2010—2021年国内外老年多重慢病研究热点分析

背景 随着人口老龄化进程的加快,同时患有多种慢病已成为老年人的常态,老年多重慢病相关研究也不断丰富,但鲜有对其研究进展及热点进行分析。目的 分析国内外老年多重慢病的研究热点,揭示近十年来（2010—2021年）老年多重慢病领域研究前沿的热点主题,为相关研究者追踪前沿信息提供参考。方法 基于文本挖掘技术和文献计量学等方法,检索Web of Science核心合集、Scopus、中国知网、万方数据知识服务平台、维普网、PubMed、中华医学会期刊全文数据库、APA-PsycINFO美国心理学会数据库中老年多重慢病领域的相关文献,检索时间为2010—2021年。使用CiteSpace 6.1.3、PASW 18、BICOMB 2.04等软件对文献的发文量趋势、来源、作者、机构、关键词等方面进行分析及可视化,并绘制战略坐标图对领域研究热点进行分析。结果 最终纳入老年多重慢病相关文献9 392篇,其中外文文献5 776篇,中文文献3 616篇。2010—2021年老年多重慢病领域中外文献发文量均呈指数型增长,中文文献年增长率为13.27%,外文文献年增长率为15.84%,该领域正处于发展阶段。中...     

基于CiteSpace的国内外老年人多重慢病研究的可视化分析

目的:利用CiteSpace软件对国内外老年人多重慢病的研究热点及其变化进行可视化分析。方法:检索2000-2020年中国知网、万方、维普数据库及PubMed和Web of Science数据库中老年人多重慢病相关的研究文献，筛选并提取文献信息，应用CiteSpace软件对纳入的文献进行关键词共现、突现分析。结果:共筛选出中文文献349篇，发文量整体呈现波动上升趋势；共筛选出英文文献761篇，发文量呈现平缓上升趋势。英文文献在临床医学领域、流行性病学领域、卫生管理领域中出现频次前两位的关键词均为多重用药(强度为6.42)及衰弱(强度为6.73),近年来对住院(强度为1.35)、生活质量(强度为1.19)和抑郁(强度为0.94)的关注度提升。而中文文献在以上3个领域最高频的关键词分别为多重用药(频次为17)、影响因素(频次为47)、生活质量和社区护理(频次均为4),文献多集中于研究综合评估(强度为0.97)、疾病管理(强度为1.13)和医养结合(强度为0.53)。结论:相比于英文文献关注老年人的复合健康问题，提出建立以人群为导向，与多重慢病相适应的整合型诊疗模式，中文文献仍侧重于从单一疾...     

基于共词分析法的PET-CT护理研究热点的文献计量学研究

目的 基于共词分析法对近年来有关PET-CT的护理研究进行文献计量学研究,明确该领域的研究热点及发展方向,为相关护理研究人员提供参考。方法 以题名“PET”+“CT”+“护理”为检索式,检索中国期刊全文数据库中的相关文献,检索时段为建库时间至2022年1月。将数据以RefWorks格式导出,通过CiteSpace软件进行计算及分析,并以最小生成树算法生成可视化知识图谱,绘制总文献数统计图、文献被引网络图、关键词共现频次统计图、作者合作发文聚类分析图、发表单位分布图。结果 2003—2021年共有167篇相关文献;被引次数最高的为潘中允教授主编的专著《PET/CT诊断学》（2008年版）;共现频次最高的关键词为“受检者”“FDG（显像剂）”“图像质量”等关键词;合作发文量最高的作者为陈伟（第三军医大学第一附属医院）;发文最多的机构为淄博万杰医院、山东省立医院、安徽医科大学附属省立医院及解放军济南军区总医院。结论 目前,PET-CT护理领域的研究热点为显像剂、受检者、护理配合、图像质量、静脉注射,对相关护理研究工作者具有一定的参考价值,以期提供更优质的PET-CT检查及护理服务。     

基于CiteSpace国际病耻感领域的热点分析

目的 ：探讨国内外病耻感的研究热点,分析病耻感未来发展趋势,以期为后续相关研究提供参考。方法 ：分别检索Web Of Science和中国知网数据库2017―2021年国内外关于病耻感研究相关文献,使用Excel和CiteSpace 5.8.R3软件对发文量、国家地区合作、关键词共现、关键词聚类以及突现词分析进行可视化图谱绘制。结果 ：共纳入英文文献7013篇,中文文献702篇。国际上美国发文量最多,中国排名第五;荷兰是中心性最大的国家。高频关键词和关键词聚类结果显示影响因素、应对方式、生活质量、健康以及心理护理是国内外主要的研究热点。国际上病耻感领域的研究前沿是自我病耻感和模型构建;患者家属连带内在病耻感、社会功能以及病耻感最新研究进展将成为国内病耻感研究新趋势。结论 ：通过对比国内外病耻感研究热点和趋势,国内病耻感研究在后续可以加强与其他国家之间的交流和合作,多关注公众病耻感研究和干预研究。     

