塞来昔布对骨科围手术期镇痛的疗效评估

[目的]观察塞来昔布(西乐葆)对骨科围手术期患者术后镇痛的疗效及安全性。[方法]选择2004~2005年住院手术患者,共64例,随机分组,分别给予西乐葆或镇痛泵进行术后镇痛。西乐葆给药时间:一般于手术前8~12 h,即患者手术禁食前首次给药,手术后6 h患者可进食后再次给药,手术后3~5 d按手术大小及患者疼痛程度决定停药时间。给药剂量:西乐葆首次服用400 mg,大手术可加大剂量。观察患者疼痛VAS评分、药物不良反应及患者满意度。[结果]西乐葆的术后镇痛效果与镇痛泵相似,但发生不良反应比及患者总体满意度优于镇痛泵。[结论]西乐葆对手术后镇痛具有满意的疗效及安全性,适合于骨科围手术期术后镇痛。     

Efficacy of lumiracoxib in relieving pain associated with knee osteoarthritis: a 6‐week,randomized, double‐blind,parallel‐group study

Aim: The aim of the current study was to assess the efficacy, safety, and tolerability of lumiracoxib 200 mg once daily (o.d.) in relieving osteoarthritis (OA) knee pain in patients in China, Taiwan, and South Korea. Methods: Patients of either sex (aged ≥ 18 years) with symptomatic, primary OA of the knee for ≥ 3 months were eligible for inclusion if they had OA pain intensity of ≥ 40 mm (100 mm visual analogue scale [VAS]) in the target knee joint during the previous 24 h. Patients were required to undergo regular non‐steroidal anti‐inflammatory drug therapy for ≥ 6 weeks. After 3–7 days of screening, patients were randomized (1 : 1) to receive either lumiracoxib 200 mg o.d. or celecoxib 200 mg o.d. The primary efficacy comparison between the study groups was overall OA pain intensity (VAS) in the target knee after 6 weeks of treatment. Results: The mean overall OA pain intensity (VAS) in the target knee after 6 weeks decreased from 60.6 mm to 35.7 mm and 60.5 mm to 36.1 mm in the lumiracoxib and celecoxib groups, respectively. Both study groups showed similar results in terms of improvement in both patient's and physician's global assessment of disease activity and functional health status. The percentage of adverse events (AEs) in the lumiracoxib and celecoxib groups (40.3% and 37.9%, respectively) was similar, as was the proportion of treatment‐related AEs (21.0% and 18.2%, respectively). Conclusions: Lumiracoxib 200 mg o.d. provided effective and well‐tolerated pain relief similar to that achieved with celecoxib 200 mg o.d. in knee OA patients.     

EFFECTS OF p53 GENE THERAPY COMBINED WITH CYCLOOXYGENASE-2 INHIBITOR ON CYCLOOXYGENASE-2 GENE EXPRESSION AND GROWTH INHIBITION OF HUMAN LUNG CANCER CELLS

Background Gene therapy by adenovirus-mediated wild-type p53 gene transfer has been shown to inhibit lung cancer growth in vitro, in animal models, and in human clinical trials. The antitumor effect of selective cyclooxygenase （COX）-2 inhibitors has been demonstrated in preclinical studies. However, no information is available on the effects of p53 gene therapy combined with selective COX-2 inhibitor on COX-2 gene expression and growth inhibition of human lung cancer cells. Methods We evaluated the effects of recombinant adenovirus-p53 （Adp53） gene therapy combined with selective CADX-2 inhibitor on the proliferation, apoptosis, cell cycle arrest of human lung adenocarcinoma A549 cell line, and the effects of tumor suppressor exogenous wild type p53 on COX-2 gene expression. Results Ad-p53 gene therapy combined with selective COX-2 inhibitor celecoxib shows significant synergistic inhibition effects on the growth of human lung adenocarcinoma A549 cell line. Exogenous p53 gene can suppress COX-2 gene expression. Conclusions Significant synergistic inhibition effects of A549 cell line by the combined Ad-p53 and selective COX-2 inhibitor celecoxib may be achieved by enhancement of growth inhibition, apoptosis induction and suppression of COX-2 gene expression. This study provides first evidence that the administration of p53 gene therapy in combination with COX-2 inhibitors might be a new clinical strategy for the treatment or prevention of NSCLC.     

塞来昔布对大鼠化学性乳腺癌的抑制作用及机制

目的 观察环氧化酶-2(cyclooxygenase-2,COX-2)选择性抑制剂塞来昔布对化学致癌剂7,12-二甲基苯蒽(7,12-dimethybenz[a]anthracene,DMBA)化学诱发的大鼠乳腺癌的抑制作用并探讨其机制.方法 将DMBA油剂灌胃复制大鼠乳腺癌模型,大鼠分为对照组(24只)和实验组(25只),观察塞来昔布对大鼠乳腺癌的抑制作用,并采用基因芯片技术了解治疗后2组肿瘤的基因表达谱差异.结果 实验组塞来昔布处理后乳腺肿瘤的数目、直径、体积分别为(2.56±1.26)个、(1.162±0.355)cm、(1.967±1.725)cm.;明显小于实验前的(3.40±1.22)个、(1.948±0.481)cm、(8.794±6.389)cm3;明显小于对照组(3.88±1.73)个、(2.231±0.736)cm、(10.268±5.447)cm3,差异有显著性意义(均P＜0.01).对照组COX一2蛋白表达为62.5%(15/24),实验组COX-2蛋白表达为36.0%(9/25),差异有显著性意义(P＜O.05).基因表达谱显示两组之间表达丰度差异2倍及以上的基因共有243条,其中表达上调2倍或以上的基因片段124条,表达下调2倍或以上的基因片段119条,发现功能不明的新基因6条,其中表达上调的4条.结论 塞来昔布能抑制DMBA诱发的大鼠乳腺癌进展,其机制和多种基因改变有关.     

