Co-citation analysis, co-word analysis and strategic coordinates are combined to make known the subject theme evolu-tion. The research history of general surgery is described by eo-citation eluster analysis, citation strategic diagram is pictured by the theory of strategy coordinates to learn more about the novelty and attention of each hot topic. The present research focused on general surgery that would be found by co-words cluster analysis, and stages of development about each topic are discussed by strategic coordinates based of cluster results. It is helpful to provide a decision-making reference for professionals and managers.

Lack of specific symptoms and signs makes clinical diagnosis of trichinellosis difficult. Epidemiological information is important, such as a history of ingesting raw or undercooked meat. An outbreak can be traced to a group of people dining together. Usual manifestations include abdominal pain or diarrhea with general discomfort in the enteric stage, and fever, eyelid or facial edema, muscle pain in acute stage. Complications, such as myocarditis, pneumonia, encephalitis, may develop in severe cases. Eosinophilia appears between 2 and 5 weeks after infection. Enzyme-linked immunosorbent assay(ELISA) using the excretory-secretory(ES) antigens of the muscle larvae or synthetic tyvelose as antigen is sensitive and specific, the serological method of choice as a screening test. Western blotting is needed to confirm the positive ELISA. Definitive diagnosis depends on the finding of larvae in a muscle biopsy specimen. Albendazole is the drug of choice for its treatment, 20-30 mg/(kg?d), two times daily for 5-7 days. Glucocorticosteroids are given only to severe cases and always be used in combination with albendazole, since they could prolong the intestinal phase of the infection and increase the muscle larval burdens.

Objective To explore the medicinal values of the buds of Lonicera ruprechtiana Regel.by analyzing its chemical constituents. Methods The buds of Lonicera ruprechtiana Regel.were extracted with 70% ethanol,the extractives were purified with macroporous resin and isolated with silica gel and ODS column chromatography.NMR,UV,IR Spectrometers were used to obtain spectroscopic data.Results According to the single spot in TLC,five compounds were isolated from the buds of Lonicera ruprechtiana Regel.,and their structures were identifited through physico-chemical constants and spectroscopic analysis.Five compounds were isolated from the buds of Lonicera ruprechtiana Regel.,and they are daucosterol (Ⅰ);7S-O-methylmorroniside(Ⅱ);neohesperidin(Ⅲ);benzyl-O-?-D-xylopyranosyl-(1→6)-?-D-glucopyranoside (Ⅳ);6'-O-?-D-apiofuranosyl sweroside (Ⅴ).Conclusion All these compounds are isolated from the buds of Lonicera ruprechtiana Regel.for the first time.

Objective To analyze nursing intervention and digoxin treatment of elderly heart failure patients taking digoxin drug compliance reasons. Methods Select Red Cross Hospital of Hangzhou on March 21, 2015 to March 21, 2016, 110 cases of senile heart failure patients as the research object, take the envelope random grouping scheme, divided into normal group and experimental group two groups, each group are occupying 55 cases. Among them to digoxin therapy on conventional therapy alone, in the experimental group were markedly drug treatment and corresponding nursing intervention, compared two groups of patients' medication compliance and quality of life score. Results the patients in the experimental group were 98.18% and 81.82% respectively, and the comparison groups were significantly different(P<0.05). The experimental group after treatment the patient's quality of life score of each dimension (physical function, psychological state, the doctor-patient relationship, independence, social relations, the personal faith and the general quality of life) were significantly better than the conventional group(P<0.05). Conclusion For elderly patients with heart failure to take scientific and reasonable method for nursing to improve the adherence of digoxin drugs, improve the quality of life, is worth popularizing practice.

Objective To analyze the effect of persistent nursing intervention on long-term therapeutic compliance of statins in elderly patients with coronary heart disease. Methods A total of 100 cases of elderly patients with coronary heart disease from December 24, 2015 to February 24, 2017 in Hangzhou city of Zhejiang Province, the Red Cross Hospital as the research object. They were divided into two groups by dynamic randomized odd number grouping. Two groups of patients were treated with statins for a long time, while were given general care, continuous care intervention, to explore the two groups of patients with lipid changes, the total effective rate of treatment, the incidence of adverse reactions, treatment compliance differences. Results Large differences are observed in lipid changes group and control group, the total efficiency of treatment and treatment compliance than the control group, the adverse reaction was lower than that of control group, the difference was statistically significant (P<0.05). Conclusion Continuing nursing intervention has a certain effect of intervention in long-term treatment compliance of statins in elderly patients with coronary heart disease.

