Objective:To analyze the epidemiological characteristics and genotypes of human rhinovirus (HRV) in patients with upper respiratory tract infection in Qingdao in the winter of 2020.Methods:Throat swab samples were collected from 101 patients with upper respiratory tract infection in Qingdao from November 2020 to January 2021. Quantitative PCR was used to detect 15 common respiratory viruses in the samples. HRV-positive samples were further analyzed with RT-PCR to amplify and sequence HRV VP4/VP2 gene. A phylogenetic tree was constructed based on the sequencing results and homology analysis was conducted.Results:Six common respiratory viruses were detected in the 101 patients. Thirty-four cases (34/101, 33.66%) were single pathogen infection and two cases were multiple infection (2/101, 1.98%). The positive rate of HRV was the highest (21.78%, 22/101). Twenty HRV VP4/VP2 sequences were successfully amplified. Phylogenetic analysis showed that there were 16 strains of HRV-A subtype and four strains of HRV-C subtype and 14 serotypes were involved.Conclusions:HRV was one of the leading viral pathogens causing upper respiratory tract infection in Qingdao in the winter of 2020 and the predominant subtype was HRV-A.

Objective:To investigate the safety and dose of 4D template (real-time adjustable angle template) in the treatment of advanced malignant tumors with 125I seeds. Methods:98 patients with advanced malignant tumors admitted to Department of Thoracic Surgery of Shaanxi Provincial Tumor Hospital were treated with 4D template-navigated radioactive 125I seed implantation from June 2018 to December 2019. Preoperative TPS plan, intraoperative optimization, postoperative verification of immediate dose and postoperative evaluation of implantation dose were performed. The treatment results were observed. Results:All 98 patients completed the seed implantation. The implantation dose of GTV of implantation site receiving external irradiation was (12 489±414) cGy and the dose of no external irradiation was (15 036±514) cGy. V 100% was 84.7%-94.1%, and 88.2%-93.7%. The implantation dose of CTV was (7 450±621) cGy, and (9 080±761) cGy. The quality of dose implantation was evaluated as: excellent in 89 cases (91%, 89/98), good in 7 cases (7%, 7/98), fair in 2 cases (2%, 2/98), and poor in 0 case, respectively. The symptom relief rate of patients with pain was 92%(36/39). The 1-and 2-year local control rates were 61%, 36% and 82%, 54% in patients treated with and without external irradiation, respectively. The difference was statistically significant ( P=0.02). The incidence rates of pneumothorax and hemoptysis were 19%(9/48) and 10%(5/48). No corresponding complications were observed in other parts of the patients. Conclusion:4D template-assisted 125I seed therapy is safe and effective for malignant tumors, and intraoperative adjustment of needle angle and dose optimization can realize the precise control of implantation dose.

Objective:To understand the prevalence of coxsackievirus A6 (CV-A6) in hospitalized patients with hand, foot and mouth disease in autumn and winter of 2019, and the genetic characteristics of VP1 region and the relation-ship between germline evolution.Methods:A total of 104 throat swabs from hospitalized patients with hand, foot and mouth disease in Qingdao in autumn and winter of 2019, and screen positive specimens were collected using enterovirus universal real-time PCR technology. Then the universal typing primers in the VP1 region were used to amplify the positive samples, the amplified segments were sequenced and BLAST comparison was performed. CV-A6 VP1 full-length primers were used to amplify the BLAST comparison of CV-A6 positive samples, sequence the ampli-fied products, analyze the homology of nucleotides and amino acids through DNAstar and MEGA software, and construct a phylogenetic tree.Results:Among 104 throat swab samples, 60 were positive for enterovirus, and the overall positive rate was 57.7%, of which the positive rate of CV-A6 was 26.9% (28/104), and the rate of coxsackievirus A16 (CV-A6) was 30.8% (32/104). Twenty-eight CV-A6 positive samples were subjected to full-length amplification, sequencing, comparison and homology analysis of the VP1 region, and 22 positive sequences were obtained. The nucleotide homology was 93.6% to 99.9%, and the amino acid homology was 98.0%-100%. Phylogenetic analysis showed that 22 CV-A6 strains belonged to the D3 subtype in the D genotype.Conclusions:The pathogens causing hospitalized hand, foot and mouth disease in Qingdao in autumn and winter of 2019 were CV-A6 and CV-A16. The prevalent strains of CV-A6 were mainly D3 subtypes.

