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.

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^+.

Lymphocyte Subsets and Sister-chromatid Exchanges in the Students Exposed to Formaldehyde Vapor

The present report evaluates the effects of formaldehyde (FA) exposure on peripheral lymphocytes by using heth genetic and immunological parameters. Twenty-three non-smoking students in the study had inhalation exposure to 0.508 ±0. 299 mg/m3 of FA for a Period of 8 weeks (3h × 3 times each week) during anatomy classes. As for composition of lymphocyte subsets after FA exposare,significant increase was found in the percentage of CD19(B cells), while sighficant decrease was observed in CD3(total T cells), CD4(T helper-inducer cells), and CD8(T cytotoxic-suppressior cells) with a P<0 .01. Increase in the ratio of T-helper-inducer cells to T-cytotoxic-suppressor cells (T4 / T8) was also observed with statistical sighcance after exposure (P < 0.001). In the meanwhile,no significant difference (P > 0 .05) was reported between lymphocyte prolifendion rate and sisterchromatid exchange (SCE) at the exposure level and duration. It is suggested that the lymphocyte subsets may be most susceptible to the effects of FA, though a single immunological endpoint is rarely related with pathophysiological interpretation.

Effects of Radiofrequency Ablation on Lymphocyte Subsets and Type 1/Type 2 T Cell Subpopulations in Patients with Hepatocellular Carcinoma

Objective： To evaluate whether radiofrequency ablation （RFA） might have an influence on immune status in hepatocellular carcinoma （HCC） patients. Methods： We measured the T lymphocytes, B lymphocyte and NK cells, and determined the population of Thl, Th2, Tcl and Tc2 of peripheral blood samples taken from 26 HCC patients before and after RFA. Results： The proportion of Typel cells （Thl and Tcl） and NK cells were significantly increased after RFA, especially in patients of the following subgroups： male, age〉55 years, pathological grade Ⅰ-Ⅱ tumor, clinical stage Ⅰ-Ⅱ or Child-Pugh A and B. Conclusion： TypeⅠ cells and NK cells in HCC patients were increased in a short period after RFA.

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.

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.

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.

NK ACTIVITY OF LYMPHOCYTE SUBSETS AND THE EFFECTS OF LOW DOSE RADIATION

This work was supported by the National Natural Science Foundation of China (No. 3870902). Objective: To determine the NK activity of lymphocyte subsets and the effects of low dose radiation. Methods: Lymphocyte subsets were separated by monoclonal antibodies. The NK activity of each subset on tumor cells was detected by radioactive release method. Results: The results showed that besides NK cells, CD 4, CD 8 and B cells alone can kill tumor cells. But the cellkilling activity of NK cells appeared to be strongest. There was synergistic effect between CD 4 and NK cells. The activity of mixed lymphocytes was more than that of only one subset. The effect of low dose radiation (LDR) on NK activity of panlymphocytes or NK cells was different. Conclusion: This paper demonstrated that NK activity of mononuclear cells was called “NK activity of lymphocytes”, but it is not true. Only when NK cells were separated by monoclonal antibodies, its killer activity can be called “activity of NK cells”.

STUDIES ON LYMPHOCYTE SUBSETS, HUMORAL IMMUNITY AND THEIR RELATIONSHIP WITH SELENIUM IN PATIENTS WITH KASHIN-BECK DISEASE

Objective To study the humoral immunity status and distribution pattern of lymphocyte subgroups of peripheral blood mononuclear cell (PBMC) in patients with Kashin-Beck Disease (KBD), and their relationship with erythrocyte selenium. Methods 23 X-ray diagnosed patients, 22 age- and sex- matched healthy children in KBD affected area (KAA), and 25 in KBD non-affected area (KNAA) were randomly selected. Immunohistochemistry with monoclonal antibodies anti-CD4, anti-CD8, anti-CD20 was conducted to analyze the lymphocyte subsets. Serum IgM, IgA, IgG, Complement C3 and C4 were assayed using rate nephelometry (Array 360 System, USA). The contents of erythrocyte selenium was determined by 2,3-diaminonaphthalene fluorescence assay. Results CD4+ and CD8+ cells percentage in PBMCs and serum IgA were significantly lower in KAA than those in KNAA(P< 0.05). CD20+ percentage in KAA displayed a decreasing trend compared to KNAA, although not statistically significantly. No statistical differences were found in CD4/CD8 ratio, serum IgG, IgM, C3 and C4 levels. Erythrocyte selenium level in KAA still showed a pronounced decrease compared to that in KNAA. Correlation analysis showed that erythrocyte selenium contents had a strong association with the CD4 cell percentage (r= 0.625, P< 0.05), as well as serum IgA (r= 0.462, P< 0.05). In addition, a moderate correlation between the serum IgA and CD4+ percentage (r= 0.130, P> 0.05) was found. Conclusion These results suggested that children in KAA had a comparably low cellular immunity level and their humoral immunity status was also in a state of moderate immune suppression. Of this immune disorder in Kashin-Beck disease patients, selenium deficiency probably played a critical role via affecting the distribution pattern of peripheral blood lymphocyte. Selenium-deficiency and immune impairment maybe both have something to do with the cause-effect chain of KBD.

