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Objective:As a newly emerging thing, the construction and operation management of research wards are still being explored. According to the previous practice, this study summarized and shared the key points of a demonstration research ward in Beijing, and provided a reference for the development of domestic research wards.Methods:Focusing on improving the efficiency and quality of clinical research, this article summarizes and shares the experience of research ward construction. In addition, this study explores how to maintain the high-quality sustainable development of research wards from the aspects of improving core competence, system construction, and talent training.Results:Professional teams, innovative operation modes, as well as intelligence and informatization could improve the quality of clinical research. Besides, the improvement of core competence, talent training, and policy support ensure sustainable development of research wards.Conclusions:As clinical research platforms, the development paths of research wards need to be clarified further. The standardized construction and sustainable development of research wards can effectively improve clinical research capability and promote the transformation of scientific achievements.
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ObjectiveThe purpose of this study is to investigate and analyze the needs of public health nursing courses and specialty settings under the COVID-19 pandemic. MethodsA total of 576 medical students majored in clinical medicine， preventive medicine， pharmacy， and nursing from a Shanghai university participated in this survey. The Questionnaire Star App was used to collect students' knowledge， attitude and behavior about public health safety and emergency preparedness， public health related curriculum and public health nursing specialty， through self-administered approach. ResultsThere were significant differences in the knowledge of emergency nursing among students with different majors and grades. Over 80% of the participants agreed that "public health popularization should be strengthened". Over 60% were willing to "invest more time and energy in learning and understanding public health-related disease prevention and control knowledge". The school has carried out corresponding training or practice activities in public health education. Compared with nursing major， students with other majors performed better in paying attention to and participating in the training or practical activities of public health education. More than 70% agreed that it was necessary to set up public health nursing courses， especially nursing specialty， with the approval rate as high as 92.3%. Students believed that "2 class hours per week"， and "1/10 of the total class hours" was appropriate. In terms of course teaching， nursing students put forward more expectations on teaching objectives， methods， and characteristic courses. ConclusionUndergraduates lack knowledge of public health nursing， but most of them， especially nursing undergraduates， have a strong desire to learn and have a positive attitude towards opening public health nursing courses. However， there are still problems such as insufficient attention to and insufficient understanding of the courses. More efforts should be made to enhance the public health nursing education on public health emergencies， optimize the relevant settings of courses， so as to train nursing personnel suitable for the current health service needs in China.
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Objective To describe the characteristics and registration status of clinical trials of new drugs for nonalcoholic steatohepatitis (NASH), and to provide a reference for the design and implementation of clinical trials of new drugs for NASH. Methods The U.S. Clinical Trials Database, China Clinical Trial Registry, and Center for Drug Evaluation, National Medical Products Administration, were searched for clinical trials of new drug registration and interventional studies with NASH as the indication published up to August 6, 2021, using NASH in English and Chinese characters as the keywords, and liver cirrhosis was excluded. Two researchers independently searched and screened the articles to extract relevant information. Results A total of 196 clinical trials of new drug registration or interventional studies for NASH were included, among which there were 174 trials registered abroad and 22 trials registered in China, and the number of registrations tended to increase year by year. The numbers of phase Ⅰ, phase Ⅰ/Ⅱ(including Ⅰb/Ⅱa), phase Ⅱ, phase Ⅱ/Ⅲ, and phase Ⅲ clinical trials were 45(23.0%), 8(4.1%), 112(57.1%), 4(2.0%), and 19(9.7%), respectively. The main drug types included farnesoid X receptors, fibroblast growth factors, peroxisome proliferator-activated receptor agonists, and glucagon-like peptide-1, with numbers of 16(8.16%), 14(7.14%), 11(5.61%), and 13(6.63%), respectively. The clinical trials of innovative drugs for NASH initiated by the sponsors in European and American regions accounted for the highest proportion, and there was a gradual increase in the number of clinical trials of innovative drugs in China in recent years, with a similar distribution of single-center and multicenter clinical trials. As for the trials with NASH patients as subjects, the numbers of trials with pathology, imaging, and clinical diagnosis as the main inclusion criteria were 125, 66, and 42, respectively. Phase Ⅰ clinical trials used safety, tolerability, and pharmacokinetic parameters as the main assessment indices, while phase Ⅱ and phase Ⅲ clinical trials often used safety and efficacy as the main assessment indices. The number of clinical trials for the registration of innovative drugs for NASH was relatively low but kept increasing in China, and there were fewer clinical trials of innovative traditional Chinese medicine drugs compared with innovative chemical drugs. Conclusion There is a significant increase in the registration of international clinical trials of innovative drugs for NASH, and most of these trials are in the early phases, with large differences in inclusion criteria and assessment indices, a lack of unified evaluation indices, and relatively few trials with new designs. There are fewer clinical trials of innovative drugs for NASH in China than in European and American countries, and the number of such trials is gradually increasing in China.
