47(4): 357-361.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.05
Abstract( 210 )   HTML( 3 )     PDF(997KB)( 41 )

Objective: To analyze the clinical features and prognosis of cervical adenocarcinoma (AC) and adenosquamous carcinoma of cervix (ASC). Methods: The clinical data of 237 patients, including 201 cases of AC and 36 cases of ASC (FIGO stage ⅠB1-ⅡA), who underwent surgery in Qilu Hospital between September 2007 and September 2016 were reviewed. Clinical features of two groups were compared, and Kaplan-Meier survival analysis was performed to evaluate the prognosis. Results: A larger proportion of ASC patients had lymphovascular space invasion compared with AC patients (P < 0.01), but no significant differences were observed in the age, FIGO stage, size of tumor, depth of stromal invasion, parametrial invasion, lymphatic metastasis and risk grade between two groups (all P>0.05). The 5-year overall survival rates of AC and ASC groups were 79.4% and 78.3%, and the 5-year recurrence-free survival rates were 77.4% and 73.0%. Among patients received concurrent chemoradiotherapy, the 5-year overall survival rates were 71.0% and 61.4%, and the 5-year recurrence-free survival rates were 68.8% abd 61.1%, respectively. No significant differences were observed in 5-year overall survival rates and recurrence-free survival rates between AC and ASC patients (all P>0.05). Conclusion: Lymphovascular space invasion was more likely to occur in patients with ASC, but there was no significant difference in the prognosis between AC and ASC patients.

Paraffin section thickness in immunohistochemical detection of p16 expression in cervical tissue samples
CHEN Zhiqiang,MI Xianjun,CHEN Ang,DUAN Lifeng,DAI Xinzhen,DENG Wentong
J Zhejiang Univ (Med Sci), 2018, 47(4): 362-366.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.06
Abstract( 191 )   HTML( 1 )     PDF(1031KB)( 19 )

Objective: To investigate paraffin section thickness in immunohistochemical detection of p16 expression in cervical tissue samples. Methods: p16 immunohistochemical staining was performed in 150 cases of chronic cervicitis, 126 cases of low-grade squamous intraepithelial lesions(LSIL), 96 cases of high-grade squamous intraepithelial lesions (HSIL) and 78 cases of cervical cancer from January 2014 to March 2018 in Zhongshan Boai Hospital. The results of p16 protein expression in paraffin sections with thickness of 2, 3, 4, 5 and 6 μm were compared using Logistic regression analysis. Results: With the increase of slice thickness, the staining of p16 protein in nucleus gradually increased. The thickness of cervical slices in chronic cervicitis and cervical cancer samples had no significant effect on the positive rate of p16 protein(χ2=7.817 and 1.332, both P>0.05), while the thickness of slices in LSIL and HSIL samples had significant effect on the positive rate of p16 protein (χ2=17.688 and 10.182, P < 0.05 or P < 0.01). The stable and reliable results were obtained when the slices were between 3 and 5 μm thick. Conclusion: Paraffin sections with thickness of 3.0-5.0 μm are recommended for immnohistochemical staining of p16 protein in cervical tissue samples.

Incidence of lung cancer in Jiashan, Zhejiang province: trend analysis from 1987 to 2016 and projection from 2017 to 2019
LI Chen,ZHU Yao,YANG Jinhua,XU Dongsheng,WANG Jianbing,CHEN Kun,LI Qilong
J Zhejiang Univ (Med Sci), 2018, 47(4): 367-373.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.07
Abstract( 171 )   HTML( 2 )     PDF(1031KB)( 61 )

