tbuckley/cabot-search huggingface dataset:
DUETTE: A randomized phase II study to assess a second maintenance treatment with olaparib (ola) or ola+ceralasertib (cer), in patients (pts) with platinum-sensitive relapsed (PSR) epithelial ovarian cancer who have previously received PARP inhibitor maintenance treatment (NCT04239014).
Authors: Amit M. Oza, Andrew Pierce, Alan Lau, Nisha Kurian, Graeme Parr, Si-Houy Lao-Sirieix, Mei Lin W. Ah-See, Emma Dean, Bienvenu Loembé
Journal: Journal of Clinical Oncology (2020)

TPS6104 Background: Ovarian cancer is the leading cause of death from gynecological cancers in the USA, and the fifth most common cause of cancer death in women. Ola is a PARPi approved for first-line maintenance treatment of BRCA-mutated advanced ovarian cancer in women who achieve a complete or partial response to platinum-based chemotherapy. Ola is also efficacious in combination with bevacizumab in the same population, independent of BRCA mutation status. Cer is a potent, oral, selective inhibitor of ATR. ATR is a critical DDR kinase that is activated in response to replication stress and stalled replication forks. There is no second maintenance standard of care for patients with PSR ovarian cancer who have previously received a PARPi in the maintenance setting. Pre-clinical models have shown that several mechanisms of PARPi resistance may be overcome by ATR inhibition, such as BRCA reversion, replication fork protection and DDR rewiring. DUETTE will select pts with tumor response or stable disease after second or third-line platinum-based treatment, with the expectation to enrich for non-BRCA reversion PARPi resistance mechanisms. The study will address the role of a second maintenance treatment following prior 1L or 2L maintenance, an emerging population of unmet need, and includes translational studies that aim to further our knowledge of clinical PARPi resistance mechanisms and predictors of treatment response. Methods: DUETTE is a global, multi-center, phase II study. 192 pts with PSR epithelial ovarian cancer who have previously received PARPi maintenance treatment, will be retreated with platinum and those who have not progressed after ≥ 4 cycles will be randomized (1:1:1) to 3 treatment arms: Arm 1, open-label: cer 160 mg once daily (qd) days 1 to 7 plus ola 300 mg twice daily (bd); Arm 2, blinded: ola monotherapy 300 mg bd and Arm 3, blinded: ola-placebo. Treatment is administered in 28-day cycles. All pts will be stratified by BRCA status (mutation or wildtype) and response to most recent line of platinum-based chemotherapy (CR/PR or SD). The primary endpoint is to assess the efficacy of maintenance ola monotherapy and cer+ola combination therapy compared with placebo by PFS using blinded, independent central review. Secondary endpoints are overall survival, PFS2, ORR, DoR, safety and tolerability. Enrolment is planned to start in April 2020.
Responding to SARS-CoV-2 in South Africa: what can we learn from drug-resistant tuberculosis?
Authors: Norbert Ndjeka, Francesca Conradie, Graeme Meintjes, Anja Reuter, Jennifer Hughes, Xavier Padanilam, Nazir Ismail, Yulene Kock, Iqbal Master, Rodolfo Romero, Julian te Riele, Martin Enwerem, Hannetjie Ferreira, Gary Maartens
Journal: European Respiratory Journal (2020)

<b>Rapid adoption of new diagnostic tools, parallel process of research and implementation, decentralisation of services, the use of personal protective equipment, as well as strong partnership and collaboration, could strengthen the fight against COVID-19</b>https://bit.ly/2XupDNe
急性肺动脉栓塞多层螺旋CT右心功能评价临床应用
Authors: 郭志军, 刘海涛, 何敬堂, 张景, 王兴宏, 迟红卫
Journal: BMJ (2011)

回顾性分析42例临床确诊急性肺动脉栓塞(APE)患者的CT肺血管成像(CTPA)图像和多层螺旋CT(multi-slice spiral CT,MSCT)右心功能参数,探讨MSCT对急性肺动脉栓塞右心功能的临床评价价值。
Risk factors of metabolic syndrome and insulin resistance in type 2 diabetic patients
Authors: Nan Zhang, Yujie Lyu, Gang Wan, Jingna Qu, Xiaoli Sun, Xianglei Bu, Guangran Yang, Shenyuan Yuan
Journal: BMJ (2016)

Objective
To investigate the risk factors of insulin resistance (IR) and metabolic syndrome (MS) in type 2 diabetic patients.


