氧化锌软膏联合1%联苯苄唑乳膏对改善外阴阴道假丝酵母菌病患者外阴不适症状的疗效观察

目的:观察氧化锌软膏联合1%联苯苄唑乳膏局部外涂对改善外阴阴道假丝酵母菌病(VVC)患者外阴不适症状的疗效。方法:选择2017年1月至6月在本院妇科门诊就诊的VVC患者148例,根据外阴不适的轻、中、重程度随机分为研究组和对照组,每组各74例。两组患者均阴道内给予克霉唑阴道片1片(睡前),研究组在此基础上于外阴不适处联合外涂氧化锌软膏及1%联苯苄唑乳膏,早晚交替各1次;对照组仅每晚外涂1%联苯苄唑乳膏1次。3天后,比较两组的临床应用效果。结果:研究组和对照组有效率分别为87.84%(65/74)和71.62%(53/74),研究组显著高于对照组(P0.05);两组轻度外阴不适患者治疗后总有效率分别为97.14%(34/35)和94.59%(35/37),差异无统计学意义(P0.05);中度外阴不适患者总有效率分别为82.61%(19/23)和54.55%(12/22),研究组显著高于对照组(P0.05);重度外阴不适患者总有效率分别为75.00%(12/16)和40.00%(6/15),研究组显著高于对照组(P0.05)。结论:氧化锌软膏联合1%联苯苄唑乳膏局部交替外涂用于治疗伴中、重度外阴不适症状的VVC患者的临床疗效显著优于单用1%联苯苄唑乳膏局部外涂。     

Age-dependent effects of sodium butyrate and hydrocortisone on acetylation of high mobility group proteins of rat liver

The in vitro acetylation of high mobility group (HMG) proteins and its modulation by sodium butyrate and hydrocortisone have been studied using liver slices of young (13-) and old (114-week-old) rats. Acetylation of total HMG proteins was significantly higher in young than old rats. HMG 1, in particular, showed greater acetylation than others. Whereas acetylation of HMG 1 and 2 decreased drastically, that of HMG 14 and 17 increased in old age. In young rats, sodium butyrate and hydrocortisone stimulated acetylation of HMG 14 and 17, and decreased that of HMG 2. Butyrate had no effect on HMG 1, but hydrocortisone decreased it. In old rats, butyrate and hydrocortisone decreased acetylation of all HMGs, except HMG 17, which was stimulated to a slight extent by butyrate.     

Topical Lyogel Containing Corticosteroid Decreases IgE Expression and Enhances the Therapeutic Efficacy Against Atopic Eczema

Hydrocortisone cream intended for atopic eczema often produces unwanted side effects after long-term use. These side effects are essentially due to repeated percutaneous administration of the medication for skin dermatitis, as atopic eczema is a relapsing disorder. Hence, there is a need to develop a new hydrocortisone formulation that will deliver the drug more effectively and require a reduced dosing frequency; therefore, the side effects could be minimized. In this study, a hydroxypropyl methylcellulose (HPMC) lyogel system based on 80% organic and 20% aqueous solvents containing 1% hydrocortisone was formulated. The hydrocortisone lyogel physicochemical characteristics, rheological properties, stability profile, and in vitro Franz cell drug release properties, as well as the in vivo therapeutic efficacies and dermal irritancy in Balb/c mice were investigated. The HPMC lyogel appeared clear and soft and was easy to rub on the skin. The lyogel also showed a higher drug release profile compared with commercial hydrocortisone cream. Similar to the cream, HPMC lyogels exhibited pseudoplastic behavior. From the mouse model, the hydrocortisone lyogel showed higher inflammatory suppressive effects than the cream. However, it did not reduce the transepidermal water loss as effectively as the control did. The dermal irritancy testing revealed that the hydrocortisone lyogel caused minimal irritation. In conclusion, HPMC lyogel is a promising vehicle to deliver hydrocortisone topically, as it showed a higher drug release in vitro as well as enhanced therapeutic efficacy in resolving eczematous inflammatory reaction compared with commercial cream.KEY WORDS: atopic eczema, eczematous inflammatory reaction, hydrocortisone, IgE, lyogel, transepidermal water loss     

Topical Application of Flurandrenolone in the Treatment of Atopic Dermatitis

The effect of flurandrenolone, 0.05%, in a cream base was compared with that of hydrocortisone, 1%, in the same base in 35 cases of atopic dermatitis, using contralateral application technique. The efficacy of flurandrenolone was found to be superior to that of hydrocortisone in 23 instances and equal in 12 cases. A fourfold dilution of this cream, flurandrenolone 0.0125%, was compared with 1% hydrocortisone cream in 18 patients and similar results were obtained. The superiority of flurandrenolone was particularly evident during the first week of application. The therapeutic efficacy of small amounts of flurandrenolone results in economic advantage to the patient and enables him to use applications of this preparation more freely.     

