ObjectiveTo elucidate the underlying mechanism through which Zhuluan decoction suppresses excessive autophagy in human ovarian granulosa cells （KGN） and ameliorates premature ovarian insufficiency （POI） via the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway. MethodsThe optimal concentration of cyclophosphamide for inducing a POI model in KGN cells was identified via the cell counting kit-8 （CCK-8） assay. Subsequently， the impacts of varying concentrations of Zhuluan decoction-containing serum on the viability of the KGN cell model were assessed. After the optimal drug concentration was determined， KGN cells were categorized into the following groups： blank control （20% blank serum）， model （20% blank serum + 5 μmol·L^-1 cyclophosphamide）， Zhuluan decoction-containing serum （20% Zhuluan decoction-containing serum + 5 μmol·L^-1 cyclophosphamide）， autophagy inhibitor （20% blank serum + 5 μmol·L^-1 cyclophosphamide + 20 μmol·L^-1 chloroquine phosphate）， autophagy inhibitor + Zhuluan decoction-containing serum （20% Zhuluan decoction-containing serum + 5 μmol·L^-1 cyclophosphamide + 20 μmol·L^-1 chloroquine phosphate）， and estradiol valerate （20% estradiol valerate-containing serum + 5 μmol·L^-1 cyclophosphamide）. Following 48 hours of incubation， flow cytometry was utilized to measure the apoptosis rate of KGN cells in each group. Western blotting was employed to quantify the protein levels of PI3K， phosphorylated （p）-Akt， Akt， p-mTOR， and mTOR， along with the expression levels of autophagy-related proteins such as Beclin1， autophagy-related 5 homolog （ATG5）， and microtubule-associated protein 1 light chain 3 （LC3）， in each group. Additionally， monodansylcadaverine （MDC） staining was performed to evaluate the extent of autophagy in each group. ResultsIncubation of KGN cells with 5 μmol·L^-1 cyclophosphamide for 48 h successfully established a POI model， marked by a significant inhibition of KGN cell proliferation. Notably， the inhibitory effect of cyclophosphamide on KGN cell proliferation exhibited a positive correlation with its concentration. Zhuluan decoction-containing serum at 20% and 30% promoted cell proliferation and mitigated the inhibitory effect of cyclophosphamide on KGN cell proliferation， with comparable therapeutic efficacy observed at both concentrations. Compared with the blank control group， the model group displayed an elevated apoptosis rate （P<0.01）， reduced protein levels of PI3K， p-Akt， and p-mTOR （P<0.01）， increased protein levels of Beclin1， LC3， and ATG5 （P<0.01）， no significant alterations in the protein levels of Akt and mTOR， and an enhanced MDC autophagy fluorescence intensity （P<0.01）. In comparison to that the model group， the apoptosis rates in the blank control group， model group， Zhuluan decoction-containing serum group， autophagy inhibitor group， autophagy inhibitor + Zhuluan decoction-containing serum group， and estradiol valerate group all reduced （P<0.05， P<0.01）， with the most pronounced reduction observed in the autophagy inhibitor + Zhuluan decoction-containing serum group. The protein levels of PI3K， p-Akt， and p-mTOR were higher in other groups than in the model group （P<0.05， P<0.01）， being the highest in the autophagy inhibitor + Zhuluan decoctio-containing serum group （P<0.01）. The protein levels of Beclin1 and ATG5 were lower in other groups than in the model group （P<0.05， P<0.01）. The expression level of LC3 declined in the Zhuluan decoction-containing serum group and the estradiol valerate group （P<0.05， P<0.01）， while it decreased without statistical significance in the autophagy inhibitor group and the autophagy inhibitor + Zhuluan decoction-containing serum group. ConclusionZhuluan decoction may activate the PI3K/Akt/mTOR pathway to inhibit excessive autophagy and counteract the detrimental effects of cyclophosphamide on the KGN cell model， thus managing POI.

