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儿童血栓性疾病防治药学实践指南

医药导报 2024年第7期43卷 1017-1038页

作者：四川省医学科学院·四川省人民医院电子科技大学医学院个体化药物治疗四川省重点实验室中华医学会临床药学分会中国心胸血管麻醉学会心血管药学分会边原不详四川省医学科学院·四川省人民医院

目的系统综述现有循证医学证据,提出儿童血栓性疾病的药物防治建议;制订全面且实用的儿童血栓性疾病防治药学实践指南,提高儿童血栓防治的合理用药水平。方法采用世界卫生组织(WHO)指南制定手册进行指南研究设计;系统检索并广泛收集全... 详细信息

目的系统综述现有循证医学证据,提出儿童血栓性疾病的药物防治建议;制订全面且实用的儿童血栓性疾病防治药学实践指南,提高儿童血栓防治的合理用药水平。方法采用世界卫生组织(WHO)指南制定手册进行指南研究设计;系统检索并广泛收集全国范围内存在的防治儿童血栓常见用药问题,采用德尔菲法调研专家并确定最终纳入的临床问题;再进行系统文献检索,对现有的原始研究、系统评价以及专业组织的指南或共识等进行综合评估,按照制定与评价系统(GRADE)方法进行质量评价,再次通过德尔菲法对推荐意见及证据级别达成共识,最终形成《儿童血栓性疾病防治药学实践指南》。结果指南在制订过程中共收集来自74位临床药学和临床医学的专家评估的29个临床问题,通过两轮调查问卷筛选出15个临床问题,并在2名方法学专家监督下制订了15项临床用药推荐意见。结论通过对临床实践的可行性和安全性进行全面评估,指南为儿科医务工作者提供了具体的抗栓用药建议,有助于提高儿童血栓的防治水平,促进更规范、更有效的医疗实践。

关键词：儿童血栓合理用药血栓防治药学实践指南

Expert consensus on the use of human serum albumin in adult cardiac surgery

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chinese Medical Journal 2023年第10期136卷 1135-1143页

作者： Fei Xiang Fuhua Huang Jiapeng Huang Xin Li Nianguo Dong Yingbin Xiao Qiang Zhao Liqiong Xiao Haitao Zhang CuiZhang Zhaoyun Cheng Liangwan Chen Jimei Chen Huishan Wang Yingqiang Guo Nan Liu Zhe Luo Xiaotong Hou Bingyang Ji Rong Zhao Zhenxiao Jin Robert Savage Yang Zhao Zhe Zheng Xin Chen on behalf of chinese Association of Cardiovascular Surgeons chinese society of Thoracic and Cardiovascular Surgery chinese society of cardiothoracic and vascular anesthesiology Department of Thoracic and Cardiovascular Surgery Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210006China Department of anesthesiology and Perioperative Medicine University of LouisvilleLouisvilleKentucky 40292United States Department of Cardiovascular Surgery Zhongshan HospitalFudan UniversityShanghai 200031China Department of Cardiovascular Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430000China Department of Cardiovascular Surgery the Second Affiliated HospitalArmy Medical UniversityChongqing 400037China Department of Cardiovascular Surgery Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 200031China Department of Critical Care Fuwai HospitalChinese Academy of Medical SciencesBeijing 100033China Department of Critical Care Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210006China Department of Cardiac Surgery People’s Hospital of Henan ProvincePeople’s Hospital of Zhengzhou UniversityFuwai Central China Cardiovascular Disease HospitalZhengzhouHenan 450003China Department of Cardiac Surgery Fujian Medical University Union HospitalFuzhouFujian 350001China Department of Cardiovascular Surgery Guangdong Cardiovascular InstituteGuangdong Provincial Key Laboratory of South China Structural Heart DiseaseGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouGuangdong 510050China Department of Cardiovascular Surgery General Hospital of Shenyang Military Area CommandShenyangLiaoning 110055China Department of Cardiovascular Surgery West China Hospital of Sichuan UniversityChengduSichuan 610041China Center for Cardiac Intensive Care Beijing Anzhen HospitalBeijing Institute of HeartLung and Blood Vessel DiseasesCapital Medical UniversityBeijing 102218China Department of Cardiopulmonary Bypass Fuwai HospitalChinese Academy of Medical SciencesBeijing 100033China Department of Cardiovascular Surgery Xijing HospitalFourth Militar

Introduction Albumin,which is a 65-kDa liver-synthesized protein,accounts for nearly 50%of total plasma protein and contributes to approximately 80%of intravascular oncotic *** helps maintain microvascular integrity,functions as an antioxidant,and transports hormones,fatty acid,bile salts,bilirubin,electrolytes(e.g.,calcium,magnesium,copper,zinc,et al.),and drugs.[1–3]Human serum albumin(HSA)is a sterile,liquid albumin product derived from large pools of human plasma by fractionation and *** medical use of HAS could date back to approximately the time of World War II.

