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One year experience with computer-assisted propofol sedation for colonoscopy

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World Journal of Gastroenterology 2017年第16期23卷 2964-2971页

作者： Otto S Lin Danielle La Selva Richard A Kozarek Deborah Tombs Wade Weigel Ryan Beecher Johannes Koch Susan mc cormick Michael Chiorean Fred Drennan Michael Gluck Nanda Venu Michael Larsen Andrew Ross Digestive Disease Institute Virginia Mason Medical CenterSeattleWA 98101United States Department of Anesthesia Virginia Mason Medical CenterSeattleWA 98101United States

AIM To report our one-year experience with computer assisted propofol sedation(CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical *** Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse. Procedural success rates, polyp detection rates, procedure times and recovery times were recorded and compared against corresponding historical measuresfrom 2286 colonoscopies done with midazolam and fentanyl from September 2013 to August 2014. Adverse events in the CAPS group were *** The mean age of the CAPS cohort was 59.9 years(48.7% male); 31.3% were ASA?Ⅰ, 67.3% ASA Ⅱ and 1.4% ASA Ⅲ. 45.1% of the colonoscopies were for screening, 31.5% for surveillance, and 23.4% for symptoms. The mean propofol dose administered was 250.7 mg(range 16-1470 mg), with a mean fentanyl dose of 34.1 mcg(0-100 mcg). The colonoscopy completion and polyp detection rates were similar to that of historical measures. Recovery times were markedly shorter(31 min vs 45.6 min, P < 0.001). In CAPS patients, there were 20(0.7%) cases of mild desaturation(< 90%) treated with a chin lift and reduction or temporary discontinuation of the propofol infusion, 21(0.8%) cases of asymptomatic hypotension(< 90 systolic blood pressure) treated with a reduction in the propofol rate, 4(0.1%) cases of marked agitation or discomfort due to undersedation, and 2 cases of pronounced transient desaturation requiring brief(< 1 min) mask ventilation. There were no sedation-related serious adverse events such as emergent intubation, unanticipated hospitalization or permanent injury. CONCLUSION CAPS appears to be a safe, effective and efficient means of providing moderate sedation for colonoscopy in relatively healthy patients. Recovery

关键词： Colonoscopy Propofol Sedation Colon cancer screening Anesthesia

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医院工作人员针头刺伤的流行病学

国际护理学杂志 1982年第2期03卷 8-16页

作者： mc cormick Rd ,朱淑婷

医院工作人员偶然被针头刺伤可引起严重医院性疾病,特别是传染性肝炎。但关于这种特殊原因的损害很少报导,作者对该院47个月期间内工作人员受针头刺伤者作回顾性分析。目的是鉴定那些工作人员及职业活动易于发生针头刺伤,并确定发病率,... 详细信息

医院工作人员偶然被针头刺伤可引起严重医院性疾病,特别是传染性肝炎。但关于这种特殊原因的损害很少报导,作者对该院47个月期间内工作人员受针头刺伤者作回顾性分析。目的是鉴定那些工作人员及职业活动易于发生针头刺伤,并确定发病率,经济损失及这种损伤的近代处理。基于这些发现订出合理的予防方针。数据的来源与方法:威斯康辛大学医院有548床位,是该校主要教学医院。医院工作人员,凡与工作有关的事故均需向办公室报告。复习在47个月期间的报告,95%的针头刺伤均记录有事故发生的周围环境及处理方法。

关键词：工作人员病人阳性 HBsAg 病毒性肝炎病毒传染性肝炎病毒病乙型肝炎乙肝免疫血清球蛋白

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飞到飓风中去

世界科学 1980年第5期 57-58页

作者： Lynde mc cormick 红叶师实

本世纪里最强大的横扫海洋的暴风——飓风“戴维”,在几千平方英里的范围内,具有几百颗原子弹那样的破坏力。加勒比海上的一些岛屿,遭受过“戴维”的骤雨、汹涌的浪潮和时速一百五十英里的暴风的浩劫,强烈地感受到飓风的凶狂。我们的计... 详细信息

