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 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.

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.

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 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.

The abnormal expression of gastrins and their receptors have close relationship with the occurrenceand the development of some colorectal neoplasms.The high expression of gastrins and their receptors promote colorectal neoplasms cell proliferation and inhibit apoptosis.The biological behavior is mainly rely on the abnormal expression of protein.Using differential proteomics can screen differential expression protein of high expression of gastrin-based colorectal neoplasms in the occurrence and development process,and then with the regulation of specific proteins to achieve the prevention and treatment of colorectal neoplasms purposes.

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.

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.