曲安奈德玻璃体注射治疗黄斑水肿的安全性长期随访分析

目的:观察2 mg、4 mg曲安奈德玻璃体注射治疗黄斑水肿的长期安全性。方法:将54例黄斑水肿患者分别采用2 mg和4mg不同剂量的曲安奈德玻璃体内注射,随访2年,观察眼压、晶状体、眼内炎症、视网膜、玻璃体等并发症。结果:两种剂量曲安奈德玻璃体内注射均可产生高眼压、白内障、非感染性眼内炎症;4 mg组白内障发生率明显高于2 mg组,其余并发症未见明显差异;两组患者均未出现严重、不可逆并发症。结论:2 mg和4 mg曲安奈德玻璃体注射治疗黄斑水肿均较安全,4 mg剂量更容易发生白内障,两种计量均需长期随访。     

ELECTRON BEAM THERAPY OF MYCOSIS FUNGOIDES

Ionizing radiation in the form of x-ray therapy is the best modality of treatment available at the present time for single, isolated lesions of mycosis fungoides. However, for generalized mycosis fungoides, generalized x-ray therapy is technically difficult and dangerous. It is now possible to employ electron beam therapy for generalized mycosis fungoides, using energies which confine the dose to the superficial layers of the skin and thus avoid hematopoietic injury. A technique for wide field electron beam therapy has been developed for this purpose which has been effective and well tolerated in limited trials to date.     

THE NATURAL HISTORY OF MYCOSIS FUNGOIDES

Mycosis fungoides is a progressive, fatal disease. Its relationship to lymphoblastomas is definite.No specific treatment is available. Palliation may be brought about by many unrelated modalities.     

激光联合注射曲安奈德治疗婴幼儿血管瘤的疗效分析

目的：分析激光联合注射曲安奈德治疗婴幼儿血管瘤的疗效。方法：将120例处于增殖期血管瘤患儿分成观察组和对照组各60例,观察组给予激光联合注射曲安奈德治疗,对照组采用激光治疗,比较两组患者的治疗疗效。结果：观察组和对照组的总有效率分别为96．7％和66．7％,两组比较具有显著差异,P〈0．05;对于表浅病灶,观察组治疗的有效率为96．8％,对照组为84．8％,两组之间无差异,P〉0．05;对于深部病灶,观察组和对照组的总有效率分别为96．6％和44．4％,具有显著差异（P〈0．05）。结论：激光联合注射曲安奈德治疗婴幼儿血管瘤具有较好的疗效,尤其对深部增殖期的血管瘤具有较好的效果,适合在临床推广应用。     

内镜下萨氏扩张器扩张联合局部注射曲安奈德治疗食管良性吻合口狭窄的疗效及安全性研究

目的:探讨食管良性吻合口狭窄经内镜下萨氏扩张器扩张联合局部注射曲安奈德治疗的临床疗效及安全性。方法:选取79例食管良性吻合口狭窄患者作为研究对象,根据数字表法将其随机分为对照组(n=38)和研究组(n=41),对照组给予内镜下萨氏扩张器扩张治疗,研究组在对照组基础上联合局部注射曲安奈德治疗,比较两组患者临床疗效、术后恢复情况以及安全性。结果:研究组治疗后总有效率为85.37%(35/41),高于对照组患者的65.79%(25/38)(x~2=4.138,P=0.002)。研究组持续症状缓解时间、再次进行内镜下扩张治疗的间隔时间均长于对照组(t=21.573、27.209,P=0.000、0.000),两组患者治疗前Stooler评分比较差异无统计学意义(t=0.266,P=0.791),两组患者治疗后Stooler评分均降低(t=16.606、25.962,P=0.000、0.000),且研究组低于对照组(t=7.407,P=0.000)。研究组术后并发症总发生率为19.51%(8/41),低于对照组患者的42.11%(16/38)(x~2=4.760,P=0.009)。结论:食管良性吻合口狭窄经内镜下萨氏扩张器扩张联合局部注射曲安奈德治疗后,可获得较好的疗效,患者临床症状得到改善,同时还可减少并发症发生率,临床应用价值较高。     

Triamcinolone activation of renal ammonia production.

The effects of scillaren and dinitrophenol on bilirubin excretion by the perfused rat liver were studied. Both compounds inhibited bile flow, scillaren by 20 to 40%, and dinitrophenol by 60 to 80%. Bilirubin excretion was also impaired. However, the effect of scillaren on bilirubin excretion was less than that on bile flow, as indicated by an increase in the bile bilirubin concentration, whereas dinitrophenol had a greater effect on bilirubin excretion than on bile flow. Dinitrophenol also inhibited the hepatic removal of unconjugated bilirubin from the perfusate, probably because it impaired the initial uptake and/or storage of unconjugated bilirubin by the perfused liver.     

