Impact of oxaliplatin and trastuzumab combination therapy on tumor markers and T lymphocyte subsets for advanced gastric cancer

BACKGROUND Advanced gastric cancer(AGC)remains a challenging malignancy with poor prognosis.The combination of oxaliplatin and trastuzumab has shown promising results in AGC treatment.This study aimed to investigate the effects of oxaliplatin and trastuzumab combination therapy on serum tumor markers and T lymphocyte subsets in patients with AGC and to explore their potential as predictive biomarkers for treatment response.AIM To investigate the impact of oxaliplatin and trastuzumab combination therapy on serum markers and T cell subsets in patients with AGC.METHODS This prospective study enrolled 60 patients with AGC.All patients received oxaliplatin(130 mg/m^(2),every 3 weeks)and trastuzumab(8 mg/kg loading dose,followed by 6 mg/kg every 3 weeks)for six cycles.Serum carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9),and cancer antigen 72-4(CA72-4)were measured before and after treatment.T-lymphocyte subsets,including CD3+,CD4+,CD8+,and CD4+/CD8+ratios,were also evaluated.The clinical response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1.RESULTS After six cycles of treatment,the CEA,CA19-9,and CA72-4 serum levels significantly decreased compared to baseline levels(P<0.001).The percentages of CD3+and CD4+T lymphocytes increased significantly(P<0.05),whereas the percentage of CD8+T lymphocytes decreased(P<0.05).The CD4+/CD8+ratio also significantly increased after treatment(P<0.05).Patients with a higher decrease in serum tumor markers(≥50%reduction)and a higher increase in CD4+/CD8+ratio(≥1.5-fold)showed better clinical response rates(P<0.05).CONCLUSION Oxaliplatin and trastuzumab combination therapy effectively reduced serum tumor marker levels and modulated T lymphocyte subsets in patients with AGC.Combination therapy not only has a direct antitumor effect,but also enhances the immune response in patients with AGC.Serum tumor markers and T lymphocyte subsets may serve as potential predictive biomarkers for treatment response in patients with AGC receiving combination therapy.

Correlation Study Between T Lymphocyte Subsets and Rheumatoid Arthritis

Objective:To study the effect of Helicobacter pylori infection on rheumatoid arthritis and T-lymphocyte subpopulations in patients with rheumatoid arthritis and to provide a new method for the treatment of rheumatoid arthritis by removing Helicobacter pylori from patients.Methods:60 patients with rheumatoid arthritis admitted to the hospital from May 2022 to May 2023 were selected for the study,and all patients underwent a 13-carbon urea breath test to detect gastric H.pylori and the test results showed that 20 cases were negative and 40 cases were positive.The 40 positive patients were divided into the treatment group(n=20)and non-treatment group(n=20)by random number table method and the treatment group was given anti-Helicobacter pylori treatment,and the non-treatment group was given maintenance rheumatoid basic treatment,comparing the anti-cyclic citrulline peptide(CCP),DS28 score,peripheral blood T-lymphocyte subsets(CD4^(+)T-lymphocytes,CD8^(+)T-lymphocytes,CD4^(+)/CD8^(+)ratio)before and after the treatment of patients by 13-carbon urea respiration test(pylori-negative group,20 patients)and those who were positive for the treatment of H pylori(pylori-positive group,40 patients).Besides,the correlation of peripheral blood T-lymphocyte subsets and disease activity between treatment and non-treatment groups in the pylori-positive group was identified together with the correlation of DS28 scores,TNF-αlevels,sedimentation and immunoglobulin,lymphocyte subsets in the pylori-positive treatment group and positive non-treatment group as well as the level of globulin,lymphocyte subsets,and peripheral blood lymphocytes before and after treatment.Results:Before treatment,CCP,DS28 score,CD8^(+)T lymphocyte level of the pylori-negative group were lower than that of the positive group,and CD4^(+)T lymphocyte and CD4^(+)/CD8^(+)ratio were higher than that of the positive group(P<0.05);after treatment,the indexes of the pylori-positive group improved,and there was no significant difference in the comparison of the indexes with those of the pylori-negative group(P>0.05);the positive treatment group had a DS28(3.19±1.02)points,positive non-treatment group DS28(5.36±1.85)points,non-treatment group DS28 score and CD4^(+)T lymphocytes,CD4^(+)/CD8^(+)negative correlation with CD8^(+)T lymphocytes showed a positive correlation(P<0.05);before the treatment,pylori-positive treatment group and non-treatment group DS28 scores,TNF-αlevels,peripheral blood T lymphocyte subpopulation levels were not significantly different(P>0.05);after treatment,DS28 score,TNF-αlevel,CD8^(+)T of the treatment group were lower than those of the non-treatment group,and CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)ratio were higher than those of the non-treatment group(P<0.05).Conclusion:H.pylori affects the level of T lymphocyte subsets in patients with rheumatoid arthritis,and there is a certain correlation between the two.Removal of H.pylori can improve the level of T lymphocyte subsets,which is important for the treatment of patients with rheumatoid arthritis.

