Epithelial-mesenchymal transition (EMT) is an important biological process in embryonic development and tumori-genesis. In this process, epithelial tumor cells can obtain mesenchymal phenotypes and promote tumor invasion and metastasis. EMT is controlled by multiple transcription factors, signal pathways, and microRNAs. EMT and cancer stem cells are closely related. EMT also promotes the self-renewal ability of tumor cells and the overexpression of EMT-related markers in tumor cells with stemness. Some mi-croRNAs can control EMT process and stemness. In this study, recent developments on EMT and cancer stem cells in tumor metastasis were summarized to provide new insights into target therapy of tumor metastasis and recurrence.

The corneal refractive surgery is invented and improved constantly from 1970's till now,and the excimer laser corneal refractive surgery is the important method for correcting myopia.The corneal safety of post-operation long time is the key point and always is worried by surgeon due to the surgical procedure directly on the normal corneal tissue by different types of flap and ablation. From the corneal safety of view,the advantages and disadvantages of different corneal refractive surgeries were compared and the indications for different methods were mentioned in order to provide rational clinical data.

The physical change of astigmatism in human eye is analyzed in this article.Different methods for astigmatism applied in clinic are expound and compared with advantages and disadvantages.It is important that analyzing carefully and designing customized normgram for astigmatism eye to approach the perfect visual function after reasonable treatment.

Objective To investigate the effect of dexmedetomidine on liver function,plasma cytokine levels,and oxidative stress due to ischemia/reperfusion injury in patients undergoing hepatolobectomy.Methods A total of 106 patients who underwent hepatolobectomy in General Hospital of Jizhong Energy Fengfeng Group Co.,Ltd.from January 2014 to January 2016 were enrolled and randomly divided into control group and observation group,with 53 patients in each group.The patients in the observation group were given 1 μg/kg/h dexmedetomidine within 10 minutes,followed by continuous intravenous infusion of 0.5 μg/kg/h dexmedetomidine,and those in the control group were given an equal volume of 0.9％ sodium chloride.The two groups were compared in terms of liver function parameters,plasma cytokine levels,and oxidative stress due to ischemia/reperfusion injury after anesthesia (T1),before abdominal closure (T2),and at 1,4,and 8 hours after surgery (T3,T4,and T5,respectively).The chi-square test was used for comparison of categorical data between groups;the t-test was used for comparison of indices between groups,the sphericity test was used for comparison of indices at different time points,and an analysis of variance was performed for repeated measurement data with P ＜ 0.05.Results The two groups had significantly higher alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at T2,T3,T4,and T5 than at T1 (ALT:F =43.72 and 44.16,both P ＜ 0.001;AST:F =53.87 and 65.44,both P ＜ 0.001),and the observation group had significantly lower levels than the control group atT2,T3,T4,andT5 (ALT:t =20.54,22.01,36.68,and 38.15,all P＜0.001;AST:t =32.27,41.08,52.82,and71.89,all P ＜ 0.001).The two groups had significantly higher levels of tumor necrosis factor α (TNFα) and interleukin-8 (IL-8) at T3,T4,and T5 than at T1 (TNFα:F =54.37 and 24.75,both P ＜ 0.001;IL-8:F =47.24 and 27.39,both P ＜ 0.001),and the observationgroup had significantly lower levels than the control group at T3,T4,and T5 (TNFα:t =59.39,86.32,and 83.16,all P ＜ 0.001;IL-8:t =74.47,72.29,and 76.67,all P ＜ 0.001).The two groups had a significantly higher level of malondialdehyde at T3,T4,and T5 than at T1 (F =37.65 and 17.44,both P ＜0.001),and the observation group had a significantly lower level than the control group at T3,T4,and T5 (t =17.35,19.11,and 24.12,all P ＜ 0.001).The two groups had a significantly lower level of superoxide dismutase at T3,T4,and T5 than at T1 (F =36.54 and 33.65,both P ＜0.001),and the observation group had a significantly higher level than the control group at T3,T4,and T5 (t =68.64,66.35,and 59.48,all P ＜0.001).Conclusion Dexmedetomidine can effectively inhibit liver injury,reduce the levels of cytokines,and alleviate ischemia/reperfusion injury in patients undergoing hepatectomy.

