Objective To investigate the current status and development of electronic health records (EHR) at home and abroad to grasp the development trends of EHR, so as to point out the direction of the development and relevant research on EHR. Methods Based on the Web of Science citation database and the principle of bibliometrics, we analyzed the retrieved literature in aspects of publication date, language, country/region, institution, author, etc. Results A total of 1 262 eligible studies were identified. The number of articles on EHR increased rapidly from only 2 in 1995 to 218 in 2012. In terms of country/region, the United States ranked the top in all countries (763 articles, accounting for 60.46%). In terms of institution, Harvard University ranked the top (135 articles, accounting for 10.70%). In terms of journal, the Journal of the American Medical Informatics Association ranked the top (106 articles, accounting for 8.40%). In terms of authors, David W. Bates ranked the top (45 articles, accounting for 3.57%). In terms of subject type, health care sciences services and medical informatics were mainly focused on. Conclusion The research on EHR has become a global hot spot and relevant bibliometrics will contribute to the timely and correctly grasp the whole picture of its development trends and main research direction.
Objective To survey the current situation of the systematic review (SR)/ meta-analysis (MA) related to interventions published in the Chinese medical journals entitled with evidence-based. Methods According to the inclusion and exclusion criteria, the Journal of Evidence-Based Medicine (2001.1 to 2011.12), the Chinese Journal of Evidence-based Medicine (2001.1 to 2011.12), the Chinese Journal of Evidence Based Pediatrics (2006.1 to 2011.12) and the Chinese Journal of Evidence-Based Cardiovascular Medicine (2008.1 to 2011.12) were searched for SRs/MAs related to interventions. Two reviewers extracted data independently using predesigned a data extraction form, crosschecked data, and discussed to solve discrepancy. Excel software was used to for statistical analysis. Results A total of 487 SRs/MAs were included. 379 (77.82%) SRs/MAs were published in the Chinese Journal of Evidence-Based Medicine, 70 (14.38%) in the Journal of Evidence-Based Medicine, 30 (6.17%) in Chinese Journal of Evidence-Based Pediatrics, and 8 (1.63%) in the Chinese Journal of Evidence-Based Cardiovascular Medicine. The number of SRs/MAs published generally increased during 2001 to 2011. The number of author of SRs/MAs was 5±2, the number of studies that included randomized controlled trials (RCTs) of SRs/MAs varied from 1 to 129 (median: 8), involving 20 diseases. 83 (17.04%) SRs/MAs focused on neoplasms, 64 (17.04%) on diseases of the circulatory system, and 54 (11.09%) on diseases of the genitourinary system. 82.75% of the included 487 SRs/MAs assessed the methodological quality of included RCTs. 44 (9.03%) SRs/MAs mentioned the methods of quality assessment, without reporting the results. The Cochrane Collaboration’s tool for assessing risk of bias was the most frequently used for evaluation (314 SRs/MAs, 64.48%). Conclusion The number of SRs/MAs related to interventions published in the journals entitled with evidence-based is increasing generally and their topics are extensive. However, further studies should be improved in the aspects of selecting and applying the quality assessment criteria of randomized controlled trials.