Objective To investigate the expression levels of serum CCL17 in patients with rheumatoid arthritis(RA),so as to explore its clinical sig?nificance. Methods The expression of serum CCL17 was measured by ELISA in 40 RA patients and 20 normal individuals. The correlation of se?rum levels of CCL17 with clinical active index was analyzed. Results The serum level of CCL17 in RA patients was significantly higher than those in normal controls(P<0.05). Serum CCL17 level in patient with advanced disease(DAS28≥5.1)was higher than those in medium disease activity group(3.2≤DAS28<5.1)(P<0.05). The serum level of CCL17 in RA was obviously correlated with CRP,anti?CCP,the count of PLT(P<0.05). Conclusion High level of CCL17 expression was found in serum of RA patients. Our results also proved that serum level of CCL17 has certain cor?relation with disease activity index in RA patients,which indicates CCL17 may be involved in the process of the pathogenesis and progression of RA.

Objective To evaluate the safeness of this treatment by comparing the serum IGF-Ⅰ and IGFBP3 concentration level before and after receiving rhGH treatment in pediatric patients.Methods 30 pediatric patients in our hospital receiving rhGH treatment were subjected to monitor serum IGF-Ⅰ and IGFBP3 level before and after the treatment and calculate the IGF-Ⅰ and IGFBP3 ratio.At the same time the serum T3,T4 and TSH are also assayed.Results The average increase of booly heights was(8.77?3.01)cm /y(t=7.773,P0.05),but the serum IGFBP3(t=3.759,P0.05).However,there was statistical significance of the serum IGFBP3 level between subgroups(f=22.964 P0.05).Conclusion The serum IGF-Ⅰ and IGFBP3 level are able to be used as one of clinical evaluation benchmarks to detect the risks of inducing tumor during the rhGH treatment in the pediatric patients.

The key reason for reparative process interruption of femoral head necrosis is the formation of hardening layer, which make it hard for medicine to act on the necrosis center. The research on formation mechanism of hardening layer is limited and the reason for reparative process interruption is unknown. Based on lots of pathological section and literature data, four hypotheses about the reason for reparative process interruption are proposed, including resource competition, damage of stress, disturbance of nerves and stasis of blood vessel. The internal mechanism of incomplete reparation and chronicity of hardening layer was analyze from different aspects. The four hypotheses provides a new thinking for study the reason for reparative process interruption.

Objective To evaluate the diagnostic value in pulmonary interstitial fibrosis by transbronchial lung biopsy(TBLB) and immunohistochemistry. Methods The lung tissue samples were obtained from 20 cases of pulmonary fibrosis due to different causes, including 9 cases of idiopathic pulmonary fibrosis(IPF) and 11 cases of pulmonary fibrosis caused by chronic obstructive pulmonary disease (PF COPD), by means of transbronchial lung biopsy. Hematoxylin and eosin staining, Masson trichrome staining and immunostaining with anti type Ⅲ collagen and anti type I collagen multiclonal antibodies were performed. Differences in clinical characteristics, pathological manifestations, levels, types and distribution of proliferation of collagen fibers between IPF and PF COPD were compared. Results The proliferation of collageneous fibers was significantly higher in IPF than in PF COPD( P

Objective To identify the clinical and neurophysiological features of multiple system atrophy (MSA) and explore diagnostic values using various techniques in electro neurophysiology Methods Forty four subjects diagnosed as multiple system atrophy (MSA) during 1983 to 2001 in PUMC Hospital were studied retrospectively about their clinical features, routine electromyography (EMG), nerve conductive velocity (NCV), somatosensory evoked potential (SEP), motor evoked potential (MEP), brainstem auditory evoked potential (BAEP) and visual evoked potential (VEP) The clinical features and the electroneurophysiologic results were analyzed in different subgroups (probable MSA and possible MSA, OPCA and non OPCA, classified MSA and unclassified MSA) Results Most patients were found to be suffered from autonomic failure (88 6%) and cerebella dysfunction (88 6%) The pyramidal sign was seen in 72 7% of patients No remarkable statistical differences were found in all of the above three domains The incidence of Parkinsonism was 36 4% of all the patients, which showed significant differences between probable and possible MSA (54 5% vs 18 2%), non OPCA and OPCA (50% vs 7 1%), unclassified MSA and classified MSA (52% vs 15 8%) EMG was abnormal in 7 patients (38 1%), all of them were neurogenic impairments The rates of abnormal EMG were varied differently between probable and possible MSA (54 5% vs 22 2%), non OPCA and OPCA (53 8% vs 14 3%), unclassified MSA and classified MSA (58 3% vs 12 5%), but without statistical differences The abnormal rates in BAEP,SEP, VEP and MEP were 56 7%, 28%, 23 1% and 20 0%, respectively, and there were no significant differences between subgroups Conclusions It should be hard to divide MSA into groups only by the clinical manifestations All EPs were abnormal in some extent The most sensitive test is BAEP in current study, but there were no differences among the subgroups in the rates of abnormal EPs The difference of EMG and NCV between the groups showed that the technique might be helpful in the diagnosis of MSA