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ABSTRACT Background: The role of ascitic and serum levels of various tumour biomarkers in the discrimination of cause of ascites is not well established. Objective: To evaluate the role of serum and ascitic levels of tumor biomarkers (CA 72-4, CA 19-9, CEA and CA 125) in discrimination of cause of ascites. Methods: A prospective study was conducted in consecutive patients presenting with ascites. Serum and ascitic levels of CA 19-9, CA 125, CA 72-4 and carcinoembryonic antigen (CEA) were determined at the presentation. The patients with cirrhotic ascites, tuberculous peritonitis (TBP) and peritoneal carcinomatosis (PC) were eventually included in analysis. Results: Of the 93 patients (58 males, mean age 47 years) included, the underlying cause was cirrhosis in 31, PC in 42 and peritoneal tuberculosis in 20. The best cutoff for discriminating benign and malignant ascites for serum CEA, CA 19-9 and CA 72-4 were 6.7 ng/mL, 108 IU/mL and 8.9 IU/mL, respectively. The best cutoff for discriminating benign and malignant ascites for ascitic CA 125, CEA, CA 19-9 and CA 72-4 were 623 IU/mL, 8.7 ng/mL, 33.2 IU/mL and 7 IU/mL, respectively. Conclusion: The performance of single biomarker for the prediction of underlying PC is low but a combination of serum CA 19-9 and CA 72-4 best predicted the presence of peritoneal carcinomatosis.
RESUMO Contexto: O papel dos níveis ascíticos e séricos de vários biomarcadores de tumores na discriminação da causa das ascites não está bem estabelecido. Objetivo: Avaliar o papel dos níveis séricos e ascíticos de biomarcadores tumorais (CA 72-4, CA 19-9, CEA e CA 125) na discriminação da causa das ascites. Métodos: Estudo prospectivo foi realizado em pacientes consecutivos que apresentaram ascite. Foram determinados níveis do soro e ascítico de CA 19-9, CA 125, CA 72-4 e antígeno carcinoembrínico (CEA). Os pacientes com ascites cirróticas, peritonite tuberculosa e carcinomatose peritoneal (CP) foram eventualmente incluídos na análise. Resultados: Dos 93 pacientes (58 homens, média de idade 47 anos) incluídos, a causa básica foi cirrose em 31, CP em 42 e tuberculose peritoneal em 20. O melhor corte para discriminação de ascites benignas e malignas para soro CEA, CA 19-9 e CA 72-4 foram 6,7 ng/mL, 108 UI/mL e 8,9 UI/mL, respectivamente. O melhor corte para discriminação de ascites benignas e malignas para CA 125 ascitico, CEA, CA 19-9 e CA 72-4 foram 623 UI/mL, 8,7 ng/mL, 33,2 UI/mL e 7 UI/mL, respectivamente. Conclusão: O desempenho do biomarcador único para a previsão do CP subjacente é baixo, mas uma combinação de soro CA 19-9 e CA 72-4 melhor previu a presença de carcinomatose peritoneal.
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Utilizing metabolomics technology, this study explored the change of fecal endogenous metabolites in Walker-256 rats with malignant ascites after the administration with Kansui Radix(KR) stir-fried with vinegar(VKR), sought the potential biomarkers in feces which were related to the treatment of malignant ascites by VKR and revealed the biological mechanism of water-expelling effect of VKR. Ultra-fast liquid chromatography-quadrupole-time-of-flight mass spectrometry(UFLC-Q-TOF-MS) was employed to detect the feces of rats in all groups. Principle component analysis(PCA) and partial least squares discriminant analysis(PLS-DA) were conducted to achieve pattern recognition. Combining t-test and variable importance in the projection(VIP) enabled the screening of potential biomarkers for the malignant ascites. Metabolic pathway analysis was accomplished with MetaboAnalyst. Correlation analysis was finally conducted integrating the sequencing data of gut microbiota to elucidate the mechanism underlying the water-expelling effect of VKR. The results showed that both KR and VKR could restore the abnormal metabolism of model rats to some extent, with VKR being inferior to KR in the regulation. Eleven potential biomarkers were identified to be correlated with the malignant ascites and five metabolic pathways were then enriched. Four kinds of gut microbiota were significantly related to the potential biomarkers. The water-expelling effect of VKR may be associated with the regulation of phenylalanine metabolism, biosynthesis of phenylalanine, tyrosine and tryptophan, tryptophan metabolism, glycerophospholipid metabolism, and glycosylphosphatidylinositol(GPI)-anchor biosynthesis. This study can provide a scientific basis for comprehensive understandings of the interaction between gut microbiota and host which has relation to the water-expelling effect of VKR and guide the reasonable clinical application of VKR.
