Objective To explore the clinical effect of moist dressing combined with high energy narrow band phototherapy on chronic dermal ulcer.Methods Sixty cases with dermal chronic ulcer were randomly divided into two groups equally.The experimental group was treated by moist dressing combined with high energy narrow band phototherapy,while the control group was treated by moist dressing.The areas of wound surface were compared after treating for 14 and 21 days.Result Twenty-one days after treatment,the areas of wound surface were significantly reduced in the experimental group than that in the control group(P<0.05).Conclusion Moist dressing combined with high energy narrow band phototherapy can eradicate necrotic tissue,adjust micro-environment,and promote granulation and healing in chronic dermal ulcer.

In order to understand the management measures,technique abilities and difficulties in controlling and eradicating avian diseases in parent breeding flocks,the current situation of avian disease eradication in breeding flocks was investigated by China Animal Disease Control Centre in 19 provinces in July 2015.Questionnaires investigation was conducted and the feedbacks were received from 214 parent breeding flocks.This study summarized and analyzed the information of farm management,breeding resources,avian disease surveillance and disease eradication in these flocks,which will provide the basic data to promote the avian diseases control and eradication in China.

Objective: To explore the effect of high quality nursing on the salivary fistula of the patients after parotid tumor operation. Methods: August 2015-2017 June, 60 cases of parotid tumor were selected in our hospital for parotid tumor surgery. According to the nursing intervention methods, the observation group and the control group were divided into the observation group and the control group (n=30). The control group (n=30) was given the routine nursing. The nursing satisfaction of the two groups and the incidence of depression and anxiety before and after nursing. as well as the incidence of postoperative salivary fistula were observed. Results: The total satisfaction degree of nursing in the observation group was 96.67% (29/30), the control group was 76.67% (23/30). The total satisfaction degree of nursing in the observation group was significantly higher than that of the control group, and the difference was statistically significant (χ²=17.311 4, P<0.01). After nursing, the Self-rating Depression Scale (SDS) score and the Self-rating Anxiety Scale (SAS) score of the observation group were 10.35±1.65, 13.56±1.44, which were significantly lower than 21.51±2.49, 30.42±3.58 in the control group, and the difference was statistically significant (t=20.463 5, 23.931 6, P<0.01). After nursing, physical function, cognitive function, emotional function, social function and role function score of observation group were 75.2±6.8, 70.2±7.0, 75.6±5.0, 76.8±7.3, 76.4±7.0, which were significantly higher than 60.7±6.7, 51.6±7.3, 60.8±6.2, 61.3±7.4, 61.1±7.4 of control group, the difference was statistically significant (t=8.167 3-10.177 5, P<0.0). The incidence of salivary fistula in the observation group was 10.00% (3/30) which was significantly lower than 43.33 (13/30) of the control group, and the difference was statistically significant (χ²=28.404 5, P<0.05). Conclusion The application of high quality nursing in postoperative salivary fistula of parotid tumor patients is significant. It can effectively improve the patients′ unhealthy psychological emotion, improve their quality of life and reduce the incidence of complications, which is worthy of clinical promotion.

ObjectiveTo develop school refusal reason inventory (SRRI)for children and adolescents in China and assess its reliability and validity.MethodsThe primary SSRI was made based on clinical interviews and literatures.Pretest was carried out in a small sample from a clinic.Then the final SSRI was developed after qualitative analysis and item analysis.SRRI,the Screen for Child Anxiety Related Emotional Disorders(SCARED) and Child Depression Inventory(CDI) were administered to school refusers from 7 schools in Shenyang.All the schools were selected from Shenyang City and its countryside by cluster sampling.Some of the students were retested after one month.Descriptive statistics and exploratory factor analysis were carried out to examine the reliability and validity of SRRI based on all the data.Results Item analysis indicated correlation coefficients between all the items and the total marks were higher than 0.3,and they were significant.All the critical ratios of the items were higher than 0.3.The 43 items were divided into six factors ( educational modality,factor of teachers,relationship with classmates,separated anxiety,study attitude and study environment) by exploratory factor analysis.The factor loading values were 0.372 ～0.848.The cronbach's α of each factor was 0.827,0.831,0.759,0.623,0.821 and 0.808.Retest reliability was 0.644 (P ＜ 0.01 ).Its correlation coefficient with SCARED was 0.452 and 0.548 with CDI.ConclusionAccording to Chinese cultural back ground,the SSRI corresponds with psychometric indexes.There are good reliability and validity.It is helpful to understand the reasons of school refusal behavior in children and adolescents.

