Tic disorders in children refer to the neurodevelopmental disorders usually occurring in childhood and adolescence.Guided by the theory of five-zang-organ correlation,Professor Li Yirui approaches the treatment of tic disorders in children and comorbidities primarily from the perspective of liver-spleen disharmony,and points out that the pathogenesis is due to liver-spleen disharmony,wind-phlegm disturbance,and mutual involvement of the five zang organs.In clinical practice,Professor Li established the therapeutic principle of regulating the liver and spleen,extinguishing wind,and resolving phlegm,and adopted the four liver-regulating methods(calming liver,soothing liver,clearing liver,and softening liver)to extinguish wind and stop tics,as well as the four spleen-regulating methods(replenishing spleen,activating spleen,awakening spleen,and dredging spleen)to strengthen body resistance and support healthy qi.The self-formulated Fupi Xifeng Decoction(composed of Pseudostellariae Radix,Atractylodis Macrocephalae Rhizoma,Poria,Glycyrrhizae Radix et Rhizoma,Bupleuri Radix,Paeoniae Radix Alba,Uncariae Ramulus cum Uncis,Gastrodiae Rhizoma,Pinelliae Rhizoma Praeparatum,Citri Reticulatae Pericarpium,Os Draconis,etc.)serves as the basic formula,herbs directing to the affected regions were flexibly used,and insect drugs were occasionally adopted for refractory cases.The treatment for tic disorders in children focus on simultaneous regulation of the five zang-organs by modified use of herbs for dispersing wind and benefiting lung,tranquilizing heart and calming spirit,and supplementing liver and kidney to address comorbidities and secondary symptoms.Additionally,integrated internal-external treatment,relieving the discomforts physically and mentally,and family-centered comprehensive care are also taken into account to achieve optimal outcomes.

【Objective】 To understand the current status and shortcomings of the informed consent of blood donors, and to ensure that the informed consent of blood donors complies with ethical norms and management requirements. 【Methods】 From January 1 to 31, 2022, the " Informed Consent Form for Blood Donor" and " Health Status Consultation Form", issued by 6 blood services in Beijing, Shanghai, Tianjin, Chongqing, Guangzhou and Zhejiang, were collected. The contents regarding individual informed consent were set as an analysis unit; 7 first-level codes such as the form of information disclosure, 19 second-level codes such as the title of the content to be informed, and 56 items such as the content to be informed before blood donation were established to make frequency statistics. 【Results】 The informed consent, issued by six blood centers, included such elements as the form of information disclosure, blood donation process and risks, authenticity of information, donor shielding requirements, screening for transfusion-transmitted infections, other uses of blood, and consent decisions. The second-level coding with frequency≥ 4 included 12 items(63.16%), such as the title of informed consent, truthful provision of health consultation information, and blood donation under real-name, of which precautions after blood donation, privacy statement, and withdrawal were " unexplained" frequency codes. The proportion of 56 items with frequency 1~6 was 55.36%, 12.50%, 10.71%, 17.86%, 1.79% and 1.79%, respectively. 【Conclusion】 The informed consent forms and health status consultation forms play a certain role in explaining and conducting informed consent in different places, but some contents are scattered and lack of specifications, information notification weights in shielding requirements while lacks post-donation care and privacy protection, and the decision-making process is inadequate. A standardized content framework for informed consent of blood donors should be established, the caring for blood donors should be promoted, and the full process of consent decision-making should be valued seriously.

Objective To analyze the pathologically confirmed pulmonary Actinomycosis in the 11 patients in focusing on clinical features and mis-diagnostic reasons so as to improve physicians' awareness of this rare disease and reduce the misdiagnosis.Methods We retrospectively reviewed the medical records of 11 cases with pathologically confirmed pulmonary Actinomycosis during January 2003-August 2015.The clinical data and main causes of misdiagnosis in these cases were collected and analyzed.Results The study included 11 patients with a mean age of(53.0 ± 11.6.0)years.Among the 11 cases,8 (72.7 ％) patients had complications,6 (54.5 ％) were current or ex-smokers.Main clinical manifestations of 11 cases were cough(11/11,100.0 ％),sputum(11/11,100.0 ％),hemoptysis (7/11,63.6％),chest pain(6/11,54.5％)and fever(3/11,27.3％).Ten patients presented with one lobe of lung lesions,including 4 patients in the lower lobe and 3 in the upper lobe of the left lung,2 in the upper lobe and 1 in the lower lobe of the right lung.While,the remained one case presented with lesion locating in right main bronchus.Iconography often presented as pulmonary mass shadow,consolidation shadow,spicule sign,lobulation sign,hilar and/or mediastinal lymphadenopathy and pleural effusion.Vacuolar lesions were observed in some of the focuses.Flexible bronchoscopy was performed in 8 (72.7％)patients.Among them,7 patients showed mucosal swelling and congestion,luminal occlusion with purulence secretion,2 cases with polypoid neoplasm.Initial misdiagnosis rate were 100％ (11/11),among which 7 cases were misdiagnosed as lung cancer,2 cases as fungus infection,and 1 case as pulmonary tuberculosis and 1 case as pneumonia,respectively.All patients were definitely diagnosed by biopsy finding an evidence of hyphae of Actinomycosis in lung tissue specimens.The definitive diagnosis was made by CT-guided percutaneous lung biopsy in 4 cases,by transbronchial lung biopsy (TBLB)in 5 cases and by thoracotomy or video-assisted thoracoscopic surgery(VATS) in 1 case respectively.Actinomycosis in most patients was cured with high-dose penicillin administration over a prolonged period.Conclusions The diagnosis of pulmonary Actinomycosis remains challenging via its non-specific clinical symptoms and iconography features,and the presence of comorbidity may further increase the difficulty and complexity of diagnosis,leading to delaying-or mistaking-diagnosis.Obtaining positively pathological specimens is diagnostic key.Transbronchial lung biopsy through a bronchoscope and CT-guided percutaneous needle biopsy are the priority methods.

