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| 1 | Diagnosis and Treatment of Keloids and Hypertrophic Scars—Japan Scar Workshop Consensus Document 2018显示文摘There has been a long-standing need for guidelines on the diagnosis and treatment of keloids and hypertrophic scars that are based on an understanding of the pathomechanisms that underlie these skin fibrotic diseases.This is particularly true for clinicians who deal with Asian and African patients because these ethnicities are highly prone to these diseases.By contrast,Caucasians are less likely to develop keloids and hypertrophic scars,and if they do,the scars tend not to be severe.This ethnic disparity also means that countries vary in terms of their differential diagnostic algorithms.The lack of clear treatment guidelines also means that primary care physicians are currently applying a hotchpotch of treatments,with uneven outcomes.To overcome these issues,the Japan Scar Workshop(JSW)has created a tool that allows clinicians to objectively diagnose and distinguish between keloids,hypertrophic scars,and mature scars.This tool is called the JSW Scar Scale(JSS)and it involves scoring the risk factors of the individual patients and the affected areas.The tool is simple and easy to use.As a result,even physicians who are not accustomed to keloids and hypertrophic scars can easily diagnose them and judge their severity.The JSW has also established a committee that,in cooperation with outside experts in various fields,has prepared a Consensus Document on keloid and hypertrophic scar treatment guidelines.These guidelines are simple and will allow even inexperienced clinicians to choose the most appropriate treatment strategy.The Consensus Document is provided in this article.It describes(1)the diagnostic algorithm for pathological scars and how to differentiate them from clinically similar benign and malignant tumors,(2)the general treatment algorithms for keloids and hypertrophic scars at different medical facilities,(3)the rationale behind each treatment for keloids and hypertrophic scars,and(4)the body site-specific treatment protocols for these scars.We believe that this Consensus Document will be helpful for physicians from all over the world who treat keloids and hypertrophic scars. | Rei Ogawa Sadanori Akita Satoshi Akaishi Noriko Aramaki-Hattori Teruyuki Dohi Toshihiko Hayashi Kazuo Kishi Taro Kono Hajime Matsumura Gan Muneuchi Naoki Murao Munetomo Nagao Keisuke Okabe Fumiaki Shimizu Mamiko Tosa Yasuyoshi Tosa Satoko Yamawaki Shinichi Ansai Norihisa Inazu Toshiko Kamo Reiko Kazki Shigehiko Kuribayashi | 2019 | Burns & Trauma2019，7，1： | 31 |
| 2 | Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review显示文摘Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chin ese Trauma Surge on Associati on orga nized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries.Eleven questions regarding the use of VSD in abdominal surgeries were addressed:(1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions?(2) Can VSD be preventively used for a high-risk abdominal incision w让h primary suture?(3) Can VSD be used in severely contaminated/infected abdominal surgical sites?(4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome?(5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage?(6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula?(7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess?(8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects?(9) Does VSD in crease the risk of bleeding?(10) Does VSD increase the risk of intestinal wail injury?(11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure. | Yang Li Pei-Yuan Li Shi-Jing Sun Yuan-Zhang Yao Zhan-Fei Li Tao Liu Fan Yang Lian-Yang Zhang Xiang-Jun Bai Jing-Shan Huo Wu-Bing He Jun Ouyang Lei Peng Ping Hu Yan-An Zhu Ping Jin Qi-Feng Shao Yan-Feng Wang Rui-Wu Dai Pei-Yang Hu Hai-Ming Chen Ge-Fei Wang Yong-Gao Wang Hong-Xu Jin Chang-Ju Zhu Qi-Yong Zhang Biao Shao Xi-Guang Sang Chang-Lin Yin | 2019 | Chinese Journal of Traumatology2019，22，1： | 26 |
