地塞米松治疗与细菌性脑膜炎脑源性神经营养因子及其受体基因表达的关系

目的 探讨地塞米松(DEX)治疗与细菌性脑膜炎脑源性神经营养因子(BDNF)及其受体TrkB基因表达的关系。方法 建立细菌性脑膜炎模型，分别用抗菌药物及抗菌药物加DEX治疗，用原位杂交检测脑组织BDNF mRNA和TrkB mRNA的表达。结果 单独使用抗菌药物治疗后BDNF mRNA和TrkB mRNA表达均低于感染后5d组的水平(P＜0．05)，并以BDNF mRNA下降更明显(P＜0．01)，而使用DEX与抗菌药物联合治疗后，BDNF mRNA和TrkB mRNA表达回到较高水平(P＜0．01)，BDNFmRNA达到感染后5d组水平(P＞0．05)，TrkB mRNA则超过感染后5d组水平(P＜0．05)。结论 DEX则可能通过上调内源性BDNF mRNA和TrkB mRNA表达，有利于抵御细菌性脑膜炎脑损伤。     

地塞米松联合甲巯咪唑治疗自身免疫性甲状腺炎效果及对T细胞免疫功能、炎性因子影响观察

目的 观察地塞米松联合甲巯咪唑治疗自身免疫性甲状腺炎的效果及对T细胞免疫功能、炎性因子的影响.方法 选取自身免疫性甲状腺炎79例,根据治疗方法 不同将其分为观察组(41例)和对照组(38例)两组.观察组予地塞米松磷酸钠注射液联合甲巯咪唑片治疗,对照组予甲巯咪唑片治疗,疗程均为1个月.观察比较两组治疗后临床效果,治疗前后...     

氯地滴耳液的配制及主药的含量测定

目的:制备氯地滴耳液并建立其质量控制方法。方法:以氯霉素、地塞米松磷酸钠为主药制成滴耳液,采用高效液相色谱法测定这两组分含量。结果:氯霉素和地塞米松磷酸钠的线性范围分别为125~1 250μg/m l(r=0.999 7)、2.5~25.0μg/m l(r=0.999 1),平均加样回收率分别为99.77%(RSD=0.38%)、98.06%(RSD=0.42%)。结论:该制剂配制简单,成本低,质量可控。     

氟美松在扁桃体切除术中的应用

目的观察扁桃体切除术中,局部麻醉药1％普鲁卡因中加入氟美松的影响。方法观察甲乙两组病例,甲组159例,均以1％普鲁卡因中加入氟美松1ml（5mg）,术前分别注射于两侧扁桃体的舌腭弓、咽腭弓及扁桃体间隙内。乙组71例则用1％普鲁卡因。结果比较甲乙两组病例术后的差异。证实扁桃体切除术局部麻醉药中添加氟美松可明显减轻术后病人创腔淤血、肿胀、疼痛、出血,促进白膜生长。结论该方法有助于创面愈合、缩短病程,值得临床推广使用。     

地塞米松鼓室内注射治疗难治性突发性感音神经性聋

目的：观察鼓室内地塞米松注射（IDI）治疗难治性突发性感音神经性聋（突聋）的疗效。方法：25例常规方法治疗无效的突聋患者采用IDI,首次剂量为2．5mg,此后,每2天重复注药1次（每次2．5mg）,共4次,总剂量10mg。用药期间密切观察记录听力改变、耳鸣和眩晕等情况。结果：2例失访,23例治疗完成后1个月纯音测听检查：显效3例,0．25～4．00kHz听阈平均提高48．5dB;有效5例,平均提高18．5dB;无效15例;有效率为34．8％（8／23）。结论：IDI治疗突聋,能保证药物高浓度作用于内耳,避免全身用药可能产生的不良反应;治疗操作不复杂,创伤性小,为常规方法治疗无效的突聋患者提供了再次治疗的机会。     