反相高效液相色谱法测定塞来昔布片含量

目的 :建立反相高效液相色谱法测定塞来昔布片的含量。方法 :采用ZorbaxSB -C18色谱柱 ,以 0 .0 2mol·L-1磷酸二氢钾缓冲液 (pH5 .8) 乙腈 (4 5 :5 5 )为流动相 ,流速为 1.0mL·min-1,以 5 甲基 2 硝基苯酚为内标物 ,检测波长为 2 5 2nm。结果 :塞来昔布在 10 .2～ 5 0 .1mg·L-1范围内呈良好线性 (r =0 .9998) ,平均回收率为 99.8% ,RSD为 0 .35 %。结论 :本法可用于该片的含量测定 ,操作简便 ,结果准确。     

Brief overview of selected approaches in targeting pancreatic adenocarcinoma

Introduction: Pancreatic adenocarcinoma (PDAC) has the worst prognosis of any major malignancy, with 5-year survival painfully inadequate at under 5%. Investigators have struggled to target and exploit PDAC unique biology, failing to bring meaningful results from bench to bedside. Nonetheless, in recent years, several promising targets have emerged.

Areas covered: This review will discuss novel drug approaches in development for use in PDAC. The authors examine the continued efforts to target Kirsten rat sarcoma viral oncogene homolog (KRas), which have recently been successfully abated using novel small interfering RNA (siRNA) eluting devices. The authors also discuss other targets relevant to PDAC including those downstream of mutated KRas, such as MAPK kinase and phosphatidylinositol 3-kinase.

Expert opinion: Although studies into novel biomarkers and advanced imaging have highlighted the potential new avenues toward discovering localized tumors earlier, the current therapeutic options highlight the fact that PDAC is a highly metastatic and chemoresistant cancer that often must be fought with virulent, systemic therapies. Several newer approaches, including siRNA targeting of mutated KRas and enzymatic depletion of hyaluronan with PEGylated hyaluronidase are particularly exciting given their early stage results. Further research should help in elucidating their potential impact as therapeutic options.     

Melatonin and celecoxib improve the outcomes in hamsters with experimental pancreatic cancer

Abstract: Pancreatic cancer is a major health problem because of the aggressiveness of the disease and the lack of effective systemic therapies. Melatonin (MEL) has antioxidant activity and prevents experimental genotoxicity. The specific inhibitor of cyclooxygenase‐2 (COX‐2), celecoxib (CEL), increases the efficacy of chemoradiotherapy in advanced pancreatic cancer. The objective of the study was the comparison and synergic effect of MEL and CEL during either the induction or progression phases of the tumor process, measuring parameters of oxidative stress, number of tumor nodules and survival of animals with pancreatic cancer. Pancreatic cancer was induced by N‐nitrosobis (2‐oxopropyl)amine) (BOP) in Syrian hamsters. Melatonin and/or CEL were administered during the induction, postinduction as well as during both phases. The presence of tumor nodules were observed macroscopically in pancreatic and splenic areas, and the levels of lipoperoxides (LPO), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH‐Px) in pancreatic tissue were measured. The increases in tumor nodules and LPO as well as the reductions in GSH and enzymatic antioxidants in the pancreas induced by BOP were related to a lower survival rate of animals. The administration of MEL exerted a more potent beneficial effect than CEL treatment on the reduction in tumor nodules, oxidative stress and death of experimental BOP‐treated animals. The combined treatment only exerted a synergistic beneficial effect when administered during the induction phase. Melatonin by itself had significant beneficial actions in improving the survival of hamsters.     

塞来昔布上调Cyclin D1基因甲基化水平对食管癌细胞增殖和凋亡的抑制作用

目的探究塞来昔布通过上调Cyclin D1基因甲基化水平对食管癌细胞增殖和凋亡的作用及机制。方法将细胞分为对照、转染和塞来昔布组,分别转染阴性对照载体、Cyclin D1过表达载体和Cyclin D1转染后给予60μmol/L塞来昔布。采用MTT法、流式细胞术分别检测细胞增殖、细胞周期和细胞凋亡率的变化,Western blotting法检测细胞周期和细胞凋亡相关蛋白表达水平;甲基化特异性PCR(MS-PCR)、qRT-PCR法用于检测Cyclin D1甲基化特异性扩增片段和Cyclin D1 mRNA表达水平。结果塞来昔布能够抑制Cyclin D1诱导的细胞体外增殖,阻滞细胞周期向S期转化,并促进食管癌细胞凋亡;MS-PCR结果显示塞来昔布能够上调Cyclin D1基因甲基化水平,在转录水平抑制细胞内Cyclin D1 mRNA的表达。结论塞来昔布能够通过上调Cyclin D1基因甲基化水平发挥抑制食管癌细胞增殖、促进其体外凋亡的作用。