本世纪里最强大的横扫海洋的暴风——飓风“戴维”,在几千平方英里的范围内,具有几百颗原子弹那样的破坏力。加勒比海上的一些岛屿,遭受过“戴维”的骤雨、汹涌的浪潮和时速一百五十英里的暴风的浩劫,强烈地感受到飓风的凶狂。我们的计划是,驾驶一架飞机穿过呼啸作响、异常湍急的气流,进入飓风中心,即风暴眼。我们将从几个不同的高度飞进去:首先在一千五百英尺高度飞入,接着回出来,然后升到五千英尺,飞进去又飞

关键词：加勒比海风暴眼中美洲海迈阿密美国飞行员飞行人员美元本位币风眼云堆飞机人工降雨人工降水博士

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实质性瘤病人的感染

国际护理学杂志 1986年第3期07卷 137-138页

作者： Rita D mc cormick ,陈拱诒

感染对癌症病人的转归有很大影响。Inagaki 等发现,实质性瘤病人中47%死因为感染。一、诱因(一)实质瘤病人易患感染的诱因如下。1.肿瘤生长远离血液供应(距血管200μm 以上)的瘤细胞因缺氧而死亡,形成坏死区。处在供氧充足的分裂增殖区... 详细信息

感染对癌症病人的转归有很大影响。Inagaki 等发现,实质性瘤病人中47%死因为感染。一、诱因(一)实质瘤病人易患感染的诱因如下。1.肿瘤生长远离血液供应(距血管200μm 以上)的瘤细胞因缺氧而死亡,形成坏死区。处在供氧充足的分裂增殖区与坏死区之间的细胞,虽保有活力但缺血,因而为厌氧性感染提供了适宜的环境。肿瘤组织压迫馈入血管也可造成组织缺氧。不论何种原因,肿瘤缺氧均将引起坏死。坏死组织成为细菌侵入和感染的温床,此

关键词：病人实质性瘤伤口感染营养不良

Structure of SARS-CoV-2 main protease in the apo state

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Science China(Life Sciences) 2021年第4期64卷 656-659页

作者： Xuelan Zhou Fanglin Zhong Cheng Lin Xiaohui Hu Yan Zhang Bing Xiong Xiushan Yin Jinheng Fu Wei He Jingjing Duan Yang Fu Huan Zhou Peter J.mc cormick Qisheng Wang Jian Li Jin Zhang School of Basic Medical Sciences Nanchang UiniversinNanchang 330031China College of Pharmaceutical Sciences Gannan Medical UniversityGanzhou 341000 China Laboratory of Prevention and Treatment of Cardovascular and Cerebrovascular Diseases Ministry of EducationGannan Medical UniversiyGanzhou 341000China Shenzhen Crystalo Biopharmacutical Co LtdShenzhen 518118China Jiangxi Jmerry Biopharmaceutical Co LtdGanzhou 341000China The Second Afiliaed Hospital of Nanchang Universiy Nanchang 330031China Department of Medicinal Chemisry Shanghai Instiute of Materia MedicalChinese Academy of SciencesShanghai 201203China Appled Blology Laboratory Shenyang Untversity of Chemical TechnologyShenyang 110142China Biotech&Biomedicine Science(Jiangxi)Co LtdGanzhou 341000China Jiangxi-OA1 Joint Research Isiution Nanchang UniversityNanchang 330047China Human Aging Research Instiute(HARI) School of Life SciencesNanchang UniversinNanchang 330031China School of Medicine Souhern Universiny of Science and Technologx Shenzhen 518055China Shanghai Synchroron Radiation Facilig Shanghai Advanced Research InstiueChinese Academy of SciencesShanghai 201204China Centre for Endocrinology William Harvey Research InstiuteBari's and the London School of Medicine and DentisrQneen MaryUniversity of LondonLondon ECIM 6BQUK

Dear Editor,Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)has been a global pandemic that severely threatens global health with concordant economic ***,there i... 详细信息