Methods
Total 373 type 2 diabetic patients were enrolled from Beijing Anzhen and Cuigezhuang communities, and classified as non-MS and MS based on the criteria of Chinese Diabetes Society. Islet function was measured, and correlation analysis was carried out on two indexes HOMA-IR and HOMA-β among patients with different MS components.


Results
Among 373 T2DM patients, 255 (68.3%) cases were MS T2DM and 118 (31.7%) were non-MS T2DM. The diabetic patients with MS had higher body mass index(27.21 vs. 23.84, P<0.001)and HOMA-IR(3.3 vs. 2.2, P<0.001), and increased waist circumference, neck circumference, triglyceride, uric acid, and HOMA-β, compared to none of MS diabetic patients(all P<0.05). The high density lipoprotein level in the diabetes patients. with MS was lower than that in non-MS diabetic patients(P<0.05). HOMA-IR was increased with the increasing numbers of MS components. Spearman analysis showed that the numbers of MS components were positively correlated with HOMA-IR and HOMA-β (r=0.238, 0.124, respectively, all P<0.01).


Conclusions
Diabetic patients with MS have higher body mass index, triglyceride, uric acid and IR, compared to non-MS patients.With the increasing numbers of MS components, insulin resistance becomes more prominent in diabetic patients.The results suggest that comprehensive management of insulin resistance-related factors should be strengthened in addition to blood glucose control in community health service.


Key words: 
Diabetes mellitus, type 2; Metabolic syndrome X; Insulin resistance
赣州市社区卫生服务机构现状与对策
Authors: 周小军, 袁兆康, 万红, 肖云昌, 操秋阳
Journal: BMJ (2006)

社区卫生服务(community health services)是以全科医生为主体、经济方便、综合性的基本卫生服务,是世界卫生保健服务发展的大趋势.在大力推进城市社区建设、推进城镇医疗体制改革的过程中,如何加快城市社区卫生服务的发展已成为迫切需要解决的一个重要课题.江西省赣州市的社区卫生服务工作经过几年的努力,取得了长足的进步.为了探索在经济欠发达地区的中小城市开展社区卫生服务的适宜模式,于2004年4月对赣州市章贡区社区卫生服务开展情况及面临的问题进行调查分析。
Antiphospholipid syndrome
Authors: Jallow Tracy, D'Cruz David, Lempp Heidi, 朱剑, 王一雯, 黄烽
Journal: BMJ (2017)

这是一系列来自患者的零星文章中的最后一篇，他们的经历为医生提供了生动教程。关于你的患者在想什么系列的更多信息，请联系患者编辑Rosamund Snow (rsnow@bmj.com)。
Comprehensive cross-platform comparison of methodologies for noninvasive EGFR mutation testing: Results of the RING observational trial.
Authors: Atocha Romero, Miguel Angel Molina-Vila, Eloisa Jantus-Lewintre, Amelia Insa, Patricia Cruz, Ana Collazo, Javier Perez Altozano, Oscar Juan-Vidal, Pilar Diz, Manuel Cobo, Berta Hernandez, Sergio Vazquez-Estevez, Gretel Benitez, Maria Guirado, Alejandro Rodriguez-Festa, Silvia Calabuig-Fariñas, Rafael Rosell, Carlos Camps, Ana Royuela, Mariano Provencio-Pulla
Journal: Journal of Clinical Oncology (2020)

