The incidence of papillary thyroid carcinoma(PTC)has exponentially increased in recent years.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of the reported cases of PTC.The debates and crucial issues ...The incidence of papillary thyroid carcinoma(PTC)has exponentially increased in recent years.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of the reported cases of PTC.The debates and crucial issues in PTMC management have received researchers'attention.To further improve the clinical management of PTMC in China,展开更多
Chronic pancreatitis(CP)is a progressive inflammatory disease of pancreas that alters the organ’s normal structure and functions.CP seriously affects the quality of life of patients and greatly increases the public m...Chronic pancreatitis(CP)is a progressive inflammatory disease of pancreas that alters the organ’s normal structure and functions.CP seriously affects the quality of life of patients and greatly increases the public medical burden of society.In recent years,the incidence of CP has increased worldwide.The concepts of etiology and therapies have been continuously updated.展开更多
Background: This document includes recommendations and guidelines issued by a group of Mexican researchers and specialists gathered in the First National Colloquium for the Diagnosis and Management of Chronic Myeloid ...Background: This document includes recommendations and guidelines issued by a group of Mexican researchers and specialists gathered in the First National Colloquium for the Diagnosis and Management of Chronic Myeloid Leukaemia (CML) by initiative of Instituto Nacional de Cancerología and with the support of the Leukaemia Department of the MD Anderson Cancer Center. Mexico lacks of updated information taken from its own reality on the diagnosis and treatment of CML and other haematological disorders;besides, there are no national guidelines. Aim: To publish a consensus document with guidelines for the management of CML adjusted to the national environment and overall characteristics. Method: The participants answered a DELPHI questionnaire about the overall aspects of the disease, aiming to target controversial topics, discuss them in the colloquium, and to agree on the best ones. After those meetings, a final document was drawn up. Results: The group presents recommendations for definition, diagnosis, prognosis, monitoring, and treatment of CML in Mexico. Conclusions: Having consensus guidelines for the clinical management of CML in our country will enable the consensual practice of Mexican specialists regarding the clinical approach to CML, as well as optimize the resources which allow the rational planning of the medical care strategies.展开更多
Background and Aims:The hepatitis E virus(HEV)is a zoonotic disease,and infection with HEV in humans primarily causes acute infections and can progress to chronic manifestation in immunocompromised individuals.Over th...Background and Aims:The hepatitis E virus(HEV)is a zoonotic disease,and infection with HEV in humans primarily causes acute infections and can progress to chronic manifestation in immunocompromised individuals.Over the past decade,guidelines for diagnosing and treating HEV infection have been developed.This study aimed to systematically assess the quality of current guidelines for diagnosing and treating HEV infection,and we analyzed the differences in guideline quality and primary recommendations and explored possible reasons for these differences.Methods:Guidelines published between 2013 and 2022 were searched,and studies were identified using selection criteria.The study assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation tool,extracted the primary recommendations in the guidelines,determined the highest level of evidence supporting the recommendations,and reclassified the evidence using the Oxford Centre for Evidence-Based Medicine grading system.Results:Seven guidelines were included in the final analysis.The quality of the guidelines varied widely.The discrepancies may have been caused by the lack of external experts,the failure to consider influencing factors in guideline application,and the lack of consideration of the public’s opinion.Analysis of the heterogeneity in primary recommendations revealed differences in algorithms for managing chronic HEV infection,the dosage of ribavirin,and a low level of evidence supporting the primary recommendations.Conclusions:Guideline quality and primary recommendations vary considerably.Refinement by guideline developers and researchers would facilitate updating and applying guidelines for diagnosing and treating HEV infection.展开更多
Non-specific orbital inflammation(NSOI)is a noninfectious orbital inflammation.Although it is often considered the most common diagnosis in orbital biopsies,it is an exclusionary diagnosis that requires ruling out sys...Non-specific orbital inflammation(NSOI)is a noninfectious orbital inflammation.Although it is often considered the most common diagnosis in orbital biopsies,it is an exclusionary diagnosis that requires ruling out systemic disease or other possible causes.Its characteristics include acute orbital signs and symptoms,including pain,proptosis,periorbital edema,chemosis,diplopia,and visual impairment.The clinical manifestations and histological findings of NSOI are heterogeneous,without specific diagnostic criteria or treatment guidelines,which poses significant challenges for diagnosis and treatment.This guideline provides a detailed description of the definition,classification,diagnosis,and treatment of NSOI.展开更多
To improve the diagnosis and treatment of inflammatory breast cancer(IBC),the Chinese Society of Breast Surgery(CSBrS)of the Chinese Medical Association identified the key clinical issues for clinical practice guideli...To improve the diagnosis and treatment of inflammatory breast cancer(IBC),the Chinese Society of Breast Surgery(CSBrS)of the Chinese Medical Association identified the key clinical issues for clinical practice guidelines through literature research and evaluated the relevant evidence with reference to the Grading of Recommendations Assessment,Development and Evaluation(GRADE).[1]Level of evidence standard and recommendation strength criteria are shown in previous publication.[2]Recommendation strength review committee was comprised of 31 members and all the members are breast surgeons.The target audience are Chinese breast disease specialists.The recommendation is shown in Table 1.展开更多
Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The ...Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.展开更多
With the advancement of medical research in recent years and the frequent occurrence of different types of cancer, breast cancer has gradually attracted the public’s attention. The incidence of breast cancer is risin...With the advancement of medical research in recent years and the frequent occurrence of different types of cancer, breast cancer has gradually attracted the public’s attention. The incidence of breast cancer is rising, mainly affecting women with a high mortality rate. According to the clinical treatment effect, early diagnosis and early treatment can effectively control the mortality of breast cancer and improve patient’s quality of life. Ultrasound radiomics is an emerging field that can extract quantitative high-dimensional data from ultrasound images. Recently, ultrasound radiomics has been widely used in the clinical treatment of breast cancer. This paper analyzed the research progress of ultrasound radiomics in the diagnosis and treatment of breast cancer.展开更多
BACKGROUND Gastrointestinal tumors are a major cause of cancer-related deaths and have become a major public health problem.This study aims to provide a scientific basis for improving clinical treatment effects,qualit...BACKGROUND Gastrointestinal tumors are a major cause of cancer-related deaths and have become a major public health problem.This study aims to provide a scientific basis for improving clinical treatment effects,quality of life,and prognosis of patients with gastrointestinal tumors.AIM To explore the clinical effect of the multidisciplinary diagnosis and treatment(MDT)nutrition intervention model on patients with gastrointestinal tumors.METHODS This was a case control study which included patients with gastrointestinal tumors who received radiotherapy at the Department of Oncology between January 2021 and January 2023.Using a random number table,120 patients were randomly divided into MDT and control groups with 60 patients in each group.To analyze the effect of MDT on the nutritional status and quality of life of the patients,the nutritional status and quality of life scores of the patients were measured before and after the treatment.RESULTS Albumin(ALB),transferrin(TRF),hemoglobin(Hb),and total protein(TP)levels significantly decreased after the treatment.The control group had significantly lower ALB,TRF,Hb,and TP levels than the MDT group,and the differences in these levels between the two groups were statistically significant(P<0.05).After the treatment,the MDT group had significantly more wellnourished patients than the control group(P<0.05).The quality of life total score,somatic functioning,role functioning,and emotional functioning were higher in the MDT group than in the control group.By contrast,pain,fatigue,nausea,and vomiting scores were lower in the MDT group than in the control group(P<0.05).CONCLUSION MDT nutritional intervention model effectively improves the nutritional status and quality of life of the patients.The study provides a rigorous theoretical basis for improving the prognosis of cancer patients.In the future,we intend to provide additional treatment methods for improving the quality of life of patients with cancer.展开更多
Breast cancer has surpassed lung cancer to become the most common malignancy worldwide.The incidence rate and mortality rate of breast cancer continue to rise,which leads to a great burden on public health.Circular RN...Breast cancer has surpassed lung cancer to become the most common malignancy worldwide.The incidence rate and mortality rate of breast cancer continue to rise,which leads to a great burden on public health.Circular RNAs(circRNAs),a new class of noncoding RNAs(ncRNAs),have been recognized as important oncogenes or suppressors in regulating cancer initiation and progression.In breast cancer,circRNAs have significant roles in tumorigenesis,recurrence and multidrug resistance that are mediated by various mechanisms.Therefore,circRNAs may serve as promising targets of therapeutic strategies for breast cancer management.This study reviews the most recent studies about the biosynthesis and characteristics of circRNAs in diagnosis,treatment and prognosis evaluation,as well as the value of circRNAs in clinical applications as biomarkers or therapeutic targets in breast cancer.Understanding the mechanisms by which circRNAs function could help transform basic research into clinical applications and facilitate the development of novel circRNA-based therapeutic strategies for breast cancer treatment.展开更多
Background Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awarenes...Background Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treat-ments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed. Methods National Health Commission of China assembled an expert committee for a revision of the guidelines. The com-mittee included 33 members who are specialized in diagnosis and treatment of HFMD. Results Early recognition of severe cases is utmost important in diagnosis and treatment of patients with HFMD. The key to diagnosis and treatment of severe cases lies in the timely and accurate recognition of stages 2 and 3 of HFMD, in order to stop progression to stage 4. Clinicians should particularly pay attention to those EV-A71 cases in children aged less than 3 years, and those with disease duration less than 3 days. The following indicators should alert the clinician of possible deterioration and impending critical disease: (1) persistent hyperthermia;(2) involvement of nervous system;(3) worsening respiratory rate and rhythm;(4) circulatory dysfunction;(5) elevated peripheral WBC count;(6) elevated blood glucose and (7) elevated blood lactic acid. For treatment, most mild cases can be treated as outpatients. Patients should be isolated to avoid cross-infection. Intense treatment modalities should be given for those severe cases. Conclusion The guidelines can provide systematic guidance on the diagnosis and management of HFMD.展开更多
