An Interdisciplinary Nutrition Support Team Improves Clinical and Hospitalized Outcomes of Esophageal Cancer Patients with Concurrent Chemoradiotherapy.

BACKGROUND: The prevalence of malnutrition is very high in patients with cancer. The purpose of this study was to investigate whether or not a nutrition support team (NST) could benefit esophageal cancer patients undergoing chemoradiotherapy (CRT). METHODS: Between June 2012 and April 2014, 50 esophageal cancer patients undergoing concurrent CRT were randomly assigned into two groups: The NST group and the control group. The nutritional statuses of 25 patients in the NST group were managed by the NST. The other 25 patients in the control group underwent the supervision of radiotherapy practitioners. At the end of the CRT, nutritional status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay (LOS) and the in-patient cost were also compared between these two groups. RESULTS: At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin (ALB), transferrin, and ALB parameters (P = 0.001, 0.000, and 0.000, respectively). The complication incidences, including bone marrow suppression (20% vs. 48%, P = 0.037) and complications related infections (12% vs. 44%, P = 0.012), in the NST group were lower and significantly different from the control group. In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy (96% vs. 76%, P = 0.103). Furthermore, the average LOS was decreased by 4.5 days (P = 0.001) and in-patient cost was reduced to 1.26 ± 0.75 thousand US dollars person-times (P > 0.05) in the NST group. CONCLUSIONS: A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF. Moreover, the NST could be helpful on reducing LOS and in-patient costs.

[Changes of T-helper 1 and T-helper 2 ratio in peripheral blood and decidua in hypertensive disorder complicating pregnancy].

OBJECTIVE: To investigate the role of immune response induced by different T-helper 1 and T-helper 2 (Th1 and Th2) ratio in peripheral blood and decidua from patients with hypertensive disorder complicating pregnancy in the pathogenesis of the disease. METHODS: Peripheral blood and decidua from 12 non-pregnant women (no deciduas) (normal women group), 12 healthy pregnant women (healthy pregnant women group), 10 patients with gestational hypertension (gestational hypertension group), 25 patients with pre-eclampsia (PE) (including 10 patients with mild pre-eclampsia and 15 patients with severe pre-eclampsia) (pre-eclampsia group). Th1/Th2 ratio in peripheral blood and decidua was determined by flow-cytometrically. RESULTS: The ratio of Th1/Th2 in peripheral blood with normal women group is 10.5 +/- 1.5, the ratios of Th1/Th2 in peripheral blood and deciduas with healthy pregnant women group are 9.5 +/- 2.9 and 7.6 +/- 4.6 respectively, those with gestational hypertension group are 12.1 +/- 3.4 and 13.1 +/- 5.6 respectively, those with pre-eclampsia group are 16.8 +/- 3.8 and 26.7 +/- 9.4 respectively. The ratios of Th1/Th2 in peripheral blood and deciduas with pre-eclampsia group are much higher than those with other groups, when they are compared with each other, there are statistical difference (P < 0.05). And the ratio of Th1/Th2 with pre-eclampsia in deciduas is much higher than that in peripheral blood, comparing these two aspects, there is statistical difference (P < 0.001). The changes of Th1/Th2 ratio in gestational hypertension group is an intermediate between healthy pregnant group and pre-eclampsia group. CONCLUSIONS: Hypertensive disorder complicating pregnancy is a syndrome of Th1/Th2 cell balance disturbances in vivo. Over-expression of Th1 cells and imbalance of Th1/Th2 might lead to hypertensive disorder complicating pregnancy.