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Journal of Integrative Medicine 2022年第4期20卷 288-291页

作者： Theocharis Koufakis Kalliopi Kotsa Nikolaos Papanas division of endocrinology and Metabolism and Diabetes Centre First Department of Internal MedicineMedical SchoolAristotle University of ThessalonikiAHEPA University Hospital54636 ThessalonikiGreece Diabetes Centre Second Department of Internal MedicineDemocritus University of Thrace68100 AlexandroupolisGreece

Theoretically, a new diagnosis of type 2 diabetes mellitus(T2DM) requires a dramatic change in an individual’s way of life. Weight loss and physical activity can lead to remission of diabetes, which has been associated with a lower risk of developing complications. Today, the importance of a healthy lifestyle is further highlighted by data showing that obesity and diabetes increase the risk of severe complications from coronavirus disease 2019. However, remission rarely occurs in reality, probably due to the inability of people with T2DM to adhere to the intensive lifestyle interventions that are necessary. The complexity of contributing factors may explain why making these changes is so challenging and underscore the fact that there is no magical solution for T2DM. Instead, hard work from both patients and health care providers is needed for the conversion to be achieved. This article calls for more research on the underlying reasons why adhering to a healthy way of life is so difficult for people with diabetes and obesity. Clearly defining these barriers would facilitate the planning of effective policies to promote the adoption of appropriate lifestyle changes early in the course of the disease.

关键词： Type 2 diabetes Remission Exercise Diet Lifestyle change

Amplitude of peroneal compound motor action potential increases in type 2 diabetes with thyroid autoimmunity

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Science China(Life Sciences) 2018年第8期61卷 988-991页

作者： Fanfan Zhu Boren Jiang Rongliang Ren Lizhen Yang division of endocrinology and Metabolism Shanghai Ninth People's Hospital School of Medicine Shanghai Jiaotong University

Dear Editor,Diabetic peripheral neuropathy(DPN)is a frequently occurring complication of diabetes.DPN is diagnosed on the basis of findings of neural electrophysiological study,such as the nerve conduction study(NCS).The most common NCS manifestations of DPN include slow velocity,prolonged latency,and decreased amplitude.Risk factors for DPN include age,hyperglycemia,dyslipidemia,smoking,atherosclerotic cardiovascular disease,peripheral arterial disease,diabetic nephropathy,and diabetic retinopathy.

关键词：糖尿病振幅甲状腺动脉粥样硬化马达复合类型 DPN

Adverse effects of androgen deprivation therapy in men with prostate cancer： a focus on metabolic and cardiovascular complications

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Asian Journal of Andrology 2012年第2期14卷 222-225页

作者： Lauren Collins Shehzad Basaria Department of Medicine Division of Endocrinology and MetabolismBoston University School of MedicineBostonMA 02118USA

Prostate cancer （PCa） is the most common malignancy in men. Prostate being an androgen responsive tissue, androgen deprivation therapy （ADT） is used in the management of locally advanced （improves survival） and metastatic （improves pain and quality of life） PCa. Over the past two decades, the use of ADT has significantly increased as it is also being used in patients with localized disease and those experiencing biochemical recurrences, though without any evidence of survival advantage. Hypogonadism resulting from ADT is associated with decreased muscle mass and strength, increased fat mass, sexual dysfunction, vasomotor symptoms, decreased quality of life, anemia and bone loss. Insulin resistance, diabetes and cardiovascular disease have recently been added to the list of these complications. As the majority of men with PCa die of conditions other than their primary malignancy, recognition and management of these adverse effects is paramount. Here we review data evaluating metabolic and cardiovascular complications of ADT.

