Clinical observation of splenectomy with distal pancreatectomy during cytoreductive surgery in epithelial ovarian cancer / 复旦学报（医学版）

Objective To evaluate the safety and efficacy of splenectomy with distal pancreatectomy during cytoreductive surgery in epithelial ovarian cancer(EOC).Methods A total of 17 patients from Zhongshan Hospital,Fudan University and the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)received splenectomy with distal pancreatectomy during cytoreductive surgery in EOC were recruited.Their clinicopathological characteristics,postoperative complications and survival situation were retrospective analyzed.Results Of the 17 patients,there were 13 primary cases and 4 recurrent cases.Eleven cases(64.7%)had preoperative imaging finding with metastatic lesions in the splenic hilum,among whom 6 cases had distal pancreas metastasis during the operation.The drainage was placed in the splenic fossa for the measurement of amylase levels in drain fluid and was removed after 8(3-12)days.There were 4 patients had postoperative pancreatic fistula(POPF)of grade A,3 patients had POPF of grade B and no POPF of grade C occurred.The 2 patients with POPF of grade B improved after percutaneous drainage,and the rest recovered with somatostatin,antibiotic drugs and medicines without perioperative mortality.The interval between surgery to chemotherapy was 17.5(13-37)days.The median follow-up time was 14(4-64)months and the median progression-free survival was 10(5-32)months.Conclusion Splenectomy with distal pancreatectomy as part of cytoreduction surgery in EOC is needed for optimal resection,and the complication of pancreatic fistula could be managed conservatively.

Expression of peripheral blood gammadelta T cells, treg cells and cytokines IL-17 and TGF-beta1 in patients with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of peripheral blood gammadelta T cells/CD4 CD25+ regulatory T cells(Treg) and cytokines interleukin 17 (IL-17) and transforming growth factor beta1 (TGF-beta1) in patients with allergic rhinitis.</p><p><b>METHODS</b>From March 2012 to July 2012, 32 patients with allergic rhinitis (AR group) and 20 healthy control subjects (control group) were collected. The expression of peripheral blood gammadelta T cells/Treg cells were measured by flow cytometry and the levels of IL-17 and TGF-beta1 were evaluated by ELISA. SPSS 16.0 software was used to analyze the data.</p><p><b>RESULTS</b>The percentages of gammadeltaT cells in AR group were (13.30 +/- 8.62)%, which was significantly higher (t = 5.18, P < 0.01) than those in control group (5.18 +/- 1.86)%. The percentages of Treg cells in AR group were (1.75 +/- 0.56)%, which were significantly lower (t = 7.46, P < 0. 01) than those in control group (4.76 +/- 1.74)%. The IL-17 levels in AR group were (668.55 +/- 45.15) pg/ml, which were also significantly higher (t = 8.97, P < 0.01) than those in control group (573.53 +/- 17.42) pg/ml. The TGF-beta1 levels in AR group were (0.34 +/- 0.04) pg/ml, which were also significantly lower (t = 9.51, P < 0.01) than those in control group (0.49 +/- 0.06) pg/ml. There was a negative correlation between the percentages of gammadelta T cells and Treg cells (r = -0.561, P < 0.01). There was a negative correlation between the percentages of gammadelta T cells and TGF-beta1 levels (r = -0.622, P < 0.01). A positive correlation was shown between the percentages of gammadelta T cells and IL-17 levels in AR (r = 0.469, P < 0.01). A positive correlation was shown between the percentages of Treg cells and TGF-beta1 levels in AR (r = 0.738, P < 0.01). There was no correlation between IL-17 levels and the percentages of Treg cells or TGF-beta1 levels (r value was -0.111, -0.196, all P > 0.05).</p><p><b>CONCLUSION</b>There are imbalances of gammadelta T and Treg cells in peripheral blood of patients with allergic rhinitis. gammadelta T cells may be the main cell to produce IL-17, which may play an important role in allergic rhinitis.</p>

