Diabetic foot(DF)is one of the most common complications of diabetes and is associated with high morbidity,disability,lethality and low cure-rate.The clinical diagnosis and treatment of DF need to be standardized.The ...Diabetic foot(DF)is one of the most common complications of diabetes and is associated with high morbidity,disability,lethality and low cure-rate.The clinical diagnosis and treatment of DF need to be standardized.The Chinese Diabetic Foot Cell and Interventional Therapy Technology Alliance has released six editions of guidelines and standards for clinical diagnosis and interventional treatment of DF,which filled the gap in the domestic DF treatment standard and played an important role in improving the level of diagnosis and treatment in China.In line with the latest developments in diagnosis and treatment,the Alliance,along with other 89 institutions,developed and issued the new edition based on the sixth edition to help standardize the clinical diagnosis and treatment of DF in China.展开更多
Fulminant myocarditis is an acute diffuse inflammatory disease of myocardium.It is characterized by acute onset,rapid progress and high risk of death.Its pathogenesis involves excessive immune activation of the innate...Fulminant myocarditis is an acute diffuse inflammatory disease of myocardium.It is characterized by acute onset,rapid progress and high risk of death.Its pathogenesis involves excessive immune activation of the innate immune system and formation of inflammatory storm.According to China’s practical experience,the adoption of the“life support-based comprehensive treatment regimen”(with mechanical circulation support and immunomodulation therapy as the core)can significantly improve the survival rate and long-term prognosis.Special emphasis is placed on very early identification,very early diagnosis,very early prediction and very early treatment.展开更多
With the growing influence of slow population growth and population aging,China has established the birth policy and issued a series of documents to promote maternal and fetal health and improve the birth rate.With th...With the growing influence of slow population growth and population aging,China has established the birth policy and issued a series of documents to promote maternal and fetal health and improve the birth rate.With the increase in prevalence of birth defects,timely diagnosis and intervention in utero provide possibilities to reduce unnecessary abortions and offer better prognosis.Congenital heart disease(CHD),as one of the most common congenital birth defects,is the leading cause of mortality in patients aged<5 years,and brings a heavy burden to both the affected families and society.Fetuses with CHD are associated with an increased risk of pregnancy-related complications and premature birth,and children with CHD typically face growth and developmental problems even after the correction of malformation.Therefore,management including diagnosis,treatment,and rehabilitation throughout the fetal period into childhood and even adulthood is essential for children with CHD.Based on the rapid advances in intrauterine and perinatal medicine and an in-depth collaboration among obstetrics and pediatrics,a novel diagnosis and treatment system has been established for the management of CHD in the past 2 decades in Shanghai Xinhua Hospital.This Intrauterine Diagnosis and Treatment System and Comprehensive Lifecycle Health Service of Congenital Heart Disease model provides prenatal diagnosis,intrauterine intervention,delivery room service and neonatal therapies,and postintrauterine rehabilitation for children with CHD.We have developed a four-dimensional spatiotemporal image correlation echocardiography and a three-dimensional cardiac virtual endoscopy system for the intrauterine diagnosis of CHD,dramatically raising the diagnostic utility.Our innovative and independent newborn-intervention technique has effectively reduced the re-intervention rate in patients with pulmonary atresia with intact ventricular septum and critical pulmonary stenosis.In 2018,Xinhua Hospital independently performed the case of fetal aortic valvuloplasty in Asia through a multidepartment collaborative effort.All children treated in this system achieved biventricular circulation and a better long-term postoperative outcome.We also have conducted postoperative rehabilitation therapy to promote the development and health of children with CHD.The practice of Xinhua model has reduced unnecessary abortion of CHD fetuses,reduced the mortality rate associated with critical CHD,and improved the mid-and long-term prognosis in CHD,which is essential to promote the fertility level and children’s health.Furthermore,translational medicine platform and the birth cohort Early Life Plan was constructed to explore the origins of major developmental diseases and establish an early intervention model in CHD.This practice of assessment of the intrauterine system has been expanded to other congenital defects in Xinhua Hospital,and sequential treatment of more than 2,000 cases has been completed to date.Based on practice in intrauterine management of CHD and other diseases,the concept of Intrauterine Pediatrics was proposed as a first to emphasize early prevention and intervention of childhood diseases and promote a comprehensive lifecycle service for children.The development and evolution of this system requires further attention not only from researchers but also from the government and global medical communities.展开更多
