ABSTRACT
The quality of solid organ transplantation has been improved significantly in China in recent years. However, surgical site infection (SSI) is still a main factor affecting the survival of solid organ transplantation recipients. With the joint efforts of experts in fields of organ transplantation, infectious diseases, critical care medicine, laboratory medicine and clinical pharmacy, this expert consensus systematically summarizes the experiences of SSI management in solid organ transplantation in China, focusing on basic management principles, epidemiology, risk factors, special pathogen infection and diagnostic techniques of SSI. It aims to standardize the prevention measures of SSI in transplantation centers to reduce the incidence and mortality of SSI in solid organ transplantation recipients.
ABSTRACT
Malocclusion is one of the three most common oral diseases reported by World Health Organization(WHO). In China, its incidence rate is rising. Malocclusion seriously affects the dental and maxillofacial function, facial appearance and growth development of nearly 260 million children in China, and what is more, it affects their physical and mental health development. Malocclusion occurrence is related to genetic and environmental factors. Early treatment of malocclusion can create a good dental and maxillofacial development environment, correct abnormal growth and control the adverse effects of abnormal genetic factors. It can effectively reduce the prevalence of children's malocclusion and enhance their physical and mental health. This is an urgent need from the economic perspective of our society, so it has great practical and social significance. Experts from the project group "standard diagnose and treatment protocols for early orthodontic intervention of malocclusions of children" which initiated by China National Health Institute of Hospital Administration wrote the "China Experts' Consensus on Preventive and Interceptive Orthodontic Treatments of Malocclusions of Children", which aims to guide and popularize the clinical practice, improve the clinical theory and practice level, and accelerate the disciplinary development of early treatment of children's malocclusion in China. The consensus elaborates the harmfulness of malocclusion and the necessity of early treatment, and brings up the principles and fundamental contents. Based on the law of dental and maxillofacial development, this paper puts forward the guiding suggestions of preventive and interceptive treatments in different stages of dental development ranging from fetus to early permanent dentition. It is a systematic project to promote and standardize the early treatment of malocclusion. Through scientific and comprehensive stratified clinical practice and professional training, the clinical system of early treatment of malocclusion in China will eventually be perfected, so as to comprehensively care for children's dental and maxillofacial health, and improve their oral and physical health in China.
Subject(s)
Child , Humans , China/epidemiology , Consensus , Dental Care , Malocclusion/prevention & control , Orthodontics, InterceptiveABSTRACT
This consensus established the atherosclerotic process in the adult cardiovascular disease (atherosclerotic cardiovascular diseases, ASCVD) high-risk groups use of Xinnaoning capsule in order to enhance the curative effect of key process, summarized the compatibility theory of traditional Chinese medicine, the pharmaceutical and pharmacological research characteristics of Xinnaoning Capsule, defined the accurate applicable people, the intervention time and curative effect of disease characteristics and optimization solutions of Xinnaoning Capsule, summarized the adverse reactions, taboo, matters needing attention, and non-clinical safety and other relevant evidence of Xinnaoning Capsule. This consensus is suitable for practicing physicians, practicing physicians of traditional Chinese medicine, and practicing physicians of integrated traditional Chinese and Western medicine in ASCVD related professional fields.
ABSTRACT
ShenqiJiangtang Granule is composed of Panax ginseng, Astragali Radix and other valuable Chinese herbal medicines and extract, which has the effect of replenishing qi and nourishing yin, nourishing spleen and kidney, and it is also widely used in the treatment of type 2 diabetes and complications. After more than 20 years of clinical application, abundant research data have been accumulated. In order to accurately locate the clinical position and promote the rational use of drugs, a project was established by the Chinese Society of Traditional Chinese Medicine and experts organized by the Diabetes Branch to compile this consensus. This consensus defines the application of ShenqiJiangtang Granule in the clinical treatment of prediabetes, type 2 diabetes and its complications. It is suitable for clinicians at all levels of hospitals and grass-roots medical and health institutions across the country (traditional Chinese medicine, Western medicine, integrated traditional Chinese and Western medicine).
