1.Key Points for Quality Management in Phase Ⅰ Clinical Trials of Anti-Tumor Drugs
Li GONG ; Bin LIAO ; Jie SHEN ; Juan ZHAO ; Yi GONG ; Xiaoxiao LU ; Huiyao YANG ; Sha LI ; Yongsheng LI
Cancer Research on Prevention and Treatment 2025;52(5):347-354
Phase Ⅰ clinical trials play a crucial role in the research and development of new drugs, serving as the initial studies to assess their safety, tolerability, effectiveness, and pharmacokinetic properties in humans. These trials involve uncertainties regarding safety and efficacy. Comprehensive management of all aspects of phase Ⅰ clinical trials for anti-tumor drugs is crucial to protect the rights and safety of participants. This article provides an in-depth analysis of the key points and precautions necessary for effective quality control throughout the process. The analysis is informed by guidelines such as the “Good Clinical Practice for Drugs” “Key Points and Judgment Principles for Drug Registration Verification” “Key Points and Judgment Principles for Supervision and Inspection of Drug Clinical Trial Institutions” and the standard operating procedures for quality control of the center. Topics discussed include informed consent, inclusion criteria, experimental drugs, biological samples, adverse events, and serious adverse events. The goal is to standardize quality control in phase Ⅰ clinical trials of anti-tumor drugs, ensure the authenticity and reliability of clinical trial data, and protect the rights and safety of participants.
2."Compatibility" Relationship of Active Components and Heat-clearing and Blood-cooling Effect of Rehmannia glutinosa Roots
Yaman CHEN ; Jinpeng CUI ; Juan ZHANG ; Qingpu LIU ; Haiyan GONG ; Jingwei LEI ; Fengqing WANG ; Caixia XIE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):193-201
ObjectiveTo analyze the "compatibility" relationship of sugars and glycosides and the heat-clearing and blood-cooling effect of the roots of four varieties of Rehmannia glutinosa and provide a basis for research on the pharmacodynamic material basis and quality control of R. glutinosa. MethodsThe content of sugars and glycosides in the roots of four varieties of R. glutinosa was determined during the growth period. The principal component analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA), and the "compatibility" relationship of active components were employed to screen out the differential samples. A rat model of bleeding due to blood heat was used to verify the pharmacodynamic differences and the potential active components of differential samples. ResultsThe content and proportion characteristics of various components in roots of the four varieties of R. glutinosa during the expansion stage and the maturity stage had obvious differences. The proportion of phenylethanoid glycosides at the maturity stage was higher than that at the expansion stage. The R. glutinosa variety 85-5 had special quality characteristics among the tested varieties. All the samples alleviated the symptoms in the rat model. The effect of clearing heat and cooling blood was different between the maturity stage and the expansion stage, as well as between 85-5 samples at the maturity stage and other samples. The effect of clearing heat and cooling blood of R. glutinosa roots was the result of the combined action of multiple components in R. glutinosa roots and might be related to the high proportions of polysaccharides, iridoid glycosides, and phenylethanoid glycosides. ConclusionThe growth stage and variety affect the quality of R. glutinosa roots. The effect of clearing heat and cooling blood of R. glutinosa roots was related to the content and proportions of various components. The study can provide a basis for the basic research on the active components and quality control of R. glutinosa.
3."Compatibility" Relationship of Active Components and Heat-clearing and Blood-cooling Effect of Rehmannia glutinosa Roots
Yaman CHEN ; Jinpeng CUI ; Juan ZHANG ; Qingpu LIU ; Haiyan GONG ; Jingwei LEI ; Fengqing WANG ; Caixia XIE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):193-201
ObjectiveTo analyze the "compatibility" relationship of sugars and glycosides and the heat-clearing and blood-cooling effect of the roots of four varieties of Rehmannia glutinosa and provide a basis for research on the pharmacodynamic material basis and quality control of R. glutinosa. MethodsThe content of sugars and glycosides in the roots of four varieties of R. glutinosa was determined during the growth period. The principal component analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA), and the "compatibility" relationship of active components were employed to screen out the differential samples. A rat model of bleeding due to blood heat was used to verify the pharmacodynamic differences and the potential active components of differential samples. ResultsThe content and proportion characteristics of various components in roots of the four varieties of R. glutinosa during the expansion stage and the maturity stage had obvious differences. The proportion of phenylethanoid glycosides at the maturity stage was higher than that at the expansion stage. The R. glutinosa variety 85-5 had special quality characteristics among the tested varieties. All the samples alleviated the symptoms in the rat model. The effect of clearing heat and cooling blood was different between the maturity stage and the expansion stage, as well as between 85-5 samples at the maturity stage and other samples. The effect of clearing heat and cooling blood of R. glutinosa roots was the result of the combined action of multiple components in R. glutinosa roots and might be related to the high proportions of polysaccharides, iridoid glycosides, and phenylethanoid glycosides. ConclusionThe growth stage and variety affect the quality of R. glutinosa roots. The effect of clearing heat and cooling blood of R. glutinosa roots was related to the content and proportions of various components. The study can provide a basis for the basic research on the active components and quality control of R. glutinosa.
