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.

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.

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

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 observe he effects of new Tangshenkang on α-SMA and E-cadherin of human renal tubular epithelial cell HK-2 in high concentrations of glucose; To explore the mechanism of new Tangshenkang on the prevention and treatment of diabetic renal fibrosis. Methods The HK-2 cells were cultured and divided into control group, high glucose group, animal serum control group, new Tangshenkang low-, medium-, and high-dosage group. After medicine intervention, cell proliferation was tested by MTT assay, and contents of α-SMA and E-cadherin were observed by ELISA assay. Results Compared with control group, α-SMA of HK-2 cultured with high glucose was much notable, but the content of E-cadherin significantly decreased, with statistical significance (P<0.05). The content of α-SMA of HK-2 cultured with new Tangshenkang decreased, and the content of E-cadherin increased; cell proliferation was markedly inhibited in culture medium supernatant of HK-2 cells cultured with high glucose plus new Tangshenkang compared with only high glucose, with statistical significance. Conclusion New Tangshenkang can inhibit cell proliferation and epithelial-myofibroblast transdifferentiation of HK-2 cell induced by high glucose, and prevent the development of diabetic renal fibrosis to a certain extent.

Objective To explore the effects of morroniside on the expression of Angiopoietin-1 (Ang-1) and Tie-2 in a rat after focal cerebral ischemia-reperfusion. Methods 20 male Sprague-Dawley rats were randomly divided into sham group (n=4), ischemia group (n=4), and morroniside groups (low, medium and high dosage groups, n=4). The middle cerebral artery were occluded for 30 min, and re-perfused. Morroniside was administered intragastrically once a day at dose of 30 mg/kg, 90 mg/kg and 270 mg/kg after operation. The expression of Ang-1 and Tie-2 in the ischemic ipsilateral cortex were detected with Western blotting analysis 7 days after operation. Results The expression of Ang-1 and Tie-2 increased in the ischemia group compared with the sham group (P<0.01), and both of them further increased in the morroniside groups of high dosage compared with the ischemia group (P<0.01), and the expression of Tie-2 also increased in the morroniside groups of medium dosage (P<0.001). Conclusion Morroniside could increase the expression of Ang-1 and Tie-2 in the ischemic ipsilateral cortex after ischemia-reperfusion in rats, suggesting promoting the angiogenesis after ischemia.

Objective To explore the effects of morroniside on platelet aggregation induced by adenosine diphosphate (ADP) in focal cerebral ischemia/reperfusion in rats. Methods 48 Sprague-Dawley rats were randomly divided into sham group, model group, morroniside dose groups (30 mg/kg, 90 mg/kg, 270 mg/kg) and acetyl salicilic acid (ASA) group (10 mg/kg). The model of middle cerebral artery occlusion (MCAO) was established in all rats except the sham group. Born's turbidimetry was used to measure platelet aggregation rate in rats of MCAO model (in vivo). Results Compared with the model group, the platelet aggregation decreased significantly in the morroniside high dose group (P<0.001). Conclusion Morroniside has the effect of anti-platelet aggregation in focal cerebral ischemia/reperfusion in rats.