Objective To explore the cytotoxicity of the cytotoxic T lymphocyte (CTL) induced by SW480 sonicate sensitized dendritic cells (DC) on the colon cancer cell line SW480. Methods PBMC were separated from the HLA-A*0201 donor and DC were cultured with rhGM-CSF, rhIL-4 and rhTNF-α. The same donor's primary CTL were stimulated by DC loaded with SW480 sonicate. The cytotoxicity of CTL on SW480 (HLA-A*0201 positive) and K562 (HLA-A*0201 negative) was determined by the MTT method. Results The cytotoxicity of the CTL on SW480 was stronger than that on K562 (P ＜0.05). Conclusion The DC vaccine can stimulate specific CTL which can trigger cytotoxic activity on the target cells and this cytotoxicity is related to MHC restriction.

Objective To evaluate the feasibility, safety and effectiveness of interventional occlusion with thin waist occluder for perimembranous ventricular septal defect with pseudoaneurysm. Methods During the period from March 2008 to March 2013 at Shanghai Yodak Cardiothoracic Hospital , interventional occlusion with thin waist occluder was carried out in a total of 96 patients with perimembranous ventricular septal defect (VSD) complicated by pseudoaneurysm. The patient’s age varied from 2 years to 36 years. Before the procedure, routine left ventricular angiography and ascending aortic angiography were carried out. Left ventricular angiography and ascending aortic angiography as well as the transthoracic ultrasonography were performed immediately after the procedure to observe the therapeutic results. Follow-up checkups with transthoracic ultrasonography, EKG and chest X-ray film were conducted at one week as well as at one, 3, 6 and 9 months after the surgery were conducted. Results Successful occlusion of VSD was obtained in 93 patients, with a success rate of 96.8% (93/96). After the surgery, small amount of shunt flow was detected in 8 patients, which disappeared within 48 hours in 7 patients, and in the other one the shunt flow disappeared one month later which was confirmed by follow-up examination. After the treatment, complete right bundle branch block occurred in 4 patients, complete left bundle branch block in 5 patients, and transientⅢdegree atrioventricular block in one patient. The conduction block disappeared at the time of discharge in all patients. The left ventricular end-diastolic diameter (LVEDD) decreased from preoperative (47.5 ± 5.2) mm to postoperative (45.2 ± 5.1) mm, the difference was statistically significant (t = 18.33, P < 0.01). During the follow-up period lasting for 9 months, no delayed cardiac arrhythmia, valve damage or sudden death occurred. Conclusion For the treatment of perimembranous ventricular septal defect with pseudoaneurysm, interventional occlusion with thin waist occluder is safe and effective with excellent mid-term effect. Based on the imaging findings, including the location, shape, ruptured orifice, number of the perimembranous pseudoaneurysm as well as the distance between the pseudoaneurysm and the aortic valve, to select suitable occluder and proper occlusion site is the key to ensure a successful surgery.

Objective To explore the role of compound nerve conduit, made of nerve growth factors (NGF) encapsuled by biodegradable core-shell nanofibers through coaxial electrospinning, in regeneration of injured sciatic nerves in rats. Methods The compound nerve conduits were developed from the core-shell structured biodegradable nanofibers with P(LLA-CL) as a shell and BSA/NGF or BSA as a core through coaxial electrospinning. Seventy-two Sprague-Dawley rats were randomly divided into 4 even groups. The middle segments (10 mm) of the sciatic nerve were excised and the defects were repaired with sciatic nerve autograft (group A), with P(LLA-CL) conduit (group B), with PLLA-CL conduit and one injection of NGF (group C), and with P(LLA-CL)/NGF controlled-release conduit (group D), respectively. Morphologic and functional evaluations of nerve regeneration were done by gross observation, sciatic function index, neural electrophysiological examination, resumption rates of triceps weight, histological and ultrastructural observa-tion respectively in 1, 2, 3 months after the operation. Results Three months after the operation, although partial biodegradation and small cracks could be observed, conduits remained intact in outline. Based on the functional and histological observations, nerve regeneration, nerve fibers arrangement, myelination and nerve function reconstruction in the P(LLA-CL)/NGF controlled-release conduit (group D) were similar to those in nerve autograft (group A) and significantly superior to those in groups B and C (P<0.05). Conclusion As the P(LLA-CL)/NGF-controlled release conduit has favorable mechanical properties and biocompatibility, it can effectively promote regeneration of the sciatic nerve in rats.

Exosomes are vesicular bodies secreted by living cells containing proteins and RNA, and play an important role in the process of physiology and pathology.Pancreatic cancer is one of the common gastrointestinal tumor with high morbidity and mortality.As a hotspot in oncology, exosomes have potential values in the research of development, diagnosis and treatment of pancreatic cancer.This article reviewed the role of exosomes in pancreatic cancer.

