Renal cancer is one of the most common malignancies of the urinary system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of renal cancer is challenging due to...Renal cancer is one of the most common malignancies of the urinary system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of renal cancer is challenging due to the great differences in the diagnosis and treatment of renal cancer in different regions.The Renal Cancer Expert Committee of the National Cancer Quality Control Center(NCQCC)identified a lack of authoritative quality control standards as an opportunity to utilize its multidisciplinary membership to improve the standardized diagnosis and treatment of renal cancer.The Renal Cancer Expert Committee of the NCQCC aims to promote quality control and national standardization,uniformity,and normalization of renal cancer diagnosis and treatment,which ultimately improved the survival rate and quality of life of renal cancer patients.A panel of experts with renal cancer surgery,renal cancer medicine,medical imaging,pathology and radiotherapy were drawn together and determined the quality control standards for the standardized diagnosis and treatment of renal cancer.The Indices includes 20 items that cover all key areas in the diagnosis and treatment of renal cancer,such as standard diagnosis,surgery treatment,systemic treatment,and prognostic evaluation.展开更多
During the last two decades,there have been several reports of an increasing incidence of type 2 diabetes mellitus(T2 DM) in children and adolescents,especially among those belonging to minority ethnic groups.This tre...During the last two decades,there have been several reports of an increasing incidence of type 2 diabetes mellitus(T2 DM) in children and adolescents,especially among those belonging to minority ethnic groups.This trend,which parallels the increases in prevalence and degree of pediatric obesity,has caused great concern,even though T2 DM remains a relatively rare disease in children.Youth T2 DM differs not only from type 1 diabetes in children,from which it is sometimes difficult to differentiate,but also from T2 DM in adults,since it appears to be an aggressive disease with rapidly progressive β-cell decline,high treatment failure rate,and accelerated development of complications.Despite the recent research,many aspects of youth T2 DM still remain unknown,regarding both its pathophysiology and risk factor contribution,and its optimal management and prevention.Current management approaches include lifestyle changes,such as improved diet and increased physical activity,together with pharmacological interventions,including metformin,insulin,and the recently approved glucagonlike peptide-1 analog liraglutide.What is more important for everyone to realize though,from patients,families and physicians to schools,health services and policy-makers alike,is that T2 DM is a largely preventable disease that will be addressed effectively only if its major contributor(i.e.,pediatric obesity) is confronted and prevented at every possible stage of life,from conception until adulthood.Therefore,relevant comprehensive,coordinated,and innovative strategies are urgently needed.展开更多
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
Gastric cancer is one of the most common malignancies of the digestive system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of gastric cancer is challenging ...Gastric cancer is one of the most common malignancies of the digestive system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of gastric cancer is challenging due to the great differences in the diagnosis and treatment of gastric cancer in different regions.The Gastric Cancer Expert Committee of the National Cancer Quality Control Center(NCQCC)identified a lack of authoritative quality control standards as an opportunity to utilize its multidisciplinary membership to improve the standardized diagnosis and treatment of gastric cancer.The Gastric Cancer Expert Committee of the NCQCC aims to promote quality control and national standardization,uniformity,and normalization of gastric cancer diagnosis and treatment,which ultimately improved the survival rate and quality of life of gastric cancer patients.A panel of experts with gastrointestinal cancer surgery,gastrointestinal cancer medicine,medical imaging,pathology and radiotherapy were drawn together and determined the quality control standards for the standardized diagnosis and treatment of gastric cancer.The authors then utilized a modified Delphi approach to generate consensus recommendations.展开更多
