To analyze simulated patient studies and their developmental trajectory, a comprehensive review was conducted using VOS viewer software. PubMed and CNKI databases were searched for 4 164 articles related to simulated patients. By creating keyword clouds and comparison tables, the current status and development trends of simulated patient studies at home and abroad were analyzed, and visual analysis was conducted based on these findings. Additionally, the analysis encompassed various metrics such as the number of published articles, journals, authors, and institutions involved. The findings reveal that the simulated patient studies focus on education, examination, and communication. Chinese studies on simulated patients initially demonstrated an upward trend but followed with a decline, whereas English studies have exhibited a steady upward trajectory. The application of simulated patients spans diverse fields including diagnostics, internal medicine, surgery, and medical practitioner exams, thereby greatly contributing to the advancement of medical education. It is anticipated that the number of simulated patient studies will continue to surge in the upcoming years.

Objective To employ next-generation sequencing(NGS)to analyze differentially expressed mRNAs in the gingival tissue of hypertensive rats with or without periodontitis to provide a theoretical basis for the prevention and treatment of hypertension with periodontitis.Methods After obtaining approval from the Animal Experiment Ethics Committee,a hypertensive rat model was established by administering high-salt feed containing 8％(w/w)NaCl,and a periodontitis rat model was established by ligating the first molar of the mandibular region using 3-0 sterile silk thread.Rat models of the normal control(N),hypertension(H),and hypertension with periodontitis(PH)groups were estab-lished.The blood pressure,heart rate,alveolar bone resorption,and number of osteoclasts in the alveolar bone were measured,before harvesting the gingival tissues from the three groups for NGS to analyze the expression of significantly different genes.Gene ontology(GO)enrichment analysis was performed for all significantly differentially expressed genes between the H and PH groups.Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis was per-formed.Key genes were screened by protein-protein interaction(PPI)networks,and the key gene expression in each group was verified using immunohistochemistry(IHC).The expression of key genes in the systemic circulation of each group was analyzed using enzyme-linked immunosorbent assay(ELISA).Results At the end of the experiment(11th week),the blood pressure was higher in both the H and PH groups than that in the N group(P<0.001),but there was no statistically significant difference in blood pressure between the H and PH groups.There was no statistical difference in heart rate among the 3 groups.Micro-CT showed that the distance from the cemento-enamel junction to the alveolar bone crest(CEJ-ABC)of the mandibular first molar in the PH group was significantly higher than that in the N and H groups(P<0.016 7).The number of osteoclasts in the alveolar bone of the PH group was significantly higher than that of the N and H groups(P<0.0167).No common differentially expressed genes were found among the 3 groups.There were 235 significantly differentially expressed genes in the gingival tissue between the H and PH groups,and 137 upreg-ulated genes(e.g.,P-selectin,keratin 16,and S100 calcium binding protein A)and 98 downregulated genes(e.g.,FK506 binding protein 5,mediator complex subunit 22,zinc finger and BTB domain containing 16)in the PH group compared to the H group.GO analysis showed that the major enriched biological processes(BP)were leukocyte migra-tion,the major cellular component(CC)was complex of collagen trimers,and the significant molecular function(MF)was extracellular matrix structural constituent in the H and PH groups.KEGG pathway analysis showed that signaling pathways such as cytokine-cytokine receptor interaction,IL-17 signaling pathway,and TNF-α signaling pathway were significantly enriched in the H and PH groups.PPI analysis identified four key genes affecting periodontitis in hyperten-sive conditions,including interleukin-1β(IL-1β),matrix metalloproteinase-9(MMP-9),collagen type Ⅰ alpha1(COL1α 1),and chemokine ligand 1(CXCL1).Compared to the N and H groups,the expressions of IL-1β and TNF-α were all upregulated in the gingival tissue and systemic serum in the PH group(P<0.016 7).Conclusion The differentially expressed mRNAs in hypertension with or without periodontitis included IL-1β and MMP-9,while the differentially ex-pressed signaling pathways were IL-17 and TNF-α.These results provide a theoretical reference for further investigation of the molecular regulatory mechanism of hypertension with periodontitis in the future.

Objective:To establish a HPLC method for determinating 9 components simultaneously in Swertia chirayita. Methods:By useing water Sunfire C18 column (4.6 mm× 250 mm,5 μm); Gradient elution was carried out with methanol-0.05% phosphoric acid solution as mobile phase. Setting the column temperature at 30 ℃, the flow rate at 1.0 ml/min, and the detection wavelength at 254 nm.Results:9 components showed good linear relationship within the injection quality range. The recovery rates of wertiamarin, Gentiopicroside, Angelica glycosides,Mangiferin, Isolysine, Gentianoside, Diol glycoside, 8-hydroxy-1,3,5 trimethoxyketone, and Daisy leaf gentinone were 95.38%, 92.41%, 95.14%, 91.87%, 92.24%, 92.51%, 95.08%, 91.72%, 95.74% ( n=6). Conclusion:The method is simple, efficient, sensitive, accurate, economical and practical, with repeatability and stability. It could provide reference for the quality control and comprehensive utilization of Swertia chirayita.