Subject(s)
Animals , Rats , Acetic Acid , Ascites/metabolism , Euphorbia , Feces , MetabolomicsABSTRACT
This study aims to explore the effects of chemical ingredient groups B and C in Kansui Radix stir-fried with vinegar on the diversity of gut microbiota in the rat model of malignant ascites, identify the key differential microbial taxa, and reveal the biological mechanism of water-expelling effect of the two chemical ingredient groups. The rat model of malignant ascites induced by Walker-256 cells was established, and phenolphthalein was used as the positive drug. The rats were orally administrated with corresponding agents for consecutive 7 days. On day 6, fresh feces samples were collected from the rats, and 16 S rDNA high-throughput sequencing and GC-MS were employed to determine the composition of gut microbiota and the content of short-chain fatty acids, respectively. On day 7, serum and intestinal tissue samples were collected for the determination of related indicators. Compared with the control group, the model group showed decreased feces volume and urine volume(P<0.01), increased volume of ascites and levels of Na~+, K~+, and Cl~- in urine(P<0.01), down-regulated mRNA and protein levels of intestinal AQP8(P<0.01), lowered abundance of beneficial Lactobacillus(P<0.01) while risen abundance of potential pathogenic Lachnospiraceae and Anaeroplasma(P<0.01), and reduced content of short-chain fatty acids(P<0.01). Compared with the model group, administration with chemical ingredient groups B and C alleviated all the above indicators(P<0.01). In conclusion, chemical ingredient groups B and C in Kansui Radix stir-fried with vinegar could alleviate the disordered gut microbiota in rats with malignant ascites to expel water through increasing the abundance of beneficial Lactobacillus and reducing the abundance of harmful Lachnospiraceae and Anaeroplasma. This study can provide a reference for the reasonable clinical application of Kansui Radix stir-fried with vinegar.
Subject(s)
Animals , Rats , Acetic Acid/chemistry , Ascites/drug therapy , Euphorbia/chemistry , Gastrointestinal Microbiome , Plant Roots/chemistryABSTRACT
ABSTRACT OBJECTIVE：To establish a method for content determination of paclitaxel in malignant ascites of tumor patients. METHODS：LC-MS/MS method was adopted. Using vindoline as internal standard，the content of paclitaxel in ascites of tumor patients was determined. The separation was performed on Zorbax SB-C18 column with mobile phase consisted of aqueous solution （containing 0.1％ formic acid and 10 mmol/L ammonium acetate）-acetonitrile（40 ∶ 60，V/V）at the flow rate of 0.25 mL/min. the column temperature was 30 ℃，and sample size was 5 μL. The ion source was electrospray ion source，and the detection mode was multiple ion monitoring positive ion mode. MS parameters were set as following as dry gas temperature 350 ℃，dry gas flow rate 10 L/min，capillary voltage 4 000 V. Quantitative determination was operated in the multiple reaction monitoring（MRM）mode， with the ion transitions m/z 876.5→308.0 for paclitaxel and m/z 457.3→188.1 for the internal standard. The fragment voltage/ collision energy for paclitaxel and the internal standard were 250 V/30 eV，and 150 V/20 eV，respectively. RESULTS：The linear range of paclitaxel were 25-2 500 ng/mL（r2＝0.996 5，n＝7）. The lowest limit of quantitation was 25 ng/mL. RSDs of inter-day and intra-day precision tests were 0.61％ -3.62％（n＝5，3）. Accuracies were 95.34％ -98.76％（n＝5，3）. RSDs of extraction recovery were 3.19％-3.72％（n＝3）. CV of matrix effect were 1.52％-2.93％（n＝3）. RE of stability tests were lower than 3％（n＝ 3）. CONCLUSIONS：The method is simple，accurate and suitable for the content determination of paclitaxel in malignant ascites of tumor patients.
