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Nonsteroidal anti-inflammatory drugs before endoscopic ultrasound guided tissue acquisition to reduce the incidence of post procedural pancreatitis
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作者 Mike de Jong Foke van Delft +4 位作者 Christine Roozen Erwin-Jan van Geenen Tanya Bisseling Peter Siersema Marco Bruno 《World Journal of Gastroenterology》 SCIE CAS 2024年第8期811-816,共6页
Endoscopic ultrasound(EUS)with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and auto-immune pancreatitis or to analyze cyst fluid.The most common ... Endoscopic ultrasound(EUS)with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and auto-immune pancreatitis or to analyze cyst fluid.The most common reported adverse event of fine needle aspiration and/or fine needle biopsy is acute pancreatitis,which is likely induced by the same pathophysiological mechanisms as after en-doscopic retrograde cholangiopancreatography(ERCP).According to the current European Society of Gastrointestinal Endoscopy guideline,nonsteroidal anti-inflammatory drugs are administered prior to ERCP as a scientifically proven treatment to reduce post-ERCP pancreatitis incidence rate.A single suppository of diclofenac or indomethacin prior to EUS guided tissue acquisition(TA)is harm-less in healthy adults.Since it is associated with low costs and,most important,may prevent a dreadsome complication,we strongly recommend the adminis-tration of 100 mg diclofenac rectally prior to EUS-TA.We will explain this recom-mendation in more detail in this review as well as the risk and pathophysiology of post-EUS TA pancreatitis. 展开更多
关键词 PANCREATITIS Endoscopic ultrasound Tissue acquisition nonsteroidal antiinflammatory drugs Pancreatic cancer
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Role of nonsteroidal anti-inflammatory drugs in the prevention of post-ERCP pancreatitis:a meta-analysis 被引量:38
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作者 Dai, Hui-Fen Wang, Xiao-Wen Zhao, Kui 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2009年第1期11-16,共6页
BACKGROUND: The role of prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs) for reduction of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) is debated. We performed a meta-analysis of ... BACKGROUND: The role of prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs) for reduction of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) is debated. We performed a meta-analysis of all published randomized controlled trials to evaluate the efficacy of NSAIDs in the prevention of post-ERCP pancreatitis. DATA SOURCES: Searches were conducted in the databases PubMed, EMBASE and the Cochrane Library. Six randomized clinical trials that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed. Data were extracted by two independent observers according to predetermined criteria. RESULTS: The risk of pancreatitis was lower in the NSAID group than in the placebo, group (OR: 0.46, 95% CI: 0.32 to 0.65, P < 0.0001). Two hours after ERCP, prophylactic administration of NSAIDs was associated with a lower serum amylase level (WMD: -91.09,95% CI: -149.78 to -32.40, P=0.002), but there was no difference in mean 24-hour serum amylase values (WMD: -379.00, 95% CI: -805.75 to 47.76, P=0.08). No deaths or NSAID-related complications were noted. CONCLUSIONS: Prophylactic administration of NSAIDs can reduce the incidence of post-ERCP pancreatitis; this administration in patients undergoing ERCP is recommended. Further randomized controlled trials are required before its introduction into routine care. 展开更多
关键词 META-ANALYSIS nonsteroidal anti-inflammatory drugs endoscopic retrograde cholangiopancreatography PANCREATITIS
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Effectiveness of nonsteroidal anti-inflammatory drugs in prevention of post-ERCP pancreatitis:A meta-analysis 被引量:10
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作者 Xiao Li Li-ping Tao Chun-hui Wang 《World Journal of Gastroenterology》 SCIE CAS 2014年第34期12322-12329,共8页
AIM: To investigate the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). METHODS: Two independent reviewers sea... AIM: To investigate the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). METHODS: Two independent reviewers searched Pub Med (1966 to October 2013), Embase (1984 to October 2013) and the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 4, 2013) for relevant randomized controlled trials (RCTs) studying the effectiveness of prophylactic NSAID administration in the prevention of PEP. Using the Cochrane Collaboration Handbook, meta-analyses were conducted to evaluate the overall effect of NSAIDs in preventing the incidences of PEP and moderate to severe pancreatitis. RESULTS: Eight RCTs were identified from the literature search and included 1883 patients that underwent ERCP, with 971 patients in the NSAID group and 912 patients in the placebo group. Sixty-nine out of 971 (7.11%) patients developed PEP in the NSAID group in comparison to 143 out of 912 (15.68%) patients in the placebo group. The pooled RR of PEP incidence with prophylactic NSAID administration was 0.43 (95%CI: 