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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2600122020 |
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最近更新日期: Date of Last Refreshed on: |
2026-04-08 10:20:50 |
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注册时间: Date of Registration: |
2026-04-08 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
一项评估利奈唑胺片治疗神经梅毒安全性和有效性的随机、开放标签、双臂、非劣效性临床研究 |
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Public title: |
A Randomized, Open-label, Two-arm, Non-inferiority Clinical Study to Evaluate the Safety and Efficacy of Linezolid Tablets in the Treatment of Neurosyphilis |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
一项评估利奈唑胺片治疗神经梅毒安全性和有效性的随机、开放标签、双臂、非劣效性临床研究 |
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Scientific title: |
A Randomized, Open-label, Two-arm, Non-inferiority Clinical Study to Evaluate the Safety and Efficacy of Linezolid Tablets in the Treatment of Neurosyphilis |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
冷欣颖 |
研究负责人: |
柯吴坚 |
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Applicant: |
Xinying Leng |
Study leader: |
Wujian Ke |
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申请注册联系人电话: Applicant telephone: |
+86 159 7800 0751 |
研究负责人电话:
Study leader's |
+86 180 1170 1779 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
xleng@lluita.org |
研究负责人电子邮件: Study leader's E-mail: |
kewujianstauch@163.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
日耳曼斯?特里亚斯?伊?普霍尔医院,西班牙巴塞罗那省 巴达洛纳市坎耶特路,产科大楼 2 层,邮编 08916 |
研究负责人通讯地址: |
江苏省南京市玄武区蒋王庙街 12 号 |
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Applicant address: |
Hospital Germans Trias i Pujol, 2nd Floor of Maternity Building.Road de Canyet SN, 08916 Badalona – Barcelona Spain |
Study leader's address: |
12 Jiangwangmiao Street, Xuanwu Distric t, Nanjing, Jiangsu Province |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
西班牙抗击感染基金会(Lluita) |
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Applicant's institution: |
Fight Infections Foundation (Lluita), Spain |
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研究负责人所在单位: |
中国医学科学院?肤病医院 |
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Affiliation of the Leader: |
Hospital for Skin Diseases, Chinese Academy of Medical Sciences |
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是否获伦理委员会批准: |
是 |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
(2025)科研第(068)号 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
中国医学科学院皮肤病医院医学伦理委员会 |
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Name of the ethic committee: |
Medical Ethics Committee of the Hospital for skin diseases, Chinese Academy of Medical Sciences |
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伦理委员会批准日期: Date of approved by ethic committee: |
2025-12-26 00:00:00 | ||
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伦理委员会联系人: |
聂瑾 |
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Contact Name of the ethic committee: |
Jin Nie |
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伦理委员会联系地址: |
江苏省南京市?武区蒋王庙街12号 |
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Contact Address of the ethic committee: |
12 Jiangwangmiao Street, Xuanwu District, Nanjing, Jiangsu Province |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 25 8547 0763 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
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研究实施负责(组长)单位: |
中国医学科学院皮肤病医院 |
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Primary sponsor: |
Hospital for Skin Diseases, Chinese Academy of Medical Sciences |
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研究实施负责(组长)单位地址: |
江苏省南京市玄武区蒋王庙街12号 |
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Primary sponsor's address: |
12 Jiangwangmiao Street, Xuanwu District, Nanjing, Jiangsu Province |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
欧洲研究理事会 |
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Source(s) of funding: |
European Research Council(ERC) |
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研究疾病: |
梅毒 |
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Target disease: |
