Objective To evaluate the effectiveness and safety of lentinan on immune function in patients with advanced gastric cancer. Methods We searched MEDLINE (1969-2006), EMBASE (1984-2006), OVID (1969-2006), CENTRAL (Cochrane Central Register of Controlled Trials in The Cochrane Library) (Issue 4, 2006), the Chinese Biomedicine Database (1978-2006) and CNKI (1978-2006). We also handsearched relevant journals. Pharmaceutical companies were contacted to identify additional randomized controlled trials. We assessed the identified studies in order to include high quality studies. Results Ten studies (containing 786 patients) met the inclusion criteria. Six trials shown that lentinan+FAM had significant efficacy upon patients with advanced gastric cancer compared with FAM in overall response [Plt;0.01, RR1.70, 95%CI (1.39,2.09)]. In three trials, a significant effect of lentinan+FAM group compared with FAM group in quantity of CD3+ T, T4/T8, NK was found, but lower than FAM group in side- effect of digestive system [RR0.71, 95%CI (0.55,0.91)]. The other trail identified there were fewer side effects in lentinan+FAM group compared with FAM group, though did not discribe the overall response. In case the significant heterogeneity, meta-analysis could not be used for the other three trails included, since the components of chemotherapeutic agents (ATP+Co-A+Vc; DDP+ Epirubicin+5FU; 5FU+CF+VP16) were not the same. In the three trials, overall response was statistically significant better in the lentinan group than in the control group, and lentinan group could significantly increase the quantity of CD3+ T, T4/T8, NK compared with control group. Conclusions The present meta-analysis suggested that addition of lentinan to standard chemotherapy provided a significant advantage over chemotherapy alone in terms of efficacy for patients with advanced gastric cancer. However, most of trials included in the review were of low quality, therefore, it is of necessity to conduct multi-center randomized-controlled trials of high quality.
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.
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。
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.
ObjectiveTo analyze the correlations between the immune function and inflammatory factors levels of patients with hepatocellular carcinoma (HCC) and the results of in vitro high-throughput drug sensitivity, and to provide a reference for personalized drug selection for patients with HCC. MethodsThe patients with HCC who met the inclusion criteria from December 2019 to June 2021 in the First Affiliated Hospital of Chongqing Medical University were included. The HCC cells were used to perform in vitro high-throughput drug sensitivity screening, the result was classified into sensitive and insensitive. The correlations between drug sensitivity results and immune function and inflammatory factors levels of corresponding patients were analyzed, and the relation between these indexes (P<0.05) and drug sensitivity of HCC cells to drugs or combination regimen of drugs was further analyzed by univariate logistic regression. ResultsA total of 74 patients with HCC were included in this study. The results showed that the level of interleukin-6 was negatively correlated with sorafenib, caffezomib, gemcitabine, oxaliplatin + epirubicin + irinotecan + 5-fluorouracil, oxaliplatin + irinotecan + epirubicin, and oxaliplatin + epirubicin regimens on the inhibition rates of HCC in vitro (P<0.05), and positively correlated with bortezomib (P<0.05). However, the level of interleukin-6 was not related to the sensitivity of HCC cells to these single drugs or combined regimens (P>0.05). Meanwhile it was found that tumor necrosis factor (TNF)-α was negatively correlated with cabotinib, apatinib, caffezomib, and epirubicin on the inhibition rates of HCC in vitro (P<0.05), and positively correlated with epirubicin (P<0.05). But only it was found that tumor necrosis factor-α level was related to the sensitivity of HCC cells to epirubicin (P<0.05). ConclusionsTumor necrosis factor-α level in peripheral blood of patients with HCC has a certain relation with epirubicin on inhibition rate of HCC in vitro and it might have a certain value in predicting sensitivity of HCC cells to epirubicin. Meanwhile, although it is found that level of IL-6 is related to sorafenib, caffezomib, gemcitabine, or including combination regiems including oxaliplatin and epirubicin on inhibition rates of HCC in vitro, their value is not found in predicting sensitivity of HCC cells to these single drugs or combined regimens.
ObjectiveTo study the influence of psychological intervention on the immune function and psychological state in patients undergoing chemotherapy after radical operation of colorectal cancer. MethodSixty-four patients who underwent chemotherapy after eradicative resection of rectal cancer between August 2008 and August 2013 were randomly divided into control group and intervention group. Both the two groups of patients accepted conventional chemotherapy and nursing, while patients in the intervention group were also given psychological intervention. At the beginning of and 8 weeks after the therapy, self-evaluation of anxiety scale and depression self-rating scale were used to determine the psychological state (anxiety and depression) of patients in the two groups, and we evaluated the effect of psychological intervention. At the same time, the immune index and inflammatory cytokines were determined and compared between the two groups. ResultsBefore treatment, patients in both the two groups were accompanied by mild anxiety and depression. After psychological intervention, compared with the control group, anxiety and depression of patients in the intervention group were significantly alleviated (P<0.05). Before chemotherapy, patients in the two groups were not statistically different in the immune factor index (P>0.05). After chemotherapy, compared with the control group, natural killer cells, CD3+, CD4+, CD4+/CD8+, C-reactive protein, immunoglobulin (Ig) G, interleukin (IL)-10 level of the intervention group significantly increased (P<0.05), and IL-6 and tumor necrosis factor alpha expression decreased (P<0.05). CD8+, IgA and IgM were not significantly changed (P>0.05). ConclusionsPsychological intervention can alleviate anxiety and depression and improve the immune function in patients who undergo chemotherapy after radical operation of colorectal cancer, which is an effective auxiliary treatment.
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.
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.
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.