e21518 Background: Several platforms for non-invasive EGFR testing are currently used in the clinical setting, with sensitivities ranging from 30 to 100%. Comparison studies in prospective cohorts remain limited and reports evaluating mutant allelic fractions (MAFs) are particularly scarce. The RING observational trial (ClinicalTrials.gov identifier NCT03363139) was designed to comprehensively analyze the concordance between methodologies for EGFR mutation detection in blood. Methods: Seventy-two EGFR mutant NSCLC patients were enrolled in the trial. Plasma samples were prospectively collected at progression to first line Tyrosine Kinase Inhibitor and tested for EGFR mutations by 7 methodologies; cobas EGFR Mutation Test v2, Therascreen EGFR Plasma RGQ PCR Kit, QuantStudio 3D Digital PCR System, a 5-nuclease real-time PCR assay in presence of PNA, OncoBEAM EGFR and NGS with two different gene panels, Ion Torrent Oncomine and GeneRead QIAact Lung DNA UMI Cancer Panel. Results: The agreement between all methodologies for was almost perfect for the detection of deletions in exon 19 (K = 0.86; 95%CI: 0.76-0.96) and substantial for exon 21 point mutations (K = 0.76; 95%CI: 0.63-0.89). Regarding the p.T790M resistance mutation, concordance was lower but still substantial (K = 0.68; 95%CI: 0.57-0.79). If only NGS-based technologies were considered, the agreement was almost perfect for sensitizing mutations and substantial for the resistance mutation (K = 0.84; 95%CI: 0.68-1.00, K = 0.86; 95%CI: 0.69-1.00 and K = 0.77; 95%CI: 0.60-0.95 for exon 19, exon 21 and p.T790M, respectively). Most discordant samples between methodologies had mutant allele fractions (MAFs) ≤0.5%. Sensitizing mutations were always present at higher MAFs than concomitant p.T790M, explaining the lower concordance observed for this variant. MAFs obtained by different methodologies showed an excellent reproducibility (intraclass correlation coeficients 0.85-0.97). Similarly, Passing–Bablok regression analysis showed a high correlation between methodologies when assessing MAFs. Conclusions: Our results support the use of liquid biopsies for non-invasive EGFR testing in the clinical setting and highlight the need to systematically report MAFs.
全科医学人才培养模式的探讨
Authors: 周志衡, 王家骥, 王敏, 雷毅雄, 李芳健
Journal: BMJ (2007)

我院在1997年开办临床医学全科医学专业方向教育取得的成果与经验基础上,进一步拓展全科医学教育教学改革,采用多层次、多途径、多形式、多种培养目标的育人模式,学历教育和在职人员非学历继续教育与岗位培训相结合,在培育社区全科师资、课程体系、教学模式、教学质量监控和社区实践基地建设等方面进一步进行系列探索与实践,探讨构建符合我国现阶段国情、满足社区发展急需的、具有社区卫生服务能力的高素质全科医学人才培养体系。
Practice and effects of tiered referral model for chronic non-communicable disease in Xiamen
Authors: Guobao Tang, Shuyu Yang
Journal: BMJ (2016)

通过三级医院专科医师、基层医疗机构全科医师和健康管理师三师共管慢性非传染性疾病(慢性病)模式，构建厦门市新型分级诊疗体系，并以糖尿病、高血压为例，对厦门市三师共管服务模式管理的效果进行分析。2014年，厦门市三师共管服务模式管理后，基层医疗机构门诊量增加；糖尿病患者血糖、糖化血红蛋白的达标率增加；高血压患者血压达标率逐渐上升；慢性病患者医药费用开支有所降低；患者自我健康管理能力也得到了提升。三师共管是一种适合中国国情的分级诊疗模式，可为中国推行三师共管服务模式提供可借鉴的经验。
Saudi Cancer Patient Experience: Benchmarking a single center report to the United Kingdom National Experience.
Authors: Hoda Jradi, Alanood Abdulaziz Alharbi, Maali Omar Alrashed, Mishael Ali Alshoaibi, Mohammad Alkaiyat, Abdul Rahman Jazieh
Journal: Journal of Clinical Oncology (2020)

