The speaking valve, a one-way device that restores physiological airflow, provides significant benefits for tracheostomy patients by enhancing phonation, swallowing, airway clearance, and psychological health. It also supports weaning from mechanical ventilation and promotes decannulation. However, inconsistent application in China poses potential risks. To address this, Chinese Association of Medical Rescue, Critical Care Branch, Chinese Medical Education Association, Critical Care Rehabilitation Branch jointly developed an expert consensus on the clinical application of speaking valves. This consensus includes 19 recommendations covering patient eligibility, device selection, operational protocols, adverse event management, and multidisciplinary team training. By emphasizing standardized assessment, timely monitoring, and collaborative practice, it seeks to ensure the safe and effective use of speaking valves in tracheostomy patient rehabilitation.
The global initiative for chronic obstructive lung disease (GOLD) 2025 report, released on November 11th, 2024, marks the second update since GOLD 2023. Overall, this version maintains similar definition, diagnosis, assessment, and treatment for COPD as in GOLD 2024, but with revisions and expansions in 12 specific areas. These include: added explanations and references on lung function trajectories, expanded content on dysbiosis, updates and additions to spirometry, revised cardiovascular risk information for COPD patients, updated guidance on CT imaging for COPD, new insights into the impact of climate change on COPD, updated vaccination recommendations, updated follow-up pharmacological treatments, new guidance for delivery of pulmonary rehabilitation, revised recommendations on ICS withdrawal in patients on LABA+ICS therapy, updated information on PDE3 and PDE4 inhibitors and other exacerbation-reducing medications, and additional content on pulmonary hypertension. The article introduces and interprets the new contents.
When insomnia and obstructive sleep apnea (OSA) coexist, it is referred to as comorbid insomnia and obstructive sleep apnea (COMISA). The prevalence of COMISA in the general population ranges from 0.6% to 19.3%. It is primarily characterized by difficulty falling asleep, frequent nighttime awakenings, early morning awakening, poor sleep quality, snoring or apnea during sleep, unrefreshing or nonrestorative sleep, excessive daytime sleepiness, fatigue, attention impairment, memory impairment, emotional disorders, and impaired quality of life. COMISA can lead to adverse outcomes in multiple systems and increase all-cause mortality. Therefore, it is significant to establish a guidline for the diagnosis, differential diagnosis, and standardized treatment of COMISA. The guideline was organized by the Chinese Academy Society of Sleep Medicine, Chinese Medical Doctor Association and Sleep Medicine Group, China Neurologist Association. It was formed by reviewing domestic and international COMISA diagnosis and treatment practices, through literature evidence review, and after extensive discussion. The guideline summarized the epidemiology, etiology and risk factors, pathophysiological mechanisms, clinical manifestations, assessment methods, diagnosis, differential diagnosis, and treatment studies of COMISA, providing a basis for decision-making in the diagnosis and treatment of COMISA for clinician.
The incidence of acute poisoning caused by commonly used clinical drugs has been increasing annually, yet specific antidotes are lacking for most drug poisonings. Blood purification plays a crucial role in the treatment of acute poisoning. However, there are currently no unified recommendations in China regarding its application in cases of acute poisoning from commonly used clinical drugs. This consensus centers on pharmacokinetics, summarizing and outlining the strategies for applying blood purification in the treatment of acute poisoning caused by these drugs. Its aim is to assist clinicians in improving their understanding of pharmacokinetic parameters and the corresponding blood purification methods, so that they can select the appropriate blood purification technique and develop suitable treatment plans based on the pharmacokinetic characteristics of the drug involved. Ultimately, this seeks to improve outcomes in treating patients with acute poisoning from commonly used clinical drugs.
