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地塞米松对两种急性肝损伤模型小鼠的作用
肝炎在我国发病极为普遍且种类较多、发病机制复杂.类固醇激素类药物具有强效的抗炎及免疫调节效应,是治疗严重肝病的常用药[1].本实验复制了四氯化碳(Carbon tet-raehloride,CCl4)及刀豆蛋白A(Concanavalin A,Con A)诱导的小鼠急性肝损伤模型,对比了地塞米松(dexamethasone,DXM)在两种肝损伤过程中的效应.
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AIM To study the effect of sclerotic complex agents (SCA) on the gallbladder wall of hybrid rabbits, andits therapeutic effect in hepatic cysts.METHODS The SCA containing tetracycline and dexamethasone was injected into the gallbladder of rabbitsto compare its action with those of normal saline and absolute ethylalcohol on the gallbladder wall. Thetherapeutic effects of SCA and absolute ethylalcohol on hepatic cysts were observed.RESULTS Abnormal changes were not found in the tissue cells of gallbladder in normal saline group. Butin absolute ethylalcohol group, a large amount of oozing fluid and blood appeared, the absorption processwas slow, and the fibrous tissue proliferated scarcely. In SCA group, there was less oozing fluid, no blood inthe gallbladder, and the absorption was active and the fibrous tissues grow obviously. In clinical practice,SCA possesses much advantage in the treatment of hepatic cysts, by which the cysts closed promptly, theexudation reduced from early stimulation, and no relapse occurred. The cure rates at the third, sixth,twelfth and twenty-fourth month were 65.1%, 96.2%, 98.1%, and 99.1% respectively; while in thecontrol group were 10.8%, 36.0%, 67.6% and 88.3% respectively. The difference was significant(P<0.01, <0.01, <0.01, <0.05). After the observation for 24 months, no relapse occurred in the SCAgroup, but 7 (6.3%) cases relapsed in control group (P<0.05).CONCLUSION The sclerotic agents should be used in sequence, i. e., a high concentration wasadministered to reduce and destroy the epithelium of the cysts, and to promote fiber tissue adhesion and thenthe remaining drug was used to stimulate epithelium to absorb the exudation. This combined regimen wasproved to be an ideal and effective method for treating hepatic cysts clinically.
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类固醇激素治疗急性颈髓损伤的临床观察
Objective To observe the therapeutic effect of methylprednisolone and dexamethasone on acute cervical spinal cord injury, and to explore the function and mechanism of steroid. Methods 59 patients with cervical spinal cord injury and post operation were divided into the methylprednisolone group (19 cases), the dexamethasone group (25 cases) and routine treatment group (15 cases). Based on the neural and functional grade standard of spinal cord injury, the degree of damage were assessed and the clinical data and complications were recorded. Results The function of sensory and motor in the three groups were all improved remarkably (P< 0.05). The sensory improvement of the methylprednisolone group was better than the other two groups and the motor improvement of the methylprednisolone group was better than routine treatment group. There was no difference in the treatment effect between the dexamethasone group and routine treatment group. There was no different in the complications among the three groups. Conclusion The steroid hormone can improve the function of sensory and motor in the patients with acute spinal cord injury. The theraputic effect of the methylprednisolone was better than that of the dexamethasone.
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Objective To investigate the effects of dexamethasone on the promoter activity of human al(1) procollagen gene.Methods Fibroblasts from human skin were primary cultured and subcultured. (1) The effects of dexamethasone on the human skin fibroblasts were determined by BrdU incorporation into DNA of fibroblasts. (2) Three plasmids containing various engths of 5' flanksequence of human al(1) procollagen gene and CAT as reporter gene were constructed, and were transfected into the human skin fi-broblasts by FuGENE Transfecfion Reagent. The effects of dexamethasone on 3 plasmids were determined by CAT - ELlSA. Results (1)After 24h of treatment on the fibroblasts with 110-9 ~110-4mol/L examethasone in DMEM containing 2% or 10% FCS, BrdU in-corporation into DNA showed no difference ( P > 0.05) . (2) the 3 plasmids were transfected into fibroblasts and then treated with 110-5mol/L and 110-6mol/L dexamethasones for 24h, relative CAT values were different belwent dexamethasone and control,higher dexamethasone(110 -5mol/L} and lower examethasone(110 -6mol/L) ( P <0. 05) . ConcluSion Dexamethasone has noeffects on the proliferation of human skin fibroblasts, and it has negative effect on the promoter activity of human al(1) procollagengene, which is dose- dependent.
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地塞米松对系统性红斑狼疮阴虚内热证患者外周血单一核细胞基因表达谱的影响
目的 探讨地塞米松对系统性红斑狼疮(SLE)阴虚内热证患者外周血单一核细胞(PBMC)基因表达谱的影响.方法 用地塞米松孵化SLE阴虚内热证患者PBMC,收集孵化后细胞进行PBMC的基因表达谱检测.结果 地塞米松上调85个PBMC基因,下调126个PBMC基因.结论 地塞米松调控SLE阴虚内热证患者PBMC的基因所属功能簇众多,基因编码的功能蛋白分布细胞多个部位,不是所有基因调控结果均有利于SLE缓解,一些基因调控作用对研究地塞米松治疗SLE的机制有帮助.