0.33-0.56), which demonstrates that NSAID administration after ERCP significantly reduced the incidence of PEP when compared to the placebo group (P < 0.0001). Subgroup analysis was performed and revealed that the presence (NSAID group) or absence (placebo group) of NSAIDs had no significant effect on the development of moderate to severe pancreatitis (RR = 0.79, 95%CI: 0.52-1.18). Moreover, the administration of NSAIDs as a rectal suppository (RR = 0.35, 95%CI: 0.26-0.48; P < 0.0001) was more effective than oral administration (RR = 0.97, 95%CI: 0.53-1.80) or through infusion (RR = 0.43, 95%CI: 0.12-1.54). CONCLUSION: NSAIDs effectively reduce the incidence of PEP but not of moderate to severe pancreatitis. (C) 2014 Baishideng Publishing Group Inc. All rights reserved. 展开更多
关键词 nonsteroidal anti-inflammatory drugs Post-endoscopic retrograde cholangiopancreatography pancreatitis Randomized controlled trial META-ANALYSIS
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Interaction between Helicobacter pylori infection, nonsteroidal anti-inflammatory drugs and/or low-dose aspirin use: Old question new insights 被引量:8
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作者 Carlos Sostres Carla Jerusalen Gargallo Angel Lanas 《World Journal of Gastroenterology》 SCIE CAS 2014年第28期9439-9450,共12页
Previous reports clearly demonstrated that Helicobacter pylori(H.pylori)infection,nonsteroidal anti-inflammatory drugs(NSAID)or low dose aspirin(ASA)use significantly and independently increased the risk for the devel... Previous reports clearly demonstrated that Helicobacter pylori(H.pylori)infection,nonsteroidal anti-inflammatory drugs(NSAID)or low dose aspirin(ASA)use significantly and independently increased the risk for the development of peptic ulcer disease.Today,the presence of H.pylori infection associated with low dose ASA and/or NSAID use in the same patient is becoming more frequent and therefore the potential interaction between these factors and the consequences of it has important implications.Whether NSAID intake in the presence of H.pylori infection may further increase the risk of peptic ulcer carried by the presence of only one risk factor is still a matter of debate.Studies on the interaction between the two risk factors yielded conflicting data and no consensus has been reached in the last years.In addition,the interaction between H.pylori infection and low-dose ASA remains even more controversial.In real clinical practice,we can find different clinical scenarios involving these three factors associated with the presence of different gastrointestinal and cardiovascular risk factors.These huge variety of possible combinations greatly hinder the decision making process of physicians. 展开更多
关键词 nonsteroidal anti-inflammatory drugs Low dose aspirin Helicobacter pylori infection Helicobacter pylori eradication Peptic ulcer disease
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Inflammatory myofibroblastic tumor successfully treated with chemotherapy and nonsteroidals:A case report 被引量:7
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作者 Yun-Lu Tao Zhen-Jun Wang +1 位作者 Jia-Gang Han Ping Wei 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第47期7100-7103,共4页
Inflammatory myofibroblastic tumor(IMT) occurring at retroperitoneal sites has rarely been reported.We report the case of a previously well 14-year-old girl with no history of abdominal disease whose past medical hist... Inflammatory myofibroblastic tumor(IMT) occurring at retroperitoneal sites has rarely been reported.We report the case of a previously well 14-year-old girl with no history of abdominal disease whose past medical history and family tumor history were unremarkable.She complained of intermittent abdominal pain for one month.An abdominal mass was found on physical examination and abdominal contrast-enhanced computed tomography(CT) showed a hypodense soft mass,the size and location of which suggested a well delineated retroperitoneal tumor surrounding the superior mesenteric vessels measuring 3.3 cm × 4.5 cm × 4.5 cm with enlarged lymph nodes.The patient underwent an exploratory laparotomy followed by biopsy and was subsequently diagnosed with retroperitoneal IMT.She was successfully treated with postoperative chemotherapy and oral diclofenac sodium.Following completion of therapy the mass was no longer palpable and no longer visible on CT scanning.The use of methotrexate and cisplatin for aggressive myofibroblastic tumors is also reviewed. 展开更多
关键词 Inflammatory myofibroblastic tumor RETROPERITONEUM CHEMOTHERAPY nonsteroidals THERAPY
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Characteristics and clinical outcome of nonsteroidal anti-inflammatory drug-induced acute hepato-nephrotoxicity among Chinese patients 被引量:4
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作者 Ya-Li Cao Zhi-Gang Tian +4 位作者 Fang Wang Wen-Ge Li Dan-Ying Cheng Yan-Fang Yang Hong-Mei Gao 《World Journal of Gastroenterology》 SCIE CAS 2014年第38期13956-13965,共10页
AIM: To determine the clinicopathological characteristics of nonsteroidal anti-inflammatory drug (NSAID)-induced acute hepato-nephrotoxicity among Chinese patients.
