Maculopathy caused by various fundus diseases in the late stage is a common cause of low vision. Medical technology is difficult to reverse the loss of macular function currently, so interventions that help improve the visual system, utilize residual visual function, and improve quality of life deserve attention. Damage to the fovea of the macula does not mean that the entire retinal function is impaired. There may be one or more retinal regions adjacent to the fovea that can serve as a fixation center. It is possible to form stable paracentral fixation, complete functional remodeling of the visual system, and effectively utilize residual visual function by taking appropriate training on these potential paracentral fixation points for most patients. In 2021, a clinical guideline has been published for low vision rehabilitation in China. In order to strengthen the precise management of diseases and develop a standard operating procedure for visual training specifically for patients with low vision due to macular disease, the National Clinical Research Center for Eye Diseases initiated and organized relevant domestic experts, utilizing the latest research experience at home and abroad, and through repeated discussions, this consensus (International Practice Guideline Registration Number: PREPARE-2023CN199) was formed as a reference for ophthalmologists, optometrists and rehabilitation physicians in their clinical research and practice.
Families are important venues for nutritional management of the elderly, and there is an increasing demand for continuous nutritional management services from hospital to home. It has been 7 years since the publication of the "Chinese expert consensus on home nutrition administration for the elderly (2017 edition)", and with the publication of more research evidence and the practice of home nutrition administration, there is an urgent need to update the 2017 edition of the consensus. A total of 35 recommendations or consensus opinions have been proposed in this consensus update, aiming to guide grassroots related professionals to provide scientific, reasonable and standardized home nutrition management services for the elderly population at home or in the community.
Diabetic retinopathy is one of the microvascular complications of diabetes and a major cause of blindness in adults. Early screening is an effective way to reduce blindness caused by diabetic retinopathy. The diabetic retinopathy is one of the chronic retinal diseases highlighted in the “14th Five-Year” National Eye Health Plan (2021-2025). The establishment of effective and practical community screening model is a powerful guarantee to complete early screening. It is of great significance to standardize screening methods, screening personnel duties, equipment allocation, referral conditions and screening sustainability. Chinese fundus disease and related field experts developed the consensus through a serious, comprehensive, and complete discussion, to provide more reference for establishing a suitable community screening model of diabetic retinopathy and increasing the screening rate of diabetic retinopathy.
Female pelvic floor dysfunction (PFD) is a common disease affecting women's quality of life, especially in older women. The establishment and application of multimodal evaluation system is the key to the accurate diagnosis and effective treatment of PFD. The purpose of this expert consensus is to provide a comprehensive, multi-layered assessment framework that includes clinical examinations, imaging examinations, biomechanical tests, and questionnaires to comprehensively assess pelvic floor function in women. By integrating different assessment methods, we aim to improve the early identification and diagnostic accuracy of PFD, so that personalized treatment can be developed to improve patient outcomes. The consensus also discusses the advantages and disadvantages of various assessment techniques and suggests directions for future research and clinical applications.
The high incidence of hydatid disease in seven northwestern provinces, is one of the reason of "Poverty due to illness, and return poverty due to illness" in China. The incidence of chest hydatid disease in China after hepatic hydatid disease ranks second. Department of thoracic surgery in the First Affiliated Hospital of Xinjiang Medical University is on the domestic leading position of the treatment of chest hydatid disease. Since 1956 the first case of pulmonary hydatid cyst were completed, we have successfully finished the surgical treatment of pediatric chest hydatid disease, chest hydatid disease complex, huge pulmonary hydatid cyst, mediastinal and pleural hydatid cyst, and rib hydatid in our department. To further standardize the treatment of chest hydatid disease, a special formulation of "technical specification for chest hydatid disease diagnosis expert consensus" by our department were produced, in order to help clinicians treat chest hydatid disease by more suitable strategies. This consensus was released in July 2015, for the original version. The definition, diagnosis, treatment principle, and prevention of chest hydatid disease were elaborated and clinical experiences of 60 years were combined with in this consensus, in order to help the clinicians for diagnosis, treatment, and prevention of hydatid disease.
Meige Syndrome (MS) is a neurological disorder characterized by blepharospasm, oromandibular dystonia, and spasmodic torticollis as its primary clinical manifestations. With advancements in neuroscience research and the accumulation of clinical experience, significant progress has been made in understanding the pathophysiological mechanisms, diagnostic criteria, and therapeutic strategies for MS both domestically and internationally. To standardize clinical practice and promote academic development, Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association, in collaboration with Neuro-ophthalmology Society, Chinese Research Hospital Association, organized a panel of authoritative experts. This expert panel conducted a comprehensive review of the latest research evidence and clinical experiences. Through multiple rounds of expert consultations and in-depth discussions, the original consensus was thoroughly revised and updated. The new consensus aims to provide standardized diagnostic and treatment guidelines for clinicians, foster research innovation and the development of therapeutic techniques in the field of neuro-ophthalmology, address new challenges in the diagnosis and treatment of MS, and ultimately improve patients' quality of life.
The population of various fundus diseases in China is vast, and the number of patients is continuously increasing due to the aging population. In contrast, fundus disease awareness among the general public in China is low, and grassroots screening needs urgent improvement. At the same time, the diagnosis and treatment rate are quite low, and the treatment methods for late-stage diseases are limited, resulting in poor prognosis of visual function and high blindness rate. Chronic fundus diseases require long-term, standardized treatment and long-term follow-up, which can be burdensome for patients, leading to high missed visit rates and reduced therapeutic effects. The "14th Five-Year Plan for Eye Health (2021-2025)" clearly put forward the requirements of strengthening the construction of the fundus disease prevention and control system. We urgently need to develop a management model for chronic diseases of fundus diseases tailored to China's national conditions. This will require establishing corresponding management platforms, improving personnel allocation, and enhancing compliance in the treatment of fundus diseases, to improve treatment effectiveness and fundamentally reduce blindness rates. After China's authoritative experts in the field of fundus diseases through the organization of in-depth and comprehensive thematic discussion, and the use of the improved version of Delphi method for collective decision-making and opinion consultation, a series of consensus guidance and suggestions were finally formed. These valuable professional insights will strongly promote the establishment of an appropriate chronic fundus disease management system in China, ensure that patients with fundus disease get long-term, standardized medical services, and lay a solid foundation for improving the overall prevention and treatment of fundus diseases.
Objective To explore the methodological characteristics of Chinese clinical practice guidelines/expert consensus based on usage of GRADE. MethodsCNKI, PubMed, WanFang Data databases, and Medlive.cn were electronically searched to collect Chinese clinical practice guidelines/expert consensus over the past 11 years from January 1st 2010 to December 31st 2020. Four reviewers independently extracted data according to the content of appraisal of guidelines quality evaluation tool AGREE Ⅱ. The clinical practice guidelines/expert consensus were divided into two groups based on whether GRADE was used or not. The changes and development of methodological quality in the past 11 years were explored between the two groups. ResultsIn recent years, the number of clinical practice guidelines/expert consensus which used the GRADE in China had increased annually. The practice guidelines/expert consensus which did not use GRADE had lower methodology quality (P<0.01). ConclusionsThe use of GRADE in clinical practice guidelines/expert consensus requires improvement, and mastering GRADE methodology can effectively improve the methodological quality of the clinical practice guidelines/expert consensus.