Association of T lymphocyte subset counts with the clinical features of colorectal cancer

Background:Colorectal cancer(CRC)is a common gastrointestinal malignancy.The T lymphocyte subsets are important in the develop-ment,invasion and metastasis of tumors,including CRC.Nevertheless,limited research has explored the relationship between T cell subpopu-lations and the clinical characteristics of CRC.This study compared the T lymphocyte subsets in patients with CRC and healthy individuals,and assessed the relationship between these values and clinical characteristics.Methods:Peripheral blood was collected from 100 patients with CRC and 54 healthy individuals.The numbers of CD3^(+)T,CD4^(+)T,and CD8^(+)T lymphocytes,NK cells,and the CD4^(+)T/CD8^(+)T ratio in peripheral blood were measured using flow cytometry,and were compared between CRC patients and healthy individuals.Spearman's correlation analysis was performed to investigate the relationship between the T lymphocyte subsets in patients diagnosed with CRC and the levels of carcinoembryonic antigen(CEA)and thymidine kinase 1(TK1).Receiver operating characteristic(ROC)curves were utilized to evaluate the potential utility of the T lymphocyte counts in predicting lymph node metastasis,vas-cular infiltration,and high Ki-67 expression.Results:The CRC patients had lower counts of CD3^(+)T,CD4^(+)T,and CD8^(+)T lymphocytes compared to the healthy population(P<0.05).However,no significant differences were observed in the CD4^(+)/CD8^(+)ratio or NK cells(P>0.05).Notably,the CD3^(+)T,CD4^(+)T,and CD8^(+)T lym-phocyte counts were higher in patients with stageⅠ-Ⅱdisease,no lymph node metastasis,no vascular invasion,and low Ki-67 expression than in those with stageⅢ,lymph node metastasis,vascular invasion,and high Ki-67 expression(P<0.05).There was a negative association be-tween the CD3^(+)T,CD4^(+)T,and CD8^(+)T lymphocyte counts and CEA and TK1 levels in patients with CRC.The ROC curves demonstrated that CD3^(+)T,CD4^(+)T,and CD8^(+)T lymphocyte counts had significant predictive value for lymph node metastasis,vascular infiltration,and high Ki-67 expression.Conclusions:The peripheral blood CD3^(+)T,CD4^(+)T,and CD8^(+)T lymphocyte counts are related to the clinical traits of patients with CRC and can predict the prognosis of the disease.