关键词： Albumin drugs surgery

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围术期高血压管理的指导建议

中华麻醉学杂志 2023年第12期43卷 1421-1427页

作者：中国心胸血管麻醉学会北京高血压防治协会李立环不详中国医学科学院阜外医院深圳医院麻醉科深圳518055

围术期高血压增加患者心脑血管并发症及死亡风险,规范、合理的围术期高血压管理可减少相关并发症,降低死亡率及住院费用。因此,制订围术期高血压管理策略具有重要意义。

关键词：死亡风险围术期高血压心脑血管并发症住院费用相关并发症管理策略降低死亡率

Stress Echocardiography for Chronic Coronary Syndrome:Clinical Practice Guidelines(2023)

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Journal of Geriatric Cardiology 2024年第5期21卷 475-505页

作者： Peng-Fei ZHANG Jia-Wei TIAN Tian-Gang ZHU Jue-Fei WU Xiao-Ping LENG Yi WANG Meng-Meng LI Xin-Hao LI Qian-Qian WANG Xiao-Peng FENG Jia-Yan LV Li-Xue YIN Yun ZHANG Mei ZHANG chinese society of Echocardiography,Superficial Tissue and vascular Group of chinese society of Ultrasound in Medicine,Ultrasound Professional Committee of chinese Medicine Education Association State Key Laboratory for Innovation and Transformation of Luobing Theory Key Laboratory of Cardiovascular Remodeling and Function ResearchChinese Ministry of EducationChinese National Health Commission and Chinese Academy of Medical SciencesDepartment of CardiologyQilu Hospital of Shandong UniversityJinanChina The Second Affiliated Hospital of Harbin Medical University HaerbinChina Peking University People's Hospital BeijingChina Sichuan Province People's Hospital ChengduChina Nanfang Hospital Southern Medical UniversityGuangzhouChina Peking Union Medical College Hospital Chinese Academy of Medical SciencesBeijingChina 不详

In the context of the People's Republic of China,coronary artery disease(CAD)presents a sig-nificant clinical challenge,with over 11.3 mil-lion patients ***,the diagnos-is of CAD has predominantly relied on invasive coronary angiography.[1]However,recent advances in clinical research have revealed a notable trend:a substantial 82% of patients subjected to such invas-ive diagnostics do not necessitate interventional therapy.

关键词： coronary clinical patients

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新型冠状病毒肺炎流行期间心肺复苏专家共识

中国循环杂志 2021年第5期36卷 417-422页

作者：中国心胸血管麻醉学会心肺复苏委员会中国心胸血管麻醉学会急救与复苏分会韩非敖虎山赵景顺葛晓娜李茹哲陈志不详哈尔滨医科大学附属第三医院中国医学科学院阜外医院北京急救中心

2020年世界卫生组织宣布新型冠状病毒肺炎(COVID-19)全球大流行。现有的流行病学数据表明在COVID-19流行期间,由于病毒感染的直接影响、医疗系统超负荷的间接影响以及非专业施救者和患者对感染的恐惧,心脏骤停的发生率及其预后受到不利... 详细信息

2020年世界卫生组织宣布新型冠状病毒肺炎(COVID-19)全球大流行。现有的流行病学数据表明在COVID-19流行期间,由于病毒感染的直接影响、医疗系统超负荷的间接影响以及非专业施救者和患者对感染的恐惧,心脏骤停的发生率及其预后受到不利影响。本专家共识在标准的心肺复苏干预措施基础上,提出对疑似或确诊COVID-19患者心脏骤停管理的具体建议和策略,包括心肺复苏期间个人防护装备的使用建议,心肺复苏急救事件中的感染预防策略以及在复苏过程中如何有效的响应与沟通,以降低在急救复苏期间新型冠状病毒的传播风险。

关键词：新型冠状病毒肺炎心脏骤停心肺复苏个人防护装备

儿科体外膜氧合院际转运专家共识(2022版)

