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| 1 | 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 |
| 2 | Hepatic expression and cellular distribution of the glucose transporter family显示文摘Glucose and other carbohydrates are transported into cells using members of a family of integral membrane glucose transporter (GLUT) molecules. To date 14 members of this family, also called the solute carrier 2A proteins have been identified which are divided on the basis of transport characteristics and sequence similarities into several families (Classes 1 to 3). The expression of these different receptor subtypes varies between different species, tissues and cellular subtypes and each has differential sensitivities to stimuli such as insulin. The liver is a contributor to metabolic carbohydrate homeostasis and is a major site for synthesis, storage and redistribution of carbohydrates. Situations in which the balance of glucose homeostasis is upset such as diabetes or the metabolic syndrome can lead metabolic disturbances that drive chronic organ damage and failure, confirming the importance of understanding the molecular regulation of hepatic glucose homeostasis. There is a considerable literature describing the expression and function of receptors that regulate glucose uptake and release by hepatocytes, the most import cells in glucose regulation and glycogen storage. However there is less appreciation of the roles of GLUTs expressed by non parenchymal cell types within the liver, all of which require carbohydrate to function. A better understanding of the detailed cellular distribution of GLUTs in human liver tissue may shed light on mechanisms underlying disease pathogenesis. This review summarises the available literature on hepatocellular expression of GLUTs in health and disease and highlights areas where further investigation is required. | Sumera Karim David H Adams Patricia F Lalor | 2012 | World Journal of Gastroenterology2012，18，46： | 5 |
| 3 | Season of the year influences infection rates following total hip arthroplasty显示文摘AIM To research the influence of season of the year on periprosthetic joint infections.METHODS We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau(Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked. RESULTS In all regions, winter had the highest incidence of periprosthetic infections(mean 0.98%, SD 0.1%) and was significantly higher than other seasons in the Midwest, South and West(P < 0.05 for all) but not the Northeast(P = 0.358). Acute postoperative infection rates were more frequent in the summer and were significantly affected by season of the year in the West.CONCLUSION Season of the year is a risk factor for periprosthetic joint infection following total hip arthroplasty(THA). Understanding the influence of season on outcomes following THA is essential when risk-stratifying patients to optimize outcomes and reduce episode of care costs. | Samuel Rosas Alvin C Ong Leonard T Buller Karim G Sabeh Tsun yee Law Martin W Roche Victor H Hernandez | 2017 | World Journal of Orthopedics2017，8，12： | 4 |
| 4 | Systemic chemotherapy for hepatocellular carcinoma in non-cirrhotic liver:A retrospective study显示文摘AIM:To investigate the efficacy and toxicity of systemic chemotherapy in a retrospective study of patients with hepatocellular carcinoma(HCC)occurring in normal or fibrotic liver without cirrhosis. METHODS:Twenty-four patients with metastatic or locally advanced HCC in a normal or a fibrotic liver were given systemic chemotherapy(epirubicin,cis- platin and 5-fluorouracil or epirubicin,cisplatin and capecitabine regimens).Tumor response,time to pro- gression,survival,and toxicity were evaluated. RESULTS:There were 7 women and 17 men,mean age 54±10 years;18 patients had a normal liver and 6 had a fibrotic liver(F1/F2 on biopsy).Mean tumor size was 14 cm,5 patients had portal vein thrombosis and 7 had metastasis.Patients received a median of 4 chemotherapy sessions.Overall tolerance was good. There were 5 partial responses(objective response rate =22%),and tumor control rate was 52%.Second line surgical resection was possible in two patients.Median survival was 11 mo,and 1-and 2-year overall survival rates were 50%±10%and 32%±11%,respectively. CONCLUSION:In patients with HCC in a non-cirrhotic liver,chemotherapy was well tolerated and associated with an objective response rate of 22%,including two patients who underwent secondary surgical resection. | Julien Edeline Jean-Luc Raoul Elodie Vauleon Anne Guillygomac'h Karim Boud jema Eveline Boucher | 2009 | World Journal of Gastroenterology2009，15，6： | 4 |
