China Experts Research Articles

Expert consensus on the perioperative management of co-ablation system therapy of liver tumors

This study aims to improve the quality of clinical treatment and nursing care to standardize perioperative management for patients with liver tumors undergoing co-ablation system therapy. The Committee of Ablation Therapy in Oncology, China Anti-Cancer Association; the Expert Committee on Ablation Therapy; Chinese Society of Clinical Oncology (CSCO); and the Committee of Interventional, Perioperative, and Interventional Physician Branch of Chinese Medical Doctors Association organized medical and nursing experts in China. Based on the clinical practice of co-ablation system therapy in China and relevant domestic literature, an expert consensus about perioperative management was developed. The expert consensus included the key points of perioperative management, prevention, and care of complications; discharge guidance; and follow-up management for patients undergoing co-ablation system therapy of liver tumors. The consensus on the perioperative management of co-ablation system therapy for liver tumors has finally been formulated, serving as a reference and application for medical personnel in relevant fields based on hospital and patient conditions in clinical work.

Expert consensus on endovascular reconstruction of visceral branch arteries in the treatment of aortic expansion diseases (2024 edition)

Aortic expansion diseases, especially those involving visceral branch arteries, pose significant challenges for clinicians in terms of treatment strategy selection and implementation. With the advancement of endovascular repair techniques, the mode of treatment is shifting gradually from open surgery to minimally invasive surgery, significantly reducing perioperative mortality and complication rates. However, the application of techniques for reconstructing visceral artery branches is not yet widespread, and there is considerable controversy in the management of complex cases. In response, the Vascular Surgery Group of Surgery Society of Chinese Medical Association, the Vascular Surgery Group of Cross-straits Medicine Exchange Association and the Thoracic Aorta Group of Vascular Surgeons Society of Chinese Medical Doctor Association convened relevant experts in China with extensive experience in the endovascular reconstruction of visceral branches for aortic expansion diseases, based on systematic reviews of clinical practice and domestic and international literature, and after in-depth discussions, have developed the Expert consensus on endovascular reconstruction of visceral branch arteries in the treatment of aortic expansion diseases (2024 edition). The consensus focuses on endovascular techniques involving the reconstruction of visceral artery branches, aiming to provide principled guidance for clinicians and to promote the improvement of diagnostic and treatment levels in this field within China.

Expert consensus on the perioperative management of co-ablation system therapy of lung tumors

In order to improve the quality of clinical therapy and nursing care for patients with lung tumors undergoing Co-Ablation System and standardize perioperative management, the Committee of Ablation Therapy in oncology, Chinese Anti-Cancer Association, and the Expert committee on Ablation Therapy and the Committee of Interventional Perioperative, Interventional Physician Branch of Chinese Medical Doctor Association organized medical and nursing experts in China. Based on the clinical practice of Co-Ablation System therapy in China and relevant domestic literature, a perioperative management expert consensus was developed. The expert consensus included the key points of perioperative nursing care, prevention and intervention of complications, and discharge guidance for Co-Ablation System therapy of lung tumors, to provide reference for the standardization and development of clinical management for lung tumors.

Transoral robotic surgery in pharyngolaryngeal surgery

The rise of minimally invasive surgery and the concept of rapid recovery have led to transoral surgery becoming increasingly vital in pharyngolaryngeal surgery. In 2009, the U. S. Food and Drug Administration approved the use of the da Vinci Surgical Robot for transoral robotic surgery（TORS）. Due to its high-definition lens and flexible, precise operation, TORS is rapidly gaining popularity worldwide and expanding its indications. Although some experts in China have attempted to apply TORS to treat pharyngolaryngeal diseases, compared to European and American countries, TORS in China is still in its exploratory stage. This paper briefly reviews the application of TORS in pharyngolaryngeal surgery.