关键词 nonsteroidal anti-inflammatory drug Hepato-nephrotoxicity Acute interstitial nephritis Acute hepatitis CHOLESTASIS
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Split-dose or hybrid nonsteroidal anti-inflammatory drugs and Nacetylcysteine therapy for prevention of post-retrograde cholangiopancreatography pancreatitis 被引量:3
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作者 Laura Pavel Gheorghe Gh Balan +7 位作者 Alexandra Nicorescu Georgiana Emmanuela Gilca-Blanariu Catalin Sfarti Stefan Chiriac Smaranda Diaconescu Vasile Liviu Drug Gheorghe Balan Gabriela Stefanescu 《World Journal of Clinical Cases》 SCIE 2019年第3期300-310,共11页
BACKGROUND Despite significant technical and training improvements, the incidence of postendoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) has not significantly dropped. Although many studies have... BACKGROUND Despite significant technical and training improvements, the incidence of postendoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) has not significantly dropped. Although many studies have evaluated the efficacy of various agents, e.g. nonsteroidal anti-inflammatory drugs, octreotide,antioxidants, administered via various dosages, routes(oral, intrarectal or parenteral), and schedules(before or after the procedure), the results have been conflicting.AIM To evaluate efficacy of three pharmacologic prophylactic methods for prevention of PEP.METHODS In this prospective, single-center randomized trial, patients who underwent firsttime ERCP for choledocholithiasis were randomly assigned to three groups. The first group received 600 mg N-acetylcysteine 15 min prior to ERCP, and perrectum administration of 50 mg indomethacin both prior to and after completion of the ERCP. The second group was administered only the 50 mg indomethacin per-rectum both prior to and after the ERCP. The third group was administeredper-rectum 100 mg indomethacin only after the ERCP, representing the control group given the guideline-recommended regimen. The primary end-point was PEP prevention.RESULTS Among the total 211 patients evaluated during the study, 186 fulfilled the inclusion criteria and completed the protocol. The percentages of patients who developed PEP in each of the three groups were not significantly different(χ2 =2.793, P = 0.247). Among the acute PEP cases, for all groups, 14 patients developed mild pancreatitis(77.77%) and 4 moderate. No severe cases of PEP occurred, and in all PEP cases the resolution was favorable. No adverse events related to the medications(digestive hemorrhage, rectal irritation, or allergies)occurred.CONCLUSION The efficacies of split-dose indomethacin and combined administration(Nacetylcysteine with indomethacin) for preventing PEP were similar to that of the standard regimen. 展开更多
关键词 Endoscopic retrograde cholangiopancreatography PROPHYLAXIS Postendoscopic retrograde cholangiopancreatography pancreatitis nonsteroidal antiinflammatory drugs N-ACETYLCYSTEINE
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Inhibitory effect of fluvastatin on ileal ulcer formation in rats induced by nonsteroidal antiinflammatory drug 被引量:2
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作者 Mari Hagiwara Keiko Kataoka +3 位作者 Hideki Arimochi Tomomi Kuwahara Haruyuki Nakayama Yoshinari Ohnishi 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第7期1040-1043,共4页
