Surveillance colonoscopy after endoscopic resection of colorectal adenomas is a crucial step in colorectal cancer screening. After identifying the patients at risk,a tailored follow-up colonoscopy surveillance strategy should be formulated. The follow up colonoscopy time interval after endoscopic resection of colorectal adenomas should be scheduled on the basis of past history,family history,and results of initial high quality colonoscopy examination. By reviewing the American and European guidelines for surveillance after polypectomy,a follow-up colonoscopy time interval schedule matched with the risk stratification is suggested for discussion.

5-aminosalicylic acid(5-ASA)is a first-line drug in the treatment of inflammatory bowel disease(IBD). It is a highly effective,safe,and well-tolerated drug for treatment of mild to moderate ulcerative colitis. As the emerging of new formulations of 5-ASA in recent years,the clinical indication has been extended. This article reviewed the characteristics of various formulations and clinical application of 5-ASA.

Objective To study the correlativity of laser-induced fluorescence (LIF) spectrum on the same specimen of colorectal carcinoma both in vivo and in vitro and to obtain the best diagnostic parameter in detecting colorectal carcinoma. Methods LIF spectra were analyzed from 10 patients with colorectal carcinoma during colonoscopy, and then analyzed again after resection. The cancer foci and normal mucosa more than 5 cm apart from the foci were excited by a nitrogen laser (337 nm)using a quartz optical fiber in gentle contact with the area of interest, and then the fluorescence emission was collected by the same quartz optical fiber. The LIF spectrum was analyzed using an optical multichannel analyzer (OMAⅢ). Results (1)The LIF spectrum from cancer tissues was same as that of normal tissues, both showed the main and the second peak respectively located at about 460 nm and 390 nm in vivo and in vitro. The main peak intensities in vivo from both cancer and normal tissue were significantly lower than these in vitro. The main peak intensities in vivo and in vitro from cancer tissue were decreased about 1 time to those from normal tissue.(2) The integrated spectral intensity in vivo and in vitro of cancer tissue from each patient was significantly lower than that from the corresponding normal tissue respectively, P

Objective Laser induced fluorescence spectroscopy have been used in early diagnosis of GI cancer, but the device is expensive and inconvenient. The purpose of this study was to test the effectiveness and feasibility of a new device designed by the authors. Methods Two formulas were set up based on the analysis of OMA data and a new system was established. Fifteen samples of normal tissue and 40 cases of endoscopic diagnosed cancer were tested. Results (1) First formula: general energy of fluorescence was W 359～659 nm . (2) The second: the ratio of energy integral was W 359～460 nm /W 460～659 nm . (3) The sensitivity and specificity were 93.3% and 100.0% for 15 samples of gastro intestinal cancer in vitro and were 90.0% and 92.5% respectively for gastrointestinal cancer endoscopically. Conclusions (1) The deviec may help doctors to determine the characteristics of lesion in endoscopy and the efficacy of the instrument was the same as OMA system. (2) The cost was about one tenth of that for OMA system.

Objective To study the relationship between gastric mucosa associated lymphoid tissue (MALT) lymphoma and Helicobacter pylori (H.pyori) infection retrospectively. Methods The paraffin embedded samples of the tumors in gastric intestinal tract and its corresponding normal tissues from 35 patients with non Hondgkin's lymphomas in gastric intestinal tract were sectioned. The slides, except routine histopathologic study, were submitted to immuno histochemical staining (CD 3,CD 5,CD 10 ,CD 20 ,C 23 ,CD 45 RO, kappa, lamda, cyclin, Ki67, TUNEL) and to HE staining for the detection of H. pylori infection. Results ①Twenty one cases were identified to be MALT lymphomas according to the results of immunohistochemical staining, of them 16 cases were gastric MALT lymphomas, 1 case of intestinal MALT lymphoma, and 4 cases of colonic MALT lymphomas. ② H. pylori infection in gastric MALT lymphoma was 100% except in 3 cases who had only tumor tissues, which could not be evaluated. ③ Two cases were stage Ⅰ 1 gastric MALT lymphomas, 5 were stage Ⅱ 1,and 9 were stage Ⅱ E. ④ Only 6 cases had recognized as gastric MALT lymphomas by endoscopy and biopsy. Three patients were misdiagnosed as gastric cancer, 1 as M?n?trier disease, 1 as atrophic gastritis, and 5 as chronic gastritis endoscopiclly. ⑤ One patient got a complete regression after 3 courses of anti H. pylori therapy and was in good health after 3 years of the treatment. Conclusions ① A close relation was present between H.pyloi infection and gastric MALT lymphoma. ② Early gastric MALT lymphoma may regress after eradication of H.pylori.

