Objective To explore the value and clinical safety of low-dose dexamethasone used after operation of anastomotic colorectal resection with fast-track surgery in patients with colorectal cancer. Methods Between January 2008 and December 2009, 470 patients undergoing anastomotic colorectal resection were analyzed retrospectively, who were divided into dexamethasone group and control group according to the use of low-dose dexamethasone treatment or not after operation. Postoperative adverse effect, complications, and early rehabilitations were studied. Results There was no statistical significance in postoperative incidence of adverse effect or complications between two groups (Pgt;0.05). In early rehabilitation, first ambulation of patients in the dexamethasone group was significantly earlier than that in the control group (Plt;0.05), while there was no statistical significance in first time of passing flatus, stool, and oral intake, the retain time of nasogastric tubes, urinary catheter, and drains, and postoperative hospital stay (Pgt;0.05). Conclusion Using low-dose dexamethasone after operation anastomotic colorectal resection in patients with colorectal cancer is safe and may have potential to enhance recovery after operation.
OBJECTIVE: To investigate the effects of dexamethasone on the proliferation and differentiation of bone marrow stromal cells(MSC). METHODS: MSC were isolated and cultured in vitro. After treatment with different concentrations of dexamethasone (0, 10-10, 10-9, 10-8, 10-7 and 10-6 mol/L), the proliferation and alkaline phosphatase (ALP) activity of MSC were measured to evaluate the effect of dexamethasone on the biological characteristics of MSC. RESULTS: Dexamethasone inhibited cell proliferation. With the increase of concentration of dexamethasone, the effect was enhanced, which was more significant when the concentration of dexamethasone was over 10-8 mol/L. At the same time, dexamethasone promoted the activity of ALP. This effect was enhanced with the increase of concentration of dexamethasone, but the alteration was small when the concentration of dexamethasone was over 10-8 mol/L. The effects increased with the time. The activity of ALP was enhanced 2 to 4 times with the dexamethasone for 6 days. CONCLUSION: Dexamethasone inhabit the proliferation of MSC, while induce them to differentiate into osteoblasts. The appropriate concentration of dexamethasone was 10-8 mol/L.
ObjectiveTo systematically review the effect of dexamethasone in preventing post-operative nausea and vomiting (PONV) associated with epidural opioids for post-cesarean section analgesia. MethodsWe searched PubMed, EMbase, CNKI, WanFang Data and CBM databases from inception to Dec. 31th 2015, to collect randomized controlled trials (RCTs) comparing dexamethasone with placebo/blank for the prevention of PONV associated with epidural opioids for postcesarean section analgesia. Two reviewer independently screened literature, extracted data, and assess the risk of bias of included studies. Then, meta-analysis was conducted by using RevMan 5.3 software. ResultsA total of 11 RCTs from 10 papers involving 1 011 patients were included. The results of meta-analysis showed that, compared with the placebo/ blank group, the dexamethasone group had lower incidence rates of post-operative nausea (RR=0.50, 95% CI 0.39 to 0.65, P < 0.000 01), postoperative vomiting (RR=0.39, 95% CI 0.29 to 0.52, P < 0.000 01), PONV (RR=0.37, 95% CI 0.30 to 0.46, P < 0.000 01), and rescue antiemetic (RR=0.34, 95% CI 0.19 to 0.62, P=0.000 5). ConclusionsCurrent evidence indicates that dexamethasone is effective for preventing PONV after epidural opioids for post-cesarean section analgesia. Due to the limited quantity and quality of the included studies, the above conclusion needs to be further verified by more high quality studies.
