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.

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.

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.

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 evaluate the diagnostic value of pit pattern analysis in detection of early colorectal carcinoma.Methods From November 2004 to August 2007,a total of 1496 colorectal lesions were observed by mannifying colonoscopy with 0.4%indigo carmine staining.The mucosal crypt patterns (classified according to Kudo classification criteria)of these lesions were compared with pathological diagnosis.Results In 1496 lesions,458(30.6%)were non-neoplastic,657(43.9%)were adenoma,and 381 (25.5%)were adenocarcinoma.In 657 adenoma lesions,415 were tubular adenoma,with low grade dysplasia in 363(87.5%),150 were tubulovillous adenomas with hish grade dysplasia in 61(40.7%)and 49 were villous adenoma with hiish grade dysplasia in 42(85.7%).Among the adenocarcinoma lesions,61 were early colorectal cancers and 36 were laterally spreading tumors(LST).The LST lesions ranged from 10 to 62 mm in diameter.The pit pattern of 3 cases was Type Ⅱ,14 were Type Ⅲ,17 were Type Ⅳ and 2 were Type Ⅴ.Conclusion Pit pattern analysis is important in distinguishing tumorous lesions from non-tumorous ones and in improving the diagnosis rate of early colorectal cancer,which helps in choosing appropriate managements.

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 .

Objective To evaluate the relationship between endoscopic rectal aberrant crypt foci (ACF) and colon neoplasm, including lesions with high risk of aggressive progression (adenoma with diameter ≥ 1cm, villus adenoma, tubular-villus adenoma, adenoma of high grade dysplasia, or cancer). Methods The rectum of 212 patients who underwent colonoscopy was stained by 0. 4% indigo armine, and the patient was classified into different grade according to the number of rectal ACF, namely Grade 0 as no ACF, Grade Ⅰ as 1-4, Grade Ⅱ as 5-9 and Grade Ⅲ as more than 10. The correlation between rectal ACF grade and colon lesions was analyzed. Results Of 212 patients, 72 were classified as Grade 0, 48 as Grade Ⅰ , 41 as Grade Ⅱ, and 51 as Grade Ⅲ. The detection rate of colon neoplasm and lesions with high risk of aggressive progression in patients with rectal ACF were significantly higher than that in patients without rectal ACF (OR at 95% CI was 22. 352 (6. 716 -74. 395) and 7. 982 ( 1. 838-34. 672), respcetively). Conclusion Rectal ACF may predict the detection of colon lesions, including those with high risk of aggressive progression.