环孢素A与泼尼松、水飞蓟素联合治疗Graves眼病

目的　探讨运用环孢素A(CsA)与泼尼松、水飞蓟素联合治疗Graves眼病的疗效和安全性。方法　将 36例Graves眼病的患者分为两组 ,A组 18例采用泼尼松 (完成治疗者 16例 ) ;B组 18例采用环孢素A与泼尼松、水飞蓟素联合治疗。疗程均为 3个月。疗效判断采用Given wilson积分指数系统和美国甲状腺疾病协会分级标准。结果　 3个月后 ,A组 16例中 9例 (5 6 2 % )好转 ,7例 (4 3 8% )无变化 ;B组 18例 ,其中12例 (6 6 7% )好转 ,6例 (33 3% )无变化 ;B组的好转率高于泼尼松组。各组治疗后眼病分值均有一定程度下降 ,下降幅度以B组较明显。A组中有 3例血糖增高 ,2例退出治疗 ,B组中未发现有明确的药物不良反应。结论　免疫抑制剂环孢素A与泼尼松、水飞蓟素联合治疗Graves眼病 ,其疗效优于单用泼尼松 ,且不良反应较少。     

阿奇霉素联合强的松治疗支原体肺炎临床分析

目的探讨阿奇霉素与强的松联合应用治疗支原体肺炎的临床疗效。方法回顾性地分析自2009年6月～2010年6月收治的360患者,均为临床诊断为支原体肺炎的患者。治疗组200例给予阿奇霉素与强的松联合治疗。对照组160例,阿奇霉素的服法同治疗组。不用强的松。观察两组各项临床指标的变化,及总体有效率的改变,同时比较两组不良反应的变化情况。结果两组在退热时间、咳嗽消失时间、喘息时间、啰音消退时间,肺阴影消失时间上,治疗组与对照组相比较差异有统计学意义,P﹤0.001。从对于患者的痊愈、显效、好转、无效和总有效率方面比较,治疗组效果好于对照组(P﹤0.005)。两组在治疗期间不良反应总体差异无统计学意义P﹥0.05。结论支原体肺炎发病可对患者产生免疫损害,阿奇霉素与强的松联合应用可减少损伤,缩短病程疗效确定。     

程序化药物释放纳米涂层的构建及其体外实验研究

目的构建肝素、强的松和紫杉醇程序化药物释放纳米涂层,并考察该纳米涂层的体外释放情况和对血管内皮细胞的影响。方法结合异步降解技术和静电纺织技术制备己内酯/碳酸亚乙酯共聚物[Poly（CL-co-EC）]的纳米载体;高压液相色谱法测定载药体系紫杉醇包封率和体外释放曲线;MTT实验和乳酸脱氢酶（LDH）试剂盒分别测定人血管内皮细胞的存活率和LDH释放率。结果程序化药物释放体系中肝素、强的松和紫杉醇的包封率分别为97.3%、81.2%和75.7%,载药量分别为10.4%、9.3%和14.1%。三种药物在体外均缓慢释放,60 d时累计释放量分别达到96%、55%和8%。程序化药物释放纳米涂层能显著降低血管内皮细胞的存活率并提高LDH释放率。结论程序化药物释放纳米涂层能依次缓慢释放肝素、强的松和紫杉醇,并抑制血管内皮细胞生长,对于降低支架植入术后血管再狭窄有潜在应用价值。     

小剂量利妥昔单抗联合糖皮质激素治疗儿童落叶型天疱疮一例疗效观察

【摘要】 患儿男,9岁,头皮红斑、糜烂伴瘙痒1个月,泛发全身1周。皮损组织病理：表皮内颗粒层下方水疱形成,疱内见大量棘层松解细胞,真皮浅层小血管周围淋巴细胞及嗜酸性粒细胞浸润。直接免疫荧光检查示表皮细胞间IgG、补体C3呈网状沉积,IgM、IgA阴性。酶联免疫吸附实验检测血清抗Dsg1抗体阳性（157.00 U/ml）。诊断：落叶型天疱疮。入院后应用泼尼松40 mg/d疗效欠佳,改用小剂量利妥昔单抗（每周100 mg,共4周）联合泼尼松（20 mg/d）治疗,病情控制良好。泼尼松逐渐减量至7.5 mg/d维持治疗,随访24个月病情无复发。     

复方泼尼松痔疮软膏的研制及含量测定

目的:研制醋酸泼尼松的皮肤科新制剂,并建立含量测定方法。方法:采用高效液相色谱法测定含量。用C18柱(150mm×4.6mmID,5!m)以甲醇-水(60:40)为流动相,流速0.8ml/min检测波长240nm。结果:醋酸泼尼松线形范围0.1992￣5.886!g,r=0.9999,平均回收率98.68%,RSD为1.74%(n=6)。结论:本品制备简单,含量测定用高效液相色谱法,测定方法专属性强,结果准确可靠,并能很好地控制制剂质量。     

