Objective To outline the research fronts of ten major sub-specialties in internal medicine.Methods Based on their impact factor scores and the proportion of the journals of 10 subspecialties (endocrinology & metabolism,cardiac & cardiovascular systems,hematology,infectious diseases,nephrology,gastroenterology & hepatology,respiratory system,rheumatology,critical care medicine,clinical neurology) in Journal Citation Report (JCR),and careful consulation of expert clinicians,we identified 50 journals.Their bibliographic records (including references) published in 2011 were downloaded,and the frequency of the references (citations) in each sub-specialty was counted and the highly cited records were extracted.We performed a clustering analysis according to the co-cited times among any pairs of the highly cited records.To tag each cluster of highly cited records,we browsed the titles and abstracts of all highly cited records in the same cluster,and concluded the main topics of each cluster.Finally,we extracted the current published papers devoted to particular cluster by some clustering analysis indicators.The clusters of highly cited records were considered as the intelligence base,and the main topics in current papers which citing these highly cited papers were considered as research fronts.Results Totally 50 journals on 10 sub-specialties in internal medicine were identified.A total of 202 highly cited papers,38 clusters (knowledge bases),and 152 corresponding current citing papers presenting the research fronts were selected.Conclusions We confirm and present research fronts in 10 major sub-specialties of internal medicine.This study provides a synchronic structure of contemporary research activities in internal medicine sub-specialties.

Objective To observe the effect of human immunoglobulin on elderly head and facial post herpetic neuralgia (PHN) and peripheral blood TNF-α.Methods One hundred and twenty-two inpatients with PHN aged ≥65 years old were selected and divided into the observation group (52 cases) and control group (70 cases) by the systematic sampling method.The control group was given the early conventional combined therapy,while on this basis the observation group was intravenously dripped by human immunoglobulin.The incidence rate of PHN and pain visual analog scale(VAS) score at 1,2,3 months after recovery discharge from hospital were recorded in the two groups.Other 20 healthy elderly people were selected as the healthy control group.The TNF-α level was determined in the two patients groups before and after treatment and in the healthy control group.Results The PHN occurrence rate at 1,2,3 months after discharge in the observation group was significantly lower than that in the control group(P＜0.05);the VAS score after treatment and at 1,2,3 months after discharge in the observation group was significantly lower than that in the control group (P＜0.05);serum TNF-α level after treatment in the observation group was significantly lower than that in the control group (P＜0.01),moreover which was close to the level in the healthy control group(P＞0.5).Conclusion Human immunoglobulin can reduce the PHN occurrence in the old people with head and facial herpes zoster and reduce the peripheral blood TNF-α level.

OBJECTIVETo observe the effect of Chuanhuang No.1 Recipe (CHR) on renal function and micro-inflammation in phase 3 chronic kidney disease (CKD) patients.

METHODSTotally 60 phase 3 CKD patients were randomly assigned to the treatment group (treated by CHR) and the control group (treated by Losartan Potassium), 30 in each group. All patients received basic treatment. Patients in the treatment group took CHR decoction, 400 mL each time, one dose per day, while those in the control group took Losartan Potassium, 50-100 mg per day. All medication lasted for 24 weeks. Changes of serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), serum uric acid (UA), 24 h urinary protein excretion (24 h U-pro), urinary microalbumin (U-Alb), high-sensitivity C-reactive protein (hs-CRP), serum tumor necrosis factor (TNF)-alpha, and serum IL-6 were detected and compared before and after treatment. Efficacy was also compared.

RESULTSCompared with before treatment, SCr and BUN significantly decreased in the treatment group (P<0.05, P<0.01); eGFR in- creased (P<0.05). Only UA obviously decreased in the control group (P<0.05), but with no obvious change in SCr, BUN, or eGFR. Compared with before treatment, 24 h U-pro decreased after treatment in the treatment group (P<0.05), but with less decreased level when compared with the control group. U- Alb was also significantly decreased in the control group (P<0.01). There was statistical difference in 24 h U-pro and U-Alb between the two groups after treatment (P<0.05). Compared with before treatment, hs-CRP obviously decreased after treatment in the two groups, but serum levels of TNF-alpha and IL-6 obviously decreased only in the treatment group (P<0.05). The total effective rate was obviously higher in the treatment group than in the control group (70.00% vs. 43.33%, P<0.01).

