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.

This study aimed to design and synthesize a series of novel photocaged compounds based on the precise binding mode of cyclin-dependent kinase 2 (CDK2) inhibitor AT7519 with its target, to achieve precise optical control over molecular activity. Using AT7519 as the structural foundation, different types of photoremovable protecting groups were introduced at its key interaction sites (the NH of the pyrazole ring and the NH of the piperidine ring), resulting in the synthesis of eight dual-photocaged compounds. Their structures were confirmed by NMR and mass spectrometry, and their photochemical properties—including photolysis wavelength, photolysis time, and photolysis efficiency—were systematically evaluated. The optically controlled inhibitory effects of the compounds on HCT116 cell proliferation were assessed using MTT assay. The photoresponsive characteristics of the photocaged compounds were significantly influenced by the type of photoremovable protecting group and its introduction site. Among them, compounds 1a, 1b, and 2d exhibited excellent photolysis efficiency, each achieving a rate exceeding 90%. Particularly, compounds 1b and 2d demonstrated excellent optically controlled activity: under dark conditions, their half maximal inhibitory concentration (IC50) values were both greater than 150 µmol/L, indicating negligible cell proliferation inhibitory activity; however, upon irradiation, their cell proliferation inhibitory activity significantly increased, with IC50 values comparable to those of the positive control AT7519. The obtained compounds 1b and 2d possess excellent optically controlled properties, and can be further investigated as potential candidates for optically controlled CDK2 inhibitors.

The endochondral ossification of the growth plate is crucial for the longitudinal growth of long bones. Mechanical loading plays an important regulatory role in endochondral ossification. Absence or improper mechanical loading can inhibit growth plate development, while moderate mechanical stimuli promote chondrocyte proliferation and differentiation, thereby facilitating long bone growth. Mechanosensitive structures, such as primary cilia, mechanosensitive ion channels, integrins, and the cytoskeleton, play key roles in the regulation of mechanical loading. This review summarizes how mechanical loading influences growth plate endochondral ossification and discusses potential underlying mechanisms, offering theoretical insights for the management and research of bone development disorders in children and adolescents.

In the context of an aging society,the number of elderly cancer patients is constantly increasing,and geriatric oncology has garnered significant attention in recent years.Given the heterogeneity in the health status of older patients,it has become increasingly important to provide individualized diagnosis,treatment,follow-up,and care.Thus,it must be emphasized the Comprehensive Geriatric Assessment(CGA)for elderly patients,which encompasses their physical function,nutritional status,cognitive function,emotional state,comorbidities,polypharmacy,social situation,and treatment preferences.This article provides consensus recommendations on CGA tools for elderly patients prior to anticancer treatment,offering valuable references and insights for clinical practice in China.

To investigate the effectiveness of a self-developed intelligent medical record writing assistant in enhancing the efficiency of discharge record writing and improving the quality of discharge records, and to assess physicians' satisfaction with the assistant.

Objective To analyze the current quality of treatment for hospitalized cancer patients in Bei-jing,identify major issues in treatment practices,and propose improvements.Methods Nine hospitals in Beijing were selected for examination.Expert on-site interviews and medical record sampling were conducted.The"Bei-jing Cancer Diagnosis and Treatment Quality Control Checklist"was used to assess the hardware,management,anti-cancer drug therapy,radiation therapy,and surgical treatment during cancer treatment at these hospitals from January to October 2023.The relevant problems were analyzed.Results Among the nine hospitals,two(22.2％)were equipped with laminar flow rooms,and three(33.3％)had intravenous drug preparation centers.In terms of institutional management,seven hospitals(77.8％)had standardized anti-cancer drug prescription authority management,eight(88.9％)had complete emergency plans,and five(55.6％)had oncology specialist pharmacists.Regarding anti-cancer drug therapy,the areas with higher completion rates included pathology diag-nosis support(97.6％),routine pre-treatment examinations(96.3％),adverse reaction evaluation(92.7％),discharge summaries(95.1％),and admission records(91.5％).However,the accuracy of tumor staging before treatment(70.7％)and the evaluation of therapeutic efficacy after drug treatment(76.9％)needed improvement.The oncology specialty significantly outperformed the non-oncology specialty in terms of the accuracy rate of TNM staging(86.0％vs.46.9％,P＜0.001),the completeness of informed consent forms(100％vs.68.8％,P＜0.001),the completeness of drug indication evaluation(96.0％vs.78.1％,P=0.025),the completeness of admission medical history records(98.0％vs.81.3％,P=0.008),the rationality of drug dosage(96.0％vs.75.0％,P=0.005),the rationality of drug infusion time(100％vs.62.5％,P＜0.001),and the rationality of the order of drug infusion(100％vs.87.5％,P=0.010).Although the quality of radiation therapy was high,the subsequent evaluation of therapeutic efficacy(39.3％)requires enhancement.In surgical treatment,the preoper-ative pathology diagnosis support rate(78.1％)and the accuracy of tumor staging(37.5％)were relatively low,indicating issues with incomplete preoperative evaluation and the absence of multidisciplinary discussions.Conclusions There remains significant room for improvement in the quality of cancer treatment in China.It is recommended to standardize tumor staging assessment processes,strengthen entry assessments for non-oncology departments,promote the implementation of multidisciplinary treatment models,and establish a multi-department collaborative management model.Continuous monitoring of cancer diagnosis and treatment quality indicators is es-sential to promote ongoing improvements in cancer treatment quality.

