Laterally spreading tumor is a new type of colorectal tumor found recently.For its particular shape and develptment of tumor,LST is divided as an independent tumor.LST is associated with colorectal cancer and more research is done on it .The progress of its epidemiology, oncomolecularbiology, diagnosis and therapy is reviewed.

This paper summarizes the nursing experience of 9 very low birth weight infants with catheter-related infections. Among the 132 very low birth weight infants with PICC,9 cases suffered from catheter-related infections. Three cases showed positive results on the germiculture of catheter tip and blood, two cases showed positive result only on the germiculture of blood, and four cases showed negative results on both germiculture of catheter tip and blood. One infant's parent gave up the treatment and eight cases were cured. It is suggested that closely monitoring the signs of infections and taking effective treatment and nursing care as early as possible were the key points of infection control.

While the development of simulation-based medical education in China is facing such opportunities as increasing demand, information technology and internet development, there are also dilemmas that a systematic training system has not yet been formed, the professionalism of the faculty needs to be strengthened, clinical practice cannot be fully simulated, the relevant policies and systems are not perfect, and there is a gap between the construction of the center and developed countries. It is necessary to grasp the opportunity, improve the development level, adapt to social needs, strengthen teacher training, improve the rules and regulations, develop training standards, enrich simulation cases, etc., and further promote the connotative development of simulation-based medical education.

Aim To investigate roles of ROS in oxaliplatin-induced PUMA expression and apoptosis in colon cancer cells.Methods ROS was used as an oxidative stress in vitro and PUMA expression was determined by Western blot analysis,the apoptosis induced by ROS was assessed by Hoechst 33258 dye staining,the proliferation of the colon cancer cells treated with oxaliplatin and antioxidant was determined by MTT assay.Results ROS induced apoptosis and PUMA expression in colon cancer cells;suppression of PUMA expression by stable transfecting PUMA anti-sense vector decreased apoptosis induced by ROS;oxaliplatin-induced PUMA expression was abrogated by antioxidant and the proliferation of colon cancer cells treated with oxalipla-tin was increased by antioxidant.Conclusions Our data suggests that PUMA and ROS play important roles in oxaliplatin-induced apoptosis.Oxaliplatin induces PUMA expression and apoptosis partly through ROS in colon cancer cells.

Objective To investigate the clinical significance of NaviCam magnetic-controlled capsule endoscopy (NMCE) system in the examination of upper gastrointestinal tract.Methods A total of 39 healthy volunteers were enrolled in the present study.NMCE system was used to examine upper gastrointestinal tract.The safety,gastric preparation,visualization and comfort of the subjects were evaluated.Results Visualization of the Z-line,gastric cardia,fundus,body,angulus,antrum and pylorus was subjectively assessed as more than 75％ mucosa in 19 (48.71％),37 (94.87％),25 (64.10％),30 (76.92％),39 (100.00％),39 (100.00％),and 39 (100.00％),respectively.The observation time was 1.5,3.0,8.0,17.0,3.0,3.0,5.0 min respectively.The capsule was driven into duodenum positively in 25 (64.10％).Seven subjects went into small bowel without control.The one-time visualization efficacy was 97.43％ (38/39).Only one subject felt foreign body sensation.All subjects extracted the capsule within 7 days.Conclusion Our study provides a preliminary assessment of the NMCE on its feasibility and safety.It is comfortable with no chance of cross-infection.NMCE system is a useful tool for upper GI examination and will have a good future.

Objective To investigate the effects of MEK1 specific inhibitor PD98059 on oxaliplatin-treated colorectal cancer cells and the potential mechanism. Methods Cell proliferation was assessed by MTT assay after transfecting MEK1 active plasmid into LoVo cells. LoVo cells were treated with oxaliplatin or PD98059, and the proliferation was assessed by MTT assay. PUMA expression and ERK activity were determined by Western blot. Apoptosis was assessed by Hoechst 33258 dye after PUMA expression was suppressed. Results Increasing activity of ERK enhanced the proliferation of LoVo cells. The activity of ERK was suppressed by oxaliplatin. PD98059 and oxaliplatin decreased the proliferation rate of LoVo cells synergistically. PUMA expression increased after PD98059 and oxaliplatin treatment. The suppression of PUMA expression by stably transfecting PUMA anti-sense vector decreased apoptosis induced by oxaliplatin and PD98059. Conclusion PD98059 enhances the effects of oxaliplatin on colorectal cancer cells mediated by PUMA expression.

Objective:To investigate the role of PUMA,a Bcl-2 family member,in oxaliplatin-induced apoptosis in colorectal cancer cells.Methods:In vitro,LoVo cells were treated with 1.2,2.4,4.8 ?mol/L oxaliplatin for 24 h and 4.8 ?mol/L oxaliplatin for 6,12,24 h,PUMA expression was assessed by Western blot analysis.The anti-sense PUMA plasmid was constructed by gene recombination.PUMA expression was suppressed by stable transfecting anti-sense PUMA plasmid into LoVo cells.The apoptosis was assessed by flow cytometry analysis(FCM) and proliferation rate was assessed by MTT assay.Results:Oxaliplatin induced PUMA expression in a time-and dose-dependent manner;stable cell lines expressing the anti-sense PUMA vector were established and named LoVo puma(-/-) cells;oxaliplatin-induced apoptosis was decreased by suppression of PUMA expression;the proliferation rate in LoVo puma(-/-) cells was higher than that in LoVo cells after oxaliplatin treated.Conclusion:Our data suggest that PUMA plays an important role in oxaliplatininduced apoptosis in LoVo cells and the sensitivity of LoVo cells to oxaliplatin was abrogated by suppression of PUMA expression.

