Betamethasone Dipropionate Loaded in Nanoliposomes vs Conventional Betamethasone Dipropionate: Comparative Study of Permeability and Penetrability in Vitro and ex Vivo

A betamethasone dipropionate (BD) liposomal cream was developed to treat rheumatological, inflammatory, allergic diseases and psoriasis. BD is a corticosteroid, anti-inflammatory, and immunosuppressant. However, adverse effects are associated with prolonged topical use. For this reason, liposomes were loaded with BD because they offer excellent biocompatibility, bio adhesiveness, and penetrability that improve the effects caused by the conventional drug. Liposomal dispersions were prepared by emulsification using phospholipid 90 (lipid) and Tween 80 (surfactant). The particle size, polydispersity index (PDI), and zeta potential were measured using a particle analyzer. The betamethasone (BM) percentage of encapsulated active (EA) ingredient was also determined through High Performance Liquid Chromatography (HPLC). The Franz cell and tape stripping characterized these in vitro and ex vivo. Then the final formulation reached a particle size of 70.80 ± 3.31 nm, a PDI of 0.242 ± 0.038, a zeta potential of −11.68 ± 0.77 mv and encapsulate active of 83.1% ± 2.4, complying with the parameters of a nanotechnological formulation. In vitro and ex vivo studies confirmed significantly efficacy of the cream over the commercial product, through the greater penetration into the pig ear skin, resulting in an improved drug. Finally, the liposomal cream demonstrated significant potential for enhanced percutaneous absorption, attributed to its nanometric size. This innovative nanotechnology approach aims to reduce the frequency of topical applications, thereby minimizing the side effects associated with psoriasis treatment.

Anastomotic stoma coated with chitosan film as a betamethasone dipropionate carrier for peripheral nerve regeneration

Scar hyperplasia at the suture site is an important reason for hindering the repair effect of peripheral nerve injury anastomosis. To address this issue, two repair methods are often used. Biological agents are used to block nerve sutures and the surrounding tissue to achieve phys- ical anti-adhesion effects. Another agent is glucocorticosteroid, which can prevent scar growth by inhibiting inflammation. However, the overall effect of promoting regeneration of the injured nerve is not satisfactory. In this regard, we envision that these two methods can be combined and lead to shared understanding for achieving improved nerve repair. In this study, the right tibial nerve was transected 1 cm above the knee to establish a rat tibial nerve injury model. The incision was directly sutured after nerve transection. The anastomotic stoma was coated with 0.5 × 0.5 cm^2 chitosan sheets with betamethasone dipropionate. At 12 weeks after injury, compared with the con- trol and poly （D, L-lactic acid） groups, chitosan-betamethasone dipropionate film slowly degraded with the shape of the membrane still intact. Further, scar hyperplasia and the degree of adhesion at anastomotic stoma were obviously reduced, while the regenerated nerve fiber structure was complete and arranged in a good order in model rats. Electrophysiological study showed enhanced compound muscle action potential. Our results confirm that chitosan-betamethasone dipropionate film can effectively prevent local scar hyperplasia after tibial nerve repair and promote nerve regeneration.

Development of a topical ointment of betamethasone dipropionate loaded nanostructured lipid carrier

The purpose of this study was to design an innovative topical ointment containing betamethasone dipropionate loaded nanostructured lipid carrier (BD-NLC) for the treatment of atopic dermatitis (AD). BD-loaded NLC was produced with precirol ATO 5 and oleic oil (OA) by melt emulsification method. Effects of surfactant concentration, amount of solid lipid and liquid lipid on skin retention and skin penetration were investigated by in vitro percutaneous permeation experiment. The optimized BD-NLC showed a homogeneous particle size of 169.1 nm (with PI = 0.195), negatively charged surface (-23.4 mV) and high encapsulation efficiency (85%). Particle morphology assessed by TEM revealed a spherical shape. In vitro skin permeation study was carried out to investigate the percutaneous behaviors of W/O ointment with BD-NLC and Carbopol emulgel ointment with BD-NLC. W/O ointment with BDNLC showed high skin retention (35.43 μg/g) and low penetration (0.87 μg/ml). In vitro drug release studies were carried out to demonstrate the drug releasing properties of the two ointments. W/O ointment with BD-NLC showed an advantage for skin retention as it was better for drug release. The tissue distribution test suggested that BD distribution was skin > muscle > blood. Self-made topical ointment in mice showed no skin irritation. The animal experiments indicated that BD-loaded NLC ointment was effective and safe for topical use.