Background:Clinical and epidemiological studies revealed that estrogen replacement therapy was associated with a significant reduction in risk of colorectal cancer in postmenopausal women.In our previous studies,estrogen increased the expression of mismatch repair (MMR)gene MLH1 in colonic cancer cells,and re-expression of MLH1 in MLH-deficient colonic cancer cells significantly increased the estrogen-induced apoptosis.Aims:To investigate the signaling pathway implicated in the MLH1-mediated apoptosis in colonic cancer cells induced by estrogen and the roles of p53 and its related genes in this apoptotic pathway.Methods:Plasmid containing wild type human MLH1 (hMLH1)full length cDNA was transfected into MLH1-deficient human colonic cancer cell line HCT116.By using HCT116 cells transfected with empty plasmid as controls,the apoptotic DNA ladder was determined by electrophoresis and the expressions of p53 and other apoptosis-related proteins were assessed by Western blotting under the condition with or without estrogen stimulation. Results:17β-estradiol (E2 )at the concentration of 10 -8 mol/L induced significant apoptosis in HCT116 cells transfected with hMLH1.In HCT116 cells transfected with hMLH1 and stimulated with E2 (group D),the protein expressions of caspase-3,caspase-9,p53,Bax and cytoplasmic cytochrome C increased significantly when compared with HCT116 cells stimulated with E2 only (group B);expressions of the abovementioned proteins were also higher in group D than in group C (transfected with hMLH1 only).Conclusions:MMR gene MLH1 is involved in estrogen-induced apoptosis of human colonic cancer cell line HCT116 by activating p53 signaling and mitochondrial apoptotic pathway.

Objective To investigate the value and safety of colonoscopy in patients aged 80 years and over.Methods Clinical and endoscopic data of 1 249 patients aged 80 years and over collected from December 2005 to December 2015 at PLA army General Hospital were analyzed retrospectively.Results The average age was 83.03 years.Reasons for receiving colonoscopy included constipation with abdominal distension(19.38 ％)and hematochezia(10.57％).The completion rate of colonoscopy for the entire length was 94.50 ％.There were no abnormal findings in 492 cases (39.39 ％).Colonic polyps (31.62 ％) and colorectal cancer (14.25 ％) were among the major lesions detected with colonoscopy.Colorectal neoplasms were found in 58.33％ of the 132 patients with hematochezia.The total complication rate from colonoscopy and treatment was 0.72％,with the complication rate from treatment at 1.32％.Conclusions Constipation with abdominal distension and hematoehezia are the main reasons for undergoing colonoscopy for very elderly patients.Colon polyps and colorectal cancer are common disorders in elderly patients over 80 years of age and people with hematochezia in this age group are at high risk of having colorectal cancer.Colonoscopy is a safe and effective procedure and an important examination method for very elderly patients with hematochezia.

Background:Ulcerative colitis(UC)is often accompanied by a variety of extraintestinal manifestations. Recently, the role of extraintestinal manifestations in diagnosis and treatment of UC has aroused widespread concern in clinical practice. Aims:To study the extraintestinal manifestations of patients with UC in order to elevate diagnosis level of UC. Methods:A total of 208 inpatients from June 2008 to September 2011 at Beijing Military General Hospital were enrolled. The extraintestinal manifestations of UC were retrospectively analyzed. Results:The ratio of male to female was 1. 14: 1, mean age was(41. 17 ± 13. 57)years,mean disease duration was(62. 6 ± 79. 4)months. Thirty-three patients had proctitis,52 had left-sided colitis,and 123 had extensive colitis. Forty-nine patients were mild UC,80 were moderate UC, and 79 were severe UC. The incidence of extraintestinal manifestations was 28. 8%(60 / 208);13 patients(6. 3% )had more than one extraintestinal manifestation. The main extraintestinal manifestations were oral ulcer(13. 0% ),arthropathy (11. 1% ),hepatobiliary disease( 3. 8% ) and skin lesion( 1. 4% ). The trend of incidence of extraintestinal manifestations increased from patients with proctitis,left-sided colitis to extensive colitis(21. 2% ,28. 8% ,30. 9% , respectively),however,the difference was not statistically significant(P > 0. 05). No significant difference in incidence of extraintestinal manifestations in patients with mild UC,moderate UC and severe UC was found(22. 4% ,33. 8% ,27. 8% , respectively)(P > 0. 05). Conclusions:Patients with UC are often accompanied by extraintestinal manifestations,and the recognition of extraintestinal manifestations is helpful for improving diagnosis and treatment level of UC.

