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1.
China Pharmacy ; (12): 129-135, 2022.
Article in Chinese | WPRIM | ID: wpr-913100

ABSTRACT

Chinese patent medicine is an important part of pharmaceutical products in China. In order to speed up the establishment of an effective evaluation index system for the variety selection and clinical application of Chinese patent medicine in line with the characteristics of traditional Chinese medicine ,so as to scientifically select drugs and carry out the clinical application evaluation of Chinese patent medicine in a standardized and reasonable manner ,Jiangsu Society of Traditional Chinese Medicine and Traditional Chinese Medicine Special Committee of Nanjing Pharmaceutical Society have organized the formulation of this expert consensus. Consensus experts have used literature research method ,brainstorming method ,analytic hierarchy process , Delphi method ,etc. to build an evaluation index system for the selection and clinical application of Chinese patent medicine , including 24 secondary indicators and 102 tertiary indicators ,from the seven dimensions of safety ,effectiveness,economy, innovation,suitability,accessibility and clinical application (primary indicators ). It is expected to provide decision-making basis for the variety selection and evaluation of Chinese patent medicine by the pharmaceutical management and pharmacotherapeutics committee(group)of medical institutions ,promote medical institutions at all levels to continuously optimize the medication catalogue and medication structure ,and accelerate the formation of the “1 + X ”(“1”for the essential medicine ,“X”for non-essential medicine ) medication model dominated by essential drugs ,promote medical institutions to use Chinese patent medicines scientifically ,reasonably and safely ,so as to improve the quality of pharmaceutical care ,control the irrational drug use and cost ,and better meet the drug use needs of the people.

2.
Article in Chinese | WPRIM | ID: wpr-920819

ABSTRACT

@#Objective    To assess the efficacy of lymphadenectomy in different regions for esophageal squamous cell carcinomas located differently according to the lymph node grouping by Chinese expert consensus. Methods    The medical records of 1 061 patients (886 males and 175 females with a median age of 60 (54, 65) years with esophageal cancer from March 2011 to December 2017 in our hospital were retrospectively analyzed. According to the pathological report, the lymph nodes were regrouped according to the Chinese lymph nodes grouping standard of esophageal cancer. The metastasis rate of each group of lymph nodes, the 5-year survival rate of metastatic patients and efficacy index (EI) were calculated. Results    The upper thoracic esophageal cancer mainly metastasized to the lymph nodes of C201-203 groups. The middle and lower thoracic tumors mainly metastasized to the lymph nodes of C205-207 groups. The lower thoracic tumor had a higher rate of metastasis to the abdominal lymph nodes. According to the metastasis rate, the mediastinal lymph nodes were divided into three regions: an upper mediastinum (C201-204), a middle mediastinum (C205-206), and a lower mediastinum (C207-209). The EIs of lymph nodes of C201-203 and C205-207 groups were higher. For patients with C201-207 groups metastasis, the 5-year survival rates ranged from 13.39% to 21.60%. For patients with positive lymph nodes in each region, tumors at different primary locations had no statistical difference in long-term survival (P>0.05). Patients with lymph nodes of C205 group in the upper thoracic tumors had lower EI and those in the middle and lower thoracic tumors had higher EIs. Conclusion    The effect of lymph node dissection in each area varies with the location of the tumor. No matter where the tumor is, it is necessary to dissect the upper mediastinal lymph nodes, especially the lymph nodes adjacent to the left and right recurrent laryngeal nerves. Group C205 should be classified into the lower mediastinal lymph nodes.

3.
Article in Chinese | WPRIM | ID: wpr-920814

ABSTRACT

@#Resection is one of the most important treatments for esophageal squamous cell carcinoma, and routine postoperative follow-up is an effective method for early detection and treatment of recurrent metastases, which can improve patients' quality of life and prognosis. This consensus aims to provide a reference for colleagues responsible for postoperative follow-up of esophageal squamous cell carcinoma patients in China, and further improve the standardization of the diagnosis and treatment of esophageal squamous cell carcinoma.

