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我的设计我做主:MedSci临床研究方案设计活动(第二轮)-立题公布(1)

2015-07-08 MedSci MedSci原创

任务目标:完成一份辅助生殖相关的临床研究设计 在发布的立题选项中,看下方 任务一(2015.7.6发布):临床研究立题(方向) 请各位从以下研究立题中选择一个,开展后续的研究设计任务: A. 卵巢低反应对于IVF妊娠结局的影响 B. OHSS发生的相关风险因素 C. XX激素水平(或者其他biomarker指标)是否可以预测IVF妊娠结局 D. 两种促排方

任务目标:完成一份辅助生殖相关的临床研究设计

在发布的立题选项中,看下方

任务一(2015.7.6发布):临床研究立题(方向)

请各位从以下研究立题中选择一个,开展后续的研究设计任务:

A. 卵巢低反应对于IVF妊娠结局的影响

B. OHSS发生的相关风险因素

C. XX激素水平(或者其他biomarker指标)是否可以预测IVF妊娠结局

D. 两种促排方案(或IVF过程中的其他方案/辅助方案)之间的比较

E. 对于肥胖或体重超标者实施体重控制或干预(减轻体重)对于IV     妊娠结局的影响

F. 二甲双胍是否有助于改善PCOS患者的IVF结局(或者对于二甲双胍相关治疗方案优化的研究)


经过微信群统计出的投票结果:



经过统计发现更多的老师选择了F选项,即“二甲双胍是否有助于改善PCOS患者的IVF结局(或者对于二甲双胍相关治疗方案优化的研究)”。紧随其后的是E选项,即“对于肥胖或体重超标者实施体重控制或干预(减轻体重)对于IVF妊娠结局的影响”。


我们非常认同各位的选择,确实这些研究方向是目前辅助生殖相关研究的热点,那么今天我在这里与大家分享一下关于这几个立题的“完善、细化”的建议,并提供一些相关的信息,供大家参考。


二甲双胍是否有助于改善PCOS患者的IVF结局(或对于二甲双胍相关治疗方案优化的研究)

这个立题看似有一定的新意,相关的研究成果有哪些呢?检索“metformin and pcos and pregnancy”(fig 1 Pubmed上粗略的检索结果),如果进一步限定在IVF领域,则文献数量较少,仅有18篇。最近的文献发表于2014年,因此可以说这个研究还有值得挖掘的地方,算是一个不错的立题。

正在进行或已经结束的注册研究也有一些(fig 2 www.clinicaltrials.gov上注册的研究,fig 3 注册研究分布的国家、地区)。数据显示,国内尚没有相关的注册研究。(大家不妨抢先注册一个哦!)

此类研究设计有一定的“规律”可循,如果最后选择这个方向,我们会在“任务二·研究类型的选择”中与大家进行探讨。

分析这个立题,我们不难发现其中的几个关键词,即“metformin”、“PCOS”、“pregnancy/IVF”(因为IVF可借鉴的研究不多,我们可以参考一些自然受孕的案例,将其研究设计“移植”到我们的研究设计中)。立题需要进一步“细化”,我们提供以下建议,并附上相关的参考文献:

a)Metformin用于PCOS患者有什么作用?这个问题对于临床医生并不困难,一些文献也给出了相应的“答案”,比如临床妊娠率/活产率[1]、OHSS发生[2]、流产率等[3];这些研究设计关键是针对xx(受试者,Patients)metformin有xxx效果(结局,Outcomes),请大家参考一下给出的文献,不难发现这几个研究在Patients、Outcomes上都下了很大的功夫,这些要素都应该在立题阶段进行明确。

b) 其实metformin的应用也不局限在PCOS患者上,比如有PCO,但没有高雄激素 (and no evidence of clinical or biochemical hyperandrogenism)[4],这个研究的创新点,不难发现,也是在Patients上。

c) 还有一些案例可以供大家参考的[1, 5, 6],我也有一些建议,既然是应用metformin,大家不妨在Outcomes中加入针对血糖、胰岛素抵抗、体重变化的结局观察。
      
希望通过这样的分析,能使大家进一步熟悉“立题”的技巧。

Figure 1 Pubmed上粗略的检索结果(检索“metformin and pcos and pregnancy”,限定clinical trail)


https://www.clinicaltrials.gov/ct2/results?term=biomarker+and+IVF+&Search=Search

Figure 3注册研究分布的国家、地区


参考文献:

1.Kjotrod, S.B., et al., Use of metformin before and during assisted reproductive technology in non-obese young infertile women with polycystic ovary syndrome: a prospective, randomized, double-blind, multi-centre study. Hum Reprod, 2011. 26(8): p. 2045-53.

