Chinese expert consensus on the surgical treatment of primary palmar hyperhidrosis (2021 version)

Primary palmar hyperhidrosis (PPH) is a pathologic condition of excessive sweating on hands that has adverse impacts on patients’ social activity, professional life, and psychological state. Endoscopic thoracic sympathicotomy (ETS) is by far the treatment choice for PPH with the most stable and durable curative effects, but special attention should be given to the side effects of the surgery, especially compensatory hyperhidrosis (CH). This consensus is the second version of the Chinese Expert Consensus on the Surgical Treatment of PPH by the China Expert Committee on Palmar Hyperhidrosis (CECPH), which was published 10 years ago. This consensus emphasizes the need for special attention and careful assessment of the patients’ feelings, as well as their emotional and mental state, and emphasizes that distress due to palmar sweating and the desire for treatment are prerequisites for diagnosis. It also provides a more nuanced delineation of CH and reviews all new attempts to prevent and treat this side effect. New evidence of the epidemiology, pathogenesis of PPH, and indications for surgery were also assessed or recommended.     

肺结节评估四大指南比较分析

近20年来,随着计算机断层扫描(computed tomography,CT)技术的提高和肺癌高危人群筛查的普及,越来越多的肺部小结节被发现,然而肺结节的定性诊断仍有很多困难.肺结节是临床上一种常见的现象,恶性结节早期发病比较隐匿,如果不进行早期干预,其病程迅速、恶性程度强、预后差.如果能在早期阶段对病灶进行手术切除,将会明显改善肺癌患者的预后.目前针对肺结节的处理指南层出不穷,但各大指南均未达成统一的共识.本文拟对在国内影响最大的四个指南:美国国家综合癌症网络非小细胞肺癌(non-small cell lung cancer,NSCLC)临床实践指南、美国胸科医师协会肺癌诊疗指南、Fleischner-Society肺结节处理策略指南、肺结节的评估亚洲共识指南所推荐的肺结节诊断和处理策略进行介绍和分析.     

Contemporary issues in toxicology the role of metabonomics in toxicology and its evaluation by the COMET project

The role that metabonomics has in the evaluation of xenobiotic toxicity studies is presented here together with a brief summary of published studies. To provide a comprehensive assessment of this approach, the Consortium for Metabonomic Toxicology (COMET) has been formed between six pharmaceutical companies and Imperial College of Science, Technology and Medicine (IC), London, UK. The objective of this group is to define methodologies and to apply metabonomic data generated using (1)H NMR spectroscopy of urine and blood serum for preclinical toxicological screening of candidate drugs. This is being achieved by generating databases of results for a wide range of model toxins which serve as the raw material for computer-based expert systems for toxicity prediction. The project progress on the generation of comprehensive metabonomic databases and multivariate statistical models for prediction of toxicity, initially for liver and kidney toxicity in the rat and mouse, is reported. Additionally, both the analytical and biological variation which might arise through the use of metabonomics has been evaluated. An evaluation of intersite NMR analytical reproducibility has revealed a high degree of robustness. Second, a detailed comparison has been made of the ability of the six companies to provide consistent urine and serum samples using a study of the toxicity of hydrazine at two doses in the male rat, this study showing a high degree of consistency between samples from the various companies in terms of spectral patterns and biochemical composition. Differences between samples from the various companies were small compared to the biochemical effects of the toxin. A metabonomic model has been constructed for urine from control rats, enabling identification of outlier samples and the metabolic reasons for the deviation. Building on this success, and with the completion of studies on approximately 80 model toxins, first expert systems for prediction of liver and kidney toxicity have been generated.     

《世界胃肠病组织指导意见:COVID-19和肝病患者的照护》摘译

世界卫生组织于2020年3月11日宣布新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)疫情全球大流行,截至2020年7月中旬,全球COVID-19的确诊病例已超过1400万例,其中近60万例死亡。COVID-19的中位潜伏期为4 d,主要影响呼吸系统,常见临床表现为发热、咳嗽和呼吸困难。入院时,半数以上患者的胸部CT表现为磨玻璃样影,80%以上患者淋巴细胞减少。14%~76%的COVID-19患者存在肝功能异常,但常无症状,肝脏生化指标升高主要表现为ALT、AST、GGT水平升高,胆红素水平略升高,ALP水平一般正常。     

