Objective To study features and significance of clinical stages and types of severe acute respiratory syndrome (SARS). Methods The clinical features of 330 patients with SARS were analyzed by SPSS 11.0 and SDAS software packages, and the standard for classification of clinical stages and types of SARS were studied. Results The disease course of SARS could be divided into four stages, namely, incubation stage, initial stage, climax stage and convalescence stage. The period of incubation stage was 1~12 (5.70?2.45) days. The initial stage was the pathoformic phase during 1 st~10 th (3.98?2.48) days after the onset. The fever was the first symptom and there were usually no catarrhal symptoms. Meanwhile, no abnormality was found in the chest X-ray examination. The climax stage included 3 sequential phases of pulmonary inflammatory exudation, pulmonary tissue consolidation and ARDS or multi-organ failure. In the phase of pulmonary inflammatory exudation, there were serious cough, mild shortness of breath and hypoxemia. Furthermore, chest X-ray examination showed that there was exaggeration of lung markings, haziness or patchy opacity. In the phase of pulmonary tissue consolidation, type I respiratory failure was usually seen in the patients. Shortness of breath and hypoxemia became more serious. Chest X-ray examination showed that the area of consolidation continued to enlarge to include the entire lung. The convalescence stage usually appeared 3 weeks after the onset and lasted for 5～56 (24.37?8.81) days. This stage could further be divided into phase I (complete recovery) and phase II (possible existence of pulmonary fibrosis). SARS could be clinically classified into mild type (ordinary type), severe type and extremely severe type (fulminant type) with a mortality of zero, 5.76% and 61.54%, respectively. There were very great differences in clinical features in three types of SARS. Conclusions SARS could be divided into the incubation stage, initial stage, climax stage and convalescence stage. The climax stage included 3 phases, i.e. pulmonary inflammatory exudation, pulmonary tissue consolidation, and ARDS or MOF. The convalescence stage could be divided into phase I (complete recovery) and phase II (possible existence of pulmonary fibrosis). SARS could be classified as mild type, severe type and extremely severe type.

Objective To analyze the clinical features of severe acute respiratory syndrome(SARS) in order to look for premonitory signs of deterioration of patients suffering from SARS. Methods Three hundred and thirty patients with SARS referred to the Chinese Disease Center(CDC) in Beijing were studied retrospectively by SPASS and SDAS software. The data reviewed included clinical manifestations, laboratory findings, and X-ray pictures. Results The prognosis of mild SARS was good with a cure ratio of 100%. Chest radiography revealed opacity or small subtle opacity in lung periphery in 53.1%, there were no signs of acute lung injury in 67.2%, and the opacity disappeared rapidly. In patients with severe SARS, the disease course was longer(41.3?5.6day), the duration of high fever was longer (8.66?3.22day), with the highest temperature reaching 39.04?0.71℃. The duration of respiratory insufficiency was also longer(8.80?4.56day), and 71.8% of them manifested acute lung injury, involving a large area of the lung, with central lesions in 21.8% or mixed in 50%. The opacity was denser, and it took a longer period to resolve. The levels of LDH, HBDH, ESR and CK-MB were high, with HBDH/LDH ratio ranged from 0.8 to 1.0. The mortality was high(14.54%). Logistic regression analysis showed that the premonitory mode of deterioration of the disease was P y=1=? s /(1+? s)(S=-10.598+0.102A+0.592B+0.077C+0.494D), with sensitivity of 86.67%, and specificity 80%, and it was correlated with age, duration of respiratory insufficiency, ESR, and duration of high temperature. Conclusions The premonitory mode of deterioration of SARS is a new, simple, low-cost, biomathematically and pathophysiogically based index. It allows the prediction of deterioration and severity of SARS.

Objective To analyze the single factor affecting prognosis of SARS, and to establish a model of regression analysis for multiple factors affecting the prognosis of the disease. Methods SPSS 11.0 and SDAS software packages were used to retrospectively analyze the clinical features of SARS in 165 clinically confirmed severe cases. Meanwhile, single-factor and logistic multivariate regression analyses were conducted for SARS prognosis to establish a regression model for SARS prognosis analysis. Results (1) In patients with SARS, the age was significantly correlated to prognosis (r=0.506, P0, then P y=1 was over 0.5, it denoted death of the patient. In condition of S

Objective To explore the relationship between complications and prognosis of chronic severe hepatitis(CSH).Methods The clinical data of 520 patients with CSH treated in our hospital were retrospectively analyzed.Results The most common complications of CSH were ascites,electrolyte disturbance and spontaneous peritonitis,and their total occurring rate was over 50%.Among all the complications,cerebral edema and cerebral hernia had the worst prognosis,failure in treatment and mortality were 100%.Secondary were followed by hepato-renal syndrome,upper digestive tract hemorrhage and hepatic encephalopathy that resulting to effectless rate and mortality of 90% .The effectiveless rate and mortality rose along with increase in number of complications .Meanwhile,the severity of hepatic encephalopathy was closely related to mortality in the patients.Conclusions Effective treatment of complications of CSH and reduction of occurring rate of the complications are very important for decreasing mortality of patients with CSH.

