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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 | Symptoms and Subtypes in Pediatric Functional Dyspepsia: Relation to Mucosal Inflammation and Psychological Functioning显示文摘 | Jennifer V Schurman Meenal Singh Vivekanand Singh Nancy Neilan Craig A Friesen | 2010 | Journal of Pediatric Gastroenterology and Nutrition2010，，3： | 2 |
| 3 | Validated gradient stability indicating HPLC method for determining Diltiazem Hydrochloride and related substances in bulk drug and novel tablet formulation显示文摘A stability-indicating liquid chromatographic method has been developed and validated for the determination of Diltiazem Hydrochloride(DTZ) together with its six related substances(Diltiazem sulphoxide,Imp-A,Imp-B,Imp-D,Imp-E,and Imp-F) in a laboratory mixture as well as in a novel tablet formulation developed in-house.Efficient chromatographic separation was achieved on a Hypersil BDS C_18(150 mm*4.6 mm,5.0 μm) with mobile phase containing 0.2% Triethylamine(TEA) in gradient combination with acetonitrile(ACN) at a flow rate of 1.0 mL/min and the eluent was monitored at 240 nm.In the developed method,the resolution of DTZ from any pair of impurities was found to be greater than 2.0.The test solution and related substances were found to be stable in the diluent for 24 h.The developed method resolved the drug from its known impurities,stated above,and also from additional impurities generated when the formulation was subjected to forced degradation;the mass balance was found close to 99.9%.Regression analyses indicate correlation coefficient value greater than 0.997 for DTZ and its six known impurities.The LOD for DTZ and the known impurities was at a level below 0.02%.The method has shown good,consistent recoveries for DTZ(99.8-101.2%) and also for its six known impurities(97.2-101.3%).The method was found to be accurate,precise,linear,specific,sensitive,rugged,robust,and stability-indicating. | Vivekanand A.Chatpalliwar Pawan K.Porwal Neeraj Upmanyu | 2012 | Journal of Pharmaceutical Analysis2012，2，3： | 2 |
| 4 | Chronic kidney disease: global dimension and perspectives显示文摘 | Vivekanand Jha Guillermo Garcia-Garcia Kunitoshi Iseki Zuo Li Saraladevi Naicker Brett Plattner Rajiv Saran Angela Yee-Moon Wang Chih-Wei Yang | 2013 | The Lancet2013，，9888： | 2 |
| 5 | Therapeutic angiogenesis in Buerger’s disease (thromboangiitis obliterans) patients with critical limb ischemia by autologous transplantation of bone marrow mononuclear cells显示文摘 | Vishnu Motukuru Kalkunte R. Suresh Vivekanand Vivekanand Sumanth Raj K.R. Girija | 2008 | Journal of Vascular Surgery2008，，6： | 2 |
| 6 | Removal of SO2 by activated carbon fibers in the presence of O2 and H2O显示文摘 | VIVEKANAND G RITESH A NISHITH V | 2006 | Carbon2006，44，1： | 1 |
| 7 | Flow accelerated corrosionand its control measures for the secondary circuit pipelines inIndia nuclear power plants 显示文摘 | Vivekanand Kain Roychowdhury S | 2008 | Journal of Nuclear Materials2008，，383： | 1 |
| 8 | Removal of SO2 by activated carbon fibers in the presence of O2 and H2O显示文摘 | VIVEKANAND G RITESH A NISHITH V | 2006 | Carbon2006，44，1： | 1 |
| 9 | Outcomes of angio- some and non-angiosome targeted revascularization in critical lower limb ischemia显示文摘 | Kabra A Suresh KR Vivekanand V | 2013 | J Vasc Surg2013，57，1： | 1 |
| 10 | Effect of wall temperature modulation on the heat transfer characteristics of droplet-train flow inside a rectangular microchannel显示文摘The numerical studies of water–oil two-phase slug flow inside a two-dimensional vertical microchannel subjected to modulated wall temperature boundary conditions have been discussed in the present paper.Many researchers have contributed their efforts in exploring the characteristics of Taylor flows inside microchannel under constant wall heat flux or isothermal wall conditions.However,there is no study available in the literature which discusses the impact of modulated thermal