Dongying

Stroke is the second leading cause of death worldwide, with ischemic stroke being the most common type. The current best treatment for acute ischemic stroke is intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA) given within 4.5 hours of symptom onset. However, some patients experience stroke progression or early blood vessel reocclusion after thrombolysis, which worsens neurological function and outcomes. This is believed to be caused by increased platelet activation after thrombolysis, which peaks within the first 2 hours. This clinical trial is testing whether starting oral aspirin early after intravenous thrombolysis can improve functional outcomes without causing more bleeding problems. Patients are randomly assigned to receive either 300 mg aspirin tablets or matching placebo tablets as soon as possible after enrollment. If swallowing is difficult, tablets can be crushed and given through a nasogastric tube. Both groups receive best medical management according to guidelines. The study is a Phase 3, multicenter, randomized, placebo-controlled trial. Participants will be followed for 90 days after stroke to measure their functional recovery using the modified Rankin scale (mRS). Researchers will check if patients have a good outcome defined as an mRS score of 0 or 1 at 90 days. During the study, patients undergo assessments including neurological exams and imaging to confirm eligibility and monitor safety. The trial aims to determine if early aspirin treatment after thrombolysis is safe and can help prevent neurological decline and improve recovery.

The study population are patients with acute anterior circulation large vessel occlusion stroke and planned to undergo endovascular treatment. All participants are randomly assigned in a 1:1 ratio to the tocilizumab group or the placebo group. In tocilizumab group, participants will receive tocilizumab combined endovascular treatment. And in placebo group, participants will receive placebo combined endovascular treatment. All participants will be visited immediately postoperatively, at 24 hours, 7 days, and 90 days after randomization.

This trial investigates treatments for adults aged 18 to 75 with HER2-positive advanced gastric or gastroesophageal junction adenocarcinoma that cannot be removed by surgery or has spread to other parts of the body. It is a Phase II, randomized, open-label study comparing two treatment approaches as first-line therapy. The study aims to evaluate the effectiveness of Disitamab Vedotin combined with Sintilimab and S-1 versus Trastuzumab plus chemotherapy, with or without Sintilimab. Participants will receive one of the two treatment combinations. One group will be treated with Disitamab Vedotin (2.5 mg/kg IV every 3 weeks), Sintilimab (200 mg IV every 3 weeks), and S-1 (40-60 mg twice daily for 14 days every 3 weeks). The other group will receive Trastuzumab (initial dose 8.0 mg/kg, then 6.0 mg/kg IV every 3 weeks) plus chemotherapy drugs that may include Oxaliplatin, Capecitabine, 5-FU, or Cisplatin, with or without Sintilimab. The study is conducted across multiple centers and participants are closely monitored throughout treatment. During the study, participants will undergo various assessments to measure treatment response, specifically the objective remission rate at six months after the last participant finishes treatment. Researchers will monitor health status, organ function, and any side effects. Eligibility checks include confirming HER2-positive status and measurable tumors, with performance status and life expectancy considered. The study aims to gather important data on these treatments' safety and effectiveness over the study period.

Researchers are evaluating the safety and effectiveness of combining two drugs, iparomlimab and tuvonralimab (QL1706), with chemotherapy to treat adults aged 18 to 75 who have a specific type of advanced stomach or gastroesophageal junction cancer that is HER2-negative and has low PD-L1 expression. This phase II single-arm trial focuses on patients whose cancer cannot be removed by surgery or has spread to other parts of the body. The study aims to better understand how this combination treatment affects progression-free survival over 12 months after the last participant joins. The treatment involves giving iparomlimab and tuvonralimab intravenously at a dose of 5 mg/kg on the first day of each 3-week cycle until the disease worsens or side effects become intolerable. Chemotherapy includes oxaliplatin at 130 mg/m2 intravenously on day 1 of the first six 3-week cycles and capecitabine tablets taken orally twice daily at 1000 mg/m2 from days 1 to 14 of each cycle until disease progression or intolerable toxicity. This regimen combines immunotherapy agents with chemotherapy drugs in a planned schedule to assess their combined effect on the cancer. Participants will have measurable cancer lesions assessed by standard criteria and must have a good performance status and adequate organ function before joining. Researchers will monitor participants regularly for disease progression, side effects, and overall health during treatment. The main outcome measured is progression-free survival 12 months after the last participant starts the study. The study includes careful follow-up and safety assessments throughout the treatment period and beyond to evaluate the long-term effects of the therapy.

