Human metapneumovirus (HMPV)is a recently discovered virus associated with respiratory tract infection. Most infections with HMPV occurred during winter and spring. Children, elderly subjects and immunosuppressed hostsare susceptible. The consequences of HMPV infections ranged from mild upper respiratory tract infection to severe bronchiolitis or pneumonia. There are three different kinds of methods for the diagnosis of HMPV infections, detection of virus antigen-antibody, virus isolation by culture, and RNA detection by reverse transcription-PCR. Symptomatic therapy is the main method of treatment.

Objective To investigate the effect of early jejunal nutrition combined with enteral infusion of traditional Chinese medicine in the treatment of severe acute pancreatitis.Methods 10 patients with Severe acute pancreatitis were selected as group A,the implementation of the X-line built-jejunal tube through the nose,early enteral nutrition and joint Dachengqi Tom jejunum treatment.10 patients with severe pancreatitis were selected as group B,taken TPN nutrition therapy.Results A group of patients with abdominal pain and bloating relief at the time was better than group B( P ＜ 0.01 ) ; A group of mortality and multiple organ failure was less than the number of cases in group B ( P ＜ 0.01 ).Conclusion The effects of early enteral nutrition combined with enteral infusion of traditional Chinese medicine was more effective than the traditional treatment.

Objective To investigate the clinical characteristics of upper gastrointestinal diseases in very old people (aged ≥ 90 years),and to explore the necessity and safety of the gastroscopy for the super elderly people.Methods Clinical data of 50 very old people were retrospectively analyzed.Results The total detection rate of upper gastrointestinal disease was 76.0％ (38/50),in which the reflux esophagitis (RE) was the most common (26.0％),followed by erosive gastritis (20.0％),atrophic gastritis (18.0 ％),peptic ulcer (12.0 ％),gastrointestinal cancer (10.0％),duodenitis (8.0％) and fundic gland polyps (6.0％) respectively.RE lesions detected by gastroscopy were mainly mild and were divided into endoscopic grade LA-A (46.1％),LA-B (30.8％),LA C (7.7％),and LA-D (15.4％) according to the Los Angeles classification.The most common symptoms were abdominal distension and anorexia,and the both incidences were 12.0％.There was no significant difference in the prevalence of clinical symptoms between the elderly people with upper gastrointestinal disease and without abnormal gastroscopic findings [44.7％ (17/38) vs.41.7％ (5/12),x2 =0.035,P＞0.05].22 patients (44.0％) underwent gastroscopy under intravenous anesthesia.Conclusions The incidence of upper gastrointestinal disease is high in very old people,and mild reflux esophagitis is the most common.Clinical symptoms are little or asymptomatic in most very old people.Gastroscopy under intravenous anesthesia is safe and feasible for the very old people.

Objective To investigate the value of acoustic radiation force impulse (ARFI) in differential diagnosis between benign and malignant breast tumors.Methods Virtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ) of ARFI elastography were used to estimate the properties and extent and measured the shear wave velocities (SWV) of the breast tumors,respectively.Results The mean SWV of breast cancer and benign lesion were (7.84 ±2.51)m/s and (2.79 ±0.92)m/s.There was significant difference in the SWV between benign and malignant breast tumors (P ＜ 0.01).The area under curve (AUC) of receiver operating characteristic (ROC) curve of the SWV in differentiating benign from malignant breast tumors was 0.886.With SWV 4.4 as cut-off,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value in the diagnosis of malignant from benign breast tumors were 78.7％,100％,91.7％,100％,88％,respectively.Conclusions ARFI elastography could reflect the elastic characteristics of breast tumors,which might be useful for the differential diagnosis between benign and malignant breast tumors.

