A randomized,double-blind crossover trial of paracetamol 1000 mg four times daily vs ibuprofen 600 mg: effect on swelling and other postoperative events after third molar surgery

AIMS: To evaluate the effect of a 3-day regimen of ibuprofen 600 mg x 4 on acute postoperative swelling and pain and other inflammatory events after third molar surgery compared with a traditional regimen of paracetamol 1000 mg x 4. METHODS: A controlled, randomized, double-blind, cross-over study where 36 patients (26 females, 10 males) with mean age 23 (range 19-27) years acted as their own controls. All patients were subjected to surgical removal of bilateral third molars. After one operation the patients received tablets of ibuprofen 600 mg x 4 for 3 days. After the other operation they received an identical regimen of paracetamol 1000 mg tablets. Swelling was objectively measured (mm) with a standardized face bow and the patients scored their pain intensity (PI) on a 100-mm visual analogue scale. RESULTS: There was no statistically significant difference between paracetamol and ibuprofen treatment with respect to effect on acute postoperative swelling. Swelling after paracetamol on the third postoperative day was 1.8% less than that after ibuprofen. Mean (95% CI) difference between treatments was -0.3 (-4.7, 4.1) mm. On the sixth postoperative day swelling after ibuprofen was 2.3% less than that after paracetamol. Mean (95% CI) between treatments was 0.2 (-2.4, 2.8) mm. There was no statistically significant difference in pain intensity between the paracetamol and the ibuprofen regimen on the day of surgery. The mean (95% CI) difference between the treatments for summed pain intensity on the day of surgery (SUMPI 3.5-11) was 3.31 (-47.7, 54.3) mm. Two patients developed fibrinolysis of the blood clot (dry socket) after receiving ibuprofen while none did this after paracetamol treatment. There was no noticeable difference between treatments with respect to appearance of haematomas/ecchymoses or adverse effects which all were classified as mild to moderate. CONCLUSIONS: A 3-day regimen of ibuprofen 600 mg x 4 daily does not offer any clinical advantages compared with a traditional paracetamol regimen 1000 mg x 4 daily with respect to alleviation of acute postoperative swelling and pain after third molar surgery.     

奥沙利铂联合氟尿嘧啶/亚叶酸钙一线治疗转移性大肠癌2周方案与3周方案的对比研究

目的：比较奥沙利铂（L-OHP）联合5-氟尿嘧啶/亚叶酸钙（5-FU/CF）的2周方案与3周方案一线治疗转移性结直肠癌的临床疗效及不良反应。方法：66例转移性结直肠癌患者随机接受治疗。A组,予L-OHP85mg/m^2,第1天,静脉滴注2h,同时或之后予CF200mg/m^2,静脉滴注2h,续5-FU400mg/m^2,静脉推注,600mg/m^2持续静脉滴注22h,次日重复CF与5-FU。每2周重复1次,每2次计为1周期。B组,予L-OHP130mg/m^2,第1天,静脉滴注2h,CF200mg/m^2,静脉滴注2h,续5-FU375-425mg/m^2静脉滴注4-6h,连用5d,每3周重复1次,每次计为1周期。结果：A、B两组疗效相近,RR分别为42.9%和38.7%（P〉0.05）。两组病例不良反应发生率相似,主要表现为消化道反应、神经系统毒性和脱发。结论：L-OHP联合5-FU/CF的2周方案与3周方案均可作为晚期转移性大肠癌一线治疗的选择之一。     

重度有机磷农药中毒改良治疗方案的临床研究

目的：探讨改良治疗重度有机磷农药中毒方案的可行性及其临床应用价值。方法：将我科59例重度有机磷农药中毒患者采用改良治疗方案（从洗胃方式、呼吸道管理、复能剂使用到阿托品使用途径进行改良），与既往按传统方案治疗的62例重度中毒患者进行对照比较。结果：改良组治愈57例，显著高于传统组（治愈49例，P〈0．05），而阿托品中毒率、农药中毒反跳率、阿托品用量及住院时间均低于传统组，差异有显著性（P〈0．05）。结论：改良治疗方案救治重度有机磷农药中毒较传统治疗方案疗效显著。     

固本消瘤胶囊联合FOLFOX4方案治疗晚期大肠癌的临床研究

目的观察固本消瘤胶囊联合FOLFOX4方案治疗晚期大肠癌的疗效。方法78例晚期大肠癌患者随机分成治疗组(38例)、对照组(40例)。78例晚期大肠癌患者接受OXA85mg/m2静脉点滴2h,d1;CF200mg/m2静脉点滴2h,5-FU400mg/m2静脉推注后续以600mg/m2持续静脉点滴22h,d1-2;2周重复,为1周期。治疗组同时口服固本消瘤胶囊。应用4周期后判定疗效。结果治疗组与对照组的临床受益率(CR PR SD)分别为76.3%、57.5%(P<0.05)。固本消瘤胶囊联合FOLFOX4方案能提高患者的细胞免疫功能,缓解化疗药物的毒副反应,改善患者的生活质量。结论固本消瘤胶囊联合FOLFOX4方案治疗晚期大肠癌有较好的近期疗效。     

