硝酸舍他康唑栓剂体内药效学实验研究

目的评估硝酸舍他康唑栓剂治疗大鼠念珠菌性阴道炎模型的疗效。方法取SD大鼠建立念珠菌性阴道炎模型,随机分成治疗组(4个剂量)、基质对照、阳性对照、阴性对照和空白对照共8组,硝酸舍他康唑栓剂和对照药分别每天给药1次,共治疗7天。分别于疗程结束时、停药1周后、2周后作真菌培养以判定疗效。结果硝酸舍他康唑栓剂对白念珠菌和热带念珠菌引起SD大鼠念珠菌性阴道炎的治愈率为100%(5/5),停药2周后仍保持满意的治疗效果。结论硝酸舍他康唑栓剂对念珠菌性阴道炎有较好的疗效。     

综合疗法治疗复发性念珠菌性包皮龟头炎

目的探讨口服氟康唑胶囊、外用曲安奈德益康唑乳膏联合包皮环切术防治复发性念珠菌包皮龟头炎的疗效。方法采用随机分组法,治疗组(46例)给予氟康唑胶囊200mg,1次/d,连服3d,外用曲安奈德益康唑乳膏,早、晚各1次,2周为1个疗程,炎症控制后行包皮环切术。对照组(40例)给予氟康唑胶囊连服6d,曲安奈德益康唑乳膏外用2周。治疗后2周及2,4和6个月时随访。结果 2周后,两组痊愈率分别为89.13%和85.00%,差异无统计学意义(P>0.05)。两组有效率分别为100.00%和95.00%,差异无统计学意义(P>0.05)。2,4,6个月治疗组复发率分别为4.88%,9.76%和9.76%,对照组复发率分别为23.53%,38.24%和50.00%,两组比较差异均有统计学意义(P均<0.05)。结论综合疗法治疗复发性念珠菌包皮龟头炎安全有效,并能有效减少复发。     

Why do different criteria for 'cure' yield different conclusions in comparing two treatments for bacterial vaginosis?

OBJECTIVE: The objective of this study was to determine why different criteria for response to treatment of bacterial vaginosis (BV) led to markedly different conclusions about treatment efficacy in a randomized trial comparing metronidazole gel versus metronidazole/nystatin ovules. STUDY: We compared the impact of two treatment regimens on individual components of Amsel and Nugent criteria at follow-up visits 14, 42, and 104 days after initiating treatment. RESULTS: Compared with gel, ovules more effectively eliminated amines, clue cells, and Gardnerella, Prevotella, or Mobiluncus morphotypes from vaginal fluid, thus achieving cure based on "usual" criteria (absence of BV by Amsel or Nugent criteria), but did not more effectively restore Lactobacillus morphotypes or lower vaginal pH, thus not meeting Federal Drug Administration (FDA) criteria for cure. CONCLUSION: Because early vaginal recolonization by lactobacilli was poor after both gel and ovules, FDA draft criteria for cure missed marked differences in treatment efficacies against Gardnerella, clue cells, and amines. Cure defined more "usually" may give more useful information.     

Use of topical povidone‐iodine resulting in an iododerma‐like eruption

Iododerma is a rare skin eruption that is usually induced by the systemic use of iodide‐containing radiographic contrast medium or treatment with oral potassium iodide therapy. Iododerma has also rarely been reported to occur following topical application of iodine. We herein report the case of a 42‐year‐old male who developed multiple pinpoint pustules on both lower extremities. Three days after the eruption began, the patient started applying topical 10% povidone‐iodine solution to the lesions. During this treatment, the lesions enlarged into multiple 2–9‐cm pus‐filled bullae, limited to the treated areas. Lesional bacterial culture swab and Gram stain were negative. Blood cultures were also negative and the patient's white blood cell count was normal. A punch biopsy specimen revealed pseudoepitheliomatous hyperplasia and dermal‐epidermal separation with epidermal necrosis and underlying abscess formation. A superficial and deep perivascular, interstitial and perifollicular infiltrate containing numerous neutrophils, with abscess formation and eosinophils was also seen. This histology was consistent with iododerma and the patient's lesions involuted following cessation of topical iodine use, leaving only post‐inflammatory hyperpigmentation. In summary, our patient likely had a folliculitis that was then treated with topical povidone‐iodine that led to iododerma. Although it remains possible that the reaction was an unusual contact hypersensitivity response, the ulceration, pseudoepitheliomatous hyperplasia and abscess formation do support an iododerma‐like eruption.     

