1.Documentation archiving in clinical data management.
Acta Pharmaceutica Sinica 2015;50(11):1410-4
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.
2.Intrahepatic Transplantation of Porcine Islet to Four Patients with Type 1 Diabetes
Zhaohui MO ; Wei WANG ; Bing LI
Journal of Chinese Physician 2001;0(10):-
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.
3.Preparation and clinical application of cDNA microarray for combined detection of hepatitis virus
Zhaohui SUN ; Shuyan WANG ; Min WEI
Medical Journal of Chinese People's Liberation Army 2001;0(11):-
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
4.Measurement of the concentration of three anti-tuberculosis drugs in the focus of spinal tuberculosis and its clinical significance
Zhaohui GE ; Zili WANG ; Minji WEI
Chinese Journal of Orthopaedics 2000;0(02):-
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.
5.Determination of Naringin and Hesperidin in Zengshi Keli by HPLC
Zhaohui GUO ; Shuchang WEI ; Xiaomei OUYANG
Chinese Journal of Information on Traditional Chinese Medicine 2006;0(07):-
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.
6.Surgical treatment of Hashimoto's disease with thyroid nodules
Jin CHEN ; Zhaohui WANG ; Wei WANG
Journal of Endocrine Surgery 2009;3(6):409-411
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.
7.Master documentation and records in the clinical data management.
Hualong SUN ; Gang XU ; Wei LI ; Zhaohui WEI ; Li DING
Acta Pharmaceutica Sinica 2015;50(11):1365-6
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.
8.Advances in radionuclide molecular imaging of pancreatic β-cells
Ye LIU ; Wei FANG ; Tianpei HONG ; Zhaohui ZHU ; Haining WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2013;(1):74-78
In both type 1 and type 2 diabetes mellitus,β-cell mass (BCM) is lost.Various treatments are developed to restore or reconstruct BCM.The development of non-invasive methods to quantify BCM in vivo offers the potential for early detection of β-cell dysfunction prior to the clinical onset of diabetes.PET imaging with radioligands that directly target the pancreatic β-cells appears promising.The ability to determine the BCM has been investigated in several targets and their corresponding radiotracers,including radiolabeled receptor ligands,antibodies,metabolites and reporter genes.Therefore,we summarize the recent progress in radionuclide molecular imaging of pancreatic β-cells.
9.cAMP/PKA signal activation prevents chemical-induced podocyte injury
Kai WEI ; Xiaoying LI ; Zhaohui NI ; Hua TAO ; Leyi GU
Chinese Journal of Nephrology 2013;29(10):754-760
Objective To investigate the role of activated cylic AMP(cAMP) signaling in chemical-induced podocyte injury.Methods Eight-weeks-old male BalB/C mice were randomly divided into three groups:control group,Adriamycin (ADR) group and Forskolin+ADR group.ADR nephropathy models were established by tail intravenous injection,and part of them were injected Forskolin,an agonist of adenylate cyclase,intraperitoneally.Phosphorylation of cAMP response element binding protein (CREB) was detected by laser confocal microscopy,morphology of foot processes were determined with transmission electron microscope,and WT-1 expression in glomeruli were detected by immunohistochemistry.Conditionally immortalized podocytes were treated with puromycin aminonucleoside (PAN),Exchange protein directly activated by cAMP (Epac) agonist 8-pCPT-2-O-Me-cAMP (2Me),protein kinase A (PKA) antagonist H89 and its agonist pCPT-cAMP(pCPT).Western blot was used to detect the expression levels of Epac,caspase3 and cleaved caspase3.PKA activity was assayed using cAMP-dependent protein kinase detection system.Cell viability was determined by a cell count kit and podocyte apoptosis was estimated by TUNEL staining.Mitochondrial membrane potential was evaluated by JC-1 staining.Results (1)Compared with ADR group,the urine albumin decreased significantly (P < 0.05) among Forskolin + ADR group and the WT-1 positive cells per glomerulus increased obviously (P < 0.05).(2)PAN decreased podocyte number in a time-dependent manner (P < 0.05),pre-treatment with pCPT obviously inhibited PAN induced podocyte decrease (P <0.05),but H89 prevented the effect of pCPT in a dose-dependent manner (P < 0.05).(3)JC-1 staining showed that the percentage of podocyte with green fluorescence for control,PAN and pCPT+PAN group were (12.67±2.15)%,(31.35±4.60)% and (16.96 ± 2.51)% respectively (P < 0.05),and pretreatment with H89 inhibited the effect of pCPT (P < 0.05).(4) PAN promoted podocyte apoptosis and cleaved caspase3 expression (P < 0.05),and pretreatment with pCPT significantly prevented PAN-induced podocyte apoptosis and cleaved caspase3 expression (P < 0.05).Conclusions cAMP signaling activation ameliorated podocyte injury in ADR nice and PAN-induced podocyte apoptosis,and cAMP/ PKA pathway may mediate these processes.
10.The value of 18F-FDG PET/CT in diagnosing giant cell arteritis presenting as fever of unknown origin
Yan LIU ; Wei ZHANG ; Zhaohui ZHU ; Xinping TIAN ; Huanling WANG
Chinese Journal of Internal Medicine 2014;53(9):701-705
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.