Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination...Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion.This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence,aiming to provide general guidance on appropriate imaging examination selection,comprehensive and accurate imaging assessment for early orthodontic treatment patients.展开更多
The research and development of new traditional Chinese medicine(TCM)drugs have progressively established a novel system founded on the integration of TCM theory,human experience,and clinical trials(termed the“Three ...The research and development of new traditional Chinese medicine(TCM)drugs have progressively established a novel system founded on the integration of TCM theory,human experience,and clinical trials(termed the“Three Combinations”).However,considering TCM's distinctive features of“syndrome differentiation and treatment”and“multicomponent formulations and complex mechanisms”,current TCM drug development faces challenges such as insufficient understanding of the material basis and the overall mechanism of action and an incomplete evidence chain system.Moreover,significant obstacles persist in gathering human experience data,evaluating clinical efficacy,and controlling the quality of active ingredients,which impede the innovation process in TCM drug development.Network pharmacology,centered on the“network targets”theory,transcends the limitations of the conventional“single target”reductionist research model.It emphasizes the comprehensive effects of disease or syndrome biological networks as targets to elucidate the overall regulatory mechanism of TCM prescriptions.This approach aligns with the holistic perspective of TCM,offering a novel method consistent with TCM's holistic view for investigating the complex mechanisms of TCM and developing new TCM drugs.It is internationally recognized as a“next-generation drug research model”.To advance the research of new tools,methods,and standards for TCM evaluation and to overcome fundamental,critical,and cutting-edge technical challenges in TCM regulation,this consensus aims to explore the characteristics,progress,challenges,applicable pathways,and specific applications of network pharmacology as a new theory,method,and tool in TCM drug development.The goal is to enhance the quality of TCM drug research and development and accelerate the efficiency of developing new TCM products.展开更多
The five-year survival rate of gastric cancer in China is close to those in European and North Americancountries but far lower than those in the Republic of Korea and Japan where national gastric cancerscreening syste...The five-year survival rate of gastric cancer in China is close to those in European and North Americancountries but far lower than those in the Republic of Korea and Japan where national gastric cancerscreening systems have been established.It is of great significance to build a high-quality gastric cancerscreening system adaptive to China's national conditions.Due to the large number of people at risk ofgastric cancer and the uneven distribution of medical resources,it is still difficult for China to carry out anationwide gastroscopy screening program for gastric cancer.Gastric oral contrast ultrasonography(OCUS)is a promising,non-invasive tool for initial gastric cancer screening,offering a painless,radiationfreealternative.Based on two 2020 OCUS consensuses,this document analyzes national gastric cancerscreening strategies and challenges to elaborate on the necessity,feasibility,and current problems ofpreliminary ultrasound screening in China.It details the key aspects of OCUS,including indications,contraindications,operator requirements,contrast agent standards,and essential scanning protocols.Italso introduces the standardized ultrasound sections and the Stomach Ultrasound Report and Data System(Su-RADS)and proposes the relevant consensus opinions.After several rounds of discussions and voting byexperts from multiple societies,a total of 17 consensus opinions have been formed on OCUS as a preliminary screening technique for gastric cancer,with the aim of standardizing the popularization ofOCUS.In addition,the consensus calls for conducting nationwide multicenter prospective studies toimprove the level of evidence and provide big data support for the construction of a preliminary gastriccancer ultrasound screening system that is in line with China's national conditions.展开更多
Objective:To develop an expert consensus on subcutaneous injection for allergen-specific immunotherapy.Methods:Relevant domestic and international literature was reviewed,and nursing experts experienced in subcutaneou...Objective:To develop an expert consensus on subcutaneous injection for allergen-specific immunotherapy.Methods:Relevant domestic and international literature was reviewed,and nursing experts experienced in subcutaneous injection of allergen-specific immunotherapy were interviewed to form the initial draft of the consensus.A total of 85 experts from 42 hospitals nationwide were invited to participate the discussions.Through two rounds of expert consultations,adjustments,revisions,and improvements to the initial draft,an online meeting was held to form the final version of the consensus.The content approved by more than 75%of the expert group is retained.Results:The expert consensus includes operational standards for subcutaneous injection of allergen-specific immunotherapy,identification and management of adverse reactions,and health education.Conclusion:The consensus demonstrates strong scientific rigor and practicality,providing guidance for nursing practices in the field of clinical allergology.展开更多