Twice weekly fluticasone propionate added to emollient maintenance treatment to reduce risk of relapse in atopic dermatitis: randomised,double blind,parallel group study

Objective To explore the efficacy and safety of fluticasone propionate, cream and ointment, applied twice weekly in addition to maintenance treatment with emollients, in reducing the risk of relapse of chronic recurrent atopic dermatitis.Design Randomised, double blind, parallel group study of 20 weeks'' duration.Setting Dermatology outpatient clinics (6 countries, 39 centres).Participants Adult (aged 12-65) patients with moderate to severe atopic dermatitis who were experiencing a flare.Methods Participants applied fluticasone propionate (0.05% cream or 0.005% ointment; once or twice daily) regularly for four weeks to stabilise their condition. The patients whose disease was brought under control then continued into a 16 week maintenance phase, applying emollient on a daily basis with a bath oil as needed and either the same formulation of fluticasone propionate or its placebo base (emollient alone) twice weekly to the areas that were usually affected.Main outcome measure Time to relapse of atopic dermatitis during maintenance phase.Results 376 patients entered the stabilisation phase, and 295 continued into the maintenance phase. After 16 weeks in the maintenance phase, the disease remained under control in 133 patients (87 using fluticasone propionate twice weekly, 46 using emollient alone), 135 (40 fluticasone propionate, 95 emollient) had experienced a relapse, and 27 had discontinued. Median time to relapse was six weeks for emollient alone compared with more than 16 weeks for additional fluticasone propionate. Patients who applied fluticasone propionate cream twice weekly were 5.8 times less likely (95% confidence interval 3.1 to 10.8, P < 0.001) and patients using fluticasone propionate ointment 1.9 times less likely (1.2 to 3.2, P=0.010) to have a relapse than patients applying emollient alone. The groups showed no differences in adverse events.Conclusion After atopic dermatitis had been stabilised the addition of fluticasone propionate twice weekly to maintenance treatment with emollients significantly reduced the risk of relapse.     

Development and Evaluation of Curcumin-loaded Elastic Vesicles as an Effective Topical Anti-inflammatory Formulation

Curcumin has diverse biological activities including antioxidant and anti-inflammatory activity. However, its clinical use for topical application is limited due to its poor aqueous solubility and thus, minimal cutaneous bioavailability. Elastic vesicles (EVs) of curcumin were prepared to improve its cutaneous bioavailability and to use it for topical anti-inflammatory effect. Ex vivo skin permeation and retention studies were performed to check if incorporation of curcumin into EVs could improve its permeation into and retention in the skin. Evaluation of acute and chronic anti-inflammatory effect was done using xylene-induced acute ear edema in mice and cotton pellet-induced chronic inflammation in rats, respectively. A significant improvement in flux (nine times) across murine skin was observed when aqueous dispersion of curcumin (flux − 0.46 ± 0.02 μg/h/cm²) was compared with curcumin-loaded EVs (flux − 4.14 ± 0.04 μg/h/cm² ). Incorporation of these curcumin-loaded EVs into a hydrophilic ointment base resulted in higher skin retention (51.66%) in contrast to free curcumin ointment (1.64%) and a marketed formulation (VICCO® turmeric skin cream). The developed ointment showed an effect similar (p < 0.05) to the marketed diclofenac sodium ointment (Omni-gel®) in suppression of acute inflammation in mouse; a significant inhibition (28.8% versus 3.91% for free curcumin) of cotton pellet-induced chronic inflammation was also observed. Thus, curcumin-loaded EVs incorporated in hydrophilic ointment is a promising topical anti-inflammatory formulation.KEY WORDS: anti-inflammatory, curcumin, elastic vesicles, topical formulation     

