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Standardization of cancer biobank in precision medicine era
JI Jiafu
Journal of ZheJiang University(Medical Science), 2016, 45(4): 331-334.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.01
Abstract( 84 )   HTML (   PDF(921KB)( 172 )

Tumor specimens have a great role in basic and clinical translational researches on cancer, especially in the era of precision medicine. Thus the standardization of cancer biobank is of high importance. The establishment and maintenance of cancer biobank require comprehensive quality management, so as to provide high quality service for basic and clinical researches. At present, sample-oriented collection and management, and clinical and pathological data annotation are the main focuses of biobank standardization in China.

Expression of CD10 in tumor-associated fibroblast of cancerized or recurrent colorectal adenomas
ZHENG Jiangjiang, ZHU Yin, LI Changshui, LI Yinya, NIE Qianqian, ZHU Ziling, DENG Hong
Journal of ZheJiang University(Medical Science), 2016, 45(4): 335-341.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.02
Abstract( 96 )   HTML (   PDF(1033KB)( 162 )

Objective: To investigate the expression of CD10 in tumor-associated fibroblasts (TAF) in colorectal adenomas and its relation to cancerization and recurrence of adenoma. Methods: Tissue samples of low-grade adenoma (n=50), high-grade adenoma (n=50) and colorectal adenocarcinoma (n=50) were collected, and tissue samples at the distal margin of corresponding colorectal lesions were taken as controls. The expression of CD10 in the stromal TAFs, and the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells were detected by immunohistochemistry (Envision). The correlation of CD10 expression in stromal TAFs with the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells was analyzed by Spearmen. One hundred samples of low-grade colorectal adenoma were collected, including 57 non-recurrent cases and 43 recurrent cases (16 cases of recurrent adenoma and 27 cases of recurrent adenocarcinoma); the expression of stromal TAF CD10 were determined and compared among groups. Results: There was no TAF in normal colorectal mucosa. The expression rates of TAF CD10 in low-grade adenoma, high-grade adenoma and colorectal adenocarcinoma were 22%, 50% and 78%, respectively (all P<0.05). The expression of Ki-67 and β-catenin in low-grade adenoma, high-grade adenoma, colorectal adenocarcinoma was on a rising trend (all P<0.01). The expression of CyclinD1 in high-grade adenoma was higher than that in colorectal adenocarcinoma and low-grade adenoma (all P>0.05). The expression of p53 in colorectal adenocarcinoma and high-grade adenoma was higher than that in low grade adenoma (all P<0.01). The expression of TAF CD10 was correlated with the expression of p53, Ki-67 and β-catenin-nucleus(r=0.264、0.307、0.320, all P<0.01),but not correlated with CyclinD1 and β-catenin-membrane (r=0.012、-0.073, all P>0.05). The TAF CD10 level was significantly higher in low-grade adenoma with recurrence than that in those without recurrence (P<0.05).The expression of CD10 in recurrent colorectal adenocarcinoma was higher than that in recurrent adenoma (P<0.05). Conclusion: The expression of TAF CD10 is increased gradually in the process of adenoma-cancer, indicating that it may play an important role in the canceration of adenoma. Adenomas with high expression of CD10 TAF are likely to be recurrent and cancerized, and detection of TAF CD10 combined with p53, Ki-67 and β-catenin may be of value in predicting canceration or recurrence of colorectal adenoma.

Expression of miR-let-7e-3p in cervical intraepithelial neoplasm and cervix carcinoma and its clinical significance
CHEN Xiaojing, XU Junfen, YE Jing, CHENG Xiaodong, XIE Xing, LYU Weiguo
Journal of ZheJiang University(Medical Science), 2016, 45(4): 342-348.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.03
Abstract( 115 )   HTML (   PDF(1118KB)( 291 )

