胰腺癌黏蛋白4基因修饰的树突状细胞疫苗构建及对胰腺癌细胞的免疫效应

Objective To obtain the dendritic cells ( DC)-based vaccine modified by adenovirus containing MUC4 gene , and evaluate the anti-tumor efficacy of DC vaccine to pancreatic tumor cells. Meth-ods The mRNA sequence of tumor associated antigen, MUC4, was obtained from NCBI, and MUC4 se-quence was acquired through the restriction enzyme sites and over lap PCR, then subcloned into adenovirus plasmid to create recombinant adenovirus ( rAd-MUC4) . The DCs were infected by rAd-MUC4 virus and then stimulated the lymph cells from the same donor to induce MUC4 specific cytotoxicity T lympbocytes ( CTL) . The efficacy of CTL was analyzed by LDH releasing assay. Elispot was used to detect the IFN-γ release. Results The recombinant adenovirus containing MUC4 ( sv12) gene was obtained. The MUC4-induced CTL could specifically kill the Capan-1 pancreatic tumor cells [ ( 13. 7±6.0)% , ( 21.4± 4. 7)% , (36.1±9. 5)% at ratios of 10: ,20: ,40: ] , higher than MCF-7 and Bxpc-3 cells respectively, P < 0. 05. The spots number of CTL induced by rAd-MUC4 was ( 139.1±23.3) , more than GFP and PBS control group,P<0.05. Conclusion The Muc4 gene modified DC vaccine could induce the proliferation of CTL, which provided a significant cytotoxicity to HLA-matched MUC4 positive tumor cell lines in vitro.     

胰腺癌黏蛋白4基因修饰的树突状细胞疫苗构建及对胰腺癌细胞的免疫效应

Objective To obtain the dendritic cells ( DC)-based vaccine modified by adenovirus containing MUC4 gene , and evaluate the anti-tumor efficacy of DC vaccine to pancreatic tumor cells. Meth-ods The mRNA sequence of tumor associated antigen, MUC4, was obtained from NCBI, and MUC4 se-quence was acquired through the restriction enzyme sites and over lap PCR, then subcloned into adenovirus plasmid to create recombinant adenovirus ( rAd-MUC4) . The DCs were infected by rAd-MUC4 virus and then stimulated the lymph cells from the same donor to induce MUC4 specific cytotoxicity T lympbocytes ( CTL) . The efficacy of CTL was analyzed by LDH releasing assay. Elispot was used to detect the IFN-γ release. Results The recombinant adenovirus containing MUC4 ( sv12) gene was obtained. The MUC4-induced CTL could specifically kill the Capan-1 pancreatic tumor cells [ ( 13. 7±6.0)% , ( 21.4± 4. 7)% , (36.1±9. 5)% at ratios of 10: ,20: ,40: ] , higher than MCF-7 and Bxpc-3 cells respectively, P < 0. 05. The spots number of CTL induced by rAd-MUC4 was ( 139.1±23.3) , more than GFP and PBS control group,P<0.05. Conclusion The Muc4 gene modified DC vaccine could induce the proliferation of CTL, which provided a significant cytotoxicity to HLA-matched MUC4 positive tumor cell lines in vitro.     

腹腔开放并发肠空气瘘191例诊疗分析

目的探讨腹腔开放患者并发肠空气瘘的临床诊治特点。方法采用观察性研究方法。对南京大学医学院附属金陵医院(东部战区总医院)暨全军普通外科研究所2012年1月至2021年1月期间, 收治的腹腔开放并发肠空气瘘患者的临床资料进行回顾性分析。观察指标主要为患者的基本信息、原发病、腹腔开放原因、肠空气瘘的瘘口位置及其瘘口管理策略(三套管近端肠管收集肠液, 远端回输;或使用3D打印肠瘘支架进行封堵)、腹腔开放治疗时间、确定性手术(切除瘘段肠管后, 采取腹壁组织层次分离技术并根据缺损大小及腹壁顺应性, 选择放置生物补片行肠道重建和腹壁修补)等待时间及腹壁缺损处理方法、入住重症监护室(ICU)和总住院时间等。根据腹腔开放创面临时关腹的措施分为创面植皮组和单纯缝合皮肤组, 并分析比较两组患者的临床特征和治疗情况。结果共计收治214例腹腔开放并发肠空气瘘的患者, 除去23例死亡(11例多器官功能衰竭, 5例腹腔出血, 4例肺部感染, 气道出血、坏死性筋膜炎及外伤致颅脑损伤各1例)外, 191例实施确定性手术的患者纳入分析。男性156例(81.7%), 年龄(46.5±2.5)岁。原发病中外伤89例(46.6...     

