1.Clinical practice guidelines for intraoperative cell salvage in patients with malignant tumors
Changtai ZHU ; Ling LI ; Zhiqiang LI ; Xinjian WAN ; Shiyao CHEN ; Jian PAN ; Yi ZHANG ; Xiang REN ; Kun HAN ; Feng ZOU ; Aiqing WEN ; Ruiming RONG ; Rong XIA ; Baohua QIAN ; Xin MA
Chinese Journal of Blood Transfusion 2025;38(2):149-167
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.
2.Expert consensus on drug therapy for gastric cancer
Branch CHEMOTHERAPY ; Association SPECIAL
China Pharmacy 2025;36(3):257-268
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.
3.Expert consensus on quality control of home-based pharmaceutical services in the close-knit regional medical community of Sichuan and Chongqing
Association Medical CHONGQING ; Center CHONGQING ; Chongqing THE
China Pharmacy 2025;36(14):1689-1696
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.
4.Challenges and strategies for implementing the STAR tool for comprehensive evaluation of guidelines: A qualitative study with Chinese clinicians.
Nan YANG ; Xu WANG ; Hongfeng HE ; Jungang ZHAO ; Yishan QIN ; Yueyan LI ; Janne ESTILL ; Junmin WEI ; Yaolong CHEN
Chinese Medical Journal 2025;138(21):2681-2692
BACKGROUND:
The STAR (Scientific, Transparent, and Applicable Rankings) working group conducts regular evaluations of Chinese guidelines and consensus statements. This study gathered insights from STAR working group members using qualitative interviews.
METHODS:
From March to August 2023, members of the STAR specialist committees were interviewed using semi-structured interview outline. The interviewees were selected through purpose-based sampling. Subject analysis was employed to summarize the findings.
RESULTS:
We conducted interviews with 37 members from 36 committees and summarized the contents into four main themes and 16 specific topics. The value of STAR in enhancing the development and selection of high-quality guidelines in China was commonly mentioned. Challenges identified included the lack of resources and suboptimal organizational structures, collaboration, and evaluation efficiency. Suggestions for the STAR tool included developing extensions for different guideline types, adjusting certain items, and better covering guideline applicability. The promotion of STAR and the consideration of an international committee for global outreach were also highlighted.
CONCLUSION
STAR has exerted a substantial influence on the evaluation of Chinese guidelines, and the insights gained from interviews offer valuable directions for its further enhancement.
Humans
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China
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Qualitative Research
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Practice Guidelines as Topic
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Interviews as Topic
5.STAR Recommendations: A novel framework for generating recommendations.
Xu WANG ; Janne ESTILL ; Hui LIU ; Qianling SHI ; Jie ZHANG ; Shilin TANG ; Huayu ZHANG ; Xueping LI ; Zhewei LI ; Yaxuan REN ; Bingyi WANG ; Fan WANG ; Juan JUAN ; Huixia YANG ; Xiuyuan HAO ; Junmin WEI ; Yaolong CHEN
Chinese Medical Journal 2025;138(14):1643-1646
6.International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025).
Sheng-Sheng ZHANG ; Lu-Qing ZHAO ; Xiao-Hua HOU ; Zhao-Xiang BIAN ; Jian-Hua ZHENG ; Hai-He TIAN ; Guan-Hu YANG ; Won-Sook HONG ; Yu-Ying HE ; Li LIU ; Hong SHEN ; Yan-Ping LI ; Sheng XIE ; Jin SHU ; Bin-Fang ZENG ; Jun-Xiang LI ; Zhen LIU ; Zheng-Hua XIAO ; Jing-Dong XIAO ; Pei-Yong ZHENG ; Shao-Gang HUANG ; Sheng-Liang CHEN ; Gui-Jun FEI
Journal of Integrative Medicine 2025;23(5):502-518
Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy*
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Humans
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Medicine, Chinese Traditional/methods*
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Practice Guidelines as Topic
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Drugs, Chinese Herbal/therapeutic use*
7.Expert consensus on pharmaceutical active consultation service in medical institutions
Association Pharmaceutical CHONGQING ; Institutions THE
China Pharmacy 2024;35(23):2837-2843
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.
8.A Standardized Approach to Recommending Diagnostic Criteria in Chinese Clinical Practice Guidelines
Qi ZHOU ; Qinyuan LI ; Hongfeng HE ; Dongrui PENG ; Huayu ZHANG ; Ye WANG ; Kehu YANG ; Yaolong CHEN
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1432-1438
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.
9.Preliminary exploration on operation process for autologous ozonized blood transfusion
Jianjun WU ; Yan BAI ; Yanli BAI ; Zhanshan ZHA ; Jing CHEN ; Yahan FAN ; Jiwu GONG ; Shouyong HUN ; Hongbing LI ; Zhongjun LI ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Jiubo LIU ; Jingling LUO ; Xianjun MA ; Deying MENG ; Shijie MU ; Mei QIN ; Hui WANG ; Haiyan WANG ; Qiushi WANG ; Quanli WANG ; Xiaoning WANG ; Yongjun WANG ; Changsong WU ; Lin WU ; Jue XIE ; Pu XU ; Liying XU ; Mingchia YANG ; Yongtao YANG ; Yang YU ; Zebo YU ; Juan ZHANG ; Xiaoyu ZHOU ; Xuelian ZHOU ; Shuming ZHAO
Chinese Journal of Blood Transfusion 2023;36(2):95-100
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.
10.Development of the Scientific, Transparent and Applicable Rankings (STAR) tool for clinical practice guidelines.
Nan YANG ; Hui LIU ; Wei ZHAO ; Yang PAN ; Xiangzheng LYU ; Xiuyuan HAO ; Xiaoqing LIU ; Wen'an QI ; Tong CHEN ; Xiaoqin WANG ; Boheng ZHANG ; Weishe ZHANG ; Qiu LI ; Dong XU ; Xinghua GAO ; Yinghui JIN ; Feng SUN ; Wenbo MENG ; Guobao LI ; Qijun WU ; Ze CHEN ; Xu WANG ; Janne ESTILL ; Susan L NORRIS ; Liang DU ; Yaolong CHEN ; Junmin WEI
Chinese Medical Journal 2023;136(12):1430-1438
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
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Surveys and Questionnaires
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Practice Guidelines as Topic
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Humans

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