e14138 Background: Diagnosis and treatment of cancer are regarded as stressful experiences impacting the patients and their families. This study aims at comparing the Saudi cancer patient experience with the United Kingdom cancer patient experience throughout their continuum of care. Methods: Results from the United Kingdom (UK) National Cancer Patient Experience Survey (NCPES 2017) were compared to the reported results from the experience of 100 cancer patients for the same year at the National Guard Health affairs Health system in Riyadh, Saudi Arabia. Similar concepts relating to the experience were investigated and compared. Results: Compared to the UK survey, the Saudi survey had mainly higher score regarding receiving an overall positive cancer care. Scores related to provision of clear answers to all important questions, judging the hospital staff as always working well together, and family members being given the opportunity to communicate with the doctor were significantly higher among Saudis. The UK patient scored significantly higher on receiving information about diagnostic tests, treatment side effects, and discharge instructions, and being informed about support groups and on-going cancer research. Conclusions: The overall experience of the Saudi cancer patients compared favorably to the UK cancer patients; however, in the domain of information provision as an essential part of the cancer experience is still lacking in the Saudi cancer care approach. Quality improvement should focus on the findings of this study for better health outcomes. [Table: see text]
Effects of passive smoking on vascular endothelial function in office women
Authors: Liang Yu, Li Gao, Wen-dong Qu, Lun Liu
Journal: BMJ (2008)

Objective To explore the effects of passive smoking on vascular endothelial function in office women.Methods Totally,94 healthy office women volunteers from urban(36 women)and townships or towns(58 women)were divided into three groups based on the extent of their daily exposure to passive smoking,group A exposed to one to eight cigarettes,group B exposed to nine to 15 cigarettes,and group C exposed to more than 15 cigarettes,respectively,with 20 healthy young women without exposure to passive smoking as controls.Internal diameter of the brachial artery Was measured by color Doppler ultrasound scanning for each of the participants and its changes were observed before and after congestive reaction of the brachial artery test and nitroglycerin test.Results Thirteen of 36 office women from urban and 38 of 58 from townships or towns exposed to passive smoking of more than eight cigarettes daily,with chi-square of 7.74,P=0.0054.The brachial artery in groups A,B and C dilated less than that in the controls did.The brachial artery in group C dilated less than that in the groups A and B did.Conclusion Passive smoking could damage vascular endothelial dilatation function in office women.

Key words: 
Smoking; Tobacco smoke pollution; Endothelium,vascular
氟西汀致抗利尿激素分泌不当综合征一例
Authors: 陈建清, 胡良凯, 张建民
Journal: BMJ (2009)

患者女,78岁.因反复中上腹烧灼感一年余,恶心、纳差2周,于2008年10月20日入院.患者1年前胃镜检查提示胆汁反流性胃炎,有反复中上腹烧灼感,长期服用胃黏膜保护剂.因焦虑症长期服用氟哌噻吨美利曲辛片(商品名黛力新),3周前改服盐酸氟西汀胶囊(商品名百忧解,20 mg/粒)每天1粒。
A phase Ib study of lenvatinib (LEN) plus pembrolizumab (PEMBRO) in unresectable hepatocellular carcinoma (uHCC).
Authors: Andrew X. Zhu, Richard S. Finn, Masafumi Ikeda, Max W. Sung, Ari David Baron, Masatoshi Kudo, Takuji Okusaka, Masahiro Kobayashi, Hiromitsu Kumada, Shuichi Kaneko, Marc Pracht, Konstantin Mamontov, Tim Meyer, Kalgi Mody, Tomoki Kubota, Corina E. Dutcus, KENICHI SAITO, Abby B. Siegel, Leonid Dubrovsky, Josep M Llovet
Journal: Journal of Clinical Oncology (2020)

