OBJECTIVETo assess the effect of perioperative administration of a selective cyclooxygenase 2 inhibitor (celecoxib) on pain management and recovery of function after total knee arthroplasty (TKA).

METHODSRandomized, controlled trial conducted from January 2005 through February 2006, 60 patients underwent TKA for osteoarthritis or rheumatoid arthritis were randomly divided into group of perioperative, administration of celecoxib (Study group, n = 30) and postoperative administration of celecoxib (Control group, n = 30). Patients in Study group were given oral celecoxib 3 d before TKA, 200 mg twice daily, and extended to 5 d postoperatively; patients in Control group were given oral celecoxib 2 h after TKA, 200 mg twice daily, and extended to 5 d postoperatively. All operations were finished by the same surgeon group.

RESULTSThe postoperative patient-controlled analgesia (PCA) consumption was significantly less in Study group than in Control group [(43 +/- 12) ml vs. (53 +/- 12) ml, P < 0.05]. The pain scores of postoperative 4, 8, 12 h, 1, 2 d in Study group were 6.1 +/- 1.2, 5.0 +/- 1.3, 4.3 +/- 1.1, 3.4 +/- 1.2, significantly less than in Control group (P < 0.05); There were no intergroup significant differences in the pain scores of postoperative 3, 4, 5 d (P > 0.05). There were no intergroup significant differences in respect to the side-effect occurrence, operation time and postoperative drainage, postoperative analgesic consumption (P > 0.05). The time to achieve 90 degrees knee flexion was significantly shorter in Study group than in Control group [(6.2 +/- 1.7) d vs. (8.6 +/- 1.8) d, P < 0.05].

CONCLUSIONSPerioperative administration of the selective Celecoxib holds the effect of preemptive analgesia. Compared with postoperative administration, perioperative administration of celecoxib can alleviate the early postoperative pain score, reduce the consumption of postoperative analgesic, accelerate the recovery of joint motion and thus increase the patient satisfaction.

Aged ; Arthroplasty, Replacement, Knee ; Celecoxib ; Cyclooxygenase 2 Inhibitors ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Pain, Postoperative ; drug therapy ; Perioperative Care ; Pyrazoles ; administration & dosage ; Sulfonamides ; administration & dosage

OBJEVTIVETo evaluate the therapeutic effects of different therapeutic regimens for non-small-cell lung cancer (NSCLC) with or without EML4-ALK rearrangement.

METHODSTwenty-one ALK-positive and 50 ALK-negative NSCLC patients who received voluntarily EML4-ALK testing and 75 NSCLC patients without AL testing were enrolled in this study. The 3 groups of patients received different treatments, and the therapeutic effects, progression-free survival (PFS), and treatment-related adverse events were analyzed.

RESULTSCrizotinib treatment obviously prolonged the PFS in EML4-ALK-positive patients with an objective response rate (OOR) of 61.9% and a median response duration of 16 months, which were significantly better than those in with ALK-negative patients and patients without ALK testing who received different second-line therapies.

CONCLUSIONCrizotinib is superior to platinum-based chemotherapy in NSCLC patients with ALK rearrangement. ALK rearrangement id not a modifier of the effect of chemotherapy regimens in NSCLC patients.

Carcinoma, Non-Small-Cell Lung ; drug therapy ; Disease-Free Survival ; Humans ; Lung Neoplasms ; drug therapy ; Oncogene Proteins, Fusion ; Pyrazoles ; administration & dosage ; therapeutic use ; Pyridines ; administration & dosage ; therapeutic use

BACKGROUNDMultimodal cocktail periarticular injection (MCPI) with a large volume of low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or steroids have shown good pain control and improvement in range of motion after surgery. This study compares the efficacy of pain control after total knee arthroplasty, using multimodal cocktail periarticular injection with steroid or without steroid.

METHODSThis is a prospective, double-blinded, randomized and control study. Seventy-two patients with osteoarthritis that met clinical criteria for total knee arthroplasty were recruited into the study, and were randomized to receive either multimodal cocktail periarticular injection with steroid or without steroid. Pain was assessed by visual analogue scale (VAS) at preoperative and postoperative at rest, and during activity. The range of motion was recorded preoperatively and postoperatively. The amount of daily and cumulative morphine consumption were measured by patient-controlled analgesia in the first 72 hours postoperatively. The duration of celecoxib usage was also recorded at the last follow-up.

