Therapeutic efficacy of methylprednisolone sodium succinate via diverse administration routes for mid- to high-frequency sudden sensorineural hearing loss.

BACKGROUND: Sudden sensorineural hearing loss (SSNHL), characterized by a rapid and unexplained loss of hearing, particularly at moderate to high frequencies, presents a significant clinical challenge. The therapeutic use of methylprednisolone sodium succinate (MPSS) via different administration routes, in combination with conventional medications, remains a topic of interest. AIM: To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid- to high-frequency SSNHL. METHODS: The medical records of 109 patients with mid- to high-frequency SSNHL were analyzed. The patients were divided into three groups based on the route of administration: Group A [intratympanic (IT) injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection], Group B (intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection), and Group C (single IT injection of MPSS). The intervention effects were compared and analyzed. RESULTS: The posttreatment auditory thresholds in Group A (21.23 ± 3 .34) were significantly lower than those in Groups B (28.52 ± 3.36) and C (30.23 ± 4.21; P < 0.05). Group A also exhibited a significantly greater speech recognition rate (92.23 ± 5.34) than Groups B and C. The disappearance time of tinnitus, time to hearing recovery, and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C (P < 0.05). The total effective rate in Group A (97.56%) was significantly greater than that in Groups B and C (77.14% and 78.79%, χ 2 = 7.898, P = 0.019). Moreover, the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B (4.88%, 3.03% vs 2.57%, χ 2 = 11.443, P = 0.003), and the recurrence rate in Group A was significantly lower than that in Groups B and C (2.44% vs 20.00% vs 21.21%, χ 2 = 7.120, P = 0.028). CONCLUSION: IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS. This approach effectively improves patients' hearing and reduces the risk of disease recurrence.

Epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China: a hospital-based retrospective study.

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death. China has the largest population of patients with traumatic spinal cord injury. Previous studies of traumatic spinal cord injury in China have mostly been regional in scope; national-level studies have been rare. To the best of our knowledge, no national-level study of treatment status and economic burden has been performed. This retrospective study aimed to examine the epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China at the national level. We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China. Patient epidemiological and clinical features, treatment status, and total and daily costs were recorded. Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program. The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall (annual percentage change, -0.5% and 2.1%, respectively). A total of 10,053 (74.7%) patients underwent surgery. Only 2.8% of patients who underwent surgery did so within 24 hours of injury. A total of 2005 (14.9%) patients were treated with high-dose (≥ 500 mg) methylprednisolone sodium succinate/methylprednisolone (MPSS/MP); 615 (4.6%) received it within 8 hours. The total cost for acute traumatic spinal cord injury decreased over the study period (-4.7%), while daily cost did not significantly change (1.0% increase). Our findings indicate that public health initiatives should aim at improving hospitals' ability to complete early surgery within 24 hours, which is associated with improved sensorimotor recovery, increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.

Influence of ganglioside combined with methylprednisolone sodium succinate on efficacy and neurological function in patients with acute myelitis.

BACKGROUND: Acute myelitis (AM) can lead to sudden sensory, motor and autonomic nervous dysfunction, which negatively affects their daily activities and quality of life, so it is necessary to explore optimization from a therapeutic perspective to curb the progression of the disease. AIM: To investigate the effect of ganglioside (GM) combined with methylprednisolone sodium succinate (MPSS) on the curative effect and neurological function of patients with AM. METHODS: First, we selected 108 AM patients visited between September 2019 and September 2022 and grouped them based on treatment modality, with 52 patients receiving gamma globulin (GG) + MPSS and 56 patients receiving GM + MPSS, assigned to the control group (Con) and observation group (Obs), respectively. The therapeutic effect, neurological function (sensory and motor function scores), adverse events (AEs), recovery (time to sphincter function recovery, time to limb muscle strength recovery above grade 2, and time to ambulation), inflammatory factors (IFs) [interleukin (IL)-6, C-reactive protein (CRP), and tumor necrosis factor (TNF)-α] and other data of the two groups were collected for evaluation and comparison. RESULTS: The Obs had: (1) A significantly higher response rate of treatment than the Con; (2) Higher scores of sensory and motor functions after treatment that were higher than the baseline (before treatment) and higher than the Con levels; (3) Lower incidence rates of skin rash, gastrointestinal discomfort, dyslipidemia, osteoporosis and other AEs; (4) Faster posttreatment recovery of sphincter function, limb muscle strength and ambulation; and (5) Markedly lower posttreatment IL-6, CRP and TNF-α levels than the baseline and the Con levels. CONCLUSION: From the above, it can be seen that GM + MPSS is highly effective in treating AM, with a favorable safety profile comparable to that of GG + MPSS. It can significantly improve patients' neurological function, speed up their recovery and inhibit serum IFs.