In this editorial,we comment on an article by Xu et al.This article describes a case of crawling-type gastric adenocarcinoma(CRA)distinguished by its rare occurrence and diagnostic complexity.We reviewed the detailed ...In this editorial,we comment on an article by Xu et al.This article describes a case of crawling-type gastric adenocarcinoma(CRA)distinguished by its rare occurrence and diagnostic complexity.We reviewed the detailed case-report findings showcasing clinical,pathological,and molecular characteristics of CRA that shed light on its elusive nature and challenges for early detection and treatment.This case underscored the significance of advanced diagnostic tools such as endoscopic submucosal dissection.Emphasis was placed on the molecular peculiarities of CRA,including the higher mutation rates of genes such as TP53 and RHOA and the notable absence of HER2 amplification,differentiating it from more conventional forms of gastric adenocarcinoma.In this editorial,we advocate for a multidisciplinary approach to effectively manage this rare subtype and highlight the necessity for precision in both diagnostic and therapeutic strategies.Moreover,a heightened awareness urging the adoption of advanced diagnostic techniques and collaborative approaches is necessary among clinicians and researchers.We aim to contribute to the ongoing discourse in gastrointestinal oncology,emphasizing the importance of recognizing and addressing the complexities associated with rare cancer subtypes such as CRA.展开更多
As peer reviewers of the World Journal of Gastroenterology,our weekly routine involves immersing ourselves in the newly published issue,particularly focusing on the realm of colorectal cancer(CRC)research.We diligentl...As peer reviewers of the World Journal of Gastroenterology,our weekly routine involves immersing ourselves in the newly published issue,particularly focusing on the realm of colorectal cancer(CRC)research.We diligently sift through various contributions,ranging from comprehensive reviews to original articles and other scholarly works.Through meticulous examination,we discern the most notable papers,delving into each with careful scrutiny to distill their merits and shortcomings.Undoubtedly,this undertaking demands considerable time and effort.Yet,it stands as an indispensable pursuit,affording us a profound comprehension of the latest breakthroughs in CRC research.Moreover,these meticulously curated selections furnish readers with invaluable resources,serving as enduring references for the nuanced exploration of this dynamic field.展开更多
Behçet's disease(BD)is a chronic inflammatory disorder prone to frequent re-currences,with a high predilection for intestinal involvement.However,the ef-ficacy and long-term effects of surgical treatment for ...Behçet's disease(BD)is a chronic inflammatory disorder prone to frequent re-currences,with a high predilection for intestinal involvement.However,the ef-ficacy and long-term effects of surgical treatment for intestinal BD are unknown.In the current issue of World J Gastrointest Surg,Park et al conducted a retrospec-tive analysis of 31 patients with intestinal BD who received surgical treatment.They found that elevated C-reactive protein levels and emergency surgery were poor prognostic factors for postoperative recurrence,emphasizing the adverse impact of severe inflammation on the prognosis of patients with intestinal BD.This work has clinical significance for evaluating the postoperative condition of intestinal BD.The editorial attempts to summarize the clinical diagnosis and treatment of intestinal BD,focusing on the impact of adverse factors on surgical outcomes.We hope this review will facilitate more precise postoperative management of patients with intestinal BD by clinicians.展开更多
Introduction: Congenital optic disc anomalies in children refer to structural variations of the optic nerve head present from birth. These deformations involve the size, shape, color, and vessels of the optic disc. Al...Introduction: Congenital optic disc anomalies in children refer to structural variations of the optic nerve head present from birth. These deformations involve the size, shape, color, and vessels of the optic disc. Although often asymptomatic, these anomalies can impact the visual development of the child, underscoring the importance of a thorough fundus examination for early detection and appropriate medical follow-up. We present two cases of congenital optic disc anomalies in children, illustrating the diagnostic challenges and complexity of their management. Case 1: A 3-year-old girl presented with a white spot in her left eye present since birth. Uncorrected distance visual acuity was 2/10 in the right eye, while she could perceive hand movements at 2 meters with the left eye. Normal examination in the right eye showed leukocoria, microphthalmia, and a white mass at the center of the optic disc on fundus examination in the left eye. Ocular imaging, including ultrasound and optical coherence tomography (OCT), confirmed the diagnosis of persistent hyperplastic primary vitreous (PHPV) in its mixed form in the left eye. Management included prescribing full optical correction and functional rehabilitation, without resorting to surgery. The course was marked by persistent amblyopia leading to a poor prognosis. Case 2: A 7-year-old girl consulted for vision disturbance in her right eye. Visual acuity was finger counting at 2 meters in the right eye and 10/10 in the left eye. Anterior segment examination revealed no abnormalities in both eyes. However, fundus examination highlighted a large funnel-shaped excavation associated with central glial proliferation, wheel spoke vessels, and neuroretinal ring atrophy in the right eye. Optical coherence tomography (OCT) of the right eye confirmed the diagnosis of isolated unilateral Morning Glory syndrome. Management included full optical correction and orthoptic rehabilitation. The course was marked by the absence of ocular complication and maintenance of visual stability in the right eye. The prognosis seemed favorable. Conclusion: Congenital optic disc anomalies in children exhibit great clinical variability and require an individualized diagnostic and therapeutic approach.展开更多
