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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 | Obesity pandemic in China:epidemiology,burden,challenges,and opportunities显示文摘China faces a substantial burdensome pandemic of obesity.Recent data from the Chinese Centre for Disease Control and Prevention suggested that over an estimated 8.1%of Chinese adults(85 million Chinese adults)had obesity in 2018,which was three times the level in 2004.[1]To understand the trends of overweight and obesity in China,we accessed the country/territory-level year-specific data of age-standardized summary exposure value(SEV,standing for the pooled proportion among the population),deaths,and disability-adjusted life of years(DALYs)for high body mass index(BMI,high BMI was defined as the BMI level higher than theoretical minimum risk exposure level[25 kg/m2])and its associated diseases for 204 countries/territories between 1990 and 2019 using data from the Global Burden of Disease Collaborative Network.[2]Previous literature described detailed methods for the data synthesis.[3,4]Using the country/territory-level data by year,we calculated the estimated annual percentage changes(EAPCs)with 95%uncertainty intervals(UI)to estimate the annual changing patterns of age-standardized SEV,death,and DALY rates among 204 countries/territories.To compare statistics from China and other regions,we calculated the corresponding estimates from regions including global,North Africa and Middle East,Sub-Saharan Africa,Western Pacific Region,European Union,Latin America and Caribbean,and South Asia. | Jing Li Qingyang Shi Qingyang Gao Xiong-Fei Pan Li Zhao Yazhou He Haoming Tian Zhiming Zhu Sheyu Li | 2022 | Chinese Medical Journal2022，，11： | 3 |
| 3 | Study on the migration of nerve stem cell in vitro Induced by glioma cells显示文摘Objective: Previous studies have shown that glioma cells induced the migration of nerve stem cells (NSCs) in vivo. This study was exploring whether this situation could happen in vitro. Methods: Supernatant from C6 glioma cell lines or astrocytes cultured in serum-free medium growing in logarithmic phase were separately placed in lower chambers and NSCs were placed in the upper chambers of Trans-well culture system. After 36 h co-incubation, these NSCs spheres occurred on the middle membrane were counted. Results: Results demonstrated that the supernatant from C6 glioma cell culture, not from the astrocytes, enhanced the migration of NSCs (P<0.01). Conclusion: Some components in C6 glioma cell culture can attract the migration of NSCs. | Yilu Gao Shuzi Gao Yi Fen Sheyu Lin Mei Liu | 2005 | Journal of Nanjing Medical University2005，19，6： | 2 |
| 4 | Acceleration mechanism of particles in the Type-I cometary plasma显示文摘 | Li Zhongyuan Guo Sheyu | 1992 | Earth Moon and Planets1992，，3： | 1 |
| 5 | Acceleration mechanism of particles in the Type-I cometary plasma显示文摘 | Li Zhongyuan Guo Sheyu | 1992 | Earth Moon and Planets1992，，3： | 1 |
| 6 | Association of Interleukin 6 gene polymorphisms with genetic susceptibilities to spastic tetraplegia in males: A case-control study显示文摘 | Mingjie Chen Tongchuan Li Sheyu Lin Dan Bi Dengna Zhu Qing Shang Caiyun Ma Honglian Wang Lei Wang Yiting Zhang Lin He Changlian Zhu Qinghe Xing | 2013 | Cytokine2013，，： | 1 |
| 7 | A new light trapping TCO for nc-Si: H solar cells 显示文摘 | Anna Selvan J A Alan E Delahoy Sheyu Guo | 2006 | Solar Energy Materials&Solar Cells2006，90，： | 1 |
| 8 | The new structure of fibre glass reinforced plastics bolt显示文摘 | MA Nianjie LIU Sheyu | 2003 | Jounnal of Coal Science&Engineering2003，，1： | 1 |
| 9 | Promoter met hylation assay of SASH1 gene in breast eancer显示文摘 | Sheyu L Hui L Junyu Z | 2013 | J BUON2013，18，4： | 1 |
| 10 | New evidence-based clinical practice guideline timely supports hospital infection control of coronavirus disease 2019显示文摘The outbreak of the coronavirus disease 2019(COVID-19,previously named 2019-nCoV)has become a serious public health situation in China.1,2 As of February 18,2020,over 70000 patients were diagnosed with COVID-19,including thousands of healthcare providers.Chinese hospitals,especially those in Hubei Province,are facing increasing admission of infected patients,and the epidemics involve hospitals across all levels. | Sheyu Li Zhiyong Zong Xin Sun Weimin Li | 2020 | Precision Clinical Medicine2020，3，1： | 1 |
| 11 | Precision medicine in cardiorenal and metabolic diseases with routinely collected clinical data:a novel insight显示文摘Dear Editor,Evidence-based medicine guides modern clinical practice.Quantitative evidence synthesis facilitates clinical decision-making after comprehensive interviews between clinicians and patients.Individualised concern is always critical,not only for the diversity of patients’values and preferences,but also for questioning whether the treatment response of the individual is in line with the population.Precision medicine aims to choose the right treatment for each person. | Sheyu Li Qingyang Shi Valentyn Litvin Charles F.Manski | 2022 | Precision Clinical Medicine2022，5，4： | 0 |
