ABSTRACT
Objective To observe the shenqifuzheng injection (SFI) combined with PG therapy (gemcitabine and cisplatin) in patients with non-small cell lung cancer (NSCLC). Method 76 patients with NSCLC were selected from August 2011 to August 2013 and randomly divided into observation group and control group. Each group had 38 cases. The control group received gemcitabine and cisplatin, observation group were gave SFI on the basis of control group. The total efficiency, disease control rate, quality of life and incidence of adverse reactions were observed after treatment in each group. Results The total effective rate was 47.37%in observation group , 42.11%in control group, there was no significant difference between two groups. The disease control rate in observation group was 81.58%higher than 57.89%in control group, the difference was statistically significant (χ2=3.990, P<0.05). The improvement rate in quality of life was 60.53%in observation group better than 31.58%in the control group , the difference was statistically significant (χ2=5.296, P<0.05).The decrease incidence of white blood cell (χ2=4.491, P<0.05) and platelets (χ2=4.491, P<0.05) in observation group were significantly lower compared with the control group, while, there were no difference of liver damage and gastrointestinal reactions between two groups. Conclusion SFI is helpful to improve the efficacy of PG therapy in patients with NSCLC and relieve the side effects of chemotherapy.
ABSTRACT
This study examined the postoperative plasma endotoxin level, plasma endotoxin inactivation capacity and clinical outcome after administration of an enteral diet supplemented with glutamine, arginine and ω-3-fatty acid in patients undergoing gastrointestinal operations on an prospective, randomized and double-blind design. 40 patients undergoing gastrointestinal operations were randomized into two groups, with each having 20 patients. One group received standard enteral nutrition and the other was fed the formulation supplemented with glutamine, arginine and ω-3-fatty acid. The two groups were isonitrogenous. The infusion was started from day 1 after surgery and continued for 7 days. Blood samples were collected on the morning of day 1 before operation and on the morning of 1, 4 and 7 day(s) after operation and analyzed for plasma endotoxin level and endotoxin inactivation capacity (EIC). Our study found no differences between the two groups on plasma endotoxin level. After surgery a rapid reduction in plasma endotoxin inactivation capacity was observed in both groups, a significant recovery of the plasma endotoxin inactivation capacity was observed on morning of day 4 after surgery in the study group (0.12±0.02 EU/mL and 0. 078±0.022 EU/mL respectively, P＜0.01). Shortened hospital stay was observed in the experimental group (11.7±2.0 days in the control group and 10.6±1.2 days in the experimental group respectively, P=0.03). It is concluded that perioperative parenteral nutrition supplemented with glutamine, arginine and ω-3-fatty acid ameliorated postoperative immunodepression but without direct effect on endotoxemia.
ABSTRACT
To establish stable methods for detecting plasma endotoxin level and endotoxin inactivation capacity in a normal population and general surgical patients and evaluate their perioperative changes. 50 healthy people and 50 patients receiving gastrointestinal operation were enrolled, their plasma endotoxin levels and plasma endotoxin inactivation capacity were assayed. Our results showed that plasma endotoxin levels were 0.044 +/- 0.009 EU/ml in the normal population and 0.044 +/- 0.023 EU/ml in the preoperative patients. Endotoxin level peaked 3 h after the operation (0.223 +/- 0.041 EU/ml), and then decreased rapidly on the first day after the operation (0.134 +/- 0.164 EU/ml). Endotoxin inactivation capacity also had the same time course as endotoxin level. Systemic inflammatory response syndrome and infection induced another elevation in the time course. It is concluded that establishing the endotoxin standard curve by using pyrogenic free water is better than by using plasma. Plasma endotoxin inactivation capacity can be used as an indirect indicator of postoperative immune depression. Plasma endotoxin level and endotoxin inactivation capacity peaked shortly after operation, indicating surgical stress is closely related with the changes.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Colorectal Neoplasms , Blood , General Surgery , Endotoxins , Blood , Limulus Test , Methods , Postoperative Period , Reference Values , Stomach Neoplasms , Blood , General Surgery , Stress, Physiological , Blood , Systemic Inflammatory Response Syndrome , BloodABSTRACT
Objective To study the relationship between bacterial translocation,endotoxemia and nitric oxide(NO) in portal hypertensive rats.Method Portal hypertension was induced by portal vein stenosis(PVS) in 30 rats subdividing into 3 groups:group B (Model),group C in which L arginine was given,and group D receiving L NAME.10 additional normal rats served as control (group A).Two weeks after, mesenteric lymph nodes (MLN),spleen and blood samples were collected for bacterial cultures.Portal pressure,endotoxin and NO 2 - levels were measured.The permeability of intestinal mucosa was assayed using Lanthanum as tracer and the mucosa ultrastructure in ileum was observed.Results[WT5”BZ] The bacterial translocation rates in MLN in the PVS groups was higher than in control.The endotoxin levels elevated in the PVS group.NO 2 - level and portal pressure were lower in group D than in group B.In the PVS group,the tracer was observed in the lamina properia and epithelium layers.[WT5”HZ] Conclusions Bacterial translocation and endotoxemia in portal hypertension were in response to enhanced permeability of intestinal mucosa,which are responsible for the increased NO level.