ObjectiveTo investigate the domestic and abroad hypertension-related clinical trial registration and to analyze the registration of hypertension-related clinical researches in China.MethodsUsing hypertension as the keyword, we searched ClinicalTrials.gov and Chinese Clinical Trial Registry (ChiCTR) from January 2008 to December 2018. We analyzed the collected data on the distribution of registered clinical researches, annual trends, sample sizes, trial progress, research types, study designs, blind methods, clinical stages, the number of participating institutions, the leading institutions, etc.ResultsThe total number of registered hypertension-related clinical trails was 4 991 all over the world, and 551 items were conducted in China. Most of the sample sizes of Chinese hypertension-related clinical trials were 100 to 999. The main types of trials were interventional studies (393 items, 71.32%), followed by observational studies (126 items, 22.87%). Randomized parallel control studies (300 items, 76.34%) were the key component of interventional studies, while cohort studies (61 items, 48.41%) were the chief component of observational studies. The main stages of clinical trials were stage Ⅲ (80 items) and stage Ⅳ (122 items). There were 369 domestic single-center clinical trials (66.97%), 89 domestic multi-center clinical trials (16.15%), and 93 international multi-center clinical trials (16.88%). Among the 93 international multi-center trials of hypertension, only 25 were led by China.ConclusionsThe number of Chinese hypertension-related clinical trial registrations increased year by year and then decreased slightly, but the amount of registrations is limited. The quantity and scale of multicenter clinical studies were not as good as America. China should strengthen the awareness of clinical research registration, strengthen the publicity and supervision of the registration of clinical researches by the department of science and management, improve the number of clinical trial registrations, make Chinese clinical researches more transparent, and strive to lead more international multi-center clinical trials.
To study the effect of intraperitoneal hyperthermic double distiled water and cis-diamminedichloro-platinum(DDP) perfusion to the peritoneal cancerous ascites,intraperitoneal injection of H22 cancer cells (2×107 tumor cell,each mouse) were performed in LACA mice. Five days after cancer cells injection, intraperitoneal perfusion of simple hypertherrnic (43℃) double distiled water(group Ⅰ) isotonic fluid (group Ⅱ ). DDP (group Ⅲ ), and hypertherrnic double distiles water perfusion combined with DDP (guoup Ⅳ ) were performed .The results showed that cancer cells in the peritoneal cavity of LACA mice were seriously damaged, the production of ascites was markedly inhibited and the survival days of LACA mice were prolonged in all groups . .The intraperitoneal hyperthermic double distilled water perfusion with DDP group showed more effective result as compared with the other groups,Only 1 peritoneal implanted dissemination was found after treatment in this group,Basing on the experimental from September 1991 through September 1993,intraperitoneal hyperthermic double distiled water perfusion with DDP was used to treat 32 advanced gastric cancer patients after radical gastrectomy with satisfactory results.
Local hypothermia as a preventive method to reperfusion injury of skeletal muscles was studied. Sixteen Japanese rabbits were divided into four groups at random. Before the tourniquet was inflated, a cold gel pack was applied to the right hind leg of each rabbit for 15 minutes to produce local hypothermic condition, without application of tourniquet the left hind limb was under local hypothermic condition as a control. The duration of tourniquet ischemia was 4 hours, and then reperfusion for one and two hours in the A and B groups respectively; in the C and D groups the duration of ischemia was 5 hours, and reperfusion for one and two hours, respectively. The muscle temperature averaged 16.6 degrees C with a needle thermocouple in the hind limb under local hypothermia. The serum K+, LA, SOD, LPO were determined from bilateral femoral veins, and electron and light microscopic studies of sural muscles were done in the post-reperfusion period. It was found that the K+, LA, LPO were lower than that of the control groups (P lt; 0.01), but SOD was higher than that of the control group (P lt; 0.01). Electron and light microscopic studies showed sight but reversible damage of muscular structure with the possibility of in the hypothermic groups cell regeneration. Basing on this experimental results, this method was applied in 45 cases reparative and reconstructive surgery of limbs. The duration of application of tourniquet averaged 2 hours and 57 minutes, the longest being 4 hours and 31 minutes, when the muscle temperature had reduced to 22.4 degrees C. There were no postoperative complications associated with this technique. Local hypothermia appeared to be a safe and effective method of decreasing the reperfusion damage after ischemia.
