耳科学

颞部及前额联合经颅磁刺激治疗耳鸣的初步研究经颅重复低频磁刺激能够降低过度兴奋的神经元的活性，并间接调节大脑相关区域的功能。基于这一理论，多家临床研究机构通过对颞区的听皮层进行经颅低频磁刺激，结果证明这种方法对主观性耳鸣有治疗作用。此外，前额的大脑皮层也因为参与感觉的整合以及大脑由上而下的抑制过程而被认为与耳鸣的产生有关。Kleinjung等通过研究比较了传统的单纯颞部经颅磁刺激与颞部及前额联合经颅磁刺激这两种方法治疗耳鸣的效果，将32例耳呜患者分为两组，每组16人。其中一组患者采用单纯低频磁信号刺激左侧颞区听皮层，刺激频率为1Hz；另一组患者在进行颞部磁刺激之前还对其左侧的额叶皮层背外侧区进行了高频磁刺激，     

基于PubMed数据库探讨鼻息肉治疗与诊断的可视化分析

目的 通过检索Pubmed数据库中关于鼻息肉诊断及其治疗的相关文献,进一步探索该领域的研究现状和热点。方法 基于PubMed数据库检索结果,运用文献计量学及词频分析法,时间限定为建库至2021年12月31日,收集所有关于鼻息肉治疗与诊断的相关研究。再利用VOSviewer软件构建知识图谱进行文献可视化分析。结果 共纳入文献2170篇,从1950年Pubmed建库至今,发文量逐年增多;美国是世界鼻息肉的科研中心,我国具有一定的影响力;鼻息肉诊断与治疗研究主要集中在手术治疗、药物干预、研究人群、并发症等方面。结论 目前国外鼻息肉治疗与诊断相关的研究热点仍集中在手术和给药等相关话题上,未来研究趋势可能在鼻息肉与下呼吸道炎症、免疫等相关学科方面,且国内外在此领域学术差距较大,国内研究者要加强合作,做到研究与国际接轨。     

强脉冲光应用于干眼的文献计量学可视化分析

目的 文献计量学分析近年强脉冲光在干眼领域的相关应用,全面了解其研究现状、发展趋势及关注热点。方法 文献来源于Web of Science(WOS)核心合集数据库、中国知网(CNKI)数据库,检索时间2013-01-01至2022-12-31,使用CiteSpace 5.7.R5对发文量、国家、期刊等进行可视化分析。结果 该领域发文量总体呈现上升趋势;全球共有70个机构开展了对该领域的研究,目前中国为发文量最多的国家;研究主要集中在睑板腺功能障碍性干眼,并结合了特有的中医疗法。结论 强脉冲光应用于干眼领域的研究还较为新颖,仍处于不断探索阶段,本研究所示结果可提供一定参考。     

国内BPPV研究文献计量及可视化分析

目的 分析国内良性阵发性位置性眩晕(BPPV)相关研究的发展历程,总结研究的特征和热点,为今后对该病的研究提供依据和方向.方法 应用计算机检索中国知网、维普"中文科技期刊数据库"、万方数据库中2015年以前国内关于BPPV研究的相关文献,通过文献计量方法和可视化方法分析文献的时间分布、期刊分布、高产作者分布、研究机构分布、高频主题词以及研究热点分布.结果 自1981年到2015年共检索到国内关于BPPV研究的文献922篇(共2021位作者,涉及研究机构309所),发表于297种期刊上,文献数量整体呈逐步上升趋势,期刊分布较广;核心期刊群尚未完全形成,排名前13种期刊(4.38%,13/297)共发表相关论文292篇(31.67%,292/922),主要发文期刊相对较集中;排名前17位的作者共发表文献222篇(24.08%,222/922),排名前12位的研究机构共发表文献137篇(14.86%,137/922);高产作者大多属于高产机构;通过对主题词的分析发现,BPPV的研究集中在发病机制、诊断方法、治疗手法等方面,近几年出现了一些新的方向,如:药物治疗和手法治疗的对比分析研究,突发性聋、梅尼埃病等继发性BPPV的研究.结论 我国关于BPPV的研究逐渐深入,继发于突发性聋、梅尼埃病等的继发性BPPV将会成为研究的新重点.     

重复经颅磁刺激对耳鸣患者听觉处理功能的影响

目的 探讨不同刺激频率的重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)对主观性耳鸣患者听觉处理功能的影响.方法 10例主观性耳鸣患者随机分为低频组和高频组进行rTMS治疗,每组5例,低频组采用1 Hz刺激频率,高频组采用10 Hz刺激频率,每天1次,...     