| 3 | 胃肠的内视镜的 submucosal 解剖材料的病理学的评估基于日本指南显示文摘 Endoscopic surgery first started as snare polypectomy and then progressed to endoscopic mucosal resection (EMR). In order to resect a lesion that is more than 2 cm, endoscopic submucosal dissection (ESD) was developed. ESD therapy has now been established and is being used for early stage neoplastic lesions in the stomach, colon, esophagus, larynx and pharynx. In ESD specimens, we deal with relatively small lesions; therefore, more meticulous and precise pathological diagnosis is required compared to that in surgically resected specimens. In addition, we should be expert in the eligibility criteria of the different organs for ESD therapy. Here, we explain the biopsy diagnosis, including the Japanese group classification as well as the Vienna classification, handling the specimen, including fixation, photography, cutting and paraffin embedding, histological type, depth, vascular invasion and evaluation of the surgical margins, based on the latest Japanese guidelines. Japanese histopathology diagnostic criteria for the stomach, colon and esophagus are also described. We also demonstrate some examples of those mentioned above. | Koji Nagata Michio Shimizu | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，11： | 16 |
| 4 | Controversies regarding and perspectives on clinical utility of biomarkers in hepatocellular carcinoma显示文摘The prevalence of hepatocellular carcinoma(HCC)worldwide parallels that of persistent infection with the hepatitis B virus(HBV)and/or hepatitis C virus(HCV).According to recommendations by the World Health Organization guidelines for HBV/HCV,alpha-fetoprotein(AFP)testing and abdominal ultrasound should be performed in routine surveillance of HCC every 6 mo for high-risk patients.These examinations have also been recommended worldwide by many other HCC guidelines over the past few decades.In recent years,however,the role of AFP in HCC surveillance and diagnosis has diminished due to advances in imaging modalities.AFP was excluded from the surveillance and/or diagnostic criteria in the HCC guidelines published by the American Association for the Study of Liver Diseases in 2010,the European Association for the Study of the Liver in 2012,and the National Comprehensive Cancer Network in 2014.Other biomarkers,including the Lens culinaris agglutinin-reactive fraction of AFP(AFP-L3),des-γ-carboxyprothrombin,Dickkopf-1,midkine,and micro RNA,are being studied in this regard.Furthermore,increasing attention has focused on the clinical utility of biomarkers as pre-treatment predictors for tumor recurrence and as post-treatment monitors.Serum and tissue-based biomarkers and genomics may aid in the diagnosis of HCC,determination of patient prognosis,and selection of appropriate treatment.However,further studies are needed to better characterize the accuracy and potential role of these approaches in clinical practice. | Pei-Pei Song Ju-Feng Xia Yoshinori Inagaki Kiyoshi Hasegawa Yoshihiro Sakamoto Norihiro Kokudo Wei Tang | 2016 | World Journal of Gastroenterology2016，22，1： | 15 |
| 5 | Intra-abdominal pressure:Time ripe to revise managementguidelines of acute pancreatitis?显示文摘AIM: To systematically review evidence on pathophysiology of intra-abdominal pressure(IAP) in acute pancreatitis(AP) with its clinical correlates. METHODS: Systematic review of available evidence in English literature with relevant medical subject heading terms on Pub Med, Medline and Scopus with further search from open access sources on internet as suggested by articles retrieved. RESULTS: Intra-abdominal hypertension(IAH) is increasingly gaining recognition as a point of specific intervention with potential to alter disease outcome and improve mortality in AP. IAH can be expected in at least 17% of patients presenting with diagnosis of AP to a typical tertiary care hospital(prevalence increasing to 50% in those with severe disease). Abdominal compartment syndrome can be expected in at least 15% patients with severe disease. Recent guidelines on management of AP do not acknowledge utility of surveillance for IAP other than those by Japanese Society of Hepato-BiliaryPancreatic Surgery. We further outline pathophysiologic mechanisms of IAH; understanding of which advances our knowledge and helps to coherently align common observed variations in management related conundrums(such as fluid therapy, nutrition and antibiotic prophylaxis) with potential to further individualize treatment in AP. CONCLUSION: We suggest that IAP be given its due place in future practice guidelines and that recommendations be formed with help of a broader panel with inclusion of clinicians experienced in management of IAH. | jiten jaipuria vimal bhandari avneet singh chawla mohit singh | 2016 | World Journal of Gastrointestinal Pathophysiology2016，7，1： | 14 |
