新氢化可的松凝胶的制备及质量控制

目的研制新氢化可的松凝胶。方法以硫酸新霉素、氢化可的松为主药制备凝胶,采用抗生素微生物检定法和紫外分光光度法测定凝胶中硫酸新霉素、氢化可的松的含量。结果硫酸新霉素效价为标示量的90%～110%,氢化可的松的平均回收率为100.16%,RSD为0.18%,临床有效率为86.45%。结论该凝胶制备工艺简单,成本低廉,性质稳定,质量可控,疗效确切。     

RP—HPLC法测定醋酸氢化可的松乳膏中醋酸氢化可的松的含量

目的：建立了RP—HPLC法测定醋酸氢化可的松乳膏中醋酸氢化可的松的含量。方法：采用AgilentHC C18（4．6IDATI×250mm,5μm）色谱柱,乙腈-水（36：64）为流动相,检测波长254nm,流速1．0ml／min,柱温40℃。结果：醋酸氢化可的松在0．506～202．4μg／ml浓度范围内呈良好线性关系（r=0．99999）;醋酸氢化可的松乳膏的平均回收率为99．28％,RSD为0．42％（n=9）。结论：该方法快速、简便、准确、灵敏、重现性好,并能有效控制药品质量。     

Cortisol levels in patients with severe community-acquired pneumonia

Objectives To evaluate cortisol levels and prevalence of adrenal insufficiency in patients with severe community-acquired pneumonia (CAP). Design and setting Retrospective cohort study in a 24-bed medical-surgical intensive care unit (ICU). Patients Forty patients with severe CAP admitted to the ICU from March 2003 and May 2005. Measurements and results Random cortisol levels were measured up to 72 h after ICU admission. A threshold of 20 μg/dl was considered for the diagnosis of adrenal insufficiency. Median cortisol levels were 15.5 μg/dl (IQR 10.8–25.1), and 26 patients (65%) met the criteria for adrenal insufficiency. Other cutoff levels of cortisol were evaluated, and 30 patients (75%) had cortisol levels below 25 μg/dl and 19 (47.5%) had cortisol levels below 15 μg/dl. When only patients with septic shock (n = 19) were evaluated, 12 (63%) had adrenal insufficiency. Conclusions Relative adrenal insufficiency occurs in a high proportion of patients with severe CAP. This finding highlights the importance of measuring cortisol levels and may help explain the potential benefits of hydrocortisone infusion in these patients.     

Suitability of a liquid chromatography assay of neomycin sulfate to replace the microbiological assay for neomycin in USP Monographs

The current USP National Formulary contains 65 Monographs for drug formulations containing neomycin. All 65 Monographs prescribe a bioassay for neomycin assay. This bioassay, based on cell culture, is labor intensive, has poor precision, and cannot be adapted for purity or identification. High-performance anion-exchange chromatography with integrated pulsed amperometric detection (HPAE-IPAD), a liquid chromatography technique, has been shown to be suitable for neomycin purity analysis and neomycin assay of an over-the-counter first aid cream (Hanko and Rohrer [17]). Here we propose that an HPAE-IPAD assay can replace the bioassay in the 65 neomycin-containing Monographs. We applied the HPAE-IPAD assay to four neomycin-containing drug products representing the four classes of formulations found in the 65 Monographs, liquid, solid, suspension, and cream. Each drug was analyzed with two chromatography systems, and on 3 separate days. For all products, HPAE-IPAD measurements were precise and accurate with respect to the label concentrations. There was also high accuracy for spike recovery of neomycin from the four drug products throughout 70–150% of the labeled concentration. These results suggest that an HPAE-IPAD assay would be an accurate assay for neomycin, and would be faster and more precise than the current bioassay.     

Effect of Aqueous Cream BP on human stratum corneum in vivo

Background Aqueous Cream BP is widely prescribed to patients with eczema to relieve skin dryness. The formulation contains sodium lauryl sulphate (SLS), a chemical that is a known skin irritant and a commonly used excipient in personal care and household products. The chronic effects of Aqueous Cream BP application on skin barrier function have not been determined. Objectives To characterize and assess skin barrier function of healthy skin after application of Aqueous Cream BP and to study the physical effects of the formulation on the stratum corneum (SC). Methods The left and right volar forearms of six human volunteers were each separated into treated and control sides. The treated sides of each forearm were subjected to twice daily applications of Aqueous Cream BP for 4 weeks at the end of which concomitant tape stripping and transepidermal water loss (TEWL) measurements were made. The untreated sides of the forearms were not exposed to any products containing SLS during the study period. Results Changes in SC thickness, baseline TEWL and rate of increase in TEWL during tape stripping were observed in skin treated with Aqueous Cream BP. The mean decrease in SC thickness was 1·1 μm (12%) (P = 0·0015) and the mean increase in baseline TEWL was 2·5 g m^?2 h^?1 (20%) (P < 0·0001). Reduced SC thickness and an increase in baseline TEWL, as well as a faster rate of increase in TEWL during tape stripping, were observed in 16 out of 27 treated skin sites. Conclusions The application of Aqueous Cream BP, containing ～1% SLS, reduced the SC thickness of healthy skin and increased its permeability to water loss. These observations call into question the continued use of this emollient on the already compromised barrier of eczematous skin.     

