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Is it necessary to stop glucagon-like peptide-1 receptor agonists prior to endoscopic procedure? A retrospective study

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World Journal of Gastroenterology 2024年第26期30卷 3221-3228页

作者： Haider Ghazanfar Nismat Javed Abeer Qasim Franklin Sosa Faryal Altaf Shazia Khan Jaydeep Mahasamudram Abhilasha Jyala Sameer Datta Kandhi Dongmin Shin Nikhitha Mantri Haozhe Sun Siddarth Hanumanthu Harish Patel Jasbir Makker Bhavna Balar Anil Dev Sridhar Chilimuri Division of Gastroenterology Department of Internal MedicineBronxCare Health SystemIcahn School of Medicine at Mount SinaiBronxNY 10457United States department of Internal medicine BronxCare Health SystemIcahn School of Medicine at Mount SinaiBronxNY 10457United States

BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1 RA)are effective in diabetes and obesity,reducing hyperglycemia by increasing insulin release and delaying gastric ***,they can cause gastroparesis,raising concerns about aspiration during *** guidelines advise discontinuing GLP-1 RA before surgery to reduce the risk of pulmonary *** To evaluate the effect of GLP-1 RAs on gastric residual contents during endosco-pic *** A retrospective chart review at Bronxcare Health System,New York,from January 2019 to October 2023,assessed gastric residue and aspiration in GLP-1 RA patients undergoing endoscopic *** groups were compared based on dietary status before the *** included demographics,symptoms of gastroparesis,opiate use,hemoglobin A1c,GLP-1 agonist indication,endo-scopic details,and aspiration *** SPSS was used for analysis,cal-culating means,standard deviations,and applying Pearson’s chi-square and t-tests for associations,with Pcally significant(P=0.03).Out of 31 patients with digestive symptoms,13%had residual food,all from the regular diet group(P=0.130).No complications were reported during or after the *** The study reflects a significant rise in GLP-1 RA use for diabetes and obesity.A 24-hour liquid diet seems safe for endoscopic procedures without *** with upper gastrointestinal symptoms might have a higher residual food risk,though not statistically *** research is needed

关键词： Glucagon-like peptide-1 agonists Gastroparesis Endoscopic procedures Residual food Complications

Sex Determination in Homo sapiens as a Multi-Step Process: Potential for Development of Variants and Sex Differences in Disease Risk

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Journal of Biomedical Science and Engineering 2024年第1期17卷 13-34页

作者： David A. Hart department of Surgery Faculty of Kinesiology McCaig Institute for Bone & Joint Health University of Calgary Cal-gary Canada

Reproduction via cis-binary mechanisms appears to have evolved fairly early in the evolution of complex organisms, and a system committed to prior to evolution of humans. While the evolution of a chromosomal-specific approach has been a successful strategy for survival of a large variety of species including humans, the fidelity of sex determination leading to 100% cis-binary outcomes is not achieved in many species, with evidence for homosexual or bisexual behaviour evident in more than 1500 species. Thus, such outcomes indicates that sex determination is a multi-step process and not a single event, and as such, could lead to the appearance of variants during the process which developed much earlier than humans. Variants could arise either due to intrinsic variation in the steps of determination, or also be influenced by environmental factors of a biological or psychological nature. In contrast to homosexual variants which do not require interventions such as hormone therapy or surgery, expression of gender dysphoria, is more based in psychology, but also has biological underpinnings and can be influenced by such hormonal interventions and surgery. While the numbers of those with gender dysphoria is small (~0.6% - 1.0% of population), the attention given to this issue raises the possibility of biological and psychological environmental factors impacting the emergence of some of those expressing gender dysphoria. Furthermore, transitioning from male-to-female or female-to-male can have consequences regarding disease risks latter in life, including the appearance of autoimmune diseases. This review will attempt to review some of the evidence regarding sex determination, discuss why the system has potentially not been improved upon during evolution, how a potential role for sex chromosome function on neurodevelopment may be central to variation in humans, and how commitment to the current strategy is likely integrated into other sex-related events such as puberty, pre