| 6 | Irritable bowel syndrome and functional constipation management with integrative medicine: A systematic review显示文摘BACKGROUND Irritable bowel syndrome(IBS)and functional constipation(FC)are two commonly encountered functional gastrointestinal disorders in clinical practice and are usually managed with Western medicines in cooperation with traditional Chinese medicine(TCM)interventions.Although clinical practice guidelines(CPGs)have been developed to assist clinicians with their decisions,there are still gaps in management with regard to integrative medicine(IM)recommendations.AIM To comprehensively review the currently available CPGs and to provide a reference for addressing the gaps in IBS and FC management.METHODS We searched mainstream English and Chinese databases and collected data from January 1990 to January 2019.The search was additionally enriched by manual searches and the use of publicly available resources.Based on the development method,the guidelines were classified into evidence-based(EB)guidelines,consensus-based(CB)guidelines,and consensus-based guidelines with no comprehensive consideration of the EB(CB-EB)guidelines.With regard to the recommendations,the strength of the interventions was uniformly converted to a 4-point grading scale.RESULTS Thirty CPGs met the inclusion criteria and were captured as data extraction sources.Most Western medicine(WM)CPGs were developed as EB guidelines.All TCM CPGs and most IM CPGs were identified as CB guidelines.Only the 2011 IBS and IM CPG was a CB-EB set of guidelines.Antispasmodics and peppermint oil for pain,loperamide for diarrhea,and linaclotide for constipation polyethylene glycol and lactulose as osmotic laxatives,bisacodyl and sodium picosulfate as stimulant laxatives,lubiprostone and linaclotide as prosecretory agents,and prucalopride were strongly recommended or recommended in FC.TCM interventions were suggested based on pattern differentiation,while the recommendation level was considered to be weak or insufficient.CONCLUSION WM CPGs generally provide a comprehensive management algorithm,although there are still some gaps that could be addressed with TCM.Specific high-quality trials are needed to enrich the evidence. | Liang Dai Linda LD Zhong Guang Ji | 2019 | World Journal of Clinical Cases2019，7，21： | 14 |
| 7 | Interpretation of breast cancer screening guideline for Chinese women显示文摘Breast cancer is the most common malignant tumor in Chinese women.Early screening is the best way to improve the rates of early diagnosis and survival of breast cancer patients.The peak onset age for breast cancer in Chinese women is considerably younger than those in European and American women.It is imperative to develop breast cancer screening guideline that is suitable for Chinese women.By summarizing the current evidence on breast cancer screening in Chinese women,and referring to the latest guidelines and consensus on breast cancer screening in Europe,the United States,and East Asia,the China Anti-Cancer Association and National Clinical Research Center for Cancer(Tianjin Medical University Cancer Institute and Hospital)have formulated population-based guideline for breast cancer screening in Chinese women.The guideline provides recommendations on breast cancer screening for Chinese women at average or high risk of breast cancer according to the following three aspects:age of screening,screening methods,and screening interval.This article provides more detailed information to support the recommendations in this guideline and to provide more direction for current breast cancer screening practices in China. | Yubei Huang Zhongsheng Tong Kexin Chen Ying Wang Peifang Liu Lin Gu Juntian Liu Jinpu Yu Fengju Song Wenhua Zhao Yehui Shi Hui Li Huaiyuan Xiao Xishan Hao | 2019 | Cancer Biology & Medicine2019，16，4： | 10 |
| 8 | Thyroid function reference ranges during pregnancy in a large Chinese population and comparison with current guidelines显示文摘Background: A correct thyroid function reference range is important for the accurate diagnosis of thyroid disease during pregnancy. However, there is no consensus on whether thyroid function reference ranges in Chinese population should follow the America Thyroid Association (ATA) guidelines. This study aimed to establish a thyroid function reference range more suited to the Chinese population by evaluating the current thyroid function reference range in pregnant Chinese women and comparing it to the ATA guidelines. Methods: A total of 52,027 