| 12 | A New Approach to Revising Regulations on the “Five Guarantees” Support System in Rural Areass: A Case Study of Shandong Province显示文摘A grassroots survey conducted in Shandong reveals that failure to implement regulations on the “five guarantees” support system for rural households is far more serious than has been estimated by government departments at different levels. Particularly serious is the fact that so far the households enjoyed “five guarantees” under the regulations only reach about 40% of the rural households eligible to enjoy the preferential treatment decreed by the regulation. In our view, the root cause of the problem is the innate weakness of the provisions of the regulation and unfavorable changes in the external environment for its implementation, | GongSen WangLiejun SheYu | 2005 | Social Sciences in China2005，26，2： | 0 |
| 13 | Supramolecular assembly of Cp1-11 peptide and insulin for rapid-acting formulation显示文摘In order to improve the life quality of diabetic patients,it is very important to develop rapid-acting insulin formulations that can mimic the physiological meal-time secretion profile of insulin in healthy people.Although several insulin analogues have been designed to provide postprandial glycemic control,still there are some serious disadvantages.A supramolecular strategy is presented here to inhibit insulin aggregation and improve its bioactivity by using Cp1-11 peptide.As a fragment of C-peptide in proinsulin,Cp1-11 peptide was found to influence insulin oligomerization by supramolecular interactions.This work demonstrates that the Cp1-11 peptide can interact with oligomeric insulin and facilitate its disaggregation into the physiologically active monomeric form.Computer simulation indicates that Cp1-11 can insert into the space between the C-terminal tail and the N-terminal helix of the B-chain of insulin,causing dissociation of the insulin dimer.The supramolecular assembly of Cp1-11 and insulin can improve the bioavailability and therapeutic effect of insulin on the control of in vivo blood glucose levels.These results suggest that Cp1-11 peptide can modulate the intermolecular interaction of aggregated insulin and prevent the transition from monomeric to multimeric states,and shows great potential for the development of an effective rapid-acting strategy to treat diabetes. | Weigang Wang Sheyu Li Zhouxiang Zhao Anna Zhou Yanpeng Liu Yantao Chen Mingchang Lin Guosong Chen Chunmei Ding Jianshu Li | 2017 | Journal of Bioresources and Bioproducts2017，2，3： | 0 |
| 14 | Visit-to-visit glycated hemoglobin A1c variability in adults with type 2 diabetes: a systematic review and meta-analysis显示文摘Background:Current practice uses the latest measure of glycated hemoglobin(HbAlc)to facilitate clinical decision-making.Studies have demonstrated that HbAlc variability links the risk of death and complications of diabetes.However,the role of HbAlc variability is unclear in clinical practice.This systematic review summarized the evidence of visit-to-visit HbAlc variability regarding different metrics in micro-and macro-vascular complications and death in people with type 2 diabetes.Methods:We searched PubMed,EMBASE(via OVID),and Cochrane Central Register(CENTRAL,via OVID)for studies investigating the association between HbAlc variability and adverse outcomes in patients with type 2 diabetes and performed random-effects meta-analysis stratified by HbAlc variability metrics in terms of standard deviation(SD),coefficient of variation(CV),and HbAlc variability score(HVS).Results:In people with type 2 diabetes,the highest quantile of all three HbAlc variability metrics(HbAlc-standard deviation[HbAlc-SD],HbAlc-coefficient of variance[HbAlc-CV],and HVS)is associated with increased risks of all-cause mortality,cardiovascular events,progression to chronic kidney disease,amputation,and peripheral neuropathy.For example,the hazard ratio of HbAlc-SD on all-cause mortality was 1.89 with 95%confidence interval(95%CI)1.46–2.45(HbAlc-CV 1.47,95%CI 1.26-1.72;HVS 1.67,95%CI 1.34–2.09).Conclusions:High HbAlc variability leads to micro-and macro-vascular complications of type 2 diabetes and related death.People with type 2 diabetes and high HbAlc variability need additional attention and care for the potential adverse outcomes. | Furong Qu Qingyang Shi Yang Wang Yanjao Shen Kaixin Zhou Ewan R.Pearson Sheyu Li | 2022 | Chinese Medical Journal2022，135，19： | 0 |
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