Immune dysfunction plays a pivotal role in the pathogenesis and progression of severe viral pneumonia.Both hyperactivated immune responses and immunosuppressive states may adversely affect clinical outcomes.Glucocorticoids,widely utilized as immunomodulatory agents,hold significant therapeutic value in managing this condition.Elucidating the intricate mechanisms underlying immune dysregulation in these patients,accurately assessing individualized immune profiles,and optimizing glucocorticoid regimens alongside other immunomodulatory interventions are critical to improving clini-cal success rates.This review synthesized current progress in research on immune disorders and glu-cocorticoid therapy in severe viral pneumonia,providing theoretical foundations for clinical practice to enhance patient prognosis.

Objective Based on the Hood Policy Tool perspective on China's DIP policy text mining,word frequen-cy analysis and clustering analysis of the policy content,to explore the actual policy in each pilot region,to further analyze the reasons,to provide a scientific and reference for the subsequent policy adjustment and implementation.Methods Policies were included in this study from platforms such as local healthcare protection bureaus,local health-care commissions,local people's government portals,and NVivo,from which policy documents with a high degree of relevance to DIP were selected.NVivo 20.0 software was used for text coding,word frequency analysis,and analysis based on Hood's policy tool dimensions and regional distribution dimensions to further explore DIP policy specifics.Results A total of 27 policies were included,covering all pilot provinces,with a total of 1,707 policy codes.Authoritative,fiscal,informational,and organizational policy instruments accounted for 54.9％,20.3％,16.9％,and 7.9％,respectively.The percentage of coded reference points in the East,Central,West,and Northeast regions were 23.0％,20.2％,44.5％,and 8.7％,respectively.Conclusion The use of DIP policy tools in the pilot regions focused on authoritative tools and less on organization tools.Among the authoritative policy tools,the sub-tools of mechanism building were mostly used,while the sub-tools of standards and norms were less used.The focus of the policy tools varies among the pilot regions,and the use of policy tools should be tailored to the local context.

OBJECTIVE:To observe the efficacy and safety of valsartan combined with prednisone in the treatment of idiopath-ic pulmonary fibrosis. METHODS:50 patients with idiopathic pulmonary fibrosis were randomly divided into control group and ob-servation group. Control group was orally given 0.5 mg/(kg·d)Prednisone acetate tablet in 1-4 weeks,then maintained with 0.125 mg/(kg·d)in 5-12 neeks,2-3 times a day;observation group was additionally given 80 mg Valsartan capsule,orally,once a day. The treatment course for both groups was 6 months. Pulmonary function indicators [forced vital capacity(FVC),peak expiratory flow rate (PEFR),and forced expiratory volume in one second (FEV1)],serum inflammatory factor indicators [interleukin-13(IL-13), IL-18,transforming growth factor-β1(TGF-β1)] level,matrix metalloproteinase-9(MMP-9),MMP-2 contents and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). Before treatment,there were no significant differences in the pulmonary function indicators,serum inflammatory factor indicators,MMP-9 and MMP-2 contents between 2 groups(P>0.05);af-ter treatment,pulmonary function indicators in 2 groups were significantly higher than before,and observation group was higher than control group,MMP-9 and MMP-2 contents were significantly lower than before,and observation group was lower than con-trol group(P<0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Valsartan combined with prednisone can significantly improve the pulmonary function of patients with idiopathic pulmonary fibrosis,and reduce the contents of serum inflammatory cytokines and matrix metalloproteinases,with good safety.

Objective To investigate the signal transduction pathway mechanisms of rats with liver fibrosis regulated by leptin and interfering effects of mistletoe alkali .Methods The hepatic fibrosis in rats model was established by injecting carbon tetrachloride .Forty-five SD rats were randomly divided into normal group ,model group and therapeutic group.All rats except rats in normal group were intraperitoneally injected with 40%carbon tetrachloride in peanut oil with a dose of 2.0 mL/100g according to the body weight twice a week for 8 weeks.Then, the therapeutic group was given mistletoe alkali (8g/(kg· d)) for 8 weeks via gastrogavage.Rats in normal and model group were served with distilled water at the same time.At the end of the 16th week, blood and tissue specimens were taken from all the rats .The influence of mistletoe alkali on liver morphology in liver fibrosis rat model was reviewed by HE and Masson staining .The effects of mistletoe alkali on the expression of Leptin and its receptor ( OB-Rb ) in HSC in fibrosis rat model were determined by immunohistochemistry (IH).The expression of JAK2, STAT3 and the activity of phospho -JAK2, phospho-STAT3 were detected by Western blotting analysis .Results The degree of fibrosis of the model group was more severe than the normal group and the treatment group , which suggested that mistletoe alkali can reverse liver fibrosis in rats . Immunohistochemical staining showed that mistletoe alkali reduced the hepatic expression of leptin and OB -Rb in rats with liver fibrosis in comparison with their expression in the model group .Compared with the normal group , the expression of JAK2 and STAT3 increased in the model group .However, the expression of JAK2 and STAT3 decreased in the medication groups compared with the model group .Conclusion Mistletoe alkali can effectively ameliorate liver fibrosis in rats possibly through inhibiting hepatic leptin and its receptor expressions , which through inhibiting hepatic leptin and its receptor expressions , thus inhibit the JAK2/STAT3 signaling pathway .

Objective To investigate the expressions and clinical significance of survivin, and lymphatic vessel endothelial hyaluronan receptor 1 ( LYVE-1) in gastric cancers.Methods The expres-sions of survivin and LYVE-1 were detected with streptavidin avidin-peroxidase ( SP) immunohistochemical method in 70 cases of gastric cancers and 50 cases of normal gastric tissues.The relationship between the expressions of survivin and LYVE-1 with the clinicopathological parameters was analyzed.Results The ex-pression rate of survivin was 65.71%(46/70) in gastric cancers, and 6.00% (3/50) in normal gastric tissues, with statistically significant difference between two groups (χ2 =43.048, P <0.01) .The expres-sion of survivin was different in gastric cancers:survivin expression rate was 76.92%in poorly differentia-ted gastric carcinomas, 75.00%in T3 ~T4 gastric carcinomas, 75.61%in the positive lymph node metas-tasis of gastric cancers, and 77.08%in the Ⅲ~Ⅳ gastric cancer tissues; which was significantly higher than the highly differentiated (51.61%), T1 ~T2(38.89%), lymph node-negative (51.72%), andⅠ~Ⅱperiod (40.91%) ( P <0.05).The expression of survivin in gastric cancers was no obvious correlation with the age, gender and tumor site ( P >0.05).The expression rate of LYVE-1 was 32.86%(23/70) in gastric cancers, and 4.00%(2/50) in gastric ulcers, with significant difference between two groups (χ2 =14.726, P <0.01) .The expression of LYVE-1 was different in gastric cancers:LYVE-1 expression rate was 40.38%in T3 ~T4 gastric carcinomas, 46.34%in the positive lymph node metastasis of gastric canc-ers, 41.67% in the Ⅲ ~Ⅳ gastric cancer tissues; which was significantly higher than the T1 ~T2 (11.11%), lymph node-negative (13.79%), andⅠ~Ⅱperiod (13.64%) ( P <0.05).The expres-sion of LYVE-1 in gastric cancers was no obvious correlation with the age, gender, tumor site, and the de-gree of differentiation ( P >0.05 ) .There was a positive correlation between expressions of survivin and LYVE-1 in gastric cancers ( r =0.271, P <0.05).Conclusions Survivin and LYVE-1 were abnormally expressed in gastric cancers with a colose relationships between two parameters.They might play important roles in tumorigenesis and progression of a gastric cancer.