AIM: To evaluate the opioid-sparing effect of selective cyclooxygenase-2(COX-2) inhibitors on short-term surgical outcomes after open colorectal surgery.METHODS: Patients undergoing open colorectal resection within an...AIM: To evaluate the opioid-sparing effect of selective cyclooxygenase-2(COX-2) inhibitors on short-term surgical outcomes after open colorectal surgery.METHODS: Patients undergoing open colorectal resection within an enhanced recovery after surgery protocol from 2011 to 2015 were reviewed. Patients with combined general anesthesia and epidural anesthesia, and those with acute colonic obstruction or perforation were excluded. Patients receiving selective COX-2 inhibitor were compared with well-matched individuals without such a drug. Outcome measures included numeric pain score and morphine milligram equivalent(MME) consumption on postoperative day(POD) 1-3, gastrointestinal recovery(time to tolerate solid diet and time to defecate), complications and length of postoperative stay.RESULTS: There were 75 patients in each group. Pain score on POD 1-3 was not significantly different between two groups. However, MME consumption and MME consumption per kilogram body weight on POD 1-3 was significantly less in patients receiving a selective COX-2 inhibitor(P < 0.001). Median MME consumption per kilogram body weight on POD 1-3 was 0.09, 0.06 and nil, respectively in patients receiving a selective COX-2 inhibitor and 0.22, 0.25 and 0.07, respectively in the comparative group(P < 0.001), representing at least 59% opioidreduction. Patients prescribing a selective COX-2 inhibitor had a shorter median time to resumption of solid diet [1(IQR 1-2) d vs 2(IQR 2-3) d; P < 0.001] and time to first defecation [2(IQR 2-3) d vs 3(IQR 3-4) d; P < 0.001]. There was no significant difference in overall postoperative complications between two groups. However, median postoperative stay was significantly 1-d shorter in patients prescribing a selective COX-2 inhibitor [4(IQR 3-5) d vs 5(IQR 4-6) d; P < 0.001]. CONCLUSION: Perioperative administration of oral selective COX-2 inhibitors significantly decreased intravenous opioid consumption, shortened time to gastrointestinal recovery and reduced hospital stay after open colorectal surgery.展开更多
The discovery of COX-2 provides a novel target developing more effective NSAIDs with fewer side effects. On the basis of results from the structure-activity relationships (SAR) of selective COX-2 inhibitors, we have d...The discovery of COX-2 provides a novel target developing more effective NSAIDs with fewer side effects. On the basis of results from the structure-activity relationships (SAR) of selective COX-2 inhibitors, we have designed and synthesized some promising compounds.展开更多
Objective:To explore the new treatment strategies for radiation proctitis,which is the most common complication of pelvic tumor malignancies.Methods:Four cases of patients with severe radiation proctitis were treated ...Objective:To explore the new treatment strategies for radiation proctitis,which is the most common complication of pelvic tumor malignancies.Methods:Four cases of patients with severe radiation proctitis were treated with high-dosage vitamin C(VC,12–24 g/d,iv)combined with cyclooxygenase-2(cyclooxygenase-2,COX-2)inhibitors.Results:For these four cases,the diarrhea,hematochezia,tenesmus,pain,and other symptoms were significantly improved.The edema of the rectal wall is also significantly improved in the imaging review.Conclusion:The high-dosage VC combined with the treatment of severe radiation proctitis is safe and effective.展开更多
