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Objective To evaluate the effect of methylprednisolone sodium succinate combined with tropisetron on postoperative nausea and vomiting(PONV)under microvascular decompression of hemifacial spasm.Methods From January to June 2019,485 patients undergoing microvascular decompression for facial spasm at Department of Neurosurgery,Peking University People's Hospital were randomly assigned into two groups with random number table method.For group A(n=242),2 ml saline was administrated by intravenous drip before induction and 5 mg tropisetron after operation.For group B(n=243),40 mg methylprednisolone sodium succinate was administrated by intravenous drip before induction and 5 mg tropisetron after operation.The anesthesia time,operation time,and incidence of PONV in 0-24 h and 24-48 h were recorded for the comparison of the remedial treatment rate of nausea and vomiting between the two groups.Results There was no significant difference in age,gender,smoking history,body mass index value,American Society of Anesthesiologists score,medical history,surgical side,PONV history,operation time or anesthesia time between the two groups(all P > 0.05).The incidence of PONV in group A was 35.5% and 18.2% during 0-24 h and 24-48 h,respectively,which was significantly higher than that(18.5%,χ
Subject(s)
Humans , Antiemetics , Double-Blind Method , Hemifacial Spasm/surgery , Indoles , Methylprednisolone Hemisuccinate/therapeutic use , Microvascular Decompression Surgery , TropisetronABSTRACT
Objective:To observe the effect of Tongluo Shenggu capsule （TLSGC） on glucocorticoid-induced vascular endothelial cell functional damage， and to preliminally explore the mechanism of action through MEK-ERK signaling pathway. Method:The blood vessel of aorta rings of normal SD rats were induced <italic>in vitro</italic> intervention with methylprednisolone sodium succinate （MPS， 0.04 g·L<sup>-1</sup>） and/or vascular endothelial growth factor （VEGF， 20 μg·L<sup>-1</sup>）， and were treated with TLSGC（12.5， 25， 50 μg·L<sup>-1</sup>） continuously for 5 days to observe the number， length and area of microvascular ring buds．In addition， human umbilical vein endothelial cells （HUVEC） induced by VEGF（20 μg·L<sup>-1</sup>） were added into MPS（0.04 g·L<sup>-1</sup>） and TLSGC （12.5， 25， 50 μg·L<sup>-1</sup>） were added. Then， Transwell migration， Transwell invasion and lumen formation experiments were used to detect the migration， invasion and lumen formation ability of HUVEC， respectively. The content of nitric oxide（NO） in the cell supernatant was detected by nitrate reductase method， the content of endothelin 1（ET-1） in the cell supernatant was detected by dry powder method. Moreover， the protein contents of vascular endothelial growth factor receptor 2 （VEGFR2）， extracellular signal-regulated kinase （ERK）， phospho-extracellular signal-regulated kinase （p-ERK）， mitogen extracellular kinase1（MEK） and phosphorylated mitogen extracellular kinase1（p-MEK） in the cells were determined by Western blot. Result:Compared with the normal group， MPS could significantly inhibit the number， length and area of VEGF-induced rat thoracic aortic ring microvessels， HUVEC cell migration， invasion and lumen formation ability. It could reduce NO content and increase ET-1 content. MPS could also significantly reduce the protein content of VEGF-induced VEGFR2， p-MEK and p-ERK in HUVEC（<italic>P</italic><0.05，<italic>P</italic><0.01）. Compared with the model group， TLSGC could dose-dependently increase the number， length and area of MPS-induced abnormally reduced rat thoracic aortic ring microvessels， promote MPS-induced abnormally decreased HUVEC cell migration， invasion and lumen formation ability. It could increase the protein contents of NO， VEGFR2， p-MEK and p-ERK in HUVEC， and reduce abnormally increased ET-1 content（<italic>P</italic><0.05<italic>，P</italic><0.01）. Conclusion:TLSGC has a protective effect on the damage of angiogenesis and secretion of vascular endothelial cells induced by glucocorticoid， and the mechanism may be related to the activation of MEK/ERK signaling pathway.