30例犬小孢子菌致体癣病例的临床分析

目的 通过对30例犬小孢子菌致体癣病例的临床分析,探讨城市犬小孢子菌病的常见感染来源及防治方案.方法 收集2012年6～7月就诊于我院有宠物接触史(猫、狗)的体癣患者30例,对其致病菌种做真菌培养鉴定,对结果进行临床分析.给予患者外用联苯苄唑软膏或特比萘芬软膏治疗.结果 30例患者均在发病前接触过猫或狗,病程不长,真菌培养结果显示均为犬小孢子菌,经治疗后均痊愈.结论 30例犬小孢子菌致体癣患者皮损特征相似,外用抗真菌软膏可得到有效治疗.     

Induction of granulopoiesis of mastocytoma cells: ultrastructural and cytochemical studies on production of serotonin in a cultured mouse mastocytoma cell line

Electron microscopic observations of an originally established mouse mastocytoma cell line (BSP-MST-2) revealed that the cytoplasm of many of the MST-2 cells contained small and low osmiophilic granules and a few mature electron-dense granules. Fluorescent- and immuno-histochemical examinations also suggested the immaturity of granules as the cytoplasmic reaction for serotonin (5-HT) was weak. Induction of further maturation of granules was investigated by administration of various chemical agents. Among the chemicals examined, sodium butyrate and hydrocortisone were effective. In the presence of 1 mM sodium butyrate for 24 h, the cytoplasmic granules contained an abundant dense matrix. MST-2 cells incubated with hydrocortisone at 5 micrograms/ml for 24 h showed a somewhat different granulopoietic pattern from those incubated with sodium butyrate, including numerous electron-dense progranules. Fluorescent- and immuno-histochemical studies showed increased reactions of cytoplasmic 5-HT of both butyrate- and hydrocortisone-treated MST-2 cells. The specificity of these morphological and cytochemical changes was confirmed by treatment with reserpine, a drug which depletes cellular 5-HT; electron-dense materials were virtually diminished and cytochemical reactions were significantly decreased. The mode of induced production of 5-HT in mastocytoma granules is discussed, in relation to mastocyte differentiation.     

Topical Fat Reduction

The fat on women's thighs is more difficult to mobilize due to increased α-2 adrenergic receptor activity induced by estrogen. Lipolysis can be initiated through adipocyte receptor stimulation (β adrenergic) or inhibition (adenosine or α-2 adrenergic) or by inhibition of phosphodiesterase. Since many women desire regional thigh fat loss, a series of clinical trials were initiated using one thigh as a double-blinded control. Trial #1: Five overweight women had injections of isoproterenol at intervals around the thigh three times a week for 4 weeks with diet and walking. Trial #2: Five overweight woman had ointment containing forskolin, yohimbine and aminophylline applied to the thigh five times a week for 4 weeks after hypertonic warm soaks with a diet and walking. Trial #3: Eighteen overweight women were divided into three groups of six and trial #2 was repeated with each agent alone vs. placebo using forskolin, yohimbine or aminophylline in separate ointments. Trial #4: Thirty overweight women had 10% aminophylline ointment applied to the thigh five times a week for 6 weeks with diet and walking. Chemistry panel, theophylline level and patch testing wereperformed. Trial#5: Twelve women had trial #4 repeated with 2% aminophylline cream without a diet or walking. Trial #6: Trial #5 was repeated with 0.5% aminophylline cream. All trials except yohimbine ointment gave significantly more girth loss from the treated thigh (p < 0.05 to p < 0.001). Chemistry panel showed no toxicity. Theophylline was undetectable and patch testing was negative. We conclude that topical fat reduction for women's thighs can be achieved without diet or exercise.     

