Objective To replace the endogenous CTL epitope LLD in HBsAg with EYILSLEEL of glypican(GPC3)in order to prepare a GPC3-HBsAg multiple peptides vaccine for HBV infection.Methods The HBsAg/GPC3 DNA was amplified by gene splicing by overlap extension(SOEing)PCR from pcHBsAg plasmid and then inserted into pBSSK+ vector to construct a pBSSK/GPC3 vector.The vector was then identified by PCR,double digesting and sequencing.The fragment encoding GPC3 CTL epitope EYILSLEEL was obtained by double digesting the plasmid pBSSK/GPC3 and then inserted into pcDNA3.1+ vector.Results Sequencing and restrict endonulease digestion indicated that eukaryotic expression vector pcDNA-HBsAg/GPC3 was constructed successfully.Conclusion The endogenous CTL epitope LLD of HBsAg is replaced by the EYILSLEEL,and an eukaryotic expression vector pcDNA-HBsAg/GPC3 is constructed.

To study if the immune response in vivo induced by dendritic cells (DC) pulsed with tumor extract can inhibit the growth of implanted tumor and reject the challenge of tumor cells in nudes, we isolated and purified DC from hepato-cellcular cancer(HCC) patient with combination of granulocyte /macrophage colony stimulating factor and interleukin 4; extracted tumor-associated antigen from human hepatocellcular cancer cell line HepG2 tumor cells; initiated the T lymphocyte with DC pulsed by the TAA to product cytotoxic T lymphocyte (CTL); implanted the CTL to inhibit the growth of implanted tumor in nudes and protected the nudes against the further challenge of HepG2 tumor cells, and further found that the CTL induced by DC pulsed with TAA from HepG2 tumor cells can inhibit the growth of implanted tumor in nudes and protect the nudes against the further challenge of HepG2 tumor cells. The results suggest, as a new concept anti-tumor vaccine, DC pulsed by TAA may play an important role in therapy and prevent against tumor.

Objective To investigate the relationship between early colonic cancer and the pit patterns of abnormal colonic mucosa. Methods We examined the pit patterns of 124 polypi in 139 patients by magnifying colonoscopy and stereomicroscopy, and compared the relations between the pit patterns and pathological diagnosis of polypi. Results 5 cases of LST(laterally spreading tumor)and 9 cases of advanced cancer were found out of 124 polypi in 139 patients. 1 among these 5 cases of LST showed Ⅲ L pit pattern, and 4 showed Ⅳ pit pattern with both magnifying colonoscopy and stereomicroscopy. Magnifying colonoscopy showed high coincidence rate with stereomicroscopy. Conclusion Pit patterns are found to be very important in disguishing tumorous lesions from non-tumorous lesions, and to discover early colonic cancer. Ⅴ pit pattern indicates that the polyp is carcinomatous.

Objective The laterally spreading tumor (LST) of the large intestine have received a great deal of study in Japan, but no report of such cases was found in China. We here of report 46 cases of LST (47 lesions, because one of the patients was found to have two lesions) diagnosed in our hospital in last two years. The morphological features under endoscopy, pit pattern, pathology and treatment under endoscopy were studied. Methods The 47 lesions of LST were found in a total of 5 735 patients who underwent colonoscopic examination in the last two years (from 01-12-2000 to 30-11-2002). The site, size and morphological features of LST were recorded, and the pit pattern was classified with magnification. 42 patients (totally 42 lesions) received colonoscopic surgery, and the rest refused to accept endoscopic therapy, therefore only a biopsy was done for pathological study. In those patients who accepted colonoscopic surgery, 14 patients were treated by mucosal resection (EMR) after injection of saline solution, 24 were treated by piecemeal mucosal resection (EPMR) after injection of saline solution, in 3 patients the lesion was removed by high frequency loop resection, and Cap-EMR was performed using distal hyaline hat attachment fitted to the end of endoscope. The resected or biopsy specimens were studied pathologically. Results 47 lesions of LST were found in a total of 5863 patients who underwent colonoscopic examination. The distrihution of LST lesions were as follows. 22 lesions were situated in the rectum, 10 lesions in the sigmoid colon, 7 lesions in the descending colon, 4 lesions in the transverse colon, 2 lesions in the ascending colon, and 2 lesions were located in the cecum. Macroscopic type: 25 lesions were homogeneous granular type, 12 lesions were mixed nodular granular type, 8 lesions were flat elevated type, and 2 lesions were pseudo-depressed type. The pit pattern as revealed under magnifying endoscopy indicated that 2 lesions were of type II pit, 8 lesion of type II+III L pit, 9 lesions of type III L pit, and 28 lesions of type IV. The pathological diagnosis revealed that 28 lesions were villous adenomas in which 7 lesions showed early malignant degeneration (6 intramucosal cancer and 1 submucosal cancer). 11 lesions were tubular adenomas, in which 1 was intramucosal cancer, 2 lesions were hyperplastic polyp, and 6 lesions were mixed hyperplastic polyps (serrated adenomas). Conclusion The LST manifest some special features, and their incidence may be higher in China than in Japan. EMR or EPMR may be considered as a good method for treatment for LST.

