| Part 1 Mapping knowledge domains analysis of Neuroprotective agent in strokeObjective: To systematically organize the literature regarding the neuroprotective agent in the treatment of stroke,to reveal the development in stroke-neuroprotective agent field,clearly and accurately reveal the knowledge structure,hot spots and development trend.Methods:Searching the literature on the field of stroke-neuroprotective agents in 2005-2018 based on Web of Science Core Collection database.The document type of Review&Article and the language of “English” were selected.The Citespace III software and the literature statistical tools provided in the WOS database were used for statistical analysis and drawing knowledge domains map,VOSviewer software was used for cluster analysis and hotspot analysis.Results:A total of 1990 articles related to the field of stroke-neuroprotective agents were retrieved from 2005-2018 on WOS Core Collection database.There were a slow upward trend in the field of stroke-neuroprotective agents in global.The quantity and quality of the literature in this field in the United States was much higher than that of other countries.The international influence of Chinese literature was a little weak,cooperation between European countries was relatively close and other countries was less.The main research institutions were universities,it was showed close comparison among institutions with obvious regional distribution characteristics.Cluster analysis results of highly cited literature showed that there were mainly four clusters,which focus on the study of the physiological mechanism of stroke and brain injury,the study of alteplase in the treatment of acute ischemic stroke and the development of neuroprotective agents,studies of neuroprotective agents NXY-059,and other interventions for the treatment of acute ischemic stroke.Key words co-occurrence and cluster analysis showed that the hotspots mainly focus on the study of cerebral ischemia in 2005-2018,the establishment of rat cerebral ischemia model was important.The physiological mechanism of apoptosis,oxidative stress and inflammatory response disease was a hot spot of neuroprotective strategy.The hotspots changed over time.Burst analysis shows that the neuroprotective strategy against inflammatory response may become the future research direction.Conclusion: Up to now,the exploration regarding the neuroprotective agents is still in process.The research of neuroprotective agents is still deepening and the attention is getting higher.The physiological mechanisms of apoptosis,oxidative stress and inflammatory response are the current development direction of neuroprotective agents.Part 2 Network Meta-analysis of Neuroprotective Agents for Improving Neurological Function on Acute Ischemic StrokeObjective: To systematic evaluation the effects of five neuroprotective agents improving the neurological function on acute ischemic stroke.Methods: The database of Pub Med/Medline,Embase,Web of Science,Siomed,CNKI,Wanfang database and QVIP were researched.Randomized controlled trials on improving neurological function in acute ischemic stroke of edaravone,butylphthalide,monosialoganglioside,citicoline,and vinpocetine was collected.The quality of the literatures that met the inclusion and exclusion criteria were evaluated and the network Meta-analysis was performed by R software.Results: A total 52 documents were included,involved 4903 patients.Network Meta-analysis showed that compared with the basic treatment,edaravone and monosialoganglioside displayed significant effects on the improvement of neurological function and the improvement of daily living ability,there was no statistical difference between them.The results showed that butylphthalide could improve the neurological function to a certain extent,whereas the improvement of daily living ability was weak.Butylphthalide sodium chloride injection was slightly better than butylphthalide soft capsule,but there was no statistical difference between them.Vinpocetine showed a weaker improvement in neurological function and improvement of daily living ability,there is no statistical difference compared to basic treatment.There was no statistical difference between citicoline and basic treatment.The comparison between neuroprotective agents,the degree of improvement of neurological function by different neuroprotective agents was basically no statistical difference.Conclusion: Edaravone and gangliosides had a better effect on the improvement of neurological function in acute cerebral infarction,followed by butylphthalide;vinpocetine and citicoline were not effective.The five neuroprotective agents included could improve the neurological function in a short period of time,but the overall efficacy was not significant.The high-quality head-to-head studies were needed to further verify the results. |
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