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1
2018 Chinese Guideline on Menopause Management and Menopause Hormone Therapy
, Qi YU
2018, 9(6): 512-525. doi: 10.3969/j.issn.1674-9081.2018.06.007
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Abstract:
This guideline has been announced by experts of Menopause Group, Obstetrics and Gynecology Branch, Chinese Medical Association on menopause management and menopause hormone therapy (MHT) to help healthcare professionals in optimizing their management of transitionally menopausal and postmenopausal women. New results on MHT and menopause management after 2012 as well as all of the important information from main international guidelines were reviewed. Levels of evidence and grades of recommendations were also included. The standardized MHT flowcharts of diagnosis and treatment were retained and improved from the last version. The menopause staging system, Stages of Reproductive Aging Workshop +10 (STRAW+10), was added to facilitate the understanding on clinical, biological, and endocrine changes in the reproductive aging process for doctors in this field. Vasomotor symptoms (VMS), genitourinary syndrome of menopause, and prevention ofmenopause-related low bone mass and osteoporosis were reconfirmed as the indications for MHT. The risks of MHT depend on types, dosages, time of use, management, start-up time, and whether progesterone is used. To maximize the benefits and minimize the risks, MHT should be individualized based on the updated evidence, and the benefit-risk ratio should be reassessed annually. For women within 10 years after menopause, or younger than 60 years old with no contraindications, MHT for the treatment of VMS and prevention of bone loss and fractures has the most favorable benefit-risk ratio. Premature ovarian insufficiency patients should be treated with hormone replacement therapy till the average age of natural menopause and followed by the postmenopausal MHT.
2
围手术期患者低体温防治专家共识(2017)
2017, 8(6): 352-358. doi: 10.3969/j.issn.1674-9081.2017.06.007
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3
Clinical Practice Guideline for Primary Lung Cancer(2022 Version)
General Office of National Health Commission of the People's Republic of China
2022, 13(4): 549-570. doi: 10.12290/xhyxzz.2022-0352
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4
Risk Factors of Breast Cancer in China: A Case-Control Study
Ya-li XU, Qiang SUN, Guang-liang SHAN, Jin Zhang, Hai-bo Liao, Shi-yong Li, Jun JIANG, Zhi-min Shao, Hong-chuan JIANG, Nian-chun SHEN, Yue SHI, Cheng-ze YU, Bao-ning ZHANG, Yan-hua CHEN, Xue-ning DUAN, Bo LI
2011, 2(1): 7-14. doi: 10.3969/j.issn.1674-9081.2011.01.002
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Abstract:
  Objective  To screen the risk factors associated with breast cancer among Chinese women, with an attempt to provide evidence for the evaluation of breast cancer risks among Chinese women on an individual level.  Methods  A case-control study on 416 breast cancer patients and 1156 age-and region-matched controls was conducted in 14 hospitals in 8 provinces/municipalities of China.Conditional logistic regression was applied to analyze the association between risk factors and breast cancer.  Results  The risk factors of breast cancer among Chinese women included higher body mass index(BMI ≥ 24)(OR=4.07, 95%CI:2.98-5.55), history of benign breast disease biopsy(OR=1.68, 95%CI:1.19-2.38), age of menarche ≥ 14 years(OR=1.41, 95%CI:1.07-1.87), psychological depression(for grade 1-4, OR=2.15, 95% CI:1.26-3.66;for grade 5-9, OR=3.48, 95% CI:2.03-5.95), menostasia(OR=2.22, 95% CI:1.50-3.28), family history of breast cancer(OR=1.72, 95%CI:1.15-2.58), and family history of cancer other than breast cancer(OR=1.55, 95%CI:1.22~1.98)(all P < 0.05 when compared between the 416 breast cancer patients and 1156 controls).Although use of oral contraceptives(OC)(OR=1.59, 95% CI:0.83-3.05)was associated with an increased risk of breast cancer, the difference was not statistically significant(P > 0.05).  Conclusions  Many risk factors including BMI ≥ 24, history of benign breast disease biopsy, age of menarche ≥ 14 years, psychological depression, menostasia, family history of breast cancer, and family history of cancer other than breast cancer may contribute to breast cancer among Chinese women.This research provides a basis for the individualized evaluation of risks of breast cancer and the population-based interventions in China.