Objective: To investigate the expression of microRNA (miRNA, miR) let-7e-3p in different cervical lesions and its clinical significance. Methods: The expression of miR-let-7e-3p in the tissues of normal cervix (n=26), high-grade squamous intraepithelial lesion (HSIL) (n=37), and cervix carcinoma (n=101) were detected by reverse transcription and quantitative polymerase chain reaction (RT-qPCR). The correlation of miR-let-7e-3p expression with the clinicopathological parameters of patients with cervical cancer was analyzed. miR-let-7e-3p mimic was transfected into cervical carcinoma Siha cells. The cell cycle and apoptosis were determined by flow cytometry; cell proliferation was determined by CCK-8 kit; and the migration and invasion of cells were determined by Transwell assay. Results: The relative expression levels of miR-let-7e-3p in normal cervix, HSIL, and cervical carcinoma were 1.45±0.24, 0.79±0.05 and 0.46±0.04, respectively (all P<0.05). After transfection with miR-let-7e-3p mimic, the S-phase fraction and apoptosis rate of Siha cells were increased significantly compared with control group[(29.76±6.6)% vs (13.38±1.3)%, P<0.05; (5.98±1.38)% vs (3.53±0.79)%, P<0.05, respectively]. OD of transfected Siha cells at 48, 72 and 96 h were 0.57±0.11,0.65±0.04 and 0.84±0.14, which were significantly lower than those of untransfected Siha cells (0.74±0.05, 0.93±0.10 and 1.47±0.14, all P<0.05). The migration and invasion abilities of transfected Siha cells were not significantly changed (all P>0.05). Conclusion: The expression of miR-let-7e-3p is down-regulated in cervical neoplasms, which is associated with cell cycle arrest and proliferation inhibition of cervical cancer cells.

Effect of DJ-1 silencing by RNA interference on growth of xenografted human laryngeal squamous cell carcinoma Hep-2 cells in nude mice
SHEN Zhisen, DENG Hongxia, YE Dong, ZHANG Jian, QIU Shijie, LI Qun, CUI Xiang
Journal of ZheJiang University(Medical Science), 2016, 45(4): 349-355.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.04
Abstract( 88 )   HTML (   PDF(1119KB)( 188 )

Objective: To investigate the effect of silencing DJ-1 on xenografted human laryngeal squamous cell carcinoma (LSCC) Hep-2 cells in nude mice. Methods: Xenograft model of human LSCC was established by subcutaneous transplantation of Hep-2 cells in 24 nude mice. The LSCC-bearing nude mice were randomly divided into 3 groups (n=8 in each):DJ-1 siRNA low dose group and DJ-1 siRNA high dose group were injected in tumors with 20 μg of DJ-1 siRNA or 40 μg of DJ-1 siRNA in 50 μL, respectively; control group was injected with 5% glucose solution in 50 μL, twice a week for 3 weeks. The weight and size of tumors were measured before injection. The animals were sacrificed 48 h after the final treatment, and the tumors were harvested and weighed. The apoptosis and proliferation of tumor cells were determined; the expressions of Caspase-3 and Ki-67 in tumor specimens were detected with immunohistochemistry. The expression of DJ-1, PTEN, survivin mRNA and protein in tumor tissues were detected by RT-PCR and Western blotting, respectively. Results: Tumor weight in low dose group[(0.66±0.15)g] and high dose group[(0.48±0.11)g] were significantly lower than that in control group[(0.83±0.16)g, all P<0.05]. The inhibition rates of low dose group and high dose group were (20.48±0.18)% and (42.16±0.13)%, respectively. Immunohistochemistry showed that the expression of Caspase-3 was increased and Ki-67 was reduced in tumor specimens, compared with the control group (all P<0.05). RT-PCR and Western blot results showed that in low dose group and high dose group the mRNA and protein expression of DJ-1 and survivin significantly decreased (all P<0.05), while PTEN mRNA and protein content increased (all P<0.05). Conclusion: High dose DJ-1 siRNA can inhibit the tumor growth in human LSCC xenograft nude mouse model, which indicates that down-regulating DJ-1 and survivin, and up-regulating PTEN expression may lead to blockage of PI3K-PKB/Akt signaling pathway and promoting tumor cell apoptosis.

