The transforming growth factor-?(TGF-?)-Smad signaling pathway has an important role in carcinogenesis. In recent years, some investigations have revealed the functions of TGF-? super-family ligands, receptors, Smads protein, up stream and down stream regulators and cross-talk among many signaling pathways in gastrointestinal cancers, lung cancer and other cancers. This review attempts to collate and integrate the extensive body of in vivo and in vitro studies about TGF-?-Smad signaling pathway and Smad4 in cancers.

Objective:To construct and identify the small hairpin RNA(shRNA) expression vector for Smad 4/DPC 4 gene. Methods:Three shRNA sequences targeting Smad 4 were designed by software and cloned into the expression vector pGCsi-H1/Neo/GFP.DNA sequencing was used to confirm that the plasmids were constructed correctly.The constructed plasmids with different shRNA and the control plasmid were transiently transfected into the 293 cell line cells.Fluorescene quantitative PCR was used to detect the efficiency of RNA interference against Smad 4. Results:Double enzyme(HindⅢ and BamHⅠ) digestion(analysis) and DNA sequencing confirmed that Samd 4 specific shRNA expression vectors were constructed successfully.Fluorescene quantitative PCR showed that the inhibition rates of Smad 4 mRNA expression in cells transfected with shRNA expression vector psiSmad 4-1,psiSmad 4-2 and psiSmad 4-3 were 39.00%,8.80% and 73.80%,respectively,which indicated Smad 4 mRNA expression was specifically inhibited. Conclusion:Smad 4 pGCsi-H1/Neo/GFP/shRNA plasmid was constructed successfully,which may provide a novel applicable strategy for gene therapy and study of its role in carcinogenesis.

Gastrointestinal benign stricture is one of common diseases in clinics , endoscopic dilation is its preferred treatment . However , for the dilation ineffective refractory strictures , it represents a difficult management problem given the limited therapeutic in-terventions available .Mitomycin-C is an antibiotic which has the dual role of anti-tumor and anti-proliferation.As an anti-proliferative drug, it was first applied in the field of ophthalmology .Local auxiliary application of MMC can be a feasible and safe measurement to improve the efficacy of refractory esophageal strictures .The aim of this study is to perform a systematic review which employs mitomycin C in the treatment of refractory esophageal strictures caused by corrosion , endoscopic submucosal dissection , esophageal atresia repara-tion and radiotherapy .

Enhancing medical humanitarian activities in clinical teaching is demanded by modern medicine and education.It contains the modern values of constructing a harmonious doctor-patientrelationship and adjusting to medical education and modern medical model development.We put forward several countermeasures such as establishing concept of respect for people,improving teachers'humanistic caring ability,strengthening management to enhance students' sense of responsibility,enhancing students' doctor-patient communication skills,and abiding by relevant laws and regulations in the current situation which lacks humanistic care,doctor-patient communication and legal concept.

Objective To explore the mechanisms of TGF-? 1?TGF-? 1RⅡ and NF-?B on the angiogenesis in patients with hepatocellular carcinoma.Methods The expression of TGF-? 1 ?TGF-? RⅡ and NF-?B protein in 36 cases of HCC and surrounding HCC tissue was separately detected using immunohistochemistry technique.To observe the relationship of TGF-? 1 protein and MVD, TGF-? 1RⅡ protein and MVD, NF-?B and TGF-? 1 protein, using CD34 labelling vessel endothelial cell. Results The expression of TGF-? 1 and MVD in HCC tissue was higher than that in surrounding HCC tissue (P

Objective To study the technique of placemen t of Nitinol stent for relieving malignant pylorus or duodenal obstruction, and to assess its clinical effectiveness.Methods In this group the strictures were caused by gastric car cinoma at the antrum (n=2), anastomosis site of previous gastrojejunostomy (n=2 ), gastric carcinoma at the cardia (n=4), colon cancer (n=1), pancreatic cancer (n=3) and duodenal cancer (n=4). Under fluoroscopic guidance the Nitinol stent w as inserted into pylorus or duodenal obstruction sites via oral cavity in all ca ses. Complications and clinical status were investigated during the study period .Results Successful stent placement was achieved in 15 cases. Tw o patients had undergone double stent placement (pylorus stent and bile duct ste nt). The rate of improvement in abdominal distention and vomiting 1 week after p rocedure was 73 3% and 86 7% respectively. Procedure-related complications ne ver occurred.Conclusion Nitinol alloy network stent is a safe and efficaciou s method for palliating malignant pylorus or duodenal obstruction, and improves patient's living quality.

