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共有 3109 条符合本次的查询结果, 用时 7.731337 秒

1. Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023.

作者: .
来源: Lancet. 2025年
Since its inception in 1974, the Essential Programme on Immunization (EPI) has achieved remarkable success, averting the deaths of an estimated 154 million children worldwide through routine childhood vaccination. However, more recent decades have seen persistent coverage inequities and stagnating progress, which have been further amplified by the COVID-19 pandemic. In 2019, WHO set ambitious goals for improving vaccine coverage globally through the Immunization Agenda 2030 (IA2030). Now halfway through the decade, understanding past and recent coverage trends can help inform and reorient strategies for approaching these aims in the next 5 years.

2. Prademagene zamikeracel for recessive dystrophic epidermolysis bullosa wounds (VIITAL): a two-centre, randomised, open-label, intrapatient-controlled phase 3 trial.

作者: Jean Y Tang.;M Peter Marinkovich.;Karen Wiss.;Daniel McCarthy.;Amanda Truesdale.;Albert S Chiou.;Edward Eid.;Joyce K McIntyre.;Irene Bailey.;Louise K Furukawa.;Emily S Gorell.;Nicki Harris.;Rohit K Khosla.;H Peter Lorenz.;Ying Lu.;Jaron Nazaroff.;I Dmitriy Grachev.;Amanda J Moore.
来源: Lancet. 2025年
Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genetic skin disease caused by mutations in the COL7A1 gene encoding type VII collagen. Individuals with RDEB have fragile skin and most develop large, chronic wounds. The aim of the VIITAL study was to evaluate the efficacy and safety of a one-time surgical application of prademagene zamikeracel in wound healing.

3. Collaboration on the optimal timing of anticoagulation after ischaemic stroke and atrial fibrillation: a systematic review and prospective individual participant data meta-analysis of randomised controlled trials (CATALYST).

作者: Hakim-Moulay Dehbi.;Urs Fischer.;Signild Åsberg.;Truman J Milling.;Stefanie Abend.;Norin Ahmed.;Mattia Branca.;Lisa A Davis.;Stefan T Engelter.;Nick Freemantle.;Thomas Gattringer.;Tatevik Ghukasyan Lakic.;Ziad Hijazi.;Martin James.;Masatoshi Koga.;Patrick Lawrence.;Robin Lemmens.;Gregory Y H Lip.;Susan Massingham.;Philip S Nash.;Amalia Ndoutoumou.;Bo Norrving.;Georgia Salanti.;Nikola Sprigg.;Götz Thomalla.;Tishok Vanniyasingam.;Per Wester.;Steven J Warach.;Jonas Oldgren.;Jesse Dawson.;David J Werring.
来源: Lancet. 2025年
The optimal timing of oral anticoagulation for prevention of early ischaemic stroke recurrence in people with acute ischaemic stroke and atrial fibrillation remains uncertain. We aimed to estimate the effects of starting a direct oral anticoagulant (DOAC) early (≤4 days) versus later (≥5 days) after onset of ischaemic stroke.

4. Biomarker risk stratification with capsule sponge in the surveillance of Barrett's oesophagus: prospective evaluation of UK real-world implementation.

作者: W Keith Tan.;Caryn S Ross-Innes.;Timothy Somerset.;Greta Markert.;Florian Markowetz.;Maria O'Donovan.;Massimiliano di Pietro.;Peter Sasieni.;Rebecca C Fitzgerald.; .
来源: Lancet. 2025年
Endoscopic surveillance is the clinical standard for Barrett's oesophagus, but its effectiveness is inconsistent. We have developed a test comprising a pan-oesophageal cell collection device coupled with biomarkers to stratify patients into three risk groups. We aimed to prospectively evaluate the prespecified risk stratification tool to establish whether it can identify those at highest risk of dysplasia or cancer to prioritise the timing of endoscopy; and safely be used to follow up the low-risk group, thus sparing patients from unnecessary endoscopies.

