A co-words network for high frequency words was established using the title information of papers pub-lished in 22 medical journals from 2005 to 2013.The evolution of medical scientific research topics was analyzed with the visual analysis software NEViewer, which showed that medical research in China was focused on basic and application studies with the prevention and treatment of frequently encountered diseases and the associated technical methods as the two main directions, and that medical scientific research topics would remain their stable status in a rather long period.The hot medical topics were explained.

Background and purpose:Thermal ablation (radiofrequency ablation, RFA/microwave ablation, MWA) is the most commonly used minimally invasive technique for the treatment of liver cancer. Real-time shear wave elastography (SWE) is a new type of ultrasonic imaging technology, which was used in our study to monitor thermal ablation of liver cancer. This study aimed to investigate the stiffness change of liver cancer and that of surrounding liver parenchyma before and after thermal ablation, and to evaluate the application of SWE for monitoring thermal ablation for liver cancer.Methods:From Oct. 2014 to Apr. 2015, a total number of 36 patients, with 39 lesions, were treated with RFA or MWA and got complete response. SWE examination was performed before and after ablation. The SWE-mean, SWE-min, SWE-max, SWE-SD of lesions and the surrounding liver parenchyma were measured. Statistical analysis was made to compare the stiffness changes of liver cancer with those of the surrounding liver parenchyma before and after thermal ablation, and to determine whether there were differences between two different ablation modes.Results:Before and after ablation, the SWE-mean of lesions was (30.09±11.67) kPavs (52.11±17.56) kPa,SWE-min was (10.46±8.22) kPavs (20.57±11.42) kPa, SWE-max was (51.50±20.84) kPavs (88.54±27.75) kPa, SWE-SD was (10.63±4.30) kPavs (16.89±7.72) kPa; There were statistically signiifcant differences (P<0.05). Before and after ablation, the SWE-mean of surrounding liver parenchyma was (8.84±2.82) kPavs (8.91±2.78) kPa, SWE-min was (4.77±1.95) kPavs (4.69±1.90) kPa, SWE-max was (13.82±3.79) kPavs (14.34±3.97) kPa, SWE-SD was (3.24±1.32) kPavs (3.37±1.29) kPa; There were no statistically signiifcant differences (P>0.05). After ablation, the SWE-mean of RFA and MWA was (45.55±10.91) kPavs (60.59±20.99) kPa, SWE-min was (18.95±8.86) kPavs (25.93±10.93) kPa, SWE-max was (76.58±15.51) kPavs (104.01±32.59) kPa, SWE-SD was (13.82±3.52) kPavs (20.85±9.77) kPa; There were statistically signiifcant differences (P<0.05).Conclusion:SWE can quantitively analyze the stiffness of lesions. The ablation zone became stiffer after RFA or MWA, and the ablation zone of MWA was stiffer than that of RFA. Two kinds of ablation methods did not signiifcantly affect the stiffness of liver parenchyma around the lesion. SWE could potentially be used to monitor thermal ablation of liver cancer.

Case discussion is an effective approach,which combines basic theory with clinical medicine.It can evoke students' interest and cultivate their creative thinking capacity.Moreover,it can improve teachers' general ability in teaching pathophysiolo- gy.In this article,we discuss the application of case discussion in pathophysiology teaching.

Objective To screen altered proteins of hippocampus in the stress-induced depression (STRID) rat model, and explore the potential molecular mechanism. Methods Twenty Sprague-Dawley rats were randomly divided into the control group and STRID group, 10 rats in each group. Chronic unpredictable mild stress (CUMS) methods including fasting for solids and liquids, electric foot-shock, reversing day and night, cold water swimming, cage tilt, scare stimulation and tail pinch were conducted on STRID rats with no repeats for 28 days to make up the depression animal model. The control group was normally fed during this period. After the stress stimulation, the hippocampus protein samples were used for two dimensional electrophoresis to screen the differentially expressed protein, and then mass spectrum identification and function analyze were conducted. Results Compared with the control group, 34 proteins were altered in STRID group. Among which, 18 were up-regulated, and 16 were down-regulated. The differentially expressed proteins mainly located in cytoplasm, mitochondrion, extracellular exosome and myelin sheath. The involved signaling pathways included metabolic pathway, oxidative phosphorylation pathway, and Alzheimer's disease, Parkinson's disease and Huntington's disease pathways. Conclusion The altered proteins and dysfunction of nerve signaling, and the excess of oxidative phosphorylation in hippocampus of STRID rats may be one of the pathogenesises.