Objective:To establish consensus on Chinese Herbal Medicine(CHM)for rheumatoid arthritis(RA)among 21 Singaporean experts,this study addressed the lack of CHM clinical practice guidelines(CPGs)in Singapore.Despite adva...Objective:To establish consensus on Chinese Herbal Medicine(CHM)for rheumatoid arthritis(RA)among 21 Singaporean experts,this study addressed the lack of CHM clinical practice guidelines(CPGs)in Singapore.Despite advancements in RA therapies,the disease's progressive nature and high costs of novel treatments worsen disparities in management and outcomes.The initiative aimed to bridge this gap by developing expert-backed recommendations for CHM use in RA care.Methods:The group of experts conducted two rounds of Delphi surveys containing 29 items identified from a literature review.Consensus was defined as≥75%of votes in dichotomized ratings on a fivepoint ordinal scale for recognition.Items that did not reach consensus were discussed in a focus group with four selected experts.Results:Nineteen experts completed both rounds of Delphi surveys.A consensus was reached for 27 items,which encompassed Chinese medicine rationale,pattern differentiation,management,CHM prescription,and co-effectiveness with pharmacological therapy.Collective expert opinions were formed for the two remaining items.All items received a recognition score>3.5.Conclusions:The consensus derived from this study provides a foundation for CHM CPGs for RA in Singapore.However,the findings are limited by the demographic composition of the experts and the representativeness of the patient pool.展开更多
Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health,function,and aesthetics,ensuring both patient satisfaction and long-term stability.Managing ...Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health,function,and aesthetics,ensuring both patient satisfaction and long-term stability.Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues,especially in severe cases.Therefore,close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment,along with diligent patient compliance throughout the entire process,is crucial for achieving favorable treatment outcomes.Moreover,long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success.This expert consensus,informed by the latest clinical research and practical experience,addresses clinical considerations for orthodontic treatment of periodontal patients,delineating indications,objectives,procedures,and principles with the aim of providing clear and practical guidance for clinical practitioners.展开更多
Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common den...Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture,primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography(CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis,differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.展开更多
With the growing emphasis on maternal and child oral health,the significance of managing oral health across preconception,pregnancy,and infancy stages has become increasingly apparent.Oral health challenges extend bey...With the growing emphasis on maternal and child oral health,the significance of managing oral health across preconception,pregnancy,and infancy stages has become increasingly apparent.Oral health challenges extend beyond affecting maternal wellbeing,exerting profound influences on fetal and neonatal oral development as well as immune system maturation.This expert consensus paper,developed using a modified Delphi method,reviews current research and provides recommendations on maternal and child oral health management.It underscores the critical role of comprehensive oral assessments prior to conception,diligent oral health management throughout pregnancy,and meticulous oral hygiene practices during infancy.Effective strategies should be seamlessly integrated across the life course,encompassing preconception oral assessments,systematic dental care during pregnancy,and routine infant oral hygiene.Collaborative efforts among pediatric dentists,maternal and child health workers,and obstetricians are crucial to improving outcomes and fostering clinical research,contributing to evidence-based health management strategies.展开更多
Locoregional spread of abdominopelvic malignant tumors frequently results in peritoneal carcinomatosis(PC). The prognosis of PC patients treated by conventional systemic chemotherapy is poor, with a median survival of...Locoregional spread of abdominopelvic malignant tumors frequently results in peritoneal carcinomatosis(PC). The prognosis of PC patients treated by conventional systemic chemotherapy is poor, with a median survival of < 6 mo. However, over the past three decades, an integrated treatment strategy of cytoreductive surgery(CRS) + hyperthermic intraperitoneal chemotherapy(HIPEC) has been developed by the pioneering oncologists, with proved efficacy and safety in selected patients. Supported by several lines of clinical evidence from phases Ⅰ, Ⅱ and Ⅲ clinical trials, CRS + HIPEC has been regarded as the standard treatment for selected patients with PC in many established cancer centers worldwide. In China, an expert consensus on CRS + HIPEC has been reached by the leading surgical and medical oncologists, under the framework of the China Anti-Cancer Association. This expert consensus has summarized the progress in PC clinical studies and systematically evaluated the CRS + HIPEC procedures in China as well as across the world, so as to lay the foundation for formulating PC treatment guidelines specific to the national conditions of China.展开更多