Fas and Bc1-2 EXpression on T Lymphocyte Subsets in the Peripheral Blood of Relapsing Patients with Condyloma Acuminatum

Objective: To study the expression of Fas and Bcl-2proteins on T lymphocyte subsets in the peripheralblood of relapsing patients with condyloma acuminatum(CA) and healthy controls. Methods: Flow cytometry (permeabization andstaining procedure with conjugated antibodies) wasused. Results: We observed that the expression of Fasprotein on CD4^+ T lymphocyte subset of CA patientswas significantly higher than that of healthy controls(P<0.01). Conclusions: Increased expression of Fas proteinon CD4^+ T lymphocyte subset may be a cause of de-creased percentage of CD4^+ T lymphocyte subset. Thisinduces the increased ratio of CD4^+/CD8^+.

Detection of T lymphocyte subsets of children with Helicobacter pylori infection

AIM: To study the transformation of T lymphocyte subsets in children with Heliobacter pylori (H pylori) infection. METHODS: The H pylori infection status were determined by a combination of ELISA and Western blot (immunoblot) technique in 98 children and T lymphocyte subsets in peripheral blood were determined by flow cytometrical analysis.RESULTS: There were 75 children positive with H pylori infection and 23 negative in 98 children. Comparing the proportion of peripheral blood T lymphocytic subsets in children with H pylori infection and without H pylori infection, it was found that a higher proportion of CD4 T-cells in infected children (39.02±7.71 vs34.25±10.73,t = 2.246,P＜0.05) and higher value of CD4 to CD8 T-cells ratio (1.51±0.52 vs 1.25, t= 2.104,P＜0.05) were present, but there were not significant differences in CD3 T-cells and CD8 T-cells (73.11±10.02 vs69.49±17.08, 27.22±6.07vs 28.27±8.67, P＞0.05).CONCLUSION: Th1 cell-mediated immune responses may be induced by H pylori infection in children.

Observation of T Lymphocyte Subsets in the Liver of Patients with Advanced Schistosomiasis and Advanced Schistosomiasis Accompanied with Hepatitis B

T lymphocyte subsets in the liver were detected by Avidin-Biotin Complex (ABC) assay in 22 patients with advanced schistosomiasis (AS) and 5 cases of AS accompanied with hepatitis B. T lymphocytes in the liver of AS patients were distributed in the peripheral layer of egg granuloma or the area near eggs in non-granuloma. No infiltrative T lymphocytes were observed in area with extensive fibrosis. There was infiltration of many T cells in the portal tract, piecemeal and focal necro- sis area as well as in hepatic sinus in AS patients accompanied with hepatitis B. CD8+ T cells (sup pressor/cytotoxic T cells, Ts/Tc) in the liver were predominant in the two groups. In AS patients, marked hepatic fibrosis, a small number of T cell infiltration and slight hepatocellular degeneration and necrosis were observed. However, obvious hepatocellular degeneration and necrosis were seen in AS patients accompanied with hepatitis B, and 3 cases of them developed active liver cirrhosis. The results indicated immune response was weak in the liver in AS patients and T. cells might be predominant in the subset of CDS+ T lymphocytes. Cellular immune response was relatively strong in AS patients accompanied with hepatitis B and the infiltrative CD8+ T lymphocytes might be mainly Tc cells.

Study on T lymphocyte subsets and NK cells in patients with Graves' disease combined with type 2 diabetes

Objective To investigate changes in T lymphocyte subsets and NK cells in patients with simple Graves’ disease(GD)and Graves’ disease combined with type 2 diabetes mellitus(GD/T2DM).Methods Fifteen cases of GD/T2DM were selected from our hospital from November 2001 to November 2004.Before and after therapy thyroid function,thyroglobulin antibody(TGA),thyroid microsomal antibody(TMA)and blood glucose level were measured,and T lymphocyte subsets(CD3,CD4,CD8,CD4/CD8)and NK cells(CD56)were measured by immunofluorescence double labeling monoclonal antibody and flow cytometry,respectively.At the same time,comparison was made with simple GD(15 cases),T2DM(15 cases)and healthy control(20 cases).Results Before therapy,CD4/CD8,CD4 and NK cells in GD/T2DM were less than normal,and there was no significant difference in comparison with simple GD(P<0.05).In T2DM group,only CD4/CD8 and CD4 were less than those of healthy controls(P<0.05).When thyroid function recovered after 1 to 3 months of methimazole treatment in both GD/T2DM and simple GD groups,various indexes recovered,which were more obvious in simple GD.Conclusion Immune hypofunction of GD may be the key to the immune abnormality of GD/T2DM,which is more significant than that of simple GD or T2DM.The recovery of thyroid function and immune abnormality is not consistent,and the recovery of GD is more significant than that of GD/T2DM.

