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江西中医药大学实验动物伦理终结报告
2019-10-15 09:53     (点击: )

江西中医药大学实验动物伦理终结报告

End report of laboratory animal ethics   executed in Jiangxi University of traditional Chinese Medicine

报告日期(Report date)  (year)  (month) (day)                                  动物实验伦理审查申请书编号(Applicant number   for animal experiment ethics examine)

课题名称(Project   name)

申请人姓名(applicant name)           技术职称(Technical title)       岗位证书编号(Post certificate number)   动字(    )第    

项目负责人(Project Leader)           技术职称(Technical title)       联系电话(Contact phone)                     手机(Mobile phone)

申请者单位或部门(Applicant unit or department)                 负责人(Leader)

拟进

动物

情况

动物来源(Animal   resources)

品种品系(Species   or strains)              等级(Grade)        规格(Specifications)   

数量(quantity)   (其中:♀  只;♂   )

申购日期(Date   of purchase)    (year)  (month)    (day)

进驻日期(Entering date)   (year)  (month)    (day)

结束日期(End   date)       (year)  (month)    (day)

一、手术过程中实际动物福利保障措施(包括减轻动物痛苦措施等)(Safeguard   measures exactly performed for animal welfare during operation, including   measures to alleviate the pain of animals, etc.):

 

 

 

 

 

 

 

二、危险物品、药品安全实际处置措施(包括针头、有害药品的安全处置措施等)(Safety management measures exactly performed to hazardous   substances, drug, including safety management measures of needles, the safe   disposal of hazardous drugs, etc. )

 

 

 

 

 

 

 

三、实验结束后处置动物的具体情况(包括处置的方式等)   (Details of assays exactly performed for animal   sacrifice, etc. after the end of the   experiment, including methods to end animal life, etc.)

 

 

 

 

 

 

 

 

 

项目负责人签名(Project Leader signature)

 

主管单位负责人意见(Comments of the   person in charge of the competent authority)

 

           

 

 

                                           签章(signature)

 (year)  (month)    (day)

伦理委员会评审决议(Ethics committee review decision)

 

 

 

 

 

                  伦理委员会主任委员签章(Ethics   committee chairman signature)

(year)  (month)    (day)

说明1.此表一式二份,正反面打印。在伦理审查通过后返还项目负责人一份,伦理委员会留存一份。2.编号由伦理委员会秘书填写。3.联系电话填本项目申报联系人的电话。4.实验要点只写摘要。5.申请单位或部门填到科室,主管单位签章为学院主管科研的领导签章。

Notes: 1. this form has two copies,positive and negative print. one will be returned to the project leader, another will be retained in   the ethics committee after the ethical review is passed by the committee of ethics. 2. The project number will be given by the ethics committee secretary. 3 Contact phones should be filled by the project applicant. 4. The item of “Experimental point” should be filled with project summary only. 5. The item of “application units or departments” should be filled with department; the signature of the competent unit should be performed by the leader in charge of scientific research in the college or institute.

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