Objective To study the effect of autogenous bone marrow on guided bone regeneration (GBR),and evaluate the repairing ability of GBR in bone defect with autogenous bone marrow. Methods Ten mm segmental defects were produced in both radii of 18 rabbits. The defect was bridged with a silicon tube. Autogenous bone marrow was injected into the tube on the experimental group at 0, 2,4 weeks after operation, and peripheralblood into the control group at thesame time. The X-ray, gross, histological and biochemical examinations were observed invarious times. Results The new bone formation of experimental group was prior to that of control group; calcium and alkaline phosphatase of experimental groupwere higher than those of control group. The experimental group had all been healed at the tenth week, but no one healed in control group. Conclusion It can be conclude that autogenous bone marrow can stimulate bone formation and facilitate GBR in bone defect.
To promote the accessibility and application of guidelines, it is necessary to establish a professional guideline database to adapt to the rapid growth of TCM clinical practice guidelines. This study described the framework design, technology module, information management, and quality control of the clinical practice guideline database of traditional Chinese medicine (G-TCM). G-TCM had included 658 TCM clinical practice guidelines, which would provide a platform for clinicians, researchers, guideline makers (revision), and evaluators to quickly query and obtain clinical guideline information, and play a supporting role in promoting the standardization and accessibility of TCM clinical practice guidelines and better guiding clinical practice.
The 2020 ACC/AHA Guideline for the Management of Patients with Valvular Heart Disease not only updates aortic valve stenosis, mitral regurgitation, prosthetic valves, infective endocarditis and antithrombotic treatment on the basis of the 2017 guidelines update for valvular heart disease, but also involves aortic valve regurgitation, bicuspid aortic valve, mitral stenosis, tricuspid regurgitation, combined valve disease, pregnancy with valvular disease, valve disease complicated with coronary heart disease, valve disease complicated with non-cardiac surgery and the prospect of comprehensive management of valve disease. It covers a wide range of contents, which are introduced in detail and comprehensively. This paper interprets some highlights and core issues, including the top 10 take-home messages, the severity of valvular heart disease, and the updates in the management of aortic valve stenosis, aortic valve regurgitation, bicuspid aortic valve, mitral stenosis and mitral regurgitation.
Radiation proctopathy, which can be categorized as acute and chronic, is defined as the radiation damage to the rectum caused by radiation therapy in patients with pelvic malignancies. Chronic radiation proctopathy can cause complications such as rectal bleeding, which severely affects patients’ quality of life. At present, endoscopic therapy has become the primary method for diagnosis and treatment of bleeding from chronic radiation proctopathy. In October 2019, the American Society for Gastrointestinal Endoscopy (ASGE) published "ASGE guideline on the role of endoscopy for bleeding from chronic radiation". The guideline described the effectiveness and safety of different endoscopic therapies such as argon plasma coagulation, bipolar electrocoagulation, heater probe, radiofrequency ablation, cryoablation, etc. in the treatment of bleeding from chronic radiation. This paper interprets it to provide references for clinicians in the treatment of bleeding from chronic radiation.
Postoperative gastrointestinal disorder (POGD) is a common complication after surgery under anesthesia. Strategies in combination with traditional Chinese medicine and Western medicine have shown some distinct effects but standardized clinical practice guidelines are not available. Thus, a multidisciplinary expert team from various professional bodies including the Perioperative and Anesthesia Professional Committees of the Chinese Association of Integrative Medicine (CAIM), jointly with Gansu Province Clinical Research Center of Integrative Anesthesiology/Anesthesia and Pain Medical Center of Gansu Provincial Hospital of Traditional Chinese Medicine and WHO Collaborating Center for Guideline Implementation and Knowledge Translation/Chinese Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Center /Gansu Provincial Center for Medical Guideline Industry Technology/Evidence-based Medicine Center of Lanzhou University was established to develop evidence-based guidelines. Clinical questions (7 background and 12 clinical questions) were identified through literature reviews and expert consensus meetings. Based on systematic reviews/meta-analyses, evidence quality was analyzed and the advantages and disadvantages of interventional measures were weighed with input from patients’ preferences. Finally, 20 recommendations were developed through the Delphi-based consensus meetings. These recommendations include disease definitions, etiologies, pathogenesis, syndrome differentiation, diagnosis, and perioperative prevention and treatment.
In February 2020, the American College of Gastroenterology (ACG) published the latest guideline on chronic pancreatitis, and put forward practical recommendations on the etiology, natural history, diagnosis, treatment, prognosis and follow-up of chronic pancreatitis. This paper aims to provide references for the diagnosis and treatment of chronic pancreatitis in China by interpreting the main content of the guideline and comparing it with related guidelines or consensuses domestically and abroad.
Diabetic retinopathy (DR) is the most common cause of preventable blindness in the working-age population. In addition to optimizing the hyperglycemia, hypertension, hyperlipidemia and other risk factors, regular fundus examination is essential for early diagnosis asymptomatic DR and timely treat the sight-threatening DR, so as to reduce blindness and severe visual impairment caused by DR. Clinical practice guidelines for the screening and management of DR have been implemented throughout the world, but there are reasonable differences between existing guidelines in the recommended timing of first retinal examination, screening intervals, methods for examination and criteria for referral to an ophthalmologist. It is of great clinical significance to have a detailed understanding of the current guidelines for DR screening and their clinical basis.
Enteral nutrition can improve patient’s nutritional status, reduce the incidence of complications, and promote the patient’s rehabilitation. For patients with stroke, enteral nutrition is the first choice for nutritional support. Nurses not only participate but also play important roles in the whole process of nutrition management in stroke. Therefore, standardizing the nursing practice in enteral nutrition and developing nursing guideline in line with Chinese clinical practice is of great significance. In the guideline, 18 key clinical questions had been established via the Delphi method, and for each question, detailed recommendations had been constructed. It is expected to provide clinical standards for enteral nutrition in patients with stroke, and to improve the nutritional management and disease prognosis of stroke patients.
Foreign body in the digestive tract is one of the common critical diseases in the gastroenterology department, and it is the most common in children. Due to the wide variety of foreign body ingestion, the treatment methods are diverse, and the potential risks and complications are constantly escalating. If the treatment is not timely or improper, serious consequences will occur. However, there are no guidelines for foreign bodies in the digestive tract for children in China. Therefore, the development of evidence-based guidelines for the management of foreign bodies in the digestive tract of children, based on clinical practice in China, is of great significance in effectively guiding and promoting the management of foreign bodies in the digestive tract of children. In order to provide guidance and decision-making basis for clinicians at all levels who treat children with foreign bodies in the digestive tract, we complied with standard development process, collaborated with multidisciplinary expertise, based on available evidence, combined with clinical practice, adopted the grading of recommendations assessment, development and evaluation (GRADE) approach, and followed the reporting items for practice guidelines in healthcare (RIGHT) to develop this guideline for the management of foreign bodies in the digestive tract of children.