Iter-4360dd15-0056-transcript
第 56 轮执行轨迹
→ call search_memory({"limit":10,"query":"4360dd15 NEXT_FOCUS PMID 10 条候选 研究类型 保留 排除 理由"})【tool:search_memory】
{"ok": true, "results": [{"title": "Iter-4360dd15-0055-transcript", "tags": "iteration transcript", "modified": "20260424195425000", "preview": "!! 第 55 轮执行轨迹
→ call search_me"}, {"title": "Iter-4360dd15-0051-transcript", "tags": "iteration transcript", "modified": "20260424194527000", "preview": "!! 第 51 轮执行轨迹 → call search_memory({\"limit\":10,\"query\":\"4360dd15 10 条候选 PMID 题名 研究类型 保留 排除 理由\"}) → call list_recent({\"n\":8}) → call list_by_tag({\"limit\":20,\"tag\":\"4360dd15\"}) 【tool:search_memory】 {\"ok\": true, \" → call list_recent({"n":8})
【tool:list_recent】
{"ok": true, "items": [{"title": "Iter-4360dd15-0055-reflection", "modified": "20260424195432000", "tags": "iteration reflection"}, {"title": "NEXT_FOCUS", "modified": "20260424195432000", "tags": "pinned focus"}, {"title": "先判原始性再补 PMID", "modified": "20260424195432000", "tags": "lesson evidence-retrieval clinical-trials filtering"}, {"title": "Iter-4360dd15-0055-transcript", "modified": "20260424195425000", "tags": "iteration transcript"}, {"title": "Longitudinal analysis is not an automatic exclusion in trial titles", "modified": "20260424195414000", "tags": "4360dd15 lesson evidence-retrieval clinical-trials method"}, {"title": "Iter-4360dd15-0054-reflection", "modified": "20260424195244000", "tags": "iteration reflection"}, {"title": "先用题名锁定原始性", "modified": "20260424195244000", "tags": "lesson evidence-retrieval clinical-trials filtering"}, {"title": "Iter-4360dd15-0054-transcript", "modified": "20260424195237000", "tags": "iteration transcript"}]}
→ call read_note({"title":"NEXT_FOCUS"})
【tool:read_note】
{"ok": true, "title": "NEXT_FOCUS", "tags": "pinned focus", "text": "!! 下轮焦点（来自 mission `4360dd15` · Iter-0055）\n\n下一轮必须只做一件事：把剩余 10 条候选逐条补全 PMID、研究类型与保留/排除理由，并优先清除 extension、follow-up、secondary analysis。"}
→ call search_memory({"limit":8,"query":"4360dd15 剩余 10 条 候选 extension follow-up secondary analysis PMID 研究类型"})
【tool:search_memory】
{"ok": true, "results": [{"title": "Iter-4360dd15-0055-transcript", "tags": "iteration transcript", "modified": "20260424195425000", "preview": "!! 第 55 轮执行轨迹
→ call search_me"}, {"title": "Iter-4360dd15-0051-transcript", "tags": "iteration transcript", "modified": "20260424194527000", "preview": "!! 第 51 轮执行轨迹 → call search_memory({\"limit\":10,\"query\":\"4360dd15 14 候选 PMID 研究类型 保留 排除 理由\"}) → call list_recent({\"n\":8}) → call list_by_tag({\"limit\":20,\"tag\":\"4360dd15\"}) 【tool:search_memory】 {\"ok\": true, \"resu → call search_memory({"limit":20,"query":"4360dd15 14 candidates audit table PMID title study type retain exclude"})
【tool:search_memory】
{"ok": true, "results": [{"title": "Iter-4360dd15-0055-transcript", "tags": "iteration transcript", "modified": "20260424195425000", "preview": "!! 第 55 轮执行轨迹
→ call search_me"}, {"title": "Iter-4360dd15-0051-transcript", "tags": "iteration transcript", "modified": "20260424194527000", "preview": "!! 第 51 轮执行轨迹 → call search_memory({\"limit\":10,\"query\":\"4360dd15 10 条候选 PMID 题名 研究类型 保留 排除 理由\"}) → call list_recent({\"n\":8}) → call list_by_tag({\"limit\":20,\"tag\":\"4360dd15\"}) 【tool:search_memory】 {\"ok\": true, \" → call read_note({"title":"Iter-4360dd15-0053-final-audit-14-candidates"})
【tool:read_note】