Objective To evaluate the short-term effects and complications of transoral endoscopic suturing in the treatment of gastroesophageal reflux diseases (GERD). Methods Sixteen patients with GERD, confirmed by gastroscopy, upper gastrointestinal barium meal examination, and esophageal pH value examination, received gastroesophageal suturing by using an endoscopic suturing device (manufactured by Bard Co.). The site of suturing was 1cm below the dentation line, with a suture interval of 1.5cm and a knot interval of 2.0cm. Symptom severity scoring, esophageal 24-hour pH monitoring and the degree of esophagitis before and 1 month after the operation were compared respectively. Results A total of 42 sutures and 21 knots were made in the 16 cases. The mean operation time was 30 min. The sum of heartburn scores and regurgitation scores before the treatment were 39 (mean, 2.44) and 32 (mean, 2.0), and those after the treatment were 11 (mean, 0.68) and 10 (mean, 0.63), respectively, with statistical significances between preoperation and postoperation ( ? 2 =19.5 and 16.33; P

Cancers of the digestive system account for a large portion of malignant tumors in humans,and the trend is on the rise.The formation of neovascularization is the dominant factor in the metastasis of tumors.The vascular endothelial growth factor(VEGF) is well documented as the most potent inducer of angiogenesis.It promotes the formation of new blood vessels in several aspects,such as proliferation of endothelial cells,endothelial cell migration and increased vascular permeability.So VEGF is regarded as an important factor in the development of digestive system tumors.The purpose of this review is to investigate the relationship between VEGF and digestive system tumors.

Objective To investigate the clinical situation of inflammatory bowel disease (IBD).Methods The clinical features and treatment features of 122 patients with IBD were investigated.Results In 122 IBD patients,54 cases had ulcerative colitis (UC),the lesion was in colon,hospital number visited was median 3,the ratios of using amino salicylic acid salts,hormones,immunosuppressive agents,biological agents and antibiotics was 100.0％ (54/54),55.6％ (30/54),24.1％ (13/54),7.4％ (4/54) and 75.9％ (41/54); 68 cases had Crohn disease (CD),the lesion was in the ileocolic,hospital number visited was median 4,the ratios of using amino salicylic acid salts,hormones,immunosuppressive agents,biological agents and antibiotics was 95.6％ (65/68),58.8％ (40/68),47.1％ (32/68),11.8％ (8/68) and 79.4％ (54/68).The uses of CD in patients with immunosuppression,quinolone antibiotics in patients of CD were higher than those of patients with UC,the use of herbal medicine in patients of CD was lower than that in patients of UC,the difference was statistically significant (P ＜ 0.05).Conclusion The main drugs currently used to treat IBD are amino salicylic acid preparation,corticosteroids,immunosuppressive agents,biological agents.

Objective To learn the relationship and operating mechanism between medical staff's loyalty and patient satisfaction.Methods Medical staff and inpatients of a tertiary hospital in Nanjing were sampled at a 1:2 ratio for study,with 840 questionnaires released and 269 valid questionnaires recovered;medical staff service quality as perceived by inpatients served as the intermediate variable,with Mplus7.0 used to build a structural formula model for an empirical study of the relationship between staff loyalty and patient satisfaction.Results Staff loyalty exerts certain positive influence on patient satisfaction and staff service quality ( P < 0.001 ); service quality also exerts some positive influence on patient satisfaction (P<0.001);staff loyalty indirectly exerts positive influence(P<0.001)via the service quality as perceived by patients(mediation effect value 0.364 > direct effect value 0.143).Conclusions Structural formula model can reveal the relationship and extent of the influence of staff loyalty on patient satisfaction.This indicates that hospitals should enhance the loyalty,medical competence and communication skills of their medical staff for higher patient satisfaction.