Human Practices
Overview
With the aging of population approaching and lifestyles changing, the number of patients with chronic musculoskeletal pain is increasing. For many middle-aged and elderly people, this pain seriously reduces their quality of life. Chronic musculoskeletal pain mainly has the problem of high prevalence rate, low awareness rate, low treatment rate, and low remission rate. The treatment and remission rate are intimately related to the classification of pain. But noceptive pain and neuropathic pain are not easily distinguished.Our project hopes to distinguish between these two kinds of pain by detecting miRNAs and assist doctorss in pain classification, so as to facilitate accurate diagnosis and medication.
We carried out a human practice activities based on the project. In the activities we got an in-depth understanding of the social problems we faced. We conducted a series of interviews, discussions, and education activities, which made our project more responsive to social needs. We hope that more people can pay attention to chronic musculoskeletal pain, reasonably prevent it, and seek seeking medical treatment as soon as possible if they encounter related problems.
Background research
Background
At the beginning of the project, we regularly carried out a lot of literature research activities and brainstorming. Through extensive literature research, we gradually understand the social problems associated with chronic musculoskeletal pain. In addition, in the subsequent literature survey, we found that there is a lot of literature pointing out that miRNA has a high correlation with pain. After discussions and communications with teachers, we decided to start our project on the theme of chronic musculoskeletal pain.
Questionnaire
In order to further understand the significance of our project and people's needs, we released a questionnaire to the community. We collected 377 valid questionnaires, of which 44.83% were male and 55.17% were female. The proportion of 16 to 28 years old is 42.71%, 29 to 40 years old is 13.79%, and the proportion of 41 years old or older is 43.5%. In the survey, 35% of CMP patients reported a pain score of 5-6. The average pain score for all respondents was 4.8. Eighty percent of the respondents said they did not know about CMP, while 60 percent of the respondents and their family members were or had been affected by CMP. This led us to realize the high prevalence and low awareness of CMP. In the survey of CMP patients, 80% of people do not know how to properly deal with CMP, some people will choose to go to the hospital to see a doctor, about 30% of people will choose to buy painkillers or ointment, a quarter of people will choose not to deal with it at all. It also makes us realize that the problem of low treatment and remission rates of chronic musculoskeletal pain is very serious.
To get a deeper understanding of the problems we face, we interviewed doctors, researchers, and pain-drug companies to make sure we were doing something meaningful.
We interviewed Dr. Lu Guijun in June. Dr. Lu suggested that the classification of chronic musculoskeletal pain is helpful for clinical medication guidance. Under the premise of richer data, we may find more connections, which will provide great support for the scientific research of clinical diagnosis and treatment of diseases and drugs.
Guijun Lu,male, chief physician, Director of pain Department, Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University, head of hospice care team, director of pain department, Xiamen Changgung Hospital
From June to July, we interviewed Mr. Guo Xiao, a staff member of the analgesic drug team of Motti Company. In the interview, Mr. Guo Xiao mentioned that chronic pain can seriously affect people's quality of life, and people's medical awareness has been improving in the past two years, and the proportion of people seeking medical treatment has increased. Patients seeking pain treatment are mainly the elderly, who have more experience with chronic pain. Guo Xiao said further research is needed to determine whether there are specific drugs for different types of pain.
Xiao Guo, male,former staff member of the analgesic drug group of Motti Company
We still have many problems with clinical drug use. In order to get a detailed understanding of the medication problems of different chronic musculoskeletal pain, we interviewed the distinguished associate researcher Hu Weiwei of China Pharmaceutical University and the Affiliated Hospital of China Pharmaceutical University Dr. Zheng Jinshi. During the interview, they explained the differences between clinical drugs in detail, which was of great help to the development of our project.