THE EFFECT OF LOCAL RADIOTHERAPY ON T LYMPHOCYTE SUBSETS OF CANCER PATIENT

In the study,we utilized the OKT monoclonal antihuman T Iymphocyte antibodies by indirect immunoenzyme staining method to determinc T lymphocyte subsets in the peripheral blood of 72 cancer patients treated by local radiotherapy.The haematological assays were performed immediately Pre-and Postradiotherapy.In the postoperative radiotherapy group(PR group) of 40 breast cancer patients treated by prophylactic postoperative radiotherapy,after radiotherapy blood platelet,white blood cell and lymphocyte count decreased significantly.CD2,CD4 and CD8 cell counts all very significantly decreased.Proportion of CD2 and CD2 had no apparent change but proportion of CD8 increased significantly.The group appeared apparent hypoimmunity.While the complete response group(CR group) of 32 cancer paticnts treateil with local radiothcrapy,after radiotherapy blood Platelet,white blood cell and lymphocyte count had no significant decrease.CD2,CD4 and CD8 cell count had no significant decrease.Proportion of CD2,CD4 and CD8 had no apparent change.The CR group had no apparent hypoimmunity.Comparing decrease rate of immunologic parameters in these two groups,decrease rate of white blood cell,lympheeyte and T lymphocyte subsets count in CR group significantly were slightened rather than pR group.This study proved that effect of radiation-damaging tumor cell enhance antigenicity of the tumor and stimulate host cell immunity including a type of T-lymphogenesis.Induced hypoimmunity by postoperative radiotherapy should be avoided in this point of view.

THE CHANGES OF PERIPHERAL BLOOD T LYMPHOCYTE SUBSETS IN PATIENTS WITH PRIMARY HEPATIC CARCINOMA BOTH PRE-TACE AND POST-TACE

Objective To observe the variations of the cellular immunological function in patients with primary hepatic carcinoma both pre-TACE(transcatheter arterial chemoembolization,TACE).Methods T lymphocyte subset CD4,CD8 and CD4/CD7 ratio in 45 patients with primary hepatic carcinoma both pre-TACE and post-TACE were measured by flow Cytometer,and compared with the result of T lymphocyte subset in 19 healthy people as normal control samples.Results The CD4 and CD4/CD8 ratio in patients with primary hepatic carcinoma were significantly lower than those in normal control(P<0.05),while CD8 higher(P<0.05);The CD4 and CD4/CD8 ratio in patients with primary hepatic carcinoma were much more lower after TACE than those before TACE(P<0.05),while CD8 was higher but had no significant difference(P>0.05).Conclusion The cellular immunological function in patients with primary hepatic carcinoma decreased and is much more lower after TACE.

Rapid loss of both CD4^+ and CD8^+ T lymphocyte subsets during the acute phase of severe acute respiratory syndrome

Objective To study the alteration of peripheral lymphocyte subsets in severe acute respiratory syndrome (SARS) patients and to help improve the early diagnosis of the disease Methods Anti coagulating blood samples from 98 SARS patients in the acute phase, 56 normal healthy blood donors, and from patients infected by HIV, CMV and EBV were collected The T lymphocyte subsets were counted by flow cytometry using fluorescence labeled specific monoclonal antibodies Results A significant decrease was observed in all SARS patients in their peripheral CD4 + and CD8 + T lymphocyte absolute counts [256(104)×10 6/L and 256 (117)×10 6/L, respectively], which were also lower than those of the patients infected with HIV, CMV and EBV All patients infected with HIV, CMV and EBV had significantly higher CD8 + T lymphocyte counts in comparison with normal controls Conclusions Decrease of both CD4 + and CD8 + T lymphocytes of patients is related to onset of SARS T lymphocyte subset analysis would help improve the early diagnosis of the disease

