目的探讨鼓室内注射泼尼松龙与地塞米松治疗难治性突发性耳聋的临床疗效及对血液流变学的影响。方法选取2019年6月至2020年6月湖北省宜昌市中心人民医院收治的106例难治性突发性耳聋患者,采用随机数字表法分为泼尼松龙组(鼓室内注射泼...目的探讨鼓室内注射泼尼松龙与地塞米松治疗难治性突发性耳聋的临床疗效及对血液流变学的影响。方法选取2019年6月至2020年6月湖北省宜昌市中心人民医院收治的106例难治性突发性耳聋患者,采用随机数字表法分为泼尼松龙组(鼓室内注射泼尼松龙)和地塞米松组(鼓室内注射地塞米松),每组53例。观察两组治疗前后的血液流变学指标,趋化因子高迁移率族蛋白B1(high mobility group protein-B1,HMGB1)和中性粒细胞激活肽-78(epithelial neutrophil-activating peptide-78,ENA-78)的水平,气导纯音听阈(pure tone audiometry,PTA)水平,并比较两组的疗效及用药安全性。结果治疗前两组的全血高血黏度、全血中血黏度、全血低血黏度、全血黏度、红细胞聚集指数、血细胞比容等血液流变学指标比较差异无显著性(P>0.05),治疗后两组上述指标均明显低于治疗前,且泼尼松龙组明显低于地塞米松组,差异均有显著性(P<0.05)。相比治疗前,两组治疗后的HMGB1、ENA-78水平均明显降低,且泼尼松龙组明显低于地塞米松组,差异有显著性(P<0.05)。两组治疗后的PTA水平均明显低于治疗前,且泼尼松龙组明显低于地塞米松组,差异有显著性(P<0.05)。泼尼松龙组治疗总有效率(90.57%)明显高于地塞米松组(79.25%),差异有显著性(P<0.05)。两组治疗期间的不良反应发生率比较差异无显著性(P>0.05)。结论与地塞米松相比,鼓室内注射泼尼松龙治疗难治性突发性耳聋可有效改善血液流变学指标,提高各频率听力,临床疗效更为显著,且用药安全性好。展开更多
AIM： To compare the efficacy of pentoxifylline and prednisolone in the treatment of severe alcoholic hepatitis, and to evaluate the role of different liver function scores in predicting prognosis.METHODS： Sixty-eigh...AIM： To compare the efficacy of pentoxifylline and prednisolone in the treatment of severe alcoholic hepatitis, and to evaluate the role of different liver function scores in predicting prognosis.METHODS： Sixty-eight patients with severe alcoholic hepatitis （Maddrey score ≥ 32） received pentoxifylline （n = 34, group Ⅰ） or prednisolone （n = 34, group Ⅱ） for 28 d in a randomized double-blind controlled study, and subsequently in an open study （with a tapering dose of prednisolone） for a total of 3 mo, and were followed up over a period of 12 mo.RESULTS： Twelve patients in group Ⅱ died at the end of 3 mo in contrast to five patients in group Ⅰ. The probability of dying at the end of 3 mo was higher in group Ⅱ as compared to group Ⅰ （35.29% vs 14.71%, P = 0.04; log rank test）. Six patients in group I developed hepatorenal syndrome as compared to none in group Ⅰ. Pentoxifylline was associated with a significantly lower model for end-stage liver disease （MELD） score at the end of 28 d of therapy （15.53± 3.63 vs 17.78± 4.56, P=0.04）. Higher baseline Maddrey score was associated with increased mortality.CONCLUSION： Reduced mortality, improved risk-benefit profile and renoprotective effects of pentoxifylline compared with prednisolone suggest that pentoxifylline is superior to prednisolone for treatment of severe alcoholic hepatitis.展开更多
The Chinese medicine compound, ]isuikang, can promote recovery of neurological function by inhibiting lipid peroxidation, scavenging oxygen free radicals, and effectively improving the local microenvironment after spi...The Chinese medicine compound, ]isuikang, can promote recovery of neurological function by inhibiting lipid peroxidation, scavenging oxygen free radicals, and effectively improving the local microenvironment after spinal cord injury. However, the mechanism remains unclear. Thus, we established a rat model of acute spinal cord injury using a modified version of Allen＇s method. Jisuikang （50, 25, and 12.5 g/kg/d） and prednis- olone were administered 30 minutes after anesthesia. Basso, Beattie, and Bresnahan locomotor scale scores and the oblique board test showed improved motor function recovery in the prednisone group and moderate-dose Jisuikang group compared with the other groups at 3-7 days post-injury. The rats in the moderate-dose Jisuikang group recovered best at 14 days post-injury. Hematoxylin-eosin staining and transmis- sion electron microscopy showed that the survival rate of neurons in treatment groups