Expert consensus on perioperative management for liver tumors treated with co-ablation system therapy

Co-ablation system therapy is currently in its early stages of application in tumor treatment in China. The associated protocols for perioperative management are not yet well-developed and suffer from a lack of corresponding guidelines or consensus. This study aims to improve the quality of clinical treatment and nursing care and to standardize perioperative management for patients with liver tumors undergoing co-ablation system therapy. The Committee of Ablation Therapy in Oncology, China Anti-Cancer Association, and the Committee of Interventional Perioperative, Interventional Physician Branch of the Chinese Medical Doctor Association organized medical and nursing experts in China. Based on the clinical practice of co-ablation system therapy in China and the relevant domestic literature, an expert consensus regarding perioperative management was developed. The expert consensus includes the key points of perioperative management, prevention and care of complications, discharge guidance, and follow-up management for patients who have undergone co-ablation system therapy of liver tumors. The consensus on the perioperative management of co-ablation system therapy for liver tumors has finally been formulated, providing a reference and application for medical personnel in relevant fields based on hospital and patient conditions in clinical work.

How to Define In-Vitro Fertilization Success: A Delphi Consensus among China Experts

Background: A Delphi consensus was conducted to formulate an expert opinion on the definition of in-vitro fertilization (IVF) success, to provide a reference basis for clinical practice. Methods: Chinese experts in assisted reproductive technology (ART) were surveyed using the Delphi method. Based on the literature related to IVF success, eight experts developed a framework of statements and items. A questionnaire was then distributed to 23 experts to canvas their opinions on these statements. If consensus was not achieved, the statement was revised and revoted upon until a consensus was reached. Results: Consensus was reached for 19 statements related to the definition of IVF success, the most relevant of which are summarized as follows: (1) Goal of IVF treatment ([Formula: see text] statement): to attain a healthy live birth in the shortest possible time and with the lowest possible risks; (2) Definition of IVF success ([Formula: see text] statements): effectiveness, safety, and efficiency of IVF treatment should be included in the definition of success, with the cumulative live birth rate per ovarian stimulation cycle within 2 years being a performance indicator (PI) of success, and IVF success should be measured from a patient-centered perspective, including the patient’s burden and satisfaction. (3) Assurance of IVF success ([Formula: see text] statements): to provide evidence-based treatment and avoid the introduction of IVF add-ons into routine clinical practice without any clear evidence of benefit, optimize treatment quality by establishing and monitoring key PIs, and improving quality control systems. (4) Hurdles of IVF success ([Formula: see text] statements): cycle cancellation before oocyte pickup and treatment discontinuation after failed cycles are hurdles of success to IVF. Conclusions: Based on the Delphi method, the expert opinion on the definition of IVF success has been formed, which could complement guidelines and may help improve treatment outcomes.

The importance and feasibility of hospital interventions to prevent and manage patient aggression and violence against physicians in China: a Delphi study

BackgroundAggression and violence by patient (and their relatives/friends) is widely acknowledged as a serious occupational hazard, with physicians being particularly susceptible to witnessing and experiencing such incidents within hospitals. Research has shown that the negative consequences of such aggression and violence are not only felt at the individual level, but also at the team and organizational levels. Understanding how to prevent and manage this behavior towards physicians in hospitals is urgent and not fully researched. While there are many potentially effective interventions, it is unclear which ones would be valuable and feasible for Chinese hospitals. Because patient aggression and violence may occur more frequently in Chinese hospitals than in other countries, this suggests that cultural differences play a role and that tailored interventions may be needed.MethodWe conducted a Delphi study to reach a consensus on the importance and feasibility of hospital interventions to prevent and manage patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. Seventeen experts in China were invited to complete online questionnaires over three rounds.ResultsAfter three rounds, consensus was achieved concerning 44 interventions, five other interventions were rejected, and no consensus was reached on another two. These interventions were clustered into eight categories: environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-event actions, and hospital policy. Each category is considered important in preventing and managing patient (and their relatives/friends) aggression and violence towards physicians in Chinese hospitals. This study also investigated the feasibility of the suggested interventions and found that 36 of the 44 interventions were considered not only relevant, but also feasible for implementation in Chinese hospitals.ConclusionsThis study provides an overview of interventions that can be implemented in Chinese hospitals to prevent and manage patient (and their relatives/friends) aggression and violence before, during, and after a violent incident occurs.