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Objective:To retrospectively analyze the effect of hormone combined with cerebral glycoside carnosine and dehydration drugs in traumatic optic neuropathy (TON) patients.Methods:The enrolled 215 TON patients in our hospital from February 2014 to September 2021 were randomly divided into the combination group ( n=143) and routine group ( n=142). The baseline data, visual acuity recovery before and after treatment and adverse reactions of each group were compared. Univariate analysis was conducted to analyze the differences in indicators of good prognosis and visual acuity improvement between the two groups. Results:The effective rate of vision recovery in the combination group was significantly increased than that in the routine group ( P<0.05). After treatment, the intraocular pressure and visual field defect in the combination group were significantly decreased than those in the routine group ( P<0.05). Univariate subgroup analysis showed that there were statistically significant differences between TON patients with age ≤40 years, residual light sensation after injury, visit time ≤24 h, and VEP not extinguished with combined treatment of hormone, brain glycoside carnotin and dehydrating drugs and the routine group ( P<0.05). Univariate subgroup analysis showed that TON patients with optic canal fracture without optic nerve swelling and tortuosity had a good prognosis after treatment with combined hormone, cerebral glucoside carnosine and dehydration, which was statistically different from that in the routine group ( P<0.05). Conclusions:Brain glycosides carnosine and dehydration therapy on the basis of combined hormone a prednisolone sodium succinate treatment can improve vision in TON patients, lighten the optic nerve injury, will not increase the occurrence risk of adverse reactions, and have higher security. It is necessary to focus on high-risk patient over 40 years old, more than 24 h of treatment time, VEP extinction, optic nerve swelling poor efficacy. It is worthy of clinical promotion.
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Objective@#To investigate the effect of methylprednisolone sodium succinate combined with azithromycin in the treatment of severe mycoplasma pneumonia.@*Methods@#From December 2015 to October 2017, a total of 85 children with severe mycoplasma pneumonia in the General Hospital of Gujiao Mining Area were divided into two groups according to the random number table method, 42 cases in the control group were treated with azithromycin, and 43 cases in the observation group were treated with azithromycin+ methylprednisolone sodium succinate.The clinical efficacy, disappearing time of symptoms and signs(fever, cough, pulmonary rales) and the level of serum C reactive protein(CRP) were compared between the two groups.The changes of serum levels of immunoglobulin M(IgM), IgA and IgG in two groups before and after treatment were also statistically analyzed.@*Results@#The total effective rate of the observation group was 93.02%(40/43), which was higher than that of the control group [76.19%(32/42)] (χ2=4.647, P=0.031). The disappearing time of fever, cough and pulmonary rales in the observation group were shorter than those in the control group(t1=4.787, P1=0.000, t2=5.746, P2=0.000, t3=6.418, P3=0.000). After treatment, the serum level of CRP in the observation group was lower than that in the control group(t=16.797, P=0.000). After treatment, the serum levels of IgM, IgA and IgG in the observation group were higher than those in the control group(t1=7.593, P1=0.000, t2=3.583, P2=0.001, t3=10.277, P3=0.000).@*Conclusion@#Methylprednisolone sodium succinate combined with azithromycin can reduce the inflammatory reaction of children with severe mycoplasma pneumoniae, regulate their immunity and promote the recovery of symptoms and signs.Besides, its efficacy is obvious.
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AIM: To determine the pharmacokinetics and distrubution of methylprednisolone sodium succinate ( MPS ) and its metabolic product methylprednisolone ( MP ) in eye tissues and blood plasma after MPS periocular injection in rabbits.?METHODS:After periocular injection of MPS 10mg, the concentrations for MP and its prodrug conmpound were quantified at different time points using mass spectrum-liquid chromatography in plasma and ocular tissues -slera, choroid and retina, vitreous, iris, aqueous humor, lens and optic nerve.? RESULTS: After periocular injection, the time of maximum concentration ( Tmax ) for MPS in ocular tissues was 0. 25 to 1h, in blood plasma was 0. 25h. Tmax for its metablite MP in ocular tissues was 0. 5 to 6h, in blood plasma was 0. 5h. The maximum MPS and MP concentration ( Cmax ) and the area under the curve ( AUC0-t ) in ocular tissues from high to low in turn was sclera, optic nerve, the choroid and the retina, iris and lens. The drug concentration of lens was not only the lowest among all tissues, but also much lower than others by far the content, and its mean residence time was the longest.?CONCLUSION: Periocular administration of MPS is an effective way to intraocular drug transmission. It achieves a satisfactory drug distribution in sclera, optic nerve,choroid and retina. It is not easily absorbed by lens.