低频重复经颅磁刺激治疗耳鸣的疗效分析

目的 探讨低频重复经颅磁刺激治疗耳鸣的有效性和安全性.方法 选取听力正常的主观性耳鸣患者102例,其中颅鸣患者34例(26~65岁,平均53±12.59岁),耳鸣患者68例(31~69岁,平均51±12.29岁);采用1 Hz低频脉冲刺激患者左侧颞顶部,每次一次性连续给予1 000次脉冲刺激,脉冲间隔时间为10 s,5次/周,连续2周.所有患者治疗前后采用视觉模拟量表(visual-analogue scale,VAS)评估耳鸣的严重程度.结果 治疗后,34例颅鸣患者中,24例颅鸣减轻或消失,总有效率为70.59%(24/34),其中2例患者自觉颅鸣完全消失(5.88%,2/34),22例自觉颅鸣响度减轻(64.71%,22/34), 治疗前VAS平均分为5.09±1.01分,治疗后降为3.06±1.77分;68例耳鸣患者总有效率为64.71%(44/68),44例耳鸣减轻或消失(64.71%,44/68),其中1例耳鸣完全消失(1.47%,1/68),43例自觉耳鸣减轻(63.24%,43/68);治疗前VAS评分为5.68±1.51分,治疗后降为3.75±2.11分.两组患者治疗前后纯音听阈无显著变化,且无一例出现头痛、头晕、头皮灼伤、癫痫发作、耳鸣加重等不良反应.结论 低频重复经颅磁刺激治疗耳鸣安全有效,其中颅鸣患者效果更佳.     

对侧抑制性rTMS联合多奈哌齐治疗脑卒中后非流畅性失语

目的 探讨对侧抑制性重复经颅磁刺激(rTMS)联合多奈哌齐治疗脑卒中后非流畅性失语的疗效。方法 92例脑卒中后非流畅性失语患者分为对照组(n=46)和联合组(n=46)。两组患者均接受相同的语言康复训练和多奈哌齐治疗，联合组在此基础上增加对侧抑制性rTMS治疗，对照组在此基础上增加假刺激治疗。比较两组波士顿诊断性失语症检查(BDAE)分级、汉语失语成套测验(ABC)各分项分值及失语商(AQ)评分、日常生活交流能力量表(CADL-T)评分、美国国立卫生院神经功能缺损评分(NIHSS)和改良Rankin量表评分(mRS)、语言功能明显改善率(AQ评分提高30分及以上)和神经功能预后良好率(mRS评分≤2分)。用二元Logistic回归法分析语言功能改善与rTMS治疗的相关性。结果 与治疗前比较，两组治疗4周后BDAE分级、ABC各分项分值、AQ、CADL-T、NIHSS、mRS评分均有明显改善，但联合组的改善程度大于对照组(P<0.05)。联合组语言功能明显改善率(58.70%)和神经功能预后良好率(82.61%)明显高于对照组(32.61%和45.65%)(P<0.05)。L...     

2006～2010年变应性鼻炎针灸研究的文献计量学分析

目的了解针灸治疗变应性鼻炎临床研究现状和发展水平、推断研究热点,为针灸标准化研究提供客观可靠的数据.方法 检索《中国期刊全文数据库》(CNKI)2006～2010年间的针灸治疗过敏性鼻炎研究的全部文献,采用文献计量学方法进行统计分析.结果 2006～2010年间CNKI数据库共收录针灸治疗变应性鼻炎临床研究文献125篇,文献研究呈逐年上升趋势,其中2篇文献报道受基金资助;临床研究75篇,综述等其他研究50篇;文献报道以《上海针灸杂志》等杂志为主;研究机构主要分布在广东省、北京市及山东省.在75张针灸处方中,鼻局部的迎香、印堂,头部风池、上星及百会,上肢穴位合谷,及背部大椎、肺俞等选用频次最高;刺灸方法以传统毫针与灸法为主;35篇随机对照研究文献的STRICTA标准符合率较低.结论 针灸治疗本病临床有效,但因选穴、刺灸方法及疗程等没有统一的标准,故无法通过科学依据证实其有效性,应加强治疗过程标准化针灸治疗方案.     

