Treatment of low frequency decreased sensorineural hearing loss by postaural injection of Methylprednisolone / 中国耳鼻咽喉头颈外科

OBJECTIVE To analyze the effect of postaural injection in treating SNHL and the influence on ROS,sVCAM-1 levels.METHODS 242 low frequency descent sensorineural hearing loss patients from Jan.2010 to Jul.2016 in our hospital were selected as the research sbjects.They were randomly divided into two groups(n=121).All patients were treated with ginkgo biloba extract intravenous drip.The control group was treated with Methylprednisolone intravenous drip,while the observation group was treated with postaural injection of Methylprednisolone.The clinical effects between the two groups were compared after 14 days of treatment.The ABR result,serum ROS,sVCAM-1 levels were also copmpared before and after treatment.RESULTS The effective rates of 2 groups were 82.64％,61.16％ respectively,which indicated significant difference (P＜0.05).The Ⅰ and Ⅴ waves of observation group were decreased,and they was significantly lower than that of the control group(P＜0.05),the R-R interval between Ⅰ and Ⅴ waves of the 2 groups showed no significant difference (P＞0.05).After treatment,the serum ROS level of 2 groups were (0.66 ± 0.38) ng/ml,(2.31± 1.12) ng/ml respectively,the sVCAM-1 level of two groups were (230.5 ±26.4) ng/ml,(312.6 ±47.2) ng/ml respectively,the observation group was significantly lower than that of the control group (t=10.985,11.953,P＜0.05).CONCLUSION Methylprednisolone can improve the clinical effect in treating low frequency descent SNHLby improving the concentration of drugs in ear and increasing the activity of Na+/K+-ATP enzyme in blood vessel;It can also decrease ROS and sVCAM-1 level,alleviate oxidative stress,reduce vascular endothelial damage,which is worthy of recommendation.

Acute renal failure in a patient with epidermolysis bullosa acquisita

Abstract: Epidermolysis bullosa acquisita is a severe autoimmune subepidermal bullous disease. In this report, we described for the first time a patient with epidermolysis bullosa acquisita who developed acute renal failure. There is a possibility that epidermolysis bullosa acquisita and acute renal failure's pathogenesis shared some common autoimmune pathways. Moreover, acute blood volume reduction may be another cause of prerenal kidney failure. Further studies are needed to verify our hypothesis.

Efetividade da metilprednisolona na fase aguda do trauma raquimedular: revisão sistemática dos ensaios clínicos randomizados / Effectiveness of methylprednisolone in the acute phase of spinal cord injuries: a systematic review of randomized controlled trials

A corticoterapia tem sido testada como protetor neuronal no trauma. Os estudos multicêntricos avaliando a metilprednisolona (MP) na recuperação neurológica após trauma revelaram-se promissores (NASCIS). Porém, várias, críticas às suas metodologias foram publicadas. OBJETIVO: Revisar a literatura relacionada ao uso da metilprednisolona comparada com placebo. MÉTODOS: A análise feita somou a média da melhora obtida nos grupos de pacientes que usaram MP e placebo (PL) à média dos escores dos grupos na linha de base, antes de tratamento, obtendo-se o resultado neurológico final de ambos os grupos. RESULTADOS: O escore motor do grupo MP foi apenas 2,5 pontos maior que o PL em um ano de seguimento. O escore motor em indivíduos intactos é de 70 pontos. A melhora nos escores sensitivos foi igualmente discreta (1,1 e 1,7 pontos para sensibilidade a picadas e tato respectivamente). A taxa de complicações observada em grupo de pacientes em torno de 60 anos foi alta com o uso de MP. CONCLUSÃO: As diferenças na magnitude do benefício clínico obtido (não confirmado por outros estudos) com o uso da MP e com o PL não são significativas em confronto com o potencial de complicações do uso da medicação.

Steroid therapy has been tested as a protector in spinal cord injury. Multicenter studies evaluating the methylprednisolone (MP) in post traumatic neurological recovery have shown promising results according to NASCIS. A large number of critical studies related to the NASCIS results have been published. OBJECTIVE: To review literature related to use of methylprednisolone compared with placebo. METHODS: This analysis added the average improvement achieved in groups of patients who used MP and placebo (PL) to the average scores of groups at baseline, before treatment, resulting in the final neurological outcome for both groups. RESULTS: The motor score of the MP group was only 2.5 points higher than the PL in a one year follow-up. In neurologically intact patients, the total score is 70 points. Improvement in sensitive scores was also discrete (1.1 and 1.7 points for the pinprick and light touch respectively). A high rate of complications was observed in a group of patients about 60 years old who used MP. CONCLUSION: Differences in the clinical magnitude of benefit obtained (not confirmed by other studies) with the use of MP or PL are not significant, in comparison with the potential for complications when using methylprednisolone.