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Cancer Communications 2022年第10期42卷 937-970页

作者： Peixin Chen Yunhuan Liu Yaokai Wen Caicun Zhou School of Medicine Tongji UniversityShanghai 200092P.R.China Department of Medical Oncology Shanghai Pulmonary HospitalSchool of MedicineTongji UniversityShanghai 200433P.R.China Department of Respiratory and Critical Care Medicine Huadong HospitalFudan UniversityShanghai 200040P.R.China

In China,lung cancer is a primary cancer type with high incidence and mortality.Risk factors for lung cancer include tobacco use,family history,radiation exposure,and the presence of chronic lung diseases.Most early-stage non-small cell lung cancer(NSCLC)patients miss the optimal timing for treatment due to the lack of clinical presentations.Population-based nationwide screening programs are of significant help in increasing the early detection and survival rates of NSCLC in China.The understanding of molecular carcinogenesis and the identification of oncogenic drivers dramatically facilitate the development of targeted therapy for NSCLC,thus prolonging survival in patients with positive drivers.In the exploration of immune escape mechanisms,programmed cell death protein 1(PD-1)/programmed death-ligand 1(PD-L1)inhibitor monotherapy and PD-1/PD-L1 inhibitor plus chemotherapy have become a standard of care for advanced NSCLC in China.In the Chinese Society of clinical Oncology’s guidelines for NSCLC,maintenance immunotherapy is recommended for locally advanced NSCLC after chemoradiotherapy.Adjuvant immunotherapy and neoadjuvant chemoimmunotherapy will be approved for resectable NSCLC.In this review,we summarized recent advances in NSCLC in China in terms of epidemiology,biology,molecular pathology,pathogenesis,screening,diagnosis,targeted therapy,and immunotherapy。

关键词： non-small cell lung cancer screening targeted therapy immunotherapy epidermal growth factor receptor(EGFR)mutation programmed cell death protein 1(PD-1) programmed deathligand 1(PD-L1) clinical trials clinical guidelines

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Current guidelines for the management of celiac disease:A systematic review with comparative analysis

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World Journal of Gastroenterology 2022年第1期28卷 154-175页

作者： Alberto Raiteri Alessandro Granito Alice Giamperoli Teresa Catenaro Giulia Negrini Francesco Tovoli Division of Internal Medicine Hepatobiliary and Immunoallergic DiseasesIRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy

BACKGROUND Wheat and other gluten-containing grains are widely consumed,providing approximately 50%of the caloric intake in both industrialised and developing countries.The widespread diffusion of gluten-containing diets has rapidly led to a sharp increase in celiac disease prevalence.This condition was thought to be very rare outside Europe and relatively ignored by health professionals and the global media.However,in recent years,the discovery of important diagnostic and pathogenic milestones has led to the emergence of celiac disease(CD)from obscurity to global prominence.These modifications have prompted experts worldwide to identify effective strategies for the diagnosis and follow-up of CD.Different scientific societies,mainly from Europe and America,have proposed guidelines based on CD's most recent evidence.AIM To identify the most recent scientific guidelines on CD,aiming to find and critically analyse the main differences.METHODS We performed a database search on PubMed selecting papers published between January 2010 and January 2021 in the English language.PubMed was lastly accessed on 1 March 2021.RESULTS We distinguished guidelines from 7 different scientific societies whose reputation is worldwide recognized and representative of the clinical practice in different geographical regions.Differences were noted in the possibility of a no-biopsy diagnosis,HLA testing,follow-up protocols,and procedures.CONCLUSION We found a relatively high concordance between the guidelines for CD.Important modifications have occurred in the last years,especially about the possibility of a no-biopsy diagnosis in children.Other modifications are expected in the next future and will probably involve the extension of the non-invasive diagnosis to the adult population and the follow-up modalities.

关键词： Celiac disease Gluten Gluten-free diet Gluten sensitivity clinical guidelines Non-invasive diagnosis Histopathological findings Serological markers Genetics

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Diverticulitis is a population health problem:Lessons and gaps in strategies to implement and improve contemporary care

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1007-1019页

作者： Stephanie Lee Stovall Jennifer A Kaplan Joanna K Law David R Flum Vlad V Simianu Department of Surgery Virginia Mason Franciscan HealthSeattleWA 98101United States Department of Gastroenterology Virginia Mason Franciscan HealthSeattleWA 98101United States Department of Surgery University of Washington MedicalSeattleWA 98195United States

The disease burden of diverticulitis is high across inpatient and outpatient settings,and the prevalence of diverticulitis has increased.Historically,patients with acute diverticulitis were admitted routinely for intravenous antibiotics and many had urgent surgery with colostomy or elective surgery after only a few episodes.Several recent studies have challenged the standards of how acute and recurrent diverticulitis are managed,and many clinical practice guidelines(CPGs)have pivoted to recommend outpatient management and individualized decisions about surgery.Yet the rates of diverticulitis hospitalizations and operations are increasing in the United States,suggesting there is a disconnect from or delay in adoption of CPGs across the spectrum of diverticular disease.In this review,we propose approaching diverticulitis care from a population level to understand the gaps between contemporary studies and real-world practice and suggest strategies to implement and improve future care.

关键词： Diverticulitis Hospitalization Elective Emergent surgery clinical guidelines Diverticular disease

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The Importance of Evidence for the Integration of Traditional and Complementary Medicine into Western Healthcare?

