Prognostic impact of preoperative nutritional and immune inflammatory parameters on liver cancer

The immune response to tissue damage or infection involves inflammation,a multifaceted biological process distinguished by immune cell activation,mediator secretion,and immune cell recruitment to the site of injury.Several blood-based immune-inflammatory biomarkers with prognostic significance in malignancies have been identified.In this issue of the World Journal of Gastrointestinal Surgery,they examined the prognosis of liver cancer radical resection in relation to pre-operative systemic immune-inflammation and nutritional risk indices.Comparing older and younger individuals often reveals compromised nutritional and immu-nological statuses in the former.Therefore,performing preoperative evaluations of the nutritional status and immunity in geriatric patients is critical.In addition to being a primary treatment modality,radical resection is associated with a sig-nificant mortality rate following surgery.Insufficient dietary consump-tion and an elevated metabolic rate within tumor cells contribute to the increased proba-bility of malnutrition associated with the ailment,consequently leading to a sub-stantial deterioration in prognosis.Recent studies,reinforce the importance of nu-tritional and immune-inflammatory biomarkers.Prior to surgical intervention,geriatric nutritional risk and systemic immune-inflammatory indices should be prioritized,particularly in older patients with malignant diseases.

Long-term modulation of the immune system by perinatal nutrition

Nutrition during perinatal period is more critical for the developme nt of the immune system than during adulthood, and the relationship between earl y nutrition and diseases in later life has been established. In humans and labor atory animals, the plasticity of metabolic function in foetuses or neonates enab les them to adapt to malnutrition for survival; however, such an adaptation, as usually evidenced by retarded growth, stunted development of lymphoid organs and impaired immunocompetence, can maintain and persist into later life even when n utrition is improved. Early nutrition may thus programme' the immune system of a nimals. Limited experimental studies have also revealed that long-term immunity against nematode parasites in sheep can be enhanced by a short-term protein su pplementation shortly after weaning, a form of 'nutritional programming', but su ch an effect appears to vanish if the nutritional status of young animals alread y meets at least the requirement for maintenance.

Impact of nutritional support on immunity,nutrition,inflammation,and outcomes in elderly gastric cancer patients after surgery

BACKGROUND Postoperative rehabilitation of elderly patients with gastric cancer has always been the focus of clinical attention.Whether the intervention by a full-course nutritional support team can have a positive impact on the postoperative immune function,nutritional status,inflammatory response,and clinical outcomes of this special population has not yet been fully verified.AIM To evaluate the impact of full-course nutritional support on postoperative comprehensive symptoms in elderly patients with gastric cancer.METHODS This is a retrospective study,including 60 elderly gastric cancer patients aged 70 years and above,divided into a nutritional support group and a control group.The nutritional support group received full postoperative nutritional support,including individualized meal formulation,and intravenous and parenteral nutrition supplementation,and was regularly evaluated and adjusted by a professional nutrition team.The control group received routine postoperative care.RESULTS After intervention,the proportion of CD4+lymphocytes(25.3%±3.1%vs 21.8%±2.9%,P<0.05)and the level of immunoglobulin G(12.5 G/L±2.3 G/L vs 10.2 G/L±1.8 G/L,P<0.01)were significantly higher in the nutritional support group than in the control group;the changes in body weight(-0.5 kg±0.8 kg vs-1.8 kg±0.9 kg,P<0.05)and body mass index(-0.2±0.3 vs-0.7±0.4,P<0.05)were less significant in the nutritional support group than in the control group;and the level of C-reactive protein(1.2 mg/L±0.4 mg/L vs 2.5 mg/L±0.6 mg/L,P<0.01)and WBC count(7.2×10^(9)/L±1.5×10^(9)/L vs 9.8×10^(9)/L±2.0×10^(9)/L,P<0.01)were significantly lower in the nutritional support group than in the control group.In addition,patients in the nutritional support group had a shorter hospital stay(10.3 d±2.1 d vs 14.8 d±3.6 d,P<0.05)and lower incidence of infection(15%vs 35%,P<0.05)in those of the control group.CONCLUSION The intervention by the nutritional support team has a positive impact on postoperative immune function,nutritional status,inflammatory response,and clinical outcomes in elderly patients with gastric cancer.

