皮损内注射治疗瘢痕疙瘩规律停药的临床研究

目的：探讨皮损内注射得宝松规律性停药对治疗瘢痕疙瘩临床效果的影响。方法：选择2007年1月-2014年12月期间到本院就诊的符合瘢痕疙瘩诊断的患者156例,采用随机数字表法将其分成A、B两组,A组为试验组共81例,B组为对照组共75例。A组在瘢痕疙瘩皮损内注射,采取逐渐减少浓度的方法规律停药;B组采用常规疗程停药方法。观察6个月,评估两组患者治疗效果及复发情况。结果：两组在治疗后1个月与治疗后6个月效果差异均无统计学意义（P>O.01）;治疗组复发率低于对照组,两组比较差异有统计学意义（P相似文献   

高频超声生物显微镜动态观察局部注射二丙酸倍他米松治疗病理性瘢痕

目的采用高频超声生物显微镜(HFB,40MHz)观察二丙酸倍他米松治疗病理性瘢痕的临床效果。方法对39例接受二丙酸倍他米松局部注射治疗患者(治疗组)和20例未接受任何治疗患者(对照组)以40MHz探头行高频超声,于第1、31、61、91天测量瘢痕横径、垂直厚度;以DFY型超声图像诊断仪测量其面积、平均灰度值、声强值;结合温哥华瘢痕量表(VSS)对瘢痕评分。结果治疗组:第31、61、91天较治疗前横径、垂直厚度明显减小(P均0.05),面积、平均灰度值、平均声强值明显减小(P均0.05),VSS评分明显降低(P均0.01);第61天较第31天、第91天较第61天以上各参数均明显减小(P0.05),评分明显降低(P0.01)。对照组:各参数及评分均降低,但差异无统计学意义(P均0.05)。结论高频超声显微镜能无创、定量观察二丙酸倍他米松局部治疗后病理性瘢痕改变,对评价治疗情况有一定临床价值。     

Treatment of distal ulcerative colitis with beclomethasone enemas: High therapeutic efficacy without endocrine side effects

Sixteen patients with 18 attacks of distal ulcerative colitis were treated randomly with either 0.5 mg topically administered beclomethasone dipropionate (BDP) or 5 mg betamethasone phosphate (BMT). The effect of the steroid enemas on adrenocortical function was examined by ACTH tests, which were performed before and 20 days after treatment. At completion of the trial, a marked suppression of the adrenocortical function was found in seven of eight patients treated for nine attacks with BMT but not in any patients in the BDP group (P<0.01). The mean posttreatment basal and stimulated plasma cortisol levels in the BMT group were significantly lower as compared with the BDP group. The overall therapeutic response assessed by score systems was comparable in the two treatment groups. It is concluded that, in the topical treatment of ulcerative colitis, BDP is preferable to BMT because it exerts an equal anti-inflammatory action without affecting adrenocortical function.     

Effects into adulthood of single or repeated antenatal corticosteroids in sheep

OBJECTIVE: To determine effects of maternal or fetal injections of betamethasone on postnatal growth and arterial pressure. STUDY DESIGN: We measured body weight, arterial pressure, and heart rate serially in sheep born after single or repeated maternal or fetal betamethasone injections. At approximately 3.5 years, organ weights were measured. RESULTS: Repeated maternal betamethasone injections caused intrauterine growth restriction, and low body weight and blood pressure at 3 months. From 6 months to 3 years, body weight, blood pressure, and heart rate were not affected by treatment. At approximately 3.5 years, brain weight was reduced after single or repeated maternal betamethasone by 13% and 18%, respectively (P = .001). Fetal betamethasone reduced brain weight by 7% to 8% (P = .018). Weights of other organs were not affected by treatment. Brain weight was unrelated to body weight at approximately 3.5 years (P = .649) but was related to birth weight (P = .029). CONCLUSION: Prenatal betamethasone does not have long-term effects on blood pressure but causes a persistent deficit in brain weight.     

Choice and dose of corticosteroid for antenatal treatments

Although antenatal glucocorticoids are standard of care for women at risk of preterm delivery before 32 to 34 weeks' gestation, the choice and dosing of the corticosteroid has not been standardized. An analysis of the trial data demonstrates that the risk of neonatal death is decreased with betamethasone, but not dexamethasone. Other clinical data also indicate that betamethasone is the drug of choice for antenatal treatment. The pharmacology of the corticosteroids suggests that a lower total glucocorticoid dose per treatment may be as effective as the current treatment recommendations. However, a change from current practice will require further randomized controlled trials.     

