Intraoperative cell salvage (IOCS) has been widely applied as an important blood conservation measure in surgical operations. However, there is currently a lack of clinical practice guidelines for the implementation of IOCS in patients with malignant tumors. This report aims to provide clinicians with recommendations on the use of IOCS in patients with malignant tumors based on the review and assessment of the existed evidence. Data were derived from databases such as PubMed, Embase, the Cochrane Library and Wanfang. The guideline development team formulated recommendations based on the quality of evidence, balance of benefits and harms, patient preferences, and health economic assessments. This study constructed seven major clinical questions. The main conclusions of this guideline are as follows: 1) Compared with no perioperative allogeneic blood transfusion (NPABT), perioperative allogeneic blood transfusion (PABT) leads to a more unfavorable prognosis in cancer patients (Recommended); 2) Compared with the transfusion of allogeneic blood or no transfusion, IOCS does not lead to a more unfavorable prognosis in cancer patients (Recommended); 3) The implementation of IOCS in cancer patients is economically feasible (Recommended); 4) Leukocyte depletion filters (LDF) should be used when implementing IOCS in cancer patients (Strongly Recommended); 5) Irradiation treatment of autologous blood to be reinfused can be used when implementing IOCS in cancer patients (Recommended); 6) A careful assessment of the condition of cancer patients (meeting indications and excluding contraindications) should be conducted before implementing IOCS (Strongly Recommended); 7) Informed consent from cancer patients should be obtained when implementing IOCS, with a thorough pre-assessment of the patient's condition and the likelihood of blood loss, adherence to standardized internally audited management procedures, meeting corresponding conditions, and obtaining corresponding qualifications (Recommended). In brief, current evidence indicates that IOCS can be implemented for some malignant tumor patients who need allogeneic blood transfusion after physician full evaluation, and LDF or irradiation should be used during the implementation process.

OBJECTIVE To guide the clinical medication of gastric cancer， enhance patients’ survival rates， improve patients’ quality of life， and provide a reference for clinicians in making treatment decisions. METHODS The nominal group method was employed， wherein members of the expert group from the Department of Oncology at Chongqing University Cancer Hospital collaboratively discussed and established the outline for the preparation of the Expert Consensus on Drug Treatment of Gastric Cancer. The writing team of experts systematically searched， analyzed， and summarized the relevant content outlined， as well as formulated consensus statements based on the current situation in China， clinical needs， and research evidence. After multiple rounds of meetings and discussions， the experts from the Chemotherapy Group of the Chongqing Medical Oncology Branch and the Special Committee on Rare and Difficult Cancers of Chongqing Medical and Biotechnology Association revised the recommendation and ultimately reached the consensus content and recommendation level through voting. RESULTS & CONCLUSIONS This consensus encompasses perioperative drug therapy for gastric cancer， first-line drug therapy for advanced metastatic gastric cancer， second-line drug therapy for advanced metastatic gastric cancer， third-line and subsequent drug therapies for advanced gastric cancer， and drug therapy for peritoneal metastasis of gastric cancer. The release of this consensus offers standardized management suggestions for the individualized medication of gastric cancer by medical institutions in China， which is of great significance for enhancing the clinical efficacy and medication safety associated with gastric cancer treatment.

OBJECTIVE To provide reference for further unifying and standardizing the quality of home-based pharmaceutical services in close-knit regional medical community of Sichuan and Chongqing， and ensuring medication safety of patients. METHODS Under the guidance of the Chongqing Medical Association and the Chongqing Pharmaceutical Administration Quality Control Center， and led by the Bishan Hospital Affiliated to Chongqing Medical University and the Yongchuan Hospital Affiliated to Chongqing Medical University， 14 medical institutions in the Sichuan-Chongqing region jointly participated. Based on existing regulations， guidelines， and expert consensus， questionnaire survey was conducted to investigate the implementation status of home- based pharmaceutical services within the close-knit regional medical community of Sichuan and Chongqing. Subsequently， the Delphi method was employed for expert consultation and the analytic hierarchy process was used to determine indicator weights， ultimately establishing a quality control system for home-based pharmaceutical services in the close-knit regional medical community of Sichuan and Chongqing. RESULTS & CONCLUSIONS This consensus has established a quality control system for home-based pharmaceutical services within the close-knit regional medical community of Sichuan and Chongqing， encompassing three dimensions： service qualification evaluation， necessity evaluation， and service quality evaluation. Among them， service quality evaluation serves as the core component of the quality control system， incorporating 16 secondary indicators， which are further classified into 9 core indicators and 7 general indicators based on their significance. Meanwhile， this consensus proposes a phased quality control strategy. Under the framework of the close-knit regional medical community in Sichuan and Chongqing， this strategy takes execution priority and execution effectiveness as 69 its core. It allows for flexible handling of the rigid requirements concerning service qualifications and necessity， thereby providing a unified and operable quality control toolkit for the close-knit regional medical community in Sichuan and Chongqing.