| 5 | p53-mediated transcriptional regulation and activation of the actin cytoskeleton regulatory RhoC to LIMK2 signaling pathway promotes cell survival显示文摘响应 DNA 损坏的房间命运的中央仲裁人是 p53,它调整涉及房间周期拘捕,幸存和 apoptosis 的基因的表示。尽管 DNA 损坏开始的许多回答被描绘了,肌动朊细胞骨架管理者的角色大部分是未知的。我们现在显示出那 RhoC 和秘鲁利玛机场之代号 kinase (LIMK2 ) 2 是 genotoxic 代理人导致的直接 p53 目标基因。尽管 RhoC 和 LIMK2 在肌动朊细胞骨架规定有生长得很好的角色,我们的结果显示 LIMK2 的激活也有支持幸存的功能追随者 DNA 损坏。由调停 siRNA 的击倒或选择的药理学封锁的 LIMK 抑制敏化房间到无线电 -- 或化疗,以便当与 LIMK 抑制结合了时,当单身地管理了时,是尚不致命的治疗导致了房间死亡。我们的调查结果建议把 LIMK 禁止者与 genotoxic 治疗相结合能比单个代理人的管理更有效,并且加亮在肌动朊细胞骨架管理者和 DNA 之间的一个新奇连接导致损坏的房间幸存机制。 | Daniel R Croft Diane Crighton Michael S Samuel Filipe C Lourenco June Munro Jenifer Wood Karim Bensaad Karen H Vousden Owen J Sansom Kevin M Ryan Michael F Olson | 2011 | Cell Research2011，21，4： | 3 |
| 6 | Indication of liver transplantation in severe alcoholic liver cirrhosis: quantitative evaluation and optimal timing显示文摘 | Bartholomeus Johannes Veldt Fabrice Lainé Anne Guillygomarc’h Laurence Lauvin Karim Boudjema Michel Messner Pierre Brissot Yves Deugnier Romain Moirand | 2002 | Journal of Hepatology2002，，1： | 2 |
| 7 | Methods for the study of starch retrogradation 显示文摘 | A Abd Karim^* M H Norziah C C Seow | 2000 | Food Chemistry2000，，71： | 1 |
| 8 | On the roles of protein and starch in the aging of non-waxy rice flour 显示文摘 | Teo C H Karim A Abd Cheah P B | 2000 | Food Chemistry2000，69，3： | 1 |
| 9 | Improved drought tol erance without undesired side effects in transgenic plants produ cing trehalose显示文摘 | Karim S Aronsson H Ericson H | 2007 | Plant Molecular Biology2007，64，4： | 1 |
| 10 | Characterisation of composite films made of konjac glucomannan (KGM), carboxymethyl cellulose (CMC) and lipid 显示文摘 | Cheng L H Karim A A Seow C C | 2008 | Food Chem2008，107，1： | 1 |
| 11 | Mobile phone applications in academic library service: A students' feedback survey 显示文摘 | Karim N S A Dams S H Hussin R | 2006 | Cam- pus- Wide Information System2006，23，1： | 1 |
| 12 | Methods for the Study of Starch Retrogradation显示文摘 | Karim A A Norziah M H Seow C C | 2000 | Food Chemistry2000，71，1： | 1 |
| 13 | A quick signal of starvation induced autophagy:Transcription versus posttranslational modification of LC3显示文摘 | Karim MR Kawanago H Kadowaki M | 2014 | Anal Biochem2014，22，465： | 1 |
| 14 | Salinity effects on germination, growth, and seed production of the halophyte Cakile maritime显示文摘 | AHMED D KARIM B H CLAUDE G | 2004 | Plant and Soil2004，262，： | 1 |
| 15 | Complete and partial catalytic oxidation of methane over substrates with enhanced transport properties 显示文摘 | Lyubovsky M Karim H Menacherry P | 2003 | Catalysis today2003，83，： | 1 |
| 16 | Electrospinning fabrication and characterization of poly (viny alcohol)/montmorillonite/silver hybrid microfibers for antibacterial applications 显示文摘 | Park J H Karim M R Kim I K | 2010 | Colloid polym Sci2010，1，： | 1 |
| 17 | Sudanese library anxiety constructs显示文摘 | Abusin K A Zainab A N Karim N H A | 2011 | Information Development2011，27，3： | 1 |
| 18 | Effects of sodium dodecyl sulphate and sonication treatment on physicochemical properties of starch显示文摘 | Chan H T Bhat R Karim A A | 2010 | Food Chemistry2010，120，： | 1 |
| 19 | Production of bioenergy and biochemical from industrial and agricultural wastewater显示文摘 | Angenent L T Karim K Al-Dahhan M H | 2004 | Trends in Biotechnology2004，22，9： | 1 |
| 20 | Probabilistic multi robot path planning in dynamic environments: A comparison between a* and Dfs显示文摘 | Shwail S H Karim A and Turner S | 2013 | International Journal of Computer Applications2013，82，7： | 1 |
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