4.
Article in Chinese | WPRIM | ID: wpr-920526

ABSTRACT

@#Alveolar bone is an important anatomic basis for implant-supported denture restoration, and its different degrees of defects determine the choices of bone augmentation surgeries. Therefore, the reconstruction of alveolar bone defects is an important technology in the clinical practice of implant restoration. However, the final reconstructive effect of bone quality, bone quantity and bone morphology is affected by many factors. Clinicians need to master the standardized diagnosis and treatment principles and methods to improve the treatment effect and achieve the goal of both aesthetic and functional reconstruction of both jaws. Based on the current clinical experience of domestic experts and the relevant academic guidelines of foreign counterparts, this expert consensus systematically and comprehensively summarized the augmentation strategies of alveolar bone defects from two aspects: the classification of alveolar bone defects and the appropriate selection of bone augmentation surgeries. The following consensus are reached: alveolar bone defects can be divided into five types (Ⅰ-0, Ⅰ-Ⅰ, Ⅱ-0, Ⅱ-Ⅰ and Ⅱ-Ⅱ) according to the relationship between alveolar bone defects and the expected position of dental implants. A typeⅠ-0 bone defect is a bone defect on one side of the alveolar bone that does not exceed 50% of the expected implant length, and there is no obvious defect on the other side; guided bone regeneration with simultaneous implant implantation is preferred. Type Ⅰ-Ⅰ bone defects refer to bone defects on both sides of alveolar bone those do not exceed 50% of the expected implant length; the first choice is autologous bone block onlay grafting for bone increments with staged implant placement or transcrestal sinus floor elevation with simultaneous implant implantation. Type Ⅱ-0 bone defects show that the bone defect on one side of alveolar bone exceeds 50% of the expected implant length, and there’s no obvious defect on the other side; autologous bone block onlay grafting (thickness ≤ 4 mm) or alveolar ridge splitting (thickness > 4 mm) is preferred for bone augmentation with staged implant placement. Type Ⅱ-Ⅰ bone defects indicate that the bone plate defect on one side exceeds 50% of the expected implant length and the bone defect on the other side does not exceed 50% of the expected implant length; autologous bone block onlay grafting or tenting techniques is preferred for bone increments with staged implant implantation. Type Ⅱ-Ⅱ bone defects are bone plates on both sides of alveolar bone those exceed 50% of the expected implant length; guided bone regeneration with rigid mesh or maxillary sinus floor elevation or cortical autologous bone tenting is preferred for bone increments with staged implant implantation. This consensus will provide clinical physicians with appropriate augmentation strategies for alveolar bone defects.

5.
Article in Chinese | WPRIM | ID: wpr-880390

ABSTRACT

Robotic minimally invasive surgery is an important trend in the modern surgical techniques. The publish of Chinese Expert Consensus on Robotic Surgery for Colorectal Cancer (2015 Edition) has played an important role in the standardization, promotion and application of robotic colorectal cancer surgery. With the concept update and technological progress, robotic colorectal cancer surgery has been further developed. Based on this, on the basis of 2015 expert consensus, the Chinese Expert Consensus on Robotic Surgery for Colorectal Cancer (2020 Edition) is revised and published to supplement, update and improve the theoretical and technical system, so as to better guide clinical practice.


Subject(s)
China , Colorectal Neoplasms/surgery , Consensus , Humans , Minimally Invasive Surgical Procedures/standards , Robotic Surgical Procedures/standards
6.
Chinese Journal of Lung Cancer ; (12): 217-235, 2021.
Article in Chinese | WPRIM | ID: wpr-880263

