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| 1 | 促进2型糖尿病患者行为的可持续性改变:澳大利亚美好生活俱乐部的自我健康管理计划的评价显示文摘本文分析了澳大利亚美好生活俱乐部18个月的监测数据。美好生活俱乐部是澳大利亚联邦政府资助的'分担卫生服务项目'的一个研究项目,旨在促进50岁及以上糖尿病患者的慢性病自我管理。该项目的干预措施是跨理论行为改变模型和通过电话的动机谈话技术。在患者参加项目的基线、第6个月、第18个月收集数据。数据包括人口学信息、慢性病种类、健康行为、对健康的认识、锻炼程度、功能状态、自我效能、情绪状态、服务利用,以及9个目标行为的改变阶段。本文报告了150名接受18个月监测的患者数据。结果表明,在8个自我评价的症状中,有6个症状明显改善,差异有统计学意义。接受干预的患者对自我健康管理的信心在短期内明显增强。患者的卫生服务利用呈现减少趋势,但无统计学差异。卫生服务利用没有减少的原因,归因于参加者之间卫生服务利用方式的差异较大。参加项目第6个月时,患者行走的活动量增加,但第18个月时回到基线水平。这些发现表明,动机谈话技术能够在行为改变的最初阶段发挥作用,不过如果要长期地维持行为改变,则需要确定个体化和结构性的策略。 | Colette Browning Shane Thomas Jane Sims Lindner Helen Kelly J | 2009 | 中国全科医学2009，12，23： | 18 |
| 2 | 钠-葡萄糖共转运蛋白-2抑制剂或胰高血糖素样肽-1受体激动剂治疗成人2型糖尿病:临床实践指南显示文摘临床问题对于存在不同心血管风险及肾脏结局的2型糖尿病患者,在原有生活方式干预和/或其他降糖药物的基础上加用钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂的获益及风险是什么?现行做法几十年来,2型糖尿病的治疗决策都以控制血糖为主导。SGLT-2抑制剂和GLP-1受体激动剂在传统观念中常被用于二甲双胍治疗后血糖仍控制不佳的患者。目前这一现状已经发生了改变,这得益于多项临床研究结果。研究显示SGLT-2抑制剂和GLP-1受体激动剂拥有独立于药物降糖作用之外的对于动脉粥样硬化性心血管病(CVD)和慢性肾脏病(CKD)的获益。建议本指南阐述了针对不同风险分层的成人2型糖尿病患者使用SGLT-2抑制剂或GLP-1受体激动剂的建议。•伴有3种或更少的心血管风险因素且不存在CVD或CKD:不建议启动SGLT-2抑制剂或GLP-1受体激动剂治疗。(推荐等级:弱)•伴有3种以上心血管风险因素且不存在CVD或CKD:建议启动SGLT-2抑制剂治疗,不建议启动GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD或CKD:建议启动SGLT-2抑制剂治疗和GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD和CKD:建议启动SGLT-2抑制剂治疗(推荐等级:强)和GLP-1受体激动剂治疗。(推荐等级:弱)•对于那些想要进一步降低CVD和CKD结局风险的患者:推荐优先启用SGLT-2抑制剂治疗而非GLP-1受体激动剂治疗。(推荐等级:弱)这项指南是如何制订的一个由患者、临床医生和方法学家共同组成的国际小组提出了这些推荐意见。这些推荐意见基于可信度较高的指南的标准,并使用GRADE分级方法进行评估。该小组采用了息者个体化的观点。证据一项关于获益与风险的系统综述和网络meta分析(764项随机对照研究,包括421346例参与者)发现SGLT-2抑制剂和GLP-1受体激动剂可以降低总体死亡率、心肌梗死发生率、终末期肾病或肾衰竭的发生率(中等至高等质量的证据)。在不同的亚组中这些药物对卒中、因心力衰竭所致住院和其他主要不良事件有不同的影响。药物绝对获益的程度因患者个体风险的不同有很大的差异。(例如,对于接受了超过5年药物治疗的1000例患者,在最低风险人群中死亡人数减少了5人,在最高风险人群中死亡人数减少了48人)。一项关于预后的综述确认了14种风险预测模型,其中一种(RECODe)在证据总结中报告了大部分基线风险评估数据,小组利用该模型以支持风险分层的建议。考虑到患者的价值观及个体差异,指南推荐的支撑证据包括一项对已发表论文的系统综述、一项患者焦点小组研究、一项临床问题总结,以及一项指南调查。指南解读我们依据不同的CVD和CKD风险水平,综合考虑获益、风险和其他因素的平衡,以及每一个风险组别的实际问题,来对推荐意见进行分层。本指南强烈建议CVD和CKD患者使用SGLT-2抑制剂治疗,这说明专家组认为其具有显著的获益。而对于其他成人2型糖尿病患者,推荐等级较弱,这说明专家组想要在获益、风险及治疗花费上取得一个更好的平衡。临床医生通过该指南可以使用可靠的风险计算模型,如RECODe,来明确其患者的个体心血管和肾脏疾病风险。医患交互式总结临床证据和制订决策有助于患者知晓治疗选择,包括进行共同决策。2型糖尿病人群(全球患病率不断增长1-2)正面临着不断增加的心血管疾病、肾脏病和其他并发症的风险3。数十年来,2型糖尿病的管理始终以控制血糖及糖化血红蛋白(HbA1c)为治疗目标4-5,但是,最近的高质量随机对照研究已经对这种以血糖为中心的治疗模式发起了挑战。研究结果显示,强化血糖控制未必会降低大血管不良事件,它还可能带来不利影响监管机构现在要求新型糖尿病药物必须证明其具有心血管和肾脏获益才能获得批准。对两类新药--钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂(见框图1)的临床试验结果显示,在现有治疗方案(常规治疗)之上加用这些药物,对死亡、心肌梗死、卒中、心力衰竭和肾脏的结局(如进展为终末期肾病)都有获益8-12。 | Sheyu Li Per Olav Vandvik Lyubov Lytvyn Gordon H Guyatt Suetonia C Palmer Rene Rodriguez-Gutierrez Farid Foroutan Thomas Agoritsas Reed A C Siemieniuk Michael Walsh Lawrie Frere David J Tunnicliffe Evi V Nagler Veena Manja Bjφrn Olav Asvold Vivekanand Jha Mieke Vermandere Karim Gariani Qian Zhao Yan Ren Emma Jane Cartwright Patrick Gee Alan Wickes Linda Fems Robin Wright Ling Li Qiukui Hao Reem A Mustafa 无 郭鹤鸣(译) | 2021 | 英国医学杂志中文版2021，24，9： | 7 |