Objective: To predict the incidence of lung cancer in Jiashan county from 2017 to 2019 on the basis of the incidence rates of lung cancer during 1987-2016. Methods: Lung cancer incident cases were derived from cancer registry system of Jiashan. Crude incidence, age-standardized incidence rate by the Chinese standard population (ASR China) and the world standard population (ASR world) were calculated. Annual percent change (APC) was used to examine the temporal trend, and the autoregressive integrated moving average method (ARIMA) of time series model was used to predict the incidence rates from 2017 to 2019. Results: There were 6103 lung cancer incident cases during 1987-2016 in Jiashan county. Averagely, the crude incidence rate, ASR China and ASR world were 53.77/105, 25.24/105 and 34.15/105, respectively. The crude incidence rate, ASR China and ASR world in male were 78.30/105, 34.77/105 and 51.87/105, which were higher than those in female (29.15/105, 14.31/105 and 17.99/105). Crude incidence rate increased from 27.58/105 in 1987 to 111.24/105 in 2016, and the APC was 5.28%. Crude incidence rate predicted by ARIMA model from 2017 to 2019 would be 135.64/105, 145.97/105 and 152.63/105, and the predicted crude incidence rate for 2017 was close to the real incidence rate in 2017 (135.95/105). Conclusion: The incidence of lung cancer in Jiashan has been increased dramatically over the past 30 years and will continue to increase in the future.

Economic evaluation of different chickenpox vaccination strategies
DENG Xuan,HE Hanqing,ZHOU Yang,PAN Jinren,YAN Rui,TANG Xuewen,FU Jian
J Zhejiang Univ (Med Sci), 2018, 47(4): 374-380.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.08
Abstract( 166 )   HTML( 3 )     PDF(989KB)( 34 )

Objective: To evaluate the cost/benefit of different vaccination strategies related to chickenpox vaccine. Methods: The direct economic cost and indirect economic cost caused by chickenpox were obtained through questionnaire survey. The epidemic characteristics of chickenpox in Zhejiang province were studied by literature review. Dynamic model was set up by Matlab software based on the parameters of chickenpox, to predict the incidence trends of chickenpox with different immunization strategies (no vaccination, 1-dose vaccination, 2-dose vaccination) in future 40 years (2017-2056). A cost-benefit analysis was conducted, and the sensitivities of the main parameters were analyzed. Results: Through the questionnaire survey of 105 cases, the direct and indirect economic cost per case was 506.84 Yuan and 1045.39 Yuan respectively, with the total of 1552.23 Yuan. During the prediction period (40 years), there would be 7.0908 million cases in strategy 2, which was 59.71% less than strategy 1 (17.5989 million cases). Total vaccination costs in strategy 2 were 2.366 billion Yuan, with a total economic gain of 33.741 billion Yuan and benefit/cost ratio (BCR) of 14.26:1. If strategy 3 was adopted, 2.7249 million chickenpox cases would occur, with a decrease of 84.52% compared with strategy 1. Total vaccination costs in strategy 3 was 4.495 billion Yuan, with a total economic gain of 44.309 billion Yuan and BCR of 9.86:1. Analysis showed that the vaccine price was the most sensitive variable, followed by the incidence of chickenpox in the absence of vaccine. Conclusions: In Zhejiang province, one-dose strategy and two-dose strategy were both cost effective. It is suggested that the chickenpox vaccination should be included in the immunization program in Zhejiang province.

Expression of c-FLIP in peripheral blood mononuclear cells of patients with rheumatoid arthritis and its relation with extrinsic apoptotic pathway
LIN Meina,XU Ruiyuan,ZHANG Tao,ZHANG Lin,MEI Xuqiao
J Zhejiang Univ (Med Sci), 2018, 47(4): 381-388.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.09
Abstract( 177 )   HTML( 3 )     PDF(1034KB)( 31 )

