头孢哌酮钠联合左氧氟沙星对创伤弧菌脓毒症大鼠组织中NSE S-100β蛋白和炎症因子的影响

目的 观察创伤弧菌脓毒症大鼠血清神经元特异性烯醇化酶(NSE)、S-100β蛋白和脑组织炎症因子的动态变化及头孢派酮钠联合左氧氟沙星的干预.方法 100只SD大鼠随机分正常对照组(A组,n=10)、创伤弧菌脓毒症组(B组,n=40)、抗菌药物干预组(C组,n=40)和抗菌药物对照组(D组,n=10)左后肢皮下注射创伤弧菌构建大鼠脓毒症模型,腹腔注射头孢派酮钠180 mg/kg和左氧氟沙星18 mg/kg干预.观察B、C组大鼠染菌后6、12、24、48 h血清NSE、S-100β,脑组织TNF-α、IL-6、IL-10转录和蛋白水平及光镜变化.结果 与A组比较,B组大鼠血清NSE、S-100β蛋白均明显升高(P<0.05),24 h达峰值.与相同时间点B组比较,C组血清NSE、S-100β 12、24、48 h均有明显减低(P<0.05).与A组比较,B组大鼠脑组织各时间点TNF-α、IL-6、IL-10转录和蛋白水平均明显升高(P<0.05),其中TNF-α在6 h即达峰值,而IL-6水平12 h达峰值,IL-10水平在48 h达峰值.与B组相同时间点比较,6、12、24 h点C组大鼠脑组织TNF-α水平明显降低,12、24、48 h点脑组织IL-6水平亦明显下调,而脑组织IL-10水平在各时间点均较B组明显升高(P<0.05).光镜下B组大鼠脑组织间质水肿严重,组织结构紊乱,炎症细胞侵润,血管扩张.C组大鼠脑组织间质水肿减轻,炎症细胞侵润程度降低.结论 NSE、S-100β蛋白的表达随着脑组织炎症的加重逐渐升高,敏感地反应创伤弧菌脓毒症脑损伤的变化.使用头孢哌酮和左氧氟沙星能有效抑制脑组织炎症反应,减轻脑损伤,减低血清NSE、S-100β蛋白的水平.     

高渗羟乙基淀粉对脑缺血大鼠颅内压的影响及机制探讨

目的 探讨高渗羟乙基淀粉200/0.5氯化钠注射液对脑缺血-再灌注大鼠颅内压和脑水肿的影响及可能机制.方法 采用随机对照动物实验研究方法,实验在中山大学实验动物中心进行.取28只雄性SD大鼠,随机(随机数字法)分为高渗羟乙基淀粉组、羟乙基淀粉组、对照组和假手术组.右侧大脑中动脉阻塞(middle cerebral artery occlusion,MCAO)法建立脑梗死再灌注大鼠模型,造模不成功另选大鼠再行手术补足手术组,于再灌注开始时尾静脉泵入高渗羟乙基淀粉200/0.5氯化钠注射液和羟乙基淀粉130/0.4氯化钠注射液,分别为206 mL/ (kg· d);造模后0、2、6、12、18、24 h时间点分别测量血浆胶体渗透压(plasma colloid osmotic pressure,COP)和颅内压(intracranial pressure,ICP);治疗24 h后测量右侧大脑半球含水量(brain water content,BWC).结果 高渗羟乙基淀粉组、羟乙基淀粉组和对照组术后各时间点ICP均显著高于假手术组;高渗羟乙基淀粉组术后ICP明显低于对照组和羟乙基淀粉组,但羟乙基淀粉组各时间点ICP和对照组比较差异无统计学意义.高渗羟乙基淀粉组和羟乙基淀粉组COP各时间点均显著高于对照组和假手术组,高渗羟乙基淀粉组和羟乙基淀粉组间差异均无统计学意义.高渗羟乙基淀粉组、羟乙基淀粉组和对照组脑含水量均显著高于假手术组[(81.24±0.36)％、(83.04±0.10)％、(83.14±0.41)％ vs.(78.37±0.37)％,P=0.000];高渗羟乙基淀粉组脑含水率显著低于对照组[(81.24±0.36)％ vs.(83.14±0.41)％,P=0.000)]和羟乙基淀粉组[(81.24±0.36)％ vs.(83.04±0.10)％,P=0.000];羟乙基淀粉组和对照组比较差异无统计学意义[(83.04±0.10)％vs.(83.14±0.41)％,P=0.578].结论 高渗羟乙基淀粉可明显改善脑缺血-再灌注大鼠急性期脑水肿、降低颅内压,但未能证实其提高COP对颅内压和脑水肿的影响.     