Microneedle/CD-MOF-mediated transdural controlled release of methylprednisolone sodium succinate after spinal cord injury.

A new method of transdural delivering drugs to the spinal cord has been developed, involving the use of microneedles (MNs) and a ß-cyclodextrin metal-organic framework (CD-MOF). This epidural microneedle array, dubbed MNs@CD-MOF@MPSS, can be utilized to deliver methylprednisolone sodium succinate (MPSS) to the site of spinal cord injury (SCI) in a controlled manner. MNs allows to generate micropores in the dura for direct drug delivery to the spinal cord, overcoming tissue barriers and targeting damaged regions. Additionally, the CD-MOF provides a secondary extended release after separating from the MNs. In in vitro study, inward MNs increased cellular absorption of MPSS and then reduced LPS-induced M1 polarization of microglia. And animal studies have shown that this method of drug delivery results in improved BMS scores and a reduction in M1 phenotype microphage and glial scar formation. Furthermore, the downregulation of the NLRP3-positive inflammasome and related pro-inflammatory cytokines was observed. In conclusion, this new drug platform has potential for clinical application in spinal cord diseases and is a valuable composite for minimally transdural controlled drug delivery. STATEMENT OF SIGNIFICANCE: This research presents a new epidural microneedle patch made up of microneedles (MNs) and a ß-cyclodextrin metal-organic framework (CD-MOF). The epidural microneedle patch boasts high drug loading capacity, the ability to penetrate the dura, and controlled release. When loaded with methylprednisolone sodium succinate (MPSS), it effectively reduces inflammation and improves neurological function after spinal cord injury. Therefore, it is a novel and promising drug platform for the treatment of spinal cord diseases in a clinical setting.

Selective Calpain Inhibition Improves Functional and Histopathological Outcomes in a Canine Spinal Cord Injury Model.

Calpain activation has been implicated in various pathologies, including neurodegeneration. Thus, calpain inhibition could effectively prevent spinal cord injury (SCI) associated with neurodegeneration. In the current study, a dog SCI model was used to evaluate the therapeutic potential of a selective calpain inhibitor (PD150606) in combination with methylprednisolone sodium succinate (MPSS) as an anti-inflammatory drug. SCI was experimentally induced in sixteen mongrel dogs through an epidural balloon compression technique. The dogs were allocated randomly into four groups: control, MPSS, PD150606, and MPSS+PD150606. Clinical evaluation, serum biochemical, somatosensory evoked potentials, histopathological, and immunoblotting analyses were performed to assess treated dogs during the study. The current findings revealed that the combined administration of MPSS+PD150606 demonstrated considerably lower neuronal loss and microglial cell infiltration than the other groups, with a significant improvement in the locomotor score. The increased levels of inflammatory markers (GFAP and CD11) and calcium-binding proteins (Iba1 and S100) were significantly reduced in the combination group and to a lesser extent in MPSS or PD150606 treatment alone. Interestingly, the combined treatment effectively inhibited the calpain-induced cleavage of p35, limited cdk5 activation, and inhibited tau phosphorylation. These results suggest that early MPSS+PD150606 therapy after acute SCI may prevent subsequent neurodegeneration via calpain inhibition.

Ultrasound-Triggerable Coatings for Foley Catheter Balloons for Local Release of Anti-Inflammatory Drugs during Bladder Neck Dilation.