ABSTRACT

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. The systemic antitumor therapy of advanced NSCLC has undergone renovations of chemotherapy, targeted therapy and immunotherapy, which results in greatly improved survival for patients with advanced NSCLC. Immune checkpoint inhibitors (ICIs), especially targeting programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1), has changed the treatment paradigm of NSCLC. ICIs have become the standard treatment for advanced NSCLC without epidermal growth factor receptor(EGFR) mutation or anaplastic lymphomakinase(ALK) translocation in the first- or second-line setting, and for locally advanced NSCLC following concurrent radiotherapy and chemotherapy. ICIs are also promising in adjuvant/neoadjuvant therapy. More and more ICIs have been approved domestically for the treatment of NSCLC. Led by the NSCLC expert committee of Chinese Society of Clinical Oncology (CSCO), this consensus was developed and updated based on thoroughly reviewing domestic and foreign literatures, clinical trial data, systematic reviews, experts' discussion and the consensus(2019 version). This consensus will aid domestic clinicians in the treatment of NSCLC with ICIs.
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7.
Chinese Journal of Burns ; (6): 113-125, 2021.
Article in Chinese | WPRIM | ID: wpr-880189

ABSTRACT

Recently, more and more clinical and basic studies have shown that early intervention of scars after wound healing can shorten the immature period of scars, improve the final outcome of scars, effectively prevent and control the occurrence and development of pathological scars. However, there are many methods for early management of scars with varying quality, and there is a lack of expert consensus on early scar management. Based on the existing clinical evidence of each intervention method and clinical experience of experts, more than 40 domestic experts from Standing Committee of Chinese Association of Plastics and Aesthetics Scar Medicine Branch have reached a consensus on definition, therapeutic principles, therapeutic methods, and other aspects of early scars after multiple discussions and revisions, providing reference for clinical treatment.


Subject(s)
Cicatrix/therapy , Consensus , Humans , Wound Healing
8.
Article in Chinese | WPRIM | ID: wpr-888159

ABSTRACT

Wangbi Tablets are widely used in the treatment of rheumatoid arthritis, knee osteoarthritis and other diseases at pre-sent. Long-term clinical application and research have shown that this drug has a good effect in reducing the pain of related diseases and improving symptoms. Due to the lack of guidance in the instructions and currently no relevant norms to guide the clinical application of Wangbi Tablets, in order to further improve clinicians' understanding of the drug and fully tap the clinical advantages of the drug, the Professional Committee of Orthopedics and Traumatology Drug Research of China Association of Chinese Medicine organized experts in the fields of rheumatism, orthopedics, pharmacy and methodology in Chinese and western medicine to develop expert consensus on Chinese patent medicines in accordance with the relevant requirements of the consensus methodology. Based on full consideration of clinical research evidence and expert experience, the clinical issues were summarized in the consensus, and for those clinical problems supported by evidences, the internationally recognized recommendation evaluation and formulation method GRADE was used to evaluate the evidence and form recommendations; for those clinical issues not supported by evidences, a consensus was reached through the nominal group method to form consensus recommendations. The consensus adopted a concise and clear format to form re-commendations or reach consensus suggestions on the medication regimen, medication characteristics, intervention timing, usage and dosage, course of use and safety issues for the treatment of rheumatoid arthritis and knee osteoarthritis with Wangbi Tablets. It is suggested that its application will better improve the efficacy of Wangbi Tablets in the treatment of rheumatoid arthritis and knee osteoarthritis, at the same time provide a reference for clinicians to use Wangbi Tablets in a standardized, reasonable and safe manner.


Subject(s)
Arthritis, Rheumatoid/drug therapy , Consensus , Drugs, Chinese Herbal , Humans , Medicine, Chinese Traditional , Osteoarthritis, Knee/drug therapy , Tablets
9.
Article in Chinese | WPRIM | ID: wpr-888091

