ObjectiveTo study the alteration mechanism of T follicular helper (Tfh) cells in patients with Kawasaki disease (KD).MethodsTwenty children with KD and the same number of agematched healthy subjects were studied.The proportion of CD4+CXCRS+ICOS+ T in peripheral blood was analyzed by flow cytometry.Real-time PCR was performed to detect the level of Tfh transcriptional factor( Bcl6) and its inhibitor( Blimp-1 ).The plasma concentration of IL-4 and IL-21 were determined by ELISA.ResultsThe proportion of CD4+CXCR5+ICOS+ T in patients with KD was significantly higher than healthy controls [ (2.6±0.6) ％ vs ( 1.8±0.7 ) ％,P＜0.05 ].Transcription levels of Bcl-6 were significantly elevated in patients with KD( P＜0.05),its inhibitor Blimp-1 were found to be down-regulated during acute phase of KD compared with healthy controls (P ＜ 0.05 ).The significant increase of IL-4 and IL-21 plasma concentrations were detected in patients with KD(P＜0.05),in comparison with healthy controls.ConclusionThe over activity of Tfh might be correlated with immune dysregulation in Kawasaki disease.Dysregulation of Bcl-6/Blimp-1,altered microenvironment of IL-4 and IL-21 might be correlated with the abnormal activity of Tfh cells.

Objective:To explore the application and nursing of chest radiograph combined with body surface measurement in measuring the length of PICC intubation in tumor patients.Methods:Totally 60 cases of malignant tumor patients in our hospital from March 2019 to January 2020 were selected and randomly divided into two groups by the method of random number table. 30 cases in the control group were given PICC catheterization by conventional body surface measurement; 30 cases in the observation group were given PICC catheterization combined with chest imaging data. After the intervention, the precise position of PICC catheter, indwelling time, complications, nursing satisfaction rate and quality of life were compared between the two groups.Results:After the intervention, the accurate placement rate, adjustment ratio and indwelling time of the observation group were 100.00% (30/30), 0, (146.35±21.74) d, which were significantly better than 83.33% (25/30), 16.67% (5/30) and (118.44±17.36) d of the control group, the difference was statistically significant ( tvalue was 5.495, χ 2values were 4.286, 5.455, all P<0.05); after intervention the complication rate, nursing satisfaction rate, and quality of life score in the observation group were 3.33% (1/30), 99.67% (29/30), (91.35±8.58) points, which were significantly better than the control group's 26.67% (8/30), 80.00% (24/30), (83.57±7.36) points, the difference was statistically significant ( χ 2values were 6.405, 4.043, tvalue was 3.775, P<0.05 or 0.01). Conclusion:Chest imaging data combined with body surface measurement methods combined with comprehensive care can significantly improve the accuracy of PICC catheter placement in cancer patients, reduce catheter adjustment and the deviation of actual length from the ideal length, extend the indwelling time, reduce complications, and improve patients Care satisfaction rate and quality of life.

Objective To investigate the species and hosts of Paragonimus and its infection rate in eastern part of Zhenghe County,Fujian Province,so as to determine the local foci of Paragonimus. Methods The snails,crabs and stools of wild cats were collected for the examinations of cercariae,metacercariae and eggs of Paragonimus. The geographical and environmental conditions of the areas were also investigated. Results A total of 4 890 Pseudobythinella jianouensis snails and 1 035 Semisul?cospira liberlina snails were examined,and the cercariae of Paragonimus were only found in P. jianouensis,with an infection rate of 0.10%(5/4 890). Bottapotamon zhengheensis sp. nov. as the second intermediate host of P. skrjabini,were examined, and the infection rate was 85.29%(29/34)and the average numbers of metacercariae per crab and per gram of crab tissues were 3.85 and 0.62,respectively. Thirty?six Sinopotamun fujianensis crabs,as the second intermediate host of P. westermani,were examined,and the infection rate was 38.89%(14/36)and the average numbers of metacercariae per crab and per gram of crab tissues were 6.43 and 0.03,respectively. The eggs of Paragonimus were detected in 1 of 2 muck specimens of wild cats. Conclu?sion The data suggest that there is a focus of middle?to?high level of infection caused by P. westermani and P. skrjabini in the eastern part of Zhenghe County.