ObjectiveTo elucidate the underlying mechanism through which Zhuluan decoction suppresses excessive autophagy in human ovarian granulosa cells （KGN） and ameliorates premature ovarian insufficiency （POI） via the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR） signaling pathway. MethodsThe optimal concentration of cyclophosphamide for inducing a POI model in KGN cells was identified via the cell counting kit-8 （CCK-8） assay. Subsequently， the impacts of varying concentrations of Zhuluan decoction-containing serum on the viability of the KGN cell model were assessed. After the optimal drug concentration was determined， KGN cells were categorized into the following groups： blank control （20% blank serum）， model （20% blank serum + 5 μmol·L^-1 cyclophosphamide）， Zhuluan decoction-containing serum （20% Zhuluan decoction-containing serum + 5 μmol·L^-1 cyclophosphamide）， autophagy inhibitor （20% blank serum + 5 μmol·L^-1 cyclophosphamide + 20 μmol·L^-1 chloroquine phosphate）， autophagy inhibitor + Zhuluan decoction-containing serum （20% Zhuluan decoction-containing serum + 5 μmol·L^-1 cyclophosphamide + 20 μmol·L^-1 chloroquine phosphate）， and estradiol valerate （20% estradiol valerate-containing serum + 5 μmol·L^-1 cyclophosphamide）. Following 48 hours of incubation， flow cytometry was utilized to measure the apoptosis rate of KGN cells in each group. Western blotting was employed to quantify the protein levels of PI3K， phosphorylated （p）-Akt， Akt， p-mTOR， and mTOR， along with the expression levels of autophagy-related proteins such as Beclin1， autophagy-related 5 homolog （ATG5）， and microtubule-associated protein 1 light chain 3 （LC3）， in each group. Additionally， monodansylcadaverine （MDC） staining was performed to evaluate the extent of autophagy in each group. ResultsIncubation of KGN cells with 5 μmol·L^-1 cyclophosphamide for 48 h successfully established a POI model， marked by a significant inhibition of KGN cell proliferation. Notably， the inhibitory effect of cyclophosphamide on KGN cell proliferation exhibited a positive correlation with its concentration. Zhuluan decoction-containing serum at 20% and 30% promoted cell proliferation and mitigated the inhibitory effect of cyclophosphamide on KGN cell proliferation， with comparable therapeutic efficacy observed at both concentrations. Compared with the blank control group， the model group displayed an elevated apoptosis rate （P<0.01）， reduced protein levels of PI3K， p-Akt， and p-mTOR （P<0.01）， increased protein levels of Beclin1， LC3， and ATG5 （P<0.01）， no significant alterations in the protein levels of Akt and mTOR， and an enhanced MDC autophagy fluorescence intensity （P<0.01）. In comparison to that the model group， the apoptosis rates in the blank control group， model group， Zhuluan decoction-containing serum group， autophagy inhibitor group， autophagy inhibitor + Zhuluan decoction-containing serum group， and estradiol valerate group all reduced （P<0.05， P<0.01）， with the most pronounced reduction observed in the autophagy inhibitor + Zhuluan decoction-containing serum group. The protein levels of PI3K， p-Akt， and p-mTOR were higher in other groups than in the model group （P<0.05， P<0.01）， being the highest in the autophagy inhibitor + Zhuluan decoctio-containing serum group （P<0.01）. The protein levels of Beclin1 and ATG5 were lower in other groups than in the model group （P<0.05， P<0.01）. The expression level of LC3 declined in the Zhuluan decoction-containing serum group and the estradiol valerate group （P<0.05， P<0.01）， while it decreased without statistical significance in the autophagy inhibitor group and the autophagy inhibitor + Zhuluan decoction-containing serum group. ConclusionZhuluan decoction may activate the PI3K/Akt/mTOR pathway to inhibit excessive autophagy and counteract the detrimental effects of cyclophosphamide on the KGN cell model， thus managing POI.

