Unveiling osteoprotective potential of biologically active naringenin in rats with dexamethasone-induced osteoporosis

Objective To investigate the protective effects of naringenin(NRG)against dexamethasone(DEX)-induced osteoporosis(OP)in rats.Methods Molecular docking of NRG was done with AutoDock Vina 1.2.0 software.Forty-eight female Wistar rats were randomly divided into six groups(n=8 each):normal control(NC),DEX(7 mg/kg,i.m.),NRG-low(NRG-L;25 mg/kg,i.g.),NRG-medium(NRG-M;50 mg/kg,i.g.),NRG-high(NRG-H;100 mg/kg,i.g.),and alendronate(ALN;0.25 mg/d,i.g.)groups.OP was induced by administering DEX once a week for five weeks in all groups except NC group.Begining in the third week after the initial DEX administration,the rats in NRG-L,NRG-M,NRG-H,and ALN groups received the corresponding treatments daily for three weeks,while NC and DEX groups received no additional treatment.Serum samples were collected at the end of the experiment for biochemical,bone turnover,antioxidant,lipid profile,and inflammatory cytokine analyses.Femur bones underwent physical parameter testing and histopathological examination.Results The molecular docking results illustrated that NRG docked with calcitonin(CT),lowdensity lipoprotein(LDL),bone morphogenetic protein(BMP),vascular endothelial growth factor(VEGF)receptor,forkhead transcription factors,and osteoprogenitor cells showed good binding energy.In rats administered with 25,50,and 100 mg/kg NRG,there was a significant enhancement in serum biochemical indices,characterized by a reduction in tartrate-resistant acid phosphatase(TRAP),parathyroid hormone(PTH),and an elevation in osteocalcin(OC)and CT levels(P<0.05,P<0.01,and P<0.001,respectively).Despite no significant changes in thickness,weight,and length(P>0.05),there was a marked increase in bone mineral density(BMD)(P<0.01,P<0.001,and P<0.001,respectively).Antioxidant enzyme markers showed significant upregulation,with higher glutathione,superoxide dismutase,and catalase,and a concurrent decrease in malondialdehyde(MDA)(P<0.05,P<0.01,and P<0.001,respectively).The lipid profile also improved significantly,with lower cholesterol(CH),triglycerides(TG),and low-density lipoprotein(LDL)levels,and an increase in high-density lipoprotein(HDL)level(P<0.05,P<0.01,and P<0.001,respectively).Inflammatory cytokine levels were reduced,as evidenced by decreases in tumor necrosis factor(TNF),interleukin(IL)-6,and IL-1β(P<0.05,P<0.01,and P<0.001,respectively).Furthermore,histological alterations revealed obvious improvements,and the body weight of rats treated with NRG showed an increase compared with DEX group.Conclusion These findings imply that NRG exhibited a protective effect against DEX-induced OP in rats as it promotes the bone formation process by increasing the number of bone turnover markers including OC and CT,and restoring of antioxidant status,lipid metabolism,and inflammatory markers.

Dexamethasone implant in naive versus refractory patients with diabetic macular edema:a Meta-analysis