Syphilis |
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研究疾病代码: |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
II期临床试验 | ||||||||||||||||||||||
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Study phase: |
2 |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
1.主要目的 评估利奈唑胺相较于标准治疗注射用青霉素钠治疗在实现神经梅毒的临床、脑脊液及血清学复合治愈终点的非劣效性。 2.次要目的 (1)评估利奈唑胺与注射用青霉素钠治疗相比的临床、脑脊液和血清学治愈率。 (2)评估利奈唑胺与标准注射用青霉素钠治疗相比的临床、脑脊液和血清学方面的治愈时间进程。 评估利奈唑胺治疗与标准注射用青霉素钠相比治疗神经梅毒的安全性。 (3)评估随机分配至利奈唑胺组的18名参与者体内利奈唑胺的药代动力学(PK)参数,包括基于实测药代动力学特征数据得出的 24 小时曲线下面积(AUC24h)及脑脊液与血药浓度比。 3.探索性目的: (1)鉴定梅毒螺旋体与神经梅毒临床表现相关的基因组学特征(基因组学)。 (2)鉴定与神经梅毒临床表现相关的抗原及宿主对梅毒螺旋体的体液免疫应答(蛋白质组学)。 (3)获取生物样本用于进一步研究。 |
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Objectives of Study: |
1. Primary objectives To assess the non-inferiority of linezolid compared with standard ACPG treatment in achieving composite clinical, Cerebrospinal fluid(CSF), and serological cure of neurosyphilis. 2. Secondary objectives (1) To assess the rates of CSF, serological, and clinical cure of linezolid compared with standard ACPG treatment. (2) To assess the time course of clinical, CSF and serological cure of linezolid compared with standard ACPG treatment. (3) To characterize the pharmacokinetic (PK) parameters of linezolid in a subset of participants, including AUC24h and CSF: blood ratio derived from observed pharmacokinetic profile data. 3. Exploratory objectives (1) To identify genomic traits of TP that are associated to neurosyphilis clinical manifestations (genomics). (2) To identify antigens and host humoral response to TP that are associated to neurosyphilis clinical manifestations (proteomics). (3) Biological samples will be obtained for further studies. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
要获得参与研究的资格,参与者必须满足以下标准: 1.筛查访视时年龄为 18 至 70 周岁(含18及70周岁),性别不限。 2.诊断为无症状、症状性神经梅毒、眼梅毒或耳梅毒,包括下列情况之一(有关诊断标准、临床表现及具体评估的详细信息,参见研究方案附录4): (1)无症状神经梅毒伴治疗失败:早期或晚期梅毒患者经规范治疗后,在排除再感染可能后,分别于1年或2年内血清快速血浆反应素试验(rapid plasma reagin,RPR)或血清甲苯胺红 非加热血清试验(toluidine red unheated serum test ,TRUST)滴度未实现四倍下降,和/或高人类免疫缺陷病毒 (Human Immunodeficiency Virus, HIV)感染风险(CD4+ T 细胞计数<350个/μL且 RPR/TRUST≥1:32); (2)脑膜神经梅毒:症状性脑膜炎和/或颅神经麻痹; (3)脑膜血管梅毒; (4)实质性神经梅毒:麻痹性痴呆。 (5)脊髓神经梅毒:脑脊膜脊髓炎、横贯性脊髓炎、树胶肿、神经根病、脊髓痨。 (6)混合型神经梅毒:血管性神经梅毒与实质性神经梅毒。 (7)眼梅毒,经过眼科医生确认; (8)耳梅毒,经过耳科医生确认。 3.签署书面知情同意书,同意参加临床试验。 4.能够遵守研究方案的要求。 5.有生育能力的女性,应在治疗期间采用高效避孕方法(禁欲、激素避孕、宫内节育器 [IUD]、或自身或伴侣存在解剖结构或功能异常所致的不育)。 6.青霉素皮试阴性。 7.HIV阴性或阳性参与者均可入组。其中,HIV阳性者需已接受抗逆转录病毒治疗(ART)至少3个月,且病毒载量低于检测下限。 8.实验室血液检测确诊梅毒 梅毒螺旋体和非梅毒螺旋体检测均为阳性且非梅毒螺旋体检测滴度≥1: 8。若为实质性或脊髓神经梅毒,即使滴度<1:8,但存在符合神经梅毒的MRI异常表现时亦可。* 9.实验室脑脊液确诊神经梅毒 (1)对于非HIV患者,至少符合以下3 项实验室标准中的 1 项: o 脑脊液性病研究实验室试验( Venereal Disease Research Laboratory test, VDRL)/RPR/TRUST阳性 o 脑脊液白细胞计数>5 个/ μL o 脑脊液蛋白浓度>45mg/dL (2)在 HIV 患者中,由于 HIV 本身会导致轻微的脑脊液细胞增多,至少符合以下4项实验室标准中的 1 项: o脑脊液VDRL/RPR/TRUST阳性 o脑脊液白细胞计数>20个/ μL o脑脊液白细胞计数>5个/ μL且CD4+ T 细胞计数<200个/ μL o脑脊液白细胞计数>5个/ μL且CD4+ T 细胞计数≥200个/ μL且CSF梅毒螺旋体检测为阳性 在眼梅毒或耳梅毒(无论是否感染HIV)的诊断中,若临床表现符合疾病特征,则无需强制要求脑脊液(CSF)实验室检测结果呈阳性。然而,若存在CSF异常,该结果可用于评估治疗效果。 *非梅毒螺旋体试验滴度阈值设定为1:8,用于确认活动性感染并实现治疗反应的可靠血清学监测。采用≥1:8的临界值可准确评估主要疗效终点(定义为随访时非梅毒螺旋体滴度下降≥4倍)。当滴度较低(<1:8)时,因血清固定状态可能持续存在且无显著变化,这将为结果解读引入干扰因素。 |
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Inclusion criteria |
To be eligible to participate in the study, a participant must meet the following criteria: 1. Aged 18 to 70 years at screening visit, any gender. 2. Asymptomatic or symptomatic neurosyphilis, ocular or otic syphilis, which includes one of the following (see Appendix 4 of research protocol for diagnostic criteria and further details on clinical presentation and specific assessments): (1) Asymptomatic neurosyphilis in the context of treatment failure evidenced by a non-fourfold decrease in serum rapid plasma reagin (RPR) or toluidine red unheated serum test (TRUST) titer within one or two years of treatment for early or late syphilis, respectively, without suspicion of reinfection and/or high risk HIV (CD4<350 and RPR/TRUST≥1:32). (2) Meningeal neurosyphilis: Symptomatic meningitis or cranial nerve palsies. (3) Meningovascular neurosyphilis. (4) Parenchymal neurosyphilis: General paresis. (5) Spinal neurosyphilis: meningomyelitis, transverse myelitis, gummas, radiculopathy, tabes dorsalis. (6) Mixed-type neurosyphilis: vascular and parenchymal neurosyphilis. (7) Ocular syphilis based on an examination performed by an ophthalmologist. (8) Otic syphilis based on an examination performed by an otorhinolaryngologist. 