Analysis on key points of ethics review of horizontal scientific research projects: Based on the ethics review management system of horizontal scientific research projects in a tertiary hospital / 中华医学科研管理杂志

Objective:This paper aims to promote the standardization of ethics review of horizontal scientific research projects and improve the ethics review quality by analyzing the current ethics review practice in a certain tertiary hospital, identifying common problems during the review process, illustrating relevant causes and proposing corresponding solutions.Methods:Through introducing the current situation of ethics review of horizontal scientific research projects in a tertiary level hospital, the differences between the main points of ethics review of horizontal scientific research projects and government-funded scientific research projects were analyzed, so as to sort out the common problems and possible causes in the process of ethics review of horizontal scientific research projects, and then explore the possible corresponding solutions.Results:Based on the characteristics of horizontal research projects, ethics review should focus on their scientific and social values, potential conflicts of interest, protection of subjects′ rights and interests, and whole-process management and quality assurance. At present, there are still many problems, such as a large number of projects, but not many projects with high research value, inadequate project process management, and ineffective implementation of ethics review opinions.Conclusions:The hospital should further improve the management system of horizontal scientific research project approval, bring in more comprehensive review regarding to both scientific and ethics review, engage more experts at the outset of project funding decision-making, set up ethics specialists, strengthen the process management of horizontal scientific research projects, strengthen ethical publicity and education, and improve the ethical awareness of researchers to fully protect the rights and interests of subjects and promote the high-quality development of clinical research.

Analysis on the Key Points of Clinical Research Management Based on the Scientific Research Big Data Platform of a Tertiary Hospital / 中国医学伦理学

With the rapid development of healthcare big data and artificial intelligence technology, how to utilize the massive medical data generated based on clinical diagnosis and treatment has become an important issue to be solved in the field of clinical research. Clinical diagnosis and treatment data is an essential part of healthcare big data, and also the main field of healthcare big data research. With the continuous deepening and extensive development of informatization, hospitals have accumulated a large number of patient-centered clinical diagnosis and treatment data. Deeply mining and analyzing these data through big data technology can provide reference for precise diagnosis and treatment, and standardized prevention and control of diseases. However, conducting relevant research still faces many difficulties and blockages, such as the increased risk of data leakage or abuse, and the difficulty in implementing informed consent. To safely, legally and efficiently utilize clinical diagnosis and treatment data to conduct clinical research and fully tap into the value of these precious medical resources, a tertiary hospital in Beijing has built a research big data platform and developed relevant systems to effectively solve the problems of blockages and difficulties in the application of rich clinical resources to clinical research, and improve the service quality of medical institutions and the conversion rate of scientific research achievements. By introducing the key points and management methods in the implementation of clinical research based on the scientific research big data platform, analyzing and exploring the existing problems and improvement measures, this paper aimed to provide theoretical basis and system reference for high-quality and efficient health and medical big data clinical research, inspire and promote the continuous improvement of medical research management, and promote the development of medical and health science and technology innovation.

Establishing human research protection program and its influence on promoting the whole process management of clinical research / 中华医学科研管理杂志

Objective:Improve the quality of clinical research at different stages for better protection of human subject.Methods:Introduce the operational and the administrative experiences of establishing the human research protection program in our hospital.Results:Establish human research protection program can promote the direct communication and cooperation among relevant departments of clinical research, strengthen the whole process management of clinical research.Conclusions:Developing comprehensive human research protection program and related policies play a positive role in promoting the high-quality development of clinical research in hospitals.

Discussion on the conflict of interests in the achievements transformation in hospitals / 中华医院管理杂志

With the constant growth of national investment in science and technology, biomedical scientific and technological achievements keep mushrooming. Hospitals, as a powerful force in high-tech research and development, experimental translation and industrialization of biomedicine research, play an important role in the transfer and translation of scientific and technological achievements. This paper analyzed the conflicts of interest in the achievements translation in hospitals, and considered that conflicts of interest are widespread in practice. Under the background of encouraging innovation and promoting the achievements translation, projects with conflicts of interest should be carried out in hospitals conditionally. While reducing the conflicts of interest, the achievements translation should be done properly.

Discussion on the conflict of interests in the achievements transformation in hospitals / 中华医院管理杂志

With the constant growth of national investment in science and technology,biomedical scientific and technological achievements keep mushrooming.Hospitals,as a powerful force in high-tech research and development,experimental translation and industrialization of biomedicine research,play an important role in the transfer and translation of scientific and technological achievements.This paper analyzed the conflicts of interest in the achievements translation in hospitals,and considered that conflicts of interest are widespread in practice.Under the background of encouraging innovation and promoting the achievements translation,projects with conflicts of interest should be carried out in hospitals conditionally.While reducing the conflicts of interest,the achievements translation should be done properly.

Cerebrovascular reserve capacity of patients with ischemic cerebral white matter lesions / 实用医学杂志

Objective To investigate the changes of cerebrovascular reserve capacity (CVR) in patients with ischemic white matter lesions (WML). Methods 126 patients with WML were divided into mild lesion, moderate lesion, severe WML groups and a normal control group by brain MRI. Blood pressure, blood sugar, blood fat were measured and past medical histories were recorded in details. All the patients were routinely examined using TCD to evaluate CVR. Hypercapnia was induced by inhaling the CO2 they breathed themselves and hypocapnia was done by voluntary hyperventilation. Results Age, hypertension, diabetes mellitus and Apo-A were the independent risk factors for WML. Compared with the controls , CVR decreased significantly in the severe and moderate WML groups (P < 0.05). The extent of WML negatively correlated to the cerebrovascular reserve capacity (rs = -0.273, -0.392). Conclusions Age, hypertension, diabetes mellitus and Apo-A are the independent risk factors for WML. CVR is significantly decreased in the WML.