Heat stroke(HS)is a fatal disease caused by thermal damage in the body,and it has a very high mortality rate.In 2015,the People’s Liberation Army Professional Committee of Critical Care Medicine published the first e...Heat stroke(HS)is a fatal disease caused by thermal damage in the body,and it has a very high mortality rate.In 2015,the People’s Liberation Army Professional Committee of Critical Care Medicine published the first expert consensus on HS in China,Expert consensus on standardized diagnosis and treatment for heat stroke.With an increased understanding of HS and new issues that emerged during the HS treatment in China in recent years,the 2015 consensus no longer meet the requirements for HS prevention and treatment.It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage,is more practical and is more in line with China’s national conditions.This new expert consensus includes new concept of HS,recommendations for laboratory tests and auxiliary examinations,new understanding of diagnosis and differential diagnosis,On-site emergency treatment and In-hospital treatment,translocation of HS patients and prevention of HS.展开更多
Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis an...Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis and treatment of lumbar disc herniation have been published domestically and internationally.According to the expert consensus,clinicians could adopt tailored and personalized diagnosis and treatment management strategies for lumbar disc herniation patients.展开更多
Thrombocytopenia is a common complication of critical care patients.The rates of bleeding events and mortality are also significantly increased in critical care patients with thrombocytopenia.Therefore,the Critical Ca...Thrombocytopenia is a common complication of critical care patients.The rates of bleeding events and mortality are also significantly increased in critical care patients with thrombocytopenia.Therefore,the Critical Care Medicine Committee of Chinese People’s Liberation Army(PLA)worked with Chinese Society of Laboratory Medicine,Chinese Medical Association to develop this consensus to provide guidance for clinical practice.The consensus includes five sections and 27 items:the definition of thrombocytopenia,etiology and pathophysiology,diagnosis and differential diagnosis,treatment and prevention.展开更多
1 Introduction Early detection and diagnosis of stable coronary artery disease （SCAD） is essential for proactive secondary prevention of myocardial infarction （MI）, control of disease progress, and reduction of mo...1 Introduction Early detection and diagnosis of stable coronary artery disease （SCAD） is essential for proactive secondary prevention of myocardial infarction （MI）, control of disease progress, and reduction of mortality. Clinical decision-making in modem medicine is increasingly dependent on cardiovascular imaging techniques. 2012 ACCF/AHA/ACP/AATS/ PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease has been issued by American Heart Association （AHA）. European Society of Cardiology （ESC） has issued 2013 ESC guidelines on the management of stable coronary artery disease.展开更多
Cold injury refers to local or systemic injury caused by a rapid, massive loss of body heat in a cold environment. The incidence of cold injury is high. However, the current situation regarding the diagnosis and treat...Cold injury refers to local or systemic injury caused by a rapid, massive loss of body heat in a cold environment. The incidence of cold injury is high. However, the current situation regarding the diagnosis and treatment of cold injury in our country is not ideal. To standardize and improve the level of clinical diagnosis and treatment of cold injury in China, it is necessary to make a consensus that is practical and adapted to the conditions in China. We used the latest population-level epidemiological and clinical research data, combined with relevant literature from China and foreign countries. The consensus was developed by a joint committee of multidisciplinary experts. This expert consensus addresses the epidemiology, diagnosis, on-site emergency procedures, in-hospital treatment, and prevention of cold injury.展开更多
This is an expert consensus on the evaluation and treatment of thoracolumbar spinal injury, estab- lished from February 2009 to July 2010. The expert consensus consists mainly of six parts with a total of 54 recommend...This is an expert consensus on the evaluation and treatment of thoracolumbar spinal injury, estab- lished from February 2009 to July 2010. The expert consensus consists mainly of six parts with a total of 54 recommendations including the overview （one item）; pre-hospital care （one item）; evaluation and diagnosis （13 items）; treatment （23 items）; prevention and treatment of major com- plications （12 items）; and rehabilitation （four items）. This is the first time that Chinese experts have published a consensus on spine and spinal cord injury. The expert consensus was established based on Delphi methods, literature analysis, and clinical experiences. Each