increased after 3-7 days of administration. Further, the structure of neurons and glial cells was more distinct, especially in prednisolone and moderate-dose Jisuikang groups. Western blot assay and immunohistochemistry showed that expression of brain-derived neurotrophic factor （BDNF） in injured segments was maintained at a high level after 7-14 days of treatment. In contrast, expression of nerve growth factor （NGF） was down-regulated at 7 days after spinal cord injury. Re- al-time fluorescence quantitative polymerase chain reaction showed that expression of BDNF and NGF mRNA was induced in injured segments by prednisolone and Jisuikang. At 3-7 days after injury, the effect of prednisolone was greater, while 14 days after injury, the effect of moder- ate-dose Jisuikang was greater. These results confirm that Jisuikang can upregulate BDNF and NGF expression for a prolonged period after spinal cord injury and promote repair of acute spinal cord injury, with its effect being similar to prednisolone.展开更多
Acute hepatic failure due to hepatitis B virus(HBV)can occur both during primary infection as well as after reactivation of chronic infection.Guidelines recommend considering antiviral therapy in both situations,altho...Acute hepatic failure due to hepatitis B virus(HBV)can occur both during primary infection as well as after reactivation of chronic infection.Guidelines recommend considering antiviral therapy in both situations,although evidence supporting this recommendation is weak.Since HBV is not directly cytopathic,the mechanism leading to fulminant hepatitis B is thought to be primarily immunemediated.Therefore,immunosuppression combined with antiviral therapy might be a preferred therapeutic intervention in acute liver failure in hepatitis B.Here wereport our favourable experience in three hepatitis B patients with fulminant hepatic failure who were treated by combining high-dose steroid therapy with standard antiviral treatment,which resulted in a rapid improvement of clinical and liver parameters.展开更多
文摘目的探讨鼓室内注射泼尼松龙与地塞米松治疗难治性突发性耳聋的临床疗效及对血液流变学的影响。方法选取2019年6月至2020年6月湖北省宜昌市中心人民医院收治的106例难治性突发性耳聋患者,采用随机数字表法分为泼尼松龙组(鼓室内注射泼尼松龙)和地塞米松组(鼓室内注射地塞米松),每组53例。观察两组治疗前后的血液流变学指标,趋化因子高迁移率族蛋白B1(high mobility group protein-B1,HMGB1)和中性粒细胞激活肽-78(epithelial neutrophil-activating peptide-78,ENA-78)的水平,气导纯音听阈(pure tone audiometry,PTA)水平,并比较两组的疗效及用药安全性。结果治疗前两组的全血高血黏度、全血中血黏度、全血低血黏度、全血黏度、红细胞聚集指数、血细胞比容等血液流变学指标比较差异无显著性(P>0.05),治疗后两组上述指标均明显低于治疗前,且泼尼松龙组明显低于地塞米松组,差异均有显著性(P<0.05)。相比治疗前,两组治疗后的HMGB1、ENA-78水平均明显降低,且泼尼松龙组明显低于地塞米松组,差异有显著性(P<0.05)。两组治疗后的PTA水平均明显低于治疗前,且泼尼松龙组明显低于地塞米松组,差异有显著性(P<0.05)。泼尼松龙组治疗总有效率(90.57%)明显高于地塞米松组(79.25%),差异有显著性(P<0.05)。两组治疗期间的不良反应发生率比较差异无显著性(P>0.05)。结论与地塞米松相比,鼓室内注射泼尼松龙治疗难治性突发性耳聋可有效改善血液流变学指标,提高各频率听力,临床疗效更为显著,且用药安全性好。
文摘AIM： To compare the efficacy of pentoxifylline and prednisolone in the treatment of severe alcoholic hepatitis, and to evaluate the role of different liver function scores in predicting prognosis.METHODS： Sixty-eight patients with severe alcoholic hepatitis （Maddrey score ≥ 32） received pentoxifylline （n = 34, group Ⅰ） or prednisolone （n = 34, group Ⅱ） for 28 d in a randomized double-blind controlled study, and subsequently in an open study （with a tapering dose of prednisolone） for a total of 3 mo, and were followed up over a period of 12 mo.RESULTS： Twelve patients in group Ⅱ died at the end of 3 mo in contrast to five patients in group Ⅰ. The probability of dying at the end of 3 mo was higher in group Ⅱ as compared to group Ⅰ （35.29% vs 14.71%, P = 0.04; log rank test）. Six