Objective To establish a HPLC method for determining the content of oleanolic acid in Radix araliae armatae.Methods Stationary phase was Lichrospher-C18(4.6 mm?250 mm,5 ?m),mobile phase was methanol-0.2% phosphoric(85:15),detection wavelength was 210 nm,flow rate was 1.0 mL/min and column temperature was 30 ℃.Results There was good linearity in the range of 0.059～0.59 ?g for oleanolic acid.The average recovery of oleanolic acid were 95.4% with RSD=0.67%(n=6).Conclusion This method is rapid and accurate.It can be applied to control the quality of Radix araliae armatae effectively.

Evidence-based medicine emphasizes making project of diagnosis and therapy on the basis of the most objective research results. The current condition in which domestic medicine is dominant in hepatobiliary surgery and teaching needs to be changed urgently. The procedure of application of evidence-based medicine in teaching of hepatobiliary surgery is explained by an actual example. Evidence-based medicine plays an important role in teaching and quick progress in all of the hepatobiliary surgery.

Objective To investigate the therapeutic efficacy of HPV16 E7 peptide pulsed dendritic cells (DCs) in recurrent condyloma acuminate (CA). Methods A total of 32 cases of recurrent CA (more than 3 times) were divided into the treatment group and the control group. Patients (11 cases, HPV16 +and HLA A2 +) in the treatment group received treatment with DCs, while the other 21 cases in the control group were treated with interferon. A follow up of 6 months was conducted in all patients. The pathological lesions, the peripheral T cell subpopulations of the patients, and the therapeutic efficacy before and after treatment were observed. Results The size of the lesions became smaller or disappeared in the treatment group. The infiltrated lymphocytes increased, but the koilocytotic cells decreased in the lesions. No significant change in the peripheral T cell subpopulations was found before and after therapy. The recurrence rates in the treatment group and the control group were 18.2% and 61.9%, respectively. Conclusion The therapy by E7 peptide pulsed dendritic cells can improve the local immune status in the skin and reduce the recurrence rate significantly in patients with recurrent CA.

Positive selection and differential selective pressure analyses were carried out to study Haemagglutinin (HA) genes of H9N2 influenza viruses from different hosts in this paper. Results showed that, although most positions in HAs were under neutral or purifying evolution, a few positions located in the antigenic regions and receptor binding sites were subject to positive selection and some of them were even positively selected at the population level. In addition, there were always some positions differentially selected for viruses from different hosts. Both selection pressure working on HA codons and positions differentially selected might account for the extension of the host range and adaptations to different hosts of H9N2 influenza viruses.

Human enterovirus 71 viruses have been long circulating throughout the world. In this study, we performed a positive selection analysis of the VP1 genes of capsid proteins from Enterovirus 71 viruses. Our results showed that although most sites were under negative or neutral evolution, four positions of the VP1 genes were under positive selection pressure. This might account for the spread and frequent outbreaks of the viruses and the enhanced neurovirulence. In particular, position 98 might be involved in neutralizing antibodies, modulating the virus-receptor interaction and enhancing the virulence of the viruses. Moreover, both positions 145 and 241 might correlate to determine the receptor specificity. However, these positions did not display much difference in amino acid polymorphism. In addition, no position in the VP1 genes of viruses isolated from China was under positive selection.

Objective To evaluate the efficacy of self-expanding metallic stents(SEMS)for acute proximal colon obstruction due to colon carcinoma.Methods From September 2004 to June 2010, a total of 81 patients(47 males and 34 females, aged 18-94 yr, mean 66.2 ± 7.5 yr)with acute proximal colon obstruction(proximal to spleen flex)caused by colon carcinoma were treated by SEMS.The success rate of stent drainage, safety of the procedure and the surgical removal rate of the carcinoma were evaluated.Results The tumors were located in transverse colon in 18(22.2%)patients, in hepatic flexure in 42 (51.9%)and in ascending colon in 21(25.9%).The success rate of stenting was 100%(81/81), and endoscopic decompression using SEMS placement was technically successful in 78 of 81 patients(96.3%).92.3%(72/78)patients underwent radical surgery 8 ± 1 days after stenting, among whom 5 underwent simultaneous hepatic metastasis foci resection and 3 others received partial resection of duodenum.Incidence of postoperative complications was 4.2%(3/72), including one case of poor healing and 2 cases of cardiopulmonary complications, which were all cured with conservative treatments.No perioperative death occurred.Conclusion Management of acute proximal colon obstruction due to colon carcinoma by using SEMS placement is effective and safe, which can be considered as a bridge method before curative surgery.