recommendation is supported by and was interpreted using multi-level evidences. The level of agreement with the rec- ommendation among the panel members was assessed as either low, moderate, or strong. Each panel member was asked to indicate his or her level of agreement on a 5-point scale, with ＂1＂ cor- respondJng to neutrality and ＂5＂ representJng maxJmum agreement. Scores were aggregated across the panel members and an arithmetic mean was calculated. This mean score was then translated into low, moderate, or strong. After all of the votes were collected and calculated, the results showed no low-level recommendations, 10 moderate-level recommendations, and 44 strong-level recom- mendations. An expert consensus was reached and was recognized by Chinese spine surgeons. Wide-scale adoption of these recommendations is urgent in the management of acute thora- columbar spine and spinal cord injury in a broader attempt to create a standard evaluation and treatment strategy for acute thoracolumbar spine and spinal cord injury in China.展开更多
Early childhood caries(ECC)is a significant chronic disease of childhood and a rising public health burden worldwide.ECC may cause a higher risk of new caries lesions in both primary and permanent dentition,affecting ...Early childhood caries(ECC)is a significant chronic disease of childhood and a rising public health burden worldwide.ECC may cause a higher risk of new caries lesions in both primary and permanent dentition,affecting lifelong oral health.The occurrence of ECC has been closely related to the core microbiome change in the oral cavity,which may be influenced by diet habits,oral health management,fluoride use,and dental manipulations.So,it is essential to improve parental oral health and awareness of health care,to establish a dental home at the early stage of childhood,and make an individualized caries management plan.Dental interventions according to the minimally invasive concept should be carried out to treat dental caries.This expert consensus mainly discusses the etiology of ECC,caries-risk assessment of children,prevention and treatment plan of ECC,aiming to achieve lifelong oral health.展开更多
This consensus was compiled by first-line clinical experts in the field of pain medicine and was organized by the Chinese Association for the Study of Pain.To reach this consensus,we consulted a wide range of opinions...This consensus was compiled by first-line clinical experts in the field of pain medicine and was organized by the Chinese Association for the Study of Pain.To reach this consensus,we consulted a wide range of opinions and conducted indepth discussions on the mechanism,indications,contraindications,operational specifications and adverse reactions of ozone iatrotechnique in the treatment of pain disorders.We also referred to related previous preclinical and clinical studies published in recent years worldwide.The purpose of this consensus is to standardize the rational application of ozone iatrotechnique in pain treatment,to improve its efficacy and safety and to reduce and prevent adverse reactions and complications in this process.展开更多
Neuropathic pain(NPP)is a kind of pain caused by disease or damage impacting the somatosensory system.Ion channel drugs are the main treatment for NPP;however,their irregular usage leads to unsatisfactory pain relief....Neuropathic pain(NPP)is a kind of pain caused by disease or damage impacting the somatosensory system.Ion channel drugs are the main treatment for NPP;however,their irregular usage leads to unsatisfactory pain relief.To regulate the treatment of NPP with ion channel drugs in clinical practice,the Chinese Association for the Study of Pain organized first-line pain management experts from China to write an expert consensus as the reference for the use of ion channels drugs.Here,we reviewed the mechanism and characteristics of sodium and calcium channel drugs,and developed recommendations for the therapeutic principles and clinical practice for carbamazepine,oxcarbazepine,lidocaine,bulleyaconitine A,pregabalin,and gabapentin.We hope this guideline provides guidance to clinicians and patients on the use of ion channel drugs for the management of NPP.展开更多
On the basis of continuous improvement in recent years,radiofrequency therapy technology has been widely developed,and has become an effective method for the treatment of various intractable pain.Radiofrequency therap...On the basis of continuous improvement in recent years,radiofrequency therapy technology has been widely developed,and has become an effective method for the treatment of various intractable pain.Radiofrequency therapy is a technique that uses special equipment and puncture needles to output ultra-high frequency radio waves and accurately act on local tissues.In order to standardize the application of radiofrequency technology in the treatment of painful diseases,Chinese Association for the Study of Pain(CASP)has developed a consensus proposed by many domestic experts and scholars.展开更多
The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the result...The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following thefirst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system.展开更多
基金supports by the National Natural Science Foundation of China(Nos.82201135)"2015"Cultivation Program for Reserve Talents for Academic Leaders of Nanjing Stomatological School,Medical School of Nanjing University(No.0223A204).