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.

Detection of lymphocyte subsets and regulatory T cells in peripheral blood of patients with acute leukemia and its clinical significance

Objective To study the changes of lymphocyte subsets and regulatory T cells in peripheral blood of patients with acute leukemia(AL) and its clinical significance.Methods The different levels of peripheral blood lymphocyte subsets and regulatory T cells of 60 AL patients and 40 normal controls were detected with flow cytometry.Results Compared with the normal controls,the percentages of CD3+ T cells,CD4+ T cells,CD16+CD56+ NK cells and the ratio of CD4+ /CD8+ obviously decreased in newly diagnosed AL group(P <0.05),while their percentages of CD8+ T cells and CD19+ B cells significantly increased(P <0.01).The percentage of CD4+ T cells and the ratio of CD4+ /CD8+ in acute lymphoblastic leukemia(ALL) group were much lower than those in acute myelogenous leukemia(AML) group(P <0.01).Compared with these in control group,the proportions of CD4+ CD25high Treg cells and CD4+ CD25+ T cells in newly diagnosed AL group were significantly increased(P <0.01).Conclusion Cellular immune function is significantly abnormal in patients with AL.Compared with AML patients,ALL patients had poorer cellular immune function.The increased CD4 + CD25high Treg cells might be one of the important reasons of immunosuppression in AL.Detection of lymphocyte subsets and regulatory T cells is of clinical value on the evaluation of therapeutic effect and prognosis in AL patients.

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.

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.

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.

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.

He Jie Tang in the treatment of chronic hepatitis B patients

AIM： To explore the effect of He .lie Tang （decoction for medication） on serum levels of T lymphocyte subsets, NK cell activity and cytokines in chronic hepatitis B patients. METHODS： Eighty-five patients with chronic hepatitis B were divided randomly into two groups. Fifty patients in group I were treated with He .lie Tang （HIT） and 35 patients in group II were treated with combined medication. The levels of T-lymphocyte subsets （CD^3＋, CD^4＋, CD^8＋）, NK cell activity, cytokines （TNF-α, IL-8, sIL-2R） were observed before and after the treatment. Another 20 normal persons served as group 3. RESULTS： The level of CD^4＋ cells and NK cell activity were lower, whereas the level of CD^8＋ cells in patients was higher than that in normal persons （t = 2.685, 3.172, and 2.754 respectively; P〈0.01）. The levels of TNF-α, IL-8, and sIL-2R in chronic hepatitis B patients were higher than those in normal persons （t = 3.526, 3.170, and 2.876 respectively; P〈0.01）. After 6 months of treatment, ALT, AST, and TB levels in the two groups were obviously decreased （t = 3.421, 3.106, and 2.857 respectively; P〈0.01）. The level of CD^4＋ cells and NK cell activity were increased whereas the level of CD^8＋ cells decreased （t = 2.179, 2.423, and 2.677 respectively; P〈0.05） in group I. The levels of TNF-α, IL-8, and sIL- 2R in group I were decreased significantly after the treatment （t = 2.611, 2.275, and 2.480 respectively; P〈0.05） but had no significant difference in groupII after the treatment （t = 1.906, 1.833, and 2.029 respectively; P〉0.05）. The total effective rate had no significant difference between the two groups （X^2 = 2.882, P〉0.05） but the markedly effective rate was significantly different between the two groups （X^2 = 5.340, P〈0.05）. CONCLUSION： HIT is effective in treating chronic hepatitis B. HIT seems to exert its effect by improving the cellular immune function and decreasing inflammatory cytokines in chronic hepatitis B patients. The function of HIT in protecting liver function in the process of eliminating virus needs to be further studied.