4519 Background: LEN is a multikinase inhibitor of VEGFR 1–3, FGFR 1–4, PDGFRα, RET, and KIT, approved for first line (1L) treatment of uHCC. PEMBRO, an anti-PD-1 monoclonal antibody, was granted accelerated approval for the treatment of patients (pts) with HCC after sorafenib therapy. We assessed the safety and efficacy of LEN + PEMBRO in uHCC. Methods: In this phase 1b trial (NCT03006926), pts received LEN 12 mg/day (bodyweight [BW] ≥60 kg) or 8 mg/day (BW &lt;60 kg) orally + PEMBRO 200 mg IV on Day 1 of a 21-day cycle. Primary endpoints were safety and tolerability for Part 1 and objective response rate (ORR) and duration of response (DOR) by mRECIST and RECIST v1.1 per independent imaging review (IIR) in the 1L setting for Part 2. Results: 104 pts (part 1, n=6; part 2, n=98) were enrolled. No DLTs were reported in Part 1; 100 pts were included in the 1L analysis of LEN + PEMBRO–4 pts (part 1) excluded due to prior sorafenib. At data cutoff (October 31, 2019) and median follow-up of 10.6 months, 37 pts continued treatment (LEN only, n=3; both drugs, n=34); median duration of treatment was 7.9 months (LEN, 7.6 months; PEMBRO, 7.4 months). Median OS was 22.0 months (95% CI 20.4–not estimable [NE]), median PFS was 8.6 months (95% CI 7.1–9.7), and ORR was 36% (95% CI 26.6–46.2) (RECIST v1.1 per IIR). Additional efficacy outcomes are shown in the table. Treatment-emergent adverse events (TEAEs) occurred in 99% of pts (grade ≥3, 85%; grade ≥4, 23%). The most common grade ≥3 TEAE was hypertension (18% of pts). Treatment-related AEs (TRAEs) occurred in 95% of pts (grade ≥3, 67%; grade ≥4, 4%). The most common grade ≥3 TRAE was hypertension (17% of pts). 36% of pts had serious TRAEs and 3 pts died from a TRAE (acute respiratory failure/acute respiratory distress syndrome, n=1; intestinal perforation, n=1; abnormal hepatic function, n=1). Conclusions: LEN + PEMBRO has promising antitumor activity with a tolerable safety profile. An ongoing phase 3 trial (NCT03713593) is assessing LEN + PEMBRO vs LEN alone as 1L therapy for uHCC. Clinical trial information: NCT03006926 . [Table: see text]
高校医院开展社区卫生服务的优势与劣势分析
Authors: 吴庆波
Journal: BMJ (2009)

积极推进城市医疗卫生服务体制改革,大力发展社区卫生服务,为居民提供安全、有效、便捷、经济的公共卫生服务和基本医疗服务,是政府社会管理和公共服务职能的重要组成部分[1].高校医院是高等院校的重要卫生资源,在满足广大师生员工及附近社区居民的基本卫生保健需求方面发挥着重要作用,如何看待高校医院参与社区卫生服务是摆在政府与学校有关部门方面的重要课题,现结合本院实际与有关资料分析如下:
Case 19-2020: A 74-Year-Old Man with Acute Respiratory Failure and Unclear Goals of Care
Authors: Juliet C. Jacobsen, Kathy M. Tran, Vicki A. Jackson, Emily B. Rubin
Journal: New England Journal of Medicine (2020)

A Man with Acute Respiratory Failure and Unclear Goals of Care A 74-year-old man with lymphoma was admitted to the hospital during the Covid-19 pandemic because of rapidly progressive respiratory f...
Research advances on ventilator-associated pneumonia
Authors: Xiaoding Liu, Dexin Liu
Journal: BMJ (2016)

Ventilator-associated pneumonia (VAP) is the most common hospital acquired infection, which increases the burden of patients significantly. Early diagnosis and effective prevention are important for VAP management. The guidelines for diagnosis, prevention and treatment of ventilator-associated pneumonia was issued by Chinese Society of Critical Care Medicine Chinese Medical Association in 2013. This article reviews the new progress of the diagnosis, treatment and prevention of VAP after the guideline was published.


Key words: 
Pneumonia, ventilator-associated; Diagnosis; Therapy
初次发现高血压后的检查和治疗
Authors: 吴海云
Journal: BMJ (2012)

初次发现高血压的病人,都应该进行全面的检查,以排除继发性高血压,并寻找合并的其他心血管病危险因素,评估今后发生心脑血管事件的风险.绝大多数原发性高血压病人,都需要终身服用降压药,并对合并的其他危险因素综合干预。
Pay more attention to the humanities in individual difference of patients
Authors: 曾昭耆
Journal: BMJ (2006)