Objective To evaluate the trends, dominant diseases and clinical outcomes of the global interventional therapy for tumors based on evidence, so as to provide references for standard access of interventional technology. Methods Such databases as PubMed, EMbase, Web of Science, The Cochrane Library, CBM, CNKI and VIP were electronically and comprehensively searched for relevant clinical or fundamental studies about interventional therapy for tumors from inception to September, 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria and extracted data. Then, descriptive analysis was performed using SPSS 13.0 and Microsoft Excel 2003 software. Results Totally, 4 544 studies were included, consisting of 4 136 (91.0%) clinical studies and 408 (9.0%) fundamental studies. These clinical studies including 155 systematic reviews (SRs), 338 randomized controlled trials (RCTs), 1 191 clinical controlled trials (CCTs), and 2 451 case series or case reports (CSs/CRs). Transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) were the most clinically frequenly-used interventional technologies for tumors, accounting for 32.6% and 17.1% of the total, respectively. Hepatocellular carcinoma (HCC) was the dominant tumor, which was mentioned in 99 SRs (57.6%), 198 RCTs (58.6%), 824 CCTs (69.1%) and 1 191 CSs/CRs (48.6%), following by colorectal liver metastases (CLM). Radiofrequency ablation (RFA) treating HCC resulted in a higher rate of 3-year survival (12 SRs/Meta-analyses) and lower recurrence (10 SRs/Meta-analyses) compared with percutaneous ethanol injection (PEI). Compared with hepatic resection (HR), RFA treating HCC resulted in lower rates of 3-year (11 SRs/Meta-analyses) and 5-year survival (9 SRs/Meta-analyses), and no significant difference was found in 1-year survival between the two groups (17 SRs/Meta-analyses). Preoperative TACE before HR or liver transplantation could not improve the survival for patients with advanced HCC (6 SRs/Meta-analyses), but postoperative TACE might prolong the 1-and 3-year survival (3 SRs/Meta-analyses). TACE combined with other interventional therapy (i.e., RFA, PEI) could also prolong the survival of HCC patients. For the treatment of uterine leiomyoma, uterine artery embolization (UAE) resulted in less hospital duration or operative time, and it caused a higher re-intervention rate, compared with surgery, but it lacked long-term outcomes. Conclusion Interventional therapy is an optional and promising technology for patients with tumors. We should well-consider currently available best clinical evidence as well as local medical facilities or skill level when applying them to clinical practice, so as to perform relevant interventional techniques with scientific, rational and standardized methods.
Objective To investigate the hot topics of research on evidence-based medicine in 2002. Method To search MEDLINE for papers on evidence-based medicine published in 2002, identify high-frequency subject headings related to research on evidence-based medicine, and cluster the high-frequency subject headings according to rates they appeared in common papers. Results 545 papers, 1 554 subject headings, 30 high-frequency subject headings on evidence-based medicine, and nine clustering categories of high-frequency subject headings were identified through search. Conclusions Both high-frequency subject headings and their clustering categories suggested that “evidence-based practice guidelines and their innovation”, “evidence-based health research and health policy”, “methodology on systematic reviews and randomized clinical trials”, “method of evidence-based decision making and its application in various subjects”, were the hot topics of evidence-based medicine. They provided useful references for Chinese medical professionals to practice evidence-based medicine.
Objective To analyze the citation classics articles， and approach the research development history and the research direction in the future about surgical treatment for type 2 diabetes. Methods The most frequently cited articles had published in Social Sciences Citation Index database by the end of October 30， 2012 were retrieved. The 50 most frequently cited articles were selected. Articles were evaluated for several characteristics， including number of citations， publication time， country of origin， institution， journal， publication type of article， and authorship. Results The most frequently cited article received 1 751 citations and the least frequently cited article received 73 citations， with a mean of 242.76 citations per article. These citation classics were published in 18 high-impact journals， led by Annals of Surgery and Obesity Research as 10 papers. Of the 50 articles， 18 articles were clinical observational study， 20 articles concerned basic science， 10 articles were review articles， and 2 articles were commentary. These citation classics were published from 1990 to 2009， most of them （40） from 2000 to 2009. Three institutions produced 2 top-cited articles， including Medical College of Virginia， Monash University， and East Carolina University. These articles originated from 14 countries， the top was USA （22 articles）. Two persons authored 3 published papers （Cummings DE and Rubino F）. Conclusion Most “citation classics” in research about surgery for type 2 diabetes are observational studies published in high-impact journals by US-based authors after 1990.
Histological studies and morphometry quantitative analysis have been performed on trial rabbit’s dilated common bile duct(CBD),which does not dilate simultaneously.The results shows:①Epithelia of rabbit’s CBD have a ber reparable function,which is fairly significant to the prevention of bile duct’s further injure under the pathogenic situation.②The smooth muscle cell(SMC)of the CBD is the histological basis of contraction,some SMC can be seen in contracting state under light microscope.This indicates that the SMC in rabbit’s CBD possess contracting function.③The collagenous and elastic fibers have the normal histological morphometric characteristics and quantity in it’s dilatation process,and no breekdown and degeneration of the fibers can be detected.Because of the morphological structure of these sections is quite similiar with normal ones,theoretically,we suspect that when pathological change of bile duct’s distal portion is relieved and the bile pressure is normal again.It is possible for this dilating bile duct to return to its formal shape and size.
