There are about 36818 clinical studies being (or have been) conducted in China. The country of the clinical trial is determined by the location of where the clinical research is being studied. Most studies are often held in multiple locations & countries.
Acute Respiratory Distress Syndrome (ARDS) is often complicated by Right Ventricular Dysfunction (RVD), and the incidence can be as high as 64%. The mechanism includes pulmonary vascular dysfunction and right heart systolic dysfunction. Pulmonary vascular dysfunction includes acute vascular inflammation, pulmonary vascular edema, thrombosis and pulmonary vascular remodeling. Alveolar collapse and over distension can also lead to increased pulmonary vascular resistance, Preventing the development of acute cor pulmonale in patients with acute respiratory distress. ARDS patients with RVD have a worse prognosis and a significantly increased risk of death, which is an independent risk factor for death in ARDS patients. Therefore, implementing a right heart-protective mechanical ventilation strategy may reduce the incidence of RVD. APRV is an inverse mechanical ventilation mode with transient pressure release under continuous positive airway pressure, which can effectively improve oxygenation and reduce ventilator-associated lung injury. However, its effect on right ventricular function is still controversial. Low tidal volume (LTV) is a mechanical ventilation strategy widely used in ARDS patients. Meta-analysis results showed that compared with LTV, APRV improved oxygenation more significantly, reduced the time of mechanical ventilation, and even had a tendency to improve the mortality of ARDS patients However, randomized controlled studies have shown that compared with LTV, APRV improves oxygenation more significantly and also increases the mean airway pressure. Therefore, some scholars speculate that APRV may increase the intrathoracic pressure, pulmonary circulatory resistance, and the risk of right heart dysfunction but this speculation is not supported by clinical research evidence. In addition, APRV may improve right ventricular function by correcting hypoxia and hypercapnia, promoting lung recruitment and reducing pulmonary circulation resistance. Therefore, it is very important to clarify this effect for whether APRV can be safely used and popularized in clinic.we aim to conduct a single-center randomized controlled study to further compare the effects of APRV and LTV on right ventricular function in patients with ARDS, pulmonary circulatory resistance (PVR) right ventricular-pulmonary artery coupling (RV-PA coupling), and pulmonary vascular resistance (PVR).
Caudal analgesia with ropivacaine is commonly used in sub-umbilical pediatric surgery. However, increasing the dosage of ropivacaine has not been found to prolong the action significantly while complications will be serious. Ketamine as an additive to caudal administration had been shown to prolong the duration of postoperative analgesia, while the analgesic effectiveness of S-ketamine, the S(+)-enantiomer of ketamine with less possibility to induce psychomotor disturbances, is not clear. In this prospective randomized double-blind clinical trial , the investigators aimed to study the effect of S-ketamine as additive on the duration of caudal analgesia.
This study aims to establish a multicenter, large-scale, prospective cohort of patients with ischemic stroke. Various biological samples such as blood, feces, and urine are collected to identify biomarkers associated with ischemic stroke. By integrating demographic information, clinical indicators, imaging parameters, and biomarker parameters, the study aims to develop risk assessment, early warning, and prognosis prediction models. Additionally, the study aims to identify key genes and explore relevant signaling pathways related to ischemic stroke.
Background: Postoperative pulmonary complications (PPCs) may extend the length of stay of patients and even increase perioperative mortality after video-assisted thoracoscopic (VATS) pulmonary surgery. Thoracic paravertebral block (TPVB) can provide effective analgesia after VATS, however little is known about the effect of TPVB on PPCs. This study aims to determine whether TPVB combined with general anesthesia results in reducing PPCs and achieve perioperative lung protection in VATS pulmonary surgery compared with simple general anesthesia. Methods: A total of 302 patients undergoing VATS lobectomy/segmentectomy will be randomly divided into two groups: Paravertebral block group (PV group) and Control group (C group). Patients of PV group will receive thoracic paravertebral block: 15 ml of 0.5% ropivacaine will be administered to the T4 and T7 thoracic paravertebral spaces respectively before general anesthesia. Patients of C group will not undergo intervention. Both groups of patients adopted protective ventilation strategy during operation. Perioperative protective mechanical ventilation and standard fluid management will be applied in both groups. Patient controlled intravenous analgesia was used for postoperative analgesia. The primary endpoint is the composite outcome of PPCs within 7 days after surgery. Secondary end points include blood gas analysis, postoperative lung ultrasound score, NRS score, QoR-15 score, hospitalization related indicators and long-term prognosis indicators.
