肿瘤患者常常具有不适应情绪和行为反应,如焦虑、抑郁、悲伤、愤怒、恐惧等。针对这类患者的特征,我们对肿瘤科查房模式进行探讨,旨在缓解患者的不良情绪,提高肿瘤患者的治疗疗效,降低医疗风险。
In order to investigate pre-and postoperative changes of prostagladin E2 (PGE2) and cellular immune function in patients with gastric cancer (GC), we measured T cell subsets, natural killer cell activity (NKCA) and PGE2 in peripheral blood (PB) of 31 GC patients and 30 controls with APAAP method, LDH release method and radioimmunoassay respectively. The results showed：① a significantly higher levels of PGE2, and a markedly lower levels of CD+4/CD+8 ratio in GC patients before surgery as compared with the controls. The PGE2 had a significant negtive coorelation with CD+4/CD+8 ratio and NKCA respectively.②PGE2 in PB of GC patients gradully declined to normal levels after surgery, moreover PGE2 in tumor tissue was markedly higher than that in normal tissue, implying that the tumor may be the major source of PGE2 in PB. Dynamic determination of PGE2 in PB would be great valuable in evaluation of cellular immune state, to evaluate the effect of surgery and prognosis of patients with gastric cancer.
ObjectiveTo investigate the effects of Huaier granule combined with systemic chemotherapy on immunologic function and prognosis for advanced breast cancer patients. MethodsNinety-eight cases ofⅣstage breast cancer from March 2006 to March 2009 in this hospital were divided into control group and research group. Only systemic chemotherapy was performed in the control group, while Huaier granule combined with systemic chemotherapy was applied in the research group, and Huaier granule was given on day 1 systemic chemotherapy start. The changes of T lymphocyte subsets and IL-2 level were detected on day 1 before systemic chemotherapy and on month 6 after Huaier granule combined with systemic chemotherapy. The fatality rate and median survival time were also observed between two groups. ResultsCompared with the control group, the changes of T lymphocyte subsets and IL-2 level had no signi-ficant differences on day 1 before systemic chemotherapy between these two groups(P > 0.05). On month 6 after Huaier granule combined with systemic chemotherapy, the CD4+, CD4+/CD8+ T lymphocyte, and IL-2 level were significantly increased, the CD8+ T lymphocyte was significantly decreased in the research group as compared with the control group〔CD4+:(47.35±6.23)% versus(41.33±5.61)%, P < 0.05; CD4+/CD8+: 1.84±0.42 versus 1.47±0.33, P < 0.05; IL-2 level:(1.78±0.45)μg/L versus(1.58±0.30)μg/L, P < 0.05; CD8+:(23.26±3.25)% versus(29.77±4.12)%, P < 0.05〕. The rate of chemotherapy complications and fatality rate within 3 years were significantly decreased in the research group as compared with the control group〔rate of chemotherapy complications: 58.3%(28/48) versus 86.0%(43/50), P < 0.01; fatality rate within 3 years: 62.5%(30/48)versus 82.0%(41/50), P < 0.05〕. The median survival time in the research group was significantly longer than that in the control group(33.5 months versus 24.5 months, P < 0.01). ConclusionsThe preliminary results from this study show that Huaier granule combined with systemic chemotherapy could greatly enhance immune function, reduce side-toxicity of chemotherapy and improve prognosis in advanced breast cancer patients. It provides a beneficial exploration for cancer treatment by integration of traditional and western medicine.
To study the effects of arginine supplementation in total parenteral nutrition (TPN) on lymphocytic immune function in postoperative patients with gastric cancer. Thirty six patients with gastric cancer receiving TPN were eligible for entry into randomized and prospective clinical trial of the study. T cell subsets, NK cell activity, plasma IL-2 content and peripheral blood CD25 were measured in before and after parenteral nutrition of the patients. Results: usual TPN could not improve lymphocytic immunosuppression of postoperative patients with gastric cancer. The patients receiving arginine supplementation in TPN might enhance lymphocytic immune function by increasing CD4 level, IL-2 production and NK cell activity, but there was no significant effect of arginine on CD25 expression. Conclusion: there are some effects of supplement with arginine on releasing of the cellular immunosuppression and restoring of lymphocytic immune function.
