1.Review and reflection on the practice of pre-ethical review for drug clinical trials
Min HOU ; Xiaoyuan SHI ; Rongguo SUN ; Fang LIU ; Lei CHEN ; Zejin ZUO
Chinese Medical Ethics 2026;39(5):594-600
ObjectiveTo sort out the pre-ethical review status of drug clinical trials in a tertiary A hospital, summarize practical experience, and provide references for pre-ethical review. MethodA retrospective analysis was conducted on the ethical review of pre-ethical projects in a tertiary A hospital from 2018 to 2023. ResultsFrom 2018 to 2023, a total of 285 pre-ethical projects were reviewed in this tertiary hospital, including 79 projects where it served as the leading unit. Among these, 279 clinical trials ultimately received approval of the ethical review committee, while 6 projects were not approved due to sponsors’ refusal to modify study protocols. In terms of trial phases, phase III clinical trials constituted the largest proportion, and the oncology center was the department with the highest number of projects. In 2023, the average time for pre-ethical review projects from submission to approval was 43 calendar days, 3 days longer than for other project types. In 2023, this hospital reviewed 75 pre-ethical review projects, including 58 where it served as a participating unit. Among these, 42 projects received approval later than the leading unit, while 9 projects were approved earlier than the leading unit’s ethical approval date. Among the pre-ethical review projects applied in 2023, 70 projects obtained drug clinical trial notifications from the National Medical Products Administration, while 5 projects had unknown notification status due to the lack of ethical approval or discontinuation. Of the projects receiving approval notifications, 16 were annotated with matters requiring enhanced attention during clinical trials, and 7 necessitated protocol improvements. ConclusionThis tertiary A hospital has implemented multiple measures to optimize the management of pre-ethical review. This ethical review model does not compromise the quality of ethical review and contributes to accelerating the initiation of clinical trials. Notably, it is crucial to construct a patient-centered drug development system. Clinical trials guided by this concept align with ethical values, laying the foundation for the smooth conduct of clinical trials, assisting in the drug development process, and safeguarding patients’ medication needs.
2.Efficacy of intelligent wireless endoscopy in transurethral resection of the prostate
Chao FANG ; Zeping ZUO ; Chaozhao LIANG ; Zongyao HAO ; Hongtao YU ; Jinhai ZHU ; Yuesheng WANG
Journal of Modern Urology 2026;31(2):135-139
Objective To analyze the clinical efficacy of intelligent wireless endoscopy in transurethral resection of the prostate, so as to provide evidence for clinical application. Methods A retrospective analysis was conducted on the clinical data of 70 patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate at Tongling People's Hospital during Jan. 2023 and Dec. 2024. Based on the type of endoscopes used, patients were divided into a wireless endoscopy group and a traditional endoscopy group, with 35 patients in either group. Differences between the two groups were compared in terms of surgical preparation time, operation time, postoperative hospital stay, catheter indwelling time, intraoperative blood loss, surgical complications, and operating comfort during the procedure. Results All 70 operations were successfully completed without severe urinary incontinence. The wireless laparoscopy group demonstrated significantly shorter surgical preparation time compared to the traditional laparoscopy group [(12.14±2.39)min vs. (14.89±0.80)min, P<0.001].There was no statistically significant difference in the operation time between the two groups [(93.51±34.49)min vs. (101.71±34.87)min, P=0.326]. There were no statistically significant differences between the two groups in postoperative hospital stay, catheter indwelling time, intraoperative blood loss, and surgical complications (P>0.05). The wireless endoscopy group demonstrated significantly higher operating comfort compared to the traditional endoscopy group [(3.94±0.77) vs. (2.57±0.61), P<0.001]. Conclusion The use of intelligent wireless endoscopy for transurethral resection of the prostate is comparable to traditional endoscopy in surgical efficacy and patient safety, but it can shorten preoperative preparation time and improve operator comfort.