Road transportation plays a crucial role in society and daily life,as the functioning and durability of roads can significantly impact a nation's economic development.In the whole life cycle of the road,the emerge...Road transportation plays a crucial role in society and daily life,as the functioning and durability of roads can significantly impact a nation's economic development.In the whole life cycle of the road,the emergence of disease is unavoidable,so it is necessary to adopt relevant technical means to deal with the disease.This study comprehensively reviews the advancements in computer vision,artificial intelligence,and mobile robotics in the road domain and examines their progress and applications in road detection,diagnosis,and treatment,especially asphalt roads.Specifically,it analyzes the research progress in detecting and diagnosing surface and internal road distress and related techniques and algorithms are compared.In addition,also introduces various road gover-nance technologies,including automated repairs,intelligent construction,and path planning for crack sealing.Despite their proven effectiveness in detecting road distress,analyzing diagnoses,and planning maintenance,these technologies still confront challenges in data collection,parameter optimization,model portability,system accuracy,robustness,and real-time performance.Consequently,the integration of multidisciplinary technologies is imperative to enable the development of an integrated approach that includes road detection,diagnosis,and treatment.This paper addresses the challenges of precise defect detection,condition assessment,and unmanned construction.At the same time,the efficiency of labor liberation and road maintenance is achieved,and the automation level of the road engineering industry is improved.展开更多
Acute pancreatitis(AP)is a common acute abdominal condition of the digestive system.In recent years,treatment concepts,methods,and strategies for the diagnosis of AP have advanced,and this has played an important role...Acute pancreatitis(AP)is a common acute abdominal condition of the digestive system.In recent years,treatment concepts,methods,and strategies for the diagnosis of AP have advanced,and this has played an important role in promoting the standardization of AP diagnosis and treatment and improving the treatment quality of AP patients.On the basis of previous guidelines and expert consensus,this guideline adopts an evidence-based,problem-based expression;synthesizes important clinical research data at home and abroad in the most recent 5 years;and forms 29 recommendations through multidisciplinary expert discussion,including diagnosis,treatment,and follow-up.It is expected to provide evidence support for the treatment of AP in the clinical setting in China.展开更多
Rosacea is a chronic inflammatory skin disease that primarily affects the centrofacial areas and mainly manifests as recurrent flushing and erythema.In recent years,there has been progress in the understanding of the ...Rosacea is a chronic inflammatory skin disease that primarily affects the centrofacial areas and mainly manifests as recurrent flushing and erythema.In recent years,there has been progress in the understanding of the diagnosis and treatment of rosacea.Therefore,a group of dermatological experts updated the guidelines based on the 2016 expert consensus statement on rosacea diagnosis and treatment in China.These new guidelines propose diagnostic criteria for rosacea at different sites to further standardize the diagnosis and treatment of rosacea in China.展开更多
Contents1. Overview2. Risk factors for urothelial carcinoma of bladder3. Diagnosis of urothelial carcinoma of bladder3.1 Signs and symptoms of urothelial carcinoma of bladder3.1.1 Symptoms3.1.2 Signs3.2 Imaging examin...Contents1. Overview2. Risk factors for urothelial carcinoma of bladder3. Diagnosis of urothelial carcinoma of bladder3.1 Signs and symptoms of urothelial carcinoma of bladder3.1.1 Symptoms3.1.2 Signs3.2 Imaging examination3.2.1 Ultrasonography3.2.2 CT examination3.2.3 MRI examination3.2.4 IVU3.2.5 Chest plain X-ray film/CT plain scan3.2.6 Bone scintigraphy3.2.7 Positron emission tomography-CT (PET-CT).展开更多
Psoriasis is an immune-mediated chronic,recurrent,systemic inflammatory disease induced by the combination of hereditary and environmental factors.The etiology of psoriasis involves hereditary,immune,environmental,and...Psoriasis is an immune-mediated chronic,recurrent,systemic inflammatory disease induced by the combination of hereditary and environmental factors.The etiology of psoriasis involves hereditary,immune,environmental,and other factors,and its pathogenesis is considered to involve excessive proliferation of keratinocytes or inflammatory activation of synovial cells and chondrocytes within joints;these processes are caused by an immune response that is mainly mediated by T lymphocytes and various other immune cells.Psoriasis is an incurable disease,and the goal of treatment is to control the progression of disease and maintain long-term efficacy.Treatment protocols should be based on the patients’conditions.Patients with mild psoriasis can be mainly treated with topical agents,and those with moderate to severe psoriasis can be treated with systemic medications.Targeted biological agents can be appropriately chosen for cases of psoriasis that are resistant to traditional systemic treatment.New drugs and treatments for psoriasis continue to evolve and emerge,and our updated guidelines are designed to deliver new achievements from China and physicians worldwide and to keep pace with global progress on psoriasis research.Compared with the previous two editions,part of contents have been modified and revised in the present guidelines;this will further facilitate standardization and increase the efficiency of the diagnosis and treatment of psoriasis in China,and improve patients’quality of life.展开更多
文摘The incidence of papillary thyroid carcinoma(PTC)has exponentially increased in recent years.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of the reported cases of PTC.The debates and crucial issues in PTMC management have received researchers'attention.To further improve the clinical management of PTMC in China,
文摘Chronic pancreatitis(CP)is a progressive inflammatory disease of pancreas that alters the organ’s normal structure and functions.CP seriously affects the quality of life of patients and greatly increases the public medical burden of society.In recent years,the incidence of CP has increased worldwide.The concepts of etiology and therapies have been continuously updated.