关键词： Sex Determination Variant Development Fidelity of Sex Determination Biological Sex Determination Species Variation

Gambogenic acid induces apoptosis via upregulation of Noxa in oral squamous cell carcinoma

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Chinese Journal of Natural medicines 2024年第7期22卷 632-642页

作者： CHENG Xinran FENG Mengyuan ZHANG Anjie GUO Jian GONG Yunlai HU Xiaohui HAN Quanbin LI Shengbao YU Xianjun department of Gastroenterology Taihe HospitalHubei University of MedicineShiyan 442000China Laboratory of Inflammation and Molecular Pharmacology School of Basic Medical Sciences&Biomedical Research InstituteHubei Key Laboratory of Wudang Local Chinese Medicine ResearchSchool of PharmacyHubei University of MedicineShiyan 442000China Inflammation-Cancer Transformation and Wudang Chinese medicine Research Hubei Talent Introduction and Innovation Demonstration BaseHubei University of MedicineShiyan 442000China School of Chinese medicine Hong Kong Baptist UniversityHong Kong 999077China

Gambogenic acid(GNA),a bioactive compound derived from the resin of Garcinia hanburyi,has demonstrated significant antitumor ***,its mechanisms of action in oral squamous cell carcinoma(OSCC)remain largely *** study aimed to elucidate the apoptotic effects of GNA on OSCC cell lines cal-27 and *** results indicated that GNA induced apoptosis by upregulating the pro-apoptotic protein *** investigations revealed that GNA treatment led to the generation of reactive oxygen species(ROS),which activated endoplasmic reticulum(ER)stress,culminating in cell *** of ROS production and ER stress pathways significantly mitigated GNA-induced Noxa upregulation and subsequent ***,in vivo studies using a murine xenograft model demonstrated that GNA administration effectively inhibited the growth of cal-27 ***,these findings underscore GNA’s potential as a therapeutic agent for the treatment of OSCC.

关键词： Oral squamous cell carcinoma Gambogenic acid Apoptosis Noxa ROS/ER stress

Clinical profile and outcomes in very elderly patients with atrial fibrillation anticoagulated with rivaroxaban: data from the EMIR study

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Journal of Geriatric Cardiology 2024年第7期21卷 723-732页

作者： Francisco Marín Manuel Anguita Sánchez Iñaki Lekuona Marcelo Sanmartín Fernán-dez Vivencio Barrios Carlos Perez Muñoz Juan Cosín-Sales Alejandro IPérez Cabeza Vanesa Roldán Schilling Carles Rafols Priu Esteban Orenes-Piñero María Asunción Es-teve-Pastor department of Cardiology Hospital Clínico Universitario Virgen de la ArrixacaIMIB-ArrixacaUniversity of MurciaCIBERCVMurciaSpain department of Cardiology Hospital Reina Sofía CórdobaIMIBICUniversity of CordobaCIBERCVCórdobaSpain Hospital Galdakao-Usansolo BizkaiaSpain department of Cardiology Hospital Uni-versitario Ramony CajalCIBERCVMadridSpain department of Cardiology University Hospital Ramóny CajalAl-caláUniversityMadridSpain Medical Center La Capillita Sanlúcar de Barrameda.Private cardiology clinicJerez de la FronteraSpain department of Cardiology Hospital Arnau de VilanovaValenciaSpain department of Car-diology Virgen de la Victoria University HospitalCIBERCV.MalagaSpain department of Haematology Hospital Clínico Universitario Virgen de la ArrixacaUniversity of MurciaMurciaSpain department of Medical Affairs Bayer HispaniaBarcelonaSpain department of Biochemistry and Molecular Biology-A University of MurciaMurciaSpain

Objectives To analyze the clinical profile,adequacy of treatment with rivaroxaban and outcomes in octogenarians with atrial fibrillation(AF),taking rivaroxaban in clinical *** Observational and non-interventional study that included AF adults recruited from 79 Spanish centers,anticoagulated with rivaroxaban ≥ 6 months before being *** were analyzed according to age(≥ 80 vs.cal practice,around one third of patients taking rivaroxaban are *** patients have many comorbidities and a high thromboembolic *** that,rates of adverse events remain *** is adequately prescribed in the majority of octogenarians.