Objective To analyze the epidemiological characteristics of brucellosis for improving its clinical and laboratory diag‐nostic ability .Methods The clinical and laboratorial data of the patients with brucellosis in our hospital from January 2013 to Sep‐tember 2015 were retrospectively analyzed .Results In 39 cases of brucellosis ,the majority had the sheep‐contacting history and the clinical manifestations were mainly fever (100 .0% ) ,bone and joint pain(64 .1% ) ,hidrosis(51 .3% ) ,weak(33 .3% ) ,lymph node en‐largement(23 .1% ) and hepatosplenomegaly(12 .8% ) .The laboratory detections showed the abnormal liver function ,rapid erythro‐cyte sedimentation rate(ESR) ,hypersensitive C ‐ reactive protein(hs‐CRP)increase ,lymphocytes percentage increase ,positive for brucellosis antibody agglutination test ,positive blood culture or medulloculture ,which was identified as Brucella melitensis by bacte‐riology .Conclusion The clinical manifestations of brucellosis are diversity and is easy to be misdiagnosed .The sporadic cases in northern Jiangsu area are increased year by year .The epidemiological clue should be paid attention to and the recognition on brucel‐losis should be strengthened .The patients with fever of undetermined origin should be conducted the blood culture and brucellosis antibody agglutination test as early as possible .

Objective To explore the efficacy and safety of infliximab (IFX) treatment in inducing and maintaining deep remission (DR) in patients with moderate to severe Crohn's disease (CD).Methods From February 2012 to April 2014,the clinical data of 26 patients with moderate to severe CD received IFX treatment were retrospectively analyzed.Laboratory indexes (erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),albumin),Crohn's disease activity index (CDAI),Crohn's disease simplified endoscopic score (SES-CD),rate of DR and side effects were observed before treatment,at week 14 and week 30.The t test was performed for normal distribution measurement data comparison between two groups.Wilcoxon signed rank test was performed for non normal distribution measurement data comparison between two groups.Chi square test and Fisher exact probability method were used for rate comparison.Results In 26 patients with CD,at week 14,the CDAI significantly decreased compared with that before treatment (225.0(124.0,265.0) vs 80.0(67.0,124.7),Z=-4.265,P＜0.01); ESR and CRP levels also significantly decreased while body mass index (BMI) and albumin levels increased.The rate of clinical remission,mucosal healing under endoscope and DR was 80.0 ％ (21/26),42.3 ％ (11/ 26) and 34.6％ (9/26),respectively.The rate of clinical remission was higher in patients with the disease course less than one year (92.3％ vs 69.2％,P=0.32).At week 30,the CDAI of patients significantly decreased compared with that before treatment (225.0(124.0,265.0) vs 81.5(67.0,111.0),Z=-4.877,P＜0.01); the ESR and CRP levels significantly decreased; while the BMI and albumin levels increased.The rate of clinical remission,mucosal healing under endoscope and DR was 88.5 ％ (23/26),57.7％(15/26) and 53.8％ (14/26),respectively.Rate of clinical remission was higher in patients with the disease course less than one year (100.0％ vs 76.9％,P=0.22).The differences in the rates of clinical remission,mucosal healing and DR between week 14 and week 30 were not statistically significant.Conclusion IFX could induce and maintain DR in patients with moderate to severe CD.

Objective Neuroinflammation following traumatic brain injury (TBI) may give rise to neurodisorder.This study aimed to investigate the effect of intranasal delivery of nerve growth factor ( NGF) on neuroinflammation following TBI and its action mechanism in rats. Methods Thirty-six male adult Sprague-Dawley rats were equally divided into a sham , a TBI, and a TBI+NGF group.The rats in the TBI +NGF group were treated with NGF intranasally at 12 and 24 hours after TBI.The levels of IL-1βand TNF-αin the injured cerebral cortex were detected by ELISA , the DNA-binding activity of NF-κB evaluated by EMSA , and the expres-sion of amyloid-β( Aβ42 ) determined by Western blot . Results NGF attenuated the inflammation following TBI .Compared with the TBI group, the level of IL-1βwas obviously decreased in the TBI +NGF group at 12 hours (70.65 ±3.10 vs 37.51 ±1.92) and 24 hours (68.85 ±8.10 vs 36.23 ±2.99, P<0.05), and so was that of TNF-α(47.12 ±7.38 vs 27.63 ±5.77 and 56.15 ±11.20 vs 29.94 ±8.62, P<0.05).The DNA-binding activity of NF-κB was reduced to 111.62 ±0.49 and 131.52 ±0.88, and the expression of Aβ42 to 0.23 ±0.008 and 0.52 ±0.004 at 12 and 24 hours respectively after treatment with NGF , both with statistically significant differences from the TBI group (P<0.05). Conclusion Intranasal administration of NGF attenuates TBI-induced neuroinflamma-tion in rats, which may be associated with its regulatory effect on the Aβ42/NF-κB signaling pathway .