Hypothyroidism is one of the focuses of attention in the field of thyroid surgery, but postoperative hypoparathyroidism has always been an unavoidable complication for surgeons. Currently, there is still controversy over the definition and classification of postoperative hypoparathyroidism, and there are significant differences in the definition and incidence of permanent hypoparathyroidism among different studies. The author provides preliminary suggestions and ideas for the diagnosis and definition of hypoparathyroidism based on relevant guidelines, literature, and clinical experience, in order to provide more accurate diagnosis and treatment plans for postoperative hypoparathyroidism.
Lifestyle medicine is an emerging medical specialty of 20-year-history. It is more cost effective and environmentally friendlier in managing chronic health conditions of individuals and populations than the conventional allopathic medicine. By summarizing the development, implementation and prospects of lifestyle medicine in America, this paper aims to contribute to the advancement of lifestyle medicine in China.
目的 评估国际抗癫痫联盟(ILAE)耐药癫痫定义专家共识在发展中国家、发展中地区应用的可行性及应用中存在的问题。 方法 2010年12月9日-2011年2月18日,连续登记癫痫专科门诊患者409例。共纳入183例患者,根据ILAE耐药癫痫新定义对每位纳入患者癫痫分类进行评估。 结果 耐药癫痫患者18例(8.7%),临床治愈患者29例(14.1%),不能判断为159例(77.2%)。入组患者共涉及癫痫药物治疗方案321项。根据ILAE定义步骤一分类为不确定的治疗方案共有199项(62.00%),其中数量最多的为服药剂量<50% WHO限定日剂量有157例(78.89%)。 结论 由于治疗剂量未能够达到国际统一标准,大量患者分类不明确,使得该共识应用面临巨大挑战,但目前为止该共识对于发展中地区耐药癫痫治疗有很强的指导促进意义,对未来耐药癫痫的早期识别有非常大的应用潜力。
Objective To provide evidence for the definition, current development and prospect of Evidence-based pharmacy through systematically assessing the extant literatures. Methods We searched CBM, VIP, CNKI, PubMed, EMbase, and Google for supplement. We extracted definitions of evidence-based pharmacy, types of studies, published year, topics of studies, and the author information from the included studies. We compared the definitions on different domains, and assessed the current development of evidence-based pharmacy literature. Results a) The definition of evidence-based pharmacy: We found 4 definitions, and there were great differences among them on the people who practiced evidence-based pharmacy as well as the methods and areas of the practice. b) The evidence-based pharmacy literature: 12 English and 202 Chinese articles were included in the review. The number of Chinese evidence-based pharmacy articles was increasing annually, especially in recent 3 years; Most of their authors were from hospitals, especially from pharmacy department; Their study orientations mostly involved clinical pharmacy and hospital pharmacy; The topics mainly refered to the practice and development of clinical pharmacy, rational drug use, and development of hospital pharmacy. Conclusion a) There is yet no consensus on the definition of evidence-based pharmacy. b) Few researchers worldwide know or show interest in evidence-based pharmacy, while, so far, more and more researchers are getting to know evidence-based pharmacy in China. c) Further efforts should be made to develop the theoretical system of evidence-based pharmacy and the pattern of its practice.
ObjectiveTo summarize the terms and definitions related to neurofibromatosis type 1 (NF1) with a view to standardizing and unifying the existing terminology system. Methods To review the research literature related to NF1 at home and abroad, and to summarize the expressions of the disease and related terms. Results There are still some limitations in the current knowledge of NF1, especially in the expression of the terminology, and there are discrepancies in the description and naming of NF1-related features in different medical literatures and clinical guides. There are differences in the description and naming of NF1-related features in different medical literature and clinical guidelines. Through a systematic review of the literature, this paper provides a detailed compendium and summary of the terms and definitions of NF1-related clinical manifestations, pathological features, and genetic types, and further standardizes and unifies existing diagnostic criteria and terminology systems. ConclusionThe terms and definitions of NF1-related clinical manifestations are summarized to enhance the knowledge of clinicians and researchers related to NF1.
Through summarizing the definition, concept, and development of patient registry, and also retrieving ClinicalTrials.gov, we introduce its application areas, application range, disease, research number. Based on the application situation, we present the challenges faced now and future development of direction.
Objective To further comprehend the definition, molecular mechanism, and clinical significance of perineural invasion (PNI) so as to explore new therapy for the tumors. Methods The literatures about the definition, molecular mechanism, and clinical study of PNI were reviewed and analyzed. Results At present, widely accepted definition of PNI was that at least 33% of the circumference of the nerve should be surrounded by tumor cells or tumor cells within any of three layers of the nerve sheath. The newest theory on molecular mechanism of PNI was that PNI was more like infiltration, invasion, not just diffusion. “Path of low-resistance” and “Reciprocal signaling interactions” were the main theories. More recently, the studies had demonstrated that “Reciprocal signaling interactions” could more clearly explain the mechanism of PNI. Stromal elements, including fibroblasts, seemed to play a key role in the complex signaling interactions driving PNI. Neurotrophins and axonal guidance molecules had been implicated in promoting the progress of PNI. PNI was a prognosis index in the cancers of the head and neck, stomach, pancreas, colon and rectum, and prostate, which was positive indicated that the patients would have a poor prognosis and a low 5-year survival rate. Conclusions The mechanism of PNI is very complex, and its clear mechanism is still undefined. Keeping on researching the mechanism of PNI could provide theoretical foundation to disclose the mechanism and the therapy of PNI.
Bias in clinical trials or systematic reviews may result in overestimation or underestimation of the benefits or harms of the interventions, and conclusions may be false. Meta-epidemiological study is an important tool to identify and quantify the impact of potential bias characteristics, and it can provide empirical evidence for controlling the bias. This paper summarized the origin, development and definition of the meta-epidemiology study, and discussed the challenges and development trends, so as to provide references for carrying out the meta-epidemiological studies.