CONCLUSIONCHR could efficiently improve the renal function of phase 3 CKD patients and alleviate the micro-inflammation.

Adult ; Blood Urea Nitrogen ; C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Inflammation ; Interleukin-6 ; metabolism ; Losartan ; therapeutic use ; Male ; Middle Aged ; Phytotherapy ; Renal Insufficiency, Chronic ; drug therapy ; Tumor Necrosis Factor-alpha ; metabolism ; Urea

Arsenic from environmental contamination is a risk factor for kidney disease, and the clinical use of arsenic also triggers a new concern that the potential kidney damage caused by exposure to clinical doses of arsenic trivalent. So far, the undergoing mechanisms contributing to arsenic nephrotoxicity mostly remain unclear, and universally accepted methods for preventing this complication are limited too. Ancient Chinese medical scientists recognized the toxicity of arsenic long ago, and there were some records of Chinese herbs against arsenic poisoning in ancient books of Chinese medicine. In the past decade, several herbal formulations, as well as some potentially active compounds extracted from Chinese herbs, have been employed to prevent arsenic nephrotoxicity both in vivo and in vitro and showed better therapeutic effects. The present paper thus summarizes and discusses these Chinese medicine methods in preventing such a public health problem. In addition, we call for large, well-designed, randomized, and controlled clinical trials to be performed to further assess the efficacy and safety of these potential methods of Chinese medicine against arsenic nephrotoxicity.

OBJECTIVE: To establish the 2-dimensional electrophoresis(2-DE) profiles of peripheral blood mononuclear cells(PBMC) in patients with hepatocellular carcinoma(HCC) and health adults. METHODS: The total proteins from PBMC in patients with HCC and healthy adult were separated by immobilized pH gradient-based 2-DE. The differential expression proteins were analyzed by PDQuest analysis software. RESULTS: The well-resolved, reproducible 2-DE patterns of PBMC in patients with HCC and healthy adults were obtained. For HCC, the average spots of 2-DE maps were 1 206 +/- 48, and the average matching rate was 90.8%. For normal adults, the average spots were 1 123 +/- 37, and the average matching rate was 92.6%. CONCLUSION The well-resolved, reproducible 2-DE patterns of PBMC in patients with HCC and healthy adults are established. These proteomic analysis methods are useful to screen the potential biomarkers in the early diagnosis, treatment and prognosis monitor in patients with malignant tumor.
Adult ; Carcinoma, Hepatocellular ; blood ; Electrophoresis, Gel, Two-Dimensional ; methods ; Female ; Humans ; Leukocytes, Mononuclear ; cytology ; metabolism ; Liver Neoplasms ; blood ; Male ; Middle Aged ; Proteomics ; methods

OBJECTIVETo develop a traction reductor for the reduction of lower limb fractures during the minimally invasive surgery and explore its safety and efficacy.

METHODSFrom February 2007 to March 2009, closed or limited open reduction plus percutaneous plate and screw internal-fixation were conducted in 34 patients with fracture of distal femur and tibia metaphysic, among which there were 3 distal femoral fractures (2 33-B, 1 33-C), 14 proximal tibial fractures (9 41-A, 3 41-B, 2 41-C) and 17 distal tibial fractures (9 43-A, 5 43-B, 3 43-C, 2 Gustilo I a), according to the Association for Osteosynthesis-Orthopaedic Trauma Association (AO-OTA) classification. Besides, closed reduction plus interlocking intramedullary nailing on tibial shaft fracture were applied in 36 patients (7 42-A, 21 42-B, 8 42-C, 2 Gustilo I a). All the 70 patients, with an average age of 37.6 years (range: 17 to 63 years) and average time before surgery of 4.7 d (range: 0.7 to 12.0 d), underwent reduction by self-designed traction reductor for lower limb fracture in the surgery. The reduction duration and C-arm fluoroscopy time were recorded. Recovery of the force line of affected limbs after surgery was determined by whether the line from anterior superior iliac spine to the interdigit between the first and second toe-web passed the patella center. And the distance from bilateral anterior superior iliac spine to medial malleolus tip as well as the difference between lower limbs were recorded to determine the recovery of length after surgery. Meanwhile, the varus-valgus and anteroposterior angulations after reduction were measured by AP and lateral X-ray.

