Objective To study the relationship between the change of T lymphocyte subsets and NK cells in esophageal cancer patients and radiotherapy effect.Methods The levels of T lymphocyte subsets and NK cells were detected by flow cytometry in 56 cases with histologically confirmed esophageal cancer treated with radiotherapy and contrasted to the healthy people.Results In patients with esophageal cancer,peripheral blood T cells,Th cells,Th / Ts were decreased significantly compared with the control group [(58.3±5.2) ％ vs (65.8±7.2) ％,(28.7±5.0) ％ vs (38.1±7.7) ％,(1.0±0.3) vs (1.6+2.7),all P ＜ 0.05],while the Ts cells were significantly increased [(28.8±5.3) ％ vs (25.4±5.7) ％,P ＜ 0.05].There was no significant difference between peripheral blood T lymphocyte subsets,Th/Ts ratio change and patient age,sex,tumor staging,histological differentiation and pathological lesions.After radiotherapy,the levels of peripheral blood T cells,Th cells,Th/Ts cell ratio and NK cells in esophageal cancer patients were increased [(66.9±4.5) ％ vs (59.4±4.9) ％,(40.6±5.6) ％ vs (29.1±4.2) ％,(1.6+0.5) ％ vs (1.0±0.4) ％,(16.2±3.9) ％ vs (14.6±3.2) ％,all P ＜ 0.05],while the Ts cells decreased [ (25.4±3.6) ％ vs (28.4±5.7) ％,P ＜ 0.05].The increasing degree of peripheral blood T cells,Th cells were closely related to the lesion progress,the difference was significant (both P ＜ 0.05).Conclusion Cellular immune function in patients with esophageal cancer is low.Detection of T lymphocyte subsets,NK cells can be used for immune monitoring of patients with esophageal cancer.

Objective:There are significant differences in the distribution of gut microbiota among different populations in different regions.This study mainly explores the structure and distribution of gut microbiota between cow's milk protein allergy（CMPA）children and healthy children in Xiamen,Fujian,and further explores the correlation between gut microbiota and the occurrence and development of CMPA.Methods:Fecal samples have been collected from 30 children with CMPA diagnosed at Xiamen Children’s Hospital from June 2022 to March 2023,and fecal samples from 30 healthy children of the same age have also been collected.The structure and distribution of gut microbiota between the two groups were analyzed using 16S rDNA gene sequencing and bioinformatics analysis.Results:The structure and distribution of gut microbiota between CMPA children and healthy children were quite different.There were no significant differences in α diversity index between groups（ P>0.05）.The analysis of similarities test results showed that there was a significant difference in the distribution of gut microbiota between two groups（ R=0.037, P<0.05）.The β diversity index from PCA showed that there was a significant difference in bacterial community structure between two groups（ P<0.05）.Compared with healthy children,the abundance of Akkermansia in CMPA children was significantly decreased and the abundance of Corynebacterium was significantly increased in CMPA children.LEfSe showed that Proteobacteria were mainly enriched in CMPA children,while Lachnospiraceae were mainly enriched in healthy children.In addition,KEGG analysis showed that the top enrichment of 20 pathways,such as Fructose and mannose metabolism,was significantly decreased in CMPA children（ P<0.05）.COG analysis showed that the enrichment of pathways such as Galactose mutarotase and related enzymes was significantly decreased in CMPA children（ P<0.05）,while the enrichment of pathways including Predicted metal-sulfur cluster biosynthetic enzyme and other two pathways was significantly increased（ P<0.05）. Conclusion:There are significant differences in the structure and distribution of gut microbiota between CMPA children and healthy children,suggesting that a strong correlation between the occurrence and development of CMPA and the gut microbiota.

Objective:To search, evaluate, and summarize the best evidence for difficult peripheral intravenous catheterization in children.Methods:Following the "6S" evidence pyramid model, literature related to the management of difficult peripheral veins in children was searched in both English and Chinese databases including UpToDate, BMJ Best Practice, National Guidelines Clearinghouse, the Joanna Briggs Institute Evidence-Based Health Care Database, PubMed, Medlive, SinoMed, CNKI, and Wanfang Database. The search period was from the establishment of the database to January 2023. Two researchers trained in systematic evidence-based nursing, independently evaluated the quality of included literature and extracted relevant evidence.Results:Five articles were included: two guidelines, two expert consensuses, and one systematic review. 19 best evidence were summarized, covering five aspects: difficult vein quality management, difficult vein assessment, difficult intravenous catheterization site and needle type selection, difficult intravenous catheterization auxiliary methods, and handling of failed difficult intravenous catheterization.Conclusions:This study summarizes the best evidence for difficult peripheral intravenous catheterization in children, demonstrating clinical nursing practicality. It provides evidence-based guidance for pediatric nursing staff performing difficult intravenous catheterization.