(a)Weiwei Hu, male,Distinguished Associate researcher of China Pharmaceutical University, master tutor.(b)Jinshi Zheng, male,attending doctor of Affiliated Hospital of University of Traditional Chinese Medicine
Project promotion
Internal communication
In order to promote our project, we participated in many meetings for cooperation and communication. Through continuous communication, our project is gradually improving. In the meeting, we raised awareness of chronic musculoskeletal pain by introducing our project.
External communication
At the CCIC conference, we shared our project with students from other teams. At the same time, the study and exchange of other teams also broadened our vision. We further explained the relationship between our hardware and biology and provided suggestions for the development of HP.
CRISPR meetup
In this meeting, everyone shared CRISPR knowledge, exchanged their views on CRISPR, and shared the experimental progress of each team in detail. We had a lot of discussions and exchanges on wet and dry experiments, modeling, software and hardware, and wikis, and learned a lot from them.
We also had a lot of extra communications, which helped us in different ways.You can click here to jump to the communication website for more details.
Communication and cooperation
Deep communication
First and foremost, we had built an in-depth cooperation bond with CPU_CHINA and FAFU respectively this year.
Through cooperating with CPU_CHINA, we exchanged ideas about the biological route program and jointly held many educational lectures to popularize our projects.
When it comes to FAFU, we discussed ideas for conducting human social practice in April and May. We attended the CCIC Hardware Round-table together to exchange and improve our hardware project experiences. From April to September we conducted popular online meetings to advance our mutual projects. In July and August we collaborated again to implement HP related work, contributing to profound impact of our projects
You can click here to jump to the collaboration website for more details.
Interview famous institute
In order to make sure that our project can serve the community, we interviewed Mr. Zhao Yingliang, Northern regional manager of Hangzhou Yunhu Medical Technology Co., Ltd. many times from August to September.
We consulted Mr. Zhao about the advantages of our project and the areas that should be improved. Mr. Zhao pointed out that there is no POCT device for pain classification in the market at present. It is very novel and valuable for us to classify and detect chronic musculoskeletal pain. At the same time for our current equipment, we still need to consider the front-end, middle-end, and back-end positioning problems. The front end should be convenient to identify and classify patient samples, the middle end should be automatic, and the transmission of the back end still needs to be considered.
This gives us a clearer picture of our strengths, but it also gives us a clearer picture of what we still need to improve in the future.
Yingliang Zhao , male, Northern Regional manager of Hangzhou Yunhu Medical Technology Co., LTD
Education
The use of synthetic biology to solve problems is so important that this year we have launched a major campaign to promote synthetic biology in education.
Chronic musculoskeletal pain has a serious problem of low awareness. In order to make more people pay attention to chronic musculoskeletal pain and increase people's awareness, we popularize relevant knowledge to people through education, improving the impact of the project.
You can click here to jump to the education website for more details.
Conclusion
Through human practice, our project can be more in line with the needs of society. We asked people about their knowledge of chronic musculoskeletal pain, which shows a serious social problem. Interviews with doctors and people involved with analgesic companies confirmed the value of our program. In the subsequent meetings, discussions, exchanges, and cooperation as well as institutional interviews, our project was gradually promoted. Along with the project, we conducted a lot of educational activities to raise public awareness of synthetic biology and chronic musculoskeletal pain and provided positive feedback on the low awareness rate.
Facing the problems of high prevalence, low awareness, treatment, and remission rates of chronic musculoskeletal pain, we hope to assist doctors in pain classification by detecting miRNAs, so as to facilitate accurate diagnosis and medication. Questionnaires and interviews with doctors and institutions also allowed us to determine the value of our project. The subsequent market research and team communication helped us gradually improve the project in the hope that the project could be socially responsible and beneficial.