Clear,Aqueous Topical Drop of Triamcinolone Acetonide

The objective of this study was to develop a clear aqueous mixed nanomicellar formulation (NMF) of triamcinolone acetonide (TA) with a combination of nonionic surfactant hydrogenated castor oil 60 (HCO-60) and octoxynol-40 (Oc-40). In order to delineate the effects of drug-polymer interactions on entrapment efficiency (EE), loading efficiency (LE), and critical micellar concentration (CMC), a design of experiment (DOE) was performed to optimize the formulation. In this study, full-factorial design has been used with HCO-60 and OC-40 as independent variables. All formulations were prepared following solvent evaporation and film rehydration method, characterized with size, polydispersity, shape, morphology, EE, LE, and CMC. A specific blend of HCO-60 and Oc-40 at a particular wt% ratio (5:1.5) produced highest drug EE, LE, and smallest CMC (0.0216 wt%). Solubility of TA in NMF improved 20 times relative to normal aqueous solubility. Qualitative ¹H NMR studies confirmed the absence of free drug in the outer aqueous NMF medium. Moreover, TA-loaded NMF appeared to be highly stable and well tolerated on human corneal epithelial cells (HCEC) and human retinal pigment epithelial cells (D407 cells). Overall, these studies suggest that TA in NMF is safe and suitable for human topical ocular drop application.     

我国首次发现的暗纹节菱孢所致皮肤真菌病的毒理实验及病理分析

从患者皮损处皮屑及活检组织中分离出的暗纹节菱孢Arthriniumphaeospermum（Corda）Ellis菌株制成混悬菌液,用兔、豚鼠及小鼠（LACA）进行动物毒理实验。表皮直接涂抹法接种,四周后未见皮肤损害;划破表皮涂沫法及皮下注射法接种,两周后实验动物的皮肤都出现浸润性斑块、小给节、皮下脓肿及脱毛的症状,对照组动物正常。再用腹腔注射法接种,小鼠两周后死亡,病解所见,腹膜、肠系膜、腹壁及肝等处,均出现散在的灰白色小脓肿;心、肺、肝、脾及肾均有病变。豚鼠两周后仍存活,当即处死解剖所见与小鼠病解改变相同。对实验动物皮损、腹膜、肠系膜、胃及肝等处的小脓肿组织进行了病理检查,结果发现皮损及器官组织均有明显的病理浸润,由多种细胞构成的浸润性肉芽肿。在病理浸润内可见大小不等的球形、卵圆形、棱形及晶体形的棕色、红色孢子．其病理改变与患者皮损病理改变相一致,其不同点是实验动物有小脓肿,肉芽肿内可见多核巨噬细胞,而在病人皮损中很少见到。     

玻璃腔内注射曲安奈德联合真武汤加减治疗视盘血管炎继发黄斑水肿的临床疗效观察

目的:探讨玻璃腔内注射曲安奈德结合真武汤加减治疗视盘血管炎继发黄斑水肿的临床疗效及安全性。方法:选择2013年12月到2017年4月在我院诊治的视盘血管炎继发黄斑水肿患者142例(142眼)作为研究对象,根据信封随机抽签法分为观察组与对照组,每组各71例。对照组给予玻璃腔内注射曲安奈德治疗,观察组在对照组治疗的基础上给予真武汤加减治疗。治疗1个月后,比较两组治疗前后视力、黄斑中心凹厚度的变化情况及不良反应的发生情况。结果:治疗后,观察组与对照组的视力均明显优于治疗前(P0.05),且观察组视力明显优于对照组(P0.05)。治疗后,观察组与对照组的黄斑中心凹厚度分别为168.34±22.19μm和267.35±34.11μm,均明显低于治疗前[516.35±45.20μm和522.14±23.01μm](P0.05),且观察组治疗后黄斑中心凹厚度明显低于对照组(P0.05)。两组治疗后发生玻璃体积血、新生血管性青光眼、瞳孔区模性渗出等并发症,发生率对比差异无统计学意义(P0.05)。结论:与单用玻璃腔内注射曲安奈德治疗相比,玻璃腔内注射曲安奈德结合真武汤加减治疗视盘血管炎继发黄斑水肿的安全性更高,且能有效减轻黄斑水肿,缩小黄斑区域,提高视力。     

蕈样肉芽肿与扁平苔藓、慢性皮炎湿疹浸润细胞的免疫组化比较研究

目的探讨免疫表型对蕈样肉芽肿与扁平苔藓、慢性皮炎湿疹鉴别诊断的意义。方法本研究应用ABC免疫组化技术检测15例蕈样肉芽肿,17例慢性皮炎湿疹,17例扁平苔藓,6例正常皮肤的CD1a、CD8、ICAM-1和CD7的表达情况。结果1.蕈样肉芽肿表皮CD1a,CD8,ICAM-1的阳性细胞密度明显高于扁平苔藓、皮炎湿疹和正常皮肤。2.蕈样肉芽肿真皮中CD1a阳性细胞的线性密度高于扁平苔藓、慢性皮炎湿疹和正常皮肤,蕈样肉芽肿真皮内CD8阳性细胞百分比较慢性皮炎湿疹增多,蕈样肉芽肿真皮表达ICAM-1抗原的细胞百分比高于扁平苔癣和慢性皮炎湿疹。3.慢性皮炎湿疹、扁平苔藓真皮内CD7阳性细胞百分比高于蕈样肉芽肿和正常皮肤。结论CD1a、CD8、ICAM-1、CD7免疫表型的研究可能为蕈样肉芽肿和扁平苔藓、慢性皮炎湿疹等一些炎症性皮肤病的鉴别诊断提供一定的线索。