Objective To detect the expression of tumor necrosis factor-α-induced protein-8 like-3 (TIPE3) in colonic mucosa of patients with colon cancer,and to analyze the correlation between its abnormal expression and clinicopathological features of patients with colon cancer.Methods The expression of TIPE3 mRNA in 58 cases of colon cancer and tumor adjacent tissues was detected by realtime polymerase chain reaction (RT-PCR).The expression of TIPE3 at protein level in 83 cases of colon cancer and tumor-adjacent tissues was determined by SP immunohistochemistry.Nonparametric rank-sum test and chi-square test were performed for statistical analysis.Results The relative expression of TIPE3 mRNA in the colon cancer tissues was 0.719 (0.104 to 0.887),which was lower than that of tumor-adjacent tissues (4.770,1.732 to 6.800),and the difference was statistically significant (Z=-6.345,P＜0.05).There was no statistically significant difference in the expression of TIPE3 mRNA in colon cancer tissues between different gender,age and TNM stage (all P＞0.05).The expression of TIPE3 mRNA in group of patients with lymph node metastasis (0.113,0.061 to 0.375) was lower than group of patients without lymph node metastasis (0.489,0.327 to 0.956;Z=3.815,P＜0.01).The expression of TIPE3 mRNA of patients survived less than five years after operation (0.104,0.049 to 0.220) was lower than that of patients survived over five years (0.482,0.266 to 0.908;Z=-3.653,P＜0.01).The expression of TIPE3 mRNA of patients with recurrence after operation (0.188,0.091 to 0.493) was lower than that of patients without recurrence (0.409,0.233 to 1.010;Z=-2.431,P=0.015).The recurrence rate of TIPE3 mRNA high expression group in five years after operation was lower than that of TIPE3 mRNA low expression group (23.1％,6/26 vs 56.2％,18/32);and the difference was statistically significant (x2 =6.508,P＜0.05).The expression of TIPE3 at protein level of colon cancer tissues (44.6 ％,37/83) was lower than that of tumor-adjacent tissues (68.7 ％,57/83;x2 =8.004,P＜0.05).The expression of TIPE3 at protein level was not correlated with age and gender (both P＞0.05).The positive expression rate of patients at stage Ⅱ was higher than that of patients at stage Ⅲ (60.5％,23/38 vs 29.7％,1/37);and the difference was statistically significant (x2 =7.174,P＜ 0.05).The positive expression rate of TIPE3 in group of patients with lymph node metastasis was lower than that of groups of patients without lymph node metastasis (28.2％,11/39 vs 59.1％,26/44),and the difference was statistically significant (x2=7.983,P =0.005).Conclusions The expression of TIPE3 in colon cancer tissues is lower than that in tumor-adjacent tissues.Furthermore,it is correlated with lymph node metastasis,recurrence rate and survival rate.TIPE3 may be involved in the genesis,development,invasion and metastasis of colon cancer.

Objective To investigate the chemical constituents of the marine sponge Theonella swinhoei collected from the Xisha Islands in the South China Sea .Methods The petroleum ether and dichloromethane extract of the marine sponge T . swinhoei were purified by solvent extraction and chromatographic methods including vacuum liquid chromatography (VLC) , medium pressureliquidchromatography(MPLC),thinlayerchromatography(TLC)onsilicagel,highperformanceliquidchro-matography(HPLC) ,and Sephadex LH-20 .The chemical structures were determined by spectroscopic analysis and comparison with the reported data .Results Eight compounds were isolated and their structures were determined as cholest-7-ene-3β,5α, 6β-triol (1) ,ergosta-7 ,22-diene-3β,5α,6β-triol (2) ,25-norcycloartane-3β,6α,16β,24-tetraol (3) ,sinuflexibilin D (4) ,14-de-oxycrassin (5) ,N-(2-phenylethyl)-(9Z)-tetradecanamide(6) ,N-(2-phenylethyl)-tetradecanamide (7) ,7 ,8-dimethyl-isoallox-azine (8) .Conclusion Compounds 1～ 7 were isolated from the sponge of genus Theonella for the first time .

Objective:To investigate the current state of standardized training in trauma surgeons in medical institutions in Shanghai.Methods:Questionnaire surveys, focus discussions and expert conferences were conducted to investigate the professional background, status of standardized training on trauma care knowledge, training needs and suggestions in 236 trauma surgeons in 25 Shanghai medical institutions.Results:The investigation revealed that only 59.3% (140/236) of the trauma surgeons had received a standardized training on trauma care knowledge. Of them, those who participated in the training by an international, domestic and local medical institution accounted for 26.4% (37/140), 47.1% (66/140) and 84.3%(118/140), respectively. Only 83 surgeons (70.3%) received regular training and most of them 66.3% (55/83) did in a low frequency of 1-2 times a year. Only 12.7% (15/118) of the surgeons received a training course of ≥48 classes (45 min per class) in the past 3 years. The training courses by medical institutions were mostly lectures on theoretical knowledge and training of a single skill while the simulated scenario drills accounted for less than 48.3%(57/118). The surgeons who had received a standardized training on trauma care were more likely to use their training knowledge to grade and score the patients with trauma, significantly more than those who had not( P<0.05). Conclusions:The coverage, time or frequency of standardized training on trauma care was not enough in Shanghai. The standardized training of trauma care surgeons should be strengthened in all medical institutions and be supervised by the management administration. A set of standardized materials and assessment standards for trauma care training should be formulated as soon as possible which fits the domestic conditions in China. Training bases should be established in Shanghai for standardized care of severe trauma and trauma specialists. A training system for trauma specialists should be established to promote traumatology in shanghai.