Objective:To explore the therapeutic effect of CO 2 fractional laser with topical triamcinolone and intrakeloid injection of triamcinolone. Methods:From January 2019 to December 2021, 24 cases of keloid patients in the outpatient clinic of the Department of Plastic Surgery and Aesthetics Hospital, all female, aged 22-53 years, were randomly divided into treatment group 1 (12 cases), treated with CO 2 fractional laser + local topical triamcinolone, and treatment group 2 (12 cases), treated with intra-local triamcinolone injection. The treatment was done every 4 weeks for 4-9 times and followed up for 1 year. Keloid size was assessed before and after each treatment and scarring was evaluated with the Vancouver Keloid Scale. Results:After treatment, the change in keloid size was greater in the treatment group 2 than that in the treatment group 1 (85.4% and 60.1%, χ 2=6.19, P<0.05), and the Vancouver Keloid Scale score showed that it was significantly lower in the treatment group 1 (7.8±1.5 versus 4.4±1.3, t=4.58, P<0.05) compared with the treatment group 2 (8.6±0.9 versus 4.5±1.3, t=3.45, P<0.05). During and at the end of treatment, the pain scores of the treatment group 1 were significantly lower than those of the treatment group 2, and patients′ comfort and compliance were significantly improved. Conclusions:Fractional laser combined with topical triamcinolone is a more suitable treatment option for patients with pain-sensitive keloids.

Objective:Evaluation of the efficacy and safety of ultra-picosecond 1 064 nm laser treatment for enlarged facial pores.Methods:From November 2022 to April 2023, 31 female patients with enlarged facial pores, aged between 28 and 52 (35.2±5.5) years old, were treated at the Medical Aesthetics Center of Xi′an International Medical Center Hospital. They received ultra-picosecond 1 064 nm laser fractional handpiece treatment once every 4 weeks for a total of 3 times. One month after the last treatment, facial pore changes were evaluated using facial pore scores and VISIA pore feature count absolute values, and adverse reactions were assessed.Results:All 31 patients completed the treatment. The facial pore scores before and after treatment were 4 (4, 5) and 2 (2, 3), respectively, indicating a statistically significant ( Z=-4.99, P<0.001) decrease in facial pore scores compared to before treatment. The absolute values of VISIA facial pore counts before and after treatment were 859 (829, 1147) and 652 (632, 731), respectively. The absolute value of VISIA pore count after treatment was lower than that before treatment, and the difference was statistically significant ( Z=-4.86, P<0.05 ). Conclusions:Ultra-picosecond laser can effectively improve enlarged facial pores without significant adverse reactions.

Objective:To analyze the application effect of condition scale in nursing management of children bronchial asthma in acute attack stage.Methods:A total of 136 children with acute attack of bronchial asthma admitted to Shanxi Children's Hospital from January 2020 to December 2021 were selected by convenience sampling method, and randomly divided into observation group and control group according to random number table method, 68 cases in each group. Children in the observation group received graded nursing intervention based on disease scale, while children in the control group received routine nursing intervention. The first second forced expiratory volume (FEV 1), forced vital capacity (FVC), ratio of FEV l/FVC, peak expiratory flow rate (PEF), medical intervention frequency, the number of ICU transfer and length of stay were compared between the two groups. Results:The results of repeated measurement ANOVA showed that there were intergroup, time and interaction effects on the levels of FEV 1, FVC, FEV 1/FVC and PEF in the two groups, and the differences were statistically significant ( P<0.05). The frequency of medical intervention in observation group was less than that in control group, and the length of hospitalization was shorter, with statistical significance ( P<0.05). There was no significant difference in ICU patients transferred between the two groups ( P>0.05) . Conclusions:Application of Condition Scale in nursing management of children with acute attack of bronchial asthma can improve the lung function of children with acute attack bronchial asthma more effectively, reduce the frequency of medical intervention, shorten the length of hospital stay, and significantly improve the nursing effect.

Objective To investigate whether capsular polysaccharides of Streptococcus pneumoniae serotypes 6A and 6B contained in 13-valent pneumococcal conjugate vaccine ( PCV13 ) could induce cross- protective antibodies against newly discovered serotypes 6C and 6D and the differences between them. Methods New Zealand rabbits were radomly divided into three groups and respectively muscularly administrated with three doses of PCV13, PCV6A and PCV6B on days 0, 14 and 28. PCV6A and PCV6B were conjugates of capsular polysaccharides of serotypes 6A and 6B chemically coupled with diphtheria toxin mutant CRM197. Serum samples were collected on days 0 and 35. Enzyme-linked immunosorbent assay (ELISA) recommended by World Health Organization (WHO) was used to quantitatively measure serotype-specific antibodies to capsular polysaccharides of serotypes 6A, 6B, 6C and 6D. Opsonophagocytosis assay ( OPA) of WHO pneumococcal serology reference laboratory was used to determine antibody functional activities targeting serotypes 6A, 6B, 6C and 6D. Results Immunization rabbits with PCV13 induced the secretion of antibodies to capsular polysaccharides of serotypes 6A and 6B. These antibodies were able to not only cross-react with capsular polysaccharides of serotypes 6C and 6D but also recognize and bind to target Streptococcus pneumoniae serotypes 6A, 6B, 6C and 6D, resulting in the activation of complements and further phagocytosis of target bacteria by differentiated HL60 cells. Bactericid-al titers were largely even among these serotypes except for serotype 6D which was slightly lower. PCV6A could induce antibody against capsular polysaccharide of serotype 6A, which was able to cross-react with capsular pol-ysaccharides of serotypes 6B, 6C and 6D and showed higher bactericidal titers to serotypes 6A, 6B and 6C over serotype 6D. PCV6B could induce antibody against capsular polysaccharide of serotype 6B, which was able to cross-react with capsular polysaccharides of serotypes 6A, 6C and 6D and showed higher bactericidal titers to se-rotypes 6A, 6B and 6C over serotype 6D. Antibody concentrations and bactericidal titers specific to serotypes 6A, 6B, 6C and 6D were significantly increased following immunization with PCV13, PCV6A or PCV6B (P<0. 01). Conclusion PCV13 containing pneumococcal serotypes 6A and 6B induced antibodies against capsular polysaccharides of serotypes 6A and 6B in New Zealand rabbits, which were able to cross-react with capsular polysaccharides of serotypes 6C and 6D and provide cross-protection to bacteria of serotypes 6C and 6D. Both serotypes of 6A and 6B contained in PCV13 contributed to the induction of cross-protective antibodies, especially to serotype 6C.

