Colorectal cancer( CRC) is one of the most common tumor,which has complicated pathogene-sis.it is estimated that the vast majority of CRCs is non-hereditarysporadic cancerswith no apparent evidence of an inherited component.Sporadic CRC results from the cumulative effects of multiple genetic and epigenetic al-terations caused by somatic mutations, which may be the indirect result of several environmental factors them-selves.There are at least 3 major genetic alternations that lead to colorectal carcinogenesis:(1)The chromosomal instability(CIN)pathway;(2)The microsatellite instability(MSI)pathway;(3)The cytosine-phospho-guanine ( CpG) island methylator phenotype( CIMP) pathway,while DNA methylation,modifications in histone proteins and microRNAs( miRNAs) are analyzed in the field of epigenetic alterations.This review summarizes the newest bio-molecular progression involved in CRC pathogenesis,for the purpose of improving strategy for prevention,surveil-lance,early diagnosis and therapy.

BACKGROUND:Few reports focus on biocompatibility of nano fluoridated hydroxyapatite for dental implants. OBJECTIVE:To investigate the biocompatibility in vitro of nano fluoridated hydroxyapatite modified for dental implants.
METHODS:We utilized sol-gel method to prepare nano fluoridated hydroxyapatite and nanohydroxyapatite powders. (1) Hemolysis test:0.01, 0.15, 0.2 g/L nano fluorinated hydroxyapatite solution, saline and distil ed water at a volume of 10 mL were added into 0.2 mL diluted rabbit anti-coagulation blood samples, respectively. Then the supernatant was detected by absorbance values. (2) In vitro cytotoxicity test:Passage 2 L929 cel s were respectively cultured in culture media containing 100%, 50%nano fluorinated hydroxyapatite extract, 100%hydroxyapatite extract, phenol solution and RPMI1640. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was employed to measure absorbance values at days 2, 4, 7 of culture.
RESULTS AND CONCLUSION:Hemolysis test in vitro showed the hemolysis rates of nano fluorinated hydroxyapatite groups were less than 5%, which were accorded with haemolysis demand of medical materials. The cytotoxicity test in vitro showed during cultivation, the adherence rate of L929 cel s cultured in 100%and 50%nano fluorinated hydroxyapatite extracts were increasing and cel density was rising up. Cel s were fusiform or polygon, which had no evident differences from negative controls in morphology. Nano fluorinated hydroxyapatite showed nontoxic to L929 cel s in vitro.

Objective To investigate the efficacy and safety of tiotropium bromide aerosol combined with salmeterol in the treatment of ACOS. Methods 76 patients with ACOS were enrolled in this study from October 2014 to November 2016. They were divided into experimental group and control group according to the random number table method. The test group was given tiotropium bromide combined with salmeterol Casson aerosol treatment, the control group was given salmeterol tacrolone aerosol treatment, compared the two groups of patients with clinical efficacy and adverse reactions. Results The total effective rate was 92.11% in the experimental group and 73.68% in the control group, the difference was statistically significant (Z = 4.547, P<0.05). The ACT score of the test group was higher than that of the control group, the CAT score was lower than that of the control group, the difference was statistically significant (P<0.05); The incidence of adverse reactions in the test group was 10.53%, the incidence of adverse reactions in the control group was 13.16%,the difference was not statistically significant (χ2 = 0.126). Conclusion Tiotropium powder combined with salmeterol tegon aerosol in the treatment of bronchial asthma-chronic obstructive pulmonary syndrome is reliable and worthy of clinical practice.

Objective To improve the pipeline which is the second grade of oxygen pressure reducer in order to reduce the oxygen resistance. Methods This device accesses oxygen storage devices in the original pipeline which absorbs oxygen in the atmospheric with the second grade pressure reducer. Results Accessing oxygen storage devices almost can eliminate the additional resistance which is produced by the second pressure reducer. Conclusion The accessing device fully meets the demand of the people with weak breathing, who accesses oxygen for oxygen therapy via the second grade pressure reducer. Meantime, the device expands the scope of services and efficacy of the medical equipment.

The “vertical tongue”method was used in speech training for 12 patients with functional speech disorder of consonant /L/.Af-ter treatment,the average vocal intilligibility of the 12 patients increased from 86.3% to 98.9%(P <0.05)./L/consonant average intelligi-bility increased from 42.9% to 85.2%(P <0.05).