Efficacy and safety of low dose compound betamethasone in the treatment of mild knee osteoarthritis

Objective:To investigate the efficacy and safety of intra-articular injection of low-dose compound betamethasone in the treatment of mild knee osteoarthritis.Methods:From September 2018 to December 2019,90 patients with mild knee osteoarthritis were divided into complete dose group and low dose group according to the treatment sequence,45 cases in each group.The complete dose group was treated with intra-artiular injection of betamethasone(1ml)and sodium hyaluronate(2ml),once a week,three times as a course of treatment.The low dose group was treated with intra-artiular injection of betamethasone(0.3ml)and sodium hyaluronate(2ml),once a week,three times as a course of treatment.Lysholm scores、the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)and visual analogue scale(VAS)were compared between the two groups before and after treatment,and the efficacy and safety of the two groups were evaluated.Results:80 patients were followed up with an average of(4.96±1.50)months ranging from 3 to 8 months,and 10 cases(11.11%)were dropped out,including 2 cases in the complete dose group,2 cases in the midway withdrawal group,and 1 case in the treatment course less than the treatment course;3 cases in the low dose group lost the follow-up,and 2 cases dropped out.Compared with that before treatment,Lysholm scores were significantly improved,WOMAC scores and VAS scores were significantly decreased in the two groups at 3 weeks,6 weeks and 12 weeks after treatment(P<0.001).The Lysholm scores of low dose group were78.10±2.16,86.78±2.55,80.90±2.26,WOMAC scores were 61.00±1.38,39.03±1.98,45.76±1.66 and VAS scores were 2.23±0.89,0.78±0.73 and 1.05±0.85 in low dose group at 3 weeks,6 weeks and 12 weeks after treatment.There was no significant difference between the two groups(P>0.05).No drugrelated adverse reactions occurred in both groups.Conclusion:The curative effect of low dose compound betamethasone intra-articular injection in the treatment of mild knee osteoarthritis is equivalent to that of complete dose compound betamethasone.It can improve the function and symptoms of knee joint,and is safe and effective.

Impact of Prophylactic Betamethasone Indication on the Neonatal Outcome in 38-Week Pregnancies Prior to Elective Cesarean Section

Objective: To assess whether the use of prenatal betamethasone in pregnancies with elective Caesarean section (C-section) at 38 weeks has a similar risk of adverse neonatal respiratory outcomes than elective C-section at 39 weeks. Methods: Retrospective cohort study of pregnant patients with singleton pregnancies and elective C-section at term in a one-year period. Cases were C-section at 38 weeks of gestation with a complete course of betamethasone started 48-hours before. As a control group, pregnancies with a C-section at 39 weeks without betamethasone were included. Results: During the study period, 186 patients were included. Of these, 91 were delivered at 38 weeks and 95 at 39 weeks. There were no significant differences in maternal age and parity. Moreover, there were no significant differences in respiratory complications (respiratory distress syndrome [RDS] = 0% vs 1.1%;p = 1.0, transitory tachypnea [TT] = 0% vs 0%) and admission to Neonatal Intensive Care Unit (NICU) (8.8% vs 6.3%;p = 0.7) between deliveries at 38 weeks and 39 weeks, respectively. Conclusion: Prophylactic use of betamethasone in early term pregnancies who undergo an elective C-section at 38 weeks is associated with similar adverse neonatal respiratory outcomes than patients with C-section at 39 weeks without corticosteroids.

Acrodermatitis Continua of Hallopeau With Excellent Response to Topical Calcipotriol/Betamethasone Ointment:A Report of Two Cases

Introduction:Acrodermatitis continua of Hallopeau(ACH)is an uncommon chronic cutaneous disorder.Up to date,its treatment is still difficult and frustrating although various topical and systemic agents alone or in different combinations have been tried with variable benefits.Herein,we report two cases of ACH successfully treated with calcipotriol/betamethasone ointment.Case presentation:Two cases of ACH were characterized by thumb involvement alone and showed an excellent response to calcipotriol/betamethasone ointment(1 g:calcipotriol 50µg and betamethasone 0.5 mg).Discussion:Treatment of ACH is challenging for physicians.Multiple systemic therapies and topical drugs have been applied,however,no universally effective treatment regimen has yet been established for long-lasting remission.Combination of calcipotriol and betamethasone is more effective in treating psoriasis than the individual components alone,and the current 2 cases with ACH were reported to be treated successfully by the calcipotriol/betamethasone ointment.Conclusion:Topical calcipotriol/betamethasone compound is an optional agent for the treatment of ACH with a novel effect.

