Qian Dong Nan Miao Zu Dong Zu Zi Zhi Zhou

Primary aldosteronism (PA) is a common cause of secondary high blood pressure, but its best diagnosis and treatment methods are still difficult to establish. This research thoroughly evaluates adrenal venous sampling (AVS), focusing on important clinical, technical, and methodological questions. The goal is to understand how AVS-guided care affects long-term health and biochemical results to improve patient outcomes and management. The study involves patients with PA undergoing adrenal venous sampling through either the antecubital or femoral vein to identify whether aldosterone overproduction is coming from one side or both sides of the adrenal glands. This procedure helps classify the subtype of PA, which guides treatment decisions including potential adrenalectomy. The study also aims to refine AVS protocols and standardize clinical practice. Participants will be monitored for major adverse cardiovascular events (MACE) for one year after the AVS procedure. Researchers will assess clinical and biochemical outcomes to better understand the impact of AVS-guided management on patient prognosis. The study collects detailed information to optimize diagnosis, treatment decisions, and long-term care for individuals with primary aldosteronism.

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.

Researchers are evaluating shorter, all-oral treatment regimens for people with rifampicin-resistant tuberculosis (RR-TB), including those with pre-extensively drug-resistant TB (Pre-XDR-TB). This phase 3 trial compares seven different 9-month oral drug combinations to the 9-month standard of care (SOC) for RR-TB patients susceptible to fluoroquinolones. For those resistant to fluoroquinolones, a 9-month bedaquiline-containing regimen is compared to a conventional 20-month treatment. The study aims to assess if these shorter regimens are as effective and safe as the longer standard treatments. The experimental treatments include combinations of bedaquiline, linezolid, fluoroquinolones (moxifloxacin or levofloxacin), cycloserine, clofazimine, pyrazinamide, and other drugs. Each 9-month regimen uses no more than two major QT-prolonging drugs to reduce side effects. Treatment duration may be extended by 2 months if lung cavities remain or cultures are positive at month 2. For patients resistant to pyrazinamide based on baseline molecular testing, that drug is stopped without replacement. The control groups receive the current national guideline regimens, either 9 months for fluoroquinolone-susceptible or 20 months for Pre-XDR-TB. Participants undergo regular assessments including molecular drug susceptibility testing using whole gene sequencing at baseline. Researchers monitor treatment outcomes, safety, and side effects over a total of 21 months after randomization. The main outcome measured is a favorable treatment result at the end of the study. Participants are followed closely with clinical evaluations to understand the effectiveness and tolerability of these shorter, precision-based oral regimens.

Researchers are evaluating the safety and effectiveness of a drug called JX10 compared to a placebo in adults who have suffered an Acute Ischemic Stroke (AIS) and arrive for treatment between 4.5 and 24 hours after symptom onset. The study aims to determine if JX10 improves functional recovery, measured by the modified Rankin Scale, and to assess the risk of symptomatic intracranial hemorrhage associated with the drug. The study has two parts: during Part 1, participants are randomly assigned to receive either JX10 at doses of 1 mg/kg or 3 mg/kg, or a placebo. In Part 2, participants receive the optimal JX10 dose identified in Part 1 or placebo. JX10 is a thrombolytic agent given to help dissolve blood clots causing the stroke. Participants will be monitored for outcomes including the proportion who have no or minimal symptoms 90 days after treatment and the occurrence of symptomatic bleeding within 36 hours after randomization. The study includes clinical assessments, imaging to confirm stroke and salvageable brain tissue, and safety monitoring to evaluate bleeding risks. The trial enrolls adults aged 18 to 90 years with specific stroke characteristics and follows them closely through treatment and recovery.

Tuberculosis (TB) is a major global infectious disease, and controlling it is challenging due to the difficulty patients have in following long and complex treatment plans. This research aims to evaluate high-dose rifapentine in treating rifampicin-sensitive pulmonary tuberculosis and to explore if the treatment duration can be shortened to 17 weeks. The study is a multicenter, non-inferiority randomized controlled trial conducted in two stages to assess the safety, effectiveness, and drug behavior of different rifapentine doses. Participants will receive one of several treatment regimens: a short regimen with rifapentine at 10mg/kg, 15mg/kg, or 20mg/kg daily combined with isoniazid, pyrazinamide, and moxifloxacin, all taken orally; or a standardized regimen with rifampicin, isoniazid, pyrazinamide, and ethambutol during an intensive phase, followed by rifampicin and isoniazid in the continuation phase. The first stage focuses on determining tolerability and pharmacokinetics to select doses for the second stage, which confirms efficacy and safety. During the study, participants will be monitored over 108 weeks after randomization to assess treatment success and tolerability. Researchers will evaluate drug safety, effectiveness, and pharmacokinetics throughout treatment and follow-up. The trial includes regular assessments to track participants' health and response to therapy, aiming to reduce treatment duration and adverse effects while improving outcomes for patients with rifampicin-sensitive tuberculosis.

Researchers are comparing two types of total intravenous anesthesia—remimazolam and propofol—in patients who are at moderate to high risk and undergoing major elective noncardiac surgery under general anesthesia. This Phase 4 randomized controlled trial aims to determine if using remimazolam can increase the number of days patients are alive and out of the hospital within 30 days after surgery compared to propofol. The study focuses on patients aged 45 years and older with specific health risks undergoing surgeries expected to last more than 2 hours with postoperative stays longer than 2 days. Participants receive either remimazolam or propofol administered intravenously for both induction and maintenance of general anesthesia during their surgery. The trial is conducted across multiple centers and involves strict criteria to select patients with conditions such as coronary artery disease, stroke history, heart failure, diabetes, or other listed risks. The study excludes patients undergoing certain types of surgeries or with severe organ dysfunction to ensure safety and appropriate comparison. During the study, researchers will monitor patients for 30 days after surgery, focusing on the primary outcome of days alive and out of the hospital. Safety and recovery will be closely tracked, including the need for postoperative ventilatory support and any complications during the hospital stay. The total involvement includes surgery and follow-up assessments to evaluate the effectiveness and safety of the anesthesia methods in this patient population.

Objective: To investigate whether patients with cerebral vasospasm associated with aneurysmal subarachnoid hemorrhage have a better prognosis with intrathecal nicardipine injection via extraventricular drainage or lumbar drainage. Design: This study is a multi-center, prospective, double-blinded, randomized controlled trial. Interventions: First, 6 ml of cerebrospinal fluid is withdrawn from the EVD or LD catheter, and then 4 ml of nicardipine hydrochloride is injected into the EVD or LD drain tube, followed by 2 ml of 0.9 % sodium chloride solution (NaCl), and then the EVD or LD tube was clamped for 2 hours after the injection was completed, then kept open as clinically necessary until the next dose (twice a day).