Objective To reveal the worldwide research status and hot topics of sleep apnea syndrome ( SAS) . Methods Articles were searched from Web of Science ( SCI) , Essential Science Indicator ( 2000 to 2010) database using sleep apnea syndrome or apnea as keywords. Retrieved documents were analyzed using the database with its own statistical functions and histcite software ( version 8.12. 16) .Results Since 1992 the international scientific papers on the SAS study showed a gradual upward trend.The United States is a world leader in this field. Recent research has focused on vascular endothelial barrier function and repair, oxidative stress, inflammation, cognitive function, special populations such as the elderlyor children patients with SAS. Conclusion Clinical researchers have paid more attention to SAS than before, but there are still many important issues unresolved.
Objective To investigate the changes of lumbar bone histomorphometry after exposure to low frequency pulsed electromagnetic fields (PEMFs), and to further understand the effect of PEMFs on osteoporosis (OP) in ovariectomizedOP rats. Methods Sixty-six 3-month-old Sprague Dawley rats were randomly divided into 4 groups: group A(n=12), groupB (n=12), group C (n=12), and group D (n=30). In group A, the ovaries were not resected as sham-ovariectomy; in groupsB, C, and D, the ovaries were resected. At 12 weeks after ovariectomy, the rats were exposed to PEMFs at 8 Hz, 3.8 mT, and 40 minutes/ day for 30 days in group B; the rats were administered with premarin [0.065 mg/(kg·d) by gavage for 30 days] in group C; in group D, the rats were housed as ovariectomy control. The hair and activity of rats were observed; the levels of serum estradiol were determined. At 30 days after intervention, all rats were sacrificed to harvest the L4 vertebrae for bone histomorphometry. Results General observation showed hair loss and decreased activity in group D, and no abnormal appearances in groups A, B, and C. The level of serum estradiol in group A was significantly higher than that in group D [(54.93 ± 23.52) pg/mL vs. (31.99 ± 23.45) pg/mL] (t=2.345, P=0.029). Histological observation showed thinness of sclerotin, bigger medullary cavity, and sparse and thinner bone trabecula in group D; uniform bone trabecula with no breakage in groups A, B, and C at 30 days after intervention. The ratio of trabecular bone area in group B was significantly higher than that in group D (P lt; 0.05); it was higher than that in groups A and C, showing no significant difference (P gt; 0.05). The trabecular thickness in group B was significantly higher than that in group D (P lt; 0.05), but it was lower than that in groups A and C, showing no significant difference (P gt; 0.05). The trabecular number in group B was significantly lower than that in group D (P lt; 0.05), but it was higher than that in groups A and C, showing no significant difference (P gt; 0.05). The trabecular separation in group B was higher than that in group D and lower than that in groups A and C, showing no significant difference (P gt; 0.05). Conclusion PEMFs at 8 Hz and 3.8 mT can significantly improve the character of bone microstructure in ovariectomized OP rats, increase the ratio of bone trabecular area and trabecular thickness, and decrease the trabecular number.
Objective To study the effect of Shengguzaizaosan on experimental fracture healing. Methods Thirty six-month-old Chinchilla rabbits were made the models with 3 mm bone defect in the middle of two-side radius and were divided randomly into 3 groups: Shengguzaizaosan group(group A, n=10), Xianlinggubao group(groupB, n=10) and control group(group C, n=10). Five rabbits were sacrificed 14 days and31 days after operation respectively. The double marks with tetracyslin hydrochloride were given on the 4th day and the 5th day for the first mark and on the 11th day and the 12th day for the second mark in the rabbits sacrificed 14 days later,and on the 20th day and the 21st day for the first mark and on the 28th day andthe 29th day for the second mark in the rabbits sacrificed 31 days later. The samples were taken to make the bone histomorphometry study. Results When compared group A with group C, there were significant differences(P＜0.01) in osteoid area density, osteoid mean width, active osteoblastic surface, mineralization surface and dynamic parameters after 14 days,and in mean width of mineralization callus, active osteoblastic surface and mean depth of lacunae after31 days. There was a approximate effect between group B and group C. when compared group B with group A, there were significant differences(P＜0.05) in osteoclastic index,mineralization surface,bone formation rate after 14 days, and in osteoid surface,mean depth of lacunae and bone formation rate after 31 days. Conclusion Shengguzaizaosan can increase osteoid,accelerate mineralization rate and bone formation rate, and reduce mineralization lag time at early period of fracture. It can increase mineralization calluswidth and resorption of osteoclast at later period of fracture. To some extent, shengguzaizaosan can accelerate the experimental fracture healing.