Application of acute physiology and chronic health evaluation Ⅱ score in the timing of noninvasive ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease / 中华危重病急救医学

Objective:To explore the application of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score in the timing and nursing of noninvasive ventilation for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:106 AECOPD patients admitted to Haikou People's Hospital from January 2018 to October 2019 were selected as the study objects. According to the method of random number table, the patients were divided into observation group and control group, with 53 patients in each group. The control group selected the timing of noninvasive ventilation treatment according to the standards of Mechanical ventilation (second edition), weaned according to Clinical practice of mechanical ventilation, and received routine nursing in intensive care unit (ICU), including creating comfortable indoor environment, reasonable diet, condition monitoring, psychological nursing and complications nursing. On the basis of the control group, the patients in the observation group were given noninvasive ventilation when APACHE Ⅱ score was more than 10, and were weaned when APACHE Ⅱ score was less than or equal to 10. According to APACHE Ⅱ score < 10, 10-14, 15-19 and ≥ 20, the patients were given level-3 care, level-2 care, level-1 care and intensive care. The pulmonary function before and 3 days after the noninvasive ventilation treatment was monitored, and the duration of mechanical ventilation, the length of ICU stay, endotracheal intubation rate, incidence of complication [ventilator associated pneumonia (VAP)] and ICU mortality were recorded. The self-designed questionnaire of nursing satisfaction was used to evaluate the patients' nursing satisfaction. Results:There was no significant difference in general data such as gender or age between the two groups. After 3 days of noninvasive ventilation, the forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio of the two groups were increased significantly as compared with those before treatment, especially in the observation group, with statistical significances as compared with the control group [FEV1 (L): 3.02±0.22 vs. 2.54±0.19, FVC (L): 3.01±0.32 vs. 2.13±0.28, FEV1/FVC ratio: 0.89±0.08 vs. 0.79±0.08, all P < 0.05]. Compared with the control group, the duration of mechanical ventilation and length of ICU stay in the observation group were significantly shortened [duration of mechanical ventilation (days): 4.32±0.73 vs. 8.42±1.94, length of ICU stay (hours): 32.23±10.22 vs. 38.52±9.85, both P < 0.01]. The intubation rate, incidence of VAP and ICU mortality in the observation group were significantly lower than those in the control group [intubation rate: 1.9% (1/53) vs. 13.2% (7/53), incidence of VAP: 1.9% (1/53) vs. 15.1% (8/53), ICU mortality: 1.9% (1/53) vs. 13.2% (7/53), all P < 0.05]. The nursing satisfaction of patients in the observation group was significantly higher than that in the control group [96.2% (51/53) vs. 75.5% (40/53), P < 0.01]. Conclusions:APACHE Ⅱ score can be used to guide the choice of noninvasive ventilation treatment opportunity and nursing intervention measures for AECOPD patients. It can significantly improve the pulmonary function of patients, improve the treatment effect, reduce the incidence of complications, and improve the satisfaction of patients with nursing, which is effective in clinical application.

Influence of primary caesarean section on re -caesarean operation of advanced pregnant women / 中国基层医药

Objective To investigate the influence of primary caesarean section on re -caesarean operation of advanced pregnant women.Methods 251 advanced pregnant women were chosen to research,and they were divid-ed into research group(traditional abdominal longitudinal incision)and control group (novel abdominal transverse incision)by primary caesarean section.The clinical indicators,abdominal adhesion and complication occurrence between the two groups were compared.Results Operation time[(57.98 ±12.26)min vs.(78.39 ±17.54)min], amount of bleeding during operation[(248.59 ±17.32)mL vs.(377.18 ±56.04)mL],anal exhaust time[(40.26 ± 7.25)h vs.(56.02 ±8.23)h]and length of stay[(7.21 ±2.06)d vs.(9.94 ±3.13)d]of the research group were all lower than the control group,the differences were statistically significant (t =10.576,24.018,16.129,8.069,all P <0.05).The severity of abdominal adhesion of the research group was lighter than the control group,and the differ-ence was statistically significant (U =2.601,P <0.05).No severe complications such as asphyxia occurred in the two groups.Postpartum hemorrhage and abdominal adhesion occurrence in the research group were lower than the control group ,there was significant difference in abdominal adhesion between the two groups (χ2 =1 8 .8 6 2 ,P <0.05).Conclusion Primary caesarean section has influence on clinical indicator,abdominal adhesion severity and complications in re -caesarean operation of advanced pregnant women,and novel abdominal transverse incision has greater influence,traditional abdominal longitudinal incision little.

