基于CiteSpace知识图谱软件分析中医住院医师规范化培训的热点和趋势

目的　通过CiteSpace知识图谱软件分析1998年至今中医住院医师规范化培训研究的进展、热点和未来趋势。方法　检索中国知网中关于中医住院医师规范化培训的相关文献。经Refworks格式转换后,利用CiteSpace 5.6 R3软件进行知识图谱的构建。分别绘制中医住院医师规范化培训研究相关文献的作者合作、机构合作、关键词共现,以及分时区研究热点视图。结果　共获得259篇相关文献,作者253名,发表文章最多的是任献青和崔瑾（各4篇）,发表文献最多的机构为北京中医药大学（23篇）。共有259个关键词,得到频次大于5且中心度大于0.1的关键词16个,关键词聚类标签14个。共探测到15个突现词,并据此展开趋势讨论。结论　中医住院医师规范化培训的研究趋势主要跟随政府职能部门出台的相关政策而定,研究热点则取决于各规培基地在实际应用中所遇到的阻碍和困境。     

基于中国知网的国内助产教育研究热点与趋势可视化分析

目的　分析近20年我国助产教育研究现状、发展趋势及前沿热点。方法　以"助产教育"OR"助产教学"为主题,检索中国知网数据库中2001年至2021年期刊文献。运用CiteSpace 5.7R5软件对其进行可视化分析,并生成知识图谱。结果　本研究共纳入中文文献548篇,年度发文量呈整体上升趋势;国内助产教育研究领域已形成明显核心团队,核心作者群间合作较少;《卫生职业教育》《中华护理教育》《中国高等医学教育》是载文量前3的杂志;关键词聚类显示频次最高的6个主题依次是助产专业、助产人员、助产教育、实践教学、分娩方式、教学模式,形成了助产教育等10个聚类群;我国助产教育领域研究前期多为临床技能教学、结构性考核、教学模式等研究,近3年逐渐转变为模拟教学、翻转课堂、产后康复等方面。结论　我国助产教育研究范围较广且形成明显核心团队,但相关性较弱且研究团队间交流合作较少,高层次助产教育领域研究不足。助产教育者和研究者应给予足够重视,对相关方面展开深入研究。     

基于文献的图书馆领域慕课研究热点分析

目的探索图书馆领域慕课的研究热点,以期为今后慕课的应用与研究提供参考。方法检索中国学术期刊网络出版总库(CNKI)有关图书馆慕课研究的相关文献,利用书目共现分析系统(BICOMB)和SPSS 19软件对文献的高频关键词进行聚类分析。结果共检出870篇有效文献,共得到关键词3224个。其中,词频≥12次的有效高频关键词22个,对它们进行聚类分析,得到图书馆领域慕课研究的3个热点,分别为服务创新、信息素养教育和版权服务。结论通过聚类分析对图书馆领域慕课热点进行研究具有可行性,图书馆慕课的内容应当涉及更多领域,研究方向更加多样化。     

医学课程思政研究热点与发展趋势的可视化研究

目的 探索医学课程思政领域研究热点和发展趋势,分析存在的问题,为医学课程思政发展提供参考。方法 检索中国知网数据库收录于2017至2021年的医学课程思政文献,通过Excel软件和Citespace软件对纳入研究的1 257篇文献的发文时间及发文量、主要作者及研究机构、关键词、突变词进行可视化分析。结果 医学课程思政文献发文量呈上升趋势;赵文星、刘瑞婷、杨红梅等人发文较多;菏泽医学专科学校、福建卫生职业技术学院、上海健康医学院等机构发文较多;频次较高的关键词有“教学改革”“生物化学”“思政教育”等;中介中心性较强的关键词有“实践教学”“思政课程”“医学英语”“人文素质”等;突变强度较高的关键词有思政教育、思政课程、职业素养等。结论 医学课程思政是当前医学教育的热点研究,当前研究主题包括教学改革和教学实践两个方面,明晰课程思政评价的逻辑并逐步构建起课程思政评价体系与机制是今后的研究热点。     

新建医学本科高校科研竞争力调查：以沪陕浙闽地区四校为例

目的　通过对比研究我国四所新建医学本科高校办学初期的科研竞争力,为医学院校建设和发展提供参考。方法　选取沪陕浙闽地区四所始建于2015年的年轻公办医学院作为研究样本,采用CNKI与WoS国内外数据库,对四校于2016至2020五年内发表于中外核心期刊的高水平学术文献从发文量、学科分布、来源出版物、基金资助等角度进行计量分析和对比研究。结果　四校的中外核心文献发文趋势递增,但在顶尖国际期刊上发文量较少。陕校多数指标领先于其他三校、沪浙两校指标较为接近、闽校则不占优势,表明四校间存在科研竞争力的阶段性差距。结论　上述差距与四校建校基础、办学定位、科研力量悬殊等差异有关。新建医学本科高校应不断深化医学教育综合改革,提升包括科研竞争力在内的办学综合实力。     

