Castleman's disease is a rare disorder of the lymphoid system characterized by noncancerous growths that may develop in lymph node tissues throughout the body. The incidence of this disease has been increasing in recent years. Because of the difficulty of diagnosis and high-misdiagnosis, more and more clinicians have paid close attention to this disease. By the clinical work, and with the help of related reports, the preliminary summary of this disease is made.

Requirement for Medical English teaching in physical medicine physicians training has been on the agenda to fit the new condition of globalization. According to the development of physical medicine in China and students English level, courses of medical English were set to match the requirements of both scientific research and clinic works. We try to improve students' medical English level through lectures in multimedia classroom and a lot of practical activities after class.

ObjectiveTo study the effects of oral administration of mannitol and intramuscular injection of anisodamine in magnetic resonance enteroclysis.Methods After complete intestinal cleaning,29 patients undergoing magnetic resonance enteroclysis were orally administered with 5% oral isotonic mannitol solution 2000 mL and treated with intramuscular injection of anisodamine before the operation.The adverse reactions were observed,the image quality was inspected and the dilatation of small bowel was detected.Results All of the patients lived through the magnetic resonance enteroclysis.Two patients contracted Crohn’s disease with mild nausea consciousness.Conclusion For magnetic resonance imaging,preoperative oral administration of 2.5% oral isotonic mannitol solution and intramuscular injection of anisodamine after complete intestinal cleaning is beneficial for fully expanding the small intestine,achieving quality imaging and therefore improving the diagnosis of small intestinal lesions.

OBJECTIVETo evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection.

METHODSTen patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured.

RESULTSAs compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7±15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin: (285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01; transferrin: (4.86±0.21) vs. (3.60±0.25) g/L, P<0.05; pre-albumin: (291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05].

CONCLUSIONSmall intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.

Objective To investigate caring behavior and empathy ability of outpatient nurses and analyse the correlation between them,and explore the influencing factors of caring behavior,then to provide basis for the management of outpatient nurses.Methods Convenience sampling method was employed to enroll 335 outpatient nurses from class 3 Grade A hospitals in Guangdong Province from February to April 2023 as research subjects.Surveys were conducted with general information questionnaire,caring behaviors inventory and the Jefferson scale of empathy-health professionals.Pearson correlation was used to analyze the correlation between caring behavior and empathy ability of outpatient nurses,and multiple regression was used to analyze the influencing factors of caring behavior.Results A total of 307 outpatient nurses completed the study.The total score of caring behavior of outpatient nurses was(5.14±0.72)points and the scores of each dimension were opinion selection,perspective-taking and emotional care from high to low.The total score of empathy ability of outpatient nurses was(5.81±0.66)points,and was at a high level,and the scores of each dimension were opinion selection,perspective-taking and emotional care from high to low.Pearson correlation analysis showed that the total score of caring behavior and scores of each dimension of outpatient nurses were positively correlated with the total score of empathy ability and scores of each dimension(all P<0.01).Multiple linear regression analysis showed that opinion selection was an independent factor affecting the caring behavior of outpatient nurses(P<0.01).Conclusions The caring behavior and empathic ability of outpatient nurses are both at a high level,and their caring behavior is related to their empathic ability.The empathy ability of outpatient nurses is the key to affect their caring behavior.Hospital managers should teach outpatient nurses to consider problems from the standpoint of patients and give humanistic care to patients,so as to improve outpatient'medical experience and improve outpatients'satisfaction.

Objective To evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection. Methods Ten patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured. Results As compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7± 15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin:(285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01﹔transferrin:(4.86±0.21) vs. (3.60± 0.25) g/L,P<0.05﹔pre-albumin:(291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05]. Conclusion Small intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.

Objective To evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection. Methods Ten patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured. Results As compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7± 15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin:(285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01﹔transferrin:(4.86±0.21) vs. (3.60± 0.25) g/L,P<0.05﹔pre-albumin:(291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05]. Conclusion Small intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.

Objective To explore the effect of application of a modified disposable flushing consumables for sterilised water flushing in digestive endoscopy.Methods Self-comparison method was applied in this study.The traditional flushing device was used in digestive endoscopy prior to December 2019.From January 2020,a modified flushing was applied,of which sterilised flushing water was fed through a disposable flushing pipe and made it free from the reuse of the storage bottle that held the sterilised water in the traditional flushing device.The results of microbial culture,cost of consumables and time required for preparation of the flushing were compared between pre-and post-modification of the flushing device.Results The samples of flushing water before and after the device modification had both passed the microbial culture tests.With the traditional flushing,it took 2 days for collection,cleaning and re-use of a bottle after the proper sterilisation process,and the time required for assembly and disassembly of the modified flushing was about(8.15±1.42)minutes with the cost of consumables at(29.81±4.65)Yuan.While of the modified flushing with disposable consumables,the overall cost of the consumables was(8.15±1.42)Yuan,and it took about(2.00±0.22)minutes for assembly and disassembly the device.The modified flushing was simple to operate and the consumables were readily available.Conclusions The improved disposable consumables for flushing are easy and convenient to handle.They are cost effective and time saving and safe for the digestive endoscopy.