Therapeutic effects of recombinant hepatitis B virus vaccine combined with interferon α-1 b in patients with chronic hepatitis B / 中华传染病杂志

Objective To investigate the therapeutic effects of recombinant yeast hepatitis B virus(HBV)vaccine combined with interferon(IFN)α-1b and determine the rational dosage of HBV vaccine for the further clinical study with larger sample.Methods Two hundreds and sixteen patients with chronic hepatitis B(CHB)were enrolled in this randomized,multi-center,double-blinded and placebo-controlled clinical trial.All the subjects were not treated with antiviral drugs within 6 months and randomly divided into 90μg,60μg and placebo groups with a ratio of 1:1:1.All the patients were intramuscularly administrated with 90μg or 60μg recombinant HBV vaccine or placebo at week 0,2,6,10,14,18,22,respectively.Meanwhile,they were also treated with IFNα-1b 50μg,3 times a wcek for 24 weeks.All patients were followed up for 24 weeks after withdrawal of anti-HBV therapy.Serum HBV DNA level,HBeAg titer and liver function were monitored frequently.Interferon-γ secreting lymphoeytes were detected by Enzyme-linked immunospot(ELISPOT)in part of the patients.Results The serum HBV DNA levels were(6.03±1.79),(5.52±1.82)and(6.29±1.70)log10 copy/mL at week 24 of treatment in high dose,low dose and placebo groups,respectively (P=0.458).And the serum HBV DNA levels were(5.92±1.98),(5.49±1.99)and(6.16±1.76)log10 copy/mL at weck 24 after withdrawal of treatment,respectively(P=0.720).The rates of patients whose HBV DNA＜1×105 copy/mL in these three groups were 30.4%,39.4% and 20.8% at week 24 of treatment,respectively and there was significant difference between high dose group and low dose group(P=0.015).The rate of patients whose HBV DNA＜1×105 copy/mL at week 24 after withdrawal was highest in low dose group,but no significant differences before and after treatment in these three groups(P=0.257).The HBV DNA negative rates were 17.4%,25.4% and 6.9% in these three groups,respectively,which were significantly different(P=0.012).At week 24 of treatment and week 24 after withdrawal of treatment,the alanine aminotransferase normalization rate,HBeAg seroconversion rate were highest in low dose group,but no significant differences in these three groups.ELISPOT positive rates at week 24 of treatment and week 24 after withdrawal of treatment in high close and low dose groups were higher than that in placebo group(P＜0.05).The incidence of adverse events was similar and there was no drug related severe adverse events in each group.Conclusion Recombinant HBV vaccine maybe contribute to anti-HBV therapy and 60μg of dosage seems to be rational.

Therapeutic Effectiveness of Adefovir Dipivoxil Monotherapy or Adefovir Dipivoxil Combined with Lamivudine on Patients with Hepatitis B-related Cirrhosis / 医学研究杂志

Objective To assess the therapeutic effectiveness of monotherapy of adefovir dipivoxil (ADV) and lamivudine (LAM),or ADV administered in combination with LAM,in order to find the effective and secure therapy for decompensated cirrhosis patients following chronic hepatitis B. Methods Totally 64 decompensated cirrhosis patients following chronic hepatitis B were divided into 2 groups by using a prospective randomized grouping method. In group A,patients received the therapy of adefovir dipivoxil (10mg/d) combined with lamivudine (100mg/d); and in group B,a monotherapy of adefovir dipivoxil (10mg/d) was used. The period of treatment was 48 weeks. Levels of serum ALT,HBeAg and HBV-DNA were detected in week 12,24,36 and 48 respectively. The liver function was evaluated with Child scores on these time points. Data were analyzed by a blinded independent investigator. Results After 48 weeks treatment,HBV DNA negative conversion rate of the two groups were 87.1%and 78.8%.The virtual rate were 96.8% and 87.9%;HBeAg negative conversion rate were 83.9%,and 57.6%. HBeAg/anti-HBe seroconversion rates of the two groups were 41.9%and 24.2%. Normalization of serum ALT levels were observed in 96.8% patients of group A and 97.0% of group B. Conclusion The combination therapy of adefovir dipivoxil (ADV) and lamivudine (LAM) could reduce the occurrence of drug resistance,and increase the anti-viral effect. It is a secure management for chronic hepatitis B virus infection.

