Immunology: Immunosuppression by corticosteroid has no effect on the pregnancy rate in routine in-vitro fertilization/embryo transfer patients

Immunosuppression by exogenous corticosteroids has been usedto improve the rates of embryo implantation and pregnancy inin-vitro fertilization (IVF) patients who have micromanipulatedembryos replaced. The present study was conducted, in a prospectivedesign, to evaluate effects of corticosteroid on the pregnancyrate in IVF/embryo transfer patients who have non-micromanipulatedembryos replaced. Infertile women <40 years old with tubalfactor were included in this study. Patients were grouped accordingto the different follicle stimulation protocols, and receivedvarious doses of 16-methylprednisolone (0, 16 or 60 mg/day)for 4 days from the day of oocyte retrieval. The mean age, durationof infertility, length of folliculogenesis and serum oestradiolconcentrations at the time of human chorionic gonadotrophin(HCG) injection were not significantly different between controland corticosteroid-treated groups of patients. Short-term immunosuppressionby 16-methylprednisolone administration did not show any effectson the pregnancy and miscarriage rates in IVF/embryo transferpatients. Also, immunosuppression showed no dose effects inany groups. There was no relationship between the types of folliclestimulation protocols and the effect of 16-methylprednisolone.Therefore, we concluded that short-term immunosuppression byexogenous corticosteroids in IVF/embryo transfer patients whohave embryos with intact zona pellucida replaced has neitherpositive nor negative effects on pregnancy rates.     

表面麻醉下小切口非超乳青光眼白内障联合手术临床观察

目的 观察表面麻醉下小切口非超乳青光眼白内障联合手术的治疗效果。方法 观察住院患者34例34眼，白内障并急性闭角型青光眼6例，慢性闭角型青光眼8例，原发开角型青光眼8例，白内障膨胀期继发青光眼12例。采用圈垫式劈核技术行小切口非超乳白内障摘除并人工晶体植入术，隧道内剪除小梁组织，剪除相应根部虹膜。结果 术中急性闭角型青光眼麻醉效果稍差，其余麻醉效果尚好；术后视力不同程度提高，眼压控制良好。结论 表面麻醉下小切口非超乳青光眼白内障联合手术效果可靠，值得临床应用。     

核心组蛋白分子过乙酰化与慢性阻塞性肺疾病糖皮质激素抵抗

染色体核心组蛋白分子作为各种炎症因子和炎症信号转导的关键性终端蛋白质分子，具有基因转录“开关”分子的功能，其活性受组蛋白转乙酰酶/脱乙酰酶（HAT/HDAC）的调节。HAT活性增高，组蛋白分子过乙酰化，DNA表现为解链效应，促进基因转录；而HDAC活性增高则出现相反的效应，基因转录变沉默。HAT和HDAC的动态平衡对基因的转录活性和炎症反应程度的调节起关键作用。慢性阻塞性肺疾病（COPD）肺部氧化应激反应的持续存在，明显降低了肺组织HDAC酶的活性，组蛋白乙酰化/去乙酰化平衡被打破，组蛋白分子过乙酰化、炎症蛋白基因的转录和炎症蛋白的合成得到加强，阻断了糖皮质激素的抗炎症反应效应。小剂量氨茶碱恢复COPD肺组织HDAC活性，减少炎症介质和细胞因子合成和释放，能够改善气道炎症对糖皮质激素治疗的反应性。     

Increased nasal mucosal interferon and CCL13 response to a TLR7/8 agonist in asthma and allergic rhinitis

1. Download : Download high-res image (168KB)
2. Download : Download full-size image

     