Animals ; Disease Progression ; Kidney Diseases ; physiopathology ; Kidney Glomerulus ; drug effects ; pathology ; Rats ; Renal Agents ; pharmacology ; Renin-Angiotensin System ; drug effects ; Sclerosis

BACKGROUND:Integrated Traditional Chinese and Western Medicine minimaly invasive treatment for halux valgus based on wrapped curtain method with “8”-shaped bandage and sub toe pad external fixation has been used for a long time in the clinic. This method abandons the internal implant fixationandexternal plaster fixation. After surgery, patients could take care of themselves. However, theactivity of the broken end may cause fracture nonunion, which once aroused scholars’ question. Recently, with the continuous improvement of foot biomechanics research, foot finite element model and applications become a reality.
OBJECTIVE:To evaluate thestability of osteotomy after the operation of wrapped curtain method with“8”-shaped bandage and sub toe pad external fixation on the basis of static finite element method.
METHODS:A young female volunteer with halux valgus was selected, whose body weight was 58 kg, and right foot halux abductor valgus angle was 24°; intermetatarsal angle was 13°; proximal articulator set angle was 7°; distal articulator set angle was 7°. CT was used to scan the right foot. ABAQUS software was applied to establish a finite element model of right foot halux valgus bone, and model of the first metatarsal neck minimaly invasive osteotomy was simulated based on wrapped curtain method with external fixation. Von Mises stress and displacement at the osteotomy endwere calculated.
RESULTS AND CONCLUSION:(1) The maximum stress was 0.067 MPa without external fixation, and the maximum stress was 1.258 MPa with the external fixation. Stress was mainly distributed in the outer edge of the osteotomy. (2) The maximum absolute displacement was 0.363 mm without external fixation, and the maximum absolute displacement was 0.716 mm with external fixation. The two largest displacements were both in the Z-axis direction. Statistical analysis confirmed that the four nodes absolute displacement and stress were significantly different (P< 0.01). (3) The maximum relative displacement was 0.101 mm. The maximum relative displacement was 0.046 mm with external fixation. The maximum relative displacement without external fixation was-0.102 mm and occurred in the Z-axis. The maximum relative displacement with external fixation was 0.110 mm and occurred in the Y-axis. (4) One-way analysis of variance confirmed that the four nodes relative displacements were not statisticaly significant in X-axisand Y-axis (P> 0.05). The four nodes relative displacements were statisticaly significant in Z-axis (P< 0.05). (5) These findings suggest that the external fixation based on wrapped curtain method after halux valgus surgery could effectively reduce osteotomy displacement. The moderate stress and elastic fixation are conducive to fracture healing.

Objective To identify gene mutations in two families with epidermolytic hyperkeratosis (EHK).Methods Clinical data were collected from two families with EHK.Peripheral blood was isolated from the probands and unaffected family members in the families as well as from 50 healthy controls.PCR was performed to amplify the encoding exons and flanking intron regions of KRT1 and KRT10 genes followed by direct DNA sequencing.Results Two mutations in the KRT10 gene,including a heterozygous acceptor splice site mutation in intron 4 (c.1030-2 A＞G) and a heterozygous missense mutation c.467 G＞A,were identified in the probands of both families,but absent in the unaffected family members or healthy controls.ConclusionThe splice site mutation c.1030-2 A＞G and missense mutation c.467 G＞A might be responsible for the phenotype of EHK in the two families.