OBJECTIVE To further standardize the implementation and management standards of pharmaceutical active consultation in medical institutions and provide a reference for providing high-quality pharmaceutical services. METHODS Guided by the Chongqing Pharmaceutical Association and led by the Third Affiliated Hospital of Chongqing Medical University， a panel of experts consisting of pharmaceutical and medical management professionals from multiple medical institutions was established to discuss the basic requirements， service processes， quality control， and evaluation improvement of pharmaceutical active consultation. The drafting team then organized， summarized， analyzed and revised the opinions， and provided feedback to ultimately form a consensus. RESULTS & CONCLUSIONS This consensus provides a detailed exposition of the basic requirements， service processes， quality control， and evaluation improvement of pharmaceutical active consultation， offering standards for the implementation of pharmaceutical active consultation in medical institutions in China， which is of major implications for strengthening the pharmaceutical service capabilities of medical institutions.

Diagnostic criteria, as a critical component of clinical practice guidelines, play a direct role in guiding clinicians' diagnostic and treatment decisions. Although China has increasingly emphasized the development and updating of clinical guidelines in recent years, research focusing on the diagnostic criteria within these guidelines remains limited. This paper aims to explore the types of diagnostic criteria, the issues they present, and the processes involved in their formulation. Based on this analysis, suggestions are proposed to improve the recommendation and application of diagnostic criteria in Chinese guidelines.

BACKGROUND: This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability. METHODS: This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability. RESULTS: STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min. CONCLUSION The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
Reproducibility of Results ; Surveys and Questionnaires ; Practice Guidelines as Topic ; Humans

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Building a strong public health system has become an urgent task in the new era. Based on more than eight years of systematic research， we believe that five aspects need to be prioritized for a strong system. First， we should change the perspective on public health， using the word “gonggong jiankang” to replace “gonggong weisheng” and the word “gonggong jiankang tixi” to replace “gonggong weisheng tixi”， to lead the public health system development. Second， we should develop a suitable public health system and continuously improve the health capacity for governance. Third， we should make it clear that the goal of building a strong system is not far-fetched， and we need to consolidate the existing institutional advantages of China’s public health system： when encountering major problems， we can maintain a unified goal and mobilize the whole society to cooperate effectively to accomplish the goal. However， we need to make up for shortcomings one by one， especially to solve the key problem of lacking a strong coordination mechanism in daily work. Fourth， we should pursue excellence and consolidate the“suitable” mechanism proven in the process of coping with the COVID-19， so that efficient mechanisms to deal with major issues can be used in routine work， and efforts should be made to consolidate the advantages of prevention and control of infectious diseases and emergency response，so as to achieve the balanced development of regions categories and units.Finally， it is necessary to strengthen the coordination of government and research institutions， in the aspects of technological innovation， talent team building and accurate consulting services， and work together to pursue a suitable and strong system to realize the modernization of the health system and capacity for governance.

Transparency Ecosystem for Research and Journals in Medicine (TERM) working group summarized the essential recommendations that should be considered to review and publish a high-quality guideline. These recommendations from editors and reviewers included 10 components of essential requirements: systematic review of existing relevant guidelines, guideline registration, guideline protocol, stakeholders, conflicts of interest, clinical questions, systematic reviews, recommendation consensus, guideline reporting and external review. TERM working group abbreviates them as PAGE (essential requirements for Publishing clinical prActice GuidelinEs), and recommends guideline authors, editors, and peer reviewers to use them for high-quality guidelines.
Humans ; Practice Guidelines as Topic

The outbreak of COVID-19 has exposed many shortcomings in disease control and prevention system (DCPS) of China. Resolving the problems and strengthening the DCPS became the top priority in China’s public policy agenda. This paper revealed the problems of the system regarding policy-making, regulations, operation mechanism and staff, and proposed several strategies from three aspects of legal construction, management system, and operation mechanism, including: 'Prevention first' should be incorporated into the national legal system, all the departments should be engaged in 'Healthy China 2030' initiative, laws and regulations should be amended, new disease prevention and control management institutions should be set up, a high-quality professional team should be retained, the regional health information exchange channels should be strengthened, the coordinated mechanism for disease prevention and control should be normalized, the long-term investment mechanism should be established, and the equipment renewal and reserve system should be improved.