Clinical trials

Prior to the quasi-experiment, this study performed semi-structured interviews among Bachelor of Medicine and Bachelor of Surgery(MBBS) undergraduate students from the Belt and Road International Medical College, Zhejiang University. Based on learning science, cognitive load theory and causal inference frameworks, the interview outline focused on system usability, feedback quality, learning reasoning processes, cognitive burden and instructional optimization advice. Each 20-30 minute individual interview was audio-recorded with participants' informed consent and verbatim transcribed for standardized qualitative analysis. The quasi-experiment recruited no fewer than 60 MBBS students. The sample size was determined by intergroup statistical power analysis to guarantee around 30 participants per group for valid intergroup comparison. All eligible students were randomly assigned into two groups with balanced demographic and academic baseline characteristics. The experimental group (n=30) received structured epidemiological learning assisted by the (Socratic Agent for Guided Epidemiology) SAGE (Artificial Intelligence)AI agent with professional Socratic cognitive guidance. The control group (n=30) adopted general large language model (LLM)-based learning without systematic thinking intervention. Participants with clinically diagnosed severe mental disorders, cognitive dysfunction or inability to finish the complete research process were excluded. A baseline epidemiological knowledge pre-test confirmed no significant academic differences between the two groups via independent samples t-test, and all participants had no prior experience of AI-assisted medical learning. The semi-structured interviews were conducted to collect students' authentic learning experiences, interactive perceptions and cognitive characteristics during the use of SAGE agent and general LLMs, providing qualitative evidence for the iterative optimization of AI teaching tools. All interviewees completed baseline assessments and preliminary AI learning trials, ensuring qualified professional foundation and genuine interactive experience. Conducted by trained researchers, the standardized interviews centered on three core themes: system usability and feedback clarity; AI-induced changes in information extraction, hypothesis formulation and causal inference; and common learning barriers including interactive obstacles, comprehension difficulties, cognitive overload and potential AI over-reliance. Transcribed interview data were analyzed through thematic analysis to summarize typical user experience patterns. Qualitative outcomes were triangulated with quantitative experimental results to revise the SAGE teaching protocol, optimize agent prompt chains and improve the interpretation of experimental findings. The quasi-experiment consisted of three standardized stages. In the pre-test stage, all participants signed informed consent, completed a 25-item clinical epidemiology knowledge scale, an 11-item reasoning ability test and a demographic questionnaire to establish consistent baseline levels. In the intervention stage, the experimental group received standardized training in confounder identification and causal inference construction in strict accordance with the SAGE teaching protocol. The SAGE agent improved students' advanced epidemiological reasoning ability through continuous multi-round Socratic questioning and targeted cognitive guidance. The control group received equal-duration learning in the same experimental environment, only using conventional search engines and unguided LLMs for basic information retrieval without any cognitive and thinking intervention. All participants submitted screenshots to record their accurate AI tool usage duration after completing learning tasks. In the post-test stage, all participants finished parallel-version epidemiological knowledge assessments and unified reasoning ability tests. Validated scales were adopted to evaluate students' cognitive load, system usability, learning satisfaction and academic self-confidence. Students' final scores of the Epidemiology course were collected as supplementary indicators of long-term learning effectiveness. Upon the completion of data collection, backend AI interaction logs were summarized and strictly screened. Invalid samples with insufficient interaction rounds or incomplete responses were excluded to ensure high data quality and reliable experimental conclusions.

This study examines the efficacy and safety of Bushen Huoxue Simiao formula for tonifying the kidneys and promoting blood circulation in treating postoperative complications of upper urinary tract stones, thereby providing evidence-based medical evidence and treatment strategies for clinical practice.

Background: The clinical management of major depressive disorder (MDD) is hampered by the lack of objective biomarkers and high inter-individual variability in drug response, with conventional antidepressants achieving only a 50% response rate. Objective and Design: This prospective, randomized, parallel-controlled trial aims to enroll 220 MDD patients, who will be allocated 1:1 to either a pharmacogenomics (PGx)-guided therapy group (treatment selection based on genetic testing) or a conventional treatment group (treatment as usual per guidelines), with a 12-week follow-up. Additionally, a matched healthy control cohort will be included for cross-sectional biomarker comparisons. Intervention and Outcomes: Patients in the PGx group undergo buccal swab testing for key genetic polymorphisms (e.g., CYP2D6, CYP2C19) to inform antidepressant type and dosage. The primary outcome is the 12-week response rate (≥50% reduction in HAMD-17 score from baseline). Secondary outcomes include remission rate, incidence of adverse drug reactions, and medication adjustment frequency. Exploratory Aims: Multidimensional baseline data-including resting-state fMRI (VMHC), peripheral blood biomarkers (inflammatory cytokines, thyroid function, BDNF), urinary metabolites, and gut microbiome-will be integrated to construct a predictive model for treatment efficacy and to identify novel MDD biomarkers. Scientific Significance: This study seeks to validate the clinical utility of PGx-guided prescribing and to advance the shift from symptom-based diagnosis towards a biological-characteristic-based precision medicine framework for depression.