Selective cyclooxygenase （COX）-2 inhibitors （coxibs） were developed as one of the anti-inflammatory drugs to avoid the various side effects of non-steroidal anti-inflammatory drugs （NSAIDs）. However, coxibs also...Selective cyclooxygenase （COX）-2 inhibitors （coxibs） were developed as one of the anti-inflammatory drugs to avoid the various side effects of non-steroidal anti-inflammatory drugs （NSAIDs）. However, coxibs also have an ability to inhibit tumor development of various kinds the same way that NSAIDs do. Many experimental studies using cell lines and animal models demonstrated an ability to prevent tumor proliferation of COX-2 inhibitors. After performing a randomized study for polyp chemoprevention study in patients with familial adenomatous polyposis （FAP）, which showed that the treatment with celecoxib, one of the coxibs, significantly reduced the number of colorectal polyps in 2000, the U.S. Food and Drug Administration （FDA） immediately approved the clinical use of celecoxib for FAP patients. However, some coxibs were recently reported to increase the risk of serious cardiovascular events including heart attack and stroke. In this article we review a role of COX-2 in carcinogenesis of gastrointestinal tract, such as the esophagus, stomach and colorectum, and also analyze the prospect of coxibs for chemoprevention of gastrointestinal tract tumors.展开更多
This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse ...This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.展开更多
目的探讨前列地尔联合艾塞那肽对2型糖尿病患者的疗效及对血清脂肪特异性丝氨酸蛋白内抑制剂(vaspin)和内抑素(NES)的影响。方法选取130例糖尿病患者,随机均分为观察组和对照组,每组65例。对照组给予艾塞那肽治疗,观察组给予艾塞那肽联...目的探讨前列地尔联合艾塞那肽对2型糖尿病患者的疗效及对血清脂肪特异性丝氨酸蛋白内抑制剂(vaspin)和内抑素(NES)的影响。方法选取130例糖尿病患者,随机均分为观察组和对照组,每组65例。对照组给予艾塞那肽治疗,观察组给予艾塞那肽联合前列地尔治疗,治疗2周后观察2组患者的生化功能、血管功能、肾功能及血清Vaspin和NES水平。结果治疗前2组患者的生化功能、血管功能、肾功能及血清vaspin和NES水平比较差异无统计学意义,治疗后2组患者的空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1C)、体质量指数(BMI)、空腹C肽、餐后2 h C肽、三酰甘油(TG)和总胆固醇(TC)均显著下降,观察组下降更显著(P<0.05);治疗后2组患者的尿总蛋白、尿素氮(BUN)和血肌酐(SCr)均显著下降,观察组下降更显著(P<0.05);治疗后2组患者的收缩期血管峰值血流速度(PSV)和内膜中层厚度(IMT)均降低,且观察组下降更显著,狭窄率均升高,且观察组升高更显著(P<0.05);治疗后2组患者的血清vaspin和NES水平均显著升高,且观察组升高更显著(P<0.05);2组患者均未出现严重的不良反应。结论前列地尔联合艾塞那肽治疗2型糖尿病患者的效果较好,可有效控制血糖,显著升高血清vaspin、NES水平,改善患者的血管功能、肾功能,降低糖尿病的并发症发生率。展开更多
文摘AIM: To evaluate the opioid-sparing effect of selective cyclooxygenase-2(COX-2) inhibitors on short-term surgical outcomes after open colorectal surgery.METHODS: Patients undergoing open colorectal resection within an enhanced recovery after surgery protocol from 2011 to 2015 were reviewed. Patients with combined general anesthesia and epidural anesthesia, and those with acute colonic obstruction or perforation were excluded. Patients receiving selective COX-2 inhibitor were compared with well-matched individuals without such a drug. Outcome measures included numeric pain score and morphine milligram equivalent(MME) consumption on postoperative day(POD) 1-3, gastrointestinal recovery(time to tolerate solid diet and time to defecate), complications and length of postoperative stay.RESULTS: There were 75 patients in each group. Pain score on POD 1-3 was not significantly different between two groups. However, MME consumption and MME consumption per kilogram body weight on POD 1-3 was significantly less in patients receiving a selective COX-2 inhibitor(P < 0.001). Median MME consumption per kilogram body weight on POD 1-3 was 0.09, 0.06 and nil, respectively in patients receiving a selective COX-2 inhibitor and 0.22, 0.25 and 0.07, respectively in the comparative group(P < 0.001), representing at least 59% opioidreduction. Patients prescribing a selective COX-2 inhibitor had a shorter median time to resumption of solid diet [1(IQR 1-2) d vs 2(IQR 2-3) d; P < 0.001] and time to first defecation [2(IQR 2-3) d vs 3(IQR 3-4) d; P < 0.001]. There was no significant difference in overall postoperative complications between two groups. However, median postoperative stay was significantly 1-d shorter in patients prescribing a selective COX-2 inhibitor [4(IQR 3-5) d vs 5(IQR 4-6) d; P < 0.001]. CONCLUSION: Perioperative administration of oral selective COX-2 inhibitors significantly decreased intravenous opioid consumption, shortened time to gastrointestinal recovery and reduced hospital stay after open colorectal surgery.