Objective To explore the effect of resistance exercise on glycolipid metabolism in over-weight or obese people,with the aim of providing reference for the clinical development of appropriate resist-ance exercise programs.Methods PubMed,Cochrane Library,EmBase,Web of Science,CNKI,Wanfang Data Knowledge Service Platform and VIP database were systematically searched to obtain the relevant litera-ture on the effects of resistance exercise on glucose and lipid metabolism from the establishment of the library to December 31,2023 in overweight and obese populations.The type of literature was limited to randomized controlled studies in which the exercise intervention included resistance exercise in the test group but did not include resistance exercise in the control group.The literature was screened by 2 researchers according to in-clusion and exclusion criteria and relevant data were extracted.Meta-analysis of included literature was per-formed using RevMan 5.3 software,and publication bias was assessed using funnel plots.Results A total of 17 papers and 700 study subjects were included,with 351 cases in the test group,and 349 cases in the control group.Meta-analysis results showed that compared with the control group,the glycosylated hemoglobin of the test group with resistance exercise[SMD(95％CI)=-0.30(-0.53--0.07),P=0.010],fasting blood glucose[SMD(95％CI)=-0.58(-0.90--0.26),P＜0.001],insulin re-sistance index[SMD(95％CI)=-0.90(-1.42--0.38),P＜0.001],and low-density lipoprotein cholesterol(LDL-C)[SMD(95％CI)=-0.28(-0.53--0.04),P=0.020]levels were reduced.Subgroup analysis showed that the glucose metabolism levels of the test group with only resistance exercise and a combination of resistance-anaerobic exercise were significantly lower than those of the control group(both P＜0.05).The heterogeneity of the effect of resistance exercise on glucose metabolism in Asian popu-lations(I2=57％)was smaller than that in Caucasion(I2=76％)and other populations(I2=94％),and the level of decrease in glucose metabolism indexes was significant[SMD(95％CI)=-1.15(-1.73--0.57),P＜0.001].Conclusion Resistance exercise can significantly reduce the level of glycolipid me-tabolism indexes in overweight or obese people.