Objective To investigate the effect of detail management in ward drug administration.Methods Details management for ward drug management were applied,including the standardization of the drug storage,storage method,to carry out new knowledge learning,to strengthen the drug management,to set up the standardized nursing medication process identification and optimization measures.Results details management,the incidenues of drug mixed and delayed delivery were lower;the time of checking drug was significantly shorter(P<0?001).Conclusions The details management are the effective measures to ensure drug quality and safety.

OBJECTIVETo study the diagnosis and the differential diagnosis of nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL).

METHODS245 cases of Hodgkin's lymphoma (HL) diagnosed between 1980 and 2000 from 3 hospitals in Guangzhou were reviewed. Four cases of NLPHL were confirmed according to the WHO classification of lymphoid neoplasms. Among the other 3 cases of NLPHL, 2 collected from other clinical centers and 1 from Fudan University Cancer Hospital. Immunohistochemistry (IHC) were performed on paraffin sections through SP technique using a panel of markers to define the large neoplastic cells (CD45, CD20, CD15, CD30 and vimentin) as well as the non-neoplastic background cells (CD3, CD20, CD45RO, CD57, CD68 and TIA-1).

RESULTSSeven patients with NLPHL were 4 males and 3 females, age 29 to 70 years, average 43.8 years. All patients had lymphadenopathy. Histologically, in NLPHL, instead of the structure of normal lymph nodes, the tumor tissue became nodular in architecture. Characteristic lymphocytic and histiocytic (L&H) cells with scant cytoplasm and large multilobulated nuclei distributed among a predominant population of small lymphoid cells. The large cells exhibited a CD45+, CD20+, but CD15-, CD30- and vimentin-phenotype. The background cellularity was relatively rich in B cells and the majority of T-cells infiltrated were CD57(+) cells. TIA-1+ cells were few.

CONCLUSIONSNLPHL can be diagnosed according to the morphologic and immunophenotypic features rather than by morphology alone. It is important to distinguish this tumor from its morphologic mimics, such as lymphocyte-rich classical Hodgkin's lymphoma (LRCHL) and T-cell rich B-cell lymphoma (TCRBCL). The immunophenotype of neoplastic cells and background cells are the helpful criteria for the differential diagnosis.

Objective To detect the possible epitopes of 52 000 dalton Ro/SSA autoantigen and selectively clone the antigen fragment containing the leucine zipper motif. Methods The structure of 52 000 dalton Ro/SSA autoantigen was analyzed by protein structure analysis system. The cDNA encoding the antigen fragments from amino acid (aa) 119 to 264 was amplified from cDNA first strands of human heart by polymerase chain reaction (PCR). The PCR product was inserted into the vector pMTY4, and transfected E. coli pop 2136 for fusion protein production. Results Computer analysis showed that the 52 000 dalton Ro/SSA antigen had alpha helixes in its structure, and had good antigenicity, moderate flexibility and poor surface probability. The PCR product was 440bp in length. The recombinant fusion protein was 28 000 dalton. DNA sequencing proved the accuracy of the research. Conclusion The 52 000 dalton Ro/SSA autoantigen has good antigenicity. The cloning of the antigen fragment will help to elucidate the possible role of leucine zipper motif in forming the epitope of the antigen.

Objective To investigate the role of Ro52 antigen fragment from amino acid (AA) 119 to 264 that contains leucine zipper motif in forming the epitopes of Ro52 autoantigen. Methods cDNA encoding Ro52 antigen fragment from aa 119 to 264 was amplified by PCR from human heart cDNA first strand. The obtained cDNA fragment was inserted into vector pMTY4 and transformed into E. coli pop2136 for fusion protein expression. The recombinant fusion protein was then purified, and the antigenicity was determined by immunoblotting. Results A 28 000 Dalton fusion protein was obtained. It was highly expressed in host E. coli pop2136. 61.90% of the anti-full-length Ro52 positive sera reacted with the fusion protein in immunoblotting. Conclusion The results suggest that the antigen fragment from the 119 AA to 264 AA that contains the leucine zipper motif represents an important epitope region in Ro52 autoantigen.

Objective:[WT5BZ]To explore the molecular mechanism of protection of zinc against hepatic ischemia reperfusion injury(HIRI). [WT5HZ]Methods:[WT5BZ]The expression of hepatic metallothionein 1(MT 1)gene and regulation by zinc were determined by RT PCR(reverse transcription polymerase chain reaction)in HIRI rats. [WT5HZ]Results:[WT5BZ]1.Hepatic MT 1 mRNA was expressed in all groups;2.The level of hepatic MT 1 mRNA in HIRI group(ischemia 30 min,reperfusion 90 min)was significantly lower than control.After zinc supplementation,the content of hepatic MT 1 mRNA was increased significantly;3.The hepatic MT 1 expression was also enhanced by zinc in normal rats. [WT5HZ]Conclusion:[WT5BZ]The results of our studies suggest that the regulation of hepatic MT 1 genes by zinc is one of the main ways contributed to the mechanism of protection by zinc in HIRI.