中国听力语言康复科学杂志文献库建设初探

目的以《中国听力语言康复科学杂志》为对象,探讨建立学科文献数据库的方法与意义。方法通过整理期刊资源分布,概括了文献库的结构、类型、规模和特点,介绍了文献库的检索特点和检索途径,从文章结构及文章性质对文献库进行了深入分析。结果文献库涵盖听力学、康复教育、耳科学、言语矫治等专业文献1281篇,其中听力学专业文献515gg,康复教育学文献451篇,言语矫治专业文献143篇,耳科学文献118篇,心理学专业文献30篇,信息类文献24篇。文章性质方面,方法与技术类文献666篇,占全部文献的一半以上;基本理论类文献418篇,基本概念类文献100篇,趋势动态类文献97篇。结论中国听力语言文献库的建设对我国听力语言康复学科的发展具有重要的意义和作用。     

基于CiteSpace的口腔癌患者术后护理研究热点与趋势分析

目的 应用可视化方法分析近20年国内口腔癌患者术后护理研究热点及趋势。方法 以“口腔癌”“手术”“护理”等为研究主题,检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(Sino Med)2002年1月1日~2022年1月1日的文献,采用Cite Space6.1.R6软件对纳入文献的作者、机构、关键词进行可视化分析。结果 共纳入文献584篇,文献发文量呈逐渐上升趋势;发文量前三的作者是黄秋雨、张丽萍和何杏芳,发文量前三的机构是中山大学孙逸仙纪念医院、四川大学华西口腔医院和中山大学第二附属医院;关键词共现网络中心性前三位(去除检索词)的关键词为“并发症”“生活质量症”“围手术期”;关键词共形成10个聚类,22个突现词。结论 知识图谱近20年国内口腔癌患者术后护理研究的内容丰富,主要体现在分级护理、心理干预来舒缓术后疼痛感受、调节负面情绪、改善进食体验及提高生活质量等方面。目前研究热点为质性研究及心理干预研究,研究趋势为心理干预研究。     

Measuring and inducing brain plasticity in chronic aphasia

Brain plasticity associated with anomia recovery in aphasia is poorly understood. Here, I review four recent studies from my lab that focused on brain modulation associated with long-term anomia outcome, its behavioral treatment, and the use of transcranial brain stimulation to enhance anomia treatment success in individuals with chronic aphasia caused by left hemisphere stroke. In a study that included 15 participants with aphasia who were compared to a group of 10 normal control subjects, we found that improved naming ability was associated with increased left hemisphere activity. A separate study (N = 26) revealed similar results in that improved anomia treatment outcome was associated with increased left hemisphere recruitment. Taken together, these two studies suggest that improved naming in chronic aphasia relies on the damaged left hemisphere. Based on these findings, we conducted two studies to appreciate the effect of using low current transcranial electrical stimulation as an adjuvant to behavioral anomia treatment. Both studies yielded positive findings in that anomia treatment outcome was improved when it was coupled with real brain stimulation as compared with a placebo (sham) condition. Overall, these four studies support the notion that the intact cortex in the lesioned left hemisphere supports anomia recovery in aphasia. LEARNING OUTCOMES: Readers will (a) be able to appreciate the possible influence of animal research upon the understanding of brain plasticity induced by aphasia treatment, (b) understand where functional changes associated with anomia treatment occur in the brain, (c) understand the basic principles of transcranial direct current stimulation, and (d) understand how brain stimulation coupled with aphasia treatment may potentially improve treatment outcome.     

Repetitive transkranielle Magnetstimulation

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, painless method used to stimulate areas of the brain through the intact skull by means of magnetic fields. Depending on the stimulation frequency, the effect on concurrent brain areas is either inhibiting or exciting. As a result, it should be possible to inhibit compensatory hyperactivation in certain brain areas or to temporarily enhance cortical excitability. Therefore, rTMS potentially represents an adjuvant treatment for aphasia. In this article, the literature regarding rTMS as a treatment for aphasia is reviewed and followed by a case report of a 79-year-old man who 3 years after stroke received rTMS (3?×?10 sessions) in combination with articulation therapy. Even though linguistic assessments did not show enhancements in language skills, the patient’s family reported changes in communication patterns and behavior and explicitly asked to continue the rTMS treatment sessions. Reasons why no enhancements could be reported might be found in the type of language disorder (a comorbid speech disorder) or the stimulation protocol. Further studies are needed to evaluate the true potential of rTMS in the treatment of aphasia.     

