The incidence of perioperative sleep disorders in patients with cervical spondylosis is high, which affects the physiological and psychological rehabilitation effect of patients after surgery. The expert consensus (preliminary draft) was prepared by summarizing expert experience and recommendations. After expert review and revision, the consensus was formed. The consensus was developed based on existing evidence-based medical evidence and expert clinical experience, which is scientific and practical and can provide a basis for clinical medical personnel to prevent and treat perioperative sleep disorders in patients with cervical spondylosis.
Osteonecrosis of the femoral head (ONFH) is a common and refractory disease in the clinic. Although the exact pathophysiological mechanism is not fully understood, it is believed to be closely related to the interruption of intra-bone circulation and eventual bone tissue death. The prevention and treatment of ONFH is always a great challenge for orthopedists. The diagnostic level of ONFH has been continuously improved with the development of imaging techniques such as MRI and the in-depth understanding of the disease in recent years.There are many treatment methods for ONFH, which are generally considered individually and comprehensively according to factors such as the patient’s age, osteonecrosis stage, classification, and compliance with joint-sparing treatment. There is currently no unified standard. ONFH staging and classification play an important reference value for doctors to choose treatment options. In recent years, based on the characteristics of ONFH in Chinese people, the academic community has proposed Chinese staging and China-Japan Friendship Hospital (CJFH) classification. The consensus also introduces them together with the international Association Research Circulation Osseous (ARCO) staging to provide guidance for individualized treatment of ONFH. In order to further standardize the diagnosis of ONFH and expand the treatment of ONFH, the Association Related to Circulation Osseous, Chinese Microcirculation Society (CSM-ARCO) organized domestic experts in the field of ONFH to jointly formulate the expert consensus, in order to provide reference for the standardized diagnosis of ONFH and the selection of individualized diagnosis and treatment techniques.
With the widespread application of minimally invasive esophagectomy, inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE) has gradually become one of the alternative surgical methods for transthoracic esophagectomy due to less trama, fewer perioperative complications and better short-term efficacy. However, there is no uniform standard for surgical methods and lymph node dissection in medical centers that perform IVMTE, which affects the standardization and further promotion of IVMTE. Therefore, on the basis of fully consulting domestic and foreign literature, our team proposed an expert consensus focusing on IVMTE, in order to standardize the clinical practice, guarantee the quality of treatment and promote the development of IMVTE.
Patellofemoral osteoarthritis (PFOA) is one of the most common causes of anterior knee pain in middle-aged and elderly population. In general, elementary therapy and drug therapy are the preferred choices for PFOA management. However, for those who cannot achieve satisfactory effectiveness with standard non-surgical treatment, surgical therapy stands as an alternative treatment. The surgical therapy includes repair surgery and reconstruction surgery. The choice of surgical plans for PFOA management mainly depends on the etiology, pathogenesis, location, and severity of the lesions. To aid clinical decision-making, the National Clinical Research Center for Geriatric Disorders (Xiangya Hospital) and the Joint Surgery Branch of the Chinese Orthopedic Association arranged nationwide orthopedic specialists to set up a work panel. After reviewing the research progress of surgical therapy and the latest guidelines and consensus for PFOA management, the work panel discussed repeatedly to reach this consensus. The present consensus aims to provide valid evidences for clinical practices of the surgical therapy of PFOA, so as to avoid inappropriate and irregular treatment behaviors, reduce surgical trauma, improve surgical efficacy and the quality of life, and to ease the burden of PFOA.
We update the "2021 expert consensus on clinical pathway for transcatheter aortic valve replacement in China" using the Delphi method. By searching for evidence related to the clinical pathways of transcatheter aortic valve replacement (TAVR) in PubMed, CIKI, and Wanfang Database over the past four years, 35 core viewpoints were proposed in four directions: TAVR team composition and clinical evaluation, perioperative imaging assessment, surgical process, and perioperative and postoperative long-term management of patients. The specific updates include: refining the responsibilities and composition of the TAVR team, clarifying the steps and content of clinical evaluation; emphasizing the core position of CT in perioperative imaging assessment, and introducing the application of new technologies such as artificial intelligence, numerical simulation, and 3D printing; optimizing the TAVR surgical process, including anesthesia selection, access establishment, valve selection and release, and others; and proposing management strategies for special types of patients (such as emergency TAVR, simplified TAVR, pure aortic regurgitation, combined coronary heart disease and atrial fibrillation). In addition, the consensus also emphasizes the importance of postoperative follow-up and rehabilitation, and provides detailed antithrombotic and rehabilitation guidance. The update of this consensus will further promote the standardized development of TAVR technology in China and improve clinical treatment effects.