大承气汤对脓毒症大鼠p38MAPK信号转导通路的影响

目的 观察大承气汤对脓毒症大鼠肝脏p38丝裂原活化蛋白激酶(p38MAPK)表达水平的影响,进一步揭示大承气汤治疗脓毒症的机制.方法 将60只健康雄性SD大鼠随机分为假手术组(n=20)、脓毒症组(n=20)、大承气汤组(n=20),应用大鼠盲肠结扎穿孔(CLP)复制脓毒症模型.假手术组开腹轻扰肠管后关腹,脓毒症组、大承气汤组均为脓毒症模型.大承气汤组在术前2 h和术后每4 h予以大承气汤灌胃.分别于术后2、6、12、24 h每组取5只大鼠,腹主动脉采血,用ELISA方法 检测大鼠血浆IL-6、TNF-α浓度,取肝组织进行免疫组化检测及观察p38MAPK表达.结果 与脓毒症组比较,大承气汤组大鼠肝脏p38MAPK表达水平受到抑制,炎症因子释放减少(P<0.05).结论 大承气汤对脓毒症大鼠的肝脏产生保护作用,可能是由于抑制大鼠肝脏p38MAPK表达来实现的.     

安宫牛黄丸对大鼠脑出血后水通道蛋白-4表达的影响

目的:探讨安宫牛黄丸对大鼠脑出血(intracerebral hemorrhage)后脑水肿及脑组织水通道蛋白-4(aquaporin-4,AQP-4)表达的影响.方法:将SD大鼠随机分为正常对照(CON)组、假手术(SHAM)组、脑出血(ICH)组、安宫牛黄丸治疗(AGNHW)组.每组分为5个时间点,分别为6、12、24、48、72 h,每个时间点5只大鼠.采用自体股动脉血注入尾状核建立大鼠脑出血模型,HE染色观察各组血肿周围神经细胞形态学改变,免疫组织化学方法观察各组血肿周围脑组织AQP-4表达的变化.结果:大鼠实验性脑出血后AQP-4表达升高,48 h达到高峰,72 h仍高于正常;脑出血后6 h可见神经细胞坏死,24～48 h时段达到高峰,脑组织损伤程度与AQP-4表达呈显著正相关(r=0.829,P<0.001);安宫牛黄丸处理后,脑组织损伤减轻,AQP-4表达下降.结论:脑出血后AQP-4表达与脑组织损伤程度呈显著正相关,安宫牛黄丸能够有效抑制大鼠脑出血后AQP-4蛋白表达,减轻脑水肿.     

葡萄籽原花青素对脑缺血再灌注大鼠氧化应激与学习记忆的影响

目的探讨葡萄籽原花青素(GSPE)对脑缺血再灌注大鼠学习记忆能力的影响及其机制。方法72 只健康雄性Sprague-Dawley 大鼠分为假手术组(n=18)、模型组(n=18)、GSPE低剂量组(20 mg/kg, n=18)和GSPE高剂量组(200 mg/kg, n=18)。造模前,GSPE各组灌胃4 周,假手术组和模型组给予蒸馏水10 ml/kg &#8901;d。线栓法制备脑缺血再灌注损伤模型。分别于缺血2 h 再灌注后12 h、24 h、48 h 各取6 只大鼠,行Morris 水迷宫测试,HE染色观察脑组织形态变化,检测大鼠脑组织超氧化物歧化酶(SOD)、丙二醛(MDA)的含量。结果与假手术组比较,模型组Morris 水迷宫测试潜伏期延长,穿台次数减少(P<0.05);HE染色显示脑组织神经元逐渐坏死;SOD含量降低,MDA含量增加(P<0.05)。与模型组比较,GSPE高剂量组各相同时间点潜伏期缩短,穿台次数增加(P<0.05);HE染色显示脑组织神经元核固缩和空泡减少;SOD含量增加,MDA含量降低(P<0.05)。结论GSPE可以减轻脑缺血区病理改变,减轻缺血再灌注后脂质过氧化,改善脑缺血再灌注大鼠的学习记忆功能。     