3.Current Status of Prediction Models of Traditional Chinese Medicine for Emerging Acute Infectious Diseases
Jiaxin ZUO ; Chengyang JING ; Tiantian ZHOU ; Fang HAN ; Di WANG ; Xing LIAO ; Jing HU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):247-254
ObjectiveTo analyze the current status of traditional Chinese medicine (TCM) prediction model research for emerging acute infectious diseases, in order to provide reference for subsequent model construction and optimization. MethodsEight databases, including PubMed, Cochrane Library, and Embase, were systematically searched to comprehensively collect Chinese and English literature on TCM prediction models for emerging acute infectious diseases. The search period ranged from database inception to July 5, 2024. Reporting quality compliance was evaluated using the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis—Traditional Chinese Medicine (TRIPOD-TCM) guideline. Risk of bias and applicability were assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). ResultsA total of 21 studies were included, comprising 11 early warning model studies, 5 diagnostic model studies, 3 prognostic model studies, and 2 prescription prediction model studies, involving 84 models in total. The diseases involved were mainly viral infectious diseases such as coronavirus disease 2019 (COVID-19) and hepatitis B. The most frequently applied TCM theory was the "five movements and six climates" theory. The most commonly used modeling method was neural network-based approaches. The most frequently reported predictive factors were meteorological variables, including daily mean temperature, wind speed, precipitation, relative humidity, and vapor pressure. In terms of reporting quality, the included studies showed poor item-level compliance, with only 13 sub-items achieving compliance rates above 50%. Overall compliance ranged from 27% to 59% across studies. Although the included studies showed relatively good applicability, all were assessed as having a high risk of bias. The main sources of bias included inappropriate handling of missing data, absence of calibration methods, and unreasonable validation strategies, indicating deficiencies across multiple stages of model development. ConclusionCurrent research on TCM prediction models for emerging acute infectious diseases exhibits distinctive modeling characteristics. These models are based on traditional TCM theories such as the "five movements and six climates", incorporate TCM-specific features as predictive variables, and use TCM syndromes as outcomes. However, they generally suffer from low reporting compliance and a high risk of bias. Future studies should systematically design model development and validation processes, adhere to TRIPOD-TCM reporting standards, and apply PROBAST or develop dedicated bias risk assessment tools for TCM prediction models to improve methodological quality and promote their translation into clinical practice.
4.Impact of peer dating behavior and cohabitation with parents on sexual behaviors among secondary vocational school students
JIA Xin, FANG Yuhang, JIN Yan, ZUO Xiayun, YU Chunyan, LIAN Qiguo, LI Lihe, HONG Ping, TU Xiaowen
Chinese Journal of School Health 2025;46(5):657-661
Objective:
To understand the moderating effect of cohabitation with parents on the association between peer dating behavior and sexual behaviors among secondary vocational school students, so as to provide a scientific basis for preventing sexual behaviors among secondary vocational school students.
Methods:
From March to April 2021, an electronic questionnaire survey was conducted among 3 180 students from 6 vocational schools in Shanghai (urban, suburban, exurban) and Shaanxi (Shangluo, Ankang, Baoji) using cluster sampling. Spearman correlation analysis was used to investigate the relationship of cohabitation with parents, peer dating behavior and sexual behaviors among secondary vocational school students. Binary Logistic regression analysis was performed to investigate the role of cohabitation with parents on peer dating behavior and sexual behaviors among secondary vocational students.
Results:
There was a significant negative between cohabitation with parents and sexual ( r =-0.04); and there was a positive correlation between peer dating behavior and sexual behaviors ( r =0.24), as well as cohabitation with parents and peer dating behavior ( r =0.04)( P <0.05). Multivariable Logistic regression analysis showed an association between peer dating behavior and the occurrence of sexual behaviors ( OR=2.79-12.95, P <0.05). Cohabitation with parents played a moderating role in the association between peer dating behavior and sexual behaviors, and a signification interaction was found between cohabitation with parents and reporting that a small part or about half of their peers had dating behavior ( OR =0.48, P <0.05).
Conclusions
The more peers dating behavior are associated with a higher risk of sexual behaviors among secondary vocational school students, and cohabitation with parents can partly reduce this risk. School and family sexuality education for secondary vocational students should be strengthened to improve their interpersonal skills and decision-making, and ability to resist peer pressure, so as to reduce their risk of sexual behaviors.