ObjectiveTo explore the mechanisms of Yangjing Tongluo prescription （YJTL） in the treatment of intrauterine adhesion （IUA） from the perspective of oxidative stress mediated by the Kelch-like ECH-associated protein 1/nuclear factor erythroid 2-related factor 2/heme oxygenase-1 （Keap1/Nrf2/HO-1） signaling pathway. MethodsA total of 48 rats with normal estrous cycles were selected and randomly divided into a normal group （n=8） and a modeling group （n=40）. An IUA rat model was established using a dual-injury method combining surgical curettage and infection. Eight rats were randomly selected from the modeling group for a pilot experiment to confirm successful model establishment. After successful modeling， the remaining 32 rats were randomly divided into a model group， a low-dose YJTL group （YJTL-L）， a high-dose YJTL group （YJTL-H）， and a Progynova group. Rats in the normal and model groups were administered purified water （15 mL·kg^-1） by gavage daily， while rats in the YJTL-L， YJTL-H， and Progynova groups received YJTL at doses of 6.43 and 12.86 g·kg^-1 and Progynova at 2.06 × 10^-4 g·kg^-1， respectively， for 14 consecutive days. The general condition， uterine morphology， and uterine index of the rats were monitored. Histopathological changes in uterine tissue were observed using hematoxylin-eosin （HE） staining. Serum levels of reactive oxygen species （ROS） and glutathione peroxidase （GSH-Px） were measured by enzyme-linked immunosorbent assay （ELISA）. Protein expression levels of Keap1， Nrf2， and HO-1 in endometrial tissue were detected by Western blot. Immunofluorescence （IF） was used to assess the distribution of Nrf2 and HO-1， as well as the expression of Nrf2 in the cytoplasm and nucleus. ResultsCompared with the normal group， rats in the model group exhibited poor mental status and reduced mobility， markedly edematous and tortuous uterine morphology， decreased gland number， and inflammatory reactions in the endometrium， along with an increased uterine organ index （P<0.05）. Serum ROS levels were significantly increased （P<0.05）， while serum GSH-Px levels were significantly decreased （P<0.05）. In endometrial tissue， Keap1 protein expression was increased （P<0.05）， whereas Nrf2 and HO-1 protein expression was decreased. Mild nuclear translocation of Nrf2 was observed， accompanied by increased relative fluorescence intensity of nuclear Nrf2 and decreased relative fluorescence intensity of cytoplasmic HO-1. Compared with the model group， all treatment groups showed varying degrees of improvement in the above symptoms and pathological changes. Serum ROS levels were reduced （P<0.05）， serum GSH-Px levels were increased （P<0.05）， Keap1 protein expression in endometrial tissue was decreased， and Nrf2 and HO-1 protein expression was increased in a dose-dependent manner （P<0.05）. Notably， significant nuclear translocation of Nrf2 was observed， with correspondingly increased relative fluorescence intensity of nuclear Nrf2 and enhanced relative fluorescence intensity of cytoplasmic HO-1. ConclusionYJTL may enhance antioxidant capacity and repair oxidative damage to the endometrial basal layer by regulating the Keap1/Nrf2/HO-1 signaling pathway.

Guishenwan （GSW）， originating from Jingyue Quanshu （Zhang Jingyue's Complete Works）， is a classic traditional Chinese medicine （TCM） formula with a history of over 400 years. Designed for kidney essence deficiency syndrome， it is clinically applied to treat diseases associated with essence-blood deficiency， such as ovarian insufficiency diseases in women， oligospermia-induced infertility in men， and lumbar disc herniation. Numerous studies have confirmed its significant efficacy and advantages in managing ovarian insufficiency diseases， including diminished ovarian reserve （DOR）， premature ovarian insufficiency （POI）， and premature ovarian failure （POF）. According to recent literature， the therapeutic mechanisms of GSW in treating ovarian insufficiency diseases involve regulating the hypothalamic-pituitary-ovarian axis （HPOA） function， ameliorating reproductive endocrine disorders， improving ovarian function， modulating relevant signaling pathways， and exerting immunoregulatory and anti-inflammatory effects. A review of GSW in clinical treatment revealed that clinical applications of GSW， particularly in combination with Western medicine， not only alleviate symptoms but also compensate for the limitations of hormone replacement therapy， thereby reducing recurrence， minimizing adverse reactions， and enhancing safety. This review aims to provide a scientific basis for the rational clinical use of GSW in ovarian insufficiency diseases， offer innovative TCM strategies for developing novel ovarian-protective drugs， promote the integration of TCM and Western medicine in reproductive medicine， and ultimately contribute a Chinese approach to global management of ovarian insufficiency diseases.

Dry eye （DE） is a prevalent multifactorial disease of the ocular surface， clinically characterized by tear film homeostasis imbalance accompanied by related ocular surface symptoms. Specifically， the tear film is a thin liquid layer of tears covering the cornea and conjunctiva through blinking， while tear film homeostasis serves as the foundation for maintaining normal ocular surface structure and function. Insufficient tear secretion and excessive tear film evaporation lead to tear hyperosmolarity and the production of inflammatory mediators， disrupting tear film homeostasis and subsequently forming DE. Additionally， cascade reactions are triggered， resulting in a "vicious cycle of DE" that exacerbates the disease severity and prolongs its duration. Therefore， for DE treatment， it is crucial to restore tear film homeostasis and terminate this vicious cycle. Traditional Chinese medicine （TCM）， which differentiates and treats DE based on systemic conditions， often achieves favorable therapeutic outcomes， offering additional treatment options for DE. Studies have demonstrated that TCM can alleviate DE by regulating tear film homeostasis and terminating the vicious cycle. This review systematically summarizes recent basic experimental research in China and abroad on TCM in alleviating DE by regulating tear film homeostasis， aiming to provide a theoretical basis for clinical treatment and an insight for research design.