认识个体差异性,对临床医生有十分重要的意义.因为,大多数教科书或其他专业文献,在介绍某种疾病时,通常主要讲的是概貌.医生头脑里对一些疾病留下的印象,也主要是它们的典型表现.例如,细菌性痢疾的特点为腹痛、腹泻、脓血便,伴里急后重;肺炎的特点为寒战、高热,咳嗽、胸痛,铁锈色痰等等.但在临床实际中,严重的中毒性痢疾可能至死连一次大便都没有;老年人的肺炎也可能发热不明显,咳嗽也不重,而主要表现为精神障碍.究其原因,除疾病本身的变化外,患者机体的个体差异性也有很大关系。
Evaluation of Sleepstrip in screening for sleep disorder breathing
Authors: Qian Cai, Hua Zou, Yi-qing Zheng, Hui Ye
Journal: BMJ (2010)

Thirty outpatients were monitored by polysomnography ( PSG) and Sleepstrip at same time. Evaluation of Sleepstrip on sleep disorder breathing (SDB) was performed with results of PSG as the gold standard. Among 30 patients, 25 were male, 5 female with an average age of 41. The average body mass index was 27 ±5. Sleep time was(492 ±68)min, sleep latent period(25 ±30)min; sleep efficiency (90 ± 10)% , the lowest SaO_2(76 ± 12)%. All Sleepstrip proceeded successfully. Six cases monitored by Sleepstrip were different from that monitored by PSG. Spearman correlation between Sleepstrip grading and AH1 value was 0.916. Sensitivity and specificity of Sleepstrip were 100% and 75% when AHI 15 was taken as the cut-off value. Sleepstrip is a convenient and comparatively accurate device in screening for SDB.

Key words: 
Polysomnography ;  Mass screening
Efficacy of titanium elastic intramedullary nail for treatment of clavicular shaft fractures in young and adolescent patients
Authors: Lei Han, Yungen Hu, Weili Fang, Bo Jin
Journal: BMJ (2019)

From January 2012 to January 2017, 98 patients with clavicular fractures were treated with titanium elastic intramedullary nail(TEN), including 58 males and 40 females with an average age of 14.5 years (11-18 years).The mean time from injury to surgery was 4.2 d (2-7 d).Sixty nine cases were treated by closed reduction and 29 cases by 2-3 cm incision. Constant function scores and disability of the arm shoulder and hand (DASH) scores were compared before surgery and 4 wks after surgery; Neer function scores at 3 months after surgery were compared between the injured side and unaffected side. All patients were reexamined at a mean follow-up of 6.5 months (3-8 months), and fracture union was determined by X-ray.The results showed that the bony union was ranged from 8-16 weeks with an average of 12.4 weeks. There were 4 cases with soft tissue irritation; no cases of infection, TEN broken, delayed healing were observed. The Constant score rose from 41.7±4.8 before operation to 92.6±3.2 at 4 weeks after operation (t=16.67, P 0.05). The TEN was removed after showing bone healing on X-ray film. The study indicates that using TEN has advantages of less invasiveness, reliable fixation and rapid functional improvement of shoulder for treatment of clavicular fracture in young and adolescent patients.


Key words: 
Clavicle; Fractures,bone; Adolcscent; Fracture fixation,intramedullary
Progress in use of beta-blockers for cardiovascular diseases
Authors: 冯庆芝
Journal: BMJ (2005)

β受体阻滞剂(beta-blocker)过去多作为抗心律失常药应用于临床,近年来其应用范围逐渐扩大,现已应用于抗高血压、纠正心肌缺血、改善心功能[1],品种及剂型也日新月异,其作用机制是多方面的,至今尚未完全清楚,不同制剂作用机制亦有差别,其核心作用是预防儿茶酚胺的心脏毒性作用。
Hemodialysis Device for Very Small Pediatric Patients
Authors: Rebecca Voelker
Journal: JAMA (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
糖尿病的胰岛素治疗
Authors: 翁建平, 许雯
Journal: BMJ (2004)

自1922年胰岛素首次用于治疗糖尿病以来,随着对糖尿病病理生理和发病机制认识的深入,胰岛素的应用越来越广泛.据报道,美国已诊断的糖尿病患者中约40%接受胰岛素治疗.目前经典的胰岛素治疗适应证如下: ① 1型糖尿病;② 2型糖尿病患者经饮食、运动及口服降糖药治疗效果欠佳,或并发各种急性并发症、严重慢性并发症,以及合并严重感染、应激状态时;③妊娠糖尿病;④继发性糖尿病。