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主题：【糖尿病系列】写在前面 -- 青方
家园 【糖尿病系列】写在前面 做科普工作，首先要介绍一下作者，不是为别的，是让大家看看作者的资格。遵守一下规则，我也介绍一下自己，介绍一下我的有始无终的科普之路。
谦虚在这时候是万万使不得的，不过我也没有必要吹嘘自己，因为实在是没什么值得吹嘘的。我5年的医学院毕业后，在临床工作了2年，1年内科1年急诊，然后考上了硕士博士一起读的那种以临床为主的研究生，到了北京，专业就是内分泌。又5年之后毕业，是一个真正的M.D.加有些软弱的Ph.D.。然后回到太太所在的医院，目的是为了结束两地分居的痛苦。
上岗之后，主要看糖尿病，那时候国内糖尿病已经开始快速上升了，门诊量越来越大，我每天跟病人都重复差不多同样的东西，就是宣传教育。对于糖尿病病人，基本知识掌握的越多的人，病就控制的越好，反之就越差，科普宣传是迫在眉睫的。
年轻的激情引导着我，我开始免费开班，每个周末给病人上半天课，我还办报纸，不定期出一份8版的“糖尿病之友”，我写文章，我排版，我找公司资助印刷，有时候自己也出钱。报纸一共出了3期，多次搬家，均已经散失了。课坚持了3个月。然后我的激情被人利用，我被卷入到医院院长之间的斗争中，一切都停止了。之后的几个月的时间，想来是我一生到现在最黑暗的一段时间，我开始联系出国，甚至准备下海，我不干了。这个时候，太太怀孕了，一切冲动都暂停下来。
之后，我大女儿2个月的时候，因为孩子太小，我又是一个人痛苦地离开了太太和我的女儿，去了欧洲作博士后。几个月后，太太带着孩子也到了欧洲，欧洲的那段时间是平静幸福的。一天收到医院院长的来信，“广阔天地，大有作为，你回来吧”。我就回国了，当时和我太太讲，怎么不得给我个副院长干干。
一报到，院长热情洋溢的谈话让我觉得太好了不象是真的。然后门诊大夫不足，说我先去顶顶，一顶就是3个月，院长见面都躲着我。一天我到了院长办公室，扔下一封辞职信，说一句：你说破天，我也辞职了。当时辞职的事还不普遍，院长说单位里唯一的一位归国博士后辞职，那不是笑话吗，你在想想。我还是那句：说破天，我也辞职了，不管你批不批，今天都是我在这医院的最后一天。
然后我再联系出国，我帮别的实验室建立方法，帮别人翻译材料，赚的钱居然比我当大夫还多。大夫不当了，科普的热情依然没减，我建了一个糖尿病和肥胖科普的小网站，又开始了凌晨4点起床写文章的生活，交了钱买了独立域名，刚准备大干，美国来了信，不久全家来了美国，一切都停止了。现在想起来，当时和院长说的最后一天，居然是我当大夫的最后一天，真是让人感慨呀。
正如我的“一个梦想”里说的，这么多年过去了，从电视上看，怎么国内糖尿病的教育还是主要让卖药的来做，“专家们”的铜臭，再次点燃了在心底依然没有熄灭的激情，我也许还可以做些什么。
回想起来，在国内的时候我写的科普，和现在所有的糖尿病的科普一样，不仅枯燥，还更象医学院的教科书，光看题目脑袋就大了，是太脱离群众了。现在跳到圈子外面来，有了更多的自由，科普就不能这样写了，要活泼有趣才行。就按照这个宗旨，希望大家监督。
本帖一共被 2 帖 引用 (帖内工具实现)家园 敬佩＋支持！ 说实话俺觉得科普文章特别难写，要把专业知识写得老百姓看得懂又不走样真的很难。好的科普真是太难能可贵了，期待青方兄好文。
家园 我来这里挖墙角，^_^ 看到青方兄有如此志愿，很是佩服。
以前我在“天涯虚拟社区”（www.tianyaclub.com)呆过，那里有个“天涯医院”的板块，也有不少糖尿病的病人咨询问题。如果青方兄有什么作品，除了在西西河贴一份，不如也在那里贴一份？
在此先谢谢了。^_^
家园 医术高，人格也高，敬佩！！！ 家园 佩服啊 青方兄直道而行，有古人之风，真的是无比钦敬，鲜花一朵，聊表敬意。
家园 佩服 佩服，敬重。
老学兄！
家园 请教：from FORBES Magazin，哪种药更有前途？ The high levels of blood sugar that occur in diabetes can damage the kidneys, heart and liver. Based on a protein found in the saliva of the venomous Gila monster, this injection lowers blood sugar only when it is too high. It helped patients in three late-stage clinical trials, each of which tested exenatide in combination with different diabetes drugs, and may help patients lose weight. Merck and Novartis are developing pills that work through a similar mechanism. Exenatide was submitted to the FDA on June 30. A new drug application has been accepted by the FDA, and a regulatory decision is expected by April 30, 2005.