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Objective To analyze the clinical value of serum and ascites tumor markers in the diagnosis of benign and malignant ascites ,and to provide reference for clinical diagnosis and treatment of ascites .Methods A total of 168 patients with ascites in Third Affiliated Hospital of Liaoning University of Chinese Medicine from November 2015 to June 2016 were selected .All patients were collected abdominal paracentesis ascites ,analysis of ascites tumor markers .Vein blood sample were collected ,centrifuged up-per serum and detected tumor markers including CA153 ,BXTM and CEA ,all patients underwent pathological test for diagnosis of benign and malignant ascites .The normal distribution method was used to determine the standard of judging malignant ascites and serum ,with the pathological diagnosis as the gold standard ,the four grid diagnosis table was used to calculate the sensitivity and specificity of different combination of ascites tumor markers and serum tumor markers in diagnosis of benign and malignant ascites . Results Among 168 cases ,56 cases were diagnosed with malignant ascites ,112 cases with benign ascites by pathological test .Com-bined detection results of three tumor markers in ascites :57 cases were malignant ,111 were benign .Combined detection results of three tumor markers in serum :64 cases were malignant ,104 cases were benign .The sensitivity and specificity of three tumor mark-ers in ascites were 85 .71% and 91 .96% respectively ,which were higher than 82 .41% and 83 .93% of the three tumor markers in serum .Conclusion The sensitivity and specificity of three tumor markers in ascites for diagnosis of benign and malignant ascites were superior ,which could be used as an important auxiliary means for diagnosis on the overall condition of patients with ascites , and provides an important reference for the subsequent selection other inspection methods .
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Objective To analyze the clinical value of serum and ascites tumor markers in the diagnosis of benign and malignant ascites ,and to provide reference for clinical diagnosis and treatment of ascites .Methods A total of 168 patients with ascites in Third Affiliated Hospital of Liaoning University of Chinese Medicine from November 2015 to June 2016 were selected .All patients were collected abdominal paracentesis ascites ,analysis of ascites tumor markers .Vein blood sample were collected ,centrifuged up-per serum and detected tumor markers including CA153 ,BXTM and CEA ,all patients underwent pathological test for diagnosis of benign and malignant ascites .The normal distribution method was used to determine the standard of judging malignant ascites and serum ,with the pathological diagnosis as the gold standard ,the four grid diagnosis table was used to calculate the sensitivity and specificity of different combination of ascites tumor markers and serum tumor markers in diagnosis of benign and malignant ascites . Results Among 168 cases ,56 cases were diagnosed with malignant ascites ,112 cases with benign ascites by pathological test .Com-bined detection results of three tumor markers in ascites :57 cases were malignant ,111 were benign .Combined detection results of three tumor markers in serum :64 cases were malignant ,104 cases were benign .The sensitivity and specificity of three tumor mark-ers in ascites were 85 .71% and 91 .96% respectively ,which were higher than 82 .41% and 83 .93% of the three tumor markers in serum .Conclusion The sensitivity and specificity of three tumor markers in ascites for diagnosis of benign and malignant ascites were superior ,which could be used as an important auxiliary means for diagnosis on the overall condition of patients with ascites , and provides an important reference for the subsequent selection other inspection methods .
