ABSTRACT
Objective To study the effect of parenteral nutrition combined with chemotherapy on nutritional status and immunity function of patients with gastrointestinal cancer.Methods 100 gastrointestinal cancer patients were treated as research subjects,and they were randomly divided into the treatment group and the control group.The control group was not given special treatment during chemotherapy,while the observation group patients were given nutritional support according to the gastrointestinal function after admission.The nutrition indicators of ALB,TF,PA, immune function parameters IgA,IgG,IgM,T lymphocyte subsets and T cell immune function indicators(CD +4 ,CD +8 and CD +4 /CD +8 )were counted after the four courses.Results There was no significant difference between the preop-erative and after fourth courses of treatment(t =0.093,P >0.05)between the two groups in nutrition.Within group comparisons,data of Tf and PA levels in the observation group were significant different compared with the control group after fourth courses of treatment (t =3.302,P <0.05).After the first 4 postoperative course,IgM index was statistically significant(t =4.135,P <0.05)different between the two groups,three indicators within the observation group were higher than the preoperative level indicators,the difference was statistically significant(t =3.426,P <0.05).After the first 4 postoperative course,the CD +4 level was significantly higher in the observation group,the difference was statistically significant(t =0.087,P <0.05).Comparison between the two groups after the first four courses,the CD +4 /CD +8 level was higher than that of preoperative patients with a significant difference(t =3.359,P <0.05).Intra -group comparison of the control group,four courses of CD +8 was significantly lower than that of the pre-operative patients(t =3.265,P <0.05).Conclusion Parenteral nutrition combined with chemotherapy can improve the nutritional status of patients with malignant tumors of alimentary tract and improve the body's immune function, give parenteral nutrition support treatment and provide a theoretical basis for the digestive tract malignant tumor during chemotherapy.It is worthy of clinical popularization.
ABSTRACT
Objective To study the effect of parenteral nutrition combined with chemotherapy on immune function in patients with digestive tract malignant tumor. Methods One hundred patients with digestive tract malignant tumor were selected, and they were divided into the observation group and the control group by random digits table method with 50 cases each. The patients in control group during chemotherapy did not receive special treatment, and the patients in observation group were given parenteral nutrition support according to the gastrointestinal function during chemotherapy. The nutrition index, immune function index and T lymphocyte subsets after treatment were observed. Results The transferrin, prealbumin, IgA, CD4+and CD4+/CD8+levels after treatment in observation group were significantly higher than those in control group: (2.41±0.53) g/L vs. (2.15±0.57) g/L, (0.28±0.07) g/L vs. (0.20±0.08) g/L, (3.25±1.19) g/L vs. (2.85±1.01) g/L, 0.403±0.065 vs. 0.323±0.083 and 2.15±1.02 vs. 1.35±0.73, while the IgM in observation group was significantly lower than that in control group: (1.02 ± 0.35) g/L vs. (1.48±0.78) g/L, and there were statistical differences ( P0.05). Conclusion Parenteral nutrition combined with chemotherapy can improve the immune function in patients with digestive tract malignant tumor, and provide a theoretical basis for the treatment of parenteral nutrition combination with chemotherapy.
