晚期非小细胞肺癌中医证型与免疫功能相关性研究

目的:探讨晚期非小细胞肺癌患者中医证型与T细胞亚群、IFN-γ、IL-4、IgG、IgA、IgM之间的关系。方法:按照中医辨证分型标准,将89例晚期非小细胞肺癌患者分成肺脾气虚型、痰湿瘀阻型、气阴两虚型、气滞血瘀型、肺肾阴虚型,并作相关测定。结果:本组患者患者与正常对照比较,CD3、CD4、CD4/CD8、IFN-γ明显减少(P<0.001),而IL-4明显增多(P<0.001)。CD8、IgG、IgA、IgM无明显改变(P>0.05)。各证型组之间比较,按照气滞血瘀型、肺脾气虚型、痰湿瘀阻型、气阴两虚型的顺序,CD4、CD4/CD8、IFN-γ依次减少(P值分别为<0.05,<0.01,<0.01);而CD8、IL-4依次增多(P值分别为<0.05,<0.01)。CD3、IgG、IgA、IgM无明显改变(P>0.05)。提示:晚期非小细胞肺癌患者中医证型可反映机体的免疫功能。

超前镇痛管理对非小细胞肺癌患者围手术期免疫功能、预后的影响分析

【目的】探讨超前镇痛管理对非小细胞肺癌（NSCLC）患者围手术期免疫功能、预后的影响。【方法】将本院在2015年1月至2016年7月收治的NSCLC患者115例，按照随机、双盲的分配原则分为观察组58例和对照组57例。观察组采用超前镇痛管理，对照组采用常规镇痛模式。观察两组不同镇痛管理对围手术期免疫功能、预后的影响。【结果】观察组术后6h、1d、3d的视觉模拟评分法（VAS）均明显低于对照组，其差异均有统计学意义（P〈0．05）；两组患者术前CD4＋与CD8＋水平比较差异无统计学意义（P〉0．05），而术后均有不同程度下降，且明显低于术前，但观察组仍高于对照组，其差异均有统计学意义（P〈0．05）。观察组首次下床时间为（2．72±0．92）d，发生肺部感染、肺不张、胸腔积液分别为3．45％、0．00％、0．00％，均明显少于对照组，其差异有统计学意义（P〈0．05）。【结论】超前镇痛管理可更有效的减轻NSCLC患者围手术期的疼痛，并保护免疫功能，改善其预后，值得临床推广应用。

瑞芬太尼复合丙泊酚麻醉对非小细胞肺癌根治术患者免疫功能及术后瞻妄的影响

【目的】探讨瑞芬太尼复合丙泊酚麻醉对非小细胞肺癌(NSCLC)根治术患者外周血T淋巴细胞、皮质醇(Cor)、血糖及术后瞻妄的影响。【方法】本院拟实施肺癌根治术的90例NSCLC患者,随机分为两组,各45例;观察组采取瑞芬太尼复合丙泊酚麻醉、对照组采取芬太尼复合丙泊酚麻醉。比较两组患者术前、术后2h患者外周血中T淋巴细胞亚群、血清Cor、血糖水平及术后瞻妄的发生率。【结果】两组患者的手术时间相比较差异无显著性(P>0.05);观察组的丙泊酚用量显著低于对照组(P<0.05)。术前观察组和对照组的外周血T淋巴细胞、血清Cor、血糖水平相比较差异无显著性(P>0.05);术后2h观察组的外周血中CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05),CD8^(+)测定值低于对照组(P<0.05);术后2h,观察组的血清Cor、血糖水平低于对照组(P<0.05)。观察组术后48h内的瞻妄发生率为6.67%(3/45),明显低于对照组的22.22%(10/45)(P<0.05)。【结论】瑞芬太尼复合丙泊酚麻醉对NSCLC根治术患者T淋巴细胞亚群、Cor、血糖水平的影响更小,患者术后发生瞻妄的情况更少。

CD_4^+CD_(25)^(high)T细胞在小细胞肺癌患者外周血中的表达及意义

目的:探讨CD4+CD25h igh调节(抑制)性T细胞在小细胞肺癌患者外周血中的表达情况及其意义。方法:应用流式细胞技术检测40例初诊小细胞肺癌患者,18例CE及CAP方案交替化疗后完全缓解的小细胞肺癌患者外周血中的CD4+CD25h ighT细胞,计算它们占CD4+T细胞的比率。结果:初诊小细胞肺癌患者CD4+CD25h ighT细胞占CD4+T细胞的比率(6.69±2.32)%,高于健康对照组(4.13±1.25)%(P<0.01);经化疗后完全缓解的小细胞肺癌患者外周血CD4+CD25h ighT细胞占CD4+T细胞的比率与初诊时相比无明显变化。结论:小细胞肺癌患者外周血中CD4+CD25h igh调节T细胞占CD4+T细胞的比率增高,它们对小细胞肺癌患者具有免疫抑制作用。