3. Signature of written informed consent to take part in the clinical trial. 4. Ability to comply with the requirements of the study protocol. 5. If women of childbearing potential, use of a highly effective method of contraception (abstinence, hormonal contraception, intra-uterine device [IUD], or infertility due to anatomical or functional sterility in self or partner) committed during the study. 6. Negative Penicillin Allergy Skin Test 7. HIV-negative or HIV-positive, if in antiretroviral therapy (ART) for at least 3 months and with an undetectable viral load. 8. Laboratory blood confirmation of syphilis Reactive treponemal and non-treponemal tests, with a non-treponemal test titer of 1:8 or higher. In cases of parenchymal or spinal neurosyphilis, a titre <1:8 is acceptable if MRI abnormalities consistent with neurosyphilis are present. 9. Laboratory CSF confirmation of neurosyphilis, assessed by lumbar puncture, after meeting all other inclusion criteria and none of the exclusion criteria: (1)In non-HIV individuals, meeting at least 1 out of the following 3 criteria: o CSF-Venereal Disease Research Laboratory test(VDRL) or CSF-RPR or CSF-TRUST reactive o CSF-White Blood Cells(WBC) count >5 cells/μL o CSF protein concentration >45 mg/dL (2)In HIV individuals, as HIV itself causes mild CSF pleocytosis, meeting at least 1 out of following 4 criteria: o CSF-VDRL or CSF-RPR or CSF-TRUST reactive o CSF-WBC >20 cells/μL o CSF-WBC >5 cells/μL and CD4 <200 cells/ μL o CSF-WBC >5 cells/μL and CD4 >=200 cells/ μL and reactive CSF-treponemal test In the context of ocular or otic syphilis, both in non-HIV and HIV individuals, reactive CSF laboratory criteria are not required if clinical findings are consistent. Nonetheless, CSF abnormalities, when present, will be useful to assess the effect of treatment. The non-treponemal test titer threshold of 1:8 is used to confirm active infection and to allow reliable serologic monitoring of treatment response. The >=1:8 cutoff allows accurate evaluation of the primary efficacy endpoint, defined as a >=4-fold decline in non-treponemal titer at follow-up. Lower titers (<1:8) may persist without significant change due to the serofast state and would introduce a confounding factor for outcome interpretation. Participants with parenchymal or spinal neurosyphilis may be included even if the non-treponemal titre is <1:8, provided that MRI shows abnormalities consistent with neurosyphilis, as these clinical forms may present with low titres. |
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排除标准: |
1.已知对利奈唑胺、青霉素和/或赋形剂过敏,尤其是已知对青霉素、头孢菌素或其他β-内酰胺药物过敏和/或对大豆或花生过敏。 2.乳糖或半乳糖不耐症或葡萄糖-半乳糖吸收不良。 3.妊娠期或哺乳期妇女,或随访期间怀孕。 4.目前正在接受治疗的药物可能与研究药物发生相互作用(见研究计划的附录表2)。 5.在首次服用研究药物前至少30天或5个半衰期(以较长者为准)接受过任何研究性化学或生物制剂治疗,或目前正在参加另一项干预性临床研究。 6.在随机分组前 1 周内服用过任何具有潜在抗梅毒螺旋体活性的抗生素例如β内酰胺类(如青霉素及头孢菌素类)、大环内酯类、四环素类,或在随机分组前 2 周内肌肉注射过青霉素。 7.骨髓抑制,定义为出现以下任一情况: o 绝对中性粒细胞计数(ANC)<1,000/μL o 血红蛋白<9 g/dL o 血小板计数<100,000/μL 8.医生认为MRI 或其他检查结果提示参与者的症状存在与神经梅毒无关的其他潜在病因。 9.认知功能受损、意识模糊状态,或经医生判断存在其他可能导致无法提供有效知情同意或无法依从研究程序的情况。 10.重度免疫抑制:具体包括:①晚期HIV感染者(即患有艾滋病界定疾病者);②当前正在接受化疗者;③正在接受全身性皮质类固醇治疗、且剂量相当于泼尼松≥20毫克/天、持续超过2周者。设定此项排除标准,旨在最大程度降低参与者的安全风险,并避免因免疫状态差异对免疫反应及治疗结果的评估造成混杂效应。然而,HIV感染已得到控制者(即接受抗逆转录病毒治疗病情稳定,且病毒载量检测不到)可被纳入研究;因为已有公开证据表明,此类患者对于神经梅毒治疗的临床反应与普通患者相当。 11.活动性或未充分治疗的肺结核。 12.当前或过去一年内有晚期恶性肿瘤病史。 13.高血压未控制的患者、嗜铬细胞瘤或甲状腺功能亢进症患者。 |
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Exclusion criteria: |