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激活蛋白-1在皮肌炎患者外周血单一核细胞中的表达及糖皮质激素对其表达的影响
目的 探讨激活蛋白-1(AP-1)在皮肌炎患者外周血单一核细胞(PBMC)中的表达及糖皮质激素对其表达的影响.方法 分别提取15例正常人和20例皮肌炎患者(为未使用过糖皮质激素的初发患者或停止糖皮质激素治疗1个月以上者,初发12例,复发8例)的PBMC,每例的PBMC等分为2份,一份加入含80 μmol/L地塞米松和10%小牛血清的RPMI 1640培养液培养48 h后待用,另一份直接-80℃保存待用.用电泳迁移率改变实验检测不同组别PBMC中AP-1的活性.结果 AP-1在正常人PBMC中为低表达(灰度面积值为4.93±0.15 mm2).皮肌炎初发组和复发组患者PBMC加地塞米松前的AP-1表达(灰度面积值分别为30.23±0.49 mm2和34.79±0.61 mm2)均明显高于地塞米松处理后AP-1表达(灰度面积值分别为5.59±0.39 mm2和5.69±0.39 mm2),地塞米松处理前复发组PBMC的AP-1活性高于初发组(P<0.01).结论 AP-1活性增强可能是导致皮肌炎炎症反应及复发的重要因素之一.糖皮质激素可以一定程度抑制AP-1活性.
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乌司他丁联合地塞米松治疗创伤性肺损伤的临床疗效观察
急性肺损伤(acute lung injury,ALI)是指由心源性以外各种肺内外致病因素导致的急性、进行性缺氧性呼吸衰竭[1],是临床常见的危重症之一,严重ALI终诱发或加重急性呼吸窘迫综合征(ARDS)和多脏器功能障碍综合征(MODS),若不到及时有效的控制,ALI可迅速发展为ARDS,增加死亡率.研究表明,适时干预全身炎性反应,特别早期阻断炎症反应所致的损伤,将有助于改善ALI患者的预后.
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糖皮质激素在非感染性角膜疾病和角膜屈光手术中的应用
糖皮质激素在眼科应用广泛,其主要作用有三:消炎,抗过敏,免疫抑制.传统糖皮质激素如泼尼松龙(prednisolone)、地塞米松(dexamethasone),通常称为"硬激素",长期应用不良反应较多,可以导致激素性青光眼、激素性白内障,诱发或加重感染,诱发或加剧溃疡病.
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糖皮质激素在非感染性角膜疾病和角膜屈光手术中的应用
糖皮质激素在眼科应用广泛,其主要作用有三:消炎,抗过敏,免疫抑制.传统糖皮质激素如泼尼松龙(prednisolone)、地塞米松(dexamethasone),通常称为"硬激素",长期应用不良反应较多,可以导致激素性青光眼、激素性白内障,诱发或加重感染,诱发或加剧溃疡病.因此医生应当了解药物的浓度、作用时间、常见的副作用,以便于指导患者合理用药.氯替泼诺(loteprednol)是一种新型的"软激素"(soft steroid),在发挥作用后迅速代谢灭活,很少出现全身及眼部的不良反应.
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硅油预防肠粘连的实验研究与临床应用
目前,尚无一种能完全防止肠粘连的可靠方法.我们从1983年7月至1985年3月,用二甲基硅油(简称硅油)进行了防止腹膜粘连的实验,并应用于临床,防治粘连性肠梗阻获得了较满意的效果.
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综合应用中西药物预防术后肠粘连的实验研究
术后肠粘连和粘连性肠梗阻的发病率在小儿剖腹术中约占6%,且发病率逐年增高.因此,术后肠粘连的预防甚为重要.对术后肠粘连的预防,国外多应用皮质激素类或促进局部纤溶的药物,国内则广泛应用中药制剂.但文献报告多为单独用某种药物.
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小儿肾上腺皮质癌
婴幼儿肾上腺皮质功能性病变,表现为使皮质醇症时,多系肾上腺皮质癌.我院1960~1979年共收治4例,均经手术切除.近期2例随访已超过2年,情况良好;1例术后死亡;1例未随访.今简要报导及讨论如下.
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Severe Hypokalemia due to Combination Use of Dexamethasone and Calcium Gluconate for Diabetics with Infection:A Case Report
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A case of a 53-year-old man with adult T-lymphoblastic lymphoma (T-LBL) in mediastinum who survived more than 33 months in our hospital was reported. LBL was more common in school-age and teenage boys than adults. The reported patient manifested progressive dyspnea. Chest CT scanning showed a huge irregular soft tissue shadow in anterior mediastinum which extended into posterior mediastinum and left chest wall. The tumor was 20 cm×15 cm×15 cm in size in left upper mediastinum and its boundaries with pericardium and left lower lung were unclear. The diagnosis of T-lymphoblastic lymphoma was confirmed by immunohistochemical staining. After surgery, he received five chemotherapy courses including Gem, CTX and VCR and biological therapies with IL-2 and IFN-α2b. About 16 months later, he complained of diplopia in the left eye without any evidence of recurrence. Blood examination which showed leukemoid reaction twice returned to normal after dehydration, hormone and thalidomide treatments. Finally, his condition became worse and died of pulmonary infection 33 months after ifrst medical service. In summary, T-LBL is a rare disease which may result in poor prognosis even if the patient has received immediate chemotherapy. Hormone and thalidomide can be applied to treat adult T-LBL.