Dermatitis de contacto por povidona yodada tras cirugía: un dilema diagnóstico

We present 7 cases of postsurgical contact dermatitis due to povidone iodine. The diagnosis was based on the clinical manifestations, the history of exposure, the site of the lesions, and the results of patch tests. This type of dermatitis can develop in the area of surgery or at distant sites exposed to povidone iodine during the surgical intervention. Patch tests with 10% povidone iodine in petrolatum were positive in all patients. Based on the results of the same tests in a control group, we recommend the use of petrolatum rather than water as the vehicle for the diagnosis of this form of contact dermatitis. Repeated open application tests with a commercially available solution of povidone iodine were negative. We conclude that the presence of the solution under occlusion during surgery is necessary both for the symptoms to develop and for the diagnosis to be made. This condition may be underdiagnosed.     

Topical 2% mupirocin versus 2% fusidic acid ointment in the treatment of primary and secondary skin infections

The efficacy and side effects of topical mupirocin (Bactroban) and fusidic acid (Fucidin) ointment were compared in a double-blind, randomized trial in 70 patients who came to the Dermatologic Clinic of L'Enfant Jésus Hospital with primary or secondary (or both) skin infections. Thirty-five patients were treated with mupirocin and 35 patients were treated with fusidic acid three times a day for seven days. Clinical and bacteriologic assessments were conducted before and after treatment. The efficacy of mupirocin, in terms of resolution and improvement of clinical signs and symptoms of infection, as well as of the elimination of infecting organisms, was similar to that of fusidic acid. Of 34 patients (1 could not be evaluated) treated with mupirocin, a clinical cure was achieved in 18, and significant improvement was demonstrated in 15. Similarly, of 35 patients treated with fusidic acid, a clinical cure was achieved in 18 and improvement occurred in 15. Bacteriologic cure rates were 97% (30 of 31 patients evaluated) in the mupirocin-treated group, compared with 87% (27 of 31 patients evaluated) in the fusidic acid-treated group. No side effects were observed in either treatment group. Because topical 2% mupirocin has little or no potential for irritation, systemic side effects, or cross-resistance with other antibiotics, its efficacy is likely to make this new compound a useful agent for the treatment of superficial skin infections.     

Clinical and bacteriological evaluation of a twice daily regimen of epicillin capsules for the treatment of skin infections

Fifty-five patients with impetigo, ecthyma, or folliculitis caused by epicillin-sensitive strains of Streptococcus pyogenes or Staphylococcus aureus were treated with 500 mg epicillin capsules twice daily for an average duration of 9 days. Bacteriological and clinical examinations were performed at 2-day intervals. Favourable clinical responses (excellent or good) were obtained in 95% of the patients. No side effects were observed.     

果酸联合丹参酮治疗痤疮疗效评价

目的:评价果酸联合丹参酮治疗寻常痤疮的疗效。方法:90例寻常痤疮患者随机分成两组,治疗组采用果酸治疗,每周2次,同时口服丹参酮胶囊,4粒/次,3次/d;对照组单纯用果酸治疗,8周后观察疗效。结果:治疗组有效率为80.43%,对照组为61.36%,两组疗效比较差异有显著性(P0.05),两组均未发现明显不良反应。结论:果酸联合丹参酮治疗寻常痤疮疗效较好。     

Oral itraconazole for the treatment of seborrhoeic dermatitis: an open, noncomparative trial

BACKGROUND: Seborrhoeic dermatitis is an inflammatory cutaneous disorder in which the colonization of the affected area by Malassezia has been proved to play a key role. OBJECTIVE: To perform a noncomparative open clinical study with oral itraconazole capsule (200 mg/day x 7 days) and consecutive usage 200 mg/day for the first 2 days of the following 2 months in patients with seborrhoeic dermatitis. METHODS: Twenty-nine patients were enrolled to determine the efficacy and safety of oral itraconazole. The patients were evaluated according to itching, burning, erythema, desquamation and seborrhoea, each scored on a 0-4 scale on days 15 (T15), 30 (T30), 60 (T 60) and 90 (T90). Itraconazole capsule 100 mg was given twice a day for 1 week and then, after a 3-week interval, patients used itraconazole capsule 200 mg/day for the first 2 days of the following 2 months. The clinical response was graded as markedly effective, effective, moderate or ineffective. RESULTS: A clinical improvement (evaluated as markedly effective or effective) was observed in 23 patients (83%) at T15, 21 (76%) at T30, 20 (72%) at T60 and 17 (61%) at T90. At baseline, the mean +/- SD total clinical scores were 10.44 +/- 2.45, 1.98 +/- 0.5, 2.97 +/- 1.12, 3.15 +/- 1.74 and 3.30 +/- 1.90 at T0, T15, T30, T60 and T90, respectively. Compared with baseline values, itraconazole capsule significantly reduced the mean +/- SD total score as well as individual erythema and desquamation (Wilcoxon's signed test-two tailed) (P < 0.0001). No drug-related systemic adverse event was observed during the study. CONCLUSIONS: Seborrhoeic dermatitis shows marked reduction in inflammation when treated with itraconazole. The anti-inflammatory activity of oral itraconazole and efficacy on Malessezia suggests that itraconazole capsule will be first oral treatment option in future in severe seborrhoeic dermatitis.     