Effects of early enteral nutrition on immune function of severe acute pancreatitis patients

AIM:To investigate the effects of early enteral nutrition (EEN) on the immune function and clinical outcome of patients with severe acute pancreatitis (SAP).METHODS:Patients were randomly allocated to receive EEN or delayed enteral nutrition (DEN).Enteral nutrition was started within 48 h after admission in EEN group,whereas from the 8 th day in DEN group.All the immunologic parameters and C-reactive protein (CRP) levels were collected on days 1,3,7 and 14 after admission.The clinical outcome variables were also recorded.RESULTS:Sixty SAP patients were enrolled to this study.The CD4+ T-lymphocyte percentage,CD4+/CD8+ ratio,and the CRP levels in EEN group became significantly lower than in DEN group from the 7 th day after admission.In contrast,the immunoglobulin G(IgG) levels and human leukocyte antigen-DR expression in EEN group became significantly higher than in DEN group from the 7 th day after admission.No difference of CD8+ T-lymphocyte percentage,IgM and IgA levels was found between the two groups.The incidences of multiple organ dysfunction syndrome,systemic inflammatory response syndrome,and pancreatic infection as well as the duration of intensive care unit stay were significantly lower in EEN group than in DEN group.However,there was no difference of hospital mortality between the two groups.CONCLUSION:EEN moderates the excessive immune response during the early stage of SAP without leading to subsequent immunosuppression.EEN can improve the clinical outcome,but not decrease the hospital mortality of SAP patients.

Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer

To explore the effect of early enteral nutrition （EN） on postoperative nutritional status, intestinal permeability, and immune 6anction in elderly patients with esophageal cancer or cardiac cancer. Methods： A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group （n=50） and parenteral nutrition （PN） group （n=46） based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase （DAO） activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme- linked immunosorbent assay （ELISA）. Results： After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group （P〈0.05）, whereas the EN group had significantly higher albumin levels than the PN group （P〈0.05）. On the 7th postoperative day, the DAO activity, D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group （all P〈0.05）. In addition, the EN group had significantly higher IgA, IgG, IgM, and CD4 levels than the PN group （P〈0.05） but significantly lower IL-2, IL-6, and TNF-a levels （P〈0.05）. Conclusions： In elderly patients with esophageal cancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier （by reducing plasma endoxins）, and enhance the immune function

Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury:Effects on Immune Function,Nutritional Status and Outcomes

Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN)with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patientswith severe traumatic brain injury (STBI).Methods A prospective randomized control trial was carried out from January 2009 to May 2012 inNeurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow ComaScale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were administratedEN, PN or EN＋PN treatments respectively. The indexes of nutritional status, immune function,complications and clinical outcomes were examined and compared statistically.

Enteral nutrition and immune modulation of acute pancreatitis

Enteral nutrition has been strongly recommended by major scientific societies for the nutritional management of patients with acute pancreatitis.Providing severe acute pancreatitis patients with enteral nutrition within the first 24-48 h of hospital admission can help improve outcomes compared to parenteral nutrition and no feeding.New research is focusing in on when and what to feed to best improve outcomes for acute pancreatitis patients.Early enteral nutrition have the potential to modulate the immune responses.Despite this consistent evidence of early enteral nutrition in patients with acute pancreatitis,clinical practice continues to vary due to individual clinician preference.Achieving the immune modulating effects of enteral nutrition heavily depend on proper placement of the feeding tube and managing any tube feeding associated complications.The current article reviews the immune modulating effects of enteral nutrition and pro-and prebiotics and suggests some practical tools that help improve the patient adherence and tolerance to the tube feeding.Proper selection of the type of the tube,close monitoring of the tube for its placement,patency and securing its proper placement and routine checking the gastric residual volume could all help improve the outcome.Using peptide-based and high medium chaintriglycerides feeding formulas help improving feeding tolerance.