AIM: Nonsteroidal anti-inflammatory drugs (NSAIDs)cause gastrointestinal damage as one of their side effects in humans and experimental animals. Lipid peroxidation plays an important role in NSAID-induced ulceration. ... AIM: Nonsteroidal anti-inflammatory drugs (NSAIDs)cause gastrointestinal damage as one of their side effects in humans and experimental animals. Lipid peroxidation plays an important role in NSAID-induced ulceration. The aim of this study was to investigate the inhibitory effect of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA)reductase inhibitors on the ulceration in small intestines of rats.METHODS: The effects of three HMG-CoA reductase inhibitors, fluvastatin, pravastatin and atorvastatin on ileal ulcer formation in 5-bromo-2-(4-fluorophenyl)-3-(4-methylsulfonylphenyl) thiophene (BFMeT)-treated rats were examined. Antioxidative activity of the inhibitors was measured by a redox-linked colorimetric method.RESULTS: Fluvastatin, which was reported to have antioxidative activity, repressed the ileal ulcer formation in rats treated with BFMeT an NSAIDs. However, the other HMG-CoA reductase inhibitors (pravastatin and atorvastatin)did not repress the ileal ulcer formation. Among these HMG-CoA reductase inhibitors, fluvastatin showed a significantly stronger reducing power than the others(pravastatin, atorvastatin).CONCLUSION: Fluvastatin having the antioxidaitive activity suppresses ulcer formation in rats induced by NSAIDs. 展开更多
关键词 Ileal ulcer FLUVASTATIN HMG-CoA reductase inhibitors nonsteroidal antiinflammatory drug
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Gastric body diaphragm-like stricture as a rare complication of nonsteroidal anti-inflammatory drugs
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作者 Li-Li Wu Yun-Sheng Yang +1 位作者 Feng-Chun Cai Shu-Fang Wang 《World Journal of Gastroenterology》 SCIE CAS 2013年第23期3703-3706,共4页
Increased risk due to nonsteroidal anti-inflammatory drugs (NSAIDs) therapy has been observed in patients. Although diaphragm-like stricture in the small bowel and colon induced by NSAIDs therapy has been rarely repor... Increased risk due to nonsteroidal anti-inflammatory drugs (NSAIDs) therapy has been observed in patients. Although diaphragm-like stricture in the small bowel and colon induced by NSAIDs therapy has been rarely reported, gastric body diaphragm-like stricture has not been reported. We describe the first case of gastric body diaphragm-like stricture due to NSAIDs in a 44-year-old male patient who was successfully treated by an endoscopic approach to avoid complicated surgery. This case highlights new insight into the disadvantages of NSAIDs and provides new data for future clinical studies. 展开更多
关键词 Gastric GASTROSCOPY DIAPHRAGM STRICTURE nonsteroidAL ANTI-INFLAMMATORY drug
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Endoscopic and histopathological evaluation of acute gastric injury in high-dose acetaminophen and nonsteroidal anti-inflammatory drug ingestion with suicidal intent
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作者 Aliye Soylu Can Dolapcioglu +5 位作者 Kemal Dolay Aydin Ciltas Nurgul Yasar Mustafa kalayci Halil Alis Nurten Sever 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第43期6704-6710,共7页