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Objective To explore the effect of compound sophora flavescens injection on intraperitoneal chemotherapy of cisplatin in malignant ascites of gastric cancer patients and its influence on immune function.Methods 90 cases with malignant ascites of gastric cancer failures were researched,who from May 2014 to May 2016.According to random number table, they were divided into observation group and control group, 45 cases in each group.The control group was treated with intraperitoneal chemotherapy of cisplatin alone, and the treatment group was treated by intraperitoneal chemotherapy with compound Kushen injection combined with cisplatin.The two groups of patients before and after treatment, compared the level of immune function indicators, while observing the two groups of patients after treatment, short-term efficacy, quality of life improvement and adverse reactions.Results Observation group of patients with efficient and control rates were higher than the control group patients, but no obvious difference between groups.The stability factor of 55.55%of patients with observation group was obviously higher than that of control group 22.22%of the patients, the clear difference between groups (P<0.05).Before the treatment, two groups of patients of CD3 +, CD4 +, CD8 +and CD4 +/CD8 +T cell subsets and NK cells was no significant difference.After treatment, two groups of patients of CD3 +, CD4 +, CD4 +/CD8 + T cell subsets and NK cells were significantly increased than before treatment ( P<0.05 ) , and CD8 + than before treatment significantly reduced ( P <0.05 ) , while the observation group of CD3 +, CD4 +, CD4 +/CD8 +T cell subsets and NK cells was significantly higher than that of control group ( P <0.05 ) , and CD8 + was significantly lower than control group (P <0.05).The control group in the improvement of quality of life of patients with effective rate of 35.55%compared with 80.00% of the observation group of patients, significantly lower, more obvious differences between groups (P <0.05).Observation group of patients the incidence of gastrointestinal reaction and liver function abnormalities were 0.00%, 8.88%, significantly lower than the control group patients were 11.11%, 22.22%, there exists significant difference between groups (P <0.05).Fatigue, nausea, vomiting and 2 groups of patients compared the incidence rate of no significant difference.Conclusion The combined use of compound Kushen injection combined with cisplatin intraperitoneal perfusion chemotherapy in patients with malignant ascites of gastric cancer for treatment,effect is remarkable,Can effectively improve the patient's T cell subsets and NK cells,Improve the patient's immune function.
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Objective:To explore the effects and mechanism of anti IL-9 antibody on malignant ascites ( MA) of hepatic carci-noma in mice.Methods:A mouse model of MA was established by mouse H 22 cell line.45 mice were divided randomly into experi-mental group,negative control group and blank control group at 24 hours after modeling,with 15 mice in each group.The experimental group was injected intraperitoneally with anti IL-9 antibody;the negative control group was injected with isotype IgG antibody;the blank control group was injected with normal saline .The weight and behavior of the mice were measured before each injection .Five mice of each group was sacrificed at 24 hours after the last injection to measure the volume of MA .The level of VEGF,MMP-2,IL-9 and IFN-γin MA were determined with ELISA assay;the survival time of rest mice were recorded and compared .Results:The mean volume of MA of experimental group,negative control group and blank control group were (6.70±1.52)ml,(10.28±1.75)ml,(10.36±2.30) ml,respectively,the MA volume of experimental group were lower as compared to negative control group and blank control group ( P0.05 ) .Conclusion:Intraper-itoneal injection anti IL-9 antibody on H22 ascites-bearing mice can effectively inhibit the generation of the MA .The mechanism may be related to the inhibition of the expression of the VEGF and IL-9.
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Objective: To investigate the efficacy of triple exits linker for temperature regulation of ovarian cancer patients with ascites in hyperthermic intraperitoneal perfusion using HGGZ-102 type body cavity heat perfusion machine. Methods: From April 2013 to September 2014, 39 ovarian cancer patients with ascites did not use triple exits linker (as the control group). From October 2014 to May 2015, 45 ovarian cancer patients with ascites used triple exits linker during hyperthermic intraperitoneal perfusion (as the study group). The patients in two groups were treated with TP regimen (paclitaxel on d 1, and hyperthermic peritoneal perfusion with cisplatin on d 1 and d 8; repeated every 3 weeks with a total of six cycles). The temperature of the drugs inflowing into abdominal cavity and outflowing from abdominal cavity in two groups was examined. Results: In the study group, the threshold temperatures of the drugs inflowing into abdominal cavity for three cycles were precisely controlled at 43.5-44.5 , and the maximal temperature when drugs outflowing from abdominal cavity reached target temperature (39.5-40.5 ). The effective rates of ascite subsided were 71.1% and 46.2% in the study group and the control group, respectively. There was significant difference between the two groups (P 0.05). Conclusion: Application of triple exits linker for temperature regulation of ovarian cancer patients with ascites in hyperthermic intraperitoneal perfusion can control the temperature accurately and improve the therapeutic effect.