Bladder neck contracture (BNC) is a complication of the surgical treatment of benign and malignant prostate conditions and is associated with the partial or complete blockage of urination. Correction of this condition usually requires repeated surgical intervention, which does not guarantee recovery. Balloon dilation is a minimally invasive alternative to the surgical dissection of tissues; however, it significantly reduces the patient's quality of life. Additional local anti-inflammatory treatment may reduce the number of procedures requested and increase the attractiveness of this therapeutic strategy. Here, we report about an ultrathin biocompatible coating based on polylactic acid for Foley catheter balloons that can provide localized release of Prednol-L in the range of 56-99 µg in the BNC zone under conventional diagnostic ultrasound exposure. Note that the exposure of a transrectal probe with a conventional gray-scale ultrasound regimen with and without shear wave elastography (SWE) was comparably effective for Prednol-L release from the coating surface of a Foley catheter balloon. This strategy does not require additional manipulations by clinicians. The trigger for the drug release is the ultrasound exposure, which is applied for visualization of the balloon's location during the dilation process. In vivo experiments demonstrated the absence of negative effects of the usage of a coated Foley catheter for balloon dilation of the bladder neck and urethra.

RBC-hitchhiking chitosan nanoparticles loading methylprednisolone for lung-targeting delivery.

Hyper-inflammation associated with cytokine storm syndrome causes high mortality in patients with COVID-19. Glucocorticoids, such as methylprednisolone sodium succinate (MPSS), effectively inhibit this inflammatory response. However, frequent and chronic administration of glucocorticoids at high doses leads to hormone dependence and serious side effects. The aim of the present study was to combine nanoparticles with erythrocytes for the targeted delivery of MPSS to the lungs. Chitosan nanoparticles loading MPSS (MPSS-CSNPs) were prepared and adsorbed on the surface of red blood cells (RBC-MPSS-CSNPs) by non-covalent interaction. In vivo pharmacokinetic study indicated that RBC-hitchhiking could significantly reduce the plasma concentration of the drug and prolong the circulation time. The mean residence time (MRT) and area under the curve (AUC) of the RBC-MPSS-CSNPs group were significantly higher than those of the MPSS-CSNPs group and the MPSS injection group. Moreover, in vivo imaging and tissue distribution indicated that RBC-hitchhiking facilitated the accumulation of nanoparticles loading fluorescein in the lung, preventing uptake of these nanoparticles by the liver. Furthermore, compared with the MPSS-CSNPs and MPSS treatment groups, treatment with RBC-MPSS-CSNPs considerably inhibited the production of inflammatory cytokines such as TNF-α and IL-6, and consequently attenuated lung injury induced by lipopolysaccharide in rats. Therefore, RBC-hitchhiking is a potentially effective strategy for the delivery of nanoparticles to the lungs for the treatment of acute lung injury and acute respiratory distress syndrome.

Patterned Drug-Eluting Coatings for Tracheal Stents Based on PLA, PLGA, and PCL for the Granulation Formation Reduction: In Vivo Studies.

Expandable metallic stent placement is often the only way to treat airway obstructions. Such treatment with an uncoated stent causes granulation proliferation and subsequent restenosis, resulting in the procedure's adverse complications. Systemic administration of steroids drugs in high dosages slows down granulation tissue overgrowth but leads to long-term side effects. Drug-eluting coatings have been used widely in cardiology for many years to suppress local granulation and reduce the organism's systemic load. Still, so far, there are no available analogs for the trachea. Here, we demonstrate that PLA-, PCL- and PLGA-based films with arrays of microchambers to accommodate therapeutic substances can be used as a drug-eluting coating through securely fixing on the surface of an expandable nitinol stent. PCL and PLA were most resistant to mechanical damage associated with packing in delivery devices and making it possible to keep high-molecular-weight cargo. Low-molecular-weight methylprednisolone sodium succinate is poorly retained in PCL- and PLGA-based microchambers after immersion in deionized water (only 9.5% and 15.7% are left, respectively). In comparison, PLA-based microchambers retain 96.3% after the same procedure. In vivo studies on rabbits have shown that effective granulation tissue suppression is achieved when PLA and PLGA are used for coatings. PLGA-based microchamber coating almost completely degrades in 10 days in the trachea, while PLA-based microchamber films partially preserve their structure. The PCL-based film coating is most stable over time, which probably causes blocking the outflow of fluid from the tracheal mucosa and the aggravation of the inflammatory process against the background of low drug concentration. Combination and variability of polymers in the fabrication of films with microchambers to retain therapeutic compounds are suggested as a novel type of drug-eluting coating.

Postauricular injection of methylprednisolone sodium succinate as a salvage treatment for refractory sudden sensorineural hearing loss.

