苯丙酮尿症的临床实践指南

苯丙酮尿症为常染色体隐性遗传病,是常见的氨基酸代谢异常之一,在中国的平均发病率约为1/11000,表现为南方地区低、北方(尤其是西北地区)高的特征。苯丙酮尿症是可以治疗的遗传病,被列为中国新生儿筛查疾病之一。经筛查确诊的新生儿通过及时控制苯丙氨酸的摄人可以达到满意的治疗效果。本指南旨在总结关于苯丙酮尿症的医学遗传学知识和临床处置要点,以提高临床人员对该病的诊断水平、规范开展新生儿筛査,对患者临床管理的规范化提供建议。     

The use of bisphosphonates in children: review of the literature and guidelines for dental management

Bisphosphonates are inhibitors of osteoclastic bone resorption with therapeutic benefit in a variety of bone disorders in both adults and children. While these agents have been routinely used in adults for the past three decades, their more recent introduction into paediatric medicine means there is a paucity of data on long‐term safety and effects on dental development. There is uncertainty regarding the dental management of children treated with bisphosphonates, particularly when invasive dental procedures, such as extractions and oral surgical procedures, are required. There are limited data with which to make recommendations about the dental management of patients treated with bisphosphonates, and there are no published recommendations that specifically address paediatric patients. This paper aims to outline paediatric uses and adverse effects of bisphosphonates and present recommendations on the dental management of children receiving bisphosphonates.     

《欧洲帕金森病物理治疗指南》康复方案解读

本文对《欧洲帕金森病物理治疗指南》进行解读,介绍循证医学证据下帕金森病物理治疗方案选择及物理治疗形式和内容。     

2019版《中国消化内镜诊疗相关肠道准备指南》解读

随着内镜技术的发展和普及,肠镜检查的重要性进一步突显,肠道准备作为肠镜检查的前提条件显得尤为重要。为进一步改进我国内镜检查前肠道准备的方法,提高内镜检查的质量,结合我国实际情况,中国医师协会内镜医师分会消化内镜专业委员会联合中国抗癌协会肿瘤内镜学专业委员会对旧版指南进行了更新。本文对2019版《中国消化内镜诊疗相关肠道准备指南》的更新内容进行解读,以期更好地加深内镜医护人员对《新指南》的认知和理解,指导患者进行肠道准备,从而最大程度提高肠镜诊疗效果,更大程度的使患者获益。     

Nursing interventions for adults following a mental health crisis: A systematic review guided by trauma‐informed principles

There exists a growing need for health and service providers to respond to persons in a manner that recognizes the prevalence and impact of trauma in individuals and prevent inadvertent re‐traumatization in the routine process of care. The experience of mental health crisis in of itself can have traumatic and impactful effects on individuals. Trauma‐informed approaches to care offer a framework to provide crisis intervention responses that are based on the acknowledgement of the prevalence and impact of trauma and define trauma not by the event per se, but by the impact of an experience of trauma. The integration of trauma‐informed principles in the context of crisis intervention is a current practice gap. In order to inform a portion of a best‐practice guideline for registered nurses and the interprofessional team, a systematic literature review was conducted to primarily identify nursing interventions within four weeks of a mental health crisis, with a secondary focus on identifying particular interventions that included trauma‐informed principles. The systematic review yielded 21 quantitative and qualitative studies related to nursing interventions for mental health crisis, 10 of which referred to one or more principles of trauma‐informed approaches. There was a lack of studies on nursing interventions explicitly linked to implementation of trauma‐informed principles, highlighting future research needs and focused efforts to integrate trauma‐informed principles into crisis intervention practices.     

体现实践成果，引领未来方向:国际妇产科联盟2018年宫颈癌分期解读

一直以来,国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)的宫颈癌分期都是临床分期。但随着诊断技术的发展、手术方式的进步以及对宫颈癌预后的了解加深,过去的FIGO分期已不能很好地推测宫颈癌预后及指导临床治疗选择。因此,FIGO在2009年宫颈癌分期的基础上,引入了近10年来宫颈癌诊治的新进展,形成了2018年宫颈癌分期。新的分期主要体现在肿瘤大小的分层更加细化,且纳入了淋巴结转移情况。本文对FIGO的2018年宫颈癌分期变化及其临床意义进行解读。     

Treatment strategies in urticaria

Urticaria is a common group of disorders encountered in dermatology and in a variety of other fields. In particular, acute urticaria and angiooedema are common medical emergencies, which are treated in the first instance in the Accident and Emergency Department, whereas chronic urticaria poses a challenge in the long-term treatment. This review presents the latest evidence about the treatment for urticaria and is based on the most recent international guidelines (GA²LEN, Global Allergy and Asthma Network, 2009). Patients with acute and chronic urticaria are often not treated appropriately and this review provides a guide for any clinician to treat the underlying cause as well as the symptoms of this disorder according to the latest evidence. Many new therapies are available to patients with urticaria refractory to common therapies and it is important to consider second- and third-line therapies.