Objective:To determine a relationship between ultrasound shear wave elastography (SWE) and pathological lessions of renal tissues in children with chronic kidney disease (CKD).Methods:It was a cross-sectional observational study, involving children admitted to the Department of Pediatrics of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to December 2021 with definite pathological diagnosis through kidney biopsy. The SWE was used to determine the Young's modulus (elastic modulus) of the cortex and medulla of the upper, middle, and lower poles of the kidney. The renal histopathology was classified or graded. The statistical method was used to analyze the relationship between Young's modulus of the inferior polar cortex (YM cor) and medulla (YM med) of the right kidney and renal pathology. Results:The study included 110 children with definite pathological diagnosis through renal biopsy, aged (10.1±3.4) years old (2-17 years old), with 55 males (50.0%). The body mass index was (20.6±2.4) kg/m 2, and mean arterial pressure was (95±24) mmHg. There were 94 patients (85.4%) with CKD stage 1, 8 patients (7.3%) with CKD stage 2, and 8 patients (7.3%) with CKD stage 3. There was no significant difference of YM cor and YM med in the upper and middle poles of the right kidneys, and YM med in the lower poles of right kidneys in CKD patients with different stages (all P>0.05). Both YM cor [(15.75±3.36) kPa] and YM med [(13.50±2.43) kPa] of CKD stage 3 patients were significantly higher than those of CKD stage 1 patients [(12.94±2.45) kPa, (11.88±2.23) kPa](both P<0.05). There was no significant difference of YM cor and YM med in the lower poles of right kidneys between stage 1 and stage 2 CKD patients (both P>0.05). YM cor[(17.93±3.23) kPa] and YM med [(15.50±1.48) kPa] in patients with crescentic glomerulonephritis were higher than those in patients with focal segmental glomerulosclerosis [(12.71±2.42) kPa, (11.57±2.63) kPa] and mesangial proliferative glomerulonephritis [(12.73±2.04) kPa, (11.48±2.10) kPa](all P<0.05). There was no significant difference of YM cor and YM med between focal segmental glomerulosclerosis and mesangial proliferative glomerulonephritis (both P>0.05). YM cor [(16.30±2.63) kPa] and YM med [(15.54±1.59) kPa] of Lee's Ⅳ grade of IgA nephropathy were higher than those of Lee's Ⅲ grade [(13.32±2.70) kPa, (12.57±2.50) kPa](both P<0.05), while the International Study of Kidney Disease in Children grade of purpura nephritis had no significant correlation with YM cor and YM med (both P>0.05). YM cor [(15.41±2.37) kPa] and YM med [(13.82±2.59) kPa] of interstitial fibrosis/tubular atrophy (T1/T2) group of IgA nephropathy mixed with purpura nephritis were significantly higher than those of T0 group's [(12.99±2.40) kPa, (11.79±2.05) kPa] (both P<0.05). Moreover, crescent formation (C1) group had a higher YM cor [(14.21±2.77) kPa] and YM med [(12.80±2.47) kPa] than those in C0 group [(12.73±2.15) kPa, (11.59±1.97) kPa] (both P<0.05), while YM cor and YM med were unrelated to the mesangial hypercellularity (M), endocapillary cellularity (E), segmental sclerosis or adhesion (S) indicators (all P>0.05). In lupus nephritis patients, YM cor ( r=0.744, P=0.035) and YM med ( r=0.728, P=0.009) were favorably linked with the chronic index, but not with the activity index (both P>0.05). Conclusions:Renal interstitial fibrosis/tubular atrophy and crescentic development are connected with YM cor and YM med at the lower pole of the kidney as measured by SWE. SWE can be used to assess the chronic renal lesions in children with CKD in the early and middle stages. It may develop into a new noninvasive way to assess renal pathology.

Metastatic prostate cancer is one of the most malignancies and do harm to the health and life expectancy of men. The popularization and application of 68Gallium or 18Fluorine labeled prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) benefit for the excellent diagnostic efficacy, unique value in the diagnosis of metastatic prostate cancer, clinical decision-making guidance, efficacy in monitoring and prognosis evaluation. 223Radium and 177Lu-PSMA radioligand therapy (RLT) could effectively alleviate bone pain, and prolong the overall survival time (OS) as wellas progression-free survival time (PFS) with good safety. In addition, survival of patients with metastatic prostate cancer is expected to be further improved with the advance in the combination therapies with PSMA RLT, androgen-deprivation therapy (ADT), chemotherapy, targeted therapy and immunotherapy.