5
中国成人艰难梭菌感染诊断和治疗专家共识
2017, 8(2-3): 131-138. doi: 10.3969/j.issn.1674-9081.2017.03.010
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6
Chinese Guidelines for Diagnosis and Treatment of HIV/AIDS (2018)
and Hepatitis C Professional Group AIDS, Tai-sheng LI, Fu-sheng WANG, Fu GAO
2019, 10(1): 31-52. doi: 10.3969/j.issn.1674-9081.2019.01.006
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Abstract:
Acquired immunodeficiency syndrome (AIDS) is an important public health problem in China. In 2005, the first edition of the guidelines for the diagnosis and treatment of AIDS was formulated by the AIDS Professional Group of Society of Infectious Diseases of Chinese Medical Association, which was updated in 2011 and 2015, respectively. The fourth edition of the guidelines in 2018 is revised on the basis of the third edition and updated according to national clinical practice and the latest research results. The new research progress in opportunistic infections and human immunodeficency virus(HIV) associated cancers, antiretroviral therapy, HIV post-exposure prophylaxis, and prevention of mother to child transmission were updated in these guidelines. In the 2018 edition, pre-exposure prophylaxis is mentioned for the first time. The strategy of whole course management of HIV infection is put forward and how to do the whole course management of HIV infection is detailed in this version. These guidelines will be updated regularly according to the latest clinical evidence.
7
Campaigning for the Transformation from Anesthesiology to Perioperative Medicine: Interpretation on the Anesthesia Part of Consensus on ERAS and Guidelines for the Pathway Management in China (2018)
Tian-long WANG, Yu-guang HUANG
2018, 9(6): 481-484. doi: 10.3969/j.issn.1674-9081.2018.06.001
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Abstract:
As Consensus on ERAS and Guidelines for the Pathway Management in China (2018) was published, China has taken an important step forward in promoting the enhanced recovery protocol. The interpretation of its anesthesia part has an important guidance for anesthesiologists to better understand clinical practice methods and the pathway of perioperative management. The interpretation made a deep evidence-based exploration in the anesthesia-related core parts from the guideline, aiming to further disclose the direction of the development of clinical practice of anesthesiology in the near future from the vision of perioperative medicine.
8
Epidemiological Survey on Postoperative Delirium in Elderly Noncardiac Surgical Patients
Gang TAN, Xiang-yang GUO, Ai-lun LUO, Yu-guang HUANG, Jian-qing XU
2011, 2(4): 319-325. doi: 10.3969/j.issn.1674-9081.2011.04.008
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Abstract:
  Objective  To investigate the incidence of delirium after noncardiac surgery among elderly patients and explore the possible perioperative risk factors.  Methods  In this cross-sectional study using cluster sampling, totally 718 patients aged 65 or older who had undergone elective noncardiac surgeries in our hospital from August to December 2006 were enrolled. Patients were interviewed at the day before surgery and an informed consent was obtained. The same interviewer evaluated the patients prospectively for delirium with the Confusion Assessment Method (CAM) on the preoperative day 1, postoperative day 1, day 2, and day 3. Other information including previous medical history, comorbidities, anesthetics, and perioperative medications were also recorded.  Results  Delirium occurred in 80 patients (11.1%) at during the first three postoperative days, among whom transient symptoms were more frequent than continuous delirium status (68, 85% vs. 12, 15%). The Logistic stepwise regression analysis indicated that the perioperative risk factors of delirium included advanced age (OR:1.480, 95% CI:1.070-2.046), history of stroke (OR:2.862, 95% CI:1.432-5.720), use of meperidine (OR:3.196, 95% CI:1.574-6.488) or scopolamine (OR:2.537, 95% CI:1.523-4.227), hypotention during the operation (OR:1.780, 95% CI:1.070-2.960), long-duration operations (≥ 3 h) (OR:2.610, 95% CI:1.538-4.431), and ICU admission after surgeries (OR:2.187, 95% CI:1.077-4.442).  Conclusions  Advanced age or previous history of stroke are the most important risk factors of postoperative delirium. The incidence of postoperative delirium may be decreased by avoiding other risk factors such as perioperative hypotension, usage of meperidine and scopolamine, and long-duration operation.
