中国高尿酸血症相关疾病诊疗多学科专家共识

The prevalence of hyperuricemia (HUA) in China has been increasing rapidly during the past decade and this disease has stepped up to the second most common metabolic disease following diabetes mellitus.Different disciplinary panels have developed guidelines and consensus on hyperuricemia and gout in respective fields.However,hyperuricemia has been well illustrated to be related to multiple organ disorders such as kidney injuries,endocrine and metabolic abnormalities,and cardiocerebrovascular diseases etc.A multi-disciplinary expert consensus on hyperuricemia and its related diseases will therefore provide a more comprehensive understanding in the diagnosis and treatment of the diseases.The following manuscript is the first consensus established by a task force including rheumatologists,nephrologists,endocrinologists,cardiologists,neurologists,urologists and traditional Chinese medicine experts.This consensus aims at promoting multi-disciplinary collaboration and providing guidelines in clinical practice for general practitioners,doctors from different disciplines at different levels.

中国磁控胶囊胃镜临床应用专家共识(2017年,上海)

Gastric diseases are very common in China , especially gastric cancer with a continuous high level of morbidity and mortality .As an important screening method of gastric diseases , magnetically-controlled-capsule-gastroscopy ( MCCG ) has already been widely used in medical institutions worldwide . Several clinical trials have already showed that MCCG has comparable accuracy in diagnosing gastric diseases compared with conventional gastroscopy .Furthermore, MCCG has the advantages of anesthesia free , no risks of cross infection , and excellent compliance .Thus MCCG could be a potential alternative technique of conventional gastroscopy .Based on the clinical practice of MCCG during recent years , Chinese doctors have gained a lot of experience .In order to standardize and popularize the application of MCCG , the expert consensus for the clinical application of MCCG was developed through several discussions and modifications among Chinese experts in the field of capsule endoscopy .

中国巴雷特食管及其早期腺癌筛查与诊治共识(2017,万宁)

Patients with Barrett's esophagus (BE)/columnar lined esophagus (CLE) and adenocarcinoma are increasing,in whom 0.61％ BE/CLE would develop to adenocarcinoma.The prognosis of esophageal cancer is related to the tumor stage at diagnosis.To standardize the screening,diagnosis and therapy of BE and adenocarcinoma in China,31 digestive diseases and digestive endoscopy experts and digestive histologists drafted the consensus on the basis of clinical experience and references.The consensus defined BE as a complication of gastroesophageal reflux disease.The normal distal squamous epithelial lining is replaced by columnar epithelial.The squamous-columnar junction (SCJ) is above the gastroesophageal junction (GEJ) ≥ 1 cm and proved by endoscopy and histology.Adenocarcinoma developing in BE mucosa is called BE adenocarcinoma.The early BE adenocarcinoma is divided into 4 stages:M1,M2,M3 and M4,according to the depth of tumor infiltration without expanding beyond mucosa.Because 90％ esophageal cancers are esophageal squamous cell carcinoma (ESCC) in China,this consensus emphasizes the significance of screening BE and adenocarcinoma in esophageal cancers.The diagnosis of BE should meet the following criteria:under endoscopy,the normal distal squamous epithelial lining is replaced by columnar epithelial (SCJ is above the GEJ ≥ 1 cm),which is confirmed by histology.The lesion should be further assessed by electron staining endoscopy such as narrow band imaging (NBI),flexile spectral imaging color enhancement (FICE),i-scan,and endoscopic ultrasonography (EUS) to choose the optimal therapy.Endoscopic resection such as endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) is preferred.Radiofrequency ablation (RFA),photodynamic therapy (PDT),cryotherapy,Argon plasma coagulation (APC) are alternative therapeutic regimens yet should be administrated cautiously.The standardized histologic result is very important,which can be used to assess the response effect,further treatment and follow-up schedule.It is recommended that the follow-up would better be done with high resolution endoscope.Patients without intestinal metaplasia in the four quadrants of BE and the length ＜ 3 cm is recommended to be excluded from the follow-up.BE with intestinal metaplasia ＜ 3 cm is recommended only follow-up for 3-5 years.BE and metaplasia ≥ 3 cm is recommended to be observed every 2-3 years.

支气管哮喘急性发作评估及处理中国专家共识

Asthma exacerbations can do a lot of harm to the patients and consume large amounts of medical resources. This consensus is based on the domestic and foreign guidelines and literatures to standardize the evaluation and management of asthma exacerbations in China. Asthma exacerbations are characterized by a progressive increase in symptoms of shortness of breath, cough, wheezing or chest tightness and progressive decrease in lung function,and usually require modification of treatment.Recognizing risk factors and triggering factors of asthma exacerbations is helpful for the prevention and long-term management. Evaluation of asthma exacerbations is based on symptoms, lung function, and arterial blood gas. Management is stratified according to the severity of disease. Different regimens to treat asthma exacerbations are discussed in this consensus. Glucocorticoids should be used properly. Overuse of antibiotics should be avoided. Management of life-threatening asthma is discussed separately. Special attention should be paid in some special respects, such as asthma during peri-operation period, gestation period, and childhood. Diagnosis and management of complications are also of great significance and are discussed in details.

中国巴雷特食管及其早期腺癌筛查与诊治共识(2017万宁)

食管癌发病率在我国大陆已居各类肿瘤第 3 位,死亡率居第 4 位 [1],越来越受到人们重视.食管癌在组织类型上分为食管鳞状细胞癌(简称食管鳞癌)和食管腺癌.虽然我国食管癌的组织类型以食管鳞癌为主,但是随着世界范围胃食管反流病的增加 [2],我国巴雷特食管(Barrett's esophagus)/ 食管下段柱状上皮化生和食管腺癌的发病率也在增加,同样威胁着人们的生命.并且有报道显示,在食管腺癌中有 80％ 与巴雷特食管密切相关 [3],而我国巴雷特食管的癌变率和西方国家相近,为 0.61％ 左右 [4].食管癌患者的预后与诊断时的肿瘤分期密切相关,所以对于早期食管腺癌的筛查是治愈食管腺癌和提高其生存率的关键所在,而对巴雷特食管的筛查、诊治是预防食管腺癌的关键所在.因此,制定我国的巴雷特食管、早期食管腺癌的筛查与诊治共识亦尤为重要.

The impact of maintenance therapy on progression?free survival and overall survival as well as quality of life of Chi?nese patients with metastatic colorectal cancer has long been under discussion. Recently, some phase III clinical trials have revealed that maintenance therapy can signiifcantly prolong the progression?free survival while maintain an acceptable safety proifle. Based on this evidence and common treatment practice in China, we now generated one Expert Consensus on Maintenance Treatment for Metastatic Colorectal Cancer in China to further specify the neces?sity of maintenance therapy, suitable candidates for such treatment, and appropriate regimens.