Objective To provide experimental basis for the study of SGC7901 gastric cancer cell-dendritic cell fusion vaccine. Methods The fusion of SGC7901 gastric cancer cells and dendritic cells was induced by PEG. We obtained pure fusion cells by selective culture with HAT/HT culture systems. The growth curve characters, clone abilities, abilities to irritate T lymphocytes and the ability to grow were detected. Results The fusion cells had weaker proliferative abilities and clone abilities with increased abilities to irritate T lymphocytes. The CPM value of T lymphocytes were 15083?231、 9608?83、 4214?135、 3020?28 respectively when they were co-cultured with the fusion cells on different proportions. Conclusion SGC7901 gastric cancer cell-dendritic cell fusion cells keep strong abilities to irritate T lymphocytes while inable to grow into new planted tumors in immunodeficiency animals.

Objective To explore the efficacy and safety of fondaparinux combined with tirofiban in patients with high risk unstable angina (UA) undergoing complex percutaneous coronary intervention (PCI).Methods A total of 389 patients were enrolled and randomized into two groups receiving either fondaparinux with tirofiban or enoxaparin with tirofiban.Bleeding,thrombosis and main adverse cardiovascular events (MACE) were compared between the two groups during hospitalization,at week 2 and week 4 after discharge.Results No severe bleeding was observed during hospitalization in the both groups,while lower rate of mild and minor bleeding was shown in the fondaparinux group (0 vs 1.5％ and 18.2％ vs 34.5％,P =0.04 and P ＜0.001 respectively).No difference was found between the two groups in the rate of MACE during hospitalization,at week 2 and week 4 weeks after discharge.The rates of death,recurrent myocardial infarction,refractory myocardial ischemia and target vessel revascularization were 0.5％ vs 1.0％,0.5％ vs 1.0％,1.6％ vs 1.0％ and 2.1％ vs 1.5％ during hospitalization;0 vs0,1.0％ vs 0.5％,1.0％ vs 1.5％,0.5％ vs 1.0％ at week2 after discharge; 0.5％ vs0.5％,0.5％ vs0.5％,2.6％ vs 2.0％,0 vs 0.5％ at week 4 after discharge (all P values ＞ 0.05).Conclusion The combination therapy of fondaparinux and tirofiban is of good safety and efficacy in high risk UA patients undergoing complex PCI.

Objective To study the effect and mechanism of human gastric cancer cell's apoptosis in simulated CO2 pneumoperitoneum environment by HIF-1α. Methods We used a closed box to simulate CO2 pneumoperitoneum environment, a standard surgical insufflator maintained pressure of the box at 0,5,10 and 15 mm Hg respectively. MKN-45 cell's HIF-1α mRNA and protein expression were observed before and after silencing cell's HIF-1α by real time RT-PCR and Western blot. Cell's bcl-2/bax was studied by immunohistochemistry before and after silencing HIF-1α. Cell's apoptosis ratio was measured using Annexin V-FITC/PI double labelled staining. Results In 15 mm Hg group, MKN-45 cell's HIF-1α mRNA and protein expression were significantly higher than control group (P<0.01 ), while the difference was not significant among 0,5,10 mm Hg group and control group (P>0.05). In 15 mm Hg CO2 pressure, cell's bcl-2/bax was obviously lower than in control group (P<0.05) and apoptosis ratio was more than control group(P<0.01). When HIF-1α was silenced, cell's bel-2/bax and apoptosis ratio weren't significantly different between 15 mm Hg group and control group (P>0.05 ). Conclusions MKN-45 cell's apoptosis did not experience any alterations under 0,5,10 mm Hg.15 mm Hg CO2 pneumoperitoneum environment enhanced cell's apoptosis probably by way of HIF-1α.

Objective To investigate the expression and clinical significance of tumor infiltrating dendritic cells(TIDCs) within gastric tumor tissues.Methods Immunohistochemistry(IHC),in-situ hybridization(ISH) and flow cytometry were applied to detect the expression of S100,CD83 mRNA and CD83 on DCs in 45 gastric adenocarcinoma tissues.The co-relationship of the S100 and CD83 expression with clinical(pathological) features was analyzed.Results IHC showed that S100 expression was unevenly distributed(within) 42 cancer tissue and CD83 was only expressed in tumor-adjacent tissue and normal tissue.ISH showed that CD83 mRNA was limitedly expressed within 7 samples.S100 expression had no significant(correlation) with clinical pathological features,while CD83 reversely correlated with TNM stages.Detected by flow cytometry,CD83 was expressed in low level in all 45 gastric cancer tissues and negative correlations were found with lymph node metastasis and TNM stages of gastric cancer(r=-0.879,P