pregnant women were enrolled from January 2013 to December 2016. Thyroid stimulating hormone (TSH), free thyroxine (FT4), and thyroid peroxidase antibody (TPOAb) levels were tested during the first and third trimesters of pregnancy. Reference ranges of TSH and FT4 were established from the 2.5th and 97.5th percentiles of the TPOAb-negative population of women. The Mann-Whitney U test was used to compare thyroid hormones between the TPOAb-positive and TPOAbnegative groups. Results: We obtained that the TSH reference ranges were 0.03 to 3.52 mU/L and 0.39 to 3.67 mU/L, and the FT4 reference ranges were 11.7 to 19.7 pmol/L and 9.1 to 14.4pmol/L, in the firstand third trimester, respectively. If we used the 2011 ATA criteria about 7.0% and 4.0% pregnant women would be over diagnosed in first and third trimester, respectively, compared with local population thyroid hormone reference. When we compared our local criteria with the new 2017 ATA criteria, about 1.2% and 0.8% pregnant women would have a missed diagnosis in first and third trimester, respectively. Conclusions: Based on our data, which is in line with the current ATA guidelines, a population-based thyroid function reference range would be the first choice for diagnosis of thyroid disease during pregnancy in China. In case such population-based thyroid function reference ranges are unavailable in the east of China, our reference ranges can be adopted, if the same assay is used. | Xi Yang Yu Meng Yong Zhang Chen Zhang Fei Guo Shuai Yang Rong Ding Jian-Xia Fan | 2019 | Chinese Medical Journal2019，，5： | 9 |
| 9 | Study on the proposed environmental guidelines for Cd, Hg, Pb and As in soil of China显示文摘This paper deals with the soil-environmental standard. According to the current situation of researching on the soil-environmental quality guideline at home and abroad, and on the basis of the foundations and principles of enacting the soil-environmental standard, the soil environment quality guideline values of Hg, Cd, Pb and As were suggested. | Wu Yanyu, Tian Junliang Zhou QixingInstitute of Applied Ecology, Chinese Academy of Sciences, Shenyang 110015, ChinaNorthwest Institute of Water and Soil Conservation, Chinese Academy of Sciences, Shaanxi 712100, China | 1992 | Journal of Environmental Sciences1992，4，1： | 7 |
| 10 | Update on thyroid ultrasound: a narrative review from diagnostic criteria to artificial intelligence techniques显示文摘Objective Ultrasound imaging is well known to play an important role in the detection of thyroid disease, but the management of thyroid ultrasound remains inconsistent. Both standardized diagnostic criteria and new ultrasound technologies are essential for improving the accuracy of thyroid ultrasound. This study reviewed the global guidelines of thyroid ultrasound and analyzed their common characteristics for basic clinical screening. Advances in the application of a combination of thyroid ultrasound and artificial intelligence (AI) were also presented. Data sources An extensive search of the PubMed database was undertaken, focusing on research published after 2001 with keywords including thyroid ultrasound, guideline, AI, segmentation, image classification, and deep learning. Study selection Several types of articles, including original studies and literature reviews, were identified and reviewed to summarize the importance of standardization and new technology in thyroid ultrasound diagnosis. Results Ultrasound has become an important diagnostic technique in thyroid nodules. Both standardized diagnostic criteria and new ultrasound technologies are essential for improving the accuracy of thyroid ultrasound. In the standardization, since there are no global consensus exists, common characteristics such as a multi-feature diagnosis, the performance of lymph nodes, explicit indications of fine needle aspiration, and the diagnosis of special populations should be focused on. Besides, evidence suggests that AI technique has a good effect on the unavoidable limitations of traditional ultrasound, and the combination of diagnostic criteria and AI may lead to a great promotion in thyroid diagnosis. Conclusion Standardization and development of novel techniques are key factors to improving thyroid ultrasound, and both should be considered in normal clinical use. | Xiao-Wen Liang Yong-Yi Cai Jin-Sui Yu Jian-Yi Liao Zhi-Yi Chen | 2019 | Chinese Medical Journal2019，，16： | 7 |