5.Construction and validation of a risk prediction model for early post-injury respiratory failure in patients with traumatic cervical spinal cord injury
Xuanxuan DAI ; Zhongqi ZUO ; Zibei DONG ; Shuang GE ; Fang WANG ; Guanyong GU ; Hangbo LI ; Liqing LI ; Tingting AN ; Lanjuan XU
Chinese Journal of Trauma 2025;41(6):549-556
Objective:To construct a risk prediction model for early post-injury respiratory failure in patients with traumatic cervical spinal cord injury (TCSCI) and validate its efficacy.Methods:A retrospective cohort study was conducted to analyze the clinical data of 393 TCSCI patients admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2020 to October 2024, including 294 males and 99 females, aged 18-82 years [59(45, 72)years]. Among them, 76 patients had respiratory failure (19.3%). The patients were randomly divided into the training set ( n=275) and validation set ( n=118) at a ratio of 7∶3. According to the presence of respiratory failure within one week after admission, 275 patients in the training set were divided into respiratory failure group ( n=53) and non-respiratory failure group ( n=222). The demographic data, injury characteristics, laboratory test results, and imaging findings of the patients were collected. Risk factors were determined through univariate analysis and multivariate Logistic regression analysis and a nomogram prediction model was constructed. The area under the receiver operating characteristic (ROC) curve (AUC) and Hosmer-Lemeshow test were used to evaluate the discrimination and calibration of the model. Decision curve analysis (DCA) was plotted to evaluate the clinical effectiveness of the prediction model. Results:The results of the univariate analysis showed that there were significant differences in history of respiratory diseases, causes of injury, Glasgow coma scale (GCS), American Spinal Injury Association (ASIA) classification, ASIA-motor score (AMS), injury severity score (ISS), clinical pulmonary infection score (CPIS), hypoproteinemia and cervical vertebra fracture and dislocation between the respiratory failure group and non-respiratory failure group in the training set ( P<0.05). The results of multivariate Logistic regression analysis indicated that GCS, ASIA classification, CPIS, and hypoproteinemia were independent risk factors for early post-injury respiratory failure in TCSCI patients ( P<0.05). Based on the above four variables, a Logistic regression equation was constructed: Logit( P)=2.361-0.675×ASIA classification+0.419×CPIS-0.358×GCS+0.854×hypoproteinemia. In the prediction model established based on this equation, the AUC was 0.96 (95% CI 0.94, 0.99) in the training set and 0.89 (95% CI 0.82, 0.96) in the validation set. In the calibration curves of the training set and validation set, the prediction curve and reference curve were approximately overlapping, with the average absolute errors of 0.04 and 0.03. DCA results demonstrated that both the training and validation sets exhibited positive net benefits when threshold probabilities fell within ranges of 0%-78% and 0%-87%, respectively. Conclusion:The risk prediction model for early post-injury respiratory failure in TCSCI patients based on GCS, ASIA classification, CPIS and hypoproteinemia has good predictive efficacy and clinical practicability.