肝包虫病影像学诊断专家共识

包虫病是呈全球性分布的人畜共患性疾病,已成为严重危害全世界公共卫生健康的问题。影像学技术在肝包虫病的早期诊断、术前评价及疗效监测方面发挥着至关重要的作用。目前包虫病影像诊断缺乏统一共识,不利于影像专业人员学习培训以及临床对于包虫病的规范诊断与治疗,为此由首都医科大学附属北京佑安医院和新疆医科大学第一附属医院联合多家医院的感染与炎症放射学专家,在充分学习国际指南、文献以及国内外最新研究成果的基础上,结合循证医学对建立指南及标准的方法学要求,针对肝包虫病影像学诊断依据、诊断原则、诊断标准和鉴别诊断形成共识,为临床医师在肝包虫病影像学临床应用中提供明确的诊断依据。     

乙型肝炎病毒相关早期肝细胞癌影像学检查与诊断标准共识

早期肝细胞癌(eHCC)病理诊断标准已建立并于2009年更新,但目前国内外均未确定eHCC影像学诊断标准。中华医学会放射学分会传染病学组联合中国医师协会放射医师分会感染影像专业委员会、中国研究型医院学会感染与炎症放射学专业委员会、中国性病艾滋病防治协会感染(传染病)影像工作委员会、中国医院协会传染病分会传染病影像学组和北京影像诊疗技术创新联盟组织国内10余省市40多名专家共同努力形成本共识,旨在为相关专业医生诊断eHCC提供帮助。     

中国居民肥胖防治专家共识

肥胖及相关慢性病已成为中国及全球重大公共卫生问题。中国制定和实施了一系列相关防控政策和行动方案,但肥胖及相关慢性病问题尚未得到有效控制。在国内外最新相关指南和研究成果基础上,中国营养学会肥胖防控分会等机构邀请34位相关专家,经过多轮研究和会商,就当前和未来中国肥胖防治议题达成了《中国居民肥胖防治专家共识》,指导推动未来...     

53例分裂症患者与正常人性犯罪行为的对照分析

目的　探讨分裂症患者与正常人性犯罪行为的差异。方法　对 5 3例分裂症患者与 5 3名正常人的性犯罪行为进行了对照分析。结果　分裂症组与对照组比较 ,在作案前相关因素、作案年龄、作案动机、作案对象、作案方式及作案后表现等方面差异有显著意义 ( P<0 .0 5或 P<0 .0 1 )。结论　分裂症患者性犯罪作案特点及相关因素是评定其辨认和控制能力的重要依据     

Russian Consensus on Exo- and Endocrine Pancreatic Insufficiency After Surgical Treatment

The Russian consensus on exo- and endocrine pancreatic insufficiency after surgical treatment was prepared on the initiative of the Russian Pancreatic Club using the Delphi method. Its goal was to consolidate the opinions of national experts on the most relevant issues of diagnosis and treatment of exo- and endocrine insufficiency after surgical interventions on the pancreas. An interdisciplinary approach is ensured by the participation of leading gastroenterologists and surgeons.     

Definition of Synchronous Oligometastatic Non–Small Cell Lung Cancer—A Consensus Report

IntroductionImproved outcome has been shown in patients with synchronous oligometastatic (sOM) NSCLC when treated with radical intent. As a uniform definition of sOM NSCLC is lacking, we developed a definition and diagnostic criteria by a consensus process.MethodsA pan-European multidisciplinary consensus group was established. Consensus questions were built on the basis of current controversies, and definitions were extracted from a survey, cases and a systematic review. This statement was formulated during a consensus meeting.ResultsIt was determined that definition of sOM NSCLC is relevant when a radical treatment that may modify the disease course (leading to long-term disease control) is technically feasible for all tumor sites with acceptable toxicity. On the basis of the review, a maximum of five metastases and three organs was proposed. Mediastinal lymph node involvement was not counted as a metastatic site. Fludeoxyglucose F 18 positron emission tomography–computed tomography and brain imaging were considered mandatory. A dedicated liver magnetic resonance imaging scan was advised for a solitary liver metastasis, and thoracoscopy and biopsies of distant ipsilateral pleural sites were recommended for a solitary pleural metastasis. For mediastinal staging, fludeoxyglucose F 18 positron emission tomography–computed tomography was deemed the minimum requirement, with pathological confirmation recommended if this influences the treatment strategy. Biopsy of a solitary metastatic location was mandated unless the multidisciplinary team is of the opinion that the risks outweigh the benefits.ConclusionA multidisciplinary consensus statement on the definition and staging of sOM NSCLC has been formulated. This statement will help to standardize inclusion criteria in future clinical trials.