Background:Insufficient physical activity and prolonged sedentary behavior have emerged as major global public health challenges.Short bouts(≤10 min)of accumulated exercise(SBAE)throughout the day may be a promising ...Background:Insufficient physical activity and prolonged sedentary behavior have emerged as major global public health challenges.Short bouts(≤10 min)of accumulated exercise(SBAE)throughout the day may be a promising strategy to mitigate the adverse effects of prolonged sitting and promote physical activity,ultimately promoting overall health.However,previous ambiguity in defining this concept has resulted in a fragmented and inconsistent evidence base,impeding practical applications,the development of guidelines,and policymaking.The purpose of this study is to establish an operational definition of SBAE by synthesizing systematic reviews and research trials alongside an expert consensus.Additionally,it seeks to evaluate acute and long-term efficacy and feasibility,providing evidence-based recommendations for practice and future research directions.Methods:A literature search was performed across PubMed and Web of Science,followed by systematic screening and summarization of eligible studies based on predefined inclusion criteria.Inclusion criteria encompassed various modes/types of SBAE(bouts lasting≤10 min,performed multiple times daily with≥30 min intervals);both aerobic and resistance exercise were considered.Relevant systematic reviews and research trials were included.Methodological quality,risk of bias,and evidence certainty were assessed.Expert consensus was obtained through a survey to evaluate recommendations and agreement levels on findings.Results:After analyzing 27 systematic reviews,135 research studies,and an expert consensus involving 48 researchers from 11 countries,SBAE is defined as any exercise mode of activity,regardless of intensity,that is accumulated in either continuous or intermittent bouts lasting≤10 min per session(including multiple intermittent sets)that are performed multiple times(≥2 sessions/day)per day,with intervals of≥30 min between bouts or otherwise sufficient time for recovery.When used to interrupt prolonged periods of sedentary time,SBAE mitigates the acute adverse effects of sedentary behavior on more than 10 clinical biomarkers of endocrine,cardiovascular,and brain health/function among adults of diverse ages and conditions.Moreover,SBAE was superior for improving acute glycemic control compared to a single continuous exercise session.As a long-term intervention(average of 11 weeks),SBAE can improve over 20 health outcomes,including peak oxygen uptake,resting blood pressure,and metabolic health.Additionally,SBAE might be more effective than continuous exercise for improving longer-term glycemic control and body composition.Long-term completion rates for SBAE interventions are generally high(95%),with low dropout rates(12%)and high adherence rates even without supervision(85%),and its safety has been preliminarily validated.Conclusion:An operational definition of SBAE is provided along with its classification and acute and long-term efficacy.Practical exercise prescription recommendations and evidence-based strategies for various populations and contexts are provided.Future research should focus on generating high-quality evidence for SBAE in 5 key areas:quantification and monitoring,population-specific responses,optimization of exercise prescriptions,intervention efficacy,and practical implementation.Additionally,addressing policy,environmental,and promotional barriers is crucial for transitioning from expert consensus to public consensus,and for facilitating the application of this strategy in real-world environments.展开更多
Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions,including bronchiectasis,pulmonary malignancies,tuberculosi...Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions,including bronchiectasis,pulmonary malignancies,tuberculosis,aspergillosis,and vascular malformations.^([1-3]) A metaanalysis involving patients with massive hemoptysis reported a mortality rate of 3.5%.^([4])This underscores the critical importance of prompt and eff ective embolization of the responsible artery to improve outcomes,particularly in patients presenting with life-threatening hemoptysis.展开更多
The robotic surgical system has been applied in liver surgery.However,controversies concerns exist regarding a variety of factors including the safety,feasibility,efficacy,and cost-effectiveness of robotic surgery.To ...The robotic surgical system has been applied in liver surgery.However,controversies concerns exist regarding a variety of factors including the safety,feasibility,efficacy,and cost-effectiveness of robotic surgery.To promote the development of robotic hepatectomy,this study aimed to evaluate the current status of robotic hepatectomy and provide sixty experts'consensus and recommendations to promote its development.Based on the World Health Organization Handbook for Guideline Development,a Consensus Steering Group and a Consensus Development Group were established to determine the topics,prepare evidence-based documents,and generate recommendations.The GRADE Grid method and Delphi vote were used to formulate the recommendations.A total of 22 topics were prepared analyzed and widely discussed during the 4 meetings.Based on the published articles and expert panel opinion,7 recommendations were generated by the GRADE method using an evidence-based method,which focused on the safety,feasibility,indication,techniques and cost-effectiveness of hepatectomy.Given that the current evidences were low to very low as evaluated by the GRADE method,further randomized-controlled trials are needed in the future to validate these recommendations.展开更多
Despite its crucial role in interventional therapies for liver malignancy,cone-beam computed tomography(CBCT)has not yet been fully integrated into clinical practice due to several complicating factors,including nonst...Despite its crucial role in interventional therapies for liver malignancy,cone-beam computed tomography(CBCT)has not yet been fully integrated into clinical practice due to several complicating factors,including nonstandardized operations and limited recognition of CBCT among interventional radiologists.In response,the Chinese College of Interventionalists has released a consensus statement aimed at standardizing and promoting the application of CBCT in the interventional therapies for liver malignancy.This statement summarizes CBCT scanning techniques,and operational standards,and highlights its potential applications in clinical practice.展开更多