| 3 | Therapeutic and prophylactic thalidomide in TNBS-induced colitis: Synergistic effects on TNF-α, IL-12 and VEGF production显示文摘AIM: To evaluated the therapeutic and prophylactic effect of thalidomide on 2, 4, 6-trinitrobenzene sulfonic acid (TNBS)-induced colitis. Thalidomide has been reported to downregulate the expression of tumor necrosis factor a (TNF-α), IL-12, and vascular endothelial growth factor (VEGF), hallmarks of intestinal inflammation in Crohn's disease (CD). METHODS: Male Wistar rats were divided in five groups of ten animals each. Four groups received a rectal infusion of TNBS in ethanol. The first group was sacrificed 7 d after colitis induction. The second and third groups received either thalidomide or placebo by gavage and were sacrificed at 14 d. The fourth group received thalidomide 6 h before TNBS administration, and was sacrificed 7 d after induction. The fifth group acted as the control group and colitis was not induced. Histological inflammatory scores of the colon were performed and lamina propria CD4+ T cells, macrophages, and VEGF+ cells were detected by immunohistochemistry. TNF-a and IL-12 were quantified in the supernatant of organ cultures by ELISA. RESULTS: Significant reduction in the inflammatory score and in the percentage of VEGF+ cells was observed in the group treated with thalidomide compared with animals not treated with thalidomide. Both TNF-αand IL-12 levels were significantly reduced among TNBS induced colitis animals treated with thalidomide compared with animals that did not receive thalidomide. TNF-αlevels were also significantly reduced among the animals receiving thalidomide prophylaxis compared with untreated animals with TNBS-induced colitis. Intestinal levels of TNF-αand IL-12 were significantly correlated with the inflammatory score and the number of VEGF+ cells. CONCLUSION: Thalidomide significantly attenuates TNBS-induced colitis by inhibiting the intestinal production of TNF-α, IL-12, and VEGF. This effect may support the use of thalidomide as an alternate approach in selected patients with CD. | Ana Teresa Carvalho Heitor Souza Antonio Jose Carneiro Morgana Castelo-Branco Kalil Madi Alberto Schanaider Flavia Silva Fernando Antonio Pereira Júnior Márcia G Pereira Cláudio Tortori Ilana Dines Jane Carvalho Eduardo Rocha Celeste Elia | 2007 | World Journal of Gastroenterology2007，13，15： | 6 |
| 4 | DOCK8 regulates signal transduction events to control immunity显示文摘在编码 DOCK8 的基因的基因变化引起亢奋的免疫球蛋白 E 症候群(AR 催促) 的一种正染色体的后退的形式,是指了 DOCK8 缺乏。在人的 DOCK8 缺乏导致联合免疫不全疾病(首领) 的发作,临床上与多样的微生物引起的病原体,和倾向与长期的感染联系了到恶意。DOCK8 调整多样的有免疫力的房间子类型的功能,现在正在变得清楚,特别地淋巴细胞,驾驶天生、适应的有免疫力的回答。早研究证明 DOCK8 为淋巴细胞幸存,移植和有免疫力的触处形成被要求,它当 DOCK8 不在时翻译到差的病原体控制。然而,更最近的进展在调整控制 transcriptional 活动, cytokine 生产和有免疫力的房间的功能的极化的信号 transduction 事件为 DOCK8 指向了一个关键角色。这里,我们在我们 DOCK8 功能的理解总结最近的进展,对象把有免疫力的回答提升到多样的外部刺激的发信号的中介的一个新兴的角色给予特别注意。 | Conor J Kearney Katrina L Randall Jane Oliaro | 2017 | Cellular & Molecular Immunology2017，14，5： | 5 |
| 5 | Entry of hepatitis B and C viruses — recent progress and future impact显示文摘 | Thomas F Baumert Luke Meredith Yi Ni Daniel J Felmlee Jane A McKeating Stephan Urban | 2013 | Current Opinion in Virology2013，，： | 3 |