AIM:To evaluate the efficacy and safety of the intravitreal dexamethasone implant in naive and refractory patients with diabetic macular edema(DME).METHODS:PubMed,Embase,Web of Science,and Medline databases were searched.The main outcomes were best-corrected visual acuity(BCVA)and central retinal thickness(CRT).The secondary outcomes included mean number of injections,intraoperative or postoperative complications including intraocular pressure(IOP)elevation and cataract.RESULTS:Ten comparative studies involving a total of 1000 DME eyes including 402 naive eyes and 598 refractory eyes were selected.The postoperative BCVA in the naive group was significantly better than in the refractory group[mean difference(MD)-0.11,95% confidence interval(CI)-0.17 to-0.05,P=0.0003;MD 8.69,95%CI 5.08 to 12.30,P<0.00001].Additionally,the naive group got greater improvement of BCVA change as well as more gains of BCVA letters than the refractory group[MD 7.71,95%CI 2.02 to 13.40,P=0.008;odds ratio(OR)2.99,95%CI 2.05 to 4.37,P<0.00001].The subgroup analysis revealed that the naive group had significantly higher BCVA gains of≥5,≥10,and≥15 letters compared to the refractory group(P=0.002,0.0001,0.003,respectively).No significant difference was detected between the two groups in either postoperative CRT(MD-22.36,95%CI-46.39 to 1.66,P=0.07)or the overall mean number of injections(MD-0.08,95%CI-0.38 to 0.22,P=0.61).Intraoperative and postoperative complications including the elevation of IOP(OR 0.47,95%CI 0.20 to 1.13,P=0.09)and cataract(OR 1.78,95%CI 0.97 to 3.24,P=0.06)showed no significant differences between the two groups during the follow-up time.CONCLUSION:Intravitreal dexamethasone implants for DME can improve anatomical and functional outcomes in both naive and refractory eyes and have a well-acceptable safety profile.Moreover,naive eyes maintain better visual outcomes than refractory eyes.It provides further evidence of better visual response when used for naive eyes as firstline therapy.

Dexamethasone implant for refractory macular edema secondary to diabetic retinopathy and retinal vein occlusion

AIM:To evaluate the efficacy,timing of retreatment and safety of dexamethasone(DEX)implant on macular edema(ME)secondary to diabetic retinopathy(DME)and retinal vein occlusion(RVO-ME)patients who were refractory to anti-vascular endothelial growth factor(VEGF)treatment.METHODS:This retrospective study included 37 eyes received at least one DEX implant treatment for DME or RVO-ME between January 1,2019,and January 1,2023.These refractory DME and RVO-ME cases received at least 5 anti-VEGF injections and failure to gain more than 5 letters or a significant reduction in central retinal thickness(CRT).The best corrected visual acuity(BCVA)and CRT were measured at baseline,and at 1,3,4 and 6mo post-DEX implant injection.Adverse events such as elevated intraocular pressure(IOP)and cataract were recorded.RESULTS:For RVO cases(n=22),there was a significant increase in BCVA from 0.27±0.19 to 0.35±0.20 at 6mo post-DEX injection(P<0.05)and CRT decreased from 472.1±90.6 to 240.5±39.0μm at 6mo(P<0.0001).DME cases(n=15)experienced an improvement in BCVA from 0.26±0.15 to 0.43±0.20 at 6mo post-DEX implant injection(P=0.0098),with CRT reducing from 445.7±55.7 to 271.7±34.1μm at 6mo(P<0.0001).Elevated IOP occurred in 45.9% of patients but was well-controlled with topical medications.No cases of cataract or other adverse events were reported.CONCLUSION:DEX implants effectively improve BCVA and reduce CRT in refractory DME and RVO-ME.Further research with larger cohorts and longer follow-up periods is needed to confirm these findings and assess long-term outcomes.

High-dose dexamethasone regulates microglial polarization via the GR/JAK1/STAT3 signaling pathway after traumatic brain injury