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Objective To evaluate the clinical efficacy and safety of celiac continued circulatory hyper -thermia perfusion with chemotherapy in the treatment of cancer with ascites .Methods Databases including the Cochrane Library MEDLINE,PubMed,Embase,CBM,VIP,CNKI and WanFang Data,and the other sources as supplying .The literatures were screened according to the inclusion criteria ,extracted data and assessed the meth-odological quality ,and then meta -analysis was performed using RevMan 5.0.2 software.Results Totally 14 RCTs with 867 patients were included .Meta-analysis showed that compared intraperitoneal chemotherapy ,with celiac continued circulatory hyperthermia perfusion had a significant difference in CR ( OR=3.18,95%CI:2.18~4.64,P<0.00001),PR(OR=2.05,95%CI:1.51~2.77,P<0.00001),overall effective rate(OR=4.88, 95%CI:3.59~6.46,P<0.00001).The incidence of adverse reactions was no statistically significant in the two groups.Conclusion Celiac continued circulatory hyperthermia perfusion with chemotherapy in the treatment of cancer with ascites demonstrates better efficacy and safety ,but it still needs to verify the above conclusion .
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Objective To explore the value of detection of systemic and local oxidation antioxidation level of ascites in the differential diagnosis of benign and malignant ascites.Methods Thirty-five patients with malignant ascites hospitalized in the Yidu Central Hospital of Weifang from December 2012 to November 2013 as the malignant ascites, and 35 cases of benign ascites as the control group.The ascites of malignant ascites group and plasma total antioxidant capacity (T-AOC) level of two group were detected by ferric ion reduction method.Plasma malonaldehyde (MDA) level of two group were detected by thiobarbituric acid content assay.Peripheral blood mononuclear cell (PBMCs) and tumor associated lymphocytes (TALS) in ascites were isolated by Ficoll density gradient centrifugation,the DNA damage of PBMCs and TALS were detected by single cell gel electrophoresis (SCGE) , expressed in the tailing rate.The value in the diagnosis of benign and malignant ascites was judged according to the analysis of above indexes.Results (1) The difference analysis : the levels of T-AOC in plasma in malignant ascites group was (9.26 ± 1.88)mM, significantly lower than that in benign ascites group((11.26± 1.78) mM, t =16.520,P =0.000);T-AOC levels of malignant ascites group ascites was (6.59± 1.38) mM, significantly lower than the plasma levels of T-AOC ((9.22± 1.86) mM, t =13.869, P =0.000);the MDA level of malignant ascites group was (6.26± 1.83) nM, significantly higher than that of serum benign ascites((3.26±1.12) nM,t=18.267,P=0.000);tailing rate of PBMCS in malignant ascites group was (17.9 ± 6.7) ％, significantly higher than that in benign ascites group ((9.6 ± 5.3) ％, P＜ 0.01);tailing rate of TALS in malignant ascites group was (442.6± 10.8) ％, significantly higher than that of PBMCS ((17.2±6.1)％ ,P＜0.01).(2)The correlation analysis: there was a negative correlation between plasma T-AOC and MDA in malignant ascites group (r =-0.518, P ＜ 0.01), tailing rate of T-AOC and TALS ascites (r =-0.566,P＜0.01) ,tailing rate of plasma T-AOC and PBMCS(t =-0.472,P＜0.01);there was a positive correlation between the tailing rate of plasma MDA and PBMCS (r =0.476, P ＜ 0.05).Conclusion In the malignant ascites group, there is oxidative stress in the whole body and the ascites, and the local oxidative stress in the ascites is more obvious.The sensitivity and accuracy of the diagnosis of malignant ascites can be increases by detected by the detection of the local oxidation resistance of the whole body and the ascites.