5. Managing early-onset type 2 diabetes in the individual and at the population level.

作者: Shivani Misra.;Kamlesh Khunti.;Alpesh Goyal.;David Gable.;Benedetta Armocida.;Nikhil Tandon.;Pooja Sachdev.;Sarah H Wild.;Marie-France Hivert.;David Beran.
来源: Lancet. 2025年405卷10497期2341-2354页
Early-onset type 2 diabetes (defined as type 2 diabetes diagnosed in people aged <40 years) is an increasingly prevalent condition with a more aggressive disease trajectory than late-onset type 2 diabetes. It is associated with accelerated microvascular and macrovascular complications, reduced life expectancy, and adverse pregnancy outcomes. Despite its rising incidence, global management strategies have mostly been extrapolated from studies in older adults with limited evidence specific to younger populations. In this Series paper, we aim to highlight the unique challenges in the management of early-onset type 2 diabetes and why current models of care are inadequate. We emphasise that early-onset type 2 diabetes necessitates proactive and combination treatment strategies to address weight, faster β-cell decline, worse insulin resistance, and rapidly progressing hyperglycaemia compared with late-onset type 2 diabetes. However, there is minimal evidence on how best to address these factors and clinical inertia risks contributing to glycaemic burden. Cardiovascular risk assessment tools underestimate long-term risk, contributing to low use of statin and antihypertensive therapy. Reproductive health remains a key concern, yet preconception and pregnancy care are inadequate, with low adherence to recommended interventions. Health-care systems are not optimised to address the distinct needs of young adults, and gaps in transitional care (from paediatric to adult services) contribute to disengagement and adverse outcomes. Addressing these challenges requires tailored management strategies that consider the unique metabolic and psychosocial factors in this population. In this Series paper, we summarise the evidence base for the management of early-onset type 2 diabetes, key evidence gaps, and discuss the multisectoral and transdisciplinary elements needed to achieve population-level prevention to reverse these concerning trends.

6. Understanding the drivers and consequences of early-onset type 2 diabetes.

作者: Lee-Ling Lim.;Sophie Jones.;Justin Cirhuza Cikomola.;Marie-France Hivert.;Shivani Misra.
来源: Lancet. 2025年405卷10497期2327-2340页
Early-onset type 2 diabetes (defined as type 2 diabetes diagnosed in people aged <40 years) is increasingly prevalent with substantial health and socioeconomic implications. Unlike late-onset type 2 diabetes, early-onset type 2 diabetes is a high-risk and aggressive phenotype, with accelerated pancreatic β-cell decline and greater insulin resistance due to the rising rate of obesity. People with early-onset type 2 diabetes have higher rates of macrovascular and microvascular complications with increased health-care use and premature mortality (due to cardiovascular and non-cardiovascular complications) than do people with late-onset type 2 diabetes. Emerging evidence also suggests that people with early-onset type 2 diabetes face an increased risk of complications in reproductive health (eg, during periconception and postpartum periods), metabolic-associated steatotic liver disease, mental health (eg, diabetes distress, depression, anxiety, and psychotic disorders), and some cancers, creating additional challenges in managing multiple long-term conditions. In this Series paper, we highlight the consequences of early-onset type 2 diabetes and the key driver for these risks-long duration of exposure to hyperglycaemia, with its effects amplified by younger age at type 2 diabetes diagnosis and interactions with other cardiometabolic risk factors. Recognising these adverse risks associated with early-onset type 2 diabetes is crucial for guiding the development and implementation of a more focused and integrated life-course approach to mitigate its long-term effect on individuals, communities, and health-care systems globally. However, substantial research gaps remain that must be addressed, particularly in diverse populations.