Objective To investigate specific cellular immune response induced by dendritic cells(DCs) activated by human papilloma virus (HPV) 16 E7 peptide. Methods DCs separated from peripheral blood mononuclear cells were induced with granulocyte/macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4), the DCs were then activated by HPV 16 E7 peptide. After that the surface antigens on the DCs were detected by flow cytometer. Homogenic mixed lymphocyte reaction (HMLR) with DCs was performed. LDH release assay was also used to detect the activity of cytotoxic T lymphocytes(CTL)to Caski tumor cells, which was induced by DCs. Results The surface antigens on the activated DCs were highly expressed, such as CD1a(58.4 ? 6.7)%, CD80(70.6 ? 3.4)% and HLA-DR(74.8 ? 4.2)%. HMLR showed that the activated DCs stimulated T cell proliferation significantly. Antigen-specific CTL induced by the activated DCs specifically killed Caski tumer cells, but had no effect on SiHa and AN3CA cells. Conclusions DCs loaded with HPV 16 E7 peptide can induce highly effective and specific cellular immune response.

ObjectiveTo assess the clinical application of endoscopic submucosal dissection(ESD) for early esophageal carcinomas and pre-malignant lesions. MethodsESD was performed for early esophageal carcinomas and intraepithelial neoplasms without submucosal infiltration. First, normal saline was injected into the submucosa to elevate the lesion from the muscle layer. Then, the surrounding mucosa of the lesion were cut, and the lesion was dissected along the connective tissue of the submucosa. ResultsOf 15 early esophageal carcinomas and intraepithelial neoplasms, ranging from 2.5 to 4.5 cm (mean size 3.2 cm) , 14 (93.3%) underwent ESD successfully . All 14 lesions were confirmed pathologically, and no basal or dissected margin was involved. The mean ESD procedure time (from fluid injection to complete dissection) was 75 min ( ranging from 45 to 150 min). Minor bleeding (mean volume 30 ml) occurred in all lesions, which was stopped by electric coagulation, argon plasma coagulation and clamps. No delayed bleeding occurred. The perforation rate of ESD was 0(0/15). Fourteen patients were followed up after ESD for 6 to 18 months (mean=11.5), and healed with no residue or recurrence. ConclusionESD is a novel endoscopic procedure to reseet early esophageal carcinomas and pre-malignant lesions, with which large lesions can be resected and pathological information can be provided.

Objective To evaluate the clinical value of endoscopic piecemeal mucosal resection (EPMR) and endoscopic submucosal dissection (ESD) for treatment of esophageal mucosal lesion with diameter larger than 15 mm.Methods The data of 261 patients with esophageal mucosal lesions ≥15 mm and undergoing ESD (n=198) or EPMR (n=63) in Endoscopy Center of Zhongshan Hospital from September 2009 to August 2011 were retrospectively analyzed.Therapeutic effect, complications, and local recurrence were compared between the two groups.Results The lesion size was significantly larger in the ESD group than that in the EPMR group (3.02±1.13 mm VS 2.66±0.95 mm, P<0.05).The rates of en bloc resection, complete resection, and curative resection were 100% (198/198), 96% (190/198), and 94% (187/198), respectively in the ESD group.Only samples with horizontal margin obtained the pathological assessment in the EPMR group, and 2 cases were positive.The incidence of short-term complications including massive bleeding and perforation was no statistically different (P>0.05) between the two groups.The rate of postoperative esophageal stricture was higher in the EPMR group than that of the ESD group [22.6% (14/62) VS 6.2% (12/194),P<0.05] except for 5 cases with further surgery treatment (4 cases in the ESD group and 1 case in the EPMR group).The local recurrence rate was also higher in the EPMR group than that of the ESD group [11.5% (7/61) VS 3.7% (7/190), P<0.05], except for 10 cases with positive margin.Conclusion The therapeutic effect of ESD is superior to that of EPMR for esophageal mucosal lesions with diameter larger than 15 mm due to lower rate of local recurrence and acceptable complications.

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection for the treatment of colorectal large laterally spreading tumor. Methods ESD was applied to treat 150 cases of colorectal LST with diameter larger than 4 cm. The morphological features of LST, distribution, the clinicopathological data and the en-bloc resection rate, complete resection rate, complications were retrospectively evaluated. Results There were 87 patients with LST-granular lesions and 63 patients with LST-nongranular lesions. Colorectal LST mainly distributed in the rectum for 109 cases (72.7%), sigmoid colon for 13 cases (8.7%), descending colon for 5 cases (3.3%), transverse colon for 8 cases (5.3%), ascending colon for 13 cases (8.7%), cecum for 2 cases (1.3%). There were 23 patients with low-grade neoplasia, 104 patients with high-grade intraepithelial neoplasia, 7 with intramucosal carcinoma and 16 with submucosal carcinoma. The en-bloc resection rate and complete resection rate were 92.7% (139/150) and 89.3%(134/150). Adverse events were intra-operative bleeding in 12 patients (8.0%), postoperative bleeding in 2 patients (1.3%), perforation in 3 patients (2.0%), postoperative stenosis in 3 patients (2.0%). Conclusion Colorectal large LST-NG has higher potential for malignancy. ESD is a safe and effective method to provide en-bloc and complete resection of colorectal large LST.