Objective:To explore the clinical characteristics and influencing factors of therapeutic effect of unicentric Castleman disease (UCD).Methods:A retrospective case series study was conducted. The clinical data of 38 patients with UCD who were admitted to Heze Municipal Hospital, Tianjin First Central Hospital or Hematology Hospital of Chinese Academy of Medical Sciences from January 2015 to October 2024 were collected, and their general data, clinical manifestations, laboratory tests, pathological types, treatment methods and therapeutic effect were analyzed. Multivariate logistic regression model was used to analyze the independent influencing factors of incomplete remission of UCD after treatment.Results:Among the 38 patients, 20 (52.6%) were male and 18 (47.4%) were female, with the age of (36±12) years; there were 11 cases (28.9%) of fever, 10 cases (26.3%) of fatigue and 9 cases (23.7%) of night sweats. Cervical lymphadenopathy was most commonly found (17 cases, 44.7%); there were 10 cases (26.3%) of anemia, 5 cases (13.2%) of leukocytosis, 8 cases (21.1%) of thrombocytosis, 18 cases (47.4%) of elevated C-reactive protein (CRP), 18 cases (47.4%) of elevated erythrocyte sedimentation rate (ESR), 11 cases (28.9%) of elevated IgG, 4 cases (10.5%) of elevated IgA, and 7 cases (18.4%) of elevated IgM; the main pathological type was hyaline vascular type (25 cases, 65.8%), 7 cases (18.4%) were plasma cell type, and 6 cases (15.8%) were mixed type. Twenty-seven cases (71.1%) underwent surgery at the beginning (20 cases received complete resection), the other 11 cases (28.9%) were treated by drugs to get tumor shrinkage, and among them, 8 cases were re-operated (5 cases received complete resection, 3 cases received partial resection). There were complete remission in 24 cases (63.2%), partial remission in 7 cases (18.4%), disease stability in 5 cases (13.2%) and disease progression in 2 cases (5.3%). In the incomplete remission group, the proportion of patients with hyaline vascular type was lower than that in the complete remission group [35.7% (5/14) vs. 83.3% (20/24)], elevated ESR [78.6% (11/14) vs. 29.2% (7/24)] and elevated CRP [71.4% (10/14) vs. 33.3% (8/24)] were higher than those in the complete remission group, and the differences were statistically significant (all P < 0.05); there were no statistically significant differences in the proportions of patients with different gender, age > 36 years, fatigue, night sweats, fever, elevated white blood cells, elevated platelets, anemia, lymphadenopathy, elevated IgG, elevated IgA, and elevated IgM between the two groups (all P > 0.05). Multivariate logistic regression analysis showed that the plasma cell or mixed pathological type (compared with hyaline vascular type, OR = 4.32, 95% CI: 1.47-12.67, P = 0.008) and elevated ESR (compared with non-elevated ESR, OR = 3.56, 95% CI: 1.25-10.13, P = 0.016) were independent risk factors for incomplete remission of UCD patients. Conclusions:The clinical manifestations of UCD patients are heterogeneous; ESR and pathological type may be the influencing factors of therapeutic effect, and they are the potential indicators for evaluating the therapeutic effect of such patients.

Medical professional spirit is an indispensable and important component in the modern medical system.It not only plays a key role in the harmonious development of doctor-patient relationships,but also is of great significance for the im-provement of medical quality and medical services.This article will start from the problems faced by the medical environment in the broader context,and take the cultivation of the"Guangdong Doctor"spirit,namely"cherishing life,respecting science,be-ing willing to contribute,and being united and enterprising",as an example to explore the importance of reshaping the medical professional spirit.Through specific measures such as strengthening professional spirit education,setting up role models,promo-ting the advanced,improving systems,strengthening supervision,and creating a good working environment,which aims to en-hance the professional quality and ethics of doctors,with the expectation of providing useful references for promoting harmonious doctor-patient relations and improving the quality of medical services.

Medical professional spirit is an indispensable and important component in the modern medical system.It not only plays a key role in the harmonious development of doctor-patient relationships,but also is of great significance for the im-provement of medical quality and medical services.This article will start from the problems faced by the medical environment in the broader context,and take the cultivation of the"Guangdong Doctor"spirit,namely"cherishing life,respecting science,be-ing willing to contribute,and being united and enterprising",as an example to explore the importance of reshaping the medical professional spirit.Through specific measures such as strengthening professional spirit education,setting up role models,promo-ting the advanced,improving systems,strengthening supervision,and creating a good working environment,which aims to en-hance the professional quality and ethics of doctors,with the expectation of providing useful references for promoting harmonious doctor-patient relations and improving the quality of medical services.