文摘Early correction of childhood malocclusion is timely managing morphological,structural,and functional abnormalities at different dentomaxillofacial developmental stages.The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion.This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence,aiming to provide general guidance on appropriate imaging examination selection,comprehensive and accurate imaging assessment for early orthodontic treatment patients.
基金supported by the National Medical Products Administration Commissioned Research Project (No.20211440216)the National Administration of Traditional Chinese Medicine Science and Technology Project (No.GZY-KJS-2024-03)+3 种基金the State Key Laboratory of Drug Regulatory Science Project (No.2023SKLDRS0104)the Basic Research Program Natural Science Fund-Frontier Leading Technology Basic Research Special Project of Jiangsu Province (No.BK20232014)the Programs Foundation for Leading Talents in National Administration of Traditional Chinese Medicine of China“Qihuang scholars”Projectthe Tianjin Administration for Market Regulation Science and Technology Key Projects (No.2022-W35)。
文摘The research and development of new traditional Chinese medicine(TCM)drugs have progressively established a novel system founded on the integration of TCM theory,human experience,and clinical trials(termed the“Three Combinations”).However,considering TCM's distinctive features of“syndrome differentiation and treatment”and“multicomponent formulations and complex mechanisms”,current TCM drug development faces challenges such as insufficient understanding of the material basis and the overall mechanism of action and an incomplete evidence chain system.Moreover,significant obstacles persist in gathering human experience data,evaluating clinical efficacy,and controlling the quality of active ingredients,which impede the innovation process in TCM drug development.Network pharmacology,centered on the“network targets”theory,transcends the limitations of the conventional“single target”reductionist research model.It emphasizes the comprehensive effects of disease or syndrome biological networks as targets to elucidate the overall regulatory mechanism of TCM prescriptions.This approach aligns with the holistic perspective of TCM,offering a novel method consistent with TCM's holistic view for investigating the complex mechanisms of TCM and developing new TCM drugs.It is internationally recognized as a“next-generation drug research model”.To advance the research of new tools,methods,and standards for TCM evaluation and to overcome fundamental,critical,and cutting-edge technical challenges in TCM regulation,this consensus aims to explore the characteristics,progress,challenges,applicable pathways,and specific applications of network pharmacology as a new theory,method,and tool in TCM drug development.The goal is to enhance the quality of TCM drug research and development and accelerate the efficiency of developing new TCM products.
基金supported by the CAMS Innovation Fund for Medical Sciences(2023-I2M-C&T-B-016)lthe National High Level Hospital Clinical Research Funding(2022-PUMCH-C-048)l the Noncommunicable Chronic Diseases-National Science and Technology Major Project(2024ZD0520600).
文摘The five-year survival rate of gastric cancer in China is close to those in European and North Americancountries but far lower than those in the Republic of Korea and Japan where national gastric cancerscreening systems have been established.It is of great significance to build a high-quality gastric cancerscreening system adaptive to China's national conditions.Due to the large number of people at risk ofgastric cancer and the uneven distribution of medical resources,it is still difficult for China to carry out anationwide gastroscopy screening program for gastric cancer.Gastric oral contrast ultrasonography(OCUS)is a promising,non-invasive tool for initial gastric cancer screening,offering a painless,radiationfreealternative.Based on two 2020 OCUS consensuses,this document analyzes national gastric cancerscreening strategies and challenges to elaborate on the necessity,feasibility,and current problems ofpreliminary ultrasound screening in China.It details the key aspects of OCUS,including indications,contraindications,operator requirements,contrast agent standards,and essential scanning protocols.Italso introduces the standardized ultrasound sections and the Stomach Ultrasound Report and Data System(Su-RADS)and proposes the relevant consensus opinions.After several rounds of discussions and voting byexperts from multiple societies,a total of 17 consensus opinions have been formed on OCUS as a preliminary screening technique for gastric cancer,with the aim of standardizing the popularization ofOCUS.In addition,the consensus calls for conducting nationwide multicenter prospective studies toimprove the level of evidence and provide big data support for the construction of a preliminary gastriccancer ultrasound screening system that is in line with China's national conditions.