富氢羟乙基淀粉对非控制性失血性休克大鼠血浆炎症因子和氧化损伤的影响研究

目的探讨富氢羟乙基淀粉(HHES)对非控制性失血性休克大鼠血浆白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超氧化物歧化酶(SOD)和丙二醛(MDA)的影响及其作用机制。方法制备非控制性失血性休克大鼠模型,30只Wistar雄性大鼠随机分为三组,每组10只,sham组(假处理组)、对照组(休克+输注羟乙基淀粉)、实验组(休克+输注富氢羟乙基淀粉)。观察各组在0 min、45 min、105 min、225 min的平均动脉压(MAP)、心率和24 h存活率,以及复苏后血浆IL-6、TNF-α、SOD和MDA水平的变化。结果输液后45 min、105 min和225 min各时间点实验组和对照组MAP、HR比较,差异无统计学意义(P 0. 05)。在105 min、225 min时间点实验组IL-6、TNF-α、MDA水平较对照组降低,而实验组SOD水平较对照组增高,差异有统计学意义(P 0. 01)。结论富氢羟乙基淀粉对非控制性失血性休克大鼠有复苏作用,能抑制失血性休克引起的炎症反应,减少MDA生成和SOD消耗,从而减轻氧化损伤。     

多器官功能障碍综合征大鼠血清及肝组织中基质金属蛋白酶-9的表达及意义

目的 检测基质金属蛋白酶-9(MMP-9)在多器官功能障碍综合征(MODS)大鼠外周血清及肝组织中表达的变化,探讨细胞外基质的破坏在MODS肝损伤中的作用.方法 将40只成年雄性SD大鼠随机分为正常对照组(8只)、MODS模型组(32只),模型组又分为造模后6、12、24、48 h不同时相,每组8只.采用"二次打击"即眼球失血加腹腔注射脂多糖(LPS)制备MODS模型:大鼠左眼球取血2 mL/100 g,4 h后无菌腹腔注射LPS 5 mg/kg.造模完成后在不同时相点收集标本.对照组予以腹腔注射等量的生理盐水.肉眼、光镜观察肝组织形态结构变化,酶联免疫吸附试验(ELISA)法检测血清MMP-9水平,免疫组化法检测肝组织MMP-9蛋白的表达.结果 正常对照组肝组织结构无改变,MODS组肝组织损伤较重.造模后6～24 h MODS组血清MMP-9水平高于正常对照组(P<0.05),其峰值见于造模后12 h(P<0.05),24 h开始下降,48 h虽高于正常对照组,但差异无统计学意义.造模后6～48 h MODS组肝组织MMP-9的阳性表达较正常对照组有所增加(P<0.01,P<0.05),其峰值见于造模后12 h(P<0.01).结论 细胞外基质的破坏是引起MODS肝损伤的一个重要因素,早期检测MMP-9水平的变化,可能对MODS组织器官功能损害的早期诊断和预后判断有重要价值.     

局部亚低温对大鼠脑出血模型脑组织中紧密连接相关蛋白-5表达的影响

目的:探讨局部亚低温对大鼠脑出血(intracerebral hemorrhage,ICH)模型紧密连接相关蛋白-5(Claudin-5)表达的影响以及局部亚低温减轻ICH后水肿的可能机制。方法:选取雄性SD大鼠216只,采用自体血注入法制备ICH模型,并随机分为ICH组和ICH加局部亚低温(ICH+H)组。每组又分为假手术组以及ICH后6 h、12 h、24 h、3 d、7 d组共6个亚组。ICH+H组于注血后给予局部亚低温治疗。采用免疫组织化学法检测Claudin-5的表达,采用伊文思蓝法进行血脑屏障通透性的检测,采用干湿质量法进行脑组织含水量的检测。结果:ICH组大鼠血肿周围脑组织中Claudin-5表达在ICH后6 h开始减少,ICH后24 h下降最显著,ICH后7 d时仍低于假手术组(P<0.05);ICH组大鼠在ICH后6 h开始出现血脑屏障通透性及脑组织含水量增加(P<0.05),在ICH后3 d达到高峰,然后逐渐消退。ICH+H组大鼠ICH后各时间点Claudin-5表达均高于ICH组(P<0.05),而血脑屏障通透性、脑组织含水量则低于ICH组(P<0.05)。结论:局部亚低温可能通过提高Claudin-5的表达来抑制ICH后脑水肿的形成。     