Objective:To evaluate the 10-year protective effect and immunogenicity of quadrivalent human papillomavirus (HPV) vaccine in Chinese women aged 20 to 45 years.Methods:From October 2019 to April 2020, a long-term follow-up study was conducted on the subjects of the Phase III clinical trial of the quadrivalent HPV vaccine (NCT00834106). Participants underwent a questionnaire survey, venous blood sampling, gynecological examination, cervical exfoliated cell pathology examination, and serum neutralizing antibody titers for HPV-6, 11, 16, and 18 were measured using a pseudovirus neutralization assay. The results of the cytological examination and the positive rate and titers of serum antibodies of different cervical exfoliated cells were compared.Results:A total of 889 subjects were followed up, including 240 in the control group, 453 in the vaccination group and 196 in the post-trial vaccination group. The age of the control group was (40±7) years old, which was higher than that of the supplementary vaccination group and the vaccination group [(38±4) and (38±6) years old, respectively] ( P<0.05). There were no statistically significant differences in condom use and sexual frequency among all groups (all P values>0.05). The abnormal proportion of cervical exfoliation cytopathology in the vaccination group was 3.7% (17/453), which was significantly lower than that in the control group [9.6% (23/240)] and post-trial vaccination group [5.6% (11/196)] ( P<0.05). There were two cases of cervical intraepithelial neoplasia (CIN) grade 1 in the vaccination group, two cases of CIN grade 1 and three cases of CIN grade 2 and above in the control group, and no CIN grade 1 and above cases in the post-trial vaccination group. The positive rate of HPV-18 antibody was 35.5% (161/453) in the vaccination group and 76.0% (149/196) in the post-trial vaccination group, which was significantly lower than that of other types ( P<0.05). The neutralizing antibody GMT ratio between the vaccination group and the control group ranged from 2.62 to 25.33 (9.05 to 83.08). Conclusion:Protective neutralizing antibodies are sustained in Chinese women aged 20 to 45 years after ten years of vaccination with quadrivalent HPV vaccine.

Objective:To evaluate the 10-year protective effect and immunogenicity of quadrivalent human papillomavirus (HPV) vaccine in Chinese women aged 20 to 45 years.Methods:From October 2019 to April 2020, a long-term follow-up study was conducted on the subjects of the Phase III clinical trial of the quadrivalent HPV vaccine (NCT00834106). Participants underwent a questionnaire survey, venous blood sampling, gynecological examination, cervical exfoliated cell pathology examination, and serum neutralizing antibody titers for HPV-6, 11, 16, and 18 were measured using a pseudovirus neutralization assay. The results of the cytological examination and the positive rate and titers of serum antibodies of different cervical exfoliated cells were compared.Results:A total of 889 subjects were followed up, including 240 in the control group, 453 in the vaccination group and 196 in the post-trial vaccination group. The age of the control group was (40±7) years old, which was higher than that of the supplementary vaccination group and the vaccination group [(38±4) and (38±6) years old, respectively] ( P<0.05). There were no statistically significant differences in condom use and sexual frequency among all groups (all P values>0.05). The abnormal proportion of cervical exfoliation cytopathology in the vaccination group was 3.7% (17/453), which was significantly lower than that in the control group [9.6% (23/240)] and post-trial vaccination group [5.6% (11/196)] ( P<0.05). There were two cases of cervical intraepithelial neoplasia (CIN) grade 1 in the vaccination group, two cases of CIN grade 1 and three cases of CIN grade 2 and above in the control group, and no CIN grade 1 and above cases in the post-trial vaccination group. The positive rate of HPV-18 antibody was 35.5% (161/453) in the vaccination group and 76.0% (149/196) in the post-trial vaccination group, which was significantly lower than that of other types ( P<0.05). The neutralizing antibody GMT ratio between the vaccination group and the control group ranged from 2.62 to 25.33 (9.05 to 83.08). Conclusion:Protective neutralizing antibodies are sustained in Chinese women aged 20 to 45 years after ten years of vaccination with quadrivalent HPV vaccine.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective: To observe the alteration of brain glucose metabolic network in patients with somatoform disorders (SFD). Methods: ¹⁸F-fluorodeoxyglucose (FDG) PET images of 18 SFD patients (10 males, 8 females; age: (39.5±12.0) years; illness duration: (3.67±3.20) years) and 21 matched healthy controls (13 males, 8 females; age: (43.9±8.4) years) in Huashan Hospital of Fudan University from October 2011 to December 2012 were enrolled to construct the brain glucose metabolic networks for 2 groups (SFD group, control group) respectively. Then the global network properties (normalized clustering coefficient, normalized shortest path length, small-worldness and global efficiency) and local parameters (clustering coefficient and betweenness centrality of the node) were calculated using the graph theory. Differences between 2 groups were compared by permutation test with 1 000 permutations. The top 20% (18/90) were classified as Hub nodes based on the results of clustering coefficient and betweenness centrality of the node. Results: Small-worldness of SFD patients was similar to that of healthy controls (σ>1). There were decreased tendency in normalized clustering coefficient and global efficiency, and increased tendency in normalized shortest path length in SFD patients, but without significant differences (P>0.05). Compared to healthy controls, the betweenness centrality of left pallidum, left amygdala, left precuneus and right angular gyrus increased (permutation test, P<0.05); the betweenness centrality of left middle temporal gyrus, right superior occipital gyrus decreased (permutation test, P<0.05); the clustering coefficients of bilateral pallidum, bilateral thalamus, and left amygdala decreased (permutation test, P<0.05). Most changed Hub nodes (16/24) belonged to limbic system. Conclusion The changes of topological properties of brain glucose metabolic network in SFD patients including the decreased tendency of small-worldness and global efficiency, as well as the altered Hub nodes, may provide valid imaging evidences for brain dysfunction of somatization symptoms.