To enhance the overall health management for patients with gynecologic malignant tumors, and to fully leverage the role of primary healthcare institutions in screening and rehabilitation, the Gynecological Oncology Group of the Oncology Department of Capital Medical University, in collaboration with experts in general medicine, nutrition, psychology, rehabilitation medicine, nursing, and health statistics, has formulated the Expert Consensus on Management of Common Gynecological Malignancies Combining General Practice and Specialist. This consensus, based on evidence from evidence-based medicine, the current status of primary medical institutions, and relevant guidelines for the management of gynecological malignancies, emphasizes the early identification of gynecological malignancies and proactive intervention in related health issues. Community management of patients with common gynecological malignancies should be centered around gynecologists or general practitioners, in collaboration with a multidisciplinary oncology rehabilitation team. The management covers aspects such as prevention, screening, follow-up and referral, psychological counseling, exercise rehabilitation, nutrition management, continuity of care, systematic health education, and social function recovery, aiming to prolong survival and enhance the quality of life for patients.
Behavior and lifestyle interventions (BLIs) can reduce blood glucose and blood pressure, regulate blood lipids, control obesity, reduce cardiovas cular events and are a first-line treatment for chronic diseases such as diabetes mellitus. BLIs include helping patients maintain a healthy diet, adhere to physical exercise, maintain a normal weight, ensure good sleep, avoid smoking and alcohol abuse, make good psychological adjustments, establish good social support, as well as scientific self-monitoring of blood glucose and adherence to drug therapy. Except for the severe hyperglycemia and acute complications requiring medication, patients with newly diagnosed diabetes mellitus should first undergo BLIs. BLIs should follow the principles of effectiveness-centered, mutual trust establishment, problem-solving orientation, integration, and individulization. Common strategies for BLIs include applying behavior change theories, utilizing behavior change technologies, effectively emlpoying communication strategies, improving patient behavior skills, and implementing patient-centered self-management education and support (DSMES). The steps of BLIs include evaluating behavior, lifestyle and their influencing factors, setting behavioral goals, developing intervention plans, and conducting interventions and effectiveness evaluation. The evaluation measures for the effectiveness of BLIs include process indicators, clinical outcomes, socio-psychological and behavioral outcomes, patient reports, and health outcomes. Evaluation can be performed using a combination of qualitative and quantitative methods. Common evaluation tools include the SDSCA, PAM, and DMSES.
The rapid development of new technologies such as artificial intelligence and large language models has brought new transformations to clinical medical practice. Both domestically and internationally, research and practical exploration of intelligent general practitioners have begun, but a consensus has yet to be formed. Against this backdrop, experts and scholars from Tsinghua University Vanke School of Public Health, Peking University School of Public Health, Chinese Association of General Practitioners of Chinese Medical Doctor Association and several other domestic institutions collaboratively developed a consensus. The background of these experts spans multiple disciplines, including general medicine, public health, artificial intelligence, and evidence-based medicine. Based on extensive literature review both domestically and internationally and through multiple rounds of expert discussions, the Chinese Expert Consensus on Artificial Intelligent General Practitioner (AIGP) was finally formulated. It includes 17 core consensus concerning the definition, characteristics, applications, challenges and recommendations of AIGP. This consensus aims to provide scientific references to promote the empowerment of general practitioners with intelligent technology and enhance the smart service level of primary healthcare.
Test anxiety disorder is a group of symptoms related to stress caused by tests, exams, evaluations, and others. It is among the severe psychological problems in exams. Long-term test anxiety is likely to cause tension, fear, irritability, depression, and other negative emotions, and it disturbs working memory, attention, and other cognitive abilities and even leads to suicidal ideation. In order to standardize the clinical diagnosis and treatment of test anxiety disorder, under the organization of the Test Anxiety Disorder Collaboration of the Chinese Society of Psychosomatic Medicine, this expert consensus was formulated by 13 experts in the field of psychiatry and psychology. We collaborate and announce the expert consensus based on current research and clinical experience. We hope the consensus can provide clinicians with scientific and comprehensive guidance on test anxiety disorder, including epidemiology, etiology, clinical manifestations, evaluation, and treatment.