Objective:To express rationally engineered antibodies against EGFR and assess their affinity to EGFR and anti-tumor cell migration effect. Methods:L and V_H genes of humanized antibodies against EGFR were designed and synthesized. Genes encoding V_H and C_H were connected and then cloned into a pIRES based bicistronic expression vector. Gene encoding the corresponding L gene was also cloned into the same vector. 293T cells were transfected with the recombinant plasmid and the antibody expression was confirmed by Western blotting. The antibodies were purified by protein A based affinity chromatography. Binding of the humanized antibody to the EGFR was assessed by Surface Plasmon Renainance with Biacore3000, and the biological activity of the humanized antibody was determined by tumor cell invasion test.Results:Three expression vectors were constructed and the humanized anti-EGFR antibodies were expressed and purified successfully. In reducing SDS-PAGE, the antibodies exhibited two bands of approximately 25×10~3and 50×10~3, respectively. Western blot assay showed that the humanized antibodies had recognition specificity to goat-human IgG antiserum. Biacore assay revealed that the humanized antibody C3 binds to EGFR with high affinity(6.13×10~(-10)M). Cell migration test showed that C2,C3 and C5 could suppress growth and migration of tumor cells.Conclusion:Three anti-EGFR humanized antibodies (C2,C3 and C5) have been constructed and expressed successfully, and the C3 antibody retained high affinity for EGFR and showed improved inhibitory effect on tumor cell growth and migration.

Objective To obtain antibiotic-resistant mutants producing metabolites with antitumor activity from wild-type actinomycete strains without antitumor activity. Methods An actinomycete strain L35-1 was used as an initial strain for obtaining antibiotic-resistant mutants, which is a marine-derived wild-type strain without antitumor activity with an inhibition rate of 2.8% at the 1000 μg/ml of high sample concentration on K562 cells. The antibiotic-resistant mutants both from auto-mutagenesis and chemical mutagen-induced mutagenesis were selected by single colony isolation on antibiotic-containing plates according to the method for obtaining drug-resistant mutants in ribosome engineering. The antitumor activity was assayed by the MTT method using K562 cells for the mutants with aqueous acetone extracts of the whole broth of their fermentation.Results A total of 114 neomycin-resistant (ner) and 68 streptomycin-resistant (str) mutants, all from auto-mutagenesis, was obtained on drug-containing plates. Among them, the 7 ner and 3 str mutants appeared to be bioactive with an inhibition rate above 20% at the 100 μg/ml sample concentration on K562 cells. On the other hand, 41 str and 32 ner mutants from DES-induced mutagenesis and 46 ner mutants from NTG-induced mutagenesis were obtained by mutagen-induced mutation coupled with the single colony isolation on antibiotic-containing plates, among which, one str mutant from DES-induced mutagenesis and one ner mutant from NTG-induced mutagenesis were bioactive with an inhibition rate over 20% at the 100 μg/ml sample concentration on K562 cells. Conclusions The present result has revealed that the wild-type actinomycete strains without bioactivity might become a great source initial strains to obtain bioactive mutants by drug-resistant mutation technique.

ObjectiveTo investigate the role of overexpressed proinflammatory cytokines in the pathogenesis of cerebral palsy (CP).MethodsLevels of tumor necrotic factor-α (TNF-α) and interleukin-6 (IL-6) in serum of 31 CP children, 20 healthy children (as controls), 37 neonates with CP risk factors such as hypoxic-ischemic injury and/or perinatal infection, and 20 healthy neonates (as controls) were measured by enzyme-linked immunosorbent assays (ELISA) retrospectively.ResultsLevels of TNF-α and IL-6 of CP children and neonates with CP risk factors were significantly higher than that of healthy controls (P<0.05). TNF-α level of CP children was significantly higher than that of neonates with CP risk factors (P<0.05), but there was no significant difference in IL-6 level between two groups.ConclusionOverexpressed proinflammatory cytokines play an important role in the pathogenesis of CP and may be an independent risk factor of CP.