The treatment of oral aphthous ulceration or erosive lichen planus with topical clobetasol propionate in three preparations: a clinical and pilot study on 54 patients

BACKGROUND: This study evaluated the clinical use of a corticosteroid in three preparations (topical clobetasol propionate ointment, clobetasol propionate in an oral analgesic base, and clobetasol propionate in an adhesive denture paste). METHODS: Fifty-four patients (34 males and 20 females) with a history of vesiculo-ulcero-erosive oral lesions were selected: 24 with oral erosive lichen planus and 30 with aphthae. The subjects enrolled were randomly divided into three groups, each of 18 patients (10 with aphthae and 8 with lichen planus): the first was treated with topical clobetasol propionate ointment (0.05%) directly on the lesion(s) three times a day; the second with clobetasol propionate in an adhesive denture paste in equal amounts (1:1) two times a day; the third with clobetasol propionate in an oral analgesic base (Orabase-B) in equal amounts (1:1) two times a day. Each subject scored his or her symptoms daily from most severe (7) to none (0) by verbal assessments using a categorical scale. RESULTS: In all cases, the administration of the corticosteroid was effective in producing remission of symptoms in each group of patients. Significant differences (P<0.05) between groups were determined by the Kruskal-Wallis test. The Dunn test was used in order to detect which group differs from the others; clobetasol and adhesive denture paste correlated with an early remission of pain in lichen and apthous lesions. CONCLUSION: The results suggest that topical application of clobetasol in an adhesive denture paste is an effective drug for symptomatic oral vesiculo-erosive and/or ulcerative lesions.     

Efficacy and tolerability of fluticasone propionate nasal drops 400 μg once daily compared with placebo for the treatment of bilateral polyposis in adults

BACKGROUND: Chronic eosinophilic rhinosinusitis underlies a range of respiratory disorders including nasal polyposis. Surgical and medical methods are used to control polyps, with topical steroids commonly being used for their anti-inflammatory properties. Fluticasone propionate nasal drops (FPND) is a formulation developed specifically for an effective and well tolerated corticosteroid treatment of nasal polyposis. OBJECTIVES: To assess efficacy and tolerability of FPND in the treatment of bilateral nasal polyposis in adults. METHODS: This multicentre, randomized, parallel-group study compared FPND 400 microgram once daily (o.d.) with placebo for 12 weeks in adult patients with mild to moderate bilateral polyposis. The primary efficacy endpoint was visual assessment of polyp size by the physician at monthly clinic visits. Nasal blockage, rhinitis, peak nasal inspiratory flow (PNIF), olfactory function and requirement for polypectomy were also assessed at visits. The patients kept diary card records of symptoms, PNIF, and use of rescue antihistamine. Additional safety data were provided by a 12-week open extension, when all patients received FPND 400 microgram o.d. RESULTS: After 12 weeks double-blind treatment with FPND (n = 52) or placebo (n = 52), polyp size was reduced in 27% and 16% of patients, respectively; clinical reduction of nasal blockage significantly favoured FPND over placebo (55% vs 22%; P = 0.002), and clinic PNIF had increased significantly with FPND (by 52 L/min vs -3 L/min for placebo; P < 0.001). Diary card measurements showed significant benefits of FPND vs placebo for daily PNIF, nasal blockage, rhinitis and use of loratadine rescue medication. Both treatments were well tolerated and no serious adverse events occurred during randomized treatment. Epistaxis was more frequent with FPND than placebo but was generally mild and did not result in withdrawals. Mean serum cortisol levels did not change significantly with either treatment. CONCLUSION: This study showed FPND 400 microgram o.d. to be an effective and well tolerated treatment for bilateral nasal polyposis in adults.     

Nebulized Fluticasone Propionate vs. Budesonide as Adjunctive Treatment in Children with Asthma Exacerbation

Objectives: To compare the effects of nebulized fluticasone propionate (FP) and nebulized budesonide (BUD) in addition to inhaled salbutamol in children with mild asthma exacerbation. Methods: The study was a multicenter, randomized, single-blind, parallel group design. One hundred and sixty-eight children, aged 4-15 years, were randomly allocated to receive either nebulized FP (250 mcg) or nebulized BUD (500 mcg) twice daily for 10 days. On presentation, at the end of treatment, and after a 7-day follow-up, clinical assessment and pulmonary function measurements were performed. Daytime and nighttime asthma symptom scores, the use of rescue salbutamol, and morning/evening peak expiratory flow (PEF) values were recorded at home during the treatment period. Morning cortisol concentration (51 children) and overnight urinary cortisol excretion (30 children) were also measured in six centers at the start and at the end of the treatment. Results: Improvement of morning PEF was significantly higher in patients treated with FP (p = 0.032). The percentage of symptom-free nights was significantly higher in the BUD group (p = 0.006), but no difference was found in symptom-free days. No intergroup difference was detected in the percentage of days/nights free from rescue medication and in pulmonary function tests performed in outpatient settings. There was no evidence of hypothalamo-pituitary-adrenal axis suppression. Conclusions: A short course of nebulized FP has the same effects as a double dose of nebulized BUD, when either drug is added to bronchodilator therapy in children with mild asthma exacerbation.     