ABSTRACT
Objective To study the value of plasma level of matrix metalloproteinase-9 (MMP-9) for the early diagno-sis of Kawasaki disease. Methods The difference in MMP-9 level was studied by retrospective nested case-control method between children with early Kawasaki disease, Henoch-Sch?nlein purpura (HSP) or respiratory infection, and healthy control children. The associations of MMP-9 with serum procalcitonin, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also analyzed. The cutoff-value, sensitivity and speciifcity of MMP-9, ESR and CRP in diagnosis of Kawasaki disease were studied by ROC curve. The areas under ROC curves were compared among different diagnostic markers to deter-mine their signiifcances in diagnosis of Kawasaki disease. Results The plasma level of MMP-9 was increased in early phase of Kawasaki disease, and higher than that in children with HSP or respiratory infections and in healthy controls (P<0.05). If MMP-9, ESR and CRP cutoff value were set to be 90.23 ng/ml, 56.5 mm/h and 27.55 mg/L, the sensitivity, speciifcity and area under ROC curve was 83.3%, 86.4%and 0.904, 95.8%, 66.1%and 0.807, 83.3%, 74.6%and 0.789 respectively. The diagnostic performance of MMP-9 for Kawasaki disease was better than that of ESR and CRP. Conclusions The plasma level of MMP-9 is increased in the early stage of Kawasaki disease. The sensitivity and speciifcity of MMP-9 in diagnosis of Kawasaki disease are highest if cutoff value is set to be 90.23 ng/ml.
ABSTRACT
Objective To explore the therapeutic value of bronchoscopy in pediatric status asthmaticus.Methods A total of 16 children with status asthmaticus received standard medical therapies (therapy group) from January 2008 to August 2010 in pediatric intensive care unit (PICU) at First Hospital,Xiamen University.However,l0 of them underwent fiberoptic bronchoscopy and bronchoalveolar lavage (BAL) (bronchoscopy group) along with standard medical therapies from September 2010 to July 2012.The values of oxygenation index (PaO2/FiO2),arterial partial pressure of carbon dioxide (PaCO2),blood oxygen saturation (SaO2),heart rate (HR),respiratory rate (RR) within 1 hour before bronchoscopy procedure,within 6 hour post procedure and within 24 hour post procedure were observed.The extinction time of wheezing sound,PICU length of stay and admission length of stay were observed between therapy and bronchoscopy groups.Results Bronchoscopies revealed a lot of thick mucus plugs and secretions.Large airways were lavaged for clearance of obstructive secretions with normal saline.Within BAL fluid counts of the bronchoscopy group,there were neutrophilia (n =8),eosinophilia (n =4) and neutrophilia/ eosinophilia (n =3).Within BAL fluid cultivation of the bronchoscopy group,4 patients had positive results for Streptococcus pneumoniae (n =2),Pseudomonas aeruginosa (n =1) and Staphylococcus aureus (n =1).In bronchoscopy group,the values of PaO/FiO2,PaCO2,SaO2,HR and RR were 319 ± 19,(40 ±4) mm Hg(1 mm Hg =0.133 kPa),(92.6 ± 1.5) ％,(128 ± 12) rates/min and (35 ± 4) breaths/min within 6 hour post procedure versus 255 ± 24,(54 ± 5) mm Hg,(89.2 ± 2.6) ％,(148 ± 10) rates/min and(50 ± 6)breaths/min within I hour before procedure (P ＜ 0.01).At 24 hour post procedure,the values of PaO2/FiO2,PaCO2,SaO2,HR,RR for bronchoscopy group were 354 ± 21,(40 ± 3) mm Hg,(93.4 ±1.1)％,(125±9)rates/min and(34 ±3)breaths/min versus 317 ±21,(46 ±4)mm Hg,(90.1±2.5) ％,(138 ± 8) rates/min and (43 ± 3) breaths/min respectively for therapy group (P ＜ 0.01).The extinction time of wheezing sound was (67 ± 22) hours for bronchoscopy group vs.(98 ± 23) hours for therapy group(P ＜ 0.01).The mean PICU length of stay was (1.6 ± 0.7) days for bronchoscopy group vs.(2.6 ± 0.7) days for therapy group (P ＜ 0.01).The mean admission length of stay was (5.0 ± 0.7) days for bronchoscopy group vs.(6.6 ± 1.2) days for therapy group(P ＜ 0.01).All patients for bronchoscopy group tolerated the procedure without any complications.Conclusion As a safe adjunctive therapy in pediatric status asthmaticus,flexible bronchoscopy with bronchial lavage may reduce the admission and PICU length of stay and alleviate clinical symptoms.