RESUMO
Background: Under-recruitment in clinical trials has become a worldwide problem, and has many causes that need to be understood. Clinical Research Nurses (CRNs) provide a new research perspective. Aim: To understand the current situation about the informed consent rate after the participation of CRNs and analyse the possible influencing factors. Methods: This cross-sectional study was conducted at a hospital. A convenience sample was used to study patients with pulmonary nodules who underwent day surgery from March to May 2023. Patients first received information from doctors and a second session by CRNs was provided for those who initially were hesitant about the research. A questionnaire survey was conducted using an online survey platform to collect information. Results: After education by doctors, 208 patients were hesitant and CRNs conducted a second education session, the CICARE model was used for communication. Following this session a further 161 patients were willing to participate. Finally, 374 patients were willing to participate. Related factors include age, education level and the attitude of self-assessed family members towards their participation in clinical projects. Conclusions: CRNs' participation can improve patients' willingness to participate. It is crucial to pay attention to the role of CRNs and propose a new model of CRNs involvement in clinical research based on identifying factors.
RESUMO
TNF-related apoptosis-inducing ligand (TRAIL) represents one potential and ideal anti-tumor drug, because it kills cancer cells specifically without targeting normal cells. However, acquired drug resistance to TRAIL usually impedes the clinical use of TRAIL on cancer patients. In the present study, we established in vitro TRAIL-resistant cervical cancer cell lines through long-term exposure to TRAIL. Interestingly, we observed significant upregulation of c-FLIP in TRAIL-resistant Hela and SiHa cells (Hela-TR and SiHa-TR) compared to their parental Hela and SiHa cells. Although Hela-TR and SiHa-TR cells exhibited low-sensitivity to TRAIL treatment, knockdown of c-FLIP significantly increased the cytotoxicity of TRAIL to them. In contrast to high protein level of c-FLIP, expression of miR-126 was significantly downregulated in Hela-TR and SiHa-TR cells. Results of western blot analysis, luciferase assays and bioinformatics proved that c-FLIP was the target of miR-126. Furthermore, as c-FLIP is the cellular antagonist to caspase-8, transfection with miR-126 promoted the activation of caspase-8 induced by TRAIL. As a result, miR-126 increased the TRAIL-induced apoptosis in Hela-TR and SiHa-TR cells. In addition, miR-126 was also able to increase the cytotoxicity of TNF-α and FasL (caspase-8 inducers) to Hela-TR and SiHa-TR. We demonstrate that miR-126 impairs drug resistance to TRAIL, TNF-α and FasL through inhibiting the expression of c-FLIP in cervical cancer.