Preparation of human single chain Fv antibody specifically against hepatitis C virus E2 antigen / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To identify human single chain Fv antibody (ScFv) against hepatitis C viral E2 antigen and its value clinically.</p><p><b>METHODS</b>The recombinant phages were panned by E2 antigen which was coated in a microtiter plate. After five rounds of biopanning, 56 phage clones were identified specific to E2 antigen. The affinity and specificity of ScFv were evaluated by ELISA and immunohistochemistry, respectively.</p><p><b>RESULTS</b>The data of E2-ScFv DNA digestion and DNA sequencing showed that the ScFv gene was composed of 750bp. ELISA and immunohistochemistry demonstrated that the human single chain Fv antibody against HCV E2 antigen had a specific combination character with hepatitis C virus E2 antigen.</p><p><b>CONCLUSIONS</b>ScFv, having a sutestantial affinity and specificity and being easy to prepare, is valuable in the detection of HCV E2 antigen.</p>

Clinical and pathological characteristics and pathogenesis of autoimmune hepatitis / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>To explore the clinical and pathological characteristics and pathogenesis of autoimmunohepatitis (AIH).</p><p><b>METHODS</b>The serum and liver biopsy specimens and clinical data of 26 cases with patients with AIH were analyzed and scored according to the criteria of International autoimmune hepatitis (IAIHG, 1999). The changes of dendritic cells (DC) in the liver tissues were observed with a panel of DC markers (CD-80/B7-1, CD-86/B7-2, CD-1a and HLA-DR) and immunohistochemistry, and the activation of hepatic stellate cells (HSC) and the expression of TGF-alpha were also detected. Liver tissue specimens from 10 patients with chronic viral hepatitis B and C respectively and 5 normal liver specimens were chosen as controls.</p><p><b>RESULTS</b>Mean aggregate scores of 26 AIH cases, including 21 cases of type B (80.8%) and 5 cases of type C (19.2%), which were 18.6 +/- 1.4 and 19.1 +/- 2.1 respectively. There were significant differences between the type B and type C in the average age levels of serum ALT and AST, and alpha-Glo (P <0.001 or P< 0.01 or P <0.05). Histological features of all the AIH liver tissues showed the lesions of chronic active hepatitis such as interface hepatitis/piecemeal necrosis (100%), obvious lobular inflammation (type B 95.2%, type C 100%), bridging necrosis (57.1% type B, 80.0% type C, P<0.05), rosetting of liver cells (71.4% type B, 100% type C, P<0.01), central lobular confluent necrosis (33.3% type B, 80.0% type C, P<0.001), predominant plasmacytic infiltration (type B 95.2%, type C 20.0%, P<0.001). The rates of increased and concentrated DC in the portal and lobular areas, especially in the active lesions in type B and type C AIH were 85.7% (18/21) and 5/5 respectively. It was found that DC and lymphocytes surrounded the hepatocytes which partly expressed HLA-DR antigen, while there were no or a few HLA-DR positive hepatocytes in controls. Meanwhile, the number of alpha-SMA positive HSC and the expression of TGF- were obviously increased in AIH liver tissues.</p><p><b>CONCLUSIONS</b>Several clinical and pathological features of AIH were identified in this study. As an antigen-presenting cell, DC might play an important role in the pathogenesis of AIH. In China, sub-type B of AIH might be more frequent than sub-type C and there were differences in clinical aspects, serology and pathology between the two types.</p>

Features of onset of chronic severe hepatitis in 520 cases / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To discuss features of onset of chronic severe viral hepatitis (CSH).</p><p><b>METHODS</b>The patterns of onset of 520 cases of CSH were analyzed by SPASS and STATA software.</p><p><b>RESULTS</b>1. Within less than 10 days, less than 2 weeks, 2 to 4 weeks, 4 weeks to 6 months, 10.4%, 18.1%, 17.1% and 64.8% of 520 cases deteriorated into severe hepatitis respectively. 2. There were no definite predisposing factors in more than 40% cases. There were 1 to 3 or more predisposing factors in more than 30% cases. The incidence of concurrent infection was the highest (P<0.01). 3. The pathogenic basis in more than 50% cases was cirrhosis. 4. Hepatic encephalopathy did not occur in more than 50% of the cases. Ascites occurred in more than 75% of cases. Hepatic encephalopathy first occurred in less than 5% cases and ascites in more than 10% of cases. 5. The latest time for occurrence of hepatic encephalopathy was later than the time of deteriorating into severe hepatitis.</p><p><b>CONCLUSIONS</b>1. Gradual deterioration into CSH was found in all the 520 cases. 2. The predisposing factors, pathogenic bases, incidence and occurring time of hepatic encephalopathy, firstly occurring complication and so on in CSH are not the same as those in acute and subacute severe hepatitis. Therefore, CSH should be independently named and the study of CSH should be strengthened.</p>