ABSTRACT

The formulation of expert consensus on clinical application of Chinese patent medicines, in means of exploring the effective combination of experience and evidence to form a research method in line with the characteristics of Chinese patent medicines, is an important transitional stage for clinical researches on Chinese patent medicines. Pre-searching is a new step in the formulation of expert consensus on clinical application of Chinese patent medicines. Before steps of interview and investigation on clinical application, pre-searching is conducted to collect publications and literature on certain variety and similar Chinese patent medicines; the publications on related medical classics and formulas of this variety; the recommendation condition of this variety in clinical practice guidelines and expert consensus; and the medication regimens recommended in disease-specific guidelines. Pre-searching is designed to know about the advantages of certain variety of Chinese patent medicine as well as its potential problems recorded in the literature, which is helpful to find out the clinical positioning of Chinese patent medicines, develop reasonable clinical questions and provide ideas for formal literature searching. However, it is not the direct basis for developing clinical questions. Moreover, interviews and investigations are still needed to further clarify the clinical positioning of Chinese patent medicines and develop reasonable questions. This paper took expert consensus on clinical application of Yanshen Jianwei Capsules as an example to introduce the pre-searching process and methods used during formulation of expert consensus on clinical application of Chinese patent medicines, and to further discuss the role of pre-searching to facilitate the formulation of clinical questions on selection of participants, interventions, controls and outcomes.


Subject(s)
Capsules , China , Consensus , Drugs, Chinese Herbal , Humans , Medicine, Chinese Traditional , Nonprescription Drugs
10.
Article in Chinese | WPRIM | ID: wpr-911986

ABSTRACT

This article introduces two methodological articles published by the American College of Obstetricians and Gynecologists in September 2021 on their development of clinical practice guidelines and clinical expert consensus, focusing on the composition of the guidelines committee, declaration and management of conflicts of interest, and the detailed development process. On this basis, reflections and suggestions for the development of guidelines and consensus in obstetrics and gynecology in China are presented from the perspective of developing a handbook for standardized guideline development, registration and reporting of guidelines, use of available evidence, management of conflicts of interest, and regular evaluations of relevant published guidelines.

11.
Chinese Journal of Trauma ; (12): 865-875, 2021.
Article in Chinese | WPRIM | ID: wpr-909950

ABSTRACT

Traumatic rib fractures are the most common injury in thoracic trauma. Previously,the patients with traumatic rib fractures were mostly treated non-surgically,of which 50%,especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities,being unable to retain a full-time job. In the past two decades,thanks to the development of internal fixation material technology,the surgical treatment of rib fractures has achieved good outcomes. However,there are still some problems in clinical treatment,including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans,and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore,the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association,in conjunction with national multidisciplinary experts,formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures(2021)following the principle of evidence-based medicine,scientific nature and practicality. This expert consensus puts forward some clear,applicable,and graded recommendations from aspects of preoperative imaging evaluation,surgical indications,timing of surgery,surgical methods,rib fracture sites for surgical fixation,internal fixation methods and material selections,treatment of combined injuries in rib fractures,in order to provide references for surgical treatment of traumatic rib fractures.

12.
Chinese Critical Care Medicine ; (12): 903-918, 2021.
Article in Chinese | WPRIM | ID: wpr-909426

ABSTRACT

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.

13.
Article in Chinese | WPRIM | ID: wpr-908311

ABSTRACT

Objective:To form the consensus of nursing experts in accelerated rehabilitation surgery in perioperative period of chronic rhinosinusitis in order to promote the standardized development of accelerated rehabilitation surgery nursing in perioperative period of chronic rhinosinusitis in China.Methods:By consulting the literature evidence and combining with the clinical practice experience, the consensus draft was formed by more than 5 nurses in charge of nursing. According to the Grading of Recommendations Assessment, Development and Evaluation System, (GRADE), the evidence quality and recommendation grade of each item were evaluated.Results:The consensus covered 4 aspects of pre-hospital care guidance, including preoperative care, postoperative care, and discharge care for chronic rhinosinusitis, with a total of 12 items, including health education, individualized treatment guidance, network platform use, adaptive training, diet management, activity guidance, pain management, and discharge follow-up.Conclusions:The content of this consensus covers all aspects of accelerated rehabilitation surgery nursing during perioperative period of chronic rhinosinusitis, which is scientific, rigorous and authoritative, and can provide reference and guidance for accelerated rehabilitation surgery nursing in the perioperative period of chronic rhinosinusitis.