血必净对创伤弧菌脓毒症大鼠肺组织核因子-κB p65表达作用的研究

目的 观察创伤弧菌脓毒症大鼠肺组织核因子-κB(NF-κB)p65基因及蛋白表达,并探讨血必净对其的干预作用.方法 SD大鼠110只,随机分为正常组(A组,n＝10)、创伤弧菌脓毒症组(B组,n＝50,采用大鼠左下肢皮下注射创伤弧菌悬液制作大鼠创伤弧菌脓毒症模型)和血必净治疗干预组(C组,n＝50,感染后半小时腹腔注射血必净4 mL/kg).B、C组于染菌后1、6、12、24、48 h活杀(各时间点n=10),采用逆转录-聚合酶链式反应(RT-PCR) 法、Western blot法和双抗体夹心酶联免疫吸附法(ELISA)分别检测大鼠肺组织NF-κB p65的基因与蛋白表达及IL-10的含量,数据采用单因素方差分析.结果 与A组比较,B组大鼠肺组织创伤弧菌感染后6、12 h NF-κB p65 mRNA表达量与6、12、24和48 h肺组织NF-κB p65蛋白表达量均明显增高 (P<0.05);与B组相同时间点比较,C组6 h肺组织NF-κB p65 mRNA表达量与12、24及48 h肺组织NF-κB p65 蛋白表达量明显减少(P<0.05); 与A组比较,B组创伤弧菌菌感染12、24和48 h IL-10的含量明显增加(P<0.05),与B组相同时间点比较,C组24 h(52.444±9.605)肺组织IL-10的含量明显增高(P<0.05);感染后48 h,大鼠肺内血管明显充血,间质水肿并伴炎性浸润,肺泡腔塌陷,血必净干预后,肺组织损伤有所减轻.结论 NF-κB参与了创伤弧菌脓毒症肺损伤过程;血必净能抑制NF-κB p65的表达,从而起到保护创伤弧菌脓毒症大鼠肺组织的作用.     

亚低温对急性脊髓损伤后肿瘤坏死因子-α表达及运动功能恢复的影响

目的 观察大鼠脊髓损伤(SCI)后亚低温对肿瘤坏死因子-α (TNF-α)mRNA表达及运动功能恢复的影响,探讨其可能的作用机制.方法 72只SD大鼠随机分为对照组(n=24)、常温组(n=24)和亚低温组(n=24),每组再分为六个亚组,每亚组4只,参照改良Allen法建立大鼠脊髓(T9)中度损伤模型,亚低温组给予亚低温治疗5 h,而对照组不做亚低温处理.分别于损伤后6 h、12 h、24 h、72 h、1周和4周,利用 Tarlov评分检测亚低温对大鼠SCI后运动功能恢复的影响;然后将大鼠处死,利用半定量 RT-PCR方法观察损伤段脊髓组织中TNF-α mRNA表达的变化.结果 亚低温组TNF-α mRNA表达SCI后6~72 h明显少于常温组(P<0.05),而运动功能评分每个时间点都明显高于常温组(P<0.05).结论 亚低温可明显抑制SCI后TNF-α的表达,具有良好的恢复运动功能的作用.     