Therapeutic efficacy in BALB/C mice of extract from marine alga <Emphasis Type="Italic">Canistrocarpus cervicornis</Emphasis> (Phaeophyceae) against herpes simplex virus type 1

Studies with diterpenes from marine brown alga Canistrocarpus cervicornis showed the antiviral potential of the products from this alga in controlling the replication of HSV-1 and maintaining low cytotoxicity. Hence, the aim of this work was to evaluate the anti-herpetic efficacy of C. cervicornis extract ointment in BALB/c mice. To test the anti-herpetic efficacy in vivo, four groups of BALB/c mice (n?=?5) were used: 1—untreated, 2—extract ointment (2 % or 0.4 mg cm^?2 dose^?1), 3—Acyclovir cream (5 % or 1.0 mg cm^?2 dose^?1), and 4—ointment base. The right midflank of each mouse was clipped and depilated with a chemical depilatory. After 2 days, the skin area was scratched and inoculated with HSV-1. The ointments and cream were applied three times a day over a 16-day period, beginning 1 h after virus inoculation. The development of skin lesions was continuously monitored and scored. To evaluate the effect of C. cervicornis topical treatment on biochemical parameters and on body weight, two uninfected groups were formed: an untreated group and a group treated with ointment C. cervicornis extract (2 %). The signs of infection appeared from the second day after infection, while on the 10th day of the experiment, the ointment base and untreated groups had significantly more severe lesions than did the groups that were treated with extract (p?<?0.05) or acyclovir (p?<?0,01). The topical application of extract ointment did not change body weight, hepatic, or renal function suggesting that the extract has a low toxicity in this route of administration. These results suggest that the extract may be useful in reducing the severity of HSV-1 cutaneous lesions.     

Regulation of butyrate uptake in Caco-2 cells by phorbol 12-myristate 13-acetate

Butyrate and the other short-chain fatty acids (SCFAs) are the most abundant anions in the colonic lumen. Also, butyrate is the preferred energy source for colonocytes and has been shown to regulate colonic electrolyte and fluid absorption. Previous studies from our group have demonstrated that the HCO(3)(-)/SCFA(-) anion exchange process is one of the major mechanisms of butyrate transport across the purified human colonic apical membrane vesicles and the apical membrane of human colonic adenocarcinoma cell line Caco-2 and have suggested that it is mainly mediated via monocarboxylate transporter-1 (MCT-1) isoform. However, little is known regarding the regulation of SCFA transport by various hormones and signal transduction pathways. Therefore, the present studies were undertaken to examine whether hydrocortisone and phorbol 12-myristate 13-acetate (PMA) are involved in a possible regulation of the butyrate/anion exchange process in Caco-2 cells. The butyrate/anion exchange process was assessed by measuring a pH-driven [(14)C]butyrate uptake in Caco-2 cells. Our results demonstrated that 24-h incubation with PMA (1 microM) significantly increased [(14)C]butyrate uptake compared with incubation with 4alphaPMA (inactive form). In contrast, incubation with hydrocortisone had no significant effect on butyrate uptake in Caco-2 cells compared with vehicle (ethanol) alone. Induction of butyrate uptake by PMA appeared to be via an increase in the maximum velocity (V(max)) of the transport process with no significant changes in the K(m) of the transporter for butyrate. Parallel to the increase in the V(max) of [(14)C]butyrate uptake, the MCT-1 protein level was also increased in response to PMA incubation. Our studies demonstrated that the butyrate/anion exchange was increased in response to PMA treatment along with the induction in the level of MCT-1 expression in Caco-2 cells.     

The status of corticosteroid therapy in dermatology

Therapy with systemic corticosteroids, despite attendant serious risks, is mandatory in diseases such as pemphigus, acute disseminated lupus erythematosus and some cases of exfoliative dermatitis that are ordinarily fatal, for in such cases life may be prolonged and the patients made comfortable. If no contraindications exist, therapy with corticosteroids is desirable, for diseases of short duration-contact dermatitis, serum sickness reactions and drug eruptions of all kinds-provided the causative factors have been removed and the reactions are causing severe distress.On the basis of encouraging reports in the literature corticosteroid therapy may be instituted with justification for a group of unrelated, intractable and discomforting diseases such as maddening pruritus ani, sclerema neonatorum, dermatomyositis, certain cases of sarcoidosis, berylliosis, Behcet's syndrome, universal calcinosis, Reiter's disease and ulcers of sickle-cell anemia. One must always bear in mind the well-defined contraindications to corticosteroid therapy and the hazards of its use, particularly if therapy is to be prolonged. Results from topical hydrocortisone therapy are particularly pleasing in chronic eczematous otitis externa and especially when it is combined with an antibiotic drug. Results are excellent also in nuchal eczema, dermatitis of the eyelids and in pruritus ani. More often than not, hydrocortisone ointment and lotions benefit more than do other standard remedies such diseases as atopic eczema, contact dermatitis, lichen simplex-chronicus and eczematized phases of conditions such as psoriasis and superficial mycotic infections. Preparations containing a combination of hydrocortisone and an antibiotic are more useful than hydrocortisone alone. When used with discrimination, with full attention to the selection of cases and proper concentration in the correct vehicle, hydrocortisone preparations in combination with antibiotics are excellent antieczematous agents.     