基金supported by the Peking Union Medical College Hospital Central High-Level Hospital Clinical Research Fund(2022-PUMCH-B-130).
文摘Objective:To develop an expert consensus on subcutaneous injection for allergen-specific immunotherapy.Methods:Relevant domestic and international literature was reviewed,and nursing experts experienced in subcutaneous injection of allergen-specific immunotherapy were interviewed to form the initial draft of the consensus.A total of 85 experts from 42 hospitals nationwide were invited to participate the discussions.Through two rounds of expert consultations,adjustments,revisions,and improvements to the initial draft,an online meeting was held to form the final version of the consensus.The content approved by more than 75%of the expert group is retained.Results:The expert consensus includes operational standards for subcutaneous injection of allergen-specific immunotherapy,identification and management of adverse reactions,and health education.Conclusion:The consensus demonstrates strong scientific rigor and practicality,providing guidance for nursing practices in the field of clinical allergology.
基金supported by the Nanyang Technological University Start-Up Grant(#022387‒00001).
文摘Objective:To establish consensus on Chinese Herbal Medicine(CHM)for rheumatoid arthritis(RA)among 21 Singaporean experts,this study addressed the lack of CHM clinical practice guidelines(CPGs)in Singapore.Despite advancements in RA therapies,the disease's progressive nature and high costs of novel treatments worsen disparities in management and outcomes.The initiative aimed to bridge this gap by developing expert-backed recommendations for CHM use in RA care.Methods:The group of experts conducted two rounds of Delphi surveys containing 29 items identified from a literature review.Consensus was defined as≥75%of votes in dichotomized ratings on a fivepoint ordinal scale for recognition.Items that did not reach consensus were discussed in a focus group with four selected experts.Results:Nineteen experts completed both rounds of Delphi surveys.A consensus was reached for 27 items,which encompassed Chinese medicine rationale,pattern differentiation,management,CHM prescription,and co-effectiveness with pharmacological therapy.Collective expert opinions were formed for the two remaining items.All items received a recognition score>3.5.Conclusions:The consensus derived from this study provides a foundation for CHM CPGs for RA in Singapore.However,the findings are limited by the demographic composition of the experts and the representativeness of the patient pool.
基金supported by the National Key R&D Program of China(2022YFC2504200)Chongqing Young and Middle-aged Medical Excellence Team ProjectJiangsu Province Key Research and Development Program(BE2022670)。
文摘Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health,function,and aesthetics,ensuring both patient satisfaction and long-term stability.Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues,especially in severe cases.Therefore,close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment,along with diligent patient compliance throughout the entire process,is crucial for achieving favorable treatment outcomes.Moreover,long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success.This expert consensus,informed by the latest clinical research and practical experience,addresses clinical considerations for orthodontic treatment of periodontal patients,delineating indications,objectives,procedures,and principles with the aim of providing clear and practical guidance for clinical practitioners.
基金supported by the National Natural Science Foundation of China(no. 82320108004)the Construction Engineering Special Fund of “Taishan Scholars” of Shandong Province (ts20190975)the National Clinical Key Specialty(Periodontology) Construction Project。
文摘Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture,primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography(CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis,differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
基金supported by grants from the National Natural Science Foundation of China(82270958)the Major Science and Technology Projects in Yunnan Province(202302AA310038)the National Key Clinical Specialty Development Project of Pediatric Dentistry Division of China(20230610)。
文摘With the growing emphasis on maternal and child oral health,the significance of managing oral health across preconception,pregnancy,and infancy stages has become increasingly apparent.Oral health challenges extend beyond affecting maternal wellbeing,exerting profound influences on fetal and neonatal oral development as well as immune system maturation.This expert consensus paper,developed using a modified Delphi method,reviews current research and provides recommendations on maternal and child oral health management.It underscores the critical role of comprehensive oral assessments prior to conception,diligent oral health management throughout pregnancy,and meticulous oral hygiene practices during infancy.Effective strategies should be seamlessly integrated across the life course,encompassing preconception oral assessments,systematic dental care during pregnancy,and routine infant oral hygiene.Collaborative efforts among pediatric dentists,maternal and child health workers,and obstetricians are crucial to improving outcomes and fostering clinical research,contributing to evidence-based health management strategies.