护理干预对小儿漏斗胸术后康复的影响

目的 探讨护理干预对小儿漏斗胸术后康复的影响。方法 选取2010年3月-2014年6月收治在上海远大心胸医院胸外科的漏斗胸矫形患儿281例,将2013年之前的141例作为对照组,按常规护理;2013年之后的140例作为观察组,施行术前患儿及家属的心理干预、疼痛管理、饮食与排便管理、计划性功能锻炼等护理干预,比较两组术后下地时间、排便时间、出院时间、患儿功能锻炼依从性及家属配合程度。结果 两组术后下地时间、排便时间、出院时间均缩短,患儿功能锻炼依从性及家属配合程度均提高,有统计学意义（P＜0.05）。结论 漏斗胸矫形术前对患儿及家属心理干预,术后加强疼痛、饮食和排便管理,协助功能锻炼有利于术后康复,明显缩短住院时间。     

Comparison of tobramycin 0.3%/dexamethasone 0.1% and tobramycin 0.3%/loteprednol 0.5% in the management of blepharo-keratoconjunctivitis

In this clinical trial, investigators compared the effectiveness of 2 commercially formulated antibiotic/steroid combinations - tobramycin 0.3%/dexamethasone 0.1% (Tobradex; Alcon, Fort Worth, Tex) and tobramycin 0.3%/loteprednol 0.5% (Zylet; Bausch & Lomb Inc., Rochester, NY) - for rapidly controlling inflammation in patients with blepharo-keratoconjunctivitis. Investigators in this randomized, parallel-group, double-masked study examined 40 eyes of 40 patients with blepharo-keratoconjunctivitis. Patients received tobramycin 0.3%/dexamethasone 0.1% or tobramycin 0.3%/loteprednol 0.5% twice daily in the test eye, according to the randomization schedule. At baseline, the ocular surface was graded on a scale of 3 (extensive) to 0 (minimum) for 4 components: blepharitis, conjunctivitis, ocular discharge, and corneal punctate epithelial keratopathy (PEK). Only those patients with moderate to extensive inflammation (cumulative score >6) were included in the study. At follow-up 3 to 5 d later, the ocular surface was regraded so that treatment response could be evaluated. No statistically significant difference was noted between groups in pretreatment scores for blepharitis (P=.31), discharge (P=.62), conjunctivitis (P=1.0), and PEK (P=.57), or for total ocular inflammation (P=.87). Mean posttreatment scores were as follows: total ocular surface scores, 1.8 and 3.4 (P=.002); blepharitis scores, 0.9 and 1.35 (P=.017); discharge scores, 0.2 and 0.6 (P=.025); and conjunctivitis scores, 0.15 and 0.6 (P=.013) for tobramycin/dexamethasone and tobramycin/loteprednol, respectively. Corneal PEK scores were not significantly different between treatments. Tobramycin 0.3%/dexamethasone 0.1% significantly decreased clinical signs of ocular inflammation (ie, blepharitis, discharge, conjunctivitis) and total ocular inflammation scores when compared with tobramycin 0.3%/loteprednol 0.5% in patients with moderate to severe blepharo-keratoconjunctivitis. The 2 regimens also provided comparably rapid decreases in corneal PEK.     

0.5%、0.75%左布比卡因与0.5%、0.75布比卡因用于较低位硬膜外阻滞麻醉的临床观察

目的比较0.5％、0．75％左布比卡因和0.5％、0．75％布比卡因用于低位硬外阻滞麻醉的效果和安全性,探讨左布比卡因用于低位硬膜外阻滞麻醉的有效性和优越性。方法选择ASAⅠ～Ⅱ级下肢手术接受硬膜外阻滞麻醉的病人76例,随机分为四组,A组（19例）用0．5％左布比卡因20ml,B组（19例）用0,5％布比卡因20ml,C组（19例）用0．75％左布比卡因20ml,D组（19例）用0．75％布比卡因20ml,手术部位为股都及其以下区域。硬外穿刺间隙为第3～4腰椎棘间隙,骶向置管3cm。注药后测定阻滞平面和起效时间,判定下肢运动阻滞程度,记录术后创口开始疼痛时间和下肢运动恢复时间,并记录可能的并发症。结果A组和C组各1例阻滞失败外,四组其余病例阻滞起效时间均〈12min（P〉0．05）;注药20min后C组和D组分别有12例和13例下肢完全不能举动,A组和B组无一例下肢完全不能举动（P〈0．01）;A组运动阻滞程度低于B组,而痛觉阻滞时间长于B组（P〈0．01）;A组和B组运动阻滞程度、痛觉阻滞时间及下肢运动恢复时间均低于C组和D组（P〈0．01）;C组痛觉阻滞时间明显长于D组,运动阻滞时间明显短于D组（P〈0．01）,而运动阻滞程度相似（P〉0．05）。感觉阻滞优良率100％。无局麻药中毒病例及特殊并发症出现。结论0．75％左布比卡因和0．750k布比卡因用于低位硬膜外阻滞麻醉的效果相似并具有一定的术后镇痛效应,0．5％左布比母因可用于肌松程度要求低的下肢手术,0．75左布比卡因适用于任何下肢手术的硬膜外阻滞麻醉。     

