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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 | Cementomimetics——constructing a cementum-like biomineralized microlayer via amelogenin-derived peptides显示文摘Cementum is the outer-,mineralized-tissue covering the tooth root and an essential part of the system of periodontal tissue that anchors the tooth to the bone. Periodontal disease results from the destructive behavior of the host elicited by an infectious biofilm adhering to the tooth root and left untreated,may lead to tooth loss. We describe a novel protocol for identifying peptide sequences from native proteins with the potential to repair damaged dental tissues by controlling hydroxyapatite biomineralization. Using amelogenin as a case study and a bioinformatics scoring matrix,we identified regions within amelogenin that are shared with a set of hydroxyapatite-binding peptides (HABPs) previously selected by phage display. One 22-amino acid long peptide regions referred to as amelogenin-derived peptide 5 (ADP5) was shown to facilitate cell-free formation of a cementum-like hydroxyapatite mineral layer on demineralized human root dentin that,in turn,supported attachment of periodontal ligament cells in vitro. Our findings have several implications in peptide-assisted mineral formation that mimic biomineralization. By further elaborating the mechanism for protein control over the biomineral formed,we afford new insights into the evolution of protein-mineral interactions. By exploiting small peptide domains of native proteins,our understanding of structure-function relationships of biomineralizing proteins can be extended and these peptides can be utilized to engineer mineral formation. Finally,the cementomimetic layer formed by ADP5 has the potential clinical application to repair diseased root surfaces so as to promote the regeneration of periodontal tissues and thereby reduce the morbidity associated with tooth loss. | Mustafa Gungormus Ersin E Oren Jeremy A Horst Hanson Fong Marketa Hnilova Martha J Somerman Malcolm L Snead Ram Samudrala Candan Tamerler Mehmet Sarikaya | 2012 | International Journal of Oral Science2012，4，2： | 5 |
| 3 | Mid - infrared sepctroscopy coupled to sequential injection analysis for the on - line monitoring of the acetone - butanol fermentation process显示文摘 | Mustafa Kansiz Richard Gapes J Don Mc Naμghton | 2001 | Analytical Chimica Acta2001，438，： | 1 |
| 4 | Production of transforming growth factor betal and prostaglandin E2 by osteoblast-like cells cultured on titanium surfaces blasted with TiO2 particles显示文摘 | Mustafa K Rubinstein J Lopez BS | 2003 | Clin Oral Implants Res2003，14，1： | 1 |
| 5 | High-resolution nuclear magnetic resonance spectroscopy--applications to fatty acids and triacylglycerols显示文摘 | Jie M S Mustafa J | 1997 | Lipids1997，32，10： | 1 |
| 6 | Polypropylene/polystyrene blends-preliminary studies for compatibilization by aromatic-grafted polypropylene显示文摘 | Syed Mustafa S J Nor Azlan M R Ahmad Fuad M Y | 2001 | J Appl Polym Sci2001，82，： | 1 |
| 7 | Project risk assessment using the analytic hierarchy process 显示文摘 | Mustafa M A Al-Bahar J F | 1991 | IEEE Transactions on Engineering Management1991，38，1： | 1 |
| 8 | Determining optimal surface roughness of Ti02 blasted titanium implant material for attachment, proliferation and differentiation of cells derived from human mandibular alveolar bone 显示文摘 | Mustafa K Wennerberg A Wroblewski J | 2001 | Clin Oral Implants Res2001，12，5： | 1 |
| 9 | Elastic deflections of the blank holder in deep drawing of sheet metal显示文摘 | Steven W J Mustafa A | 1996 | Journal of Materials Processing Technology1996，59，： | 1 |
| 10 | Immunogenicity of Mobacterium tuberculosis RD1 region gene products ininfected cattle 显示文摘 | Mustafa A S Cockle P J Shaban F | 2002 | Clin Exp Immunol2002，1130，1： | 1 |
| 11 | Asymmetric plane flow with application to ice jams显示文摘 | Tatinclaux J C Mustafa G M | 1983 | Journal of Hydraulic Engineering1983，103，11： | 1 |
| 12 | Hemifacial spasm intraoperative electromyographic monitoring as a guide for microvascular decompression显示文摘 | Mooij J J Mustafa MK van Weerden Tw | 2001 | Neurosurgery2001，49，6： | 1 |
| 13 | Association analysis of the vitamin D receptor gene,the type I collagen gene COL1A1 ,and the estrogen receptor gene in idiopathic osteoarthritis 显示文摘 | Loughlin J Sinsheimer JS Mustafa Z | 2000 | J Rheumatol2000，27，3： | 1 |
| 14 | Determining optimal surface roughness of TiO2-blasted titanium implant material for attachment, proliferation and differentiation of cells derived from human mandibular alveolar bone显示文摘 | MUSTAFA K WENNERBERG A WROBLEWSKI J | 2001 | Clin Oral Impl Res2001，12，： | 1 |
| 15 | Insulin resistance and endothelial dysfunction: Are epoxyeicosatrienoic acids the link 显示文摘 | Mustafa S Shamla V Mcneill J H | 2009 | Exp Clin Cardiol2009，14，2： | 1 |
| 16 | Project risk assessment using the analytic hierarchy process显示文摘 | Mustafa M A FAI-Bahar J | 1991 | IEEE Trans on Engineering Management1991，1，38： | 1 |
| 17 | Unusual presentation of human giant off (ecthyma eontagiosum) 显示文摘 | Key S J Catania J Mustafa S F | 2007 | J Craniofac Surg2007，18，5： | 1 |
| 18 | CrossRanking of Decision Making Units in Data Envelopment Analysis显示文摘 | Angiz M Z Mustafa A Kamali M J | 2013 | Applied Mathematical Modelling2013，，37： | 1 |
| 19 | Immunohistochemical analysis of cytokines and apoptosis in tuberculous lymphadenitis 显示文摘 | Mustafa T Mogga S J Mfinanga S G | 2006 | Immunology2006，117，4： | 1 |
| 20 | Polypropylene/Polystyrene Blends-Preliminary Studies for Compatibilization by Aromatic-grafted Polypropylene 显示文摘 | Mustafa S J S Azlan M R N Fuad M Y A | 2001 | Journal of Applied Polymer Science2001，82，2： | 1 |
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