patients in group I developed hepatorenal syndrome as compared to none in group Ⅰ. Pentoxifylline was associated with a significantly lower model for end-stage liver disease （MELD） score at the end of 28 d of therapy （15.53± 3.63 vs 17.78± 4.56, P=0.04）. Higher baseline Maddrey score was associated with increased mortality.CONCLUSION： Reduced mortality, improved risk-benefit profile and renoprotective effects of pentoxifylline compared with prednisolone suggest that pentoxifylline is superior to prednisolone for treatment of severe alcoholic hepatitis.
基金supported by the National Natural Science Foundation of China,No.81573997the Natural Science Foundation for Colleges and Universities in Jiangsu Province of China,No.15KJD360001the Natural Science Foundation of Jiangsu Province of China,No.BK2011180
文摘The Chinese medicine compound, ]isuikang, can promote recovery of neurological function by inhibiting lipid peroxidation, scavenging oxygen free radicals, and effectively improving the local microenvironment after spinal cord injury. However, the mechanism remains unclear. Thus, we established a rat model of acute spinal cord injury using a modified version of Allen＇s method. Jisuikang （50, 25, and 12.5 g/kg/d） and prednis- olone were administered 30 minutes after anesthesia. Basso, Beattie, and Bresnahan locomotor scale scores and the oblique board test showed improved motor function recovery in the prednisone group and moderate-dose Jisuikang group compared with the other groups at 3-7 days post-injury. The rats in the moderate-dose Jisuikang group recovered best at 14 days post-injury. Hematoxylin-eosin staining and transmis- sion electron microscopy showed that the survival rate of neurons in treatment groups increased after 3-7 days of administration. Further, the structure of neurons and glial cells was more distinct, especially in prednisolone and moderate-dose Jisuikang groups. Western blot assay and immunohistochemistry showed that expression of brain-derived neurotrophic factor （BDNF） in injured segments was maintained at a high level after 7-14 days of treatment. In contrast, expression of nerve growth factor （NGF） was down-regulated at 7 days after spinal cord injury. Re- al-time fluorescence quantitative polymerase chain reaction showed that expression of BDNF and NGF mRNA was induced in injured segments by prednisolone and Jisuikang. At 3-7 days after injury, the effect of prednisolone was greater, while 14 days after injury, the effect of moder- ate-dose Jisuikang was greater. These results confirm that Jisuikang can upregulate BDNF and NGF expression for a prolonged period after spinal cord injury and promote repair of acute spinal cord injury, with its effect being similar to prednisolone.
文摘Acute hepatic failure due to hepatitis B virus(HBV)can occur both during primary infection as well as after reactivation of chronic infection.Guidelines recommend considering antiviral therapy in both situations,although evidence supporting this recommendation is weak.Since HBV is not directly cytopathic,the mechanism leading to fulminant hepatitis B is thought to be primarily immunemediated.Therefore,immunosuppression combined with antiviral therapy might be a preferred therapeutic intervention in acute liver failure in hepatitis B.Here wereport our favourable experience in three hepatitis B patients with fulminant hepatic failure who were treated by combining high-dose steroid therapy with standard antiviral treatment,which resulted in a rapid improvement of clinical and liver parameters.
