ABSTRACT
Objective:To observe the clinical effect of elemene injection in the perioperative treatment of esophageal cancer.Methods:A total of 180 patients with esophageal cancer who underwent surgical treatment in the Affiliated Hospital of Hebei University from January 2017 to July 2018 were selected and divided into the experimental group ( n=90) and the control group ( n=90) according to the random sequence number generated by the computer. In the experimental group, the thoracic cavity was rinsed and the elemene was instilled and intravenously instilled. The control group was treated with normal saline. Safety indexes, short-term efficacy indexes, immune indexes, tumor marker levels and long-term benefit indexes were observed in the two groups. Results:The incidences of leukocytosis, thrombocytopenia, low hemoglobin, elevated creatinine, transaminase elevation, nausea and vomiting in the experimental group were 43.33% (39/90), 0 (0/90), 5.55% (5/90), 6.67% (6/90), 4.44% (4/90) and 0 (0/90), those in the control group were 53.33% (48/90), 1.11% (1/90), 2.22% (2/90), 4.44% (4/90), 7.78% (7/90) and 1.11% (1/90), and there were no significant differences between the two groups ( χ2=1.802, P=0.179; P=1.000; χ2=0.595, P=0.441; χ2=0.424, P=0.515; χ2=0.871, P=0.351; P=1.000). The postoperative extubation time in the experimental group was (173.36±41.09) h, the postoperative hospital stay was (14.82±4.35) d, the Karnofsky functional status (KPS) score was 81.43±3.89, and those in the control group was (175.76±40.46) h, (15.34±5.22) d and 80.49±2.67, respectively. The differences between the two groups were not statistically significant ( t=-0.395, P=0.695; t=-0.726, P=0.472; t=1.890, P=0.061). The total amount of drainage fluid in the experimental group was (665.39±201.31) ml, and the incidence of anastomotic fistula was 1.11% (1/90), which were significantly lower than those in the control group [(732.67±213.84) ml and 8.89% (8/90)], with statistically significant differences ( t=-2.173, P=0.032; χ2=4.211, P=0.040). Before treatment, there were no statistically significant differences in immune function between the two groups (all P>0.05). One week after surgery, there was no statistically significant difference in CD3 + between the two groups [(55.45±6.96)% vs. (53.71±6.54)%, t=1.728, P=0.087]; CD4 + , CD4 + /CD8 + and NK cells in the experimental group were higher than those in the control group, and the differences were statistically significant [(29.43±5.05)% vs. (25.92±8.06)%, t=3.501, P=0.001; 1.30±0.21 vs. 1.23±0.20, t=0.229, P=0.028; (254.20±15.21)/μl vs. (237.05±10.73)/μl, t=2.741, P=0.007]. The levels of tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in the experimental group were (1.37±0.18) ng/ml, (1.26±0.28) ng/ml, (0.89±0.17) ng/ml and (1.06±0.24) ng/ml, significantly lower than those in the control group [(2.86±0.42) ng/ml, (2.92±0.45) ng/ml, (2.38±1.55) ng/ml, (2.82±0.15) ng/ml], and the differences were statistically significant ( t=13.928, P=0.014; t=19.728, P=0.011; t=17.924, P=0.006; t=16.625, P=0.003). The 1-year recurrence rate was 2.22% (2/90) in the experimental group, and the half-year mortality rate was 1.11% (1/90) in the experimental group, and 5.56% (5/90) and 2.22% (2/90) in the control group, with no statistically significant differences ( χ2=0.595, P=0.441; χ2=0.000, P=1.000). Conclusion:Elemene tumor-free sequential treatment combined with postoperative intravenous drip has a positive effect on postoperative recovery of patients with esophageal cancer, which can prevent the occurrence of postoperative anastomotic fistula, improve patients′ immune function, reduce the levels of tumor markers, and it is safe and feasible.
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OBJECTIVE:To observe clinical efficacy and safety of citalopram in the treatment of depression patients after lung cancer operation. METHODS:114 depression patients after lung cancer operation were selected and randomly divided into observa-tion group and control group (n=57). Control group was given routine treatment as nutrition support and electrolyte balance,but had no anti-depression drugs;observation group was given Citalopram tablet 20 mg orally,qd. Two groups were treated for 6 weeks. Clinical efficacy,HAMD and HAMA scores,each score and total score of SF-36 were observed before and after treatment. The occurrence of ADR was recorded. RESULTS:The total effective rate of observation group was 87.72%,which was significant-ly higher than that that of control group(71.93%),with statistical significance(P0.05);HAMA score and HAMD score of 2 groups decreased significantly after treatment,the observation group was lower than the control group;each score and total score of SF-36 increased significantly,the observation group was higher than the control group,with statistical sig-nificance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Citalopram is effective and safe for depression af-ter lung cancer operation,can improve mental state and quality of life.
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Objective To compare the egicacy and security of intracoronary administration of tirofiban combined high-dose adenosine during percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (STEMI).Methods Eighty-eight cases with STEMI were randomly divided into observation group(44 cases) who were accepted 2 times intracoronary adenosine(2 mg,10 ml 0.9％ NaCl),and control group(44 cases) who were afforded only 10 ml 0.9％ NaCl by prospective,double-blind,and random study.The two groups were received10 g/kg tirofiban after aspiration catheter in the culprit lesion distal bolus injection of 3 rain,at the same time,continuous infusion of 0.15 g/(kg · min) for 24 h.The postoperative coronary arteriography and electrocardiogram were evaluated.Meanwhile,the postoperative myocardial blush grade(MBG),thrombolysis in myocardial infarction (TIMI),corrected TIMI frame counts (CTFC),ST-segment elevation resolution (STR) major adverse cardiac events (MACE),and adverse reactions of adenosine were recorded.Results There was no significant difference in terms of postoperative TIMI and STR between two groups (P ＞ 0.05).The CTFC of observation group was (24.4 ± 4.9) frames,significant better than that of control group((21.9 ±3.7) frames;t =2.701,P ＜0.01).The ratio of MBG in observation group was 24/44,higher than that of control group(14/44 ; x2 =4.632,P ＜ 0.05).There were no significant difference regarding of the ratio of death,MACE,target vessel revascularization,grade of NYHA between observation and control group at followed up for 1 and 12 month (P ＞ 0.05).The ratio of patients with blood pressure decrease ≥ 10 mm Hg,new second degree atrioventricular block in observation group were 15.9％ and 20.5％,higher than that in control group (2.3％ and 15.9％ ; x2 =4.950,7.221 ; P =0.026,0.007).The adverse reaction was transient.Conclusion The intracoronary administration of tirofiban combined high-dose adenosine during PCI in patients with STEMI plays an effective role on improvement of myocardial perfusion.