4.An overview of real-world study in clinical transfusion
Jiashun GONG ; Fengxia LIU ; Xueyuan HUANG ; Hang DONG ; Chunhong DU ; Juan WANG ; Rong HUANG ; Rong GUI
Chinese Journal of Blood Transfusion 2025;38(7):991-996
Real-world study (RWS), based on multi-source data from real medical environments, is gradually becoming an important supplement to traditional randomized controlled trials, and its application in the field of transfusion medicine is becoming increasingly widespread. This article systematically reviews the definition and methodological system of RWS, examines its application cases in clinical blood transfusion research, and discusses the advantages, limitations, and future research directions of RWS, aiming to provide a reference for evidence-based research in blood transfusion medicine.
5.An overview of real-world study in clinical transfusion
Jiashun GONG ; Fengxia LIU ; Xueyuan HUANG ; Hang DONG ; Chunhong DU ; Juan WANG ; Rong HUANG ; Rong GUI
Chinese Journal of Blood Transfusion 2025;38(7):991-996
Real-world study (RWS), based on multi-source data from real medical environments, is gradually becoming an important supplement to traditional randomized controlled trials, and its application in the field of transfusion medicine is becoming increasingly widespread. This article systematically reviews the definition and methodological system of RWS, examines its application cases in clinical blood transfusion research, and discusses the advantages, limitations, and future research directions of RWS, aiming to provide a reference for evidence-based research in blood transfusion medicine.
6.Analysis on Application and Funding Situation of General,Young Scholar and Regional Scholar Programs from NSFC in Field of Integrated Traditional Chinese and Western Medicine in 2023
Yuan XU ; Zipeng GONG ; Juan LI ; Jinwei ZHANG ; Xuewei LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(2):172-178
By combing the application and funding situation of general, young scholar and regional scholar programs from National Natural Science Foundation of China(NSFC) in field of integrated traditional Chinese and western medicine in 2023, this paper summarizes the distribution of supporting units, application and funding hotspots, and the problems of application and funding projects in this discipline, in order to provide a reference for applicants and supporting organizations to understand the hotspot dynamics and reporting requirements of the discipline. In 2023, the discipline of integrated traditional Chinese and western medicine received a total of 2 793 applications, and there were 1 254 applications for general programs, 1 278 applications for young scholar programs, and 261 applications for regional scholar programs. The amounts of project funding obtained by the three were 145, 164 and 35, respectively, and the funding rates were 11.56%, 12.83% and 13.41% in that order. From the situation of obtaining funding, the age distribution of the project leaders who obtained funding for the general, young scholar and regional scholar programs were mainly distributed in the age of 40-46, 30-34, 38-44 years, respectively. Within the supported programs, the Chinese medicine affiliations accounted for 55.52%. With respect to research subjects, the proportion of one single Chinese herbs, or monomers, or extracts accounted for 29.4%, but the proportion of Chinese herb pairs or prescriptions accounted for 47.1%. Research hotspots included ferroptosis, bile acid metabolism, macrophages, mitochondria, microglia, exosomes, intestinal flora, microecology and so on. The current research mainly focused on the common key problems of the advantageous diseases of Chinese and western integrative medicine, but still need to be improved in the basic theories of Chinese and western medicine and multidisciplinary cross-disciplinary research.