基金Supported by Key Project of the National Natural Science Foundation of China,No.81230031
文摘Locoregional spread of abdominopelvic malignant tumors frequently results in peritoneal carcinomatosis(PC). The prognosis of PC patients treated by conventional systemic chemotherapy is poor, with a median survival of < 6 mo. However, over the past three decades, an integrated treatment strategy of cytoreductive surgery(CRS) + hyperthermic intraperitoneal chemotherapy(HIPEC) has been developed by the pioneering oncologists, with proved efficacy and safety in selected patients. Supported by several lines of clinical evidence from phases Ⅰ, Ⅱ and Ⅲ clinical trials, CRS + HIPEC has been regarded as the standard treatment for selected patients with PC in many established cancer centers worldwide. In China, an expert consensus on CRS + HIPEC has been reached by the leading surgical and medical oncologists, under the framework of the China Anti-Cancer Association. This expert consensus has summarized the progress in PC clinical studies and systematically evaluated the CRS + HIPEC procedures in China as well as across the world, so as to lay the foundation for formulating PC treatment guidelines specific to the national conditions of China.
文摘Heat stroke(HS)is a fatal disease caused by thermal damage in the body,and it has a very high mortality rate.In 2015,the People’s Liberation Army Professional Committee of Critical Care Medicine published the first expert consensus on HS in China,Expert consensus on standardized diagnosis and treatment for heat stroke.With an increased understanding of HS and new issues that emerged during the HS treatment in China in recent years,the 2015 consensus no longer meet the requirements for HS prevention and treatment.It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage,is more practical and is more in line with China’s national conditions.This new expert consensus includes new concept of HS,recommendations for laboratory tests and auxiliary examinations,new understanding of diagnosis and differential diagnosis,On-site emergency treatment and In-hospital treatment,translocation of HS patients and prevention of HS.
文摘Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis and treatment of lumbar disc herniation have been published domestically and internationally.According to the expert consensus,clinicians could adopt tailored and personalized diagnosis and treatment management strategies for lumbar disc herniation patients.
文摘Thrombocytopenia is a common complication of critical care patients.The rates of bleeding events and mortality are also significantly increased in critical care patients with thrombocytopenia.Therefore,the Critical Care Medicine Committee of Chinese People’s Liberation Army(PLA)worked with Chinese Society of Laboratory Medicine,Chinese Medical Association to develop this consensus to provide guidance for clinical practice.The consensus includes five sections and 27 items:the definition of thrombocytopenia,etiology and pathophysiology,diagnosis and differential diagnosis,treatment and prevention.
文摘1 Introduction Early detection and diagnosis of stable coronary artery disease （SCAD） is essential for proactive secondary prevention of myocardial infarction （MI）, control of disease progress, and reduction of mortality. Clinical decision-making in modem medicine is increasingly dependent on cardiovascular imaging techniques. 2012 ACCF/AHA/ACP/AATS/ PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease has been issued by American Heart Association （AHA）. European Society of Cardiology （ESC） has issued 2013 ESC guidelines on the management of stable coronary artery disease.
文摘Cold injury refers to local or systemic injury caused by a rapid, massive loss of body heat in a cold environment. The incidence of cold injury is high. However, the current situation regarding the diagnosis and treatment of cold injury in our country is not ideal. To standardize and improve the level of clinical diagnosis and treatment of cold injury in China, it is necessary to make a consensus that is practical and adapted to the conditions in China. We used the latest population-level epidemiological and clinical research data, combined with relevant literature from China and foreign countries. The consensus was developed by a joint committee of multidisciplinary experts. This expert consensus addresses the epidemiology, diagnosis, on-site emergency procedures, in-hospital treatment, and prevention of cold injury.