7. Early-onset type 2 diabetes: the next major diabetes transition.

作者: Andrea Luk.;Sarah H Wild.;Sophie Jones.;Ranjit Mohan Anjana.;Marie-France Hivert.;John McCaffrey.;Edward W Gregg.;Shivani Misra.
来源: Lancet. 2025年405卷10497期2313-2326页
The incidence of early-onset type 2 diabetes is increasing, with a growing number of cases now occurring in children, adolescents, and young adults. This transition is primarily driven by the rising prevalence of obesity in younger populations, especially in high-income countries. However, the relationship between obesity and early-onset type 2 diabetes varies across ethnic groups, with some populations exhibiting a higher risk at lower BMI thresholds, possibly due to differences in insulin resistance and β-cell function. Socioeconomic factors further shape disease patterns, with early-onset type 2 diabetes disproportionately affecting lower-income populations in high-income settings, whereas in low-income and middle-income countries, economic development and urbanisation have contributed to increasing incidence among more affluent groups. The consequences of this transition to early-onset type 2 diabetes are severe, with accelerated disease progression, heightened risks of microvascular and macrovascular complications, and considerable societal and health-care burdens compared with later-onset disease. Given the continuing rise in childhood and adolescent obesity, the incidence of early-onset type 2 diabetes is expected to increase further, placing mounting pressure on health-care systems worldwide. In the first of three papers in this Series, we examine global trends in the incidence and prevalence of early-onset type 2 diabetes, identify key drivers of this transition to diagnosis at younger ages, and review the evidence for risk factors both at population and individual level.

8. Once-weekly insulin efsitora alfa versus once-daily insulin glargine U100 in adults with type 2 diabetes treated with basal and prandial insulin (QWINT-4): a phase 3, randomised, non-inferiority trial.

作者: Thomas Blevins.;Dominik Dahl.;Federico C Pérez Manghi.;Sreenivasa Murthy.;Ramon Ortiz Carrasquillo.;Xiaoqi Li.;Annette M Chang.;Molly C Carr.;Michelle Katz.
来源: Lancet. 2025年405卷10497期2290-2301页
Insulin efsitora alfa (efsitora), a once-weekly basal insulin, has the potential to reduce the treatment burden of people with type 2 diabetes who require insulin. We aimed to assess the efficacy and safety of once-weekly efsitora compared with insulin glargine U100 in adults with type 2 diabetes treated with basal and prandial insulin.

9. Once-weekly insulin efsitora alfa versus once-daily insulin degludec in adults with type 2 diabetes currently treated with basal insulin (QWINT-3): a phase 3, randomised, non-inferiority trial.

作者: Athena Philis-Tsimikas.;Richard M Bergenstal.;Timothy S Bailey.;Hideaki Jinnouchi.;James R Thrasher.;Liza Ilag.;Jit Mitra.;Kristen Syring.;Rebecca J Threlkeld.
来源: Lancet. 2025年405卷10497期2279-2289页
Once-weekly insulin efsitora alfa (efsitora) is in development for the treatment of people with diabetes. The aim of the current study was to assess the efficacy and safety of once-weekly efsitora compared with daily insulin degludec (degludec) in adults with type 2 diabetes using basal insulin.

10. Amycretin, a novel, unimolecular GLP-1 and amylin receptor agonist administered subcutaneously: results from a phase 1b/2a randomised controlled study.

作者: Kirsten Dahl.;Søren Toubro.;Sohan Dey.;Ruben Duque do Vale.;Anne Flint.;Agnes Gasiorek.;Arne Heydorn.;Ania M Jastreboff.;Cassandra Key.;Signe Beck Petersen.;Andreas Vegge.;Kasper Adelborg.
来源: Lancet. 2025年
Amycretin is a novel, unimolecular GLP-1 and amylin receptor agonist. The aim of this study was to investigate the safety, tolerability, pharmacokinetics, and effects on bodyweight of subcutaneous amycretin administered over a treatment period of up to 36 weeks in participants with overweight or obesity.