新型局部浸润麻醉应用于人工全膝关节置换的早期效果评估

背景:全膝关节置换后患者会经历明显的疼痛,这对功能恢复存在负面影响,探索并寻求有效的镇痛手段具有重要的临床价值。目的:为探求全膝关节置换患者有效的围术期镇痛策略,首次提出了一种由吗啡、氟比洛芬酯和复方倍他米松配置而成的新型局部浸润麻醉制剂,同时探讨该方案的有效性及安全性。方法:对2023年11月至2024年4月在安徽医科大学第一附属医院关节外科接受初次单侧全膝关节置换60例患者的临床资料进行回顾性分析,根据置换过程中是否使用局部浸润麻醉将患者分为对照组与研究组,每组30例。研究组在全膝关节置换过程中关节腔周围注射吗啡、氟比洛芬酯及复方倍他米松配置而成的局部浸润麻醉制剂,而对照组术中未使用任何镇痛药物作为空白对照。记录并比较两组患者在术后不同时间节点的疼痛目测类比评分、膝关节活动度、膝关节学会评分、术后膝关节肿胀程度及术后并发症的发生情况。结果与结论:①与对照组相比,研究组患者置换后6,12及24 h的疼痛目测类比评分更低,差异有显著性意义(Z=-2.367,-2.906,-4.199,P<0.05);但在术后48,72 h,两组患者的疼痛目测类比评分并无显著性差异(Z=-1.287,-1.478,P>0.05);②置换后第3天,研究组患者的膝关节活动度和膝关节学会评分均优于对照组,差异有显著性意义(t=-2.519,-8.027,P<0.05);③研究组患者术后的膝关节肿胀程度轻于对照组,差异有显著性意义(Z=-2.818,P<0.05);④在术后早期,两组患者的发热发生率相比无显著性差异(P>0.05),两组均未发生切口愈合不良及假体周围感染;⑤结果表明:在全膝关节置换过程中应用由吗啡、氟比洛芬酯及复方倍他米松组成的局部浸润麻醉制剂,可以明显减轻患者术后早期疼痛,并显示出较高的安全性,但仍需大样本的前瞻性研究提供数据支持。

A Formal Synthesis of Betamethasone

A formal synthesis of betamethasone from 5α-pregnane-3β,16β,20S-triol is described.Key transformations are a bromination-acetylation of triol,an SN2 reaction of the resulting C16α-bromide with dimethylcopperlithium to get the required C16β-methyl group,and a double hydroxylation to prepare the dihydroxyacetone side chain.

超高效液相色谱-串联质谱法快速测定动物组织中地塞米松与倍他米松药物残留

在承担糖皮质激素风险监测任务时,发现2个现行有效的关于检测动物组织中糖皮质激素的国家标准(农业部1031号公告-2—2008《动物源性食品中糖皮质激素类药物多残留检测液相色谱-串联质谱法》和GB/T 21981—2008《动物源食品中激素多残留检测方法液相色谱-质谱/质谱法》)中的样品前处理均采用了固相萃取方法,从而导致了检测过程中过柱净化烦琐、氮吹浓缩时间长、检测成本高、生态环境不友好等诸多弊端。在经过大量实验研究及经实际工作应用检验的基础上,研究简化了动物组织中地塞米松和倍他米松残留检测中样品前处理固相萃取过柱和氮吹过程,建立了快速、准确、灵敏的动物组织(牛肝、牛肉、猪肝与猪肉)中残留的地塞米松和倍他米松的超高效液相色谱-串联质谱的同时检测方法。样品在盐析条件下经乙腈提取,正己烷脱脂,采用电喷雾多反应监测、负离子模式测定,对动物组织中地塞米松和倍他米松进行定性和定量。地塞米松和倍他米松的检出限可达0.5μg/kg,定量限可达1.0μg/kg。在地塞米松和倍他米松的质量浓度为0.1~50.0μg/L,峰强度与质量浓度的线性关系良好(R 2>0.99)。在地塞米松和倍他米松的1.0、2.0、5.0μg/kg添加浓度下,方法的平均回收率在83.3%~98.2%。希望该研究可为实验室大批量检测此类药物在动物组织中的残留提供一定的借鉴。