Diabetic microvascular disease (DMiVD) is the most common chronic complication of diabetes mellitus, and early identification and effective intervention can significantly improve patients' quality of life and prognosis. The Diabetes and Microcirculation Professional Committee of Chinese Society of Microcirculation and the Primary Endocrine and Metabolic Diseases Group of the Chinese Society of Endocrinology have convened experts in the field to revise the Expert Consensus on Screening and Prevention of Diabetic Microvascular Diseases for Primary Care (2024), based on the 2021 edition, considering the latest research advances and the specific needs of primary care. This consensus elaborates the screening methods, comprehensive management and prevention strategies for DMiVD (diabetic retinopathy, diabetic kidney disease, distal symmetric polyneuropathy and diabetic cardiomyopathy), clarifies the graded diagnosis and treatment and referral processes, emphasizes the importance of preventing and treating DMiVD, and offers guidance and recommendations for physicians, particularly primary care physicians and general practitioners. The aim is to reduce the incidence, progression, and disability associated with DMiVD, ultimately lowering morbidity and mortality rates.
Obstructive sleep apnea (OSA) is prevalent in the elderly population due to the weakened neuromuscular function of the upper airway and unstable respiratory regulation in the elderly. OSA is a risk factor for a variety of common chronic diseases, and affects cognitive function and multi-system organ function in the elderly. Therefore, it is essential to provide effective therapeutic interventions for OSA in the elderly. The Sleep Medicine Branch of the Chinese Geriatrics Society, as the initiator, organized domestic experts in related fields to repeatedly discuss the operation process, requirements, specific ways and methods of noninvasive positive pressure ventilation (NPPV) treatment for elderly OSA patients with reference to domestic and international clinical studies, and finally made this expert consensus, which is aimed at standardizing the treatment of NPPV in elderly OSA patients in China to provide a reference.
Clinical practice guidelines can standardize medical behaviors, improve the quality of medical services, rationalize resource allocation, and safeguard the rights of patients. However, all of these are achieved based on the rigorous design, scientific formulation, and standardized reporting of guidelines. With the nation's high attention to the standardization of traditional Chinese medicine, many clinical practice guidelines for traditional Chinese medicine or integrated traditional Chinese and Western medicine have been published. Traditional Chinese medicine orthopedics, as a discipline with obvious advantages in specialization in the field of traditional Chinese medicine, is witnessing a rapid increase in the number of clinical practice guidelines, prompting the discipline to gradually move towards standardization, modernization, and internationalization. However, many issues are increasingly emerging in this context, attracting widespread attention from researchers. This article systematically reviews and summarizes the current status and challenges of the development of clinical practice guidelines in orthopedics of traditional Chinese medicine, and proposes targeted strategies. Currently, the development of clinical practice guidelines in orthopedics of traditional Chinese medicine faces many challenges, including inaccurate positioning of clinical problems, a lack of high-quality clinical evidence, insufficient standardization in guideline formulation, a shortage of multidisciplinary talent development, and various issues regarding guideline updating and implementation. In future research, professional societies/associations should strengthen guidance on guideline formulation. Researchers should focus on improving the quality of original research, enhance learning and research in guideline methodology, prioritize guideline updating and adaptation, and promote the dissemination and implementation of guidelines, aiming to develop high-quality guidelines and promote the standardization of orthopedics of traditional Chinese medicine.
Lumbar disc herniation is one of the most common causes of low back pain, and the number of cases has been increasing year by year in recent years. High-quality guidelines can standardize clinical diagnosis and treatment behaviors and improve medical quality, and screening and formulating high-quality guidelines are of great significance for standardizing the clinical practice of lumbar intervertebral disc herniation.
To systematically evaluate the methodological quality of clinical practice guidelines and expert consensus for lumbar intervertebral disc herniation, and to analyze the high-quality guidelines and consensus recommendations, in order to provide reference for the prevention and treatment of lumbar intervertebral disc herniation.
Clinical practice guidelines and expert consensus on lumbar intervertebral disc herniation were searched from the establishment of each database to October 31, 2023. At the same time, Dangdang.com and others were manually searched to obtain the guidelines for lumbar intervertebral disc herniation published in the form of monographs. After the consistency evaluation was passed by two researchers, the methodological quality of the included guidelines and consensus was evaluated using the AGREE Ⅱ tool, and the high-quality guidelines and consensus recommendations were analyzed.
A total of 15 guidelines and consensus were included, and the final recommendation level of 9 guidelines was B (can be recommended after modification), and 6 guidelines and consensus were C (not recommended for the time being). Recommendations mainly include bed rest, medication, surgical treatment, etc.
