In recent years, clinical research shows the trend of globalization. Due to characteristics of the huge number and relative concentration of patients, the wide variety of diseases, a high patient enrolment rate, lower trials costs, and so on, China and India become a focus of this trend. However, China and India also have their own advantages in the aspects of diseases, infrastructure, policies, regulations, regulatory environment, language, and culture. The key question to address is: how to increase the shares in the trial market in the future and to enhance the international status of China’s clinical research? Before we answer this question, we must understand the present situations of clinical research resources in China and India. So, we searched the relevant literature at home and abroad by computer and hand to analyze advantages and efficiency of clinical research resources in China and India.
In recent years, CRO has developed rapidly in China, and has played an important role in improving the level of Chinese clinical trials and drug development. However, the development of CRO industry also has problems. This paper discusses the beneficial factors of the main problems and the future direction of CRO, in attempt to attract the attention of government supervision and management departments and CRO industries.
Objective To investigate the risk factors of early allograft dysfunction (EAD) following C-Ⅱ donation after cardiac death (DCD) liver transplantation. Methods The data of 46 donors and recipients of C-ⅡDCD liver transplantation between March 2012 and August 2015 were retrospectively analyzed. The baseline data such as democracy, death cause, donor warm ischemic time (DWIT) and cold ischemic time (CIT) in EAD group and the non-EAD group (control group) was compared, and whether these factors were risk factors of EAD was investigated by univariate and multivariate analyses. Statistical cut-off values for significant factors of the unfavorable analysis were defined by receiver operating characteristics (ROC) analysis. The 6-month and 1-year graft survival rate were compared. Results The EAD group had a longer DWIT compared with the group [(17.6±4.7) and (12.7±6.2) minutes, P=0.009]; meanwhile, the EAD group had a longer CIT compared with the control group [(13.7±4.7) and (11.0±3.5) hours, P=0.020]. The other factors in both groups showed no statistical significance (P>0.05). The ROC curve revealed the cut-off values of DWIT and CIT were 17.50 minutes [area under the curve (AUC)=0.713, P=0.020] and 9.85 hours (AUC=0.723, P=0.015), respectively. The multivariate logistic regression analysis showed the DWIT [odds ratios (OR)=1.340, 95% confidence interval (CI)(1.042, 1.654), P=0.008] and CIT [OR=1.396, 95% CI (1.075, 1.698), P=0.015] were all independent risk factors of EAD. The 6-month and 1-year graft survival rate of the EAD group and the control group was 85.7% vs. 92.3% (P=0.607) and 71.4% vs. 84.6% (P=0.587), respectively. Conclusions EAD may occured in C-Ⅱ donors with DWIT≥17.50 minutes or CIT≥9.85 hours in DCD liver transplantation. The livers can be used as a resource for clinical use and also have a good outcome.
Objective To analyze the incidence and mortality of asthma in China from 1990 to 2019, and to explore the influence of age, period and cohort on the incidence and mortality of asthma. Methods Using the Global Burden of Disease (GBD) 2019 database, the incidence and mortality of asthma in China from 1990 to 2019 were analyzed, and the time variation trend of age-standardized incidence and mortality was analyzed by using Joinpoint software, and the average annual variation percentage was calculated. The age-period-cohort model was constructed to analyze the influence of age, period and birth cohort on the incidence and mortality trend of asthma. Results In 2019, the incidence of asthma in China was 264.44/100 000, and the mortality rate was 1.74/100 000. The incidence rate of asthma in males (300.94/100 000) and mortality rate (1.99/100 000) were higher than those in females (226.51/100 000 and 1.49/100 000). From 1990 to 2019, the age-standardized incidence of asthma in China showed a downward trend, but the trend was not statistically significant (P>0. 05), and the age-standardized mortality showed a downward trend, with an average annual decrease of 4.90%, with a statistically significant trend (P<0.05). The results of age effect showed that the incidence of asthma in China showed a downward trend, and the death first showed a downward trend, and then increased in the age group of 55-59. The results of period effect show that the risk of asthma is decreasing, and then it is increasing from 2015 to 2019, and the risk of asthma mortality is decreasing. The results of cohort effect show that the later people are born, the lower the risk of asthma onset and death. The death of asthma is attributed to behavioral risk, high body mass index and tobacco, and the occupational risk tends to decrease. ConclusionsFrom 1990 to 2019, the incidence and mortality of asthma in China showed a decreasing trend, and the incidence and mortality of men were higher than that of women. The risk factors of behavioral risk, high body mass index and tobacco were still on the rise, so corresponding measures should be taken to carry out early screening, early detection, and early treatment for key populations.