文摘Background: This document includes recommendations and guidelines issued by a group of Mexican researchers and specialists gathered in the First National Colloquium for the Diagnosis and Management of Chronic Myeloid Leukaemia (CML) by initiative of Instituto Nacional de Cancerología and with the support of the Leukaemia Department of the MD Anderson Cancer Center. Mexico lacks of updated information taken from its own reality on the diagnosis and treatment of CML and other haematological disorders;besides, there are no national guidelines. Aim: To publish a consensus document with guidelines for the management of CML adjusted to the national environment and overall characteristics. Method: The participants answered a DELPHI questionnaire about the overall aspects of the disease, aiming to target controversial topics, discuss them in the colloquium, and to agree on the best ones. After those meetings, a final document was drawn up. Results: The group presents recommendations for definition, diagnosis, prognosis, monitoring, and treatment of CML in Mexico. Conclusions: Having consensus guidelines for the clinical management of CML in our country will enable the consensual practice of Mexican specialists regarding the clinical approach to CML, as well as optimize the resources which allow the rational planning of the medical care strategies.
基金supported by The National Natural Science Foundation of China(82360108 to YMT)Medicine Leading Talents of Yunnan Province(L-2019013 to YMT)+3 种基金The Yunnan Wanren Project(YNWR-MY-2018-028 to YMT)The Chen Jie Expert Workstation of Yunnan Province(202305AF150065 to YMT)Clinical Research Project of the Second Affiliated Hospital of Kunming Medical University(2020ynlc010,yn1IT2021017 to YMT)China Liver Health—Special project of prevention and treatment of hepatitis E(CLH2023-FHEV-08 to YMT).
文摘Background and Aims:The hepatitis E virus(HEV)is a zoonotic disease,and infection with HEV in humans primarily causes acute infections and can progress to chronic manifestation in immunocompromised individuals.Over the past decade,guidelines for diagnosing and treating HEV infection have been developed.This study aimed to systematically assess the quality of current guidelines for diagnosing and treating HEV infection,and we analyzed the differences in guideline quality and primary recommendations and explored possible reasons for these differences.Methods:Guidelines published between 2013 and 2022 were searched,and studies were identified using selection criteria.The study assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation tool,extracted the primary recommendations in the guidelines,determined the highest level of evidence supporting the recommendations,and reclassified the evidence using the Oxford Centre for Evidence-Based Medicine grading system.Results:Seven guidelines were included in the final analysis.The quality of the guidelines varied widely.The discrepancies may have been caused by the lack of external experts,the failure to consider influencing factors in guideline application,and the lack of consideration of the public’s opinion.Analysis of the heterogeneity in primary recommendations revealed differences in algorithms for managing chronic HEV infection,the dosage of ribavirin,and a low level of evidence supporting the primary recommendations.Conclusions:Guideline quality and primary recommendations vary considerably.Refinement by guideline developers and researchers would facilitate updating and applying guidelines for diagnosing and treating HEV infection.
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)Jiangxi Double-Thousand Plan High-Level Talent Project of Science and Technology Innovation(No.jxsq2023201036)Key R&D Program of Jiangxi Province(No.20223BBH80014).