Although microglial polarization and neuroinflammation are crucial cellular responses after traumatic brain injury,the fundamental regulatory and functional mechanisms remain insufficiently understood.As potent anti-inflammato ry agents,the use of glucoco rticoids in traumatic brain injury is still controversial,and their regulatory effects on microglial polarization are not yet known.In the present study,we sought to determine whether exacerbation of traumatic brain injury caused by high-dose dexamethasone is related to its regulatory effects on microglial polarization and its mechanisms of action.In vitro cultured BV2 cells and primary microglia and a controlled cortical impact mouse model were used to investigate the effects of dexamethasone on microglial polarization.Lipopolysaccharide,dexamethasone,RU486(a glucocorticoid receptor antagonist),and ruxolitinib(a Janus kinase 1 antagonist)were administered.RNA-sequencing data obtained from a C57BL/6 mouse model of traumatic brain injury were used to identify potential targets of dexamethasone.The Morris water maze,quantitative reverse transcription-polymerase chain reaction,western blotting,immunofluorescence and confocal microscopy analysis,and TUNEL,Nissl,and Golgi staining were performed to investigate our hypothesis.High-throughput sequencing results showed that arginase 1,a marker of M2 microglia,was significantly downregulated in the dexamethasone group compared with the traumatic brain injury group at3 days post-traumatic brain injury.Thus dexamethasone inhibited M1 and M2 microglia,with a more pronounced inhibitory effect on M2microglia in vitro and in vivo.Glucocorticoid receptor plays an indispensable role in microglial polarization after dexamethasone treatment following traumatic brain injury.Additionally,glucocorticoid receptor activation increased the number of apoptotic cells and neuronal death,and also decreased the density of dendritic spines.A possible downstream receptor signaling mechanism is the GR/JAK1/STAT3 pathway.Overactivation of glucocorticoid receptor by high-dose dexamethasone reduced the expression of M2 microglia,which plays an antiinflammatory role.In contrast,inhibiting the activation of glucocorticoid receptor reduced the number of apoptotic glia and neurons and decreased the loss of dendritic spines after traumatic brain injury.Dexamethasone may exe rt its neurotoxic effects by inhibiting M2 microglia through the GR/JAK1/STAT3 signaling pathway.

Treatment Efficacy and Safety of Bortezomib Combined with Dexamethasone and Lenalidomide Chemotherapy Regimen for Multiple Myeloma

Objective:To analyze the effect of bortezomib combined with dexamethasone and lenalidomide in the treatment of multiple myeloma.Methods:60 cases of multiple myeloma patients admitted to our hospital from January 2022 to December 2023 were selected randomly,with 30 cases in each group.Bortezomib combined with dexamethasone was administered in the control group,and bortezomib combined with dexamethasone and lenalidomide was given to the observation group,and the treatment effect was analyzed.Results:After treatment,CD^(3+)and CD^(4+)of the observation group were higher than that of the control group,CD^(8+)was lower than that of the control group,and the total treatment efficiency was higher,which was statistically significant(P<0.05),and there was no difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Bortezomib combined with dexamethasone and lenalidomide is effective in the treatment of multiple myeloma as it regulates the immune function and is safe,thus it can be promoted in clinical practice.

Observation of the Curative Effect of the Dexamethasone Vitreous Cavity Implant for the Treatment of Irvine-Gass Syndrome

Objective To investigate the clinical efficacy of dexamethasone vitreous cavity implants(Ozurdex)for the treatment of macular edema(Irvine-Gass Syndrome)after cataract surgery.Method Eight patients(eight eyes)with Irvine-Gass syndrome were enrolled for vitreous injections with Ozurdex.The patients included six men(six eyes)and two women(two eyes)with a mean age of 67.12±11.92 years.Changes in the patients best-corrected visual acuity(BCVA),central macular thickness(CMT),and intraocular pressure were compared before and after treatment.Result The mean visual acuity BCVA of the patients was 0.81±0.26 before implantation,which improved to 0.20±0.12,0.13±0.09,and 0.15±0.13 at 2 weeks,1 month,and 3 months after implantation,respectively(P<0.001).The patient’s mean CMT before implantation was 703.00±148.88μm,and it reduced to 258.87±37.40μm,236.25±28.74μm,and 278.00±76.82μm at 2 weeks,1 month,and 3 months after implantation,respectively(P<0.001).Conclusion The dexamethasone vitreous cavity implant(Ozurdex)is a safe and effective treatment,which can effectively improve patient’s visual acuity and reduce macular edema associated with cataract surgery.