Objective To discuss the MSCT performances of appendix mucinous cystadenoma in order to improve the preoperative diagnosis.Methods MSCT plain and enhanced findings of mucinous appendix mucinous cystadenoma proved by pathology in 6 pa-tients were analyzed retrospectively.Results CT showed cystic dilatation of the appendix in 2 patients with heterogeneous density, and cystic mass in the right iliac fossa in 4.As for the cystic wall,uniform thin wall was seen in 4,curvilinear mural calcification in 3 and septation in 2.Dynamic enhanced CT showed the ring mural enhancement in 4.In addition,the blurred surrounding fatty tis-sues were seen in 2.Conclusion MSCT findings of mucinous appendiceal cystadenoma appeared as cystic dilatation or cystic mass in the right iliac fossa,curvilinear mural calcification and enhanced wall.

Objective:To investigate the stability of flurbiprofen axetil lipid microspheres injection combined with 0. 9% sodium chloride injection or 5% dextrose injection, and provide theoretical basis for the clinical application. Methods:The content changes of flurbiprofen axetil in the mixture of flurbiprofen axetil lipid microspheres injection and 0. 9% sodium chloride injection or 5% dextrose injection were determined in 5 h at 25℃ away from light, and the changes in the appearance and particle size of flurbiprofen axetil lip-id microspheres were investigated. The changes in the appearance and particle size of flurbiprofen axetil lipid microspheres in the mix-ture of flurbiprofen axetil lipid microspheres injection and 0. 9% sodium chloride injection before and after freezing and thawing were also investigated. Results:The appearance, particle size and content had no significant changes in all mixtures in 5 h at 25 ℃ away from light. The appearance and particle size of flurbiprofen axetil lipid microspheres in the mixture before and after freezing and thawing had no significant changes as well. Conclusion:The mixture of flurbiprofen axetil lipid microspheres injection and 0. 9% sodium chlo-ride injection or 5% dextrose injection is stable in 5 h away from light.

OBJECTIVE To analyze the situation of extended spectrum ?-lactamases(ESBLs)and AmpC enzyme produced by nosocomial Escherichia coli isolates in 2005-2007.METHODS ESBLs were detected by double disk synergy test and disk diffusion confirmatory test.AmpC enzyme was detected by the three dimensional assay.Chi square test was used to test the significance.The application of different kinds of antimicrobials before the results of etiology be presented and the resistence rate of the ESBLs both producing and no producing were compared respectively.RESULTS The detectable rate of ESBLs in E.coli isolates of nosocomial and community infection was 55.1% and 21.3% and the detectable rate of AmpC enzyme nosocomial E.coli isolates was 17.4%.All strains were 100% susceptible to meropenem and imipenem but resistant to 15 other antimicrobials in different degree.The sensitivity to Piperacillin/tazobactam,cefoperazone/sulbactam and amikacin were relatively high.CONCLUSIONS The carrying rate of ESBLs from nosocomial E.coli isolates is high and AmpC enzyme and other resistance genes,which lead to multiple drug resistance.Standardized management of antimicrobials application should be strengthened and the consciousness of rational antimicrobials utilization should be raised.

OBJECTIVE To explore the clinical characteristics of nosocomial infection of lower respiratory tract by coagulase negative staphtylococci(CNS) and their drug resistance to common antibiotics.METHODS The clinical data and drug resistance of CNS of 37 nosocomial infection cases and 68 cases with colonization of lower respiratory tract by CNS were analyzed retrospectively,and the study mainly was focused on the risk factors and basic clinical features of nosocomial infection of lower respiratory tract by CNS.The resistance to common antibiotics of CNS was also summarized.RESULTS The risk factors were determined,which included long duration,age more than 65 years old,chronic obstructive pulmonary disease,the use of antibiotic suchs as carbapenems,the third generation cephalosporin,fluoroquinolones and concurrent infection of fungus.The mortality rate of infection was higher than after colonization.The clinical characteristics of nosocomial infection of lower respiratory tract by CNS included that the temperature of patients was focus on 37.5-38.5 ℃,peripheral blood routine of patients appearsed normal mostly and the lung imaging displayed the bilateral exudation changing near 50% the total.The 105 isolates of CNS were resistant to multi-antibiotics,the drug resistance rate to rifampicin and sodium fusidate was relatively low and resistant strains to vancomycin and teicoplanin were not detected.CONCLUSIONS The toxemia symptoms of nosocomial infection of lower respiratory tract by CNS are mild and the clinical manifestation is atypical.It is more likely to catch nosocomial infection of lower respiratory tract by CNS for the patients who are with low immunity and applied with broad spectrum antibiotic for long-term.

Objective Spastic pelvic floor syndrome (SPFS) is a common chronic functional constipation characterized by irregular defecation,low defecation frequency,difficult defecation,and discomfort and pain in the anus and perineum.The pathophysiologic mechanism of the disease has not yet been clearly understood,so there is no targeted treatment.At present,biofeedback therapy is an effective,safe and non-invasive method for the treatment of spastic pelvic floor syndrome,which is often combined with Chinese medicine and psychological intervention in clinical treatment.