关键词： patients atrial bleeding

Correlation of periodontal inflamed surface area with glycated hemoglobin,interleukin-6 and lipoprotein(a)in type 2 diabetes with retinopathy

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World Journal of Diabetes 2024年第4期15卷 686-696页

作者： Nusreen Jamal Thazhe Poyil Rosamma Joseph Vadakkekuttical Chandni Radhakrishnan department of Periodontics Government Dental College(Affiliated to Kerala University of Health Sciences)Calicut 673008KeralaIndia department of medicine Government Medical College(Affiliated to Kerala University of Health Sciences)Calicut 673008KeralaIndia

BACKGROUND The two-way relationship between periodontitis and type 2 diabetes mellitus(T2DM)is well *** hyperglycemia contributes to increased periodontal destruction and severe periodontitis,accentuating diabetic *** inflammatory link exists between diabetic retinopathy(DR)and periodontitis,but the studies regarding this association and the role of lipoprotein(a)[Lp(a)]and interleukin-6(IL-6)in these conditions are scarce in the *** To determine the correlation of periodontal inflamed surface area(PISA)with glycated Hb(HbA1c),serum IL-6 and Lp(a)in T2DM subjects with *** This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without *** subjects were assessed for periodontal parameters[bleeding on probing(BOP),probing pocket depth,clinical attachment loss(cal),oral hygiene index-simplified,plaque index(PI)and PISA],and systemic parameters[HbA1c,fasting plasma glucose and postprandial plasma glucose,fasting lipid profile,serum IL-6 and serum Lp(a)].RESULTS The proportion of periodontitis in T2DM with and without DR was 47.5%and 27.5%*** of periodontitis,cal,PISA,IL-6 and Lp(a)were higher in T2DM with DR group compared to T2DM without DR *** difference was observed in the mean percentage of sites with BOP between T2DM with DR(69%)and T2DM without DR(41%),but there was no significant difference in PI(P>0.05).HbA1c was positively correlated with cal(r=0.351,P=0.001),and PISA(r=0.393,P≤0.001)in study subjects.A positive correlation was found between PISA and IL-6(r=0.651,Pcal and IL-6(r=0.527,Pcal and Lp(a)(r=0.631,P<0.001)among study *** Despite both groups having poor glycemic control and comparable plaque scores,the periodontal parameters were higher in DR as compared to T2DM without *** a bidirectional link exists between periodontitis and DM,the presence of DR may have contr

关键词： Type 2 diabetes mellitus Periodontitis Periodontal inflamed surface Area Glycated Hb Diabetic retinopathy

Combination treatment of inflammatory bowel disease:Present status and future perspectives

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World Journal of Gastroenterology 2024年第15期30卷 2068-2080页

作者： John K Triantafillidis Constantinos G Zografos Manousos M Konstadoulakis Apostolos E Papalois Inflammatory Bowel Disease Unit "Metropolitan General"HospitalHolargos 15562AtticaGreece Hellenic Society for Gastrointestinal Oncology 354 Iera OdosChaidari 12461AtticaGreece The 2^(nd)department of Surgery University of AthensSchool of MedicineAretaieion HospitalAthens 11528Greece Unit of Surgical Research and Training The 2^(nd)Department of SurgeryUniversity of AthensSchool of MedicineAretaieion HospitalAthens 11528Greece