Effect of a novel EZH2 inhibitor GSK126 on prostate cancer cells
LIN Weiren, CHEN Yatian, ZENG Linghui, YING Rongbiao, ZHU Feng
Journal of ZheJiang University(Medical Science), 2016, 45(4): 356-363.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.05
Abstract( 84 )   HTML (   PDF(1293KB)( 198 )

Objective: To investigate the effect of a novel EZH2 inhibitor GSK126 on cell growth, apoptosis and migration of prostate cancer cells. Methods: Prostate cancer PC-3 and DU145 cells were treated with GSK126 at different doses. Cell growth was detected by sulforhodamine assay. Cell apoptosis was assayed by Annexin V-/PI kit. Transwell chamber and wound healing assays were conducted to detect cell migration. The mRNA level was detected by quantitative PCR, and protein expression was detected by Western blot analysis. Results: GSK126 showed significant effect on cell growth and apoptosis when the dose was higher than 50 μmol/L. Wound healing assay revealed that scratch space in PC-3 cells was significantly increased in a dose-dependent manner in GSK126-treated groups[(247.2±24.4),(347.2±19.2) and (410.5±18.1) μm in low, medium and high dose (5.0, 20.0, 50.0 μmol/L), respectively] as compared with the control group[(171.3±17.8) μm](all P<0.05). Transwell assay showed that migrated PC-3 cells in control group was 322.0±17.9,while those in GSK126-treated groups were 198.3±15.4 (low),82.7±6.2 (medium) and 30.2±4.1 (high), and the differences between the control group and GSK126-treated groups were significant(all P<0.05). In addition, GSK126 up-regulated E-cadherin mRNA expression and down-regulated N-cadherin and Vimentin mRNA expression, whereas had no significant effect on Snail, Fibronectin and VEGF-A mRNA expression. The protein expression of E-cadherin was elevated but VEGF-A protein did not change in GSK126-treated groups. Similar results were exhibited in DU145 cell. Conclusion: GSK126 can significantly inhibit cell migration and invasion in prostate cancer PC-3 and DU145 cells, which may be resulted from its effect on epithelial-mesenchymal transition. GSK126 may be used as a potential anti-prostate cancer dug in clinic.

Effect of RAD18-siRNA on proliferation and chemotherapy sensitivity of human esophageal squamous cell carcinoma ECA-109 cells
LOU Pengrong, SUN Xiaonan, ZHOU Jundong, ZOU Shitao
Journal of ZheJiang University(Medical Science), 2016, 45(4): 364-370.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.06
Abstract( 97 )   HTML (   PDF(1060KB)( 131 )

Objective: To investigate the effect of RAD18-siRNA on cell proliferation and chemotherapy sensitivity of esophageal squamous cell carcinoma (ESCC) ECA-109 cells. Methods: RAD18-siRNA was transfected into human ECA-109 cells by Lipofectamine 3000. Quantitative PCR and Western blot were performed to detect RAD18 and CyclinD1 expression; CCK-8 assay was used to determine cell proliferation and chemotherapy drug sensitivity; flow cytometry was used to determine cell cycle. Correlation between RAD18 and CyclinD1 mRNA expression was analyzed by Pearson's correlation. Results: Compared with non-transfected cells, the expression of RAD18 in RAD18-siRNA group was significantly decreased (P<0.05). The cell proliferation was inhibited (P<0.05) and the cell number of G1 phase was increased, G2/M phase cells decreased (P<0.05) in RAD18-siRNA group. After treatment with different concentrations of cisplatin or 5-FU, the survival rate of the two cell groups was reduced (all P<0.05), and the IC50 of RAD18-siRNA group was significantly lower than that of non-transfected group (P<0.05). The mRNA expression of RAD18 was positively correlated with CyclinD1 expression in ESCC tissues(r=0.478, P<0.01). Conclusion: Down-regulated expression of RAD18 can decrease the cell proliferation and increase chemo-sensitivity of ESCC cells, and CyclinD1 may participate in the process.

Expression of microRNA-221/222 in patients with monoclonal gammopathy of undetermined significance and multiple myeloma
YANG Suwen, WANG Wei, JIN Hong, ZHONG Yuhong, XIE Xinyou
Journal of ZheJiang University(Medical Science), 2016, 45(4): 371-378.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.07
Abstract( 65 )   HTML (   PDF(1076KB)( 116 )