Effects of radical cholecystectomy on nutritional and immune status in patients with gallbladder carcinoma

INTRODUCTION Carcinoma of the gallbladder is the most commonneoplasm in biliary tract,and its incidence has beenrising in recent years.The rate of correct diagnosisin early gallbladder carcinoma has been raised afterthe wide use of CT,ultrasound scans and frozensection examination.Now radical cholecystectomyis advocated as the best management for patientswith early gallbladder carcinoma.In the

Effect of postoperative early enteral nutrition on clinical outcomes and immune function of cholangiocarcinoma patients with malignant obstructive jaundice

BACKGROUND Most cholangiocarcinoma patients with malignant obstructive jaundice(MOJ)have varying degrees of malnutrition and immunodeficiency preoperatively.Therefore,perioperative nutritional support has important clinical significance in the treatment of cholangiocarcinoma.AIM To investigate the effects of postoperative early enteral nutrition(EEN)on immunity function and clinical outcomes of cholangiocarcinoma patients with MOJ.METHODS This prospective clinical study included 60 cholangiocarcinoma patients with MOJ who underwent surgery.The patients were randomly divided into an experimental group and a control group according to the nutrition support modes.The control group received postoperative total parenteral nutrition(TPN),whereas the experimental group received postoperative EEN and parenteral nutrition(PN;EEN+PN).The clinical outcomes,postoperative immune function,incidences of surgical site infection and bile leakage,intestinal function recovery time,average hospitalization days,and hospitalization expenses of the two groups were assessed on postoperative days(PODs)1,3,and 7.RESULTS The CD3+T,CD4+T,CD8+T,and CD4+T/CD8+T cell count and the immunoglobulin(Ig)G,IgM,and IgA levels in the EEN+PN group were significantly higher than those in the TPN group on PODs 3 and 7(P<0.05),whereas no significant differences in the CD3+T,CD4+T,CD8+T,and CD4+T/CD8+T cell counts and IgG,IgM,and IgA levels before operation and on POD 1 were found between the two groups(P>0.05).The intestinal function recovery time and postoperative hospital stay were shorter(P<0.001 for both)in the EEN+PN group than in the TPN group.The hospitalization expenses of the EEN+PN group were lower than those of the TPN group(P<0.001).However,the incidence of abdominal distension was higher than in the EEN+PN group than in the TPN group(P<0.05).The incidence rates of biliary leakage and surgical site infection were not significantly different between the two groups(P>0.05).CONCLUSION A postoperative EEN program could reduce the incidence of postoperative complications and improve the clinical outcomes and immune functions of cholangiocarcinoma patients with MOJ and is thus beneficial to patient recovery.

Effects of enteral immunonutrition on immune function in patients with multiple trauma

BACKGROUND：Enteral immunonutrition （EIN） refers to addition of some specific nutrients in enteral nutrition （EN）, which can help to increase the immune function, and reduce the inflammatory reaction and septic complications. This study aimed to determine whether EIN can improve the immune function in multiple trauma patients. METHODS：Thirty-two patients with multiple trauma who had been admitted to the general ICU of Changzheng Hospital, Shanghai, from March 2007 to May 2008, were randomly divided into two groups： an enteral immunonutrition group （EIN group, n=16） and an enteral nutrition group （EN group, n=16）. EIN suspension （RuiNeng produced by Sino-Swed Co., Ltd） and ordinary nutrition liquid （RuiSu produced by Sino-Swed Co., Ltd） were given to patients of the EIN group and EN group respectively for at least for 14 days. Peripheral blood lymphocyte count （TLC）, immunoglobulin （IgG, IgM, IgA）, and T-lymphocyte subsets （CD3, CD4, CD8, CD4 / CD8） were detected on the 1st day after grouping, and the 7th day and 14th day after nutritional support. RESULTS： TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher in the EIN group on the 7th and 14th day than that on the 1st day （P〈0.05）, and continually increased with a prolonged time of EIN. The parameters of immune function in the EN group on the 7th day didn＇t change significantly compared with those on the 1st day after grouping; on the 14 th day, TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher than those on the 1st day after grouping （P〈0.05）, but were significantly lower than those in the EIN group on the 14th day （P〈0.05）. CONCLUSION： Compared with the general formula EN, EIN is more helpful for the recovery of humoral and cellular immune function in the early post-multitraumatic phase.

