IL-2 and IFN- can significantly induce NK cells to produce and enhance antitumor activity,[29] and low concentration of these cells in cervical cancer has been shown to predict severe disease.[30] IL-4 has the effect of inhibiting the growth of breast tumors.[31] Therefore, the increase in the content of Isavuconazole IL-2, IL-4, and IFN- may have a positive effect on the immune function and prognosis of cancer patients. which did not involve any interest of cancer patients, so the ethical review is not necessary. 2.2. Search strategy A systematic computer-based literature search was conducted using relevant databases, including the Cochrane Library, EMBASE, PubMed, Web of Science, Chinese Biomedical Literature Database, Chinese Journal Full-Text Database, VIP Database, and Wanfang Database. We used the following search terms: cancer or tumor or tumors or tumours Rabbit polyclonal to CDKN2A or carcinoma or neoplasm or neoplasms or oncology or oncological; and psychological or psychology or emotion or psychotherapy; and recovery or reduce or therapy or treatment or therapeutical or support or counsel; and immune or immunology; and immunological and random controlled trials or random. 2.3. Study selection and data extraction After eliminating duplicates using EndNote X7, the title, keywords, abstracts, and contents of all the articles retrieved were independently screened by two reviewers to check if they met the inclusion criteria. If there was any disagreement or doubt about potentially relevant articles, three reviewers jointly decided whether or not the study should be included in this review. Two independent reviewers extracted the data from each study, including authors, year of publication, type and stage of cancer, size of sample, mean patient age, intervention method, type of adjuvant treatment, duration of intervention, and immune outcome. 2.4. Data analysis/synthesis We used Review Manager 5.3 (Cochrane Collaboration, Oxford, United Kingdom) for the meta-analysis. Since the parameters for the measurement of immune status were continuous data, the mean and standard deviation were used to collate the results of the studies. Heterogeneity was tested for all combined results by means of a statistic (calculated using a chi-square test), and inconsistency was calculated using an em I /em 2 index to determine the impact of heterogeneity. The presence of significant heterogeneity suggests diversity in the various characteristics of the studies, including stage of disease, age, diagnosis, gender, setting, intervention time, and type of assay. When the heterogeneity Isavuconazole test was not statistically significant ( em I /em 2? ?60%, em P /em ? ?.05), a fixed model was used; otherwise, a random effect model or subgroup analysis was used. However, when the heterogeneity of a subgroup analysis was still high ( em I /em 2? ?60%, em P /em ? ?.05), the random effect model was used. 2.5. Literature quality analysis Two independent reviewers assessed the internal validity of the studies using Cochrane Collaboration’s tool (CCT) for assessing risk of bias Any disagreements were resolved by consultation with a third reviewer. The CCT[11] is an effective instrument for the evaluation of the internal validity of randomized controlled Isavuconazole trials. The quality of a study was classified as strong, moderate, or weak on the basis of the following six domains: 1. selection bias: random sequence generation and allocation concealment; 2. performance bias: blinding of participants and personnel; 3. detection bias: blinding of outcome assessment; 4. attrition bias: incomplete outcome data; 5. reporting bias: selective outcome reporting; and 6. other bias. If the study was without bias, it was considered to be of high quality; if there was some literature bias, it was deemed to be of moderate quality; and if there was evidence of all types of bias, the study was classified as being of poor quality. 3.?Results 3.1. Study selection After removal of duplicates using EndNote X7, and screened for title and their data abstracted by the inclusion criteria, 29 publications were finally included in this review (Fig. ?(Fig.11). Open in a separate window Figure 1 Flow chart of the study selection process. Study characteristics, publication bias, and quality of studies Twenty-nine studies were included in the meta-analysis, including 17 English studies and 12 Chinese studies. In all studies, the cytokine concentrations were reported.