消癌平注射液联合新辅助化疗对NSCLC患者免疫功能的影响

【目的】探讨消癌平注射液联合新辅助化疗对非小细胞肺癌（NSCLC）患者免疫功能的影响。【方法】本院择期手术的Ⅱ～Ⅲa期NSCLC患者88例，随机分为两组，各44例，对照组给予术前新辅助化疗，观察组给予消癌平注射液联合术前新辅助化疗，末次化疗结束后2～3周行手术，评估两组一临床疗效及化疗毒副反应，比较两组肿瘤标志物癌胚胎抗原（CEA）、细胞角质蛋白19可溶性片段（CYFRA21-1）、血管生长因子（VEGF）、T淋巴细胞水平、NK细胞水平和患者1年生存率。【结果】观察组治疗有效率为54．55％（24／44）高于对照组的31．82％（14／44），观察组消化道反应和白细胞减少率分别为40．91％（18／44）、27．27％（12／44）低于对照组的65．91％（29／44）、47．73％（21／44），且差异有显著性（P〈0．05）；观察组治疗后CEA、CYFRA21—1、VEGF低于对照组，CD4＋。细胞比例、CD4＋／CD8＋T淋巴细胞比值、NK细胞水平均高于对照组，且差异有显著性（P〈0．05）。观察组1年存活率81．82％（36／44）与对照组77．27％（34／44）比较差异无显著性（P〉0．05）。【结论】消癌平注射联合新辅助化疗NSCLC患者可提高免疫功能，降低CEA、CYFRA21—1、VEGF水平，提高临床疗效。

复方苦参注射液联合化疗对晚期NSCLC患者外周血调节性T、B淋巴细胞的影响

【目的】探讨复方苦参注射液联合化疗对晚期非小细胞肺癌（NSCLC）患者外周血调节性T、B淋巴细胞的影响。【方法174例晚期NSCLC患者随机分为了两组，各37例。对照组给予化疗治疗，观察组在对照组基础上给予复方苦参注射液治疗。21d为1个化疗周期，治疗2个周期后评估两组疗效及化疗毒副作用，比较其相关指标变化。【结果】观察组治疗总有效率为72．97％（27／37），略高于对照组的56．76％（21／37），但差异无显著性（P〉0．05）；观察组化疗后CD4＋CD25＋调节性T细胞、CD19＋CD5＋B淋巴细胞占CD19＋B细胞比例、CD19＋CD5＋CD1d＋Breg细胞占CDαB细胞比例、白介素10（IL-10）、血浆转化生长因子α（TGF-α）水平低于对照组，CD8＋CD28＋T细胞水平高于对照组（P〈0．05）；观察组化疗后癌胚胎抗原（CEA）、碳水化合物抗原（CA125）、细胞角质蛋白19（CYFRA21—1）水平低于对照组，且差异有显著性（P〈0．05）；两组胃肠道反应、血小板减少、脱发发生率比较差异无显著性（P〉0．05），观察组Ⅲ～Ⅳ级白细胞减少的几率为10．81％（4／37），低于对照组的32．43％（13／37）（P〈0．05）。【结论】复方苦参注射液联合化疗治疗晚期NSCLC患者可改善外周血调节性T、B淋巴细胞免疫功能，降低血清肿瘤标志物，减少化疗毒副反应。

Expression of caveolin-1 in clear cell renal cell carcinoma and its correlation with microvessel density

Objective:The aim of the study was to investigate the clinicopathologic significance of caveolin-1 expression in clear cell renal cell carcinoma (CCRCC) and its correlation with microvessel density (MVD).Methods:The expression of caveolin-1 was detected by the immunohistochemistry method,while the microvessel density was detected by the immunohistochemistry expression of CD34.Results:In the CCRCCs,the positive rate of caveolin-1 was 67.4%,the over expression of caveolin-1 was not related with sex and age,but related with clinicopathologic parameter,such as tumor sizes,clinical TMN stage,nuclear stage and survival time (P < 0.05).The MVD of positive caveolin-1 cases was significantly higher than that without caveolin-1 expression (P < 0.05).Conclusion:The expression of caveolin-1 is helpful in the prognostic evaluation of CCRCCs and it may be involved in the tumor angiogenesis.