Esophageal cancer(EC)is particularly common in China.With the continuing progress of multi-disciplinary therapy including early screening,minimally invasive techniques,radiotherapy and chemotherapy,the 5-year survival...Esophageal cancer(EC)is particularly common in China.With the continuing progress of multi-disciplinary therapy including early screening,minimally invasive techniques,radiotherapy and chemotherapy,the 5-year survival of EC has been improved in China.However,there are considerable disparities in the diagnosis and treatment quality among different regions.The Esophageal Cancer Expert Committee of the National Cancer Quality Control Center(NCQCC)considers a set of authoritative quality control standards as an opportunity to eliminate the disparities and improve the overall survival and quality of life of EC.To further promote the quality control for standardized diagnosis and treatment of EC,the National Cancer Center commissioned the Esophageal Cancer Quality Control Expert Committee to draft and formulate the Chinese Quality Control Indices for Standardized Diagnosis and Treatment of Esophageal Cancer(2022 edition).The Indices includes 21 items that cover all key areas in the diagnosis and treatment of esophageal cancer,such as medical oncology,radiation oncology,endoscopy,and pathology.展开更多
Non-alcoholic fatty liver disease(NAFLD)is highly prevalent in patients with diabetes mellitus and increasing evidence suggests that patients with type 2diabetes are at a particularly high risk for developing the prog...Non-alcoholic fatty liver disease(NAFLD)is highly prevalent in patients with diabetes mellitus and increasing evidence suggests that patients with type 2diabetes are at a particularly high risk for developing the progressive forms of NAFLD,non-alcoholic steatohepatitis and associated advanced liver fibrosis.Moreover,diabetes is an independent risk factor for NAFLD progression,and for hepatocellular carcinoma development and liver-related mortality in prospective studies.Notwithstanding,patients with NAFLD have an elevated prevalence of prediabetes.Recent studies have shown that NAFLD presence predicts the development of type2 diabetes.Diabetes and NAFLD have mutual pathogenetic mechanisms and it is possible that genetic and environmental factors interact with metabolic derangements to accelerate NAFLD progression in diabetic patients.The diagnosis of the more advanced stages of NAFLD in diabetic patients shares the same challenges as in non-diabetic patients and it includes imaging and serological methods,although histopathological evaluation is still considered the gold standard diagnostic method.An effective established treatment is not yet available for patients with steatohepatitis and fibrosis and randomized clinical trials including only diabetic patients are lacking.We sought to outline the published data including epidemiology,pathogenesis,diagnosis and treatment of NAFLD in diabetic patients,in order to better understand the interplay between these two prevalent diseases and identify the gaps that still need to be fulfilled in the management of NAFLD in patients with diabetes mellitus.展开更多
Pre-pregnancy glucose metabolism is normal, only during pregnancy diabetes known as gestational diabetes mellitus. Currently, the diagnostic criteria for gestational diabetes mellitus are IADPSG criteria (Internationa...Pre-pregnancy glucose metabolism is normal, only during pregnancy diabetes known as gestational diabetes mellitus. Currently, the diagnostic criteria for gestational diabetes mellitus are IADPSG criteria (International Association of Diabetes and Pregnancy Study Group), and 75 g oral glucose tolerance test is recommended at 24 - 28 weeks of gestation. Gestational diabetes is associated with many pregnancy complications, such as macrosomia, preterm delivery and increased cesarean section rates, and neonatal complications such as hypoglycemia, hypoxia, and respiratory distress syndrome. Early identification of high-risk groups can be carried out for early prevention and intervention which are conducive to improving mothers and infants perinatal outcome. For the treatment of gestational diabetes, lifestyle interventions, such as improved diet combined with exercise to control blood sugar, are recommended first. For patients with poor blood glucose control, insulin is recommended for blood glucose control, and oral drug use is still controversial.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
目的:探索营养干预与规范化治疗在妊娠期糖尿病(GDM)孕妇中的应用效果。方法:选择2021年1月—2023年3月瑞金市妇幼保健院收治的102例GDM孕妇。按随机数字表法分为常规组和联合组,各51例。常规组实施规范化治疗,联合组在常规组的基础上...目的:探索营养干预与规范化治疗在妊娠期糖尿病(GDM)孕妇中的应用效果。方法:选择2021年1月—2023年3月瑞金市妇幼保健院收治的102例GDM孕妇。按随机数字表法分为常规组和联合组,各51例。常规组实施规范化治疗,联合组在常规组的基础上实施营养干预。比较两组的糖脂代谢指标、营养状态及妊娠结局。结果:干预后,联合组餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)及空腹血糖(FPG)均低于常规组,差异均有统计学意义(P<0.05)。干预后,联合组三酰甘油(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)均低于常规组,差异均有统计学意义(P<0.05),而两组高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P>0.05)。干预后,联合组血红蛋白(Hb)、血浆白蛋白(ALB)及血清总蛋白(TP)均高于常规组,差异均有统计学意义(P<0.05)。干预后,联合组不良妊娠结局发生率低于常规组,差异有统计学意义(P<0.05)。结论:营养干预联合规范化治疗能显著改善GDM孕妇的糖脂代谢和营养状态,并有效降低不良妊娠结局的风险。展开更多