替勃龙联合雌三醇软膏治疗老年性阴道炎疗效观察

目的：观察替勃龙联合雌三醇软膏治疗老年性阴道炎的临床疗效。方法：124例老年性阴道炎患者随机分为替勃龙联合雌三醇软膏治疗组（A组）62例和单用雌三醇软膏活疗组（B组）62例,两组进行疗效及复发情况比较。结果：A组临床治愈率高于B组,差异有显著性（P〈0．01）。A组复发率低于B组,差异有显著性（P〈0．01））。两组用药前后子宫内膜厚度比较,差异无显著性（P〉0．05）。结论：替勃龙联合雌三醇软膏用于治疗老年性阴道炎可明显增强疗效,缩短疗程和减少复发。     

曲安奈德乳膏、贴膏、皮下封闭治疗160例疥疮结节疗效分析

目的观察曲安奈德以多种方式疗治疥疮结节的疗效.方法将疥疮结节患者160例随机分为A、B、C三组,用曲安奈德外擦、贴膏、皮下封闭三种方式进行治疗,同时口服氯雷他定.结果曲安奈德贴膏、皮下封闭治疗组的有效率达100%,曲安奈德乳膏组有效率为66.1%,三组交叉表法对比有显著性差异(Sig=0.000).结论通过曲安奈德皮下封闭,贴膏治疗疥疮结节疗效理想,优于直接将曲安奈德外涂.     

高效液相色谱法测定川贝清肺膏中甘草酸的含量

目的：建立高效液相色谱法（HPLC）测定川贝清肺膏中甘草酸的含量。方法：采用Kromasil-C18（4.6 mm×150 mm,5μm）为色谱柱;流动相：乙腈-水-冰醋酸（37∶63∶2）;检测波长：250 nm;流速：1 ml/min;柱温为室温（25℃）。结果：样品中甘草酸得到很好的分离,当甘草酸在10.0～104.0μg范围内呈线性关系（r=0.999 9,n=5）,平均加样回收率为100.99%,RSD为0.96%（n=6）。结论：本法简便、准确、可靠、专属性强、重现性好,可用于川贝清肺膏中甘草酸的含量测定。     

红光照射联合复方氟米松治疗慢性湿疹临床疗效观察

目的:探讨红光照射治疗慢性湿疹的疗效及其安全性。方法:将慢性湿疹患者随机分为治疗组和对照组,治疗组采用复方氟米松联合红光照射治疗,对照组仅用复方氟米松治疗。治疗4周后观察两组疗效及不良反应。结果:治疗组总有效率91.43%,显著高于对照组总有效率的62.86%(P<0.05);平均显效时间治疗组(8.09±3.23)d,明显短于对照组的(11.54±3.45)d(P<0.05)。结论:氟米松联合红光治疗慢性湿疹是一种有效、安全的治疗方法。     

5-氨基水杨酸保留灌肠治疗慢性溃疡性结肠炎280例观察

目的探讨5-氨基水杨酸保留灌肠治疗慢性溃疡性结肠炎的临床效果。方法分别采用5-氨基水杨酸保留灌肠（0.9%NaCl-60ml＋5-氨基水杨酸制剂4 g,保留灌肠,Qd）和常规治疗法（0.9%NaCl-60ml＋氢化可的松100mg,保留灌肠,Qd）对慢性溃疡性结肠炎患者进行治疗,比较其治疗效果。结果 5-氨基水杨酸保留灌肠治疗可加快慢性溃疡性结肠炎患者粘液脓血便及腹泻症状的缓解。但对患者的腹疼症及里急后重症状的治疗,两组方法无明显差异。5-氨基水杨酸保留灌肠治疗法能够有效提高慢性溃疡性结肠炎患者的治疗有效率（其有效率为98.58%）。结论针对慢性溃疡性结肠炎患者采用5-氨基水杨酸保留灌肠治疗,可明显提高患者的治疗有效率,加快部分临床症状的缓解。