Control of Transdermal Permeation of Hydrocortisone Acetate from Hydrophilic and Lipophilic Formulations

The purpose of this research was the preparation of four formulations containing hydrocortisone acetate (HCA) for topical application, including two aqueous systems (hydrophilic microemulsion and aqueous gel) and two systems with dominant hydrophobicity (hydrophobic microemulsion and ointment). The formulations were tested for the release and permeation of HCA across an animal membrane. The release of HCA was found comparable for the four systems. The two microemulsions promote permeation across an ex-vivo membrane, examined by means of a Franz cell. Hydrophobic microemulsion guarantees the highest solubility (2,370 μg/ml) and flux (133 μg/cm².h) of the drug, since it contains almost 40% Transcutol, a permeation enhancer. Gel and ointment provide lower solubility and flux, being the values, related to the ointment, the lowest ones (562 μg/ml and 0.4 μg/cm².h). Experimental results allow the conclusion that gel and ointment can be suitable when it is desirable to minimize absorption of topically applied HCA as to keep the drug restricted to the diseased area and prevent side effects of the systemic presence of HCA.     

Observations on the systemic effect of topical clobetasol propionate (Dermovate).

Topical application of clobetasol propionate in a strength of 0-05% in cream or ointment (Dermovate) suppressed the hypothalamic-pituitary-adrenal axis in both normal people and patients with diseased skin. In normal people the 9 am serum cortisol level was suppressed when between 45 and 90 g was applied weekly. Insulin stress test results in patients with diseased skin showed an abnormally small response after long-term application of similar amounts. We conclude that long-term administration should be restricted to less than 50 g a week.     

Alterations in the activities of subcellular fractions marker enzymes in rat liver and brain by hydrocortisone and corticosterone treatment

The effect of subcutaneous injection of hydrocortisone and corticosterone on the activity values of some subcellular fractions marker enzymes from rat liver and brain was investigated and compared with controls (without treatment with hormones). The following enzymes were studied (subcellular fraction are shown between parentheses): N-acetyl-beta-D-glucosaminidase and beta-glucuronidase (lysosomes); succinate dehydrogenase = SDH (mitochondria); glucose-6-phosphatase (endoplasmic reticulum); 5'-nucleotidase and Na+-K+-Mg2+ ATPase (plasma membrane). The specific activity of lysosomal enzymes from liver showed no change when rats were injected either with hydrocortisone or corticosterone. The same enzymes from brain showed significant increases in their activities with both hydrocortisone or corticosterone except beta-glucuronidase; this enzyme gave activity values remaining between the control levels, after treatment with corticosterone. The activity of mitochondrial SDH was increased after corticosterone injection either in liver or brain. After hydrocortisone injection, its activity rises significantly in brain (72%), but it falls in liver compared to the control values. Glucose-6-phosphatase behaves similarly in brain or liver fractions; its activity increases always after corticosterone treatment and decreases by hydrocortisone. The plasma membrane marker enzymes did not change practically in brain fractions, excepted Na+-K+-Mg2+ ATPase which tends to rise its activity after hydrocortisone injection. In liver fractions, both 5'-nucleotidase and Na+-K+-Mg2+ ATPase activities increase either by corticosterone or hydrocortisone treatment, except 5'-nucleotidase which specific activity decreases in liver after hydrocortisone treatment.     

Successful treatment of herpes labialis with topical acyclovir.

A double blind, placebo controlled trial of 5% acyclovir cream, applied topically five times a day for five days, was carried out in 49 patients with recurrent herpes labialis. These patients had a total of 74 episodes, 34 of which were treated with the 5% acyclovir cream and 40 with matching placebo. First episodes and all episodes treated with acyclovir cream had significantly shorter times to formation of ulcer or crust and to complete healing (p less than 0.05 for all variables). The duration of all symptoms and proportion of patients developing itching was also reduced by acyclovir cream in first episodes, though the difference was not significant. When the patient started treatment early in the course of a first episode acyclovir cream significantly reduced the percentage of lesions progressing beyond the papular stage (p less than 0.05). Acyclovir cream is well tolerated and effective for the treatment of recurrent herpes labialis.     