Objective: To investigate the expression of apoptosis related protein cellular Fas associated death domain like interleukin 1 converting enzyme inhibitory protein (c-FLIP) in peripheral blood mononuclear cells (PBMCs) of patients with rheumatoid arthritis and its relation with extrinsic apoptotic pathway. Methods: Sixty patients with rheumatoid arthritis were collected from Zhangzhou Affiliated Hospital of Fujian Medical University during January 2014 and June 2015, including 22 patients with low activities (DAS28 < 3.2), 20 patients with middle activities (3.2 ≤ DAS28 ≤ 5.1), and 18 patients with high activities (DAS28>5.1). And 25 healthy controls were also collected. The mRNA and protein expression levels of c-FLIP and the extrinsic apoptotic pathway related proteins Fas-associated protein with death domain (FADD), caspase-8 in PBMCs were detected by real-time RT-PCR and Western blot, respectively. Correlations between c-FLIP and FADD, caspase-8 in PBMCs were analyzed by pearson test. Results: mRNA expression levels of c-FLIP, FADD and caspase-8 in PBMCs of patients with rheumatoid arthritis were all higher than those of healthy controls (all P < 0.05). mRNA expression levels of FADD and caspase-8 in patients with middle activities were significantly higher than those in patients with low activities (all P < 0.05), but the mRNA expression level of c-FLIP was not significantly higher than that in patients with low activities. mRNA expression level of c-FLIP in patients with high activities was higher than those in patients with middle or low activities (all P < 0.05), while the mRNA expression level of caspase-8 was lower than those in patients with middle or low activities (all P < 0.05). mRNA expression level of FADD in patients with high activities was higher than those in patients with low activities (P < 0.05). Pearson analysis showed that there was a positive correlation between c-FLIP and FADD mRNA expression (r=0.323, P < 0.05), and negative correlation between c-FLIP and caspase-8 mRNA expression (r=-1.104, P < 0.05). The protein expression levels of c-FLIP and FADD in patients with middle activities were significantly higher than those in control group and patients with low or high activities (P < 0.05 or 0.01). The protein expression levels of caspase-8 in patients with middle and high activities were significantly higher than those in control group and patients with low activities (P < 0.05 or P < 0.01), and the protein expression level of caspase-8 in patients with high activities was higher than that in patients with middle activities (P < 0.05). Conclusion: c-FLIP may be involved in the extrinsic apoptotic pathway in rheumatoid arthritis, and can provide reference for the evaluation of disease activities.

Vitamin D3 regulates mononuclear phagocyte polarization induced by serum from patients with ankylosing spondylitis
WANG Shengnan,LYU Wang,LIN Suxian,LU Yang,JIANG Jianchang,ZHU Xiaochun
J Zhejiang Univ (Med Sci), 2018, 47(4): 389-394.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.10
Abstract( 151 )   HTML( 9 )     PDF(1040KB)( 32 )

Objective: To investigate the effect of vitamin D3 on polarization of monocyte macrophages induced by serum from patients with ankylosing spondylitis (AS). Methods: Twenty AS naïve patients and 20 healthy controls from Wenzhou People's Hospital during January 2016 and December 2017 were enrolled. The macrophages were differentiated from THP1 cells induced by phorbol 12-myristate 13-acetate (PMA), and then co-cultured with the serum from healthy subjects (control group) or AS patients. Vitamin D3 was added in the medium mixed with serum from AS patients. Flow cytometry was used to analyze the ratio of CD68 and CD206 positive cells, and RT-PCR was performed to detect the mRNA expression of inducible nitric oxide synthase(iNOS) and arginase-1(Arg-1). Results: THP1 cells could be polarized into mononuclear-macrophages with the induction of PMA. The proportion of CD206 positive cells in AS-serum group was lower than that in the control group (t=9.434, P < 0.05), while the proportion of CD68 positive cells was higher than that in the control group (t=43.920, P < 0.05). The proportion of CD206 positive cells in vitamin D3 group was higher than that in AS-serum group (t=8.895, P < 0.05), while the proportion of CD68 positive cells was lower than that in AS-serum group (t=9.089, P < 0.05). mRNA expression of Arg-1 in AS-serum group was lower than that in the control group (t=8.899, P < 0.05), while mRNA expression of iNOS was higher than that in the control group (t=3.656, P < 0.05). mRNA expression of Arg-1 in vitamin D3 group was higher than that in AS-serum group (t=6.219, P < 0.05), while mRNA expression of iNOS was lower than that in AS-serum group (t=5.876, P < 0.05). Conclusion: Vitamin D3 can regulate the polarization of mononuclear macrophages for immunoregulation in patients with AS.

