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 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 relationship between the level of serum-insulin like growth factor-1( IGF-1) and the nut ritional status of cancerous cachexia. Methods Colon cancer CT-26 cells were implanted subcutaneously to 30 liver2specified IGF-1 gene deleted (L ID) C57BL/ 6 mice to establish cancerous cachexia model and theother 30 C57BL/ 6 mice were included as cont rol group. The serum levels of IGF-1 , cytokine TNF-αand IL-6 , bloodglucose , albumin and t riglyceride were detected respectively on day 14 , 18 and 22 af ter the plantation of tumor. Thebody weight of mice , tumor weight and the weight af ter tumor removed in two group s were measured respectively.Results Af ter the plantation , the levels of IGF-1 in L ID group at different times were all significantly lower thanthose in cont rol group ( Plt; 0. 05) . The serum levels of TNF-α, IL-6 , blood glucose and t riglyceride were ascendinggradually over time ( Plt; 0. 05) , but weight s af ter tumor removed and the level of albumin were descending in twogroup s ( Plt; 0. 05) . Compared with the cont rol group , the serum levels of IL-6 , TNF-α, blood glucose and t riglyceride in L ID tumor-bearing mice were all significantly higher at different time point s ( P lt; 0. 05) . On day 18 and 22 ,the weight s af ter tumor removed and the amount of ingestion in L ID group were significantly lower than those in thecont rol group ( Plt; 0. 05) . Conclusion Compared with the low level of IGF-1 in cancerous cachexia , normal level ofserum IGF-1 may represent lower degree of cancerous cachexia2related cytokines and better nut ritional state , whichmay provide a novel idea of the therapy of cancerous cachexia.
Objective To study the protective effect of exogenous matrix metalloproteinases9(MMP-9) inhibitor Doxycycline against lung injury during cardiopulmonary bypass(CPB) in dogs. Methods Twenty healthy mongrel puppies(weighed 10 -12 kg) were divided into control group (n=10) and experimental group(n=10) with random number table. In control group, no measure was taken to protect lung before and after CPB. In experimental group, the feeding food was mixed with Doxycycline (30 mg/kg, body weight) daily for three days before operation. Enzymelinked immunosorbent assay(ELISA) was used to measure the plasma concentration of MMP-9. Hemodynamic and respiratory parameters in two groups were monitored. The preoperative and postoperative alveolararterial oxygen partial pressure difference (A-aDO2) and respiratory index(RI) were calculated. The myeloperoxidase（MPO）activity of bronchoalveolar lavage fluid（BALF）was determined by colorimetry. The total protein of BALF was measured by Coomassie Brilliant Blue G-250. After CPB, light microscope and electronic microscope were used to observe the morphological changes of lung tissue. The dry to wet weight index(W/D) was calculated. Results In both groups, the plasma concentrations of MMP-9 increased significantly as the time of CPB prolonged. The plasma MMP-9 at 150 min and 270 min after CPB in experimental group decreased significantly than those in control group (9.45±5.29 [CM(159mm]ng/ml vs. 18.66±5.90 ng/ml,t=3.664, P=0.005;16.63±2.90 ng/ml -vs.26.17±5.96 ng/ml, t=5.216, P=0.001). MPO activity, total protein of BALF, W/D, postoperative A-aDO2 and RI in experimental group decreased significantly than those in control group. There were significant differences between two groups（t=5.622,P=0.000; t=5.081, P=0.001; t=2.266, P=0.050; t=4.927, P=0.001; t=6.679,P=0.000）. The lung histopathology and electronic microscope showed that the lung injury reduced significantly. Conclusion Doxycycline plays a role in lung protection by inhibiting the secretion of MMP9, reducing the degradation of cell basement membrane, pulmonary neutrophil infiltration and pulmonary edema. Key words: Cardiopulmonary bypass; Acute lung injury; Matrix metalloproteinase; Doxycycline; Lung protection
Objective To investigate the operative characteristic and results of the modified Fontan procedure, and improve the application of Fontan procedure in the clinic. Methods From Sep. 1992 to June 2006, 77 cases (aged 2.5 years to 20.0 years) with a wide range of complicated congenital heart diseases underwent the modified Fontan procedure.Right atriumpulmonary artery connection were performed in 21 cases, intraatrium fenestrated baffle or conduit total cavopulmonary connection were performed in 28 cases, extracardiac conduit total cavopulmonary connection were performed in 24 cases, atrium wall lateral tunnel total cavopulmonary anastomosis were performed in 2 cases, extracardiac pericardialtube total cavopulmonary anastomosis was performed in 1 case, and extracardiac direct total cavopulmonary connection was performed in 1 case. Results In early postoperative period, there were 1 case of successful reoperation and 5 death, the cause of death were heart failure (3 cases), arrhythmia (1 case) and cerebral hemorrhage (1 case). The early survival rate was 93.5%(72/77), with 92.0% free from failure. The eject fractions of left ventricle (LVEF) after operation were increased than those before operation （68.5%±4.0% vs.62.0%±4.5%,P=0.032） and left ventricular enddiastolic diameter (LVEDD) were decreased than those before operation （52.5±7.8mm vs.62.5±11.0mm, P=0.013）. A total of 63 cases (87.5%) were followed up from 1 to 15 years after operation. In late postoperative period, there were 4 cases of death, and 1 of successful re-operation. Late survival rate was 88.3%, with 86.0% free from failure. Conclusion In the treatment for complicated congenital heart diseases, the modified Fontan procedure could result in good early and longterm outcome, and the choices for surgical procedure are various.