Correlation between preoperative systemic immune inflammation index, nutritional risk index, and prognosis of radical resection of liver cancer

BACKGROUND Radical surgery is the most commonly used treatment for hepatocellular carcinoma(HCC).However,the surgical effect remains not ideal,and prognostic evaluation is insufficient.Furthermore,clinical intervention is rife with uncertainty and not conducive to prolonging patient survival.AIM To explore correlations between the systemic immune inflammatory index(SII)and geriatric nutritional risk index(GNRI)and HCC operation prognosis.METHODS This retrospective study included and collected follow up data from 100 HCC.Kaplan–Meier survival curves were used to analyze the correlation between SII and GNRI scores and survival.SII and GNRI were calculated as follows:SII=neutrophil count×platelet count/lymphocyte count;GNRI=[1.489×albumin(g/L)+41.7×actual weight/ideal weight].We analyzed the predictive efficacy of the SII and GNRI in HCC patients using receiver operating characteristic(ROC)curves,and the relationships between the SII,GNRI,and survival rate using Kaplan–Meier survival curves.Cox regression analysis was utilized to analyze independent risk factors influencing prognosis.RESULTS After 1 year of follow-up,24 patients died and 76 survived.The area under the curve(AUC),sensitivity,specificity,and the optimal cutoff value of SII were 0.728(95%confidence interval:0.600-0.856),79.2%,63.2%,and 309.14,respectively.According to ROC curve analysis results for predicting postoperative death in HCC patients,the AUC of SII and GNRI combination was higher than that of SII or GNRI alone,and SII was higher than that of GNRI(P<0.05).The proportion of advanced differentiated tumors,tumor maximum diameter(5–10 cm,>10 cm),lymph node metastasis,and TNM stage III-IV in patients with SII>309.14 was higher than that in patients with SII≤309.14(P<0.05).The proportion of patients aged>70 years was higher in patients with GNRI≤98 than that in patients with GNRI>98(P<0.05).The 1-year survival rate of the SII>309.14 group(compared with the SII≤309.14 group)and GNRI≤98 group(compared with the GNRI>98 group)was lower(P<0.05).CONCLUSION The prognosis after radical resection of HCC is related to the SII and GNRI and poor in high SII or low GNRI patients.

RESEARCH OF NUTRITIONAL AND IMMUNE STATUS IN PATIENTS WITH GALLBLADDER CARCINOMA RADICAL CHOLECYSTECTOMY

Objective To inquire the nutritional and immune status in patients with gallbladder carcinoma before and after radical cholecystectomy.Methods The nutritional and immune status in patients with gallbladder carcinoma were assessed in 1 week before surgery, and on 3rd day, 7th day, 14th day and 21st day after operation respectively.Results All of the nutritional parameters but the serum level of iron, TIBC and transfterrin recovered within 3 week after operation. Remarkable decrease of serum IgG, IgA, IgM and C 3, C 4 complement, IL 2, CD 4, CD 4/CD 8 ratio, and the remarkable increase of serum SIL 2R and CD 8( P <0.01) on 3rd day after operation.Conclusion Adequate iron should be supplemented after the radical cholecystectomy for gallbladder carcinoma in the third postoperative week. Radical cholecystectomy with complete resection of the tumor and removal of lymph nodes played the important roles in the recovery of immune function.

Effect of enteral and parenteral nutritional diet intervention on recovery, nutritional status and immune functi on for gastric cancer patients after radical gastrectomy

Objective:To explore the effect of enteral and parenteral nutritional diet intervention on recovery, nutritional status and immune function for gastric cancer patients after radical gastrectomy.Methods:A total of 180 patients with gastric cancer treated in our hospital from January 2016 to December 2017 were selected, and randomly divided into the control group and the observation group by computer, each with 90 cases. Control group received parenteral nutrition intervention, and observation group received enteral and parenteral nutritional diet intervention. Cellular immune function, humoral immune function, nutritional status, and complications occurrence rate were compared between two groups.Results: The levels of cellular immune function between the two groups had no difference before intervention (P>0.05). After intervention, the observation group had higher levels of CD3+, CD4+, and CD4+/CD8+ as well as lower level of CD8+ than those of control group (P<0.05). The IgM, IgA, and IgG levels between the two groups had no difference before treatment (P>0.05), which were decreased after treatment (P<0.05), and were lower in the observation group than those in the control group (P<0.05). The albumin and prealbumin levels between the two groups had no difference before intervention (P>0.05), which were increased after treatment, and were higher in observation group than those in the control group (P<0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P<0.05).Conclusion:The application of enteral and parenteral nutritional diet intervention can promote the recovery, improve the nutritional status and immune function for gastric cancer patients after radical gastrectomy, which has fewer complications.

