回顾性分析不同方法治疗甲状腺相关性眼病眼压的变化

目的:比较甲基强的松龙静脉冲击治疗及眼外肌手术治疗甲状腺相关性眼病(thyroid-associated ophthalmopathy,TAO)前后眼压(intraocular pressure,IOP)的变化.方法:回顾性分析收集2008-01/2010-12于我院眼科就诊的26例42眼TAO患者,患者行甲基强的松龙静脉冲击治疗或眼外肌手术,比较术前、术后第一眼位及上视时的眼压变化.结果:患者16例32眼采用甲强龙冲击治疗,治疗前平均眼压第一眼位时为21.13±4.10mmHg,向上注视时为23 75±5.67mmHg,治疗后分别为16.81±3.69mmHg(P＜0.05),18.50±4.03mmHg(P＜0.05);10例10眼采用眼外肌斜视手术,术前平均眼压第一眼位时为18.40±2 49mmHg,上视时为24.70±3.63mmHg,术后分别为17 30±1.55mmHg(P＞0.05),18.60±2.20mmHg(P＜0 01);术前眼压≥21mmHg的TAO患者眼压下降明显(P＜0.05).结论:两组患者用不同的方法治疗后眼压显著下降,但是眼外肌斜视手术前后眼压在第一眼位时的变化没有统计学差别.     

The effect of steroid pulse therapy on the development of acute pancreatitis induced by closed duodenal loop in rats

Background: Background: The aim of the present study was to evaluate the effect of a high dose of methylprednisolone (MP) on the development of acute pancreatitis (AP) in rats induced by closed duodenal loop (CDL). Methods: Pancreas web weight, volume of ascites, hematocrit, serum amylase activity, concentrations of interleukin (IL)-1β and IL-6, organ blood flow in both the pancreas and the kidney, and histological findings of the pancreas were studied 6 h after the induction of AP. Results: The intravenous administration of MP (30 mg/kg body weight) significantly reduced the increase in pancreas web weight, volume of ascites, hematocrit, serum amylase activity, concentrations of IL-1β and IL-6, histological edema, and necrosis observed in CDL pancreatitis. The administration of MP also apparently improved both the pancreatic and the renal blood flow. Conclusions: The present results suggest that these cytokines influence at least the progression of AP, and that the mechanism by which MP pulse therapy inhibits the development of AP partly involves the inhibition by MP of the release of the cytokines. Received: July 19, 2001 / Accepted: December 14, 2001     

Serum cytokine changes induced by direct hemoperfusion with polymyxin B-immobilized fiber in patients with acute respiratory failure

BackgroundPolymyxin B-immobilized Fiber therapy (PMX-DHP) may improve the prognosis of patients with rapidly progressive interstitial lung diseases (ILDs). However, the mechanisms by which PMX-DHP ameliorates oxygenation are unclear. The present study aimed to clarify the changes in serum cytokine concentrations during PMX-DHP with steroid pulse therapy.MethodsPatients with acute respiratory failure (ARF) and rapidly progressive ILDs, acute exacerbation of idiopathic pulmonary fibrosis (IPF), or acute respiratory distress syndrome (ARDS), and treated with PMX-DHP were assessed, including patients with IPF. The serum concentrations of 38 cytokines were compared between the ARF and IPF groups before treatment. In the ARF group, cytokine levels were compared before, immediately after PMX-DHP, and the day after termination of steroid pulse therapy.ResultsFourteen ARF and eight IPF patients were enrolled. A comparison of the cytokine levels before treatment initiation revealed that EGF, GRO, IL-10, MDC, IL-12p70, IL-15, sCD40L, IL-7, IP-10, MCP-1, and MIP-1β were significantly different between the two groups. In the ARF group treated with PMX-DHP, the concentrations of MDC, IP-10, and TNF-α continuously decreased during treatment (P < 0.01). Further, the cytokine levels of GRO, IL-10, IL-1Ra, IL-5, IL-6, and MCP-1 decreased after the entire treatment period, with no change observed during the steroid-only period (P < 0.01, except GRO and MCP-1). Although PMX-DHP significantly reduced eotaxin and GM-CSF serum levels (P < 0.01 and P < 0.05), these levels did not change after treatment.ConclusionsPMX-DHP combined with steroid pulse therapy might reduce GRO, IL-10, IL-1Ra, IL-5, IL-6, and MCP-1 levels in ARF, contributing to better oxygenation in the disorder.     