Objective To analyze the related risk factors of re-nonunion after primary revision for femoral shaft nonunion subsequent to failed intramedullary nailing. Methods A retrospective study was performed in 61 patients with femoral shaft nonunion subsequent to failed intramedullary nailing from June 2008 to June.All patients were divided into re-nonunion group(22 cases)and non-re-nonunion group (39 cases) according to diagnostic criteria of bone re-nonunion. Univariate analysis was used to analyze 14 factors that may lead to the occurrence of re-nonunion after revision for femoral shaft nonunion subsequent to failed intramedullary nailing including age, gender, body mass index (BMI), smoking, alcohol abuse, injury reason, fracture types, intramedullary nail types, locking screws technology for intramedullary nail, bone nonunion sites, bone nonunion time, pathological types of bone nonunion, primary revision methods and autologous bone graft or not, and multi-factor logistic regression analysis was performed on the factors showing a significant difference. Results Univariate analysis showed significant difference in smoking (χ2= 6.564, P = 0.036), BMI (χ2= 6.783, P = 0.021), bone nonunion sites(χ2=7.316,P=0.011),primary revision methods(χ2=8.069,P=0.003)and autologous bone graft or not(χ 2=6.668,P=0.027).Logistic regression analysis showed that primary revision methods(OR=1.027,95% CI 0.028-0.463,P<0.05)and autologous bone graft or not(OR=1.024,95% CI 0.006-0.363, P < 0.05) were independent risk factors for re-nonunion after revision of femoral shaft nonunion subsequent to failed intramedullary nailing. Conclusions Primary revision methods and autologous bone graft or not are independent risk factors for re-nonunion after revision of femoral shaft nonunion subsequent to failed intramedullary nailing.By strictly controlling the surgical indications and combining with autogenous bone grafting,it is possible to reduce the occurrence of nonunion after primary revision of the femoral shaft nonunion subsequent to failed intramedullary nailing.

Objective To explore the effect of primary exchange reamed nailing (ERN) and augmentation compression plating (ACP) combined with autogenous bone grafting (ABG) on health-related quality of life in patients with dystrophic or atrophic nonunion of femoral shaft after intramedullary nailing. Methods The study used a prospective study method. Sixty- two patients with femoral shaft nonunion after intramedullary nailing from August 2010 to October 2016 were selected, and the patients were divided into ERN group (group A, 32 cases) and ACP group (group B, 30 cases) by random digits table method. In group A, isthmus nonunion was in 18 cases (56.2％), and non-isthmus nonunion in 14 cases (43.8％); in group B, isthmus nonunion was in 16 cases (53.3％), and non-isthmus nonunion in 14 cases (46.7％ ). The health- related quality of life was compared between 2 groups, including physical component summary (PCS) and mental component summary (MCS) in the- 12- item short form health survey (SF- 12), brief pain inventory- severity (BPI- S) and brief pain inventory- interference (BPI- I). Results Fifty-four patients were followed-up for more than 1 year, and the mean follow-up time was 18.3 (13 to 37) months. All patients successfully achieved bone union, and the mean time was 5.8 (4 to 8) months. Significant improvements in terms of SF-12 PCS and SF-12 MCS score were noted after operation for patients with isthmus nonunion in both groups (t=3.148, 2.156, 2.456 and 2.559; P < 0.05), but there were no significant differences before and after operation in group A with non-isthmus nonunion (P >0.05). At the last follow-up, SF-12 PCS and SF-12 MCS in group B were significantly improved compared with those in group A: (45.2 ± 5.8) scores vs. (33.6 ± 4.7) scores and (48.8 ± 6.5) scores vs. (39.4 ± 5.6) scores, and there were statistical difference (P<0.05); SF-12 BPI-S and BPI-I showed obvious relief: (4.6 ± 2.1) scores vs. (6.2 ± 2.5) scores and (5.2 ± 1.9) scores vs. (6.8 ± 2.7) scores, and there were statistical differences (P<0.05); however there were no statistical difference in SF-12 PCS, SF-12 MCS, BPI-S and BPI- I between 2 groups (P>0.05). Conclusions Compared with ERN combined with ABG, ACP combined with ABG can significantly improve the quality of life in patients with dystrophic or atrophic nonunion of femoral shaft after intramedullary nailing. It has greater advantage on the improvement of health-related quality of life, especially for patients with non-isthmus nonunion.

Objective:To use the spatiotemporal distribution model and INLA algorithm to study the spatiotemporal characteristics and influencing factors of tuberculosis in Shanghai and to provide a theoretical basis for formulating regional tuberculosis epidemic prevention and control measures.Methods:Based on the data of registered pulmonary tuberculosis cases in Shanghai during 2013-2020 derived from the tuberculosis management information system of China Disease Control and Prevention Information System, the hierarchical Bayesian model was adopted to fit the tuberculosis case data, identify the spatiotemporal variation characteristics of tuberculosis, and explore the potential socioeconomic characteristics and other factors related to health services and spatiotemporal characteristics.Results:From 2013 to 2020, 29 281 registered tuberculosis cases were reported in Shanghai, with an average annual incidence of 25.224/100 000. From 2013 to 2020, the incidence trend increased first and then decreased, the highest incidence was reported in 2014 (27.991/100 000). The incidence of tuberculosis in Shanghai is characterized by spatial clustering. Through the spatial characteristics and risk analysis of the reported incidence of tuberculosis, it is found that the high-risk area of tuberculosis in Shanghai is the suburban communities, whereas downtown communities are the low-risk areas. The incidence risk of pulmonary tuberculosis is associated with the gross domestic product per capita ( RR=0.48), the number of beds per 10 000 persons ( RR=0.56), the normalized vegetation index ( RR=0.50), and the night light index ( RR=0.80). Conclusions:With the steady progress of tuberculosis prevention and control in the central urban area of Shanghai, special attention should be paid to the prevention and control in the suburbs further to improve the social and economic level in the suburbs and increase the coverage rate of urban green space, to reduce the incidence of tuberculosis and reduce the disease burden of tuberculosis in Shanghai.

