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1
The Standard for Diagnosis and Treatment of Chinese Colorectal Cancer（2023 Version）
General Office of National Health Commission of the People's Republic of China, Oncology Branch of the Chinese Medical Association
2023, 14(4): 706-733. doi: 10.12290/xhyxzz.2023-0315
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2
Parallel Doctors and Parallel Hospitals: Impact and Perspective of ChatGPT-like AIGC and AGI on Medicine and Medicare
WANG Feiyue
2023, 14(4): 673-679. doi: 10.12290/xhyxzz.2023-0220
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Issues related to the impact of ChatGPT-like artificial intelligence generated content (AIGC) and artificial general intelligence (AGI) technologies on medicine and medicare have been presented and discussed. We believe that advances in medical foundation models, scenarios engineering, and medical operations with operating systems would lead to parallel doctors in parallel hospitals, i.e., digital, robotic, and human doctors working in parallel within cyber-physical-social spaces under three modes: autonomous, parallel, and expert/emergency operations. Under decentralized/distributed autonomous organizations/operations (DAO) and DeSci, as well as DeMed and DeHospitals, the vision for individual patients with her/his personalized digital hospital could be a reality in the future.
3
Digital Doctors and Parallel Healthcare: From Medical Knowledge Automation to Intelligent Metasystems Medicine
WANG Feiyue
2021, 12(6): 829-833. doi: 10.12290/xhyxzz.2021-0586
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This paper proposes the concept of digital doctors and their roles in parallel healthcare for the digital transformation of medical services based on atificial intelligence and intelligent technology. By integrating complexity medicine, transdisciplinary medicine, and systematized intelligent medicine, we outline an ACP-based parallel healthcare and federated hospitals for preventive, proactive, precise, and personalized medical services.
4
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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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.
5
Interpretation on Management Guideline for the Off-label Use of Drugs in China(2021 Edition)
ZUO Wei, LIU Rongji, SUN Yajia, ZHANG Bo, CHEN Yaolong, ZHANG Shuyang
2023, 14(1): 86-93. doi: 10.12290/xhyxzz.2022-0588
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Off-label drug use represents a reasonable need for diagnosis and treatment in some cases, but it faces potential risks with drug safety and legal challenges. However, there was no guideline on how to manage the off-label drug use in China. Therefore, Peking Union Medical College Hospital, in cooperation with Evidence-based Medicine Center of Lanzhou University, established a working group and an expert group consisting of multidisciplinary group of experts to develop the Management Guideline for the Off-label Use of Drugs in China (2021). The Guideline is guided by the Law on Doctors of the People's Republic of China and the World Health Organization Guideline Development Manual. This is the first management guideline on the off-label use of drugs, aiming to improve the stakeholders' understanding of this topic and establish a standardized management procedure in China. This guideline has determined nine questions and proposed a total of twenty-three recommendations. The English version of the guideline was published in September 2022. This paper offers a detailed interpretation of the key points of the guidelines in order to provide suggestions and references for the management of off-label drug use.
6
Clinical Practice Guidelines for ERAS in China (2021)(Ⅰ)
Chinese Society of Surgery, Chinese Society of Anesthesiology
2021, 12(5): 624-631. doi: 10.12290/xhyxzz.20210001
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7
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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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.
8
Interpretation on the 2023 Chinese Menopause Symptom Management and Menopausal Hormone Therapy Guidelines
CHEN Rong
2023, 14(3): 514-519. doi: 10.12290/xhyxzz.2023-0190
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The essence of menopause is ovarian failure, which has a significant impact on women's health. The goal of menopausal management is to relieve menopause-related symptoms, and hopefully, prevent chronic diseases in old age. Based on comprehensive lifestyle management, various health care measures including menopausal hormone therapy have been carried out under the guidance of professional medical practitioners so as to improve and enhance the quality of life of middle-aged and elderly women. The 2023 Chinese Menopause Symptom Management and Menopausal Hormone Therapy Guidelines was officially published in January 2023, and this article interprets the core points of the guidelines, especially the main updates, in order to better guide clinical practice.
9
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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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.
10
Expert Consensus on Nucleic Acid of Amplification Techniques Test for the Diagnosis of Pathogens in Adult Respiratory Tract Infections(2023)
The Committee of Chinese Laboratory Medical Education, Chinese Thoracic Society of the Chinese Medical Association
2023, 14(5): 959-971. doi: 10.12290/xhyxzz.2023-0338
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Respiratory tract infection is one of the most prevalent medical conditions. Rapid and accurate diagnosis of pathogens is crucial for precise and effective treatment. However, the sensitivity of traditional microbiological and immunological techniques for respiratory pathogens detection is low.The development and clinical applications of nucleic acid testing technology have dramatically improved the ability to diagnose respiratory pathogens. The rational usage of appropriate nucleic acid testing techniques, based on the underlying diseases, the type of respiratory tract infections, and pathogen spectrum, as well as the correct understanding of its diagnostic sig- nificance, has become an important clinical challenge. Therefore, the Committee of Chinese Laboratory Medical Education and Chinese Thoracic Society initiated a multi-disciplinary Chinese expert consensus. Based on both the domestic and international guidelines and literature, the expert consensus analyzes the clinical application scenarios, technical characteristics, and performance validation requirements pertaining to real-time fluorescence polymerase chain reaction (PCR), isothermal amplification technology, digital PCR, nucleic acid point-of-care testing, and metagenomics next generation sequencing. Furthermore, it also examines the wide-ranging applications of these techniques in diagnosing and managing respiratory tract infections, including acute upper respiratory tract infections, tracheobronchitis, community-acquired pneumonia, hospital-acquired pneumonia/ventilator-associated pneumonia, acute exacerbation of chronic obstructive pulmonary disease, tuberculosis, and respiratory infections in immunocompromised adults. We hope the consensus will provide helpful reference for clinicians.
11
Prospects and Challenges:when Medical Imaging Meets Artificial Intelligence
Zheng-yu JIN
2018, 9(1): 2-4. doi: 10.3969/j.issn.1674-9081.2018.01.001
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With the rapid development of artificial intelligence, there is a general consensus of opinion that radiologists' workload can be dramatically reduced with the aid of intelligent image recognition. On the issues of comprehensive diagnosis and treatment, however, there is no certain answer whether or not artificial intelligence can provide better suggestions and comments. Currently, in China, the artificially intelligent imaging technique is mainly focused on simple image recognition, but there is a lack of experience in the accumulation of medical data and the analysis of radiological reports. The mode of integrating artificial intelligence with medical imaging science has just begun. We believe that the progress of science and technology will continue to be the engine of human civilization.
12
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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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.
13
2023 Chinese Expert Consensus Statement for Prevention and Management of Perioperative Hypothermia
National Center for Quality Assurance of Anesthesia
2023, 14(4): 734-743. doi: 10.12290/xhyxzz.2023-0266
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The 2023 Chinese Expert Consensus Statement for Prevention and Management of Perioperative Hypothermia is an update of the 2017 Chinese Expert Consensus Statement for Prevention and Management of Perioperative Hypothermia. It is intended to provide patient-centric recommendations for clinicians to prevent and manage inadvertent hypothermia. It offers advice on assessing patient's risk of hypothermia, measuring and monitoring temperature as well as preventing patients from hypothermia before, during and after surgery. It also provides new evidence on hypothermia and adverse outcomes, and temprature management for special patients care considerations including pediatric, pregnancy, trauma, liver transplantation and sepsis.
14
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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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.
15
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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