Effect of glutamine enteral nutrition on the postoperative nutrition status and immune function in elderly patients with gastrointestinal tumor

Objective: To explore the clinical efficacy of glutamine enteral nutrition in the treatment of gastrointestinal tumor in elderly patients and the effect in improving the nutrition and immunity. Methods: A total of 92 elderly patients with gastrointestinal tumor who were admitted in our hospital from June, 2014 to March, 2016 were included in the study and randomized into the control group (n=46) and the treatment group (n=46). The patients in the two groups were given adjuvant chemotherapy 2 weeks after operation and routine enternal nutrition 1 d after operation. On the basis of routine enternal nutrition, the patients in the treatment group were given glutamine granules for intensive treatment. The patients in the two groups were continuously given 10 d nutrition support. The gastrointestinal function recovery and intestinal mucosal barrier recovery before and after operation in the observation group were compared. The levels of related nutrition and immune indicators before and after operation in the two groups were detected and compared. Results: The first exhaust and first defecation time after operation in the treatment group was significantly shortened when compared with the control group. When compared with before operation, L/M and plasma DAO level 1 d and 10 d after operation in the control group were significantly elevated. L/M and plasma DAO level 1 d after operation in the treatment group were significantly elevated, while those 10 d after operation were significantly reduced when compared with before operation. L/M and plasma DAO level 1 d and 10 d after operation in the treatment group were significantly lower than those in the control group. The serum TP, Alb, PA, and TRF levels 1 d and 10 d after operation in the two groups were significantly elevated when compared with before operation, and those in the treatment group were significantly higher than those in the control group. When compared with before operation, the plasma IgA and IgG levels, CD4+, and CD4+/CD8+1 d after operation in the two groups were significantly reduced, while CD8+was significantly elevated. The plasma IgA and IgG levels, CD4+, and CD4+/CD8+10 d after operation in the two groups were significantly elevated when compared with 1 d after operation, while CD8+was significantly reduced. Moreover, the plasma IgA and IgG levels, CD4+, and CD4+/CD8+10 d after operation in the treatment group were significantly higher than those in the control group or when compared with before operation, while CD8+was significantly lower than that in the control group or when compared with before operation. Conclusions: Glutamine enteral nutrition in the treatment of gastrointestinal tumor in elderly patients can effectively improve the postoperative intestinal mucosal barrier function, promote the postoperative gastrointestinal function recovery, correct malnutrition, and enhance the humoral immunity and cellular immunity function, with efficacy significantly superior to that by the routine enternal nutrition.

Influence of dietary n-3 LC-PUFA on growth, nutritional composition and immune function in marine fish Sebastiscus marmoratus

Abstract A 60-day feeding experiment was conducted to investigate the influence of dietary omega-3 long-chain polyunsaturated fatty acids （n-3 LC-PUFA） on growth, nutritional composition and immune function of marine fish Sebastiscus marmoratus. Five diets containing 3.6, 10.2, 18.2, 26.5, or 37.0 g/kg n-3 LC-PUFA were prepared. The results reveal significant influences of dietary n-3 LC-PUFA on the final weight, weight gain, specific growth rate, feed conversion ratio, and condition factor. As dietary n-3 LC- PUFA increased, weight gain and specific growth rate increased and were significantly higher in groups fed 18.2, 26.5 and 37.0 g/kgthan in groups fed 3.6 and 10.2 g/kg （P〈0.05）; there was no significant difference between groups fed 18.2, 26.5, or 37.0 g/kg （P〉0.05）. With increasing dietary n-3 LC-PUFA, eicosapentaenoic acid and docosahexenoic acid content in muscle and liver increased significantly, immunoglobulin class M content gradually increased from 9.1 to 14.8 Ixg/L, and lysozyme activity content increased from 1 355 to 2 268 U/mL. Broken line model analysis according to weight gain indicated that a dietary n-3 LC-PUFA level of 18.2 g/kg is essential for normal growth at a fat level of 125 g/kg. Therefore, appropriate dietary n-3 LC-PUFA not only promote growth and improve the n-3 LC-PUFA content, but also enhance immune function in S. marmoratus.