6.Research of 3D printing model in analysis of anterior disc displacement with reduction
Bo-yu AN ; Fang-tong JIAO ; Shun ZHANG ; Wan-tong YU ; Ai-she DUN ; Zuo-qin ZHAO
Journal of Regional Anatomy and Operative Surgery 2025;34(8):653-657
Objective To deeply understand the anatomical basis of temporomandibular joint disorders,and explore and master the pathological characteristics of anterior displacement of temporomandibular joint disc through cadaveric dissection and 3D printing technology.Methods By dissecting the temporomandibular joints of 40 head and neck specimens,the bilateral structures of the temporomandibular joints were measured to obtain condyle and articular disc data.3D modeling was carried out using 3ds Max software and printed out a model of temporomandibular joint.The pathological model of the anterior disc displacement with reduction(ADDwR)was simulated by adjusting the opening degree,the position of the articular disk,and the position of the condyle of the model.Results The precise data of the right and left temporomandibular joint discs and condyle were successfully obtained by dissection and measurement.The thickness of the anterior band of left temporomandibular joint discs was(2.02±0.57)mm,the thickness of the middle band was(1.46±0.33)mm,the thickness of the posterior band was(3.00±0.46)mm,the anterior-posterior diameter was(9.60±0.72)mm,and the internal-external diameter was(17.73±0.84)mm.While the thickness of the anterior band of right temporomandibular joint discs was(1.84±0.35)mm,and the thickness of the middle band was(1.43±0.28)mm,the thickness of posterior band was(3.08±0.49)mm,the anterior-posterior diameter was(9.30±0.88)mm,and the internal-external diameter was(17.38±1.10)mm.The internal-external diameter of the left temporomandibular joint condyle was(18.97±0.41)mm,and the anterior-posterior diameter was(8.56±0.43)mm;the internal-external diameter of the right temporomandibular joint condyle was(18.86±0.75)mm,and the anterior-posterior diameter was(8.40±0.30)mm.The standard temporomandibular joint model was printed out by the measured data.The model was utilized to simulate the physiological state of temporomandibular joint under normal conditions,as well as the three pathological states of closed mouth,closed mouth to open mouth,and open mouth in the case of ADDwR.Conclusion The temporomandibular joint model can more intuitively present the changes of anatomical structure in reversible temporoman-dibular joint disorders,which is helpful for understanding and mastering the different classification of this disease.
7.Systematic review of a body image assessment tool for burn patients
Ning LIU ; Jingling LI ; Shunli ZUO ; Xiuyuan ZHU ; Yiping FANG ; Lihong QIU
Chinese Journal of Nursing 2025;60(4):478-486
Objective The measurement characteristics of body image specificity evaluation tools for burn patients were systematically evaluated,aims to provide reference for selecting appropriate assessment tools.Methods CNKI,Wanfang data knowledge service platform,VIP database,China Biomedical Literature Service system,PubMed,Embase,Web of Science,PsycINFO and CINAHL were searched by computer to collect and evaluate the measurement characteristics of burn patients'body image specificity evaluation tools from the establishment of the database to April 15,2024.There were 2 researchers who independently reviewed the collected literature,looked for the full text and extracted information.At the same time,the methodological quality and measurement performance of such assessment tools were systematically evaluated under the guidance of consensus-based standards for the selection of health measurement instrument(COSMIN)guidelines.Finally,the quality and strength were rated to form a recommendation.Results A total of 6 studies were included,including 3 evaluation tools for body image specificity of burn patients,namely the Body Image Quality of Life Inventory into Brazilian Portuguese(BIQLI-BP),Satisfaction with Appearance Scale(SWAP),and the Derriford Appearance Scale 59(DAS59).In the development of PROMs,the overall quality of BIQLI-BP,SWAP and DAS59 is"doubtful".In terms of content validity,the methodological quality of BIQLI-BP,SWAP and DAS59 was evaluated as"doubtful".In terms of construct validity,the methodological quality of SWAP and DAS59 was evaluated as"good"and"very good"respectively,while the methodological quality of BIQLI-BP was"inadequate".In terms of internal consistency,the methodological quality of BIQLI-BP,SWAP and DAS59 was"very good".In terms of stability,the BIQLI-BP and DAS59 were"unreported",and the methodological quality evaluation of the SWAP was"doubtful".In terms of criterion validity,the BIQLI-BP and DAS59 scales were"unreported",and the methodological quality evaluation of the SWAP scale was"inadequate".In terms of measurement errors,the BIQLI-BP and DAS59 scales were"unreported",and the methodological quality evaluation of the SWAP scale was"doubtful".In the aspect of hypothesis test,except that the DAS59 scale is"unreported",the methodological quality of BIQLI-BP scale is"very good"and the evaluation of SWAP scale is"doubtful".Conclusion Among the existing body image specificity evaluation tools for burn patients,the SWAP has good measurement performance and it can be recommended for the time being.The number of specific evaluation tools for body image of burn patients in China is relatively insufficient,and more localization studies should be carried out in the future.