The methodological quality of the clinical practice guidelines and expert consensus for lumbar intervertebral disc herniation needs to be further improved, and some treatment methods are controversial, and the recommendations of the guidelines need to be further improved and unified to optimize clinical practice.
Hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia are collectively referred to as the "three highs", which often coexist in the same individual. It significantly increases the risk of hospitalization, death, and relevant burdens for affected people. It is necessary to jointly control the risk and standardize the treatment of hypertension, T2DM and dyslipidemia. Primary healthcare institutions have become the main battlefield for the prevention and treatment of chronic diseases. Existing clinical evidence provides important insights into the prevention, treatment, and management of the "three highs", although norms, consensus, and guidelines for the co-management of the "three highs" in primary healthcare institutions at domestic and foreign are current not available. Four academic organizations led by Beijing Hypertension Association organized primary healthcare workers and invited experts and scholars from medical fields of cardiovascular diseases, endocrine, pharmacy, and public health services to participate in the consensus. Through widely soliciting clinical practice needs of primary healthcare workers, integrating and evaluating the evidence related to the prevention and treatment of the "three highs" in primary healthcare institutions, the consensus for primary healthcare in the prevention and treatment of the "three highs" including 21 opinions was developed after multiple rounds of discussions, revisions, and voting. The recommended opinions of this consensus aim to improve the awareness and ability of primary healthcare workers in the prevention and treatment of the "three highs", provide scientific strategic support, implement management with primary healthcare characteristics, and lay a solid foundation for comorbidity co-management.
Lumbar spinal stenosis is one of the most common causes of low back and leg pain. However, there is a lack of evidence-based guidelines for the treatment of lumbar spinal stenosis with integrated traditional Chinese medicine and western medicine. To standardize the diagnosis and treatment of lumbar spinal stenosis with a combination of traditional Chinese medicine and western medicine, this guideline strictly followed the relevant guiding principles for the development of guidelines both domestically and internationally. A multidisciplinary working group was established. We adopted the GRADE approach to grade the quality of evidence and the strength of recommendation. Finally recommendations on the treatment of lumbar spinal stenosis with integrated traditional Chinese medicine and western medicine were formed, aiming to standardize clinical practice. This guideline is for patients with all degrees of lumbar spinal stenosis.
Binge-eating disorder (BED) is a type of eating disorder characterized by recurrent episodes of binge eating. Patients with BED have recurrent impulsive and out-of-controlled binge eating behavior, which can lead to gastrointestinal disorders, obesity, and the resulting metabolic and functional disorders of various systems and other physical problems; and it is also often co-morbid with affective disorder, anxiety disorders, substance use disorders, and other mental disorders, which need to be taken seriously. However, the recognition of BED in China was late, and it is difficult to achieve early identification and diagnosis, resulting in a prolonged course of disease. Therefore, under the organization of the Eating Disorders Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association, together with the Eating Disorders Research Collaboration Group of the Psychiatric Medicine Society of the Chinese Medical Association, an expert group composed of 15 psychiatrists and evidence-based medicine experts, and 2 internal medicine experts, formulated this expert consensus based on evidence-based medical evidence, domestic and foreign guidelines and expert consensus, and expert experiences. The aim of this study is to improve the recognition, diagnosis and treatment of BED by psychiatrists, internists and general practitioners in China.
Low-density lipoprotein cholesterol (LDL-C) is a pathogenic risk factor for atherosclerotic cardiovascular disease (ASCVD). In recent decades, the prevalence of dyslipidemia in the Chinese population increases continuously, it is urgent to improve blood lipid management in China. It is particularly important to carry out standardized blood lipid management at primary healthcare institutions. The Chinese Guideline for Lipid Management (Primary Care Version 2024) concisely recommends that LDL-C should be the preferred intervention target in lipid management, and the target values of LDL-C should be determined based on ASCVD risk stratification. The present guideline recommends to use moderate-intensity statins at the beginning of treatment on the basis of lifestyle intervention. If the LDL-C target level can not be reached, other lipid-lowering drugs like cholesterol absorption inhibitors or (and) proprotein convertase subtilisin/kexin type 9 inhibitors should be jointly used for the purpose of reaching the target value. The present guideline also provides blood lipid management strategies for special populations. We aim to provide guidance for primary healthcare professionals to carry out blood lipid management, and comprehensively improve their ability on blood lipid management, and thereby improve the primary and secondary prevention of ASCVD in China.