Day surgery wards have advantages such as the ability to quickly free up beds and possessing necessary medical resources, making them a focal department for the integration of emergency and routine medical care within healthcare institutions. The Day Surgery Nursing Committee of Sichuan Tianfu New Area Medical Association gathered experts from relevant fields, took into account the actual situation and previous practices of integrating emergency and routine medical care in day surgery wards, and developed this expert consensus. It covers the aspects of emergency plans, process mechanisms, spatial preparations, personnel preparations and deployment, material preparations, and information sharing and coordination of the management model of integrating emergency and routine medical care in day surgery wards, so as to provide professional guidance and references for the management model of integrating emergency and routine medical care in day surgery wards, and offer new ideas and methods to maximize patient treatment during emergency situations.
Daytime hip arthroplasty refers to a medical procedure where a patient undergoes admission, surgery, and discharge all within a single day (24 hours). The establishment of daytime hip arthroplasty centers signifies a significant paradigm shift in the development model of modern hospitals. While numerous nationally accredited large medical institutions are undertaking daytime hip arthroplasty in various forms and scales, there remains a lack of standardized system processes and criteria. In this context, the National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Bone and Joint Specialty Committee of the China Ambulatory Surgery Alliance, Joint Surgery Branch of the Chinese Orthopedic Association, and Osteoarthritis Study Group of the Chinese Association of Orthopedic Surgeons have collaboratively organized experts in the relevant field domestically. Leveraging international experiences in daytime hip arthroplasty and integrating them with the clinical practices of well-established medical institutions conducting daytime surgeries in China, they have arrived at consensus recommendations. These recommendations cover the establishment of daytime hip arthroplasty centers, policies, procedures, and perioperative management. The ultimate goal is to provide reference points and guidance for the standardized implementation of daytime hip arthroplasty.
Getting out of bed early after surgery is an important measure to promote the clinical concept of accelerated rehabilitation surgery and promote physical and mental rehabilitation of patients. However, at present, the specific implementation plan for early postoperative ambulation of patients undergoing anterior cervical surgery has not formed a unified standard, and there is a lack of reliable evidence to recommend and guide clinical nursing practice. To this end, the Orthopaedic Nursing Professional Committee of Chinese Nursing Association, the Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Rehabilitation Medical Association, and the Nursing Group of Orthopaedic Professional Committee of Sichuan Medical Association, based on evidence-based medical evidence and combined with the clinical experience of experts in related fields, formed an expert consensus on the theme of early postoperative get-out activities of patients undergoing anterior cervical surgery. To provide reference for clinical work, 9 recommendations on early ambulation of patients undergoing anterior cervical surgery were put forward.
Based on the current situation of patients with retinal diseases in China and the clear requirements of the "14th Five-Year Plan for Eye Health (2021-2025)" to strengthen the construction of the prevention and control system for retinal diseases, experts in the field of retinal diseases in China have conducted in-depth and comprehensive thematic discussions, and used the modified Delphi method for collective decision-making and opinion solicitation, ultimately forming consensus and consistent guidance suggestions for the management of chronic diseases of retinal diseases that are in line with China's national conditions. This consensus includes key content such as definitions, treatment plans, and follow-up frequency for the management of chronic diseases of the fundus. It clearly proposes relevant measures to improve the management process of chronic diseases of the fundus, and elaborates on the advantages and feasibility of establishing an online remote platform for the management of chronic diseases of the fundus, in order to assist doctors in formulating personalized treatment plans and ensure that patients receive standardized treatment and follow-up. This consensus will provide guidance and reference for the management of chronic diseases and long-term standardized diagnosis and treatment of major fundus diseases in China.
In order to further regulate the application of 3D reconstruction in thoracic surgery, the Chinese Expert Consensus Group on the Application of Integrated 3D Reconstruction with Artificial Intelligence in Thoracic Surgery conducted discussions and developed this consensus. This consensus is based on the clinical experience and existing prospective or retrospective studies of 3D reconstruction technology in various scenarios of thoracic surgery and summarizes recommendations, and also appends a list of 3D reconstruction technology application scenarios that are currently controversial, not fully studied, or still in the exploratory stage, to provide direction and evidence for future clinical research and disease diagnosis and treatment, and to reach a consensus.