Sweet surrender? Changing autonomobile structures of feeling

ABSTRACT Imaginaries of smart, sustainable autonomous vehicles carrying people of all ages and abilities to relax en-route to myriad destinations, evoke a sweet surrender to the machine. But such technocratic visions clash with visions of non-anthropocentric autonomy. The urgency of mobility transformation in the face of ecological overshoot makes this a site of turbulence where new “structures of feeling” are emerging. But how to study changing structures of feeling and apply insights? In this paper we discuss an exploratory study with twelve users of autonomous vehicles, non-users, engineers, and experts in China and the UK who used galvanic skin response sensors to probe their autonomobile emotions. Extending Christian Nold’s Bio Mapping approach, we discuss fissures in values and norms about mobility and the prospect of doughnut mobilities, concluding with reflections on applied mobilities research.

China expert consensus on clinical practice of vestibular evoked myogenic potentials testing(2024)

China expert consensus on clinical practice of vestibular evoked myogenic potentials testing(2024)

China expert consensus on clinical practice of video head impulse test (2024)

China expert consensus on clinical practice of video head impulse test (2024)

China expert recommendations on anaplastic lymphoma kinase-tyrosine kinase inhibitors treatment for advanced non-small cell lung cancer (2024 edition)

Anaplastic lymphoma kinase (ALK) fusion represents one of pivotal driver genes within the realm of non-small cell lung cancer (NSCLC). ALK-tyrosine kinase inhibitors (ALK-TKI) have demonstrated remarkable therapeutic efficacy for patients afflicted with ALK-positive NSCLC. As of June 27, 2023, seven ALK-TKI, including crizotinib, ceritinib, alectinib, ensartinib, brigatinib, lorlatinib, and iruplinalkib, have garnered approval from the China National Medical Products Administration (NMPA)(ranking according to the approval time for marketing by NMPA), providing individualized treatment modalities for ALK-positive NSCLC patients. To standardize the application of ALK-TKI, the Chinese Association for Clinical Oncologists and the Medical Oncology Branch of China International Exchange and Promotive Association for Medical and Health Care has organized experts to compile the " China expert recommendations on anaplastic lymphoma kinase-tyrosine kinase inhibitors treatment for advanced non-small cell lung cancer (2024 edition)". This treatment expert recommendation provides recommendations in four aspects, encompassing ALK fusion testing, ALK-TKI targeted therapy, ALK-TKI adverse events management, and patient post-treatment follow-up, thus serving as a valuable reference for the standardized treatment of Chinese advanced ALK fusion-positive NSCLC.

Security in context (SiC): a novel theoretical and empirical approach to the US–China rivalry

The twenty-first-century global arena is profoundly shaped by the intensifying US–China rivalry. While theories in the US, such as the Thucydides’ Trap and the Clash of Civilizations, forecast a prospective ‘Cold War II,’ many experts in China propound a ‘divided peace,’ advocating for the stable coexistence of dual powerhouses. Introducing a nuanced lens, the ‘Security in Context’ (SiC) approach argues for a more interconnected and multi-dimensional understanding of great power dynamics. This study dives into the practicalities of a SiC approach, examining key strategies including the Trans-Pacific Partnership, the Belt and Road Initiative, and the Free and Open Indo-Pacific Strategy. As we venture into the era of economic and technological decoupling, epitomized by measures like the Chip Act and Restrict Act, the paper suggests that the SiC framework remains central to deciphering the evolving US–China narrative, even in the face of burgeoning uncertainties.

A qualitative interview study on colorectal cancer screening in China.

The effectiveness of triage screening for colorectal cancer (CRC) is not fully achieved in Chinese populations, mainly due to low compliance to colonoscopy follow-up. This study aimed to collect viewpoints of experts in China on ongoing screening programs and emerging screening tests for CRC, which may help to improve effectiveness of CRC screening in the country. We conducted 15 semi-structured interviews with experts involving CRC screening in China during October to November of 2020. Interview topics included personal characteristics, work context, opinions on ongoing screening programs, challenges and opportunities in optimization of screening strategies, and prospects for CRC screening in near future. To analyze the data, we used a generic qualitative research approach inspired by grounded theory, including open, axial, and selective coding. This analysis revealed a total of 83 initial categories, 37 subcategories and 10 main categories, which included 4 core categories of current modality for CRC screening, factors influencing screening effectiveness, optimization of CRC screening modality, and prospects for development of CRC screening. The results provide insight into the factors underlying the challenges of the ongoing CRC screening programs in China: the most important concern is the low compliance to colonoscopy, followed by the low specificity of the currently-used initial tests. The experts proposed to use quantitative instead of qualitative fecal immunochemical test (FIT), and optimize risk assessment tools to improve specificity of initial tests. Regarding the emerging screening tests, 9 of 15 experts did not think that the novel techniques are good enough to replace the current tests, but can be used complementarily in opportunistic screening for CRC. The viewpoints of Chinese experts suggested that use quantitative FIT or optimize risk assessment tools may help to identify high-risk individuals of CRC more accurately, improve adherence to colonoscopy, and thus fully achieve the effectiveness of screening.