BACKGROUND: Postauricular steroid administration has been popular for treating sudden sensorineural hearing loss. However, there are few reports on its use in patients with refractory sudden sensorineural hearing loss (RSSNHL). AIMS: The objective of this study was to investigate the therapeutic efficacy of postauricular steroid injection as a salvage treatment for RSSNHL patients. METHODS: This retrospective study enrolled 63 RSSNHL patients between January 2016 and January 2019. Thirty-three patients of them who have been divided into the treatment group received postauricular methylprednisolone sodium succinate injection. The remaining 30 patients who formed the control group did not receive any steroid as a salvage therapy. Improvements in hearing were evaluated between pre-salvage therapy and 3 months follow-up after salvage therapy. RESULTS: The median hearing gain in PTA was 9.88 dB HL (quartile range 7.58, 18.65) in the treatment group and 0.90 dB HL (quartile range 0.00, 4.90) in the control group (P<0.01). According to the criteria of Furuhashi, the total percentage for effective prognosis was 48.48% (16/33) in the treatment group and 10.00% (3/30) in the control group (P<0.01). The time interval from onset to study entry was significantly and independently associated with the prognosis for RSSNHL patients (P< 0.01). CONCLUSIONS: The present findings suggest that postauricular corticosteroid administration as a salvage treatment demonstrated better results than no treatment for RSSNHL patients. The time interval from onset to study entry was mainly the prognostic factor for RSSNHL patients. It is therefore considered that postauricular corticosteroid administration may be used as a salvage therapy for RSSNHL patients.

[Application of Methylprednisolone Sodium Succinate Combined with Tropisetron in Prevention of Nausea and Vomiting under Microvascular Decompression of Hemifacial Spasm].

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 2=7.331,P=0.007;8.2%,χ 2=4.364,P=0.037)in group B.The application rate of antiemetic drugs in group A was 15.2% and 8.7% during 0-24 h and 24-48 h,respectively,which was significantly higher than that(5.3%,χ 2=5.327,P=0.021;2.0%,χ 2=4.432,P=0.035)in group B.Conclusion The combination of methylprednisolone sodium succinate and tropisetron can effectively prevent PONV under microvascular decompression of hemifacial spasm,with the performance superior to single drug treatment.

Application of Methylprednisolone Sodium Succinate Combined with Tropisetron in Prevention of Nausea and Vomiting under Microvascular Decompression of Hemifacial Spasm / 中国医学科学院学报

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

Clinical analysis of hormone combined with cerebral glycoside carnosine and dehydrating drugs in the treatment of traumatic optic nerve injury / 中华急诊医学杂志

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.

Protective Effect of Tongluo Shenggu Capsule on Function Damage of Human Umbilical Vein Endothelial Cells Induced by Glucocorticoid / 中国实验方剂学杂志

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^-1） and/or vascular endothelial growth factor （VEGF， 20 μg·L^-1）， and were treated with TLSGC（12.5， 25， 50 μg·L^-1） 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^-1） were added into MPS（0.04 g·L^-1） and TLSGC （12.5， 25， 50 μg·L^-1） 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.

Effect of methylprednisolone sodium succinate combined with azithromycin in the treatment of severe mycoplasma pneumonia and its influence on the immune function / 中国基层医药

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.

Intermittent injection of Methylprednisolone Sodium Succinate in the treatment of Cervical Spinal Cord injury complicated with incomplete paraplegia.

OBJECTIVE: To evaluate the clinical efficacy and safety of intermittent injection of methylprednisolone sodium succinate in the treatment of cervical spinal cord injury complicated with incomplete paraplegia. METHODS: Seventy-eight patients with cervical spinal cord injury complicated with incomplete paraplegia who were admitted between August 2016 and December 2017 were enrolled and grouped into an observation group and a control group using random number table, 39 in each group. Patients in the control group were given vertebral body decompression and bone grafting and internal fixation according to the severity of spinal cord compression, while patients in the observation group were treated by methylprednisolone sodium succinate in addition to the same treatment as the control group. The clinical efficacy and medicine associated adverse reactions were compared between the two groups. RESULTS: The cure rate of the observation group was significantly higher than that of the control group (46.2% (18/39) vs. 20.5% (8/39)). After the treatment, the Japanese Orthopaedic Association (JOA) score and American Spinal Cord Injury Association (ASIA) score of the two groups after treatment were significantly higher compared to before treatment, and the scores of the observation group were much higher than those of the control group (P<0.05). The incidence of adverse reactions of the observation and control groups was 15.4% and 17.9% respectively, and the difference was not statistically significant (P>0.05). CONCLUSION: Intermittent injection of methylprednisolone sodium succinate has definite efficacy in treating cervical spinal cord injury complicated with incomplete paraplegia, with a low incidence of adverse reactions; hence it is worth promotion.