肠内营养对肠瘘非甲状腺疾病综合征病人甲状腺功能的作用研究

目的:肠瘘病人容易发生非甲状腺疾病综合征(NTIS),探讨肠内营养(EN)治疗对肠瘘合并NTIS病人甲状腺功能的作用. 方法:回顾性分析80例肠瘘合并NIIS并接受EN治疗的病人,统计纳入病人住院期间甲状腺功能和其他实验室指标的变化. 结果:80例病人EN支持治疗后,66例NTIS病情缓解,14例未缓解,有效率82.50％.多变量Cox比例风险模型表明,从入院到开始接受全量EN治疗的时间为NTIS获得缓解的独立风险因素. 结论:EN治疗有助于缓解肠瘘病人NTIS的症状.     

克罗恩病合并肠瘘273例临床特征与预后分析

目的 分析克罗恩病（CD）合并肠瘘病人的临床特征及预后状况。方法 回顾性分析2001年1月至2015年6月南京大学医学院附属金陵医院就诊的CD合并肠瘘的273例病人资料，分析其临床特征、肠瘘特点、临床用药方案及预后转归。结果 273例病人中，男女比为2.5:1；起病年龄为29（22，40）岁；确诊年龄为31（25，42）岁；起病至确诊的间隔时间为22（8，31）个月；最常见的首发症状分别为腹痛（78.0%）、腹泻（28.9%）及发热（26.0%）；确诊时最常见的发病部位为末端回肠（56.8%）；确诊时最常见的发病性质为穿透性病变（54.9%），其次为狭窄（42.1%）、无狭窄无穿孔（2.9%）及肛周病变（19.0%）。共并发肠瘘442例次，其中肠外瘘有327例次（73.9%），最常见的类型为回结肠吻合口瘘124例次（28.1%），肠内瘘有115例次（26.1%），其中肠膀胱瘘38例次（8.6%）。肠内（91.9%）及肠外（72.9%）营养联合柳氮磺胺吡啶（57.9%）及雷公藤多苷（48.0%）是治疗此类病人的最为常用的方法；共有227例（83.1%）病人行抗感染治疗，β-内酰胺类（77.6%）及硝基咪唑类（56.0%）是最常用药物。所有入选病人共接受外科手术625例次，确诊后1、3及5年的累积手术率分别为34.4%、59.0%及63.0%。共有9例（3.3%）病人在随访期间死亡，确诊后1、3、10年的累积存活率分别为98.5%、97.8%和96.7%。
结论 与西方及其他亚洲国家文献资料相比，该中心CD合并肠瘘病人在性别比、发病部位、手术率及死亡率等方面均存在一定差异，尚须继续进一步随访及深入研究。     

