Recent clinical trials have reported that methylprednisolone sodium succinate administered within 8 hours improves neurological recovery in human spinal cord injury (SCI). Methylprednisolone, however, was ineffective and possibly even deleterious when given more than 8 hours after injury. This finding suggests that a therapeutic time window exists in spinal cord injury. In order to determine the doses, durations and timing of methylprednisolone treatment for optimal neuroprotection, a single or two bolus dose of methylprednisolone (30 mg/kg) was administered at 10, 30, 120, 150 and 240 min. after three graded spinal cord injury. The primary outcome measure was 24-hour spinal cord lesion volumes estimated from spinal cord Na+ and K+ shifts. A single 30 mg/kg dose of methylprednisolone at 10 min. after injury significantly reduced 24-hour lesion volumes in injured rat spinal cords. However, any other methylprednisolone treatment starting 30 min. or more after injury had no effect on 24-hour lesion volumes compared to the vehicle control group. Moreover, delayed treatment increased lesion volumes in some cases. These results suggest that the NYU SCI model has a very short therapeutic window.
Animal ; Drug Administration Schedule ; Male ; Methylprednisolone Hemisuccinate/therapeutic use ; Methylprednisolone Hemisuccinate/administration & dosage* ; Neuroprotective Agents/therapeutic use ; Neuroprotective Agents/administration & dosage* ; Rats ; Rats, Long-Evans ; Spinal Cord/pathology ; Spinal Cord Injuries/pathology ; Spinal Cord Injuries/drug therapy*

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
Antiemetics ; Double-Blind Method ; Hemifacial Spasm/surgery* ; Humans ; Indoles ; Methylprednisolone Hemisuccinate/therapeutic use* ; Microvascular Decompression Surgery ; Tropisetron

OBJECTIVETo study the efficacy of early, enough methylprednisone combined with immunoglobulin in treatments of severe hand-foot-mouth disease.

METHODS568 patients of severe hand-foot-mouth disease involved were randomized into group A and group B. Patients of both groups all accepted symptomatic treatment, supportive therapy and the treatment of control intracranial pressure. And patients in group A received the treatment of early, enough methylprednisone combined with immunoglobulin, whereas patients in group B received conventional therapy. RESULTS; Curative rate of group A was better than that of group B, otherwise incidence rate of critical illness was less than that of group B. The control time of fever, erythra, neurological symptoms, features of pneumonia and increased leukocyte of group A was shorter than that of group B, and no more recent or Long-term treatment-related adverse reaction in group A.

CONCLUSIONEarly, enough methylprednisone combined with immunoglobulin is effective, safe in treating severe hand-foot-mouth disease, and worthy to recommand its clinical use.

Adult ; Aged ; Biomedical Research ; Drug Therapy, Combination ; Female ; Hand, Foot and Mouth Disease ; drug therapy ; Humans ; Immunoglobulins ; therapeutic use ; Male ; Methylprednisolone Hemisuccinate ; therapeutic use ; Middle Aged

OBJECTIVETo analyze the efficacy of Methylprednisolone hemisuccinate intratympanic injection for refractory noise induced deafness.

METHODSOne hundred and twenty cases (215 ears) of noise induced deafness were treated with either hormone group (107 ears) or with non hormone group (108 ears). Following prior interventions, 145 ears went on to receive intratympanic Methylprednisolone hemisuccinate injection twice a week.

RESULTSAfter Intratympanic therapy, the total effective rate was 46.2%. 32 of 71 ears (45.1%) demonstrated hearing improvement in hormone group and 35 of 74 ears (47.3%) in non hormone group. The difference was statistically insignificant (P = 0.788).

CONCLUSIONIntratympanic therapy appears to provide additional treatment benefits for patients with refractory noise induced deafness who have been treated with prior interventions. The outcome is not affected by pretreatment with hormone.

Glucocorticoids ; therapeutic use ; Hearing Loss, Noise-Induced ; drug therapy ; Hearing Tests ; Humans ; Injection, Intratympanic ; Methylprednisolone Hemisuccinate ; therapeutic use ; Noise ; Treatment Outcome

OBJECTIVETo investigate the effects and apoptosis of intrathecal injection of Methylprednisolone Sodium Succinate (MPss) for acute spinal cord injury (SCI) in New Zealand rabbits.

METHODSSeventy-two healthy New Zealand rabbits were used for the procedure and were randomly divided into two groups: SCI group and SHAM group, which was both divided into 6 subgroups, such as the vehicle group, the MPss intrathecal injection groups (1.5 mg/kg, 3.0 mg/kg, 6.0 mg/kg group), the MPss intravenous injection group and the combined injection group. TARLOV score was tested daily to evaluate the motor function. The rabbits were sacrificed 7 days after the surgery and the thoracic spinal cord sections and the sacral sections where MPss was injected were harvested for HE and TUNEL staining. Two-Factors Repeated Measures analysis of variance for TARLOV scores tested at various times and One-Way ANOVA analysis of variance for data between groups were used.

RESULTSeven days after surgery in SCI group, there was no statistical difference between the TARLOV scores of intrathecal injection of MPss 3.0 mg/kg group, 6.0 mg/kg group and MPss intravenous injection group (P > 0.05), which were all better than the vehicle group (F = 4.762, P < 0.05). Referring to the lymphocyte infiltration at the injury site in SCI group, there was statistical difference between MPss intrathecal injection 6.0 mg/kg group (1.33 ± 0.21) and the vehicle group (2.67 ± 0.21) (F = 5.793, P < 0.05) and no statistical difference between intrathecal injection of MPss 6.0 mg/kg group and MPss intravenous injection group (P > 0.05). As for the lymphocyte infiltration at the intrathecal injection site in SHAM group, there was statistical difference between MPss intrathecal injection 6.0 mg/kg group (2.50 ± 0.55) and the vehicle group (0.50 ± 0.55) (F = 17.333, P < 0.05). TUNEL staining in SCI group showed statistical difference between MPss intrathecal injection 6.0 mg/kg group (6.3 ± 1.5) and the vehicle group (20.3 ± 2.2) (F = 71.279, P < 0.05).

