Functional dyspepsia(FD),characterized by persistent or recurrent dyspeptic symptoms without identifiable organic,systemic or metabolic causes,is an increasingly recognized global health issue.The objective of this gu...Functional dyspepsia(FD),characterized by persistent or recurrent dyspeptic symptoms without identifiable organic,systemic or metabolic causes,is an increasingly recognized global health issue.The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine(TCM).The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries.To address these queries,a systematic literature search was conducted across PubMed,EMBASE,the Cochrane Library,China National Knowledge Infrastructure(CNKI),VIP Database,China Biology Medicine(SinoMed)Database,Wanfang Database,Traditional Medicine Research Data Expanded(TMRDE),and the Traditional Chinese Medical Literature Analysis and Retrieval System(TCMLARS).The evidence from the literature was critically appraised using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)approach.The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts,methodologists,pharmacologists,nursing specialists,and health economists,leveraging their collective expertise and empirical knowledge.The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects,including the pathogenesis according to TCM,diagnostic approaches,therapeutic interventions,efficacy assessments,and prognostic considerations.展开更多
AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to Jun...AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to June 2012,a total of 3616 patients received screening for gastric cancer by magnifying endoscopy. There were 3675 focal gastric lesions detected using conventional high definition white light endoscopy(HD-WLE) in four different referentialhospitals that were recruited for further investigation using ME and ME-NBI. The images obtained from HD-WLE,ME,and ME-NBI were reviewed by four experienced endoscopists to evaluate their diagnostic effectiveness for EGC. The diagnosis of cancerous and non-cancerous lesions was conducted by evaluating the microvascular and microsurface patterns using the VS classification system. The final endoscopic diagnosis of each lesion was determined by consultation when a disagreement occurred. We used histopathological results as the gold standard for the diagnosis of EGC.RESULTS:Among the 3675 lesions found,1508 were validated by pathological findings as chronic gastritis,1279 as chronic gastritis with intestinal metaplasia,631 as low-grade neoplasia,and 257 as EGC. The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of HD-WLE for the diagnosis of EGC were 71.2%,99.1%,85.5%,97.9% and 97.1%,respectively. The results of ME for diagnosing EGC were 81.3%,98.8%,83.3%,98.6% and 97.6%,respectively. The results of ME-NBI for the diagnosis of EGC were 87.2%,98.6%,82.1%,99.0% and 97.8%,respectively. The diagnostic sensitivity and accuracy of paired ME and ME-NBI were significantly better than those of HD-WLE(P < 0.05).CONCLUSION:HD-WLE has a relatively high accuracy for diagnosing EGC and is an effective screening tool. Further investigations of ME and ME-NBI are required to achieve superior accuracy.展开更多
AIM: To investigate the differentiated whole genome expression profiling of gastric high- and low-grade intraepithelial neoplasia and early-stage adenocarcinoma.
