复方倍他米松注射液局部注射治疗瘢痕疙瘩和增生性瘢痕的多中心研究

目的评价国产复方倍他米松注射液局部注射治疗瘢痕疙瘩和增生性瘢痕的安全性和疗效,并与进口复方倍他米松注射液(得宝松)进行对照.方法本研究采用多中心、随机盲法、阳性药物平行对照的临床研究方法.受试者分别接受国产复方倍他米松注射液和得宝松注射液治疗.在治疗前、治疗3、6,9周,选择一处无破溃皮损作为观察的靶皮损,观察临床症状和体征.结果本临床试验共入组病例144例,完成试验病例133例,其中对照组64例,试验组69例.试验结束时FAS分析临床疗效有效率(对照组为61.11%,试验组为65.28%,x3=0.27,P=0.6071)、痊愈率(对照组为2.78%,试验组为0.00%,P=0.4965)提示试验组和对照组疗效相当,经检验差异均无统计学意义(P>0.05).安全性方面,试验组共有3例不良反应发生,不良反应发生率为4.17%,两组不良反应发生情况比较差异无统计学意义(P=0.2448).结论国产复方倍他米松注射液局部注射治疗瘢痕疙瘩和增生性瘢痕安全有效,与得宝松相当.

Abstract：

Objective To compare the safety and efficacy of home - made and imported (diprospan) compound betamethasone injection in the treatment of keloid and hypeiplastic scar. Methods A multi-center, randomized, blind, positive-controlled, parallel-group clinical study was conducted. Patients with keloid or hyperplastic scar were divided into test and control groups to receive intralesional injection of compound betamethasone made in China and Schering-Plough Labo N.V. Belgium, respectively. A lesion without ulceration was selected as the target lesion for the evaluation of symptom and signs of patients at the beginning of the treatment (DO), on day 21 (D21), 42 (D42) and 63 (D63) after the initiation of treatment. Results A total of 144 patients were enrolled, and 133 patients, including 64 in the control group and 69 in the study group, completed the trial. The improvement rate was 61.11% in the control group and 65.28% in the test group (x2 = 0.27, P = 0.6071), and the cure rate was 2.78% in the control group, 0.00% in the test group (P =0.4965), indicating that there was no statistically significant difference in the efficiency between the domestic and imported injection (P> 0.05). There were 3 (4.17%) cases of adverse reaction in the test group, and no statistical difference was noted in the occurrence of side effects between the two groups (P = 0.2448). Conclusion The local injection of domestic compound betamethasone shows a favorable efficacy and safety, which are comparable to those of diprospan, in the treatment of keloid and hyperplastic scar.     

角膜炎、鱼鳞病、耳聋综合征一例及GJB2基因突变研究

目的 探讨角膜炎、鱼鳞病及耳聋综合征患者临床特征和GJB2基因突变情况,为该病临床与基因诊断提供依据。方法 收集1例角膜炎、鱼鳞病及耳聋综合征患者的临床资料,提取患者及家族成员的外周血DNA,用PCR扩增GJB2基因外显子2及其附近的剪切点,DNA直接测序法进行基因突变检测。结果 该患者存在血管化角膜炎、鱼鳞病及先天性耳聋三联征的典型临床特征,检测到GJB2基因中核苷酸序列外显子2第148位碱基由G突变为A,导致编码的连接蛋白Cx26第50位的天冬氨酸转换成天冬酰胺（D50N）。其未患病的母亲及哥哥未检测到突变位点。结论 GJB2基因突变（D50N）可能是引起鱼鳞病、角膜炎及耳聋综合征患者临床表型的原因。     

新生隐球菌血清型与艾滋病的关系

许多报道表明新生隐球菌的血清型具有明显的地理分布差异［１］。但在艾滋病（ＡＩＤＳ）和非艾滋病（Ｎｏｎ－ＡＩＤＳ）患者的感染方面其血清型是否存在差别尚未见详细报道。据此，我们用日本ＩａｔｒｏｎＬａｂｏｒａｔｏｒｉｅｓＩｎｃＣｏ公司生产的新生隐球菌血清分...     

阿维A治疗寻常性银屑病120例

为了解阿维A胶囊(商品名方希)治疗寻常性银屑病的临床疗效及安全性,中国医学科学院皮肤病医院、上海长征医院及第三军医大学西南医院于2005年8月至2006年3月共同对120例寻常性银屑病进行临床观察,并比较分次给药与一次性给药在临床疗效及安全性方面的差异.     

