Early onset vulvar Lichen Sclerosus in premenopausal women and oral contraceptives

OBJECTIVE: For vulvar Lichen sclerosus (LS) immunological factors, genetic predisposition, and decreased 5 alpha-reductase activity have been discussed as aetiological factors. During the last decade an increase of LS in young women has been suspected. Aim of this study was to evaluate data of premenopausal women with early onset LS to find potential risk factors focussing on the use of oral contraceptives. STUDY DESIGN: We retrospectively analyzed the data of 40 premenopausal patients with early onset LS regarding use of oral contraceptives (OCPs), and first occurrence of LS. To compare these data in a case-control study we analyzed a matched control group of 110 healthy women. RESULTS: All our LS patients were using OCPs compared to 73 women (66.4%) in the control group. OCPs with anti-androgenic activity (chlormadinone acetate, cyproterone acetate, dienogest, and drospirenone) were used by 28 (70%) of the LS patients and by 35 (47.9%) of the 73 women using OCPs in the control group. Thus, the odds ratio for early onset LS for women using anti-androgenic OCPs was 2.53 (95% CI: 1.12-5.75). CONCLUSION: Our data suggest that disturbance of the androgen dependent growth of the vulvar skin by OCPs and especially by OCPs with anti-androgenic properties might trigger the early onset of LS in a subgroup of susceptible young women.     

不同诱导因子对 MT-5细胞表达 HBsAg 的影响

对经 HBV-DNA 转染的 MT-5细胞的培养条件进行观察。发现重金属离子Zn 和 Cd 对 MT-5细胞表达 HBsAg 有诱导作用,而咖啡因、地塞米松、氢化可的松、丙酸睾丸酮、苯丙酸诺龙对 MT-5细胞的 HBsAg 均无诱导作用。     

沙美特罗/丙酸氟替卡松干粉剂吸入治疗成人支气管哮喘60例疗效观察

目的:探讨沙美特罗/丙酸氟替卡松干粉剂(商品名:舒利迭,葛兰素史克公司出品)吸入治疗支气管哮喘的疗效。方法:90例患者随机分为2组,治疗组采用沙美特罗/丙酸氟替卡松干粉剂50/250"g每日2次吸入,对照组采用丙酸氟替卡松气雾剂(商品名:辅舒酮,葛兰素史克公司出品)250"g每日2次吸入,治疗第4、8周两次评价患者哮喘症状和疗效。结果:在治疗第4、8周,治疗组哮喘症状和对照组相比明显减轻。结论:舒利迭为沙美特罗/丙酸氟替卡松混合吸入剂,是控制哮喘的一个良好选择。     

沙美特罗替卡松在哮喘治疗中的控制作用

目的研究沙美特罗替卡松粉吸入剂治疗支气管哮喘的临床安全性及疗效。方法选择2009年2～10月笔者所在医院110例支气管哮喘患者,随机分成治疗组和对照组,每组各55例。治疗组患者选择沙美特罗替卡松粉吸入剂治疗;对照组患者只选择丙酸氟替卡松进行治疗,观察两组患者药物反应和症状改善情况,比较两组患者咳嗽、喘息及呼吸困难消失时间。结果治疗组患者咳嗽、喘息及呼吸困难消失时间都比对照组患者短,差异有统计学意义（P〈0.05）;治疗组用药后各项肺功能改变率与对照组比较,差异有统计学意义（P〈0.05）。结论应用沙美特罗替卡松粉吸入剂治疗哮喘,不但治疗效果好而且使用安全,值得临床上推广应用。     

从运动神经元的TDP-43蛋白表达和ADAR2活性探讨肌萎缩侧索硬化症的发病机制

肌萎缩性侧索硬化症(ALS)是以上下两级运动神经元进行性丢失为特征的神经系统变性疾病,是运动神经元病(MND)中最常见的类型。运动神经元中的病理性TDP-43是ALS的病理特征。此外,散发性ALS运动神经元中作用于RNA的次黄嘌呤腺苷脱氢酶(ADAR2)减少、具有未经编辑Q/R位点的谷氨酸受体2(GluR2)表达增加,α-氨基-3-羟基-5-甲基-4-异恶唑丙酸受体(AMPAR)属性受影响,Ca2+通透性增加,Ca2+流入胞质增加导致神经元死亡。ALS运动神经元死亡包含病理性TDP-43和ADAR2活性下降,两种病理变化可能在细胞死亡中存在一定联系。ADAR2 mRNA是TDP-43蛋白的靶RNA,TDP-43蛋白在ADAR2的表达中起调节作用。近年来,研究者探讨ALS的基因治疗可能性:动物实验结果提示,外周静脉给予9型腺相关病毒载体(AAV9),可上调鼠运动神经元ADAR2,引发外源性ADAR2在中枢神经元表达,从而有效防治运动功能障碍。运动神经元的获救可能与TDP-43基因的正常表达有关。AAV9介导的ADAR2基因植入可能为ALS的基因治疗提供新的前景。     

维生素D血浆浓度与氟替卡松对COPD患者肺功能的影响

目的探讨25-羟维生素D血浆浓度与吸人性糖皮质激素对COPD患者肺功能影响的关系。方法120例重度COPD患者于初人院时进行气量测定以及清晨禁食采集血样标本，用高效液相色谱法检测25（OH）D水平；而后每日2次，每次使用500μg氟替卡松，50μg沙美特罗，疗程4周。4周后再检测第1秒用力通气量及其改变，抽取血样，检测25（OH）D水平。治疗前后测量第1秒用力呼气容积（FEV1），与25（OH）D血浆水平进行相关性分析。结果25（OH）D血浆浓度水平平均为（23．3±9．3）ng/mL．在COPD患者中普遍维生素D缺乏，约占40％。对氟替卡松起效的患者体内25（OH）D水平偏高，在使用氟替卡松4周后，第1秒用力通气量有明显改善。结论25（OH）D血浆水平与患者对氟替卡松的敏感性有关，并可提高第1秒用力通气量，提高1秒率，改善肺功能。     

