1.Analysis of the protection of compensation rights for research participants
Aijuan SHENG ; Xiaoqi WANG ; Liyan SUN ; Dongxiang ZHENG ; Fang LIU
Chinese Medical Ethics 2024;37(5):507-513
Life science and medical research involving human beings cannot be separated from the support of research participants.The safety,health,and rights and interests of research participants are the primary considerations in clinical research,and their rights and interests include the right of compensation,privacy protection,health and so on.Protecting the compensation rights of research participants is a necessary responsibility of the research-related departments and personnel.Based on laws and regulations and literature review,and combined with practical experience,this paper made an in-depth discussion on compensation rights.It puts forward the types of compensation(conventional compensation,research-related damage compensation),compensation principles(necessity,timeliness,appropriateness,fairness),compensation elements(method,amount,plan,consent,notification,and reference of compensation),compensation under special circumstances(compensation for participants without or with limited informed consent ability and withdraw from the study midway),protection measures of compensation right(sponsor/contract research organizations,research institutions,research management departments,(main)researchers and research teams,ethics(review)committee).The compensation rights should be implemented to protect research participants.
2.Research progress on clinical application of opioid-free anesthesia
Dongxiang DENG ; Guanwen LIN ; Daojie WANG ; Dongchen WU ; Yamei LIN ; Duozhi WU
Chongqing Medicine 2024;53(19):3018-3023,3028
Opioid-free anesthesia(OFA)is a multimodal analgesic strategy that combines multiple non-opioid drugs and/or techniques to obtain high-quality anesthesia.With the popularization of the concept of enhanced recovery after surgery(ERAS),OFA has become a common concern hot spot for perioperative phy-sicians.OFA is in line with the ERAS concept,and under multimodal anesthesia and pain management,it can reduce surgical stress,inflammation reaction and postoperative complications,significantly improve the prog-nosis of patients,promote postoperative rapid recovery and reduce the burden of medical and health resources.This article reviews the adverse reactions of opioids,OFA concept and indications,the clinical application of OFA in recent years,the existing controversies and problems to be solved.
3.The illness experience and demands of patients with poststroke aphasia during rehabilitation:a qualitative meta-synthesis
Huan WANG ; Shengjuan LI ; Chen LI ; Yuanyuan HE ; Yuyao XIE ; Dongxiang ZHENG
Chinese Journal of Nursing 2024;59(7):873-881
Objective To systematically evaluate and integrate qualitative studies on the disease experience and demands of stroke aphasic patients during rehabilitation,and to provide references for the development of a rehabilitation care strategy oriented to the needs of poststroke aphasia patients.Methods Computer search of PubMed,Web of Science,Embase,Cochrane Library,CINAHL,China Knowledge Network,Wanfang database,and VIP Chinese biomedical journals was conducted for qualitative research on the illness experience and demands of poststroke aphasia patients during rehabilitation from the time of database construction to May 2023.The literature was evaluated using the Australian JBI Quality Evaluation Criteria for Qualitative Research in Evidence-based Health Care Centers(2016),and the results were consolidated using an aggregative integration approach.Results A total of 18 studies were included,and a total of 1 theoretical model and 70 themes were extracted and grouped to form 7 categories,which were combined into 3 integrated outcomes:poststroke aphasia is a traumatic life event;poststroke aphasia patients actively rebuild their lives;the demands of poststroke aphasia patients during rehabilitation.Conclusion Poststroke aphasia patients during rehabilitation face difficulties in life;medical professionals should stimulate patients'positive feelings,strive to promote patients'social integration and self-management,meet patients'multidimensional and diverse rehabilitation demands,and ultimately construct personalized rehabilitation management programs oriented to patients'demands with poststroke aphasia.
