In 2005, the Chinese Invasive Fungal Infection Working Group published the first guidelines for the diagnosis and treatment of invasive fungal disease (IFD) in patients with hematological disorders and cancers, with the sixth revision released in 2020. Numerous advances in the fields of hematological oncology treatment and the diagnosis and management of IFD have significantly influenced the corresponding strategies. Therefore, the Chinese Invasive Fungal Infection Working Group has reviewed key research advances from 2020 to 2024 and released the seventh revision of the Chinese guidelines. Major revisions include: changes in the epidemiology of IFD; evaluation of novel diagnostic methods (especially PCR and metagenomic next-generation sequencing); updated recommendations on therapeutic drug monitoring and in vitro drug sensitivity test; management of breakthrough IFD; targeted therapy of Pneumocystis jiroveci pneumonia and cryptococcosis; and updated recommendation on the duration of antifungal therapy.
In recent years, Janus kinase (JAK) inhibitors have been gradually approved for the treatment of immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, juvenile idiopathic arthritis, giant cell arteritis, atopic dermatitis, alopecia areata, psoriasis, and inflammatory bowel disease. To standardize the application of JAK inhibitors in IMIDs, the expert group of this consensus has formulated the Chinese expert consensus on the treatment of immune-mediated inflammatory diseases with Janus kinase inhibitors, based on the latest research data, relevant guidelines, domestic and international literature, and clinical practice experience of the experts. This consensus provides a comprehensive introduction to treatment regimens, safety management, and medication use in specific populations, aiming to assist clinicians in making reasonable clinical decisions.
Objective: To investigate the establishment, staffing, equipment allocation, and technological capabilities of cardiac intensive care units in public secondary and tertiary hospitals in Henan Province, and to provide a reference for promoting the development of nationwide cardiac critical care. Methods: In September 2023, supported by the Henan Provincial Health Commission, Cardiac Critical Care Committee of the Chinese Medical Doctor Association conducted the first comprehensive survey on the construction of cardiac intensive care units in Henan Province. A Chi-square test was used to compare the findings between secondary and tertiary hospitals. Results: A total of 171 hospitals reported 1 602 cardiac intensive care unit beds, 1 091 physicians (physician-to-bed ratio: 0.68), and 2 298 nurses (nurse-to-bed ratio: 1.43). Tertiary hospitals had a significantly higher proportion of full-time physicians and physicians with a master's degree or above compared to secondary hospitals. Furthermore, tertiary hospitals had more nurses and a higher proportion of nurses with a bachelor's degree (all P<0.05). Regarding equipment, tertiary hospitals demonstrated higher availability of activated clotting time (ACT) analyzers, temporary pacemakers, extracorporeal membrane oxygenation (ECMO) machines, intra-aortic balloon pumps (IABP), and pulse index continuous cardiac output (Picco) monitors (all P<0.05). Among the hospitals surveyed, 123 could independently perform coronary interventional procedures, 93 could independently use an IABP, 26 could independently perform ECMO, and 53 offered continuous renal replacement therapy at the bedside. Conclusions: This study provides a preliminary understanding of the current state of cardiac critical care in Henan Province. Tertiary hospitals demonstrated advantages over secondary hospitals regarding medical staffing, the proportion of highly educated personnel, the availability of advanced equipment, such as ACT analyzers, temporary pacemakers, IABP, and Picco monitors, as well as in the performance of advanced procedures, including IABP and ECMO.
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