口服白三烯受体拮抗剂与吸入糖皮质激素治疗小儿咳嗽变异型哮喘合并变应性鼻炎的对比研究

目的对比研究口服白三烯受体拮抗剂（LTRA）与吸入糖皮质激素（ICS）对dxJL咳嗽变异型哮喘合并变应性鼻炎的防治效果。方法54例2-5岁患儿随机分为LTRA组（27例）和ICS组（27例）。LTRA组口服孟鲁司特钠，每次4mg，睡前服用1次；ICS组患儿规律吸入布地奈德气雾剂，每日200-400μg，采用储雾罐辅助吸入。药物治疗3个月后继续随访观察15个月。结果LTRA组与ICS组比较．控制症状所需的平均天数为（8．31±3．69）d和（7．20±2．78）d；症状缓解率为92．6％和96．3％，差异无统计学意义（P〉0．05）。在病程的18个月LTRA组复发率（36．0％）显著高于ICM组（15．4％）。转化为典型哮喘者。LTRA组7例（28．0％），ICS组2例（7．7％），差异有统计学意义（P〈0．05）。结论口服LTRA控制小儿咳嗽变异型哮喘合并变应性鼻炎的近期疗效与ICS相当。可作为一线药物使用。但接受LTRA治疗的患儿远期复发率或者转化为典型哮喘的比率高于ICS治疗的患儿。     

Burden of preschool wheeze and progression to asthma in the UK: Population-based cohort 2007 to 2017

1. Download : Download high-res image (208KB)
2. Download : Download full-size image

     

Glucocorticoid-induced attenuation of mucosal exudation of fibrinogen and bradykinins in seasonal allergic rhinitis

The mucosal plasma exudate with its proteins, enzymes, derived peptides, and matrix molecules is an important factor in inflammatory airway diseases. This study investigated whether topical glucocorticosteroid treatment influences mucosal exudation of bulk plasma (fibrinogen) and the generation of plasma-derived mediators (bradykinins) in seasonal allergic rhinitis. Twenty-two patients with birch-pollen-induced allergic rhinitis participated in a double-blind, randomized, placebo-controlled study during the birch pollen season in 1989. After a 2-week run-in period, the participants received treatment with budesonide (200 μg per nasal cavity and day) or placebo. The patients kept a diary to record their daily nasal symptoms (itching, sneezing, nasal blockage, and secretion). The amount of birch pollen in the air was determined with the aid of a Burkhard pollen trap. A nasal lavage was performed once a week, and the levels of bradykinins and fibrinogen were determined in the lavage fluid samples. The birch pollen season was very mild, resulting in only minor nasal symptoms. In spite of the low pollen exposure, treatment with budesonide reduced the lavage fluid levels of both bradykinins and fibrinogen. The present results show that topical glucocorticosteroid treatment attenuates plasma exudation and the generation of plasma-derived mediators in seasonal allergic rhinitis. This action may not result from simple vascular antipermeability effects of the drug but may rather reflect the anti-inflammatory efficacy of topical glucocorticoids in the airway mucosa.     

外用药脂质体为载体的透皮制剂研究进展

对脂质体作为外用透皮吸收药物的载体及其与角质层的相互作用、检测技术及临床应用等方面进行综述.     

消炎愈创软膏的实验研究

目的　观察消炎愈创软膏的消炎抗菌促愈合作用 ,为临床应用提供依据。方法　用小鼠耳廓二甲苯致炎试验、疮疡试验观察消炎愈创软膏的消炎抗菌促愈合作用。结果　 5 %剂量组能显著抑制二甲苯引起的小鼠耳廓肿胀 [5 %制剂肿胀度和对照组 :(3.0± 1.0 ) m g vs (7.1± 1.0 ) m g,P <0 .0 0 1];对金黄色葡萄球菌具有显著的抑制或杀灭作用 ,对大鼠局部创口有促进愈合的作用。     

脂质体作为皮肤局部给药载体的研究进展

目的了解脂质体作为皮肤局部给药载体的研究进展.方法以大量有代表性的文献进行分析、归纳,阐述了脂质体作为皮肤局部给药载体的特点、机制、处方设计、实验研究及新型脂质体的研究.结果脂质体作为皮肤局部给药的载体具有许多优点,但作用机制不一,影响因素很多,新型脂质体的研究使脂质体皮肤给药的前景更为广阔.结论外用脂质体制剂将有巨大的发展潜力.