Sirolimus combined with oseltamivir and corticosteroid treatment for a puerpera with severe pneumonia caused by 2009 pandemic H1N1: A case report.

Severe pneumonia in patients infected with the 2009 pandemic H1N1 (pH1N1) virus was partially attributed to excessive immune response. Anti-virus treatment for these patients was insufficient. Here we reported the therapy effect of sirolimus, an immunosuppressor, combined with oseltamivir and corticosteroid for a puerpera with severe pneumonia caused by pH1N1 virus. This patient has infected with the pH1N1 virus in late pregnancy, and antiviral therapy was not implemented timely. She developed severe pneumonia and ARDS rapidly and need receive a cesarean section on the 39th week after pregnancy. After giving birth to a healthy baby, she received a combination of oseltamivir, sirolimus and corticosteroid, and improved in the following days. Moreover, the cytokines in serum and viral loads in BALF decreased significantly. She recovered without infectious symptoms and was discharged. Sirolimus combined with oseltamivir and corticosteroid is likely responsible for lowering the viral loads, reducing the patient's cytokine level, and further improving her clinical outcomes. It provides evidence that adjuvant treatment was beneficial to patients with severe pneumonia induced by the pH1N1 virus.

Clinical efficacy of γ-globulin combined with dexamethasone and methylprednisolone, respectively, in the treatment of acute transverse myelitis and its effects on immune function and quality of life.

Effects of γ-globulin combined with dexamethasone or methylprednisolone in the treatment of acute transverse myelitis (ATM) were investigated. A retrospective analysis of medical records from 136 ATM patients admitted to Linzi District People's Hospital from July 2014 to September 2017 was performed. Patients treated with dexamethasone combined with γ-globulin were in group A (66 cases), and patients treated with methylprednisolone combined with γ-globulin were in group B (70 cases). Clinical efficacy, recovery time of bone marrow function and incidence rate of adverse reactions were analyzed and compared between the two groups. T-lymphocyte subsets in peripheral blood of both groups were detected by Flow cytometry. Quality of life of patients was assessed by the Quality of Life Scale (SF-36) developed by the American Institute of Medicine. Time of sensory recovery, self-walking, improving muscle strength at two levels and urination recovery after treatment in group B were significantly shorter than those in group A (P<0.001); effective rate of treatment in group B was significantly higher than that in group A (P<0.05); incidence rate of adverse reactions in group B was significantly lower than that in group A (P<0.05); ratios of CD3+, CD4+, CD8+ cells and CD4+/CD8+ in peripheral blood of group A and group B after treatment were significantly higher than those before treatment (P<0.05); scores of general health (GH), physical function (PF), role physical (RP), body pain (BP), social function (SF), role emotional (RE), mental health (MH) and vitality (VT) in group B after treatment were significantly higher than those in group A (P<0.05). In conclusion, clinical efficacy of γ-globulin combined with methylprednisolone in the treatment of ATM patients shows definitely fewer adverse reactions, which can improve their immune function and quality of life.

Identification of Key Metabolites for Acute Lung Injury in Patients with Sepsis.

BACKGROUND: The study aimed to detect critical metabolites in acute lung injury (ALI). METHODS: A comparative analysis of microarray profile of patients with sepsis-induced ALI compared with sepsis patients with was conducted using bioinformatic tools through constructing multi-omics network. Multi-omics composite networks (gene network, metabolite network, phenotype network, gene-metabolite association network, phenotype-gene association network, and phenotype-metabolite association network) were constructed, following by integration of these composite networks to establish a heterogeneous network. Next, seed genes, and ALI phenotype were mapped into the heterogeneous network to further obtain a weighted composite network. Random walk with restart (RWR) was used for the weighted composite network to extract and prioritize the metabolites. On the basis of the distance proximity among metabolites, the top 50 metabolites with the highest proximity were identified, and the top 100 co-expressed genes interacted with the top 50 metabolites were also screened out. RESULTS: Totally, there were 9363 nodes and 10,226,148 edges in the integrated composite network. There were 4 metabolites with the scores > 0.009, including CHITIN, Tretinoin, sodium ion, and Celebrex. Adenosine 5'-diphosphate, triphosadenine, and tretinoin had higher degrees in the composite network and the co-expressed network. CONCLUSION: Adenosine 5'-diphosphate, triphosadenine, and tretinoin may be potential biomarkers for diagnosis and treatment of ALI.

Distribution of an intravenous injectable nimodipine nanosuspension in mice.

The distribution of an intravenous injectable nimodipine nanosuspension with mean particle size of both 300 and 650 nm in mice was systemically investigated compared with that of a nimodipine ethanol formulation (Nimotop) and a nanosuspension coated with Tween-80. The results showed that the 650-nm nanoparticles provided significantly higher drug concentrations in the liver, spleen and lungs because of their capture by Kupffer cells in the mononuclear phagocyte system, but lower drug concentrations in the brain compared with Nimotop and smaller nanoparticles. These nanoparticles failed to give increased brain concentrations even when coated with Tween-80. The 300-nm nanoparticles could effectively increase drug concentrations in the brain and remarkably reduce drug concentrations in the liver, spleen and lungs, indicating that the nimodipine nanosuspension may be a promising formulation with no ethanol, but the particle size must be small.

Preparation and characterization of intravenously injectable nimodipine nanosuspension.

The purpose of this study was to develop an alternative, improved and better tolerated injectable nimodipine nanosuspension compared with commercially available ethanol solution. In this study, nimodipine nanosuspension was prepared by high-pressure homogenization (HPH). The effects of the production parameters such as pressure, cycle numbers and crushing principles on the mean particle size, 99% diameter and polydispersity of the nanosuspension were investigated. Characterization of the product was performed by scanning electron microscope (SEM) and differential scanning calorimeter (DSC). The safety of the nimodipine nanosuspension was discussed with special attention to contamination by microparticles and the increase in saturation solubility C(s). Irritability study in rabbits showed that this formulation provided less local irritation and phlebitis risks than the commercial ethanol product, which represented a promising new drug formulation for intravenous therapy of subarachnoid hemorrhage (SAH)-related vasospasm.