14.
Article in Chinese | WPRIM | ID: wpr-908005

ABSTRACT

Seizure is the most common neurological critical disease in the neonatal period, most of which is symptomatic.Seizure is usually caused by acute brain injury, and only electrical seizure is more commonly seen.Neonatal seizures are not easy to be included in the epilepsy classification established by the International League Against Epilepsy (ILAE). As a result, a Neonatal Seizures Task Force was established by the ILAE to develop a modification of the 2017 ILAE classification of seizures and epilepsies.The neonatal classification framework emphasizes the role of electroencephalography (EEG) in the diagnosis of neonatal seizure, which includes a classification of seizure types especially in newborns.The type of seizure in adults and older children mainly depends on clinical characteristics, while many newborns only have electric seizures.Therefore, electric seizures are included in the classification scheme.Clinical events without corresponding EEG changes are not included.Neonatal seizures are all focal seizures, and focal and generalized seizures are unnecessarily to be categorized.Seizures can be classified by abnormal motor episodes (automata, clonic, myoclonic, tonic) and non-motor episodes (autonomic, behavioral changes) or sequential presentation.The new classification can be used to more specifically classify neonatal seizures.

15.
Article in Chinese | WPRIM | ID: wpr-908004

ABSTRACT

Micronutrients, as coenzymes and cofactors for many metabolic processes, play an important role in parenteral nutrition, but the guidelines and expert consensus published cannot fully solve the problem with clinical application of micronutrients.Parenteral Provision of Micronutrients to Pediatric Patients: an International Expert Consensus Paper, released in September 2020 in the Journal of Parenteral and Enteral Nutrition, presented recommendations about common clinical questions for the assessment of micronutrients deficiency in children and the parenteral provision of micronutrients.The main content of International Expert Consensus Paper was interpreted in this article.

16.
Article in Chinese | WPRIM | ID: wpr-906349

ABSTRACT

Traditional Chinese medicine (TCM) and western medicine have their respective advantages and limitations in the diagnosis and treatment of common otorhinolaryngology head and neck diseases. Although the integrated TCM and western medicine exhibits definite curative effects, there is no consensus on the otorhinolaryngology head and neck diseases responding specifically to TCM or integrated TCM and western medicine, as well as the diagnosis and treatment schemes. The China Association of Chinese Medicine (CACM) thus organized the otorhinolaryngology head and neck specialists of both TCM and western medicine to discuss the etiology, pathogenesis, and clinical diagnosis and treatment methods of common otorhinolaryngology head and neck diseases with the results of multiple clinical trials taken into account. The acute pharyngitis, chronic pharyngolaryngitis, paraesthesia pharyngis, hysterical aphasia, allergic rhinitis, subjective tinnitus, and otogenic vertigo were confirmed to respond specifically to TCM or integrated TCM and western medicine. Then a mutually agreed diagnosis and treatment scheme and recommendation with integrated TCM and western medicine was formulated as a reference for clinical practice, thus benefiting more patients.

17.
Article in Chinese | WPRIM | ID: wpr-906314

ABSTRACT

In recent years, the incidence of neurological diseases has been increasing year by year. To give full play to the advantages of traditional Chinese medicine (TCM) in the treatment of neurological disorders, identify the breakthrough point of integrating TCM with western medicine, and further standardize the clinical diagnosis and treatment of TCM, the China Association of Chinese Medicine organized neurologists in TCM and western medicine to carry out in-depth discussion on the neurological diseases responding specifically to TCM and integrated TCM and western medicine, such as stroke, headache, vertigo, multiple sclerosis, and epilepsy, aiming to formulate a well-recognized and integrated treatment protocol for TCM and western medicine and improve the efficacy of neurological disorders. Furthermore, the treatment suggestions of the corresponding diseases in TCM and western medicine were proposed to provide references for clinical practice and scientific research.

