Objective To compare the effectiveness of botulinum toxin type A ( BTXA) and ethyl alcohol ( EA) in treating lower extremity spasticity after stroke. Methods This was a randomized, case-control study. A to-tal of 92 eligible stroke survivors completed the study. They were randomly divided into a BTXA group of 48 and an EA group of 44 according to a random number table. The gastrocnemius, soleus and posterior tibial muscles of the af-fected limb were chosen as injection sites. The BTXA group was injected with 50 to 200 IU of BTXA ( at 50 U/ml) at one to four sites in each muscle, with a total injection dose of less than 600 U. The EA group was injected with less than 10 ml of 50% EA (0.1 to 0.5 ml at each site). Before and 2, 4 and 12 weeks after the injection, both groups were evaluated using the modified Ashworth scale (MAS), a 3 m timed up and go test (TUG), a timed 10 meter walk ( 10m-WT) and each was asked to assess their pain level using a visual analogue scale ( VAS) . Any adverse re-actions were also observed. Results Two weeks after the injection, the average MAS score of both groups had im-proved significantly compared to that before the injection. The average improvement in the BTXA group was signifi-cantly less than in the EA group. No significant differences were found in other measurements. After four weeks the average MAS score of the BTXA group was still significantly different from that before injection or from 2 weeks previ-ously, but the EA group now showed no significant difference from before the injection. The average TUG, 10m-WT and VAS scores of both groups had improved significantly compared to those of the earlier time points. Twelve weeks after the injection, the average MAS, TUG, 10m-WT and VAS scores of the BTXA were still significantly improved compared to before the injection, but in the EA group only the average score VAS reading was significantly improved. There were then significant differences between the two groups in all of the measurements. Conclusions Both BTXA and EA can relieve muscle spasticity. Both take effect within 2 weeks, but the former has fewer side effects than the latter and a longer duration of therapeutic effect.

Objective:To understand the cognition and attitude of medical staff towards medical ethics review, analyze possible influencing factors, to put forward relevant suggestions for strengthening ethical management in the future.Methods:From November 2021 to May 2022, a self-designed questionnaire and general data questionnaire on the cognition and attitude of medical staff to ethical issues in clinical research were used to investigate 408 medical staff from two first-class ternary hospitals in Hunan Province, data was analyzed to explore the respondents′ cognition and attitude, as well as related influence factors.Results:The average cognitive score of medical staff was 65.41, and the average attitude score was 91.83. Many possible influence actors regarding the cognition were identified, including degree, technical title, professional field, number of clinical research projects engaged as investigators, number of clinical research projects conducted as principle investigators, whether the hospital has established an ethics committee, and research ethics training experiences. While the influence factors of attitude were experiences of conducting and engaging in clinical research, the construction of hospital ethics committee and research ethics trainings.Conclusions:Medical staffs have the willingness to explore more research ethics knowledge, while their cognition of research ethics should be improved. Root-cause analysis should be conducted to identify influencing factors for improvement. The research management department should strengthen the publicity and training of clinical research ethics of medical staff, to improve their clinical research ethics knowledge literacy, and ensure the well-functioning of clinical research ethics review.