| 11 | Expert consensus of Chinese Association for the Study of Pain on the application of ozone therapy in pain medicine显示文摘This consensus was compiled by first-line clinical experts in the field of pain medicine and was organized by the Chinese Association for the Study of Pain.To reach this consensus,we consulted a wide range of opinions and conducted indepth discussions on the mechanism,indications,contraindications,operational specifications and adverse reactions of ozone iatrotechnique in the treatment of pain disorders.We also referred to related previous preclinical and clinical studies published in recent years worldwide.The purpose of this consensus is to standardize the rational application of ozone iatrotechnique in pain treatment,to improve its efficacy and safety and to reduce and prevent adverse reactions and complications in this process. | Zhi-Gang Zhuang Li-Juan Lu Bao-Gan Peng Ke Ma Zhen-Yu Cai Zhi-Jian Fu Guang-Zhao Liu Jin-Feng Liu Wen-Tao Liu Xiao-Hong Li Tao Song Da-Sheng Wu Jing Yao Peng Yao Jian-She Yu Yan-Qing Liu | 2021 | World Journal of Clinical Cases2021，9，9： | 7 |
| 12 | Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline(updated version)显示文摘The novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the cause of a rapidly spreading illness,coronavirus disease 2019(COVID-19),affecting more than seventeen million people around the world.Diagnosis and treatment guidelines for clinicians caring for patients are needed.In the early stage,we have issued'A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)';now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline.We formed a working group of clinical experts and methodologists.The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas:chemoprophylaxis,diagnosis,treatments,and discharge management.We searched the literature for direct evidence on the management of COVID-19,and assessed its certainty generated recommendations using the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach.Recommendations were either strong or weak,or in the form of ungraded consensus-based statement.Finally,we issued 34 statements.Among them,6 were strong recommendations for,14 were weak recommendations for,3 were weak recommendations against and 11 were ungraded consensus-based statement.They covered topics of chemoprophylaxis(including agents and Traditional Chinese Medicine(TCM)agents),diagnosis(including clinical manifestations,reverse transcription-polymerase chain reaction(RT-PCR),respiratory tract specimens,IgM and IgG antibody tests,chest computed tomography,chest X-ray,and CT features of asymptomatic infections),treatments(including lopinavirritonavir,umifenovir,favipiravir,interferon,remdesivir,combination of antiviral drugs,hydroxychloroquine/chloroquine,interleukin-6 inhibitors,interleukin-1 inhibitors,glucocorticoid,qingfei paidu decoction,lianhua qingwen granules/capsules,convalescent plasma,lung transplantation,invasive or noninvasive ventilation,and extracorporeal membrane oxygenation(ECMO)),and discharge management(including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge).We also created two figures of these recommendations for the implementation purpose.We hope these recommendations can help support healthcare workers caring for COVID-19 patients. | Ying-Hui Jin Qing-Yuan Zhan Zhi-Yong Peng Xue-Qun Ren Xun-Tao Yin Lin Cai Yu-Feng Yuan Ji-Rong Yue Xiao-Chun Zhang Qi-Wen Yang Jianguang Ji Jian Xia Yi-Rong Li Fu-Xiang Zhou Ya-Dong Gao Zhui Yu Feng Xu Ming-Li Tu Li-Ming Tan Min Yang Fang Chen Xiao-Ju Zhang Mei Zeng Yu Zhu Xin-Can Liu Jian Yang Dong-Chi Zhao Yu-Feng Ding Ning Hou Fu-Bing Wang Hao Chen Yong-Gang Zhang Wei Li Wen Chen Yue-Xian Shi Xiu-Zhi Yang Xue-Jun Wang Yan-Jun Zhong Ming-Juan Zhao Bing-Hui Li Lin-Lu Ma Hao Zi Na Wang Yun-Yun Wang Shao-Fu Yu Lu-Yao Li Qiao Huang Hong Weng Xiang-Ying Ren Li-Sha Luo Man-Ru Fan Di Huang Hong-Yang Xue Lin-Xin Yu Jin-Ping Gao Tong Deng Xian-Tao Zeng Hong-Jun Li Zhen-Shun Cheng Xiao-Mei Yao Xing-Huan Wang | 2020 | Military Medical Research2020，7，3： | 6 |
