Abstract: Objective　To explore the efficacy and safety of photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) combined with antifungal drugs combined and comprehensive nursing intervention in the treatment of refractory kerion. Methods　From January 2019 to December 2022，6 cases of refractory kerion who were treated at the Fifth People's Hospital of Hainan Province with photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) combined with antifungal drugs. A solution with 20% concentration of ALA solution was uniformly dropped on the cotton sheet, shielded from light for 3 h, and irradiated with (633±10) nm LED red light for 20-30 min. The treatment was performed once a week, with one treatment course consisting of three sessions. Prior to treatment, debridement and fire needles pre-treatment were performed. Provide timely and targeted psychological care during treatment to alleviate psychological negative disorders and health education. Follow-up examinations were conducted 6 months after the treatment to evaluate clinical efficacy, safety and patient satisfaction. Results　Six children received standard ALA-PDT combined with antifungal drugs, supplemented by comprehensive nursing intervention. The cure rate of children reached 100%, and no disease relapse or atrophic scar was found. The satisfaction rate of patients and their families was 100%. Conclusions　PDT combined with antifungal drugs has obvious clinical efficacy in the treatment of kerion, especially when combined with comprehensive nursing intervention. This approach can help to relieve patients' anxiety, improve treatment outcomes, enhances patient compliance, and further improve patients' satisfaction.

Objective To study the imaging value in diagnosis of congenital cholangiectasis.Methods The clinical and imaging (CT and ultrasonics) data of 6 patients with congenital cholangiectasis were restrospectively analyzed with literature review.Results According to Todani's classifications of cholangiectasis,there were type I in one case,CT showed cystic hypodense shadow with thin and smooth wall;type IV in 4 cases,CT showed cystic or fusiform extension of intra-and extra-hepatic bile ducts;type V in one case,CT showed cystic extension of intra-hepatic bile ducts,and the central spot enhancement could be seen on contrast-enhanced CT scan.6 cases underwent ultrasonic examinations,ultrasound showed extension of intra-and extra-hepatic bile ducts in 6 cases,choledochal cyst in one.4 cases suspected with congenital cholangiectasis,and misdiagnosed in one.In company with cholecystitis and cholelithiasis in one,biliary carcinoma in one and cirrhosis in one.Conclusion CT and US are of important value in diagnosis of congenital cholangiectasis.

Objective To establish a method for the determination of tetrahydropalmatine in Fuyantai Capsule. Methods TLC Scanning was used. with n-hexane ∶chloroform ∶methanol(7 ∶3 ∶0.5)as developer,scanned by double-wavelength reflection,?S=275 nm,?R=370 nm,slit 1.2?1.2 mm,SX=3.Results The linear range of tetrahydropalmatine concentration was 0.2～1.0 ?g and r=0.9992. The average recovery was 96.7 %and RSD was 1.92 %.Conclusion This method is accurate with a good reproducibility and can be used for the quality control of Fuyantai capsule.

AIM: To establish a method for the determination of ephedrine hydrochloride in Juyuanzhike Tablets (Radix Platycodonis,Radix Polygalae,ephedrinelydrochloride,etc.). METHODS :Ephedrine hydrochloride in Juyuanzhike Tablets were determined by HPLC. RESULTS : The linear range was 0.2～1.6 ?g,r =0.9999.The average recovery was 97.7% and RSD was 0.58%,respectively. CONCLUSION : The method is simple,feasible and reproducible. It can be used for the quality control of Juyuanzhike Tablets.

Objective To explore the pathogenesis mechanism of hyperoxic lung injury and the effective means for its clinical treatment,the difference of the gene expressions between lung tissues of hyperoxic lung injury and normal lung was compared.Methods The differentially expressed genes between lung tissues of hyperoxic lung injury and normal lung were obtained from PubMed.The dysregulated genes in lung tissues of hyperoxic lung injury were analyzed by a series of bioinformatics methods,including pathways,gene ontology and functional annotation clustering analysis.Results 467 lines of differentially expressed genes were found and genes more than 2-fold regulated were 189.We sought the mapping of genes in the KEGG databases through functional annotation tools,and we discovered there were 5 lines of pathways with difference having outstangding statistical significance through metabolic pathways enrichment degree analysis.It reflected the pathways were closely related to hyperoxic lung injury (the 2-fold upregulated genes were 14,the 2-fold down-regulated genes were 6).GO analysis revealed that these genes were involved in hematopietic cell lineage,axon guidance,adherens junction,T cell receptor signaling pathway and focal adhesion.Conclusions Therefore,it is believed that the above-mentioned 20 lines of gnes are the major ones for the hyperoxic lung injury and the research on them will provide effective means for revealing the molecular mechanism of hyperoxic lung injury and identifying the targeted therapy.