Post-COVID-19 condition is defined as the presence of symptoms that cannot be explained by other diagnoses, lasting for at least 2 months, occurring three months after a possible or confirmed SARS-CoV-2 infection. It is the result of a complex interplay of biological, psychological, and sociocultural factors, characterized by a high number of affected individuals, complex pathogenesis, diverse symptoms, and a significant need for long-term care. The diagnosis is considered exclusionary and can be classified into six subtypes, including non-severe COVID-19 multiorgan sequelae, pulmonary fibrosis sequelae, myalgic encephalomyelitis or chronic fatigue syndrome, postural orthostatic tachycardia syndrome, post-intensive care syndrome, and medical or clinical sequelae. Based on comprehensive evaluation, treatment and care can be provided through a multidisciplinary approach involving medication, diet, exercise, psychological interventions, patient education, and other methods.
Global initiative for chronic obstructive lung disease (GOLD) 2024 report was released on November 13th, 2023. In general, the definition, diagnosis, assessment, and therapy of chronic obstructive pulmonary disease (COPD) are the same as GOLD 2023, with corresponding content added in ten aspects, including the expansion of the information about PRISm, a new section on hyperinflation, further clarification about pre-bronchodilator spirometry, a new section on screening for COPD in targeted populations, the update of blood eosinophil count, the update of interstitial lung abnormalities, the revision of the section on smoking cessation, the update of vaccination recommendations for people with COPD, the expansion of managing inhaled therapy, and the addition of pharmacotherapies for smoking cessation. The article introduces and interprets the new contents.
Anorexia nervosa (AN) is a type of eating disorders characterized by self-starvation, significant loss of body mass, and malnutrition. AN has the highest mortality rate among all psychiatric disorders, leading to severe psychopathologic symptoms and life-threatening medical complications. However, AN cannot be recognized and diagnosed early in China, resulting in a prolonged course of the disease. Therefore, under the organization of the Eating Disorders Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association, together with the Eating Disorders Research Collaboration Group of the Psychiatric Medicine Society of the Chinese Medical Association, this expert consensus was formulated by 16 medical experts based on evidence-based medical evidence, domestic and international guidelines and expert consensus, expert experience, etc., in order to improve the recognition, diagnosis and treatment of AN among domestic professionals.
Insomnia is the most common sleep disorder, which not only causes individual health damage, but also brings heavy social and economic burden. The traditional insomnia treatment model has the disadvantages of complicated process and high cost. With the development of information technology, the more convenient and low-cost digital therapy for insomnia (DTI) has been increasingly utilized. However, there is still a lack of standardized guidelines for DTI globally. To address this issue, the China Sleep Research Society collaborated with domestic experts in sleep medicine and medical engineering to develop the Expert Consensus on Digital Therapies for Insomnia in China, elaborates on the definition, indications, core principles, research and development, promotion and application, education and training, data protection, ethical supervision, aiming to establish a unified and comprehensive framework for DTI.
Clinically, patients with cardiovascular disease widely have psycho-psychological problems, which interact with each other and aggravate the disease state. Psycho-cardiology is a discipline formed by the intersection and integration of cardiology and psychology, which emphasizes the attention to cardiovascular diseases and the mental state of patients. Experts from the Psycho-cardiology Group of the Psychosomatic Medicine Society of the Chinese Medical Association formulated Chinese Expert Consensus on the Construction Standardization of Psycho-cardiology Outpatient after reviewing literature and conducting discussions, in order to improve the diagnosis and treatment capacity of psycho-cardiology in China, promote medical institutions at all levels to set up psycho-cardiology outpatient, and continuously improve the medical service system of psycho-cardiology in China.