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中华儿科杂志 2022年第12期60卷 1253-1257页

作者：中国心胸血管麻醉学会体外生命支持分会中国医师协会儿童重症医师分会周成斌封志纯郭予雄胡燕洪小杨陆国平林茹郑贵浪王伟王旭不详广东省心血管病研究所广东省人民医院(广东省医学科学院)心外科广州510080 解放军总医院第七医学中心儿科医学部北京100700 广东省人民医院(广东省医学科学院) 解放军总医院第七医学中心复旦大学附属儿科医院浙江大学医学院附属儿童医院国家儿童健康与疾病临床医学中心上海儿童医学中心中国医学科学院阜外医院

危重症患儿由于诊疗的需求,常面对极大的转运风险。与成人相比,儿童危重症院际转运是一项极具挑战性的工作。近年来,体外膜氧合(ECMO)技术广泛应用于常规治疗无效的儿童急性呼吸和(或)循环衰竭,并在院际转运救治中发挥着不可替代的作用... 详细信息

危重症患儿由于诊疗的需求,常面对极大的转运风险。与成人相比,儿童危重症院际转运是一项极具挑战性的工作。近年来,体外膜氧合(ECMO)技术广泛应用于常规治疗无效的儿童急性呼吸和(或)循环衰竭,并在院际转运救治中发挥着不可替代的作用,但国内尚无适用于儿童的ECMO院际转运技术规范或共识指南。依据国内开展经验,并结合国外相关研究,从儿童ECMO院际转运的各个环节形成本共识,以指导临床实践,提高ECMO转运安全性。

关键词：循环衰竭院际转运体外膜氧合专家共识危重症患儿 ECMO 临床实践儿科

Clinical application and management of temporary mechanical circulatory support:A clinical consensus

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chinese Medical Journal 2024年第10期137卷 1135-1139页

作者： Nianguo Dong Liangwan Chen Xin Chen Huishan Wang Yingbin Xiao Xianqiang Wang Jinsong Huang Yang Yan Pramod Bonde Neel Sodha Pavan Atluri Juan Pablo Maureira AndréVincentelli Masanobu Yanase Yixuan Wang Haitao Zhang Xiaotong Hou Yoshijuki Takami Pascal Leprince Thierry Folliguet Frank W Sellke chinese society for Thoracic and Cardiovascular Surgery chinese Association of Cardiovascular Surgeons Cardiac Critical Care Professional Committee of chinese Medical Association chinese society of Extracorporeal Life Support European society of Cardiovascular and Endovascular Surgery French society of Thoracic and Cardiovascular Surgery Japanese society for Cardiovascular Surgery Japanese society of Artificial Organs Department of Cardiovascular Surgery Union Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China Department of Cardiovascular Surgery Fujian Medical University Union HospitalFuzhouFujian 350000China Department of Thoracic and Cardiovascular Surgery Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210000China Department of Cardiovascular Surgery General Hospital of Northern Theater CommandShenyangLiaoning 110000China Department of Cardiovascular Surgery Xinqiao HospitalThird Military Medical UniversityChongqing 400037 China Department of Cardiovascular Surgery Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100000 China Department of Cardiovascular Surgery Guangdong Provincial Cardiovascular InstituteGuangdong General HospitalGuangdong Academy of Medical SciencesGuangzhouGuangdong 510000 China Department of Cardiovascular Surgery First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710061China Department of Cardiac Surgery Yale School of Medicine330 Cedar St204 BoardmanNew HavenCT 06510USA Department of cardiothoracic Surgery Alpert Medical SchoolBrown University Rhode Island HospitalProvidenceRI 02912USA Department of Cardiovascular Surgery Department of SurgeryUniversity of PennsylvaniaPhiladelphiaPA 19113USA Department of Cardiovascular Surgery and Transplantation University Hospital of NancyUniversity of LorraineVandoeuvre-lès-Nancy 54500France Department of Cardiovascular Surgery University Hospital of LilleUniversity of LilleLille 59037France Department of Cardiology Fujita Health University School of MedicineToyoakeAichi 470-1192Japan Department of Adult Surgical Intensive Care Unit Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100000China Department of Cardiac Intensive Care Beijing Institute of HeartLung and B