RESULTSThere were no differences between the non-steroid and steroid groups with regard to VAS at rest and during activity, or range of motion, at any postoperative observation time. The postoperative Knee Society Knee Score in the steroid group improved significantly as compared with that in non-steroid group at the one-month (84.1±13.1 and 65.9±12.1; P < 0.0045), three-month follow-up (90.2±16.3 and 72.5±16.6; P < 0.0027), but after postoperative six-month the Knee Society Knee Score showed no significant difference between the groups. There was no significant difference in consumption of the morphine about daily or total consumption within 72 hours between the two groups. The duration of celecoxib usage in patients in the steroid group was significantly shorter than that in the non-steroid group ((7.2±0.7) compared with (10.5±1.9) weeks; P = 0.012).

CONCLUSIONThe patients who received the steroid injection had faster rehabilitation and less non-steroidal antiinflammatory drugs consumption.

Aged ; Arthroplasty, Replacement, Knee ; methods ; Celecoxib ; Cyclooxygenase 2 Inhibitors ; administration & dosage ; therapeutic use ; Female ; Humans ; Injections, Intra-Articular ; Male ; Pain Measurement ; Pyrazoles ; administration & dosage ; therapeutic use ; Steroids ; administration & dosage ; therapeutic use ; Sulfonamides ; administration & dosage ; therapeutic use

There have been many advances in obesity treatment, including life-style modification and pharmacological and surgical treatments. It seems that the most remarkable advances in obesity treatment are those of pharmacological strategies. However, weight loss medications have a long history of development. The FDA has withdrawn anti-obesity drugs such as fenfluramine, dexfenfluramine, and phenylpropylamine due to unwanted side effects. Sibutramine was voluntarily withdrawn from the market, and new drugs such as rimonabant have been suspended in the middle of clinical study due to unacceptable side effects. Last year, the FDA approved two new anti-obesity drugs for the treatment of obesity. Lorcaserin is a selective 5-hydroxytryptamine receptor 2c (5-HT2c) agonist whose pharmacological mechanism of action is similar to those of fenfluramine and dexfenfluramine. However, lorcaserin is specific for 5-HT2c, which is located almost exclusively in the CNS and is not found on heart valves. Three exciting phase 3 clinical trials for lorcaserin have been published recently. Lorcaserin has been shown to successfully result in weight reduction, and the drug was not found to lead to heart disease, as is the case with some other such drugs. Furthermore, the FDA also approved controlled release phentermine/topiramate (PHEN/TPM CR), a drug composed of immediate-release phentermine and controlled-release topiramate. Weight reduction by PHEN/TPM CR is better than any other anti-obesity drugs in the world. Along with this excellent efficacy, however, come painful side effects that clinicians should consider.
Anti-Obesity Agents ; Benzazepines ; Cyclobutanes ; Dexfenfluramine ; Fenfluramine ; Fructose ; Heart Diseases ; Heart Valves ; Obesity ; Phentermine ; Piperidines ; Pyrazoles ; Serotonin ; United States Food and Drug Administration ; Weight Loss

A double blind multicenter study of patients suffering from presenile and senile cataracts was performed, bendazac Iysine salt (Bendaline(R))or a placebo was administered orally to the patients and the results were analyzed. Although subjective variability in visual acuity and in the clinical course of cataracts should be taken into consideration together with the short duration of the observation period, the results obtained demonstrate an improvement in the Bendaline(R) treated group with regard to visual acuity and lens opacity, and an aggravation in the group of patients receiving the placebo.
Administration, Oral ; Adult ; Aged ; Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Cataract/*drug therapy ; Clinical Trials as Topic ; Double-Blind Method ; Female ; Humans ; Indazoles/*administration & dosage ; Male ; Middle Aged ; Pyrazoles/*administration & dosage ; Random Allocation ; Tablets ; Visual Acuity/*drug effects

OBJECTIVETo compare clinical effects of spinal leveraging manipulation and medicine for the treatment of degenerative scoliosis in pain and function.