The treatment of patients with inflammatory bowel disease(IBD),especially those with severe or refractory disease,represents an important challenge for the clinical *** seems to be no exaggeration to say that in these patients,not only the scientific background of the gastroenterologist is tested,but also the abundance of“gifts”that he should possess(insight,intuition,determ-ination,ability to take initiative,etc.)for the successful outcome of the *** daily clinical practice,depending on the severity of the attack,IBD is treated with one or a combination of two or more pharmaceutical *** combin-ations include not only the first-line drugs(e.g.,mesalazine,corticosteroids,antibiotics,etc)but also second-and third-line drugs(immunosuppressants and biologic agents).It is a fact that despite the significant therapeutic advances there is still a significant percentage of patients who do not satisfactorily respond to the treatment ***,a part of these patients are going to *** recent years,several small-size clinical studies,reviews,and case reports have been published combining not only biological agents with other drugs(e.g.,immunosuppressants or corticosteroids)but also the combination of two biologi-cal agents simultaneously,especially in severe *** our opinion,it is at least a strange(and largely unexplained)fact that we often use combinations of drugs in a given patient although studies comparing the simultaneous administration of two or more drugs with monotherapy are very *** mentioned above,there is a timid tendency in the literature to combine two biological agents in severe cases unresponsive to the applied treatment or patients with severe extraintestinal *** appropriate dosage,the duration of the administration,the suitable timing for checking the clinical and laboratory outcome,as well as the treatment side-effects,should be the subject of intense clinical research *** this

关键词： Biologics for immune-mediated conditions Dual-targeted treatment Combination treatment Inflammatory bowel disease Crohn’s

The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2023

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Cancer Communications 2024年第1期44卷 127-172页

作者： Feng-Hua Wang Xiao-Tian Zhang Lei Tang Qi Wu Mu-Yan Cai Yuan-Fang Li Xiu-Juan Qu Hong Qiu Yu-Jing Zhang Jie-Er Ying Jun Zhang Ling-Yu Sun Rong-Bo Lin Chang Wang Hao Liu Miao-Zhen Qiu Wen-Long Guan Sheng-Xiang Rao Jia-Fu Ji Yan Xin Wei-Qi Sheng Hui-Mian Xu Zhi-Wei Zhou Ai-Ping Zhou Jing Jin Xiang-Lin Yuan Feng Bi Tian-Shu Liu Han Liang Yan-Qiao Zhang Guo-Xin Li Jun Liang Bao-Rui Liu Lin Shen Jin Li Rui-Hua Xu department of Medical Oncology Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhouGuangdongP.R.China department of Gastrointestinal Oncology Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Peking University Cancer HospitalBeijingP.R.China department of Radiology Peking University Cancer HospitalBeijingP.R.China department of Endoscopy Center Peking University Cancer HospitalBeijingP.R.China department of Pathology Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center of Cancer MedicineGuangzhouGuangdongP.R.China department of Gastric Surgery Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhouGuangdongP.R.China department of Medical Oncology The First Hospital of China Medical UniversityShenyangLiaoningP.R.China department of Medical Oncology Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and TechnologyWuhanHubeiP.R.China department of Radiotherapy Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhouGuangdongP.R.China department of Medical Oncology Zhejiang Cancer HospitalHangzhouZhejiangP.R.China department of Medical Oncology Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiP.R.China department of Surgical Oncology The Fourth Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangP.R.China department of Medical Oncology Fujian Cancer HospitalFuzhouFujianP.R.China Tumor Center The First Hospital of Jilin UniversityChangchunJilinP.R.China department of General Surgery Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongP.R.China department of Radiology Zhongshan HospitalFudan UniversityShanghaiP.R.China department of

The 2023 update of the Chinese Society of Clinical Oncology(CSCO)Clini-cal Guidelines for Gastric Cancer focuses on standardizing cancer diagnosis and treatment in China,reflecting the latest advancements in evidence-based medicine,healthcare resource availability,and precision *** updates address the differences in epidemiological characteristics,clinicopatho-logical features,tumor biology,treatment patterns,and drug selections between Eastern and Western gastric cancer *** revisions include a structured template for imaging diagnosis reports,updated standards for molecular marker testing in pathological diagnosis,and an elevated recommendation for neoadju-vant chemotherapy in stage III gastric *** advanced metastatic gastric cancer,the guidelines introduce new recommendations for immunotherapy,anti-angiogenic therapy and targeted drugs,along with updated management strategies for human epidermal growth factor receptor 2(HER2)-positive and deficient DNA mismatch repair(dMMR)/microsatellite instability-high(MSI-H)***,the guidelines offer detailed screening recommendations for hereditary gastric cancer and an appendix listing drug treatment regimens for various stages of gastric *** 2023 CSCO Clinical Guidelines for Gastric Cancer updates are based on both Chinese and international clinical research and expert consensus to enhance their applicability and relevance in clinical practice,particularly in the heterogeneous healthcare landscape of China,while maintaining a commitment to scientific rigor,impartiality,and timely revisions.