Comparison of the effects of fluticasone propionate, aqueous nasal spray and levocabastine on inflammatory cells in nasal lavage and clinical activity during the pollen season in seasonal rhinitics

BACKGROUND: Treatment options for allergic rhinitis include antihistamines, decongestants, anticholinergics, cromolyn sodium and corticosteroids. As the nose is a small organ, comprising less than 1% of total body mass and surface area, it seems logical to confine treatment of rhinitis to the diseased organ. OBJECTIVE: To evaluate the effects of therapy with intranasal fluticasone propionate (FP), both on subjective symptoms and pathophysiological mechanisms, in rhinitis patients during pollen season when the patients were symptomatic. METHODS: We used a double-blind, placebo (PLA)-controlled, randomized, double dummy, parallel group study of the effect of 6 weeks treatment. The double-blind comparison was made between the following three treatments: FP aqueous nasal spray, 200 microg taken once daily, levocabastine (LEV) nasal spray, 200 microg taken twice daily and PLA nasal spray. Clinical evaluation and the levels of cells and mediators in nasal washing were performed before and after treatments. Twenty-four patients (11 men and 13 women, aged 17-50 years, mean age 30.1 +/- 8.5) with strictly seasonal allergic rhinitis to Parietaria entered the study. Clinical evaluation and the levels of inflammatory cells (eosinophils and activated eosinophils, i.e. EG2+) and their mediators (tryptase, eosinophil cationic protein, eosinophil protein X and neutrophil myeloperoxidase) in nasal-lavage were performed before and after treatments. RESULTS: Treatment with FP significantly increased, with respect to placebo, the percentage of days without sneezing (P < 0. 001), nasal blockage (P < 0.001), rhinorrhea (P < 0.001), nasal itching (P < 0.001). Furthermore, treatment with FP showed additional benefits with respect to LEV. The percentage of days without nasal blockage was significantly higher in the FP group that in the placebo group (P = 0.018). The same applied to rhinorrhea (P = 0.009). The percentages of days without sneezing and itching were instead not significantly different between the two groups. As expected, no significant differences were observed in baseline medians of the rhinitis symptom scores as well as in mean values of all mediators and eosinophils in nasal lavages of the various groups under study. After treatment the mean of subjective symptoms as well as all values in nasal lavage level fell significantly only in the FP group, whereas no significant changes were observed either in LEV or PLA groups. Accordingly, significant differences were observed at the end of the treatments between the values of fluticasone group vs LEV and PLA group values. Significant correlations between these values and symptom scores were found, according with literature data suggesting a pathogenetic role for these mediators and eosinophils in rhinitis. CONCLUSION: FP (200 microg once daily) affords a significant degree of improvement in rhinitis control during pollen season, as measured by subjective and objective parameters, compared with LEV (200 microg twice daily) and PLA. The therapeutic benefits of intranasal FP are reflected in, and may be caused by, the decrease in nasal inflammatory cells.     

Testosterone-induced changes in testicular antioxidant system

Summary. In order to investigate the role of testosterone propionate (TP) on the antioxidant system of the rat testis, lipid peroxidation (LPX) and activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) of the testis of testosterone-treated and control rats were compared. The results indicate that TP administration to intact adult rats resulted in a significant decline in protein content of various subcellular fractions. This is accompanied with significant elevation in LPX levels of various sub-cellular fractions suggesting induction of oxidative stress. Activities of three enzymes related to the metabolism of superoxide radical (SOD) and hydrogen peroxide (CAT and GPx) of testis, were found to be significantly decreased in response to TP treatment. The role of testosterone in regulating testicular spermatogenesis through oxidative stress is discussed.     

去势Beagle犬前列腺增生模型的建立

目的 :利用Beagle犬建立前列腺增生模型。　方法 :2年龄雄性Beagle犬 2 4只 ,随机分成对照组和 3个剂量的实验组共 4组 ,每组 6只 ,去势 2个月后 ,肌注给药。实验组分别给予丙酸睾酮 (TP) 0 .8、2 .5、7.5mg/kg ,对照组给予等体积溶剂。 2个月后 ,处死 12只动物 ,取前列腺组织 ,称重测量体积 ,放免法测定血清及前列腺组织中双氢睾酮 (DHT)水平 ,组织切片观察前列腺腺腔面积及腺上皮细胞高度。B超测量去势前、后 2个月及给予TP 2个月时犬前列腺体积。　结果 :B超结果显示 ,去势 2个月后 ,各组犬前列腺体积较去势前均明显缩小 (P均 <0 .0 1) ;给予TP 2个月后 ,各实验组犬前列腺体积明显大于对照组 (P均 <0 .0 1)。各实验组犬前列腺湿重及实际体积与对照组相比 ,均明显增重增大 (P均 <0 .0 5 ) ,并存在剂量依赖关系。犬血清及前列腺中DHT含量随TP剂量的增大而增加。显微图像分析结果显示 ,犬前列腺腺腔面积随TP剂量增大而增加 ,腺上皮细胞高度也随TP剂量增大而增高。　结论 :给予去势Beagle犬TP 2个月后 ,可成功建立前列腺增生模型。     