Objective:To analyze the epidemiological characteristics and co-infections of pathogens in children with pneumonia in autumn and winter of 2019 in Qingdao.Methods:From August to November in 2019, 77 children with pneumonia in three hospitals in Qingdao were selected as the research subjects. Throat swabs were collected, nucleic acid was extracted, and 20 common respiratory pathogens were detected by single tube multiplex PCR.Results:Among the 77 cases, the incidence of pneumonia in boys (53.2%) was slightly higher than that in girls (46.7%). Children aged 1-2 years accounted for 10.3% of the total cases, children aged 3-6 years accounted for 61%, and children aged 7-13 years accounted for 20.7%. Twenty-nine cases (38.10%) had high white blood cells; 16 cases (20.77%) had high neutrophil count; 30 cases (38.96%) had high lymphocyte count; the pathogen detection rate was 77.92% of cases, among whom Mycoplasma pneumoniae (MP) was 59.74%, Bocavirus was 10.39%(8/77), adenovirus was 7.79% (6/77), rhinovirus was 3.89% (3/77), parainfluenza virus type 4 was 3.89% (3/77), Bordetella pertussis was 3.89% (3/77), parainfluenza virus type 2 was 2 2.59% (2/77), coronavirus nl63/hku1 was 2.59% (2/77), coronavirus OC43 was 2.59% (2/77), human metapneumovirus was 1.29% (1/77), Parainfluenza virus type 3 was 1.29%(1/77). The 24 cases of virus infection accounted for 31.16% (24/77). The co-infection with two pathogens accounted for 18.18%.Conclusions:Many kinds of pathogens were detected in children with pneumonia in autumn and winter of 2019, in Qingdao. The prevalence of Mycoplasma pneumoniae infection was the highest. Many common viral infections were found in the cases. A high proportion of co-infection was detected in these pneumonia cases.

[Abstract] Objective: To investigate the short-term clinical efficacy and safety of intraperitoneal perfusion of natural killer (NK) cells in the treatment of ovarian cancer with ascites. Methods: The clinical data of 15 ovarian cancer patients with ascites effusion, who received NK cell perfusion in the Qinhuai Medical District of the General Hospital of Eastern Theater Command from November 2016 to January 2019, were analyzed. The peripheral blood was collected to isolate the peripheral blood mononuclear cells, and to further obtain the NK cells after culture. NK cell suspension was intraperitoneally perfused into the abdominal cavity (no less than 2×109 cells/ time). The volume of peritoneal effusion, the level of serum tumor marker CA-125, the level of serum cytokines IL-2, INF-γ and TNF-α as well as the changes in peripheral blood lymphocyte subsets were detected before and after the treatment; Moreover, the clinical efficacy and adverse reactions were observed. Results: The effective rate of intraperitoneal perfusion of NK cells was 66.7%, and there were no obvious treatment-related adverse reactions. Compared with before treatment, the serum tumor marker CA-125 level significantly decreased after treatment (P<0.05), and the levels of IL-15, IFN-γ and TNF-α increased significantly (P<0.05 or P<0.01), while there was no significant changes in peripheral blood lymphocyte subsets (all P>0.05). Conclusion: Intraperitoneal infusion of NK cells in the treatment of ovarian cancer associated peritoneal effusion has a good short-term clinical efficacy with little adverse reactions, which is a promising method for the treatment of cancerous peritoneal effusion.