2.Palomba, S., et al., Metformin reduces risk of ovarian hyperstimulation syndrome in patients with polycystic ovary syndrome during gonadotropin-stimulated in vitro fertilization cycles: a randomized, controlled trial. Fertil Steril, 2011. 96(6): p. 1384-1390.e4.

3.Liu, L., et al., A comparison of the miscarriage rate between women with and without polycystic ovarian syndrome undergoing IVF treatment. Eur J Obstet Gynecol Reprod Biol, 2014. 176: p. 178-82.

4.Swanton, A., et al., Do women with ovaries of polycystic morphology without any other features of PCOS benefit from short-term metformin co-treatment during IVF? A double-blind, placebo-controlled, randomized trial. Hum Reprod, 2011. 26(8): p. 2178-84.

5.Jinno, M., K. Kondou, and K. Teruya, Low-dose metformin improves pregnancy rate in in vitro fertilization repeaters without polycystic ovary syndrome: prediction of effectiveness by multiple parameters related to insulin resistance. Hormones (Athens), 2010. 9(2): p. 161-70.
6.Qublan, H.S., et al., Metformin in the treatment of clomiphene citrate-resistant women with polycystic ovary syndrome undergoing in vitro fertilisation treatment: a randomised controlled trial. J Obstet Gynaecol, 2009. 29(7): p. 651-5.

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    2016-01-27 I come

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  4. 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likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zmB9pc2e9cCbAxB29ZZibomUTs8miaRbd2iaOGfYmWoWGmNb9mx0ceqRMIeBMsQY9icxiaG7ZQicIpu3JQ/0, createdBy=610d93578, createdName=周子萌, createdTime=Thu Jul 09 08:38:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31741, encodeId=880231e41f4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31742, encodeId=ba9a31e42bc, content=等待揭晓, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=)]
    2015-07-11 cmn

    不对,看错了…

    0

  5. 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likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zmB9pc2e9cCbAxB29ZZibomUTs8miaRbd2iaOGfYmWoWGmNb9mx0ceqRMIeBMsQY9icxiaG7ZQicIpu3JQ/0, createdBy=610d93578, createdName=周子萌, createdTime=Thu Jul 09 08:38:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31741, encodeId=880231e41f4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31742, encodeId=ba9a31e42bc, content=等待揭晓, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=)]
    2015-07-11 cmn

    二甲双胍是否有助于改善PCOS患者的IVF,国外已经有注册了。

    0

  6. 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  7. 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createdName=ms8543593053280928, createdTime=Sat Aug 22 02:59:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2016223, encodeId=5be7201622345, content=<a href='/topic/show?id=5fc458e751c' target=_blank style='color:#2F92EE;'>#方案设计#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58775, encryptionId=5fc458e751c, topicName=方案设计)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Sep 16 08:59:00 CST 2015, time=2015-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32357, encodeId=7d473235e39, content=不对,看错了…, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sat Jul 11 12:49:00 CST 2015, time=2015-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32355, encodeId=84703235528, content=二甲双胍是否有助于改善PCOS患者的IVF,国外已经有注册了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sat Jul 11 12:47:00 CST 2015, time=2015-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606536, encodeId=416816065361f, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Fri Jul 10 07:59:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31930, encodeId=65f231930bc, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Thu Jul 09 13:38:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31786, encodeId=d1db31e86de, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zmB9pc2e9cCbAxB29ZZibomUTs8miaRbd2iaOGfYmWoWGmNb9mx0ceqRMIeBMsQY9icxiaG7ZQicIpu3JQ/0, createdBy=610d93578, createdName=周子萌, createdTime=Thu Jul 09 08:38:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31741, encodeId=880231e41f4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31742, encodeId=ba9a31e42bc, content=等待揭晓, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=)]
    2015-07-09 huaxipanxing