文摘The discovery of COX-2 provides a novel target developing more effective NSAIDs with fewer side effects. On the basis of results from the structure-activity relationships (SAR) of selective COX-2 inhibitors, we have designed and synthesized some promising compounds.
基金Leading Discipline Construction Support Project(Oncology),Zhongnan Hospital of Wuhan University(XKJS202005),China.
文摘Objective:To explore the new treatment strategies for radiation proctitis,which is the most common complication of pelvic tumor malignancies.Methods:Four cases of patients with severe radiation proctitis were treated with high-dosage vitamin C(VC,12–24 g/d,iv)combined with cyclooxygenase-2(cyclooxygenase-2,COX-2)inhibitors.Results:For these four cases,the diarrhea,hematochezia,tenesmus,pain,and other symptoms were significantly improved.The edema of the rectal wall is also significantly improved in the imaging review.Conclusion:The high-dosage VC combined with the treatment of severe radiation proctitis is safe and effective.
文摘Selective cyclooxygenase （COX）-2 inhibitors （coxibs） were developed as one of the anti-inflammatory drugs to avoid the various side effects of non-steroidal anti-inflammatory drugs （NSAIDs）. However, coxibs also have an ability to inhibit tumor development of various kinds the same way that NSAIDs do. Many experimental studies using cell lines and animal models demonstrated an ability to prevent tumor proliferation of COX-2 inhibitors. After performing a randomized study for polyp chemoprevention study in patients with familial adenomatous polyposis （FAP）, which showed that the treatment with celecoxib, one of the coxibs, significantly reduced the number of colorectal polyps in 2000, the U.S. Food and Drug Administration （FDA） immediately approved the clinical use of celecoxib for FAP patients. However, some coxibs were recently reported to increase the risk of serious cardiovascular events including heart attack and stroke. In this article we review a role of COX-2 in carcinogenesis of gastrointestinal tract, such as the esophagus, stomach and colorectum, and also analyze the prospect of coxibs for chemoprevention of gastrointestinal tract tumors.
文摘This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.
文摘目的探讨前列地尔联合艾塞那肽对2型糖尿病患者的疗效及对血清脂肪特异性丝氨酸蛋白内抑制剂(vaspin)和内抑素(NES)的影响。方法选取130例糖尿病患者,随机均分为观察组和对照组,每组65例。对照组给予艾塞那肽治疗,观察组给予艾塞那肽联合前列地尔治疗,治疗2周后观察2组患者的生化功能、血管功能、肾功能及血清Vaspin和NES水平。结果治疗前2组患者的生化功能、血管功能、肾功能及血清vaspin和NES水平比较差异无统计学意义,治疗后2组患者的空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1C)、体质量指数(BMI)、空腹C肽、餐后2 h C肽、三酰甘油(TG)和总胆固醇(TC)均显著下降,观察组下降更显著(P<0.05);治疗后2组患者的尿总蛋白、尿素氮(BUN)和血肌酐(SCr)均显著下降,观察组下降更显著(P<0.05);治疗后2组患者的收缩期血管峰值血流速度(PSV)和内膜中层厚度(IMT)均降低,且观察组下降更显著,狭窄率均升高,且观察组升高更显著(P<0.05);治疗后2组患者的血清vaspin和NES水平均显著升高,且观察组升高更显著(P<0.05);2组患者均未出现严重的不良反应。结论前列地尔联合艾塞那肽治疗2型糖尿病患者的效果较好,可有效控制血糖,显著升高血清vaspin、NES水平,改善患者的血管功能、肾功能,降低糖尿病的并发症发生率。