长期吸入丙酸氟替卡松对支气管哮喘患者肾上腺皮质功能的影响

目的　评价长期吸入丙酸氟替卡松 (FP)对哮喘患者肾上腺皮质功能的影响。方法非急性发作期支气管哮喘患者 80例 ,中度 42例 ,重度 38例。使用FP治疗前 1周为筛选期 ,测定早晨 8时血浆皮质醇。中度患者吸入FP气雾剂 50 0 μg/d ,重度患者吸入FP 750 μg/d。治疗期至少 1年以上。治疗结束时测定FEV1 %与PEF ,同时测定早晨 8时的血浆皮质醇。结果　吸入FP50 0 μg/d组治疗前、后早晨 8时血浆皮质醇值分别为 (1 0 8 5± 50 7) μg/L和 (1 0 3 8± 48 1 ) μg/L(P >0 0 5) ;吸入FP 750 μg/d组分别为 (1 0 2 4± 48 6) μg/L和 (1 0 0 5± 51 4) μg/L(P >0 0 5)。两组比较无显著性差异 (P >0 0 5)。两组患者吸入FP 1年后血浆皮质醇值均在正常范围内。结论　长期吸入FP 50 0 μg/d和 750 μg/d对于中、重度哮喘患者均可达到有效的治疗效果 ,而对肾上腺皮质功能无明显的抑制作用     

Biochemical profile of propionyl-L-carnitine

This article briefly discusses biochemical reactions involved in the metabolism of propionate, propionylCoA, and propionyl-L-carnitine in the heart. The aim is to understand the way in which propionyl-L-carnitine can exert a protective effect on the ischemic/reperfused heart. The protection of the plasmalemma by propionyl-L-carnitine during acidosis of the heart is also discussed. One protective mechanism is based on the ability of propionate to replenish mitochondria with dicarboxylic acid intermediates of the citric acid cycle and to increase the cellular content of carnitine, both of which may stimulate the generation of energy in the postischemic reperfusion phase. Another mechanism presumes a stabilizing action of acylcarnitines upon biomembranes.     

复方丙酸氯倍他索软膏联合UVB治疗寻常型银屑病的临床疗效及护理

目的探讨用复方丙酸氯倍他索软膏联合UVB照射，并配合护理措施治疗寻常型银屑病的临床疗效。方法治疗组于患处外涂复方丙酸氯倍他索软膏，每天2次，行UVB全身照射，1周2～3次，并配合适当的护理措施。对照组于患处外涂复方丙酸氯倍他索软膏，每天2次。根据PASI评分标准评价疗效。结果治疗组有效率88．46％，对照组有效率65．38％，经统计学处理，x^2=7．8000，P〈0．01；治疗组复发率19．05％，对照组复发率53．85％，经统计学处理，x^2=4．4472，P〈0．05。结论复方丙酸氯倍他索软膏联合UVB照射并配合适当的护理措施是治疗寻常型银屑病的有效方法。     

吸入糖皮质激素对哮喘儿童血清IgE的影响

Objective To discuss the significance of serum IgE before and after inhale glucocorticoid treat-ment of children's asthma. Methods 520 children with asthma were seleceted from the outpatient. Different type of fluticasone propionate were given to different age groups: Aerosol type by a spacer in less than 5 years old,and in-halant (Seretide) 5 years and the above. The dosage was between 200 μg/day to 375 μg/day. IgE was tested before and 3 months after the treatment. Results Serum IgE decreased significantly in 3 months treatment [ from (496.12±24.75) kU/L to (390.71±18.71) kU/L] (t=7.337,P<0.01). The change of IgE was related to clinical effect and age. The level increased in those less than 3 years [(307.05±34.71)kU/L vs (483.09±41.78) kU/L] (t=2.963,P=0.004),but decreased between 4 to 5 years old group [(543.46±51.03) kU/L vs (316.93±29.30) kU/L] (t=3.368,P=0.000) ,and decreased between 6 to 14 years old group[ (586.30±37.19)kU/L vs (387.61±27.60) kU/L] (t=4.827,P=0.000). In fluticasone group IgE level changed from (468.91±32.81) kU/L to (359.03±22.79) kU/L after treatment (t=5.988,P<0.01),which decreased from (586.30±37.19) kU/L to (387.6±27.60) kU/L in Salmeterol group (t=4.827,P<0.01). In 260 cases of IgE below 300 kU/L 109 cases (41.92%,109/260) increased while in 260 cases of IgE above 300 kU/L,total IgE lev-el increased in 45 cases (16.15% ,45/260) after treatment,with statistical significance(χ<'2>=37.789,P=0.000). Conclusion Inhale glucocorticoid can make the level of IgE decreased.