Dexamethasone potentiates the insulin-induced Srebp-1c expression in primary rat hepatocytes

The impacts of dexamethasone(Dex)and thyroid hormone T3 on the insulin-stimulated Srebp-1c expression were studied in primary rat hepatocytes. Primary hepatocytes from Sprague-Dawley rats were isolated, cultured and treated with insulin in the presence or absence of the indicated reagents over time. The mRNA levels of indicated genes were determined using real-time PCR. Insulin treatment induced the Srebp-1c expression and suppressed the Pck1 expression in a time-dependent manner. Dex treatment alone reduced the Srebp-1c expression, whereas potentiated the insulin-induced its expression, which reached to a level that was higher than the insulin alone group. On the other hand, insulin treatment completely suppressed the Dex-induced Pck1 expression in the same cells. T3 treatment did not affect the expressions of Srebp-1c and Pck1 alone or in the presence of absence of insulin or Dex. Interestingly, insulin treatment induced the Rxrg m RNA expression level in the absence or presence of T0901317, a specific agonist for the liver X receptor. Dex and insulin mutually affect each other's ability to regulate the expression levels of hepatic genes involved in glucose and fatty acid metabolism. Insulin induced Rxrg expression in primary hepatocytes, which may contribute to the induction of Srebp-1c expression in the same cells.

Combination of cataract surgery with intravitreal injection of dexamethasone intravitreal implant(Ozurdex)for uveitis-induced cataract

AIM:To evaluate the long-term results of patients with chronic uveitis-induced cataract by phacoemulsification with IOL implantation and intravitreal injection of dexamethasone(DEX)intravitreal implant(Ozurdex).METHODS:The study included 32 eyes of 26 patients treated with DEX implant due to chronic uveitis-induced cataract and followed up for at least a year.Best-corrected visual acuity(BCVA),intraocular pressure(IOP),anterior chamber reaction,central macular thickness(CMT),intraoperative and postoperative complications and uveitis recurrence were analyzed retrospectively.RESULTS:A successful surgery was performed in all patients.The average follow-up period was 12mo.The female/male ratio was 13/13.Mean age was 45.65±3.83y(range 26 to 65y).Etiologically,rheumatic arthritis occurred in 6 patients(18.75%),ankylosing spondylitis in 4(12.50%),HLA-B27 associated uveitis in 3(9.38%),Vogt-KoyanagiHarada-associated uveitis in 4(12.50%),Behcet’s disease in 2(6.25%),and 7(21.88%)suffered from unknown diseases.All 32 eyes had varying degrees of improvement at 12mo after surgery,with 2 eyes showing BCVA of 0.1 or below(6.25%),6 having 0.1-0.5(18.75%),18 of 0.5-1.0(56.25%),and 6 of 1.0 or above(18.75%).No cases with increased IOP were observed.The values of mean CMT was increased at day 1,decreased at 1,3mo after surgery and increased at 6,12mo after surgery.No severe uveitis reactions,such as fibrinous exudates in the anterior chamber and exudative membrane formation on the anterior surface of the IOL,were observed after surgery.CONCLUSION:The present studies show that intravitreal injection of Ozudex during cataract operation can provide a new option for the clinical treatment of uveitis-induced cataract.

The therapeutic mechanism of dexamethasone in lung injury induced by hydrogen sulfide

The lung is one of the primary target organs of hydrogen sulfide(H2S),as exposure to H2S can cause acute lung injury(ALI)and pulmonary edema.Dexamethasone(Dex)exerts a protective effect on ALI caused by exposure to toxic gases and is commonly used in the clinic;however,the underlying mechanisms remain elusive,and the dose is unclear.Methods:In vivo experiments:divided C57BL6 mice into 6 groups at random,12 in each group.The mice were exposed to H2S for 3 h and 5 or 50 mg/kg Dex pretreated before exposure,sacrificed 12 h later.The morphological changes of HE staining and the ultrastructural changes of lungs under transmission electron microscopy were evaluated.The wet/dry ratio of lung tissue was measured.Bronchial alveolar lavage fluid(BALF)protein content and lung permeability index were detected.The expression of AQP5 protein was measured by immunohistochemistry and Western Blot(WB).In vitro experiments:divided human lung adenocarcinoma cell line A549 into 4 groups.1μmol/L dexamethasone was added to pre-incubation.The WB analyzed the protein of p-ERK1/2,p-JNK,and p-p38 in MAPK pathway after 1 h of NaHS exposure;six hours after NaHS exposure,the AQP5 protein was measured by WB.Results:Dex treatment could significantly attenuate the H2S-induced destruction to the alveolar wall,increase the wet-to-dry weight ratio and decrease pulmonary permeability index,with high-dose dexamethasone seemingly functioning better.Additionally,our previous studies showed that aquaporin 5(AQP 5),a critical protein that regulates water flux,decreased both in a mouse and cell model following the exposure to H2S.This study indicates that tThe decrease in AQP 5 can be alleviated by Dex treatment.Additionally,the mitogen activated protein kinase(MAPK)pathway may be involved in the protective effects of Dex in ALI caused by exposure to H2S since H2Sinduced MAPK activation could be inhibited by Dex.Conclusion:The present results indicate that AQP 5 may be considered a therapeutic target for Dex in H2S or other hazardous gases-induced ALI.