医学英语EMP课程在医学本科整合医学教育中的应用研究

目的　探索医学英语EMP课程（English for medical purpose）在医学本科整合医学教育中的应用。方法　将参与重庆医科大学整合医学教育的本科生120名分为EMP组和传统医学英语教学组。两组大纲知识点没有差异。授课方式方面,EMP组结合整合医学教育,按照器官系统进行医学专业英语教学,传统组按照传统的以构词法和词句理解为基础的医学英语教学方式进行。采用SPSS 24.0进行t检验。结果　医学英语词汇考试成绩EMP教学组高于传统教学组[（85.00±3.52）vs. （65.67±3.33）]。EMP教学组学生发表文献综述14篇,传统教学组发表6篇。教师采用随机双盲的方式对学生的综述进行评分（百分制）。结果表明,EMP教学组学生专业词汇应用评分高于传统教学组[（84.52±2.34）vs.（70.98±1.45）];综述内容科学性评分EMP组高于传统教学组[（88.87±4.68）vs.（71.87±2.41）];语法评分EMP组高于传统教学组[（90.01±7.24）vs.（76.00±3.76）]。结论　医学英语EMP课程能较好地配合医学本科整合医学教育,提高学生应用医学英语检索文献的能力和按照器官系统来认识医学英语的能力。     

近20年痛风的文献计量学及可视化分析

[目的] 使用CiteSpace软件分析近20年痛风相关研究的的热点与发展趋势。[方法] 分析了2000年1月至2019年12月期间Web of Science数据库中关于痛风的文献,采用CiteSpace软件对文献进行作者、国家、机构的合作网络分析,关键词分析和聚类分析,以及作者、期刊、文献的共被引分析,并绘制相关可视化图谱。[结果] 检索出8 782篇文献,发文量基本呈上升趋势。发文量最多的作者是Nicola Dalbeth,发文最多的国家是美国和中国。发文最多的机构是Univ Auckland（奥克兰大学）和Univ Otago（奥塔哥大学）。关键词频次最高的为gout（痛风）、hyperuricemia（高尿酸血症）等。通过对关键词的分析体现了痛风的机制研究和防治是目前的研究热点。发文量最多的杂志为Annals of The Rheumatic Diseases、Arthritis Rheumatology等。[结论] 通过CiteSpace软件对痛风文献的分析发现,研究热点主要体现在NOD-like receptor protein 3（NLRP3）炎性体和巨噬细胞极化的基础研究,以及关于痛风防治的临床研究,这对痛风未来的研究选题具有一定参考意义。     

116项继续医学教育项目评估结果及影响指标分析

目的　分析116项继续医学教育项目评估结果并探讨影响评估结果的指标,为明确项目质量评估重点提供参考。方法　采用卡方检验、Fisher精确检验对28个指标的评估结果进行单因素分析,采用logistic回归进行多因素分析。结果　logistic回归显示：项目基本信息一致性[OR=6.712,95%CI（1.314~34.275）]、主办单位是否提供教材[OR=109.386,95%CI（2.577~4 642.659）]、现场学员与签到人数是否符合[OR=13.296,95%CI（2.440~72.456）]、学员考核材料反馈[OR=19.069,95%CI（3.713~97.929）]、教师评估材料反馈[OR=13.497,95%CI（2.672~68.181）]和主办单位是否按要求送审学分[OR=51.326,95%CI（4.999~526.996）]为继续医学教育项目评估结果合格与否的影响指标。结论　继续医学教育管理部门应健全项目评估制度,根据研究结果改进并完善评估指标,重视影响评估结果的指标,发挥评估指标的导向作用。     

基于共词分析的近3年国内护理教育研究热点

目的了解近3年国内护理教育领域研究热点。方法以中国知网、万方数据库和维普数据库中2015年1月至2017年12月收录的护理教育研究文献中的关键词作为研究对象,运用书目共现分析Bicomb软件、SPSS 21.0统计软件对检索出的关键词进行词频分析和共词聚类分析。结果共检索到相关文献3 275篇,截取高频关键词42个。共词聚类分析结果显示,近3年国内护理教育研究热点为:护理教学体系改革实践,护理实践教学中多种教学方式的探索应用,循证护理在护理教育中的应用,临床护理带教及管理模式构建,护生人文关怀研究,护理专业人才培养及人文教育,护生评判性思维能力研究。结论对国内近3年护理教育领域的研究热点进行共词聚类分析有利于了解此阶段护理教育发展现状及趋势。     

基础+应用的教学方法在肌骨超声继续医学教育中的应用探索

目的　以北京大学第三医院超声诊断科主办的国家级继续医学教育项目"肌骨超声及超声新技术精品学习班"的研究结果为依据,探讨分析依托肌骨超声的基础+应用教学方法的效果。方法　选取2019年4月14日至4月18日和2019年9月9日至9月13日参加该项目的109名学员为研究对象。采用问卷调查和操作考试、理论考试的方式评价肌骨超声精品小班培训效果。采用SPSS 21.0软件进行t检验。结果　调查结果表明,80.0%以上的学员对学习班讲授内容、教学计划和教材很满意或满意。通过学习班培训,学员们的最大收获是操作能力[67（30.7%）]和理论水平[53（24.3%）]得到明显提高;所有109名学员操作考试均达标;不同职称、学历及是否来自基层医院的学员理论考试平均成绩均为75~80分,且差异均无统计学意义（P>0.05）。结论　肌骨超声精品小班可以提高学员在肌骨系统的操作能力和理论水平。该学习班模式能保证教学质量,也为继续医学教育开拓了新的方向。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.