Meta-analysis of replacement time for long-term indwelling catheter in patients with silicone catheter in China / 现代临床护理

ObjectiveTo explore the best time for replacing the long-term indwelling catheter in patients with silicone catheter.MethodsDomestic literature were retrieved and analyzed using Cochrane systematic review,and the meta-analysis of randomized controlled trials was conducted in accordance with inclusion criteria and exclusion criteria so as to look into the most suitable time for replacing the indwelling catheter for patients with silicone catheter at clinical trials.The replacement frequency for the catheters of different size together with the relevant infections in urinary tract infection and relative risk(RR)were used as values for effectiveness of interventions.ResultsA total of 11 literature were retrieved. Meta-analysis results suggested that the RR values of urinary tract infections when the catheters were replaced once every two weeks vs. every four weeks,and once every three weeks vs. every four weeks were 0.51[95% CI(0.40,0.66),P <0.001],0.79[95% CI(0.58,1.08),P = 0.14],respectively.The urinary infection rate of replacing a silicone cathether every 2 weeks was higher than that of every 4 weeks,but there was no difference between that of every 3 weeks and 4 weeks.Conclusion According to the nature of silicone catheter material as well as the clinical indexes, it is most reliable to replace a silicone catheter every four weeks to reach a best clinical outcome.

Study of cerebrovascular reserve capacity in obstructive sleep apnea-hypopnea syndrome / 中国综合临床

Objective To assess cerebrovascular reserve capacity in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods One hundred and fourteen patients with OSAHS and 43 normal persons were enrolled in this study.The patients were divided into mild,moderate,severe according to apnea hypopnea index (AHI) and LSaO2 (lowest arterial oxygen saturation).All the patients and normal persons were routinely examined using transcranial Doppler (TCD) and end-tidal carbon dioxide partial pressure(ETCO2) to evaluate cerebrovascular reserve.Hypercapnia was induced by inhaling the CO2 which produced by the patients themselves,and hypocapnia was elicited by voluntary hyperventilation.Results CVR in the severe and moderate OSAHS were significantly lower than that in the control group [ (1.80 ± 1.34) ％/mm Hg and (1.43 ±1.05)％/mm Hg vs (2.93 ±0.93)％/mm Hg,P ＜0.05] when patients in the condition of hypocapnia.And there was no significant difference on CRV between the mild OSAHS group and control group [ (2.53 ±1.83 ) ％/mm Hg vs ( 2.93 ± 0.93 ) ％/mm Hg,P ＞ 0.05 ].When patients in the condition of Hypercapnia,CRV in the severe and moderate OSAHS were also significantly lower than that in the control group [ ( 1.83 ±1.32) ％/mm Hg and (1.08 ± 1.00)％/mm Hg vs (3.32 ± 1.53)％/mm Hg,P ＜ 0.05),AHI was negatively correlated with the cerebrovascular reserve at the condition of hypercapnia and hypocapnia (r=-0.665,-0.721; P ＜ 0.05 ).Conclusion Inhaling CO2 is a effective method for assessing CVR.Cerebrovascular reserve capacity is associated with AHI.Reduced CVR causes hemodynamics change being severe hypoxia in the moderate and severe OSAHS.

The clinical feature and gene mutation of three pedigrees with spinocerebellar ataxia MA / 中国医师杂志

Objective To investigate the clinical features and the gene mutation of patients with spinocerebellar ataxia type3 and type7.Methods The trinucleotide repeat mutations were detected by polymerase chain reaction (PCR),agarose gel electrophoresis method,and DNA sequencing in 13 patients,4 related members and 4 common members from 3 spinocerebellar ataxia families.Results Among the 13 patients,four patients had SCA3/MJD(CAG) n expansion mutation(n = 65 ～ 74),nine patients had SCA7 allele expansion for 40 ～ 52 times.Patients with type 3 or 7 showed significant difference in nervous system injury.Conclusion The difference of clinical feature might be used in diagnosis of SCA3/MJD and SCA7,but genotype determination would be the only method of definite diagnosis.

Effects of ginkgo leat extracts and dioyridamole injection on the Alzheimer's diseases rats / 中国基层医药

Objective To observe the depositing regions of the cerebral neurons containing A?_ 42 neurons and to study the effects of ginkgo leaf extracts and dioyridamole injection on the memory,the deposition of A?_ 42 in the brain of Alzheimer's disease(AD) model rats induced by aluminium chloride(AlCl_3).Methods The experimental AD model of rats was established by 30% AlCl_3.The rats of treatment group received ginkgo leaf extracts and dioyridamole injection for consecutive six months.Latent period and the intensity of electric shock was evaluated by a passive-avoidence test before and after administration respectively.The morphology and the number of A?_ 42 neurons of the model rats brain by light microscope observation as well as immnohistochemistry.Results (1)After treatment,latent period of the rats prolonged and the intensity of electric shock reduced as compared with AlCl_3 group.(2)The depositing regions of A?_ 42 were found mainly in pyramidal cell layer of CA_1 hippocampus formation and polymorphical cell layer of dentate gyrus,external main stratum of entorhinal region and Ⅲ,Ⅵ,Ⅴ cell layer of cortex(parietal,temporal).The color of A?_ 42 positive substance was brown or brown yellow in the cytoplasm and its dendrites or branches.Significant reducing of A?_ 42 neurons occurred in treatment group(hippocampus P0.05).Conclusion Ginkgo leaf extracts and dioyridamole injection can improve the AD model rats ability of learn and memorizing,which mechanisms are achived by preventing A? from depositing and clearing deposited A?.