Distribution and clonality of T cell receptor Vγ and Vδ subfamily in peripheral blood of patients with allergic rhinitis before and after immunotherapy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the distribution and clonality of T cell receptor (TCR) Vγ and Vδ subfamily in peripheral blood of patients with allergic rhinitis before and after 1 year treatment with immunotherapy.</p><p><b>METHODS</b>The specific IgE and the complementary determinant region 3 (CDR3) of TCR V γ (I-III) and Vδ(1-8) subfamily genes in mononuclear cells were amplified from 10 effective cases of allergic rhinitis before and after 1 year treatment with immunotherapy, to observe the distribution and utilization of TCR Vγ and Vδ repertoire. The positive PCR products were further labeled with RT-PCR and analyzed by gene scan technique to determine the CDR3 size and evaluate the clonality of the detectable TCR Vγ and Vδ T cells. Peripheral blood of 10 healthy adults served as controls.</p><p><b>RESULTS</b>All symptoms were significantly improved after 1 year specific immunotherapy, but no changes were seen in specific IgE [(22.89 ± 9.60) kU/L before treatment, (19.62 ± 7.63) kU/L after treatment, Z = 1.051, P > 0.05]. No statistically significant differences of expression levels of the TCR Vγ I-III subfamily genes were found between patients with allergic rhinitis normal control group (t value were -0.679, -0.516, -0.808, all P > 0.05), but significantly decreased after 1 year treatment. There were statistically significant differences of expression levels of the TCR VγI-II subfamily genes before and after treatment (t value were -2.904, -2.217, all P < 0.05). 5.30 ± 0.82, 4.90 ± 0.57 and 5.20 ± 1.40 out of TCR Vδ (1-8) subfamilies were selectively expressed in T cells in patients with allergic rhinitis before and after 1 year treatment and normal control group, predominantly for TCR Vδ 1, 2, 3 and 6. The TCR Vδ 6 subfamily was found to have statistically significant differences in these groups (Fisher's Exact Test, P < 0.05). Compared with the normal control group and the allergic rhinitis group before treatment, a significant higher frequency of Vδ 6 oligoclonal was identified in T cells in patients with allergic rhinitis after 1 year treatment.</p><p><b>CONCLUSIONS</b>There was difference in the expression levels of the TCR Vγ I-III subfamily genes and distribution and clonality of TCR Vγ and Vδ subfamily T cells in peripheral blood of patients with allergic rhinitis before and after 1 year treatment. Specific immunotherapy can be effective in alleviation of the symptom in patients with allergic rhinitis during the early stage, possibly by inducing TCR γδ T cells, especially the TCR Vδ6 subfamily, and possibly no significant relativity between symptom and specific IgE.</p>

Clinical research on the quality of life in patients with allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the quality of life (QOL) outcome in patients with allergic rhinitis (AR).</p><p><b>METHODS</b>A prospective trial was conducted to survey the QOL status of 101 AR patients, in contrast to that of 121 healthy individuals and 97 chronic pharyngitis (CP) patients by generic questionnaire medical outcomes study short-form 36-items health survey (SF-36), and to survey the most troublesome problems of AR patients by disease-specific questionnaire rhinoconjunctivitis quality of life questionnaire (RQLQ). The correlation between SF-36 and RQLQ had also been analyzed. All the results were analyzed statistically.</p><p><b>RESULTS</b>By the assessment of SF-36, the scores of 3 domains (x ± s, the same as follow, the scores were 78.02 ± 18.37, 56.13 ± 17.49, 78.81 ± 16.47, respectively) of AR patients were less than those (84.00 ± 18.36, 74.69 ± 14.13, 83.78 ± 14.31) of healthy individuals (P < 0.05), and the scores of 7 domains (the scores were: 91.78 ± 11.78, 79.16 ± 30.23, 78.02 ± 18.37, 56.13 ± 17.49, 78.81 ± 16.47, 67.66 ± 39.57, 68.78 ± 13.65, respectively) of AR patients were similar with those (94.12 ± 6.88, 80.67 ± 32.38, 73.57 ± 17.96, 59.73 ± 16.58, 80.41 ± 17.01, 63.58 ± 39.99, 66.43 ± 13.71) of CP patients (P > 0.05). By the assessment of RQLQ, in AR patients, both the nasal symptoms and the practical problems got the highest scores (the scores were 2.70 ± 1.29, 2.53 ± 1.37 respectively). According to the assessment of the correlation between SF-36 and RQLQ, the correlation was weak (r = -0.199 ∼ -0.526, P < 0.05).</p><p><b>CONCLUSIONS</b>The QOL of AR patients decreased compared with that of healthy individuals, but similar with that of CP patients. The most troublesome problems in AR patients were nasal symptoms and the practical problems. Both SF-36 and RQLQ were suitable for assessing the health status of AR patients. SF-36 and RQLQ each covered a different part of the QOL of AR patients, and the combination of the two questionnaires could improve the QOL measurement.</p>