The incidence of psychiatric dizziness is high. If clinicians do not have enough knowledge about it, they are prone to misdiagnose psychiatric dizziness as posterior circulation ischemic attack, cervical dizziness, vestibular peripheral vertigo or other diseases, thus leading to inappropriate examinations and treatments. With the increasing emphasis on psychosomatic diseases, the Holistic Health Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association formulated the Chinese Expert Consensus on Diagnosis and Treatment of Psychiatric Dizziness in combination with the latest evidence in relevant fields at home and abroad, as well as the opinions of experts in psychosomatic health, mental disorders, vertigo and other fields. This consensus elaborated the concept, etiology and pathogenesis, clinical characteristics, diagnosis and evaluation, and various treatment approaches of psychiatric dizziness, and formulated the final expert consensus after multidisciplinary expert communication, aiming to provide a reference basis for standardized diagnosis and treatment of psychiatric dizziness.
Bulimia nervosa is a type of eating disorders characterized by recurrent binge eating and compensatory behaviors to prevent weight gain, as well as excessive concern about body shape and mass. The patients with bulimia nervosa present with disturbed eating behavior, resulting in electrolyte abnormalities, gastrointestinal disorders, metabolic and endocrine disorders and other physical problems; secondly, the bulimia nervosa patients are often co-morbid with a variety of mental disorders such as bipolar disorder, depression, substance use disorders, which need to be taken seriously. However, bulimia nervosa and even eating disorders cannot be recognized and diagnosed at an early stage in China, which leads to a prolonged course of the disease. Therefore, under the organization of the Eating Disorders Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association, in conjunction with the Eating Disorders Research Collaboration Group of the Psychiatric Medicine Society of the Chinese Medical Association, this expert consensus was formulated by 12 experts in the field of psychiatry and evidence-based medicine based on evidence-based medicine, domestic and foreign guidelines and expert consensus and expert experience, in order to improve the recognition, diagnosis and treatment of bulimia nervosa by psychiatric professionals and general practitioners in China.
Chronic obstructive pulmonary disease (COPD) is one of the major chronic disease seriously affecting the health of Chinese residents. There are national and international guidelines and consensus on the diagnosis, treatment and management of COPD. However, there is no expert consensus on integrated traditional Chinese and western medicine management for COPD by now. Therefore, Chinese and western medicine experts with rich experience in the diagnosis and treatment of COPD in China were invited to formulate this consensus based on relevant domestic and foreign guidelines, consensus and personal experience, which includes early recognition and diagnosis of COPD, disease assessment, integrated traditional Chinese and western medicine treatment for stable COPD, evaluation, intervention measures of traditional Chinese and modern medicine, follow-up and management of acute exacerbation of COPD, so as to further improve the level of diagnosis, treatment and management of COPD in China.
Lumbar spinal stenosis (LSS) is a common disease in orthopedics. The American Society of Pain and Neuroscience (ASPN) published a new version of minimally invasive treatment practice guidelines in 2022 to improve the clinical efficacy of LSS. A total of seven treatments for LSS were included in the guidelines, including percutaneous image-guided lumbar decompression (PILD), interspinous spacers (ISP), interspinous fusion (ISF), intrathecal drug delivery systems (IDDS), spinal cord stimulation (SCS), epidural steroid injections (ESI) and open decompression. Based on the guidelines, this paper summarizes and discusses the research progress of minimally invasive treatment of LSS in the context of the clinical situation, aiming to provide a reference for clinicians and further related researches.
In order to standardize scientific drug use in vertigo, the Vertigo Committee of the Chinese Medical Education Association established an expert group to form Expert Consensus on Betahistine Mesylate in the Treatment of Vertigo after repeated discussion based on the existing medical evidence, and combined with the rich clinical experience of experts. The consensus includes the pharmacological basis of histamines, the strength of recommendation, dosage, course, review methods, medication for special populations, adverse drug reactions and other aspects of betahistine mesylate in common vertigo diseases (such as benign paroxysmal position vertigo, Menieres disease, and vestibular neuritis, etc.) to guide doctors in clinical work.