Genetic polymorphism is associated with irritable bowel syndrome(IBS)in terms of susceptibility and clinical manifestations.Previous studies have shown that genetic polymorphism might play a key role in the onset and ...Genetic polymorphism is associated with irritable bowel syndrome(IBS)in terms of susceptibility and clinical manifestations.Previous studies have shown that genetic polymorphism might play a key role in the onset and progression of IBS by modulating components of its pathogenesis such as the gut-brain axis,gastrointestinal motility,inflammatory activity,and immune status.Although underlying pathophysiological mechanisms have not been fully clarified,the potential ethnic differences that are present in worldwide genetic studies of IBS deserve attention.This review surveyed numerous studies focusing on IBSassociated single nucleotide polymorphisms,and investigated the ethnic disparities revealed by them.The results demonstrate the need for more attention on ethnic factors in IBS-related genetic studies.Taking ethnic backgrounds into accounts and placing emphasis on disparities potentially ascribed to ethnicity could help lay a solid and generalized foundation for transcultural,multi-ethnic,or secondary analyses in IBS,for example,a meta-analysis.Broader genetic studies considering ethnic factors are greatly needed to obtain a better understanding of the pathophysiological mechanisms of IBS and to improve the prevention,intervention,and treatment of this disease.展开更多
Background： Tuberculosis （TB） remains a worldwide problem. Intestinal TB （ITB） constitutes a major public health problem in developing countries and has been associated with significant morbidity and mortality. T...Background： Tuberculosis （TB） remains a worldwide problem. Intestinal TB （ITB） constitutes a major public health problem in developing countries and has been associated with significant morbidity and mortality. The aim of this study was to characterize the clinical, radiological, endoscopic, and pathological features of ITB and to define the strategy for establishing the diagnosis. Methods： A retrospective study （from January 2000 to June 2015） was carried out in Peking Union Medical College Hospital and all hospitalized cases were diagnosed as ITB during the study period were included. The relevant clinical information, laboratory results, microbiological, and radiological investigations were recorded. Results： Of the 85 cases, 61 cases （71.8%） were ranged from 20 to 50 years. The ileocecal region was involved in about 83.5% （71/85） of patients. About 41.2% （35/85） of patients had co-existing extra ITB, especially active pulmonary TB. Abdominal pain （82.4%） was the most common presenting symptom followed by weight loss （72.9%） and fever （64.7%）. Both T-cell spot of TB test （T-SPOT.TB） and purified protein derivatives （PPD） tests were performed in 26 patients： 20 （76.9%） positive T-SPOT.TB and 13 （50.0%） positive PPD were detected, with a statistical significant difference （P- 0.046）. Twenty cases （23.5%） were histopathology and/or pathogen confirmed TB; 27 cases （31.8%） were diagnosed by clinical manifestation consistent with ITB and evidence of active extra ITB; 38 cases （44.7%） were diagnosed by good response to diagnostic anti-TB therapy. Conclusions： ITB is difficult to diagnose even with modem medical techniques due to its nonspecific clinical and laboratory features. At present, combination of clinical, endoscopic, radiological, and pathological features continues to be the key to the diagnosis of ITB.展开更多
基金supported by the National Key R&D Program of China(No.2019YFC1712000),but independent of it。
文摘Functional dyspepsia(FD),characterized by persistent or recurrent dyspeptic symptoms without identifiable organic,systemic or metabolic causes,is an increasingly recognized global health issue.The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine(TCM).The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries.To address these queries,a systematic literature search was conducted across PubMed,EMBASE,the Cochrane Library,China National Knowledge Infrastructure(CNKI),VIP Database,China Biology Medicine(SinoMed)Database,Wanfang Database,Traditional Medicine Research Data Expanded(TMRDE),and the Traditional Chinese Medical Literature Analysis and Retrieval System(TCMLARS).The evidence from the literature was critically appraised using the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)approach.The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts,methodologists,pharmacologists,nursing specialists,and health economists,leveraging their collective expertise and empirical knowledge.The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects,including the pathogenesis according to TCM,diagnostic approaches,therapeutic interventions,efficacy assessments,and prognostic considerations.
基金Supported by Profession Specific Funded Projects in Standar-dization of Targeted Therapy and Cell Therapy and Applied Research of Early Diagnosis and Treatment for Cancer from Chinese Ministry of Health,No.200902002
文摘AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to June 2012,a total of 3616 patients received screening for gastric cancer by magnifying endoscopy. There were 3675 focal gastric lesions detected using conventional high definition white light endoscopy(HD-WLE) in four different referentialhospitals that were recruited for further investigation using ME and ME-NBI. The images obtained from HD-WLE,ME,and ME-NBI were reviewed by four experienced endoscopists to evaluate their diagnostic effectiveness for EGC. The diagnosis of cancerous and non-cancerous lesions was conducted by evaluating the microvascular and microsurface patterns using the VS classification system. The final endoscopic diagnosis of each lesion was determined by consultation when a disagreement occurred. We used histopathological results as the gold standard for the diagnosis of EGC.RESULTS:Among the 3675 lesions found,1508 were validated by pathological findings as chronic gastritis,1279 as chronic gastritis with intestinal metaplasia,631 as low-grade neoplasia,and 257 as EGC. The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of HD-WLE for the diagnosis of EGC were 71.2%,99.1%,85.5%,97.9% and 97.1%,respectively. The results of ME for diagnosing EGC were 81.3%,98.8%,83.3%,98.6% and 97.6%,respectively. The results of ME-NBI for the diagnosis of EGC were 87.2%,98.6%,82.1%,99.0% and 97.8%,respectively. The diagnostic sensitivity and accuracy of paired ME and ME-NBI were significantly better than those of HD-WLE(P < 0.05).CONCLUSION:HD-WLE has a relatively high accuracy for diagnosing EGC and is an effective screening tool. Further investigations of ME and ME-NBI are required to achieve superior accuracy.