基金supported by Peking University First Hospital Domestic Multicenter Clinical Research Special Fund-Central High Level Hospital Clinical Research Business Fund(grant number:2022CR54)Peking University Medical Innovation Translation Special Fund(grant number:2022FY03)+2 种基金Peking University First Hospital Scientific and Technological Achievement Transformation Incubation Guidance Fund(grant number:2022CX02)2020 Capital Health Development Research Spe-cial Project(grant number:2020-2Z-40713)National Key Research and Development Program Scheme(grant number:2023YFC2415500)。
文摘Renal cancer is one of the most common malignancies of the urinary system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of renal cancer is challenging due to the great differences in the diagnosis and treatment of renal cancer in different regions.The Renal Cancer Expert Committee of the National Cancer Quality Control Center(NCQCC)identified a lack of authoritative quality control standards as an opportunity to utilize its multidisciplinary membership to improve the standardized diagnosis and treatment of renal cancer.The Renal Cancer Expert Committee of the NCQCC aims to promote quality control and national standardization,uniformity,and normalization of renal cancer diagnosis and treatment,which ultimately improved the survival rate and quality of life of renal cancer patients.A panel of experts with renal cancer surgery,renal cancer medicine,medical imaging,pathology and radiotherapy were drawn together and determined the quality control standards for the standardized diagnosis and treatment of renal cancer.The Indices includes 20 items that cover all key areas in the diagnosis and treatment of renal cancer,such as standard diagnosis,surgery treatment,systemic treatment,and prognostic evaluation.
文摘During the last two decades,there have been several reports of an increasing incidence of type 2 diabetes mellitus(T2 DM) in children and adolescents,especially among those belonging to minority ethnic groups.This trend,which parallels the increases in prevalence and degree of pediatric obesity,has caused great concern,even though T2 DM remains a relatively rare disease in children.Youth T2 DM differs not only from type 1 diabetes in children,from which it is sometimes difficult to differentiate,but also from T2 DM in adults,since it appears to be an aggressive disease with rapidly progressive β-cell decline,high treatment failure rate,and accelerated development of complications.Despite the recent research,many aspects of youth T2 DM still remain unknown,regarding both its pathophysiology and risk factor contribution,and its optimal management and prevention.Current management approaches include lifestyle changes,such as improved diet and increased physical activity,together with pharmacological interventions,including metformin,insulin,and the recently approved glucagonlike peptide-1 analog liraglutide.What is more important for everyone to realize though,from patients,families and physicians to schools,health services and policy-makers alike,is that T2 DM is a largely preventable disease that will be addressed effectively only if its major contributor(i.e.,pediatric obesity) is confronted and prevented at every possible stage of life,from conception until adulthood.Therefore,relevant comprehensive,coordinated,and innovative strategies are urgently needed.
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 by“Beijing Municipal Administration of Hospitals Incubating Program”(No.PX2018043)。
文摘Gastric cancer is one of the most common malignancies of the digestive system,and the number of deaths continues to increase.The standardized management of the diagnosis and treatment of gastric cancer is challenging due to the great differences in the diagnosis and treatment of gastric cancer in different regions.The Gastric Cancer Expert Committee of the National Cancer Quality Control Center(NCQCC)identified a lack of authoritative quality control standards as an opportunity to utilize its multidisciplinary membership to improve the standardized diagnosis and treatment of gastric cancer.The Gastric Cancer Expert Committee of the NCQCC aims to promote quality control and national standardization,uniformity,and normalization of gastric cancer diagnosis and treatment,which ultimately improved the survival rate and quality of life of gastric cancer patients.A panel of experts with gastrointestinal cancer surgery,gastrointestinal cancer medicine,medical imaging,pathology and radiotherapy were drawn together and determined the quality control standards for the standardized diagnosis and treatment of gastric cancer.The authors then utilized a modified Delphi approach to generate consensus recommendations.
基金supported by the Special Program for Basic Re-source Survey of the Ministry of Science and Technology(grant number:2019FY101101)National Key R&D Program of China(grant num-ber:2021YFC2501000).