Integrated Human Practices
Our team hopes to promote a closer connection between our project and society through in-depth communication with professionals. In order to understand the medical status of chronic musculoskeletal pain, POCT devices, and market conditions, we conducted the following interviews:
Problem
Through various investigations, we have learned the social status and diagnosis and treatment problems of chronic musculoskeletal pain. To confirm the actual situation in the hospitals, learn more about the patients’ needs, and listen to clinicians’ opinions, this June, we contacted Mr. Guijun Lu, director of the Pain Department of Beijing Tsinghua Changgung Hospital, who has many years of clinical experience. We introduced our project to him in detail, asked about our concerns, and received his recognition and suggestions.
Guijun Lu, male,chief physician, Director of pain Department, Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University, head of hospice care team, director of pain department, Xiamen Changgung Hospital
In our communication with Dr. Guijun Lu , Dr. Lu believes that our project has certain practical significance and is helpful for clinical diagnosis.
We learned from Doctor Lu that the most troubling aspect of pain is physical and mental torture. Pain will reduce the quality of life of patients and make them lose hope. Also, Dr. Lu points out that different types of chronic musculoskeletal pain require different medications. Therefore, our project has important clinical guiding significance in the accurate distinction between the causes of chronic musculoskeletal pain through miRNA.
Dr. Lu emphasized that pain is a subjective experience, and only those who can feel pain will be treated clinically. This helped us to further improve the positioning and object orientation of the project, that is, to make relevant diagnoses for conscious patients without loss of sensory functions or psychological disorders. Therefore, it should be used together with the VAS scale for pain assessment.
In addition, Dr. Lu also pointed out that the current method of detecting inflammatory factors has certain limitations in the diagnosis of nociceptive pain. The detection of miRNAs in our project is expected to make up for the shortcomings of inflammatory factors.
Dr. Lu had doubts about the correlation between miRNA and pain, and then we demonstrated the reliability of our project to Dr. Lu through the presentation of data.
In terms of the analgesics market and medications, we interviewed Mr. Xiao Guo , a former staff member of the analgesic drug team of Motti Company, hoping to get some feedback on the follow-up medication of our project. During July 2022, we consulted Mr. Guo Xiao several times and got some suggestions.
Xiao Guo, male,former staff member of the analgesic drug group of Motti Company
We learned from Mr. Xiao Guo that people's awareness of pain treatment has been gradually increasing, and the proportion of people seeking medical treatment has increased significantly, which will promote the development of pain treatment and fully demonstrate the potential of our development in this market. This is a positive sign for our pain classification equipment.
Mr. Guo was not aware of the differences in medication between nociceptive and neuropathic pain. "If we can find out how different types of chronic musculoskeletal pain are treated differently, your project will be innovative and meaningful," Guo said.
Mr. Guo's doubts and suggestions reflect the "low awareness" of pain classification in today's society. Our interview with Dr. Lu, and further investigations that followed, revealed the difference between different types of pain medications and solved Mr. Guo's problem. At the same time, we launched more publicity work to popularize the knowledge of chronic musculoskeletal pain and pain classification.
In response to the question that the difference between the pharmacy of nociceptive and neuropathic pain is still not clear, we visited and verifyed Weiwei Hu, Distinguished Associate researcher of China Pharmaceutical University
Weiwei Hu, male,Distinguished Associate researcher of China Pharmaceutical University, master tutor
Mr.Hu pointed out that nociceptive pain and neuropathic pain are treated differently because of the different pathological mechanisms of the two types of pain. This corroborates Dr. Lu's description. At the same time, Mr. Hu also told us about the harm of analgesic drug abuse. Mr. Hu also hopes that our program will help doctors use drugs accurately through the auxiliary classification of pain.
Dr. Jinshi Zheng , physician-in-charge of the Affiliated Hospital of Chinese Medicine University, gave us more detailed medication information.
Zheng Jinshi, male,attending doctor of Affiliated Hospital of University of Traditional Chinese Medicine
Dr. Zheng pointed out that neuropathic pain is caused by vascular and nerve problems, and pain relief is mainly based on antispasmodic and anxiolytic painkillers. The antispasmodic drugs used in neuropathic pain include atropine, belladonna tablets, anisodamine, and anti-anxiety drugs such as diazepam and carbamazepine.