ObjectiveTo understand the current situation and challenges of basic research on respiratory diseases in China.MethodsTo summarize and analyze the application and projects funded in the field of respiratory medicine (Code: H01 and H1615) from National Natural Science Foundation of China (NSFC) during 2010 to 2017.ResultsA total of 2 191 projects of 11 766 applications were funded by NSFC in the field of respiratory medicine and the total subsidy fund reached ￥981 279 000. A total of 1 130 projects of 5 915 applications were funded in the Research Projects, including 1 021 General Program projects, 14 Key Program projects, 16 Major Research Plan projects, 1 Major Research Program project, 2 Program projects of Joint Funds, 30 International (Regional) Cooperation and Exchange Program projects, and 46 Emergency Management Program projects. A total of 1 061 projects of 5 851 applications were funded in the Talent Projects, including 853 Young Scientists Fund projects, 191 projects of Fund for Less Developed Regions, 4 projects of Distinguished Young Scholars, 4 projects of Excellent Young Scientists Fund, and 9 projects of the Research Fund for International Young Scientists. The projects funded were mainly distributed in the field of respiratory inflammation and infection, asthma, chronic obstructive pulmonary disease, pulmonary circulation and pulmonary vascular disease. The top three research directions were asthma (19.0%), acute lung injury and acute respiratory distress syndrome (15.4%), chronic obstructive pulmonary disease (12.7%), pulmonary circulation and pulmonary vascular disease (12.7%) in sequence. Average funding rate of respiratory tumor (application code: H1615) was 17.2%.ConclusionsSince the Department of Health Science of NSFC was established in 2009, with the increasing of NSFC budget, the basic research in the field of Respiratory Medicine has been developed rapidly. With the efforts of scientific researchers and clinical medical workers, research in the field of respiratory medicine will achieve rapid development in China.
This paper introduces the application and funding of evidence-based research projects on traditional Chinese medicine (TCM) of the National Natural Science Foundation of China (NSFC) in 2019 in terms of clinical research and methodology research, summarizes the primary problems existing in evidence-based research on TCM, discusses the quality of evidence-based research on TCM in clinical research, highlights the characteristics of TCM and reveals the evidence-based methodology on TCM.
Objective To explore the management practices of projects supported by National Natural Science Foundation in a large general hospital. Methods We carried out an overall analysis on the data of projects supported by National Natural Science Foundation of China from 2011 to 2016 in West China Hospital of Sichuan University. The characteristics of researchers who were granted the foundation were also studied. Results In the recent six years, there were 767 projects granted by the National Natural Science Foundation in the hospital, with an average of 127 projects a year. The Department of Medical Sciences was the top source of approval for the projects (690 items), and its granted projects covered all the categories set by the foundation committee. Most of the researchers who got the fund were between 25 and 40 years of age (501 projects). Researchers in charge of general projects were mainly professors with an age of (43.54±7.28) years old in average. Researchers in charge of Projects for Distinguished Young Scholars were mainly of medium-grade professional titles, and their average age was (32.01±3.05) years old. Moreover, among these young scholars, the age of male researchers [(31.27±2.23) years old] was significantly younger than that of female scholars [(32.90±3.62) years old](P<0.01). Conclusion It is more and more important for National Natural Science Foundation of China to study the accumulation of early research of young scholars and the leading role of the hospital in basic research, personnel training and discipline construction.
Objectives To analyze evidence-based medicine (EBM) related projects funded by National Natural Science Foundation of China (NSFC) from 2000 to 2019. Methods The online NSFC database, Internet-based Science Information System, Biomart.cn, and MedSci.com were searched to obtain all EBM grants funded by NSFC. The achievements, Chinese papers and SCI-indexed papers, were obtained by searching the database of CNKI, VIP, SinoMed, WanFang Data and Web of Science. All data screened and extracted manually, and then managed and analyzed with Microsoft Excel 2016 software. Results The NSFC has funded 94 projects regarding EBM, with a total amount of 44.763 million Yuan (RMB) since 2000. Beijing, Shanghai, Guangdong and Sichuan ranked highly in the number of projects and their undertaking institutions and total amount of fundings. General programs and youth scientist programs constituted the main parts of fundings. The funded projects mainly originated from three subjects of new technologies and methods of TCM, health management and policy, clinical basis of integrated Chinese and western medicine. General programs contributed the most articles, while the distinguished young scientist programs had the highest average outputs. Three papers from Chinese EBM Center were published on BMJ and were highly cited. Conclusions Support of NSFC on EBM has increased continuously for the last twenty years, but it is still below the average. The fundings are unbalanced in areas and institutions. The supported research fields change every year, and show a trend of subjects aggregation.