Therapeutic Effect of Integrative Traditional Chinese and Western Medicine on 51 SARS Patients and Its Influence on Their TLymphocyte Subsets

Objective: To observe the clinical effect of integrative Chinese a nd western medicine (ICWM) in treatment of patients with severe acute respirator y syndrome (SARS) and its influence on their T lymphocyte subsets.Methods: Fifty one patients with SARS of severe type were obser ved with synchronous non randomized controlled method. They were divided into the ICWM group (29 patients) and the western medicine (WM) group (22 patients). Western medical treatment was applied to both groups, but to the ICWM group, Ch inese medicine was given additionally. The therapeutic course was 2-3 weeks for both groups. Clinical effect and changes of T lymphocyte subsets (CD4 +) aft er treatment were observed.Results: In the ICWM group, 26 patients (89.66%) were cured and 3 (10.34%) died, while in the WM group, 12 (54.55%) cur ed and 10 (45.45%) died, thus comparison of the cure rate between the two groups showing significant difference ( P <0.01). The score of clinical symptoms in the ICWM group was decreased from 7.14±5.20 scores before treatment to 1.82±3. 75 scores after treatment, while in the WM group, it lowered from 7.36±3.84 sco res before treatment to 5.17±4.17 scores after treatment, significant diffe rence shown in the comparison of the values between the two groups after treatme nt (P<0.01). Immunological function test showed that CD4 + T lymphocyte in the ICWM group rose from 361±278 cells/mm 3 before treatment to 630±454 c ells/mm 3 after treatment, showing significant difference( P <0.01 );bu t in the WM group, it merely rose from 288±186 cells/mm 3 to 376±285 cells/mm 3 in the corresponding period (P>0.05). Conclusion: ICWM could improve the clinical symptoms of SARS pa tients markedly, enhance their T lymphocyte immune function, and reduce their mortality.

T LYMPHOCYTE SUBSETS OF PERIPHERAL BLOOD AND THEIR RELATIONSHIP WITH BETA－2－MICROGLOBULIN IN MULTIPLE MYELOMA

patients with multiple myeloma (MM) were investigated for lymphocyte subsets using APAAP (Alkaline Phosphastase Anti-Alkaline Phosphatase) technique and a panel of monoclonal antibodies.Radioimmunoassay was used to examine serum beta-2-microglobulin (Sβ2-MG).The results showed that OKT3, OKT4 positive cells and OKT4/OKT8 ratio reduced significantly. OKT8 positive cells increased sharply in MM. We conclude that,in MM,all patients have severe abnormalities in the number and proportion of T cells.The level of S β2-MG increased significantly, especially in the initial and relapsing patients.But,we did not find the relationship between Sβ2-MG and T subsets.

T Lymphocytes and Th1/Th2 Cytokines in Peripheral Blood of Patients with Recurrent Genital Herpes

Objective: This study analyzed the T lymphocytes and Th1/Th2 type cytokine profile shift in the peripheral blood ofpatients with recurrent genital herpes (RGH). Methods: Immunofluorescent staining or cell surface antigenand intracellular cytokines(IL-2、IL-4、IL-12、IFN-r)inperipheral blood from 20 RGH patients and 10 controls wereanalyzed using flow cytometric techniques. Results: RGH patients had signiflcantly lower levels ofCD3^+T cells, CD4^+T cells and CD4^+ T/ CD8^+ T cells ratiocompared to control levels (P<0.001), and IL-2-producing,IFN-r-producing and IL-12-producing T cells were increasedin RGH patients (CD4^+T: P<0.001, CD8^+T: P<0.05respectively), whereas IL-4-producing T cells were increased inRGH patients compared to controls (CD4^+T: P<0.05; CD8^+T:P<0.001 respectively). Conclusions: RGH patients have T lymphocyte subsetvariations and Th1/Th2 cytokine changes. The increase in Th2cells Th1/Th2 imbalance may have important implications forRGH pathogenesis.

