下腔静脉广泛新鲜血栓形成Budd-Chiari综合征的综合介入治疗

目的探讨下腔静脉广泛新鲜血栓形成Budd-Chiari综合征的综合介入治疗的价值。方法15例Budd-Chiari综合征合并下腔静脉广泛新鲜血栓形成患者,综合采取包括大腔导管血栓抽吸、球囊导管扩张、腔静脉临时滤器植入、静脉内插管溶栓以及内支架植入等综合介入治疗。结果经7~10 d的系统治疗,所有病例症状体征消失,下腔静脉完全再通,未出现肺栓塞、出血等严重并发症。结论采取综合介入方法治疗下腔静脉广泛新鲜血栓形成Budd-Chiari综合征疗效确切、安全。     

下肢深静脉血栓形成的时间与导管局部溶栓疗效关系

目的探讨经导管局部溶栓治疗下肢深静脉血栓形成(DVT)的溶栓时间与疗效关系。方法56例患者,病程1~14 d者22例(A组),病程15~40 d者34例(B组)。全部患者均经右颈内静脉途径置入导管行尿激酶溶栓治疗。结果A组:导管溶栓时间为5~11 d,平均为(7.1±5.9)d;血栓完全溶解19例(86.4%),部分溶解3例(13.6%)。B组:导管溶栓时间为7~18 d,平均为(11.3±7.2)d,显著高于A组(P<0.05),血栓完全溶解28例(82.4%),部分溶解6例(17.6%),2组比较差异无统计学意义(P>0.05)。结论对于病程较长的下肢DVT,延长导管溶栓时间,可获得较好的疗效。     

布-加综合征介入治疗——导丝贯穿法行下腔静脉和肝静脉成形术

目的介绍布-加综合征介入治疗的新技术,评价导丝贯穿法行下腔静脉和肝静脉成形术的应用价值。方法54例布-加综合征患者,其中43例下腔静脉节段性闭塞采用经颈静脉途径穿刺破膜后将导丝由颈静脉途径进入下腔静脉、经股静脉引出;10例经皮经肝穿刺肝静脉,导丝经右心房、上腔静脉、颈静脉引出,1例导丝经股静脉进入下腔静脉、副肝静脉进入,经肝静脉和颈静脉引出,导丝贯穿于下腔静脉或肝静脉后以球囊扩张闭塞段。结果54例患者采用此项技术全部取得成功,临床症状消失,未出现并发症。结论贯穿法行下腔静脉和肝静脉成形术特别适用于下腔静脉节段性闭塞和肝静脉闭塞的病例,是一种简便、安全和实用的方法。     

肿瘤Ki-67抗原HLA-A2限制性细胞毒性T淋巴细胞表位的鉴定

Objective To identify the HLA-A2-restricted CTL epitopes encoded by antigen segment of Ki-67 for preparation of tumor vaccines. Methods Two epitope prediction databases ( BIMAS and SYFPEITHI) were used to predict the epitopes of Ki-67, and 7 peptides were synthesized as the candi-dates. The prediction was evaluated by peptide-binding test. ELISPOT was used to inspect the IFN-γ secre-ted by CTLs in order to reflect the immunogenicity of the peptides. Results The purities of synthetic pep-tides and positive control peptide were all above 95%. Peptide-binding test displayed that LQGETQLLV (280-288) of Ki-67 could bind with HLA-A2 molecule more strongly. ELISPOT assay displayed that LQGETQLLV could induce activation of specific CTLs. Conclusion LQGETQLLV (280-288) might be the HLA-A2-restricted CTL epitope of Ki-67 antigen.     

肿瘤Ki-67抗原HLA-A2限制性细胞毒性T淋巴细胞表位的鉴定

Objective To identify the HLA-A2-restricted CTL epitopes encoded by antigen segment of Ki-67 for preparation of tumor vaccines. Methods Two epitope prediction databases ( BIMAS and SYFPEITHI) were used to predict the epitopes of Ki-67, and 7 peptides were synthesized as the candi-dates. The prediction was evaluated by peptide-binding test. ELISPOT was used to inspect the IFN-γ secre-ted by CTLs in order to reflect the immunogenicity of the peptides. Results The purities of synthetic pep-tides and positive control peptide were all above 95%. Peptide-binding test displayed that LQGETQLLV (280-288) of Ki-67 could bind with HLA-A2 molecule more strongly. ELISPOT assay displayed that LQGETQLLV could induce activation of specific CTLs. Conclusion LQGETQLLV (280-288) might be the HLA-A2-restricted CTL epitope of Ki-67 antigen.     