BACKGROUND Renal involvement in lymphoma is commonly associated with widespread nodal or extranodal lymphoma.Primary renal diffuse large B-cell lymphoma is an extremely rare extranodal lymphoma,accounting for fewer th...BACKGROUND Renal involvement in lymphoma is commonly associated with widespread nodal or extranodal lymphoma.Primary renal diffuse large B-cell lymphoma is an extremely rare extranodal lymphoma,accounting for fewer than 1%of all renal masses.Interestingly,the patient in this study had a renal vein tumor thrombus that was observed after laparoscopic radical nephrectomy.CASE SUMMARY We report the case of a 56-year-old female patient with primary renal lymphoma and a renal vein tumor thrombus whose first symptom was right pain in the back and gross hematuria.Histopathology revealed primary renal diffuse large B-cell lymphoma.The patient received 8 standard cycles of rituximab with cyclophosphamide,doxorubicin,vincristine,and prednisone chemotherapy after surgery,and no obvious signs of recurrence were observed during the one-year follow-up.CONCLUSION We evaluated comprehensive treatment of primary renal diffuse large B-cell lymphoma and multidisciplinary management of this malignancy.展开更多
Fulminant myocarditis is primarily caused by infection with any number of a variety of viruses. It arises quickly, progresses rapidly, and may lead to severe heart failure or circulatory failure presenting as rapid-on...Fulminant myocarditis is primarily caused by infection with any number of a variety of viruses. It arises quickly, progresses rapidly, and may lead to severe heart failure or circulatory failure presenting as rapid-onset hypotension and cardiogenic shock,with mortality rates as high as 50%–70%. Most importantly, there are no treatment options, guidelines or an expert consensus statement. Here, we provide the first expert consensus, the Chinese Society of Cardiology Expert Consensus Statement on the Diagnosis and Treatment of Fulminant Myocarditis, based on data from our recent clinical trial(NCT03268642). In this statement, we describe the clinical features and diagnostic criteria of fulminant myocarditis, and importantly, for the first time,we describe a new treatment regimen termed life support-based comprehensive treatment regimen. The core content of this treatment regimen includes(i) mechanical life support(applications of mechanical respirators and circulatory support systems,including intraaortic balloon pump and extracorporeal membrane oxygenation),(ii) immunological modulation by using sufficient doses of glucocorticoid, immunoglobulin and(iii) antiviral reagents using neuraminidase inhibitor. The proper application of this treatment regimen may and has helped to save the lives of many patients with fulminant myocarditis.展开更多
目的探讨与分析美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)指南结合多学科协作诊疗模式(multi-disciplinary team,MDT)在住培学员结直肠癌诊疗教学中的应用价值。方法研究对象选取2017年7月—2021年12月在广州...目的探讨与分析美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)指南结合多学科协作诊疗模式(multi-disciplinary team,MDT)在住培学员结直肠癌诊疗教学中的应用价值。方法研究对象选取2017年7月—2021年12月在广州医科大学附属第一医院进行住培的139名学员,其中2017年7月—2020年6月的住培学员69名(对照组),2020年7月—2021年12月的住培学员70名(多学科协作诊疗模式组)。对照组给予NCCN指南的常规结直肠癌诊疗教学,多学科协作诊疗模式组在对照组教学的基础上给予基于多学科协作诊疗模式的结直肠癌诊疗教学,两组教学时间持续3个月。比较两组的教学效果。结果教学后多学科协作诊疗模式组的自我动机信念、任务分析、自我监控及调节、自我评价等自我学习能力评分都高于对照组,差异有统计学意义(P<0.05)。两组教学前后的理论成绩与操作成绩都高于教学前,差异有统计学意义(P<0.05),多学科协作诊疗模式组也高于对照组,差异有统计学意义(P<0.05)。教学后多学科协作诊疗模式组对于教学方法、教学效果、教学氛围的满意度为100%、100%、98.57%,均明显高于对照组的81.16%、81.61%、79.71%,差异有统计学意义(P<0.05)。结论NCCN指南结合MDT模式在住培学员结直肠癌诊疗教学中的应用能提高自我学习能力,也可提高学员的理论成绩与操作成绩,提高住培学员的满意度。展开更多
文摘Diabetic foot(DF)is one of the most common complications of diabetes and is associated with high morbidity,disability,lethality and low cure-rate.The clinical diagnosis and treatment of DF need to be standardized.The Chinese Diabetic Foot Cell and Interventional Therapy Technology Alliance has released six editions of guidelines and standards for clinical diagnosis and interventional treatment of DF,which filled the gap in the domestic DF treatment standard and played an important role in improving the level of diagnosis and treatment in China.In line with the latest developments in diagnosis and treatment,the Alliance,along with other 89 institutions,developed and issued the new edition based on the sixth edition to help standardize the clinical diagnosis and treatment of DF in China.
