Objective To explore the methods of identifying factitious/fraudulent disorders (M?n-chausen syndrome), enhancing the understanding of their predisposing factors, clinical features, and underlying psychopathology. Method After a final diagnosis of factitious fever was made, data of 4 patients presenting with a puzzling fever of unknown origin were analyzed and compared with those of other cases reported in the English literature. Result It was confirmed that the elevated temperature recorded in the clinical charts of the 4 patients was faked by manipulating of the thermometer. Conclusion These 4 cases show the existence of factitious/fraudulent disorders in China, possibly related to an abnormal psychology, but the tricks employed by the patients are relatively simple compared with those used abroad.

Objective:To observe the change of CD4 + T cells of SARS patients in early stage of disease and determine its clinical significance on the progress of disease and therapy selection.Methods:Detection the absolute counts of T cell subset from the peripheral blood samples of 52 SARS patients in initial 10 days' duration by Flow cytometry.Serial frontal chest radiographs had done and the progression of disease was observed during the treatment of all patients.Results:The 34 cases among the 52 patients were in normal range of CD4 + cell absolute count.At the same time,their pulmonary lesions were in limited degree and the states of an illness were stabilization and the pulmonary lesions were absorbed quickly.Therefore they reuired the treatment without corticosteroids.The other 18 patients were with low CD4 + cell absolute count, of which 13 cases showed progressive deterioation of radiographic change and were treated with corticosteroids additional.The other 5 cases with the mild low of absolute count of CD4 + cells were also static during the period of observation,and no treatment with coticosteroids.There was statistically significant relation between two groups(P=0 000).The results of Pearson correlate analysis between absolute count of CD4 + cells and pulmonary lesions were r=-0 737;P=0 000;The result between absolute count of CD4 + cells and corticosteroids treatment were r=-0 573;P=0 000.Conclusion:Peripheral blood CD4 + cell absolute counts of SARS patients on early stage of onset were negatively related to the degree of pulmonary lesions.The patients with remarkable decrease of CD4 + cell were in need of treatment with corticosteroids.

Objective To investigate the status and clinical and epidemiological characteristics of human metapneumovirus (hMPV) and human bocavirus (HBoV) infections in children with acute respiratory tract infections (ARTIs) in Taiyuan. Methods A total of 549 children with ARTIs from November 2012 to May 2013 and November 2013 to May 2014 were recruited. The pharyngeal swab specimens were collected. The hMPV and HBoV were detected by using real-time PCR. Results In 549 children, 56 children (10.2%) were hMPV positive on swab specimens, 15 children (2.7%) were HBoV positive on swab specimens. The detection rates of hMPV and HBoV in November 2012 to May 2013 were 12.3%and 2.0%, respectively, and in November 2013 to May 2014 were 6.5%and 4.0%, respectively. The detection rate of hMPV was signiifcantly different between two periods (P<0.05), while the detection rate of HBoV has no signiifcant difference between two periods. In different months, the detection rate of hMPV and HBoV showed no signiifcant difference. The highest detection rates of hMPV and HBoV were all in children younger than two years old. The highest detection rate of hMPV was in children with asthmatic bronchitis or bronchiolitis. Conclusion In Taiyuan, during the monitoring periods, the ARITS are associated with childhood hMPV and HBoV infection especially in infants and toddlers. hMPV is one of the most important pathogens in infants and toddlers with wheezing.