Glial Fibrillary Acidic Protein and Vimentin Expression Is Regulated by Glucocorticoids and Neurotrophic Factors in Primary Rat Astroglial Cultures

The neurotrophic factors epidermal growth factor (EGF), basic fibroblast growth factor, (bFGF), insulin‐like growth factor I (IGF‐I) and insulin (INS) regulate neural and astroglial cell functions. Glucocorticoids may influence the metabolism of astroglial compartment and are key hormones in neurodegenerative events. This study was designed to assess the interactions between growth factors and dexamethasone (DEX) on cytoskeletal proteins (GFAP and vimentin) expression in 25 days in vitro (DIV) astrocyte cultures. An increase in GFAP and vimentin expression was observed after 12 h pretreatment with bFGF and subsequent treatment for 60 h with DEX. GFAP immunoreactivity was decreased after 24 h progression growth factors (EGF, IGF‐I and INS) addition, when compared to control 36 h DEX and bFGF‐pretreated cultures for the last 12 h. Vimentin immunoreactivity was decreased after 12 h bFGF pretreatment and subsequent 60 h DEX addition in astrocyte cultures compared to 12 h bFGF‐pretreated ones. Pretreatment for 36 h with DEX plus bFGF in the last 12 h and subsequent treatment for 24 h with DMEM (Dulbecco's modified Eagle medium; DMEM) + BSA (bovine serum albumine) (harvesting), or with progression growth factors (EGF, IGF‐I or INS) alone or two of them together, stimulated GFAP expression, compared to untreated controls. Immunochemical analysis of the mitogen‐activated protein kinase ERK2 suggests an involvement of this enzyme in the control of GFAP expression. The above findings support the view of an interactive and complex dialogue between growth factors and glucocorticoids during astroglial cell proliferation and maturation in culture. This may have implications in therapeutic approach of neurologic disorders associated with astrogliosis, including cerebrovascular disease.     

Successful therapy of macrophage activation syndrome with dexamethasone palmitate

Macrophage activation syndrome (MAS) is a severe and potential life-threatening complication of childhood systemic inflammatory disorders. Corticosteroids are commonly used as the first-line therapy for MAS. We report four patients with MAS who were successfully treated with dexamethasone palmitate (DexP), a liposome-incorporated dexamethasone, much more efficient than free corticosteroids. DexP effectively inhibited inflammation in MAS patients in whom the response to pulse methylprednisolone was not sufficient to manage their diseases. DexP was also effective as the first-line therapy for MAS. Based on these findings, DexP is an effective therapy in treating MAS patients.     

地塞米松局部注射治疗突眼性甲状腺病远期疗效

目的：探讨地塞米松局部注射治疗突眼性甲状腺病（Graves痛）的远期疗效。方法：将82例Graves痛患者分为治疗组（用抗甲状腺药物治疗同时双侧甲状腺注射地塞米松）和对照组（单用抗甲状腺药物治疗），观察两组甲状腺变化、病情变化及复发等情况。结果：①治疗组甲状腺较对照组明显缩小，P〈0．01；②治疗组抗甲状腺药物副作用（如皮疹、白细胞减少、肝功能损害等）较对照组发生少，甲亢症状减轻较对照组明显，P〈0．05；③治疗组复发1例（2．4％），对照组复发9例（22％），甲状腺肿大程度与复发呈正相关。结论：局部注射地塞米松可促使肿大的甲状腺回缩，减轻甲亢症状，还可以减少抗甲状腺药物副作用，能显著降低复发率。     

氨溴索雾化液的稳定性考察

目的考察氨溴索雾化液中主要成分的配伍稳定性。方法按处方配制氨溴索雾化液，冰箱2～8 ℃冷藏保存，于0,1,2,3,4 d观察雾化液外观，并采用反相高效液相色谱法测定盐酸氨溴索及地塞米松磷酸钠的含量。结果氨溴索雾化液在5 d内外观无变化，主要成分含量均保持在初始浓度的96%以上。结论雾化液在2～8 ℃保存条件下，5 d内性质稳定。