ObjectiveTo investigate the mechanism by which Zhuluan decoction improves ovarian function in a cyclophosphamide （CTX）-induced premature ovarian insufficiency （POI） rat model through regulating the adenosine monophosphate-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR）/Unc-51-like kinase 1 （ULK1） signaling pathway. MethodsA POI rat model was established via intraperitoneal injection of CTX. Ten rats were randomly selected as the normal control group. The remaining 50 successfully modeled rats were randomly divided into the model group， the estradiol valerate group （0.1 mg·kg^-1）， low-dose （7 g·kg^-1）， medium-dose （14 g·kg^-1）， and high-dose （28 g·kg^-1） Zhuluan decoction groups， with 10 rats per group. All groups received intragastric administration for 21 consecutive days. Changes in body weight， uterine， and ovarian indices were observed across groups. Hematoxylin and eosin （HE） staining was used to examine ovarian pathological alterations and count follicles at various stages in cross-sections. Enzyme-linked immunosorbent assay （ELISA） measured serum estradiol （E₂）， follicle-stimulating hormone （FSH）， and anti-Müllerian hormone （AMH） levels. Western blot （WB） and immunohistochemistry （IHC） were used to detect the expression levels of AMPK， mTOR， ULK1 and their phosphorylated proteins， Beclin1， Bcl-2-associated X protein （Bax）， and Bcl-2 in ovarian tissues of each group. ResultsCompared with the normal group， model rats exhibited slower body weight gain （P<0.01）， significantly reduced uterine and ovarian organ indices （P<0.01）， reduced ovarian volume， irregular follicular morphology， unclear cumulus and oocyte structures， and a significant reduction in the number of primordial follicles （P<0.01）. Conversely，the numbers of secondary and atretic follicles significantly increased （P<0.01）. Serum E₂ and AMH levels significantly decreased， while FSH levels significantly elevated（P<0.01）. The expression of AMPK， ULK1， Bax， and Beclin1 was increased （P<0.01）， while that of mTOR and Bcl-2 was decreased （P<0.01）. Compared with the model group， the estradiol valerate group and the medium- and high-dose Zhuluan decoction groups showed significantly increased body weight， uterine organ index， and ovarian organ index （P<0.01）， while the low-dose Zhuluan decoction group showed no statistically significant difference. Ovarian volume increased across all treatment groups， with improved follicular morphology and structure. The number of primordial follicles significantly increased （P<0.01）， while the number of atretic follicles significantly decreased （P<0.01）. The number of secondary follicles decreased in the estradiol valerate group and the high-dose Zhuluan decoction group （P<0.01）， with no significant difference in the low- and medium-dose Zhuluan decoction groups. E₂ and AMH levels significantly increased， while FSH levels significantly decreased in all treatment groups （P<0.05， P<0.01）. The estradiol valerate group and medium- and high-dose Zhuluan decoction groups showed significantly reduced expression of AMPK， ULK1， Bax， and Beclin1 （P<0.05， P<0.01）， while mTOR and Bcl-2 expression levels were significantly elevated （P<0.01）. The low-dose Zhuluan decoction group exhibited significantly reduced expression of ULK1， Beclin1， and Bax （P<0.05）， while Bcl-2 expression was significantly increased （P<0.05）. ConclusionZhuluan decoction improves serum hormone levels in POI rats and mitigates chemotherapy （CTX）-induced damage to ovarian structure and function， exerting ovarian protective effect. This mechanism may involve regulating the AMPK/mTOR/ULK1 signaling pathway to inhibit excessive autophagy and apoptosis.

