糖尿病的胰岛素治疗及治疗2.pptVIP

患者的外周血造血干细胞采集（经过动员后采集） →造血干细胞冻存 →患者经过大剂量免疫抑制剂进行预处理 →输入保存的造血干细胞 大致步骤：动员剂动员?采集骨髓?干细胞分离?干细胞回输（介入的方式） * 诺和锐?是中国上市的第一个胰岛素类似物。这是诺和锐?的分子结构图,它是由诺和锐?替代人胰岛素B28的脯氨酸而形成的生物合成的人胰岛素类似物，这种结构的变化降低诺和锐?分子间的聚合力。 * * 首先，从药效学的研究结果可以看出，诺和锐30每日三次注射与基础-餐时方案的药效学曲线是相似的，这张图是利用钳夹实验的原理以葡萄输注率来比较诺和锐30 每日三次注射和基础-餐时多次注射药效学结果，从图中可以看出两种方案达到最大时间-效应曲线是相似的。 * 那么临床治疗中诺和锐30每日二次注射应该如何转为每日三次注射治疗呢？（如幻灯片介绍内容） DISCUSSION Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) are the two peptides responsible for the majority of nutrient-stimulated insulin secretion GLP-1 causes most of the incretin effect, GIP is responsible for about 20% to 30% of the incretin effect on beta-cell function GLP-1 is synthesised and released from the L-cells located predominantly in the ileum and colon, and to a lesser extent, in the duodenum and jejunum GIP is synthesised and released from intestinal K-cells, which are primarily located in the duodenum and proximal jejunum BACKGROUND Although the incretin effect was first proven in the 1960s, it was approximately 15-20 years later that GIP and GLP-1 were identified GIP and GLP-1 are members of the glucagon peptide super-family and share considerable amino acid identity The two forms of GLP-1 secreted after meal ingestion, GLP-1 (7-37) and GLP-1(7-36) amide differ by a single amino acid Both peptides are equipotent and exhibit identical plasma half-lives and biological activities acting through the same receptor; however, the majority (80%) of circulating active GLP-1 appears to be GLP-1 (7-36) amide DISCUSSION Release of increased levels of both glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) is stimulated by ingestion of nutrients and mediated by multiple factors The biologically active forms of GIP and GLP-1 both have half-lives of approximately 2–7 minutes as they are rapidly degraded by dipeptidyl peptidase-4 (DPP-4) BACKGROUND GIP is encoded by the ProGIP gene GLP-1 is generated by tissue-specific p