复方甲硝唑栓联合倍美力软膏治疗老年性阴道炎的临床研究

目的：探讨复方甲硝唑栓联合倍美力软膏治疗老年性阴道炎的临床疗效和安全性。方法：选取2011年1月至2012年12月来本院妇科就诊的老年性阴道炎患者共130例作为研究对象。根据入院时间将患者随机分为观察组和对照组,每组各65人。对照组采用甲硝唑栓进行治疗,观察组加用倍美力软膏进行联合治疗。对比两组临床表现改善情况、血清激素水平和临床疗效。结果：治疗后,与对照组相比,观察组白带增多、阴道瘙痒和阴道壁红肿充血症状明显缓解（χ^2=4.33、4.01、6.39,P均〈0.05）;治疗后,与对照组相比,观察组血清FSH水平升高幅度较大（U=8.43,P〈0.05）,E2降低幅度较大（U=5.59,P〈0.05）;观察组治愈率和总有效率分别为63.08%和95.38%,均高于对照组（44.62%,81.54%）（χ^2=4.46、6.10,P均〈0.05）。结论：复方甲硝唑栓联合倍美力软膏治疗老年性阴道炎较单纯应用复方甲硝唑栓具有明显的优势,给药方便,安全可靠,值得在临床上进一步推广。     

Q开关1064nm Nd:YAG激光碳膜术治疗中重度痤疮疗效与安全性评价

目的:评价Q开关1064 nm Nd:YAG激光碳膜术治疗寻常痤疮的疗效与安全性。方法:中重度痤疮患者166例随机分为实验组(83例)和对照组(83例)。对照组给予米诺环素胶囊100 mg,1天2次口服;克林霉素甲硝唑搽剂外用,1天3次。实验组在对照组治疗的基础上行Q开关1064 nm Nd:YAG激光碳膜术,10天治疗一次。结果:治疗40天后实验组有效率为87.76%,明显高于对照组的65.31%,差异有显著性(P0.05)。两组均未见明显不良反应发生。结论:Q开关1064 nm Nd:YAG激光碳膜术可提高药物治疗痤疮的疗效。     

Profuse scabies: kinetic curves of parasitologic cure with an association of benzyl benzoate and sulfiram

BACKGROUND: In vitro exposure to benzyl benzoate (25 p. 100) kills Sarcoptes scabiei within three hours. The aim of our study was to determine in vivo elimination of Sarcopte scabiei with a benzyl benzoate-sulfiram association. METHODS: Medical charts of patients hospitalized for disseminated scabies from 1993 to 1999 were reviewed retrospectively. The diagnosis of scabies was confirmed by microscopic determination. Parasitological examinations were conducted every day or every two days until negative results. Patients were treated by successive applications of benzyl benzoate until parasitological cure. RESULTS: Twenty patients were included in the study. The median delay of parasitological cure was seven days. After 15 days, 95 p. 100 of patients were cured. Two cutaneous side-effects were reported. DISCUSSION: Despite immediate in vitro efficacy, benzyl benzoate action is delayed in vivo. The time of parasitological negativation after one application of benzyl benzoate is unknown. Therefore, it is not currently possible to determine whether our therapeutic regimen was excessive or not.     

Comparative study of bacampicillin and ampicillin in the treatment of uncomplicated gonorrhoea.

Bacampicillin hydrochloride, a pro-drug ester of ampicillin trihydrate which is hydrolysed to ampicillin after absorption, was used in a randomised comparative study of ampicillin 3.5 g and bacampicillin 1.6g (each with probenecid 1 g) in the treatment of uncomplicated gonorrhoea. This dose of bacampicillin was selected because in serum it gives approximately the same peak concentration of ampicillin as 3.5 g of the present drug. Genital, pharyngeal, and anal cultures were performed at the initial visit and at follow up 5-9 days after treatment. There was no statistically significant difference in the microbiological or clinical response of patients with genital gonorrhoea who were treated with ampicilin and those treated with bacampicillin. At 5-9 days after treatment, 93% of the ampicillin-treated patients and 89% of the bacampicillin-treated patients had negative genital, pharyngeal, and anal culture results; furthermore, 87% and 89% respectively had no symptoms of infection. Fewer gastrointestinal side effects were noted in the patients treated with bacampicillin.     