Objective To evaluate the therapeutic effects and adverse events on treatment of primary premature ejaculation (PE) with paroxetine hydrochloride and/or tamsalosin .Methods 225 cases of healthy men ,a history of lifelong PE and an intravaginal e‐jaculation latency time(IELT) < 120 sec were included in this study .The patients were divided into three groups(with 75 cases in each group) .Group A were given paroxetine hydrochloride 20 mg/d for 8 weeks ;group B were given tamsalosin 0 .2 mg/d for 8 weeks ;group C were given paroxetine hydrochloride and tamsalosin for 8 weeks .The effects and adverse events were evaluated by the overall change and fold increase in average IELT and the mean change in all four measures of the premature ejaculation profile (PEP) .Results The reliable data from 198 patients were achieved .The mean IELT after treatment were significantly improved in all groups than that of before treatment (P<0 .05) .The mean IELT in group C was increased for 8 .15 min after treatment .The in‐creased folds of mean IELT in group C (8 .02 folds) was significantly higher than that in group B (1 .98 folds)and group A (6 .92 folds)(P<0 .01) .The mean PEP scores that include measures of perceived control over ejaculation ,satisfaction with sexual inter‐course ,ejaculation‐related personal distress ,ejaculation‐related interpersonal difficulty were significantly improved in all groups after treatment .The mean PEP scores in group C had more significant improvements than that in group A and B .The prevalence of ad‐verse events in group A ,B ,C were 10 cases(13 .3% ) ,2 cases(2 .6% ) and 9 cases(12 .0% ) ,respectively .Conclusion Paroxetine hydrochloride combined with tamsalosin lead to better therapeutic effects and could be a priority selection for the treatment of pri‐mary PE .

BACKGROUND:A large number of experiments have shown that bone marrow mesenchymal stem cels (BMSCs) have good effects on the treatment of lung disease or improvement of lung injury, and its therapeutic effect is mainly oriented to reduce the inflammatory response. OBJECTIVE: To study the effects of BMSCs combined with reduced glutathione in murine models of bleomycin-induced lung injury. METHODS:BMSCs were isolated from a male NOD/SCID mouse and cel morphology and phenotype were observed. Sixty-four female NOD/SCID mice were randomly divided into a control group, a model group, a BMSCs group and a BMSCs+reduced glutathione group (combined group). The control group received intratracheal injection of normal saline, the model group received intratracheal injection of bleomycin, and the BMSC group received BMSCs injectionvia the tail vein at 2 hours after intratracheal injection of bleomycin, and combined group received BMSCs+reduced glutathione injection via the tail vein at 2 hours after intratracheal injection of bleomycin. Al mice were kiled after 7 days, and levels of tumor necrosis factor-α, interleukin-β, malondialdehyde in lung tissue were detected and lung tissue specimens were obtained for pathological examination. RESULTS AND CONCLUSION:BMSCs were fibroblast-like cels, Positive for CD10, CD13 and CD44, but negative for CD34 and CD45. Compared with the control group, the levels of tumor necrosis factor-α, interleukin-β and malondialdehyde were increased in the model group, while decreased significantly in the BMSCs group and combined group (P < 0.05), especialy in the combined group (P < 0.05). Pathological examination showed that more serious lung injury was observed in the model group and BMSCs group than the combined group. These findings indicate that BMSCs combined with reduced glutathione can more effectively protect against bleomycin-induced lung injury.

Objective To explore the value of two dimensional and color Doppler flow imaging(2D CDFI)for the diagnosis and differentiation of the carotid body tumor.Methods Retrospective analysis was made on 12 patients with carotid body tumor examined by 2D CDFI,and differentiations were conducted between several similar diseases.All the cases were confirmed by surgical pathology.Results The carotid body tumor in 2D CDFI was shown as follows: Low echoic substantial masses were found in the carotid branch with clearly boundary,and or partly outline.Most in small size were located at the branch of common carotid artery,so the interval between external and internal carotid arteries was enlarged.The masses in big size always grew around common cartid artery internal carotid artery and external carotid artery.More color flow signals were detected in the masses,and most were artery flow.The relationship between the mass and the carotid was shown clearly by 2D CDFI.Conclusions 2D CDFI is a valuable and practical method in diagnosis of carotid body tumors.

Objective To explore more satisfactory results in correcting the aesthetically short nose combined with low and blunt nasal tip by using autologous cartilage grafts.Methods External rhinoplasty approach was preferred.Nasal septal cartilage and auricular cartilage or rib cartilage of patients were adopted,as necessary,various shapes of grafts were carved,such as septal extention graft,columella strut and shift graft.Then we used these autologous cartilage grafts with suture and removal techniques to correct the aesthetically short nose combined with low and blunt nasal tip.The length of the nose (n-prn) and the projection of nasal tip (sn-prn) were measured before and after the operation.Paired t-test was adopted to evaluate the results.Results Thirty-one patients accepted the nasal tip rhinoplasty with autologous cartilage whose nasal tip was over rotation,blunt and low.All the patients were followed up for 3 months.Thirty patients satisfied with the results,accounting for 96.7 ％ of the total.()ne (3.3 ％) patient dissatisfied with the result because of postoperative asymmetry nostrils.Nose length before and after surgery was significantly different (P＜0.05).Nasal tip projection before and after surgery was also significantly improved (P＜0.05).Conclusions It is an effective method to use autologous cartilage graft for correcting the aesthetically short nose combined with low and blunt na sal tip,with low complications.

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.