中文SCI科技期刊现状与影响力提升建议

【目的】 研究我国中文SCI科技期刊的现状,以期为其影响力提升和未来发展提供思考。【方法】 利用网站调研(期刊官网和Web of Science数据库等)、微信公众号运营情况查询及统计分析等方法对中文SCI科技期刊进行较全面的数据采集与分析。【结果】 18种中文SCI科技期刊有深厚的历史积淀和良好的发展基础,但整体上仍存在一些问题,如国内影响力不如优秀的纯中文期刊(国内影响力排名不够靠前),国际影响力不高(JCR分区仅为Q3或Q4区),国际化发展程度不够(国际编委占比为0的期刊高达11种,缺乏国际新媒体宣传),不够重视网络首发(仅9种期刊有网络首发)等。【结论】 在目前国内良好政策环境下,我国中文SCI科技期刊需要坚守初心,可根据各自期刊定位制定个性化发展策略,从而发展成为旗舰期刊甚至是世界一流期刊。     

基于CNKI的中医药治疗癫痫的知识图谱分析＊

目的 运用科学知识图谱的手段，分析中医药治疗癫痫的研究进程并提炼重点。方法 设置检索时间为1990年至2020年，检索对象为中国知网（CNKI）该领域的相关文献，运用CiteSpace软件科学、准确地分析这些文献的作者信息、研究（发文）机构、关键词情况。结果 共计纳入文献793篇，马融-张喜莲、刘金民、谢炜、王洪图-张丽萍等领导核心作者团队，北京、广州以及广西中医药大学、天津中医药大学第一附属医院、南方医科大学等单位为主要进行相关研究的机构，高频关键词包括大鼠、难治性癫痫、小儿癫痫、海马、脑电图等，作用机制、网络药理学、肠道菌群、氧化应激、分子生物学等为近年来的热点与前沿。结论 通过借用知识图谱的分析能帮助提炼国内中医药治疗癫痫研究领域的重点，全面分析并科学判断近年来该领域的热点及前沿，为未来的研究夯实基础并把握方向。     

基于LDA模型的中医药人工智能领域主题演化分析＊

目的 梳理总结中医药人工智能领域近40年的研究情况，分析该领域研究主题演化过程，发现热点主题和研究前沿。方法 本研究检索了CNKI和WOS中中医药人工智能领域的文献，根据生命周期理论划分不同时间片，将文献摘要作为研究对象，采用LDA主题模型挖掘文本主题，分析主题的演化过程，识别热点主题。结果 纳入中英文文献2750篇，根据生命周期理论划分中医药人工智能领域发展阶段，分别建立全局和各阶段的LDA模型，挖掘出全局热点主题有中医专家系统、中医辅助诊断系统、中医药数据挖掘等，发现主题演化路径并进行可视化展示。结论 中医药与人工智能主要的结合点在中医智能系统、中医药知识组织和中医智能诊疗机器人这3方面，这3个方向的研究均离不开神经网络技术的支持，同时也结合了关联规则发现、复杂网络研究等方法。     

浅谈脑梗死的中医病因病机与中医药治疗近况

脑梗死是缺血性卒中之一,随着人口老龄化发展趋势,目前已越居我国居民致残和死亡的首要病因。中医药治疗脑梗死有着重要特色和优势,目前在医学领域中仍占着不可动摇的地位,现就针对古代医家及近现代医家对中风病中医病因病机认识,以及中医药治疗方面针对经典方、经验方、中成药、中医外治等方面进行总结综述。     

Improving capacity to care for patients with intellectual and developmental disabilities: The value of an experiential learning model for family medicine residents

BackgroundPatients with intellectual and developmental disabilities (IDD) are more likely to experience poor health outcomes and family physicians receive inadequate training to provide appropriate care to this patient group. Little prior research has studied how to effectively train family physicians to care for patients with IDD.ObjectiveThe aim of this pilot study was to assess the value of adding an experiential component to didactic education strategies to improve family medicine resident perceived comfort, skills and knowledge related to caring for patients with IDD.MethodsStructured education programs for residents were implemented at three primary care practices in Ontario, Canada. Two practices received didactic information only (didactic-only group); one received didactic information and an experiential training model including clinical interactions and a written reflection on that experience (didactic plus experiential group). In this separate-sample pre-post design, residents were invited to complete a brief anonymous survey prior to and following the training assessing their perceived comfort, skills and knowledge related to patients with IDD.ResultsAt baseline, there were no significant differences between the two groups of residents. At follow up, the experiential group reported significantly higher levels of comfort, skills, and knowledge compared to baseline for most items assessed, while in the didactic-only group most items showed little or no improvement.ConclusionThis pilot study suggests that providing residents the opportunity to participate in clinical encounters with patients with IDD, as well as a structured process to reflect on such encounters, results in greater benefit than didactic training alone.     