Insulin is an incredibly effective drug. There's only one problem: It is only available as an injection, which often scares patients away. Clinical trials have shown that Exubera, or inhaled insulin, works as well as injected insulin for both Type 1 and Type 2 diabetes. Worries that it might cause pulmonary problems have lingered. Recently released studies seem to confirm the product's safety, but a new drug application may not be filed until sometime in 2005, when more safety data are available. Eli Lilly and Alkermes are working on a similar drug.
The competition to develop drugs that target more than one of the cellular signals called peroxisome proliferation activation receptors (PPARs) is one of the most heated contests in the drug industry. Such medicines could control both cholesterol and blood sugar. Unfortunately, two recent attempts faltered after causing cancer in laboratory animals. Among those remaining, AstraZeneca's Galida is in late-stage trials, trailing an effort by Bristol and Merck. Hints of kidney safety issues have some worried; AstraZeneca is running clinical trials in patients with kidney problems to try and dispel those concerns. Eli Lilly and GlaxoSmithKline are working on similar drugs.
LAF237 is racing a similar drug from Merck, MK-0431, to become the first pill to raise a protein called glucagon-like peptide. The payoff would be a drug that controls blood sugar only when it is too high, cutting the risk of hypoglycemia. At the moment, Novartis has released more data on its drug than Merck, including a useful comparison to exenatide, the injection being developed by Eli Lilly. Findings presented June 7 indicated that the drug can effectively control blood sugar both alone and in combination with another diabetes drug, metformin. Novartis expects to submit an application to regulators in 2006.
MK-0431 is racing a similar drug from Novartis, LAF237, to become the first pill to raise a protein called glucagon-like peptide. The payoff would be a drug that controls blood sugar only when it is too high, cutting the risk of hypoglycemia. Merck even hopes that its drug may cause weight loss in diabetics but has released less data than Novartis. A Food and Drug Administration application is expected in 2006.
Bristol-Myers Squibb is leading the race to develop drugs that target more than one of the cellular signals called peroxisome proliferation activation receptors (PPARs). Such medicines could control both cholesterol and blood sugar. Unfortunately, two recent attempts faltered after causing cancer in laboratory animals. But Bristol's muraglitazar is powering ahead. On April 28, the drug giant announced it had inked a deal with rival Merck to co-develop and promote the drug, which could by submitted to the U.S. Food and Drug Administration within the next nine to 12 months.
家园 个人观点 胰岛素的替代剂型，例如口服和鼻喷的，理论上还有些漏洞，未来不一定很乐观。
针对PPARr的药，市场上已经有一些了，新的更合理或更好的类似药物，应该有比较稳定的市场，而且这类药已经比较成熟。
GLP－1类似药物，也许是最有前途的，现在的关于GLP的科研是个很热门的领域，结果基本都是正面的。
FDA的标准其实很简单，有效加副作用小。出了问题，会被毫不客气地踢出市场。
家园 敬佩。如果前面的那些印刷的东西在，都可以发到西西来 家园 好一位青方兄！ 让俺这个功利透顶的家伙很惭愧，送花！
家园 得,青方兄要成我们全家的恩人了.先代表父母说声谢谢! 家园 没说的,送花! 渡己渡人,功在千秋呀!
家园 青方兄古道热肠，令人钦佩。也送花一朵。 家园 好文呀 有点舍不得转来科技版的，但科技版想必人气较旺，让多些人了解还是好些。