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Objective To investigate the efficacy and safety of different schemes of methylprednisolone sodium succinate in the treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A hundred patients with AECOPD were selected and divided into the control group and the observation group by random number table ,with 50 cases in each group .The control group received intravenous injec-tion of methylprednisolone sodium succinate ,40mg/d,the treatment course was 15d.The observation group received intravenous injection of methylprednisolone sodium succinate ,40 mg/d,the treatment course was 5d.The lung function indicators(RV/TLC,FEV1),blood gas indicators (PaCO2,PaO2,PaO2/FiO2),quality of life index(QLI) score and incidence of adverse reactions were detected and compared between the two groups before and after treatment .Results Compared with before treatment,the RV/TLC of the observation group[(44.2 ±7.4)% vs.(56.7 ±11.1)%]and control group[(43.2 ±7.1)%vs.(55.2 ±10.2)%]after treatment decreased significantly ,the FEV1 of the observa-tion group and control group [(69.7 ±8.7)L vs.(52.4 ±11.6)L,(67.2 ±8.1)L vs.(54.8 ±11.5)L]significantly increased,the differences were statistically significant (t=3.656,3.985,3.364,3.875,all P<0.05),but the differ-ences between the two groups were not statistically significant (t=2.869,1.969,all P>0.05).Compared with before treatment,the PaCO2 of the observation group and control group [(35.7 ±4.5) mmHg vs.(49.6 ±5.2) mmHg,(36.2 ±5.4) mmHg vs.(48.6 ±5.2) mmHg] decreased significantly,and the PaO2 [(84.9 ±13.2) mmHg vs .(50.2 ±4.6)mmHg,(81.1 ±12.3)mmHg vs.(49.6 ±4.9)mmHg]and PaO2/FiO2[(222.5 ±30.7)mmHg vs .(119.3 ±14.6)mmHg,(217.4 ±25.6)mmHg vs.(117.2 ±15.5)mmHg]increased significantly,the differences were statistically significant (t =4.656,3.876,4.985,4.364,3.989,4.875,all P <0.05),but the differences between the two groups were not statistically significant (t=2.526,1.234,1.986,all P>0.05).After treatment,the improvement degree of QLI in the observation group was significantly better than that in the control group [(8.7 ± 2.2)points vs.(7.1 ±1.9)points],the difference was statistically significant (t=4.675,P<0.05).In the observa-tion group,there were 1 case of gastrointestinal discomfort ,2 cases of elevated blood sugar ,and in the control group , there were 4 cases of gastrointestinal discomfort ,2 cases of elevated blood sugar , and 2 cases of hypokalemia .The incidence rate of adverse reactions in the observation group was significantly lower than that in the control group (6.0%vs.20.0%),the difference was statistically significant (χ2 =4.332,P<0.05).Conclusion The short -term methylprednisolone in the treatment of elderly patients with AECOPD has similar effect with conventional dose , but it has minor adverse reactions ,and can improve the quality of life of patients .
