中国颅内动脉粥样硬化性疾病防治研究现况及对策

目的 基于文献计量学方法分析全球颅内动脉粥样硬化性疾病研究发展趋势,分析中国相关研究的现况及不足,探讨适宜的应对策略。 方法 检索SCI-Expanded数据库1900—2018年全球颅内动脉粥样硬化性疾病研究相关文献,采用Web of Science自带软件及Excel 2007等软件进行定量分析,指标包括文献量、被引频次、h指数、基金论文比、高贡献机构等;单独分析来源于中国的相关文献,并与美国、日本、德国进行比较。 结果 1900—2018年全球共产出与颅内动脉粥样硬化性疾病相关的文献8 468篇,总被引频次189 950次,篇均被引频次22.43,h-index为155。美国是全球颅内动脉粥样硬化性疾病研究的绝对主力,贡献了全球30.53%的论文产出以及43.81%的被引频次,论文整体的h-index也很高,达121。中国(不含中国台湾地区)相关论文产出整体呈上升趋势,总论文产出1 157篇,位列全球第二,从1991年第1篇论文发表,到2003年达14篇,再到2014年达105篇、2018年达189篇,呈现迅猛发展的势头,其中首都医科大学贡献最大,居全球论文产出机构排名第一。但中国相关论文研究质量仍较美国低,有待进一步提升。 结论 中国颅内动脉粥样硬化性疾病相关研究尽管起步较晚,但近年来取得了迅猛发展,在全球的影响力越来越大;然而高影响力论文仍较缺乏,未来需要进一步加强随机对照试验(randomized controlled trial,RCT)、病因学、影像诊断学及治疗学等热点研究,从数量提升转化为质量提升。      

基于文献挖掘的国际补充替代医学研究现状与趋势分析

目的：把握目前国际补充替代医学（complementary and alternative medicine, CAM）研究的发展态势,为我国中医药相关工作的开展提供参考依据和科学的量化信息支持。 方法：以PubMed数据库为检索源,国际CAM科技论文为研究对象,采用普赖斯指数增长定律、布拉德福定律等信息计量学经典方法和关联规则等文本挖掘技术,对目前国际CAM研究的文献增长规律,高生产力国家、机构,核心期刊,以及研究的热点、前沿领域进行系统、全面的分析。 结果：1998~2010年,国际CAM科技论文量呈上升趋势,且增长规律符合普赖斯指数增长定律;开展CAM研究的国家和地区范围广泛;期刊分布核心趋势明显;高等院校是研究的主体;植物药、针灸、心身疗法、整体疗法等是研究的热点疗法;肿瘤（乳腺癌）、慢性疾病（中风、糖尿病、高血压）、心身疾病（心理应激、焦虑、抑郁、精神障碍）、疼痛（下腰背痛、颈痛）等则是采用CAM疗法进行干预的主要病症。 结论：CAM研究将继续增加;肿瘤的CAM防治研究仍是世界范围内的关注重点;主要疗法的临床疗效、安全性与生物学基础是CAM研究的重要任务;心身疗法研究不断增多,临床疗效与生物机制研究是关键;CAM干预症状受到重视,研究前景广阔;CAM符合并有助于促进现代医学模式的发展与完善;中医药是CAM研究的重要领域,中国的优势地位面临挑战。     

Distal femoral arthropometry in Nigerians and its correlation to total knee replacement implants

IntroductionTotal Knee replacement (TKR) is performed to relieve pain and restore both the mechanical axis and joint line whenever indicated. Most of prostheses being used for TKR were manufactured using dimensions from Caucasians'' measurements. This study documented the dimensions of distal femora of Nigerians and correlated the dimensions with different TKR prostheses.Materials and methodsFifty-six matured femora were measured. Dimensions of distal femora from other regions were retrieved from published articles. The dimensions of TKR prosthesis were extracted from product monographs. Analyses were done with Microsoft excel 2010 (Microsoft Corporation, Redmond, Washington, United States) and STATA version 13 (StataCorp, Texas. USA). Statistical significance was set at p ≤ 0.05ResultsThe average Mediolateral dimension was 79.3 ± 4.4 mm. The anterioposterior dimensions of the medial and lateral condyles were 63.7 ± 3.6 mm and 64.9 ± 3.3 mm respectively. There were no significant differences between the left and right distal femur. The average aspect ratio calculated was1.23 ± 0.05. There was a mismatch of aspect ratio of the distal femora and those of the prostheses. Equations that can be useful both clinically and in forensic medicine were generated.ConclusionThis study has provided measurements that can be considered when the designing of a suitable femoral component of total knee prosthesis for Nigerians. This study also provided equations that can be used to estimate the dimensions of the medial and the lateral condyles and femoral length from parts of distal femur in forensic medicine.FundingSelf-funded     