Hepatocellular carcinoma(HCC)is one of the most frequent cancers worldwide among patients with cirrhosis,and its management and treatment is in continuous evolution due to the introductions of new therapeutic option.I...Hepatocellular carcinoma(HCC)is one of the most frequent cancers worldwide among patients with cirrhosis,and its management and treatment is in continuous evolution due to the introductions of new therapeutic option.It represents most common primary malignancy of the liver,developing in 90%of cases of un underlying liver disease(1)[chronic HBV and HCV hepatitis,dysmetabolic liver disease].展开更多
文摘Background:Insufficient physical activity and prolonged sedentary behavior have emerged as major global public health challenges.Short bouts(≤10 min)of accumulated exercise(SBAE)throughout the day may be a promising strategy to mitigate the adverse effects of prolonged sitting and promote physical activity,ultimately promoting overall health.However,previous ambiguity in defining this concept has resulted in a fragmented and inconsistent evidence base,impeding practical applications,the development of guidelines,and policymaking.The purpose of this study is to establish an operational definition of SBAE by synthesizing systematic reviews and research trials alongside an expert consensus.Additionally,it seeks to evaluate acute and long-term efficacy and feasibility,providing evidence-based recommendations for practice and future research directions.Methods:A literature search was performed across PubMed and Web of Science,followed by systematic screening and summarization of eligible studies based on predefined inclusion criteria.Inclusion criteria encompassed various modes/types of SBAE(bouts lasting≤10 min,performed multiple times daily with≥30 min intervals);both aerobic and resistance exercise were considered.Relevant systematic reviews and research trials were included.Methodological quality,risk of bias,and evidence certainty were assessed.Expert consensus was obtained through a survey to evaluate recommendations and agreement levels on findings.Results:After analyzing 27 systematic reviews,135 research studies,and an expert consensus involving 48 researchers from 11 countries,SBAE is defined as any exercise mode of activity,regardless of intensity,that is accumulated in either continuous or intermittent bouts lasting≤10 min per session(including multiple intermittent sets)that are performed multiple times(≥2 sessions/day)per day,with intervals of≥30 min between bouts or otherwise sufficient time for recovery.When used to interrupt prolonged periods of sedentary time,SBAE mitigates the acute adverse effects of sedentary behavior on more than 10 clinical biomarkers of endocrine,cardiovascular,and brain health/function among adults of diverse ages and conditions.Moreover,SBAE was superior for improving acute glycemic control compared to a single continuous exercise session.As a long-term intervention(average of 11 weeks),SBAE can improve over 20 health outcomes,including peak oxygen uptake,resting blood pressure,and metabolic health.Additionally,SBAE might be more effective than continuous exercise for improving longer-term glycemic control and body composition.Long-term completion rates for SBAE interventions are generally high(95%),with low dropout rates(12%)and high adherence rates even without supervision(85%),and its safety has been preliminarily validated.Conclusion:An operational definition of SBAE is provided along with its classification and acute and long-term efficacy.Practical exercise prescription recommendations and evidence-based strategies for various populations and contexts are provided.Future research should focus on generating high-quality evidence for SBAE in 5 key areas:quantification and monitoring,population-specific responses,optimization of exercise prescriptions,intervention efficacy,and practical implementation.Additionally,addressing policy,environmental,and promotional barriers is crucial for transitioning from expert consensus to public consensus,and for facilitating the application of this strategy in real-world environments.
文摘Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions,including bronchiectasis,pulmonary malignancies,tuberculosis,aspergillosis,and vascular malformations.^([1-3]) A metaanalysis involving patients with massive hemoptysis reported a mortality rate of 3.5%.^([4])This underscores the critical importance of prompt and eff ective embolization of the responsible artery to improve outcomes,particularly in patients presenting with life-threatening hemoptysis.
基金Supported by National Key Research and Development Program of China,No.2017YFC0110405National Natural Science Foundation of China,No.81500499
文摘The robotic surgical system has been applied in liver surgery.However,controversies concerns exist regarding a variety of factors including the safety,feasibility,efficacy,and cost-effectiveness of robotic surgery.To promote the development of robotic hepatectomy,this study aimed to evaluate the current status of robotic hepatectomy and provide sixty experts'consensus and recommendations to promote its development.Based on the World Health Organization Handbook for Guideline Development,a Consensus Steering Group and a Consensus Development Group were established to determine the topics,prepare evidence-based documents,and generate recommendations.The GRADE Grid method and Delphi vote were used to formulate the recommendations.A total of 22 topics were prepared analyzed and widely discussed during the 4 meetings.Based on the published articles and expert panel opinion,7 recommendations were generated by the GRADE method using an evidence-based method,which focused on the safety,feasibility,indication,techniques and cost-effectiveness of hepatectomy.Given that the current evidences were low to very low as evaluated by the GRADE method,further randomized-controlled trials are needed in the future to validate these recommendations.
文摘Despite its crucial role in interventional therapies for liver malignancy,cone-beam computed tomography(CBCT)has not yet been fully integrated into clinical practice due to several complicating factors,including nonstandardized operations and limited recognition of CBCT among interventional radiologists.In response,the Chinese College of Interventionalists has released a consensus statement aimed at standardizing and promoting the application of CBCT in the interventional therapies for liver malignancy.This statement summarizes CBCT scanning techniques,and operational standards,and highlights its potential applications in clinical practice.
文摘Hepatocellular carcinoma(HCC)is one of the most frequent cancers worldwide among patients with cirrhosis,and its management and treatment is in continuous evolution due to the introductions of new therapeutic option.It represents most common primary malignancy of the liver,developing in 90%of cases of un underlying liver disease(1)[chronic HBV and HCV hepatitis,dysmetabolic liver disease].