BACKGROUND:Atherosclerosis is a common complication in diabetic nephropathy and hemodialysis patients. The effect of hemodialysis duration and other relative factors on the atherosclerosis of patients with diabetic nephropathy needs to be further observed and explored. OBJECTIVE:To observe the atherosclerosis in the patients with different hemodialysis durations, then to evaluate the effect of hemodialysis duration and other relative factors on atherosclerosis of patients with diabetic nephropathy. METHODS:The intima-media thickness of the carotid artery in the diabetic nephropathy hemodialysis group, non-diabetic nephropathy hemodialysis group and end-stage renal disease non-hemodialysis group was detected with high-frequency ultrasonic testing, and the healthy volunteers were as the normal control group. The relationship between the intima-media thickness of the carotid artery in the hemodialysis patients and hemodialysis duration was analyzed, and the changes of insulin resistance in each group were compared. RESULTS AND CONCLUSION:Compared with the normal control group, the intima-media thickness of the carotid artery in the diabetic nephropathy hemodialysis group and non-diabetic nephropathy hemodialysis group was increased (P<0.01);there was no significant difference of intima-media thickness of the carotid artery between 24 hours diabetic nephropathy hemodialysis group and end-stage renal disease non-hemodialysis group (P>0.05);the intima-media thickness of the carotid artery in the 60 months diabetic nephropathy hemodialysis group was higher than that in the 24 hours diabetic nephropathy hemodialysis group (P<0.05);the intima-media thickness of the carotid artery in the 60 months diabetic nephropathy hemodialysis group was significantly higher than that in the end-stage renal disease non-hemodialysis group (P<0.01). There was no significant difference of intima-media thickness of the carotid artery between 60 months diabetic nephropathy hemodialysis group, end-stage renal disease non-hemodialysis group and 24 hours diabetic nephropathy hemodialysis group (P>0.05). The homeostasis model of assessment-insulin resistance value in the 24 hours diabetic nephropathy hemodialysis group was slightly lower than that in the diabetic nephropathy non-emodialysis group (P<0.05), and the homeostasis model of assessment-insulin resistance value in the 60 months diabetic nephropathy hemodialysis group was significantly lower than that in the diabetic nephropathy non-emodialysis group (P<0.01). The development of atherosclerosis on diabetic nephropathy patients can be affected by hemodialysis to some extent. And the effect is correlated with the hemodialysis duration.

Inflammatory breast carcinoma (IBC) is a particularly local advanced breast cancer,which has characters of high invasion,high metastasis and high human mortality.Because of high malignancy and rapid development,extensive body metastasis often happens in early stage and the prognosis is very poor.Currently,the therapy strategy of operation,chemotherapy combined with radiotherapy is used to treat IBC.However,the effect is always very limited.Now,the advances in researches of molecular biology and cancer immunology bring hope.Some recent progresses of therapy in IBC are reviewed in the article.

Objective To investigate the effect of parental presence on the anxiety of children during induction of anesthesia with sevoflurane. Methods One hundred and twenty children (ASA Ⅰ or Ⅱ ) aged 2-12 yr weighing 12-32 kg were assigned to one of 2 groups using a random number table ( n = 60 each): control group (group C) and parental presence group (group P). Preoperatiave visit was made the day before surgery in both groups. In group P a parent played with toys with the children for 15 min before induction of anesthesia, while in group C a nurse played with them. Anesthesia was induced with 8% sevoflurane in O2 delivered at 6 L/min through a scented face mask held by the parent or anesthesiologist talking with them in soft words. Modified Yale preoperative anxiety scale (mYPAS) was used to measure anxiety of the children during preoperative visit, before and during induction of anesthesia. Induction compliance checklist (ICC) was used to measure behavioral compliance during induction. ICC score ＞ 5 implied failure of induction of anesthesia with sevoflurane. Adverse events were recorded. Results The mYPAS scores were significantly lower before and during induction of anesthesia in group P than in group C (P ＜ 0.05), but there was no significant difference in ICC scores between the 2 groups ( P ＞0.05). There was no failure of induction in group P while in group C there were 3 failures. Cough occurred in 2 patients in group P but in 3 patients in group C. One patient vomited during induction of anesthesia in group C.Conclusion Parental presence is effective in reducing anxiety of children during induction of anesthesia.

In coloreetal cancer,there are multiple abnormally expressed microRNA (miRNA),suggesting that the miRNA may be involved in tumor development process.Recently,more and more evidence shows that miRNA are more stable in the blood,compared with mRNA,which makes circulating miRNA are helpful to become the non-invasive tumor marker for the diagnosis,treatment and prognosis evaluation in coloreetal cancer.

Visceral hypersensitivity is the core pathogenesis process of functional gastrointestinal disorders( FGIDs). Numerous studies showed that psychological stress plays a key role in the development of visceral hypersensitivity. Brain center is the key part involved in psychological stress-induced visceral hypersensitivity, especially senior central sensitization. However,the specific pathophysiological mechanism remains unclear. This article reviewed studies on central role mechanism of psychological stress-induced visceral hypersensitivity.