The Effect of Dexamethasone versus Methylprednisolone in the Treatment of COVID-19 Patients in Jordan

Background: Previous studies focused on the treatment effect of steroids versus no steroids in treating severe COVID-19 patients, a few studies evaluated outcomes for treating those patients with either dexamethasone or methylprednisolone. Currently, we evaluate the difference in mortality associated with treating COVID-19 patients with dexamethasone versus methylprednisolone. Methods: With a retrospective multicenter study, records were reviewed for the admitted patients with severe COVID-19 during the peak of the severe COVID-19 pandemic. All admitted patients on dexamethasone or methylprednisolone were included. Patients were analyzed as all populations and propensity scores matched patients. Propensity scores were calculated for several confounders by the generalized linear model, and a “greedy” near-neighbor matching algorithm was used. Continuous variables with nonnormal distribution were analyzed by Wilcoxon signed rank test. Chi-squared and Fischer exact test analyzed categorical variables. P-values were adjusted by the Bonferroni method for both data cohorts. Body mass index was in categories. Radiological findings were divided into five categories. The outcomes: mortality, the need for home oxygen therapy, recovery, and residual symptoms on discharge were analyzed by an independent two-sample test for equality of proportions (with Yates correction), and logistic regression analysis. Results: Among the 1128 reviewed records, patients on dexamethasone or methylprednisolone were 1071, and the propensity score-matched patients were 784: dexamethasone 393 and methylprednisolone 391. There was no significant difference in the characteristics of patients between the two steroids (p-value and adjusted p-value > 0.05) for most variables. PSM adjusted a few discrepant variables before analysis. The outcome of the unmatched patients demonstrated dexamethasone benefit in the need for home oxygen therapy ( 0.05). However, matched patients demonstrated significantly lower mortality associated with dexamethasone treatment (difference -2.68%, 95%CI, -1.0, -0.004, p = 0.03, and OR 1.7, p = 0.017), and no difference for the other outcomes, including the need for home oxygen therapy (p-value > 0.05). Conclusion: Dexamethasone treatment caused significantly less mortality than methylprednisolone in treating our COVID-19 patients, but no significant difference in recovery, the need for home oxygen therapy, and residual symptoms on discharge.

