基于CiteSpace可视化分析代谢组学在中医药领域的研究现状及趋势＊

目的 应用可视化方法分析代谢组学在中医药领域的现状及趋势。方法 检索中国知网数据库（CNKI）和Web of Science 核心合集数据库2021年3月15日之前收录的中医药领域代谢组学研究的相关文献，应用CiteSpace软件对纳入的文献进行关键词、作者、研究机构等内容进行可视化分析。结果 共纳入中文文献247篇，英文文献350篇。文献数量在波动中迅速上升。中、英文文献作者合作网络显示，张爱华是中医药领域代谢组学研究发文量最多的作者，并形成了核心研究团队。发文机构显示，中国医学科学院是该领域的重要研究机构，机构间合作紧密。中、英文文献关键词分析显示，研究内容主要集中在核磁共振、代谢标记物、冠心病、质谱技术、代谢通路等相关领域。结论 中医药领域代谢组学研究的热点主要为中医药治疗代谢性疾病的机制研究。研究趋势为卵泡代谢组学研究及中药有效成分的研究。     

基于CiteSpace的结直肠癌患者生命质量研究

目的：通过中英文文献了解结直肠癌患者生命质量研究现状及发展趋势。方法：运用CiteSpace对中国知网（CNKI）、万方数据知识服务平台、中国生物医学文献数据库、Web of Science核心数据集、PubMed、Cochrane Library中收录的关于结直肠癌患者生命质量研究的中英文文献进行可视化分析。结果：检索得到中文文献1 285篇，英文文献871篇，中英文文献发文量均呈上升趋势，相关研究关注的重点主要是结直肠癌患者造口、抑郁、免疫、肠道功能、化疗及化疗药物，但机构之间、学者之间合作程度及研究类型等方面存在一定差异。结论：中文文献相关研究起步晚、发展快，但在研究质量与研究深度等方面与英文文献相比还有一定差距；国内学者之间、机构之间应加强合作，关心患者肠道功能、心理状况，提高患者体力活动水平，开展更多高质量研究。     

Anatomic vs. reverse shoulder arthroplasty for glenohumeral osteoarthritis with intact rotator cuff: a retrospective comparison of patient-reported outcomes using the systems outcomes database with up to 5-year follow-up

BackgroundThe growing enthusiasm for the use of reverse shoulder arthroplasty (RSA) in the treatment of primary glenohumeral osteoarthritis (GHOA) with an intact rotator cuff is based on data derived from single-center studies with limited generalizability and follow-up. This study compared patient-reported outcomes (PROs) between RSA and total shoulder arthroplasty (TSA) for the treatment of primary GHOA with up to 5-year follow-up and examined temporal trends in the treatment of GHOA between 2012 and 2021.MethodsA retrospective review was performed on patients with primary GHOA undergoing primary arthroplasty surgery from the Surgical Outcomes System global registry between 2012 and 2021. PROs including the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE) score, and visual analog scale (VAS) for pain were compared between RSA and TSA at 1, 2, and 5 years postoperatively.ResultsA total of 4451 patients were included, with 2693 (60.5%) undergoing TSA and 1758 (39.5%) undergoing RSA. Both RSA and TSA provided clinically excellent outcomes at 1 year postoperatively (ASES: 80.8 ± 17.9 vs. 85.9 ± 15.2, respectively; SANE: 74.8 ± 24.7 vs. 79.5 ± 22.9; VAS pain: 1.3 ± 2.0 vs. 1.1 ± 1.7; all P < .05) that were maintained at 2 years (ASES: 81.3 ± 19.3 vs. 87.3 ± 14.9; SANE: 74.8 ± 26.2 vs. 79.7 ± 24.7; VAS pain: 1.3 ± 2.1 vs. 1.0 ± 1.6; all P < .05) and 5 years (ASES: 81.7 ± 16.5 vs. 86.9 ± 15.3; SANE: 71.6 ± 28.5 vs. 78.2 ± 25.9; VAS pain: 1.0 ± 1.7 vs. 1.0 ± 1.7; all P < .05), with statistical significance favoring TSA. After controlling for age and sex, there was an adjusted difference of 4.5 units in the ASES score favoring TSA (P = .005) at 5 years postoperatively but no differences in adjusted SANE (P = .745) and VAS pain (P = .332) scores. The use of RSA for GHOA grew considerably over time, from representing only 17% of all replacements performed for GHOA in 2012 to nearly half (47%) in 2021 (P < .001).ConclusionRSA as a treatment for GHOA with an intact rotator cuff seems to yield PROs that are largely clinically equivalent to TSA extending to 5 years postoperatively. The observed statistical significance favoring TSA appears to be of marginal clinical benefit based on established minimal clinically important differences and may be a result of the large sample size. Further research using more granular clinical data and examining differences in range of motion and complications is warranted as it may change the value analysis.     

