Clinical trial, an important research method, plays a crucial role in the development of medicine. It provides important decision support for medical workers. Medical research proposal should be posted at clinical trial registries. Researchers should update original data and research results, which contributes to data sharing. Clinical trial registration can avoid repetitive research and make clinical trials more transparent and standardized. This paper briefly introduces the clinical trial registration, including the definition, the significance, the history, the scope of registration, the organization of registration, and some common problems in the process of registration. Taking the application of clinical trial registration in the field of neurological research as an example, the article describes the current application status of clinical trial registration and explores it’s value and deficiency in specific clinical research, to provoke the awareness on trial registration, which can help to improve the quality of clinical trials.
Objective To sum up the research advances of the seed cell and the culture system using in tissue engineering cartilage. Methods The recent original articles about the seed cell and the culture system in tissue engineering cartilage were extensively reviewed. Results At present, autologous or homologous cells is still major seed cell and the three dimensional culture system is also major system for tissue engineering cartilage. Conclusion The source of seed cell for tissue engineering cartilage. Conclusion The source of seed cell for tissue engineering cartilage should be further explored, and the culture system need to be improved and developed.
The management of malignant pleural effusion remains a clinical challenge. In November 2018, American Thoracic Society, Society of Thoracic Surgeons, and Society of Thoracic Radiology summarized the recent advances and provided 7 recommendations for clinical problems of the management of malignant pleural effusion. This paper interprets these recommendations to provide references for management and research on malignant pleural effusion.
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.
ObjectiveTo clarify the application value of thyroid organoids in basic research and clinical translation of thyroid diseases, analyze the key challenges currently faced, and prospect future development directions. MethodsRelevant domestic and international literatures in recent years were systematically searched. This review summarized the construction strategies of thyroid organoids, and their application progress in disease model establishment (e.g., thyroid cancer, Hashimoto thyroiditis), drug screening, and personalized treatment. ResultsThyroid organoids can highly simulate the morphological structure and gene expression profile of native thyroid tissue. In terms of disease modeling, they can accurately reproduce the pathological characteristics and immune microenvironment of thyroid diseases. In drug screening, organoids can predict the response to radioactive iodine therapy and the sensitivity to targeted drugs, with high consistency between their drug sensitivity results and clinical efficacy. In mechanism research, organoids have been successfully used to reveal the roles of abnormal mitogen-activated protein kinase/phosphatidylinositol 3 kinase-protein kinase B signaling pathways, epithelial-mesenchymal transition, ferroptosis, and immunoregulatory mechanisms in thyroid carcinogenesis and disease progression, providing experimental evidence for target identification. ConclusionsAs an in vitro model that highly simulates the in vivo environment, thyroid organoids have become an important platform for thyroid disease research. Although challenges remain in standardized construction and clinical translation, with technical optimization and research evidence accumulation, they hold broad prospects in the field of precision medicine.
OBJECTIVE To investigate the feasibility of repairing the whole layer defects of tibial plateau by implanting tissue-engineering cartilage. METHODS: The chondrocytes of 2-week-old rabbits were cultured and transferred to the 3rd generation, and mixed with human placenta collagen-sponge. The whole layer defects of tibial plateau in adult rabbits were repaired by the tissue-engineering cartilage in the experimental group; the defects were left un-repaired in control group. The repair results of defects were observed after 4, 12 and 24 weeks. RESULTS: In experimental group, no obvious new cartilage formation was seen 4 weeks after operation; some new cartilage formation was found after 12 weeks. Histological observation showed that chondrocytes had irregular edge, honeycombing structure and that cartilage cavities formed around the chondrocytes. After 24 weeks, obvious new cartilage formation was found with smooth surface, and linked with the tissues around it, but the defect was not repaired completely; histological results showed that cartilage cavities formed and that cartilage matrix was stained positively for toluidine blue. In control group, the defect was not repaired. CONCLUSION: The tissue-engineering cartilage can repair the defects of the whole layer cartilage of tibial plateau in rabbits, it is feasible to repair the whole layer cartilage defects of tibial plateau by this method.