RESULTSThe reduction duration was 12.7 min (range: 7 to 31 min); X-ray fluoroscopy time, 1.3 min (range: 0.4 to 3.0 min); length difference between both lower limbs (6.5 ± 1.1) mm; and axial alignment difference (7.0 ± 1.8) mm. The X-ray result showed that varus-valgus angle was (2.75 ± 0.16)°; and anteroposterior angulation (5.13 ± 0.51)°.

CONCLUSIONThe traction reductor for lower limb fracture could achieve satisfying fracture reduction in the minimally invasive surgery of distal femur, tibia metaphysic and tibial shaft fracture.

Adolescent ; Adult ; Equipment Design ; Female ; Fractures, Bone ; surgery ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Traction ; instrumentation ; Young Adult

OBJECTIVETo investigate the changes of endoplasmic reticulum stress-induced apoptosis in pulmonary tissue of rats with hypoxic pulmonary hypertension.

METHODSTwenty two male SD rats were randomly divided into control group and 4-week hypoxia-hypercapnia group (n=11). The mean pulmonary arterial pressure (mPAP) and the mean carotid arterial pressure (mCAP) were monitored, and the weight ratio of right ventricle (RV) to left ventricle plus septum (LV + S) were measured. The rattish pathological model were assessed by mPAP, mCAP, RV/(LV+ S), vessel wall area/total area (WA/TA), vessel cavity area/total area (CA/TA) and media thickness of pulmonary arteriole (PAMT). The pulmonary apoptotic cells were detected by Hoechst staining. RT-PCR was used to study the genetic expression of caspasel2, glucose regulated protein 78 (GRP78) and GRP94 in pulmonary tissue. The expression of GRP94 and GRP78 proteins in pulmonary tissue were determined by using immunohistochemistry.

RESULTS(1) (The mPAP, RV/(LV + S), WA/TA and PAMT were respectively higher by 50.5%, 37.3%, 72.5% and 137% in hypoxic group than those in control group, while CA/TA was lower by 41.9% (all P < 0.01). There was not significant difference of mCAP between the two groups. (2) Hoechst staining showed that the pulmonary apoptotic cells in hypoxic group outnumbered markedly than those in control group, and the apoptotic cells were mainly in pulmonary tissue, while they were rare in pulmonary vascular smooth muscle cell. (3) Compared with control group, the expression of pulmonary caspasel2, GRP78 and GRP94 mRNA in hypoxic group were higher by 144%, 137% and 80.7% (all P < 0.05), respectively. (4) The expression of pulmonary GRP78 and GRP94 proteins were up-regulated in hypoxic group, and these proteins mainly localized in pulmonary vascular endothelial cell.

CONCLUSIONThe endoplasmic reticulum stress-induced apoptosis may be one of the mechanism of hypoxic pulmonary hypertension and pulmonary vascular wall remodeling.

Animals ; Apoptosis ; physiology ; Caspase 12 ; metabolism ; Endoplasmic Reticulum Stress ; physiology ; Heat-Shock Proteins ; metabolism ; Hypercapnia ; physiopathology ; Hypertension, Pulmonary ; etiology ; pathology ; physiopathology ; Hypoxia ; complications ; physiopathology ; Lung ; pathology ; Male ; Membrane Glycoproteins ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the chemical constituents of the corm of the planted Cremastra appendiculata.

METHODThe compounds were isolated by column chromatography with silica gel and Sephadex LH-20, and their structures were elucidated by means of spectroscopic methods including 2D NMR techniques.

RESULTSix compounds were isolated, and identified as isohircinol (I), flavanthrinin (II), p-hydroxyphenylethyl alcohol (III), 3,4-dihydroxyphenylethyl alcohol (IV), daucosterol (V), beta-sitosterol (VI).

CONCLUSIONThese compounds were not previously isolated from this plant, and isohircinol (I) was obtained from natural source for the first time.

Orchidaceae ; chemistry ; Phenylethyl Alcohol ; analogs & derivatives ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Sitosterols ; chemistry ; isolation & purification