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 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.

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.

Astrocytes are the most abundant neuronal cells in the central nervous system.It plays an important physiological role.In the process of cerebral ischemia,astrocyte activation is one of the major changes in the central nervous system.The activated astrocytes can play a neuroprotective role through the mechanisms such as maintaining ionic balance,regulating energy metabolism,removing excitatory amino acids,against oxidative stress,and secreting neuroprotective substances.However,astrocyte activation after cerebral ischemia also has its disadvantage.This article reviews the neuroprotective and damage roles of astrocyte activation during cerebral ischemia.It also investigates its regulatory mechanisms in order to provide new ideas for the treatment of ischemic stroke.

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.

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 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.

Transjugular intrahepatic portosystemic shunt (TIPS) has been developed for two decades in order to treat portal hypertension accompanying with upper gastrointestinal hemorrhage and refractory ascites.TIPS may cause the development of hepatic encephalopathy (HE).TIPS induces portalsystemic shunt and leads to hemodynamics chaos. Hepatic encephalopathy belongs to the complications of the portal hypertension. There are many possible predictors of the post-TIPS HE. The relationship between TIPS and HE was reviewed.

Flow cytometric immunophenotyping has evolved from two-parameter quantitative measurement of peripheral blood lymphocytes to five-or more parameter qualitative evaluation of bone marrow and lymph node in hematopathology.Leukemia/lymphoma immunophenotyping represents an important addition to histomorphology in the diagnosis,classification and monitoring of hematolymphoid neoplasms.The complexity of five-or more parameter analyses and the interpretation of the data rely on standardization and validation of the instrument,the reagent and the procedure.In addition,clinical flow cytometry laboratories in U.S.A are required to document proficiency testing,sample preparation as well as accuracy,specificity,sensitivity and precision of methodology.CLSI and UCCC recommend that each laboratory should validate its own qualitative and quantitative procedures.This paper introduces the procedures for validation and quality control in a clinical flow cytometry laboratory in the United States.

0.05).Conclusion:The diabetes itself does not affect the sulfonylurea receptor(SUR2)expression in myocardial tissues.Sulfonylureas at treatment dosage have no effect on receptor expression of SUR2.