\# Clinical Trial Summary Template (Based on your endometrial polyp study) The goal of this clinical trial is to learn if cold knife hysteroscopic polypectomy (Yiwu procedure) works to treat multiple endometrial polyps in women. It will also learn about the surgical safety of cold knife hysteroscopic polypectomy (Yiwu procedure). The main questions it aims to answer are: Does cold knife hysteroscopic polypectomy (Yiwu procedure) achieve a 1-year postoperative recurrence rate that is non-inferior to electroresection hysteroscopic polypectomy? What intraoperative and postoperative adverse events and complications do participants experience after receiving either surgical treatment? Researchers will compare cold knife hysteroscopic polypectomy (Yiwu procedure) to standard electroresection hysteroscopic polypectomy to verify whether the cold knife technique can reduce endometrial polyp recurrence without increasing surgical risks. Participants will: Receive either cold knife hysteroscopic polypectomy or conventional electroresection hysteroscopic polypectomy as standardized surgery Attend clinic follow-up visits at 3, 6 and 12 months after surgery for physical examinations and transvaginal ultrasound scans Complete clinical assessment records including menstrual status, abnormal uterine bleeding symptoms, pain conditions and patient satisfaction scores throughout the 1-year follow-up period

This is a prospective, randomized, double-blind, placebo-controlled clinical trial designed to evaluate the efficacy and safety of spirulina supplementation in patients with radiation-induced oral mucositis (RIOM) receiving radiotherapy for head and neck cancer. Participants will be randomly assigned to receive either spirulina tablets or placebo in addition to standard oral care during radiotherapy. The primary objective is to determine whether spirulina reduces the severity of oral mucositis. Secondary outcomes include the incidence and duration of severe oral mucositis, oral pain, nutritional status, quality of life, treatment interruption, and adverse events. The findings of this study may provide evidence for an effective and safe adjunctive intervention to improve the management of radiation-induced oral mucositis and enhance the quality of life of patients undergoing radiotherapy.

This study combines retrospective data analysis with a single-center prospective non-interventional cohort study to understand postoperative sleep disturbance on the first night after video-assisted thoracoscopic (VATS) lobectomy or segmentectomy. It mainly wants to answer the question: Can perioperative data collected along the clinical timeline dynamically predict which patients will experience clinically significant sleep disturbance on their first postoperative night? Participants undergoing elective VATS lung resection will have multidimensional data systematically collected from preoperative screening (including PSQI and GAD-7), intraoperative anesthetic parameters, PACU-to-ward handover, pre-bedtime symptom burden, and follow-up through 1 month. Three dynamic prediction models (M0 preoperative screening, M1 early postoperative update, and M2 pre-bedtime main model) will be developed using logistic regression with RCSQ-assessed sleep disturbance as the primary outcome, while an explanatory model will quantify the impact of nighttime disruptions such as intravenous infusions, vital sign monitoring, nursing entries, and awakenings.

This is a single-arm prospective clinical study conducted at The Fourth Affiliated Hospital of Zhejiang University School of Medicine. Previous basic research has found that patients with type 2 diabetic nephropathy have higher blood lead levels than ordinary people, and lead accumulation may accelerate kidney function decline. A total of 42 eligible participants will be enrolled, who are diagnosed with type 2 diabetic nephropathy, have baseline blood lead ≥5 µg/dl, CKD stage ≤3 and 24-hour urinary protein \<8 g. All subjects will receive oral dimercaptosuccinic acid (DMSA) capsules for lead removal according to standardized treatment courses for up to 3 months. During treatment, blood lead, urine lead, renal function and other indicators will be tested monthly. After the 3-month intervention, all participants will be followed up for 12 months, with relevant laboratory examinations conducted every 3 months to observe changes in renal function. The main goal of this study is to evaluate whether oral lead chelation therapy can slow the progression of kidney damage in patients with high lead burden and type 2 diabetic nephropathy, and provide clinical evidence for the intervention of lead-induced kidney injury in diabetic populations. Patients with hypertension, hyperlipidemia, autoimmune diseases, malignant tumor history, previous occupational lead exposure or drug allergies will not be enrolled. No healthy volunteers will be recruited, and individual raw patient data will not be shared externally after the study.

Based on previous basic experiments revealing that patients with type 2 diabetic nephropathy exhibit higher blood lead levels than the general population, this study aims to systematically evaluate the impacts of short-term and long-term blood lead exposure on renal function progression in such patients, so as to provide novel epidemiological evidence for clinical intervention.