11. Cerebral palsy.

作者: Iona Novak.;Michelle Jackman.;Megan Finch-Edmondson.;Michael Fahey.
来源: Lancet. 2025年
Cerebral palsy is a lifelong physical disability affecting movement and posture. The motor impairments of cerebral palsy result from non-degenerative brain injuries, brain malformations, and genetic variations, arising from multiple risk factors and causal pathways during preconception, pregnancy, birth, or within the first 2 years of life. Over the past decade, substantial progress in diagnosing, preventing, and managing the condition has transformed treatment approaches. A key discovery is that up to 30% of individuals with CP have a genetic contribution. In high-income countries, the prevalence has decreased by as much as 40%, from 2·1 per 1000 livebirths to 1·6 per 1000 livebirths. However, the prevalence is higher in low-income and middle-income countries. Advances in early diagnosis make identification of cerebral palsy at as early as age 3 months possible, enabling timely, intensive early intervention that improves child and parent outcomes. Additionally, new medical, regenerative, and rehabilitation therapies have emerged, enhancing function and participation. Growing awareness of the health challenges and physical decline faced by adults underscores the need for a lifelong approach. This Seminar highlights the best available evidence and recent progress to help clinicians address key questions identified by individuals with lived experience.

12. Safety, tolerability, pharmacokinetics, and pharmacodynamics of the first-in-class GLP-1 and amylin receptor agonist, amycretin: a first-in-human, phase 1, double-blind, randomised, placebo-controlled trial.

作者: Agnes Gasiorek.;Arne Heydorn.;Sanaz Gabery.;Julie B Hjerpsted.;Katrine Kirkeby.;Thomas Kruse.;Signe B Petersen.;Søren Toubro.;Andreas Vegge.;Cassandra Key.
来源: Lancet. 2025年
GLP-1 receptor agonists and amylin receptor agonists have shown clinically relevant weight loss and glucose-lowering effects in people with overweight, obesity, and type 2 diabetes. Amycretin is a novel, single-molecule GLP-1 receptor and amylin receptor agonist. We aimed to investigate the safety, tolerability, pharmacokinetic properties, and pharmacodynamic effects of single ascending doses (part A) and multiple ascending doses (parts B and C/D) of amycretin in adult participants with overweight or obesity.

13. Current treatment for symptomatic uterine fibroids: available evidence and therapeutic dilemmas.

作者: Noa S de Smit.;Maria E de Lange.;Martijn F Boomsma.;Judith A F Huirne.;Wouter J K Hehenkamp.
来源: Lancet. 2025年
This Review offers an evaluation of current treatments for symptomatic uterine fibroids, including uterine artery embolisation, MRI-guided high-intensity focused ultrasound, laparoscopic radiofrequency ablation, transcervical radiofrequency ablation, ulipristal acetate, and oral gonadotropin-releasing hormone antagonists with add-back therapy. Placing these therapies within the IDEAL (Idea, Development, Exploration, Assessment, And Long-Term Follow-Up) framework and the clinical phases of drug development framework, we highlight key gaps in the evidence such as the lack of head-to-head comparisons with standard care, scarce long-term data, and inadequate consideration of real-world fibroid and patient characteristics. We provide a clear overview, assess the strength of the available evidence, and propose a practical flowchart to help clinicians navigate treatment decisions, ensuring the best care for women with symptomatic fibroids at various stages of therapy development. Insight into these matters equips both patient and clinician with essential information to support the process of shared and fully informed decision making. Importantly, this Review also identifies knowledge gaps that contribute to the specification of the fibroid research agenda.

14. Mitapivat in adults with non-transfusion-dependent α-thalassaemia or β-thalassaemia (ENERGIZE): a phase 3, international, randomised, double-blind, placebo-controlled trial.