文摘Non-specific orbital inflammation(NSOI)is a noninfectious orbital inflammation.Although it is often considered the most common diagnosis in orbital biopsies,it is an exclusionary diagnosis that requires ruling out systemic disease or other possible causes.Its characteristics include acute orbital signs and symptoms,including pain,proptosis,periorbital edema,chemosis,diplopia,and visual impairment.The clinical manifestations and histological findings of NSOI are heterogeneous,without specific diagnostic criteria or treatment guidelines,which poses significant challenges for diagnosis and treatment.This guideline provides a detailed description of the definition,classification,diagnosis,and treatment of NSOI.
文摘To improve the diagnosis and treatment of inflammatory breast cancer(IBC),the Chinese Society of Breast Surgery(CSBrS)of the Chinese Medical Association identified the key clinical issues for clinical practice guidelines through literature research and evaluated the relevant evidence with reference to the Grading of Recommendations Assessment,Development and Evaluation(GRADE).[1]Level of evidence standard and recommendation strength criteria are shown in previous publication.[2]Recommendation strength review committee was comprised of 31 members and all the members are breast surgeons.The target audience are Chinese breast disease specialists.The recommendation is shown in Table 1.
基金supported by the National Natural Science Foundation of China,No.32130060(to XG).
文摘Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.
基金This paper is a science and technology project of Qingyang City,“Comparative Study of Different Parts of Daylily based on the Association of Composition,Antibacterial,and Antioxidant.”(No.:QY-STK-2022B-146)Research on the Effects of Carvacrol on Autophagy,Apoptosis and Invasion,and Migration of Triple-Negative Breast Cancer Cells and its Mechanism(No.:2021B-279)Research Results of the Innovation Fund Project of Gansu Provincial Universities“Study on Antioxidant Activity of Stem and Leaf Extracts of Daylily.”(No.2022A-129)。
文摘With the advancement of medical research in recent years and the frequent occurrence of different types of cancer, breast cancer has gradually attracted the public’s attention. The incidence of breast cancer is rising, mainly affecting women with a high mortality rate. According to the clinical treatment effect, early diagnosis and early treatment can effectively control the mortality of breast cancer and improve patient’s quality of life. Ultrasound radiomics is an emerging field that can extract quantitative high-dimensional data from ultrasound images. Recently, ultrasound radiomics has been widely used in the clinical treatment of breast cancer. This paper analyzed the research progress of ultrasound radiomics in the diagnosis and treatment of breast cancer.
文摘BACKGROUND Gastrointestinal tumors are a major cause of cancer-related deaths and have become a major public health problem.This study aims to provide a scientific basis for improving clinical treatment effects,quality of life,and prognosis of patients with gastrointestinal tumors.AIM To explore the clinical effect of the multidisciplinary diagnosis and treatment(MDT)nutrition intervention model on patients with gastrointestinal tumors.METHODS This was a case control study which included patients with gastrointestinal tumors who received radiotherapy at the Department of Oncology between January 2021 and January 2023.Using a random number table,120 patients were randomly divided into MDT and control groups with 60 patients in each group.To analyze the effect of MDT on the nutritional status and quality of life of the patients,the nutritional status and quality of life scores of the patients were measured before and after the treatment.RESULTS Albumin(ALB),transferrin(TRF),hemoglobin(Hb),and total protein(TP)levels significantly decreased after the treatment.The control group had significantly lower ALB,TRF,Hb,and TP levels than the MDT group,and the differences in these levels between the two groups were statistically significant(P<0.05).After the treatment,the MDT group had significantly more wellnourished patients than the control group(P<0.05).The quality of life total score,somatic functioning,role functioning,and emotional functioning were higher in the MDT group than in the control group.By contrast,pain,fatigue,nausea,and vomiting scores were lower in the MDT group than in the control group(P<0.05).CONCLUSION MDT nutritional intervention model effectively improves the nutritional status and quality of life of the patients.The study provides a rigorous theoretical basis for improving the prognosis of cancer patients.In the future,we intend to provide additional treatment methods for improving the quality of life of patients with cancer.
基金supported by the Basic and Applied Basic Research Foundation of Guangdong Province(2022A1515220184).
文摘Breast cancer has surpassed lung cancer to become the most common malignancy worldwide.The incidence rate and mortality rate of breast cancer continue to rise,which leads to a great burden on public health.Circular RNAs(circRNAs),a new class of noncoding RNAs(ncRNAs),have been recognized as important oncogenes or suppressors in regulating cancer initiation and progression.In breast cancer,circRNAs have significant roles in tumorigenesis,recurrence and multidrug resistance that are mediated by various mechanisms.Therefore,circRNAs may serve as promising targets of therapeutic strategies for breast cancer management.This study reviews the most recent studies about the biosynthesis and characteristics of circRNAs in diagnosis,treatment and prognosis evaluation,as well as the value of circRNAs in clinical applications as biomarkers or therapeutic targets in breast cancer.Understanding the mechanisms by which circRNAs function could help transform basic research into clinical applications and facilitate the development of novel circRNA-based therapeutic strategies for breast cancer treatment.