The current acceptance, accessibility and recognition of Chinese and Ayurvedic medicine in the United States in the public, governmental, and industrial sectors

<正>To assess the current level of acceptance in the United States of complementary and alternative medicine,recent research into the prevalence, acceptance,accessibility,and recognition of complementary and alternative therapies were reviewed.Several signs point to an increasing acceptance of complementary and alternative medicine in the United States;the use of complementary and alternative medicine is significantly increasing,many aspects of Chinese medicine and Ayurveda are becoming mainstream,practitioners in the United States are beginning to be licensed,and insurance companies are beginning to cover some complementary and alternative therapies.Remaining challenges to true acceptance include the restrictive Western mindset,the absence of published studies,a lack of consistent manufacturing processes and quality standards,and a fear of adulteration. Although the field still faces many challenges,alternative and complementary medicine,including Chinese medicine and Ayurvedic medicine,is becoming more accepted and accessible in the United States.     

基于Web of Science检索和文献计量学方法的危重症医学热点初步研究

目的 分析全球危重症医学研究现状,挖掘该领域的研究热点。方法 检索2007－2017年危重症医学领域的研究论文,利用Web of Science、期刊引证报告（JCR）和Echarts软件等对其进行综合分析,采用VOSviewer软件提取与分析研究范围内论文的题目和摘要,并选择出高频关键词。同时分析2007－2017年危重症医学研究领域论文产出有重要贡献的国家变化。结果 符合入选标准的论文共51 928篇,其中论著45 696篇、综述6 232篇。通过生成高频关键词热图,发现当前的危重症医学术语热点包括管理、功能、观察研究、创伤、试验。2007－2017年,美国是危重症医学研究领域论文产出最多的国家。2007年和2017年,美国论文数量分别占论文总数的43.74%（1 872/4 280）和46.78%（2 288/4 891）。结论 当前的危重症医学术语热点包括管理、功能、观察研究、创伤、试验,美国在全球危重症医学研究领域依然占据首席地位。     

A retrospective analysis of JAPMA publication patterns, 1991-2000

A retrospective analysis of 878 articles published in JAPMA from 1991 to 2000 was conducted to investigate changing patterns of publication activity in podiatric medicine. Most of the articles published in JAPMA were case reports (37%), followed by literature reviews (33%) and original research (30%). The Journal has covered a wide range of topic areas, with the most common being foot surgery (14%). A breakdown of the proportion of original research versus review articles and case reports for each topic area revealed that while orthotic therapy and biomechanics attract considerable attention from researchers, other important specialty areas such as foot surgery, dermatology, pediatrics, and rheumatology continue to be represented primarily by literature reviews and case reports. Two significant trends were observed: a gradual increase in the proportion of original research articles and a steady increase in the number of articles by authors outside the United States. These findings provide valuable insight into patterns of publication in podiatric medicine and raise a number of issues regarding the ongoing development of the profession.     

温州医科大学2011—2020年SCI论文知识图谱分析

目的：对温州医科大学2011—2020年发表的SCI论文进行可视化计量分析,为加强机构学科建设提供参考。方法：选取温州医科大学2011—2020年被Web of Science数据库收录的论文,利用Bibexcel、Pajek等可视化分析工具,从论文数量、被引频次、学科分布、来源期刊、作者、合作机构、共被引文献、研究热点等方面进行可视化分析。结果：温州医科大学2011—2020 年发表SCI论文数量逐年增长,论文被引频次也呈现上升趋势;发文量主要集中在临床医学、药学等优势学科;发文量最多的20本期刊中,中科院分区2区及以上的期刊有3 种,仅占15%;合作团队最显著的是李校堃、瞿佳所分别带领的药学团队和眼视光团队;合作最多的国内外机构分别是浙江大学、美国路易斯维尔大学;共被引网络的核心节点为LIVAK等发表的一批文献;机构研究热点为癌症治疗、疾病诊断、药物研究等主题。结论：在“双一流”建设背景下,温州医科大学可通过强化优势学科发展,优化学科专业布局,深化国际国内合作,改革科研评价制度等措施,吸引更多高层次人才与团队,促进高质量论文的发表,不断提升学科专业的建设水平。     