关键词： drugs al. acute

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新生儿囊性纤维化筛查与治疗强度减低有关

世界核心医学期刊文摘（儿科学分册） 2006年第2期2卷 24-25页

作者： Sims E.J. mc cormick J. Mehta G. Mehta A. 郭战宏 Division of Maternal and Child Health Sciences Ninewells Hospital and Medical School University of Dundee Dundee DD1 9SY United Kingdom

Objectives: To determine whether the improved clinical status after newborn screening (NBS) for cystic fibrosis (CF) segregates with increased therapeutic intervention compared with presentation by clinical diagnosis (CD). Study design: In 2002, two populations (1 to 9 years of age) who presented (excluding meconium ileus) by NBS ≤ 3 months of age or by CD were compared in an observational, cross-sectional design. NBS and CD populations (184 and 950 patients, respectively) were divided into 3-year age groups (1 to 3, 4 to 6, and 7 to 9 years)-. Therapies of duration >3 months were compared together with Pseudomonas aeruginosa infection status. Results: NBS patients≤ 6 years of age received significantly fewer and less demanding therapies not explained by age, genotype, geography, or social deprivation. In 7-to 9-year-olds, significantly fewer NBS patients received intravenous antibiotics. NBS patients without P aeruginosa infection received significantly fewer therapies, but no differences were found between intermittently or chronically infected NBS and CD populations. Comparable results were found in Δ F508/Δ F508 subpopulations. Conclusions: CF populations diagnosed by NBS are associated with reduced treatment compared with age and genotype-matched CD control subjects.

关键词：新生儿筛查治疗强度囊性纤维化绿脓杆菌感染临床诊断胎粪性肠梗阻 NBS 观察性研究年龄组抗生素治疗

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肾综合征出血热血清流行病学定群研究

中华预防医学杂志 1991年第6期25卷 329-331页

作者：李永良徐志一叶克龙汤一苇刘兆麟童政马秋荣 J.mc cormick S.Fisher-Hoch Suyu Ruo 上海医科大学流行病学教研室浙江省建德县卫生防疫站美因疾病控制中心特殊病原科

在浙江省建德县两个村中进行肾综合征出血热(HFRS)定群血清流行病学研究。1325名HFRS扰体阴性者1年后30人抗体阳转,年感染率为2.26%。其中临床病人2人,发病率为0.151%;隐性感染率为2.11%。2～4岁儿童和60岁以上老人未见HFRS感染,5～14... 详细信息

在浙江省建德县两个村中进行肾综合征出血热(HFRS)定群血清流行病学研究。1325名HFRS扰体阴性者1年后30人抗体阳转,年感染率为2.26%。其中临床病人2人,发病率为0.151%;隐性感染率为2.11%。2～4岁儿童和60岁以上老人未见HFRS感染,5～14岁组感染率较低(1.42%),15～59岁青壮年感染率较高(1.47%～4.26%)。男性感染率(2.57%)略高于女性(1.96%)。分层分析和Logistic回归分析发现住房位于村边,室外有稻草堆和养猫是感染HFRS的危险因素,OR值分别为3.0932,8.3629和4.9970。在两村捕获的鼠类中检出HFRS抗原和抗体。

关键词：出血热,病毒性流行病学方法

Burden of nonalcoholic fatty liver disease and advanced fibrosis in a Texas Hispanic community cohort

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World Journal of Hepatology 2015年第11期7卷 1586-1594页

作者： Jen-Jung Pan Susan P Fisher-Hoch Chaoru Chen Ariel E Feldstein Joseph B mc cormick Mohammad H Rahbar Laura Beretta Michael B Fallon Division of Gastroenterology Hepatology and Nutrition Department of Internal Medicine the University of Texas Health Science Center at Houston School of Public Health Brownsville Campus the University of Texas Health Science Center at Houston Division of Gastroenterology Hepatology and Nutrition Department of Pediatrics University of California at San Diego Division of Clinical and Translational Sciences Department of Internal Medicine the University of Texas Health Science Center at Houston Division of Epidemiology Human Genetics and Environmental Sciences School of Public Health the University of Texas Health Science Center at Houston Department of Molecular and Cellular Oncology the University of Texas MD Anderson Cancer Center