鞘内注射两性霉素B联合其他抗真菌药治疗隐球菌性脑膜炎2例

隐球菌性脑膜炎是一种死亡率高、预后较差的疾病，美国国家过敏与感染病研究所(NIAID)推荐的治疗药物主要是两性霉素B(AmB)，同时联合应用其他抗真菌药物，如伊曲康唑、氟康唑及氟胞嘧啶。但是，AmB的不良反应较大，常见的有低血钾、肝肾功能损害、骨髓抑制等。部分病人由于这些不良反应而不能继续静脉使用这一药物。笔者在临床上对2例隐球菌性脑膜     

隐球菌性脑膜炎患者脑脊液隐球菌活性的研究

目的 对隐球菌性脑膜炎（隐脑）患者脑脊液进行隐球菌活性研究。方法 对脑脊液标本进行电镜观察。动物接种和中性红染色检查。结果 透射电镜观察见在治疗早期，多数标本菌体较为完整，常能见到出芽现象；在治疗后期，胞浆水肿，荚膜结构排列紊乱常见，通过对连续多次常规真菌培养不生长而镜检阳性的脑脊液标本进行动物接种，结果全部感染，中性红染色检查见多数标本中均存在一定数量的深血红色菌体，结论 上述方法可以对隐脑患者脑脊液隐球菌菌体活性进行动态观察，作为临床疗效监测的重要指标。     

2003年中国中西医结合学会皮肤性病学术会议内容简介

从感染性皮肤病、皮肤美容、其他皮肤病三部分 ,介绍 2 0 0 3年中国中西医结合皮肤性病学术会议学术交流简况。     

Bloom综合征1例

1　病例资料　患儿男 ,10岁。颧部反复出现红斑 9年。约 1岁时面部出现红斑 ,日晒后加重 ,无瘙痒。反复发作 ,夏重冬轻。患儿足月顺产 ,出牙、直立等生长发育均正常 ,但行走至今不稳。家族史 :父母非近亲结婚 ,健康 ,身高无异常。家族中无类似病史及其他遗传病史。体检 :发育差 ,对答切题 ,声调尖细。身高 10 9ｃｍ ,体重 16ｋｇ ,身材比例相称 ,四肢较细。双耳廓较大 ,竖起。皮肤科情况 :颧部对称性淡红斑 ,表面少量白色鳞屑、毛细血管扩张 ,并散在褐色粟粒大小斑疹。躯干、四肢未见咖啡斑、色素增深、色素减退斑及鱼鳞病样皮损 ,口唇未见…     

加巴喷丁胶囊治疗疱疹后神经痛的多中心临床观察

Objective To observe the clinical efficacy and safety of gahapentin in the treatment of postherpetic neuralgia. Methods A multicenter, randomized, double-blind, placebo-controlled, parallel design, 6-week study was performed. Patients with postherpetic neuralgia were recruited into this study and randomly divided into two groups to receive gabapentin or placebo 1800 mg daily in three divided doses with a forced titration schedule, respectively. The primary efficacy measure was change in the pain score based on a visual analogue scale from baseline to the final week of therapy, and secondary measure was the improvement in sleep quality scored on a 5-point severity scale. Efficacy and safety evaluation was performed at baseline, and 1, 3, and 6 weeks atter the treatment. Results One hundred and forty-one patients were recruited in four clinical centers, and 125 patients completed the trial, of whom 66 were in the treatment group and 59 in the control group. An improvement was observed in both pain scores and sleep scores on week 1, 3 and 6 in both two groups, and the improvement was greater in gabapentin-treated group than that in the control group. The response rate was 29.58% and 57.75%, respectively in gabapentin-treated group on week 1 and 3, com-pared to 13.04% and 40.58%, respectively, in the control group (t = 5.94, 4.12, respectively, both P ＜0.05).Gabapentin was well tolerated, and the most common adverse events were dizziness, vertigo, somnolence and transient abnormality of hepatic function. Conclusion Gabapentin could markedly reduce pain intensity and improve sleep quality with a low incidence of adverse events in patients with postherpetic neuralgia.     

新生隐球菌不同变种所致小鼠原发性皮肤感染的比较

目的：探讨新生隐球菌不同变种在原发性小鼠新生隐球菌皮肤感染中的作用。方法：按照我们建立的原发性皮肤隐球菌感染模型的方法，将新生隐球菌新生变种标准野生株B3501与格特变种标准株ATCC32609分别皮内接种于免疫抑制与非抑制的BALB／c小鼠，皮损真菌培养与组织病理检查确证感染。观察2种隐球菌感染的病程，比较皮损形成与消退的平均时间。结果：2种变种的新生隐球菌皮下接种于BALB／c小鼠后，可以在免疫抑制与非抑制的BALB／c小鼠皮肤上产生丘疹、结节、溃疡、传染性软疣样皮损，皮损可以自愈，真菌培养与病理确证为隐球菌感染。2种菌株只在免疫正常小鼠的皮损形成时间上存在差异。结论：新生变种与格特变种的新生隐球菌均可以造成BALB／c小鼠相似的皮肤感染。推测2种变种对原发性皮肤感染的致病力可能无差异，新生变种发病较多可能与其分布有关。