ABSTRACT
Purpose To investigate the expression of the heavy chain of Ig protein, and observed it's value on differential diagnosis and significance on clinical pathological. Methods50 cases of non-Hodgkin's lymphoma (NHL) were collected as experimental group, including 30 cases of MALToma, 10 cases of follicular lymphoma (FL), and 10 cases of plasmacytoma(PC), 10 cases of reactive lymphoid hyperplasia (RLH) were collected as control group. The expression of IgM, IgA, IgD, IgG and IgE were detected by immunohistochemistry in the two groups. Results The lower positive rates of IgM, IgA were observed in the experimental group, MALToma, PC, and the lower positive rates of IgG, IgA were observed in FL (P＜ 0.05 ). The positive rate and expression intensity of IgM showed a rising trend (P＜ 0.05), and the positive rate of IgG show a downward trend (P＞0.05) in FL, MALToma, PC. There were three patterns of the heavy chain expression in the two groups: a single type expression, all negative expression, and a various type expression. The positive rates of a single type/ all negative heavy chain expression were 86.7％, 60％, 80％, 0 respectively in MALToma, FL, PC and RLH, the differences were statistically significant (P＜ 0.05 ). The positive rate of IgG was related to the type of tumor cells in MALToma(P＜ 0.05 ). Conclusion The expressions of IgM and IgG show a contrast trend in FL, MALToma, PC, and support that the most of MALToma and PC which come from postgerminal center experience class switch recombination, and frequently express a single IgG. A single type/all negative heavy chain expression is a frequent event in the MALToma, and it's helpful to the differential diagnosis of MALToma and RLH.
ABSTRACT
Objective To investigate the impact of enhanced recovery after surgery (ERAS)on immune function in patients undergoing laparoscopic hepatectomy.Methods Sixty patients undergoing laparoscopic hepatectomy (34 males,26 females,aged 38-57 years,ASA Ⅰ or Ⅱ),were randomly divided into two groups:enhanced recovery after surgery group (group E)and non-enhanced recovery after surgery group (group C).The patients in group E received enhanced recovery after surgery,while the patients in group C received routine perioperative management and anesthesia methods.The operation method and time,the volume of bleeding,the intraoperative fentanyl con-sumption,the volume of fluid input,the preoperative and postoperative CVP and temperature were recorded in the two groups.Blood samples were obtained before induction (T0 ),at the end of opera-tion (T1 ),on day 1 (T2 ),day 3 (T3 ),day 7 (T4 )after operation for determination of plasma con-centration of IgA,IgM,IgG and the percentages of T lymphocyte subsets (CD3+ ,CD4+ ,CD8+ ) and CD4+/CD8+ ratio were detected with flow cytometry.Furthermore,the visual analogue scale (VAS)score and Ramsay score were evaluated 4 hours,8 hours,24 hours and 48 hours after opera-tion in two groups.Results Compared with group C,the intraoperative fentanyl consumption,the volume of fluid input and the postoperative CVP in group E were significantly decreased,while the postoperative temperature was significantly increased (P < 0.05 ).Compared with T0 , the percentages of CD3+ ,CD4+ ,the CD4+/CD8+ ratio and the plasma concentration of IgA,IgM,IgG in group E on T1-T3 were significantly decreased,the percentages of CD3+ ,CD4+ ,the CD4+/CD8+ratio and the plasma concentration of IgA,IgM,IgG in group C on T1-T4 were significantly decreased (P <0.05).Compared with group C,the percentages of CD3+ ,CD4+ ,the CD4+/CD8+ ratio and the plasma concentration of IgA,IgM,IgG in group E on T1-T4 were significantly increased (P <0.05),the visual analogue scale (VAS)score 4 hours,8 hours,24 hours after operation were signifi-cantly decreased (P <0.05).The comparision of Ramsay scores at all the time points between two groups were similar.Conclusion ERAS applied to patients undergoing laparoscopic hepatectomy can reduce the intraoperative fentanyl consumption,prevent the occurrence of hypothermia and provide satisfactory postoperative analgesia,which can significantly improve the immune function in patients.