This pilot clinical trial studies gene therapy in treating patients with HIV-1 infecetion combined with lymphoma undergoing 7shRNA lentiviral vector transduced CD34+ hematopoietic stem cell transplant. Giving chemotherapy before a stem cell transplant stops the growth of cancer cells by stopping them from dividing or killing them. After treatment, CD34+hematopoietic stem cells are mobilized and collected from the patient's peripheral blood. The CD34+stem cells are then isolated and transduced with lenti-7shRNA vector and reinfused to the patient to replace the blood-forming cells that were destroyed by the chemotherapy.
To investigate the efficacy of AL2846 capsules in combination with TQB2450 injection or Docetaxel injection in patients with advanced NSCLC who have previously failed immune checkpoint inhibitors (anti-PD-1 monoclonal antibody, anti-PD-L1 monoclonal antibody), regardless of new anti-tumor treatment and early termination of treatment.
Previous studies have shown that there are alterations in the number and affinity of interferon receptors during interferon therapy and that such alterations recover to varying degrees some time after the end of treatment. It can be conjectured that the rest period of pulsed therapy facilitates the recovery of type I interferon receptors and thus the next round of IFN therapy compared to a continuous regimen of interferon.
The high incidence rate, high Case fatality rate rate and high rate of neurological impairment of cardiac arrest pose a serious threat to the health of the whole population, and also bring a huge economic burden. In recent years, the "American Heart Association AHA Cardiopulmonary resuscitation and Cardiovascular Emergency Guide" has always emphasized the importance of "life chain" for the survival of patients with cardiac arrest. The hospital's survival chain emphasizes early warning recognition and activation of emergency response systems, immediate high-quality CPR, rapid defibrillation, advanced life support, and post arrest care. However, there is an urgent need for improvement and enhancement in all aspects of the chain of life for cardiac arrest. Millimeter wave radar can transmit radar signals that penetrate non-metallic substances such as clothing, detect the micro motion signals caused by human respiration and heartbeat, and then process the signals. By calculating the frequency or phase shift information in the radar echo, patient activity information can be obtained, achieving contactless and real-time detection of patient activity in the room. And it can achieve tracking of targets in scenarios where multiple people exist, while monitoring the physical signs of each target in real-time [7]; Our team has developed Cardiopulmonary resuscitation Quality Monitoring Index (CQI) and Cardiopulmonary resuscitation Ventilation Mode (CPRV) in the early stage, which are very helpful to monitor and improve the quality of Cardiopulmonary resuscitation; In recent years, the application of bedside echocardiography (PoCUS) in emergency has been significantly expanded. Although transthoracic echocardiography (TTE) can provide valuable diagnostic information for patients with cardiac arrest, it has important limitations in dynamic compression of Cardiopulmonary resuscitation. TEE can overcome many limitations of TTE, and the combination of the two can achieve visualization of resuscitation, Many signs of Cardiopulmonary resuscitation that had not been found before have been found. On the other hand, international guidelines recommend that the compression site of Cardiopulmonary resuscitation should be in the lower half of the sternum. However, research shows that there are great changes in the shape of the chest and the organizational structure directly below the compression site in normal people. The left ventricle is located in the lower quarter of the sternum, lower than the lower third of the sternum. When Cardiopulmonary resuscitation is carried out according to the current guidelines, only a small part of the ventricle is subjected to external compression, and for spinal deformity, obesity There is no corresponding research and recommendation for pregnant women and other special groups, and the extensive development of chest CT Iterative reconstruction provides the possibility of individualized evaluation. In addition, the COVID-19 in China has not yet been completely controlled. For patients suspected or confirmed to be infected with novel coronavirus, it is still challenging to carry out Cardiopulmonary resuscitation that may produce aerosols when wearing protective equipment. In summary, establishing a clinical decision-making system for the survival chain under the new situation and optimizing the survival chain process in the guidelines is of great significance for improving the survival rate and prognosis of patients with cardiac arrest, and is of great value for improving national health levels and reducing the economic burden on the government.
Research on the Role of Circ0014614 in the Formation and Development of ET
This study compares the results of the existing coagulation monitoring technology to the Ultrasound-based viscoelastic hemostasis analysis, a new method, using small amount of extra blood obtained during routine blood draws in surgery patients.