| 6 | Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer (SIGGAR): a multicentre randomised trial显示文摘 | Wendy Atkin Edward Dadswell Kate Wooldrage Ines Kralj-Hans Christian von Wagner Rob Edwards Guiqing Yao Clive Kay David Burling Omar Faiz Julian Teare Richard J Lilford Dion Morton Jane Wardle Steve Halligan | 2013 | The Lancet2013，，： | 3 |
| 7 | Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)显示文摘 | Claudia Allemani Hannah K Weir Helena Carreira Rhea Harewood Devon Spika Xiao-Si Wang Finian Bannon Jane V Ahn Christopher J Johnson Audrey Bonaventure Rafael Marcos-Gragera Charles Stiller Gulnar Azevedo e Silva Wan-Qing Chen Olufemi J Ogunbiyi Bernard R | 2015 | The Lancet . 2015 (9972)2015，，： | 2 |
| 8 | Computed tomographic colonography versus barium enema for diagnosis of colorectal cancer or large polyps in symptomatic patients (SIGGAR): a multicentre randomised trial显示文摘 | Steve Halligan Kate Wooldrage Edward Dadswell Ines Kralj-Hans Christian von Wagner Rob Edwards Guiqing Yao Clive Kay David Burling Omar Faiz Julian Teare Richard J Lilford Dion Morton Jane Wardle Wendy Atkin | 2013 | The Lancet2013，，： | 2 |
| 9 | Hematopoietic AMPK [Beta]1 reduces mouse adipose tissue macrophage inflammation and insulin resistance in obesity显示文摘 | Galic Sandra Fullerton Morgan D Schertzer Jonathan D Sikkema Sarah Marcinko Katarina Walkley Carl R Izon David Honeyman Jane Chen Zhi-Ping van Denderen Bryce J Kemp Bruce E Steinberg Gregory R | 2011 | Journal of Clinical Investigation2011，，12： | 2 |
| 10 | Incident frailty and cognitive impairment by heart failure status in older patients with atrial fibrillation: the SAGE-AF study显示文摘Background Atrial fibrillation(AF) and heart failure(HF) frequently co-occur in older individuals. Among patients with AF, HF increases risks for stroke and death, but the associations between HF and incident cognition and physical impairment remain unknown. We aimed to examine the cross-sectional and prospective associations between HF, cognition, and frailty among older patients with AF. Methods The SAGE-AF(Systematic Assessment of Geriatric Elements in AF) study enrolled 1244 patients with AF(mean age 76 years, 48% women) from five practices in Massachusetts and Georgia. HF at baseline was identified from electronic health records using ICD-9/10 codes. At baseline and 1-year, frailty was assessed by Cardiovascular Health Survey score and cognition was assessed by the Montreal Cognitive Assessment. Results Patients with prevalent HF(n = 463, 37.2%) were older, less likely to be non-Hispanic white, had less education, and had greater cardiovascular comorbidity burden and higher CHA2 DS2 VASC and HAS-BLED scores than patients without HF(all P's < 0.01). In multivariable adjusted regression models, HF(present vs. absent) was associated with both prevalent frailty(adjusted odds ratio [a OR]: 2.38, 95% confidence interval [CI]: 1.64-3.46) and incident frailty at 1 year(a OR: 2.48, 95% CI: 1.37-4.51). HF was also independently associated with baseline cognitive impairment(a OR: 1.60, 95% CI: 1.22-2.11), but not with developing cognitive