Researchers' Knowledge About the Ethical Norms of National Natural Science Foundation of China Funded Medical Research:Current Status and Suggestions / 中国医学科学院学报

Objective To understand the current status of Chinese medical researchers' knowledge regarding the ethical norms of the research involving humans or laboratory animals,and provide reference for further improving the ethics review norms. Methods The questionnaire method was employed to survey the applicants for the 2019 projects supported by the Department of Medical Sciences,National Natural Science Foundation of China (NSFC) about their knowledge of ethical requirements.Furthermore,the ethical supervision of the NSFC and affiliations at the project application and implementation stages was analyzed. Results The survey showed that 29.9% medical researchers were familiar with NSFC's ethical requirements for research involving human or laboratory animals.During the project application stage,59.0% affiliations adopted the simplified review method.Regarding the ethical supervison,95.5% medical researchers believed that the affiliations should fulfill the ethical supervision obligations and take relevant measures during the project implementation period.In addition,55.0% medical researchers fully agreed to discuss with the review experts about the ethical issues involved in the project. Conclusions The NSFC should establish rules and regulations to improve institutional management responsibilities and institutionalize the training about research ethics to comprehensively strengthening the training.Taking the management of research project ethics as a starting point,the NSFC should form a multi-party linkage between project funding and management and establish an accountability mechanism for ethics management.Furthermore,the NSFC should double the endeavors at the review of ethical issues during expert review and process management and attach importance to the research,judgment,and prevention of ethical risks.

Experiments that led to the first gene-edited babies: the ethical failings and the urgent need for better governance / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The rapid developments of science and technology in China over recent decades, particularly in biomedical research, have brought forward serious challenges regarding ethical governance. Recently, Jian-kui HE, a Chinese scientist, claimed to have "created" the first gene-edited babies, designed to be naturally immune to the human immunodeficiency virus (HIV). The news immediately triggered widespread criticism, denouncement, and debate over the scientific and ethical legitimacy of HE's genetic experiments. China's guidelines and regulations have banned germline genome editing on human embryos for clinical use because of scientific and ethical concerns, in accordance with the international consensus. HE's human experimentation has not only violated these Chinese regulations, but also breached other ethical and regulatory norms. These include questionable scientific value, unreasonable risk-benefit ratio, illegitimate ethics review, invalid informed consent, and regulatory misconduct. This series of ethical failings of HE and his team reveal the institutional failure of the current ethics governance system which largely depends on scientist's self-regulation. The incident highlights the need for urgent improvement of ethics governance at all levels, the enforcement of technical and ethical guidelines, and the establishment of laws relating to such bioethical issues.

An analysis based on network reports of workplace violence on healthcare providers in China, 2013—2016 / 基础医学与临床

Objective To explore the distribution characteristics and potential causes of workplace violence on healthcare providers which were represented in reports, thus providing measures for prevention of medical violence. Methods We collected the data of medical violent events that were reported from 2013 to 2016 by searching the Internet, and then analyzed geographical distributions, temporal distributions, causes and consequences of these re-ported events. Results These reported violent events mainly occurred in the eastern part of China, tertiary grade A hospital and emergency department. There were highest incidences in summer from May to August. Assaulters were mainly young men and unsatisfaction of therapeutic results was the main cause.Conclusions The occurence of medical violent events is related to area, time, the academic level of hospitals and department. Analysis of back-ground and the cause may provide the basis for the prevention and intervention of the medical violent events.