Prospective randomized comparison of 50%/50% versus 65%/65% tilt biphasic waveform on defibrillation in humans

It is unknown if there is a single optimal biphasic waveform for defibrillation. Biphasic waveform tilt may be an important determinant of defibrillation efficacy. The purpose of this study was to compare acute defibrillation success with a three-electrode configuration in humans using 50%/50% versus 65%/65% tilt truncated exponential, biphasic waveforms delivered through a 110-microF capacitor. Acute DFTs for biphasic waveforms with 50%/50% versus 65%/65% tilt were measured in random order in 60 patients using a binary search method. The electrode configuration consisted of a RV coil as the cathode, and a SVC coil plus a pectoral active can emulator (CAN) as the anode. The waveforms were derived from an external voltage source with 110-microF capacitance, and the leading edge voltage of phase 2 was equal to the trailing edge voltage of phase 1. Stored energy DFT (9.2 +/- 5.7 [50%/50%] vs 10.8 +/- 6.4 [65%/65%] J, P = 0.007), current DFT (10.9 +/- 4.0 [50%/50%] vs 12.0 +/- 4.4 [65%/65%] A, P = 0.002) and voltage DFT (391 +/- 118 [50%/50%] vs 424 +/- 128 [65%/65%] V, P = 0.004) were significantly lower for the 50%/50% tilt waveform versus the 65%/65% tilt waveform using this three-electrode configuration and a 110-microF capacitor. For an RV(-)/SVC plus CAN(+) electrode configuration and a 110-microF capacitor, a 50%/50% tilt biphasic waveform results in a 15% reduction in energy DFT, 9% reduction in current DFT, and 8% reduction in voltage DFT versus a 65%/65% tilt biphasic waveform.     

Cardio-renal recovery of hypoxic newborn pigs after 18%, 21% and 100% reoxygenation

OBJECTIVES: We examined the effects of 18%, 21% or 100% oxygen on the recovery of the heart and kidneys in a short-term survival model of neonatal hypoxia-reoxygenation (HR). DESIGN: Controlled, block-randomized animal study. SETTING: University animal research laboratory. SUBJECT: Large white piglets (1-3 days, 1.7-2.5[Symbol: see text]kg). INTERVENTIONS: Piglets received normocapnic hypoxia (15% oxygen) (2[Symbol: see text]h) and were reoxygenated with 18%, 21% or 100% oxygen (1[Symbol: see text]h) (n[Symbol: see text]=[Symbol: see text]7 per group) then 21% oxygen (2[Symbol: see text]h). Sham-operated pigs (n[Symbol: see text]=[Symbol: see text]7) had no HR. MEASUREMENTS AND RESULTS: Seventeen of 21 HR piglets recovered from moderate hypoxemia (mean PaO(2) 27-33[Symbol: see text]mmHg and pH 7.20-7.22, associated with tachycardia and hypotension). Systemic arterial pressure, heart rate, left renal arterial flow, oxygen transport, plasma troponin-I and creatinine levels were monitored and recovered with no differences among HR groups over 4 days after resuscitation. The 100% group had increased myocardial oxidative stress (oxidized glutathione levels) and the most cardiac HR-induced injury. There were no differences in renal oxidative stress and HR-induced injury among groups. Early oxygenation at 1[Symbol: see text]h after resuscitation correlated with the plasma troponin-I level at 6[Symbol: see text]h (r[Symbol: see text]=[Symbol: see text]-0.51 and 0.64 for SaO(2) and systemic oxygen extraction ratio, p[Symbol: see text]<[Symbol: see text]0.05, respectively) and renal HR-induced injury at 4 days (r[Symbol: see text]=[Symbol: see text]0.61 for renal oxygen delivery, p[Symbol: see text]<[Symbol: see text]0.05). CONCLUSIONS: In hypoxic piglets, 18%, 21% and 100% reoxygenation caused similar systemic and renal hemodynamic and functional recovery. The indicators of oxidative stress and HR injury in myocardial and renal tissues suggest that the reoxygenation with 100% oxygen appears sub-optimal and the use of 18% oxygen offers no further benefit, when compared with 21% oxygen.     