AIM: To evaluate endoscopic and histopathologic aspects of acute gastric injury due to ingestion of high-dose acetaminophen and nonsteroidal antiinflammatory drugs (NSAIDs) with respect to some risk factors and pat... AIM: To evaluate endoscopic and histopathologic aspects of acute gastric injury due to ingestion of high-dose acetaminophen and nonsteroidal antiinflammatory drugs (NSAIDs) with respect to some risk factors and patient characteristics. METHODS: The study group consists of 50 patients admitted to emergency department with high dose analgesic ingestion (group Ⅰ ) with suicidal intent. Thirty patients with or without mild complaints of dyspepsia (group Ⅱ) were selected as the control group. The study group was stratified according to the use of type and number of analgesics. Endoscopic findings were evaluated according to the Lanza score (LS), expressing the severity of the gastroduodenal damage and biopsies according to a scoring system based on histopathologic findings of acute erosive gastritis. RESULTS: Gastroduodenal damage was significantly more severe in group Ⅰ compared to group Ⅱ (P 〈 0.01). The LS was similar in both groups Ⅰ a and Ⅰb. However LS was significantly higher in patients who had ingested multiple NSAIDs (group Ⅰ c) compared to other patients (P 〈 0.01). The LS was correlated to age (P 〈 0.01) and total amount of drug ingested (P 〈 0.05) in group Ⅰ ; but it was not correlated with Helicobacter pylori (H pylori) infection or duration of exposure (P 〉 0.05). The biopsy score (BS) was higher in group Ⅰ than group Ⅱ (P 〈 0.01), and higher in group Ⅰb than group Ⅰa (P 〈 0.05). CONCLUSION: The histopathologic damage was more severe among NSAID ingesting patients compared to those ingesting only acetaminophen and there is no significant difference in the endoscopic findings between the groups. There is no significant difference in the LS between the groups. This lack of significance is remarkable in terms of the gastric effects of highdose acetaminophen. 展开更多
关键词 Acute gastric injury nonsteroidal anti-inflammatory drug ACETAMINOPHEN Endoscopic lesion GASTROSCOPY
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Synthesis and Characterization of Naproxen-Salicylate Derivatives as Potential Dual-Targeted Inhibitors of Dihydrofolate Reductase
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作者 Syon Schlecht Emily Gunderson +1 位作者 Ruthie Fowler Takara Aguilar 《Advances in Biological Chemistry》 CAS 2024年第4期87-102,共16页
Dihydrofolate reductase (DHFR) is an enzyme that catalyzes the reduction of dihydrofolate (DHF) to tetrahydrofolate (THF). Chemotherapy drugs such as methotrexate help to slow the progression of cancer by limiting the... Dihydrofolate reductase (DHFR) is an enzyme that catalyzes the reduction of dihydrofolate (DHF) to tetrahydrofolate (THF). Chemotherapy drugs such as methotrexate help to slow the progression of cancer by limiting the ability of dividing cells to make nucleotides by competitively inhibiting DHFR. Nonsteroidal anti-inflammatory drugs (NSAIDs) have been previously reported to exhibit competitive inhibition of DHFR, in addition to their primary action on cyclooxygenase enzymes. This interaction interferes with the enzymatic reduction of dihydrofolate to tetrahydrofolate, thereby impeding the folate metabolism pathway essential for nucleotide synthesis and cell proliferation. This activity stems from their structural resemblance to the p-aminobenzoyl-l-glutamate (pABG) moiety of folate, a substrate of DHFR. It has been established that NSAIDs containing a salicylate group (which has structural similarities to pABG), such as diflunisal, exhibit stronger DHFR-binding activity. In this