Objective:To investigate whether rumination and family functioning can predict the level of depression after 1 year of follow-up in patients with first-episode depression, and whether family functioning plays a mediating role between rumination and depression level.Methods:Sixty-five patients with first-episode depression who met the enrollment requirements were included, and all subjects were assessed the 17-item Hamilton depression scale(HAMD-17), rumination response scale(RRS) and family assessment device(FAD). All subjects were followed up for 1 year, and the predictive effects of rumination and family functioning at baseline on the level of depression after 1 year of follow-up were investigated by hierarchical linear regression analysis and mediation analysis.Results:At the baseline stage, rumination, role, affective involvement (AI) and general functioning (GF) were significantly positively associated with depression level after 1 year of follow-up in patients with first-episode depression ( r=0.49, P<0.01; r=0.30, P=0.02; r=0.43, P<0.01; r=0.50, P<0.01; respectively). Rumination, AI and GF at the baseline stage predicted depression level after 1 year of follow-up ( β=0.315, t=2.954, P=0.005; β=0.261, t=2.550, P=0.013; β=0.323, t=2.952, P=0.005). Mediation analysis showed that AI and GF partially mediated the relationship between rumination at baseline and depression level at 1 year follow-up (point estimate value for AI=0.040, 95% CI=0.012-0.090); point estimate value for GF=0.066, 95% CI=0.017-0.143). Conclusions:Rumination and family functioning at baseline in first-episode depressed patients can predict the depression level at 1 year follow-up.Family functioning partly mediates the relationship between the baseline rumination and the depression level at 1 year follow-up.

Objective To explore the mechanism underlying the poor prognosis in cerebral infarction (CI) patients with low T3 syndrome by comparing the NIHSS scores in these patients with or without low T3 syndrome.Methods One hundred and sixty-two patients with CI,admitted to our hospital from January 2010 to December 2012,were chosen in our study; the levels of thyroid hormones,including triiodothyronine (T3),four iodine thyronine (T4),thyroid stimulating hormone (TSH),free Triiodothyronine (iT3) and free four iodine thyronine (fT4),were measured by radioimmunoassay.CI lesions and TOAST distribution were determined by cranial MRI,magnetic resonance angiography (MRA) or CT angiography (CTA),and carotid ultrasonography.NIHSS scores at the worst in cerebral infarction inpatients were detected.Results In the 162 patients with CI,29 patients (17.90％) were combined with low T3 symptom and 20 had fT3 level lower than the lowest normal level (2.63 pmol/L); and T4,fT4 and TSH levels were within normal limits.T3,fr3 and TSH levels in patients with low T3 symptom were significantly lower than those of patients without low T3 symptom (P＜0.05).The distribution of TOAST showed no significant difference between patients with low T3 symptom and patients without low T3 symptom (P＞0.05).In patients with large artery atherosclerosis-internal carotid artery,the NIHSS scores at the worst in patients with low T3 level were significantly higher as compared with those in patients with normal T3 levels (P＜0.05).Conclusion The neurologic impairment is more severe in large artery atherosclerosis-intemal carotid artery patients with low T3 level than those without low T3 level,which might be responsible for the poor prognosis of the illness with low T3 syndrome.

ObjectiveTo discuss the efficacy of Williams Life Skills Training （WLST） in depressive adolescents with non-suicidal self-injury （NSSI）. MethodsA total of 88 depressive adolescents with NSSI hospitalized in Suzhou Guangji Hospital from January to June 2019 were selected and grouped according to admission order. The corresponding random number was even in intervention group （n=44） and odd as control group （n=44）. Both groups received a 4-week routine depression care， based on this， intervention group received WLST. All selected individuals were assessed using Hamilton Depression Scale-17 item （HAMD-17）， General Self-Efficacy Scale （GSES） and adolescent student life satisfaction scale at the baseline and end of treatment. Then the incidence of NSSI behavior during hospitalization and the reduction rate of HAMD-17 score at discharge were compared between the two groups. ResultsThe incidence rate of NSSI behavior during hospitalization showed significant difference between groups （χ²=11.702， P=0.001）. HAMD-17， GSES and satisfaction scores at discharge were significantly different from those at admission （t_{control group}=-5.256， 10.690， -21.220； t_{intervention group}=-12.540， 11.300， -32.840， P<0.01）. HAMD-17， GSES， satisfaction scores and the reduction rate of HAMD-17 score also showed significant differences between groups （t=0.851， -12.809， -4.883， χ²=75.990， P<0.05 or 0.01）. ConclusionApplication of WLST in depressive adolescents with NSSI may reduce the incidence rate of NSSI behavior， alleviate the degree of depression， enhance the sense of self-efficacy， and improve life satisfaction.