基金supported in part by the National Natural Science Foundation of China(81790624,81630010)Top-Notch Talent Program of Hubei Province and Tongji Hospital(2021YBJRC005)。
文摘Fulminant myocarditis is an acute diffuse inflammatory disease of myocardium.It is characterized by acute onset,rapid progress and high risk of death.Its pathogenesis involves excessive immune activation of the innate immune system and formation of inflammatory storm.According to China’s practical experience,the adoption of the“life support-based comprehensive treatment regimen”(with mechanical circulation support and immunomodulation therapy as the core)can significantly improve the survival rate and long-term prognosis.Special emphasis is placed on very early identification,very early diagnosis,very early prediction and very early treatment.
基金supported by grants from the National Natural Science Foundation of China (82130015)to Kun SunCollaborative Innovation Program of Shanghai Municipal Health Commission (2020CXJQ01).
文摘With the growing influence of slow population growth and population aging,China has established the birth policy and issued a series of documents to promote maternal and fetal health and improve the birth rate.With the increase in prevalence of birth defects,timely diagnosis and intervention in utero provide possibilities to reduce unnecessary abortions and offer better prognosis.Congenital heart disease(CHD),as one of the most common congenital birth defects,is the leading cause of mortality in patients aged<5 years,and brings a heavy burden to both the affected families and society.Fetuses with CHD are associated with an increased risk of pregnancy-related complications and premature birth,and children with CHD typically face growth and developmental problems even after the correction of malformation.Therefore,management including diagnosis,treatment,and rehabilitation throughout the fetal period into childhood and even adulthood is essential for children with CHD.Based on the rapid advances in intrauterine and perinatal medicine and an in-depth collaboration among obstetrics and pediatrics,a novel diagnosis and treatment system has been established for the management of CHD in the past 2 decades in Shanghai Xinhua Hospital.This Intrauterine Diagnosis and Treatment System and Comprehensive Lifecycle Health Service of Congenital Heart Disease model provides prenatal diagnosis,intrauterine intervention,delivery room service and neonatal therapies,and postintrauterine rehabilitation for children with CHD.We have developed a four-dimensional spatiotemporal image correlation echocardiography and a three-dimensional cardiac virtual endoscopy system for the intrauterine diagnosis of CHD,dramatically raising the diagnostic utility.Our innovative and independent newborn-intervention technique has effectively reduced the re-intervention rate in patients with pulmonary atresia with intact ventricular septum and critical pulmonary stenosis.In 2018,Xinhua Hospital independently performed the case of fetal aortic valvuloplasty in Asia through a multidepartment collaborative effort.All children treated in this system achieved biventricular circulation and a better long-term postoperative outcome.We also have conducted postoperative rehabilitation therapy to promote the development and health of children with CHD.The practice of Xinhua model has reduced unnecessary abortion of CHD fetuses,reduced the mortality rate associated with critical CHD,and improved the mid-and long-term prognosis in CHD,which is essential to promote the fertility level and children’s health.Furthermore,translational medicine platform and the birth cohort Early Life Plan was constructed to explore the origins of major developmental diseases and establish an early intervention model in CHD.This practice of assessment of the intrauterine system has been expanded to other congenital defects in Xinhua Hospital,and sequential treatment of more than 2,000 cases has been completed to date.Based on practice in intrauterine management of CHD and other diseases,the concept of Intrauterine Pediatrics was proposed as a first to emphasize early prevention and intervention of childhood diseases and promote a comprehensive lifecycle service for children.The development and evolution of this system requires further attention not only from researchers but also from the government and global medical communities.
