Methylprednisolone accelerate chest computed tomography absorption in COVID-19:A three-centered retrospective case control study from China

BACKGROUND Based on the results of some large randomized controlled trials(RCTs)confirmed the efficacy of corticosteroids in coronavirus disease 2019(COVID-19),corticosteroids have been included in World Health Organization guidelines,but remain controversial.AIM To investigate the ef
cacy and safety of low-to-moderate dose(30 to 40 mg/d)short-term methylprednisolone for COVID-19 patients.METHODS The clinical data of 70 patients diagnosed with COVID-19 who received antiviral therapy with Arbidol for 7-10 d before admission but had no obvious absorption on chest computed tomography(CT)imaging were retrospectively analyzed.Arbidol(as the control group)and methylprednisolone(as the corticosteroid group)were given respectively after admission.After treatment,chest CT was reexamined to evaluate the absorption of pulmonary lesions.Additionally,we evaluated and compared the lymphocyte count,erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),serum ferritin,lactate dehydrogenase(LDH),creatine kinase-MB(CK-MB),hypersensitive C-reactive protein(hs-CRP)and D-dimer levels,and also analyzed the incidence of toxic and side effects.RESULTS All patients in the corticosteroid group had varying degrees of CT absorption,which was significantly better than that in the control group(CT obvious absorption rate:89.47%vs 12.5%,P<0.05).The average daily dose and course of methylprednisolone in the patients with significant improvement on chest CT was(38.55±13.17)mg and(6.44±1.86)d respectively.During the treatment,the lymphocyte count,ESR,IL-6,serum ferritin,LDH,CK-MB,hs-CRP and D-dimer levels all improved gradually,indicating that both Arbidol and methylprednisolone therapy were contributed to improving the condition of COVID-19 patients.The corticosteroid regimen did not prolong the clearance time of severe acute respiratory syndrome coronavirus 2.There were no severe adverse reactions such as gastrointestinal bleeding,secondary severe infection,hypertension,diabetic ketoacidosis,mental disorders or electrolyte disorders during the whole corticosteroid treatment process.CONCLUSION Low-to-moderate dose short-term methylprednisolone can accelerate the chest CT imaging absorption of COVID-19 so as to improve symptoms and alleviate the condition in a short term,reduce the hospital stay,meanwhile avoid severe COVID-19 phases.The protocol has been proven to be effective and safe in clinical use.

Overlapping syndrome of recurrent anti-N-methyl-D-aspartate receptor encephalitis and anti-myelin oligodendrocyte glycoprotein demyelinating diseases:A case report

BACKGROUND Anti-N-methyl-D-aspartate receptor encephalitis(NMDARe)is capable of presenting a relapsing course and coexisting with myelin oligodendrocyte glycoprotein antibody disease,whereas it has been relatively rare.We describe a man with no history of tumor who successively developed anti-NMDARe and anti-myelin oligodendrocyte glycoprotein antibody disease.CASE SUMMARY A 29-year-old man was initially admitted with headache,fever,intermittent abnormal behavior,decreased intelligence,limb twitching and loss of consciousness on July 16,2018.On admission,examination reported no abnormality.During his presentation,he experienced aggravated symptoms,and the reexamination of cranial magnetic resonance imaging(MRI)indicated punctate abnormal signals in the left parietal lobe.External examination of cerebrospinal fluid and serum results revealed serum NMDAR antibody(Ab)(-),cerebrospinal fluid NMDAR-Ab(+)1:10 and Epstein-Barr virus capsid antigen antibody Ig G(+).Due to the imaging findings,anti-NMDARe was our primary consideration.The patient was treated with methylprednisolone and gamma globulin pulse therapy,mannitol injection dehydration to reduce intracranial pressure,sodium valproate sustained-release tablets for anti-epilepsy and olanzapine and risperidone to mitigate psychiatric symptoms.The patient was admitted to the hospital for the second time for“abnormal mental behavior and increased limb movements”on December 14,2018.Re-examination of electroencephalography and cranial MRI showed no abnormality.The results of autoimmune encephalitis antibody revealed that serum NMDAR-Ab was weakly positive and cerebrospinal fluid NMDAR-Ab was positive.Considering comprehensive recurrent anti-NMDARe,the patient was treated with propylene-hormone pulse combined with immunosuppressive agents(mycophenolate mofetil),and the symptoms were relieved.The patient was admitted for“hoarseness and double vision”for the third time on August 23,2019.Re-examination of cranial MRI showed abnormal signals in the medulla oblongata and right frontal lobe,and synoptophore examination indicated concomitant esotropia.The patient’s visual acuity further decreased,and the reexamination of cranial MRI+enhancement reported multiple scattered speckled and patchy abnormal signals in the medulla oblongata,left pons arm,left cerebellum and right midbrain,thalamus.The patient was diagnosed with an accompanying demyelinating disease.Serum antimyelin oligodendrocyte glycoprotein 1:10 and NMDAR antibody 1:10 were both positive.The patient was diagnosed with myelin oligodendrocyte glycoprotein antibody-related inflammatory demyelinating disease of the central nervous system complicated with anti-NMDARe overlap syndrome.The patient was successfully treated with methylprednisolone,gamma globulin pulse therapy and rituximab treatment.The patient remained asymptomatic and follow-up MRI scan 6 mo later showed complete removal of the lesion.CONCLUSION We emphasize the rarity of this antibody combination and suggest that these patients may require longer follow-up due to the risk of recurrence of two autoimmune disorders.

Synthesis of one-dimensional GaN nanorods by Tb intermediate layer with different thicknesses

GaN nanorods were synthesized by magnetron sputtering and ammonification system, and the thickness of Tb intermediate layer was changed to study the effect on GaN nanorods. The resultant was tested by scanning electron microscopy(SEM), X-ray diffraction(XRD),transmission electron microscopy(TEM), high-resolution transmission electron microscopy(HRTEM), and photoluminescence(PL) spectra. The results show that the thickness of Tb layer has an evident effect on the modality,quality, and luminescence properties of GaN nanorods. PL spectra at room temperature show a very strong emission peak at 368 nm and a weak emission peak at 387 nm, and the intensities of the peak for the produced samples reach the maximum when Tb layer is 20 nm. Finally, the optimal thickness of 20 nm of Tb intermediate layer for synthesizing GaN nanostructures is achieved.