Resumo: A participação efetiva dos estudantes de medicina tem contribuído muito para o próspero desenvolvimento da pesquisa clínica nas escolas médicas da China nos últimos anos. No entanto, com o aumento do número e tipos de projetos de pesquisa clínica dos quais os estudantes de medicina participam, questões relacionadas à ética e à alfabetização são gradualmente expostas. Este artigo lista as questões éticas que surgiram na participação de estudantes de medicina em pesquisas clínicas nos últimos anos, analisa as causas subjacentes e propõe soluções para as questões éticas acima mencionadas, com o objetivo de fornecer referência para o ensino de ética médica e gestão de projetos de pesquisa para escolas médicas.

Resumen: La participación efectiva de los estudiantes de medicina ha contribuido en gran medida al desarrollo exitoso de la investigación clínica en las escuelas de medicina de China en los últimos años. Sin embargo, con el creciente número y tipos de proyectos de investigación clínica en los que participan estudiantes de medicina, las cuestiones éticas se exponen gradualmente. Este trabajo enumera las cuestiones éticas que han surgido en la participación de los estudiantes de medicina en la investigación clínica en los últimos años, analiza las causas subyacentes y propone soluciones a las cuestiones éticas mencionadas anteriormente, con el objetivo de proporcionar referencia para la enseñanza de la ética médica y la gestión de proyectos de investigación para las escuelas de medicina.

Abstract: In recent years, the vigorous development of clinical researches carried out by medical schools is inseparable from the effective participation of medical students. However, as the number and categories of clinical research projects that medical students participate in increase, medical ethics related issues gradually occur. This article sorts out the ethical issues that arose in clinical researches, in which medical students participated, analyzes the underlying causes, and proposes solutions for the above-mentioned ethical issues, aiming to provide reference for medical ethics education and research project management for medical schools.

SUMMARY OBJECTIVE: The purpose of this study was to compare arterial stiffness and ultrasound indices in patients with and without chronic obstructive pulmonary disease. METHODS: In our retrospective study, 83 chronic obstructive pulmonary disease patients were assigned to the chronic obstructive pulmonary disease group and 80 healthy controls were enrolled. Pearson's correlation analysis software was used to analyze the correlation between arterial stiffness (including brachial ankle pulse wave velocity and ankle-brachial blood pressure index) and ultrasound index (including resistance index, pulsatility index, and intima-media thickness) at the carotid artery in chronic obstructive pulmonary disease patients. RESULTS: The ultrasound resistance index and pulsatility index level of chronic obstructive pulmonary disease group were lower than those of control group (t=6.326, 8.321, p<0.001). Compared with the control group, the chronic obstructive pulmonary disease group had higher intima-media thickness, total plaque area, and number of plaques (t=4.574, 7.493, 5.093, p<0.001). The arterial stiffness and ankle-brachial blood pressure index level in the chronic obstructive pulmonary disease group were higher than those in the control group (t=6.392, 5.109, p<0.001). Moreover, arterial stiffness in patients with chronic obstructive pulmonary disease was negatively correlated with the ankle-brachial blood pressure index, resistance index, and pulsatility index levels (p<0.05), while it is positively correlated with intima-media thickness, total plaque area, and number of plaques (p<0.05). CONCLUSION: Our results indicated that patients with chronic obstructive pulmonary disease have stiffer arteries compared with healthy control subjects; the ultrasound index could be used as an auxiliary indicator for clinical prediction of arterial stiffness, which is helpful to improve the accuracy of prediction and thus better guide clinical interventions in high-risk groups of chronic obstructive pulmonary disease in time.

RESUMO Objetivo Investigar as características clínicas de prematuros com diferentes gravidades de displasia broncopulmonar (DBP) e divulgar os fatores de alto risco para a DBP. Métodos Coleta de dados clínicos de 91 prematuros internados em UTIN com diagnóstico de DBP, categorizados em grupos de acordo com a gravidade da doença: 41 casos leves, 24 casos moderados e 26 casos graves. Foram feitas a comparação e a análise de fatores de risco perinatais, tratamento, complicações e prognóstico de lactentes com diferentes graus de gravidade. Resultados O grupo grave teve uma proporção maior de bebês com doença cardíaca congênita (DCC) do que o grupo moderado (p < 0,05) e com pneumonia e ventilação mecânica (VM) ≥ 7 dias do que o grupo leve (p < 0,05). O grupo grave também apresentou maior incidência de reintubação do que os grupos leve e moderado (p < 0,05). Os grupos apresentaram diferentes (p < 0,05) taxas de incidência de persistência do canal arterial hemodinamicamente significativa (PCAhs). A análise de ridit sugeriu que os bebês prematuros (BPs) com PCAhs, infecções pulmonares microbianas múltiplas ou pneumonia por Klebsiella pneumoniae tinham doenças mais graves. Conclusão DCC, PCAhs, VM ≥ 7 dias, reintubação, pneumonia, principalmente infecções pulmonares microbianas múltiplas, e pneumonia por Klebsiella pneumoniae estão correlacionadas com a gravidade da DBP e podem ser usadas como preditoras de progressão da DBP.

ABSTRACT Objective To investigate the clinical characteristics of preterm infants with different severities of bronchopulmonary dysplasia (BPD) and disclose the high-risk factors of exacerbating BPD. Methods Collection of clinical data of 91 preterm infants admitted to the NICU and diagnosed with BPD, categorized in groups according to the disease severity: 41 mild cases,, 24 moderate cases, and 26 severe cases. Comparison and analysis of perinatal risk factors, treatment, complications and prognosis of the infants with different severity degrees. Results The severe group had a higher proportion of infants with congenital heart disease (CHD) higher than the moderate group (P < 0.05), and a higher ratio of pneumonia and mechanical ventilation (MV) ≥ seven days than the mild group (P < 0.05). The severe group also presented higher reintubation incidence than both the mild and moderate groups (P < 0.05). The groups presented different (P < 0.05) incidence rates of hemodynamically significant patent ductus arteriosus (hsPDA) . Ridit analysis suggested that the premature infants (PIs) with hsPDA, multiple microbial pulmonary infections, or Klebsiella pneumoniae pneumonia had more severe illness. Conclusion CHD, hsPDA, MV ≥ seven days, reintubation, pneumonia, especially multiple microbial pulmonary infections, and Klebsiella pneumoniae pneumonia are correlated with the severity of BPD and can be used as BPD progression predictor.