甲强龙、地塞米松治疗突发性耳聋的应用比较

目的探讨甲强龙（MTH）及地塞米松（DEx）在治疗突发性耳聋中的·l盏床疗效。方法将95例（107耳）突发性耳聋患者随机分为MTH组和DEX组。MTH组行鼓室注射62．5mg／mLMTH0．5mL,每2天注射1次,10天为1个疗程;DEX组行鼓室注射10．0mg／mLDEX0．5mL,每2天注射1次,10天为1个疗程。两组均给予营养神经、吸氧等对症支持治疗。比较2周后4个频率（0．5kHz、lkHz、2kHz、4kHz）气导纯音听阈均值（PTA）,提高15分贝（dB）以上为有效。结果MTH组总有效49耳,有效率为86．0％。DEX组34耳,有效率为68．0％。X2=4．94,两组比较差异有显著性（P〈O．05）。结论鼓室内注射类固醇激素为治疗难治性突发性耳聋安全、有效的方法之一,并且MTH效果优于DEX。     

口服他克莫司联合糖皮质激素治疗难治性寻常型天疱疮一例

报道口服他克莫司联合糖皮质激素治疗难治性寻常型天疱疮1例。患者,男,55岁,确诊为天疱疮后给予甲泼尼龙64 mg每日1次,口服他克莫司胶囊1 mg每日2次以及其他对症治疗,治疗5周后,原有黏膜及皮肤糜烂面愈合出院。出院时患者泼尼松60 mg分2次口服,他克莫司胶囊1 mg每日2次。8个月后Dsg1抗体、Dsg3抗体转阴,泼尼松减量至15 mg每日1次,他克莫司1 mg每日1次,患者病情稳定,现仍在随访中。     

Oral Megadose Methylprednisolone Versus Intravenous Immunoglobulin for Acute Childhood Idiopathic Thrombocytopenic Purpura

Twenty children with acute idiopathic thrombocytopenic purpura (ITP) were randomized to receive either oral megadose methylprednisolone (MDMP) or intravenous immunoglobulin G (IV IgG). Normal platelet counts (150 × 10⁹/l) were obtained in 6 patients of each group in 3 days and in 8 and 9 patients treated with oral MDMP and with IV IgG within 1 week, respectively. It is concluded that oral MDMP could easily be used for the early elevation of platelet counts, which is important for ITP treatment.     

Efficacy of methylprednisolone administration in a case of continuous abnormal muscle activity syndrome

We report a 20-year-old woman with continuous abnormal muscle activity syndrome in which pharmacological blockade of different sites of the motor unit demonstrates a peripheral nerve origin for the abnormal muscle activity. The case showed no markers of autoimmune disease. A rapid recovery after high dose i.v. methylprednisolone was observed supporting the hypothesis of an autoimmune pathogenesis.     

Reduced adhesion of PBMNCs to endothelium in methylprednisolone-treated MS patients: preliminary results

Methylprednisolone (MP) is a synthetic steroid commonly used in the treatment of multiple sclerosis (MS) relapses. It has a wide spectrum of activities on immune cells: it might also act by preventing mononuclear cell/endothelium adhesion. We studied adhesion phenomena between cultured human umbilical vein endothelial cells (HUVECs) and PBMNCs (CD45⁺, CD14⁺) from 6 MS patients treated in vivo with MP. We also studied fluctuations in CD11a and CD18 levels on lymphocytes and monocytes, as well as changes in serum sICAM-1 and sVCAM-1 concentrations. After MP treatment, PBMNCs adhesion to endothelium decreased at 3 h, while it went back to baseline levels at 24 h. A tendency to increase in both CD11a and CD18 on the surface of lymphocytes was detected, while an increase in serum sVCAM-1 was seen at 3 h.     

激光视网膜损伤前后视网膜电图改变的实验研究

目的 研究激光视网膜损伤前后视网膜电图的改变及甲基强的松龙（methyl-prednisolone,MP)对损伤前后视网膜电图的二项指标（最大反应和OPs)的影响，进而从生理指标上评价MP对视网膜激光损伤的保护作用。方法 32只北京青紫蓝兔随机分成对照、治疗2组。观察其激光损伤前后2组视网膜电图的最大反应和OPs变化。结果 2组动物激光损伤前的视网膜电图比较无差异，损伤后3d内的视网膜电图二项指标亦无差异，其后2组间对应时间点的视网膜电图的二项指标有明显差异。结论 实验表明MP对激光引起的视网膜损伤后的视网膜功能保护有一定的作用。     

FatalPneumocystis pneumonia in a child treated for focal segmental glomerulosclerosis

A 4-year-old female with nephrotic syndrome secondary to focal segmental glomerulosclerosis (FSGS) was treated with pulse methylprednisolone and chlorambucil therapy. She subsequently developed fatalPneumocystis carinii pneumonia (PCP). This is the first report of a pediatric patient whose treatment for FSGS resulted in PCP raising the issue of PCP prophylaxis for these patients.The views expressed in this material are those of the authors and do not reflect the official policy or position of the United States government, the Department of Defense, or the Department of the Air Force.