Terminological Conflation in Archaeological Site Institutions: Delineating Boundaries through Interviews with Heritage Experts in Europe, China, and Israel

ABSTRACT As a fundamental component of cultural heritage, archaeological sites are protected and interpreted by diverse related institutions. However, the conceptual boundaries of these institutions are increasingly becoming blurred, resulting in theoretical ambiguities and a conflation of terminologies. This trend presents a risk of misinterpretation or misuse of terms, as evidenced in certain academic papers and institutional namings. A review of prevalent concepts across diverse geographical contexts of these institutions, coupled with the proposal of clearer theoretical definitions, may offer novel and valuable insights into their theoretical boundaries and enhance academic and public comprehension of the exact roles and functions of heritage institutions. This study – integrating an interdisciplinary literature review and field case studies with 16 semi-structured in-depth interviews with heritage experts in Europe, China, and Israel – aims to address current misconceptions and overlaps in the definitions of these institutions, analyse their scope variance across cultural regions, and advocate for diverse and open definitions.

Chinese expert consensus on laparoscopic hepatic segmentectomy and subsegmentectomy navigated by augmented- and mixed-reality technology combined with indocyanine green fluorescence imaging

Abstract Augmented- and mixed-reality technologies have pioneered the realization of real-time fusion and interactive projection for laparoscopic surgeries. Indocyanine green fluorescence imaging technology has enabled anatomical, functional, and radical hepatectomy through tumor identification and localization of target hepatic segments, driving a transformative shift in the management of hepatic surgical diseases, moving away from traditional, empirical diagnostic and treatment approaches toward digital, intelligent ones. The Hepatic Surgery Group of the Surgery Branch of the Chinese Medical Association, Digital Medicine Branch of the Chinese Medical Association, Digital Intelligent Surgery Committee of the Chinese Society of Research Hospitals, and Liver Cancer Committee of the Chinese Medical Doctor Association organized the relevant experts in China to formulate this consensus. This consensus provides a comprehensive outline of the principles, advantages, processes, and key considerations associated with the application of augmented reality and mixed-reality technology combined with indocyanine green fluorescence imaging technology for hepatic segmental and subsegmental resection. The purpose is to streamline and standardize the application of these technologies.

Concept and understanding of non-radiographic axial spondyloarthritis

Since the publication of the classification criteria for axial spondyloarthritis (axSpA) by Assessment of SpondyloArthritis international Society (ASAS), a new disease concept "non-radiographic axial spondyloarthritis (nr-axSpA)" has emerged. Some domestic experts in China have translated it as "radiologically negative" axSpA, but it can easily lead to misunderstandings literally, as not all patients with nr-axSpA are completely free from radiological abnormalities. This article briefly describes the evolution of the concept of axSpA, proposes to translate the term of nr-axSpA directly rather than "radiologically negative" axSpA, compares the differences and similarities between nr-axSpA and radiologically negative axSpA, delineates the relationship between nr-axSpA and early ankylosing spondylitis, and points out not all the patients who meet the ASAS classification criteria for nr-axSpA are genuine patients with axSpA, because of the relatively low specificity of the ASAS classification criteria. Five common scenarios easily leading to misdiagnosis of nr-axSpA are exampled to remind domestic colleagues.

Antibody drug conjugates in breast cancer in China: Highlights, challenges, and prospects.