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World Journal of Traditional Chinese Medicine 2016年第1期2卷 74-79页

作者： Nicola Robinson Allied Health Sciences School of Health & Social Care London South Bank University

Policy makers should consider improving access to treatments normally considered outside of healthcare in the west, particularly given the recent WHO strategy. However, research on integrating traditional and complementary medicines(T&CM) into conventional health care is lacking. T& CM approaches, may provide a cost effective option given the increase in chronic diseases with evidence of effectiveness of T& CM being key if such approaches are to be offered as part of integrative patient care, in most countries, an integrated healthcare approach is unavailable to patients. Evidence based clinical guidelines on T& CM should influence care provision. However evidence that is available may not even be cited. Poor use of evidence may possibly be a reflection of lack of knowledge and/or biases of guideline developers but additionally stakeholders vary in their perceived need for evidence to implement health policy change. Journal editors should focus on publishing high quality manuscripts, with clear rationales, design and reporting frameworks. Researchers should consider carrying out careful feasibility studies prior to conducting trials taking into account the UK Medical Research Council's framework on complex interventions. Examples of feasibility studies highlighting their importance for trial design are given in this paper. If preparation for more definitive studies is conducted this will in turn improve the quality of research being designed, executed and published and subsequently encourage the inclusion of evidence by guideline developers. Robust evidence is necessary in order to inform governments' health policies providing appropriate T&CM interventions which can ultimately help to provide best patient care.

关键词： Integrated medicine traditional and complementary medicine clinical guidelines evidence based medicine Delphi Technique acupuncture

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An Assessment of Awareness of Specialists in Adequate Diagnostics of Chronic Pancreatitis in Kazakhstan

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Open Journal of Epidemiology 2020年第4期10卷 446-462页

作者： Jamilya Kaibullayeva Alexander Nersesov Almagul Jumabayeva Zhanna Romanova Aliya Ualiyeva Nurailym Abu Aisulu Gainutdin Department of Gastroenterology and Hepatology Kazakh National Medical University Almaty Kazakhstan Department of Epidemiology Biomedstatistics and Evidence-Based Medicine Al-Farabi Kazakh National University of Almaty Almaty Kazakhstan

Our national center of gastroenterology provides highly specialized care, including chronic pancreatitis. Another area of our activities is educational programs, including postgraduate and fellows’ courses. Thereby, we have noted significant gaps in the knowledge of the specialists that involved in the chronic pancreatitis management. The most critical downsides are related to insufficient attention to etiology and risk factors, using outdated classifications, the lack of knowledge in arsenal of diagnostic techniques, polypharmacy or application of low level of evidence treatment methods. Finally, we have made amendments in the National clinical Protocol in Chronic Pancreatitis [1], updated the State Educational Standard for residents of the gastroenterological profile [2]. The aim of the study was the analysis of the basic knowledge among different specialists in the management of chronic pancreatitis (CP) around the country. This qualitative study consists of two parts, including focus group interviews followed by interviews with the specialists across the country, which was conducted during the period 2015-2018. In this paper, we present results of diagnostic approaches at the different levels of medical care. The general practitioners have noted the absence of modern methods of laboratory and visual diagnostics in their routine practice, therefore explaining the plenty of the complicated forms. Another issue is the low specialist’s adherence to clinical guidelines, poor knowledge of the risk factors and overestimation of the clinical presentation value except malnutrition symptoms. On the other hand, surgeons and other specialists are not ready to implement modern diagnostic tools and methods in their practice. Obviously, in accordance with the results of our study, our educational center should conduct a number of training activities, as well as develop new algorithms for medical care specialists.

关键词： Non-Interventional Diagnostic Methods Chronic Pancreatitis Symptoms clinical guidelines Specialist’s Awareness

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The infl uence of national guidelines on soft tissue sarcoma patient outcome: a single center experience

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Plastic and Aesthetic Research 2014年第1期1卷 98-102页

作者： Annu Nummi Taina APartanen Ylermi Soini Leena Berg Leena Setälä Paula Mustonen Department of Plastic Surgery and Pathology Kuopio University HospitalPL 10070029 KYS KuopioUusimaaFinland.

Aim:The aim was to study the impact of nationwide clinical practice guidelines for soft tissue sarcomas(STS),introduced in 1994 and again in 2005 in North Savo,Finland.Methods:We retrospectively reviewed all the patients whose sarcoma was treated by a multidisciplinary team between the years 2000 and 2009 with mean follow-up time of 68 months.The patients were divided into 2 groups according to years:Group A(2000–2005,72 patients)and Group B(2006–2009,64 patients).Primary outcomes were local recurrence,metastases,and overall survival.Results:Fifty-ﬁve percent were men with an average age of 59 years.The most common sarcomas were pleomorphic sarcoma(37%)and liposarcoma(26%).Although there were signiﬁcantly less amputations in Group B(A:15%,B:3%),there were more metastases(A:10%,B:23%)with an overall lower overall survival rate(A:70%,B:58%)than in Group A.Conversely,Group A had a higher 1st year survival rate(A:100%,B:87%).We found that upper limb sarcomas were more likely to be diagnosed with incisional biopsies,but there was no correlation between incisional biopsy and recurrence,metastases or survival.Conclusion:Due to nonadherence of the 2005 national treatment recommendations,there has been no improvement either in management or survival.The importance of educating guidelines to doctors referring patients to specialized units cannot be overemphasized to affect successful management in the treatment of STS.

关键词： clinical guidelines follow-up incisional biopsy soft tissue sarcoma

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