精准医疗领域的研究现状及其可视化分析

为了解精准医疗相关领域的发展现状,以MEDLINE数据库中相关文献为基础,运用文献计量法,从发展趋势、国家、机构、作者合著、研究主题等角度进行统计分析,并利用Excel、Ucinet和SciMAT数据分析软件进行可视化展示。结果表明,精准医疗研究领域处于快速发展阶段;美国在该领域的论文影响力较高;该领域的来源期刊均为相关领域核心期刊,研究成果质量较高;通过作者合著分析发现该领域作者合著网络具有“小世界效应”;通过文献主题演化分析,发现该领域研究内容越来越丰富,其中遗传组学、药物治疗、肿瘤研究所占比重较多,分析3个时间段内研究主题演化,该领域研究内容经历了宏观研究、微观研究到目前的宏观和微观相结合的研究。     

Assessing the quality of clinical and administrative data extracted from hospitals: the General Medicine Inpatient Initiative (GEMINI) experience

ObjectiveLarge clinical databases are increasingly used for research and quality improvement. We describe an approach to data quality assessment from the General Medicine Inpatient Initiative (GEMINI), which collects and standardizes administrative and clinical data from hospitals.MethodsThe GEMINI database contained 245 559 patient admissions at 7 hospitals in Ontario, Canada from 2010 to 2017. We performed 7 computational data quality checks and iteratively re-extracted data from hospitals to correct problems. Thereafter, GEMINI data were compared to data that were manually abstracted from the hospital’s electronic medical record for 23 419 selected data points on a sample of 7488 patients.ResultsComputational checks flagged 103 potential data quality issues, which were either corrected or documented to inform future analysis. For example, we identified the inclusion of canceled radiology tests, a time shift of transfusion data, and mistakenly processing the chemical symbol for sodium (“Na”) as a missing value. Manual validation identified 1 important data quality issue that was not detected by computational checks: transfusion dates and times at 1 site were unreliable. Apart from that single issue, across all data tables, GEMINI data had high overall accuracy (ranging from 98%–100%), sensitivity (95%–100%), specificity (99%–100%), positive predictive value (93%–100%), and negative predictive value (99%–100%) compared to the gold standard.Discussion and ConclusionComputational data quality checks with iterative re-extraction facilitated reliable data collection from hospitals but missed 1 critical quality issue. Combining computational and manual approaches may be optimal for assessing the quality of large multisite clinical databases.     

基于CiteSpace的口腔医学临床前教育研究热点与前沿分析

  目的  通过文献计量学方法分析口腔医学临床前教育的热点与前沿。  方法  在Web of Science核心合集中搜索口腔医学临床前教育相关文献,检索时限从建库至2022年1月1日,提取数据,采用CiteSpace软件对发文数量、国家、机构、作者、关键词等多个方面进行可视化分析。  结果  共纳入322篇论文和综述,年发文量在过去十年中总体呈上升趋势。美国的发文总量最多（98篇）,美国和英国是国家合作网络中的重要国家。发文大于5篇的发文机构有10家,纳入的文章作者总计410名,其中发文最多的1名学者发表了4篇文章。口腔医学临床前教育的相关研究热点包括计算机辅助教学、教学方法、临床技能和3D打印。其中计算机辅助教学是近十年内新的热点。研究前沿包括技术、修复、临床技能和沟通方式。  结论  文献可视化分析直观地揭示了口腔医学临床前教育的热点和前沿,为今后的研究提供了参考。     

Canadian-Trained Medical Scientists View Canadian Academia From Their American Laboratories

Interviews with 98 Canadian-trained basic medical scientists currently employed in the United States reveal that they were attracted to the United States by the belief that greater career opportunities exist in the United States than in Canada.

They attributed the failure on the part of Canada to attract scientists to Canada and to retain their own graduates to: (1) Poor recruiting methods and a failure on the part of Canadian employees to keep in touch with Canadian scientists in American graduate and postgraduate training positions. (2) Scarcity of research funds. (3) Lack of opportunity in Canada occasioned by the smaller number of medical schools and medical research institutions as compared to the United States. (4) The negative conservatism of Canadian academic circles occasioned by academic inbreeding, anti-Semitism, Anglophilia and the tight control of research, research funds and university appointments by an oldguard “establishment”.

     

Role of cytokines in Trypanosoma brucei-induced anaemia: A review of the literature

Background

Anaemia is an important complication of trypanosomiasis. The mechanisms through which trypanosomal infection leads to anaemia are poorly defined. A number of studies have implicated inflammatory cytokines, but these data are limited and inconsistent. In this article, we reviewed the published literature on cytokines associated with Trypanosoma brucei infections and their role in the immunopathology leading to anaemia.

