心理干预对围手术期乳腺癌患者情绪、自评健康及免疫功能的影响研究

Objective：Developing a generalized psychological intervention program, and explore its influence on the emotion, subjective health, and immunity function of the perioperation patients with breast cancer. Method：Sixty patients with breast cancer were randomly divided into intervention and control groups. The clinical psychological intervention was performed on patients in the intervention group for 20 days, in addition to the routine therapy and care. Levels of emotion (SAS & SDS), subjective health (SF-36), and immunity function (t lymphocyte subsets) of the patients were tested. Results: 1.There was no significant difference between the age, income, educational level, and type of prefession of the two groups. There was no significant difference between SAS, SDS, SF-36 and lymphocyte subsets（CD3+, CD4+, CD8+, CD4+/CD8+, NK） of the two groups. 2. Scores of SAS and SDS decreased significantly after intervention in experimental group, while the score of SF-36, the average value of CD4+, CD4+/CD8+, and NK increased significantly. For the control group, the score of depression decreased significantly after intervention, while the score of PF, GH, VT, SF, RE, and MH increased significantly. 3. In comparison of the intervention and control group, the intervention effect of SAS, SDS, SF-36 scores (except SF), CD3+, CD4+, CD4+/CD8+, and NK differed significantly, with the priority of experimental group. 4. SDS, SAS, and CD3+, CD4+, NK correlated in negative respectively, while SDS, SAS, and CD8+ correlated in positive. PF, RP, GH, SF, and MH of subjective health correlated in positive with every index of immunity function in positive, except negative correlation with CD4+/CD8+. BP, RE correlated with CD3+,CD4+,CD8+, and NK in positive. VT correlated in positive with CD3+, CD8+, and NK, in negative with CD4+/CD8+. Conclusions: 1. Anxiety, depression, and subjective health, correlated with immunity function in perioperation patients with breast cancer. 2. Psychological intervention can improve the emotional status, subjective health, and immune function of patients with breast cancer to the optimum in perioperative period.

细胞因子对大鼠抑郁样行为的影响

Depression is one of the most important psychological diseases to threaten human health. “Cytokine theory of depression” suggests that cytokines may play an important role in depression, which provided a new perspective in the study the mechanism and the therapy of depressive symptoms. This view is supported by various findings. Administration of pro-inflammatory cytokine or lipoposaccharide in animal induces depressive-like behavior such as anhedonia and low locomotion, which is very similar to the behavioral symptoms of depression in humans. However, the earlier researches may only pay attention to the short-time behavior effects; the effects of long-time behavior changes have not been clearly reported. In addition, there are few reports about the effects of pro-inflammatory cytokine or anti-inflammatory cytokine on the depressive-like behavior induced by chronic stressors. To further understand the role of cytokines in depression, the purpose of the present study is to investigate the dose and time effects of pro-inflammatory cytokines induced by lipoposaccharide on depressive-like behavior, sensitization effect of pro-inflammatory and blockage effect of anti-inflammatory on depressive-like behavior induced by chronic cold swimming stress. The behavioral observation was carried out using sacharin preference test, open field test and elevated-plus maze. The results indicated that: 1) The activated immunity induced by LPS i.p administration could induce significant depressive-like behavior, but these behaviors had no long-term effect; 2)The depressive-like behaviors induced by stress could be elicited earlier and kept longer by the activated immunity induced by LPS ip ; 4) The chronic activated immunity induced by LPS icv administration could provoke significant depressive-like behavior, and the depressive-like behaviors induced by stress could be enhanced by icv LPS, LPS and stress had certain interact-sensitization effect on depressive-like behavior； 5) Anti-inflammatory cytokines IL-10 icv reversed the depressive-like behaviors induced by the stress. In conclusion, cytokines play an important role in the depressive-like behavior. Both peripheral and central administration of LPS induced a certain depressive-like behavior and enhanced stress-induced depressive behavior. The anti-inflammatory cytokine IL-10 icv could reverse the depressive-like behaviors induced by the stress. Keywords: lipoposaccharide, depressive-like behavior, anhedonia, locomotion, chronic cold swimming stress

情绪应激对大鼠体液免疫功能的影响及其机制

This study was undertaken to investigate the effect of emotional stress on humoral immunoactivity and to examine whether the sympathetic nervous system was involved in the immunomodulation. In the present study, two types of emotional stressors were used. One was footshock apparatus used to cause the rats which were given footshock before, emotional stressed; the other was an empty water bottle used to cause the rats which were trained to drink water at two set times each day, emotional stressed. The effect of emotional stress on the primary immune function (anti-ovallum antibody level and spleen index), the endocrine response (corticosterone level, epinephrine and norepinephrine level), the behavioral changes (freezing, defecation, grooming and attacking behavior) were investigated. The main results were: 1. Two types of emotional stress significantly increased the level of plasma corticosterone, norepinephrine and epinephrine, as well as freezing, defecation and attacking behavior. 2. Two types of emotional stress significantly decreased the level of anti-ovallum antibody. A negative correlation between catecholamine level (epinephrine and norepinephrine) and antibody level or spleen index was found. 3. β-adrenergic receptor antagonist propranolol could reverse the immunomodulation induced by emotional stress. 4. After two types of emotional stress, c-fos expression was observed in the following brain areas or nucleus; arcuate nucleus, anterior commissure nucleus, diffuse part of dorsalmedial nucleus hypothalamus, lateral dorsal nucleus thalamus, medial nucleus amygdala, solitary nucleus, frontal cortex and cingulum. These brain areas and nucleus are involved in the central modulation of the autonomic nervous system. Taken together, these findings demonstrate that emotional stress can suppress humoral immunity and the activation of the sympathetic nervous system is involved in the humoral immunomodulation induced by emotional stress.