Objective: To detect the expression of miR-221/222 in serum and plasma cells in patients with monoclonal gammopathy of undetermined significance(MGUS) and multiple myeloma(MM), and to explore the possibility of miR-221/222 as biomarkers in the diagnosis and prognosis predicting of MGUS and MM. Methods: Bone marrow and serum samples from 14 patients with newly diagnosed MGUS, 81 patients with newly diagnosed or relapsed MM and 10 controls were collected from Sir Run Run Shaw Hospital of Zhejiang University and Tongde Hospital of Zhejiang Province during January 2013 and December 2015. The expressions of miR-221/222 in serum and in sorted CD138 positive plasma cells were detected by qRT-PCR, and the relative expression of miR-221/222 (Δct) was compared between the groups. Serum levels of miR-221 before and after treatment were compared in both remission group (n=22) and refractory group (n=13) in MM patients, and its correlation with serum level of β2-MG was assessed using Pearson's correlation analysis. Results: Serum levels of miR-221/222 in MGUS and MM groups were significantly higher than those in control group (all P<0.01), while miR-221/222 levels in plasma cells were significantly lower in MGUS and MM groups than those in the control group (P<0.05 or<0.01). No significant difference in miR-221/222 levels in serum and plasma cells was observed between MGUS group and MM group (all P>0.05). There was no correlation between miR-221/222 levels in serum and plasma cells (r=0.024 and -0.127, all P>0.05), but miR-221 levels were correlated with miR-222 levels in both serum and plasma cells (r=0.534 and 0.552, all P<0.01). Receiver operating characteristic (ROC) curves showed that the areas under the curve (AUCs) of serum miR-221/222, plasma cell miR-221/222 in diagnosis of MGUS/MM were 0.968, 0.976, 0.801 and 0.727, respectively. There was no significant difference in serum level of miR-221 among MM patients with different paraprotein isotypes (P>0.05), but serum level of miR-221 in patients with relapsed MM was higher than that in patients with newly diagnosed MM (P<0.01). Compared with the patients with MGUS or MM stageⅠ and Ⅱ, patients with MM stage Ⅲ were of higher serum levels of miR-221 (P<0.01). Serum level of miR-221 decreased after chemotherapy in the remission group (U=51.5, P<0.01), but such decrease was not observed in the refractory group (U=67.5, P>0.05). Serum level of β2-MG was positively correlated with serum level of miR-221 (r=0.524, P<0.01). Conclusion: miR-221/222 in serum and plasma cells may be biomarkers for early diagnosis of MGUS, and are helpful for diagnosis and efficacy evaluation of MM.

Efficacy of neoadjuvant chemotherapy combined with bevacizumab versus neoadjuvant chemotherapy alone for Her2-negative breast cancer: a meta-analysis of randomized controlled clinical trials
HAN Rui, WANG Guanying, ZHANG Yujiao, ZHAO Xinhan
Journal of ZheJiang University(Medical Science), 2016, 45(4): 379-386.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.08
Abstract( 52 )   HTML (   PDF(1018KB)( 124 )

Objective: To evaluate the efficacy and safety of neoadjuvant chemotherapy combined with bevacizumab versus neoadjuvant chemotherapy alone for Her2-negative breast cancer.Methods: We searched PubMed, the Cochrane Library, Web of Science, CNKI, Wanfang Database and the abstracts of major international conferences in recent 5 years to identify prospective randomized controlled clinical trials that met the inclusion and exclusion criteria. Study selection and analyses were undertaken according to the Cochrane Handbook. Meta-analysis was performed using RevMan 5.3 software.Results: Six trials were identified with 4440 eligible patients. The results of this meta-analysis showed that the rate of pathological complete response (pCR) was higher in Her-2 negative breast cancer patients receiving bevacizumab combined with neoadjuvant chemotherapy than that in patients with neoadjuvant chemotherapy alone (24.7% vs 20.1%, RR=1.23, 95%CI:1.10-1.37, P<0.01). In addition, the pCR rate rose up when bevacizumab was added to neoadjuvant chemotherapy both in hormone receptor-positive patients (13.1% vs 10.2%,RR=1.28, 95%CI:1.04-1.58,P<0.05) and in hormone receptor-negative patients (46.3% vs 37.1%, RR=1.25, 95%CI:1.12-1.39, P<0.01). Statistical differences were observed in the rate of relevant adverse events such as hypertention (3.2% vs 0.6%, RR=5.292, 95%CI:2.933-9.549, P<0.01) and mucositis (10.5% vs 2.0%, RR=5.340, 95%CI:3.743-7.617, P<0.01) between the combination group and the chemotherapy alone group. Differences in other toxicities such as febrile neutropenia, infection, surgical complications, neutropenia and hand-foot syndrome were also found to be statistically significant between the combination group and the chemotherapy alone group (all P<0.05), while such difference was not found in the occurrence of peripheral neuropathy (P>0.05). Conclusion: The addition of bevacizumab to neoadjuvant chemotherapy in Her2-negative breast cancer can significantly improve pathological complete response, but may bring more grade 3 and 4 toxicities.More neoadjuvant trials need to be done to define subgroups of Her2-negative breast cancer that would have clinically significant long-term benefit from bevacizumab treatment.

