Chronic hepatitis B(CHB)virus infection is a global public health problem,affecting more than 400 million people worldwide.The clinical spectrum is wide,ranging from a subclinical inactive carrier state,to progressive...Chronic hepatitis B(CHB)virus infection is a global public health problem,affecting more than 400 million people worldwide.The clinical spectrum is wide,ranging from a subclinical inactive carrier state,to progressive chronic hepatitis,cirrhosis,decompensation,and hepatocellular carcinoma.However,complications of hepatitis B virus(HBV)-related chronic liver disease may be reduced by viral suppression.Current international guidelines recommend first-line treatment of CHB infection with pegylated interferon,entecavir,or tenofovir,but the optimal treatment for an individualpatient is controversial.The indications for treatment are contentious,and increasing evidence suggests that HBV genotyping,as well as serial on-treatment measurements of hepatitis B surface antigen and HBV DNA kinetics should be used to predict antiviral treatment response.The likelihood of achieving a sustained virological response is also increased by extending treatment duration,and using combination therapy.Hence the paradigm for treatment of CHB is constantly evolving.This article summarizes the different indications for treatment,and systematically reviews the evidence for the efficacy of various antiviral agents.It further discusses the shortcomings of current guidelines,use of rescue therapy in drug-resistant strains of HBV,and highlights the promising clinical trials for emerging therapies in the pipeline.This concise overview presents an updated practical approach to guide the clinical management of CHB.展开更多
2019年8月28日,英国国家卫生与临床优化研究所(National Institute for Health and Care Excellence,NICE)发布了成人高血压诊断和管理指南。该指南延续了NICE一贯的简约风格,格式简洁、条目清晰、关注细节。针对血压的测量、高血压的...2019年8月28日,英国国家卫生与临床优化研究所(National Institute for Health and Care Excellence,NICE)发布了成人高血压诊断和管理指南。该指南延续了NICE一贯的简约风格,格式简洁、条目清晰、关注细节。针对血压的测量、高血压的诊断、心血管风险和靶器官损伤评估、降压治疗、血压监测和未来研究建议等方面作了推荐。该指南在高血压的诊断方面,强调了血压测量方法对诊断的重要性,将动态血压监测和家庭自测血压作为高血压诊断的必要条件。注重引导患者进行血压的自我管理,对我国临床实践具有借鉴意义。展开更多
本文利用文献分析和网站信息梳理等方法,对英国国家卫生与服务优化研究院(National Institute for Health and Care Excellence,NICE)的建立背景、目的、发展历程、评估模式及影响进行系统分析,以期为中国建设卫生技术评估体系提供模式...本文利用文献分析和网站信息梳理等方法,对英国国家卫生与服务优化研究院(National Institute for Health and Care Excellence,NICE)的建立背景、目的、发展历程、评估模式及影响进行系统分析,以期为中国建设卫生技术评估体系提供模式参考及经验借鉴。NICE是英国贯彻循证卫生决策理念的技术载体,可参考英国通过立法确定NICE临床指南对于医疗资源配置和筹资决策的影响,制定完善我国卫生治理法律法规体系,形成证据集成和决策转化应用机制以支持循证决策制定;另外,还可学习NICE加强评估机制、流程和方法工具的调试和完善,以适应政治政策变化、经济社会发展和医改深化要求;最后,我国评估机构还应学习其注重与其他行业组织和相关机构协作,利用行业学会协会、大学等科教研机构、医药企业的技术力量,高效开展证据评估和转化工作。展开更多
英国国家卫生保健与临床优化研究所(National Institute for Health and Care Excellence,NICE)于2022年3月2日发布了《职场心理健康》指南。该指南涵盖了如何在职场中为心理健康创造合适的条件,旨在促进支持性和包容性的职场环境,并帮...英国国家卫生保健与临床优化研究所(National Institute for Health and Care Excellence,NICE)于2022年3月2日发布了《职场心理健康》指南。该指南涵盖了如何在职场中为心理健康创造合适的条件,旨在促进支持性和包容性的职场环境,并帮助有心理健康问题或有潜在心理健康风险的人群。本文对该指南要点进行解读。展开更多
基金Supported by Collaborative Research Fund(CUHK3/CRF/12RHKU3/CRF11R)of the Research Grant Council Hong Kong+2 种基金National Basic Research Program of China,973 Program,No.2013CB531401CUHK Focused Investments Scheme B to HY LanTheme-based Research Scheme of the Hong Kong Re-search Grants Council,No.T12-403-11
文摘Chronic hepatitis B(CHB)virus infection is a global public health problem,affecting more than 400 million people worldwide.The clinical spectrum is wide,ranging from a subclinical inactive carrier state,to progressive chronic hepatitis,cirrhosis,decompensation,and hepatocellular carcinoma.However,complications of hepatitis B virus(HBV)-related chronic liver disease may be reduced by viral suppression.Current international guidelines recommend first-line treatment of CHB infection with pegylated interferon,entecavir,or tenofovir,but the optimal treatment for an individualpatient is controversial.The indications for treatment are contentious,and increasing evidence suggests that HBV genotyping,as well as serial on-treatment measurements of hepatitis B surface antigen and HBV DNA kinetics should be used to predict antiviral treatment response.The likelihood of achieving a sustained virological response is also increased by extending treatment duration,and using combination therapy.Hence the paradigm for treatment of CHB is constantly evolving.This article summarizes the different indications for treatment,and systematically reviews the evidence for the efficacy of various antiviral agents.It further discusses the shortcomings of current guidelines,use of rescue therapy in drug-resistant strains of HBV,and highlights the promising clinical trials for emerging therapies in the pipeline.This concise overview presents an updated practical approach to guide the clinical management of CHB.
文摘2019年8月28日,英国国家卫生与临床优化研究所(National Institute for Health and Care Excellence,NICE)发布了成人高血压诊断和管理指南。该指南延续了NICE一贯的简约风格,格式简洁、条目清晰、关注细节。针对血压的测量、高血压的诊断、心血管风险和靶器官损伤评估、降压治疗、血压监测和未来研究建议等方面作了推荐。该指南在高血压的诊断方面,强调了血压测量方法对诊断的重要性,将动态血压监测和家庭自测血压作为高血压诊断的必要条件。注重引导患者进行血压的自我管理,对我国临床实践具有借鉴意义。
文摘本文利用文献分析和网站信息梳理等方法,对英国国家卫生与服务优化研究院(National Institute for Health and Care Excellence,NICE)的建立背景、目的、发展历程、评估模式及影响进行系统分析,以期为中国建设卫生技术评估体系提供模式参考及经验借鉴。NICE是英国贯彻循证卫生决策理念的技术载体,可参考英国通过立法确定NICE临床指南对于医疗资源配置和筹资决策的影响,制定完善我国卫生治理法律法规体系,形成证据集成和决策转化应用机制以支持循证决策制定;另外,还可学习NICE加强评估机制、流程和方法工具的调试和完善,以适应政治政策变化、经济社会发展和医改深化要求;最后,我国评估机构还应学习其注重与其他行业组织和相关机构协作,利用行业学会协会、大学等科教研机构、医药企业的技术力量,高效开展证据评估和转化工作。
文摘英国国家卫生保健与临床优化研究所(National Institute for Health and Care Excellence,NICE)于2022年3月2日发布了《职场心理健康》指南。该指南涵盖了如何在职场中为心理健康创造合适的条件,旨在促进支持性和包容性的职场环境,并帮助有心理健康问题或有潜在心理健康风险的人群。本文对该指南要点进行解读。