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。

60例小儿急性感染性喉炎治疗效果临床回顾性分析

目的分析小儿急性感染性喉炎行布地奈德雾化吸入治疗方案的有效性与可行性。方法回顾性分析60例急性感染性喉炎患儿的临床资料,根据雾化治疗方案的不同分为观察组与对照组,每组30例。观察组予布地奈德雾化吸入治疗,对照组予地塞米松雾化吸入治疗。比较两组患儿的临床治疗效果、临床症状持续时间、药物不良反应发生率以及治疗前后的炎症指标。结果观察组临床治疗总有效率93.33%(28/30)显著高于对照组的73.33%(22/30),差异具有统计学意义(P<0.05)。观察组患儿的喉鸣、犬吠样咳嗽、呼吸困难、声音嘶哑、发热持续时间分别为(3.77±1.21)、(3.28±1.06)、(1.78±0.57)、(4.36±0.56)、(1.48±0.48)d,均短于对照组的(4.65±1.26)、(4.77±1.21)、(2.91±0.99)、(5.45±0.49)、(2.56±0.78)d,差异具有统计学意义(P<0.05)。治疗后,两组患儿的超敏C反应蛋白(hs-CRP)水平均较治疗前明显降低,且观察组患儿的hs-CRP水平(7.86±2.13)mg/L低于对照组的(12.67±2.75)mg/L,差异具有统计学意义(P<0.05)。观察组用药不良反应发生率6.67%低于对照组的26.67%,差异具有统计学意义(P<0.05)。结论小儿急性感染性喉炎行布地奈德雾化吸入治疗方案的效果理想,可更为显著地改善患儿的临床症状,缩短临床症状持续时间,同时其安全性较高,具有重要临床应用价值。

圣草素促进成骨细胞自噬减轻糖皮质激素诱导的细胞凋亡

背景:糖皮质激素诱导的骨质疏松症是系统性糖皮质激素治疗的常见并发症,主要表现为对成骨细胞的抑制作用。圣草素可抑制破骨细胞分化和卵巢切除术引起的骨质疏松,然而,圣草素是否调节糖皮质激素诱导的成骨细胞凋亡尚不清楚。目的:探究圣草素是否在地塞米松诱导的成骨细胞凋亡中发挥作用,及其潜在的作用机制。方法:采用不同浓度(0,0.5,1,2.5,5,10μmol/L)的圣草素或自噬抑制剂3-甲基腺嘌呤(5μmol/L)处理地塞米松预处理的成骨细胞MC3T3‐E1,然后用血红素加氧酶1的过表达载体(pcDNA-HMOX1)和空载体(pcDNA vector)转染MC3T3‐E1细胞。分别采用CCK-8和流式细胞术检测细胞活力和凋亡;采用ELISA检测半胱氨酸天冬氨酸蛋白酶3活性;采用Western blotting检测自噬相关蛋白LC3-Ⅱ/LC3-Ⅰ、p62、Atg5和Atg12表达,凋亡相关蛋白Bax和Bcl-2的表达,以及AMP蛋白激活激酶(AMPK)和p-AMPK蛋白表达。结果与结论:①低浓度的圣草素对MC3T3-E1细胞无毒性,且促进细胞增殖,并以剂量依赖性的方式促进自噬相关蛋白LC3-Ⅱ/LC3-Ⅰ、p62、Atg5和Atg12表达,降低半胱氨酸天冬氨酸蛋白酶3活性,抑制Bax蛋白表达,促进Bcl-2蛋白表达,减少地塞米松诱导的MC3T3-E1细胞凋亡;②此外圣草素可显著促进成骨细胞中血红素加氧酶1的表达;过表达血红素加氧酶1促进AMPK磷酸化,激活自噬,抑制地塞米松诱导的成骨细胞凋亡;③而3-甲基腺嘌呤处理抵消了血红素加氧酶1过表达对MC3T3-E1细胞的影响;④提示低浓度圣草素对成骨细胞无毒性,可以通过上调血红素加氧酶1的表达激活AMPK信号通路,从而促进自噬,抑制地塞米松诱导的成骨细胞凋亡;圣草素具有治疗糖皮质激素诱导骨质疏松症的巨大潜力。

地塞米松联合免疫球蛋白治疗感染性噬血细胞综合征临床研究

目的 探讨感染性噬血细胞综合征的临床特点及基层医院可行的治疗方法。方法 选取2021年1月至2023年5月我院收治的11例小儿感染性噬血细胞综合征患儿,采用地塞米松+免疫球蛋白治疗的感染性噬血细胞综合征病例诊治资料进行回顾性分析,与传统化疗为主的综合治疗对比,分析患儿治疗成功率、预后,综合评价临床疗效。结果 11例患儿均继发于感染性疾病,诊断后积极针对原发病因抗感染及地塞米松+免疫球蛋白冲击治疗,7例治愈,3例死亡,1例失访。结论 儿童感染性噬血细胞综合征为临床少见的急危重症,病死率高,积极针对原发病抗感染及联合地塞米松+免疫球蛋白冲击治疗为较有效的治疗方法,值得基层医疗机构推广。