Objective To evaluate the efficacy of dexmedetomidine in preventing agitation during recovery from general anesthesia in patients undergoing uvulopalatopharyngoplasty (UPPP).Methods Sixty adults patients with obstructive sleep apnea syndrome,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,aged 24-62 yr,with body mass index of 24-37 kg/m2,undergoing elective UPPP,were divided into dexmedetomidine group (group D) and conventional group (group C) using a random number table method,with 30 patients in each group.Dexmedetomidine was infused in a loading dose of 0.8 μg/kg over 10 min starting from 10 min before anesthesia induction,followed by a continuous infusion of 0.4 μg · kg-1 · h-1 for 30 min in group D,while the equal volume of normal saline was given instead of dexmedetomidine in group C.Anesthesia was induced and maintained by target-controlled infusion of propofol and remifentanil,and bispectral index value was maintained at 40-60 during surgery.Patients were extubated after they restored spontaneous breathing completely,opened eyes on verbal command and responded to verbal command,and then the patients were transferred to the recovery room,and oxygen was inhaled by mask.The emergence time,extubation time and development of agitation were recorded.Verbal rating scale was used to assess pain at 30 min after patients were transferred to the recovery room.Results Compared with group C,the incidence of agitation was significantly decreased,pain was reduced,and the emergence time was prolonged in group D (P＜0.05).There was no significant difference in extubation time between two groups (P＞0.05).Conclusion Dexmedetomidine can effectively prevent the occurrence of agitation during recovery from general anesthesia in patients undergoing UPPP.

Objective To evaluate the effects of different anesthetic methods on postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy.Methods Fifty-four patients of both sexes,aged 18-64 yr,with body mass index of 20-28 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective video-assisted thoracoscopic thymectomy,were allocated into 2 groups (n =27 each) using a random number table method:sevoflurane-based anesthesia group (group S) and propofol-based anesthesia group (group P).After routine anesthesia induction in two groups,anesthesia was maintained by inhaling sevoflurane and target-controlled infusion of remifentanil in group S and by target-controlled infusion of propofol and remifentanil in group P.Heart rate and mean arterial pressure were recorded before operation and at 5 and 10 min after extubation (T1.2).The intensity of pain at T2 and visual analog scale (VAS) score and consumption of morphine at 1,2,4,24 and 48 h after operation (T3-7) were recorded.The pressing times of analgesia pump,requirement for rescue analgesia and development of nausea and vomiting were recorded at T7.Results There were no significant differences in heart rate or mean arterial pressure at each time point between two groups (P＞0.05).Compared with group S,the intensity of pain was significantly alleviated at T2,and VAS scores and morphine consumption were decreased at T3,4 in group P (P＜0.05).There were no significant differences between group P and group S in VAS scores or consumption of morphine at T5-7,or pressing times of analgesia pump,requirement for rescue analgesia or incidence of nausea and vomiting at T7 (P＞0.05).Conclusion Propofol-based anesthesia provides better efficacy in alleviating postoperative acute pain in patients with myasthenia gravis undergoing video-assisted thoracoscopic thymectomy.

