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 explore the expression of MSI2 in gastric cancer and its association with clinical significance.
MethodsThe expression level of MSI2 mRNA in gastric cancer tissues and para-carcinoma tissues was detected by Real-time PCR to explore its clinical significance. The expression level of MSI2 protein was detected by Western blotting. The prognosis of patients with the ratio of MSI2 mRNA expression level in gastric cancer tissues and adjacent normal tissues was more than 2 times and below 2 times were compared.
ResultsThere was no significant difference between the expressions of MSI2 mRNA in cancer tissues and para-carcinoma tissues(P > 0.05). The expression level of MSI2 mRNA were associated with the invasion depth (P=0.017), TNM stage (P=0.028), differentiation (P=0.020), and size (P=0.030) of tumor, but no association with other clinical factors such as gender, age, and location were found. The overall survival of the patients with high expression of MSI2 mRNA was significantly shorter than that of the patients with low expression of MSI2 mRNA (χ2=4.221, P=0.040).
ConclusionMSI2 expression is associated with the gastric cancer invasion, TNM stage and differentiation, and the patients with higher expression of MSI2 mRNA have poor prognosis, which makes it possible to be a potential therapeutic target.
Objective To explore the short term and long term effectiveness of the problem-based learning (PBL) in clinical skill training. Methods A total of 162 clinical medicine undergraduates in Grade 2003 (7-years study) and 2004 (5-year study) who were supposed to intern in the internal medicine departments were randomly divided into the PBL group (n=75) and the control group with traditional training (n=87) for having their clinical skills training. Then t test was applied to compare the two groups about the scores of intern rotation examination and graduate OSCE as well. Results About the baseline: the students in the two groups got similar scores in their internal medicine exam before clinical intern rotation (84.04±7.40 vs. 82.63±8.77, P=0.287). About the short term effectiveness: compared to the control group, the students in the PBL group got higher subjective evaluation from their supervised clinicians (P=0.006). In writing examination, the students of those two group got similar scores in knowledge part (54.17±9.26 vs. 51.67±9.56, P=0.92), while the PBL group won in case reasoning question (20.39±5.27 vs. 16.51±4.90, Plt;0.001). About the long term effectiveness: in the graduate OSCE, the two groups got similar scores in skills operation such as punctures and lab results analyses (P=0.567 and P=0.741), while the students in the PBL group had better performance at the case reasoning and standard patients treating (75.59±9.85 vs. 71.11±12.01, P=0.027). Conclusion With the great short term and long term effectiveness, the PBL applied in the clinical skill training improves the students’ ability of both synthesized analyses and the integrated clinical skills such as clinical thinking and interpersonal communication, but doesn’t aim at the basic knowledge and operation skills.
ObjectivesTo investigate the current status of the clinical applicability evaluation tools, and to provide some foundation for establishment of the clinical applicability evaluation index system.Methods7 databases, 6 guideline databases and 16 academic institutions and the administrative department of health website were systematically searched from inception to April 2019. Two reviewers independently screened literature, extracted data and then included the literature related to the applicability of clinical guidelines. The CPG clinical applicability evaluation index was initially prepared through the subject comprehensive method.ResultsA total of 19 articles were finally included. Among them, there were 4 evaluation tools for the clinical applicability of the guidelines, and 15 evaluation tools for the guideline clinical applicability evaluation items. Through combing and comparison, we found that these tools had differences in evaluators, evaluation fields and items.ConclusionsThe global guidelines for clinical applicability assessment tools have different kinds of problems, such as that the tools are not targeted, the indicators are not well-formed, and the methodological knowledge requirement of the evaluators is high. There is still a lack of guidelines for clinical applicability assessment tools from target users’ view.
Perineal care is a classic topic for obstetrics. After thousands of years of practice, we have accumulated some experience and meanwhile, we are also taking some attempts. The effectiveness and reliability of these methods need evaluation. Nowadays, the best evidence comes from randomized controlled trials (RCT) and systematic reviews (SR). We searched The Cochrane Library (Issue 3, 2007), MEDLINE (Jan. 1980 to May 2007) databases and CBM-disc (Jan. 1980 to May 2007) to obtain current best evidence for perineal care.
Ethical issues in clinical research are receiving increasing attention. The application of research projects, the registration of clinical trials and the publication of scientific researches have always been involved with ethical issues. This paper elaborates ethical development and changes in Chinese clinical research from the aspects of the development of medical ethics, the establishment of ethics laws and regulations, international certification of medical ethics committee, the advantages, challenges, opportunities and innovation and development of TCM clinical research ethics as well as the certification system of TCM research ethics.
ObjectivesTo investigate the occupational stress and career burnout of postgraduates in professional degree of clinical medicine.Methods70% of postgraduates with professional degree of clinical medicine from grade 2016 to 2018 in West China Hospital of Sichuan University were sampled. The individual characteristics and occupational stress were investigated by a questionnaire, and Maslach Burnout Inventory (MBI) was used to investigate the individual career burnout. ResultsA total of 600 questionnaires were distributed and 520 valid questionnaires were retrieved, with an effective rate of 86.7%. According to the stress results, 17.5% of the students were under severe stress, 44.81% were under moderate stress, and only 1.54% were without stress. Regarding the sources of stress, 63.46% were originated from scientific research while 27.88% were originated from clinical practice. For burnout, the mean score of MBI was 40.56 with 15.00 standard deviation suggesting most of the students were in good working condition. However, a small number of students had career burnout to a certain degree and required adjustment. ConclusionsPostgraduates in professional degree of clinical medicine face the dual pressure of scientific research and clinical work. Improving the existing medical master's training system, relieving postgraduates’ stress, maintaining postgraduates’ physical and mental health are necessary and urgent. In light of this, the teaching quality of postgraduates in professional degree of clinical medicine may require improvement.
Objective To review randomized controlled trials of blood pressure (BP) lowering therapy on stroke prevention to provide evidence for clinical practice. Methods We searched Medline (1966-2003.6) and the large-sample randomized controlled trials on BP lowering regimen in patients with stroke history were reviewed. Endpoints included the ocurrance of stroke, coronary heart disease and mortality. Results Three trials of PATS, PROGRESS and HOPE were analysed. The review showed that stroke recurrent risk was reduced by 28%, CHD risk decreased by 15% and total mortality risk reduced by 11% in BP lowering treatment group compared with placebo control group. Stroke risk was reduced not only in hypertensive patients with previous cerebrovascular diseases but also in non-hypertensive patients. Conclusions BP lowering therapy is beneficial for the secondary prevention of stroke.