如意黄金散联合地塞米松对非哺乳期乳腺炎患者创周肤色及垂体泌乳素水平的影响

目的 探究如意黄金散联合地塞米松对非哺乳期乳腺炎(NPM)患者创周肤色及垂体泌乳素(PRL)水平的影响。方法 选取2021年10月至2022年9月湖北省武汉市中心医院收治的88例NPM患者作为研究对象,按照随机数字表法将患者分为对照组和观察组,各44例。对照组给予地塞米松局部注射治疗,观察组在对照组基础上给予如意黄金散局部贴敷治疗,2组均治疗1个月。比较2组治疗前后临床症状评分、PRL水平及总有效率。结果 治疗后,2组乳房肿块、痛感、创周肤色、创周肤温评分均低于治疗前,且观察组均低于对照组(均P<0.05);2组血清PRL水平均低于治疗前,且观察组低于对照组[(382±101)mU/L比(542±142)mU/L](均P<0.001)。观察组总有效率高于对照组[88.6%(39/44)比70.5%(31/44)](P=0.034)。结论 如意黄金散联合地塞米松对NPM具有良好的疗效,可显著改善患者临床症状,降低PRL水平。

地塞米松联合右美托咪定对髋关节置换术老年病人的镇痛观察

目的 探讨地塞米松联合右美托咪定对行髋关节置换术老年病人术后疼痛效果。方法 选取2020年2月至2022年2月沧州市中心医院收治的80例行髋关节置换术的老年病人,按照随机数字表法分为观察组(n=40)和对照组(n=40)。对照组于麻醉诱导前泵注右美托咪定1μg/kg,时间为10 min,之后调整剂量为0.5μg·kg^(-1)·h^(-1),直至术前30 min。观察组则在采用右美托咪定泵注的同时静脉注射5 mg地塞米松。对比两组病人术后疼痛程度、肾功能指标[血肌酐(Scr)、尿素氮(BUN)]及血清前列腺素E2(PGE2)、白细胞介素-6(IL-6)、细胞间黏附分子-1(ICAM-1)、C-反应蛋白(CRP)水平。结果 观察组病人术后12h、术后24 h的视觉模拟评分法(VAS)评分均低于对照组(P<0.05);两组术后1 h、24 h,Scr、BUN、PGE2、IL-6、ICAM-1、CRP水平在组间、时间及交互方面进行比较,差异有统计学意义(P<0.05);手术后1 h,观察组Scr、BUN水平分别为(65.33±8.06)μmol/L、(5.64±0.78)mmol/L;手术后24 h,观察组Scr、BUN、PGE2、IL-6、ICAM-1、CRP水平分别为(69.07±8.08)μmol/L、(6.06±0.88)mmol/L、(17.76±2.65)μg/L、(62.38±7.43)ng/L、(283.35±37.65)μg/L、(10.39±1.33)mg/L;手术后1 h,对照组Scr、BUN水平分别为(69.76±7.96)μmol/L、(6.16±0.86)mmol/L;手术后24 h,对照组Scr、BUN、PGE2、IL-6、ICAM-1、CRP水平分别为(69.76±7.96)μmol/L、(6.58±0.93)mmol/L、(22.73±3.36)μg/L、(79.48±9.34)ng/L、(326.86±42.45)μg/L、(14.22±1.84)mg/L。观察组术后1 h、术后24 h的Scr、BUN、PGE2、IL-6、ICAM-1、CRP水平均低于对照组(P<0.05)。结论 地塞米松联合右美托咪定能够减轻髋关节置换术老年病人术后疼痛程度,减轻肾功能损伤、降低炎症反应。