小剂量强地松、红霉素和富露施联用对大鼠肺纤维化及其转化生长因子β1干预的实验观察

目的 提供更合理的肺纤维化治疗方案。方法 100只wistar大鼠，随机抽出20只作为正常组，气管内注入生理盐水(作为阴性对照)，剩余80只经气管内注入博莱霉素造模成功后随机分为模型组20只(作为阳性对照)，大剂量强地松组20只，红霉素和富露施组20只，小剂量强地松、红霉素和富露施组20只，分别给予相应药物治疗。以上各组动物在第七，十四，三十，六十天每组随机抽出5只处死进行病理切片观察，电子计算机图像分析仅进行组织形态学、胶原和转化生长因子(TGF)β1定量分析。结果 小剂量强地松、红霉素和富露施组对模型动物干预最强。结论 小剂量强地松、红霉素和富露施联合应用治疗大鼠肺纤维化伏于经典方法。     

芪藿肾宝对类固醇性大鼠骨质疏松骨密度和生物力学的实验研究

目的　从生物力学和骨矿含量测定研究芪藿肾宝胶囊对类固醇性大鼠骨代谢的影响。方法　采用 3月龄雄性SD大鼠 2 8只 ,随机分为基础对照组、年龄对照组、激素模型组和中药治疗组。后 2组给醋酸泼尼松 4 5mg·kg-1,ig ,2次 /周 ;治疗组还给芪藿肾宝胶囊 5ml·kg-1(3 3 0g·L-1) ,ig ,6次 /周。 3个月后取股骨和第 5腰椎行骨密度测定 ,再行扭转、三点弯曲和压缩试验。结果　与年龄对照组比较 ,激素模型组股骨和第 5腰椎的总骨密度减少了 14 64 % (P <0 0 1) ;股骨干在三点弯曲试验时所承受的载荷减少了 17 1% (P <0 0 5 ) ;其余的力学参数都出现减少的趋势。芪藿肾宝预防组股骨和第 5腰椎的总骨密度有所增加 ,股骨扭转角度明显增加 40 3 % (P <0 0 5 ) ,其余的力学参数都出现增加的趋势。结论　长期使用糖皮质激素 (GC)会使大鼠皮质骨和松质骨的骨密度和力学性能下降 ,从而易致骨折 ;应用芪藿肾宝则能阻止GC所致的力学性能下降及骨密度减少     

Intravenous immunoglobulin in minimal change nephrotic syndrome: a crossover trial

To determine whether intravenous immunoglobulin (IVGG) would be an efficacious adjunct in the treatment of childhood minimal change nephrotic syndrome (MCNS), we enrolled ten patients with frequently relapsing or steroid-dependent MCNS in a double-blind crossover clinical trial. At the time of relapse of the nephrotic syndrome, patients were assigned to treatment with a single outpatient infusion of IVGG (800 mg/kg) or intravenous albumin as a control. The relapse was treated concurrently with standard doses of oral prednisone. At the time of the next relapse, patients who had first received IVGG were treated with albumin, and vice versa. There were no significant differences in the length of remission between the IVGG and albumin treatments. The study had a power of 0.72 to detect a true difference of 45 days between the two therapies. We conclude that in the dose of drug used in this trial, administered at the time of relapse in conjunction with prednisone therapy to children with frequently relapsing or steroid-dependent MCNS, IVGG does not lead to a clinically important extension of the period of remission.     

Effects of prednisone and deflazacort on mineral metabolism and parathyroid hormone activity in humans

Summary The effects of two different glucocorticoids, prednisone and deflazacort, (an oxazoline derivative of prednisolone) on bone metabolism were analyzed in 10 patients with disorders that required glucocorticoid therapy. Significant elevations in blood immunoreactive parathyroid hormone, alkaline phosphatase and urinary calcium, phosphate, hydroxyproline and nephrogenous cyclic AMP were observed during prednisone therapy in addition to an increase in the exchangeable calcium pool as estimated by⁴⁷Ca-kinetic analyses. In contrast to these changes, deflazacort therapy induced minimal, and in some instances, no changes in these indices. In fact, in studies wherein prednisone therapy was followed by deflazacort alterations in bone metabolism, iPTH, and nephrogenous cAMP observed during prednisone were reversed. The data are consistent with the fact that the skeletal effects of prednisone therapy are mediated, at least in part, by increased parathyroid hormone activity, and that deflazacort is less potent in this regard.     

Drug-protein recognition processes investigated by NMR relaxation data. A study on corticosteroid-albumin interactions

In this paper we investigated the interaction processes occurring at the protein-solvent interface for prednisolone-albumin and prednisone-albumin systems, using an approach based on the analysis of proton selective relaxation rate enhancements of the ligand in the presence of the macromolecule. The contribution from the bound ligand fraction to the observed relaxation rate in relation to protein concentration allowed the calculation of the affinity index[A]L(T) and the normalized affinity index [AI(N)]L(T) which removes the effects of motional anisotropies and different proton densities, and isolates the contribution due to a decrease in the ligand dynamics caused by the binding with the protein. This approach allowed the comparison of the binding ability of prednisolone and prednisone towards albumin.