ABSTRACT
Ornithine transcarbamylase deficiency(OTCD)is a most common ornithine cycle (urea cycle) disorder. It is a X-link inherited disorder caused by
Subject(s)
Humans , Hyperammonemia/etiology , Liver Transplantation , Nervous System Diseases/prevention & control , Ornithine Carbamoyltransferase Deficiency Disease/therapyABSTRACT
As a topical plaster developed by modern pharmaceutical technology based on traditional Tibetan medicine,Cheezheng Xiaotong Tiegao has functions of promoting blood circulation,relieving swelling and relieving pain. Since its introduction in 1993,it has been widely used in the treatment of various types of acute and chronic musculoskeletal pain and various types of spinal,joint and soft tissue diseases. In order to better standardize the clinical application and improve the clinical efficacy of Cheezheng Xiaotong Tiegao,the research and development work of the Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice was officially launched on October 19,2017,upon approval from China Association of Chinese Medicine. In this paper,main R&D process and related technical links for the experts consensus on Cheezheng Xiaotong Tiegao would be summarized,which will help the various medical workers understand,master and apply more accurately,and also provide reference for the development of experts consensus on clinical application of other topical Chinese medicines.
Subject(s)
Humans , Administration, Topical , China , Consensus , Medicine, Tibetan Traditional , Pain , Pain ManagementABSTRACT
Cheezheng Xiaotong Tiegao is a Tibetan traditional prescription,which has the functions of promoting blood circulation,relieving swelling and relieving pain. It has been widely used in various clinical departments such as orthopedics department,rheumatology department,pain management department,and rehabilitation department to treat all types of acute and chronic skeletal muscle pain. However,duet to the lack of detailed description of the specific use of various diseases in its manual,and in the published guidelines,monographs,and clinical reports,the introduction of the dominant clinical disease,usage,treatment,safety,etc. of Cheezheng Xiaotong Tiegao is not detailed. Therefore,this experts consensus statement has been prepared based on the research and analysis of clinicians and patients,evidence-based medical research and evaluation,combined with the experience of clinical experts. The experts consensus statement regulates usage,dosage,combination,safety,etc. in the treatment of acute and chronic contusion( soft tissue injury),osteoarthritis,low back pain,frozen shoulder,cervical spondylosis postoperative recovery pain and other pain relief and other skeletal muscle system diseases to provide evidence and reference for the rational and safety using of Cheezheng Xiaotong Tiegao.
Subject(s)
Humans , Consensus , Edema , PainABSTRACT
Chinese patent medicine is widely used in clinical practice, but improper use will not only weaken the efficacy of drugs, but even cause adverse consequences. Evidence-based medicine provides guidance for clinical practice based on the best available evidence, experience of experts and needs of patients. However, considering the situation of "insufficient evidence" or "very low quality" in Chinese medicine research, experts consensus is the main basis for clinical decision-making, but expert opinions on which the consensus depends are susceptible to various subjective biases. Therefore, a reliable and scientific consensus-making process is needed to maximally avoid bias on consensus. Unlike the clinical practice guidelines, there is no unified formulating process for consensus in the world today. This article learns from a set of formulating processes from some international consensus formulating institutions/associations, combined with the characteristics and current situation of traditional Chinese medicine, and draws up a set of standard process that is suitable for the clinical experts consensus on Chinese patent medicine, with the expect of providing evidence and reference for consensus makers, and then bringing evidence-based assistance for the clinical standardized application of Chinese patent medicines.
Subject(s)
Humans , Consensus , Evidence-Based Medicine , Expert Testimony , Medicine, Chinese Traditional , Nonprescription DrugsABSTRACT
The promulgation of standardized documents on traditional Chinese medicine has promoted the formulation of industrial standards of traditional Chinese medicine, including clinical practice guidelines and clinical expert consensus. In order to adapt to the current research situation of "insufficient evidence" or "very low quality" when developing clinical practice guideline in the field of traditional Chinese medicine, the author has made a retrospective study on the development of guidelines and consensus, and found that the consensus is more suitable for the current research status of Chinese patent medicine, as the stage of lack of high-quality clinical evidence will remain for a long time. However, unlike clinical practice guidelines, domestic scholars and consensus makers have insufficient understanding of the clinical experts consensus. This article will introduce the origin and status of the clinical experts consensus, the differences between clinical experts consensus and the clinical practice guidelines, and the basic principles that should be followed in the formulation of the clinical experts consensus of Chinese patent medicine, expecting to provide theory basis and reference for the normative formulation of clinical experts consensus.