wall boundary conditions on the heat transfer behavior of slug flows inside microchannels.Hence,to bridge this gap,an effort has been made to understand the heat transfer characteristics of the flow under sinusoidal wall temperature conditions.Initially,a single phase flow and heat transfer study was performed in microchannels,and the results of the fully developed velocity profile and heat transfer rate were validated with benchmark analytical results.Then an optimal selection of the combination of sinusoidal thermal wall boundary conditions has been made for the two-phase slug flow study.Later,the effects of amplitude(0 bεb 0.03)and frequency(0 bωb 750πrad·s-1)of the sinusoidal wall temperature profile on the heat transfer have been studied using the optimal combination of the wall boundary conditions.The results of the numerical study using modulated temperature conditions on channel walls showed a significant improvement in the heat transfer over liquid-only flow by approximately 50%as well as over two-phase flow without wall temperature modulation.The non-dimensional temperature contours obtained for different cases of temperature modulation clearly explain the root cause of such improvement in the heat transfer.Besides,the results based on the hydrodynamics of the flow have also been reported in terms of variation of droplet shapes and film thickness.The influence of Capillary number on the film thickness as well as heat transfer rates has also been discussed.In addition,the measured film thickness has also been compared with that calculated using standard empirical and analytical models available in the literature.The heat transfer rate obtained from the numerical study for the case of unmodulated wall temperature was found to be in a close match with a phenomenological model to evaluate slug flow heat transfer having a mean absolute deviation of 7.56%. | Vivekanand S.V.B.,Raju V.R.K. | 2020 | Chinese Journal of Chemical Engineering2020，28，3： | 1 |
| 11 | Development of a single loop EPR test method and its relation to grain boundary microchemistry for alloy 600显示文摘 | Vivekanand Kain Yutaka Watanabe | 2002 | Journal of Nuclear Materials2002，302，： | 1 |
| 12 | Impact of steam explosion on biogas production from rape strawin relation to changes in chemical composition显示文摘 | VIVEKANAND Vivekanand RYDEN Peter HORN Svein J | 2012 | Bioresour Technology2012，123，： | 1 |
| 13 | Preparation and characterization of ACF for the adsorption of BTX and SO2 显示文摘 | Vivekanand G Ashutosh S Nishith V | 2006 | Chem Eng Process2006，45，1： | 1 |
| 14 | Solid -state fermentation for gluconic acid production from sugarcane molasses by Aspergillus niger ARNU-4 employing tea waste as the novel solid support显示文摘 | Sharma A Vivekanand V Singh RP | 2008 | Bioresource Technology2008，99，9： | 1 |
| 15 | STLM:a sidewall TLM structure for accurate extraction of ultralow specific contact resistivity显示文摘 | MAJ UMDAR K VIVEKANAND S HUFFMAN C | 2013 | IEEE Electron De- vice Letters2013，34，9： | 1 |
| 16 | Removal of SO2 by activated carbon fibers in the presence of O2 and H2O 显示文摘 | VIVEKANAND G RITESH A NISHITH V | 2006 | Carbon2006，44，1： | 1 |
| 17 | Catalytic oxidation of NO by activated carbon fiber (ACF)显示文摘 | Sudhakar Adapa Vivekanand Gaur Nishith Verma | 2005 | Chemical Engineering Journal2005，，1： | 1 |
| 18 | Role of residual stresses induced by industrial fabrication on stress corrosion cracking susceptibility of austenitic stainless steel显示文摘 | Swati Ghosh Vishav Preet Singh Rana Vivekanand Kain Vivek Mittal S.K. Baveja | 2011 | Materials and Design2011，，7： | 1 |
| 19 | Role of grain boundary nature and residual strain in controlling sensitisation of type 304 stainless steel显示文摘 | Parag M. Ahmedabadi Vivekanand Kain Bhupinder Kumar Dangi I. Samajdar | 2013 | Corrosion Science2013，，： | 1 |
| 20 | 显示文摘 | Debasish D Vivekanand G Nishith V | 2004 | Carbon2004，42，14： | 1 |
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