Objectives:To investigate the intravascular ultrasound(IVUS)evaluated efficacy of the"L-sandwich"technique in the percutaneous coronary intervention treatment of true bifurcation lesions of coronary artery. Methods:Ninety-nine patients with true bifurcation lesions(medina type 1.1.1)of the coronary arteries were divided into the L-sandwich group(n=38),the double-stent group(n=32),and the main vessel(MV)single-stent with side branch(SB)drug-coated balloon(DCB)only group(n=29).The primary study endpoint was the loss of late lumen area(LLAL)in the MV,SB ostium and SB shaft at 12 months,and the secondary endpoints were minimum lumen area(MLA)at each site and major adverse cardiac events(MACE)at 12 months.As this is a proof-of-concept study,statistical analyses were performed in the as-treated(AT)analysis set. Results:At 12-month follow-up,there was no statistically significant difference in the MV LLAL among patients in the"L-sandwich"technique group,the double stent technique group,and the MV DES with SB DCB technique group([0.12±0.42]mm2 vs.[0.07±0.38]mm2 vs.[-0.01±0.31]mm2,P=0.419).Similarly,there was no statistically significant difference in the LLAL at the SB shaft([-0.11±0.45]mm2 vs.[-0.10±0.28]mm2 vs.[0.24±1.04]mm2,P=0.078],with the maximum LLAL observed in the double stent technique group and the minimum in the"L-sandwich"technique group([-0.48±0.78]mm2 vs.[0.45±0.64]mm2 vs.[0.14±1.37]mm2,P<0.001).The MV MLA was similar among the three groups([8.39±1.65]mm2 vs.[8.28±0.98]mm2 vs.[8.02±1.37]mm2,P=0.565),while the maximum MLA at the SB ostium was observed in the double stent technique group and the minimum in the MV DES with SB DCB group([5.08±0.74]mm2 vs.[5.63±0.80]mm2 vs.[3.57±1.35]mm2,P<0.001).In terms of MLA at the SB shaft,the"L-sandwich"technique group was similar to the double stent technique group,while the MV DES with SB DCB group exhibited the minimum MLA([5.94±0.72]mm2 vs.[5.86±0.59]mm2 vs.[3.74±1.07]mm2,P<0.001).Two patients in the double stent technique group underwent target vessel revascularization,there was no MACE in the other two groups(P=0.118). Conclusions:The"L-sandwich"technique is safe and feasible for the treatment of coronary bifurcation lesions.Compared with double-stent group,the SB ostium has a smaller LLAL at the time of review,and there is no significant difference in the MLA of each site,and the operation steps are significantly simplified.Use of the"L-sandwich"technique is associated with a better branching benefit compared with MV single-stent group.The"L-sandwich"technique could be used as a remedial procedure for severe entrapment in the setting of branching with DCB alone.

ObjectiveTo obtain the status of latent tuberculosis infection （LTBI） among tuberculosis （TB）-related health-care workers （HCWs） in Shanghai， and to explore the risk factors related to TB infection. MethodsA multi-center cross-sectional study was conducted by recruiting medical workers from multiple designated TB hospitals， centers for disease control and prevention， and community health service centers in Shanghai. Each subject was required to complete a questionnaire and to provide a blood sample for TB infection test. Univariate and multivariate analysis ware made in order to find risk factors relating to TB infection. ResultsA total of 165 medical workers were recruited， and the proportion of TB infection was 16.36% （95%CI： 11.49%‒22.76%）. Multivariate logistic analysis showed that clinical doctors and nurses （adjusted OR=9.756， 95%CI： 1.790‒53.188）， laboratory staffs （adjusted OR=78.975， 95%CI： 8.749‒712.918）， and nursing and cleaning workers （adjusted OR=89.920， 95%CI： 3.111‒2 598.930） had higher risk of TB infection. ConclusionThe overall LTBI prevalence among TB-related HCWs is low. However， working as doctors， nurses， laboratory staffs， nursing workers and cleaning workers are risk factors of TB infection. TB-related HCWs who work at hospitals are at risk of TB infection comparing to medical staffs who work outside hospitals.

Tuberculosis （TB） and human immunodeficiency virus infection / acquired immune deficiency syndrome （HIV/AIDS） are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years， with the promotion and application of new TB and HIV detection technologies worldwide， TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening， summarizes important progress of research and applications， and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.