ABSTRACT
Objective:To investigate the clinical efficacy of neuroendoscopic hematoma removal versus soft channel drainage in the treatment of chronic subdural hematoma. Methods:The clinical data of 102 patients with chronic subdural hematoma who received treatment in Jincheng People's Hospital from May 2018 to May 2020 were retrospectively analyzed. They were divided into the neuroendoscopy group ( n = 50) and the soft channel group ( n = 52) according to different surgical methods. Perioperative indexes, hematoma clearance rate, China Stroke Scale score, the activity of daily living score, and oxidative stress indexes were compared between the two groups. All patients were followed up for 3 months. The incidence of complications during the follow-up period was calculated. Results:The retention time of the drainage tube in the neuroendoscopy group was shorter than that in the soft channel group [(2.45 ± 0.63) days vs. (3.30 ± 0.78) days, t = 6.06, P < 0.001]. The length of hospital stay in the neuroendoscopy group was shorter than that in the soft channel group [(7.14 ± 1.65) days vs. (9.07 ± 2.11) days, t = 5.15, P < 0.001]. The hematoma clearance rate at postoperative 7 days in the neuroendoscopy group was higher than that in the soft channel group [(93.45 ± 5.50)% vs. (81.86 ± 7.24)%, χ2 = 9.12, P < 0.001]. There were no significant differences in operation time and intraoperative blood loss between the two groups (both P > 0.05). At postoperative 30 days, the China Stroke Scale score in the neuroendoscopy group was lower than that in the soft channel group [(12.74 ± 2.23) points vs. (18.67 ± 2.45) points, t = 12.79, P < 0.001]. The activity of daily life score in the neuroendoscopy group was significantly higher than that in the soft channel group [(77.69 ± 7.11) points vs. (91.35 ± 7.25) points, t = 9.60, P < 0.001]. At postoperative 7 days, glutathione peroxidase level in the neuroendoscopy group was significantly lower than that in the soft channel group [(130.75 ± 13.66) U/L vs. (148.60 ± 14.64) U/L, t = 6.37, P < 0.001]. Malondialdehyde level in the neuroendoscopy group was significantly lower than that in the soft channel group [(5.11 ± 0.65) nmol/L vs. (6.19 ± 0.74) nmol/L, t = 7.83, P < 0.001]. Superoxide dismutase level in the neuroendoscopy group was significantly higher than that in the soft channel group [(275.60 ± 22.33) U/L vs. (254.60 ± 18.55) U/L, t = 5.15, P < 0.001]. There was no significant difference in the incidence of complications between the two groups ( P > 0.05). Conclusion:Compared with soft channel drainage, neuroendoscopic hematoma removal can obtain better short-term curative effects and less oxidative stress response in the treatment of chronic subdural hematoma. Neuroendoscopic hematoma removal does not increase the incidence of postoperative complications and is highly safe.
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Objective To detect the levels of CD+4 CDHi25 CDLo127 regulatory T (Treg) cells and NKG2D-expressing NK cells in peripheral blood of lung cancer patients and investigate their relationship,and explore their roles in the immune escape of lung cancer and clinical significance.Methods The levels of CD+4 CDHi25 CDLo127 Treg cells,NK cells and NKG2D-expressing NK cells were measured in peripheral blood of 70 lung cancer patients and 50 healthy controls.Results Compared with control group,the levels of CD+4 CDHi25 CDLo127 Treg cells enormously increased [(8.4±4.1) ％,(6.7±1.7) ％] (t =3.09,P ＜ 0.05),while the value of NKG2D obviously decreased [(83.3±4.9) ％,(87.4±2.9) ％] (t =3.16,P ＜ 0.05); And the group of NK cells is not different [(15.6±8.3) ％,(17.2±4.2) ％] (t =-1.33,P ＞ 0.05); NKG2D-expressing NK cells had a perfect negative correlation with CD+4 CDLo25 CDLo127 Treg cells (r =-0.302,P ＜ 0.05).Conclusion Accumulation of Treg cells in serum may lead to the down-modulation of NKG2D-expressing NK which participates the tumor immune escape.They may be potential indicators evaluating immune functions and prognosis of lung cancers.
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Objective The aim of this study is to investigate CD+8 natural killer T cell receptors NKG2D and NKG2A expression in peripheral blood of patients with lung cancer and discuss the relation between imbalance expression of NKG2A and NKG2D and tumor immune escape. Methods Flow cytometry was used to determine the percentage of NKG2D and NKG2A-expressing of CD+8 NKT cells in peripheral blood of 95 untreated lung cancer patients and 50 healthy controls. Results NKG2D was lower expressed on CD+8 NKT in lung cancer, the level of NKG2D in patients (77.07±5.77) % was significantly lower than that in the controls (84.13±4.49) % (t =8.14, P <0.05). In the TNM stage, the level of NKG2D in patients of Ⅰ-ⅢA, ⅢB, Ⅳ stage were (81.07±5.02) %, (76.95 ±4.70)%, (72.80±5.16) %, respectively, the level of NKG2D was significantly decreased in order (F =18.74, P <0.05). NKG2A was expressed higher on CD+8 NKT in lung cancer, the level of NKG2A in patients (33.58±8.82) % was significantly higher than that in the controls (25.31 ±8.38) % (t =-5.46, P<0.05). In the TNM stage, the level of NKG2A in patients of Ⅰ - Ⅲ A, ⅢB, Ⅳ stage were (25.10±6.93) %, (33.24±3.76) %, (43.64±6.10) %, respectively, the level of NKG2A was significantly increased in order (F =75.73,P <0.05). Conclusion Imbalance expression of NKG2A and NKG2D may restrain the function of CD+8 NKT cell of lung cancer patients in peripheral blood and that may be one of important factors in tumor immunological escape.
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Objective To evaluate the clinical diagnostic application and operative efficacy of the expression of NKG2D in peripheral blood CD+8 NKT cell and its ligand sMICA in patients with esophageal or cardiac carcinoma.Methods The peripheral blood NKG2D positive CD+8 NKT cell percentage was concomitantly determined by flow cytometry in 53 preoperative patients including 29 postoperative patients with esophageal or cardiac carcinoma and 30 healthy controls.The serum sMICA was determined by ELISA.Results The peripheral blood NKG2D positive CD+8 NKT cell percentage in patients was significantly lower than that in controls [(77.632±8.972) % vs (89.053±6.515) %] (t = -6.113,P ＜0.05); with stage Ⅱ,Ⅲ,Ⅳ,it decreased significantly in order (F = 99.251,P ＜0.01);with lymph node metastasis lower than that without lymph node metastasis (t = -10.384,P ＜0.01); squamous carcinoma was higher than adenocarcinoma (t =9.899,P ＜0.01); postoperative was significantly higher than preoperative (t =-4.319,P ＜0.01).The level of serum sMICA in patients was significantly higher than that in controls [(326.28±85.407) pg/ml vs (210.00±92.560) pg/ml](t =7.292,P ＜0.01); with stage Ⅱ,Ⅲ,Ⅳ,it increased significautly in order (F =63.355,P ＜0.01); with lymph node metastasis higher than that without lymph node metastasis (t =7.770,P ＜0.01); squamous carcinoma was lower than adenocarcinoma (t =-7.593,P＜0.01); postoperative was significantly lower than preoperative (t =7.027,P ＜0.01).Serum sMICA could inhibit peripheral blood CD+8 NKT cell activation receptor NKG2D (F =142.773,P ＜0.05),determination coefficient R2 = 0.7368.Conclusion The level of peripheral blood CD+8NKT cell activation receptor NKG2D and serum sMICA in patients could be an assistant indicator for