Aberrant DNA methylation and its targeted therapy in acute myeloid leukemia
LI Xueying, ZHU Lixia, YE Xiujin
Journal of ZheJiang University(Medical Science), 2016, 45(4): 387-394.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.09
Abstract( 114 )   HTML (   PDF(963KB)( 131 )

The occurrence and development of acute myeloid leukemia (AML) is not only related to gene mutations, but also influenced by abnormal epigenetic regulation, in which DNA methylation is one of the most important mechanisms. Abnormal DNA methylation may lead to the activation of oncogene and the inactivation of tumor suppressor gene, resulting in the occurrence of leukemia. The mutations of DNA methylation enzymes associated with AML may have certain characteristics. The AML with recurrent cytogenetic abnormalities is also related to abnormal methylation. Some fusion genes can alter DNA methylation status to participate in the pathogenesis of leukemia. In addition, chemotherapy drug resistance in patients with AML is associated with the change of gene methylation status. Considering the reversibility of the epigenetic modification, targeted methylation therapy has become a hotspot of AML research.

Progress on clinical application of bevacizumab for the treatment of refractory cervical cancer
HE Bin, CHAI Yanlan, WANG Tao, ZHOU Zhenxing, LIU Zi
Journal of ZheJiang University(Medical Science), 2016, 45(4): 395-402.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.10
Abstract( 82 )   HTML (   PDF(959KB)( 153 )

Bevacizumab is increasingly used in recurrent, persistent or metastatic cervical cancer. The early retrospective case reports found that bevacizumab combined with 5-FU (including capecitabine) or paclitaxel was well tolerated and displayed encouraging anti-tumor activity in recurrent or persistent cervical cancer. Phase Ⅱ clinical trials showed that bevacizumab was well tolerated and active in the second- and third-line treatment of patients with recurrent cervical cancer. Large scale phase Ⅱ and phase Ⅲ clinical trials demonstrated that bevacizumab-containing chemotherapy was effective in the first- and second-line treatment of patients with persistent cervical cancer, prolonged survival time and improved remission rate. The article also reviews the research progress on predictive factors of bevacizumab efficacy, showing the use of imaging and biomarkers in predicting the efficacy of bevacizumab treatment. In addition, this article analyzes the cost-effectiveness of bevacizumab, finding that bevacizumab combined with chemotherapy meets the standard of cost-effectiveness.

Effect of shift rotation culture on formation and activity of encapsulated hepatocytes aggregates
CHEN Yanshan, YU Chengbo, CAO Hongcui, LI Lanjuan
Journal of ZheJiang University(Medical Science), 2016, 45(4): 403-409.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.11
Abstract( 81 )   HTML (   PDF(1318KB)( 115 )

Objective: To observe the effect of uniform and shift rotation culture on the formation and activity of the alginate-chitosan (AC) microencapsulated HepLL immortalized human hepatocytes and HepG2 cells aggregates. Methods: AC microcapsulated HepG2 and HepLL cells were randomly divided into two groups. Each group was divided into 3 subgroups according to uniform and shift rotation culture.The size and number of aggregates were observed and measured under laser confocal microscopy and inverted microscope dynamically. The amount of albumin synthesis was detected by ELISA, the clearance of ammonia was detected by colorimetry, and diazepam conversion function was detected by high performance liquid chromatography (HPLC). Results: On day 6, 8, 10, 12, 14 and 16, the number and size of the aggregates, albumin synthesis, diazepam clearance and ammonium clearance increased significantly in shift rotation culture group than in uniform group (all P<0.01). The albumin synthesis, diazepam clearance, and ammonium clearance in the microencapsulated HepLL groups were significantly higher than those of HepG2 cells at any time (all P<0.01). Conclusion: Shift rotation culture can significantly promote the formation and increase the activity of AC microencapsulated HepLL and HepG2 aggregates, and HepLL cells may be more suitable for bioartificial liver than HepG2.