GP与TP方案治疗NP方案化疗失败的非小细胞肺癌的疗效比较

目的 探讨NP方案化疗后进展的晚期非小细胞肺癌（NSCLC）应用GP和TP方案的疗效和毒性。方法 总结65例NSCLC患者均曾接受过NP方案化疗2周期，出现病情进展后所接受的化疗方案分成GP组和TP组，每例患者至少接受2个周期以上的同一方案治疗，比较两组方案治疗的效果和不良反应。结果 GP组和TP组的总有效率分别为19．35％、8．82％，两组间比较差异有显著性（P〈0．05）；1年生存率分别为22．58％、20．59％，2年生存率分别为6．45％、5．88％，GP组和TP组患者的中位生存期分别为8．1个月和7．9个月，两组间比较差异无显著性（P〉0．05）。GP组和TP组的不良反应均在可耐受范围。结论 GP方案和TP方案对NP方案化疗失败的晚期NSCLC有一定疗效，但有效率较低，GP方案较TP方案近期有效率高，中位生存期、年生存率比较差异无显著性（P〉0．05）。     

Acute toxicity and outcome among pediatric allogeneic hematopoietic transplant patients conditioned with treosulfan-based regimens

Abstract

Treosulfan-based regimens constitute a feasible and increasingly used, but still myeloablative, conditioning in pediatric allogeneic hematopoietic stem cell transplantation (HSCT). We retrospectively analyzed the acute toxicity and outcome of all consecutive (2004–2015) pediatric HSCT patients prepared for HSCT with treosulfan in a single-center setting. We included HSCTs performed for both nonmalignant (n?=?23) and malignant diseases (n?=?11). The controls were patients with nonmalignant diseases or hematological malignancies conditioned with cyclophosphamide (Cy)-total body irradiation (TBI)-based (39 patients) or busulfan-based regimens (11 patients). The major toxicities of the treosulfan-based regimens were limited to oral mucosa and skin. 50% of the patients needed IV morphine for severe mucositis compared to 31% in patients conditioned with Cy-TBI (P?=?0.02). Other toxicities were rare. The disease-free survival (DFS) of patients transplanted for nonmalignant disorders was 88.9?±?7.5% at 2?years. The event-free survival (EFS) at 2?years in this small cohort for those with a malignant disease and a treosulfan-based conditioning was 54.5?±?1.5%. We conclude that a treosulfan-based conditioning regimen gives excellent DFS in pediatric HSCT performed for a nonmalignant disorder but with substantial mucosal toxicity. In a malignant disorder a treosulfan-based regimen looks promising but larger, preferably randomized, studies are needed to prove efficacy.     

造血干细胞移植前预处理方案的全身放疗

目的 探讨适合国人ＴＢＩ剂量及方法。方法 回顾分析ＨＳＣＴ前ＴＢＩ预处理方案的毒性及对植入、生存的影响。结果 ＴＢＩ毒性未见明显增多,１２例全部植入。ＡＢＭＴ６例中复发死亡１例,１例出院后３个月死于感染;另４例目前仍无病存活已７～９年;６例ＡＬＬＯ－ＨＳＣＴ中４例仍无病存活。结论 认为国人ＴＢＬ仍以总量７～８Ｇｙ,一天内分两次给药为宜。     

不同化疗方案治疗晚期胃癌的疗效评价

目的比较FAM、UFTM、FEP和LFP／M四种化疗方案治疗晚期胃癌的效果。方法应用回顾性分析,总结出每个方案的近期和远期疗效,作出统计学处理。结果近期疗效：四种方案的有效率分别为FAM34．4％,UFTM32．6％,FEP47．0％和LFP／M44．0％。经统计学处理各组间P值均大于0．05,无显著差异。远期疗效：有效病例治后中位缓解期和生存期分别为FAM5月和11．5月,UFTM4．5月和8．5月,FEP5月和10月,LEP／M4月和9月,毒副反应在骨髓抑制方面以FAM和LFP／M为重,UFTM最轻。消化道反应以FEP和LFP／M为重,UFTM最轻．结论四种方案治疗晚期胃癌,近期疗效各组间无显著差异。但以FEP和LFP／M方案的有效率更高一些,仍可作为首选方案。UFTM方案的不良反应最轻,适用于全身状况较差,体质较弱的患者。FAM方案的生存期较长,副反应也不大,对心脏无病变的患者仍不失为较好的治疗方案。     

10-羟基喜树碱腔内注射治疗恶性胸腹水

目的观察１０－羟基喜树碱腔内注射治疗恶性胸（腹）水的疗效。方法腔内灌注１０－羟基喜树碱治疗２７例恶性胸（腹）腔积液患者。结果ＣＲ９例,ＰＲ１３例,ＮＲ５例。有效率８１．５％（２２／２７）。此局部治疗耐受性好,无明显毒副反应。结论与其它胸（腹）水治疗方法比较,该方法具有疗效高、毒副反应低的特点。