| 13 | Chinese consensus on management of tyrosine kinase inhibitor-associated side effects in gastrointestinal stromal tumors显示文摘Tyrosine kinase inhibitors(TKIs) have improved the overall survival of patients with gastrointestinal stromal tumors(GISTs), but their side effects can impact dose intensity and, consequently, the clinical benefit. To date, no guideline or consensus has been published on the TKI-associated adverse reactions. Therefore, the Chinese Society of Surgeons for Gastrointestinal Stromal Tumor of the Chinese Medical Doctor Association organized an expert panel discussion involving representatives from gastrointestinal surgery, medical oncology, cardiology, dermatology, nephrology, endocrinology, and ophthalmology to consider the systemic clinical symptoms, molecular and cellular mechanisms, and treatment recommendations of GISTs. Here, we present the resultant evidence-and experience-based consensus to guide the management of TKI-associated side events in clinical practice. | Jian Li Ming Wang Bo Zhang Xin Wu Tian-Long Lin Xiu-Feng Liu Ye Zhou Xin-Hua Zhang Hao Xu Li-Jing Shen Jing Zou Ping Lu Dong Zhang Wei-Jun Gu Mei-Xia Zhang Jian Pan Hui Cao 无 | 2018 | World Journal of Gastroenterology2018，24，46： | 6 |
| 14 | Post-polypectomy bleeding and thromboembolism risks associated with warfarin vs direct oral anticoagulants显示文摘AIM To verify the validity of the endoscopy guidelines for patients taking warfarin or direct oral anticoagulants(DOAC).METHODS We collected data from 218 patients receiving oral anticoagulants(73 DOAC users, 145 warfarin users) and 218 patients not receiving any antithrombotics(age-and sexmatched controls) who underwent polypectomy.(1) We evaluated post-polypectomy bleeding(PPB) risk in patients receiving warfarin or DOAC compared with controls;(2) we assessed the risks of PPB and thromboembolism between three AC management methods: Discontinuing AC with heparin bridge(HPB)(endoscopy guideline recommendation), continuing AC, and discontinuing AC without HPB.RESULTS PPB rate was significantly higher in warfarin users and DOAC users compared with controls(13.7% and 13.7% vs 0.9%, P < 0.001), but was not significantly different between rivaroxaban(13.2%), dabigatran(11.1%), and apixaban(13.3%) users. Two thromboembolic events occurred in warfarin users, but none in DOAC users. Compared with the continuing anticoagulant group, the discontinuing anticoagulant with HPB group(guideline recommendation) had a higher PPB rate(10.8% vs 19.6%, P = 0.087). These findings were significantly evident in warfarin but not DOAC users. One thrombotic event occurred in the discontinuing anticoagulant with HPB group and the discontinuing anticoagulant without HPB group; none occurred in the continuing anticoagulant group.CONCLUSION PPB risk was similar between patients taking warfarin and DOAC. Thromboembolism was observed in warfarin users only. The guideline recommendations for HPB should be re-considered. | Naohiro Yanagisawa Naoyoshi Nagata Kazuhiro Watanabe Tatsuhiro Iida Mariko Hamada Sakurako Kobayashi Takuro Shimbo Junichi Akiyama Naomi Uemura | 2018 | World Journal of Gastroenterology2018，24，14： | 6 |
| 15 | Pediatricians lack knowledge for the diagnosis and management of functional constipation in children over 6 mo of age显示文摘AIM To assess the knowledge of general pediatricians througout Indonesia about the diagnosis and treatment of childhood constipation.METHODS A comprehensive questionnaire was distributed to general pediatricians from several teaching hospitals and government hospitals all over Indonesia.RESULTS Data were obtained from 100 pediatricians, with a mean of 78.34 ± 18.00 mo clinical practice, from 20 cities throughout Indonesia. Suspicion of constipation in a child over 6 mo of age arises when the child presents with a decreased frequency of bowel movements(according to 87% of participants) with a mean of one bowel movement per 3.59 ± 1.0 d, hard stools(83%), blood in the stools(36%), fecal incontinence(33%), and/or difficulty in defecating(47%). Only 26 pediatricians prescribe pharmacologic treatment as first therapeutic approach, while the vast majority prefers nonpharmacologic treatment, mostly(according to 68%) The preferred nonpharmacologic treatment are high-fiber diet(96%), increased fluid intake(90%), toilet training(74%), and abdominal massage(49%). Duration of non-pharmacological treatment was limited to 1 to 2 wk. Seventy percent of the pediatricians recommending toilet training could only mention some elements of the technique, and only 15% was able to explain it fully and correctly. Lactulose is the most frequent pharmacologic intervention used(87% of the participants), and rectal treatment with sodium citrate, sodium lauryl sulfo acetate, and sorbitol is the most frequent rectal treatment(85%). Only 51% will prescribe rectal treatment for fecal impaction. The majority of the pediatricians(69%) expect