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Objective To evaluate the effect of recombinant human erythropoietin (rhEPO) combined with methylprednisolone sodium succinate (MPSS),compared to MPSS alone,in the treatment of neurological function of patients with acute spinal cord injury (SCI).Methods Twenty-one patients presenting in hospital within less than 8 hours after acute SCI were randomly divided into two groups,the control group (10 cases) and the intervention group (11 cases).The control group was treated by MPSS combined with placebo,while the intervention group received MPSS with rhEPO.Both groups received MPSS 30 mg/kg within the first hour,and if the patient was admitted within 4 hours,MPSS would be applied in the treatment with 5.4 mg/kg per hour in the subsequent 23 hours and till 47 hours if the patient was admitted within 4-8 hours after injury.The intervention group received 500 U/kg rhEPO on admission and another 500 U/kg in the next 24 hours,compared with the control group where placebo was used.The evaluation on neurologic function recovery was made on admission,24 h,72 h,one week,2 months and 6 months later,and statistical analysis was performed.Results The change in ASIA score: in the control group,the increase was seen from admission to 6 months after injury in terms of exercise,algesia and tactile sensation ((31.2±6.6) points vs.(57.8±9.8) points,(41.4±9.5) points vs.(64.3±10.6) points, (39.2±6.8) points vs,(61.5±11.3) points),the increase also took place in the intervention group ((29.5±7.2) points vs.(77.4±10.3) points,(39.7±7.2) points vs.(82.3±12.1) points,(37.4±6.2) points vs.(78.6±12.4) points).As time went on,the increase range in the intervention group became larger,compared with the control group.The difference between the two groups in ASLA score was statistically significant (P0.05).Conclusion The application of MPSS combined with rhEPO within 8 hours after acute spinal injury may be more effective than MPSS with placebo in the neurologic dysfunction recovery.
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OBJECTIVE:To discuss the effects of cyclosporine combined with methylprednisolone sodium succinate pulse thera-py on pulmonary fibrosis in patients with acute paraquat poisoning. METHODS:By retrospective study method,39 cases of acute paraquat poisoning were divided into observation group(21 cases)and control group(18 cases)according to therapy plan. Control group received blocking the absorption of poison,promoting the discharge of poison’supportive and symptomatic treatment;obser-vation group was additionally given Methylprednisolone sodium succinate for injection 1 000 mg,ivgtt,qd+Cyclosporin injection 5 mg/kg,ivgtt,qd,pulse therapy;the dose of dethylprednisolone sodium succinate decreased gradually since forth day and it had been stopped after 7 days. The serum levels of hyaluronic acid(HA),laminin(LN),Ⅳ collagen(CⅣ),Ⅲ procollagen(PCⅢ), matrix metalloproteinase(MMP)9 and serum matrix metalloproteinase inhibitors(TIMP)1, lung HRCT score were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:HA and PCⅢ of observation group on 3rd and 5th day of treatment were significantly lower than those of control group,and HA,CⅣ and PCⅢ on 7th and 14th day of treatment were significantly lower than those of control group,levels of MMP-9 in observation group on 3rd,5th,7th day of treatment were significantly low-er than those of control group,with statistical significance (P<0.05). Levels of TIMP-1 and HRCT score in 2 groups increased gradually 2 weeks after treatment,and that of observation group was significantly lower than that of control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Cyclosporin combined with methylprednisolone sodium succinate pulse therapy can significantly relieve pulmonary fibrosis in patients with acute paraquat poi-soning with good safety.
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OBJECTIVE: To establish a method of GC-Second Order Temperature Programming for determining the residual quantities of 4 organic solvents-methanol, acetonitrile, pyridine and dimethylformamide-in Methylprednisolone Sodium Succinate. METHODS: The separation was performed on DB-5 capillary column, with flame ion monitor as detector, and with high pure nitrogen, air and hydrogen as carrier gas. The column temperature was subjected to GC-Second Order Temperature Programming, with the temperature of sample injector at 200℃ and that of detector at 220℃. The make-up gas was high pure nitrogen. The split ratio was 10∶1. The sample size was 2?L and the butanone was taken as the internal standard. RESULTS: The four kinds of solvents were linear within their respective concentration range. The average recoveries of methanol, acetonitrile, pyridine and dimethylformamide were 99.4%, 99.2%, 99.3% and 99.0%, respectively, with RSD at 1.8%, 1.8%, 2.0% and 1.7%, respectively. CONCLUSION: The method was proved to be sensitive, accurate and simple.