Objective To compare the efficacy and safety of flexible ureteral lithotripsy(FURL)and non-retrograde percutaneous nephrolithotomy(NR-PCNL)for treating1.5-2.0 cm upper ureteral stones.Methods We retrospectively analyzed clinical data of 130 patients with upper ureteral stones treated between October 2022 and October 2024.Sixty-two patients underwent FURL and 68 underwent NR-PCNL.Comparisons included operative time,pre-and postoperative changes in white blood cells(WBC),hemoglobin(Hb),and creatinine(Cr),postoperative C-reactive protein(CRP)levels,stone-free rate after primary surgery,postoperative hospitalization duration,pain scores,complications,and need for auxiliary treatments.Results Compared to the FURL group,the NR-PCNL group demonstrated advantages in operative time[54.0(44.3,69.3)min vs.82.5(66.0,101.0)min,Z=-5.565,P<0.001],WBC elevation[1.9(0.5,3.5)×109/L vs.4.5(3.0,6.0)×109/L,Z=-4.528,P<0.001],and secondary surgery rate[0%(0/68)vs.14.5%(9/62),P<0.001].The FURL group showed lower Hb reduction[3.0(2.0,6.3)g/L vs.8.0(5.0,11.0)g/L,Z=-4.262,P<0.001],less postoperative Visual Analogue Scale(VAS)pain scores[1.0(1.0,2.0)points vs.2.0(1.0,2.0)points,Z=-2.840,P=0.005],and shorter hospitalization duration[2.0(1.0,2.0)d vs.3.0(2.0,3.0)d,Z=-5.815,P<0.001].No significant differences were observed in Cr elevation,CRP levels,stone-free rate after primary surgery,complications,or analgesic requirements(P≥0.05).Conclusions Both NR-PCNL and FURL are safe and effective for 1.5-2.0 cm upper ureteral stones.FURL offers better patient comfort,while NR-PCNL shows superior overall safety.

Objective To compare the effectiveness between ultrasound-guided paravertebral block(PVB)and general anesthesia in percutaneous nephrolithotomy(PCNL).Methods Clinical data of 284 patients who underwent PCNL in our hospital from January 2023 to March 2024 were collected.These were 78 cases of PVB(PVB group)and 206 cases of general anesthesia(general anesthesia group).A total of 61 cases in each of the two groups were matched with propensity score,and the operative time,intraoperative fluid infusion volume,postoperative haemoglobin changes,postoperative visual analogue scale(VAS),hospital stay,hospital costs,and incidence of postoperative complications were compared.Results The operations were completed in both groups of patients successfully,with stable vital signs during the operation and no intraoperative anesthetic complications such as bradycardia,respiratory depression,or hypotension.There were significant differences between the two groups in heart rate(HR)before the start of surgery[(66.5±10.4)beats/min vs.(77.5±11.7)beats/min,t=-5.471,P=0.000],HR at the end of surgery[(60.5±8.4)beats/min vs.(71.0±12.3)beats/min,t=-5.472,P=0.000],mean arterial pressure(MAP)before the start of surgery[(97.2±11.9)mm Hg vs.(103.1±12.3)mm Hg,t=-2.694,P=0.008],MAP at the end of surgery[(85.2±8.8)mm Hg vs.(94.3±11.6)mm Hg,t=-4.892,P=0.000],pulse oxygen saturation(SpO2)before the start of surgery[(99.0±1.1)％vs.(99.6±0.6)％,t=-3.347,P=0.001]and SpO2 at the end of surgery[(99.2±1.1)％vs.(99.8±0.4)％,t=-4.122,P=0.000].The operative time was significantly shorter in the PVB group than that in the general anesthesia group[55.0(41.5,75.5)min vs.95.0(65.0,130.0)min,Z=-5.173,P=0.000].The postoperative haemoglobin changes[5(2,11)g/L vs.8(4,11)g/L,Z=-2.099,P=0.036],postoperative VAS score[1(1,1)points vs.1(1,2)points,Z=-3.342,P=0.001],postoperative hospital stay[3(2,3)dvs.4(3,6)d,Z=-6.016,P=0.000]and hospital costs[(14 499.4±2141.0)yuan vs.(19 634.2±3846.8)yuan,t=-9.109,P=0.000]were statistically lower in the PVB group than those in the general anesthesia group.Comparison of intraoperative fluid infusion volume[600(600,600)ml vs.600(600,1100)ml,Z=-1.800,P=0.072],postoperative venting time[1(1,1)d vs.1(1,1)d,Z=-1.045,P=0.296],and phase Ⅰ stone removal rate[88.5％(54/61)vs.82.0％(50/61),x2=1.043,P=0.307]showed no significant differences between the two groups.The incidence of postoperative complications in the PVB group was significantly lower than that in the general anesthesia group[6.6％(4/61)vs.19.7％(12/61),x2=4.604,P=0.032].Conclusion Ultrasound-guided PVB in PCNL maintains stable intraoperative vital signs,reduces operative time and bleeding,alleviates postoperative pain,reduces postoperative complications and postoperative hospital stay,and saves medical costs,having a good safety and efficacy.

To investigate body composition and associated factors in adolescents undergoing long-term regular sports training.