Objective To investigate the effects of phosphcreatine preconditioning on lung injury induced by renal ischemia-reperfusion (IR) in rats.Methods Forty-five SPF male Sprague-Dawley rats, aged 8-10 weeks, weighing 180-220 g, were randomly divided into 3 groups using a random number table:sham operation group (group S), renal IR group (group IR), and phosphcreatine preconditioning group (group PCr), 15 cases in each group.The rats in group S recieved dissoci ation of renal pedicles and right nephrectomy, on top of which renal IR model was prepared in group IR and group PCr.phosphcreatine 150 mg/kg was injected in group PCr for 30 minutes before ischemia, where as rats in group S and group I/R recieved the normal saline at the same time.The blood samples were obtained from left ventricle at 6 hours after reperfusion, the arterial blood gas analysis was performed in order to determined the oxygen partial pressure (PaO2).Serum levels of malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) were also determined.Fluo 3-AM staining and flow cytometry were used to measure the concentration of alveolar macrophage calcium ions.The lung tissue was obtained with HE staining for determination of microscope examination of pathologic changes, and weight/dry (W/D) ratio were also determined.The lung tissue cell apoptotic rate was measured by Annexin V/PI apoptosis detection reagent staining and flow cytometry.Fluo 3-AM staining and flow cytometry were used to measure the concentration of alveolar macrophage calcium ions.Results Compared with group S, the histopathological demages, W/D ratio, lung tissue cell apoptotic rate, the serum levels of MDA and the concentration of alveolar macrophage calcium ions were signifcant increased (P<0.05), whereas the PaO2 and the activity of SOD were signifcantly decreased in group IR and group PCr (P<0.05).Compared with group IR, the histopathological demages, W/D ratio, lung tissue cell apoptotic rate, the serum levels of MDA and the concentration of alveolar macrophage calcium ions were signifcant decreased (P<0.05), whereas the PaO2 and the activity of SOD were signifcantly increased in group PCr (P<0.05).Conclusion Phosphcreatine preconditioning can attenuate lung injury induced by renal I/R, the mechanism is related to inhabit oxidative stress, and reduce cell apopotosis and calcium overload.

Objective To evaluate the effect of preoperative oral rehydration on postoperative recovery in patients undergoing laparoscopic radical resection of colorectal cancer.Methods Eighty patients of both sexes,aged 18-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective radical resection of colorectal cancer,were randomly divided into either routine fluid replacement group (group R) or oral rehydration group (group O) with 40 patients in each group.Fasting for solid food was performed at 8 h before surgery and for water at 6 h before surgery,and fluid was replaced according to the volume expansion during induction and 4-2-1 formula in group R.In group O,multivitamin drinks containing sugar and electrolyte was given orally according to the fasting time:12-15 ml/kg at 8 h of fasting,15-20 ml/kg at 8-12 h of fasting,with the total volume not exceeding 1 200 ml,300 ml at 3 h before surgery,and the rest of fluid was given at different times the night before surgery,and fluid replacement 1 200 ml was performed according to the basic requirement of patients and intraoperative fluid loss.Fluid replacement was maintained at a rate of 1.5 ml · kg-1 · h-1 on the day of surgery in two groups.The volume of oral fluid intake,intraoperative net volume of fluid intake and volume of intravenously given fluid on the day of surgery were recorded.The time of surgery,emergence time,time to first flatus,time to first liquid diet,first ambulation time and length of postoperative hospital stay were recorded.The development of postoperative nausea and vomiting and hypotension was recorded.Peripheral venous blood samples were collected on the morning of day 2 after admission to hospital,the day of surgery and day 1 after surgery (T0-2) for determination of the fasting blood glucose and insulin concentrations,and insulin resistance index was calculated.Results Thirty-seven and 35 patients were included in R and O groups,respectively.Compared with group R,the intraoperative net volume of fluid intake and volume of intravenously given fluid on the day of surgery were significantly decreased,fasting blood glucose and insulin concentrations and insulin resistance index were decreased,and the time to first flatus,time to first liquid diet and length of postoperative hospital stay were shortened in group O (P＜0.05).Conclusion Preoperative oral rehydration can promote postoperative recovery,which may be related to mitigating insulin resistance in patients undergoing laparoscopic radical resection of colorectal cancer.