Methodology

Articles were searched in PubMed through screening of titles and abstracts with no limitation on date of publishing and study design. Articles in English were searched using keywords “African trypanosomiasis”, “sleeping sickness”, “Trypanosoma brucei”, in all possible combinations with “anaemia” and/or “cytokines”.

Results

Twelve articles examining cytokines and their role in trypanosomeinduced anaemia were identified out of 1095 originally retrieved from PubMed. None of the articles identified were from human-based studies. A total of eight cytokines were implicated, with four cytokines (IFN-γ, IL-10, TNF-α, IL-12) showing an association with anaemia. These articles reported that mice lacking TNF-α were able to control anaemia, and that IFN-γ was linked to severe anaemia given its capacity to suppress erythropoiesis, while IL-10 was shown to regulate IFN-γ and TNF-α, providing a balance that was associated with severity of anaemia. IFN-γ and TNF-α have also been reported to work in concert with other factors such as nitric oxide and iron in order to induce anaemia.

Conclusion

IFN-γ, IL-10, and TNF-α were the three major cytokines identified to be heavily involved in anaemia caused by Trypanosoma brucei infection. The anti-inflammatory cytokine, IL-10, was shown to counter the effects of proinflammatory cytokines in order to balance the severity of anaemia. The mechanism of anaemia is multifactorial and therefore requires further, more elaborate research. Data from human subjects would also shed more light.     

《内蒙古医学杂志》近年载文现状分析

目的：分析《内蒙古医学杂志》(后称本刊)近年文稿数量和质量的发表现状，提高或继续提高其出版水平和发行质量。方法：对本刊2000～2004年间发表的2297篇文章(不含增刊发表篇数)，和不同区域、不同学历、不同职称的作者及不同栏目发表的文章进行分析。结果：本刊文稿在数量和质量上，5年间呈稳定提高趋势。结论：本刊是医药卫生工作者学术与技术交流、切磋和提高的园地、稿源的质量和数量是本刊发展和生存的基石。     

Research letter: How should abridged scientific articles be presented in journals? A survey of readers and authors

SEVERAL SCIENTIFIC AND GENERAL MEDICAL JOURNALS publish full-length articles on their Web sites and abridged versions in their print journals. We surveyed a stratified random sample of BMJ readers and authors to elicit their preferred format for the abridged print version. Each participant received a research paper abridged in 3 different formats: conventional abridged version, journalistic version and enhanced-abstract version. Overall, 45% (95% confidence interval [CI] 42%–48%) of the respondents said they liked the conventional version most, 31% (95% CI 28%–34%) preferred the journalistic version and 25% (95% CI 22%–27%) preferred the enhanced-abstract version. Twenty-eight percent (95% CI 25%–32%) indicated that use of the journalistic format for abridged articles would very likely stop them from submitting papers to BMJ, and 13% (95% CI 11%–16%) said the use of the enhanced-abstract version would stop them from submitting to BMJ. Publishers of general medical journals who publish shortened articles should consider that authors and readers prefer a more conventional style of abridged papers.     

脑卒中后抑郁相关研究文献的计量学分析

目的 通过Web of Science数据库了解脑卒中后抑郁相关研究的整体状况,为今后相关研究提供参考。方法 检索Web of Science数据库收录的关于脑卒中后抑郁的文献,采用标题检索法,检索词为“(depress*) and(stroke OR post stroke OR poststroke OR brain infraction OR cerebral infraction)”,利用Web of Science自动分析功能及Excel对检索结果从发布年份、研究主题分布、杂志分布、国家和机构分布、作者分布以及文献引用率等方面进行分析。结果 共检索到1709篇文献,文献数量呈逐年上升趋势,研究方向集中在神经学、精神病学、脑血管疾病以及老年病学等方向;来自美国的《Stroke》发表文献数量最多为194篇;美国的发表文献数量最多达407篇;发表文献数量最多的机构是伦敦大学国王学院为35篇;被引频次最多的是Hackett ML等开展的系统评价;该领域尚未形成核心团体。结论 脑卒中后抑郁的发生率高,影响深远,应当引起足够的重视。未来应开展特异性研究工具的开发,同时应注重该领域研究质量的提升,加强质性等研究的开展和应用。     

国内外循证医学信息服务研究现状及启示

在分析国内外有关循证医学信息服务研究现状的基础上,提出扩大研究主体以期增加发文数量与质量,引入信息-知识-智能转化律用以指导临床医师和临床医学馆员,建议借鉴国外经验探寻适合我国的信息服务模式、服务方式和服务内容,以紧跟国际前沿。     

梅毒患者血清固定循证医学分析

为给临床治疗提供参考,对国内1995~2005年有关梅毒血清固定的基础研究和临床研究相关文献进行循证医学分析,结果缺少A级文献,B级文献1篇,属基础研究,疗效观察3篇,均为C级文献,由于有关的文献太少且质量不高,未能为临床治疗提供充分的指导、参考。     

Ten-year survey on oncology publications from China and other top-ranking countries

Background  Cancer is a global disease that knows no borders. Over the past decade, oncology research had developed rapidly worldwide. The aim of this study was to evaluate the publication characteristics in oncology journals from China and other top-ranking countries.