1. Known allergy to linezolid, penicillin, and/or excipients, particularly known hypersensitivity to penicillin, cephalosporins, or other beta-lactam agents and/or allergy to soya or peanut. 2. Lactose or galactose intolerance or glucose-galactose malabsorption. 3. Pregnant or breastfeeding women, or willing to be pregnant during the follow-up period. 4. Current treatment with any drugs likely to interact with the study medication (see list in Appendix 2 of the research protocol). 5. Have been treated with any investigational chemical or biologic agent or currently enrolled in another interventional clinical study for at least 30 days or 5 half-lives (whichever is longer) prior to the first dose of study drug. 6. Have taken any antibiotics with potential activity against syphilis (e.g. beta lactams, cephalosporines, macrolides, tetracyclines) within 1 week prior to randomization or have been administered intramuscular penicillin within 2 weeks prior to randomization. 7. Myelosupression, defined as any of the following: o Absolute neutrophil count (ANC) < 1,000 cells/μL o Hemoglobin < 9 g/dL o Platelet count < 100,000 cells/μL 8. In the physician's opinion, the Magnetic Resonance Imaging (MRI) or other tests conducted reveal a potential alternative cause for the participant's symptoms that are unrelated to neurosyphilis. 9. Cognitive impairment, confusional state or any other process that, in the physician’s opinion, prevents from providing valid informed consent or from adequately complying with study procedures. 10. Severe immunosuppression: Specifically, ①individuals with advanced HIV infection (AIDS-defining illness);②current chemotherapy;③systemic corticosteroid therapy equivalent to ≥20 mg/day of prednisone for >2 weeks. Exclusion aims to minimize safety risks and to avoid confounding effects on immune response and treatment outcomes. Patients with controlled HIV infection (stable on ART and undetectable viral load) may be included, as this group has comparable clinical responses to neurosyphilis therapy based on published evidence. 11. Active or inadequately treated tuberculosis. 12. Current or past history (in the last year) of advanced malignancy 13. Uncontrolled hypertension, pheochromocytoma or hyperthyroidism |
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研究实施时间: Study execute time: |
从 From 2026-05-01 00:00:00至 To 2028-05-01 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2026-05-01 00:00:00 至 To 2028-05-01 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
随机序列由独立统计学家预先生成,并通过交互式网络应答系统(IWRS)进行管理和执行。以1:1比例将参与者随机分组,每个区组包含6名参与者。 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
The randomization sequence was pre-generated by an independent statistician and executed through an Interactive Web Response System (IWRS), with all procedures recorded in the audit trail. Randomization will be done in a 1:1 ratio with six participants per block. |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
公开/Public |
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盲法: |
由于干预组和对照组的给药方式、给药途径和治疗持续时间存在显著差异,因此无法进行盲法。但统计学分析将采用盲法。统计学家将不知道参与者被分配到哪个治疗组。 |
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Blinding: |
Blinding will not be carried out because the dosing, routes of administration, and treatment durations of the intervention and control groups are significantly different. However, the statistical analysis will be blinded. The statistician will not know which treatment group the participant has been allocated to.? |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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是否共享原始数据: IPD sharing |
是Yes |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
去识别化的个体患者数据及相关元数据(研究方案、数据字典)将根据合理请求进行共享,但受法规合规性的受控访问和数据共享协议的约束。不会共享任何个人可识别信息。 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
De-identified Individual Patient Data and accompanying metadata (protocol, data dictionary) will be shared upon reasonable request, subject to regulatory-compliant controlled access and data sharing agreements. No personal identifiable data will be shared. |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
数据采集: 病例记录表(Case Record Form, CRF)。 数据管理: 基于REDCap的陕西省重大疾病防控与大健康数据共享平台数据采集系统。 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Data Collection: Case Record Form (CRF). Data Management: Data collection system based on REDCap's Shaanxi Open Sharing Platform of Critical Disease Prevention and Health Data Science. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |