Five‐year efficacy of finasteride in 801 Japanese men with androgenetic alopecia

Finasteride is standard medical treatment for androgenetic alopecia; however, no large studies with 5 years or more of follow up have been performed in Japan. The authors followed Japanese men with androgenetic alopecia treated with finasteride for 5 years to evaluate long‐term treatment efficacy. Of 903 men treated with finasteride (1 mg/day), 801 patients were evaluated over 5 years by modified global photographic assessment. Although the proportion of improvement was high (99.4%), modified global photographic assessment scores after 5 years of treatment were lower in patients with more advanced disease as measured by the modified Norwood–Hamilton scale. After separating patients into “sufficient” and “insufficient” efficacy groups according to the modified global photographic assessment score after 5 years (scores ≥6 and <6, respectively), multivariate analysis showed that independent risk factors of insufficient efficacy were age at start of treatment of 40 years or more (P = 0.021) and classification on the modified Norwood–Hamilton scale (P < 0.001), whereas presence of stress at start of treatment was a negative predictor (P = 0.025). In conclusion, continuous finasteride treatment for 5 years improved androgenetic alopecia with sustained effect among Japanese. Younger age and less advanced disease at start of treatment were the key predictors of higher finasteride efficacy.     

保列治治疗合并慢性前列腺炎的良性前列腺增生症疗效观察

目的 观察保列治治疗合并慢性前列腺炎的良性前列腺增生症的临床疗效。方法 选择经临床确诊的合并慢性前列腺炎的良性前列腺增生症患者40例,口服保列治5 mg,1次/d,共3个月,分别于治疗前,治疗3个月后行国际前列腺症状评分(IPSS)、尿流率、残余尿量、前列腺体积及前列腺液常规等指标测定。结果 用药3个月后IPSS平均降低31.6％,最大尿流率平均升高38.3％,残余尿量平均减少38.6％。前列腺体积平均缩小18.1％。前列腺液白细胞计数平均减少39.8％。前列腺液检查好转率50％。前列腺体积≥40 mL组及<40 mL组的前列腺液检查好转率分别为66.7％及31.6％,两者比较P<0.05。结论 保列治治疗合并慢性前列腺炎的良性前列腺增生症,对慢性前列腺炎及良性前列腺增生症均效果良好。对慢性前列腺炎伴前列腺体积较大者效果尤佳。     

一种非同位素5α-还原酶抑制剂体外筛选模型的建立和应用

目的:建立一种非同位素5α-还原酶抑制剂体外筛选模型.方法:从大鼠前列腺组织中提取物5α-还原酶,与底物睾酮(T)以及供氢体NADPH共同组成了一种微量反应体系.反应产物二氢睾酮(DHT)用酶免技术(EIA)测定,以产物生成量确定酶活性;对反应底物、NADPH、酶浓度以及反应最佳温度和时间进行了优化.结果:当底物、NADPH、酶提取物浓度分别为0.25μM、1mM和0.3mg,37℃反应60分钟可获最大酶活性.特异性5α-还原酶抑制剂非那雄胺显著降低5α-还原酶催化产物DHT的生成.进一步对24种中药进行筛选,姜黄、夏枯草等中药提取物具有5α-还原酶抑制剂作用.结论:本文建立的非同位素方法有效、可行,可作为一种体外模型筛选和研究5α-还原酶抑制剂.     

反相高效液相色谱法测定非那雄胺及制剂的含量

目的:建立测定非那雄胺含量的高效液相色谱法.方法:采用DiamonsilTM-C18柱(200×4.6mm,5μm),以乙腈-水(50:50)为流动相,检测波长为220nm.结果:该法能很好地分离非那雄胺和其相关物质、降解产物,测定的线性范围40～140μg·ml-1,r=0.9999.结论:本法测定样品分离效果好,分析快速准确.     

Inhibition of neurosteroid synthesis increases asphyxia-induced brain injury in the late gestation fetal sheep