Intracellular Cytokine Expression Profile in Patients with Condyloma Acuminata

Objective: To study the immunological mechanisms ofCondyloma acuminata(CA) through investigating Tlymphocyte subset levels and cytokine profile in theperipheral blood of patients with CondylomaAcuminata. Methods: Tricolor and bicolor immunofluorescentstaining antibody of cell surface antigen and intracel-lular IL-2, IL-4, IL-12, IFN-Y in CD4^+ and CD8^+ T-lymphocytes from 20 patients with CA were performedand followed by flow cytometry. Results: The number of CD3^+T, CD4^+T-lymphocytescells and CD4^+/CD8^+T cells ratio were significantlydecreased(P<0.01) in patients with CA Compared tocontrols, and IL-2, IL-12, IFN-γ production in CD4^+Tcells was decreased(P<0.01), IL-4 and IFN-γ produc-tion in CD4^+T cells was not significantly different (P>0.05), while IL-2 and IL-12 production in CD8^+Tc cellswas decreased (P<0.01), whereas IFN-γ and IL-4 pro-ducing in CD4^+T cells were of no significantlydifference(P>0.05). Conclusions: There was an imbalance of T lympho-cyte subsets, Th1/Th2 cytokines and Tc1/Tc2 in theperipheral blood of CA patients, which may play animportant role in the pathogenesis and progression ofCA.

Impact of comorbid anxiety and depression on quality of life and cellular immunity changes in patients with digestive tract cancers

AIM:A study was performed to investigate the impact of comorbid anxiety and depression (CAD) on quality of life (QOL) and cellular immunity changes in patients with digestive tract cancers. METHODS: One hundred and fifty-six cases of both sexes with cancers of the digestive tract admitted between March 2001 and February 2004 in the Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University were randomly enrolled in the study. Depressive and anxiety disorder diagnoses were assessed by using the Structured Clinical Interview for DSM-IV. All adult patients were evaluated with the Hamilton depressive scale (HAMD, the 24-item version), the Hamilton anxiety scale (HAMA, a modified 14-item version), quality of life questionnaire-core 30 (QLQ-C30), social support rating scale (SSRS), simple coping style questionnaire (SCSQ), and other questionnaires, respectively. In terms of HAMD ≥ 20 and HAMA ≥ 14, the patients were categorized, including CAD (n = 31) in group A, anxiety disorder (n = 23) in group B, depressive disorder (n = 37) in group C, and non-disorder (n = 65) in group D. Immunological parameters such as T-lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared among the four groups. RESULTS: The incidence of CAD was 21.15% in patients with digestive tract cancers. The average scores of social support was 43.67±7.05 for 156 cases, active coping 20.34±7.33, and passive coping 9.55±5.51. Compared with group D, subjective support was enhanced slightly in group A, but social support, objective support, and utilization of support reduced, especially utilization of support with significance (6.16 vs7.80, P<0.05); total scores of active coping decreased, while passive coping reversed; granulocytes proliferated, monocytes declined, and lymphocytes declined significantly (32.87 vs 34.00, P<0.05); moreover, the percentage of CD3, CD4, CD8 and CD56 in T lymphocyte subsets was in lower level, respectively, and CD56 showed a significant decline in group A (26.02 vs 32.20, P<0.05), however, CD4/CD8 ratio increased. Physical function, role function, fatigue, sleeplessness and constipation had significant changes among different groups by one-way ANOVA, and group A was in poor QOL. It revealed that global health-related quality of life (QL) were positively correlated with active coping and CD56; CAD was negatively correlated with QL, active coping and CD56. Furthermore, the step-wise regression analysis suggested that utilization of support, CD56, active coping, fatigue, sleeplessness and depression were significant factors contributing to QOL. CONCLUSION: CAD, which can impair QOL and cellular immunity, occurs with a higher incidence in patients with digestive tract cancers. Hence, it is essential to improve mental health for them with specifically tailored interventions.