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UDP-glucuronosyltransferase 1A1 (UGT1A1) plays a key role in detoxification of many potentially harmful compounds and drugs. UGT1A1 inhibition may bring risks of drug-drug interactions (DDIs), hyperbilirubinemia and drug-induced liver injury. This study aimed to investigate and compare the inhibitory effects of icotinib and erlotinib against UGT1A1, as well as to evaluate their potential DDI risksUGT1A1 inhibition. The results demonstrated that both icotinib and erlotinib are UGT1A1 inhibitors, but the inhibitory effect of icotinib on UGT1A1 is weaker than that of erlotinib. The ICvalues of icotinib and erlotinib against UGT1A1-mediated NCHN--glucuronidation in human liver microsomes (HLMs) were 5.15 and 0.68 μmol/L, respectively. Inhibition kinetic analyses demonstrated that both icotinib and erlotinib were non-competitive inhibitors against UGT1A1-mediated glucuronidation of NCHN in HLMs, with thevalues of 8.55 and 1.23 μmol/L, respectively. Furthermore, their potential DDI risksUGT1A1 inhibition were quantitatively predicted by the ratio of the areas under the concentration-time curve (AUC) of NCHN. These findings are helpful for the medicinal chemists to design and develop next generation tyrosine kinase inhibitors with improved safety, as well as to guide reasonable applications of icotinib and erlotinib in clinic, especially for avoiding their potential DDI risksUGT1A1 inhibition.
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Ciclosporin A (CsA), an immunosuppressive macrolide antibiotics, is widely applied to prevent rejections after organ transplants. CsA is mainly transported by P-glycoprotein (P-gp) and metabolized by cytochrome P450 (CYP450) 3A.Genetic polymorphisms of CYP3A and MDR1 probably influence the expressions and bioactivity of CYP3A and P-gp,and may affect the pharmacokinetics of CsA.This issue summarizes the correlation between genetic polymorphisms of CYP3A and MDR1 and the pharmacokinetics of CsA to guide the rational and individualized medication.
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Sixty five patients with of ankylosing spondylitis were randomly divided into intervention group (n =32) and control group (n =33).Patients in control group received conventional treatment only ;in addition to conventional treatment,patients in intervention group also received community intervention,including health education,psychological counseling and joint function exercise.The treatment lasted for 6 months,29 patients in intervention group and 28 in control group completed the trial.The results showed that the spinal motion (flexion,extension,lateral bending),chest expantion,finger to floor distance,occiput to wall gap in intervention group were better improved than those in control group after treatment (P ＜ 0.05).The scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were lower in intervention group than those in control group after treatment (P ＜ 0.05).The results indicate that community intervention can effectively improve spinal mobility,reduce spinal deformity; relieve the anxiety and depression and improve the quality of life for patients with ankylosing spondylitis.
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[Objective] To detect HBV YMDD motif mutants using RDB hybridization assay in lamivudine treated patients with chronic hepatitis B virus infection,as well as to evaluate the detection capability for clinical application.[Method] HBV DNA was extracted from serum for a total of 242 cases,after the PCR amplification,the hybridization was performed.By comparing the RDB assay results to sequence analysis,the concordant results were analyzed.The sensitivity and detection capability for mixed infection samples are also evaluated.[Results] There are 236 of concordant results for RDB assay and sequencing were obtained in a total of 242 cases,accounting for 97.5%.For all of the cases,there are 58 cases with coexisting mutant viruses in wild type viruses,accounting for 24%.The sensitivity of RDB hybridization assay for HBV YMDD motif mutants was 103 IU/mL,and approximately 10% mutant type strains can be detected from a mixed infection sample.[Conclusion] The RDB hybridization assay for HBV YMDD motif mutants is a simple,accurate,and economic method and it may be a promising tool for clinical application.