基金Supported by Foundation of Health Commission of Guizhou Province of China,No.gzwkj2021-211.
文摘BACKGROUND Renal involvement in lymphoma is commonly associated with widespread nodal or extranodal lymphoma.Primary renal diffuse large B-cell lymphoma is an extremely rare extranodal lymphoma,accounting for fewer than 1%of all renal masses.Interestingly,the patient in this study had a renal vein tumor thrombus that was observed after laparoscopic radical nephrectomy.CASE SUMMARY We report the case of a 56-year-old female patient with primary renal lymphoma and a renal vein tumor thrombus whose first symptom was right pain in the back and gross hematuria.Histopathology revealed primary renal diffuse large B-cell lymphoma.The patient received 8 standard cycles of rituximab with cyclophosphamide,doxorubicin,vincristine,and prednisone chemotherapy after surgery,and no obvious signs of recurrence were observed during the one-year follow-up.CONCLUSION We evaluated comprehensive treatment of primary renal diffuse large B-cell lymphoma and multidisciplinary management of this malignancy.
基金funded by the National Key Basic Research Project (2012CB518004)Natural Science Fund Key Project (81630010)
文摘Fulminant myocarditis is primarily caused by infection with any number of a variety of viruses. It arises quickly, progresses rapidly, and may lead to severe heart failure or circulatory failure presenting as rapid-onset hypotension and cardiogenic shock,with mortality rates as high as 50%–70%. Most importantly, there are no treatment options, guidelines or an expert consensus statement. Here, we provide the first expert consensus, the Chinese Society of Cardiology Expert Consensus Statement on the Diagnosis and Treatment of Fulminant Myocarditis, based on data from our recent clinical trial(NCT03268642). In this statement, we describe the clinical features and diagnostic criteria of fulminant myocarditis, and importantly, for the first time,we describe a new treatment regimen termed life support-based comprehensive treatment regimen. The core content of this treatment regimen includes(i) mechanical life support(applications of mechanical respirators and circulatory support systems,including intraaortic balloon pump and extracorporeal membrane oxygenation),(ii) immunological modulation by using sufficient doses of glucocorticoid, immunoglobulin and(iii) antiviral reagents using neuraminidase inhibitor. The proper application of this treatment regimen may and has helped to save the lives of many patients with fulminant myocarditis.
文摘目的探讨与分析美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)指南结合多学科协作诊疗模式(multi-disciplinary team,MDT)在住培学员结直肠癌诊疗教学中的应用价值。方法研究对象选取2017年7月—2021年12月在广州医科大学附属第一医院进行住培的139名学员,其中2017年7月—2020年6月的住培学员69名(对照组),2020年7月—2021年12月的住培学员70名(多学科协作诊疗模式组)。对照组给予NCCN指南的常规结直肠癌诊疗教学,多学科协作诊疗模式组在对照组教学的基础上给予基于多学科协作诊疗模式的结直肠癌诊疗教学,两组教学时间持续3个月。比较两组的教学效果。结果教学后多学科协作诊疗模式组的自我动机信念、任务分析、自我监控及调节、自我评价等自我学习能力评分都高于对照组,差异有统计学意义(P<0.05)。两组教学前后的理论成绩与操作成绩都高于教学前,差异有统计学意义(P<0.05),多学科协作诊疗模式组也高于对照组,差异有统计学意义(P<0.05)。教学后多学科协作诊疗模式组对于教学方法、教学效果、教学氛围的满意度为100%、100%、98.57%,均明显高于对照组的81.16%、81.61%、79.71%,差异有统计学意义(P<0.05)。结论NCCN指南结合MDT模式在住培学员结直肠癌诊疗教学中的应用能提高自我学习能力,也可提高学员的理论成绩与操作成绩,提高住培学员的满意度。