Subcutaneous granulocyte colony-stimulating factor administration for subacute traumatic spinal cord injuries, report of neurological and functional outcomes: a double-blind randomized controlled clinical trial.

In BriefSpinal cord injury is among the most devastating neurological conditions affecting humans. The authors assessed the therapeutic efficacy of subcutaneous recombinant granulocyte colony-stimulating factor as an adjunct to classic surgical and rehabilitative treatments for subacute traumatic spinal cord injuries. This safe and noninvasive treatment may be helpful for better care and satisfaction of patients with this devastating condition throughout the world.

Time is spine: a review of translational advances in spinal cord injury.

Acute traumatic spinal cord injury (SCI) is a devastating event with far-reaching physical, emotional, and economic consequences for patients, families, and society at large. Timely delivery of specialized care has reduced mortality; however, long-term neurological recovery continues to be limited. In recent years, a number of exciting neuroprotective and regenerative strategies have emerged and have come under active investigation in clinical trials, and several more are coming down the translational pipeline. Among ongoing trials are RISCIS (riluzole), INSPIRE (Neuro-Spinal Scaffold), MASC (minocycline), and SPRING (VX-210). Microstructural MRI techniques have improved our ability to image the injured spinal cord at high resolution. This innovation, combined with serum and cerebrospinal fluid (CSF) analysis, holds the promise of providing a quantitative biomarker readout of spinal cord neural tissue injury, which may improve prognostication and facilitate stratification of patients for enrollment into clinical trials. Given evidence of the effectiveness of early surgical decompression and growing recognition of the concept that "time is spine," infrastructural changes at a systems level are being implemented in many regions around the world to provide a streamlined process for transfer of patients with acute SCI to a specialized unit. With the continued aging of the population, central cord syndrome is soon expected to become the most common form of acute traumatic SCI; characterization of the pathophysiology, natural history, and optimal treatment of these injuries is hence a key public health priority. Collaborative international efforts have led to the development of clinical practice guidelines for traumatic SCI based on robust evaluation of current evidence. The current article provides an in-depth review of progress in SCI, covering the above areas.

Pharmacokinetics of methylprednisolone sodium succinate after periocular injection into rabbits / 国际眼科杂志(Guoji Yanke Zazhi)

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.

Comparison of 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 / 中国基层医药

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 .

Efficacy and Safety of Methylprednisolone Sodium Succinate in Acute Spinal Cord Injury: A Systematic Review.

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: The objective of this study was to conduct a systematic review to assess the comparative effectiveness and safety of high-dose methylprednisolone sodium succinate (MPSS) versus no pharmacological treatment in patients with traumatic spinal cord injury (SCI). METHODS: A systematic search was performed in PubMed and the Cochrane Collaboration Library for literature published between January 1956 and June 17, 2015. Included studies were critically appraised, and Grades of Recommendation Assessment, Development and Evaluation methods were used to determine the overall quality of evidence for primary outcomes. Previous systematic reviews on this topic were collated and evaluated using the Assessment of Multiple Systematic Reviews scoring system. RESULTS: The search yielded 723 citations, 13 of which satisfied inclusion criteria. Among these, 6 were primary research articles and 7 were previous systematic reviews. Based on the included research articles, there was moderate evidence that the 24-hour NASCIS II (National Acute Spinal Cord Injury Studies) MPSS regimen has no impact on long-term neurological recovery when all postinjury time points are considered. However, there is also moderate evidence that subjects receiving the same MPSS regimen within 8 hours of injury achieve an additional 3.2 points (95% confidence interval = 0.10 to 6.33; P = .04) of motor recovery compared with patients receiving placebo or no treatment. CONCLUSION: Although safe to administer, a 24-hour NASCIS II MPSS regimen, when all postinjury time points are considered, has no impact on indices of long-term neurological recovery. When commenced within 8 hours of injury, however, a high-dose 24-hour regimen of MPSS confers a small positive benefit on long-term motor recovery and should be considered a treatment option for patients with SCI.