Expression of leukocyte immunoglobulin-like receptor A3 in CD14+ monocytes of patients with rheumatoid arthritis
ZHOU Meiju, WANG Jiawei, SUN Wenjia, WU Xinyu, XUE Jing, WU Huaxiang, DU Yan
J Zhejiang Univ (Med Sci), 2018, 47(4): 395-399.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.11
Abstract( 219 )   HTML( 6 )     PDF(1013KB)( 58 )

Objective: To investigate the expression of leukocyte immunoglobulin-like receptor A3 (LILRA3) in CD14+ monocytes of patients with rheumatoid arthritis (RA). Methods: Fifty three RA patients admitted in the Second Affiliated Hospital of Zhejiang University School of Medicine from February 2017 to August 2017, and 21 healthy subjects were enrolled in the study. The expression of LILRA3 in CD14+ monocyte subset was determined by flow cytometry, and its correlations with clinical features, laboratory examination results, antibodies and disease activity were analyzed. Results: LILRA3 percentage in the CD14+ monocyte subset of RA patients was higher than that in the healthy controls (P < 0.01). The percentage of LILRA3 was positively correlated with number of tenderness joints, number of swollen joints and erythrocyte sedimentation rate (r=0.280, 0.371, 0.341, P < 0.05 or < 0.01), but was not correlated with the age, course of disease, Sharp score, C reactive protein, blood routine index and immunoglobulin (all P>0.05). In addition, the percentages of LILRA3 in the monocytes of rheumatoid factor (RF)-positive or anti-cyclic citrullinated peptide (CCP) antibody-positive patients were significantly higher than those of the RF-or anti-CCP antibody-negative patients (all P < 0.05); and the percentage of LILRA3 in patients with DAS28>5.1 was higher than that in patients with DAS28 ≤ 5.1 (P < 0.05). Conclusion: The expression of LILRA3 is up-regulated in CD14+ monocyte subset isolated from RA patients, and it is correlated with disease activity.

Diffusion-weighted imaging texture features in differentiation of malignant from benign nonpalpable breast lesions for patients with microcalcifications-only in mammography
CHEN Shujun,SHAO Guoliang,SHAO Feng,ZHANG Minming
J Zhejiang Univ (Med Sci), 2018, 47(4): 400-404.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.12
Abstract( 169 )   HTML( 4 )     PDF(971KB)( 32 )

Objective: To evaluate the application of MR diffusion-weighted imaging(DWI) texture features in differentiation of malignant from benign nonpalpable breast lesion for patients with microcalcifications-only in mammography. Methods: The clinical and MR-DWI data of 61 patients with microcalcifications, who underwent three-dimensional positioning of breast X-ray wire from October 2012 to December 2015 in Zhejiang Cancer Hospital, were retrospectively analyzed, including 38 patients with malignant lesions and 23 patients with benign lesions. Two radiologists independently drew the regions of interest (ROI) on DWI for image segmentation, and 6 histogram features and 16 grayscale symbiosis matrix (GLCM) texture features were extracted on each ROI. The random forest algorithm was applied to select the features and built the classification model. The leave-one-out cross-validation (LOOCV) was used to validate the classifier, and the performance of the classifier was evaluated by ROC curve. Results: Six features were selected, including histogram features of mean, variance, skewness, entropy, as well as contrast (0°) and correlation (45°) in GLCM. The histogram features of mean, variance, skewness and entropy were significantly different between the benign and malignant breast lesions (all P < 0.05). The AUC of the model was 0.76, and the diagnostic accuracy, sensitivity and specificity were 77.05%, 84.21% and 65.21%, respectively. Conclusions: The texture feature analysis of DWI can improve the diagnostic accuracy of differentiating benign and malignant breast nonpalpable lesions with microcalcifications-only in mammography. Histogram features of mean, variance, skewness, entropy of DWI may be used as important imaging markers.

Application of gold nanoparticles-based lateral flow strip for dengue virus detection based on strand-displacement amplification
ZHAO Jin,XIA Haixiong,LIU Yujie,Ravinder Pal,FAN Anran,HE Zhixu,ZENG Lingwen
J Zhejiang Univ (Med Sci), 2018, 47(4): 405-412.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.13
Abstract( 380 )   HTML( 5 )     PDF(1109KB)( 62 )