ObjectiveTo analyze the clinical features, laboratory examination, imaging findings, treatment and outcome of influenza A H1N1 virus infection in China, so as to improve the clinicians' understanding of the disease.MethodsOne patient with influenza A H1N1 pneumonia was reported in this hospital. The databases of CNKI, VIP network and Wanfang data were systematically consulted. After removing the duplicate and deleting the incomplete literature published between January 1989 and August 2019, 62 literatures were included, involving 880 patients. Hence, 881 patients in total were included. The clinical manifestations, laboratory examination, imaging manifestations, treatment and prognosis were analyzed.ResultsThere were 477 males and 404 females, aged from 50 days to 86 years old, with an average age of (20.4 ±10.0) years. The most common clinical symptoms were fever (99.4%, 876/881), followed by cough (85.0%, 749/881), expectoration (38.1%, 336/881), sore throat (37.0%, 326/881) and dyspnea (33.7%, 297/881), asthenia and general pain (33.5%, 295/881) and so on. Laboratory examination in the leukocyte decreased in 249 patients (28.3%), neutrophil increased in 143 patients (16.2%) and leukocyte increased in 141 patients (16.0%). Myocardial injury was found in 370 patients (42.0%), liver injury in 303 patients (34.4%) and renal insufficiency in 84 patients (9.5%). The main imaging manifestations were spotted, patchy or flaky shadows (41.8%, 362/866) in varying degrees, with consolidation shadows (19.3%, 167/866), thickening of lung texture (11.3%, 98/866), ground glass shadows (4.5%, 39/866), and pleural effusion (5.5%, 48/866). The most common treatments were anti-virus, anti-infection, anti-inflammation, mechanical ventilation and symptomatic support. Comprehensive treatment resulted good effects. There were 37 deaths and the mortality rate was 4.2%. The main cause of death was respiratory failure.ConclusionsInfluenza A H1N1 virus infection is a preventable, controllable and treatable infectious disease, which is similar to the general influenza virus. After active comprehensive treatment, most of the influenza A (H1N1) can be cured and the prognosis is benign.
OBJECTIVE: To sum up the clinical results of bio-derived bone transplantation in orthopedics with tissue engineering technique. METHODS: From January 2000 to May 2002, 52 cases with various types of bone defect were treated with tissue engineered bone, which was constructed in vitro by allogeneous osteoblasts from periosteum (1 x 10(6)/ml) with bio-derived bone scaffold following 3 to 7 days co-culture. Among them, there were 7 cases of bone cyst, 22 cases of non-union or malunion of old fracture, 15 cases of fresh comminuted fracture of bone defect, 4 cases of spinal fracture and posterior route spinal fusion, 3 cases of bone implant of alveolar bone, 1 case of fusion of tarsotarsal joint. The total weight of tissue engineered bone was 349 g in all the cases, averaged 6.7 g in each case. RESULTS: All the cases were followed up after operation, averaged in 18.5 months. The wound in all the case healed by first intention, but 1 case with second intention. Bone union was completed within 3 to 4.5 months in 50 cases, but 2 cases of delayed union. Six cases were performed analysis of CD3, CD4, CD8, ICAM-1 and VCAM-1 before and after operation, and no obvious abnormities were observed. CONCLUSION: Bio-derived tissue engineered bone has good osteogenesis. No obvious rejection and other complications are observed in the clinical application.
OBJECTIVE: To investigate the feasibility of segmentation of latissimus dorsi on the basis of anatomy and electrophysiology. METHODS: Ten cadaveric latissimus dorsi was dissected according to the blood supply, nerve innervation. Electromyelogram (EMG) of latissimus dorsi of 13 healthy persons was recorded with superficial electrode plate in the motion of shoulder joint. The results of record were managed with statistic methods. Ten patients(including reconstruction of breast and repair of scar on elbow joint and on chest wall) were treated with the lateral inferior myocutaneous island flap. RESULTS: According to the medial and lateral vasculonervous branches, latissimus dorsi can be divided into the medial superior and lateral inferior segments. The clinical application of the segment achieved good results in reconstructing breast and in repairing scars on elbow and on chest wall. CONCLUSION: Latissimus dorsi can be divided into two segments and applied separately. The lateral inferior segment is more useful in shoulder motion.
Objective To explore the effect of applying evidence-based medicine theory to quality management in long-term-system clinical medicine teaching. Methods We introduced the concept of evidence-based quality management system of clinical medicine to the delivery of teaching with Internet-based teaching quality real time supervision system as the core. A special quality scale was used to assess the teaching quality of teachers and the results were analyzed by SPSS 10.0 using u test. Results The system stored 853 280 pieces of data from the years 2001 to 2003. Up to 96.4% (275/285) of the evaluated topics scored over 85 points. Whether the teachers had overseas experience or not and whether their ages were over 45 or not had no significant influence on the teaching quality (P ＞0.05), but their degrees had influence on the teaching quality (P ＜0.05). Conclusion In long-term-system clinical medicine teaching quality management, we should apply the concept and approach of EBM to our practice so that we can ensure that the teaching quality of long-term-system clinical medicine will improve steadily.