表达端粒酶逆转录酶siRNA的溶瘤腺病毒对裸鼠肾癌移植瘤的治疗作用

Objective To investigate the antitumor effect of oncolytic adenovirus armed with small interference RNA targeting hTERT gene for renal cancer therapy. Methods Nude mice were divid-ed randomly into 4 groups (8 mice/group),and were treated by intratumoral injections of ZD55-hTERT ( an oncolytic adenovirus armed with small interference RNA targeting hTERT gene) ,ZD55-EGFP ( an on-colytic adenovirus) and Ad-hTERT (replication-defective adenovirus armed with small interference RNA targeting hTERT gene) with three consecutive daily at 7 × 108 pfu/day or treated with PBS as a control. The expression of E1A and hTERT, and apoptosis of tumor xenografts were assessed by immunohistochemi-cal technique at the 7th day after injections. The tumor volume was measured at the 50th day after injec-tions. Results The tumor volume in ZD55-hTERT treatment group ( 124.1±27.5) was significantly less than that in ZD-EGFP (499.8±77.1 ) and Ad-hTERT ( 609.0±102.5 ) treatment groups. The E 1A pos-itive expression in ZD55-hTERT treatment group was significantly higher than that in Ad-hTERT treatment group. The hTERT positive expression in ZD55-hTERT treatment group was significantly lower than that in Ad-hTERT treatment group. ZD55-hTERT treatment of tumor xenografts resulted in an increased apoptotie cell death as compared with ZD55-EGFP and Ad-hTERT treatment. Conclusion The antitumor effect of ZD55-hTERT was more potent than oneolytie adenovirus ZD55-EGFP and Ad-hTERT.     

肿瘤Ki-67抗原HLA-A2限制性细胞毒性T淋巴细胞表位的鉴定

Objective To identify the HLA-A2-restricted CTL epitopes encoded by antigen segment of Ki-67 for preparation of tumor vaccines. Methods Two epitope prediction databases ( BIMAS and SYFPEITHI) were used to predict the epitopes of Ki-67, and 7 peptides were synthesized as the candi-dates. The prediction was evaluated by peptide-binding test. ELISPOT was used to inspect the IFN-γ secre-ted by CTLs in order to reflect the immunogenicity of the peptides. Results The purities of synthetic pep-tides and positive control peptide were all above 95%. Peptide-binding test displayed that LQGETQLLV (280-288) of Ki-67 could bind with HLA-A2 molecule more strongly. ELISPOT assay displayed that LQGETQLLV could induce activation of specific CTLs. Conclusion LQGETQLLV (280-288) might be the HLA-A2-restricted CTL epitope of Ki-67 antigen.     

肠系膜上动静脉瘘合并肠系膜动脉瘤一例

患者,女性,56岁,主诉“腹胀伴纳差半年,进行性加重2周”入院。入院查体：消瘦面容,皮肤巩膜未见黄染,腹平软,右侧腹可见一长约9cm经腹直肌手术切口瘢痕,移动性浊音（＋）。患者7年前因车祸行部分回肠切除术。外院MRA提示布加综合征,本院彩超提示肠系膜上动脉瘤。为进一步明确诊断,给予介入治疗,行下腔静脉、肝静脉造影,提示下腔静脉及肝静脉造影通畅。遂行肠系膜上动脉造影,     

颈胸段气管外伤性断裂及成形术后狭窄二例

外伤性气管断裂多见于严重的胸部闭合性损伤,而发生于颈部外伤者少见,其治疗原则是急诊、早期气管修补和成形术.2006年7月-2009年8月我院介入放射科、胸心外科和耳鼻喉科共同参与诊治2例颈胸段气管断裂患者.现报告如下.