ObjectTo observe the clinical efficacy of Huangqin Beimutang on chronic rhinosinusitis in children. MethodA randomized controlled trial （RCT） was conducted on 70 children who met the criteria for chronic rhinosinusitis， with 35 cases in the Chinese medicine group and 35 cases in the western medicine group. In the western medicine group，children received mometasone furoate nasal spray，one spray per nostril，once a day for two weeks， and also received a small dose of azithromycin suspension at 4 mg·kg^-1·d^-1，once a day，3 days a week for 2 weeks. The children in the Chinese medicine group were treated with oral Huangqin Beimutang，one dose per day for 2 weeks. Before and after treatment，the scores of primary symptoms and signs of traditional Chinese medicine （TCM），visual analogue scale （VAS） symptom scores，sinus computed tomography （CT） efficacy scores，and clinical efficacy of TCM syndromes in the two groups were evaluated，and the occurrence of adverse events was recorded. ResultThe total effective rate of clinical efficacy of TCM syndrome in the Chinese medicine group was 88.57% （31/35）， which was higher than 71.43% （25/35） in the western medicine group（χ²=8.458，P<0.05）. The VAS scores， scores of TCM primary symptoms of nasal obstruction and runny nose， and physical sign scores in both groups were lower than those after treatment （P<0.01）. The above indicators in the Chinese medicine group were superior to those in the western medicine group after treatment （P<0.05， P<0.01）. Compared with the conditions before treatment， there was no significant improvement in headache in the western medicine group， while the headache score in the Chinese medicine group decreased after treatment （P<0.01）. The CT scores of the two groups showed a downward trend， but the difference was not statistically significant. There were no adverse reactions during treatment in both groups. ConclusionHuangqin Beimutang can effectively improve the clinical symptoms of patients with chronic rhinosinusitis， and it is safe and effective.

Objective:To summarize the echocardiography and pathological features of fetal Kabuki syndrome.Methods:This study retrospectively analyzed the echocardiography and pathological features of seven fetuses with KMT2D pathogenic variants confirmed by copy number variation sequencing, and who were identified as complex congenital heart disease by fetal echocardiography, at Beijing Anzhen Hospital, Capital Medical University and other multi-center collaborative hospitals on fetal congenital heart diseases from January 2013 to May 2018. All the seven fetuses were artificially aborted. Descriptive statistics were used for data analysis. Results:(1) The seven pregnant women aged 29 (27-32) years and had an abortion at 23 (22-25) gestational weeks. There were three male and four female fetuses. (2) Pathogenic mutations in KMT2D gene were detected in all seven cases, including one nonsense mutation and six frameshift mutations. (3) All fetuses had left heart obstruction with or without aortic arch dysplasia/interruption of the aortic arch. There were three with hypoplastic left heart syndrome, two with a single ventricle, one with aortic atresia, and one with severe mitral valve dysplasia. Other cardiovascular abnormalities included aortic arch branch abnormalities, double-outlet of the right ventricle, ventricular septal defect, tricuspid atresia, pulmonary valve stenosis (nearly atresia) complicated by pulmonary dysplasia, persistent left superior vena cava, and patent or closed foramen ovale. Secondary changes included enlargement of the right atrium and right ventricle, and dilatation of the pulmonary artery or ductus arteriosus. (4) Four of the seven fetuses showed multiple extracardiac system abnormalities, including facial deformities (two cases), pulmonary dysplasia (two cases), digestive abnormalities(two cases), and urogenital system abnormalities (two cases). Conclusions:The main features of echocardiography for fetal Kabuki syndrome are left heart obstruction, often complicated by other congenital cardiovascular abnormalities.