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Objective To investigate the measurement , feasibility and clinic effect of hyperthermic intraperitoneal chemotherapy (HIPEC) guided by B ultrasound in the treatment of malignant ascites from peritoneal carcinomatosis. Methods From July 2011 to June 2013, B ultrasound-guided approach was used to perform HIPEC on 36 patients affected by malignant ascites secondary to peritoneal carcinomatosis. Every patient underwent HIPEC for three times , by way of continuous circulatory perfusion into peritoneal cavity with saline at 400 ~ 600 mL/min and intraperitoneal perfusion with 5-FU mitomycin-C and cisplatin for 90 minutes with an inflow temperature of (43 ± 0.2)℃. These patients were followed up for a long term. Results Intraoperative course was uneventful in all cases. Complete clinical regression of ascites and related symptoms was achieved in all the 26 patients, partial regression achieved in 8 patients, and no curative effect achieved in 2 cases. The acquired total clinic effectiveness was 94.44%. No postoperative deaths and complication related to the procedure occurred in this study. The KPS grades of patients rose (P < 0.001), the level of tumor markers decreased, including CA199 (P < 0.001), CEA (P < 0.001), CA125 (P = 0.003). Conclusion HIPEC guided by B ultrasound appears to be a safe, feasible and effective procedure for the treatment of debilitating malignant ascites from unresectable peritoneal carcinomatosis , which would have a clinic good perspective in future.
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Objective To explore the clinical curative effect of recombinant human endostatin injection combined with chemotherapy in the treatment of patients with advanced gastric cancer and malignant ascites,and its influence on the quality of life.Methods 62 patients with advanced gastric cancer from July 2012 to July 2015,were randomly divided into observation group (31 cases)and control group (31 cases).The control group was treated with FOLFOX6 chemotherapy,the observation group was given recombinant human endostatin injection on the basis of the treatment of the control group.The two groups were treated for 3 weeks.The curative effect,QOL score,Karnofsky score,the change of serum CEA and CA19 -9 levels and drug adverse reaction incidence before and after treatment were compared in the two groups.Results The RR of the observation group was higher than that of the control group (54.84 vs 29.03%,χ2 =4.239 3,P 0.05).Conclusion The clinical efficacy of recombinant human endostatin injec-tion combined with malignant ascites in the treatment of patients with advanced gastric carcinoma is significant,and can significantly improve the quality of life of patients,has the important research value.
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Objective: To assess the role of Th9 and Th17 cells in malignant ascites (MA). Methods: MA from 30 hepatic carcinoma patients and benign ascites from 30 cirrhotic patients were collected. Corresponding peripheral blood samples from these hepatic carcinoma and cirrhotic patients as well as 30 healthy subjects were collected. The frequency of Th9 and Th17 cells was tested by flow cytometry. Serum levels of interleukin (IL)-9 and IL-17 were examined by ELISA. Results: The observed frequency of Th9 and Th17 cells, and the IL-9 and IL-17 serum levels were significantly higher in MA patients than those in cirrhotic patients and healthy control samples ( P<. 0.05). Moreover, the Th9 cells demonstrated positive correlation with Th17 cells as well as IL-9 in MA patients; however, this positive correlation was not observed in the cirrhotic patients or healthy control samples. The frequency of Th9 and Th17 cells was distinctly higher in MA patients presenting with stage III or IV malignancy and with lymph node or distant metastasis than those in patients in stage I or II and without distant metastasis ( P<. 0.05). Conclusions: The increased frequency of Th9 and Th17 cells in MA patients suggests that these two T cell subsets play a synergistic role in MA pathogenesis. This study also demonstrated that Th9 and Th17 cells may perform their biological functions in conjunction with IL-9 production.