关键词： androgen deprivation therapy cardiovascular disease diabetes hypogonadism prostate cancer

Ovarian hyperstimulation syndrome following the use of GnRH agonist trigger of final oocyte maturation and freeze-all strategy: A case report and review of the literature

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Asian pacific Journal of Reproduction 2022年第6期11卷 292-298页

作者： Dalia Khalife Suleiman Ghunaim Lina El Taha Omar Odeh Natasha Habr Johnny Awwad Department of Obstetrics and Gynecology Division of Reproductive Endocrinology and InfertilityHaifa Idriss-ART UnitAmerican University of BeirutBeirutLebanon School of Medicine The University of JordanAmmanJordan division of Plastic and Reconstructive Surgery American University of Beirut Medical CenterBeirutLebanon

Rationale:The current literature has a surprising controversy regarding the use of low-dose human chorionic gonadotropin(hCG)for luteal support as an explanation for the development of ovarian hyperstimulation syndrome,and this is because of the gap in the listing of the predisposing factors that put women at an increased risk of ovarian hyperstimulation syndrome.Patient concerns:A case of 25-year-old woman presented with abdominal pain,distention,dyspnea,and nausea with a 6.5 kg increase in weight from baseline.Ultrasonographic examination showed bilaterally enlarged multicystic ovaries after gonadotropin-releasing hormone(GnRH)agonist triggering and cycle segmentation with no hCG rescue administration.Diagnosis:Moderate/severe ovarian hyperstimulation syndrome.Interventions:The woman was admitted to the hospital for medical management of moderate/severe ovarian hyperstimulation syndrome,and pain management was advanced to patient-controlled anesthesia with the start of low molecular weight heparin.On day 2,albumin therapy followed by a furosemide chase was started due to an increase in abdominal girth.On day 1,Cabergoline was maintained,and on day 2 the GnRH antagonist Cetrorelix was started.Outcomes:The woman’s clinical condition improved,and a clinical pregnancy was eventually achieved during the first cryo-warmed blastocyst cycle.Lessons:Ovarian hyperstimulation syndrome can still happen even after the use of GnRH agonist and avoidance of hCG support.Segmentation of in vitro fertilization with complete avoidance of hCG for luteal support remains the best approach.

关键词： Ovarian hyperstimulation syndrome Gonadotropin releasing hormone agonist In vitro fertilization Human chorionic gonadotropin support Ovulation induction Reproductive endocrinology

Pulsatile gonadotropin-releasing hormone therapy is associated with earlier spermatogenesis compared to combined gonadotropin therapy in patients with congenital hypogonadotropic hypogonadism

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Asian Journal of Andrology 2017年第6期19卷 680-685页

作者： Jiang-Feng Mao Zhao-Xiang Liu Min Nie Xi Wang Hong-Li Xu Bing-Kun Huang Jun-Jie Zheng Le Min Ursula Brigitte Kaiser Xue-Yan Wu Department of endocrinology Peking Union Medical College Hospital Key Laboratory of Endocrinology Ministry of Health Beijing 100730 China Internal Department Division of Endocrinology Diabetes and Hypertension Brigham and Women's Hospital Harvard Medical School Boston MA 02115 USA.

Both pulsatile gonadotropin-releasing hormone （GnRH） infusion and combined gonadotropin therapy （human chorionic gonadotropin and human menopausal gonadotropin [HCG/HMG]） are effective to induce spermatogenesis in male patients with congenital hypogonadotropic hypogonadism （CH H）. However, evidence is lacking as to which treatment strategy is better. This retrospective cohort study included 202 patients with CHH： twenty had received pulsatile GnRH and 182 had received HCG/HMG. Patients had received therapy for at least 12 months. The total follow-up time was 15.6 ± 5.0 months （range： 12-27 months） for the GnRH group and 28.7 ± 13.0 months （range： 12-66 months） for the HCG/HMG group. The median time to first sperm appearance was 6 months （95% confidence interval [CI]： 1.6-10.4） in the GnRH group versus 18 months （95% Ch 16.4-20.0） in the HCG/HMG group （P〈 0.001）. The median time to achieve sperm concentrations 〉5 x 106 m1-1 was 14 months （95% Ch 5.8-22.2） in the GnRH group versus 27 months （95% Ch 18.9-35.1） in the HCG/HMG group （P 〈 0.001）, and the median time to concentrations 〉10 x 106 m1-1 was 18 months （95% Ch 10.0-26.0） in the GnRH group versus 39 months （95% CI unknown） in the HCG/HMG group. Compared to the GnRH group, the HCG/HMG group required longer treatment periods to achieve testicular sizes of 〉4 ml, 〉8 ml, 〉12 ml, and 〉16 ml. Sperm motility （a ＋ b ＋ c percentage） evaluated in semen samples with concentrations 〉1 × 106 ml-1 was 43.7% ± 20.4% （16 samples） in the GnRH group versus 43.2% ± 18.1% （153 samples） in the HCG/HMG group （P= 0.921）. Notably, during follow-up, the GnRH group had lower serum testosterone levels than the HCG/HMG group （8.3 ±4.6 vs 16.2 ± 8.2 nmol 1-1, P 〈 0.001）. Our study found that pulsatile GnRH therapy was associated with earlier spermatogenesis and larger testicular size compared to combined gonadotropin therapy. Additional prospective randomized studies would be required to confirm these findings.