study, we synthesized salicylate derivatives of naproxen with the aim of exploring their potential as inhibitors of DHFR. The interactions between these derivatives and human DHFR were characterized using a combination of biochemical, biophysical, and structural methods. Through polyacrylamide gel electrophoresis (PAGE) analysis, enzymatic assays, and quantitative ELISA, we investigated the binding affinity and inhibitory potency of the synthesized salicylate derivatives towards DHFR. The findings of this study suggest the potential of salicylate derivatives of naproxen as promising candidates for the inhibition of DHFR, thereby offering novel therapeutic opportunities for modulating the inflammatory process through multiple pathways. Further optimization of these derivatives could lead to the development of more efficacious dual-targeted analogs with enhanced therapeutic benefits. 展开更多
关键词 Dihydrofolate Reductase DHFR Chemotherapy nonsteroidal Anti-Inflammatory Drugs NSAIDS Folate Metabolism Pathway Anti-Folate Novel Therapeutic Development
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非甾体抗炎药修饰查尔酮衍生物的制备和表征
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作者 李永莲 马晓敏 +4 位作者 杨杰 庄翔智 蔡楚冰 游宗霖 刘文锋 《当代化工研究》 CAS 2024年第3期45-47,共3页
长期服用非甾体抗炎药会给患者带来严重的副作用,如胃肠道出血、心血管疾病等。受查尔酮生物活性多样性的启发,本文以非甾体抗炎药(阿司匹林、布洛芬、萘普生、甲灭酸、氟灭酸、依托度酸、吲哚美辛)和查尔酮为原料,EDCI为缩合剂,DMAP为... 长期服用非甾体抗炎药会给患者带来严重的副作用,如胃肠道出血、心血管疾病等。受查尔酮生物活性多样性的启发,本文以非甾体抗炎药(阿司匹林、布洛芬、萘普生、甲灭酸、氟灭酸、依托度酸、吲哚美辛)和查尔酮为原料,EDCI为缩合剂,DMAP为催化剂,经酯化反应得到7种查尔酮衍生物,产物的收率为67%~86%。 展开更多
关键词 查尔酮 非甾体抗炎药 结构修饰 表征
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可视化针刀辅助非甾体抗炎药治疗颈型颈椎病患者的应用研究 被引量:1
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作者 仵萌 刘春岩 《国际医药卫生导报》 2024年第3期470-474,共5页
目的观察可视化针刀辅助非甾体抗炎药治疗颈型颈椎病的效果及安全性。方法本研究为随机对照试验,选取2022年1月至12月南阳医学高等专科学校第一附属医院收治的106例颈型颈椎病患者作为研究对象,采用随机数字表法分为常规组(53例)和针刀... 目的观察可视化针刀辅助非甾体抗炎药治疗颈型颈椎病的效果及安全性。方法本研究为随机对照试验,选取2022年1月至12月南阳医学高等专科学校第一附属医院收治的106例颈型颈椎病患者作为研究对象,采用随机数字表法分为常规组(53例)和针刀组(53例)。常规组男30例、女23例,年龄(35.44±5.17)岁,予以手法推拿辅助非甾体抗炎药治疗;针刀组男31例、女22例,年龄(36.15±5.22)岁,采用可视化针刀辅助非甾体抗炎药治疗。对比两组患者治疗前后的疼痛缓解情况、颈椎活动度改善情况、颈椎生理结构及功能改善情况、并发症发生情况。统计学方法采用t检验、χ^(2)检验。结果治疗1周、2周、4周后,针刀组的视觉模拟评分法(VAS)评分[(4.55±1.27)分、(3.24±0.38)分、(2.56±0.21)分]均低于常规组[(5.65±2.08)分、(4.41±1.09)分、(3.07±0.46)分],差异均有统计学意义(t=3.286、7.379、7.343,均P<0.05)。治疗后,针刀组的颈椎前屈活动度[(62.41±10.27)°]、后伸活动度[(60.45±10.24)°]、左右旋转活动度[(45.22±10.36)°]均高于常规组[(55.46±10.27)°、(54.33±10.25)°、(39.16±10.21)°],差异均有统计学意义(t=3.484、3.075、3.046,均P<0.05)。治疗后,针刀组的颈椎Cobb角[(18.24±4.41)°]、颈椎曲度[(7.63±2.25)°]、日本骨科协会评估治疗分数(JOA)[(23.36±5.41)分]均高于常规组[(15.45±4.36)°、(6.42±2.07)°、(20.18±5.22)分],差异均有统计学意义(t=3.275、2.881、3.080,均P<0.05)。针刀组治疗相关并发症发生率与常规组比较[11.32%(6/53)比7.55%(4/53)],差异无统计学意义(χ^(2)=0.832,P=0.362)。结论可视化针刀辅助非甾体抗炎药治疗颈型颈椎病能有效缓解患者疼痛,对促进颈椎活动度、生理结构及功能恢复均有积极意义,此疗法未明显增加相关并发症发生风险,安全性较高。 展开更多
关键词 非甾体抗炎药 颈型颈椎病 可视化针刀 颈椎结构 颈椎功能
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干眼症的药物治疗策略及研究进展 被引量:1
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作者 秦红倩 许卉 《中国处方药》 2024年第2期168-170,共3页
干眼症(DED)是一种复杂的多因素疾病,表现出不同的症状,这些症状可影响视觉功能,导致日常生活活动受限,工作效率降低,从而严重影响生活质量。本综述对目前临床上DED的治疗药物以及市场上正在开发的DED治疗策略进行总结,旨在对临床研究... 干眼症(DED)是一种复杂的多因素疾病,表现出不同的症状,这些症状可影响视觉功能,导致日常生活活动受限,工作效率降低,从而严重影响生活质量。本综述对目前临床上DED的治疗药物以及市场上正在开发的DED治疗策略进行总结,旨在对临床研究提供参考。 展开更多
关键词 干眼症 治疗策略 人工泪液 非甾体抗炎药 Tivanisiran IL-1R拮抗剂 EBI-005
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CDK4/6抑制剂联合非甾体芳香化酶抑制剂治疗晚期乳腺癌有效性和安全性的Meta分析
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作者 弓伟华 石瑛 任静静 《河北医科大学学报》 CAS 2024年第6期672-680,共9页