CONCLUSIONSIntrathecal injection of MPss can improve the functional recovery of lower limb and decrease apoptosis of neuron cells,which can provide same effects as the traditional intravenous injection of MPss in New Zealand rabbits.

Acute Disease ; Analysis of Variance ; Animals ; Disease Models, Animal ; Injections, Spinal ; Male ; Methylprednisolone Hemisuccinate ; administration & dosage ; therapeutic use ; Rabbits ; Recovery of Function ; Spinal Cord Injuries ; drug therapy

BACKGROUNDOptic neuritis (ON) is often the first symptom of multiple sclerosis (MS) and neuromyelitis optica (NMO) while there has been very little research reported on ON combined with Sjögren's syndrome (SS). The aim of this study is to provide different treatments and services for and NMO patients combined with SS.

METHODSTwenty-seven patients with ON combined SS were divided into two groups: corticosteroid group (C group, methylprednisolone sodium succinate, 14 patients) and corticosteroid+ immunosuppressant group (C+I group, leflunomide, 13 patients). ON relapse times in 1 year after treatment, number of patients who relapsed to NMO/MS in 1 years, visual acuity and retina nerve fiber layer (RNFL) thickness were measured. Mann Whitney-Wilcoxon test was used to compare continuous variables and Chi-square test or Fisher's exact test was to compare proportions.

RESULTSON combined with SS patients had higher incidence rates in middle-aged women who have binocular damage and heavier visual function damage or when there is an easy relapse, and the patients are often hormone dependent. The patients are more likely anti-aquaporin-4 IgG seropositive (70.4%). They are liable to form a centrocecal scotoma and tubular vision. The times of relapse decreased in patients who used immunosuppressant, and a significant difference was found between immunosuppressant and non-immunosuppressant groups in visual acuity recovery during 6-month follow-up period (P < 0.05); however, the RNFL thickness at the four quadrants was not significantly different.

CONCLUSIONSThe effect of immunosuppressant plus corticosteroid on the early onset of ON combined with SS was to provide ON remedy and to prevent recurrence in clinics. This study provides a significant reference for the prevention and treatment of ON on the basis of immunosuppressant and corticosteroid.

Adolescent ; Adrenal Cortex Hormones ; therapeutic use ; Adult ; Aged ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Magnetic Resonance Imaging ; Male ; Methylprednisolone Hemisuccinate ; therapeutic use ; Middle Aged ; Optic Neuritis ; drug therapy ; Sjogren's Syndrome ; drug therapy ; Visual Acuity ; drug effects ; Young Adult

The aim of this study is to investigate the effects of electroacupuncture, corticosteroid, and combination of two treatments on ambulatory paresis due to spinal cord injury in dogs by comparing therapeutic effects of electroacupuncture and corticosteroid. Spinal cord injury was induced in twenty healthy dogs (2.5~7 kg and 2~4 years) by foreign body insertion which compressed about 25% of spinal cord. There was no conscious proprioception, no extensor postural thrust, and ambulatory. Dogs were divided into four groups according to the treatment; corticosteroid (group A), electroacupuncture (group B), corticosteroid and electroacupuncture (group AB), and control (group C). Neurological examination was performed everyday to evaluate the spinal cord dysfunction until motor functions were returned to normal. Somatosensory evoked potentials (SEPs) were measured for objective and accurate evaluations. The latency in measured potentials was converted into the velocity for the evaluation of spinal cord dysfunctions. Pain perceptions were normal from pre-operation to 5 weeks after operation. Recovery days of conscious proprioception in groups A, B, AB, and C were 21.2+/-8.5 days, 19.8+/-4.3 days, 8.2+/-2.6 days, and 46.6+/-3.7 days, respectively. Recovery days of extensor postural thrust in group A, group B, group AB, and group C were 12.8+/-6.8 days, 13.8+/-4.8 days, 5.4+/-1.8 days, and 38.2+/-4.2 days, respectively. There were no significant differences between group A and group B. However, recovery days of group AB was significantly shorter than that of other groups and that of group C was significantly delayed (p<0.05). Conduction velocities of each group were significantly decreased after induction of spinal cord injury on SEPs (p<0.05) and they showed a tendency to return to normal when motor functions were recovered. According to these results, it was considered that the combination of corticosteroid and electroacupuncture was the most therapeutically effective for ambulatory paresis due to spinal cord injury in dogs.
Animals ; Anti-Inflammatory Agents/*therapeutic use ; Dogs ; Electroacupuncture/*veterinary ; Evoked Potentials, Somatosensory/drug effects ; Female ; Male ; Methylprednisolone Hemisuccinate/pharmacology/*therapeutic use ; Spinal Cord/drug effects/pathology ; Spinal Cord Compression/drug therapy/*therapy/*veterinary

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Humans ; Lymphoma, T-Cell ; drug therapy ; pathology ; Male ; Methylprednisolone Hemisuccinate ; administration & dosage ; Middle Aged ; Neoplasm Recurrence, Local ; drug therapy ; Remission Induction