Clinical and imaging features and genetic analysis of a case with adult-onset Krabbe disease / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate clinical and imaging features of a patient with adult-onset Krabbe disease and to detect the underlying genetic mutations.</p><p><b>METHODS</b>Clinical and cranial MRI features of the patient were analyzed. Pathogenesis, clinical manifestation, cranial MRI features and diagnostic criteria for the disease were discussed.</p><p><b>RESULTS</b>The patient had presented asymmetric limb weakness and difficulty in walking. Electromyography suggested peripheral nerve demyelination. Cranial MRI showed increased signal intensity in white matter with involvement of the corticospinal tracts. Screening of GALC gene mutation has found the patient to be heterozygous for T1685C (Ile562Thr) and homozygous for A1921G (Thr641Ala), both of which were considered to be polymorphisms. In addition, he was heterozygous for G136T (Asp46Tyr), which had not been described previously.</p><p><b>CONCLUSION</b>Clinical manifestations of adult-onset Krabbe disease may be atypical. Cranial MRI and galactocerebroside activity assay should be carried out for patients featuring chronic progressive corticospinal tract injury. An Asp46Tyr mutation probably underlies the disease in the current case.</p>

Exploring the optimal operation time for patients with hypertensive intracerebral hemorrhage: tracking the expression and progress of cell apoptosis of prehematomal brain tissues / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hypertensive intracerebral hemorrhage (HICH) is a severe disease with high morbidity and mortality. Timely removal of the hematoma through surgical procedures may effectively reduce secondary injuries. However, there has long been a debate over the proper timing of such surgery. In this study, we explored the optimal operation time for HICH patients by observing the pathological changes in perihematomal brain regions during different stages of onset.</p><p><b>METHODS</b>Twenty-five specimens of brain tissue, obtained from perihematomal region of HICH patients in different phases, were subjected to haematoxylin-eosin (HE) staining, terminal deoxynucleotidyl transferase-mediated deoxyuridine 5-triphosphate nick-end labeling (TUNEL) staining and Caspase-3, matrix metalloproteinases-9 (MMP-9) immunohistochemical staining. The changing roles of necrosis and apoptosis and the expression of MMP-9 and Caspase-3 positive cells were all observed using image analysis.</p><p><b>RESULTS</b>The obvious expression of TUNEL positive cells was recognized within 6 hours of ICH onset, reaching its peak between 6 hours and 24 hours in the early phase.</p><p><b>RESULTS</b>were highly consistent with Caspase-3 and MMP-9 positive cell counts. Necrosis was found 6 hours after ICH onset and aggravated after 12 hours.</p><p><b>CONCLUSIONS</b>In the early phase, apoptosis was seen as a major modality of injury in the brain tissue of the perihematomal region and was strongly correlated with the expression of MMP-9 and Caspase-3. The results of the present study suggest that an operation performed as soon as possible after ICH onset may be optimal for preserving the nervous system function.</p>

The Correlation between Cognitive Functions and MR Volumetric Measurements of Medial Temporal Lobe in Mild Cognitive Impairment and Different-phase Alzheimer Disease / 中国心理卫生杂志

0.05).Attention,ability of calculation(MMSE items)and DS scores were negatively correlated with left amygdala volumes(r=-0.51～-0.57,P

Application of informant questionnaire on cognitive decline in the elderly in the screening of cognitive impairment in the elderly / 中华老年医学杂志

Objective To evaluate the reliability and validity of informant questionnaire on cognitive decline in the elderly(IQCODE) in Chinese elderly patients and to estimate the efficacy of IQCODE in the screening of patients with cognitive impairment.Methods Ninety three patients with cognitive impairment and 128 community-dwelling healthy elderly over 60 years old were assessed.Informants were interviewed with the short version of the IQCODE.Results The internal consistency coefficient of IQCODE was 0.83.The correlation coefficient of test-retest reliability was 0.86.The validity coefficient of IQCODE with mini-mental state examination and activities of daily living were-0.78 and 0.71 respectively.The scores of IQCODE of the patients varied with the degree of cognitive deficits,and the differences had statistical significance.But there was no significant difference among different types of senile dementia.The scores of IQCODE of the patients with cognitive impairment were closely correlated with the degree of cognitive deficits.Conclusions IQCODE is a reliable and effective measurement for the patients with cognitive impairment.It could discriminate the cognitive impairment patients from the normal cognitive ones,and is practical in screening.But it can not distinguish different kinds of dementia.