    看看

    0

  8. 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createdName=ms8543593053280928, createdTime=Sat Aug 22 02:59:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2016223, encodeId=5be7201622345, content=<a href='/topic/show?id=5fc458e751c' target=_blank style='color:#2F92EE;'>#方案设计#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58775, encryptionId=5fc458e751c, topicName=方案设计)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Sep 16 08:59:00 CST 2015, time=2015-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32357, encodeId=7d473235e39, content=不对,看错了…, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sat Jul 11 12:49:00 CST 2015, time=2015-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32355, encodeId=84703235528, content=二甲双胍是否有助于改善PCOS患者的IVF,国外已经有注册了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyhRUzmFEmHvdIaOns4DmF3BicVffXjkOjBTiaMUIA4o7feGvE5IJ0SfSco4ib955Rx7bvWlib7j9V15xp/0, createdBy=814d1631326, createdName=cmn, createdTime=Sat Jul 11 12:47:00 CST 2015, time=2015-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1606536, encodeId=416816065361f, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Fri Jul 10 07:59:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31930, encodeId=65f231930bc, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Thu Jul 09 13:38:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31786, encodeId=d1db31e86de, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zmB9pc2e9cCbAxB29ZZibomUTs8miaRbd2iaOGfYmWoWGmNb9mx0ceqRMIeBMsQY9icxiaG7ZQicIpu3JQ/0, createdBy=610d93578, createdName=周子萌, createdTime=Thu Jul 09 08:38:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31741, encodeId=880231e41f4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31742, encodeId=ba9a31e42bc, content=等待揭晓, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=)]
    2015-07-09 周子萌

    继续学习

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=60175, encodeId=7151601e5d5, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=174, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuK9CDibOwszLoEBg36ZXqzB5NDasNV9GTfFDmBicM1V8hUS4OtTicG3IiaFIKq4wqD23LUxORRJXqjVs/0, createdBy=00e81647535, createdName=I come, createdTime=Wed Jan 27 00:15:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1688746, encodeId=b46e1688e466c, content=<a href='/topic/show?id=c011e3406a8' target=_blank style='color:#2F92EE;'>#研究方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73406, encryptionId=c011e3406a8, topicName=研究方案)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13f028628303, createdName=ms8543593053280928, createdTime=Sat Aug 22 02:59:00 CST 2015, time=2015-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2016223, encodeId=5be7201622345, content=<a href='/topic/show?id=5fc458e751c' target=_blank style='color:#2F92EE;'>#方案设计#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58775, encryptionId=5fc458e751c, topicName=方案设计)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Sep 16 08:59:00 CST 2015, time=2015-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=32357, encodeId=7d473235e39, content=不对,看错了…, beContent=null, objectType=article, channel=null, level=null, likeNumber=141, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Fri Jul 10 07:59:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31930, encodeId=65f231930bc, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Thu Jul 09 13:38:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31786, encodeId=d1db31e86de, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zmB9pc2e9cCbAxB29ZZibomUTs8miaRbd2iaOGfYmWoWGmNb9mx0ceqRMIeBMsQY9icxiaG7ZQicIpu3JQ/0, createdBy=610d93578, createdName=周子萌, createdTime=Thu Jul 09 08:38:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31741, encodeId=880231e41f4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31742, encodeId=ba9a31e42bc, content=等待揭晓, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=)]
    2015-07-09 保守主义

    继续学习

    0

  10. 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style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Fri Jul 10 07:59:00 CST 2015, time=2015-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31930, encodeId=65f231930bc, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Thu Jul 09 13:38:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31786, encodeId=d1db31e86de, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zmB9pc2e9cCbAxB29ZZibomUTs8miaRbd2iaOGfYmWoWGmNb9mx0ceqRMIeBMsQY9icxiaG7ZQicIpu3JQ/0, createdBy=610d93578, createdName=周子萌, createdTime=Thu Jul 09 08:38:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31741, encodeId=880231e41f4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=31742, encodeId=ba9a31e42bc, content=等待揭晓, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d0f31631005, createdName=保守主义, createdTime=Thu Jul 09 07:08:00 CST 2015, time=2015-07-09, status=1, ipAttribution=)]
    2015-07-09 保守主义