复方倍他米松复合罗哌卡因胸椎旁阻滞用于胸腔镜术后镇痛的效果

目的探讨超声引导下复方倍他米松复合罗哌卡因胸椎旁阻滞用于胸腔镜术后镇痛的效果。方法选择行择期胸腔镜手术患者60例,男41例,女19例,年龄18~60岁,BMI 18~25 kg/m^(2),ASAⅠ或Ⅱ级。采用随机数字表法将患者分为两组:复方倍他米松复合罗哌卡因组(B组)和罗哌卡因组(R组),每组30例。两组在麻醉诱导前行超声引导下胸椎旁阻滞,B组注射药物为加入复方倍他米松05 ml的04%罗哌卡因25 ml,R组注射药物为04%罗哌卡因25 ml。两组均采用标准化的支气管插管静脉全麻方案,术后行PCA。记录阻滞起效时间、镇痛持续时间、PCA首次按压时间,术中舒芬太尼、瑞芬太尼、丙泊酚用量,术后2、4、8、12、24、48 h静息和活动时(咳嗽)VAS疼痛评分,术后48 h PCA总按压次数和舒芬太尼补救镇痛例数,术后48 h内呼吸抑制、恶心呕吐、穿刺部位感染、尿潴留等不良反应发生情况。结果与R组比较,B组阻滞起效时间明显缩短(P<005),镇痛持续时间、PCA首次按压时间明显延长(P<005)。两组术中舒芬太尼、瑞芬太尼、丙泊酚用量差异均无统计学意义。与R组比较,B组术后8、12和24 h静息和活动时VAS疼痛评分明显降低(P<005),术后48 h PCA总按压次数明显减少(P<005),舒芬太尼补救镇痛率明显降低(P<005)。两组术后48 h内呼吸抑制、恶心呕吐、穿刺部位感染、尿潴留差异均无统计学意义。结论与单纯罗哌卡因比较,复方倍他米松作为罗哌卡因佐剂超声引导下胸椎旁阻滞用于胸腔镜手术围术期镇痛,能增强阻滞及镇痛效果,减少阿片类镇痛药物使用。

龙胆泻肝丸联合鼓室内注射倍他米松治疗分泌性中耳炎疗效研究

目的:探讨龙胆泻肝丸联合鼓室内注射倍他米松治疗分泌性中耳炎(OME)临床疗效及其对患者外周血T淋巴细胞亚群和中耳积液中高迁移率族蛋白1(HMGB1)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-33水平的影响。方法:选取252例OME患者,随机分为两组各126例。对照组给予鼓室内注射倍他米松治疗,在此基础上,观察组联合龙胆泻肝丸治疗。比较两组临床疗效、外周血T淋巴细胞亚群和中耳积液中HMGB1、TNF-α、IL-33等水平。结果:观察组总有效率91.37%高于对照组的82.54%(P<0.05)。治疗后,两组病情严重程度评分、气导平均听阈、骨导平均听阈、外周血CD8+和中耳积液中HMGB1、TNF-α、IL-33水平都显著降低,而外周血CD3+、CD4+水平和CD4+/CD8+都显著增加,都以观察组为甚(P<0.05)。观察组不良反应率10.3%与对照组8.7%比较无统计学差异(P>0.05)。结论:龙胆泻肝丸联合鼓室内注射倍他米松治疗OME的总体疗效确切,可改善患者听力,改善外周血T淋巴细胞亚群失衡以及抑制中耳积液中HMGB1、TNF-α、IL-33表达,且安全性好。

倍他米松磷酸钠注射液治疗早产有效性和安全性研究进展

倍他米松是地塞米松的同分异构体,具有抗炎、抗过敏、抗内毒素和免疫抑制等功能。倍他米松磷酸钠(BSP)注射液是倍他米松的磷酸盐制剂,作为一种糖皮质激素(ACS)类药物,其临床应用较广。BSP治疗早产已有充分的证据并被纳入各国指南,然而这些证据主要集中在高收入国家,中低收入国家相关证据则较少。我国关于BSP在产科应用疗效和安全性临床研究方面存在不足。关于倍他米松和地塞米松疗效和安全性直接比较的临床研究较少,BSP治疗早产后儿童期和成年期随访研究尚不足。因此,需进一步开展相关研究,为早产临床科学合理用药提供决策依据。