METHODSFrom July 2010 to June 2013, 38 patients with degenerative scoliosis were randomly divided into spinal leveraging manipulation group and medicine group by coin tossing. In manipulation group, there were 9 males and 11 females aged from 58 to 74 years old with an average of (66.63±7.73), the courses of diseases ranged from 3 to 8 months with an average of (5.65±2.58), spinal leveraging manipulation(following meridian to straighten tendon,relieving spasm, osteopathy and massage, clearing and activating the channels and collaterals) were performed for 30 min, once a day, 4 days for a period treatment, totally 9 courses. In medicine group, there were 8 males and 10 females aged from 57 to 70 years old with an average of (63.51±6.61) the courses of diseases ranged from 3 to 5 months with an average of (4.82±1.43), celecoxib with eperisone hydrochloride were orally taken, 4 days for a period treatment, totally 9 courses. VAS score, Cobb angle and ODI score were measured.

RESULTSAfter treatment, VAS score in manipulation group was (5.38±0.99), (6.36±1.31) in medicine group,and had significant meaning (t=2.618, P<0.05); there was significant differences in Cobb angle between manipulation group (16.51±4.89)° and medicine group (19.85±5.03) °(t=2.074,P<0.05); and had obviously meaning in ODI score between manipulation group (20.20±2.93) and medicine group (26.01±3.11) (t=5.592, P<0.05).

CONCLUSIONSpinal leveraging manipulation for degenerative scoliosis could regulate muscle balance on both side of spine, correct coronal imbalances in spine, recover normal sequence of spine, reduce and remove opperssion and stimulation of nerve root, relieve pain in leg and waist and further improve quality of life.

Aged ; Case-Control Studies ; Celecoxib ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Manipulation, Spinal ; Middle Aged ; Propiophenones ; administration & dosage ; Pyrazoles ; administration & dosage ; Scoliosis ; drug therapy ; therapy ; Sulfonamides ; administration & dosage ; Treatment Outcome

OBJECTIVE: This study was designed to prove simultaneously blocking both EGFR and COX-2-mediated pathways may be an efficient means of inhibiting cancer cell growth in NPC. METHOD: A combination of tarceva (EGFR-selective tyrosine kinase inhibitors) with celecoxib (Cox-2 inhibitor) was studied on its effects on cell growth, cell cycle progression, apoptosis and protein expression in CNE-2 cell lines by cell growth assay, flow cytometric analysis assay and Western blotting. RESULT: (1) The inhibition rate of cell growth was higher in the group treated with a combination of two agents than that the sum of rates of the two groups treated with only one agent (P < 0.05). (2) The combination of tarceva with celecoxib significantly induced G1 arrest (P < 0.05), but did not increase apoptosis rate (P > 0.05). (3) The group of combination showed less expressions of p-EGFR and COX-2 than any other group. CONCLUSION Simultaneously blocking EGFR and COX-2 mediated pathways would significantly inhibit the growth of CNE-2 cell line, increase G1 arrest and reduce the expression levels of p-EGFR and COX-2.
Apoptosis ; Celecoxib ; Cell Division ; Cyclooxygenase 2 ; metabolism ; ErbB Receptors ; metabolism ; Erlotinib Hydrochloride ; Humans ; Pyrazoles ; administration & dosage ; pharmacology ; Quinazolines ; administration & dosage ; pharmacology ; Signal Transduction ; Sulfonamides ; administration & dosage ; pharmacology ; Tumor Cells, Cultured

OBJECTIVETo evaluate effects of celecoxib (a selective cox-2 inhibitor)combined with fluvastatin (a HMG-CoA reductase inhibitor) on tumor growth and cell apoptosis in hepatocellular carcinoma xenograft in nude mice.

METHODSHepatocellular carcinoma BEL-7402 cells were inoculated subcutaneously into the left armpit of nude mice, the mice (n = 32) were then randomly divided into 4 groups: the control group, the celecoxib group,the fluvastatin group and the combination group. At the end of the study, Tumor Tissues were collected for analysis. Cell apoptosis was determined by flow cytometry analysis and TUNEL assay. Akt, p-Akt and survivin protein levels were measured by Western blot. Statistical comparisons were made using factorial analysis of variance (ANOVA) and multiple comparisons between each two groups were calculated using SNK-q test.