    等待揭晓

    0

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Nat Med:同期两项糖尿病重要成果

最近,加拿大多伦多综合医院研究所的研究人员发现,二甲双胍(最广泛使用的2型糖尿病治疗药物)和白藜芦醇——在红葡萄酒中发现的一种化合物,可触发小肠中的新信号转导通路,从而降低血糖。该研究结果以两篇论文的形式发布在四月六日同期出版的《Nature Medicine》杂志。该研究小组由Tony Lam博士和他的同事Frank Duca带领,包括研究生Clemence Cote和Brittany Rasm

PLoS One:二甲双胍对妊娠糖尿病治疗是有效的

目前“二甲双胍”成了治疗妊娠期间的糖尿病孕妇的”“新宠”,很多研究纷纷涌现该领域,因为其相比于胰岛素,安全性可靠,价格更实惠,操作更方便,患者的痛楚也更小。而胰岛素作为既往该治疗领域的龙头老大,能否稳坐“座山雕”的位置临床界也是拭目以待。关于妊娠期间的糖尿病有两种情况,一种为妊娠前已确诊患糖尿病,称“糖尿病合并妊娠”;另一种为妊娠前糖代谢正常或有潜在糖耐量减退、妊娠期才出现或确诊的糖尿病,又称为“

Lancet:二甲双胍不能改善晚期胰腺癌患者的治疗结果

背景:在临床前工作和回顾性人群研究中,抗糖尿病药物二甲双胍已证实与抗肿瘤活性和降低许多癌症(包括胰腺癌)的负担有关。因此假设这种药物可以用来作为肿瘤指示。该研究的目的是评估将二甲双胍加入到一个标准系统治疗晚期胰腺癌的治疗后的疗效,并提供一个肿瘤显示二甲双胍生存终点的临床实验的第一报告。    方法:研究人员在荷兰的四个中心做了这项双盲、随机、安慰剂对照的Ⅱ期临床试验。

JCEM:二甲双胍的抗肿瘤作用

二甲双胍是广泛认可的2型糖尿病一线治疗药物,近来研究发现,它还有潜在的抗肿瘤作用。无论是在动物,还是人体试验,都发现二甲双胍可以通过AMPK依赖的通路抑制哺乳动物类雷帕霉素靶蛋白信号通路,抑制肿瘤细胞的生长。早期的观察性研究发现,在使用二甲双胍治疗的糖尿病患者中,癌症的发生风险降低,已存在癌症的进展被阻止。而且,多项研究表明,二甲双胍可以影响NF- kB的活性。NF- kB是一种转录因子,可以激活

BMJ:糖尿病预防计划再分析

近期Jeremy B Sussman等人对一项“糖尿病预防计划”的随机对照试验经行了基于风险因素的再分析,以探究二甲双胍和生活方式干预(以控制体重和运动为目的),这两种预防措施对糖尿病高危人群的预防效果。研究成果发表在近期BMJ上。该研究纳入人群均为非糖尿病患者,但有葡萄糖代谢受损,根据糖尿病形成危险因素(由糖尿病风险预测模型得出)的高低将纳入人群分为4层,接受二甲双胍或生活方

Lancet:对于晚期慢性肾病患者,不提倡使用二甲双胍

背景:二甲双胍被推荐为2型糖尿病患者的一线治疗方法。然而,这种药物已被禁用于肾功能受损的患者,因为有乳酸性酸中毒的风险。目前的证据支持有轻度至中度慢性肾脏病患者治疗时谨慎使用。然而,目前缺乏对于晚期慢性肾脏病患者使用二甲双胍的研究。该研究的目的是评估2型糖尿病合并晚期慢性肾脏病患者使用二甲双胍的安全性(约5期)。    方法:研究人员在2000年1月1日和2009年6

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