Tinnitus and brain activation: insights from transcranial magnetic stimulation

The mechanisms underlying tinnitus are still not completely elucidated, but advances in neuroimaging and brain stimulation have provided us with new insights. Evidence suggests that tinnitus might actually be generated by central rather than peripheral structures. To illustrate the importance of brain activity changes in the pathology of tinnitus, we report the cases of 2 patients who experienced a recurrence/worsening of their tinnitus after they had undergone treatment for major depression with repetitive transcranial magnetic stimulation. We suggest that the tinnitus in these 2 patients was induced by changes in brain activity resulting from transcranial magnetic stimulation of the prefrontal cortex. We also review the pathophysiology and other aspects of tinnitus, focusing on associated brain reorganization.     

A comparison of transcranial magnetic stimulation with electroneuronography as a predictive test in patients with Bell's palsy

The aim of this study was to examine the neuronographic findings of electrical and transcranial magnetic stimulation of the facial nerve and to compare their ability to predict clinical recovery from idiopathic facial nerve palsy (Bell's palsy). Eighty-six patients were examined clinically and neurophysiologically immediately on presentation to Tampere University Hospital. Electroneuronography (ENoG) and transcranial magnetic stimulation (TMS) were performed 1–6 times for each patient. The time interval between each examination varied from 2 to 7 days. Seventy-eight patients were followed for a median period of 13 months after the onset of palsy. Facial nerve function was graded according to the House-Brackmann grading system. Relative amplitude differences of ENoG and TMS during the acute phase were then correlated with clinical outcome. Statistical analysis of the results showed that a TMS response elicitable during the first 5 days of the palsy was correlatable with a good prognosis. ENoG results correlated with clinical outcome at a later time from onset of symptoms. TMS was well tolerated and no adverse effects were seen. These results indicate that TMS is a useful method for the early prediction of outcome in patients with Bell's palsy.     

国内嗅觉障碍相关研究——基于Citespace的可视化分析

目的 对国内“嗅觉障碍”研究进行可视化分析及合理推测,尝试为学者提供该领域的研究现状及预测未来热点方向。 方法 以“嗅觉障碍”为主题词,检索建库至2020年10月20日中国知网(CNKI)的学术论文并按纳入标准进行筛选,使用Citespace软件对该研究领域所筛选文献的作者、期刊/单位及主题词进行绘制图谱及可视化分析。 结果 整体来讲,“嗅觉障碍”研究的文献发表量呈快速上升趋势。出现频次排名靠前的作者为魏永祥、倪道凤、刘钢、杭伟、姚淋尹、韩德民及刘剑锋,“嗅觉障碍”研究发文排名第1~3例的期刊为:《临床耳鼻咽喉头颈外科杂志》《国际耳鼻咽喉头颈外科杂志》《中华耳鼻咽喉头颈外科杂志》,合作高产单位并具有一定影响力的机构为首都医科大学附属北京安贞医院、中国医学科学院北京协和医院等。主题词聚类分析呈现出7个聚类:慢性鼻-鼻窦炎、帕金森病、kallmann、鼻炎、新型冠状病毒肺炎、超微结构和针刺。 结论 在“嗅觉障碍”领域,早期韩德民、李志春等国内作者对“嗅觉障碍”的研究较深长,而近年来魏永祥、倪道凤等国内作者对“嗅觉障碍”的检测方法、病因、发病机制等进行基础研究及归纳分类,是近年来嗅觉障碍研究的主力,但核心作者中心中介值均小于0.1,这表明关系较稀疏,需加强联络与合作,以期形成学术共同体提高整体影响力。根据聚类分析可知,国内作者目前对“嗅觉障碍”研究热点主要集中在嗅觉障碍与慢性鼻-鼻窦炎伴或不伴鼻息肉、帕金森病、新型冠状病毒肺炎(COVID-19)等原发病之间的联系,探索其生理病理及发病机制;不同类型嗅觉障碍的临床特点及流行病学调查;探索鼻内镜手术、针刺等不同治疗方法对嗅觉障碍的疗效。且从发文突现图可见,以上七大聚类研究范围可能将持续成为该领域重要的热点。其中慢性鼻-鼻窦炎伴或不伴鼻息肉方向是从古至今延续的热点,而COVID-19将成为未来5~10年的热点。另外,不排除COVID-19引起的嗅觉障碍与鼻腔炎症相关,且两者的相关性将会成为嗅觉障碍将来的研究热点与难点。     

Translational research in aphasia: from neuroscience to neurorehabilitation.