目的:比较针刺配合中国灸穴位贴敷与单纯针刺治疗膝骨关节的临床疗效。方法:将60例符合膝骨关节炎诊断的病员随机分为针刺加中国灸治疗组和单纯针刺对照组,两组均取穴血海、梁丘、犊鼻、膝眼、鹤顶、阳陵泉治疗,治疗组每天加用中国灸穴位贴敷治疗。10次一疗程,2个疗程后观察疗效。结果:治疗组30例中显效20例,好转8例,无效2例,总有效率为93.3%。对照组30例中显效9例,好转16例,无效5例,总有效率为83.3%。两组有效率有显著性差异（Plt;0.05）。结论:针刺配合中国灸穴位贴敷治疗膝骨关节疗效优于单纯针刺。
ObjectiveTo systematically review the willingness rate of Chinese residents to renew family doctors contract services. MethodsPubMed, Web of Science, EMbase, ScienceDirect, CNKI, WanFang Data and VIP databases were electronically searched to collect cross-sectional studies related to the willingness of Chinese residents to renew family doctors contract services from inception to November 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 23 cross-sectional studies involving 22 629 subjects were included. The results of meta-analysis showed that the willingness rate of Chinese residents to renew family doctors contract services was 84.2% (95%CI 80.0% to 88.3%). The results of subgroup analysis showed that contracted residents who were surveyed in 2011 to 2015 (85.7%), living in eastern (87.0%) and urban (84.7%), above age 60 (88.5%), females (85.1%), non-married (86.5%), with primary school and below education level (91.4%), with employee medical insurance (84.5%) and residents medical insurance (85.2%), not working (77.9%), with high and medium levels of health status (84.5%), with chronic diseases (86.7%), preferred to consult general diseases in primary health care institutions (89.5%), and walking to nearby community health service institutions requiring less than 30 minutes (86.9%) had a relatively high willingness to renew contracts. The contracted residents whose health status improved (91.0%), medical expenses reduced (91.5%) and medical portability improved (88.4%), more satisfied with contracted services (85.3%), more trusted in contracted doctors (87.9%), knowing family doctors’ name (86.7%) and contact information (84.2%) and enjoying visiting medical service (79.7%), telephone follow-up (79.6%), and health files establishment (80.1%) were more willing to renew contracts. ConclusionCurrent evidence suggests that the willingness of Chinese residents to renew family doctors contract services is high, however, it remains to be improved. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Stroke is a severe disease with high incidence, high recurrence, high disability, and high mortality rates. China has the highest prevalence of stroke in the world, where it is a leading cause of death and disability for adults. There is a struggling way to prevent and control stroke to reduce the disease burden. This review summarizes the temporal trends and characteristics of stroke in China, with an aim to provide baseline reference for stroke prevention and treatment in China. There was an increase in the incidence and prevalence of stroke in China in the past 15 years. The incidence, prevalence, mortality, and disability-adjusted life years of stroke in China were higher than those in developed countries such as the United Kingdom, the United States, and Japan. High-quality studies and standardized diagnosis and treatment are needed to overcome challenges in stroke prevention and treatment in China.
Diffuse large B-cell lymphoma is highly heterogeneous and is diagnosed according to the 2016 World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. The decision of treatment should be upon age, International Prognostic Index score and the tolerability of chemotherapy. High-dose chemotherapy and autologous stem cell transplantation is the standard care for relapsed, chemotherapy sensitive patients. Clinical trials are recommended in specific conditions.