Pivampicillin versus doxycycline in the treatment of chlamydial urethritis in men

Pivampicillin and doxycycline were compared in the treatment of chlamydial urethritis in 80 heterosexual men. The trial was carried out in a double-blind, comparative parallel group fashion. Forty patients were treated with 700 mg of pivampicillin twice daily and another 40 with 200 mg of doxycycline on the first day and thereafter with 100 mg of doxycycline and one placebo tablet daily. Both treatments lasted for 9 days. Follow-up examinations were carried out 2 weeks (14-16 days) and 4 weeks (26-30 days) after the start of treatment. Altogether five (12.5%) of the forty pivampicillin-treated patients were clinical failures and three (7.5%) still harbored Chlamydia trachomatis after treatment. The corresponding figures for the doxycycline-treated patients were two (5.1%) and one (2.6%). The difference between the treatment results of the two groups did not reach statistical significance.     

Equivalent therapeutic efficacy and safety of ivermectin and lindane in the treatment of human scabies.

OBJECTIVE: To compare the therapeutic efficacy and safety of ivermectin and lindane for the treatment of human scabies. DESIGN: Randomized, prospective, controlled, double-blind, "double-dummy," and parallel clinical study. SETTING: A single department of dermatology at a hospital in Buenos Aires, Argentina. PATIENTS: Patients were outpatients, hospitalized patients, and those referred to our hospital from nursing homes and asylums. Fifty-three patients had clinical signs and symptoms compatible with scabies. INTERVENTION: Patients received either a single oral dose of ivermectin (150-200 microg/kg of body weight) or a topical application of 1% lindane solution. Treatment was repeated after 15 days if clinical cure had not occurred. MAIN OUTCOME MEASURES: Clinical healing and adverse effects. RESULTS: Of 53 patients, 43 (81%) completed the study, 19 in the group treated with ivermectin and 24 in the group treated with lindane. At day 15, 14 patients (74%; 95% confidence interval, 48.8%-90.8%) in the group receiving ivermectin showed healing of their scabies and 13 patients (54%; 95% confidence interval, 32.8%-74.4%) in the group treated with lindane were healed. At 29 days, both treatments resulted in statistically equivalent therapeutic efficacy: 18 patients (95%; 95% confidence interval, 74.0%-99.9%) were healed with ivermectin and 23 patients (96%; 95% confidence interval, 78.9%, 99.9%) were healed with lindane (P<.02). Adverse effects from the treatments were few, mild, and transient. Results from laboratory tests showed no major abnormalities and no difference between treatments. CONCLUSIONS: Ivermectin is as effective as lindane for the treatment of scabies. Ivermectin is simpler to use and, therefore, is a promising tool to improve compliance and to control infestations.     

Review of a treatment for psoriasis using herose, a botanical formula

This study was undertaken to assess the efficacy of the herose formula as a treatment for psoriasis patients who have been previously treated with immunosuppressants. The study was an open one conducted in one center. Fifteen patients were instructed to take four herose capsules (450 mg per capsule) three times a day for 10 months. At each visit the investigator assessed each patient's PASI and therapeutic response to the treatment. The patients were treated and observed from February of 2004 to November of 2004. The results showed that the herose capsule may be an effective and safe treatment for moderate to severe plaque psoriasis.     

乳酸菌阴道胶囊联合甲硝唑泡藤片治疗妊娠合并细菌性阴道病的疗效观察

目的:探讨乳酸菌阴道胶囊联合甲硝唑泡藤片治疗妊娠合并细菌性阴道病的疗效。方法:选择妊娠合并细菌性阴道病患者72例,随机分为联合组和对照组。两组患者均予以阴道放置甲硝唑阴道泡腾片200mg,每晚1次,连用7d。联合组患者在此基础上予以乳酸菌阴道胶囊阴道放置,每晚1枚,连用7d。观察两组患者治疗结束后1周的临床疗效,并随访比较两组患者治疗后3个月和6个月内复发率。结果:联合组患者治疗后的临床总有效率明显高于对照组(χ2=4.18,P<0.05)。两组治疗结束后随访3个月和6个月内,联合组的复发率均明显低于对照组(χ2=5.35和6.11,P<0.05)。结论:乳酸菌阴道胶囊联合甲硝唑泡藤片治疗妊娠合并细菌性阴道病具有较好疗效,能降低复发率,具有治疗和预防妊娠合并细菌性阴道病复发的双重作用。     