Develop a standardized oral care protocol for stroke patients undergoing orotracheal intubation based on evidence-based practice, and validate its effectiveness through clinical trials.

This educational reform study aims to explore whether a full English course built on the DeepSeek artificial intelligence platform can improve orthopedic nurses' professional English competence. It will also examine nurses' satisfaction with AI-assisted teaching. The main questions it seeks to answer include: Will the DeepSeek-based full English course improve orthopedic nurses' professional English test scores? Will nurses' transcultural nursing self-efficacy and nurse-patient therapeutic interaction ability improve after the course training? What are nurses' experiences when using the DeepSeek AI platform for learning? Researchers will compare the English proficiency changes of the same group of orthopedic nurses before and after the training to observe the course effects. Participants will: Attend an 11-week full English course based on the DeepSeek platform, approximately 1-2 hours per week Complete a professional English written test and an oral proficiency assessment before and after the training Complete the Transcultural Self-Efficacy Tool (TSET-CV) and the Nurse-Patient Therapeutic Interaction Scale (NuPTIS) before and after the training Complete a teaching satisfaction and AI learning experience questionnaire after the course

This study aims to evaluate the therapeutic efficacy of Lecanemab in patients with Alzheimer's disease. The researchers will use a novel detection method based on mesoporous gold electrode surface-enhanced electrochemiluminescence (ECL) to monitor specific biomarkers in the patients' plasma. By tracking changes in these biomarkers, the study seeks to determine how effectively Lecanemab treats the disease and to validate this new ECL-based monitoring system as a useful tool for clinical assessment.

This study aims to evaluate the effectiveness of a clinical pharmacist-led perioperative pain management model in orthopedic surgery. It is a randomized controlled trial involving patients undergoing major orthopedic procedures. Participants will be assigned to either a standard care group or an intervention group receiving comprehensive pharmaceutical care, including preoperative medication reconciliation, intraoperative monitoring, and postoperative analgesic optimization. The primary outcome is the incidence of moderate-to-severe postoperative pain. Secondary outcomes include opioid consumption, adverse drug reactions, and patient satisfaction. This study seeks to establish an evidence-based protocol for optimizing pain management in orthopedic settings.

The goal of this randomized, parallel-controlled clinical trial is to investigate multi-dimensional biomarkers (blood, brain imaging, clinical information, and symptom assessment) in adolescents with Non-Suicidal Self-Injury (NSSI) and to evaluate the therapeutic and prognostic effects of a novel digital psychological intervention plus treatment as usual (TAU) compared to TAU alone in this population. The main question\[s\] it aims to answer \[is/are\]: What are the distinct biomarker profiles (e.g., inflammatory, endocrine, neuroimaging) associated with adolescent NSSI? Does the novel digital psychological intervention (based on CBT and DBT) combined with TAU lead to a higher clinical response rate (≥25% reduction in NSSI scale score from baseline) at 8 and 16 weeks compared to TAU alone? If there is a comparison group: Researchers will compare the digital intervention plus TAU group to the TAU-only group to see if adding the digital intervention significantly improves NSSI symptom reduction, depressive symptoms (HAMD-24 response rate), and long-term outcomes. Participants will: Undergo baseline assessments including blood sampling (inflammatory and endocrine markers, routine biochemistry), structural and resting-state functional MRI, and clinical scales (e.g., HAMD, HAMA). Use a smartphone app for 8 weeks, completing 16 self-guided digital modules (2 per week, 15-25 minutes each) based on CBT and DBT, covering topics such as NSSI psychoeducation, safety planning, emotion regulation, distress tolerance, mindfulness, and relapse prevention. Complete daily Ecological Momentary Assessment (EMA) questionnaires (1-2 minutes) on self-harm urge intensity, mood, and coping skills used; receive Ecological Momentary Intervention (EMI) when high urge is detected. Receive low-intensity remote coaching (one 20-30 min onboarding call, then two brief contacts per week via text/call/email) to support app adherence. Attend follow-up assessments at week 4, week 8 (intervention endpoint), and week 16 (study endpoint) for repeated clinical and outcome measures.

Keloids are benign fibroproliferative skin disorders characterized by excessive fibroblast activation and extracellular matrix deposition. The molecular mechanisms underlying keloid formation remain incompletely understood. This prospective observational study aims to investigate the biological characteristics of keloid tissue by comparing surgically resected keloid specimens with adjacent normal skin obtained from the same patients. Histological and molecular analyses, including histopathology, polymerase chain reaction (PCR), Western blotting, and related laboratory assays, will be performed to identify signaling pathways and key regulatory factors associated with fibroblast activation. The findings may improve the understanding of keloid pathogenesis and identify potential therapeutic targets for future treatment.