目的 系统评价细胞周期蛋白依赖性激酶(cyclin dependent kinase, CDK)4/6抑制剂联合非甾体芳香化酶抑制剂治疗晚期乳腺癌的有效性与安全性。方法 计算机检索Pubmed、Cochrane图书馆、EMbase、中国知网、万方数据库和维普数据库,以收集C... 目的 系统评价细胞周期蛋白依赖性激酶(cyclin dependent kinase, CDK)4/6抑制剂联合非甾体芳香化酶抑制剂治疗晚期乳腺癌的有效性与安全性。方法 计算机检索Pubmed、Cochrane图书馆、EMbase、中国知网、万方数据库和维普数据库,以收集CDK4/6抑制剂联合非甾体芳香化酶抑制剂治疗晚期乳腺癌的相关文献,检索时限均从建库至2023年02月01日。由2位研究者背对背筛选文献、提取数据并进行偏倚风险评估后,使用Rev Man 5.3软件进行Meta分析。结果 纳入Meta分析的文献有8篇,共2 706例患者。Meta分析结果显示,与安慰剂联合非甾体芳香化酶抑制剂治疗相比,CDK4/6抑制剂联合非甾体芳香化酶抑制剂治疗可延长晚期乳腺癌患者无进展生存期(RR=0.58,95%CI:0.51~0.64,P<0.001)、提高客观缓解率(RR=1.34,95%CI:1.20~1.48,P<0.001)和临床获益率(RR=1.11,95%CI:1.06~1.16,P<0.001)。在安全性方面,CDK4/6抑制剂联合非甾体芳香化酶抑制剂治疗患者的3~4级不良反应发生率较高(RR=2.63,95%CI:2.17~3.19,P<0.001)。其中,试验组白细胞减少、嗜中性粒细胞减少、贫血、乏力、呕吐及腹泻等不良反应发生率高于对照组(P<0.05);2组便秘和头疼的发生率差异无统计学意义(P>0.05)。结论 CDK4/6抑制剂联合非甾体芳香化酶抑制剂治疗可延长晚期乳腺癌患者的无进展生存期、提高客观缓解率和临床获益率,但该方案可能导致3~4级不良反应发生率升高。 展开更多
关键词 乳腺肿瘤 CDK4/6抑制剂 非甾体芳香化酶抑制剂
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NSAIDs对钛片表面成骨细胞增殖及功能活性的影响
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作者 谢孟 莫安春 《陆军军医大学学报》 CAS CSCD 北大核心 2024年第15期1772-1779,共8页
目的通过建立种植体表面成骨模型,研究新型与传统非甾体类抗炎药(nonsteroidal antiinflammatory drugs,NSAIDs)对钛片表面MG-63成骨细胞增殖、形态、粘附、活性和成骨相关基因表达的影响。方法将MG-63成骨细胞接种至大颗粒喷砂酸蚀(san... 目的通过建立种植体表面成骨模型,研究新型与传统非甾体类抗炎药(nonsteroidal antiinflammatory drugs,NSAIDs)对钛片表面MG-63成骨细胞增殖、形态、粘附、活性和成骨相关基因表达的影响。方法将MG-63成骨细胞接种至大颗粒喷砂酸蚀(sand-blasted,largegrit,acid-etched,SLA)钛片表面,建立种植体表面与成骨细胞结合的模型。设置一氧化氮供体型氟比洛芬(NO-氟比洛芬)组、氟比洛芬组与无药物对照组。CCK-8检测细胞增殖能力,扫描电镜观察细胞形态,MTT检测细胞粘附能力,化学法检测碱性磷酸酶(ALP)活性,茜素红染色观察钙化结节,RT-qPCR检测各组成骨细胞ALP、OCN、Runx-2 mRNA表达情况。结果细胞增殖检测结果显示,不同药物浓度组间的细胞增殖数量有统计学差异(P<0.01);NO-氟比洛芬组和氟比洛芬组细胞增殖数量均高于无药物对照组,且NO-氟比洛芬组高于氟比洛芬组,差异均有统计学意义(P<0.01)。扫描电镜观察结果显示,NO-氟比洛芬组成骨细胞最先开始复层生长。细胞粘附检测结果显示,NO-氟比洛芬组细胞粘附数量低于氟比洛芬组和无药物对照组(P<0.01)。ALP活性检测结果显示,NO-氟比洛芬组和氟比洛芬组ALP活性低于无药物对照组(P<0.01)。茜素红染色结果显示,NO-氟比洛芬组及氟比洛芬组实验观察期内未观察到典型的红色深染钙化结节。RT-qPCR分析显示,NO-氟比洛芬组OCN mRNA和氟比洛芬组Runx-2 mRNA表达量高于无药物对照组,ALP mRNA表达量低于无药物对照组(P<0.01)。结论NO-氟比洛芬和氟比洛芬均有效促进钛片表面成骨细胞的增殖能力和部分成骨相关基因表达,NO-氟比洛芬的促进效果更为明显。 展开更多
关键词 非甾体类抗炎药 成骨细胞 种植体周围骨整合
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戊己丸对吲哚美辛诱导大鼠胃溃疡的保护作用研究 被引量:1
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作者 张环 刘文 +6 位作者 伍天苔 李和蓉 金阳 张明 杜华康 王守莉 石惠云 《中华中医药学刊》 CAS 北大核心 2024年第6期129-134,I0019-I0025,共13页
目的 研究戊己丸对吲哚美辛诱导的大鼠胃溃疡的保护作用,并初步探索其可能的作用机制。方法 36只SD大鼠随机分为正常组、模型组、阳性对照组(奥美拉唑,20 mg/kg)、戊己丸低、中、高(2.52、5.04、10.08 g/kg生药量)剂量组,每组6只。各组... 目的 研究戊己丸对吲哚美辛诱导的大鼠胃溃疡的保护作用,并初步探索其可能的作用机制。方法 36只SD大鼠随机分为正常组、模型组、阳性对照组(奥美拉唑,20 mg/kg)、戊己丸低、中、高(2.52、5.04、10.08 g/kg生药量)剂量组,每组6只。各组大鼠灌胃相应药物或0.5%羧甲基纤维素钠(Carboxymethyl Cellulose, CMC-Na)水溶液,1次/d,连续7 d,于末次给药1 h后,除正常组外,其余各组均给予吲哚美辛(60 mg/kg)灌胃造模;6 h后处死大鼠,收集血清和胃组织。通过改良Guth法计算胃溃疡指数和溃疡抑制率,染色观察比较各组大鼠胃组织病理学变化;使用试剂盒测定胃组织中丙二醛(Malonaldehyde, MDA)、超氧化物歧化酶(Superoxide Dismutase, SOD)和环氧合酶1(Cyclooxygenase-1,COX-1),血清中一氧化氮(Nitric Oxide, NO)、肿瘤坏死因子(Tumor Necrosis Factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)和白细胞介素-10(Interleukin-10,IL-10)的含量;TUNEL染色法比较各组大鼠胃组织细胞凋亡情况;免疫组化法测定胃组织中环氧合酶2(Cyclooxygenase-2,COX-2)、NF-κB(p65)蛋白的表达水平。结果 与正常组相比,模型组大鼠胃组织黏膜层、黏膜下层、肌层及浆膜部分结构受损,胃溃疡指数和胃组织细胞凋亡百分比显著升高(P<0.01);MDA、TNF-α、IL-6水平显著升高(P<0.01),COX-1、NO、IL-10和SOD水平显著降低(P<0.01);COX-2和NF-κB(p65)蛋白表达显著升高(P<0.01);与模型组相比,各给药组均能改善胃组织损伤状况;戊己丸中、高剂量组和奥美拉唑组均能显著降低(P<0.01)胃溃疡指数和升高溃疡抑制率,升高COX-1、NO、IL-10水平,降低MDA、COX-2、TNF-α、IL-6和NF-κB(p65)水平,各给药组均明显降低大鼠胃组织细胞凋亡百分比,其中戊己丸中剂量组表现出良好的作用。结论 戊己丸对吲哚美辛诱导的大鼠胃溃疡有明显的保护作用,其作用机制可能与改善氧化应激抑制、炎症反应和减少细胞凋亡有关。 展开更多
关键词 戊己丸 胃溃疡 吲哚美辛 非甾体抗炎药