Objective To evaluate the efficacy of laryngeal mask airway (LMA) Guardian for airway management in the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy.Methods Sixty patients of both sexes,aged 26-64 yr,weighing 48-95 kg,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,with Mallampati grade Ⅰ-Ⅲ,scheduled for elective laparoscopic cholecystectomy under general anesthesia,were divided into group Ⅰ and group Ⅱ (n =30 each) using a random number table.In group Ⅰ,the nasogastric tube was inserted through the drain tube of LMA Guardian.In group],the nasogastric tube was inserted through the nostril before operation,and after successful LMA Guardian placement,another nasogastric tube was inserted through the drain tube of LMA Guardian.The hemodynamic parameters,SpO2,end-tidal pressure of carbon dioxide and peak airway pressure (Ppeak) were monitored during operation.The fiberoptic laryngoscopy scores were assessed after successful LMA placement,and the nasogastric tube displacement was recorded.The LMA placement time,success rate of LMA placement at first attempt,airway sealing pressure,occurrence of air leakage of LMA and nasogastric tube drainage were recorded.The bloodstains and gastroesophageal reflux were observed after removal of the LMA.The pH values were tested at the tip of LMA and on the dorsal and ventral sides of the body of LMA using pH test papers.The development of adverse reactions in the oropharynx was recorded within 24 h after operation.Results The hemodynamics was stable,the SpO2 and Ppeak were within the normal range during operation,and Ppeak was lower than airway sealing pressure in the two groups (P＞0.05),and there was no significant difference between the two groups.There was no significant difference between the two groups in the LMA placement time,success rate of LMA placement at first attempt,airway sealing pressure,score for exposure of oropharynx,development of adverse reactions in the oropharynx,consumption of anesthetics,development of bloodstains within the body of LMA and gastroesophageal reflux,and pH values at the tip of LMA and on the dorsal and ventral sides of the body of LMA (P＞0.05).Nasogastric tube drainage:the rate of nasogastric tube drainage through the LMA Guardian was 67％ in group Ⅰ;the rate of nasogastric tube drainage through the nostril was 40％,and the rate of nasogastric tube drainage though the LMA Guardian was 50％ in group Ⅱ.No nasogastric tube displacement was found after operation in group Ⅱ.Conclusion For the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy,insertion of LMA Guardian is easy,and LMA Guardian can assure good airway sealing and adequate ventilation and can be safely and effectively used for airway management in this type of patients.

Objective To determine the relationship between neuronuscular block induced by cisatracurium for tracheal intubation during anesthesia induction and types of myasthenia gravis (MG).Methods Sixty-five patients of both sexes with MG,aged 20-75 yr,weighing 53-92 kg,with body height of 155-185 cm,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective videoassisted thoracoscopic thymectomy,were enrolled in the study.Among the 65 patients,there were 8 patients with ocular MG (type Ⅰ),19 patients with mild generalized MG (type]Ⅱ a),33 patients with subacute generalized MG (type Ⅱ b),2 patients with acute MG (type Ⅲ) and 3 patients with late severe MG (type Ⅳ).Neuromuscular monitoring was initiated when the patients lost consciousness after induction of anesthesia.Cisatracurium was administrated with the initial dose of 0.05 mg/kg,and if T1 depression was less than 95％ within 6 min,cisatracurium 0.015 mg/kg was intravenously injected until T1 depression was more than 95％.The patients were then tracheally intubated.The amount of cisatracurium consumed for intubation,onset time (from the beginning of cisatracurium injection to T1 depression ＞95％) and recovery time (recovery of T4/T1 to 25％ of control height) of neuromuscular block were recorded.T1 depression ＞ 95％ within 6 min after administration of 1-fold ED95 cistracuriun was defined as sensitivity to muscle relaxants.The requirement for cistracurium ＞ 1-fold ED95 when T1 depression ＞ 95％ was defined as insensitivity to muscle relaxants.The proportion of sensitivity/insensitivity was calculated.Results There was no significant difference in the amount of cisatracurium consumed for intubation and onset time and recovery time of neuromuscular block between patients with type Ⅰ and those with type Ⅱ a (P＞0.05).Compared with patients with type Ⅰ and type]Ⅱ a,the amount of cisatracurium consumed for intubation was significantly decreased,the proportion of sensitivity/insensitivity was increased,the onset time was shortened,and the recovery time was prolonged in patients with type Ⅱ b (P＜0.05).Conclusion With the severity of MG,the consumption of cisatracurium is gradually decreased when used for tracheal intubation during anesthesia induction,and the sensitivity is gradually increased in the patients with MG.

Hypertension is the leading risk factor for death resulted from cardiovascular diseases.According to the statistics,the number of patients with hypertension in China is 270 million.At present,15 classes and 69 drugs have been approved for the treatment of hypertension,however,the treatment rate and the control rate remain low.Therefore,the research tocusing on new antihypertensive drugs are how to effectively reduce the blood pressure in patients with refractory hypertension,reduce the target organ damage in patients with complications,and reduce adverse drug reactions.This paper summarized the recent research progress of anti-hypertensive drugs on the market or in development,so as to provide references for development and application of antihypertensive drugs.