Effect of liniment levamisole on cellular immune functions of patients with chronic hepatitis B

AIM: To explore the effects of liniment levamisole on cellular immune functions of patients with chronic hepatitis B. METHODS: The levels of T lymphocyte subsets and mlL-2R in peripheral blood mononuclear cells (PBMCs) were measured by biotin-streptavidin (BSA) technique in patients with chronic hepatitis B before and after the treatment with liniment levamisole. RESULTS: After one course of treatment with liniment levamisole, the levels of CD3+, CD4+, and the ratio of CD4+/CD8+ increased as compared to those before the treatment but the level of CD8+ decreased. The total expression level of mIL-2R in PBMCs increased before and after the treatment with liniment levamisole. CONCLUSION: Liniment levamisole may reinforce cellular immune functions of patients with chronic hepatitis B.

Effect of Early Intensive Insulin Therapy on Immune Function of Aged Patients with Severe Trauma

This study examined the effect of intensive insulin therapy on immune function and inflammatory factors at the early phase after severe trauma. At day 1, 3, 5, 7 after admission, subsets of CD4＋ helper T lymphocytes （Th1/Th2） and human leukocyte antigen （HLA）-DR expression on CD14＋ monocytes were flow cytometrically measured. Levels of cytokines, including tumor necrosis factor-alpha （TNF-α）, interleukin-6 （IL-6）, interleukin-10 （IL-10） and other immunity markers, such as IgA, IgG, IgM, C3, C4 and C reaction protein （CRP） were examined in two groups. The results showed that TNF-α, IL-6 and CRP levels in the intensive insulin therapy group were significantly lower than those in the conventional therapy group, whereas IL-10 levels were substantially increased after intensive insulin therapy. C3 level at day 3, 5, 7 and C4 levels at day 5, 7 were lower in the intensive therapy group than in the conventional therapy group. Th1/Th2 ratios decreased gradually over time in both groups, and were much lower at day 3, 5, 7 in intensive therapy group. There were significant differences among day 3 to day 7 after admission in HLA-DR expression in CD14＋ monocytes. It was concluded that the intensive insulin therapy could decrease pro-inflammatory cytokines and increase anti-inflammatory cytokines in the elderly suffering from severe trauma, at the same time, with complement recovery being delayed. Moreover, intensive insulin therapy promoted immune suppression and, therefore, measures need be taken to address the issue.

Clinical Evaluation of Integrative Chinese and Western Medicine in Treating SARS

Objective:To evaluate the effective treatment with integrative Chinese and western medicine (ICWM) of severe acute respiratory syndrome (SARS). Methods: The 65 cases of SARS patients were treated with ICWM and 37 cases with western medicine (WM) alone as the control in our hospital from March 11 to April 30, 2003. The results were analyzed, with T subset profile tested for all the 102 patients. Results: Sixty-five cases of SARS patients treated with ICWM included 52 mild cases of whom 51 cases were cured (98.1%) and no patient died. As to the 13 severe cases in this group, 9 were cured (69. 2%) and 2 died (15. 4%). Of the 37 cases treated with WM alone, 16 out of the 18 common cases were cured (88. 9%) and 10 out of the 19 severe cases were cured (52. 6%), with the other 9 died (47. 4%). Comparison between the two groups (P=0. 061) showed the difference was close to the value for statistical significance. But considering that the number of samples was small, more cases are needed for further study. The immune function examination: in cases of the common type, after ICWM treatment, CD4 + T lymphocytes were increased from 360±247 cell/mm3 to 563±479 cell/mm3 (P<0. 05). In the group treated with WM alone, CD4+ T lymphocytes were increased from 331 ±193 cell/mm3 to 772±354 cell/mm3 (P<0. 05). As to the severe cases after ICWM treatment, CD4+ T lymphocytes increased from 352±279 cell/mm3 to 525±490 cell/mm3 (P>0. 05). In the group of severe cases treated with WM alone, CD4+ T lymphocytes reduced from 229±69 cell/mm3 to 205±108 cell/mm3 (P>0. 05). While after ICWM treatment, CD4+ T lymphocytes were significantly higher than that of the group treated with WM alone (P< 0. 05). Conclusion: Compared with the group treated with WM alone, ICWM can significantly improve the prognosis, reduce the mortality as well as improve the immune function of SARS patients.