Association of single nucleotide polymorphism in exon of transient receptor potential melastatin 2 gene with sepsis
FANG Minbo, CHEN Qixing, WU Shuijing, FANG Xiangming
Journal of ZheJiang University(Medical Science), 2016, 45(4): 410-415.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.12
Abstract( 65 )   HTML (   PDF(996KB)( 112 )

Objective: To investigate the association between single nucleotide polymorphism (SNP) in the 11th exon of transient receptor potential melastatin 2 (TRPM2) gene with the susceptibility and outcome of sepsis. Methods: A total of 119 septic patients and 112 normal subjects were enrolled from the First Affiliated Hospital, Zhejiang University School of Medicine. Among 119 septic patients, 62 died (fatal group) and 57 survived (survival group) within 28 days of disease onset. The genotypes of these individuals were detected using TaqMan allelic discrimination assays, and its correlations with susceptibility and outcome of sepsis were analyzed. Results: There was no significant difference in genotype frequencies and allelic frequencies of TRPM2 SNP rs1556314 between septic patients and the controls (all P>0.05). And no significant difference in genotype frequencies and allelic frequencies of TRPM2 SNP rs1556314 was observed between the survivors and fatal cases of septic patients (all P>0.05). Conclusion: The TRPM2 SNP rs1556314 does not have significant association with sepsis, but this result need to be confirmed by large scale studies.

Comparison of FibroTouch and acoustic radiation force impulse in diagnosis of liver fibrosis in patients with chronic hepatitis B
LIU Fang, WEI Lin, WANG Shanshan, HUANG Bin
Journal of ZheJiang University(Medical Science), 2016, 45(4): 416-421.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.13
Abstract( 68 )   HTML (   PDF(1012KB)( 151 )

Objective: To compare transient elastorgaphy (FibroTouch) and acoustic radiation force impulse (ARFI) in diagnosis of liver fibrosis in patients with chronic hepatitis B. Methods: One hundred and forty five patients with chronic hepatitis B underwent FibroTouch and ARFI examinations in Xixi Hospital of Hangzhou from January to November 2015. The liver stiffness (LSM) was detected by FibroTouch and the liver shear wave velocity (VTQ) was detected by ARFI; liver biopsy was performed in all patients. With biopsy results as gold standards, the diagnostic values of FibroTouch and ARFI for liver fibrosis were analyzed with Spearman correlation analysis and receiver operating characteristic (ROC) curve. Results: The correlation coefficient of FibroTouch and ARFI was 0.746 (P<0.01). FibroTouch and ARFI were significantly correlated with pathological stage determined by liver biopsy(r=0.705 and 0.727, all P<0.01). When 8.4 kPa was taken as the cut-off value of LSM and 1.49 m/s was taken as the cut-off value of VTQ, the areas under ROC (AUCs) were 0.857 and 0.836 (P>0.05) in diagnosis of fibrosis S≥2 stage; when 10.8 kPa of LSM and 1.49 m/s of VTQ were used as cut-off values, the AUCs were 0.872 and 0.881 (P>0.05) in diagnosis of S≥3 stage; when 12.3 kPa of LSM and 1.81m/s of VTQ were used as cut-off values, the AUCs were 0.875 and 0.888 (P>0.05) in diagnosis of S=4 stage. Conclusion: Both FibroTouch and ARFI can be effectively used in evaluation of liver fibrosis in patients with chronic hepatitis B.