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433例非甾体抗炎药物不良反应报告分析 被引量:2
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作者 王丽 于文雯 +3 位作者 郭瑞惠 李敏 曹广生 戚迎梅 《中国医药指南》 2024年第9期121-124,共4页
目的通过对非甾体抗炎药物(NSAIDs)致药品不良反应(ADRs)进行分析,了解NSAIDs致ADRs发生特点,为临床合理安全用药作参考。方法收集2022年10月1日至2023年9月30日,国家药品不良反应监测系统接收的济南市范围内的所有NSAIDs相关ADRs报告,... 目的通过对非甾体抗炎药物(NSAIDs)致药品不良反应(ADRs)进行分析,了解NSAIDs致ADRs发生特点,为临床合理安全用药作参考。方法收集2022年10月1日至2023年9月30日,国家药品不良反应监测系统接收的济南市范围内的所有NSAIDs相关ADRs报告,共计535例;剔除药品等相关信息不详报告,最终433例纳入统计分析,对报告一般情况、性别和年龄、NSAIDs类别、ADR发生时间、给药途径以及ADRs累及系统/器官和临床表现等进行统计分析。结果NSAIDs所致ADRs患者中,一般报告379例;严重ADR报告54例,转归情况大部分为痊愈或好转;男女性别比为1∶1.23,多发生于≥60岁人群(66.7%);NSAIDs涉及乙酸类(24.2%)、丙酸类(22.2%)、甲酸类(21.5%)等十大类别:ADRs发生时间≤1天(264例,61.0%);给药途径以口服(256例,59.1%)和静脉(133例,30.7%)为主。433例ADRs报告中累及多个系统/器官,共计551例次,其中排名前3位分别为胃肠系统(310,56.3%)、皮肤及其附件(122,22.1%)和视觉障碍(25,8.7%);54例严重报告累及多个系统/器官共计76例次,主要累及皮肤及其附件系统(40,52.6%)、胃肠系统(14,18.4%)和泌尿系统(4,5.3%),临床表现主要以皮疹、瘙痒、呕吐等为主。结论NSAIDs在临床上使用广泛,会导致不同程度ADRs,临床中应合理用药,确保用药安全。 展开更多
关键词 非甾体抗炎药物 自发报告 药品不良反应 合理用药
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CYP2C9和COX-2基因多态性对非甾体类抗炎药治疗强直性脊柱炎临床疗效的影响
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作者 杨鑫 皮文杰 +3 位作者 王利元 毕德利 李涛 李素铠 《颈腰痛杂志》 2024年第4期616-621,共6页
目的探讨细胞色素P450同工酶2C9(CYP2C9)和环氧化酶-2(COX-2)基因多态性对非甾体类抗炎药治疗强直性脊柱炎(AS)临床疗效的影响。方法选择2020年1月至2021年6月在该院就诊的117例AS患者作为观察组;根据“性别相同、年龄±1岁”的原则... 目的探讨细胞色素P450同工酶2C9(CYP2C9)和环氧化酶-2(COX-2)基因多态性对非甾体类抗炎药治疗强直性脊柱炎(AS)临床疗效的影响。方法选择2020年1月至2021年6月在该院就诊的117例AS患者作为观察组;根据“性别相同、年龄±1岁”的原则,选择同期在该院健康体检的受试者作为117例作为对照组。观察两组受试者CYP2C9*3和COX-2基因启动子区域中的1190A/G和-1195G/A基因多态性,观察AS患者治疗前后的临床资料变化,观察CYP2C9*3、COX-2-1190A/G、COX-2-1195G/A等不同基因型AS患者基于ASAS20改善标准和ASAS40改善标准的疗效是否存在差异。结果两组受试者CYP2C9*3基因型和等位基因频率差异均无统计学意义(P>0.05)。两组受试者COX-2-1290A/G基因型和等位基因频率以及COX-2-1195G/A基因型和等位基因频率的差异均存在统计学意义(P<0.05)。治疗后,AS患者晨僵持续时间、周围关节受累、指地距、枕墙距、Schober测试、ESR、CRP、BASDAI(VAS)、BASDAI≥4、BASFI(VAS)、总体评价(VAS)等指标数值均较治疗前显著降低,差异均有统计学意义(P<0.05)。117例患者中,有68例(58.12%)符合ASAS20改善标准,30例(25.64%)符合ASAS40改善标准。不同CYP2C9*3基因型(AA、AC+CC)之间的ASAS20、ASAS40改善情况差异均无统计学意义(P>0.05);不同COX-2-1290A/G基因型之间的ASAS20、ASAS40改善情况差异存在统计学意义(P<0.05),其中AA基因型患者的ASAS20和ASAS40改善率均显著高于AG+GG基因型患者(P<0.05);不同COX-2-1195G/A基因型之间的ASAS20、ASAS40改善情况差异存在统计学意义(P<0.05),其中GG+AA基因型的ASAS20和ASAS40改善率显著高于GG患者(P<0.05)。结论COX-2-1290A/G和COX-2-1195G/A多态性可增加AS患者预后不良的风险,可能是预测非甾体类抗炎药治疗AS疗效的生物学指标,而CYP2C9*3多态性与非甾体类抗炎药治疗AS疗效的关系尚有待进一步研究。 展开更多
关键词 强直性脊柱炎 非甾体类抗炎药 环氧化酶 细胞色素P450同工酶2C9 基因多态性
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老年胃溃疡出血患者再发出血的危险因素分析 被引量:2
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作者 卞卡 张巍巍 《中国烧伤创疡杂志》 2024年第1期62-65,共4页
目的探讨分析老年胃溃疡出血患者再发出血的相关危险因素。方法选取2020年3月至2022年3月许昌市中心医院收治的140例老年胃溃疡出血患者作为研究对象,收集患者性别、年龄、发病部位、胃溃疡长径、出血活动度、是否为胃溃疡A1期、是否合... 目的探讨分析老年胃溃疡出血患者再发出血的相关危险因素。方法选取2020年3月至2022年3月许昌市中心医院收治的140例老年胃溃疡出血患者作为研究对象,收集患者性别、年龄、发病部位、胃溃疡长径、出血活动度、是否为胃溃疡A1期、是否合并幽门螺杆菌(Hp)感染、有无吸烟史、有无饮酒史、合并其他慢性疾病种类(≤2种、>2种)、是否进行消化内镜治疗、是否长期使用非甾体抗炎药(NSAIDs)等资料,并根据患者止血成功后1个月内是否再发出血将患者分为发生组与未发生组。多因素Logistic回归分析老年胃溃疡出血患者再发出血的危险因素。结果140例老年胃溃疡出血患者均于止血成功后随访1个月,随访过程中21例(150%)患者再发出血,设为发生组;119例(850%)患者未再发出血,设为未发生组。单因素分析结果显示,发生组胃溃疡A1期、Hp感染、未进行消化内镜治疗、长期使用NSAIDs的患者比例均明显高于未发生组(χ^(2)=4269、7381、7580、11836,P=0039、0007、0006、0001);多因素Logistic回归分析结果显示,胃溃疡A1期、Hp感染、未进行消化内镜治疗、长期使用NSAIDs是老年胃溃疡出血患者再发出血的独立危险因素(95%CI为1039~9660、1909~58707、0059~0585、1880~18559,P=0043、0007、0004、0002)。结论胃溃疡A1期、Hp感染、未进行消化内镜治疗、长期使用NSAIDs是老年胃溃疡出血患者再发出血的独立危险因素,临床应根据患者具体情况制定针对性干预措施,以降低再出血发生风险。 展开更多
关键词 胃溃疡出血 老年 再出血 消化内镜治疗 幽门螺杆菌 非甾体抗炎药 危险因素
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