Increased density of tumor-associated lymphatic vessels correlates with poor patient survival in melanoma and other cancers, yet lymphatic drainage is essential for initiating an immune response. Here we asked whether and how lymphatic vessel density (LVD) correlates with immune cell infiltration in primary tumors and lymph nodes (LNs) from patients with cutaneous melanoma. Using immunohistochemistry and quantitative image analysis, we found significant positive correlations between LVD and CD8+ T cell infiltration as well as expression of the immunosuppressive molecules inducible nitric oxide synthase (iNOS) and 2,3-dioxygénase (IDO). Interestingly, similar associations were seen in tumor-free LNs adjacent to metastatic ones, indicating loco-regional effects of tumors. Our data suggest that lymphatic vessels play multiple roles at tumor sites and LNs, promoting both T cell infiltration and adaptive immunosuppressive mechanisms. Lymph vessel associated T cell infiltration may increase immunotherapy success rates provided that the treatment overcomes adaptive immune resistance.
The study aims to evaluate the effectiveness of different durations of aerobic exercise on hypertensive patients. Four electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) were searched from their inception until July 2018. English publications and randomized controlled trials involving aerobic exercise treatment for hypertensive population were included. Two reviewers independently extracted the data. The Cochrane's Risk of Bias tool was used to assess the quality of included studies. In this systematic review, a total of 14 articles were included, involving 860 participants. The quality of the included studies ranged from moderate to high. The results of the meta‐analysis showed that compared with the control group, significant effects of aerobic exercise were observed on reducing systolic blood pressure (SBP) (mean difference [MD] = −12.26 mm Hg, 95% confidence interval [CI] = −15.17 to −9.34, P < 0.05), diastolic blood pressure (DBP; MD = −6.12 mm Hg, 95% CI = −7.76 to −4.48, P < 0.05), and heart rate (MD = −4.96 bpm, 95% CI = −6.46 to −3.43, P < 0.05). In addition, significant reductions were observed in ambulatory DBP (MD = −4.90 mm Hg, 95% CI = −8.55 to −1.25, P < 0.05) and ambulatory SBP (MD = −8.77mm Hg, 95% CI = −13.97 to −3.57, P < 0.05). Therefore, aerobic exercise might be an effective treatment for blood pressure improvement in hypertensive patients. However, the effectiveness between the duration of different treatment needs to be well‐designed and rigorous studies will be required to verify the dataset.
Aims
To assess the effectiveness of music therapy on the quality of life, anxiety, depression and pain of patients with cancer.
Design
Systematic review.
Data Sources
Five electronic databases were searched in September 2018 for randomized controlled trials evaluating music therapy for patients with cancer.
Review Methods
The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook Version 5.1.0 and the Revman version 5.3 software was used to perform the meta‐analysis. The outcomes were overall quality of life, anxiety, depression and pain.
Results
A total of 19 trials evaluating 1,548 patients were included in this study, of which 765 were in the control group and 783 in the experimental group. Compared with standard care, music therapy can significantly increase the score of the overall quality of life in patients with cancer. In addition, music therapy was found to be more effective for decreasing the score of anxiety, depression and pain.
Conclusion
Music therapy can improve the overall quality of life of patients with cancer, with an observed optimal intervention duration of 1–2 months. Meanwhile, anxiety, depression and pain are improved as well. Nevertheless, high‐quality trials are still needed to further determine the effects of music intervention in supportive cancer care.
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