7.Predictive value of D-dimer for futile recanalization after mechanical thrombectomy in patients with acute ischemic stroke
Qianwen WANG ; Yuhui CHEN ; Jiawen YIN ; Jinyu QIAO ; Peng QI ; Juan CHEN ; Tao GONG
Chinese Journal of General Practitioners 2024;23(3):279-284
Objective:To investigate the predictive value of preoperative D-dimer level for futile recanalization (FR) after mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS).Methods:It was a nested case-control study. A total of 116 patients with large vessel occlusion (LVO) stroke, who underwent successful recanalization (modified Thrombolysis in Cerebral Infarction, mTICI≥2b) after MT at the Stroke Unit of Beijing Hospital from August 2018 to January 2022,were consecutively enrolled, including 72 males (62.1%) with the age of (72.8±13.1) years. According to the 3-month modified Rankin Scale (mRS) score after MT, patients were divided into the meaningful recanalization group (mRS 0-2, n=41) and the futile recanalization group (mRS 3-6, n=75). The baseline clinical data of enrolled patients was collected. Logistic regression analysis was used to identify the independent risk factors for FR after MT in patients with AIS. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of D-dimer for FR. Results:Multivariate logistic regression analysis showed that high baseline systolic blood pressure (SBP) ( OR=1.038, 95% CI: 1.012-1.065, P=0.004), baseline National Institutes of Health Stroke Scale (NIHSS) score≥12 ( OR=10.157, 95% CI: 3.624-28.470, P<0.001) and high preoperative D-dimer level ( OR=4.536, 95% CI: 1.379-14.922, P=0.013) were independent predictors of FR after MT in AIS patients with LVO. ROC curve analysis indicated a good predictive value of preoperative D-dimer for the occurrence of FR ( AUC=0.733, 95% CI: 0.638-0.829, P<0.05), the optimal cut-off value of D-dimer was 2.65 μg/L(Lg), with the Youden index, sensitivity, specificity and accuracy of 0.435, 53.3%, 90.2% and 66.4%, respectively. Conclusion:High preoperative D-dimer level is an independent predictor of futile recanalization after MT in AIS patients with LVO, which shows good predictive ability for futile recanalization.
8.Comparison of Differential Saponin Contents and Pro-angiogenic Activities on Zebrafish Between Freeze-dried and Sun-dried Panacis Quinquefolii Radix Decoction Pieces
Juan SHAO ; Mengdan XU ; Xuejing ZHANG ; Yunlong GUO ; Guangzhi CAI ; Jiyu GONG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(17):185-192
ObjectiveTo analyze and determine the differential components of freeze-dried and sun-dried Panacis Quinquefolii Radix(PQR), and to compare the differences in their pro-angiogenic activities. MethodFingerprints of freeze-dried and sun-dried PQR were established based on ultra performance liquid chromatography(UPLC), and chemometrics methods such as principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were combined to determine the differential saponin composition of the two decoction pieces, and six representative saponins were selected and their contents in freeze-dried and sun-dried PQR were determined by UPLC. Transgenic zebrafish line Tg(fli1a∶EGFP) embryos fertilized for 24 h were selected, and different doses of 70% methanol extracts of freeze-dried and sun-dried PQR(10, 30 mg·L-1) were used to intervene in normal zebrafish and in a zebrafish model of intersegmental vascular(ISV) injury induced by vascular endothelial growth factor(VEGF) receptor tyrosine kinase inhibitor Ⅱ(PTK787), then the development of subintestinal vein(SIV) and ISV of zebrafish was observed, SIV diameter, mean number of crossings and mean number of germinations were determined, and the ISV vascular index was calculated, in order to compare the pro-angiogenic activities of the two decoction pieces. ResultThe similarity of the fingerprints of freeze-dried and sun-dried PQR decoction pieces was>0.950, and 17 common peaks were identified, of which 6 common peaks were designated as peak 6(ginsenoside Rg1), peak 7(ginsenoside Re), peak 8(ginsenoside Rb1), peak 11(ginsenoside Rc), peak 13(ginsenoside Rb2), and peak 16(ginsenoside Rd), respectively. A total of 11 differential saponin components were screened by PCA and OPLS-DA, indicating that there were some differences in the contents of the components in the two decoction pieces. The results of determination showed that the contents of ginsenosides Rg1, Re, Rb1 and Rb2 in freeze-dried PQR were higher than those in sun-dried PQR, while the contents of ginsenosides Rc and Rd were lower than those in sun-dried PQR(P<0.05, P<0.01). In the study of the pro-angiogenic effect on normal zebrafish embryos, compared with the blank group, and the SIV vessel diameter, mean germination rate and mean crossover rate were significantly higher in the high-dose groups of freeze-dried and sun-dried PQR(P<0.01), and the vessel diameter, mean numbers of crossings and germinations in the freeze-dried PQR group were higher than those of the sun-dried PQR group(P<0.05). In the study of the pro-angiogenic effect on zebrafish embryos with ISV injury, the development of ISV in the model group was significantly inhibited when compared with the blank group, compared with the model group, different dose groups of freeze-dried and sun-dried PQR could promote the growth and sprouting of ISV, and the number of normal blood vessels in the freeze-dried PQR group was significantly higher than that in the sun-dried PQR group at the same dosage(P<0.05). ConclusionFreeze-drying can effectively avoid the loss and secondary transformation of ginsenosides in PQR, and its angiogenic activity is better than that of sun-dried PQR, which can provide a reference for the production and development of high-quality PQR decoction pieces.