Efficiency of Calamintha officinalis essential oil as preservative in two topical product types

AIMS: To verify the efficiency of Calamintha officinalis essential oil as natural preservative in two current formulations. METHODS AND RESULTS: The 1.0 and 2.0% (v/v) C. officinalis essential oil was assayed for its preservative activity in two product types (cream and shampoo). The microbial challenge test was performed following the standards proposed by the European Pharmacopoeia Commission (E.P.) concerning topical preparations using standard micro-organisms and in addition wild strains, either in single or mixed cultures were used. The results clearly demonstrated that the C. officinalis essential oil at 2.0% concentration reduced the microbial inoculum satisfying the criterion A of the E.P. in the cream formulation and the criterion B in the shampoo formulation. Standard and wild strains showed a behaviour similar, both in cream and in shampoo formulation, with no significant difference (gerarchic variance, P > 0.05). CONCLUSION: C. officinalis essential oil confirmed its preservative properties but at higher concentration than that shown in previous studies on cetomacrogol cream. SIGNIFICANCE AND IMPACT OF THE STUDY: The nature of the formulation in which an essential oil is incorporated as preservative could have considerable effect on its efficacy.     

中西医结合治疗婴儿湿疹疗效观察

目的观察中西医结合治疗婴儿湿疹的疗效。方法将87例婴儿湿疹患者随机分为治疗组和对照组,治疗组用中成药丹皮酚软膏与丁酸氢化可的松软膏,早用一种药膏晚另用一种药膏,日各1次,适量交替外涂患处;对照组用丁酸氢化可的松软膏适量外涂患处,早晚各1次。两组有渗出者均先用2%硼酸溶液湿敷,无渗出后方用膏剂外涂。结果两组有效率分别为93.18%和90.70%,无统计学差异(P>0.05)。结论中西结合治疗婴儿湿疹,能减少激素使用次数、使用量,减少激素可能导致的副作用,而获得同等疗效,且疗效确切,值得临床推广。     

Hydrocortisone normalizes oxygenation and cGMP regulation in lambs with persistent pulmonary hypertension of the newborn

In the pulmonary vasculature, cGMP levels are regulated by soluble guanylate cyclase (sGC) and phosphodiesterase 5 (PDE5). We previously reported that lambs with persistent pulmonary hypertension of the newborn (PPHN) demonstrate increased reactive oxygen species (ROS) and altered sGC and PDE5 activity, with resultant decreased cGMP. The objective of this study was to evaluate the effects of hydrocortisone on pulmonary vascular function, ROS, and cGMP in the ovine ductal ligation model of PPHN. PPHN lambs were ventilated with 100% O(2) for 24 h. Six lambs received 5 mg/kg hydrocortisone every 8 h times three doses (PPHN-hiHC), five lambs received 3 mg/kg hydrocortisone followed by 1 mg·kg(-1)·dose(-1) times two doses (PPHN-loHC), and six lambs were ventilated with O(2) alone (PPHN). All groups were compared with healthy 1-day spontaneously breathing lambs (1DSB). O(2) ventilation of PPHN lambs decreased sGC activity, increased PDE5 activity, and increased ROS vs. 1DSB lambs. Both hydrocortisone doses significantly improved arterial-to-alveolar ratios relative to PPHN lambs, decreased PDE5 activity, and increased cGMP relative to PPHN lambs. High-dose hydrocortisone also increased sGC activity, decreased PDE5 expression, decreased ROS, and increased total vascular SOD activity vs. PPHN lambs. These data suggest that hydrocortisone treatment in clinically relevant doses improves oxygenation and decreases hyperoxia-induced changes in sGC and PDE5 activity, increasing cGMP levels. Hydrocortisone reduces ROS levels in part by increasing SOD activity in PPHN lambs ventilated with 100% O(2.) We speculate that hydrocortisone increases cGMP by direct effects on sGC and PDE5 expression and by attenuating abnormalities induced by oxidant stress.