Systematic Investigation of Berberine for Treating Hepatocellular Carcinoma Based on Network Pharmacology

Objective Liver cancer is the 4th leading cause of cancer death worldwide,and hepatocellular carcinoma(HCC)accounts for the largest proportion of these deaths.Berberine is a quaternary amine compound extracted from plants such as Coptidis Rhizoma(Huang Lian,黄连)and Phellodendri Chinensis Cortex(Huang Bo,黄柏)and is considered as a potential candidate for treating HCC.This study used network pharmacology methods,reveal the core mechanism of action of berberine in the treatment of HCC,clarify its medicinal value,and locate the anti-tumor mechanism of berberine.Methods Structural information of Berberine(PubChem CID:2353)was obtained from the NCBI PubChem;ADME parameter were obtained from the Traditional Chinese Medicine Systems Pharmacology(TCMSP)database;Berberine prediction targets were collected from symmap,stitch and targetnet databases;HCC significant targets were retrieved from OncoDB.HCC and Liverome;A PPI network was established at STRING,Prediction target of berberine therapy for HCC are collected by gene mapping;The core target,pathway,biological process(BP),cellular component(CC),and molecular function(MF)of berberine in the treatment of HCC were predicted by topological analysis and enrichment analysis;the visualized"target pathway"network diagram of berberine in the treatment of HCC was established by the software of Cytoscape.Results Through PubChem and tcmsp databases,the good drugforming properties of berberine were identified;32 prediction targets of berberine were collected in symmap,stitch and targetnet databases;566 related targets of HCC were collected in oncodb.hcc and liverome databases;10 targets of berberine treatment for HCC were predicted by gene mapping,and a PPI with 10 nodes and 34 edges was established Through topological analysis and enrichment analysis,6 topologically important targets,6 related pathways and 16 BP,6 cc and 7 MF involved in Berberine treatment of HCC were obtained.Conclusions The anticancer effect of berberine is mainly involved in the regulation of cells of hepatoma cells through complex interactions between the TB52,MAPK1,CCND1,PTGS2,ESR1 that act on Hub nodes and their associated 6 pathways.The cycle is related to the immune inflammatory response,including biological processes such as proliferation and apoptosis of liver cancer cells.

Clinicopathological Significance of E-cadherin and PCNA Expression in Hunman Non-small Cell Lung Cancer

OBJECTIVE This study was designed to assess E-cadherin (E-cad)and proliferating cell nuclear antigen(PCNA)expression as well as their clinicopathological significance in hunman non- small cell lung cancers(NSCLCs).Possible molecular mechanisms of differentiation and metastasis of NSCLCs are discussed. METHODS Immunohistochemical and immunofluorescence double staining were performed to examine the expression of E-cad and PCNA in 68 primary NSCLCs cases. RESULTS The E-cad expression in squamous cell carcinomas and adenocarcinomas showed no significant difference.E-cad expression had a positive correlation with the histological- differentiated grade.A significant difference of E-cad expression was found between metastatic and non-metastatic groups.PCNA expression in squamous cell carcinomas and adenocarcinomas showed no significant difference.The PCNA expression had a reverse correlation with the histological-differentiated grade.A significant difference of PCNA expression was found between metastatic and non-metastatic groups.The E-cad and PCNA expression presented a reverse correlation. CONCLUSION E-cad expression is not associated with the histological type of NSCLC,but is associated with differentiation and metastasis of the cancer.Down-regulation of E-cad expression affects the proliferation of cancer cells.Conjoint analysis of E-cad and PCNA expression is a good way to evaluate tumor biological behavior.

全身热疗联合化疗对晚期非小细胞肺癌患者Th1/Th2细胞亚群和血浆VEGF水平的影响

目的 观察化疗、热化疗对非小细胞肺癌（NSCLC）患者Th1/Th2平衡及对细胞因子IL-2、干扰素-γ（IFN-γ）、IL-4、IL-10、血管内皮生长因子（VEGF）水平的影响.方法 50例NSCLC患者分为化疗组25例,热化疗组25例,观察其在治疗前后Th1/Th2平衡变化,以及对IL-2、IFN-γ、IL4、IL-10、VEGF的影响,并与健康对照组进行比较.结果 热化疗组较之化疗组Th1细胞比例明显升高（P =0.002）,Th2细胞比例降低（P =0.006）.治疗前化疗组与热化疗组IL-2、IFN-γ、IL-4、IL-10、VEGF差异均无统计学意义（P＞0.05）;而两组与对照组比较差异有统计学意义（P＜0.01）.化疗组和热化疗组患者治疗前后血浆IL-2、IFN-γ、IL-4、IL-10水平差异均有统计学意义（P＜0.01）,而化疗组治疗前后VEGF变化不明显（P＞0.05）.与化疗组治疗后相比,同期热化疗组血浆IL-2、IFN-γ、IL-4、IL-10、VEGF的变化差异有统计学意义（P＜0.05或P＜0.01）.结论 热化疗较单纯化疗明显改善Th1/Th2细胞亚群漂移,还可降低VEGF的表达,干预肿瘤新生血管的形成.