Objective To study the clinical characteristics of the severe acute respiratory syndrome(SARS) patients who progressed into multiple organ injury Methods Retrospective analysis was performed on the clinical data of 54 severe SARS patients with multiple organ injury in our hospital Results In 54 SARS patients,systemic inflammatory response syndrome(SIRS) developed in all cases and multiple organ injury developed in 49 cases and the mortality of patients with multiple organ injury was 22 2% Among the involved organs,lungs were the most frequently involved organ,followed by liver,heart,brain,kidney and blood system The injury in other organs was rare Conclusions Serious SARS is predisposed to progress into multiple organ injury The mortality was correlated to the number of organs involved Recognization and treatment of multiple organ injury at early stage are critical with improve cure rate of serious SARS with multiple organ injury

Objective To investigate the myocardial injury in patients with dengue fever. Methods Three hundred and ninety-eight patients with dengue fever were included in the study. Blood myocardial enzyme spectrum and electrocardiography were examined in all patients. Results Abnormal myocardial enzyme spectrum was detected in 40 patients ( 10. 1% ), including the elevation of blood CK-MB, CK, LDH, α-HBDH and AST levels and increased cTnT levels were also detected in 5 patients. In these 40 patients, 34 showed abnormal electrocardiogram. Sinus bradycardia was the most common complication, other complications including ST or T wave changes. Some patients had more than two kinds of electrocardiogram abnormalities. Conclusion Dengue vires infection may induce myocardial injury, which suggests that examinations for myocardial enzyme spectrum and electrocardiography are necessary.

Objective To investigate the clinical characters of death in AIDS patients with Penicilliosis marneffei (PSM), improving the diagnosis and treatment of PSM. Methods Retrospectively analyze the data of 27 AIDS patients died of PSM from January 2009 to December 2011 and review the relevant literatures in the past several years. Results The etiology diagnosis time ranged from 4 to 7 (4.9 ± 1.4) days from admission. There were 22 (81.5%) cases complicated with septic shock and 25 (92.6%) cases complicated with metabolic acidosis. There were 12 (44.4%) cases co-infected with pneumocyst pneumonia , 7 (25.9%) cases with TB. The main reasons accounting for the death were as follow:15(55.6%) cases died of septic shock, 5(18.5%) cases died of respiratory failure. Conclusion The death cases of AIDS patients with PSM showed the characters of relatively late etiology diagnosis and pathogenic therapy , mostly complicated with other opportunistic infections and often died of septic shock. Therefore, timely etiology diagnosis and earlier pathogenic therapy are the keys to treat the disease. Effectively controlling of the complications and co-infections may decrease the mortality.

Objective To explore the clinical and laboratory characteristics of patients with dengue fever(DF)in Guangzhou from July to September in 2006 and to improve the awareness of dengue virus infection for physicians.Methods Clinical data of 277 patients with DF admitted to our hospital in Guangzhou were retrospectively analyzed.Dengue virus was isolated from patients' blood specimens by C6/36 cell culture and typed by reverse transcriptase-polymerase chain reaction(RT-PCR)assay and gene sequencing.Results Age of the 277 patients,148 males and 129 females,averaged 36 years with a standard deviation of 17 years,ranging from 9 months to 78 years.Their most common symptoms included fever(100.0%),skin rash(85.2%),headache(69.3%),myalgia(51.3%),bone soreness (39.0%)and nausea or vomiting(39.4%),and leucopenia and/hromboeytopenia occurred in 75.5% and 62.5% of them,respectively.Elevated alanine aminotransferase(ALT)was found in 59.6%,elevated aspartate aminotransferase(AST)in 81.6%,and hypopotassemia in 53.8% of them.Serum positivity of antibody against dengue virus IgM was 90.6%,which could be detected 3 to 10 days after onset of the illness,with a mean of 6.2 days with a standard deviation of 1.9 days.Cell-cultured virus from 20 patients were identified as typed by RT-PCR and RNA sequence analyses.All patients were clinically classified as typical DF and all of them completely recovered.Conclusions DF during this epidemic in Guangzhou was caused by dengue virus-1,with typical manifestations in all the patients but more damage in the liver.Some patients demonstrated hypopotassemia,but no dengue hemorrhagic fever or dengue shock syndrome was found.All the patients experienced a good prognosis with timely diagnosis and treatment.