基于CiteSpace下肢康复机器人的研究可视化分析

目的 采用CiteSpace知识图谱分析近20年下肢康复机器人的相关文献,总结该研究领域的前沿热点及发展趋势。方法 使用计算机检索中国知网收录的自2002年1月至2022年8月下肢康复机器人的发文情况,采用NoteExpressV3.5管理和去重,采用CiteSpace.V.6.1.R2软件对纳入文献的发文情况、作者、关键词进行共现、聚类、突现分析,并绘制相应的知识图谱。结果 共纳入490篇文献,纳入研究者1364名,主要研究者30人,发文量≥5篇,最突出的作者为张立勋,发文量为15篇。共纳入研究机构387个,主要研究机构28个,发文量≥4篇,其中哈尔滨工程大学机电工程学院为发文量最多的机构,2002—2022年共发文13篇。共纳入关键词444个,其中高频关键词共20个,频次≥10。共形成15个聚类标签;通过关键词突现研究近些年下肢康复机器人的研究趋势和研究前沿。结论 下肢康复机器人研究领域的文献发文量呈现总体上升趋势,知识图谱可视化分析展示下肢康复机器人的研究现状和热点方向,为进一步的发展趋势提供依据。目前下肢康复机器人的主要研究方向有运动学、步行功能、仿真分析、外骨骼等。     

近十年我国可穿戴设备在健康管理领域的研究现状及发展趋势

背景 随着可穿戴技术的日益成熟，可穿戴设备在健康监测、评估和干预中的应用价值逐步体现，并将助力于健康管理领域的创新发展。目的 分析近10年我国可穿戴设备在健康管理领域的研究热点、前沿和趋势。方法 检索并分析中国知网数据库中2011—2021年主题为“可穿戴”的期刊文献，通过Excel表格分析纳入文献的时序和空间分布，通过CiteSpace软件对文献关键词进行可视化分析。结果 2011—2021年，我国可穿戴设备在健康管理领域的发文量总体呈上升趋势（共519篇），于2021年达到最高（85篇）。纳入文献涉及生物医学、信息科学、计算机硬件和软件技术等多门学科，发表于医学信息学杂志、中国数字医学、智慧健康等多种期刊。发文量排名前3的研究者包括中国人民解放军总医院的张政波教授、上海中医药大学的罗晓兰副教授、中国医学科学院医学信息研究所的何晓琳研究员，发文量排名前3的科研机构分别是华中科技大学（14篇），上海交通大学（10篇）和东南大学（10篇）。反映研究热点的关键词包括“移动医疗”“健康管理”“智慧医疗”等，反映研究前沿的关键词包括“老年人”“糖尿病”和“心律失常”等，反映研究趋势的关键词包括...     

网络化治理的慢性病管理文献计量分析与质量评价

目的 了解网络化治理的慢性病管理研究发展趋势,为慢性病健康管理提供研究方向与信息支持。方法 通过在中国知网（CNKI）数据库检索网络化治理的慢性病管理方面的关键词,获得相关文献,采用文献计量软件CiteSpace绘制知识图谱,使用美国卫生保健质量和研究机构（AHRQ）推荐的质量评价标准对文献进行评价。结果 共筛选出相关论文638篇,文献集中在2016—2022年发表,发文的各团队之间合作较为薄弱。关键词聚类分析结果显示,该领域研究聚焦为3类：1）网络化治理慢性病的具体实施途径;2）网络化治理的具体慢性疾病及人群;3）网络化治理慢性病的理论模式。随着时代发展,该领域现主要聚焦于借助互联网进行健康管理,“老年人”“小组工作”“综述”是该领域近期发文热点。文献质量评价结果显示,我国网络化治理的慢性病管理文献中以中等质量文献占比最多。结论 我国网络化治理的慢性病管理领域的研究热度正逐步降低,其热点主题集中于“老年人”“小组工作”“综述”,我国网络化治理的慢性病管理领域研究还需在纳入与排除标准、解释排除对象、明确慢性病诊断标准等方面做更详细的工作。     

我国近10年医学信息学研究计量分析

基于Web of Science数据库,收集2008-2017年我国作者发表的医学信息学领域的外文文献,从年度发文量、合作国家、重要发文机构和来源期刊分布4方面进行定量分析。对高频关键词进行聚类,借助Ucinet对高频关键词进行可视化分析,归纳近10年我国医学信息学领域外文文献的6大研究热点。     

我国中医翻译领域的研究现状、热点及展望 ——基于共词分析的可视化研究

目的 明确我国中医翻译领域的研究现状、热点分布及各主题发展态势.方法 以中国知识资源总库(CNKI)为数据来源,检索建库至2019年12月31日发表的中医翻译研究文献,通过文献计量学中的共词分析法,以可视化的方式,从发文情况、高频关键词、社会网络、关键词聚类及战略坐标角度对文献进行分析.结果 共纳入文献1422篇,最早...     

共病研究热点及趋势分析

目的 了解共病的研究现状、热点及发展趋势,为我国共病研究提供依据。方法 检索PubMed和Web of Science数据库自建库至2021年8月11日收录的共病相关文献,使用BICOMB软件和gCLUTO软件进行文献计量及聚类分析,使用CiteSpace进行作者、引文及关键词的突现分析。结果 共病相关研究呈现上升的趋势,作者Mercer SW发文最多,被引最多的是作者Fortin M,发文最多的机构是卡罗林斯卡学院,作者Barnett K 2012年发表在Lancet上的文章共被引最多。共提取75个高频主要主题词,归纳出7个研究热点：流行病学相关研究,包括流行现状和趋势;用药相关研究,涉及多重用药、服药依从性等;医疗支出相关研究,包括疾病花费、医疗服务等;老龄化相关研究,包括老年患者、衰弱、失能等;心理相关研究,涉及心理健康、社会支持等;共病管理相关研究,包括共病治疗、初级卫生保健服务、整合照护等;心血管和代谢性疾病的共病研究,涉及肥胖、卒中、糖尿病等。结论 共病作为当今世界范围内主要的健康威胁和公共卫生问题受到广泛关注,与单一疾病相比,共病管理更复杂,面临更多挑战,尚需研究者、医疗...     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.