ObjectiveTo explore the role of the lymphocyte subsets in the peripheral blood in diagnosis, treatment and prognosis of hemophagocytic lymphohistiocytosis (HLH) in children.MethodA total of 30 children with HLH were enrolled in this study and treated according to the HLH-2004 diagnostic guidelines. 20 children with HLH entered complete remission (CR) and 10 children with HLH died. Thirty age-matched healthy children were selected as normal controls. T cell subsets in the pe-ripheral blood were measured by lfow cytometry.ResultsCompared with control group, CD3+T and CD8+T cells were signiif-cantly increased, CD4+T and CD3-CDl6+CD56+ NK cells were signiifcantly decreased, and CD4+/CD8+ cell ratio was signiifcantly decreased in 20 CR children and 10 died children with HLH in acute phase (P<0.05). CD19+B cells was not statistically different in 20 CR children and 10 died children with HLH in acute phase from control group (P>0.05). In acute phase, the lymphocyte subsets were not statistically different between 20 CR children and 10 died children (P>0.05). In 20 CR children, the proportion of CD3-CD16+CD56+NK in CR phase was statistically different than that in acute phase (P<0.05).ConclusionsChildren with HLH have obvious changes in peripheral blood lymphocyte subsets and have cellular immunity disorders. Dynamic detection of the changes may help determine the therapeutic effect and prognosis of HLH.

Objective? To study the value of failure mode and effect analysis (FMEA) in patients undergoing digestive endoscopy. Methods? By convenience sampling, a total of 96 cases undergoing endoscopy admitted in Xinxiang Central Hospital from March 2017 to February of 2019 were selected as the study subjects. The 48 patients enrolled from March 2017 to February 2018 were taken as the control group and given conventional nursing management mode; the other 48 patients enrolled from March 2018 to February 2019 were taken as the observation group and given FMEA management. The two groups were analyzed in the average waiting time for endoscopy examination, recovery time of enterological function after simple examination and compared in terms of the incidence of adverse events regarding nursing safety. Results? The RPN value of 12 main failure modes in the observation group after FMEA management was lower than that before FMEA Management with statistical significance (P＜0.01). The average waiting time of endoscopy, the recovery time of gastrointestinal function after endoscopy, the recovery time of gastrointestinal function after endoscopy and the hospitalization time of simple examination in the observation group were shorter than those in the control group, and the differences were statistically significant (P＜ 0.01). The incidence of nursing safety adverse events in the observation group was 4.17% (2/48), lower than 18.75% (9/48) in the control group, the difference was statistically significant (P＜0.05); among them, the observation group nursing safety adverse events were mostly drug and diet, while the control group was mainly drug and other categories. Conclusions? After FMEA intervention, RPN value of failure mode items decreased significantly, which could promote early recovery of gastrointestinal function, shorten hospitalization time, and reduce the incidence of nursing safety adverse events in the process of endoscopy.