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Objective: To observe the clinical efficacy of intraperitoneal injection of recombinant human vascular endostatin combined with 5-fluorouracil (5-FU) in patients with malignant ascites, and to detect the change of percentage of endothelial cells (ECs) in ascites before and after treatment, in order to explore the clinical value of endothelial cells in treatment of malignant ascites. Methods: Thirty-nine patients with malignant ascites received two cycles of intraperitoneal inject of endostar combined with 5-FU treatment. The clinical response, change of quality of life (QOL) and the adverse events were assessed. The flow cytometry was used to detect the level of endothelial cells in malignant ascites before and after treatment. Results: In 39 patients, the objective response rate (complete response and partial response) was 43.6% (1 7/39); the rate of QOL improvement was 53.8% (21/39). The rates of grades 3-4 adverse events were low, including leukopenia in 2 patients (5.1%, 2/39), thrombocytopenia in 1 patient (2.6%, 1/39), anemia in 2 patients (5.1%, 2/39), nausea in 4 patients (10.3%, 4/39), and diarrhea in 1 patient (2.6%, 1/39). In 16 patients achieveing clinical response, the percentage of endothelial cells in malignant ascites before treatment was significantly higher than that after treatment [(0.22±0.06)% vs (0.12±0.08) %, P = 0.005]. In 21 patients achieveing improvement in QOL, the percentage of endothelial cells in malignant ascites before treatment was also significantly higher than that after treatment [(0.1 9±0.08)% vs (0.1 3±0.08) %, P = 0.032]. The percentages of endothelial cells in malignant ascites in patients not achieveing clinical response and improvement in QOL after treatment had no significant changes (P = 0.11 4, P = 0.359). Conclusion: Intraperitoneal inject of endostar combined with 5-FU treatment can effectively control the malignant ascites and improve the QOL. The level of endothelial cells in malignant ascites may become a clinical marker to predict the response to the treatment of malignant ascites.
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OBJECTIVE:To observe the clinical efficacy and ADR of Mirabilite combined with intrapetitoneal in the treatment of elderly colorectal malignant ascites. METHODS:77 cases of patients with elderly colorectal malignant ascites were randomly di-vided into treatment group (n=40) and control group (n=37). The control group received the treatment of intraperitoneal alone, while the treatment group was based on the control group additionally received Mirabilite combined with intrapetitoneal. The clini-cal efficacy,quality of life (QOL),and ADR in 2 groups were compared and statistically analyzed. RESULTS:Compared with control group,the effective rate in treatment group was 77.5% and the disease control rate was 87.5%,with significant difference (P<0.05);the QOL score in treatment group was better than control group,with significant difference(P<0.05);the incidence of local ADR in Mirabilite for external use was low. CONCLUSIONS:Mirabilite combined with intraperitoneal has better efficacy in the elderly colorectal malignant ascites and better QOL.
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Objective:To assess the role of Th9 and Th17 cells in malignant ascites (MA). Methods: MA from 30 hepatic carcinoma patients and benign ascites from 30 cirrhotic patients were collected. Corresponding peripheral blood samples from these hepatic carcinoma and cirrhotic patients as well as 30 healthy subjects were collected. The frequency of Th9 and Th17 cells was tested by flow cytometry. Serum levels of interleukin (IL)-9 and IL-17 were examined byELISA. Results: The observed frequency of Th9 and Th17 cells, and the IL-9 and IL-17 serum levels were significantly higher in MA patients than those in cirrhotic patients and healthy control samples (P Conclusions:The increased frequency of Th9 and Th17 cells in MA patients suggests that these two T cell subsets play a synergistic role in MA pathogenesis. This study also demonstrated that Th9 and Th17 cells may perform their biological functions in conjunction with IL-9 production.