Objective To observe the effects of MSH2 gene re expression on estrogen-induced apoptosis of colon cancer cells LOVO,and to explore its mechanisms.Methods According to different plasmid and whether with estradiol intervention,colon cancer LOVO cells were divided into empty plasmid with ethanol group,empty plasmid with estradiol group,MSH2 with ethanol group,MSH2 with estradiol group,estrogen receptor (ER) β with ethanol group,ERβ with estradiol group,ERβ with MSH2 and ethanol group and ERβ with MSH2 and estradiol group,and received corresponding treatment.The expression of MSH2,ERβ protein and apoptosis related caspase 3 protein were detected by Western blotting.Cell viability was measured by cell counting kit-8.Cell DNA fragments of each group were isolated with apoptosis DNA fragments isolation kit.And the DNA ladder was observed.The rate of apoptosis was detected by flow cytometer.Single factor variance analysis was performed for comparison among multiple groups,and t test was used for comparison between the two groups.Results After transfection,the expression of the MSH2 and ERβ at protein level in LOVO cells significantly increased and neither of their expression was effected by estradiol.The expression levels of caspase 3 cleavaged active fragments of ERβ with estradiol group and ERβ with MSH2 and ethanol group were higher than other groups,and there was no significant difference between these two groups.The LOVO cell viability of empty plasmid with ethanol group,empty plasmid with estradiol group,MSH2 with ethanol group,MSH2 with estradiol group,ERβ with ethanol group,ERβ with estradiol group,ERβ with MSH2 and ethanol group and ERβ with MSH2 and estradiol group was 1.72 ±0.25,1.74 ± 0.31,1.77 ± 0.35,1.74±0.33,1.70±0.34,1.02±0.48,1.71±0.31 and 1.07±0.18,respectively,and the differences between the groups were statistically significant (F=3.791,P＜0.05).Among them,the LOVO cell viability of ERβ with estradiol group was lower than that of ERβ with ethanol group,accordingly,that of ERβ with MSH2 and estradiol group was lower than that of ERβ with MSH2 and ethanol group,that of ERβ with estradiol group was lower than that of empty plasmid with estradiol group,that of ERβ with MSH2 and estradiol group was lower than that of MSH2 with estradiol group,and the differences were statistically significant (t=3.158,3.075,3.648,3.253,all P＜0.05).DNA ladder formed from DNA fragments of apoptosis cells was seen in ERβ with estradiol group and ERβ with MSH2 and estradiol group.The apoptosis rate of empty plasmid with ethanol group,empty plasmid with estradiol group,MSH2 with ethanol group,MSH2 with estradiol group,ERβ with ethanol group,ERβ with estradiol group,ERβ with MSH2 and ethanol group and ERβ with MSH2 and estradiol group was 7.86±0.19,7.87±0.39,8.39±1.02,9.05±1.54,7.54±0.99,19.77±2.35,7.76±1.32 and 19.30±1.75,respectively,and the differences between groups were statistically significant (F=45.436,P＜0.05).Among them,the apoptosis rate of ERβ with ethanol group was lower than that of ERβ with estradiol group,that of ERβ with MSH2 and ethanol group was lower than that of ERβ with MSH2 and estradiol group,that of empty plasmid with estradiol group was lower than that of ERβ with estradiol group,that of ERβ with MSH2 and estradiol group was lower than that of MSH2 with estradiol group,and the differences were statistically significant (t =8.260,9.133,8.596,7.617,all P＜ 0.05).Conclusions Estrogen may promote colon cancer cell apoptosis through ERβ pathway.The process of apoptosis maybe related with caspase protein,MSH2 may not be involved in the regulation of this signal pathway.

Objective To retrospectively analyze medical data of patients with colorectal cancer (CRC) so as to provide evidence for clinical use of opportunistic screening.Methods A total of 2450 CRC patients (male 1377,female 1073) who were treated at five hospitals in North China during October 2001 and September 2011 and had complete medical records and pathological results were recruited.The correlations of incidenceofCRCwithage,gender,tumorlocationandhistologicaltypeswere analyzed.Results Of all the CRC patients,those less than 50 years old accounted for 18.14％ ; and the incidence of CRC was substantially increased in those over 50 years old.Seventy-three percent of tumor occurred at the rectum and sigmoid colon,6％ at descending colon,7％ at transverse colon and 14％ at ascending colon.Moderately,well or poorly differentiated adenocarcinoma accounted for 50.33％,40.35％and 9.32％,respectively.Histological differentiation was not correlated with age and gender ( P ＞ 0.05 ).Conclusions Age and gender should not be considered a determination of opportunistic screening for CRC.Colonoscopy is recommended as an alternative CRC screening procedure.