PURPOSE: In this article, the authors encapsulate discussions of the Language Work Group that took place as part of the Workshop in Plasticity/NeuroRehabilitation Research at the University of Florida in April 2005. METHOD: In this narrative review, they define neuroplasticity and review studies that demonstrate neural changes associated with aphasia recovery and treatment. The authors then summarize basic science evidence from animals, human cognition, and computational neuroscience that is relevant to aphasia treatment research. They then turn to the aphasia treatment literature in which evidence exists to support several of the neuroscience principles. CONCLUSION: Despite the extant aphasia treatment literature, many questions remain regarding how neuroscience principles can be manipulated to maximize aphasia recovery and treatment. They propose a framework, incorporating some of these principles, that may serve as a potential roadmap for future investigations of aphasia treatment and recovery. In addition to translational investigations from basic to clinical science, the authors propose several areas in which translation can occur from clinical to basic science to contribute to the fundamental knowledge base of neurorehabilitation. This article is intended to reinvigorate interest in delineating the factors influencing successful recovery from aphasia through basic, translational, and clinical research.     

眼缺血综合征国内外文献特征分析

目的 分析2014年1月1日至2019年12月31日眼缺血综合征(OIS)研究领域国内外文献的特征。 方法 在CNKI及WOS数据库中分别筛查出2014年1月1日至2019年12月31日与OIS相关的文献,查找文献相关数据并进行分析。 结果 分析35篇中文文献,总共被引41次,该领域h指数为2;48篇外文文献,总共被引115次,该领域h指数为6。发表论文数量并列最多和h指数最高的机构是首都医科大学和波兰波美拉尼亚医科大学。发表论文数量最多和h指数最高的国内期刊是中华眼科杂志;发表论文数量并列最多和h指数最高的国外期刊是Journal of Ophthalmology和Plos One。国外发表论文数量最多的国家是中国,h指数和韩国并列最高。我国国家自然科学基金对OIS领域资助最多,占国内总发文量的20.8%。国外被引用次数最多的是Hayreh, SS.的一篇关于眼部血管阻塞性疾病黑矇病的患病率及发病机制的研究,其他排名前十的文献重点讨论OIS在OCT上的表现及缺血缺氧机制等方面。 结论 OIS疾病在OCT检查上的表现及缺血缺氧机制研究成为研究者关注的热点。     

A brief statistical analysis of stomatology papers published in international journals by researchers from the mainland of China--based on Thomson Reuters' journal citation reports for 2009

This paper has briefly analyzed the publication status of Chinese stomatology papers in 2009 with statistics from Journal Citation Reports provided by Thomson Scientific. Only those papers with the first author coming from the mainland of China were included for calculations. We have found a significant increase in the number of SCIE-indexed papers, most of which were published by six dental institutions in China. Among all Chinese medical institutions, West China School of Stomatology Sichuan University is the first dental institution to enter the top-20 list with the most publications, and it also ranks the 9th in the number of outstanding articles. West China School of Stomatology Sichuan University and the Forth Military Medical University are the only two dental institutions in China which have published SCIE-indexed papers over a hundred. The former has published the most SCIE-indexed stomatology papers, while the latter has the highest average impact factor. As the laboratories and funds in China have close connections with various dental hospitals, the pratice of translational medicine in dentistry is fast and fluent.     

Transcranial magnetic stimulation and subjective tinnitus. A review of the literature, 2014–2016

Subjective tinnitus is a symptom in many ENT pathologies, for which there is no curative treatment. It may be poorly tolerated by some patients, who develop attention or sleep disorder or even major anxiety and depression, severely impairing quality of life. Pathophysiological models of the genesis and maintenance of tinnitus symptomatology highlight maladaptive cerebral plasticity induced by peripheral hearing loss. Although not fully elucidated, these changes in neuronal activity are the target of various attempts at neuromodulation, particularly using repetitive transcranial magnetic stimulation (rTMS), which has been the focus of various clinical studies and meta-analyses. A recent consensus statement (Lefaucheur, 2014) reported level-C evidence (possible efficacy) for rTMS using low frequency (1 Hz) tonic stimulation targeting the left cerebral cortex. However, many questions remain concerning the use of this technique in everyday practice. The present article reports a recent literature review using the search-terms “tinnitus” and “rTMS” in the PubMed and Cochrane databases for April 2014 to December 2016.     

重复经颅磁刺激治疗慢性前庭综合征疗效评价

目的 探讨重复经颅磁刺激(rTMS)治疗慢性前庭综合征(CVS)的疗效.方法 慢性前庭综合征(CVS)患者60例,随机数字法分为对照组和治疗组各30例,两组均进行垂直方向和水平方向的平稳跟踪眼动练习,治疗组另加以rTMS治疗4周.以治疗前后两组患者的头晕评价量表(DHI)评分、冷热试验单/双侧半规管反应减退(UW)值为...