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。
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.
Objective To observe the effect of parenteral nutrition (PN) on the protein storage and immunofunction in patients with liver cirrhosis. Methods PN regimes consisted of nonprotein calories (NPC) 20-25 kcal/(kg·d) and nitrogen 0.15-0.20 g/(kg·d), the energy ratio of the glucose and fat emulsion was 2∶1. The PN solution was infused by total nutrition admixture (TNA), 12-16 hours per day for 7 days in 21 liver cirrhosis patients. Perior to the surgery and at 1st, 4th, 7th postoperative day, serum pre-Alb, transferrin (TSF), immunofunction (IgG, IgA, IgM, IgE, CH50, C3, C4, CD3, CD4, CD8, NKC), and nitrogen balance were tested. Results Serum pre-Alb, TSF, nitrogen balance and IgG, IgE, CH50, CD3, CD4, NKC were significantly decreased (Ｐ＜0.05), but the foregoing indices were higher than those of postoperative 1, 4d as compared with postoperative 7d. Conclusion These results bly indicated that postoperative nutritional support is safe and useful, and improve the patient’s nutritional status and immunofunction.
Objective To summarize the role of the relationship between liver cancer and cellular immunological function, and the role of immune therapy in clinical application. Methods To analyze the relationship between liver cancer and cellular immunological function, and the present research situation of immune therapy for liver cancer in clinical application retrospectively via review the related domestic and foreign literatures. Results The cellular immune dysfunction existed in all liver cancer patients. The state of body’s cellular immunological function is closely related with the arising and development of liver cancer, and the lowness of cellular immunological function is an important factor of hepatocellular carcinoma hard to cure or recurrence and metastasis. Immune therapy plays an important role in the treatment of liver cancer by adjusting the body’s cellular immunological function. Conclusions Liver cancer is closely related with the body’s cellular immunological function. Immune therapy is expected to offer a new way for the treatment of liver cancer, which can also be used as an important auxiliary treatment way.
【Abstract】ObjectiveTo investigate the effect of high intensity focused ultrasound (HIFU) on the immunity of patients with advanced primary liver cancer (PLC). MethodsForty cases of PLC admitted to our institution from Mar. 2003 to Dec. 2003 were included in this study. Patients were divided into 2 groups and received either HIFU or radiofrequency ablation (RFA) treatment randomly. CD3, CD4, CD8, CD4/CD8, NK, IL-2, TNF were chosen to assess the immune status before and after treatment. The results were compared statistically. ResultsThe survival rate after HIFU was 80.0%, 61.1%, 42.9%, 33.3% at 3 months, 6 months, 9 months and 1 year respectively, which was similar to that after RFA treatment. The changes of immunity parameters of CD3, CD4, CD8, CD4/CD8, NK, IL-2 and TNF were not significant after HIFU treatment. In addition, the differences of those parameters between HIFU group and RFA group were insignificant. ConclusionThere are no detrimental effects on immunity in the early period after HIFU treatment.
Objective To explore the pathogens and clinical features of immunocompromised hosts with septicaemia.Methods The data including underlying diseases, peripheral blood granulocyte count, temperature at blood sampling, management and prognosis)of 160 immunocompromised hosts with septicaemia were analyzed retrospectively．Results 8 patients had twice septicaemia in hospital stay and 3 patients had plural pathogenic septicaemia.171 strains of microorganisms were isolated from blood cultured of 160 septic immuno- compromised hosts in which 156 strains (91.2%) were bacteria, 37 strains(21.6%) were gram positive cocci, 6 strains(3.5%) were gram positive bacilli, 113 strains (66.1%) were gram negative bacilli and 15 strains (8.8%) were fungi. Staphylococcus spp (17 strains) and Streptococcus spp (14 strains) were the predominant pathogens among gram positive cocci and Corynebacteria (5 strains ) were the main pathogen in gram positive bacilli while Escherichia coli (60 strains), Klebsiella pneumoniae (20 strains) and Pseudomonas aeruginosa (15 strains) were the most common bacteria in gram negative bacilli. There were 12 strains of Staphylococcus aureus among the 17 strains of Staphylococcus spp, all of them were methicillin sensitive (MSSA). 17 strains of Escherichia coli, 2 strains of Klebsiella pneumoniae and 1 strain of Klebsiella oxytoca produced ESBLs. Candida was the only pathogens of fungemia in this study in which 4 strains of Candida albicans and 11 strains of non-albicans Candida were detected. There were 120 patients(75%) with granulocytopeniain which 103 patients were agranulocytosis. 70% of the 160 paitents had hyperpyrexia. All patients received broad spectrum antibiotics therapy in the study while 58.8% received antifungal drugs at the same time. 20 patients died of septicaemia and 19 patients gave up therapy because of their conditions deteriorated.The overall improvement rate were 75.6%. Conclusions Bacteria are the main pathogens in septicaemia of immunocom- promised host and fungemia is increasing in recent years.Agranulocytosis is a risk factor of septicaemia in immunocompromised hosts. Hyperpyrexia is one of characteristic signs of these patients.