复方甘草酸苷联合一清胶囊治疗单纯型过敏性紫癜66例疗效观察

目的评价复方甘草酸苷联合一清胶囊治疗单纯型过敏性紫癜的临床疗效。方法将126例患者随机分为两组。两组均口服氯雷他啶、芦丁片、潘生丁和一清胶囊,治疗组同时予静滴复方甘草酸苷。连续治疗2周后判定疗效。结果治疗组与对照组有效率分别为89.39%和70.00%,差异有统计学意义(P<0.05)。结论复方甘草酸苷联合一清胶囊治疗单纯型过敏性紫癜疗效确切,值得临床选用。     

Microbiological, epidemiological and clinical correlates of vaginal colonisation by Mobiluncus species.

The microbiological and epidemiological correlates of vaginal colonisation by Mobiluncus species were examined among randomly selected women attending a sexually transmitted disease (STD) clinic. Women positive for Trichomonas vaginalis were excluded. Mobiluncus spp. were detected by Gram stained vaginal smear in 21% of 633 STD clinic patients, including 53% of those with and 4% of those without bacterial vaginosis (BV), as diagnosed by clinical criteria. Gardnerella vaginalis and Mycoplasma hominis detected by vaginal culture and Mobiluncus detected by vaginal Gram stain were each independently associated with BV after adjusting by logistic regression for the presence of sexually transmitted disease pathogens, gravidity, parity and number of lifetime sexual partners (p less than 0.001 for each organism). Bacterial vaginosis was negatively correlated with isolation of lactobacilli, yeast and herpes simplex virus. After adjusting for presence or absence of BV, women with Mobiluncus were more likely to harbour G vaginalis (odds ratio 5.6, 95% confidence interval 1.6-19.5), M hominis (OR 3.7, 95% CI 2.0-7.0) and Neisseria gonorrhoeae (OR 2.9, 95% CI 1.4-6.0) and less likely to harbour vaginal yeast (OR 0.4, 95% CI 0.2-1.0); were more likely to be black (OR 2.7, 95% CI 1.5-4.6), and to have been pregnant (OR 1.8, 95% CI 1.1-3.1); but after the adjustment for BV, vaginal colonisation by Mobiluncus was not associated with symptoms of odour, abdominal pain, menstrual irregularities, or with adnexal tenderness. In summary, Mobiluncus, Gardnerella vaginalis and Mycoplasma hominis were independently associated with a clinical diagnosis of bacterial vaginosis, and Mobiluncus was further associated with the presence of BV-associated microorganisms (M hominis and G vaginalis), N gonorrhoeae, black race, and gravidity.     

Cadexomer-iodine ointment shows stimulation of epidermal regeneration in experimental full-thickness wounds

The use of iodine in wound healing is still controversial. Both wound healing-stimulating effects and toxic effects leading to impaired wound healing have been reported. In order to study the direct effects of iodine on wound healing without interference of infectious pathogens, we investigated wound-healing parameters in noninfected experimental full-thickness wounds in the pig. Topical iodine treatment with an ointment consisting of a combination of iodine and cadexomer (modified starch), was compared with cadexomer ointment, the vehicle without iodine, and with treatment with saline. Treatment lasted for 30 days, followed by 30 days of wound assessment. The rate of epithelialization, wound contraction, systemic iodine absorption and several immunohistochemical markers were evaluated. All 36 wounds healed without macroscopic signs of wound infection and reepithelialized within 21 days. During the first 9 days of treatment, wounds treated with cadexomer-iodine ointment showed significantly more epithelialization than the wounds treated with either cadexomer or saline. In addition, the epidermis of wounds treated with cadexomer-iodine ointment had significantly more epithelial cell layers from day 12 to day 30, and these wounds stained for chondroitin sulphate proteoglycans in the newly formed basement membrane zone, which was not observed with the other treatments. No negative effects of cadexomer- iodine ointment on the formation of granulation tissue, neovascularization or wound contraction were observed. During the treatment systemic iodine absorption was physiologically acceptable. These results showed that treatment with cadexomer-iodine-containing ointment had positive effects on epidermal regeneration during the healing of full-thickness wounds in the pig compared with ointment alone or saline treatment. Received: 14 April 1997