RESULTSThe combination of Celecoxib and fluvastatin resulted in a greater inhibition of tumor growth than either agent alone, the tumor inhibitory rate was 34.0% in the Celecoxib group, 25.0% in the fluvastatin group and 72.2% in the combination group. The percentages of TUNEL--positive cancer cells in the celecoxib and fluvastatin alone treatment groups were 8.5%+/-1.4% and 9.4%+/-1.7% respectively as compared to the control group which was 3.5%+/-0.8%. Combination therapy showed a significantly greater increase in tumor cell apoptosis in comparison with the control and single-therapy groups (apoptotic index: 19.4%+/-3.0%; P value is less than 0.01 versus celecoxib or fluvastatin groups). The results of flow cytometry analysis also showed the same tendency. a small number of apoptotic cells were detected in the control tumours (4.1%+/-1.6%), whereas a large number of apoptotic cells were detected in tumours treated with celecoxib (9.1%+/-2.1%) or fluvastatin (10.1%+/-2.3%) alone; and the combination therapy resulted in even more apoptotic cells (23.6%+/-5.8%; P value is less than 0.01 versus celecoxib or fluvastatin groups). Western blot analysis demonstrated that the combination of celecoxib and fluvastatin significantly down-regulated p-Akt (0.23+/-0.08 versus 1.12+/-0.07 and surviving (0.50+/-0.07 versus 1.47+/-0.19) in BEL-7402 tumours compared with the control (P value is less than 0.01 for all).

CONCLUSIONThe present study provided evidence that treatment with celecoxib in combination with fluvastatin resulted in the inhibition of HCC tumour growth in an in vivo mouse model.

Animals ; Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; drug therapy ; metabolism ; pathology ; Celecoxib ; Cell Line, Tumor ; Cyclooxygenase 2 Inhibitors ; administration & dosage ; pharmacology ; Fatty Acids, Monounsaturated ; administration & dosage ; pharmacology ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; administration & dosage ; pharmacology ; Indoles ; administration & dosage ; pharmacology ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Pyrazoles ; administration & dosage ; pharmacology ; Sulfonamides ; administration & dosage ; pharmacology ; Xenograft Model Antitumor Assays

Tepoxalin is a potent inhibitor of both the cyclooxygenase and lipoxygenase pathways of the arachidonic acid cascade, as well as a potent anti-inflammatory and control-pain (postoperation, arthritis et. al.) agent. The new method about the use of novel synthesis reagents and the first using ionic liquid as reactive solvent to synthesize tepoxalin were presented in this paper. The ionic liquid can be easily recycled and reused for several runs efficiently. The analgesic activity of tepoxalin was detected by acetic acid test on mice. The analysis of variance showed that oral administration of tepoxalin could significantly inhibit the number of writhing response within 1 hour and prolong the latent time in a dose dependent manner as compared with CMC control group (P < 0.05). At the same time, tepoxalin had the same analgesic activity as diclofenac sodium.
Administration, Oral ; Analgesics ; administration & dosage ; chemical synthesis ; pharmacology ; Animals ; Anti-Inflammatory Agents, Non-Steroidal ; administration & dosage ; chemical synthesis ; pharmacology ; Cyclooxygenase Inhibitors ; administration & dosage ; chemical synthesis ; pharmacology ; Diclofenac ; pharmacology ; Imidazoles ; chemistry ; Ionic Liquids ; chemistry ; Lipoxygenase Inhibitors ; administration & dosage ; chemical synthesis ; pharmacology ; Mice ; Pain Measurement ; drug effects ; Pyrazoles ; administration & dosage ; chemical synthesis ; pharmacology ; Random Allocation

Overexpression of cyclooxygenase-2 (COX-2) has been associated with hepatocarcinogenesis. Inhibitors of COX-2 have proapoptotic and antiproliferative effects on malignant tumors and inhibit tumor invasion to the surrounding tissues. We report here a case of complete regression of advanced hepatocellular carcinoma (HCC) during COX-2 inhibitor administration. An eighty-year-old female was diagnosed as an advanced HCC, which was associated with HCV infection. She received COX-2 inhibitor for 3 months due to degenerative arthritis of both knees. Tumor enhancement on arterial phase CT completely disappeared without specific treatment for the HCC, and the tumor size decreased on the follow-up CT scan.
Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carcinoma, Hepatocellular/*drug therapy ; Cyclooxygenase 2 Inhibitors/administration & dosage/*therapeutic use ; Diclofenac/administration & dosage/analogs & derivatives/therapeutic use ; Female ; Humans ; Lactones/administration & dosage/therapeutic use ; Liver Neoplasms/*drug therapy ; Pyrazoles/administration & dosage/therapeutic use ; Sulfonamides/administration & dosage/therapeutic use ; Sulfones/administration & dosage/therapeutic use