Objective To examine the levels of serum adipaneetin in patients with incipient chronic kidney disease (CKD, GFR≥ 60ml/min, and identify the relationship between serum adiponectin and albumin (ALB), urinary protein excretion amount, blood lipid and renal function. Methods Forty-two CKD patients and twenty normal healthy persons were involved in this study. These patients were divid- ed into two groups: nephrotic syndrome and non-nephrotic syndrome. The level of serum adiponectin, serum ALB, urinary protein excretion amount, blood lipid, renal function were measured and compared. Results The level of serum adiponectin in nephritic syndrome patients [(21.9±11.3) mg/L] and non-nephrotic syndrome patients [ ( 11.0±7.0) mg/L] was significantly higher than that in normal healthy per- sons[ (5.6±3.3) mg/L] ( P<0.01 ), and the level of serum adiponectin in nephritic syndrome patients was higher than that in non-ne- phrotic syndrome patients( P <0.01 ). Correlative analyses revealed a negatively correlation between serum adiponectin and serum total pro- tein(TP, ALB, BMI( r=-0.5680, r = -0.6241, r = -0.4083,respectively), and a positive correlation between serum adiponectin and urinary protein excretion amount ( r =0.4083). Stepwise regression analyses showed that serum adiponoctin was highly influenced by BMI, ALB and urinary protein excretion amount. Conclusion Serum adipanectin was markedly increased in incipient CKD, especially in patients with macroalbuminura. The effect of high level adiponectin in CKD was still not clear.

The frequency of inducible nitric oxide synthase (iNOS) gene (CCTTT) 14 allele was significantly lower in diabetic nephropathy group (0.044) than that in diabetics without nephropathy (0.170, P

Objective To analyze the MRI data of misdiagnosed and missed diagnosed of breast lesions and their histopathological features.Methods Data from 241 breast lesions within 121 patients were recruited in this study.The data included MRI images,uhrasounds and X-ray images were retrospectively interpreted by two radiologist and each lesion was assessed according to the BI-RADS classification.The pathologic features of miss or error diagnosed lesions on MRI were analyzed.Results In 241 breast lesions (malignance 120,bcnign 121),4 lcsions were miss diagnosed on MRI.Thcy were 2 intraductal papillomatosis and 2 fibroadenoma.All was benign.Twenty three lesions were misdiagnosed on MRI.Sixteen were overestimation,including 3 chronic inflammations,3 sclerosing adenosis,2 fibroadenoma,4 fibrocystic changes with or without atypical ductal hyperplasia (ADH),2 intraductal papilloma,1 infiltration of pectoralis major muscle and 1 axillary lymphnode metastasis.Meanwhile,there were 7 lesions were underestimation.These lesions included 2 invasive ductal carcinomas,1 mucinous adenocarcinoma,2 DCIS and 1 blunt duct adenosis with ADH and focal cancerous,1 inflammatory breast cancer underwent chemotherapy.The sensitivity and specificity and accuracy of breast MRI were 95.83 ％ (115/120),72.73 ％ (88/121),84.23 ％ (203/241),respectively.MRI findings had no difference with respect to mammogram or ultrasound was 75.10 ％ (181/241).Conclusion MRI misdiagnosis and missed often occurs in smaller breast lesions,morphologic and hemodynamic malignant manifestation atypical,especially intraductal lesions.MRI diagnosis should be combined with physical examination,X-ray mammogram and ultrasound to improve diagnostic accuracy and reduce missed diagnosis.