关键词： Chinese Society of Clinical Oncology(CSCO) gastric cancer diagnosis surgery neoadjuvant adjuvant radiotherapy chemotherapy targeted therapy immunotherapy

Influence of Helicobacter pylori infection on ghrelin levels in children

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World Journal of Gastroenterology 2012年第36期18卷 5096-5100页

作者： Zhao-Hui Deng Bo Chu Ya-Zhen Xu Bin Zhang Li-Rong Jiang department of Pediatrics Shanghai Children's Medi-cal CenterShanghai Jiaotong University School of MedicineShanghai 200127China

AIM:To compare ghrelin levels in plasma and gastric mucosa before and after Helicobacter pylori(***) treatment in children with ***-associated functional ***:Children with ***-associated functional dyspepsia were enrolled in this *** infection was confirmed by positive bacterial culture *** of the children received triple *** eradication therapy(a 2 wk course of omeprazole,amoxicillin,and clarithromycin).The children were divided into two groups based on the success of the *** treatment:group 1(eradicated)-patients who had a negative 13C-urea breath test 2 mo after the end of therapy;and group 2(non-eradicated)-patients who had a positive 13C-urea breath *** ghrelin,gastric ghrelin mRNA,and the body mass index were evaluated in both groups before and after the *** *** plasma ghrelin levels were measured by a *** expression of gastric ghrelin mRNA was determined by real-time reverse transcription polymerase chain ***:A total of 50 children with ***-associated functional dyspepsia were treated with triple *** eradication *** mean age of the children was 5.52 ± 0.83 years,and there were 28 males and 22 *** the 50 ***-positive children,30 successfully achieved eradication,and 20 did *** mean plasma ghrelin levels of group 1 were 22.17 ± 1.73 ng/L and 26.59 ± 2.05 ng/L before and after the treatment,respectively,which was a significant increase(P = 0.001).However,the mean plasma ghrelin level of group 2 before and after the *** treatment was 21.34 ± 2.40 ng/L and 22.24 ± 2.10 ng/L(P = 0.785).The plasma ghrelin levels increased substantially after treatment in group 1 but showed only minor changes in group ***,the gastric ghrelin mRNA expression in group 1 before treatment was 2.84 ± *** treatment,the level was 3.11 ± 0.65,which was significantly different(P = 0.023).The gastric ghrelin mRNA expression in g

关键词： Helicobacter pylori Functional dyspepsia Ghrelin Eradication Children

A COMPACT EMBEDDING RESULT FOR NONLOcal SOBOLEV SPACES AND MULTIPLICITY OF SIGN-CHANGING SOLUTIONS FOR NONLOcal SCHRÖDINGER EQUATIONS

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Acta Mathematica Scientia 2024年第5期44卷 1853-1876页

作者： Xu ZHANG Hao ZHAI Fukun ZHAO department of Mathematics Wuhan University of TechnologyWuhan430070China department of Mathematics Yunnan Normal UniversityKunming650500China

For any s∈(0,1),let the nonlocal Sobolev space X^(s)(ℝ^(N))be the linear space of Lebesgue measure functions fromℝN toℝsuch that any function u in X^(s)(ℝ^(N))belongs to L2(ℝN)and the function(x,y)\longmapsto\big(u(x)-u(y)\big)\sqrt{K(x-y)}is in L2(ℝN,ℝN).First,we show,for a coercive function V(x),the subspace E:=\bigg\{u\in X^s(\mathbb{R}^N):\int_{\mathbb{R}^N}V(x)u^2{\rm d}xcritical *** terms of applications,the existence of a least energy sign-changing solution and infinitely many sign-changing solutions of the nonlocal Schrödinger equation-{\cal{L}_K}u+V(x)u=f(x,u),\x\in\\mathbb{R}^N are obtained,where-{\cal{L}_K}is an integro-differential operator and V is coercive at infinity.

关键词： sign-changing solution integro-differential operator least energy variational method