{"ok": true, "title": "Iter-4360dd15-0053-final-audit-14-candidates", "tags": "4360dd15 knowledge fact audit clinical-trials", "text": "!! 第 53 轮：14 条候选的最终审计表（PMID、题名、研究类型、保留/排除理由）\n\n本轮目标：把上一轮留下的“剩余 10 条候选”补全为可审计表，并把 4 条已确认的非原始研究并入同一张表，形成完整 14 条清单。\n\n!! 结论\n- 保留：10 条，均可映射到原始临床研究\n- 排除：4 条，标题已明确为 ancillary / follow-up / extension / postextension\n\n!! 可审计表\n| PMID | 题名 | 研究类型 | 决策 | 理由 |\n|---|---|---|---|---|\n| 33977284 | Targeting the biology of ageing with mTOR inhibitors to improve immune function in older adults: phase 2b and phase 3 randomised trials. | phase 2b/3 randomized trials | 保留 | 原始随机试验 |\n| 22367193 | A single-dose placebo- and moxifloxacin-controlled study of the effects of temsirolimus on cardiac repolarization in healthy adults. | 单次给药对照研究 | 保留 | 原始临床药理试验 |\n| 29408453 | A randomized control trial to establish the feasibility and safety of rapamycin treatment in an older human cohort: Immunological, physical performance, and cognitive effects. | randomized controlled trial | 保留 | 原始随机对照试验 |\n| 22115710 | A randomized, dose-escalation study of subconjunctival and intravitreal injections of sirolimus in patients with diabetic macular edema. | dose-escalation study | 保留 | 原始剂量递增试验 |\n| 35040506 | mTOR Inhibition with Sirolimus in Multiple System Atrophy: A Randomized, Double-Blind, Placebo-Controlled Futility Trial and 1-Year Biomarker Longitudinal Analysis. | randomized double-blind placebo-controlled futility trial | 保留 | 原始试验 |\n| 25525171 | Intravitreal
→ call pubmed_search({"limit":3,"query":"35040506 sirolimus multiple system atrophy futility trial longitudinal analysis"})
→ call pubmed_search({"limit":3,"query":"29992557 4EVER trial everolimus exemestane phase IIIB"})
→ call pubmed_search({"limit":3,"query":"30564495 everolimus extension randomized controlled trial TSC seizures"})
【tool:pubmed_search】
{"ok": true, "query": "35040506 sirolimus multiple system atrophy futility trial longitudinal analysis", "results": [{"pmid": "35040506", "title": "mTOR Inhibition with Sirolimus in Multiple System Atrophy: A Randomized, Double-Blind, Placebo-Controlled Futility Trial and 1-Year Biomarker Longitudinal Analysis.", "source": "Mov Disord", "pubdate": "2022 Apr", "authors": ["Palma JA", "Martinez J", "Millar Vernetti P", "Ma T", "Perez MA", "Zhong J", "Qian Y", "Dutta S"], "url": "https://pubmed.ncbi.nlm.nih.gov/35040506/"}]}
【tool:pubmed_search】
{"ok": true, "query": "29992557 4EVER trial everolimus exemestane phase IIIB", "results": [{"pmid": "30515367", "title": "The impact of mammalian target of rapamycin inhibition on bone health in postmenopausal women with hormone receptor-positive advanced breast cancer receiving everolimus plus exemestane in the phase IIIb 4EVER trial.", "source": "J Bone Oncol", "pubdate": "2019 Feb", "authors": ["Hadji P", "Stoetzer O", "Decker T", "Kurbacher CM", "Marmé F", "Schneeweiss A", "Mundhenke C", "Distelrath A"], "url": "https://pubmed.ncbi.nlm.nih.gov/30515367/"}, {"pmid": "29992557", "title": "Efficacy and safety of everolimus plus exemestane in postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer: Results of the single-arm, phase IIIB 4EVER trial.", "source": "Int J Cancer", "pubdate": "2019 Feb 15", "authors": ["Tesch H", "Stoetzer O", "Decker T", "Kurbacher CM", "Marmé F", "Schneeweiss A", "Mundhenke C", "Distelrath A"], "url": "https://pubmed.ncbi.nlm.nih.gov/29992557/"}]}
【tool:pubmed_search】
{"ok": true, "query": "30564495 everolimus extension randomized controlled trial TSC seizures", "results": [{"pmid": "30564495", "title": "Everolimus for treatment-refractory seizures in TSC: Extension of a randomized controlled trial.", "source": "Neurol Clin Pract", "pubdate": "2018 Oct", "authors": ["Franz DN", "Lawson JA", "Yapici Z", "Ikeda H", "Polster T", "Nabbout R", "Curatolo P", "de Vries PJ"], "url": "https://pubmed.ncbi.nlm.nih.gov/30564495/"}]}
→ call pubmed_search({"limit":2,"query":"31781682 low-dose sirolimus immunoregulation therapy follow-up randomized open-label parallel-controlled trial"})
→ call pubmed_search({"limit":2,"query":"34693520 everolimus postextension phase EXIST-3 refractory seizures"})
→ call pubmed_search({"limit":2,"query":"29806044 treatment of geographic atrophy with intravitreal sirolimus ancillary study"})
【tool:pubmed_search】
{"ok": true, "query": "31781682 low-dose sirolimus immunoregulation therapy follow-up randomized open-label parallel-controlled trial", "results": [{"pmid": "31781682", "title": "Low-Dose Sirolimus Immunoregulation Therapy in Patients with Active Rheumatoid Arthritis: A 24-Week Follow-Up of the Randomized, Open-Label, Parallel-Controlled Trial.", "source": "J Immunol Res", "pubdate": "2019", "authors": ["Wen HY", "Wang J", "Zhang SX", "Luo J", "Zhao XC", "Zhang C", "Wang CH", "Hu FY"], "url": "https://pubmed.ncbi.nlm.nih.gov/31781682/"}]}
【tool:pubmed_search】
{"ok": true, "query": "34693520 everolimus postextension phase EXIST-3 refractory seizures", "results": [{"pmid": "34693520", "title": "Adjunctive everolimus therapy for tuberous sclerosis complex-associated refractory seizures: Results from the postextension phase of EXIST-3.", "source": "Epilepsia", "pubdate": "2021 Dec", "authors": ["Franz DN", "Lawson JA", "Yapici Z", "Ikeda H", "Polster T", "Nabbout R", "Curatolo P", "de Vries PJ"], "url": "https://pubmed.ncbi.nlm.nih.gov/34693520/"}]}
【tool:pubmed_search】
{"ok": true, "query": "29806044 treatment of geographic atrophy with intravitreal sirolimus ancillary study", "results": [{"pmid": "29806044", "title": "Treatment of Geographic Atrophy with Intravitreal Sirolimus: The Age-Related Eye Disease Study 2 Ancillary Study.", "source": "Ophthalmol Retina", "pubdate": "2018 May", "authors": ["Gensler G", "Clemons TE", "Domalpally A", "Danis RP", "Blodi B", "Wells J 3rd", "Rauser M", "Hoskins J"], "url": "https://pubmed.ncbi.nlm.nih.gov/29806044/"}]}
→ call write_note({"tags":["4360dd15","knowledge","fact","evidence-retrieval","clinical-trials"],"text":"!! 第 56 轮：PubMed 边界条目复核\n\n本轮只做一件事：对上一轮审计表里最容易混淆的边界条目做 PubMed 映射复核，确认题名、PMID 与研究阶段标记一致。\n\n!! 复核结果\n| PMID | PubMed 题名 | 结论 |\n|---|---|---|\n| 35040506 | mTOR Inhibition with Sirolimus in Multiple System Atrophy: A Randomized, Double-Blind, Placebo-Controlled Futility Trial and 1-Year Biomarker Longitudinal Ana)
【tool:write_note】
{"ok": true, "path": "C:\\Users\\yh599\\Documents\\GitHub\\LLM-yh\\Sisyphus\\wiki\\tiddlers\\Iter-4360dd15-0056-pubmed-boundary-confirmation.tid", "title": "Iter-4360dd15-0056-pubmed-boundary-confirmation"}
【assistant】
第 56 轮已完成：我把上一轮审计表里最容易混淆的 6 个边界条目逐条用 PubMed 复核了，确认了它们的 PMID、题名与研究阶段标记是否一致。
本轮结论：
- `35040506`：原始临床试验；题名中的 `longitudinal analysis` 是并列分析，不构成自动排除
- `29992557`：原始单臂 phase IIIB 试验
- `30564495`：`extension`，排除
- `31781682`：`follow-up`，排除
- `34693520`：`postextension`，排除
- `29806044`：`ancillary study`，排除
我已写入长期记忆：
- `Iter-4360dd15-0056-pubmed-boundary-confirmation`
这轮沉淀的可执行规则：
- `longitudinal analysis` 不能自动判为排除，必须结合是否与原始试验并列
- `extension / follow-up / ancillary / postextension` 这类标题词本身即可支持排除
<NEXT_FOCUS>下一轮最值得做的是：把 14 条候选压缩成一份“最终可用纳入集”，并为每条保留项补上统一的研究设计分类标签（RCT / single-arm / dose-escalation / pilot / phase I/II / phase III）以便后续统计。 </NEXT_FOCUS>