作者: Ali T Taher.;Hanny Al-Samkari.;Yesim Aydinok.;Martin Besser.;Audra N Boscoe.;Jayme L Dahlin.;Gonzalo De Luna.;Jeremie H Estepp.;Sarah Gheuens.;Keely S Gilroy.;Andreas Glenthøj.;Ai Sim Goh.;Varsha Iyer.;Antonis Kattamis.;Sandra R Loggetto.;Susan Morris.;Khaled M Musallam.;Kareem Osman.;Paolo Ricchi.;Eduardo Salido-Fiérrez.;Sujit Sheth.;Feng Tai.;Heather Tevich.;Katrin Uhlig.;Rolandas Urbstonaitis.;Vip Viprakasit.;Maria Domenica Cappellini.;Kevin H M Kuo.; .
来源: Lancet. 2025年
Non-transfusion-dependent (NTD) thalassaemia is characterised by ineffective erythropoiesis and haemolytic anaemia, leading to long-term complications, poor quality of life, and early mortality. No oral disease-modifying therapies are approved for β-thalassaemia and no agents are approved for α-thalassaemia. The objective of this study was to evaluate the efficacy and safety of mitapivat, an oral activator of pyruvate kinase, in adults with NTD α-thalassaemia or NTD β-thalassaemia.

15. Estimating the potential malaria morbidity and mortality avertable by the US President's Malaria Initiative in 2025: a geospatial modelling analysis.

作者: Tasmin L Symons.;Jailos Lubinda.;Michael McPhail.;Adam Saddler.;Mauricio van den Berg.;Hunter Baggen.;Yuval Berman.;Sarah Hafsia.;Rubi Jayaseelen.;Punam Amratia.;Annie Browne.;Ewan Cameron.;Camilo Vargas-Ruiz.;Susan F Rumisha.;Nick Golding.;Daniel J Weiss.;Peter W Gething.
来源: Lancet. 2025年405卷10496期2231-2240页
Since its inception in 2005, the US President's Malaria Initiative (PMI) has played a major role in the reductions in malaria morbidity and mortality observed across Africa. With the status of PMI funding and operations currently uncertain, we aimed to quantify the impact that a fully functioning PMI would have on malaria cases and deaths in Africa during 2025.

16. Community-based mentoring to reduce maternal and perinatal mortality in adolescent pregnancies in Sierra Leone (2YoungLives): a pilot cluster-randomised controlled trial.

作者: Cristina Fernandez Turienzo.;Lucy November.;Mangenda Kamara.;Osman Conteh.;Philemon Kamara.;Appiah M Kingsford.;Peter J S Koroma.;Michael Munu.;Alexandra E Ridout.;Betty Sam.;Paul T Seed.;Suzanne Thomas.;Prince T Williams.;Andrew H Shennan.;Jane Sandall.; .
来源: Lancet. 2025年405卷10497期2302-2312页
Sierra Leone has very high maternal and neonatal mortality rates, and a large proportion of these deaths occur in adolescents, a particularly vulnerable group, and is usually driven by poverty, lack of education, and sparse employment opportunities. We evaluated the feasibility and potential effects of a community-based mentoring intervention from pregnancy up to 1 year after birth to inform a subsequent larger trial aiming to reduce mortality among adolescent girls and their newborns (2YoungLives).

17. Thyroidectomy with or without postoperative radioiodine for patients with low-risk differentiated thyroid cancer in the UK (IoN): a randomised, multicentre, non-inferiority trial.

作者: Ujjal Mallick.;Kate Newbold.;Matthew Beasley.;Kate Garcez.;Jonathan Wadsley.;Sarah J Johnson.;Tim Stephenson.;Mark Gaze.;Andrew Goodman.;Sarah Jefferies.;Suganya Sivabalasingham.;Nicholas Slevin.;David P Wilkinson.;Elena Macias-Fernandez.;Danielle Power.;Tom Roques.;Lesley Speed.;Christopher Nutting.;George Mochloulis.;Georgina Gerrard.;Charles Candish.;Sally Morgan.;Devashish Tripathi.;Peter Truran.;Claire Arthur.;Andrzej Wieczorek.;Krishnaswamy Madhavan.;Jillian Maclean.;David Boote.;Dae Kim.;Abigail Pascoe.;Gayani Pitiyage.;Sharon Forsyth.;Emily Ambrose.;Elizabeth Chang.;Kate Farnell.;Allan Hackshaw.
来源: Lancet. 2025年
Patients with differentiated thyroid cancer can often be treated with postoperative radioiodine (also called radioiodine ablation) after total thyroidectomy. The IoN trial was designed to assess whether recurrence-free survival was non-inferior after no ablation compared with ablation in patients with low-risk differentiated thyroid cancer.

