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Objective To investigate the clinical efficacy of 0.1％ mometasone furoate cream in the treatment of phimosis in children.Methods A prospective study was carried out over two years period on an outpatient which basis on two groups of patients with severe phimosis.598 children with severe phimosis (Kikiros classification 4-5) aged from 2 years old to 11 years old and 8 months were selected.311 cases in the observation group and 287 cases in the control group.The observation group applied a steroid cream the foreskin twice a day for 4 weeks,and the control group used local handling of the foreskin twice a day for 4 weeks.The effects of the two groups after 2 and 4 weeks of treatment were compared.Results 29 cases in the observation group and 47 cases in the control group were loss of follow up.In the steroids group which including 282 patients,68.8％ of patients (194 cases) showed a complete response (full retraction of the foreskin) to the therapy.The total efficiency rate of the 4 stage phimosis group is higher than the 5 grade phimosis group.Patients who had a history of balanoposthitis or urinary tract infection showed poorer improvement in preputial retraction.A total of 28 out of 240 patients (11.7％) in the control group showed a complete response to the therapy.The total efficiency rate of the observation group was significantly higher than the control group (x2 =173.121,P ＜ 0.01).There were 4 cases of discomfort in the observation group and 6 cases of foreskin injured in the control group.Conclusions Topical application of 0.1％ mometasone furoate cream in the treatment of severe phimosis in children is an effective,safe and simple non-invasive treatment with less adverse reactions.
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Objective To evaluate the efficiency and safety of corticosteroid therapy for IgA nephropathy.Methods Pubmed,Medline/embase,and Te Cochrane Library databases were searched for randomized controlled trials (RCTs) of hormone therapy for IgA nephropathy from database establishment to September 2017.According to the Cochrane system evaluation method,two reviewers independently screened the literature,extracted data,evaluated the quality of the included studies and cross-checked them according to inclusion and exclusion criteria.The Cochrane bias risk method was used to evaluate the quality of the included studies.The fixed effect model was used to assess the risk of serum creatinine change and progression to end-stage renal disease (ESRD).The random-effect models were used to assess 24-hour urinary protein quantification and the incidence of adverse events leading to drug withdrawal or hospitalization.The data were pooled using RevMan 5.3 software.The quadratic variables were odds ratio (OR) and the continuous variables were mean difference (MD).The odds ratio was used as the effect variable for the two variables,and the mean variance was used as the effect variable for the continuous variable data.Results A total of 9 RCTs were enrolled.Meta-analysis showed that compared with the control group,the steroid treatment group could slow down the increase of serum creatinine by more than 50％ in IgA nephropathy patients (OR =0.15,95％ CI:0.04-0.53,P =0.003) and delay the progression to ESRD (OR =0.38,95％ CI:0.16-0.87,P =0.02),but there was no significant difference in the level of serum creatinine (MD =-0.03,95％ CI:-0.29-0.24,P =0.85),the 24 hour urinary protein quantification (MD =-0.55,95％ CI:-1.42-0.31,P =0.21),and the incidence of adverse reactions (OR =1.68,95％ CI:0.69-4.11,P =0.26).Conclusions The meta analysis showed that there was no significant difference in the safety of steroid treated IgA nephropathy compared with the control group,and may be beneficial to the long-term prognosis of patients with IgA nephropathy.
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Objective To investigate the expressions of heat shock protein(HSP)90α and HSP90β in peripheral blood mononuclear cells (PBMC) in myasthenia gravis (MG) children before and after glucocorticoid (GC) treatment,and normal control groups.Methods Fresh bloods were collected from 20 cases of children with MG before and after treatment and 19 healthy children.PBMCs were isolated,followed by measurement of the expression levels of HSP90α and β by immunocytochemistry,and HSP90α and β mRNAs by reverse transcription and polymerase chain reaction (RT-PCR).Results The positive cell ratio of HSP90α andβ of MG children before and after of GC treatment was significantly higher than control groups (P ＜ 0.05),and their mRNA expression levels was higher than control groups (P ＜ 0.05).HSP90β in MG children after GC treatment was mainly expressed in the nucleus(P ＜ 0.05).Conclusions HSP90α and β in PBMC of MG children before and after GC treatment were significantly higher than those of normal control groups.HSP90β in MG Children after GC treatment was significantly increased.The present results suggest HSP90β promote GC receptor binding and enhance GC transportation,which promotes and strengthens the physiological and pharmacological effects of GC to improve the clinical symptom of MG children.