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.     

Clinical Studies with Topical Fluocinolone Acetonide in the Treatment of Various Dermatoses

Fluocinolone acetonide cream is a new, potent topical corticosteroid. When used in conjunction with an occlusive plastic film dressing, herein described, it is highly effective in the treatment of psoriasis of the glabrous skin, pustular and paronychial psoriasis, neurodermatitis, and lichen planus. Psoriasis of the intertriginous areas responds to the local use of the fluocinolone cream alone. Relapses on cessation of treatment respond as a rule to retreatment.Indications, limitations, reactions and contraindications to this form of treatment are discussed.     

窄谱中波紫外线联合阿维A治疗斑块型银屑病疗效观察

目的:观察评价窄谱中波紫外线(NB-UVB)联合口服阿维A治疗斑块型银屑病的疗效及安全性。方法:治疗组56例给予口服阿维A 0.5 mg/d.kg,同时给予窄谱中波紫外线照射,每周3次;对照组55例给予口服阿维A 0.5 mg/d.kg,于治疗四周时进行疗效评价。结果:四周时治疗组有效率92.86%,对照组有效率76.36%,组间比较差异显著。结论:NB-UVB联合阿维A治疗斑块型银屑病疗效好,副作用少。     

Comparison of Two Therapeutic Regimens Using the Same Topical Corticoid for Stable Psoriasis

In a masked, randomized, concurrently controlled clinical trial we compared the therapeutic response of two regimens in which the same topical corticoid was used to treat 52 men who had stable psoriasis. One regimen, called reduced dose, consisted of once-a-day application of a representative potent fluorinated topical steroid ointment, fluocinonide (Lidex), combined with three-times-a-day application of its vehicle. The other regimen, called traditional dose, consisted of four-times-a-day topical application of the same steroid. Patients were assigned to one of the two regimens and observed for six weeks. Confidence intervals for the difference in true mean response under these two regimens provide good evidence that for these patients the traditional dose was not clinically superior to the reduced dose.     

Treatment of Psoriasis with Azathioprine

Azathioprine treatment benefited 19 (66%) out of 29 patients suffering from severe psoriasis. Haematological complications were not troublesome and results of biochemical liver function tests remained normal. Minimal cholestasis was seen in two cases and portal fibrosis of a reversible degree in eight. Liver biopsies should be undertaken at regular intervals if azathioprine therapy is continued so that structural liver damage may be detected at an early and reversible stage.     

Selenium and Psoriasis

Psoriasis is a chronic, immune-mediated skin disease characterized by production of reactive oxygen species due to the activation of tumor necrosis factor alpha (TNF-??), which is thought to be an important factor in inducing and maintaining psoriatic lesions. As an external factor, ultraviolet B (UVB) radiation stimulates TNF-?? production and secretion by human keratinocytes in vitro and can also reach the upper dermis and suppress endothelial cells in vitro. The selenium level in psoriatic patients has been found to be lower than expected, but studies on its role in the pathogenesis of the disease are scarce. Selenium can influence immune response by changing the expression of cytokines and their receptors or by making immune cells more resistant to oxidative stress. It was reported that selenium supplementation had inhibitory effects on TNF-?? levels in patients with psoriasis, but the details are not completely elucidated. Selenium compounds are also known to prevent the in vitro release of UVB-induced proinflammatory cytokines by inhibition of mRNA in human keratinocytes. In the present review, the protective role of selenium in oxidative stress, lesions, and immune system regulation in patients with psoriasis is summarized.     

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。     

Structure Elucidation of Gibberellin A32 and Its Acetonide

The structures of two gibberellin-like substances isolated from the immature seeds of Prunus persica, tentatively named PG–I and PG–II, were elucidated. PG–I was an ammonium salt of a novel gibberellin, ent-3α,10,12β,13,15α-pentahydroxy-20-norgibberella-l,16-diene-7,19-dioic-19,10-lactone (1), to which gibberellin number A₃₂ was allocated. PG–II was shown to be gibberellin A₃₂ acetonide (7), and concluded to be an artifact produced from gibberellin A₃₂ in the isolation process.     

Psoriasis: evolution and revolution

Psoriasis is a model disease in dermatology. It is a common disease that affects at least 2 to 3 % of the population. It is an illness characterized by an excessive reaction of the skin, in term of proinflammatory cytokines release, to no specific attacks: these attacks can be immunological, mechanical, metabolic, drug-induced or psychological. This excessive reaction is characterized by epidermal proliferation combined with incomplete terminal differentiation, as well as an inflammatory response responsible for the chronic nature of the lesions. The way to understand psoriasis is therefore to reach a better appreciation of the messages that enable the skin cells to initiate an inflammatory response, and by better understanding the way in which the inflammatory cells responsible for innate and acquired immune responses are capable of bringing about proliferation and abnormal epidermal differentiation. Taking an interest in psoriasis is therefore taking an interest in all facets of skin physiology and in all the ways the skin reacts to attacks from the environment. Every year for more than thirty years, more than 300 publications have endeavoured to explore one aspect or another of psoriasis from a clinical, epidemiological, physiopathological or therapeutic point of view. There is no new technique for observing the skin that has not been immediately applied to the study of psoriasis - which is privileged to enjoy the reflected progress made in dermatology. Nor has psoriasis remained untouched by whims of fashion, all manner of scenarios having been suggested to explain it, right from a scarring disease to an autoimmune illness through a genetic or psychosomatic disorder. Psoriasis is at the origin of a medical revolution mounted to supplement and enhance the effectiveness of evidence-based medicine ; it is the "patient-centred medicine". Psoriasis only exceptionally jeopardizes life. Conversely, it is a disease that does affect quality of life. The patient alone must be the judge of his or her quality of life, and it is therefore up to the patient, not the doctor, to gauge the severity of psoriasis and hence decide on reasonable therapeutic indications. Psoriasis, then, cannot be treated without placing the patient, not the illness, at the centre of therapeutic negotiations. The 20th century has seen the disease targeted by boundless efforts ; the 21st century will see the development of medical techniques that allow the patient, in all its complexity, to be positioned at the centre of therapeutic efforts. This revolution began in dermatology, centring around psoriasis, and is spreading progressively to all chronic disorders and all disciplines. New quite interesting therapeutic weapons are available from a few months making possible to better adjust the therapeutic strategies of psoriasis to the patients needs but they are expensive opening again the debates on the limit of the social solidarity.     

Psoriasis vulgaris and genetic markers

Summary In a sample of n=160 nonrelated male and female patients suffering from psoriasis vulgaris, blood, serum protein, and enzyme group typings have been carried out and compared with healthy controls from the same area (Rheinland-Pfalz). Marked statistically significant differences between patients and controls were found in none of the genetic blood polymorphisms considered here. However, combining previously published data from various authors with our own, significant associations between this skin disease and genetic polymorphisms such as MN, Gc, Gm(2), red cell acid phosphatase, and red cell phosphoglucomutase (PGM₁) were seen. The possible reasons for these associations are discussed.