关键词： combined gonadotropin therapy congenital hypogonadotropic hypogonadism pulsatile GnRH therapy spermatogenesis

How will the latest modifications to the CG189 NICE guidelines for obesity management likely impact clinical care?

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Hepatobiliary Surgery and Nutrition 2023年第3期12卷 413-416页

作者： Thomas M.Barber Warwickshire Institute for the Study of Diabetes Endocrinology and MetabolismUniversity Hospitals Coventry and WarwickshireClifford Bridge RoadCoventryUK division of Biomedical Sciences Clinical Sciences Research LaboratoriesWarwick Medical SchoolUniversity of WarwickCoventryUK

Based on the 2019 Health Survey for England,nearly two thirds of the adult population and one third of children(aged 2-15 years)are either overweight or obese(1).In England,obesity affects 28%of adults,20%of boys and 13%of girls(1).Obesity is a chronic,often life-long disease that associates with>50 weight-related conditions,most notably type 2 diabetes mellitus(T2D),and other dysmetabolic conditions that contribute towards the metabolic syndrome and many other conditions that impact on nearly every aspect of physiology and mental functioning(2).Obesity has a huge economic burden,with government estimates indicating the current costs of obesity in the UK at£6.1 billion to the National Health Service(NHS),and£27 billion to wider society(1).Despite this,obesity remains fundamentally misunderstood and neglected.This is reflected by woeful under-funding of management strategies for obesity(despite many of these being highly efficacious),guidelines that place time-limitations on potentially effective therapies(with possible negative outcomes that stem from subsequent weight re-gain),and a prevailing fog of obesity-related stigma that seems to pervade its way throughout society like a contagion.

关键词： Obesity compassion awareness adaptability

A case of mimicking angioedema： chin silicone granulomatous reaction spreading all over the face after receiving liquid silicone injection forty years previously

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Chinese Medical Journal 2011年第11期124卷 1747-1750页

作者： Yu-cheng Chen Mei-ling Chen Ying-ming Chiu division of endocrinology and Metabolism Department ofInternal Medicine Department of Pathology division of Rheumatology Department of Internal MedicineChanghua Christian I~Iospital Changhua TaiwanChina

Liquid injectable silicone has been used for soft tissue augmentation for five decades. Many complications following liquid silicone injection have been reported. To diagnose and manage silicone granuloma remains difficult. Silicone granuloma must be diagnosed with the history of liquid silicone injection and the histology of tissue biopsy. We presented a case of granulomatous reaction after the injection of liquid silicone for chin augmentation forty years ago, causing total facial swelling, which mimicking angioedema initially. We administered methylprednisolone to the patient. Initial response to methylprednisolone was favorable.

关键词： silicone granuloma methylprednisolone angioedema liquid silicone

High-sensitivity C-reactive protein in paediatric inflammatory bowel disease

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World Journal of Gastroenterology 2010年第23期16卷 2901-2906页

作者： Marianne Sidoroff Riitta Karikoski Taneli Raivio Erkki Savilahti Kaija-Leena Kolho division of Gastroenterology and endocrinology Hospital for Children and AdolescentsUniversity of Helsinki Department of Pathology HUSLABHelsinki University Central Hospital