A double-blind comparison of 0.25% and 0.05% desoxymethasone, 0.1% betamethasone valerate and 1% hydrocortisone creams in the treatment of eczema

The efficacy and acceptability of 0.25% and 0.05% desoxymethasone, 0.1% betamethasone valerate and 1% hydrocortisone creams were compared in patients with eczema. A double-blind parallel group multi-centre design was employed in which 96 patients were recruited by four centres. Patients used one cream for a 3-week period and follow-up assessment visits were made at weekly intervals. Efficacy variables were: erythema/redness, scaling, itching and extent of area affected. These variables were assessed by both the investigator and the patient. The 0.25% desoxymethasone was the most effective treatment, producing the greatest degree of improvement in all clinical parameters, hydrocortisone was the least effective and 0.05% desoxymethasone was of intermediate effectiveness. The 0.1% betamethasone produced similar results to 0.25% desoxymethasone for half the assessments; for the other half the results were similar to 0.05% desoxymethasone. No adverse effects were reported during the study. The results are discussed in terms of physical properties of the vehicles and corticosteroid potency.     

1%萘替芬-0.25%酮康唑乳膏与2%酮康唑乳膏和1%特比萘芬乳膏的体外抗真菌谱及抗真菌活性对比研究

目的 探讨含1%萘替芬-0.25%酮康唑的复方乳膏制剂的体外抗真菌谱与抗真菌活性,并与单一成分制剂2%酮康唑乳膏和1%特比萘芬乳膏比较.方法 选用临床分离致病真菌及马拉色菌标准株共14种29株,用琼脂扩散法作药敏试验.将各种培养基制成含2%琼脂的含菌平板,打孔后分别加入上述3种乳膏,培养7天后测定各含药孔周围的抑菌圈直径.结果 1%萘替芬-0.25%酮康唑乳膏对皮肤癣菌、各种念珠菌、申克孢子丝菌、裴氏着色真菌、禾谷镰刀菌、糠秕马拉色菌、球形马拉色菌和合轴马拉色菌等14种29株菌株,其均形成抑菌圈,抑菌圈直径均数为45.46 mm.2%酮康唑乳膏对上述实验菌株也均形成抑菌圈,抑菌圈直径均数为23.92 mm.1%特比萘芬乳膏对克柔念珠菌和白念珠菌菌丝态无抑菌圈形成,对其余实验菌株有抑菌圈形成,抑菌圈直径均数为29.81 mm.1%萘替芬-0.25%酮康唑乳膏的抑菌圈均数与2%酮康唑乳膏及1%特比萘芬乳膏的抑菌圈均数相比,其差异均有统计学意义(P=0.000).结论 含1%萘替芬～0.25%酮康唑的复方乳膏制剂体外抗真菌谱广于1%特比萘芬乳膏,抗真菌活性强于2%酮康唑乳膏及1%特比萘芬乳膏.     

Prospective comparative switch study from timolol 0.5% and latanoprost 0.005% to bimatoprost 0.03%

This prospective study compared intraocular pressure (IOP) control, cardiorespiratory function, and adverse effects in 50 patients with glaucoma and ocular hypertension. Patients on topical combination timolol-latanoprost therapy were recruited. After they had used this combination for at least 2 months, they were switched to bimatoprost monotherapy. Full ocular examination and spirometric testing were performed; a questionnaire concerned with ocular symptoms was completed, and pulse rate was recorded. Two months later, mean IOP was similar with the combination (17.2 mm Hg) and with bimatoprost (16.4 mm Hg), but mean peak expiratory flow rate, ratio of forced expiratory volume in 1 second to forced vital capacity, and heart rate had increased significantly after the switch was made to bimatoprost. Adverse effects generally were similar with these regimens; however, the incidence of hyperemia doubled after the switch had been made. Bimatoprost and the timolol-latanoprost combination were equally efficacious in lowering IOP; bimatoprost had less of an effect on cardiorespiratory function.