Objective: To investigate the rapid and accurate method for the detection of dengue virus (DENV) by using nicking enzyme assisted strand-displacement amplification (SDA) combined with gold nanoparticles-based lateral flow strip. Methods: Total RNA of the virus was extracted by using magnetic beads method and transcribed to cDNA for SDA detection system. Nicking enzyme-assisted method was used for detecting DENV, and agarose gel electrophoresis was used for analyzing the sensitivity of SDA amplification products. A gold nanoparticles-based lateral flow strip was developed based on the principle of nucleic acid base complementary pairing to design the test line and control line. The gold particles were prepared by using sodium citrate reduction method for gold nanoparticles-based lateral flow strip construction. Results: The sensitivity of the SDA method was 10 fmol/L, and the sensitivity of gold nanoparticles-based lateral flow strip based on SDA method was also 10 fmol/L. In a linear range from 10 fmol/L to 1012 fmol/L, the corresponding linear correlation coefficient (R2) of DENV was 0.98. The specificity of nanoparticles-based lateral flow strip based on SDA for DENV detection was high, which was no crossing with other control groups. Conclusion: A gold nanoparticles-based lateral flow strip based on SDA method for DENV detection has been established, which is convenient, fast, and the result is visible to naked eyes.

Research progress on roles of vitamin D in endometriosis
ZHANG Lifeng,ZHANG Xinmei
J Zhejiang Univ (Med Sci), 2018, 47(4): 413-418.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.14
Abstract( 276 )   HTML( 6 )     PDF(939KB)( 78 )

In addition to regulating calcium and phosphorus metabolism to maintain strong bones, vitamin D also has immune regulating and anti-inflammatory effects. Moreover, it is related to chronic inflammatory diseases, autoimmune diseases and cancer. Many studies indicate the roles of vitamin D in the development and progression of endometriosis including the effects on modulation of immune responses, inflammation reactions, cell proliferation and apoptosis, angiogenesis, adhesion and invasion. Vitamin D supplementation can relieve pain and improve endometrial receptivity associated with endometriosis and play a preventive and therapeutic role. This paper summarizes the roles of vitamin D in endometriosis.

Research progress on oxidative stress in pathogenesis of endometriosis
HE Jiayi,ZHANG Xinmei
J Zhejiang Univ (Med Sci), 2018, 47(4): 419-425.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.15
Abstract( 218 )   HTML( 4 )     PDF(945KB)( 49 )

A large number of studies have shown that the oxidative imbalance is common in patients with endometriosis. Abnormal respiratory chain of mitochondrial, estrogen metabolism imbalance, iron overload, and ectopic foci may increase active oxygen, reduction of antioxidant enzyme and non-enzymatic substances may result in decreased antioxidant level, and the exposure to environmental hazards may further aggravate oxidative imbalance in patients with endometriosis. This article analyzes the oxidative imbalance and its role in the pathogenesis of endometriosis from the aspects of excessive oxide production and decreased antioxidant capacity.

Research progress on nonspecific immune microenvironment in breast cancer
XU Zhili,CUI Yiyi,LI Yan,GUO Yong
J Zhejiang Univ (Med Sci), 2018, 47(4): 426-434.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.16
Abstract( 221 )   HTML( 6 )     PDF(1008KB)( 78 )

The immune microenvironment plays an important role in the occurrence and development of breast cancer. The infiltrating immune cells and the produced inflammatory cytokines in the tumor microenvironment regulate the growth, proliferation and metastasis of breast cancer. In this article, the roles and related mechanisms of nonspecific immune microenvironment in breast cancer are summarized, focusing on the natural killer cells, dendritic cells, myeloid derived suppressor cells, tumor associated macrophages, interleukins, chemokines, tumor necrosis factor-α, transforming growth factor-β and so on.

Research progress on systemic lupus erythematosus overlapping organ-specific autoimmune diseases
WANG Xingxing,WANG Panpan,YANG Xuyan
J Zhejiang Univ (Med Sci), 2018, 47(4): 435-440.   https://doi.org/10.3785/j.issn.1008-9292.2018.08.17
Abstract( 221 )   HTML( 9 )     PDF(938KB)( 63 )

Systemic lupus erythematosus (SLE) is a multiorgan-involved autoimmune disease, and it can overlap organ-specific autoimmune diseases such as autoimmune thyroid diseases, autoimmune hepatitis and inflammatory bowel disease. There may be some association between SLE and these autoimmune diseases, such as common immunological and genetic basis, but the pathogenic mechanism is still unclear. This review focuses on current knowledge regarding the prevalence and possible pathogenesis of SLE overlapping the above three autoimmune diseases.

17 articles