ICH GCP requires that all information of clinical trial should be recorded, processed, and stored in a way that allows the accurate reporting, interpretation and verification. A trial master file (TMF) contains all paper or electronic records/documentations related to a clinical trial. As a tool of the retrospective analysis, the TMF profile should be able to reproduce the full procedure of the trial completely. As a part of TMF profiles, both the accuracy and completeness of clinical data management documentation are important in data integrity. It is helpful to learn the workflow of clinical data management in different stage of a clinical trial, to understand which documents are essential, and why the documentation of clinical data management is important for data integrity. This paper elaborates how to perform the good documentation practice of clinical data management, and suggests that both the precise and efficient document management and regular quality control may ensure the high quality of clinical data documentation management on the basis of an intensive awareness of the overall process of clinical data management.

Objective To study the distribution of rifampin(RFP), isoniazid(INH) and pyrazi-namide(PZA) in the focus of spinal tuberculosis in order to provide the regimen of chemotherapy and surgi-cal treatment of spinal tuberculosis. Methods Twenty-four patients with spinal tuberculosis were divided into sclerotic group or non-sclerotic group according to the radiographic features of lesion. All patients re-ceived chemotherapy with 2SHRZ/2.5 H2R2Z2 for a duration of 4.5 months. 4 weeks after chemotherapy, all patients underwent surgery and specimen of serum, ilium and vertebral tissues including sclerotic wall, sub-normal osseous tissue, focus inside sclerotic wall (sclerotic group) and destructive focus, peripheral subnor-mal osseous tissue (non-sclerotic group) were obtained during operation at 120-130 and 180-190 minutes after oral intake in the morning respectively. The levels of 3 drugs in the specimen were measured using HPLC method. Results 1) The concentration levels of INH and PZA in serum were similar to the data in the literature, but the level of RFP was only 75% of that in the literature. The levels of 3 drugs in osseous tissue were significantly less than those of blood. 2) Concentrations of isoniazid and rifampicin in self-control ilium and sub-normal bone tissue were within or exceeded the bactericidal concentration values,and pyrazi-namide was five fold of it's minimal inhibitory concentration (MIC) in acid cellular condition. There were no significant differences between sub-normal bone and self-control ilium of 3 drugs concentration. 3) Concen-tration of 3 drugs in sclerotic bone wall were approximate to MIC respectively in sclerotic group and much lower than sub-normal bone. There was no drug distribution of focus inside sclerotic bone wall. 4) RFP and PZA in focus of non-sclerotic group corresponded to the levels of MIC respectively, though much lower than in other parts of vertebral tissues, but the INH in focus was of bactericidal level. Conclusion The sclerotic bone of affected vertebra plays an important role to block the drug's penetration into tuberculosis focus.

Objective To develop the cDNA microarray for the combined detection of hepatitis virus, and to study the feasibility of applying the microarray in clinical setting. Methods For the small and simple genome of HBV and HDV, the specific primers of PCR were designed with Primer Premier 5.0 program according to the conserved region of HBV and HDV, and 10 and 4 gene fragments were obtained respectively, which could be used as the probes of gene chip. As for the complex genome of HCV, the technique of restriction display PCR (RD-PCR) was employed. Some of gene fragments were selected which were comparatively more specific and sensitive as microarray probes. In order to explore the experimental conditions of microarray in vitro detection, three types of gene chip were prepared successively including HBV and HDV simultaneous detection, HCV detection and modified HCV detection. Results The hybridized signals on the gene chip showed that the effect in detection was satisfactory. Through the prepared gene chips mentioned above, some probes with good quality were selected and the microarray was prepared for HBV, HCV and HDV simultaneous detection. The diagnostic capability of the microarray was evaluated following the washing and scanning steps. Linearity: Serial dilutions of the target DNA or cDNA showed that a strong linear relationship existed between the various concentrations of target DNA or cDNA and the fluorescence intensities obtained from microarray assay (r=0.990 2, r=0.992 1, r=0.981 9), and that the detection range for the microarray was from 104 to 1011 copies/ml. Specificity: Samples from other viruses such as YFV, JET and DV were also subjected to the test and the results were all negative. Reproducibility: The reproducibility of this assay system was evaluated by repeated measurements, and the within-run coefficient of validation of HBV, HCV and HDV were 7.1%, 7.2% and 6.6%, respectively, while the between-run coefficient of validation was 7.9%, 8.2% and 7.6%, respectively. Accuracy: By using the BLAST and the GenBank database, the identity of the obtained sequences including 16 fragments of PCR, 24 RD fragments of HCV and some positive serum samples were verified, each sequenced product was confirmed to be a genome fragment of expected size. In order to fulfill the request of clinical diagnosis, a modified protocol for microarray detection was established. This new protocol consisted of two hours of hybridization, omitting the steps of prehybridization and purification of samples, and the hybridization temperature was elevated from 42℃ to 52℃, et al. The whole protocol could be completed in less than 8 hours. 98, 42 and 5 serum samples from hepatitis B, C and D patients and 130 samples from healthy people were analyzed, respectively, by microarray assay and real-time PCR (Taqmam method). There was a significant correlation between the results of these assays (HBV, r=0.985 4 and HCV, r=0.958 2, P

Objective To investigate the clinic effect of trans-artery intrahepatic transplantation of porcine islet in type 1 diabetic patients. Methods Four patients with type 1 diabetes were perfused newborn porcine islets through the hepatic artery.Fasting blood glucose(FBS), postprandial blood glucose (PBS), HBA1,dose of insulin and function of liver and kidney were measured before and after the transplantation.Results The levels of FBS,PBS and HBA1 were 7 4～13 5mmol/L,7 8～18 6mmol/L and 7 8～12 0mmol/L respectively before the transplantation. During one and half years after transplantation, the levels of FBS,PBS and HBA1 were 3 3～7 1mmol/L,6 0～8 8mmol/L and 6 4～7 6mmol/L respectively with notably reduced dosage of insulin(32～58%).The function of liver and kidney of the patients remained normal.Conclusions Trans-artery intrahepatic transplantation of porcine islet is effective and safe for type 1diabetic treatment.