【Objective】 To retrospectively analyze the clinical use of low-dose blood components in Dongguan and the trend of clinical pediatric blood use, so as to provide reference for better preparation and inventory management of low-dose blood components in blood centers. 【Methods】 The clinical consumption of RBCs, platelets and plasma of Dongguan Blood Center from 2015 to 2020 was counted. The compositions and changes of low-dose blood components by specifications (0.25 U, 0.5 U), years and hospitals (public grade A general hospital, public grade A specialized hospital, private grade A hospital, private hospital equivalent to grade A, regional central hospital, public township hospital, small private hospital) were analyzed. 【Results】 The cumulative growth rates of low-dose RBCs, platelets, and plasma in 6 years were 10.78%, 1 098.55% and -29.41%, respectively, and the compound annual growth rates were 2.07%, 64.34% and -6.73%, respectively. The composition of low-dose blood components in RBCs, platelets and plasma was different (P<0.05) in different levels of hospitals, among which RBCs and plasma were the mostly used in public grade A specialized hospital, accounting for 45.08% (7 272 /16 133) and 53.18% (7 199/13 373) respectively, while platelets were the mostly used in private grade A management hospitals, accounting for 77.38% (3 393/4 385), dominated by apheresis platelets 53.84% (1 144/2 125) and irradiated apheresis platelets 99.51% (2 249/2 260). The composition ratios of 0.25 U and 0.5 U RBCs used in different hospitals were significantly different (P<0.05). The 0.25 U RBCs were used mostly in public grade A hospitals (62.60%, 3 502/5 594) and 0.5 U RBCs in public grade A specialized hospitals (62.09%, 6 544/10 539). 【Conclusion】 The total consumption of low-dose blood components in clinical pediatrics from 2015 to 2020 were as follows: platelets had increased significantly year by year, RBCs had increased steadily and with fluctuation, plasma had a downward trend year by year. The consumption volume and varieties used in different levels of hospitals were uneven, which may be related to the development of pediatrics departments in hospitals and their capabilities to conduct new business. Regular monitoring of the trend of low-dose blood component consumption is of great significance to guarantee the pediatric clinical blood supply.

【Objective】 To investigate the influence of different packaging methods on the volume of low-dose(0.5 U) suspended leucocyte depleted red blood cells(SLD RBC) and provide reference for accurate labeling. 【Methods】 Bags of SLD RBC in 1.5 U and 2 U were randomly sampled to measure the weight and specific gravity of each bag, so as to estimate the blood volume.The relationship between the weight and volume of 0.5 U blood, split from different parent bags, was analyzed and the linear regression equation was put forward.The regression equation was used to calculate and analyze the difference in the volume of 0.5 U SLD RBC prepared by three different packaging methods (A: manual multi-bag average packing; B: instrument multi-bag average packing; C: manual single-bag packing) in actual work. 【Results】 The specific gravity of 1.5 U (38 bags) and 2 U SLD RBC (39 bags) were (1.090±0.011) g/mL and (1.097±0.013) g/mL, respectively, and the difference was statistically significant (P<0.05). After the 0.5 U subsidiary bags were split from the parent bags(1.5 U or 2 U), the regression equations for the volume (Y) of 0.5 U and gross weight (X) of the whole bag were respectively: Y1.5 U packing=0.902 7X-12.52 (P<0.05) and Y2 U packing=0.905 6X-13.15(P<0.05). In actual blood packaging, the average blood volume of 0.5 U subsidiary bags split from 1.5 U bag, using method A and B, were smaller than those split from 2 U bag [(62.12±5.38) mL and (62.50±6.77) mL vs (67.72±3.81) mL and(68.39±6.44)mL] (P<0.05), with the deviation of low-dose blood volume from 5.593 mL to 5.887 mL.The volume deviation by method B (10.84% and 9.42%) were greater than that by method A (8.67% and 5.63%). The average volume of 0.5 U subsidiary bags split from 1.5 U and 2 U by method C were (65.49±1.72) mL and (64.99±1.91) mL (P>0.05), with volume deviation at 2.63% and 2.94%, respectively.The mean volume value of overall 0.5 U blood (n=483) was (65.35±5.34) mL. 【Conclusion】 For packaging 0.5 U subsidiary bags, the instrument multi-bag packaging showed the largest volume deviation, followed by the manual multi-bag packaging and the single-bag packaging.The volume labeling of low-dose SLD RBC should be established, according to the specifications of parent bags and specific gravity.