文摘Background Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treat-ments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed. Methods National Health Commission of China assembled an expert committee for a revision of the guidelines. The com-mittee included 33 members who are specialized in diagnosis and treatment of HFMD. Results Early recognition of severe cases is utmost important in diagnosis and treatment of patients with HFMD. The key to diagnosis and treatment of severe cases lies in the timely and accurate recognition of stages 2 and 3 of HFMD, in order to stop progression to stage 4. Clinicians should particularly pay attention to those EV-A71 cases in children aged less than 3 years, and those with disease duration less than 3 days. The following indicators should alert the clinician of possible deterioration and impending critical disease: (1) persistent hyperthermia;(2) involvement of nervous system;(3) worsening respiratory rate and rhythm;(4) circulatory dysfunction;(5) elevated peripheral WBC count;(6) elevated blood glucose and (7) elevated blood lactic acid. For treatment, most mild cases can be treated as outpatients. Patients should be isolated to avoid cross-infection. Intense treatment modalities should be given for those severe cases. Conclusion The guidelines can provide systematic guidance on the diagnosis and management of HFMD.
基金The Third Central Hospital of Tianjin,No.2019YNR3.
文摘In this editorial,we comment on an article by Xu et al.This article describes a case of crawling-type gastric adenocarcinoma(CRA)distinguished by its rare occurrence and diagnostic complexity.We reviewed the detailed case-report findings showcasing clinical,pathological,and molecular characteristics of CRA that shed light on its elusive nature and challenges for early detection and treatment.This case underscored the significance of advanced diagnostic tools such as endoscopic submucosal dissection.Emphasis was placed on the molecular peculiarities of CRA,including the higher mutation rates of genes such as TP53 and RHOA and the notable absence of HER2 amplification,differentiating it from more conventional forms of gastric adenocarcinoma.In this editorial,we advocate for a multidisciplinary approach to effectively manage this rare subtype and highlight the necessity for precision in both diagnostic and therapeutic strategies.Moreover,a heightened awareness urging the adoption of advanced diagnostic techniques and collaborative approaches is necessary among clinicians and researchers.We aim to contribute to the ongoing discourse in gastrointestinal oncology,emphasizing the importance of recognizing and addressing the complexities associated with rare cancer subtypes such as CRA.
基金Supported by The Shandong Province Medical and Health Science and Technology Development Plan Project,No.202203030713The Science and Technology Program of Yantai Affiliated Hospital of Binzhou Medical University,No.YTFY2022KYQD06。
文摘As peer reviewers of the World Journal of Gastroenterology,our weekly routine involves immersing ourselves in the newly published issue,particularly focusing on the realm of colorectal cancer(CRC)research.We diligently sift through various contributions,ranging from comprehensive reviews to original articles and other scholarly works.Through meticulous examination,we discern the most notable papers,delving into each with careful scrutiny to distill their merits and shortcomings.Undoubtedly,this undertaking demands considerable time and effort.Yet,it stands as an indispensable pursuit,affording us a profound comprehension of the latest breakthroughs in CRC research.Moreover,these meticulously curated selections furnish readers with invaluable resources,serving as enduring references for the nuanced exploration of this dynamic field.
文摘Behçet's disease(BD)is a chronic inflammatory disorder prone to frequent re-currences,with a high predilection for intestinal involvement.However,the ef-ficacy and long-term effects of surgical treatment for intestinal BD are unknown.In the current issue of World J Gastrointest Surg,Park et al conducted a retrospec-tive analysis of 31 patients with intestinal BD who received surgical treatment.They found that elevated C-reactive protein levels and emergency surgery were poor prognostic factors for postoperative recurrence,emphasizing the adverse impact of severe inflammation on the prognosis of patients with intestinal BD.This work has clinical significance for evaluating the postoperative condition of intestinal BD.The editorial attempts to summarize the clinical diagnosis and treatment of intestinal BD,focusing on the impact of adverse factors on surgical outcomes.We hope this review will facilitate more precise postoperative management of patients with intestinal BD by clinicians.