Topical hydrocortisone,clobetasol propionate,and calcipotriol do not increase photocarcinogenesis induced by simulated solar irradiation in hairless mice

Please cite this paper as: Topical hydrocortisone, clobetasol propionate, and calcipotriol do not increase photocarcinogenesis induced by simulated solar irradiation in hairless mice. Experimental Dermatology 2010; 19 : 973–979. Abstract: Topical corticosteroids such as hydrocortisone‐17‐butyrate (HCB) and clobetasol‐17‐propionate (CP) and vitamin D₃ derivatives such as calcipotriol (CAL) are widely used to treat psoriasis. The immunosuppressive effects of corticosteroids make their topical use a concern for skin carcinogenicity. Few studies have assessed the effect of topical corticosteroids and topical vitamin D₃ derivatives on photocarcinogenesis induced by ultraviolet radiation. We investigated whether HCB, CP, or CAL can accelerate photocarcinogenesis using simulated solar radiation (SSR). HCB, CP, or CAL was applied topically to the backs of hairless, female, C3.Cg/TifBomTac‐immunocompetent mice in 16 groups of 25 mice each. The drugs were applied three times weekly followed by 0, 2, 4, or 6 standard erythema doses (SED) of SSR for 365 days or until death. No change was observed in the time required for tumor development in mice treated with HCB and 2 SED (HCB‐2SED) and HCB‐6SED. However, the time required for tumor development increased with HCB‐4SED treatment. Treatment with CP‐2SED did not change the time to onset of the first and second tumor, but all other CP treatments in combination with SSR increased the time. CAL‐2SED decreased the time to onset of the first tumor but not of the second and third tumor. CAL‐4SED and CAL‐6 SED did not change or increased the time to tumor development. Our data indicated that topical administration of HCB and CAL did not alter the photocarcinogenesis of SSR and that topical CP administration had a photoprotective effect. Thus, HCB, CP, and CAL do not increase photocarcinogenesis induced by SSR.     

The effect of fixed combination of fluticasone and salmeterol on asthma drug utilization,asthma drug cost,and episodes of asthma exacerbations

ABSTRACT

Objective: This study evaluated the use and drug costs of inhaled corticosteroids (ICSs), long-acting β₂-agonists (LABAs), and fluticasone propionate and salmeterol in a fixed-dose combination (FSC) and their relationship to asthma exacerbations before and after the market introduction of FSC in April 2001.

Methods: This is a retrospective analysis of employer-sponsored health insurance claims filed between January 1, 1998, and December 31, 2003 to detect impact of introduction of FSC (approved by the US Food and Drug Administration in August 2000) on utilization and cost of FSC, any ICS (excluding FSC), and any LABA (excluding FSC) along with utilization of medical services related to asthma exacerbations. Asthma medications were identified using National Drug Codes and Redbook, whereas asthma exacerbations were identified using ICD?9?CM primary diagnosis code 493.x. These medical and pharmacy claims were converted to rates per 100 asthma office visits.

Results: For all ICSs, the average pharmacy claims per 100 office visits increased from 383 in the year before FSC was introduced to 407 (120 [29.5%] were for FSC and 287 [70.5%] were for single-entity ICSs) in 2003. LABA prescribing increased from 72 in the year before FSC to 147 (120 from FSC, 27 single-entity LABA) in 2003 (?p < 0.001). An additional $13?511 per 100 asthma office visits was spent on the FSC product (?p < 0.001). After the introduction of FSC, there was no significant difference in asthma admissions (?p = 0.17), whereas emergency department (ED) visits increased by 0.92 visits per 100 office visits (?p = 0.03). The diagnosis and severity of asthma was inferred from the pharmacy claims and patients with chronic obstructive pulmonary disease could not be excluded. In addition, the study was not designed to assess the impact of other asthma medications on the disease and/or associated costs, and patient adherence to claimed medication could not be monitored.

Conclusions: The introduction of FSC was associated with increased LABAs/FSC patient exposure and expenditure with no change in asthma hospitalizations and an increase in ED visits.     

高效液相色谱法测定复方丙睾软膏中丙酸睾丸素含量

目的测定复方丙睾软膏中丙酸睾丸素含量。方法色谱柱为C18(250 mm×4.6 mm,5μm),流动相为甲醇-水(80∶20),流速为1.0 mL.min-1,检测波长241 nm。结果丙酸睾丸素在1~100μg.mL-1中线性关系良好(r=0.999 9),回收率大于95%,Rsd小于1%。结论该法灵敏、简便、准确,可作为本品的定量分析方法。     

少花斑鸠菊中的一个新三萜

目的 研究海南少花斑鸠菊Vernonia chunii的化学成分.方法 采用反复柱色谱法进行分离纯化,利用光谱数据及理化性质鉴定化合物的结构.结果 分离鉴定了4个化合物,分别为:羽扇豆醇丙酸酯(Ⅰ)、羽扇豆醇(Ⅱ)、齐墩果酸(Ⅲ)、胡萝卜苷(Ⅳ).结论 化合物Ⅰ为新化合物,命名为羽扇豆醇丙酸酯(lupenyl propionate),其余化合物均为首次从该植物中分离得到.