基金supported by the Capital Medical Development Foundation of Beijing,No.2005-2016the Scientific and Technique Fund of the Chinese PLA during the Eleventh Five-Year Plan Period,No.06G028
文摘This is an expert consensus on the evaluation and treatment of thoracolumbar spinal injury, estab- lished from February 2009 to July 2010. The expert consensus consists mainly of six parts with a total of 54 recommendations including the overview （one item）; pre-hospital care （one item）; evaluation and diagnosis （13 items）; treatment （23 items）; prevention and treatment of major com- plications （12 items）; and rehabilitation （four items）. This is the first time that Chinese experts have published a consensus on spine and spinal cord injury. The expert consensus was established based on Delphi methods, literature analysis, and clinical experiences. Each recommendation is supported by and was interpreted using multi-level evidences. The level of agreement with the rec- ommendation among the panel members was assessed as either low, moderate, or strong. Each panel member was asked to indicate his or her level of agreement on a 5-point scale, with ＂1＂ cor- respondJng to neutrality and ＂5＂ representJng maxJmum agreement. Scores were aggregated across the panel members and an arithmetic mean was calculated. This mean score was then translated into low, moderate, or strong. After all of the votes were collected and calculated, the results showed no low-level recommendations, 10 moderate-level recommendations, and 44 strong-level recom- mendations. An expert consensus was reached and was recognized by Chinese spine surgeons. Wide-scale adoption of these recommendations is urgent in the management of acute thora- columbar spine and spinal cord injury in a broader attempt to create a standard evaluation and treatment strategy for acute thoracolumbar spine and spinal cord injury in China.
基金supported by the National Natural Science Foundation of China(82170947)the International Science and Technology Innovation Cooperation Projects of Science and Technology Office of Sichuan Province(2019YFH0025)。
文摘Early childhood caries(ECC)is a significant chronic disease of childhood and a rising public health burden worldwide.ECC may cause a higher risk of new caries lesions in both primary and permanent dentition,affecting lifelong oral health.The occurrence of ECC has been closely related to the core microbiome change in the oral cavity,which may be influenced by diet habits,oral health management,fluoride use,and dental manipulations.So,it is essential to improve parental oral health and awareness of health care,to establish a dental home at the early stage of childhood,and make an individualized caries management plan.Dental interventions according to the minimally invasive concept should be carried out to treat dental caries.This expert consensus mainly discusses the etiology of ECC,caries-risk assessment of children,prevention and treatment plan of ECC,aiming to achieve lifelong oral health.
文摘This consensus was compiled by first-line clinical experts in the field of pain medicine and was organized by the Chinese Association for the Study of Pain.To reach this consensus,we consulted a wide range of opinions and conducted indepth discussions on the mechanism,indications,contraindications,operational specifications and adverse reactions of ozone iatrotechnique in the treatment of pain disorders.We also referred to related previous preclinical and clinical studies published in recent years worldwide.The purpose of this consensus is to standardize the rational application of ozone iatrotechnique in pain treatment,to improve its efficacy and safety and to reduce and prevent adverse reactions and complications in this process.
基金Supported by Sichuan Science and Technology Program,No.2018SZ0386。
文摘Neuropathic pain(NPP)is a kind of pain caused by disease or damage impacting the somatosensory system.Ion channel drugs are the main treatment for NPP;however,their irregular usage leads to unsatisfactory pain relief.To regulate the treatment of NPP with ion channel drugs in clinical practice,the Chinese Association for the Study of Pain organized first-line pain management experts from China to write an expert consensus as the reference for the use of ion channels drugs.Here,we reviewed the mechanism and characteristics of sodium and calcium channel drugs,and developed recommendations for the therapeutic principles and clinical practice for carbamazepine,oxcarbazepine,lidocaine,bulleyaconitine A,pregabalin,and gabapentin.We hope this guideline provides guidance to clinicians and patients on the use of ion channel drugs for the management of NPP.
文摘On the basis of continuous improvement in recent years,radiofrequency therapy technology has been widely developed,and has become an effective method for the treatment of various intractable pain.Radiofrequency therapy is a technique that uses special equipment and puncture needles to output ultra-high frequency radio waves and accurately act on local tissues.In order to standardize the application of radiofrequency technology in the treatment of painful diseases,Chinese Association for the Study of Pain(CASP)has developed a consensus proposed by many domestic experts and scholars.
基金supported by the National Natural Science Foundation of China(81970265,82270310)a Sub-Project of the National Key R&D Program“The recognition and Identification of Genetic Pathogenic Genes for Structural Birth Defects”(2021YFC2701002)+1 种基金Nanjing Science and Technology Development Project(2019060007)Jiangsu Provincial Key Research and Development Program(BE2023662).
文摘The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following thefirst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system.