Screening and cloning gene of hepatocyte protein interacting with hepatitis C virus core protein / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To clone the unknown gene of hepatocyte protein interacting with hepatitis C virus core protein.</p><p><b>METHODS</b>Using the yeast dual hybrid system 3, bait plasmids of hepatitis C virus core were constructed. After identifying hepatitis C virus core protein that could stably expressed in AH109 yeast strains, we performed yeast two hybrid by mating AH109 with Y187 that transformed with liver cDNA library plasmids pACT2 and then plated on quadrople dropout (QDO) medium and assayed for alpha-gal activity. The genes of yeast colonies that could grow on QDO and had alpha-gal activity were sequenced.</p><p><b>RESULTS</b>Among the 30 positive colonies, we blasted the gene of the sixth colony; we coined human hepatitis C virus binding protein 6(Hu Hcbp6) with Genbank, realized that the Hu Hcbp6 shares as much as 98% homology with two cDNA without knowing functions. We have proved that Hu Hcbp6 could interact with hepatitis C virus core protein.</p><p><b>CONCLUSIONS</b>Hepatitis C virus core binding protein (Hu Hcbp 6 Genbank number: AY032594) was successfully cloned and identified. The study partly paved the way for investigating physiological function of the Hu Hcbp6.</p>

Clinical studies on the short-course and efficient treatment of mumps meningitis / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the short-course and efficient way to treat mumps meningitis.</p><p><b>METHODS</b>Totally 155 cases of mumps meningitis treated by intrathecal injection with dexamethasone only once were enrolled as experimental group and 55 similar cases treated with the common therapy as control.</p><p><b>RESULTS</b>The time for recoveries of temperature, headache, the pathologic reflexes and the total time of treatment were 32 hours, 15 hours, 12 hours and 3.1 days, respectively, while those of the control group were 58 hours, 24 hours, 32 hours, 6.5 days respectively. There was statistical difference between the two groups (P<0.01 or 0.05).</p><p><b>CONCLUSIONS</b>Intrathecal injection with dexamethasone only once is efficient and safe in the treatment of mumps meningitis.</p>

Single factor study of prognosis from 520 cases with chronic severe hepatitis / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To further understand chronic severe hepatitis (CSH) and to improve the level of diagnosis and treatment and to explore the methods to reduce the fatality rate of CSH through analysing the factors related to prognosis of CSH.</p><p><b>METHODS</b>The factors related to prognosis from 520 cases with CSH were analyzed by SPASS and STATA software.</p><p><b>RESULTS</b>1. The fatality rate in cases with age > or = 40 years was higher than that in cases with age <40 years (P<0.001), there was no significant difference (P>0.05) in sex and pathogenic basis of CSH; 2. The fatality rate rose in cases with WBC > or = 10.0 x 10(9) per liter or platelet <100 x 10(9) per liter; 3. The fatality rate increased gradually with the ratio of aspartic aminotransferase to alanine aminotransferase (AST/ALT) and serum total bilirubin (TBil), appearance of deviation of TBil and ALT, decrease in prothrombin activity (PTA), total cholesterol (TC), cholinesterase and albumin (Alb) (P<0.001). 4. The fatality rate increased with appearance of complications such as ascites, electrolyte disturbance, spontaneous peritonitis and so on (P<0.001).</p><p><b>CONCLUSIONS</b>The important factors related to prognosis were age, > or = 40 years, WBC 10.0 x 10(9) per liter or platelet <100 x 10(9) per liter; the ratio of AST/ALT, TBil, Tc, cholinesterase, Alb and complication, to monitor dynamically laboratory indexes such as TBil, PTA, Tc, cholinesterase and so on and to prevent and cure various complications are important measures to reduce the fatality rate of CSH.</p>