impairment at 1 year(a OR 1.04, 95%CI: 0.64-1.70). Conclusions Among ambulatory older patients with AF, the co-existence of HF identifies individuals with physical and cognitive impairments who are at higher short-term risk for becoming frail. Preventive strategies to this vulnerable subgroup merit consideration. | Wei-Jia WANG Darleen Lessard Jane Saczynski Robert J Goldberg Alan S.Go Tenes Paul Ely Gracia David D McManus | 2020 | Journal of Geriatric Cardiology2020，17，11： | 2 |
| 11 | IL 28 B genotype is not useful for predicting treatment outcome in A sian chronic hepatitis B patients treated with pegylated interferon‐α显示文摘 | Jacinta A Holmes Tin Nguyen Dilip Ratnam Neel M Heerasing Jane V Tehan Sara Bonanzinga Anouk Dev Sally Bell Stephen Pianko Robert Chen Kumar Visvanathan Rachel Hammond David Iser Ferry Rusli William Sievert Paul V Desmond D Scott Bowden Alexander J Thomps | 2013 | J Gastroenterol Hepatol2013，，5： | 2 |
| 12 | Gastroesophageal reflux disease after diagnostic endoscopy in the clinical setting显示文摘AIM: To investigate the outcome of patients with symptoms of gastroesophageal reflux disease (GERD) referred for endoscopy at 2 and 6 mo post endoscopy. METHODS: Consecutive patients referred for upper endoscopy for assessment of GERD symptoms at two large metropolitan hospitals were invited to participate in a 6-mo non-interventional (observational) study.The two institutions are situated in geographically and socially disparate areas. Data collection was by selfcompletion of questionnaires including the patient assessment of upper gastrointestinal disorders symptoms severity and from hospital records. Endoscopic finding using the Los-Angeles classification, symptom severity and it's clinically relevant improvement as change of at least 25%, therapy and socio-demographic factors were assessed. RESULTS: Baseline data were available for 266 patients and 2-mo and 6-mo follow-up data for 128 and 108 patients respectively. At baseline, 128 patients had erosive and 138 non-erosive reflux disease. Allmost all patient had proton pump inhibitor (PPI) therapy in the past. Overall, patients with non-erosive GERD at the index endoscopy had significantly more severe symptoms as compared to patients with erosive or even complicated GERD while there was no difference with regard to medication. After 2 and 6 mo there was a small, but statistically significant improvement in symptom severity (7.02 ± 5.5 vs 5.9 ± 5.4 and 5.5 ± 5.4 respectively); however, the majority of patients continued to have symptoms (i.e. , after 6 mo 81% with GERD symptoms). Advantaged socioeconomic status as well as being unemployed was associated with greater improvement. CONCLUSION: The majority of GORD patients receive PPI therapy before being referred for endoscopy even though many have symptoms that do not sufficiently respond to PPI therapy. | Nora B Zschau Jane M Andrews Richard H Holloway Mark N Schoeman Kylie Lange William CE Tam Gerald J Holtmann | 2013 | World Journal of Gastroenterology2013，19，16： | 2 |
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