Objective To investigate the expression of COX-2,MMP-2 and TIMP-2 ,the pathological fea-tures ,and their relationship in breast cancer. Methods The expressions of COX-2 ,MMP-2 and TIMP-2 were deter-mined by S-P immunohistochemical method on tissue chips,which containing 127 cases of breast carcinoma. Results The positive rates of COX-2,MMP-2 and TIMP-2 protein were 81.1 (103/127)% ,96.9(123/127)% and 60.6 (77/127) % respectively;The expression of COX-2 was positively related to auxiliary lymph node metastasis and TNM staging (P<0.01 and P<0.05, respectively), and inversely related to PR expression (P<0.05). Further-more,the expression of COX-2 was positively correlated with MMP-2 (r=0. 290 ,P<0.01). Conclusions The ex-pression of COX-2 might be closely related to the invasion and metastasis of breast cancer and has a close relation-ship with MMP-2. The levels of MMP-2 might be partly regulated by COX-2.

Purpose To explore the biological significance of BCL-6 and ZEB2 in invasion,metastasis and prognosis of breast cancer.Methods The expressions of BCL-6,ZEB2 protein and mRNA were detected respectively in 228 cases of breast cancer and 80 cases of breast benign lesions by immunohistochemical SP two-step staining and situ hybridization.Result The expression levels of BCL-6,ZEB2 protein and mRNA in breast cancer tissues were significantly higher than in breast benign lesions (P ＜ 0.05).The expressions of BCL-6 was positively correlated with tumor size,lymphatic metastasis,histological grade,TNM staging and HER-2 expression (P ＜ 0.05).The expressions of ZEB2 was positively correlated with tumor size,lymphatic metastasis,TNM staging and HER-2 expression (P ＜ 0.05).The overall survival and relapse-free survival of BCL-6 and ZEB2 positive expression were significantly less than the negative expression (P ＜ 0.01).Conclusion The BCL-6 and ZEB2 are closely correlated with the evolution process of breast cancer,which may become important means for monitoring and warning the metastasis,invasion,and prognosis of breast cancer.

As the prevalence rate of drug-induced liver injury increases year by year, the pathogenesis of drug-induced liver injury has become the focus of attention. As a large family, CYP450 enzymes participate in almost all oxidative metabolic reactions of drugs in the human liver. Recent studies have shown that CYP450 enzyme gene polymorphisms lead to the differences in pharmacodynamics between individuals, and therefore, exploring the role of CYP450 enzyme gene polymorphisms in drug-induced liver injury may promote the understanding of the pathogenesis of drug-induced liver injury. This article reviews the CYP450 enzyme polymorphisms that have been found to be associated with drug-induced liver injury.

Objective:To analyze the features and clinical significance of damages to non pulmonary organs like the heart,kidney and peripheral blood in SARS patients.Methods:SPSS 11.0 and SDAS software packages were used to retrospectively analyze the damages to the heart,kidney and peripheral blood in 330 clinically confirmed SARS cases.Results:(1)The heart damage occurred within 1 week after SARS onset in mild cases; the rates of LDH,HBDH,CK and CK MB returning to normal were 74.2%,80.6%,100% and 100%,respectively.In severe cases,the heart damage usually occurred 1 week after SARS onset; the rates of LDH,HBDH,CK and CK MB returning to normal were 32.2%,29.5%,55.2% and 44.4%,respectively.Ten patients whose CK MB didnot return to normal died.(2) The changes of RBC count appeared after an average of 1 week (1 10 d) in 54.2% of the patients.It returned to normal in all the mild SARS cases after an average of 12.5(4 21) d but didnot in 18.4% of the severe cases ( P

Based on the significant differences in definition, clinical features, and prognosis between alcoholic hepatitis (AH) and severe AH, it is recommended to classify AH into mild and severe AH. As for the disease spectrum of hospitalized patients with alcoholic liver disease, most patients have liver cirrhosis, and about 15% have mild or severe AH. Alcoholic liver failure belongs to the category of severe AH. Severe AH is a clinical diagnosis, while alcoholic steatohepatitis is a pathological diagnosis. The clinical diagnostic criteria for severe AH tend to be consistent in European and the United States of America, but the Chinese guideline released in 2018 is not consistent with the guidelines from western countries.

Autoimmune hepatitis (AIH) is an immune-mediated inflammatory injury of hepatocytes, which can develop into liver cirrhosis and end-stage liver disease. Timely immunosuppressive therapy can help patients achieve biochemical remission and even histological remission and thus improve prognosis. However, adverse drug reactions during treatment and recurrence after withdrawal are commonly seen, and therefore, standard therapy, dose reduction at the right time, and timely drug withdrawal are important for improving patients’ prognosis. This article summarizes the advances in guidelines for the diagnosis and treatment of AIH and related studies in China and globally, so as to provide a reference for clinicians in the treatment of AIH.