8.Mechanism Study of Coptisine in Treating Ulcerative Colitis in Mice Based on Non-Targeted Metabolo-mics Technology
Shicai HUANG ; Bingyan TAN ; Ying ZUO ; Yujia LI ; Lianyu YUAN ; Sufen HAN ; Dong FANG
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(12):1724-1733
OBJECTIVE To investigate the effects of coptisine on endogenous metabolites in a dextran sulfate sodium(DSS)-in-duced ulcerative colitis(UC)mouse model,and to explore its potential mechanisms of action employing non-targeted metabolomics technology.METHODS SPF-grade male C57BL/6 mice were randomly divided into a control group,a model group,a sulfasalazine group(100 mg·kg-1),and low and high dose groups of coptisine groups(25,50 mg·kg-1).To induce ulcerative colitis(UC),all groups except the control group had free access to a 2.5%DSS solution for 7 days.At the same time,they also received daily intragastric ad-ministration of their corresponding treatments until the 10th day.Body weight changes,stool characteristics,and bloody stool occur-rence were recorded daily,and the disease activity index(DAI)was calculated.After the experiment,colon tissues were collected for pathological examination.Through UPLC-Q-TOF-MS/MS,non-targeted metabolomic analysis was performed to identify differential metabolites,and metabolic pathway enrichment analysis was conducted using the KEGG database.RESULTS Compared to the model group,coptisine significantly ameliorated weight loss,DAI scores,and pathological damage in colon tissues of UC mice(P<0.05,P<0.01).Metabolomic analysis identified 56 differential metabolites,mainly involved in purine metabolism,tryptophan metabo-lism,niacin and nicotinamide metabolism,glutathione metabolism,and the biosynthesis of phenylalanine,tyrosine,and tryptophan.Coptisine intervention significantly reversed the abnormal expression of these metabolites.CONCLUSION Coptisine can markedly improve metabolic disorders in DSS-induced UC mice by modulating multiple key metabolic pathways,thereby exerting a therapeutic effect.
9.Systematic review of a body image assessment tool for burn patients
Ning LIU ; Jingling LI ; Shunli ZUO ; Xiuyuan ZHU ; Yiping FANG ; Lihong QIU
Chinese Journal of Nursing 2025;60(4):478-486
Objective The measurement characteristics of body image specificity evaluation tools for burn patients were systematically evaluated,aims to provide reference for selecting appropriate assessment tools.Methods CNKI,Wanfang data knowledge service platform,VIP database,China Biomedical Literature Service system,PubMed,Embase,Web of Science,PsycINFO and CINAHL were searched by computer to collect and evaluate the measurement characteristics of burn patients'body image specificity evaluation tools from the establishment of the database to April 15,2024.There were 2 researchers who independently reviewed the collected literature,looked for the full text and extracted information.At the same time,the methodological quality and measurement performance of such assessment tools were systematically evaluated under the guidance of consensus-based standards for the selection of health measurement instrument(COSMIN)guidelines.Finally,the quality and strength were rated to form a recommendation.Results A total of 6 studies were included,including 3 evaluation tools for body image specificity of burn patients,namely the Body Image Quality of Life Inventory into Brazilian Portuguese(BIQLI-BP),Satisfaction with Appearance Scale(SWAP),and the Derriford Appearance Scale 59(DAS59).In the development of PROMs,the overall quality of BIQLI-BP,SWAP and DAS59 is"doubtful".In terms of content validity,the methodological quality of BIQLI-BP,SWAP and DAS59 was evaluated as"doubtful".In terms of construct validity,the methodological quality of SWAP and DAS59 was evaluated as"good"and"very good"respectively,while the methodological quality of BIQLI-BP was"inadequate".In terms of internal consistency,the methodological quality of BIQLI-BP,SWAP and DAS59 was"very good".In terms of stability,the BIQLI-BP and DAS59 were"unreported",and the methodological quality evaluation of the SWAP was"doubtful".In terms of criterion validity,the BIQLI-BP and DAS59 scales were"unreported",and the methodological quality evaluation of the SWAP scale was"inadequate".In terms of measurement errors,the BIQLI-BP and DAS59 scales were"unreported",and the methodological quality evaluation of the SWAP scale was"doubtful".In the aspect of hypothesis test,except that the DAS59 scale is"unreported",the methodological quality of BIQLI-BP scale is"very good"and the evaluation of SWAP scale is"doubtful".Conclusion Among the existing body image specificity evaluation tools for burn patients,the SWAP has good measurement performance and it can be recommended for the time being.The number of specific evaluation tools for body image of burn patients in China is relatively insufficient,and more localization studies should be carried out in the future.