Objective:To investigate the possibility of miR-125b in serum as a novel tumor marker for primary hepatocellular car-cinoma (HCC) and the diagnosis value of combined detection of miR-125b and alpha-fetoprotein (AFP) for HCC. Methods:We detected serum miR-125b expression of 65 cases of HCC patients and 30 cases of healthy controls by real-time quantitative PCR. Moreover, we analyzed the significance of miR-125b and explored the relationship between miR-125b and clinical pathological factors. Results:The level of miRNA-125b was down regulated in serum of HCC patients compared with healthy controls which showed significant differences (P<0.05). Furthermore, the expression of miRNA-125b has no distinct correlation with sex, age, HbsAg, AFP, ALT andα-GGT, which had no significant differences (P>0.05). The expression level of miRNA-125b correlated the difference with liver Cirrhosis, tumor size and tumor node metastasis (TNM) stages, which were considered significant differences (P<0.05). The receiver operating characteristic (ROC) curve analysis of serum miR-125b for the diagnosis of HCC yielded AUC of 0.917(95%CI:0.851~0.960, P<0.001)with 85.9%sensitivity and 93.5%specificity. The ROC curve analysis of combined miR-125b and AFP for HCC detection yielded AUC of 0.951(95%CI:0.894~0.982, P<0.001)with 92.9%sensitivity and 93.5%specificity. The ROC curve analysis of serum miR-125b as biomarkers for the group (AFP<20μg/L) of HCC yielded AUC of 0.889(95%CI:0.776~0.957, P<0.001)with 84.0%sensitivity and 87.1%specificity. Conclusion:Serum miRNA-125b combined with AFP has considerable clinical value for the early diagnosis of primary HCC.

Objective To evaluate the relationship between von Hippel-Lindau (VHL) gene mutations and the prognosis of Chinese sporadic clear cell renal cell carcinoma (CCRCC). Methods VHL gene mutations were detected by polymerase chain reaction (PCR), direct DNA sequencing in 74 paired specimens of sporadic CCRCC and normal kidney. The mutation findings, pathologic fea-tures and prognostic characteristics were analyzed. Results Fifty-one patients (68.9%) were in clinical stage T1, 9 patients (12.2%) were in T2 and 14 patients (18.9%) were in T3. In the aspect of pathological grade, 15 patients (20.3%) were in G1, 50 patients (67.6%) were in G2 and 9 pa-tients (12.2%) were in G3. VHL gene mutations were detected in 40 of 74 cases (54.1%). There were no significant differences of VHL gene mutations in different pathological grade and clinical stage of CCRCC, P=0.915, P=0.237, respectively. All patients were followed up for 34 to 107 months (mean 71 months). Seven patients died of CCRCC. Another 11 patients developed CCRCC related me-tastasis. Five-year tumor-free survival was 78%. The incidence of death or metastasis of CCRCC in VHL gene mutation group (15.0%, 6/40) was significant lower than non-mutation group (35.3%,12/34), P=0.043. Logistic regression results showed that lower tumor pathological grade and stage, better patients' prognosis would be (P=0.016, P=0.024, respectively). However, VHL gene muta-tion was related with better prognosis (P=0.033). This association was stronger among patients with high grade tumors (G3, P=0.048). Conclusions There are frequent VHL gene mutations in spo-radic Chinese CCRCC. Tumors' pathological grade and clinical stage are the important parameters for prognosis. However, VHL mutations are strongly associated with better cancer specific survival for CCRCC patients. These associations are relatively stronger in patients with high grade tumors.

Otjective To study whether there is the apoptosis of neural cells and the expressionof Bcl-2 protein in intracerebral hemorrhage (ICH) in model of rats, for the further understanding the mechanism of the delayed damage of the neural cells around the hematoma after ICH. Methods Fifty SD rats were randomly divided into 5 groups, ten in each. With the Group A as the control, the rest 40 were used to set up intracerebral hemorrhage model. The brains were taken out at 12th, 24th, 48th and 72th hours, respectively. Apoptosis cells were detected with terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL), and the expression of Bcl-2 protein was detected with immunochemical stainging methed (SP). Results In the control group, no apoptosis cells and Bcl-2protein were detected. In rest groups, the apoptosis cells and Bcl-2 protein were expressed in different degree.Apoptosis rates verified and corresponded with the time after ICH, with the peak at 48th -72th hour after hemorrhage.The peak rate of apoptosis cells was (24. 50± 2.69)% and Bcl-2 protein expression was (20. 76 ± 1.97)% . There was significant difference between the experimental groups and control (P＜0.05), and no linear relationship between the apoptosis rate and the expression of Bcl-2 protein. Conclusion Apoptosis may be an important factor in the secondary trauma of ICH. There is a time leg after hemorrhage. All this is instructive to clinical treatment in time. Bcl-2 protein keeps increasing in a certain time after hemorrhage, but not synchronize with the cell apoptosis. This indicates that bcl-2 has the effect to reduce the apoptosis of neural cells.