Evidence-based strategies to reduce the incidence of postoperative delirium: a narrative review

Delirium is one of the most commonly occurring postoperative complications in older adults. It occurs due to the vulnerability of cerebral functioning to pathophysiological stressors. Identification of those at increased risk of developing delirium early in the surgical pathway provides an opportunity for modification of predisposing and precipitating risk factors and effective shared decision-making. No single delirium prediction tool is used widely in surgical settings. Multi-component interventions to prevent delirium involve structured risk factor modification supported by geriatrician input; these are clinically efficacious and cost effective. Barriers to the widespread implementation of such complex interventions exist, resulting in an ‘implementation gap’. There is a lack of evidence for pharmacological prophylaxis for the prevention of delirium. Current evidence suggests that avoidance of peri-operative benzodiazepines, careful titration of anaesthetic depth guided by processed electroencephalogram monitoring and treatment of pain are the most effective strategies to minimise the risk of delirium. Addressing postoperative delirium requires a collaborative, whole pathway approach, beginning with the early identification of those patients who are at risk. The research agenda should continue to examine the potential for pharmacological prophylaxis to prevent delirium while also addressing how successful models of delirium prevention can be translated from one setting to another, underpinned by implementation science methodology.     

蒙药安神补心六味丸预防给药对心肌缺血大鼠的保护作用及氧化应激水平的影响＊

目的 研究蒙药安神补心六味丸对大鼠心肌缺血损伤的保护作用和氧化应激机制。方法 将60只大鼠随机分为空白组、模型组、阳性对照组（丹参滴丸）及蒙药安神补心六味丸低、中、高剂量组，使用腹腔注射异丙肾上腺素方法制备大鼠急性心肌缺血模型，记录并观察大鼠心电图活动变化，然后进行腹主动脉取血，分离血清，测定乳酸脱氢酶（Lactic dehydrogenase，LDH）、肌酸激酶（Creatine kinase，CK）、磷酸肌酸激酶（Creatine kinase isoenzyme，CK-MB）、谷草转氨酶（Aspartate aminotransferase，AST）、超氧化物歧化酶（Superoxide dismutase，SOD）、丙二醛（Malondialdehyde，MDA）和谷胱甘肽过氧化物酶（Glutathione peroxidase，GSH-PX）含量变化。取心肌组织固定，对大鼠心肌组织进行HE染色，通过对心肌酶学和和心肌组织形态学两个方面来考察蒙药安神补心六味丸对大鼠心肌缺血模型的保护作用。结果 与空白组比较，模型组大鼠血清中LDH活性极显著升高（P<0.01），CK、CK-MB、AST、MDA活性均显著升高（P<0.05），SOD活性显著降低（P<0.05），GSH-PX活性高度显著降低（P<0.001），且差异均具有统计学意义；与模型组比较，蒙药安神补心六味丸组高剂量组大鼠血清中LDH、CK、CK-MB、MDA活性显著降低（P<0.05），SOD活性显著升高（P<0.05），GSH-PX活性极显著升高（P<0.01），且差异均具有统计学意义。从HE染色分析，蒙药安神补心六味丸能够改善因缺血而造成的心肌组织损伤。结论 蒙药安神补心六味丸能有效改善心肌组织病理状态，减轻大鼠心肌缺血损伤，以达到保护心肌作用，机制可能与氧化应激机制相关。     

689名医学生视疲劳发生现状及其影响因素分析

目的 了解锦州医科大学在读医学专业大学生视疲劳发生现状,并探讨其可能的影响因素。方法 采用随机抽样的方法,利用纸质问卷于2021年5月对该校医学生进行视觉疲劳情况调查,采用χ2检验进行单因素分析,多因素分析采用logistic回归进行。 本次调查医学生689人,其中男生230人(33.38%),女生459人(66.62%)。医学生视疲劳量表得分M(P25～P75)为18(12～24)分,视疲劳总体发生率为61.54%,女生(66.49%)高于男生(55.65%),差异有统计学意义(χ2=5.054,P<0.05)。logistic回归分析显示,屈光不正(OR=1.875,95%CI:1.228～2.863)、工作学习时用眼姿势、眼与电脑距离、桌前使用手机姿势及时间均是视疲劳的影响因素(P<0.05)。 视疲劳在医学生群体中普遍存在,及时矫正屈光不正,保持良好用眼习惯将可能起到预防和改善视疲劳的作用。