10.Clinical Observation of Modified Zhigancao Tang in Treating Patients with Liver and Kidney Deficiency of Parkinson's Disease and Its Effect on Neuronal Signal-related Proteins
Yifo WEI ; Furong LYU ; Jia YAO ; Guonian LI ; Xianyi LUO ; Meng LUO ; Zhengzheng WEN ; Qiuqi LI ; Yihan LIU ; Linlin YANG ; Rui ZUO ; Wenxin DANG ; Fang MI ; Xiaoyan WANG ; Zhigang CHEN ; Fan LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):166-173
ObjectiveMicrotube associated protein-2 (MAP-2), alpha-tubulin (α-tubulin), and synaptophysin (SYP) are important proteins in neuronal signal communication. This paper observed the effects of modified Zhigancao Tang on the expression of serum α-Synuclein (α-Syn) and its oligomers, MAP-2, α-tubulin, and SYP of patients with liver and kidney deficiency of Parkinson's disease (PD), analyzed their correlation, and evaluated the therapeutic effect of modified Zhigancao Tang in patients with liver and kidney deficiency of PD based on α-Syn transmission pathway mediated by neuronal communication in vivo. MethodsA total of 60 patients with PD who met the inclusion criteria were randomly divided into a treatment group (30 cases) and a control group (30 cases). Both groups were treated on the basis of PD medicine, and the treatment group was treated with modified Zhigancao Tang. Both groups were treated for 12 weeks. The changes in UPDRS score, TCM syndrome score, and expression of serum α-Syn and its oligomers, MAP-2, α-tubulin, and SYP were observed before and after 12 weeks of treatment in each group. The correlation between the above-mentioned serum biological indexes and the levels of serum α-Syn and its oligomers was analyzed. ResultsAfter treatment, the TCM syndrome score, UPDRS score, UPDRS-Ⅱ score, and UPDRS-Ⅲ score of the treatment group were significantly decreased (P<0.05, P<0.01). The UPDRS score, UPDRS-Ⅱ score, and UPDRS-Ⅲ scores in the treatment group were significantly decreased compared with those in the control group after treatment (P<0.05). After treatment, the total effective rate of the control group was 63.3% (19/30), and that of the treatment group was 86.7% (26/30). The clinical effect of the observation group was better than the control group (Z=-2.03, P<0.05). The total effective rate of the observation group was better than that of the control group, and the difference was statistically significant (χ2=5.136, P<0.05). After treatment, the oligomer level of serum α-Syn and MAP-2 level in the treatment group were significantly decreased (P<0.05, P<0.01). The levels of serum α-Syn and its oligomers, as well as α-tubulin in the treatment group, were significantly decreased compared with those in the control group after treatment (P<0.05, P<0.01). Serum α-Syn was correlated with serum MAP-2 and α-Syn oligomer in patients with PD (P<0.05, P<0.01) but not correlated with serum SYP . Serum α-Syn oligomers of patients with PD were correlated with serum MAP-2 and α-tubulin (P<0.05, P<0.01) but not correlated with serum SYP level. Serum SYP of patients with PD was correlated with serum MAP-2 (P<0.05). ConclusionModified Zhigancao Tang has a therapeutic effect on patients with liver and kidney deficiency of PD by inhibiting the production of α-Syn oligomers and intervening α-Syn microtubule transport pathway in vivo.


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