Moderate-dose glucocorticoids as salvage therapy for severe pneumonia in renal transplant recipients: a single-center feasibility study

This study aimed to assess the effectiveness and safety of moderate-dose glucocorticoids (GCs) with mechanical ventilation as salvage therapy for renal transplant recipients with severe pneumonia, which was non-responsive to conventional treatment. A retrospective study was conducted involving renal transplant recipients diagnosed with severe pneumonia and did not respond to conventional treatment. All immunosuppressants were then completely withdrawn, and the patients were initially administered with methylprednisolone at doses of 2.0–2.5?mg/kg/day once every 12?h. This dosage was continued until oxygenation improved, and the treatment was gradually tapered (by 20?mg every 2–3 days) to the previous maintenance dosage. Ten patients were recruited from year 2008 to 2012. Two patients who underwent emergency endotracheal intubation were intubated on days 3 and 8, respectively, another one died from recurrent pneumothorax. The mean PaO₂/FiO₂ of the nine survivors was significantly increased by the increasing treatment duration; whereas the lung injury scores (LIS) and the sequential organ failure assessment (SOFA) score were both significantly decreased. The use of moderate-dose GCs may play a role as salvage therapy for renal transplant recipients with severe pneumonia. However, further study with larger trials to is needed.     

LED红光联合重组人表皮生长因子治疗面部激素依赖性皮炎的疗效观察

目的 探讨LED红光联合重组人表皮生长因子治疗面部激素依赖性皮炎的疗效.方法 收集40例面部激素依赖性皮炎患者,随机将患者分为联合治疗组和对照组各20例.联合治疗组患者给予LED红光照射治疗,20分/次,2次/周.每次照射后给予重组人表皮生长因子外用溶液湿敷20分钟.对照组仅单独给予LED红光照射治疗,20分/次,2次...     

Is asthma a protective factor for dengue fever? In vitro experiment and nationwide population-based cohort analysis

BackgroundDengue fever (DF) is the most rapidly spreading mosquito-borne viral disease. Practical vaccines or specific therapeutics are still expected. Environmental factors and genetic factors affect the susceptibility of Dengue virus (DV) infection. Asthma is a common allergic disease, with house dust mites (HDMs) being the most important allergens. Asthmatic patients are susceptible to several microorganism infections.MethodsA nationwide population-based cohort analysis was designed to assess whether to determine whether asthma can be a risk factor for DF.ResultsUnexpectedly, our data from a nationwide population-based cohort revealed asthmatic patients are at a decreased risk of DF. Compared to patients without asthma, the hazard ratio (HR) for DF in patients with asthma was 0.166 (95% CI: 0.118–0.233) after adjustment for possible confounding factors. In the age stratification, the adjusted HR for DF in young adult patients with asthma was 0.063. Dendritic cell-specific intercellular adhesion molecule 3-grabbing non-integrin (DC-SIGN) of dendritic cells (DCs) is an important entry for DV. Through another in vitro experiment, we found that HDM can diminish surface expression of DC-SIGN in monocyte-derived DCs and further decrease the cellular entry of DV.ConclusionsDecreased DC-SIGN expression in DCs of allergic asthmatic patient may be one of many factors for them to be protected against DF. This could implicate the potential for DC-SIGN modulation as a candidate target for designing therapeutic strategies for DF.     

AN INVESTIGATION OF THE DOSE PROPORTIONALITY OF DEFLAZACORT PHARMACOKINETICS

The dose proportionality of deflazacort was assessed following single-dose oral administration at doses of 3, 6, and 36 mg to 24 healthy young adult volunteers. The active metabolite of deflazacort (21-desacetyl deflazacort) was monitored in plasma using a sensitive, semi-microbore liquid chromatographic method. C_max averaged 10·4±5·0, 19·8±7·5, and 132·6±52·5 ng mL⁻¹ for the 3, 6, and 36 mg doses, respectively. AUC(0–∞) averaged 38·5±37·1, 64·9±20·8, and 411·7±148·5 ng h mL⁻¹ for the same three doses, respectively. Elimination half-life ranged from 1·9±0·5 h at the 6 mg dose to 2·4±1·5 h at the 36 mg dose. Regression analyses of dose versus C_max and AUC(0–∞) yielded intercepts which were not significantly different from zero (p>0·05) and slopes which were significant (p<0·05). Regression analysis of dose versus apparent oral clearance yielded a slope which was not significantly different from zero (p>0·05). These data indicate that deflazacort exhibits dose-proportional pharmacokinetics.     

Intralesional triamcinolone acetonide in notalgia paresthetica: Treatment outcomes in five patients

Numerous treatment modalities have been tried with diverse results for pruritus due to notalgia paresthetica (NP). Corticosteroids suppress ectopic neural discharges from injured nerve fibers and also have short‐lived suppressive effect on transmission in normal C‐fibers. Herein, we evaluated the efficacy of intralesional triamcinolone acetonide in the treatment of NP. The medical reports of five patients who had been diagnosed with NP and treated with intralesional triamcinolone acetonide injections were retrospectively evaluated. Triamcinolone acetonide solution was injected intradermally (10 mg/mL; 0.1 mL/cm²) every 3 weeks for a maximum of four treatments. The severity of itch was scored by the patients on a combined numerical and visual analogue scale. After treatment, reduction in itch severity scores varied between 33% and 100%.     

活检术前应用皮质醇对原发性中枢神经系统淋巴瘤病理诊断的影响

目的研究活检术前应用皮质醇是否会影响原发性中枢神经系统淋巴瘤的病理诊断。方法回顾分析2005年2月至2011年2月期间73例经立体定向活检诊断为原发性中枢神经系统淋巴瘤患者的资料。结果 73例淋巴瘤患者中,39例（53.4%）在活检术前应用皮质醇;10例（73;13.7%）未得出阳性结果,再次行立体定向活检或开颅被证实为原发性中枢神经系统淋巴瘤,其中5例（39例）术前应用过皮质醇（12.8%）,5例（34例）未使用皮质醇（14.7%）（P=1.0）。结论活检术前应用皮质醇对大部分原发性中枢神经系统淋巴瘤患者而言不影响其病理诊断。     

成人噬血细胞综合征32例临床分析

目的探讨噬血细胞综合征(HPS)患者临床特点和转归。方法对32例HPS患者的临床表现,发病过程及检验结果进行回顾分析。结果32例HPS患者均有高热(持续时间长),有不同程度肝损害(肝酶谱和胆红素升高),凝血时间延长,全血细胞减少,部分患者甘油三酯升高。外周血、淋巴结活检、骨髓检查做瑞氏染色可发现成熟单核巨噬细胞、吞噬血小板、红细胞、淋巴细胞、粒细胞现象。与肿瘤相关死亡5例,非肿瘤相关死亡3例,经激素治疗16例症状改善明显,激素无效者用CHOP方案联合化疗2例有效。结论HPS是预后凶险的临床综合征,在临床上以高热肝损害,在周围血、骨髓和淋巴结找到噬血细胞为其特点,使用皮质激素和免疫抑制剂可缓解病情,改善症状。