Allopregnanolone (AP) is a potent GABAergic agonist that suppresses CNS activity, seizure threshold, and excitotoxicity in the adult brain. AP is present in the fetal sheep brain and increases rapidly after asphyxial insult due to increased 5alpha-reductase type-2 (5alphaR-2) expression. The aim of this study was to use finasteride to suppress fetal neurosteroid synthesis, and then determine the effect on brain injury, particularly in the hippocampus, of asphyxia induced in utero by brief occlusion of the umbilical cord. Catheters and an inflatable umbilical cord cuff were implanted in fetal sheep at approximately 125 days gestation. Five days later the fetuses received either finasteride (20 mg/kg/h) or vehicle (40% hydroxypropyl-beta-cyclodextrin) for 2 h. The umbilical cord was occluded (UCO) for 5 min at 30 min after starting the infusion. The fetal brain was obtained 24 h later for examination of activated caspase-3 expression as an index of apoptosis, and to measure AP content. Finasteride treatment alone significantly reduced AP content and increased the number of caspase-3 positive cells in the hippocampus, cerebellum, and the subcallosal bundle, indicating that AP modulates the normal rate of apoptosis in the developing brain. UCO in vehicle and finasteride-treated fetuses produced a similar, marked decrease in O2 saturation (5.8+/-0.6%), but after finasteride treatment UCO caused a significantly greater increase in the number of caspase-3 positive cells in the hippocampal cornu ammonis 3 (CA3) (57.3+/-1.6%) compared with the vehicle-treated fetuses. Thus, 5alpha-reduced steroids such as AP may be protective in reducing cell death following acute fetal asphyxia. Perturbation of normal fetal neurosteroid levels in late gestation (e.g. due to preterm birth, or maternal synthetic steroid treatment to induce fetal lung maturation) could adversely affect brain development and increase its vulnerability to injury.     

Imaging prostate cancer (PCa) with [99mTc(CO)3]finasteride dithiocarbamate

This investigation aimed to modify finasteride ( 1 ) to finasteride dithiocarbamate ( 2 ) for subsequent synthesis of the rhenium analogue ( 3 ) and [^99mTc]tricarbonyl complexes ( 4 ), to assess its prostate cancer (PCa) targeting potential in a rat model. To validate the identity of ( 4) , reference ( 3) has been synthesized by using fac‐[Net₄]₂[ReBr₃(CO)₃] precursor and characterized by ¹H‐NMR, ¹³C‐NMR, ESI‐MS, and elemental analysis. The analogue ( 4) was synthesized by using fac‐[^99mTc(H₂O)₃(CO)₃]⁺ precursor, and its structure was confirmed by comparative HPLC by using ( 3) as a reference. Further, the suitability of ( 4) as a PCa imaging agent was investigated in vitro and in vivo. At room temperature, ( 4) had ≥99% radiochemical purity and remained ≥84% stable in serum. In preclinical studies, biodistribution of ( 4) in histopathologically established rat model showed adequately high in vivo uptake in the prostate attracting the possibility of using it for noninvasive imaging of PCa.     

加校正因子的主成分自身对照法同时测定非那雄胺片中2个杂质

目的：建立加校正因子的主成分自身对照法测定非那雄胺片中有关物质的含量。方法：CAPCELL PAK C₁₈色谱柱(4.6′250 mm,5 mm),流动相乙腈-水(45∶55),流速1.0 mL.min_-1,检测波长210 nm,进样量20 mL,柱温30℃。测定非那雄胺与杂质Ⅰ、Ⅱ的标准曲线方程,以斜率计算杂质相对于非那雄胺的校正因子,用相对保留时间确定各杂质的位置。结果：非那雄胺杂质Ⅰ、Ⅱ的相对保留时间分别为0.85与1.30,相对校正因子分别为2.40与0.69。结论：本方法可用于非那雄胺片中有关物质的定性及定量分析,采用加校正因子的主成分自身对照法可以更准确的反映其有关物质的含量。     

纳晶微针联合5%米诺地尔酊治疗男性雄激素脱发的临床观察

目的评估纳晶微针联合5%米诺地尔酊治疗男性雄激素脱发(AGA)的治疗效果及安全性.方法于我院皮肤科门诊收集男性AGA患者90例,随机分为3组,各组均30人.纳晶微针联合外用5%米诺地尔酊(A组)、单独纳晶微针治疗组(B组)和单独外用5%米诺地尔酊治疗组(C组),三组患者均连续治疗24周后评估疗效.结果治疗24周后,医师疗效评分方面:A组明显改善率40%,B组和C组明显改善率均为6.7%,三组患者均有改善.两组间相比,A组与B组(P<0.001)、A组与C组(P<0.001),差异均有统计学意义.患者疗效平均分:A组3.03分>C组1.93分>B组1.73分.两组间对比,A组与B组(P<0.001),A组与C组(P<0.001),差异均具有统计学意义.治疗过程中三组患者均未出现明显不良反应.结论纳晶微针联合5%米诺地尔酊治疗男性AGA比单独应用纳晶微针及单独外用米诺地尔治疗效果更佳,值得临床推广应用.