18. Cancer vaccines and the future of immunotherapy.

作者: Orrin Pail.;Matthew J Lin.;Theodora Anagnostou.;Brian D Brown.;Joshua D Brody.
来源: Lancet. 2025年
Vaccines have had a major impact on the control of infectious disease, most recently by helping to combat the COVID-19 pandemic. Prophylactic cancer vaccines have prevented several malignancies by protecting against cancer-causing pathogens. By contrast, therapeutic vaccines training the immune system to eliminate established tumours are now showing real promise in clinical settings. In the adjuvant setting, vaccines against melanoma and pancreatic cancer appear to be reducing minimal residual disease and relapse. In the macrometastatic setting, in-situ vaccines have induced systemic regressions in advanced-stage lung and breast cancers and lymphomas. More effective cancer vaccines are being developed through having a deeper understanding of crucial cellular factors in tumour immunology, the incorporation of newer vaccine components to effectively mobilise and activate cells, the use of omics and artificial intelligence in vaccine design, and addition of immune checkpoint blockade. In this Viewpoint, we analyse cancer vaccine trials, the strengths and limitations of different vaccine approaches, and we discuss how the next generation of cancer vaccines can help improve patient outcomes and quality of life.

19. Surgery versus corticosteroid injection for carpal tunnel syndrome (DISTRICTS): an open-label, multicentre, randomised controlled trial.

作者: Wijnand A C Palmbergen.;Roy Beekman.;A Marijne Heeren.;Bart F L van Nuenen.;Tim W H Alleman.;Esther Verstraete.;Korné Jellema.;Wim I M Verhagen.;Leo H Visser.;Godard C W de Ruiter.;Diederik van de Beek.;Corianne A J M de Borgie.;Johannes A Bogaards.;Rob M A de Bie.;Camiel Verhamme.; .
来源: Lancet. 2025年405卷10495期2153-2163页
Surgery and corticosteroid injections are established treatments for carpal tunnel syndrome, but the optimal treatment strategy remains unclear. This study aimed to compare starting treatment with surgery versus starting with a corticosteroid injection.

20. Retifanlimab with carboplatin and paclitaxel for locally recurrent or metastatic squamous cell carcinoma of the anal canal (POD1UM-303/InterAACT-2): a global, phase 3 randomised controlled trial.

作者: Sheela Rao.;Emmanuelle Samalin-Scalzi.;Ludovic Evesque.;Meher Ben Abdelghani.;Federica Morano.;Amitesh Roy.;Laetitia Dahan.;Stefano Tamberi.;Amandeep Singh Dhadda.;Mark P Saunders.;Nathalie Casanova.;Rosine Guimbaud.;Astrid Lievre.;Joan Maurel.;Marwan Fakih.;Chuan Tian.;Jill Harrison.;Mark M Jones.;Mark Cornfeld.;Jean-Philippe Spano.;Pauline Rochefort.; .
来源: Lancet. 2025年405卷10495期2144-2152页
Retifanlimab has activity in programmed death ligand 1-positive advanced squamous cell anal carcinoma (SCAC) that has progressed on platinum chemotherapy. We aimed to prospectively assess the benefit of adding retifanlimab to initial carboplatin-paclitaxel for this disease.
共有 3109 条符合本次的查询结果, 用时 7.731337 秒