The Immunity Induced by Recombinant Spike Proteins of SARS Coronavirus in Balb/c Mice

The immune effect of two recombinant protein fragments of spike protein in severe acute respiratory syndrome coronavirus (SARS CoV) was investigated in Balb/c mice. Two partial spike gene fragments S1 (322-1464 bp) and S2 (2170-2814 bp) of SARS coronavirus were amplified by RT-PCR, and cloned into pET-23a prokaryotic expression vector, then transformed into competent Escherichia E.coli BL21 (DE3)(pLysS) respectively. Recombinant proteins were expressed and puri- fied by Ni2+ immobilized metal ion affinity chromatography. The purified proteins mixed with com- plete Freund adjuvant were injected into Balb/c mice three times at a two-week interval. High titer antibody was detected in the serum of immunized Balb/c mice, and mice immunized with S1 protein produced high titer IgG1, IgG2a, IgG2b and IgG3, while those immunized with S2 protein produced high titer IgG1, IgG2a, but lower titer IgG2b and IgG3. Serum IFN-γ concentration was increased significantly but the concentrations of IL-2, IL-4 and IL-10 had no significant change. And a marked increase was observed in the number of spleen CD8+ T cells. The results showed that recombinant proteins of SARS coronavirus spike protein induced hormonal and cellular immune response in Balb/c mice.

Effect of Astragalus Polysaccharide on the Cell-mediated Immunity of Traumatic Stress Mice

To investigate the changes of immune functions and the effects of Astragalus polysaccharide (ASP) on the cell-mediated immunity of the traumatic stress model of mouse by amputation, 50 mice were randomly divided into 5 groups for study, in which the group A and B served as the normal control (by injecton of 0.5 ml of saline intra-peritoneally daily), and as the stress control (by intra-peritoneal injecton of 0.5 ml of normal saline into mice after amputation) respectively, to the group C, D and E of mice, 1000 mg/kg (high dose), 300 mg/kg (median dose) and 250 mg/kg (low dose). The CD4 + and CD8 + T cells as well as the expression of the c-fos protein were determined by immunohistochemical techniques, and the expressions of NF-κB mRNA and IL-10 mRNA were assayed by hybridization in situ . The experimental results showed that in comparison with the normal control group of mice (group A), the expression levels of NF-κB mRNA, IL-10 mRNA and the c-fos protein in the tissues of thymus and spleen in the stress controls were significantly elevated and the CD4 + T cells and CD4/CD8 ratio were decreased. However, in comparison with the stress control of mice (group B), the expressions of NF-κB mRNA and IL-10 mRNA were inhibited by ASP, and the CD4 + T cells and CD4/CD8 ratio were increased in groups C, D and E, but the level of c-fos protein was decreased. There was no significant difference in these parameters among group C, D and E. It is concluded that the functions of cell-mediated immunity of mice were disturbed under the stress condition of the traumatic injuries after amputation. And the immune functions can be effectively restored by the use of Astragalus polysaccharide.