文摘Introduction: Congenital optic disc anomalies in children refer to structural variations of the optic nerve head present from birth. These deformations involve the size, shape, color, and vessels of the optic disc. Although often asymptomatic, these anomalies can impact the visual development of the child, underscoring the importance of a thorough fundus examination for early detection and appropriate medical follow-up. We present two cases of congenital optic disc anomalies in children, illustrating the diagnostic challenges and complexity of their management. Case 1: A 3-year-old girl presented with a white spot in her left eye present since birth. Uncorrected distance visual acuity was 2/10 in the right eye, while she could perceive hand movements at 2 meters with the left eye. Normal examination in the right eye showed leukocoria, microphthalmia, and a white mass at the center of the optic disc on fundus examination in the left eye. Ocular imaging, including ultrasound and optical coherence tomography (OCT), confirmed the diagnosis of persistent hyperplastic primary vitreous (PHPV) in its mixed form in the left eye. Management included prescribing full optical correction and functional rehabilitation, without resorting to surgery. The course was marked by persistent amblyopia leading to a poor prognosis. Case 2: A 7-year-old girl consulted for vision disturbance in her right eye. Visual acuity was finger counting at 2 meters in the right eye and 10/10 in the left eye. Anterior segment examination revealed no abnormalities in both eyes. However, fundus examination highlighted a large funnel-shaped excavation associated with central glial proliferation, wheel spoke vessels, and neuroretinal ring atrophy in the right eye. Optical coherence tomography (OCT) of the right eye confirmed the diagnosis of isolated unilateral Morning Glory syndrome. Management included full optical correction and orthoptic rehabilitation. The course was marked by the absence of ocular complication and maintenance of visual stability in the right eye. The prognosis seemed favorable. Conclusion: Congenital optic disc anomalies in children exhibit great clinical variability and require an individualized diagnostic and therapeutic approach.
基金supported by the National Key Research and Development Program of China (No.2021YFB2601000)National Natural Science Foundation of China (Nos.52078049,52378431)+2 种基金Fundamental Research Funds for the Central Universities,CHD (Nos.300102210302,300102210118)the 111 Proj-ect of Sustainable Transportation for Urban Agglomeration in Western China (No.B20035)Natural Science Foundation of Shaanxi Province of China (No.S2022-JM-193).
文摘Road transportation plays a crucial role in society and daily life,as the functioning and durability of roads can significantly impact a nation's economic development.In the whole life cycle of the road,the emergence of disease is unavoidable,so it is necessary to adopt relevant technical means to deal with the disease.This study comprehensively reviews the advancements in computer vision,artificial intelligence,and mobile robotics in the road domain and examines their progress and applications in road detection,diagnosis,and treatment,especially asphalt roads.Specifically,it analyzes the research progress in detecting and diagnosing surface and internal road distress and related techniques and algorithms are compared.In addition,also introduces various road gover-nance technologies,including automated repairs,intelligent construction,and path planning for crack sealing.Despite their proven effectiveness in detecting road distress,analyzing diagnoses,and planning maintenance,these technologies still confront challenges in data collection,parameter optimization,model portability,system accuracy,robustness,and real-time performance.Consequently,the integration of multidisciplinary technologies is imperative to enable the development of an integrated approach that includes road detection,diagnosis,and treatment.This paper addresses the challenges of precise defect detection,condition assessment,and unmanned construction.At the same time,the efficiency of labor liberation and road maintenance is achieved,and the automation level of the road engineering industry is improved.
文摘Acute pancreatitis(AP)is a common acute abdominal condition of the digestive system.In recent years,treatment concepts,methods,and strategies for the diagnosis of AP have advanced,and this has played an important role in promoting the standardization of AP diagnosis and treatment and improving the treatment quality of AP patients.On the basis of previous guidelines and expert consensus,this guideline adopts an evidence-based,problem-based expression;synthesizes important clinical research data at home and abroad in the most recent 5 years;and forms 29 recommendations through multidisciplinary expert discussion,including diagnosis,treatment,and follow-up.It is expected to provide evidence support for the treatment of AP in the clinical setting in China.
文摘Rosacea is a chronic inflammatory skin disease that primarily affects the centrofacial areas and mainly manifests as recurrent flushing and erythema.In recent years,there has been progress in the understanding of the diagnosis and treatment of rosacea.Therefore,a group of dermatological experts updated the guidelines based on the 2016 expert consensus statement on rosacea diagnosis and treatment in China.These new guidelines propose diagnostic criteria for rosacea at different sites to further standardize the diagnosis and treatment of rosacea in China.
文摘Psoriasis is an immune-mediated chronic,recurrent,systemic inflammatory disease induced by the combination of hereditary and environmental factors.The etiology of psoriasis involves hereditary,immune,environmental,and other factors,and its pathogenesis is considered to involve excessive proliferation of keratinocytes or inflammatory activation of synovial cells and chondrocytes within joints;these processes are caused by an immune response that is mainly mediated by T lymphocytes and various other immune cells.Psoriasis is an incurable disease,and the goal of treatment is to control the progression of disease and maintain long-term efficacy.Treatment protocols should be based on the patients’conditions.Patients with mild psoriasis can be mainly treated with topical agents,and those with moderate to severe psoriasis can be treated with systemic medications.Targeted biological agents can be appropriately chosen for cases of psoriasis that are resistant to traditional systemic treatment.New drugs and treatments for psoriasis continue to evolve and emerge,and our updated guidelines are designed to deliver new achievements from China and physicians worldwide and to keep pace with global progress on psoriasis research.Compared with the previous two editions,part of contents have been modified and revised in the present guidelines;this will further facilitate standardization and increase the efficiency of the diagnosis and treatment of psoriasis in China,and improve patients’quality of life.