Objective: To study the difference in the flora structure and gene function of dental plaque in caries-free and caries-active preschool children by 16S rRNA sequencing. Methods: After oral examination of 96 preschool children aged 3-6 years, they were divided into 3 groups according to their decayed, missing and filled surface (dmfs) index: group CF with no caries (n=31), group ECC with moderate early childhood caries (n=29) and group SECC with severe early childhood caries (n=36). Dental plaques were collected, and DNA was extracted and then underwent metagenomic sequencing by Illumina HiSeq 2 500. The bacterial community structure was analyzed by Qiime. Results : A total of 12 phyla, 31 classes, 31 orders, 50 families, 92 genera and 1 104 species were found in the dental plaque samples of the three groups, most of which belonged to 9 dominant genera, including Streptococcus, Veillonella, etc. The microbial diversity of the dental plaques in the three groups was similar (P > 0.05). Veillonella, Lactobacillus, Megasphaera, and Scardovia in the SECC group were significantly higher than those in the other two groups. There was a significant correlation between the decayed, missing and filled surface (dmfs) index and the genus. Bifidobacterium, Veillonella, Lactobacillus had a positive correlation with the dmfs index, while Eikenella had a negative correlation with the dmfs index. Indicator species analysis showed that Atopobium, Veillonella, Megasphaera, Scardovia, Lactobacillus and Bifidobacterium had high indicative values in the SECC group. Conclusion There are significant differences in plaque microbiota among preschool children with different caries sensitivities. Veillonella, Megasphaera, Scardovia, Lactobacillus, Bifidobacterium and Atopobium may be the indicator genera of severe early children caries.

Objective To explore risk factors of poor early prognosis in the treatment of COVID-19 by nematevir and ritonavir tablets Paxlovid and establish the prediction model to provide reference for improving the effect of such patients. Methods 92 inpatients of COVID-19 treated with Paxlovid in three military tertiary hospital in southern Fujian from January 2023 to March 2023 were retrospectively analyzed. The clinical indicators of 92 inpatients were collected for univariate and multivariate analysis by single factor and multiple factors and the independent risk factors of poor early prognosis in Paxlovid were screened out. Logistic model equation was transformed to construct the combined predictors, and ROC curve was used to determine the area under the curve (AUC) and the optimal critical value of the combined predictors. Results Among 92 patients, 31 (33.70%) developed poor early prognosis, including 11 deaths (35.48%), 17 critical cases (54.84%) and 3 severe cases (9.68%). Multi-factor Logistic regression analysis showed that the disease days, lymphocyte count, aspartate aminotransferase(AST), C reactive protein(CRP) and ventilator-assisted ventilation were independent risk factors for poor early prognosis in Paxlovid. A formula for calculating the combined predictors (Y) was established as Y_{combinedpredictors}=7.875X_{disease days}+126.188X_{lymphocyte count}+1.438X_AST+X_CRP+220.500X_{ventilator-assisted ventilation} based on the above independent risk factors, and the ROC curve was drawn. With the maximum area under the ROC curve of the combined predictors being 0.939, the prediction value was best, and the optimal critical value of the ROC curve corresponding to the maximum Youden index (0.756) was 447.920.Theoretical accuracy of the model was 89.10%. Conclusion The disease days, lymphocyte count, AST, CRP and ventilator-assisted ventilation were independent risk factors for poor early prognosis in Paxlovid. Combined predictors could be calculated by the above risk factors before medication. The efficiency should be improved by taking more active treatment, including combining with other anti-COVID-19 drugs when the prediction result exceeds 447.920.