a positive response during the first week with a mean(± SD) of 4.1(± 2.56) d. Most participants(86%) treat during one month or even less. And the majority(67%) stops treatment when the frequency and/or consistency of the stools have become normal, or if the patient had no longer complaints.CONCLUSION These data provide an insight on the diagnosis and management of constipation in childhood in Indonesia. Although general pediatricians are aware of some important aspects of the diagnosis and mangement of constipation, overall knowledge is limited. Efforts should be made to improve the distribution of existing guidelines. These findings highlight and confirm the difficulties in spreading existing information from guidelines to general pediatricians. | Ariani Widodo Badriul Hegar Yvan Vandenplas | 2018 | World Journal of Clinical Pediatrics2018，7，1： | 6 |
| 16 | Enhanced recovery after surgery in emergency colorectal surgery:Review of literature and current practices显示文摘Enhanced recovery after surgery(ERAS), a multidisciplinary program designed to minimize stress response to surgery and promote the recovery of organ function, has become a standard of perioperative care for elective colorectal surgery. In an elective setting, ERAS program has consistently been shown to decrease postoperative complication, reduce length of hospital stay, shorten convalescence, and lower healthcare cost. Recently, there is emerging evidence that ERAS program can be safely and effectively applied to patients with emergency colorectal conditions such as acute colonic obstruction and intraabdominal infection. This review comprehensively covers the concept and application of ERAS program for emergency colorectal surgery. The outcomes of ERAS program for this emergency surgery are summarized as follows:(1) The ERAS program was associated with a lower rate of overall complication and shorter length of hospital stay – without increased risks of readmission,reoperation and death after emergency colorectal surgery; and(2) Compliance with an ERAS program in emergency setting appeared to be lower than that in an elective basis. Moreover, scientific evidence of each ERAS item used in emergency colorectal operation is shown. Perspectives of ERAS pathway in emergency colorectal surgery are addressed. Finally, evidence-based ERAS protocol for emergency colorectal surgery is presented. | Varut Lohsiriwat Romyen Jitmungngan | 2019 | World Journal of Gastrointestinal Surgery2019，11，2： | 6 |
| 17 | Benign prostatic hyperplasia and male lower urinary symptoms:A guide for family physicians显示文摘Male patients with lower urinary tract symptoms(LUTS)and benign prostatic hyperplasia(BPH)are increasingly seen by family physicians worldwide due to ageing demographics.A systematic way to stratify patients who can be managed in the community and those who need to be referred to the urologist is thus very useful.Good history taking,physical examination,targeted blood or urine tests,and knowing the red flags for referral are the mainstay of stratifying these patients.Case selection is always key in clinical practice and in the setting of the family physician.The best patient to manage is one above 40 years of age,symptomatic with nocturia,slower stream and sensation of incomplete voiding,has a normal prostatespecific antigen level,no palpable bladder,and no haematuria or pyuria on the labstix.The roles of α blockers,5-α reductase inhibitors,and antibiotics in a primary care setting to manage this condition are also discussed. | Farhad Fakhrudin Vasanwala Michael Yuet Chen Wong Henry Sun Sien Ho Keong Tatt Foo | 2017 | Asian Journal of Urology2017，4，3： | 5 |
| 18 | Therapeutic role of template-based lymphadenectomy in urothelial carcinoma of the upper urinary tract显示文摘Lymphadenectomy for urothelial carcinoma of the upper urinary tract has attracted the attention of physicians. The mapping study of lymphatic spread has shown that a relatively wide area should comprise the regional nodes for tumors of the right renal pelvis or the right upper two-thirds of the ureter. A prospective study showed that an anatomical templatebased lymphadenectomy significantly improved patient survival in tumors of the renal pelvis. This benefit was more evident for patients with p T2 stage tumors or higher. The risk of regional node recurrence is significant reduced by template-based lymphadenectomy,which is likely to be associated with improved patient