文摘Esophageal cancer(EC)is particularly common in China.With the continuing progress of multi-disciplinary therapy including early screening,minimally invasive techniques,radiotherapy and chemotherapy,the 5-year survival of EC has been improved in China.However,there are considerable disparities in the diagnosis and treatment quality among different regions.The Esophageal Cancer Expert Committee of the National Cancer Quality Control Center(NCQCC)considers a set of authoritative quality control standards as an opportunity to eliminate the disparities and improve the overall survival and quality of life of EC.To further promote the quality control for standardized diagnosis and treatment of EC,the National Cancer Center commissioned the Esophageal Cancer Quality Control Expert Committee to draft and formulate the Chinese Quality Control Indices for Standardized Diagnosis and Treatment of Esophageal Cancer(2022 edition).The Indices includes 21 items that cover all key areas in the diagnosis and treatment of esophageal cancer,such as medical oncology,radiation oncology,endoscopy,and pathology.
基金Supported by Conselho Brasileiro de Desenvolvimento Científico e Tecnológico(CNPq-Brasil)and Fundao Carlos Chagas Filho de AmparoàPesquisa do Estado do Rio de Janeiro(FAPERJ-Brasil)
文摘Non-alcoholic fatty liver disease(NAFLD)is highly prevalent in patients with diabetes mellitus and increasing evidence suggests that patients with type 2diabetes are at a particularly high risk for developing the progressive forms of NAFLD,non-alcoholic steatohepatitis and associated advanced liver fibrosis.Moreover,diabetes is an independent risk factor for NAFLD progression,and for hepatocellular carcinoma development and liver-related mortality in prospective studies.Notwithstanding,patients with NAFLD have an elevated prevalence of prediabetes.Recent studies have shown that NAFLD presence predicts the development of type2 diabetes.Diabetes and NAFLD have mutual pathogenetic mechanisms and it is possible that genetic and environmental factors interact with metabolic derangements to accelerate NAFLD progression in diabetic patients.The diagnosis of the more advanced stages of NAFLD in diabetic patients shares the same challenges as in non-diabetic patients and it includes imaging and serological methods,although histopathological evaluation is still considered the gold standard diagnostic method.An effective established treatment is not yet available for patients with steatohepatitis and fibrosis and randomized clinical trials including only diabetic patients are lacking.We sought to outline the published data including epidemiology,pathogenesis,diagnosis and treatment of NAFLD in diabetic patients,in order to better understand the interplay between these two prevalent diseases and identify the gaps that still need to be fulfilled in the management of NAFLD in patients with diabetes mellitus.
文摘Pre-pregnancy glucose metabolism is normal, only during pregnancy diabetes known as gestational diabetes mellitus. Currently, the diagnostic criteria for gestational diabetes mellitus are IADPSG criteria (International Association of Diabetes and Pregnancy Study Group), and 75 g oral glucose tolerance test is recommended at 24 - 28 weeks of gestation. Gestational diabetes is associated with many pregnancy complications, such as macrosomia, preterm delivery and increased cesarean section rates, and neonatal complications such as hypoglycemia, hypoxia, and respiratory distress syndrome. Early identification of high-risk groups can be carried out for early prevention and intervention which are conducive to improving mothers and infants perinatal outcome. For the treatment of gestational diabetes, lifestyle interventions, such as improved diet combined with exercise to control blood sugar, are recommended first. For patients with poor blood glucose control, insulin is recommended for blood glucose control, and oral drug use is still controversial.
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.
文摘目的:探索营养干预与规范化治疗在妊娠期糖尿病(GDM)孕妇中的应用效果。方法:选择2021年1月—2023年3月瑞金市妇幼保健院收治的102例GDM孕妇。按随机数字表法分为常规组和联合组,各51例。常规组实施规范化治疗,联合组在常规组的基础上实施营养干预。比较两组的糖脂代谢指标、营养状态及妊娠结局。结果:干预后,联合组餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)及空腹血糖(FPG)均低于常规组,差异均有统计学意义(P<0.05)。干预后,联合组三酰甘油(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)均低于常规组,差异均有统计学意义(P<0.05),而两组高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P>0.05)。干预后,联合组血红蛋白(Hb)、血浆白蛋白(ALB)及血清总蛋白(TP)均高于常规组,差异均有统计学意义(P<0.05)。干预后,联合组不良妊娠结局发生率低于常规组,差异有统计学意义(P<0.05)。结论:营养干预联合规范化治疗能显著改善GDM孕妇的糖脂代谢和营养状态,并有效降低不良妊娠结局的风险。