火针联合低压无针瘢痕内注射复方倍他米松治疗瘢痕疙瘩疗效及对生长因子水平、瘢痕状态的影响

目的观察火针联合低压无针瘢痕内注射复方倍他米松治疗瘢痕疙瘩的效果及对生长因子水平、瘢痕状态的影响。方法选取2021年1月—2022年2月来我院就诊100例瘢痕疙瘩患者,随机分为对照组、治疗组,每组各50例,对照组采用低压无针瘢痕内注射复方倍他米松,治疗组在对照组基础上加火针治疗,对比两组疗效、生长因子水平、瘢痕状态。结果治疗组治疗后总有效率较对照组为高(P<0.05);治疗组治疗后细胞生长因子β1(TGF-β1)、血小板源生长因子(PDGF)、表皮细胞生长因子(EGF)指标水平均较对照组为低,成纤维细胞生长因子(FGF)指标水平较对照组为高(P<0.05);观察组治疗后瘢痕状态评分均较对照组低(P<0.05)。结论火针联合低压无针瘢痕内注射复方倍他米松治疗瘢痕疙瘩疗效明显,可调节生长因子水平,还能改善瘢痕状态,促进其恢复,值得推广。

耳石症患者眩晕障碍及前庭症状运用倍他司汀联合Epley手法复位的影响研究

目的针对耳石症患者眩晕障碍及前庭症状,探讨研究运用倍他司汀联合Epley手法复位的影响。方法整理2021年1月—2024年5月解放军总医院第八医学中心收治的90例耳石症患者的病历资料,患者存在眩晕障碍及前庭症状,并经眼球震颤试验、复杂前庭反射试验确诊,按随机数表法原则分为对照组(倍他司汀治疗)与观察组(倍他司汀联合Epley手法复位治疗),每组45例。对比两组治疗前后的眩晕障碍和平衡能力评分、治疗后的前庭症状评分、临床疗效。结果治疗前,两组眩晕障碍和平衡能力评分比较,差异无统计学意义(P>0.05);治疗后,两组眩晕障碍评分均下降、平衡能力评分均提升,但观察组眩晕障碍评分较对照组更低、平衡能力评分较对照组更高,差异有统计学意义(P<0.05)。治疗后,观察组头晕、恶心、头痛、眩晕、平衡、视觉敏感6项前庭症状评分均低于对照组,差异有统计学意义(P<0.05)。观察组临床疗效高于对照组,差异有统计学意义(P<0.05)。结论针对耳石症患者眩晕障碍及前庭症状,运用倍他司汀联合Epley手法复位可改善眩晕障碍,减轻前庭症状,提升平衡能力,取得更好疗效。

二氧化碳点阵激光联合复方倍他米松治疗白癜风的疗效及对Th17相关细胞因子的影响

目的:探讨二氧化碳点阵激光联合复方倍他米松治疗白癜风的疗效及对Th17相关细胞因子的影响。方法:选取2018年1月至2020年1月该院收治的白癜风患者90例,根据随机数表法分为对照Ⅰ组(二氧化碳点阵激光)、对照Ⅱ组(复方倍他米松)和联合治疗组(二氧化碳点阵激光合并复方倍他米松),每组30例。比较各组患者的疗效、Th17相关细胞因子水平。结果:联合治疗组、对照Ⅰ组和对照Ⅱ组患者的不良反应发生率分别为13.33%(4/30)、10.00%(3/30)和6.67%(2/30),差异无统计学意义(P>0.05)。联合治疗组、对照Ⅰ组和对照Ⅱ组患者的面部-颈部、四肢和手-脚部位白斑复色时间比较,差异均有统计学意义(P<0.05);联合治疗组患者的面部-颈部、四肢和手-脚部位白斑复色时间显著短于对照Ⅰ组、对照Ⅱ组,差异均有统计学意义(P<0.05)。治疗后,联合治疗组、对照Ⅰ组和对照Ⅱ组患者的白细胞介素(IL)17、IL-22和IL-23水平比较,差异均有统计学意义(P<0.05),联合治疗组患者的IL-17、IL-22和IL-23水平显著低于对照Ⅰ组、对照Ⅱ组,差异均有统计学意义(P<0.05)。联合治疗组、对照Ⅰ组和对照Ⅱ组患者的有效率分别为90.00%(27/30)、63.33%(19/30)和56.67%(17/30),联合治疗组患者的有效率显著高于对照Ⅰ组、对照Ⅱ组,差异均有统计学意义(P<0.05)。结论:二氧化碳点阵激光联合复方倍他米松治疗白癜风安全、有效,可降低患者血清Th17细胞相关因子IL-17、IL-22和IL-23水平。