survival. The removal of lymph node micrometastases is assumed to be the reason for therapeutic benefit following lymphadenectomy. The number of resected lymph nodes can be used to assess the quality of lymphadenectomy,but not to determine the extent of lymphadenectomy. The guidelines currently recommend lymphadenectomy for patients with muscle-invasive disease,even though the current recommendation grades are still low. The present limitation of lymphadenectomy is the lack of standardization of the extent of lymphadenectomy and the randomized trials. Further studies are warranted to collect the evidence to support lymphadenectomy. | Tsunenori Kondo Toshio Takagi Kazunari Tanabe | 2015 | World Journal of Clinical Oncology2015，6，6： | 5 |
| 19 | Expert consensus of the Chinese Association for the Study of Pain on ion channel drugs for neuropathic pain显示文摘Neuropathic pain(NPP)is a kind of pain caused by disease or damage impacting the somatosensory system.Ion channel drugs are the main treatment for NPP;however,their irregular usage leads to unsatisfactory pain relief.To regulate the treatment of NPP with ion channel drugs in clinical practice,the Chinese Association for the Study of Pain organized first-line pain management experts from China to write an expert consensus as the reference for the use of ion channels drugs.Here,we reviewed the mechanism and characteristics of sodium and calcium channel drugs,and developed recommendations for the therapeutic principles and clinical practice for carbamazepine,oxcarbazepine,lidocaine,bulleyaconitine A,pregabalin,and gabapentin.We hope this guideline provides guidance to clinicians and patients on the use of ion channel drugs for the management of NPP. | Hong Xiao Ke Ma Dong Huang Xian-Guo Liu Tang-Hua Liu Qing Liu Guang-Zhao Liu Tao Song Wei Tao Da-Sheng Wu Yun-Xia Wang Xiao-Qiu Yang Xiao-Mei Zhang Hui Liu Yan-Qing Liu | 2021 | World Journal of Clinical Cases2021，9，9： | 5 |
| 20 | 2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment显示文摘Background:Helicobacter pylori(H.pylori)infection is an infectious disease with a prevalence rate of up to 50%worldwide.It can cause indigestion,gastritis,peptic ulcer,and gastric cancer.H.pylori eradication treatment can effectively control disease progression and reduce the risk of the above conditions.However,the escalating trend of antibiotic resistance presents a global challenge for H.pylori eradication.We aim to provide guidance on pharmacological treatment of H.pylori infection.Methods:This clinical practice guideline is developed following the World Health Organization’s recommended process,adopting Grading of Recommendations Assessment,Development and Evaluation in assessing evidence quality,and utilizing Evidence to Decision framework to formulate clinical recommendations,minimizing bias and increasing transparency of the clinical practice guideline development process.We used the Reporting Items for practice Guidelines in HealThcare(RIGHT)statement and The Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ)as reporting and conduct guides to ensure the guideline’s completeness and transparency.Results:Though decreasing in developed countries,the prevalence of H.pylori remains high in developing countries,causing a major public health burden.This clinical practice guideline contains 12 recommendations concerning pharmacological treatment for H.pylori eradication.Among them,it is worth highlighting that bismuth preparations are inexpensive,safe,and effective,consequently making bismuth quadruple therapy a preferred choice for initial and rescue treatment.In empirical treatment,high-dose dual therapy is equally effective compared with bismuth quadruple therapy.Conclusions:The 12 recommendations in this clinical practice guideline are formed with consideration for stakeholders’values and preferences,resource use,feasibility,and acceptability.Recommendations are generalizable to resource limited settings with similar antibiotic resistance pattern as China,and lower middle-income countries facing comparable sociological and technical challenges.Registration:Guidelines International Network(GIN)website,https://guidelines.ebmportal.com/node/69996. | Liya Zhou Hong Lu Zhiqiang Song Bin Lyu Ye Chen Jiyao Wang Jun Xia Zhan Zhao on behalf of Helicobacter Pylori Study Group of Chinese Society of Gastroenterology | 2022 | Chinese Medical Journal2022，135，24： | 5 |
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