Antibody drug conjugates (ADCs) are novel drugs that exert specific cytotoxicity against tumor cells. China approved T-Dxd in May 2023, and their introduction has changed the nation's clinical practice. Although more than 700 ADCs are being investigated worldwide, the challenges that remain in antibody engineering, drug discovery, safety management, resistance, drug selection, and sequencing hinder the further promotion and application of ADCs. Experts in China have discussed the several critical concerns related to clinical practice since 2022. Here, the authors conducted a review of ADCs and then discussed several ADCs explored in China. This study proposes several solutions and strategies to maximize the potential benefit that ADCs can provide to patients with breast cancer.

Chinese expert consensus on transradial access in percutaneous peripheral interventions

Transradial access (TRA) is a safe and comfortable approach and the preferred access for percutaneous coronary intervention. However, TRA is not widely used for peripheral interventions. Currently, there is a lack of data on patient selection, appropriate medical devices, complication prevention, and TRA adoption. Therefore, the Chinese Society of Interventional Oncology of the China Anti-Cancer Association organized nationwide experts to establish a Working Group of China Expert Consensus on TRA in percutaneous peripheral interventions in 2022, and jointly formulated this consensus to better promote the application of TRA in peripheral interventions to guide clinicians on patient selection, technical recommendations, and physician training. This consensus mainly focuses on the current situation, advantages and limitations of TRA in peripheral interventions, anatomical characteristics of the radial artery, patient selection, technical aspects, prevention and management of complications, radiation dose, and learning curve. A consensus was reached through a literature evaluation and by referring to the opinions of the expert group.

Analysis of the Key Factors Influencing Automation Transformation in Container Terminals Based on the Dempster–Shafer Evidence Interval Method

The steady growth of container volume and aggressive shipping alliances have intensified competition among terminals. With the rapid development and application of modern information and communication technology, automation is a great way to promote terminals’ sustainable development. The objectives of this study are to analyze the key factors influencing automation transformation and provide theoretical guidelines for implementing automation transformation. Based on the literature review, the main factors influencing the automation transformation of container terminals are characterized and analyzed. They are divided into four categories: technical feasibility, external promotion, self-constraints, and goals/demand. Thereafter, a novel multi-source data fusion method, the Dempster–Shafer evidence interval method (DSIM) based on Dempster–Shafer evidence theory and interval value, is proposed to fuse conflicting and uncertain opinions among experts. This method is effective for expert opinion elicitation. Using DSIM, the key factors’ relative importance and their relationship are examined based on the opinions of experts in China. The results show that technical feasibility is the most important factor category in the foundation of automation transformation. Finally, a generalized planning framework for constructing automation transformation schemes is established, providing references and suggestions for terminals’ decision-makers.

The Theory of Substantial Cognitive Capacity of Criminal Defendants with Mental Disorders in China: Theoretical Content and Judicial Application

When dealing with criminal cases involving defendants with mental disorders in China, the theory of substantial cognitive capacity holds significant importance. Although derived from the insanity defense rule of the U.S. Model Penal Code, this concept exhibits certain distinctions. Forensic experts in China frequently deem defendants with mental disorders as lacking substantial cognitive capacity, thus rendering them not criminally responsible. The Chinese theory of substantial cognitive capacity possesses its unique characteristics, setting China apart from other countries in addressing the insanity defense issue. Consequently, introducing this Chinese theory to scholars in other jurisdictions holds considerable academic value. However, the interpretation of substantial cognitive capacity and its relation to cognitive capacity remain subjects of controversy in China, with inconsistent application of this theory. Specifically, some scholars have advocated the theory of common sense cognitive capacity, effectively challenging the mainstream theory of substantial cognitive capacity. The author contends that substantial cognitive capacity should be comprehended from the perspective of the dialectical unity of “phenomenon” and “essence”. The term “substantial cognitive capacity” should be employed from a negative standpoint to underscore the progressive link between the possession of “formal” cognitive capacity and the loss of “substantial” cognitive capacity, while the theory of common sense cognitive capacity should be dismissed. The proper judicial application of the theory of substantial cognitive capacity aids in adhering to the normative requirements of criminal law, emphasizes the logic of stratified criminal theory, and furnishes the judiciary with a theoretical instrument for appropriately handling criminal cases.