Painkillers for nociceptive pain may be non-steroidal, central, or narcotic painkillers, focusing on the first use of non-steroidal painkillers, anti-inflammatory tablets, celecoxib, etc. If the pain is still not relieved, the doctor will use central tramadol, etc., and in more severe cases, the doctor will use the anesthetic pethidine, morphine, etc.
Through the interviews with Mr. Hu and Dr. Zheng, we examined the differential use of medications for different types of chronic musculoskeletal pain, which forms a closed loop with the proposal made by Mr. Xiao Guo. At the same time, it also shows that our project has a certain degree of innovation, and is expected to provide more evidence for doctors to use drugs through classification, which will have a profound impact on the treatment of chronic musculoskeletal pain and even drug research.
Design
To meet the recognized needs, our project aims to develop a miniaturized, integrated, automated, and interactive POCT device for detecting miRNA biomarkers to assist physicians in pain classification, thus facilitating accurate diagnosis and medication. The design, improvement, and output of a device need to be consulted in many aspects.
From August to September 2022, in terms of equipment targets and future output, we consulted many times Mr. Yingliang Zhao, Northern Regional manager of Hangzhou Yunhu Medical Technology Co., LTD., a manager of third-party institutions, introducing our projects and equipment to him in detail, and obtaining relevant equipment improvement suggestions.
Yingliang Zhao, male, Northern Regional manager of Hangzhou Yunhu Medical Technology Co., LTD*
Based on this interview, we have a deeper understanding of the advantages of POCT products and the parts that need to be improved in the future of our project. As mentioned by Mr. Zhao, the POCT device is simple to operate and rapid to detect, but it also has the limitation of low sensitivity. We designed a signal transduction and amplification system based on HCR to meet our detection needs through continuous modification of the probe. At the same time, in the hardware part, we improve the detection performance of the POCT equipment through the optimization of each module, so that our equipment can meet the requirements of the use scenario.
Application
In order to understand the problems we should pay attention to when our products are put into the market, we have also communicated with Mr.Yingliang Zhao about the market.
Mr. Yingliang Zhao pointed out the core issues that need to be considered in the implementation of commercial products, which was an important inspiration for our thinking. If we want to introduce our products into the market, we should take full consideration of the whole service life. In the early stages, we decide to collect patient information by scanning the code with a smartphone to match the patient information with the blood sample. In the middle stages, our automated, all-in-one design supports the automatic operation of tests, greatly reducing operational requirements. In the later stages of use, the medical staff can analyze the image through the mobile phone and then transmit it to the computer through Bluetooth to assist the doctor in further diagnosis.
Evaluation
Conclusion
Our team hopes to assist doctors in diagnosis and help solve existing diagnosis and treatment problems. Based on a large amount of literature, we confirmed the clinical significance of the classification of chronic musculoskeletal pain to clinicians, found the right project positioning, and identified the objects to which the project is oriented. What we learned about pain from experts in the drug field also convinced us that we had potential and value in the future pain market. After that, we conducted extensive research and study to finalize our product design step by step. Finally, we consulted with experts in the market to continuously improve and perfect our products, which led to the current project.
Reflection
Throughout the project, we have been reflecting on whether our project has really made a difference in the world. At different stages of the project, we interviewed different people to make our project more realistic. In the interview processes, faced with questions raised by professionals, we gave our solutions through reflection, and let them have a deeper understanding of our project.
In order to further solve the problem of low cure and remission rates in patients with chronic musculoskeletal pain, we still need to look forward to the development of drugs and the progress of medical methods. However, our project focuses on solving the problem of diagnosis and classification, which is expected to point out the direction for subsequent treatment and is also of great significance for reducing the pain of patients. And our advocacy efforts have had a positive impact on the development of treatments for chronic musculoskeletal pain.