Multidisciplinary Collaborative Clinical Research, Core Facilities and Other Clinical Services in NIDDK Program Area Diseases

有资格证书的NIDDK临床工作人员拥有必要的相关专业知识，以支持参与校内研究计划中所有研究所和中心进行的临床研究的人类受试者的患者护理需求。NIDDK临床医生需要在糖尿病、内分泌学、新陈代谢、胃肠病学、肝病、肾脏病和血液学领域的专业知识提供咨询互动，才能为整个NIH临床研究中心的患者提供专门的医疗服务。除了患者支持服务，这些咨询互动导致合作的临床调查，以促进对疾病自然历史的研究，新的诊断和治疗方法，以及促进对疾病发病机制和病理生理学的理解。 临床服务包括： 1.血糖管理服务包括对胰岛素缺乏或胰岛素抵抗的糖尿病患者进行全面管理。 2.内分泌、消化内科、肝脏内科、肾脏内科、囊性纤维化及血液内科的会诊服务。 3.胃肠内窥镜检查，包括胶囊内窥镜检查、肠道活检和治疗程序 4.肝活检和肝纤维扫描 5.肾活检、血液透析、持续静脉-静脉血液滤过、专门研究肾功能测试 6.生物储存库：收集、条形码、索引、存储和检索人体样本 7.为制定、监测、分析临床研究方案提供生物统计学支持 咨询服务和临床核心服务产生的已完成和正在进行的合作临床研究项目的例子包括： 1.转移性黑色素瘤免疫治疗、干细胞移植、化疗和新型生物抗肿瘤药物(NCI、NHLBI、NIAID)的内分泌、胃肠道、肝肾并发症； 2.移植物抗宿主病的胃肠道和肾脏并发症(NHLBI、NCI、NIAID)； 3.慢性肉芽肿性疾病(NIAID)、Hermansky-Pudlak综合征、甲基丙二酸血症、Erdheim-Chester病和膀胱癌(NHGRI)的肝肾并发症； 4.镰状细胞性贫血(NHLBI)肾、肝并发症的自然病史及处理； 5.HIV病的肾脏并发症和HIV药物治疗(NCI，NIAID)； 6.von Hippel-Lindau病(NCI)的肾脏并发症； 7.非清髓性干细胞移植患者的膜性肾病(NHLBI，NCI)； 8.ANCA相关性肾小球疾病(NIAMS)； 9.干细胞移植中肾小球内皮细胞损伤和血栓性微血管病变(NHLBI，NCI，NIAID，NIDDK)

Credentialed NIDDK clinical staff members have relevant expertise necessary to support patient care needs of human subjects involved in clinical research conducted by all institutes and centers in the intramural research program. Consultative interactions provided by NIDDK clinicians with expertise in the fields of diabetes, endocrinology, metabolism, gastroenterology, hepatology, nephrology and hematology are required for delivery of specialized medical services to patients throughout the Clinical Research Center at NIH. Beyond patient support services, these consultative interactions lead to collaborative clinical investigations to advance the study of natural history of disease, new approaches to diagnosis and treatment, as well as advancing the understanding of disease pathogenesis and pathophysiology. Clinical services include: 1. Blood Glucose Management Service involves comprehensive management of patients with insulin deficient or insulin resistant diabetes mellitus. 2. Consultation services in endocrinology, gastroenterology, hepatology, nephrology, cystic fibrosis and hematology. 3. Gastrointestinal endoscopy, including capsule endoscopy, gut biopsies and therapeutic procedures 4. Liver biopsies and liver fibroscanning 5. Renal biopsies, hemodialysis, continuous veno-venous hemofiltration, specialized research renal function tests 6. Biorepository: collection, barcoding, indexing, storing, and retrieving human samples 7. Biostatistical support for developing, monitoring, analyzing clinical research protocols Examples of completed and ongoing collaborative clinical research projects emerging from consultation services and clinical core services include: 1. Endocrine, gastrointestinal, liver and kidney complications of immunotherapy of metastatic melanoma, stem cell transplantation, chemotherapy and novel biologic anti-tumor agents (NCI, NHLBI, NIAID); 2. Gastrointestinal and renal complications of graft versus host disease (NHLBI, NCI, NIAID); 3. Liver and kidney complications of chronic granulomatous disease (NIAID), Hermansky-Pudlak syndrome, methylmalonic acidemia, Erdheim-Chester disease and cystinosis(NHGRI); 4. Natural history and management of kidney and liver complications of sickle cell anemia (NHLBI); 5. Renal complications of HIV disease and HIV drug therapies (NCI, NIAID); 6. Kidney complications of von Hippel-Lindau disease (NCI); 7. Membranous nephropathy in patients with non-myeloablative stem cell transplants (NHLBI, NCI); 8. Glomerular disease in ANCA-associated vasculitis (NIAMS); 9. Glomerular endothelial cell injury and thrombotic microangiopathy in stem cell transplants (NHLBI, NCI, NIAID, NIDDK)