Objective To detect the expression of cytokeratin 20 (CK20) mRNA (micrometastasis) in regional lymph nodes and the serum activities of CD4+ cells, CD8+ cells and NK cells, serum levels of IL-2, IL-12 and sIL-2R in peripheral blood of patients with colorectal cancer; and to investigate the relationship between them. Methods Total 281 lymph nodes of 21 patients with colorectal cancer were collected. The positive expression of CK20 mRNA in lymph nodes was detect by reverse transcription-polymerase chain reaction (RT-PCR) and the metastasis in lymph nodes was detected by conventional pathological examination; the serum activities of CD4+ cells, CD8+ cells and NK cells were detected by flow cytometry and serum levels of IL-2, IL-12 and sIL-2R were detected by ELISA method in peripheral blood of patients with colorectal cancer. Results Among the positive metastasis in the 281 lymph nodes of the 21 patients, there were 16 (5.7%， 16/281) lymph nodes in 2 patients detected by pathological examination and 140 (49.8%， 140/281) lymph nodes in 10 patients by RT-PCR. There was a significant difference between the two measures in the aspects of the detection rate and the positive cases of lymph node metastasis in the 21 patients. Before operation, the serum activities of CD4+ cells, CD4+/CD8+ and NK cells, levels of IL-2 and IL-12 in 11 patients whose CK20 mRNA in regional lymph nodes were negative expression were higher than those in the other 8 patients whose lymph nodes metastasis were negative by conventional pathological examination but CK20 mRNA were positive expression （P＜0.05）; and the serum activity of CD8+ cells and level of sIL-2R in the former ones were lower than those in the latter ones （P＜0.05）. The serum activities of CD4+（r＝－0.769） cells, CD4+/CD8+（r=－0.755） and NK cells （r=－0.532）, the levels of IL-2 （r＝－0.834） and IL-12 （r＝－0.819） were negative correlated with the expression of CK20 mRNA （P＜0.05, P＜0.01）; and the activity of CD8+ cells （r=0.562） and level of sIL-2R （r=0.751） were positive correlated with the expression of CK20 mRNA （P＜0.05）. Conclusion The micrometastasis in lymph nodes is correlated significantly with the lower immune function of patients with colorectal cancer.
ObjectiveTo investigate effect of application of thymopentin during perioperative period on immune function of patients undergoing laparoscopic assisted radical resection for rectal carcinoma. MethodsForty-two patients undergoing laparoscopic assisted radical resection for rectal carcinoma from January 2015 to April 2015 in this hospital were collected. These patients were divided into study group and control group. The patients were received routine treatment in the control group. In addition to routine treatment same as the control group, the patients were received 2 mg thymopentin every day for a week in the study group. The changes of lymphocyte count, T lymphocyte subsets (CD3+, CD4+, CD8+, and CD4+/CD8+), and immunoglobulin (IgG, IgA, and IgM) were compared on the 1st day before surgery and on the 1st day and 5th day after surgery. ResultsThe lymphocyte count, T lymphocyte subsets, and immunoglobulin on the first day after surgery were significantly lower than those on the 1st day before surgery in these two groups (P < 0.05). The lymphocyte count, T lymphocyte subsets (except for CD4+/CD8+), and immunoglobulin (except for IgA) in the study group were significantly higher than those in the control group on the 5th day after surgery (P < 0.05). The changes of lymphocyte count, T lymphocyte subsets, and immunoglobulin in the study group had no significant differences between on the 5th day after surgery and on the 1st day before surgery (P > 0.05), but which on the 5th day afer surgery were significantly lower than those on the 1st day before surgery (P < 0.05) in the control group. ConclusionApplication of thymopentin during perioperative period could accelerate recovery of immune function after operation in patients undergoing laparoscopic assisted radical resection for rectal carcinoma.
目的 探讨外伤性脾破裂脾部分切除术的手术要点及术后脾功能变化。方法 对74例外伤性脾破裂行脾部分切除术者进行回顾性分析，其中不规则脾部分切除术30例，规则性脾部分切除术44例，获1～8年随访者55例。结果 ①脾创面用明胶海绵双层三叠片处理疗效肯定，②术后各种感染率低于脾脏全切者，③术后免疫功能无变化，④成人保留脾块无再生倾向。结论 脾外伤脾部分切除术疗效肯定，安全可行。只要保留有正常血循环的1/3脾脏，其免疫功能无明显影响。