This study is aimed to evaluate the efficacy of bone health management in improving pregnancy outcomes among WWE, and establish evidence-based vitamin D supplementation strategies for childbearing-age WWE.

A Prospective Clinical Study on the Efficacy and Safety of Bacterial Lysate (OM-85) Combined with Antihistamines in the Treatment of Chronic Spontaneous Urticaria (CSU): A Single-Centre, Observational, Cohort Study

The goal of this clinical trial is to learn if the combination therapy with SKB264 and anlotinib works to treat EGFR-TKI-resistant, liver-metastatic non-squamous non-small cell lung cancer (NSCLC). It will also learn about the safety of the combination therapy with SKB264 and anlotinib. The main questions it aims to answer are: Does combination therapy with SKB264 and anlotinib increase response rate and disease control rate, prolong duation of response and progressioin-free survival. What medical problems do participants have when taking combination therapy with SKB264 and anlotinib? Researchers will compare combination therapy with SKB264 and anlotinib to a historical data (the response rate of other drugs reported in literature) to see if combination therapy with SKB264 and anlotinib works better to treat EGFR-TKI-resistant, liver-metastatic non-squamous non-small cell lung cancer (NSCLC). Participants will: 1. receive SKB264 4 mg/kg intravenously on a 14-day cycle, and take anti-H1/H2 antihistamines, acetaminophen, and dexamethasone is recommended before infusion for the first 4 infusions to prevent side effects; the regimen may be simplified starting from the 5th infusion. 2. take anlotinib 10 mg orally once daily for 14 consecutive days, followed by a 7-day rest period. 3. Visit the clinic once every week for checkups and tests

The efficacy and safety of anti-inflammation treatment (Hirudoid introduction followed by yellow light therapy) combined with tofacitinib and doxycycline in Chinese adult patients with mild to moderate erythematous telangiectatic rosacea: A prospective parallel controlled single-blind cohort study

To evaluate the differences in weight loss between liraglutide monotherapy and combined with orlistat in overweight/obese patients.

To compare the efficacy and safety of the combination of alogliptin and actoplus met with that of actoplus met alone in improving the glucose and lipid metabolism and pancreatic function in T2DM patients complicated with MAFLD.

A single-arm, open-label clinical study of irinotecan liposome combined with capecitabine, bevacizumab and camrelizumab as second-line or above treatment for patients with metastatic colorectal cancer, aiming to evaluate the efficacy and safety of irinotecan liposome combined with capecitabine, bevacizumab and camrelizumab as second-line or above treatment for patients with metastatic colorectal cancer The medication regimen is irinotecan liposome (II) + capecitabine + bevacizumab + camrelizumab until disease progression or intolerable toxicity.

This study aims to evaluate the clinical efficacy of Danhong injection in patients with septic myocardial injury through a prospective randomized controlled trial. The study will enroll 140 patients meeting criteria for septic myocardial injury, divided into a Danhong injection group and a placebo group. Primary endpoints include changes in myocardial injury markers and improvement rates in cardiac function over 7 days, while secondary endpoints include 28-day mortality rates. This will determine whether Danhong injection possesses myocardial protective effects and provide evidence-based support for expanding its clinical indications.

This randomized controlled trial investigates the effects of prone positioning versus lateral positioning at different angles (30°, 90°, 120°) on pulmonary function improvement in patients with acute respiratory distress syndrome (ARDS). Utilizing electrical impedance tomography (EIT) technology, the study monitors key parameters including ventilation distribution and ventilation-perfusion matching in real time, while integrating respiratory mechanics and blood gas analysis data to comprehensively evaluate the therapeutic efficacy of positional adjustments. The study hypothesizes that high-angle lateral positioning may reduce adverse complications associated with prone positioning while effectively improving oxygenation and pulmonary function. The ultimate objective is to provide a safer and more personalized positional therapy regimen for clinical practice, optimizing ARDS treatment strategies to reduce mortality and enhance patient survival outcomes.

This study aims to explore the application effect of Ziwu Liuzhu electronic moxibustion combined with auricular points on constipation in stroke patients through clinical controlled trials, as well as the advantages over using electronic moxibustion alone.

Alzheimer's disease is the most common memory loss disease among the elderly. This disease affects the patient's memory, language, attention, and behavioral abilities. Current research has found that in the early stages of the disease, synaptic connections between brain nerve cells become abnormal, but the specific cause is still unclear. Investigators' previous research discovered that in the brains of diseased mice, certain special substances (the miR 342 5p/AnkG-mediated pathway) might be related to this abnormality, and these substances can be detected in both blood and cerebrospinal fluid. Therefore, investigators want to further explore the specific mechanisms of abnormal nerve cell connections, seek biomarkers for early detection of the disease, and provide new ideas for early diagnosis in the future.