Objective:To study the method of intravascular angiography in vivo, analyze the clinical significance, and supply the basis of diagnosis and treatment of related orthopaedic diseases.Methods:The development was realized by improving the developer to increase the local concentration. Based on the study of Lijianmin-Chengkun Complexes and using the theory of magnetic microspheres, Fe 3O 4 magnetic microspheres with amino (negatively charged) shell are used to adsorb the aggregated ionic developer meglumine diatrizoate (positively charged diatrizoate). That is, by improving the method of developer, the magnetic microspheres can carry the developer to make new nanoparticles magnetic imaging composite particles. Under the action of external magnetic field, the magnetic imaging composite particles brought by blood circulation continue to stay and gather in the blood vessels in the magnetic field area, and the developer carried by the magnetic microspheres in the blood vessels in the magnetic field area is concentrated to reach the imaging concentration, so as to realize in vivo intravascular vascular imaging. By adjusting the ratio of the two reagents, the charge can be neutralized and condensed into small groups to improve the development efficiency. Thus, the electron microscope experiment, CT in vivo experiment, rabbit imaging experiment, experimental rabbit tissue picture confirmation, CT in vivo human body (the author is a volunteer) imaging experiment were carried out step by step. Results:Electron microscope experiment: meglumine diatrizoate, scanning electron microscope, the particle diameter is about 20 nm. Scanning electron microscope showed that the diameter of the magnetic microspheres was about 100 nm and the distribution was uniform. After the two reagents are mixed in a certain proportion, the neutralizing charge condenses into small groups, but it still has magnetohydrodynamic properties and strong paramagnetism. In vivo rabbit imaging experiment: the ideal intraosseous vascular imaging of the proximal tibia was captured. The tissue pictures of experimental rabbits confirmed that the distribution of Fe 3O 4 was obviously visible in the blood vessels in the proximal tibia on the side with magnetic field, but not on the side without magnetic field. In vivo human imaging experiment: the ideal intraosseous vascular imaging of the proximal fibula was captured. Conclusion:Through the preparation of new reagent of magnetic imaging composite particles (magnetic microspheres + meglumine diatrizoate), the concentration of in vivo bone developer can be achieved under the action of external magnetic field, and the in vivo external diameter ≥ 0.5mm can be achieved under CT thin-layer scanning.

Objective: To investigate the clinical significance of dynamic contrast-enhanced computed tomography (CT) combined with magnetic resonance imaging (MRI) in differential diagnosis of adrenal adenoma and metastasis. Methods: 120 patients with adrenal adenoma who were examined by enhanced MRI and enhanced CT before operation were collected. According to the pathological examination after operation, they were divided into adrenal adenoma group (86 cases) and adrenal metastasis group (34 cases). The difference of time-density curve between the two groups was compared, and the diagnostic criteria were evaluated by using receiver operating characteristic (ROC) curve. Results: Dynamic CT and dynamic MRI were mainly type A, followed by type C, B, D and E. Dynamic CT and dynamic MRI were mainly type B, followed by type D/E, type A and type C. There were significant differences in type A, B, C, E dynamic CT and dynamic MRI between the two groups (P<0.05); there was no significant difference in type D dynamic CT and dynamic MRI between the two groups (P>0.05). The AZ value of adrenal adenomas ranged from 0.714 to 0.825 and that of adrenal metastasis ranged from 0.872 to 0.965 at 3-30 minutes delay. Conclusions Dynamic contrast-enhanced CT combined with MRI in patients with adrenal adenoma and metastasis has a time-density difference, 5min has high discriminant value in time lapse.

This study presents a case of synchronous multiple primary cancers involving floor of mouth carcinoma with esophageal carcinoma. Literature was reviewed to summarize the incidence, location, diagnosis, treatment characteristics, and prognosis to improve understanding and awareness of the multiple primary cancer. As a result, early discovery, early diagnosis, and effective treatment can help prolong survival and improve the quality of life of patients.

Objective:To study the significance of H19 gene in the progress from normal mucosa through oral submucous fibrosis (OSF) to carcinogenesis.Methods:Real-time fluorescent quantitative PCR technique was used to detect LncRNA H19 expression level in 12 cases of normal buccal mucosa tissue,33 cases of OSF buccal mucosa tissue and 31 cases of buccal carcinoma with OSF.Results:The relative expression levels of LncRNA H19 in normal buccal mucosa tissues,OSF buccal mucosa tissue and buccal carcinoma with OSF tissue were 1.17 ±0.37,3.44 ± 1.08 and 8.88 ± 1.78 respectively(between each 2 groups,P ＜ 0.01).Conclusion:H19 may involve the occurrence and canceration of OSF.