AIM:To study whether high-sensitivity C-reactive protein(hs-CRP) measurement can aid the assessment of disease activity and glucocorticoid treatment in paediatric inflammatory bowel disease(IBD).METHODS:CRP levels were measured in 39 children with IBD undergoing colonoscopy [median age 12.8 years,Crohn's disease(CD) n=20],in 22 other children with IBD followed for acute response to glucocorticoids,and in 33 paediatric non-IBD patients.When standard CRP level was below detection limit(<5mg/L),hs-CRP was analyzed.RESULTS:Sixty-four percent(25/39) of the children with IBD undergoing colonoscopy displayed undetectable(<5mg/L) standard CRP levels.Of these,the hs-CRP measurement could not differentiate between active(median,0.2 mg/L,range,0.007-1.37,n=17) or quiescent(0.1 mg/L,0.01-1.89,n=8,P=NS) disease.Patients with ileocolonic CD had higher CRP levels(14mg/L,0.06-45,n=13) than patients with no ileal involvement(0.18 mg/L,0.01-9,n=7,P<0.01) or ulcerative colitis(UC)(0.13 mg/L,0.007-23,P<0.05).In children with active IBD treated with systemic glucocorticoids,the standard CRP was undetectable in 59% of the patients.The hs-CRP levels did not differ between patients that responded to steroid therapy and in non-responders.CONCLUSION:The measurement of hs-CRP did not prove useful in the assessment of disease activity or glucocorticoid treatment in paediatric IBD patients that had undetectable standard CRP.

关键词： C-reactive protein Crohn’s disease Ulcerative colitis Children Inflammatory markers

First experience with intracytoplasmic sperm injection for extreme oligozoospermia associated with Crohn's disease and 6-mercaptopurine chemotherapy

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Asian Journal of Andrology 2003年第1期5卷 76-78页

作者： E.Scott Sills Michael J.Tucker division of Reproductive endocrinology and Infertility Department of Obstetrics and Gynecology Atlanta Medical Center AtlantaGeorgia 30342USA

Aim: To describe the reproductive outcome following intracytoplasmic sperm injection (ICSI) for male factor infertility associated with Crohn's disease and 6-mercap-topurine (6-MP) chemotherapy. Methods: The male partner of a couple suffered from severe Crohn's disease and received a 3-month course of 6-MP for this condition. Two spontaneous conceptions were established before 6-MP, although post-chemotherapy semen analysis found the sperm concentration to be 8,000/mL. In vitro fertilization (IVF) with ICSI and embryo transfer was performed. Results: The woman underwent an uncomplicated controlled ovarian hyperstimulation sequence using a combined rec-FSH+hMG protocol, following late luteal phase pituitary downregulation. This culminated in the retrieval of 18 oocytes, 11 of which were fertilized with ICSI. She later delivered a normal male infant without urogenital anomaly. Four nontransferred blastocysts were cryopreserved. Conclusion: This report describes the first successful birth after ICSI for severe oligozoospermia associated with Crohn's disease and 6-MP therapy. We outline salient features of Crohn's disease, 6-MP pharmacology, and their relevance to human fertility.

关键词： 6-mercaptopurine chemotherapy infertility ICSI

The fate of surplus embryos in the setting of assisted reproductive technology:A scoping review

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Asian pacific Journal of Reproduction 2023年第1期12卷 1-9页

作者： I Gusti Agung Ngurah Agung Sentosa Sarrah Ayuandari Rafhani Rosyidah Agung Dewanto Department of Obstetrics and Gynaecology division of Reproductive endocrinology Fertility Faculty of MedicinePublic Health and NursingGadjah Mada UniversityYogyakartaIndonesia Departement Midwifery Muhammadiyah UniversitySidoarjoEast JavaIndonesia

Objective:To identify the attitudes of infertile couples toward their surplus frozen embryos.Methods:This study was according to PRISMA-ScR as the guideline for scoping review.Studies that assessed the attitudes of patients or infertile couples who had surplus embryos were included.We conducted systematic searches in English studies from April 2011-April 2021 using 7 databases:PubMed,Science Direct,EBSCO,Scopus,the Cochrane Library,Sage Journals,and Google Scholar.Data were charted based on author,year of publication,country,purpose,data collection,key findings,and research focus/domain.Results:A total of 37 research articles were included in the analysis.Their attitudes encompassed:supporting the donation of the surplus embryos for both research and reproductive purposes,continuing to store the frozen embryos,and disposing of the surplus embryos.Conclusions:Most of the infertile patients support donating their surplus embryos for research and reproductive purposes.

关键词： Attitude Decision making Infertile patients or couples Male infertility Female infertility Surplus embryos Embryo disposition Embryo leftover