Researchers are investigating the safety and effectiveness of remote ischemic conditioning (RIC) in patients with acute ischemic stroke caused by large vessel blockage in the brain. While endovascular thrombectomy is effective in reopening blocked vessels, many patients still suffer poor outcomes due to brain tissue damage during and after the procedure. The study aims to see if RIC, a noninvasive therapy involving brief cycles of arm blood flow restriction, can protect the brain and improve recovery in these patients. The study compares two durations of remote ischemic conditioning: one lasting 14 days and another lasting 30 days after mechanical thrombectomy. RIC is performed using an automatic device that inflates and deflates a cuff on the upper arm, with five cycles of 5-minute inflation and 5-minute deflation. This procedure is done once before thrombectomy and then twice daily during the assigned post-thrombectomy period. All patients also receive best medical management according to guidelines. Mechanical thrombectomy is done following standard practices to reopen blocked vessels safely. Participants will be monitored for 90 days after their stroke to assess recovery and safety. The main measure is the proportion of patients who achieve a good functional outcome, defined as a modified Rankin Scale score of 0 to 2 at 90 days. Throughout the study, medical evaluations, imaging, and clinical assessments will be conducted to track progress and any side effects. The study also explores how the length of RIC treatment affects patient outcomes, aiming to find the best approach to protect the brain after stroke treatment.

Researchers are investigating effective prevention and treatment strategies for osteoporotic refractures in patients with new fractures. This study includes registration and follow-up studies to gather epidemiological data, as well as a prospective treatment study using randomized controlled trials. It also aims to establish warning models for osteoporotic refractures through biomarker and imaging biomarker research using multi-omics and new imaging technologies. The treatment study compares two approaches: one group receives 60 mg of Denosumab by subcutaneous injection, and the other group receives Teriparatide treatment followed sequentially by Denosumab. This multicenter randomized controlled trial evaluates the efficacy of sequential Denosumab after 6 months of Teriparatide compared with Denosumab alone in reducing the risk of osteoporotic fractures. Participants will be monitored for up to 24 months, with the main outcomes being the incidence of new vertebral fractures and the rate of change in bone mineral density at the lumbar spine. Researchers will collect clinical data, imaging, and biomarker information to assess treatment effects and safety. The study includes careful follow-up to track fracture occurrence and changes in bone health over time.

Researchers are evaluating gastrointestinal bleeding in patients with acute coronary syndrome (ACS) who have undergone Percutaneous Coronary Intervention (PCI) and require long-term dual antiplatelet therapy (DAPT). Helicobacter pylori (Hp) infection is a common risk factor for gastrointestinal bleeding in these patients. This open-label, randomized, controlled phase 4 trial compares the effects of a novel dual eradication therapy using Vonoprazan combined with amoxicillin against routine proton pump inhibitor (PPI) treatment with pantoprazole on bleeding events in ACS patients with Hp infection and coronary stents. The study plans to enroll 2600 patients, randomly assigning 1300 to each group. The test group will receive a 14-day course of Vonoprazan 20 mg twice daily plus amoxicillin 1 g three times daily for Hp eradication, followed by 6 months of monitoring. The control group will receive pantoprazole 40 mg daily for 6 months. All patients will continue their DAPT regimen, which includes aspirin plus either clopidogrel or ticagrelor, as determined by their doctor. Hp infection will be confirmed using urea breath tests and antibody detection, and eradication success will be retested about 12 weeks after treatment. Participants will be monitored for gastrointestinal bleeding and adverse reactions over 6 months. Follow-up visits will include breath tests for Hp, safety visits for adverse event reporting, and documentation of treatment adherence. The primary outcome is the incidence of gastrointestinal bleeding within 6 months after PCI. This trial aims to provide evidence on whether Vonoprazan-based dual eradication therapy is a safe and effective alternative to routine PPI treatment in reducing bleeding risk in this high-risk patient group.