4.Guidelines for Ethical Review Entrustment Contract of Life Science and Medical Research Involving Humans
Aijuan SHENG ; Meixia WANG ; Qiang LIU ; Zhongguang YU ; Hu CHEN ; Hui JIANG ; Jiyin ZHOU ; Xiaoqi WANG ; Haibin YU ; Mingjie ZI ; Yifeng JIANG ; Lei XU ; Tao SHI ; Guizhen SUN ; Dongxiang ZHENG
Chinese Medical Ethics 2023;36(5):492-498
The passing of ethical review is a necessary conditions and prerequisite for the development of life science and medical research involving humans. At present, some medical and health institutions have no or insufficient ethical review capabilities. The lack of ethical review ability has become a bottleneck restricting the development of life science and medical research involving humans. According to documents such as Opinions on Deepening the Reform of the Review and Approval System and Encouraging the Innovation of Pharmaceutical and Medical Devices, Opinions on Strengthening the Ethical Governance of Science and Technology, institutions can entrust competent institutional ethics review committees or regional ethics review committees in writing to conduct ethical review. Entrustment ethical review provides a viable solution for institutions that need to carry out life science and medical research involving humans but do not have an ethics (review) committee or the ethics (review) committee is not competent to review. To conduct the entrustment ethical review, the entrustment between the principal and the trustee is required. According to The Measures for Ethical Review of Life Sciences and Medical Research Involving Humans, if medical and health institutions and their ethical review committees do not accept the formal entrustment to provide the ethical review opinions for other institutions, the local health authorities at or above the county level will impose administrative penalties and sanctions on the relevant institutions and personnel in accordance with the law. Signing the entrustment ethical review contract, implementing legal compliance entrusted ethical review to protect the rights and interests of the trustee and the principal, and protect the research participants.
5.Biomechanical study of different approach for lumbar interbody fusion surgeries under vibration load.
Wei FAN ; Chi ZHANG ; Qingdong WANG ; Dongxiang ZHANG ; Lixin GUO
Journal of Biomedical Engineering 2021;38(5):877-884
The human spine injury and various lumbar spine diseases caused by vibration have attracted extensive attention at home and abroad. To explore the biomechanical characteristics of different approaches for lumbar interbody fusion surgery combined with an interspinous internal fixator, device for intervertebral assisted motion (DIAM), finite element models of anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF) and lateral lumbar interbody fusion (LLIF) are created by simulating clinical operation based on a three-dimensional finite element model of normal human whole lumbar spine. The fusion level is at L4-L5, and the DIAM is implanted between spinous process of L4 and L5. Transient dynamic analysis is conducted on the ALIF, TLIF and LLIF models, respectively, to compute and compare their stress responses to an axial cyclic load. The results show that compared with those in ALIF and TILF models, contact forces between endplate and cage are higher in LLIF model, where the von-Mises stress in endplate and DIAM is lower. This implies that the LLIF have a better biomechanical performance under vibration. After bony fusion between vertebrae, the endplate and DIAM stresses for all the three surgical models are decreased. It is expected that this study can provide references for selection of surgical approaches in the fusion surgery and vibration protection for the postsurgical lumbar spine.
Biomechanical Phenomena
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Finite Element Analysis
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Humans
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Lumbar Vertebrae/surgery*
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Pedicle Screws
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Range of Motion, Articular
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Spinal Fusion
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Vibration
6. Expression of osteoprotegerin and receptor activator of nuclear factor kappa-B ligand in mandibular ramus osteotomy healing with administration of different doses of parathyroid hormone
Ning AN ; Yao LI ; Zhenglong TANG ; Xiaoyan CHEN ; Dongxiang WANG ; Qiong GAO
Chinese Journal of Stomatology 2018;53(6):413-418
Objective:
To investigate the effect of parathyroid hormone (PTH) on the bone healing of mandibular ramus osteotomy.
Methods:
The mandibular ramus osteotomy model was established in sixty rabbits and these rabbits were randomly divided into experimental group A, experimental group B and control group. In the experimental group A and experimental group B, the rabbits were given PTH (20 and 40 μg/kg respectively) every other day after operation. In the control group, 1 ml saline was given. The animals were sacrificed at 1 week, 2 weeks, 3 weeks and 4 weeks postoperatively. The new bone formation was observed by histology and cone bone CT. The expression of osteoprotegerin and receptor activator of nuclear factor kappa-B (RANKL) in the new bone was detected by real-time quantitative PCR.
Results:
The experimental groups has better osteogenesis and the bone mineral density than the control group in osteotomy area. The experimental group B showed the best osteogenesis.Osteoprotegerin mRNA expression in experimental group A (1.127±0.035, 1.742±0.049, 1.049±0.062, 1.063±0.036) was significantly higher than that in the control group in each period (0.965±0.082, 1.254±0.071, 0.793±0.061, 0.684±0.055) (
7.Osteoprotegerin/receptor activator of nuclear factor-κB ligand expression in mandibular distraction osteogenesis regulated by parathyroid hormone.
Yongdi LI ; Pengna ZHU ; Dongxiang WANG ; Jiamin CHEN ; Zhenglong TANG
West China Journal of Stomatology 2016;34(3):234-238
OBJECTIVEThis research aimed to investigate the expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) in mandibular distraction osteogenesis (DO) regulated by parathyroid hormone (PTH) and to explore the mechanism by which PTH promotes DO.