Objective: To discuss the way of early nutritional support in the patients after the liver transplantation. Methods: The nutritional support was used in 28 patients who had suffered the orthopetic liver transplantation (OLT).Parenteral nutrition was started as soon as possible after the operation. On the fourth day after the operation, enteral nutrition was also used. Results: 5 patients died from the postoperative complications. 23 patients survived and had been in better nutrition. Conclusion: The early nutrition support can play an important role in the patients recovery after OLT. EN should be administrated immediately when the gut functions.

Objective To analyze the characteristics of laboratory test resuits of dengue fever(DF)patients in Guangzhou area.Methods Routine tests were performed in the patients admission to hospital. Serology examination was performed in the patients in acute phase or recovery phase.The clinieal symptoms and teatures were analyzed and positive numbers and positivity ratios were calculated.Results The clinical symptoms of the dengue fever were typieal,with the features of fever,headache,myalgia and rash.The leukopenia rate was 76.0%,and the thromboeytopenia rate was 62.6%.The levels of ALT increased in 56.7%patients,and the levels of AST increased in 84.0%patients.Hypopotassemia was found in 46.1%patients.Dengue virus antibody IgM(DF-IgM)was detected positive from the first day to the 16th day of the onset,and the positive rate was 85.9% on the 8th day.Virus loads were positive by fluorescence real-time PCR in seven acute serum samples(within 3 days of the onset)of 51 cases whose DE-IgM were negative all the time, and the results was 105 -106 copies/ml(＜103 copies/ml means negative).Conclusions Clinical manifestations of this DF epidemic were typical including fever,headache,myalgia and skin rash.Most of the patients had decreased leukocyte and thrombocyte obviously.Liver damage was common but kidney damage was seldom.Halt of the patients got hypopotassemia.DF-IgM appeared in very early and persisted for a long time.The detection of DF-IgM within 7 days of the onset was helpful for diagnosis as early as possible.Viral load detected by real-time PCR could be another indicator of early pathogen diagnosis which provides complementation for antibody detection.

Objective To investigate the dynamic changes of dengue viral loads and IgM antibody in patients with dengue fever ( DF) and to analyze their relationships with disease severity. Methods A to-tal of 1 508 serum samples were collected from 1 140 hospitalized patients including 1 050 mild cases and 90 severe cases within 10 days after the onset of DF in Guangzhou in 2014. The viral loads were determined by using fluorescence quantitative RT-PCR. ELISA was performed to measure the dengue virus ( DENV)-spe-cific IgM antibody. Results In general, the DENV viral loads in patients declined gradually from 108 copies/ml on day 1 to 103 copies/ml on day 10 after the onset of DF. The viral loads in severe cases were significantly higher than those in mild cases on days 5 to 7 (P<0. 05). The positive rates of DENV RNA in serum samples also decreased with the disease progression from 100% on day 1 to 40% on day 10. Com-pared with the mild cases, the patients with severe DF showed higher positive rates of DENV RNA on day 6 and day 8 (P<0. 05). The DENV-specific IgM antibody could be detected on day 2 and the secretion of IgM antibody increased gradually with the disease progression. The levels of IgM antibody in mild cases were sig-nificantly higher than those in severe cases (P<0. 001). The positive rates of IgM antibody in patients in-creased form 8% on day 2 to 95% on day 6. Higher positive rates of IgM antibody were detected in mild ca-ses on days 5 and 6 as compared with those in patients with severe DF (P<0. 05). Conclusion High viral load and low level of IgM antibody during the fastigium of DF were closely associated with the disease severity.