Objective To know the situation of time delay from the patients with ischemic stroke arrived the emergency to accepted the thrombolysis treatment, and analyze the related factors in order to put forward effective process optimization measures. Methods Totally 122 patients with acute ischemic stroke admitted into a Beijing grade A tertiary hospital who needed receive thrombolysis treatment from June 2014 to June 2015 were selected as the research object according to the purpose sampling method. Then we recorded the time in the whole process which were devided into 4 steps ( arrived at the emergency department- obtained consultation of stroke physicians;obtained consultation of stroke physicians- arrived in CT chamber; arrived in CT chamber- got CT scan results; got CT scan results- accepted thrombolysis therapy ) . Results The time delayed in hospital of intravenous thrombolysis group and artery thrombolysis group were (114.95±29.48)min and (171.22±50.10)min. The step of biggest delta-T between the actual time and standard time of two groups were both from getting a CT scan results to accepting thrombolysis therapy.Conclusions The delay after getting a CT scan results is the most important reason of delay in hospital. Shorten the time of blood test, optimize the hospital management and perfect the construction of the green channel, can promote the situation of the delay in hospital, and, improve the efficiency of thrombolysis treatment.

Objective To explore the value of contrast-enhanced ultrasound in the diagnosis and classification of traumatic spleen rupture , as compared with enhanced CT. Methods The manifestations of contrast-enhanced ultrasound on surgically or clinically confirmed spleen rupture in 40 patients were retrospectively analyzed. The performance of contrast-enhanced ultrasound on diagnosis and classification was compared with that of enhanced CT. Results For 40 patients with traumatic spleen rupture , the of accuracy of enhanced CT and contrast-enhanced imaging in the diagnosis of traumatic spleen rupture was 97.5%, with no significant statistical differences (chi-square = 0, P = 1). On contrast-enhanced ultrasound examination, 14 patients were diagnosed as true splenic rupture , 9 as subcapsular spleen rupture , and 16 as central splenicrupture, with a accuracy rate of 92.5% (37/40); and accuracy rate for enhanced CT was 90.0% (36/40), there was no significant statistical difference (chi-square = 1.97, P > 0.05). Conclusions Contrast-enhanced and enhanced CT have good consistency in the diagnosis and classification of traumatic spleen rupture. Contrast-enhanced ultrasound can accurately determine the scope and degree of spleen damage , resulting in more accurate classification; and it has values in the diagnosis of traumatic spleen rupture and choice of therapies.

OBJECTIVETo detect the expression of Mycobacterium tuberculosis secreted protein Ag85B in paraffin-embedded tissues by immunohistochemistry (IHC), and to evaluate its application in the pathological diagnosis of tuberculosis.

METHODSOne hundred and five tuberculosis specimens (54 pulmonary tuberculosis, 51 lymph nodal tuberculosis) and 51 specimens of other diseases (8 lung cancer, 10 pulmonary abscess, 10 bronchiectasis, 7 lymphoma, 5 necrotizing lymphadenitis, 4 reactive hyperplasia lymphoid, and 7 sarcoidosis) were collected from January 2012 to July 2013 from Beijing Chest Hospital, Capital Medical University. One-step IHC was performed on paraffin-embedded tissues using antibody directed against Ag85B.

RESULTSIHC and Ziehl-Neelsen (ZN) acid-fast staining showed that distribution and intensity of Ag85B expression were concordant with the distribution and number of acid-fast bacilli. IHC showed significantly higher sensitivity than ZN staining (50.5%, 53/105 vs. 31.4%, 33/105; χ² = 7.877, P = 0.005). The combined sensitivity of IHC and ZN staining was 59.0%. Moreover, oil immersion was not necessary for IHC, allowing more rapid diagnosis.

CONCLUSIONIHC detection of Ag85B is a simple method with higher sensitivity than ZN staining, and demonstrated good value in the pathological diagnosis of tuberculosis.

Acyltransferases ; metabolism ; Antigens, Bacterial ; metabolism ; Biomarkers ; metabolism ; Bronchiectasis ; diagnosis ; immunology ; Humans ; Immunohistochemistry ; Lymphadenitis ; diagnosis ; immunology ; Mycobacterium tuberculosis ; immunology ; Sarcoidosis ; diagnosis ; Staining and Labeling ; Tuberculosis, Lymph Node ; diagnosis ; immunology ; Tuberculosis, Pulmonary ; diagnosis ; immunology