Comparison of 0.1 % Halcinonide with 0.05 % Betamethasone Dipropionate in the Treatment of Acute and Chronic Dermatoses

Summary

A 4-Week, Bilateral, Controlled Study Was Carried Out In 53 Patients With Various Acute And Chronic Dermatoses To Compare The Effectiveness Of 0.1% Halcinonide In A Water-Miscible Base, Applied Once Daily, With 0.05% Betamethasone Dipropionate Cream Applied Twice Daily. Patients' Response To Treatment Was Assessed At The End Of Each Week. Halcinonide Proved To Be Equally As Effective As Betamethasone Dipropionate In Most And Superior In Some Patients With Psoriasis, Lichen Chronicus Simplex, And Atopic And Neurodermatitis. There Was Also A Prompt Response To Once Daily Treatment With Halcinonide Inpatients With contact Dermatitis, Eczema Of The Hands, And More Serious Cases Of Eczema Nummular E And Allergic Skin Reactions, Many Of Whom Had Failed To Respond To Previous Topical Steroid Therapy. Both Preparations Were Well Tolerated And Side-Effects Were Noted In Only 1 Patient With Psoriasis Whose Condition Was Aggravated By Halcinonide. Only 3 Patients Had A Relapse During The 1-Month Follow-Up Period After Treatment Was Stopped.     

Mending a growth-restricted fetal heart: should we use glucocorticoids?

Clinical and experimental studies suggest that the growth-restricted fetus at increased risk of impaired cardiovascular function that likely contributes to both increased mortality rate and in survivors, to cardiovascular dysfunction apparent in childhood and later life. Fetal growth restriction is also associated with a high risk of preterm birth. Accordingly, the growth-restricted fetus is more likely than average to receive antenatal glucocorticoids to accelerate lung maturation in preparation for birth. However, glucocorticoids are powerful regulators of vascular tone and antenatal glucocorticoid administration to the intrauterine growth restriction (IUGR) fetus results in systemic cardiovascular changes that are not observed in the healthy normal grown fetus. These responses to glucocorticoids may disturb the IUGR fetus’ ability to appropriately compensate to placental insufficiency. Indeed is it possible that in the setting of severe IUGR exogenous glucocorticoids are detrimental rather than beneficial to the fetus?     

产前应用倍他米松或地塞米松对早产儿神经发育的影响研究

目的探讨产前应用倍他米松或地塞米松治疗对早产儿神经发育的影响。方法选择我院2008年1月～2011年1月收治的28～34周的早产儿200例,按照母亲产前是否应用倍他米松或地塞米松治疗的情况分为两组,对照组100例未用倍他米松或地塞米松治疗;观察组给予倍他米松或地塞米松治疗1～2个疗程,两组早产儿出生后均给予对症支持治疗。并对早产儿出生3、6、12个月的智力发育指数(MDI)和运动发育指数(PDI)量表进行检测。结果观察组早产儿胎龄平均(34.73±2.01)周,对照组为(34.59±1.98)周,两组比较差异无统计学意义(P>0.05);观察组早产儿体质包括出生体重、身长、头围、胸围等指标与对照组比较差异无统计学意义(P>0.05);观察组早产儿窒息、缺血缺氧性脑病(HIE)和颅内出血的发生率与对照组比较,差异无统计学意义(P>0.05);观察组第1天的Brazelton评分与对照组比较差异无统计学意义(P>0.05);第5天的Brazelton评分,观察组明显高于对照组,差异有统计学意义(P<0.05);两组早产儿中观察组3、6、12个月智力发育指数和运动发育指数明显高于对照组,差异有统计学意义(P<0.05)。结论产前孕妇应用倍他米松或地塞米松治疗可促进早产儿神经发育,改善脑功能。     

探讨肱二头肌长头肌腱炎的手术策略

目的探讨手术松解配合药物注射治疗顽固性肱二头肌长头肌腱炎的疗效。方法 2010年7月—2011年12月,该院对22例顽固性肱二头肌长头肌腱炎患者行松解术,术中配合使用复方倍他米松及透明质酸钠,术后2周和3个月随访肩部活动范围,并采用美国肩肘协会评分（ASES）评估。结果手术时间60～80min,平均75min,术中及术后未出现并发症。20例术后2周肩关节外展、前屈、后伸及外旋与术前比较明显改善,术后3个月改善更明显（P〈0.01）,22例术后2周及3个月ASES评分（88.7±5.2,89.2±6.6）与术前（39.5±10.1）比较,差异有统计学意义（n=22 t=20.7,21.1;P〈0.01）。结论肱二头肌长头肌腱松解术配合复方倍他米松及透明质酸钠注射是治疗顽固性肱二头肌长头肌腱炎最直接和有效的方法。     

In vitro evaluation of betamethasone esters for phototoxic potential

The phototoxicity of Betamethasone valerate and betamethasone dipropionate has been investigated on irradiation in the wavelength range of 300–400?nm, using some basic in vitro phototoxicity tests. Both esters cause photohemolysis of mouse red blood cells and photoperoxidation of linoleic acid. The photoproducts of both esters have also been found to be phototoxic. The toxicity of these photoproducts increases with further irradiation; however, they exhibit toxicity, even in the dark. The efficient inhibition of photohemolysis by the well-known free radical scavengers, such as butylhydroxyanisole and reduced glutathione, and minor inhibition by singlet-oxygen quenchers, such as sodium azide, suggests that cellular damage is mainly mediated by free radicals whereas singlet oxygen plays a minor role.