OBJECTIVE:To observe the effect of dexamethasone to intracellular free Ca2+ of frozen RPE cells. METHODS:The cultured human RPE cells were frozen for 30s at --70deg;C. The RPE cells were loaded with Fura-2/AM and analyzed using a digital imaging microscopy system,the effect of dexamethasone to intracellular free Ca2+ was measured at a serial concentration of 40, 60,100,150,200mu;g/ml. RESULTS:The concentration of intracellular free Ca in frozen human RPE cells was increased to 18.6%~29.8% by dexamethasone at concenlration of 40mu;g/ml~60mu;g/ml,while was decreased to 28.4%~35.2% at 150mu;g/ml~200mu;g/ml. CONCLUSIONS:Effect of dexamethasone showed two aspects of effect to frozen cultured human RPE ceils,that it was inhibitor at high concentration and stimulator at low concentration （Chin J Ocul Fundus Dis,1997,13: 86-88）
Purpose To evaluate the prostag landins(PG) levels and to identify the effect of dexamethasone(DXM) on PG in response to photochemical insult in rat retina. Methods The experiments were performed on 36 SD rats which were separated into two groups,control and treated groups,and the latter received daily intraperitoneal injections of DXM (1 mg/kg) for 5 consecutive days,starting 3 days before light exposure.The animals were continually exposed to green fluorescent light(510-560 nm)with an illuminance level of (1900plusmn;106.9)lx for 24 hrs.The retinal concentration of PGE 2 and 6-keto-PGF1alpha; were tested at 6hrs,1,3,7 and 14 days after light exposure. Results The PGE2 and 6-keto-PGF1alpha; levels of the control groups (37.50plusmn;2.75,48.06plusmn;4.0 4,81.90plusmn;4.89) pg/mg and (4.68plusmn;0.69,7.50plusmn;0.57,10.40plusmn;0.71) pg/mg had significantly higher values than those of the treated rats(20.60plusmn;4.28,37.36plusmn; 3.34,54.85plusmn;4.57) pg/mg and (2.50plusmn;0.59,4．68plusmn;0.81,6.87plusmn;1.10)pg/mg (Plt;0.01) after 6 hrs,1 and 3 days light exposure respectively. Conclusion By inhibition of PG synthesis,the DXM may play an ameliorative effect on retinal photochemical injury of rats. (Chin J Ocul Fundus Dis,1999,15:94-96)
ObjectiveTo systematically review the efficacy and safety of dexamethasone in the treatment of viral myocarditis.MethodsThe Cochrane Library, PubMed, EMbase, Biosis Preview, Web of Science, CBM, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on dexamethasone for patients with viral myocarditis from inception to April 30th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software.ResultsA total of 7 RCTs involving 749 patients were included. The results of meta-analysis showed that the dexamethasone treatment group exhibited an increased efficacy rate (RR=1.26, 95%CI 1.18 to 1.34, P<0.000 01), decreased levels of C-reactive protein (CRP) (MD=−11.49, 95%CI −19.25 to −3.72, P=0.004), cardiac troponin I (cTnI) (MD=−26.14, 95%CI −40.82 to −11.47, P=0.0005), and creatine kinase MB (CK-MB) (MD=−20.06, 95%CI −28.35 to −11.77, P<0.000 01), and a decreased adverse event rate (RR=0.40, 95%CI 0.24 to 0.65, P=0.000 3).ConclusionsCurrent evidence shows that dexamethasone can significantly improve the efficacy rate, reduce the levels of CRP, cTnI, and CK-MB, and reduce the incidence of adverse events in patients with viral myocarditis. Due to the limited quantity and quality of included studies, more high-quality studies are required to verify above conclusions.
OBJECTIVE: To study the hemorheology of island flap after ischemia-reperfusion injury and modulation of dexamethasone. METHODS: Sixty Wister rats were made ischemia-reperfusion injury model, and divided into two groups randomly(Group I: intraperitoneal injection of normal saline 2 ml/kg as control group; Group II: intraperitoneal injection of dexamethasone 5 mg/kg as experimental group). Flap survived areas were measured and neutrophil necrosis numbers in flaps were counted. Erythrocytes and neutrophil hemorheology were observed. RESULTS: Area survived flap in group II was larger than that in group I. Neutrophil necrosis numbers were less in group II than in group I (P lt; 0.05). Whole blood hyposhear viscosity, erythrocyte aggregation, Casson yield stress and nerutrophil adhesion ability were higher in group I than in group II (P lt; 0.05); and the neutrophil deformability was lower in group I than in group II. CONCLUSION: Flap inchemia-reperfusion can increase erythrocyte aggregation index and neutrophil adhesion ability. Dexamethasone can improve these and decrease neutrophil necrosis numbers, so as to prevent flap from ischemia-reperfusion injury.