18.
Article in Chinese | WPRIM | ID: wpr-906160

ABSTRACT

Traditional Chinese medicine (TCM) is a great treasure house, exhibiting unique advantages in the treatment of some difficult and critical diseases. The incidence rate of membranous nephropathy has increased year by year in recent years, and has become the first cause of primary glomerular diseases. However, its pathogenesis is not clear. Modern medicine often uses immunosuppressive therapy, but it often faces the problems of high side effects and high recurrence rate. The China Association of Chinese Medicine (CACM) invited clinical experts of TCM and western medicine to fully discuss membranous nephropathy, which was later confirmed to be one of the clinical diseases responding specifically to TCM. Apart from summarizing the pathogenesis and clinical diagnosis and treatment of membranous nephropathy in both TCM and western medicine, this paper also detailed TCM cognition, syndrome differentiation, and therapeutic schemes of membranous nephropathy, aiming to improve the clinical remission rate of membranous nephropathy and provide reference for its clinical treatment.

19.
Article in Chinese | WPRIM | ID: wpr-906100

ABSTRACT

In recent years, with the change in life style, social environment, and national childbearing policy, the proportion of high-risk pregnant women has increased significantly, triggering the spectrum of obstetric diseases to constantly change, which has brought new challenges to the diagnosis and treatment of obstetrics. Traditional Chinese medicine (TCM) has been proved effective in dealing with a variety of obstetric diseases, and various treatment methods are available, which can serve as alternative means for solving refractory obstetric diseases. However, most obstetric clinicians are currently less aware of the therapeutic effects of TCM, which has significantly hindered its participation in clinical treatment. Therefore, the China Association of Chinese Medicine (CACM) organized the outstanding young obstetricians of TCM and western medicine to discuss 15 obstetric diseases responding specifically to TCM or integrated TCM and western medicine, including hyperemesis gravidarum, threatened abortion, ectopic gestation, cough during pregnancy, pregnancy-induced hypertension syndrome, maternal-fetal ABO incompatibility, postpartum hypogalactia, residual pregnancy tissue in uterine cavity, puerperal infection, pantalgia after childbirth, hematoma/undesirable healing after caesarean section, postpartum urinary retention, ileus after cesarean section, pelvic floor dysfunction, and postnatal depression. The suggestions for their treatment with TCM or integrated TCM and western medicine were also proposed, aiming to provide patients with effective and personalized treatments in clinical practice and improve the diagnosis and treatment effects of obstetric diseases, thus benefiting the public. At the same time, more obstetrical clinicians are expected to understand the therapeutic effects and advantages of TCM and draw on the strengths of both TCM and western, thereby promoting the establishment of an obstetric diagnosis and treatment system with Chinese characteristics.

20.
Journal of Clinical Hepatology ; (12): 2054-2057, 2021.
Article in Chinese | WPRIM | ID: wpr-904844

ABSTRACT

Vascular complications after liver transplantation are important causes of liver dysfunction and graft loss.The incidence rate range is from 5% to 25%, and the mortality rate is high. The complex and changeable vascular conditions of the donor and recipient, anastomosis techniques, infection, and acute and chronic rejection after transplantation can all cause vascular complications of liver transplantation. The types of vascular complications are diverse and complex. According to the vascular structure, they can be divided into arterial and venous complications; according to the characteristics of blood flow, they can be divided into inflow tract (hepatic artery, portal vein) or outflow tract (hepatic vein, vena cava) disorders; according to the nature of the lesion, they can be divided into rupture, stenosis, thrombosis and pseudoaneurysm, etc; according to the time of occurrence, they can be divided into early or late. Surgical plan design and surgical operation techniques are the technical factors of early vascular complications after liver transplantation. The types of vascular complications and their accompanying clinical manifestations are closely related to the choice of diagnosis and treatment strategies and clinical outcomes. Therefore, the Perioperative Management Group of Chinese Society of Organ Transplantation of Chinese Medical Association formulated the Expert Consensus on Diagnosis and Treatment of Perioperative Vascular Complications of Liver Transplantation, aiming to standardize and optimize the clinical diagnosis and treatment of common perioperative vascular complications in liver transplant recipients.

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