基金Supported by The specific grants of Public-Funded Projects in the Health Industry,Grant 200902002
文摘AIM: To investigate the differentiated whole genome expression profiling of gastric high- and low-grade intraepithelial neoplasia and early-stage adenocarcinoma.
基金Supported by the Program of International S&T Cooperation,No.2014DFA31850National Natural Science Foundation of China,No.81870379.
文摘Genetic polymorphism is associated with irritable bowel syndrome(IBS)in terms of susceptibility and clinical manifestations.Previous studies have shown that genetic polymorphism might play a key role in the onset and progression of IBS by modulating components of its pathogenesis such as the gut-brain axis,gastrointestinal motility,inflammatory activity,and immune status.Although underlying pathophysiological mechanisms have not been fully clarified,the potential ethnic differences that are present in worldwide genetic studies of IBS deserve attention.This review surveyed numerous studies focusing on IBSassociated single nucleotide polymorphisms,and investigated the ethnic disparities revealed by them.The results demonstrate the need for more attention on ethnic factors in IBS-related genetic studies.Taking ethnic backgrounds into accounts and placing emphasis on disparities potentially ascribed to ethnicity could help lay a solid and generalized foundation for transcultural,multi-ethnic,or secondary analyses in IBS,for example,a meta-analysis.Broader genetic studies considering ethnic factors are greatly needed to obtain a better understanding of the pathophysiological mechanisms of IBS and to improve the prevention,intervention,and treatment of this disease.
文摘Background： Tuberculosis （TB） remains a worldwide problem. Intestinal TB （ITB） constitutes a major public health problem in developing countries and has been associated with significant morbidity and mortality. The aim of this study was to characterize the clinical, radiological, endoscopic, and pathological features of ITB and to define the strategy for establishing the diagnosis. Methods： A retrospective study （from January 2000 to June 2015） was carried out in Peking Union Medical College Hospital and all hospitalized cases were diagnosed as ITB during the study period were included. The relevant clinical information, laboratory results, microbiological, and radiological investigations were recorded. Results： Of the 85 cases, 61 cases （71.8%） were ranged from 20 to 50 years. The ileocecal region was involved in about 83.5% （71/85） of patients. About 41.2% （35/85） of patients had co-existing extra ITB, especially active pulmonary TB. Abdominal pain （82.4%） was the most common presenting symptom followed by weight loss （72.9%） and fever （64.7%）. Both T-cell spot of TB test （T-SPOT.TB） and purified protein derivatives （PPD） tests were performed in 26 patients： 20 （76.9%） positive T-SPOT.TB and 13 （50.0%） positive PPD were detected, with a statistical significant difference （P- 0.046）. Twenty cases （23.5%） were histopathology and/or pathogen confirmed TB; 27 cases （31.8%） were diagnosed by clinical manifestation consistent with ITB and evidence of active extra ITB; 38 cases （44.7%） were diagnosed by good response to diagnostic anti-TB therapy. Conclusions： ITB is difficult to diagnose even with modem medical techniques due to its nonspecific clinical and laboratory features. At present, combination of clinical, endoscopic, radiological, and pathological features continues to be the key to the diagnosis of ITB.