Methods  The present study was designed to study publication characteristics in oncology journals from China and other top-ranking countries, the United States (USA), Japan, Germany, the United Kingdom (UK) and France, from 2001 to 2010. We also examined the research output from the three different regions of China: the mainland of China, Hong Kong and Taiwan.

Results  Articles published in 163 journals related to oncology were retrieved from the PubMed database. The number of articles showed significantly positive trends for the six countries. The percentage of articles in the world output showed a significantly positive increase in contributions from China, especially the mainland of China. China contributed 4.5% of the total 163 journals, and 2.5% of the journals with the top 10% impact factor (IF) scores. USA contributed 31.4% of the total world output, 40.5% of the top 10% IF score journals and ranked the first.

Conclusions  This analysis described the research output from each country and region of China, and revealed the positive trend in China during 2001 and 2010. Also, by contrast with other top-ranking countries, these results imply that China falls behind the others in conducting high-quality oncology research.

     

乙型肝炎病毒在不同丙氨酸氨基转移酶状态下对Th17、Treg细胞及其比率的影响

目的探讨不同载量的乙型肝炎病毒(hepatitis B virus, HBV)在不同丙氨酸氨基转移酶(alanine aminetransferase, ALT) 状态下对慢性乙型肝炎患者辅助性T淋巴细胞17 (helper T lymphocytes 17, Th17)、调节性T淋巴细胞(regulatory T lymphocyte, Treg)及其比率的影响。方法分析兰州大学第一医院确诊为慢性乙型肝炎的患者336例，采用化学发光免疫分析仪检测乙肝抗原抗体，采用生化分析仪检测肝功能，采用荧光定量PCR分析仪检测被测者的病毒载量，采用流式细胞分析仪检测Th17、Treg细胞及其比率，其中ALT正常的乙肝患者111例(ALT < 40 U/L)，ALT≥正常上限且 < 2倍增高的慢性乙肝患者108例(40 U/L≤ALT < 80 U/L)，ALT≥正常上限2倍增高的慢性乙肝患者117例(ALT≥80 U/L)，并且按病毒载量分为低复制组(HBV DNA < 4.0 lg copies/mL)，中复制组(4.0 lg copies/mL≤HBV DNA < 6.0 lg copies/mL)，高复制组(HBV DNA≥6.0 lg copies/mL)。采用Dunnett T3方差分析在不同ALT状态下，不同载量的乙型肝炎病毒对慢性乙型肝炎患者Th17、Treg细胞及其比率的影响。对ALT≥正常上限2倍增高的乙型肝炎患者进行抗病毒治疗24周，观察治疗前后病毒学及Th17、Treg细胞及其比率的变化。结果在ALT正常组及ALT≥正常上限且 < 2倍增高的慢性乙肝组中不同载量的乙型肝炎病毒对Th17、Treg细胞及其比率的影响差异无统计学意义，而在ALT≥正常上限2倍增高的慢性乙肝患者组中，随着病毒载量的增加，Th17(低复制组3.18%±0.79%、中复制组3.78%±0.92%、高复制组4.57%±1.15%)、Treg细胞(低复制组5.52%±1.58%、中复制组5.89%±1.84%、高复制组6.37%±2.35%) 及其比率Th17/Treg (低复制组0.57±0.25、中复制组0.65±0.29、高复制组0.73±0.36) 均明显增高(P < 0.05)。恩替卡韦治疗24周后，患者HBV DNA明显下降，Th17(3.89%±1.02% vs. 2.06%±0.46%)、Treg细胞(6.02%±2.03% vs. 5.06%±1.25%)及其比率(0.65±0.28 vs. 0.41±0.14)均明显下降(P < 0.05)。结论在不同ALT状态下HBV对Th17、Treg细胞及其比率的影响不同，可以从免疫学的角度阐明HBV对机体的影响，进一步理解以ALT分组抗病毒治疗的意义，从而有助于临床治疗。