Objective:To evaluate the value of shear wave elastography (SWE) and salivary gland ultrasound scoring(SGUS) system in the diagnosis of salivary glands lesions in patients with Sj?gren′s syndrome(SS) and to compare the diagnostic efficiency of the two methods.Methods:From June 2019 to November 2020, Fifty-eight patients with suspected SS were selected from the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University. According to the 2002 American-European Consensus Group classification standard, the enrolled patients were divided into two groups: SS group (47 cases) and non-SS group(11 cases). According to symptom duration, SS group was divided into the ≤5 years group (29 cases) and the >5 years group (18 cases). Meanwhile, 40 healthy volunteers were enrolled in this study as normal control group. The diagnostic value of salivary gland ultrasound scoring system and Young′s modulus in SS were analyzed.Results:The differences in Young′s modulus of parotid gland and submandibular gland between SS group and non-SS group (or control group) were statistically significant (all P<0.05). The ultrasound score of SS group was significantly higher than that of non-SS group and control group (all P<0.05). SGUS and Young′s modulus were not significantly different between different course groups (all P>0.05). The areas under ROC curve of the mean Young′s value in parotid and submandibular gland and the SGUS were 0.801, 0.829 and 0.676, respectively. The comparison of the area under the curve between the Young′s modulus of the parotid and submandibular glands and the ultrasound score was statistically significant (all P<0.05). Conclusions:SWE and Ultrasonography scoring system have certain value in the diagnosis of salivary gland lesions in SS, and can provide important reference information for clinical diagnosis from different perspectives. The diagnostic efficiency of SWE for salivary glands lesions in patients with SS is better than that of SGUS scoring system.

Macular edema(ME)secondary to retinal vein obstruction(RVO)and consequent fundus anatomical struc-ture injury is one of the main causes of severe visual impairment.Currently,the treatment of RVO-ME is mainly aimed at controlling ME and improving visual function,and intravitreal injection of anti-vascular endothelial growth factor drugs or corticosteroid drugs is the first-line treatment method.In recent years,many clinal studies have adopted different single or combination drug treatment regimens to compare the visual function recovery of patients after surgery and during the fol-low-up,providing clinicians with the basis for selecting different treatment regimens.This article provides a brief review of the research progress of RVO-ME intravitreal drug injection therapy.

Objective:To explore the risk factors of recurrent contralateral hip fracture within 2 years after operation in elderly patients with hip fracture, construct a nomogram prediction model and validate the model.Methods:A total of 601 elderly patients with hip fracture who underwent surgical treatment in Department of Orthopedics in First Hospital of Shanxi Medical University from June 2018 to June 2020 were selected as research objects by the convenient sampling method. They were divided into the modeling set ( n=421) and the verification set ( n=180). According to the incidence of recurrent contralateral hip fracture within 2 years of follow-up, the modeling set was divided into the recurrent fracture group and the normal group, and the clinical data of the two groups were compared. Logistic regression was used to analyze the risk factors for recurrent contralateral hip fracture in elderly patients within 2 years after surgery. R 3.6 software was used to build a risk factor nomogram model for recurrent contralateral hip fracture. Receiver operating characteristic ( ROC) curve and calibration curve were used to evaluate the differentiation and consistency of the model. Results:In 601 elderly patients with hip fracture, the incidence of recurrent contralateral hip fracture within 2 years after surgery was 8.49% (51/601), among which the incidence of modeling set was 8.31% (35/421) and the incidence of verification set was 8.89% (16/180). In the modeling set, the age, female proportion, osteoporosis proportion, combined internal medical disease proportion and malnutrition proportion of patients in the recurrent fracture group were higher than those in the normal group ( P<0.05). Logistic regression analysis showed that gender, age, osteoporosis and combined internal medical diseases were the factors affecting the recurrence of contralateral hip fracture within 2 years after operation in elderly patients with hip fracture ( P<0.05). The equation for constructing a nomogram prediction model was Logit ( P) = -8.521+0.335×age+ 0.116×female +0.341× osteoporosis +0.280 ×combined internal medical diseases. The modeling set predicted the probability of recurrent contralaterial hip fracture according to the nomogram model, and plotted the ROC curve with sensitivity of 0.826, specificity of 0.804, and area under ROC curve ( AUC) of 0.876. The sensitivity of ROC curve of the validation set was 0.788, the specificity was 0.781, and the AUC was 0.830. After internal verification by Bootstrap method, the prediction model of the modeling set and the verification set were well distinguished, and the prediction probability and the actual incidence were well consistent (Hosmer-Lemeshow χ 2=0.462, P=0.674) . Conclusions:Advanced age, female, osteoporosis and combined internal medical diseases are independent risk factors for recurrent contralateral hip fractures in elderly patients with hip fractures within 2 years after surgery. The nomogram model constructed based on this has high predictive efficacy for recurrent hip fractures, which can be used to assess the risk of recurrent fractures and improve the prognosis of patients.