胰腺癌黏蛋白4基因修饰的树突状细胞疫苗构建及对胰腺癌细胞的免疫效应

Objective To obtain the dendritic cells ( DC)-based vaccine modified by adenovirus containing MUC4 gene , and evaluate the anti-tumor efficacy of DC vaccine to pancreatic tumor cells. Meth-ods The mRNA sequence of tumor associated antigen, MUC4, was obtained from NCBI, and MUC4 se-quence was acquired through the restriction enzyme sites and over lap PCR, then subcloned into adenovirus plasmid to create recombinant adenovirus ( rAd-MUC4) . The DCs were infected by rAd-MUC4 virus and then stimulated the lymph cells from the same donor to induce MUC4 specific cytotoxicity T lympbocytes ( CTL) . The efficacy of CTL was analyzed by LDH releasing assay. Elispot was used to detect the IFN-γ release. Results The recombinant adenovirus containing MUC4 ( sv12) gene was obtained. The MUC4-induced CTL could specifically kill the Capan-1 pancreatic tumor cells [ ( 13. 7±6.0)% , ( 21.4± 4. 7)% , (36.1±9. 5)% at ratios of 10: ,20: ,40: ] , higher than MCF-7 and Bxpc-3 cells respectively, P < 0. 05. The spots number of CTL induced by rAd-MUC4 was ( 139.1±23.3) , more than GFP and PBS control group,P<0.05. Conclusion The Muc4 gene modified DC vaccine could induce the proliferation of CTL, which provided a significant cytotoxicity to HLA-matched MUC4 positive tumor cell lines in vitro.     

胰腺癌黏蛋白4基因修饰的树突状细胞疫苗构建及对胰腺癌细胞的免疫效应

Objective To obtain the dendritic cells ( DC)-based vaccine modified by adenovirus containing MUC4 gene , and evaluate the anti-tumor efficacy of DC vaccine to pancreatic tumor cells. Meth-ods The mRNA sequence of tumor associated antigen, MUC4, was obtained from NCBI, and MUC4 se-quence was acquired through the restriction enzyme sites and over lap PCR, then subcloned into adenovirus plasmid to create recombinant adenovirus ( rAd-MUC4) . The DCs were infected by rAd-MUC4 virus and then stimulated the lymph cells from the same donor to induce MUC4 specific cytotoxicity T lympbocytes ( CTL) . The efficacy of CTL was analyzed by LDH releasing assay. Elispot was used to detect the IFN-γ release. Results The recombinant adenovirus containing MUC4 ( sv12) gene was obtained. The MUC4-induced CTL could specifically kill the Capan-1 pancreatic tumor cells [ ( 13. 7±6.0)% , ( 21.4± 4. 7)% , (36.1±9. 5)% at ratios of 10: ,20: ,40: ] , higher than MCF-7 and Bxpc-3 cells respectively, P < 0. 05. The spots number of CTL induced by rAd-MUC4 was ( 139.1±23.3) , more than GFP and PBS control group,P<0.05. Conclusion The Muc4 gene modified DC vaccine could induce the proliferation of CTL, which provided a significant cytotoxicity to HLA-matched MUC4 positive tumor cell lines in vitro.     

克罗恩病患者围手术期应用英夫利西的安全性

以英夫利西为代表的新兴生物制剂的问世,使得克罗恩病的药物治疗有了突破性的进展.但是,关于英夫利西在克罗恩病围手术期的应用,目前仍存在争议.本文旨在探讨克罗恩病患者围手术期应用英夫利西对术后并发症的影响.     

肠腔隔绝技术在肠空气瘘的应用

对22例肠空气瘘患者成功使用片堵技术进行肠腔隔绝,从而避免肠空气瘘带来的肠液丢失、创面污染以及肠内营养实施障碍。最终22例患者均接受了肠空气瘘切除加腹壁重建手术,成功治愈。     

克罗恩病患者健康相关生活质量及其影响因素调查

目的调查克罗恩病患者健康相关生活质量现状及影响因素。方法采用方便抽样的方法,对南京军区南京总医院普通外科研究所的115例克罗恩病患者进行问卷调查。结果患者健康相关生活质量水平不佳,应用McMaster版炎性肠病问卷调查平均得分为(161.16±28.84)分;克罗恩病疾病活动指数平均为(187.61±105.27)分,为轻度活动期;焦虑、抑郁评分分别为(7.71±3.95)分、(7.04±3.67)分,均为轻度。影响克罗恩病患者健康相关生活质量的因素为此次克罗恩病疾病活动指数、焦虑、现工作(学习)状态。结论对克罗恩病患者应切实做好疾病护理,同时加强营养支持和心理疏导,并加强社会支持。