The effect of different statistical approaches on image quality data obtained from radiological examinations

IntroductionSelection of optimal image acquisition protocols in medical imaging remains a grey area, the superimposed use of the Likert scale in radiological image quality evaluations creates an additional challenge for the statistical analysis of image quality data.Using a simulation study, we have trialled a novel approach to analysing radiological image quality Likert scale data.MethodsA simulation study was undertaken where simulated datasets were generated based on the distribution of Likert scale values according to varying image acquisition protocols from a real dataset. Simulated Likert scale values were pooled in four different ways; the mean, median, mode and the summation of patient Likert scale values of which the total was assigned a categorical Likert scale value. Estimates of bias, MAPE and RMSPE were then calculated for all four pooling approaches to determine which method most accurately represented an expert's opinion.ResultsWhen compared to an expert's opinion, the method of summation and categorisation of Likert scale values was most accurate 49 times out of the 114 (43.0%) tests. The mean 28 times out of 114 (24.6%), the median 23 times out of 114 (20.2%) and the mode 17 times out of 114 (14.9%).ConclusionWe conclude that our method of summation and categorisation of Likert scale values is most often the best representation of the simulated data compared to the expert's opinion.Implications for practiceThere is scope to reproduce this simulation study with multiple observers to reflect clinical reality more accurately with the dynamic nature of multiple observers. This also prompts future investigation into other anatomical areas, to see if the same methods produce similar results.     

Parts‐based representations of perceived face movements in the superior temporal sulcus

Facial motion is a primary source of social information about other humans. Prior fMRI studies have identified regions of the superior temporal sulcus (STS) that respond specifically to perceived face movements (termed fSTS), but little is known about the nature of motion representations in these regions. Here we use fMRI and multivoxel pattern analysis to characterize the representational content of the fSTS. Participants viewed a set of specific eye and mouth movements, as well as combined eye and mouth movements. Our results demonstrate that fSTS response patterns contain information about face movements, including subtle distinctions between types of eye and mouth movements. These representations generalize across the actor performing the movement, and across small differences in visual position. Critically, patterns of response to combined movements could be well predicted by linear combinations of responses to individual eye and mouth movements, pointing to a parts‐based representation of complex face movements. These results indicate that the fSTS plays an intermediate role in the process of inferring social content from visually perceived face movements, containing a representation that is sufficiently abstract to generalize across low‐level visual details, but still tied to the kinematics of face part movements.     

Evaluation of Eye Movement Desensitization and Reprocessing in the management of tinnitus. An observational study

ObjectivesTinnitus can induce disabling psychological suffering, requiring an integrative multimodal approach, combining neuromodulation and psychotherapeutic methods. We sought to evaluate the therapeutic efficacy and acceptability of Eye Movement Desensitization and Reprocessing (EMDR) in tinnitus.Materials and methodsThis was a single-center prospective non-comparative study. Inclusion criteria comprised: adult patient, with chronic tinnitus, Tinnitus Handicap Inventory (THI) score > 17, causing psychological distress motivating active treatment after ineffective “classic” treatment (combining advice, sound therapy and first-line drug treatment), and agreement to EMDR therapy. Therapeutic efficacy was defined by a decrease in THI or Visual Analog Scale (VAS) scores. Treatment acceptability was defined by the rate of included patients who completed therapy.ResultsThirty-eight patients were included. There was a significant reduction of 53.5% in THI score in 78.9% of patients (P < 0.0001; 64.8 ± 20.8 before versus 31.8 ± 24.7 after treatment), and of 51% in VAS score in 76.3% of patients (P < 0.0001; 7.24 ± 2.12 before versus 3.58 ± 2.03 after treatment). The treatment acceptability was 86.8%.ConclusionEMDR appeared to be an effective alternative that was acceptable to the majority of patients, after failure of “classic” first-line treatment, improving quality of life in tinnitus patients and thus relieving disability.     

Perception of a Natural Joint After Total Knee Arthroplasty

BackgroundAssessing patients’ functional outcomes following total knee arthroplasty (TKA) with traditional scoring systems is limited by their ceiling effects. Patient’s Joint Perception (PJP) question of the reconstructed joint is also of significant interest. Forgotten Joint Score (FJS) was created as a more discriminating option. The actual score constituting a “forgotten joint” has not yet been defined. The primary objective of this study is to compare the PJP and the FJS in TKA patients to determine the FJS score that corresponds to the patient’s perception of a natural joint.MethodsOne hundred TKAs were assessed at a mean of 40.6 months of follow-up using the PJP question, FJS, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Correlation between the 3 scores and their ceiling effects were analyzed.ResultsWith PJP question, 39% of the patients perceived a natural joint (FJS: 92.9; 95% confidence interval [CI], 89.4-96.4), 12% an artificial joint with no restriction (FJS: 79.5; 95% CI, 65.7-93.3), 36% an artificial joint with minor restrictions (FJS: 70.0; 95% CI, 63.2-76.9), and 13% had major restrictions (FJS: 47.3; 95% CI. 32.8-61.7). PJP has a high correlation with FJS and WOMAC (Spearman’s rho, −0.705 and −0.680, respectively). FJS and WOMAC had a significant ceiling effect with both reaching the best possible score in >15%.ConclusionPatients perceiving their TKA as a natural knee based on PJP have a FJS ≥89. PJP has a good correlation with FJS and may be a shorter, simple, and acceptable alternative.