ObjectiveTo investigate the mechanism by which Zhuluan decoction improves ovarian function in a cyclophosphamide （CTX）-induced premature ovarian insufficiency （POI） rat model through regulating the adenosine monophosphate-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR）/Unc-51-like kinase 1 （ULK1） signaling pathway. MethodsA POI rat model was established via intraperitoneal injection of CTX. Ten rats were randomly selected as the normal control group. The remaining 50 successfully modeled rats were randomly divided into the model group， the estradiol valerate group （0.1 mg·kg^-1）， low-dose （7 g·kg^-1）， medium-dose （14 g·kg^-1）， and high-dose （28 g·kg^-1） Zhuluan decoction groups， with 10 rats per group. All groups received intragastric administration for 21 consecutive days. Changes in body weight， uterine， and ovarian indices were observed across groups. Hematoxylin and eosin （HE） staining was used to examine ovarian pathological alterations and count follicles at various stages in cross-sections. Enzyme-linked immunosorbent assay （ELISA） measured serum estradiol （E₂）， follicle-stimulating hormone （FSH）， and anti-Müllerian hormone （AMH） levels. Western blot （WB） and immunohistochemistry （IHC） were used to detect the expression levels of AMPK， mTOR， ULK1 and their phosphorylated proteins， Beclin1， Bcl-2-associated X protein （Bax）， and Bcl-2 in ovarian tissues of each group. ResultsCompared with the normal group， model rats exhibited slower body weight gain （P<0.01）， significantly reduced uterine and ovarian organ indices （P<0.01）， reduced ovarian volume， irregular follicular morphology， unclear cumulus and oocyte structures， and a significant reduction in the number of primordial follicles （P<0.01）. Conversely，the numbers of secondary and atretic follicles significantly increased （P<0.01）. Serum E₂ and AMH levels significantly decreased， while FSH levels significantly elevated（P<0.01）. The expression of AMPK， ULK1， Bax， and Beclin1 was increased （P<0.01）， while that of mTOR and Bcl-2 was decreased （P<0.01）. Compared with the model group， the estradiol valerate group and the medium- and high-dose Zhuluan decoction groups showed significantly increased body weight， uterine organ index， and ovarian organ index （P<0.01）， while the low-dose Zhuluan decoction group showed no statistically significant difference. Ovarian volume increased across all treatment groups， with improved follicular morphology and structure. The number of primordial follicles significantly increased （P<0.01）， while the number of atretic follicles significantly decreased （P<0.01）. The number of secondary follicles decreased in the estradiol valerate group and the high-dose Zhuluan decoction group （P<0.01）， with no significant difference in the low- and medium-dose Zhuluan decoction groups. E₂ and AMH levels significantly increased， while FSH levels significantly decreased in all treatment groups （P<0.05， P<0.01）. The estradiol valerate group and medium- and high-dose Zhuluan decoction groups showed significantly reduced expression of AMPK， ULK1， Bax， and Beclin1 （P<0.05， P<0.01）， while mTOR and Bcl-2 expression levels were significantly elevated （P<0.01）. The low-dose Zhuluan decoction group exhibited significantly reduced expression of ULK1， Beclin1， and Bax （P<0.05）， while Bcl-2 expression was significantly increased （P<0.05）. ConclusionZhuluan decoction improves serum hormone levels in POI rats and mitigates chemotherapy （CTX）-induced damage to ovarian structure and function， exerting ovarian protective effect. This mechanism may involve regulating the AMPK/mTOR/ULK1 signaling pathway to inhibit excessive autophagy and apoptosis.

Objective:To investigate the value of serum IgG4 detection in diagnosis,treatment,evaluation and outcome of IgG4-associated diseases(IgG4-RD).Methods:By integrating the clinical data of patients,retrospectively and systematically analyze the results of common laboratory examinations,imaging examinations,pathological examinations,etc.26 patients who were diagnosed with IgG4-RD in Huaian First Hospital Affiliated to Nanjing Medical University from March 2013 to October 2023.Results:The median age of onset was 65(31～90)years old,and the male to female ratio was 3.33∶1.The first three symptoms were abdominal discomfort,skin scleral yellow stain and fever.Patients mainly involved multiple organs,the most commonly involved organs were lung,pancreas,liver,kidney,bile duct.Compared with the control group,NLR,PLR,ESR,CRP,TBIL,DBIL,ALT,AST,GGT,IgG,IgA and IgM were all abnormally elevated in the first hematological,biochemical and immune tests of the patients,the difference was statisti-cally significant,while C3 and C4 were all decreased,but there was no statistical difference.The first IgG4 level of IgG4-RD patients was correlated with the length of hospitalization,the length of return visit,and the dynamic changes of IgG4 level after return visit.Conclusion:Serum IgG4 detection plays an important role in the diagnosis and treatment of IgG4-RD.In patients with abnormally high level of IgG4,those who are sensitive to high-dose glucocorticoid therapy have a faster decline in IgG4 levels and a longer duration of symptom remission.

