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 summarize the progress of clinical research on triple-negative breast cancer(TNBC).Methods Domestic and international publications on the study of TNBC in recent years were collected and reviewed.Results The patients with TNBC were younger,and their prognosis was poorer.Besides operation,chemotherapy was the major therapeutic tool for them.Currently the targeted therapy for epidermal growth factor receptor and its signal conducting system was applied to clinical therapy gradually,and it might benefit the patients with TNBC.Conclusion The study on TNBC may bring a new way for therapy.

[Objective] To investigate the antibiotic resistance and nosocomial infections status of Staphylococcus aureus(SAU)and provide scientific evidence for disease diagnosis and reasonable use of antibiotics.[Methods]The clinical isolates were identified by VITEK-2 compact.AST-GP61 was used to detect the antibiotic susceptibility.[Results] Among 310 S.aureus isolates,SAU was isolated from ICU and department of dermatology,from sputum/throat and secretion.The drug sensitivity rate to glycopeptide antibiotics and linezolid was 100%,the incidence of oxacillin-resistant S.aureus was 53.1%.[Conclusions] S.aureus showed multidrug resistance to the commonly used antibiotics,while curing infections caused by oxacillin-resistanct S.aureus,Vancomycin,teicoplanin and linezolid were the best choice.

Objective To investigate the inter-arm invasive blood pressure differences during hip replacement in patients with lateral position and its relationship with position.Methods Sixty-six patients having underwent hip replacement in orthopedic surgery with lateral position were enrolled.Invasive blood pressure measurements were obtained from bilateral radial artery in all patients every 5 minutes.Simultaneously bilateral invasive blood pressure measurements were obtained and compared.Results At supine position,systolic pressure,diastolic pressure and mean arterial pressure of the uninjured side were (128.16 ±20.09),(69.47 ± 8.64) and (89.03 ± 10.42) mmHg (1 mmHg =0.133 kPa);systolic pressure,diastolic pressure and mean arterial pressure of the injured side were (127.90 ± 20.44),(69.86 ± 8.81) and (89.21 ± 10.71) mmHg.There was statistical difference in inter-arm diastolic pressure (P ＜ 0.05),but inter-arm systolic pressure and mean arterial pressure had no statistical differences (P ＞ 0.05).At left-lateral position,systolic pressure,diastolic pressure and mean arterial pressure of the uninjured side were (129.12 ± 21.93),(69.23 ± 8.92) and (89.19 ± 11.35) mmHg;systolic pressure,diastolic pressure and mean arterial pressure of the injured side were (129.01 ± 21.72),(69.51 ± 9.02) and (89.34 ± 11.35) mmHg.There was statistical difference in inter-arm diastolic pressure (P ＜ 0.05),but inter-arm systolic pressure and mean arterial pressure had no statistical differences (P ＞ 0.05).At right-lateral position,systolic pressure,diastolic pressure and mean arterial pressure of the uninjured side were (128.78 ± 20.34),(69.54 ± 9.06) and (89.29 ± 10.82) mmHg;systolic pressure,diastolic pressure and mean arterial pressure of the injured side were (128.27 ± 20.56),(70.00 ± 9.09) and (89.43 ± 10.89) mmHg.There were statistical differences in inter-arm systolic pressure and diastolic pressure (P ＜ 0.05),but inter-arm mean arterial pressure had no statistical difference (P ＞ 0.05).The bilateral radial artery blood pressure difference under different positions was ＜ 1 mmHg,and had no clinical practical significance.There was no correlation between blood pressure and age,sex,body mass index.Conclusion Bilateral radial artery in the same patients with invasive blood pressure has no clinical difference,and patients with lateral position operation for radial artery puncture pressure need not consider the differences of blood pressure between arms.

Objective To induce and analysis the death relative factors of peritoneal dialysis patients over the past five years in fourth ward of qiandongnan from guizhou province guiyang medical college affiliated people's hospital in endocrinology and to improve the effect of nursing intervention.Methods 492 peritoneal dialysis patients were retrospective analyzed from Mar 2009 to Mar 2014,in order to conclude the causes of the patients that ending with death (n =89) and to formulate targeted nursing measures.Results The primary disease for death of maintained peritoneal patients was cardiovascular events [41.6％(37/89)],and the second factor was infection [32.6％(29/89)].The risk factors for mortality were age (≥70 years old),diabetes,endogenous creinine clearance rate declined [＜50 L·week-1 ·m-2],change of hemodialysis to peritoneal dialysis and higher peritoneal transport status.Conclusions It's important to strengthen the nursing intervention for the peritoneal dialysis patients with coronary heart disease,and to formulate targeted nursing measures for risk factors,so as to avoid the death.

Objective To investigate the status of urogenital Ureaplasma urealyticum (Uu) infection and their drug tolerance in our area,so as to guide rational administration for the clinic.Methods Mycoplasma culture and drug susceptibility test were performed for 771 patients with urogenital infaction. The culture,identification and drug resistance of mycoplasma were carried out with one complex mycoplasma kit.Results The positive rate of Uu was 49.9%. The proportional percentage of males was 12.5% and the Uu positive rate was 22.3%,for females,the proportional percentage and Uu positive rate was 87.5% and 60.6% respectively. The population aged 21-40 was susceptible to Uu infection. The most sensitive antibioties to Uu was clindamycin (95.12%),followed by doxycycline (87.57%) and roxithromycin (86.24%).Conclusion The difference of Uu drug sensitivty was significant in different areas. So it is necessary to select antibioties by drug sensitivity. Clindamycin,doxycycline and roxithromycin may are used as preferred antibioties in treating Uu infection in our area. The drug-resistance status of spectinomycin and lincomycin was serious.

Objective To investigate the influence of Fasudil on oxidative stress in patients with early-stage diabetic nephropathy. Methods 48 patients with earl-stage diabetic nephopathy were randomly divided into control group treated with Alpha-lipoic acid and treametn group with Fasudil. All patients were under strict control of blood glucose. Changes in the levels of serum cysc, urinal mALB and 8-OHdG were observed after two weeks treatment were compared between the two groups. Results Compared to pre-treatment, the content of serum cysc, urinal mALB and 8-OHdG were significantly decreased in both groups after treatment. There was no significant difference in the content of urine mAlb , CTGF and MCP-1 between the two groups before and after treatment (P > 0.05). Conclusion Fasudil may protect kidney through a mechanism by which the level of 8-OHdG in kidney is decreased and oxidative stress is alleviated.

Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by extreme immune activation, resulting in pathologic inflammation. The HLH-2004 diagnostic criteria is used widely based on the data from pediatric patients. However, there are differences between children and adults in the etiology, clinical and laboratory characteristics for HLH. Given these differences, diagnostic scoring systems unique to adult HLH have been proposed. HLH in adults is a much more heterogeneous syndrome requiring a more individualized approach depending on the underlying trigger, disease severity, as well as genetic background.

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.