Perinatal mental disorders are one of the most common disorders during pregnancy and may lead to adverse maternal and offspring outcomes. There is an increasing number of women currently at risk for emotional problems such as anxiety and depression during pregnancy and childbirth, and women with previous mental disorders are also at risk of relapse during pregnancy. At the same time, the lack of clinical guidelines for the diagnosis and treatment of perinatal mental disorders has made the work of clinicians even more challenging. The expert writing group integrated the latest medical evidence and clinical practice in related fields at home and abroad to form the expert consensus, consisting of the epidemiology and pathogenesis, clinical manifestations, clinical evaluation, diagnosis, treatment and management of perinatal mental disorders, which can provide reference and guidance for practical clinical work. The consensus advocates comprehensive, whole-process, hierarchical, multidisciplinary and collaborative diagnosis and treatment, to help frontline clinicians screen, rationally assess and clinically diagnose perinatal pregnant women as soon as possible, as well as provide necessary psychological interventions and clinical medication for them.
Ulinastatin is mainly applied in the treatment of acute pancreatitis, but also in other common clinical critical illnesses such as shock, sepsis, evere pneumonia, cute respiratory distress syndrome, several acute poisoning, severe heat stroke, severe burns, severe trauma, and patients with sudden cardiac arrest for its roles in proteolytic enzymes inhibition and inflammatory responses regulation, which has been recommended by several guidelines/expert consensus on the diagnose and treatment of common clinical critical illness. However, there is currently a lack of consensus on the rational use of ulinastatin in terms of indications, usage, dosage, and others. Therefore, in order to promote the standardized application of ulinastatin, the expert group of expert consensus on the application of ulinastatin in common clinical critical illness summarized the mechanism, pharmacokinetics, indications of ulinastatin and its application methods in the treatment of common clinical critical illness, in order to provide a reference for the rational application of ulinastatin in clinical practice.
With the prosperous development of Internet medical care and increasing flow of electronic prescriptions, electronic prescription review has become an important guarantee for rational drug use in the online medication environment. However, in the Internet scenario, inefficient manual review with low quality increases the risk of adverse drug events. The application of the intelligent auxiliary prescription review system can significantly reduce the working pressure of pharmacists reviewing prescriptions and improve the efficiency of review, but there is a lack of setting standards and standardized management measures in the system architecture, system functions and prescription review rules setting of the Internet medical intelligent auxiliary prescription review system at present, which cannot meet the rapidly developing needs of Internet medical care. Using the construction experience of the prescription review system in medical institutions as a reference, this expert consensus makes recommendations on the construction and application of the Internet medical intelligent auxiliary prescription review system based on the functions and methods of formulating prescription review rules of the existing prescription review system, to further promote the standardization of the Internet medical prescription review work and ensure rational drug use.
Menopause-related insomnia is a common symptom of perimenopausal women, which is clinically common but easy to be neglected. Menopause-related insomnia will affect the health of perimenopausal women and even in the old age. There is still a lack of consensus and guidelines on the clinical management of menopause-related insomnia in China. In order to standardize the management of menopause-related insomnia and improve the management of menopause-related sleep health, experts were organized to develop this consensus. The management of menopause-related insomnia mainly includes the establishment of a multidisciplinary expert team, pharmacological and nonpharmacological management, which is expected to play a guiding role in the clinical practice.
The prevention and delay of disability is important for promoting healthy aging. Exercise intervention is an efficient strategy for disability prevention. Besides, exercise intervention presents significant therapeutic advantages and broad application prospects due to low cost, low implementation difficulty, high acceptance and wide application scenarios. Therefore, Nursing Group of Chinese Society of Geriatrics, Committee on Geriatric Nursing of Chinese Association of Geriatric Research, China Gerontological Nursing Alliance, National Center of Gerontology, Institute of Geriatric Medicine of Chinese Academy of Medical Sciences jointly developed and published Clinical Practice Guidelines for Exercise Interventions for the Prevention of Disability in Older Adults (2023). According to the methodologies specified in WHO Handbook for Guideline Development, the guidelines finally involve 32 recommendations and 18 clinical issues containing exercise principles, effectiveness and plans of different types of exercise, facilitators and barriers during exercise, aiming to provide a reference for the development and implementation of exercise programs for older adults at risk of disability and standardize clinical practice, thus promoting the gateway to improving physical function of the older adults, reducing the prevalence of disability, improving quality of life, contributing to healthy aging.