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Concept Renewal Leads to Behavior Progress: Interpretation on the Surgical Part of Consensus on ERAS and Guidelines for Pathway Management in China (2018)
Xiao-dong TIAN, Yin-mo YANG
2018, 9(6): 485-489. doi: 10.3969/j.issn.1674-9081.2018.06.002
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Abstract:
The concept and pathway of enhanced recovery after surgery (ERAS) have been widely accepted and proved to be beneficial in terms of improving postoperative outcomes in China. In 2018, experts from the Chinese Society of Surgery and the Chinese Society of Anaesthesia jointly organized and published the Consensus on ERAS and Guidelines for Pathway Management in China (2018) in both Chinese Journal of Practical Surgery and Chinese Journal of Anesthesiology at the same time. This consensus is incorporated with the latest literature and the experts' own clinical practice experience, and it marks a great progress of the ERAS practice in China. In this paper, we try to make an interpretation of the surgery part of the consensus, and the highlights and hot issues will be further discussed.
10
甲状腺结节的超声诊断及治疗
2010, 1(1): 34-39.
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11
Application of Deep Learning in Medical Imaging Research
Li-ming XIA, Jian SHEN, Rong-guo ZHANG, Shao-kang WANG, Kuan CHEN
2018, 9(1): 10-14. doi: 10.3969/j.issn.1674-9081.2018.01.003
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Abstract:
Deep learning, as the most popular research field in artificial intelligence, has been developing rapidly in recent years and become the focus of global attention. Deep learning has demonstrated a powerful role in many application areas. In some visual and auditory recognition tasks, deep learning even shows better performance than human beings. In medical domain, deep learning has become the top choice for researchers to analyze big data, especially medical imaging. This review briefly introduces the history and development of deep learning, and elaborates on the progress of research on deep learning in medical imaging by reviewing the latest and most influential research results. In addition, this paper briefly discusses application of deep learning in medical imaging analysis, as well as the future prospect and challenges of deep learning.
12
Outcome Measure Selection and Sample Size Estimation for Clinical Research
Yu-jen TSENG, Shi-yao CHEN
2018, 9(1): 87-92. doi: 10.3969/j.issn.1674-9081.2018.01.016
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Abstract:
The selection of outcome measures should be based on the study design, anticipated results, and available resources. Biological parameters, analysis of economic benefits, and life-quality assessment are commonly employed outcome measures. Outcome measures, observation method, and evaluation method correlate with the study design and affect the sample size estimation. The sample size should be determined according to various factors, including power, significance level, expected effect sizes and standard deviation in the case of continuous variables. In clinical research, rationally selecting outcome measures and scientifically estimating sample sizes might markedly improve the reliability and feasibility of the study results.
13
老年患者围手术期管理北京协和医院专家共识
2018, 9(1): 36-41. doi: 10.3969/j.issn.1674-9081.2018.01.008
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Clinical Practice Guidelines for ERAS in China (2021)(Ⅱ)
Chinese Society of Surgery, Chinese Society of Anesthesiology
2021, 12(5): 632-640. doi: 10.12290/xhyxzz.20210002
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15
How to Distinguish between Clinical Practice Guidelines and Expert Consensus
Yao-long CHEN, Xu-fei LUO, Ji-yao WANG, Xiao-qing LIU, Hong-cai SHANG, Ke-hu YANG
2019, 10(4): 403-408. doi: 10.3969/j.issn.1674-9081.2019.04.018
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As the most important guiding documents in the medical practice, clinical practice guidelines and expert consensuses have received more and more attention in recent years. However, partial domestic experts also have understanding biases on guidelines and consensus. Thus, we analyzed and compared guidelines and consensuses on their definition, status, development, connection, and difference. Combined with the example, we introduced good practice statement along with its formation conditions. Finally, we proposed five recommendations on how to improve the quality of clinical practice guidelines and expert consensus in China.