9.Analysis on Determination and Quantity Transfer of Standard Decoction of Ginseng Radix et Rhizoma by Fresh and Traditional Cutting
Xuejing ZHANG ; Mengdan XU ; Xiaokang LIU ; Juan SHAO ; Mengqi LU ; Xiaoyan XIE ; Guangzhi CAI ; Jiyu GONG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(9):132-140
ObjectiveTo analyze the quantity-quality transfer of standard decoction of Ginseng Radix et Rhizoma(GRR) decoction pieces produced by fresh and traditional cutting, and to provide reference for quality control and application development of the decoction pieces produced by fresh cutting. MethodTen batches of representative GRR decoction pieces produced by fresh and traditional cutting and their standard decoctions were prepared by standard process, and high performance liquid chromatography(HPLC) fingerprint of the standard decoction was established and performed on an Agilent EC-C18 column(4.6 mm×150 mm, 2.7 μm) with acetonitrile(A)-0.1% phosphoric acid aqueous solution(B) as the mobile phase for gradient elution(0-23 min, 18%-21%A; 23-35 min, 21%-28%A; 35-80 min, 28%-32%A), and the detection wavelength was 203 nm. Then similarity evaluation, principal component analysis(PCA) and partial least squares-discriminant analysis(PLS-DA) of fingerprint of the standard decoction were performed to screen the differential components with variable importance in the projection(VIP) value>1. Quantitative analysis was carried out on the screened known differential components, and combined with the indicators of the dry extract rate and the transfer rate, to explore the differences in the quantity-quality transfer between the standard decoction of GRR decoction pieces produced by fresh and traditional cutting. ResultThe fingerprint similarity of the standard decoction of GRR decoction pieces produced by fresh and traditional cutting was more than 0.950, and 18 common peaks were identified, including 9 identified common peaks. The results of PCA and PLS-DA showed that there were some differences in the contents of index components between the two standard decoctions. The contents of ginsenoside Rg1, Re and Ro in GRR decoction pieces produced by fresh cutting were higher than those in traditional decoction pieces, while the contents of ginsenoside Rb1, Rc , Rb2 and Rd were lower than those in traditional decoction pieces. The contents of ginsenoside Rg1, Re, Rb1 and Ro in the standard decoction of GRR decoction pieces produced by fresh cutting were higher than those in the standard decoction of traditional decoction pieces, while the contents of ginsenoside Rc , Rb2 and Rd were comparable between the two standard decoctions. Compared with the standard decoction of the traditional decoction pieces, the average transfer rates of ginsenoside Rg1, Rb1, Rc, Rb2 and dry extract rate of the standard decoction of GRR decoction pieces produced by fresh cutting were significantly increased(P<0.05), and the average transfer rate of ginsenoside Re and Rd also increased, but the difference was not statistically significant. ConclusionThe dry extract rate, content and transfer rate of index components of standard decoction of GRR decoction pieces produced by fresh cutting are better than those of the standard decoction of traditional decoction pieces, which can provides data support for the subsequent clinical application of fresh cutting products.
10.Immune Cell-Mediated Effect of Lipid Profile on Colorectal Cancer:A Two-Step,Two-Sample Mendelian Randomization Study
Wanli GONG ; Yaqi HOU ; Yue WANG ; Yuan LI ; Rongxuan QI ; Qi YU ; Juan ZHANG
Cancer Research on Prevention and Treatment 2024;51(10):831-839
Objective To elucidate the bidirectional causal relationship between lipid profiles and colorectal cancer(CRC)by using the two-sample and two-step Mendelian randomization(MR)methods,and to explore the mediating role and proportion of immune cells as intermediary factors.Methods The pooled statistical data related to the study were screened,and 179 lipids and CRC were analyzed using two-sample and two-step MR with the inverse variance weighted method.Simultaneously,the causal effect was verified via Bayesian weighted MR.Two-step MR analysis was conducted to determine whether a mediated effect was exerted on immune cell traits.Sensitivity,heterogeneity,and pleiotropy analyses were performed to verify the reliability of the study results.Results The causal relationship between nine lipid traits and CRC was preliminarily identified,and no reverse causal effect was found(P>0.05).The validity of the results was verified via Bayesian weighted MR(P<0.05).Twenty-seven types of immune cells were suggested to exert a causal effect on CRC.The causal effect of phosphatidylcholine(O-18:2_20:4)on CRC was determined via mediation analysis(OR:0.8579,95% CI=0.7395-0.9952,P=0.0429).The CD127-mediated proportion on CD45RA+CD4+T cells was 9.14% (β=-0.1052,P=0.0155).Conclusion A causal relationship exists between lipid traits and CRC,and the intervention of CD127 on CD45RA+CD4+T cell helps phosph-atidylcholine reduce the risk of CRC.

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