Synergetic transactivating functions of HCV core and truncated HBV middle surface protein / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the synergetic transactivating functions of HCV core and truncated HBV middle surface proteins.</p><p><b>METHODS</b>Two recombinant expression plasmids harboring HCV core and C-terminally truncated HBV middle surface protein gene were constructed, respectively. The plasmids were transfected into HepG2 cells and cotransfected HepG2 cells with reporter plasmid pSV-lacZ by lipofectamine plus reagents. The transient expressed viral proteins were identified at the transcription and translation levels. The activity of beta-galactosidase was detected, which reflected the transactivating function of the proteins.</p><p><b>RESULTS</b>The protein expression of plasmids was detected in soluble cell extracts of transiently transfected HepG2 cells. HCV core protein activated the beta-galactosidase expression at a value of 4.6 times higher than the control, while C-terminally truncated HBV middle surface protein activated at a value of 3.2 times. It reached 8.4 times transfected with the plasmids simultaneously. The transactivating effect was dose dependent.</p><p><b>CONCLUSIONS</b>It is suggested that the two kinds of virus proteins have transactivating effect on SV40 early promoter/enhancer, and they act synergistically. These contribute to explain the mechanisms of liver injury or tumorigenesis induced by HCV or/and HBV infection.</p>

Relationship Between Complications and Prognosis of Chronic Severe Hepatitis / 中国医师杂志

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.

Comparison of sequence diversity in genotype Ⅱ and Ⅲ hepatitis C virus(HCV) hypervariable region 1(HVR1) in Chinese / 第二军医大学学报

Objective: To compare the sequence diversity of HVR1 in the putative envelope protein E2 of the genotypeⅡand genotype Ⅲ HCV in Chinese. Methods: The cDNAs[nucleotide(nt)1449-1586(HCV-J) or nt1460-1582(HCV-J6)] derived from plasma of 55 patients infected with genotype Ⅱ HCV and 38 patients infected with genotype Ⅲ HCV were amplified,purified and directly sequenced by RT-nested polymerase chain reaction(PCR) and dideoxynucleotide chain termination method. Results: The HVR1 was found in amino acid(aa) 384-408 positions of both types HCV E2 protein. There were 5 similar conserved amino acids in 2 types HCV HVR1:aa385(Thr), aa389, 390, 406(Gly)and aa403(Phe).Besides, 401(Ser) was also highly conserved in genotype Ⅱ HCV HVR1. Although the variation characteristic of 2 types was similar, but the sequence diversity(SD),the kinds and frequency of some amino acids in some HVR1 positions and the conserved region near the HVR1 had some differences between 2 genotypes. Conclusion: Further study on the diversity of HVR1 and its biological significance will be helpful to understand the mechanism of HCV persistent infection and the development of HCV vaccine.

STUDY ON CLINICAL SIGNIFICANCE OF PREMONITORY MODE OF DETERIORATION OF SEVERE ACUTE RESPIRATORY SYNDROME(SARS) / 解放军医学杂志

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.

FEATURES OF CLINICAL STAGES AND TYPES OF SEVERE ACUTE RESPIRATORY SYNDROME AND THEIR CLINICAL SIGNIFICANCE / 解放军医学杂志

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.

Damage to non-pulmonary organs like heart and kidney in SARS patients:An analysis of 330 cases / 第二军医大学学报

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

THE PRELIMINARY STUDY ON INDIVIDUALLY CHARACTERIZED QUASISPECIES OF HEPATITIS B VIRUS / 解放军医学杂志

Primers were synthesized according to DNA sequence of HBV found in China, and the reverse transcriptase (RT) region in polymerase gene, HBV preC/C region and the whole genome were amplified by PCR method from the serum of 8 patients with chronic HBV infection. Then the PCR products were ligated into pGEM Teasy vectors. 27 clones were sequenced. Deduced amino acid sequences were compared, and the results showed that mutations were widely distributed in structural and non structural viral proteins. The substitution mutations occur in clones isolated from specific patients, which led to a characteristic mutation in the quasispecies group. The results indicated that the diversity of HBV gene might play an important role in the pathogenesis of chronic HBV infection.

A study on prognostic factors of severe SARS: a clinical analysis of 165 cases / 解放军医学杂志

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

Scientific countermeasures for influenza A(H1N1) / 解放军医学杂志

The epidemic situation of influenza A(H1N1) throughout the world had evoked close attention of the World Health Organization(WHO).WHO director-general pointed out that the pandemic alert level had been set at 3,which was then raised by WHO from 3 to 4 and from 4 to 5 two days later.The present paper focused on the finding of influenza virus,the influenza prevalence in history,and introduced the scientific countermeasures for influenza A(H1N1),including the spreading of influenza virus,the clinical features,treatment,main measures of prevention and control,etc.