Objective To investigate the current work situation of clinical research coordinators(CRCs)and to offer proposals for optimization and improvement.Methods An online-questionnaire was used to survey the out-of-hospital CRCs assigned by Site Management Organization(SMO)in 23 clinical trial sites in Shanghai.Results CRCs were mainly female(91.09%)and 50.78%of the employees aged between 25 and 29 years old.Most CRCs(49.61%)had a nursing background.The average score of CRC professional identity was 66.45.Among the five dimensions of professional identity,the mean score of CRC occupational social cognition was the highest,while the mean score of occupational self-reflection was the lowest.The mean score of job satisfaction was 33.51,and the mean score of intrinsic satisfaction was the highest in the three dimensions of job satisfaction,and 55.18%CRCs had considered turnover.Among the 288 people considering turnover,64.24%were due to income not meeting expectations and a low chance of promotion.CRCs faced various difficulties such as difficulty in trial projects,difficulties in project execution,and weak professional skills.Conclusion Current status and career development bottleneck of out-of-hospital CRCs are clarified through the investigation.And countermeasures and suggestions are put forward from three aspects,including the state,profession and individuals in view of CRC shortage and its career development dilemma.

Social isolation represents the development of a certain level, either partial or complete, of deprivation of socialization and may have adverse effects in many aspects for the elderly, which can be physiological, psychological and social.Meanwhile, during the course of human life, aging becomes an inevitable process and brings about changes in cognitive ability, which become an important focus of our attention.This paper reviews the research progress on the relationship between social isolation and cognitive ability in the elderly, in order to provide a new perspective for future research on social isolation and cognitive ability in the elderly and also to offer new insight on how to construct a model of intervention and health management for the elderly population with social isolation.

Objective: To investigate the coagulation function in patients with acute-on-chronic liver failure (ACLF) patients using thromboelastography (TEG), and to comprehensively and dynamically evaluate patients’ bleeding and coagulation status. Methods: The clinical data of ACLF patients were collected, and TEG was used to evaluate whole blood clotting kinetics in these patients. Routine biochemical parameters were measured, and complications were evaluated. The t-test was used for comparison of continuous data, the chi-square test was used for comparison of categorical data, and the Pearson correlation coefficient was used for correlation analysis. P < 0.05 was considered statistically significant. Results: A total of 60 patients (39 male and 21 female patients) were enrolled, with a mean age of 47.20±16.20 years. The TEG results showed that all patients had normal thrombokinetics, but TEG parameters were correlated with coagulation function, markers of systemic inflammatory response syndrome, laboratory markers, and prognosis. The patients with a higher R value had higher risks of infection (6.23±2.91 vs 4.74±1.12, P = 0.009), hepatorenal syndrome (5.64±2.54 vs 3.21±1.43 P < 0.01), and bleeding (6.71±3.51 vs 4.80±1.63, P = 0.01), and the patients with a lower K value (0.72±1.36 vs 1.64±1.43, P = 0.02), an increased α-angle (63.33°±10.02° vs 56.62°±12.13°, P = 0.03), and an increased MA (56.83±11.07 vs 50.40±10.81, P = 0.03) had increased risks of hepatic encephalopathy. Conclusion ACLF patients have low coagulation function, and TEG truly reflects the "rebalance" status of this low level. Abnormal TEG parameters suggest increased risk of complications in these patients, indicating a poor prognosis.