To analyze the transmission characteristics of newly reported HIV-infected students aged ≥18 years in Nanjing City from 2016 to 2022 and provide evidence for AIDS publicity and intervention among young students. The pol region sequences of newly reported HIV-infected students and non-student HIV-infected individuals in Nanjing City from 2016 to 2022 were collected, and the BLAST tool was used to search the published global non-Nanjing reported HIV infection sequences in the LANL HIV database. The basic molecular transmission network and regional molecular transmission network were constructed using the HIV-TRACE in a pairwise genetic distance threshold of 1.0%. 332 sequences of infected students aged≥18 years in Nanjing City, 1 904 sequences of non-student-infected individuals in Nanjing City and 1 698 non-Nanjing-infected individuals were obtained. Among the 332 infected students, the main route of infection was homosexual (96.39%), and the subtypes were CRF01_AE (37.95%), CRF07_BC (37.65%) and CRF105_0107 (10.24%). There were 890 sequences in the regional molecular transmission network, of which 21.80% were infected students in Nanjing City, 39.89% were non-student-infected individuals in Nanjing City, and 38.31% were non-Nanjing-infected individuals. In the CRF105_0107 transmission cluster, non-student-infected individuals from Nanjing accounted for 66.95% (81/121), while in the CRF07_BC transmission cluster, non-Nanjing-infected individuals accounted for 56.66% (200/353). There were 1 644 edges connected to infected students within the regional molecular transmission network, with local transmission accounting for 64.72% and regional transmission accounting for 35.28%. Regional transmission was mainly in Guangdong Province (19.83%) and other cities in Jiangsu Province (4.50%). The HIV-1 subtypes of newly reported HIV-infected students aged≥18 years in Nanjing City are mainly CRF01_AE, CRF07_BC and CRF105_0107, with local transmission as the main transmission characteristics. There is transmission between students and non-students.

Objective To investigate the clinical application value of blood routine parameters such as white blood cells(WBC),neu-trophils(NEU),lymphocytes(LYM),monocytes(MON),platelets(PLT),neutrophil to lymphocyte ratio(NLR),and platelet to lymphocyte ratio(PLR)and C-reactive protein(CRP)in children with influenza A(Flu A)virus infection.Methods 317 children with upper respiratory tract symptoms visited Department of Pediatrics,Affiliated Jiangning Hospital of Nanjing Medical University from September 2023 to May 2024 were retrospectively analyzed.According to the six kinds of nucleic acid test results of upper respiratory tract,the children were divided into the Flu A group(n=150)and disease control group(n=167).In addition,97 healthy children who underwent physical examination in our hospital during the same period were selected as the healthy control group.The finger blood of the children was collected for the detection of blood routine parameters and CRP.The Kruskal-Wallis H non-parametric test was used to compare the differences of these parameters among the three groups.The receiver operating characteristic(ROC)curve was drawn,and the area under the ROC curve(AUCROC)was used to evaluate the diagnostic value of each indicator for influenza A virus infection.Results The NLR and PLR in the Flu A group were significantly higher than those in the disease control group and healthy control group,while the levels of WBC and LYM were significantly lower than those in the disease control group and healthy control group(P＜0.05).The level of CRP in the Flu A group was higher than that in the healthy control group but lower than that in the disease control group(P＜0.05).The indicator with the best diagnostic efficacy for influenza A virus infection was LYM,whose AUCROC was 0.79.When the optimal diagnostic threshold was 1.55×109/L,its sensitivity and specificity were 0.620 and 0.837,respectively.Next were PLR and NLR,with AUCROC of 0.735 and 0.723,specificity of 0.754 and 0.826,and sensitivity of 0.693 and 0.553,respectively.The diagnostic efficacy of MON,PLT,and CRP was relatively low.The AUCROC of the combined detection of LYM,NLR,PLR,MON,PLT,and CRP for the diagnosis of influenza A virus infection could increase to 0.838.Conclusion The blood routine parameters of children with influenza A virus infection show a decrease in the level of LYM and an increase in NLR and PLR.The combined detection of LYM,NLR,PLR,MON,PLT,and CRP can improve the accuracy of early diagnosis of influenza A virus infection in children.