目的探讨腹腔镜与开腹胆囊切除术对患者肝功能及免疫功能的影响。 方法根据手术方式将84例胆囊良性病变患者分为腹腔镜胆囊切除术组（LC组，50例）及开腹胆囊切除术组（OC组，34例），比较2组患者手术前后肝功能及免疫功能指标的变化。 结果2组患者肝功能在手术前后不同时间点的差异均无统计学意义（P＞0.05）；LC组患者术后免疫功能各指标与术前比较无明显变化（P＞0.05），OC组CD3+、CD4+及CD4+/CD8+在术后1 d及3 d均较术前明显降低（P＜0.05），术后7 d恢复至术前水平（P＞0.05）。 结论LC术可引起患者术后肝功能短暂异常，但对免疫功能无明显影响，可作为胆囊切除的首选术式。
ObjectiveTo explore clinical effect of enteral nutrition (EN) through nasojejunal tube in severe acute pancreatitis (SAP).MethodsThe clinical and pathological data of 76 patients with SAP who met the inclusion criteria and treated in the Third People’s Hospital of Henan Province from June 2015 to December 2018 were retrospectively collected. According to the nutritional support therapy adopted in the course of treatment, the patients were divided into an EN group (n=44) and a parenteral nutrition group (PN group, n=32), the patients in the EN group were given the EN through the nasojejunal tube and the patients in the PN group were given the routine PN. The APACHE Ⅱ and SOFA scores, nutritional status, and immune function were observed before the treatment and on week 2 after the treatment in the two groups.ResultsThere were no significant differences in the general data of the gender, age, body mass index, etc. between the two groups (P>0.050). ① The score of APACHEⅡ or SOFA score on week 2 after the treatment in both groups was significantly lower than that before the treatment (P<0.050), which in the EN group was significantly lower than that in the PN group on week 2 after the treatment (P<0.050). ② The levels of albumin and prealbumin were increased significantly and the hemoglobin level was decreased (P<0.050) on week 2 after the treatment as compared with those before the treatment in the two groups (P<0.050), which in the EN group were significantly higher than those in the PN group on week 2 after the treatment (P<0.050). ③ The CD4, CD8, and CD4/CD8 and IgG, IgM, and IgA on week 2 after the treatment were significantly lower than those before the treatment in these two groups (P<0.050), which in the EN group were significantly higher than those in the PN group on week 2 after the treatment (P<0.050). ④ The levels of endotoxin, D-lactic acid, diamine oxidase, and serum high mobility group protein B1 on week 2 after the treatment were significantly lower than those before the treatment in the two groups (P<0.050), and which in the EN group were significantly lower than those of the PN group on week 2 after the treatment (P<0.050). ⑤ The complications rate in the EN group was significantly lower than that in the PN group [20.45% (9/44) versus 53.13% (17/32), χ2=8.786, P=0.003].ConclusionEN through nasojejunal tube has a good effect on patients with SAP, which is helpful to improve their immune and nutritional status.