16
Chinese Guidelines for Diagnosis and Treatment of Human Immunodeficiency Virus Infection/Acquired Immunodeficiency Syndrome(2021 edition)
Acquired Immunodeficiency Syndrome and Hepatitis C Professional Group, Society of Infectious Diseases, Chinese Medical Association, Chinese Center for Disease Control and Prevention
2022, 13(2): 203-226. doi: 10.12290/xhyxzz.2022-0097
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Abstract:
In 2005, the first edition of the guidelines for the diagnosis and treatment of acquired immunodeficiency syndrome(AIDS) was formulated by the AIDS Professional Group of the Society of Infectious Diseases of Chinese Medical Association, which was updated in 2011, 2015, and 2018, respectively. The 2021 edition of the guidelines was revised on the basis of the fourth edition and updated according to the national clinical practice and the latest research results. The new research progress in opportunistic infections, antiretroviral therapy, post-exposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP), the whole course of the management of HIV infection, and prevention of mother to child transmission was updated in these guidelines. In the 2021 edition, the indications, medication regimen, follow-up and monitoring, and precautions of PrEP are introduced in detail. This edition of guidelines will be updated regularly according to the latest clinical evidence.
17
术后镇痛理念新跨越:从超前镇痛到预防性镇痛
2014, 5(1): 106-109. doi: 10.3969/j.issn.1674-9081.2014.01.023
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18
标准化病人规范化培训流程
2014, 5(2): 225-227. doi: 10.3969/j.issn.1674-9081.2014.02.022
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19
Influence of Laparoscopic Cystectomy on Ovarian Reserve Function and Pregnantic Outcome in Women with Ovarian Endometriotic Cyst
Jing-hua SHI, Jin-hua LENG, Meng-hui LI, Shuang-zheng JIA, Jing-he LANG
2011, 2(2): 124-128. doi: 10.3969/j.issn.1674-9081.2011.02.007
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Abstract:
  Objective  To investigate the influence of laparoscopic ovarian cystectomy on ovarian reserve function and pregnantic outcome in women with ovarian endometriotic cyst.  Methods  A total of 176 women with ovarian cyst undergoing laparoscopic cystectomy were divided into six groups:40 patients with uni-lateral teratoma(con1), 10 patients with bilateral teratoma(con2), 40 patients with unilateral ovarian endometriotic cyst less than 35y(A), 26 patients with unilateral ovarian endometriotic cyst no less than 35y(B), 41 patients with bilateral ovarian endometriotic cyst less than 35y(C), and 19 patients with bilateral ovarian endometriotic cyst no less than 35y(D).Blood samples were obtained from patients before operation, 24 hours after operation and on the second and third day of the menstrual cycle 6 months after operation.Mean ovarian diameter were evaluated by ultrasound 6 months after operation and pregnancy outcome was recorded in the following 18 months after the operation.  Results  In the bilateral groups(C and D), the serum level of follicle stimulating hormone(FSH)increased significantly after the operation(P < 0.05), while estradiol decreased significantly(P < 0.05).No significant difference between pre-and post-operational hormone levels were observed in the unilateral groups(A and B)and control group Serum basal FSH recovered to normal 6 months after the operation in 77.8% of patients in group C and 53.3% in group D(P < 0.05).The reduction of mean ovarian diameter six months after operation was significantly different between the affected and contralateral ovaries(P < 0.05).During the follow-up, the pregnancy rate was 92.9% in controlled group, compared to 45.2% in the endometriosis group(P < 0.05)and 60%, 37.5%, 46.2%, and 16.7%, respectively, for group A, B, C, and D.  Conclusion  The ovarian reserve function decreases after laparoscopic ovarian cystectomy in women with ovarian endometriotic cyst.However, most young patients recover after 6 months.Peri-operative ovarian function assessment and ovarian protection should be carefully designed and performed for women who intend to get pregnant.
20
Expert Consensus on Anesthesia Management of Enhanced Recovery after Adult Ambulatory Surgery
Working Group of "Expert Consensus on Anesthesia Management of Enhanced Recovery after Ambulatory Surgery"
2019, 10(6): 562-569. doi: 10.3969/j.issn.1674-9081.2019.06.003
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Abstract:
The definition of ambulatory surgery by the China Ambulatory Surgery Alliance refers to an operation (excluding outpatient surgery) completed within one day (24 h). For the patients with special conditions who have to prolong hospital stays, the length of hospital stays should not exceed 48 h.Enhanced recovery after surgery (ERAS) is a series of optimized perioperative treatments with evidence-based medicine that can reduce perioperative stress and inflammatory responses, promote rapid recovery, and improve patients' perioperative safety and comfort. Ambulatory surgery has the advantages of short hospital stay and high rate of bed rotation. Based on these characteristics, optimized anesthesia management under the concept of ERAS can enhance the safety, comfort, and efficacy of ambulatory surgery.
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