Objective To establish a method for determining the content of Naringin and Hesperidin in Zengshi Keli by HPLC. Methods The Kromasil C18 column with acetonitrile-water-phosphoric acid (20∶80∶0.02) as the mobile phase was used. The flow rate was 1.0 mL/min, the detective wavelength was 283 nm, the temperature of column is 35 ℃. Results The calibration curve were linear in the range of 0.178 5～0.892 5 ?g for Naringin and 0.073 68～0.368 4 ?g for Hesperidin (r=0.999 9) respectively. The average recovery was 97.24% (RSD=1.21%) and 96.95% (RSD=1.49%) respectively. Conclusion The method was simple, accurate, reproducible and can be used for quality control of Zengshi Keli.

Objective To study the diagnosis and therapy of Hashimoto's disease (HD) with thyroid nodule. Methods The clinical data of 187 patients with nodulous Hashimoto's disease who had operation in our hospital from 1995 to 2008 were analysed retrospectively. Results The nodules coexisting with Hashimoto's disease were thyroid carcinoma, nodular goiter, thyroid follicular adenoma and lymphoma accounting for 11.2% (21/187), 26.7% (50/187), 15% (28/187) and 1.6% (3/187) respectively. Conclusions HD patients with thyroid nodules especially the single nodule that can not be distinguished from cancer should have operation in time. Ultrasound guided needle aspiration will be helpful for the preoperative diagnosis and the frozen section may guide the surgical modality.

This list of clincal data management documentation is to ensure standardized and adequate archival of trial documents and records in clinical data management, which is applicable to all of phase I-IV clinical trials.

Intravenous thrombolysis is the only treatment that has the evidence of evidence-based medicine in acute ischemic stroke. However, the narrow time window has limited the treatment opportunities of many patients. Transcranial ultrasound thrombolysis is a very promising thrombolysis-assisted method, and transcranial ultrasound plus microbubble-assisted thrombolysis is the research hotspot in recent years. At present, more suitable ultrasonic instruments for thrombolysis and a number of ways of ultrasound-assisted thrombolysis are being developed.

Objective To investigate the differences in the structures,numbers and phenotypes of the dendritic cells (DCs)at different stages in colorectal cancer (CRC)tissue,and to explore the effect of DCs in the occurrence and development of CRC.Methods 20 cases of CRC tissue were chosen as CRC group,other 20 cases of corresponding para-cancer tissue were chosen as control group.Immunohistochemical staining was used to detect the distribution, the structures,the number of positive cells at different stages;Western blotting was used to detect the expressions of CD1a and CD83.Results The results of immunohistochemical staining showed that DCs scattered among glands or vessels in both groups;the CD1a+imature DCs (imDCs)were round and oval,dendritic processes were faintly visible in both groups,and the number of CD1a+imDCs in experimental group was significantly higher than that in control group (P<0.01).The CD83+ mature DCs (mDCs)were irregular,branched in both groups,and the number of CD83+mDCs in CRC group was significantly lower than that in control group (P<0.01).The results of Western blotting method showed that the expression of CD1a protein was higher and the expression of CD83 protein was lower in CRC group than control group (P<0.01).Conclusion CD1a+imDCs may play important roles in promoting the occurrence and development of CRC;CD83+mDCs may inhibit the occurrence and development of CRC.

Objective To evaluate the clinical diagnostic contribution of 18 F-FDG PET/CT in giant cell arteritis with initial presentation as fever of unknown origin (FUO).Methods Eight cases with initial presentation as FUO diagnosed with the contribution of PET/CT were retrospectively studied in Peking Union Medical College Hospital.The radiologic manifestations of PET/CT were analyzed.Results Eight patients (4 men and 4 women) with average (63 ± 7) years (range from 55-75 years) were included in our study based on the criteria.Non-specific clinical symptoms were common in these patients,including fatigue,night sweat and weight loss.They all suffered from anemia of chronic disease.Not surprisingly,the inflammatory parameters were elevated significantly in all patients.The medical history,physical examination and routine lab and radiologic examinations couldn't reveal the causes of fever.PET/CT was performed in all of them,which demonstrated intense 18F-FDG uptake in the area of aorta and its major branches with maximal standard uptake value (SUVmax) 2.1-4.6 (3.6 ± 0.9).Immunosuppressive agents were effective to control the inflammation activity.The SUV decreased significantly after treatment in the follow-up PET/CT.Conclusions PET/CT has demonstrated high yield of diagnostic contribution in giant cell arteritis with initial presentation as fever of unknown origin.As to elderly FUO patients presenting with prominent inflammatory reaction,PET/CT may provide potential value to differentiate diagnosis from maligancies.