ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

Objective:To explore the relationship between lower respiratory tract microflora and type of anti-tuberculosis immune response, clinical characteristics in patients with pulmonary tuberculosis (PT).Methods:The clinical data of 80 patients with PT and 80 patients with non-PT from January 2018 to March 2020 in the Second Hospital of Zhejiang Medical School of Changxing District were retrospectively analyzed. All patients were treated with bronchoalveolar lavage, the bronchoalveolar lavage fluid counts of Haemophilus, Neisser coccus, Streptococcus and Veillonella were detected by germiculture, and the bronchoalveolar lavage fluid expression levels of T-bet mRNA (Th1 immune response) and GATA-3 mRNA (Th2 immune response) was detected by real-time polymerase chain reaction. The clinical symptoms of PT were recorded. The correlation was analyzed by Pearson correlation analysis.Results:There were no statistical differences in bronchoalveolar lavage fluid Neisser coccus, Veillonella and Haemophilus between patients with PT and patients with non-PT ( P>0.05); the bronchoalveolar lavage fluid Streptococcus in patients with PT was significantly lower than that in patients with non-PT (630 ± 120 vs. 1 000 ± 330), and there was statistical difference ( P<0.05). There was no statistical difference in expression level of T-bet mRNA between patients with PT and patients with non-PT ( P>0.05); the expression level of GATA-3 mRNA in patients with PT was significantly lower that in patients with non-PT: (5.883 ± 1.864) ×10 4 vs. (3.997 ± 1.186) ×10 6, and there was statistical difference ( P<0.05). Pearson correlation analysis result showed that fever was positively correlated with bronchoalveolar lavage fluid Neisser coccus and Veillonella ( r = 0.402 and 0.566, P<0.01 or <0.05); proportion of tuberculosis foci to lung area was positively correlated with T-bet and GATA-3 mRNA ( r = 0.024 and 0.442, P<0.05), the body weight loss was positively correlated with T-bet mRNA ( r = 0.112, P<0.05); GATA-3 mRNA was positively correlated with bronchoalveolar lavage fluid Neisser coccus ( r =0.332, P<0.05), T-bet mRNA was positively correlated with bronchoalveolar lavage fluid Haemophilus ( r = 0.162, P<0.05). Conclusions:There is a significant correlation between the Th1/Th2 immune response type and the bronchoalveolar lavage fluid Haemophilus and Neisser coccus in patients with PT, and the fever symptoms is also significantly related to Neisser coccus and Veillonella. There is a certain correlation between weight loss and the quantitative results of proportion of tuberculosis foci to lung area and the type of immune response.

In the present study, 89 porcine reproductive and respiratory syndrome virus (PRRSV) isolates in China during 2007 to 2012 were randomly selected from the GenBank genetic sequence database. Evolutionary characteristics of these isolates were analyzed based on the sequences of non-struc-tural protein 2 (Nsp2) and glycoprotein 5 (GP5). The genetic variations of the isolates were also compared with six representative strains. The results showed that a high degree of genetic diversity exists among the PRRSV population in China. Highly pathogenic PRRSV isolates, with a discon-tinuous deletion of a 30 amino acid residue in the Nsp2 region, remained the most dominant virus throughout 2007-2012 in China. Owing to the extensive use of representative vaccine strains, natu-ral recombination events occurred between strains. Three isolates-HH08, DY, and YN-2011-were more closely related to vaccine strains than the other isolates. Both YN-2011 and DY were the evolu-tionary products of recombination events between strains SP and CH-1R. The results of the present study provide useful information for the epidemiology of PRRSV as well as for vaccine development.