OBJECTIVE：To provide sugge stions for improving the variety of pediatric drugs and ensuring the safety of pediatric drug use in China. METHODS ：The historical evolution of laws and regulations on the marketing approval of pediatric drugs in the United States and the implementation results of relevant policies were summarized. Combined with the current situation of the development of pediatric drugs in China ，some suggestions were put forward to ensure the accessibility and safety of pediatric drug use in China. RESULTS & CONCLUSIONS ：Since 1994，the United States had issued a series of laws and regulations to encourage the development of pediatric drugs. At present ，the marketing approval of pediatric drugs were mainly based on the two laws of Best Pediatric Drug Act（BPCA）and Pediatric Research Equality Act （PREA）. From 1998 to 2019，the amount of supplements of pediatric drug information in drug instructions of the United States showed a fluctuating growth. As of April 2020，854 kinds of drugs had been modified in pediatric instructions ，792 of which had been carried out post marketing pediatric clinical research ，and the problem of incomplete pediatric instructions had also been greatly improved. At present ，China’s policies on pediatric drugs mainly included encouraging R&D innovation ，giving priority to review and approval ，and strengthening R&D technical guidance. Although certain achievements had been made ，there were still some problems ，such as imperfect policies and regulations ，and great difficulties carrying out pediatric drug clinical trials. It is suggested that our country should draw lessons from the American regulations on pediatric drugs ，pediatric research and the catalogue of pediatric drugs ，and establish a system and catalogue of ped iatric drug use suitable for China ’s national conditions ，so as to improve the effectiveness ，safety and accessibilityof pediatric drugs.

Thrombolytic therapy plays a vital role in reperfusion strategy for ST-segment elevation myocardial infarction(STEMI)patients.Previous Chinese expert consensus focused on pre-hospital thrombolysis therapy in STEMI patients was published in 2018 which tremendously promoted pre-hospital thrombolysis therapy.In recent years,plenty of research progress and results of clinical trials have been released in following areas such as STEMI reperfusion strategy,anti-platelet/anti-coagulants therapy,contemporary facilitated percutaneous coronary intervention,and so on.Meanwhile,the COVID-19 pandemic makes timely reperfusion for STEMI patients even more challenging.Therefore,this consensus has been proposed aiming to summarize recent progress in STEMI thrombolysis therapy and to provide practical & evidence-based instructions conforming to national conditions.We hope this consensus will contribute to the emergency management and long-term prognosis of STEMI patients.

Renin-angiotensin system inhibitors,angiotensin receptor neprilysin inhibitors,and mineralocorticoid receptor antagonists are the cornerstone medications for the treatment of heart failure,but they are also major causes of hyperkalemia.Patients with heart failure who develop hyperkalemia have an increased risk of mortality and rehospitalization.Reducing or discontinuing these drugs are associated with higher risk of adverse outcome than hyperkalemia itself.To reduce hyperkalemia risk in patients with heart failure and standardize the management,experts from Cardiovascular Medicine Branch of Chinese Physicians Association and Electrophysiology and Cardiac Function Branch of Chinese Society of Geriatrics developed this consensus,referring to the latest domestic and international guidelines/consensus opinions on hyperkalemia management and clinical research results,and considering the national situation and clinical practice in China.The consensus mainly includes the epidemiology of hyperkalemia in heart failure patients,standardized the use of heart failure treatment drugs,identification,monitoring,follow-up,and prevention of heart failure patient at high risk of hyperkalemia,as well as application strategies of potassium-lowering medication,aiming to provide clinicians with guidance for early prevention and treatment on heart failure medication-related hyperkalemia.

In 2019, coronavirus disease 2019 (COVID-19) broke out in China. The strictest prevention and control measures had been performed because of its high infectivity and mortality rate. Although the number of confirmed cases has decreased, it has not been eliminated. Neurosurgical doctors and nurses are facing the dual pressure resulting from the prevention and control of neurosurgical disease and novel coronavirus infection. Faced with the severe situation, we should standardize the methods of medical treatment and nursing process, so as to reduce the incidence of nosocomial infection among patients and their families in the hospital, and the occupational exposure of medical workers. We wrote the consensus in conjunction with Neural Intensive Nursing and Rehabilitation Group and Cerebral Protection in Cardiac Intensive Care Group, which is belonging to Neural Regeneration and Repair Committee of Chinese Association of Research Hospitals, and also including Nursing and Rehabilitation Group, which is belonging to Health Management Professional Committee Cell Biology Society of Liaoning Province. We referred to domestic and foreign research results and threw out suggestions for patient's receiving, prevention and control guidance, perioperative nursing, ward disinfection to provide reference for neurosurgical personnel, patients and their families.

Temporary cardiac pacing is an essential technique in the diagnosis and treatment of arrhythmias. Due to its urgency, complexity, and uncertainty, it is necessary to develop an evidence-based emergency operation norms. Currently, there is no specific consensus guidelines at home or abroad. The Emergency Branch of Chinese Medical Association organized relevant experts to draft the Chinese emergency expert consensus on bedside temporary cardiac pacing (2023) to guide the operation and application of bedside cardiac pacing. The formulation of the consensus adopts the consensus meeting method and the evidentiary basis and recommendation grading of the Oxford Center for Evidence-based Medicine in the United States. A total of 13 recommendations were extracted from the discussion on the methods of bedside temporary cardiac pacing, the puncture site of transvenous temporary cardiac pacing, the selection of leads, the placement and placement of leads, pacemaker parameter settings, indications, complications and postoperative management. The recommended consensus includes the choice between transcutaneous and transvenous pacing, preferred venous access for temporary transvenous pacing, the target and best guidance method for implantation of bedside pacing electrodes, recommended default pacemaker settings, recommended indications for sinoatrial node dysfunction, atrioventricular block, acute myocardial infarction, cardiac arrest, ventricular and supraventricular arrhythmias. They also recommended ultrasound guidance and a shortened temporary pacing support time to reduce complications of temporary transvenous cardiac pacing, recommended bedrest, and anticoagulation after temporary transvenous pacing. Bedside temporary cardiac pacing is generally safe and effective. Accurate assessment, correct selection of the pacing mode, and timely performance of bedside temporary cardiac pacing can further improve the survival rate and prognosis of related emergency patients.
Humans ; Cardiac Pacing, Artificial/methods* ; Pacemaker, Artificial ; Arrhythmias, Cardiac/therapy* ; Myocardial Infarction/therapy* ; Electrodes