复方倍他米松对坐骨神经联合股神经阻滞下膝关节单髁置换术后爆发痛的影响

目的探讨复方倍他米松对坐骨神经联合股神经阻滞下膝关节单髁置换术后爆发痛的影响。方法选择行单侧膝关节单髁置换术患者100例,男32例,女68例,年龄55~75岁,BMI 18.5~35.0 kg/m^(2),ASAⅠ—Ⅲ级。采用随机数字表法将患者分为三组:无佐剂组(C组,n=34)、地塞米松佐剂组(D组,n=33)和复方倍他米松佐剂组(B组,n=33)。麻醉诱导前三组行坐骨神经阻滞,注入0.4%罗哌卡因15 ml。之后再行股神经阻滞,C组注入0.4%罗哌卡因15 ml,D组注入0.4%罗哌卡因15 ml(含地塞米松5 mg),B组注入0.4%罗哌卡因15 ml(含复方倍他米松4 mg)。记录术后爆发痛发生情况、爆发痛评分、镇痛泵有效按压次数、阿片类药物用量和补救镇痛例数。记录术后0~24 h、24~48 h、48~72 h下地活动距离、睡眠质量评分以及不良事件发生情况。结果与C组比较,B组术后爆发痛发生率明显降低(P<0.05),镇痛泵有效按压次数、阿片类药物用量明显减少(P<0.05),补救镇痛率和术后第1晚睡眠质量评分明显降低(P<0.05)。与D组比较,B组术后爆发痛发生率和爆发痛评分明显降低(P<0.05),镇痛泵有效按压次数、阿片类药物用量明显减少(P<0.05),补救镇痛率和术后第1晚睡眠质量评分明显降低(P<0.05)。三组不同时间段下地活动距离、不良事件发生率差异无统计学意义。结论复方倍他米松佐剂可降低坐骨神经联合股神经阻滞下膝关节单髁置换术后爆发痛发生率,提供完善的镇痛效果,减少术后阿片类药物用量,提高患者术后第1晚睡眠质量。

CO_(2)点阵激光联合复方倍他米松注射液封包治疗稳定期顽固性白癜风疗效观察

目的探究CO_(2)点阵激光联合复方倍他米松封包治疗稳定期顽固性白癜风的临床疗效和安全性。方法采用单中心、随机、自身对照的研究方法,纳入2019年10月至2023年10月首都医科大学附属北京朝阳医院皮肤科经传统药物治疗和(或)光疗无效的白癜风患者48例,每例患者选取2处皮损。采用掷硬币法将96处皮损分为观察组和对照组。对照组48处皮损予0.1%他克莫司软膏涂抹,每日2次;观察组48处皮损予CO_(2)点阵激光联合复方倍他米松注射液局部封包24 h,随后涂抹0.1%他克莫司软膏,每日2次,共治疗3个月。比较2组皮损处皮损面积、复色率、临床疗效、患者满意度及生活质量以及不良反应发生情况。结果观察组有效率为91.67%,对照组有效率为70.83%,观察组有效率高于对照组(P<0.05)。治疗后2组皮损面积均缩小(P<0.05),且观察组小于对照组(P<0.05)。观察组复色率为60%(48%,70%),对照组复色率为18%(9%,24%),观察组复色率高于对照组(P<0.05)。观察组满意度评分高于对照组(P<0.05)。所有患者均能耐受治疗,观察组48处皮损中,5处(10.42%)出现持续性红斑,3处(6.25%)毛囊炎,2处(4.17%)毛细血管扩张,6处(12.5%)色素沉着,未出现皮肤瘢痕或萎缩。随访3个月后,红斑和色素沉着均已恢复正常,毛细血管扩张和毛囊炎部分恢复。对照组48处皮损中,2处(4.17%)出现毛囊炎,未出现其他不良反应,随访3个月后均已恢复正常。不良反应发生率观察组高于对照组。结论CO_(2)点阵激光联合复方倍他米松封包治疗稳定期顽固性白癜风,疗效肯定,安全性良好。