Subject(s)
Consensus , Medicine, Chinese Traditional , Nonprescription Drugs , Retrospective StudiesABSTRACT
Due to its own characteristics and research status, traditional Chinese medicine research often faces the reality of "insufficient evidence" or "very low quality" when making clinical practice guidelines. Therefore, in many cases, clinical decision-making of traditional Chinese medicine should rely mainly on expert consensus to achieve. A clear and detailed list of expert consensus report specifications will provide a good reporting tool for Chinese clinical expert consensus makers, which is very important for promoting the quality of consensus production and the promotion and application of consensus results. The author consulted the internationally published authoritative expert consensus, summarized the main points of the reports, combined with the formulation process of the clinical experts consensus of Chinese medicine, and the demonstration of clinical experts and methodologists, and then formulated the list of items for clinical expert consensus reports adapt to the field of Chinese medicine. This article introduces the entire list of items and elaborates on the key parts. It is expected to provide reference for the standardization of future clinical expert consensus reports.
Subject(s)
Consensus , Medicine, Chinese TraditionalABSTRACT
Pancreatic cysts have many histological subtypes. With development of imaging techniques such as computed tomography and magnetic resonance imaging, detection rate of pancreatic cysts has been increasing. And standardized diagnosis and treatment of pancreatic cysts remains a clinical challenge. Due to insufficient understanding of imaging features and tumor markers of pancreatic cysts, a reasonable procedure of diagnosis and treatment has not been published so far. Several guidelines for the diagnosis and treatment of pancreatic cysts with high impact have been published, including international consensus guidelines, European experts consensus statement and American Gastroenterological Association guidelines. This review focused on the diagnosis and treatment strategies and suggestions proposed by the above guidelines, and application of endoscopic ultrasonography, so as to provid references for treatment of pancreatic cysts.
ABSTRACT
Prostate neoplasms is the second most common male cancer worldwide. In China, the incidence of prostate neoplasms has been rising rapidly over the past several years. Minimally Invasive Surgery Group of Chinese Anti Cancer Association Genitourinary Oncology Committee presents the Chinese experts consensus on prostate neoplasms surgical treatment based on the present situation of prostate cancer in China and the latest developments in the world.
ABSTRACT
Objective To establish a Chinese expert consensus of the surgical management for type A aortic dissection (TAAD) by using the Delphi method.Methods A systematic review of the previously published literature related to management of TAAD at home and abroad was conducted to formulate a questionnaire of clinical consensus of the surgical treatment for TAAD.This questionnaire including seven aspects of surgical management for TAAD,namely contraindications to operative management,cannulation site,target temperature during circulation arrest,cerebral perfusion strategy,surgical procedure,distal anastomotic technique and surgical management for patients with connective tissue disease such as Marfan syndrome.From October 2015 to April 2016,we performed two rounds Delphi survey in which the current professional opinions from 55 experienced and representative cardiovascular surgeons in China,were gathered and analysed.Results The responses rates of two rounds were 80.0％ (44/55) and 77.27％ (34/44).The scores of authoritative coefficient was 0.87 and 0.83.The coefficient of concordance were 0.31 (P ＜ 0.05) and 0.32 (P ＜ 0.05).After two rounds of consultation,consensus of the surgical management for TAAD was reached on 16 items of seven aspects.Conclusion This Delphi study established an initial Chinese expert consensus concerning the surgical management for TAAD,which drew credible results and reliable conclusions.This study will helo to standardize the surgical management of TAAD in China.
ABSTRACT
OBJECTIVE:To promote rational use of Xingnaojing (XNJ) injection in medical insurance patients.METHODS:Clinical trials on indications of XNJ were searched systematically,and clinical evidence that XNJ was applied for different indications were collected and classified.A questionnaire survey was carried out in 20 medical institutions to find out the doctors' attitude and prescribing practice relating to indications,application indications,usage and dosage,timing of application and drug combination of XNJ.The results of above 2 kinds of studies were provided to a group of experts to reach consensus about guideline of XNJ.RESULTS:Guidelines of XNJ,which contained the application indications,timing of medication,dosage,treatment course and drug combination,were developed.The strength and degree of evidence were labeled for each items of recommendation.CONCLUSION:For drugs with low-quality clinical evidence,guideline should be developed according to experts' consensus which is based on evidence-based medicine.