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Objective To observe the clinical efficacy and safety of compound Kushen Injection in the patients with malignant ascites. Methods Totally 139 patients with malignant ascites were randomly divided into treatment group and control group. 30 mL compound Kushen Injection was given to the treatment group, and 100 mg cisplatin was given to the control group through peritoneal perfusion once a week, for 3 weeks. The changes of urine volume, abdominal perimeter, blood-Rt, function of liver and kidney, and gastrointestinal reaction were detected before and after treatment, with a purpose to evaluate the total efficacy and safety. Results The total effective rate was 80.56% (58/72) in treatment group, and 86.57% (58/67) in the control group, without significant difference between the two groups. The incidences of bone marrow suppression, liver and kidney damage, and nausea and vomiting of gastrointestinal reaction were lower in the treatment group than the control group. Conclusion The effects of compound Kushen Injection and cisplatin have equal efficacy for the treatment of malignant ascites, but the former was superior to the latter on safety.
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Objective To evaluate the clinical efficacy of compound Sophorae Flavescentis Radix (Kushen) injection intravenous drip combining carboplatin intraperitoneal injection in treating advanced ovarian cancer with malignant ascites. Methods Totally 160 patients with advanced ovarian cancer with malignant ascites were randomly divided into compound Kushen injection intravenous drip combining carboplatin intraperitoneal injection group (observation group) and carboplatin intraperitoneal injection group (control group). Clinical efficacy observation and evaluation were conducted from malignant ascites condition, changes in living quality (KPS score), T lymphocytes subsets and changes of the NK cells in blood samples, pain-relieving efficacy, and toxicity response. Results There were significant differences in malignant ascites between the two groups (P<0.05), with treatment group showing better improvement than the control group. In improving quality of life, the observation group had precedence over the control group (P<0.01). After treatment, CD3+, CD4+, CD4+/CD8+, NK (CD16+CD56+) in control group were obviously less than the observation group (P<0.05). The pain-relieving efficacy in the observation group was superior to that in the control group. Compared with the control group, the observation group had less gastrointestinal reaction and bone marrow suppression, with statistical significance (P<0.05). Conclusion Compound Kushen injection intravenous drip combined with carboplatin intraperitoneal injection in treating advanced ovarian cancer with malignant ascites can effectively improve the immune function and quality of life, and can be used for adjuvant chemotherapy with less side effects.
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Objective To summarize the herbal medication in treating malignant ascites based on literature. Methods TCM literatures concerning malignant ascites from CNKI (1989.1-2013.3) were retrieved. The herbs and those category, nature, flavor and meridian distribution were summarized by frequency method. The couple herbs were analyzed by hierarchical cluster analysis. Results Fifty-five qualified documents and 56 effective prescriptions were collected. A total of 164 herbs were used (668 frequencies). Six groups of herbs, cumulative relative frequency (CRF) of 61.83%, were used frequently in order as follows:the herbs for promoting diuresis and resolving dampness, invigorating qi, invigorating the blood and removing blood stasis, regulating qi, eliminating heat and toxin, excreting drastically water. The most frequently used herbs (>6 frequencies, CRF 53.74%) had 25 species. The first three places were the herbs for promoting diuresis and resolving dampness (5 species), invigorating qi (4 species), invigorating the blood and removing blood stasis (3 species). These herbs were mostly of warm nature (260 frequencies, 38.92%). The total frequency of herb-nature was 1055 and the sweet (354 frequencies, 33.55%), bitter (284 frequencies, 26.92%) and pungent (268 frequencies, 25.40%) herbs were used more frequently. The total frequency of meridian distribution was 1747 and these herbs were mostly attributed to spleen, lung, liver, and kidney meridians (>200 frequencies). The most frequently used couple-herbs included Poria and Rhizoma Atractylodis Macrocephalae, Radix Astragali and Ramulus Cinnamomi, etc. Conclusion Invigorating qi was emphasized in treating malignant ascites, combined with promoting diuresis. The herbs of the warm and cold nature, the sweet, bitter and pungent flavor, spleen, lung, liver and kidney meridians were most frequently used.