Evaluation of tear film and meibomian gland function in dry eye patients using Keratograph 5M
ZHU Kexuan, XIE Wenjia, YING Jinglu, YAO Yufeng
Journal of ZheJiang University(Medical Science), 2016, 45(4): 422-428.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.14
Abstract( 79 )   HTML (   PDF(1048KB)( 250 )

Objective: To assess the application of Keratograph 5M in evaluating tear film and meibomian gland function in patients with dry eye. Methods: A total of 144 eyes were recruited in the study, in which 72 eyes were from patients diagnosed with dry eye and 72 eyes were from healthy subjects. All subjects finished following tests or examinations:ocular surface disease index (OSDI) to evaluate eye symptoms; Keratograph 5M examination to obtain tear meniscus height (TMH), noninvasive tear break-up time (NIBUT) including first NIBUT (NIBUT-Fir) and average NIBUT (NIBUT-Ave), and infrared meibography; and fluorescein sodium staining to obtain fluorescein tearbreak-up time (FBUT). Results: Dry eye group had higher OSDI score than healthy control group, but its TMH, NIBUT-Fir and NIBUT-Ave were lower than those in healthy control group (all P<0.01). Total meiboscore in dry eye group was higher than that in healthy control group (P<0.01), and it showed a significant correlation with NIBUT-Fir and NIBUT-Ave (r=-0.449 and -0.398, P<0.01), but no correlation with ages was observed (r=0.031, P>0.05). The NIBUT-Fir and NIBUT-Ave showed a significant correlation with FBUT (r=0.833 and 0.727, P<0.01). Conclusion: Keratograph 5M is a convenient, accurate and non-invasive method to assess the function of tear film and meibomian gland, and the new meibography scoring system can evaluate the function of meibomian gland objectively and succinctly.

Fibromyalgia syndrome after comprehensive treatment of breast cancer: a case report
DING Xia, LI Yan, CUI Yiyi, SHEN Yingying, GU Jianzhong, GUO Yong
Journal of ZheJiang University(Medical Science), 2016, 45(4): 429-431.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.15
Abstract( 65 )   HTML (   PDF(919KB)( 130 )

Fibromyalgia syndrome after comprehensive treatment of breast cancer is rare and seldom reported. Here we present a case of a 50-year-old female patient,who was admitted to the hospital because of generalized fibromyalgia for 3 months and brain metastasis after the right breast carcinoma surgery for 1 month, and the clinical diagnosis was brain metastasis from breast carcinoma combined with fibromyalgia syndrome. The fibromyalgia were relieved with proper symptomatic treatment but the patient eventually died of tumor progression.

Research progress on pharmacotherapy of calcific aortic valve disease
DU Miaomiao, MA Gaigai, SHI Yuping
Journal of ZheJiang University(Medical Science), 2016, 45(4): 432-438.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.16
Abstract( 101 )   HTML (   PDF(952KB)( 179 )

With the population aging and declining incidence of rheumatic heart disease, calcific aortic valve disease (CAVD) has become the most frequent valve disease and the common cause of aortic valve replacement. Patients with CAVD need to cope with a deteriorating quality of life and valve replacement is the only effective clinical option for the patients. Therefore, early pharmacotherapy is of great significance in prevention or slow-down of the progression of CAVD. For years CAVD was considered to be a passive wear and tear process of valves, but now it is recognized as an active and multi-factorial process. Histopathologic studies have revealed that inflammation, disorder of calcium and phosphorus metabolism and dyslipidemia are involved in the process of CAVD. Clinical trials of CAVD pharmacotherapy have been carried out based on those histopathologic studies. Statin, renin-angiotensin inhibitors and anti-osteoporosis drug are well studied in recent years. This article reviews the recent research progress of the pharmacotherapy for CAVD.

Research progress on the role of epithelial-mesenchymal transition in pathogenesis of endometriosis
ZHU Tianhong, ZHANG Xinmei
Journal of ZheJiang University(Medical Science), 2016, 45(4): 439-445.   https://doi.org/10.3785/j.issn.1008-9292.2016.07.17
Abstract( 81 )   HTML (   PDF(953KB)( 146 )

Epithelial-mesenchymal transition plays an important role in the development and progression of endometriosis. Mesenchymal-epithelial transition is involved in forming localized lesions of endometriosis, while EMT is involved in the injury, repair and fibrosis induced by local inflammation of endometriosis and the process of cell invasion and metastasis. The studies of signal transduction pathway and related proteins of epithelial-mesenchymal transition in the process of endometriosis may provide new targets for diagnosis and treatment of endometriosis.

17 articles