含大剂量复方倍他米松鸡尾酒注射液在一期翻修治疗假体周围感染中的应用及安全性研究

目的研究一期翻修治疗假体周围感染(PJI)中局部应用含大剂量复方倍他米松鸡尾酒注射液的疗效及安全性。方法回顾性比较2015年1月至2020年12月于我院接受一期翻修治疗并在术中使用两种不同配方鸡尾酒注射液的170例PJI病人,其中A组72例,其鸡尾酒配方中含有复方倍他米松,B组98例,配方中不含复方倍他米松。比较两组术后的疼痛视觉模拟量表(VAS)评分、阿片类药物需求,以及术后恶心和呕吐(PONV)、感染复发、深静脉血栓形成(DVT)、肺栓塞(PE)和切口愈合不良等并发症的发生率。结果术后12、24、48 h,A组的VAS评分均显著低于B组(P<0.05),但两组术后72 h的VAS评分差异无统计学意义(P>0.05)。B组关节液白细胞计数在术后24 h明显高于A组(P<0.05),但在48 h后两组差异无统计学意义(P>0.05);B组的C反应蛋白(CRP)在术后48 h内明显高于A组(P<0.05),但在术后72 h两组差异无统计学意义(P>0.05)。A组的PONV发生率和阿片类药物使用率较B组显著较低(P<0.05)。值得注意的是,两组之间感染复发率、DVT形成、PE和切口愈合不良等并发症情况比较,差异无统计学意义(P>0.05)。结论含有大剂量复方倍他米松的鸡尾酒注射液作为一期翻修术后早期的多模式局部浸润麻醉镇痛方案,可以有效减轻术后疼痛、减少阿片类药物的消耗以及PONV发生率,但对再感染和其他并发症没有影响。

倍他米松联合硫酸镁治疗未足月胎膜早破的疗效观察

目的:探讨未足月胎膜早破的有效治疗方案。方法:选取我院收治的120例未足月胎膜早破孕妇[入院孕周28~34(33.47±3.19)周],按治疗方案分为对照组和研究组各60例。对照组给予倍他米松治疗(肌肉注射12 mg),研究组给予倍他米松联合硫酸镁治疗,2 d后评估各项指标。比较两组孕妇炎症因子(IL-2、TNF-α)水平、持续治疗时间、孕周延长时间、宫缩抑制时间、产后出血量、焦虑情况、分娩结局[Apgar评分、新生儿出生体质量、产褥感染发生率及新生儿呼吸窘迫综合征(NRDS)发生率]、新生儿肺功能及不良反应发生率。结果:治疗后两组孕妇血清IL-2、TNF-α水平均降低,且研究组均低于对照组(P均<0.01);研究组持续治疗时间、宫缩抑制时间均短于对照组,孕周延长时间长于对照组(P均<0.05);研究组Apgar评分、新生儿出生体质量均高于对照组,NRDS、出生窒息发生率均低于对照组(P均<0.05);研究组新生儿出生第1天、第7天气道阻力低于对照组,功能残气量和肺顺应性高于对照组(P均<0.01)。结论:倍他米松联合硫酸镁治疗未足月胎膜早破,可有效降低炎症反应及NRDS发生率,缩短治疗时间,改善分娩结局及肺功能,且不增加不良反应发生率。

二丙酸倍他米松有关物质的HPLC法测定

建立了高效液相色谱法测定二丙酸倍他米松(1)中的有关物质,即倍他米松(2)、倍他米松17-丙酸酯(3)、二丙酸倍氯米松(4)、6α-溴倍他米松二丙酸酯(5)。色谱柱选用COSMOSIL 5C18-MS-Ⅱ(4.6 mm×150 mm,5μm),以0.04%三氟乙酸-H2O为流动相A、0.02%三氟乙酸-乙腈为流动相B,梯度洗脱;流速为0.8 mL/min,检测波长为254 nm,柱温40℃。结果显示,1和杂质2~5均分离良好,且在各自浓度范围内线性关系良好;2~5的平均回收率(n=9)为99.8%~104.2%,RSD为4.0%~6.1%。1、2、4的检测限为0.1μg/mL,3和5的检测限为0.2μg/mL。建立的方法准确性好、灵敏度高,各组分分离较好,可用于1中有关物质的测定。