AIM: To investigate the potential burden of nonalcoholic steatohepatitis(NASH) and advanced fibrosis in a hispanic ***: Four hundred and forty two participants with available ultrasonography data from the Cameron County Hispanic Cohort were included in this study. Each participant completed a comprehensive questionnaire regarding basic demographic information, medical history, medication use, and social and family history including alcohol use. Values of the nonalcoholic fatty liver disease fibrosis score(NFS), FIB4 index, BARD score, and Aspartate aminotransferase to Platelet Ratio Index(APRI) were computed using the blood samples collected within 6 mo of liver ultrasonography from each participant. Hepatic steatosis was determined by ultrasonography. As part of univariable analysis, for continuous variables, comparisons among groups were performed with student-t test, one way analysis of variance, and Mann-Whitney test. Pearson χ2 and the Fisher exact test are used to assess differences in categorical variables. For multivariable analyses, logistic regression analyses were performed to identify characteristics associated with hepatic steatosis. All reported P values are based two-sided tests, and a P value of less than 0.05 was considered to indicate statistical ***: The mean age and body mass index(BMI) of the study participants were 49.1 years and 31.3 kg/m2, respectively. Among them, 65.6% were females, 52% had hepatic steatosis, 49.5% had metabolic syndrome, and 29% had elevated aminotransferases. Based on established cut-offs for diagnostic panels, between 17%-63% of the entire cohort was predicted to have NASH with indeterminate or advanced fibrosis. Participants with hepatic steatosis had significantly higher BMI(32.9 ± 5.6 kg/m2 vs 29.6 ± 6.1 kg/m2, P < 0.001) and higher prevalence rates of elevation of ALT(42.2% vs 14.6%, P < 0.001), elevation of aspartate aminotransferase(38.7% vs 18.9%, P < 0.001), and metabolic syndrome(6

关键词： Noninvasive biomarkers Nonalcoholic fattyliver disease Hispanics Ultrasonography Liver fibrosis

即使采用现代疗法,新生儿囊性纤维化筛查依然大有裨益

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世界核心医学期刊文摘（儿科学分册） 2006年第A3期2卷 59-60页

作者： Sims E.J. mc cormick J. Mehta G. Mehta A. 贺文龙 Division of Maternal and Child Health Sciences Ninewells Hospital and Medical School University of Dundee Dundee DD1 9SY United Kingdom

Objectives: To determine whether early identification of babies with cystic fibrosis (CF) improves outcome in the current environment of new improved treatments, considering the criticism that there may be only marginal benefit gained by CF newborn screening (NBS). Study design: We tested whether CF NBS in the setting of modern CF center care still afforded benefit using the UK CF Database (UKCFD; ***) to compare clinical outcomes in infants who underwent NBS and control subjects who were clinically diagnosed (CD). With Mann-Whitney rank tests, 184 patients who underwent NBS aged 1 to 9 years in 2002 (excluding meconium ileus) were compared with matched patients who were CD in 3-year age groups (950 control subjects). Results: Patients as old as 6 years who underwent NBS had significantly greater median height z-scores, less severe Northern chest radiography scores, better Shwachman-Kulczycki scores, and lower rates of chronic Pseudomonas aeruginosa infection. No difference was found for weight z-score or % predicted forced expiratory value in 1 second or forced volume capacity. Nutritional benefit was demonstrated in patients who underwent NBS and were homozygous for the Δ F508 mutation. Conclusions: NBS segregates with better outcomes in patients as old as 6 years compared with age and gene-matched control subjects who are CD. This cross-sec-tional study shows that infants who undergo screening derive nutritional benefit in improved median height and reduced morbidity.

关键词：囊性纤维化胎粪性肠梗阻用力呼气量营养状况临床诊断纯合子横断面研究年龄组试验设计肺容

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