Objective To observe and analyze the risk factors of secondary intraocular hypertension in diabetic macular edema (DME) patients after treatment with dexamethasone vitreous cavity implant (DEX). MethodsA retrospective observational study. A total of 352 patients with type 2 diabetes mellitus (T2DM) secondary macular edema diagnosed by ophthalmic examination and treated with DEX in Department of Ophthalmology of Harbin 242 Hospital from January 2016 to March 2022 were included in the study. Among them, 221 were males and 131 were females, with the mean age of (55.56±8.09) years. There were 194 patients with disseminated macular edema, 158 patients with cystoid macular edema. All patients underwent vitreous cavity implantation of DEX. Intraocular pressure (IOP) was measured once a month for 3 months after treatment, with IOP over than 25 mm Hg (1 mm Hg=0.133 kPa) or higher than 10 mm Hg from baseline as secondary intraocular hypertension. The relevant clinical data were collected, and the risk factors of secondary intraocular hypertension in DME patients after DEX treatment were analyzed by binary logistic regression. ResultsAmong 352 patients, 116 patients (32.95%, 116/352) were in the intraocular hypertension. Among them, 29 patients (25.00%, 29/116), 69 patients (59.48%, 69/116) and 18 patients (15.52%, 18/116) occurred intraocular hypertension at 1, 2 and 3 months after treatment, respectively. Compared with the normal IOP group, the IOP in the intraocular hypertension group increased significantly at 1, 2 and 3 months after treatment, with statistical significance (t=10.771, 21.116, 13.761; P＜0.001). Compared with normal IOP group, the patients in the intraocular hypertension group had younger age (t=6.967), longer duration of diabetes (t=5.950), longer axial length (AL) (t=14.989), higher proportion of DME grade 3 (Z=6.284), higher proportion of DEX implantation in pars plana (χ2=23.275), and higher HbA1c level (t=10.764), the differences were statistically significant (P＜0.05). Logistic regression analysis showed that longer AL [odds ratio (OR)=1.428, 95% confidence interval (CI) 1.054-1.934], DEX implantation in pars plana (OR=1.358, 95%CI 1.063-1.735), and higher HbA1c (OR=1.702, 95%CI 1.225-2.366) were the risk factors for secondary intraocular hypertension in DME patients after DEX treatment (P＜0.05), older age was a protective factor (OR=0.548, 95%CI 0.380-0.789, P＜0.05). ConclusionsLong AL, DEX implantation in pars plana and high HbA1c are the risk factors for secondary intraocular hypertension after DEX treatment in DME patients, older age is a protective factor.
ObjectiveTo systematically review the effect of pre-treating the catheters with dexamethasone for preventing PICC-associated phlebitis. MethodsWe electronically searched PubMed, EMbase, The Cochrane Library (Issue 4, 2012), CNKI, CBM, WanFang Data and CQVIP for studies about pre-treating the catheters with dexamethasone to prevent PICC-associated phlebitis from inception to March 2013. Relevant studies including grey literature were also manually searched. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed using the software RevMan 5.0. ResultsA total of 13 studies involving 1 965 cases (1 025 cases in the dexamethasone group, and 940 cases in the control group) were included. The results of meta-analysis showed that pre-treating the catheters with dexamethasone could significantly decrease the incidence of PICC-associated phlebitis (RR=0.29, 95%CI=0.22 to 0.39, P < 0.000 1). However, no significant difference was found for the PICC-associated other complications, such as pipe blockage, bleeding, swelling of puncture site, allergy and atopic catheter. ConclusionPre-treating the catheters with dexamethasone soltion before inserting could reduce the incidence of PICC-associated phlebitis. The aforementioned conclusion needs to be further validated by more high-quality and large-scale randomized controlled trials.