黏膜下注射地塞米松对种植骨增量术后镇痛及消肿的疗效观察及因素分析

目的研究黏膜下注射地塞米松对种植骨增量术后镇痛及消肿的疗效,并分析种植骨增量术后疼痛和肿胀的相关因素。方法收集2023年1月至2023年12月于南京医科大学附属口腔医院特诊科就诊的牙列缺损需实施骨增量(GBR或上颌窦内提升)的患者,测量并记录术后72 h内的疼痛和肿胀情况,以及可能的影响因素,包括性别、年龄、种植数量、手术时长、口腔卫生状况、FAC术前紧张程度及PSQ疼痛敏感性值,对两组不同时间的疼痛程度和肿胀程度进行差异比较,并对可能的影响因素进行皮尔森相关性及多元线性回归分析。结果给予地塞米松干预的患者疼痛程度在12 h起显著低于对照组,而肿胀评分在48 h开始显著低于对照组。相关性分析及回归分析显示,GBR术式对术后疼痛和肿胀有显著影响(r=0.348,P=0.030/r=0.441,P=0.005),其疼痛程度的线性回归模型同样具有统计学意义(R^(2)=0.126,P=0.030)。结论黏膜下注射地塞米松能够显著缓解种植骨增量术后患者的疼痛及肿胀不适,提高诊疗舒适度。

高压氧联合鼓室内注射治疗全频听力下降型突发性耳聋的疗效观察

目的探讨高压氧联合鼓室内注射治疗全频听力下降型突发性聋的临床治疗效果。方法选取2021年5月至2023年7月120例全频听力下降型突发性聋患者,采用随机法分为3组,每组各40例。对照组1给予常规药物治疗,对照组2给予常规药物和鼓室内注射治疗,观察组给予常规药物和高压氧联合鼓室内注射治疗,比较3组患者治疗后有效率和不良反应的发生情况。结果观察组患者治疗总有效率(95.00%)高于对照组1和对照组2的总有效率(77.50%、85.00%),差异有统计学意义(P<0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论高压氧联合鼓室内注射治疗全频听力下降型突发性聋可明显提高患者听力,且安全性较高。

地塞米松用于LQLB对妇科腹腔镜患者术后QoR的影响

目的探讨地塞米松作为佐剂行LQLB对妇科腹腔镜患者术后QoR的影响。方法选取2022年10月-2023年1月本院择期行妇科腹腔镜良性肿瘤手术患者70例,随机分为LD组(地塞米松复合罗哌卡因,n=35)和L组(罗哌卡因,n=35)行LQLB,对比2组术后QoR、VAS评分、镇痛补救情况、PONV发生率及严重程度、镇吐补救次数、术后首次肛门排气时间。结果与L组相比,LD组患者术后1d QoR-40评分更高、术后24h及48h VAS评分更低、镇痛补救次数减少、首次镇痛药物使用时间更长、术后48h内PONV发生率和严重程度更低、术后首次肛门排气时间更短,差异有统计学意义(P<0.05)。结论地塞米松作为佐剂行LQLB镇痛效果更完善、PONV发生率及严重程度降低、胃肠功能恢复快,有效提高妇科腹腔镜手术患者的术后QoR。

三路径激素联合应用治疗全聋型突发性聋的疗效分析

目的 观察三路径激素联合应用治疗全聋型突发性聋的疗效。方法 选择2020年1月至2022年12月全聋型突发性聋患者96例,随机分为观察组与对照组,对照组予地塞米松静脉滴注及常规治疗。观察组在此基础上加用鼓室和耳后地塞米松注射,共治疗10 d。结果 对照组患者听力改善22例,有效率45.83%,观察组改善30例,有效率62.50%。治疗前对照组与观察组纯音听阈均值分别为(95.3±13.2)d B HL和(96.1±13.1)d B HL,治疗后分别为(63.2±17.1)d B HL和(52.8±16.8)d B HL,观察组治疗效果优于对照组(P<0.05)。两组耳鸣、眩晕、耳闷等症状改善率差异无统计学意义(P>0.05)。结论 早期三路径激素治疗全聋型突发性聋可有效提高听力恢复,值得临床推广。