Objective To investigate time differences in directional differentiation of bone marrow mesenchymal stem cells (BMSCs) into nucleus pulposus-like cells (NPCs) in a non contact co-culture system so as to search for the best time for transplantation in vivo. Methods Six New Zealand white rabbits (aged 6 weeks, weighing 1.5-2.0 kg) were selected. BMSCs were collected and cultured for immunocytochemistry identification of CD34, CD44, CD45, and CD90; NPCs were isolated and identified immunocytochemically by RT-PCR. The 2nd passage BMSCs and the primary NPCs were co-cultured in a non contact co-culture system. The cell morphological changes were observed and the cell growth curves were made at 1, 3, and 5 passages after co-culture. The expressions of the aggrecan and collagen type II genes were detected by RT-PCR in BMSCs at 5, 10, and 15 days after co-culture; the expressions of the aggrecan and collagen type II proteins were detected by Western blot at 5, 10, 15, 20, 25, and 30 days after co-culture. Results The expressions of CD44 and CD90 were positive, CD34 and CD45 were negative in BMSCs. The expressions of the collagen type II and aggrecan were positive in NPCs. At 2 weeks after co-culture, the morphology of BMSCs changed obviously, the cells were polygonal and irregular shape. The cell growth rate showed no difference within 3 passages, but decreased obviously after 3 passages. RT-PCR showed that the expressions of collagen type II and aggrecan genes at 10 and 15 days were significantly higher than those at 5 days (P lt; 0.05), no significant difference was found between at 10 days and at 15 days (P gt; 0.05). Western blot showed that the expressions of collagen type II and aggrecan proteins gradually increased with time, and there was significant difference within 5, 10, and 15 days (P lt; 0.05), but no significant difference was found after 15 days of co-culture (P gt; 0.05). Conclusion In a non contact co-culture system, BMSCs can differentiate into the NPCs. The expression of collagen type II and aggrecan can reach a stable level at 15 days after co-culture, and it is the suitable time for transplantation in vivo.
Objective To investigate the therapeutic effect of different wavelength krypton lasers on diabetic retinopathy. Methods A total of 55 eyes (35 cases) with diabetic retinopathy underwent different wavelength k rypton lasers photocoagulation treatment, according to the different manifestati on of the affected eyes. The visual acuity, intraocular pressure，visual field,visual evoked potential were examined, and slit-lamp, ophthalmoscopy, Bultraso nography, and fundus fluorescein angiography were performed preoperatively. The patients were followed up for at least 12 months after krypton laser treatment. Results The resulting effect on visual acuity after 12 months of photocoagulation in this series revealed that, 20 eyes (36.4%) i mproved, 34 eyes (61.8%) remained no change, and one eye (1.8%) decreased. Conclusions Different wavelength krypton lasers photoco agulation can be used in treatment of diabetic retinopathy and can improve the visual acuity at certain extent. (Chin J Ocul Fundus Dis, 2001,17:178-180)
Spine is a common site of metastasis in patients with malignant tumors, and tumor metastasis to the spine can lead to pain, pathological fractures, and nerve compression. In order to optimize the diagnosis and management of patients with spinal metastases and metastatic spinal cord compression (MSCC), the National Institute for Health and Care Excellence (NICE) in the UK proposed the first diagnostic and treatment guidelines for patients with MSCC (or at risk of MSCC) in 2008. In recent years, with the rapid advancement of spinal surgery and radiotherapy technology, the standardized process of MSCC diagnosis and treatment urgently needs to be updated. In 2023, NICE launched new guidelines for spinal metastases and MSCC. Based on a thorough study of the guidelines, this article discusses and interprets pain management, corticosteroid treatment, application of bisphosphonates and denosumab, tools for assessing spinal stability and prognosis, radiation therapy, surgical timing and approach, etc., providing reference for clinical diagnosis and treatment in China.
In the new era of development, countries in the world have realized the importance of cultivating interdisciplinary and innovative talents, and China is also paying more and more attention to the cultivation of medicine-engineering talents. Compared with the cultivation of single discipline postgraduates, the cultivation of medicine-engineering postgraduates involves effective integration of multiple disciplines, and its cultivation difficulty is greater. At present, China is still in the exploration stage of the medicine-engineering postgraduates training model. Therefore, this article intends to summarize the relatively mature and advanced medicine-engineering postgraduates training models at home and abroad, and extract experiences that are in line with China’s actual development, providing some suggestions for the establishment of postgraduates training systems of medicine-engineering interdisciplinary in China.