Effects of enteral nutrition intervention on immune nutritional status and radiation damage in patients with esophageal cancer radiotherapy

Objective: To study the effects of enteral nutrition intervention on immune nutritional status and radiation damage in patients with esophageal cancer radiotherapy. Methods: Patients with esophageal cancer who underwent radiotherapy in West China Hospital, Sichuan University between January and October 2017 were chosen as the research subjects and divided into the experimental group who received enteral nutrition intervention and the control group who received routine intervention. The contents of nutrition indicators and radiation damage markers in serum as well as the contents of immune cells in peripheral blood were determined before radiotherapy and after radiotherapy ended. Results: Compared with those before radiotherapy, serum ALB, PA, TRF and RBP contents as well as peripheral blood Th cell, NK cell, Breg cell and Treg cell contents of experimental group did not change significantly while serum PDGF-BB, TGF-β1, CTGF, TNF-α and SAA contents were significantly higher after radiotherapy;serum ALB, PA, TRF and RBP contents as well as peripheral blood Th cell and NK cell contents of control group were significantly lower while serum PDGF-BB, TGF-β1, CTGF, TNF-α and SAA contents as well as peripheral blood Breg cell and Treg cell contents were significantly higher after radiotherapy;serum ALB, PA, TRF and RBP contents as well as peripheral blood Th cell and NK cell contents of experimental group after radiotherapy were higher than those of control group while serum PDGF-BB, TGF-β1, CTGF, TNF-α and SAA contents as well as peripheral blood Breg cell and Treg cell contents were lower than those of control group. Conclusion: enteral nutrition intervention can improve immune nutritional status and reduce radiation damage in patients with esophageal cancer radiotherapy.

Changes of immune response and side effects before and after nutritional intervention in cervical cancer patients with concurrent chemoradiotherapy

Objective:To investigate the changes of immune response and side effects before and after nutritional intervention in cervical cancer patients with concurrent chemoradiotherapy. Methods: A total of 160 patients with primary cervical cancer who received concurrent chemoradiotherapy in this hospital between May 2016 and September 2017 were selected as the research subjects. Their nutritional intervention plans were reviewed and used to divide the patients into the control group (n=83) who accepted conventional nutritional support and the nutritional intervention group (n=77) who accepted targeted nutritional intervention. The differences in the contents of Th1/Th2 immunity indexes and humoral immunity indexes as well as the levels of bone marrow suppression-related indexes were compared between the two groups before and after intervention.Results: Before intervention, the differences in the contents of Th1/Th2 immunity indexes and humoral immunity indexes as well as the levels of bone marrow suppression-related indexes were not statistically significant between the two groups. After intervention, serum IL-2, IFN-γ, IL-4 and IL-6 contents of nutritional intervention group were lower than those of control group;serum IgA, IgM, IgG, C3 and C4 contents were higher than those of control group;peripheral blood WBC, RBC, Hb and PLT levels were higher than those of control group.Conclusion: Nutritional intervention can effectively optimize the immune status and reduce the bone marrow suppression reaction in cervical cancer patients with concurrent chemoradiotherapy.

Effect of immune-enhanced enteral nutrition on inflammatory response and immune function in elderly patients with septic shock