Temporary mechanical circulatory support(tMCS)plays a pivotal role in managing severe or refractory cardiogenic shock(CS),furnishing essential hemodynamic support,and sustaining organ perfusion from hours to weeks,or to even *** the past decade,the utilization of tMCS has witnessed a signicant increase in American and European *** in Asia,the newly developed concepts and devices constituting tMCS have also made rapid ***,the absence of a consensus or standardized guidelines,especially for the Asian population considering inherited polymorphism,is *** address this knowledge gap,eight associations/societies and experts in thiseld came up with the present consensus after repeated discussions,more specically for the Asian *** comprehensively elucidates the commonly employed tMCS devices,criteria for patient selection,indications and contraindications,clinical management,and the optimal timing for implantation and *** goal of this statement is to promote the standardized application of tMCS and make reasonable decisions in clinical ***-length version of the consensus can be seen in Supplementary File,http://***/CM9/B883.

关键词： application statement discussions

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中国血管性认知障碍诊治指南(2024版)

中华医学杂志 2024年第31期104卷 2881-2894页

作者：中国卒中学会血管性认知障碍分会中国卒中学会血管性认知障碍分会

血管性认知障碍(VCI)是指主要由脑血管病及其危险因素导致的认知功能障碍, 是我国60岁及以上人群认知障碍的第二大原因。目前VCI尚无特效的治疗手段, 但早期识别和预防有助于降低发病风险, 改善患者预后。为了提高临床医师对VCI的知晓... 详细信息

血管性认知障碍(VCI)是指主要由脑血管病及其危险因素导致的认知功能障碍, 是我国60岁及以上人群认知障碍的第二大原因。目前VCI尚无特效的治疗手段, 但早期识别和预防有助于降低发病风险, 改善患者预后。为了提高临床医师对VCI的知晓率及重视度, 并为其规范化管理提供指导, 中国卒中学会血管性认知障碍分会在《2019年中国血管性认知障碍诊治指南》的基础上, 在临床分型、诊断流程、神经心理学评估标准、影像学评估标准等方面都进行了更新和修订, 通过系统文献检索, 包括荟萃分析、系统评价、随机对照试验、回顾性系列研究、临床病例对照研究等, 根据国际指南标准化评级系统制订的推荐等级和证据水平分类, 在VCI的病因及临床分型、临床表现、诊断标准、预防及治疗等方面共形成8条推荐意见, 并提出了适合我国临床实践的VCI标准化诊断流程, 以期为VCI规范化诊断和精准治疗提供指导方案。

关键词：认知障碍血管性认知障碍指南诊断标准诊断流程预防治疗

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主动脉夹层CT血管成像标注专家共识

中华放射学杂志 2024年第3期58卷 250-257页

作者：中华医学会放射学分会心胸学组郑敏文吕滨金征宇刘士远许荆棘李小虎刘冰赵宏亮不详空军军医大学西京医院放射诊断科西安710032 中国医学科学院、北京协和医学院、国家心血管病中心、阜外医院放射影像科北京100037 中国医学科学院、北京协和医学院、北京协和医院放射科北京100730 海军军医大学第二附属医院放射诊断科上海200003 安徽医科大学第一附属医院医学影像科

主动脉夹层是严重威胁生命的心血管急症之一,CT血管成像(CTA)是诊断主动脉夹层的首选检查方法。将基于CTA图像的人工智能应用于主动脉夹层,有助于快速辅助诊断、评估疗效和预测术后风险等。影像人工智能最核心的部分是数据的标注,为了... 详细信息

主动脉夹层是严重威胁生命的心血管急症之一,CT血管成像(CTA)是诊断主动脉夹层的首选检查方法。将基于CTA图像的人工智能应用于主动脉夹层,有助于快速辅助诊断、评估疗效和预测术后风险等。影像人工智能最核心的部分是数据的标注,为了规范主动脉夹层CTA影像数据的标注,促进人工智能更好地落地临床,中华医学会放射学分会心胸学组及国内心血管影像专家编写了主动脉夹层CTA标注专家共识,从主动脉夹层的定义和分型,标注数据来源和储存要求,标注平台、工具和方式的选择,标注人员资质、培训和考核,标注后数据的质控,标注方法和内容,标注流程等各个方面达成共识,为建设规范化的主动脉夹层CTA影像标注数据库提供了有力的技术指导和质量保障,为主动脉夹层人工智能影像模型的构建、验证、优化及推广等提供研究基础,从而推动主动脉夹层人工智能影像真正落地临床应用,最终使患者受益。

关键词：体层摄影术 X线计算机主动脉夹层人工智能标注