Objective:To investigate the correlation of plasma D-dimer levels with the response to first-line chemotherapy and the prognosis of patients with serous ovarian cancer (SOC). Methods:The preoperative plasmic D-dimer levels of 143 patients with prima-ry SOC were retrospectively evaluated. The patients were admitted to Tianjin Medical University Cancer Institute and Hospital between January 2008 and May 2010. The patients were divided into two groups on the basis of plasmic D-dimer levels. Group A consisted of 100 patients with a normal plasmic D-dimer level of≤0.3 mg/L. Group B included 43 patients with an increased plasmic D-dimer level of>0.3 mg/L. The correlations of the different plasmic D-dimer levels with clinicopathological features, therapeutic effects, and surviv-al outcomes were further analyzed. Results:The plasmic D-dimer levels were positively correlated with the staging of the Federation of International Gynecology and Obstetrics, residual tumor size, presence of malignant ascites, preoperative serum CA125 level, and neo-adjuvant chemotherapy. Group B exhibited a significantly lower (P<0.001) complete response (CR) rate of 34.88%(15/43) than group A, which yielded a CR rate of 73.00%(73/100). The progression-free survival and overall survival rates of group B were significantly lower than those of group A (25.58%vs. 50.00%and 32.56%vs. 65.00%;P<0.05). Multivariate analysis revealed that the plasmic D-di-mer level is an independent prognostic factor associated with unfavorable prognosis. Conclusion:Increased preoperative plasmic D-di-mer levels may be a potential biomarker of weak responses to first-line chemotherapy and poor clinical outcomes in patients with SOC.

Objective To investigate the characteristics of traditional Chinese medical syndrome types of fulminant and epidemic dengue fever patients admitted in Guangzhou and Xishuang banna in the year of 2013,and to ex plore the differences of etiology and pathogenesis, illness, and treatment for the patients in the two regions. Methods We collected the clinical data of 78 cases receiving integrative Chinese and western medicine from 255 patients admitted in Guangzhou Municipal Eighth People’s Hospital, and the clinical data of 39 cases receiving integrative Chinese and western medicine from 120 patients admitted in the People’s Hospital of Xishuangbanna Dai Nationality Autonomous Prefecture in the year of 2013. The traditional Chinese medical syndrome types and the syndrome scores of the total of 117 cases were investigated. The method of phenology was used for the analysis of epidemic time and epidemic region of dengue fever, and the theory of defense-qi-nutrient-blood syndrome differentiation of seasonal febrile diseases was used for the analysis of etiology and pathogenesis of dengue fever. Results ( 1) Dengue fever was epidemic in the first ten days of July and in the middle ten days of November of the year 2013 in Guangzhou region, and was epidemic in the middle ten days of August and the first ten days of October in Xishuangbanna region. The epidemicity of dengue fever in Guangzhou covered the end of summer and the whole autumn, and then disappeared before the coming of winter. In Xishuangbanna , the epidemicity of dengue fever was obvious in autumn, and disappeared in late autumn. ( 2) In the two hospitals, dengue fever patients were dominated by the syndromes of excessive heat in both Qifen and Xuefen, blood stasis blended with toxicity, excessive heat in Qifen, and lingering pathogens in order. (3) Before treatment, the scores of fever were higher in patients of Xishuangbanna hospital than those in patients of Guangzhou Eighth People’s Hospital ( P<0.01) . After treatment for 3 days, fever scores were improved in both hospitals (P<0.05 or P<0.01), but the differences between the two hospitals were insignificant (P>0.05) . After treatment for 6 days, fever disappeared in patients of both hospitals. (4) Before treatment, the scores of syndromes were higher in patients of Xishuangbanna hospital than those in patients of Guangzhou Eighth People’s Hospital ( P<0.05) . After treatment for 3 days, syndorme scores were improved in both hospitals ( P<0.01) , but the syndrome scores were higher in Xishuangbanna hospital than those in patients of Guangzhou Eighth People’s Hospital. After treatment for 6 days, syndrome scores were much improved in patients of both hospitals compared with those after treatment for 3 days (P<0.01) . Conclusion In dengue fever patients admitted in Guangzhou and Xishuangbanna region, the syndrome of excessive heat in both Qifen and Xuefen is the leading type, and then comes blood stasis blended with toxicity. The illness state of patients in Guangzhou region is milder than that of the patients in Xishuangbanna region, the time for symptom relief is about one week, and similar therapeutic effect can be achieved in the two regions .

0.05) between two groups. Abdominal distention and diarrhea occurred in 6 patients in observed group. Nitrogen balance, PA, TFN, IgA, IgG and IgM after nutritional support were better than those before nutritional support in two groups. Nitrogen balance, PA, TFN, IgA, IgG and IgM were better in observed group than those in the control group. Conclusions:Early nutritional support can improve metabolic status,the immune function and the nitrogen balance in brain operation patients.