Objective:To investigate the effect of immune-enhanced enteral nutrition on inflammatory response and immune function in elderly patients with severe septic shock.Methods:From September 2016 to October 2018,58 cases of serious septic shock patients treated in our hospital,were randomly assigned to two groups.A group-enteral nutrition emulsion group(n=29);B group-enteral nutrition mixed suspension group(n=29);The admission day,one week,two week after admission,the index data of patients',inflammation and immune were collected.Results:With the increase of admission time,CD4 and CD4/CD8 levels in the two groups were gradually increased and CD8 levels were gradually decreased.At 1 and 2 weeks after admission,CD4 and CD4/CD8 levels in the observation group were higher than those in the control group(P<0.05),and CD8 levels were lower than those in the control group(P<0.05).Each immunoglobulin index of subjects in both groups increased with the increase of admission time.The IgG and IgM levels of subjects in the observation group were higher than those in the control group(P<0.05).IgA levels of subjects in the observation group were higher than those in the control group at 1 and 2 weeks after admission(P<0.05).With the increase of admission time,the c-reactive protein concentration of subjects in the two groups decreased gradually(P<0.05).One week after admission,there was no significant difference in c-reactive protein between the observation group and the control group(P>0.05).C-reactive protein of subjects in the observation group was higher than that in the control group at 2 weeks after admission(P<0.05).With the increase of admission time,the concentration of plasma diamine oxidase(DAO)in the two groups decreased gradually,and the DAO at different time points in each group showed statistical difference(P<0.05).1 week after admission,there was no significant difference in DAO between the observation group and the control group(P>0.05).At 2 weeks after admission,the DAO of subjects in the observation group was higher than that in the control group(P<0.05).Conclusions:Immune-enhancing enteral nutrition is more helpful to control the inflammatory response in patients of serious septic shock,and it's also can modulate the immune function.

Effects of oral nutrition support on nutritional status, immune function and radiation damage in patients with nasopharyngeal carcinoma radiotherapy

Objective:To study the effects of oral nutrition support on nutritional status, immune function and radiation damage in patients with nasopharyngeal carcinoma radiotherapy.Methods:Patients with nasopharyngeal carcinoma who received radiotherapy in West China Hospital between and November January 2017 were selected and randomly divided into the nutrition support group who received oral nutrition support and the normal control group who received routine intervention. The levels of nutrition indicators and radiation damage indicators in serum as well as the contents of immune cells in peripheral blood were determined before radiotherapy and 1 week after end of radiotherapy.Results: Compared with those before radiotherapy, serum ALB, PA, TWEAK, Leptin and Ghrelin levels as well as peripheral blood CD3+CD4+, CD3+CD8+, CD3-CD19+ and CD3-CD56+ immune cell contents of nutrition support group didn't change significantly whereas serum TGF-β1, IL-6, IL-17 and MMP9 levels increased significantly 1 week after end of radiotherapy;serum ALB and PA levels as well as peripheral blood CD3+CD4+, CD3+CD8+, CD3-CD19+ and CD3-CD56+ immune cell contents of normal control group decreased significantly whereas TWEAK, Leptin, Ghrelin, TGF-β1, IL-6, IL-17 and MMP9 levels increased significantly 1 week after end of radiotherapy.Conclusion:Oral nutrition support can avoid the damage of nutritional status and immune function and reduce the radiation damage in patients with nasopharyngeal carcinoma radiotherapy.

Effect of postoperative early enteral nutrition support on anti-tumor immune response and inflammatory response process in the elderly patients with esophageal cancer

Objective: To explore the effect of postoperative early enteral nutrition support on anti-tumor immune response and inflammatory response process in the elderly patients with esophageal cancer. Methods: A total of 110 cases of elderly patients with esophageal cancer who underwent radical operation in this hospital between January 2015 and December 2017 were divided into the parenteral nutrition group (n=57) who received parenteral nutrition support and the enteral nutrition group (n=53) who received enteral nutrition support according to the postoperative nutrition intervention methods. The differences in anti-tumor immune response and inflammatory response degree were compared between the two groups of patients immediately after the patients returned to the ward (T0), 48h after nutritional support (T1) and 72h after nutritional support (T2). Results: At T0, there was no statistically significant difference in the contents of Th1/Th2 immune response and Th17/Treg immune response indexes as well as inflammatory mediators in serum between the two groups of patients. At T1 and T2, serum Th1 cytokines IFN-γ and IL-12 contents of enteral nutrition group were higher than those of parenteral nutrition group whereas Th2 cytokines IL-4 and IL-13 contents were lower than those of parenteral nutrition group;serum contents of Th17 cytokines IL-6 and IL-17 as well as Treg cytokines TGF-β and IL-10 were lower than those of parenteral nutrition group;serum inflammatory mediators hs-CRP, PGE and HMGB1 contents were lower than those of parenteral nutrition group. Conclusion: Postoperative early enteral nutrition support can effectively regulate the Th1/Th2 and Th17/Treg immune response balance and inhibit the systemic inflammatory response in elderly patients with esophageal cancer.