METHODSA rabbit mandibular DO model was established. The rabbits were randomly divided into experimental group and control group. The former were subcutaneously injected with different doses of PTH on alternate days, the latter was injected with normal saline every other day. Serum OPG levels were detected through enzyme-linked immunosorbent assay. The OPG and RANKL expression levels in the DO-induced formation of a new bone tissue were examined through immunohistochemistry staining.
RESULTSThe serum OPG levels gradually increased during distraction. At the end of the stretch, the OPG expression in the experimental group was significantly stronger than that in the control group. As the fixed period was extended, the OPG expression in the new bone gradually decreased, but the RANKL expression increased.
CONCLUSIONIntermittent subcutaneous PTH injection can upregulate the OPG expression and accelerate bone metabolism. Thus, this procedure promotes the early generation of a new bone in the mandible through DO.
Animals ; Enzyme-Linked Immunosorbent Assay ; Mandible ; NF-kappa B ; metabolism ; Osteogenesis, Distraction ; methods ; Osteoprotegerin ; metabolism ; Parathyroid Hormone ; metabolism ; RANK Ligand ; metabolism ; RNA, Messenger ; Rabbits ; Random Allocation
8.Recent advance in treatment of giant intracranial aneurysms
Dongxiang QIAN ; Shuangzhi WANG
Chinese Journal of Neuromedicine 2016;15(5):536-539
Giant intracranial aneurysms refers to the diameter of aneurysms larger than 2.5 cm,which belongs to the complicated aneurysms,accounting for about 5% ofintracranial aneurysms;rupture of the aneurysms leads to extremely high disability rate and fatality rate.At present,surgical treatment,endovascular treatment and new composite (hybrid) surgery are the three major surgical approaches.We summarize the treatment approaches to promote an update on treatment of such aneurysms and give understanding on the development and direction of aneurysm treatment.
9.Influence of STAT1 on proliferation and IFN-βsensitivity of human non-small-cell lung cancer H1299 cells
Jialu ZHAO ; Xiaoru SUN ; Dongxiang JI ; Junjie CHEN ; Mengyi WANG ; Lei JIANG ; Yuping LI ; Chengshui CHEN
Chinese Journal of Pathophysiology 2015;(5):852-856
AIM:To investigate the effect of signal transducer and activator of transcription 1 ( STAT 1 ) on proliferation and interferon-β(IFN-β) sensitivity of human non-small-cell lung cancer H1299 cells.METHODS:STAT1 or EGFP gene was transfected into H1299 cells by the lentiviral vectors system.The cell number was counted under a mi-croscope and cell proliferation was tested by MTT assay.In addition, the cells transfected with STAT1 and EGFP were trea-ted with IFN-βand cell viability was measured by MTT assay.The protein levels of p-STAT1, ICAM-1 and PCNA were de-tected by Western blot.RESULTS: Over-expression of STAT1 inhibited H1299 cell proliferation (P<0.05).H1299 cells transfected with STAT1 gene had a higher sensitivity to IFN-βthan the control cells transfected with EGFP ( P <0.05).Overexpression of STAT1 increased the protein level of p-STAT1, and reduced IACM-1 expression in H1299 cells. Moreover, STAT1 enhanced STAT1 phosphorylation and downregulated the expression of PCNA in H1299 cells treated with IFN-β.CONCLUSION:STAT1 inhibits the proliferation and enhances the IFN-βsensitivity of non-small-cell lung cancer H1299 cells.
10.Microinjection pump control continuous intrathecal injection of vancomycin for the treatment of intracranial infection
Jianquan YAN ; Dongxiang QIAN ; Peng LUO ; Zhijian WANG
Journal of Clinical Medicine in Practice 2014;(7):91-93
Objective To study the clinical curative effect of continuous intrathecal injec-tion of vancomycin controlled by microinjection pump in the treatment of intracranial infection. Methods 50 patients with intracranial infections from January 2009 to October 2012 were includ-ed in the research.22 patients treated with cerebrospinal fluid drainage from lumbar cistern and discontinuous intrathecal injection of vancomycin were in control group,and another 28 patients with continuous intrathecal injection of vancomycin by micropump were in the experimental group. Therapeutic effect was observed between the two groups.Results The patients in the control group improved more rapidly than those in the experimental group in the temperature,blood,cere-brospinal fluid and other observation index.Compared with the control group,the pain of lower back and leg,convulsions,headache and other side effects were significantly reduced in the experi-mental group.Conclusions Continuous drainage of cerebrospinal fluid in lumbar cistern and mi-croinjection pump control continuous intrathecal injection of vancomycin is a safe and effective method to treat intracranial infection.

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