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Remimazolam for sedation in gastrointestinal endoscopy:A comprehensive review

World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 385-395页

作者： Dushyant Singh Dahiya Ganesh Kumar Syeda Parsa Manesh Kumar Gangwani Hassam Ali Amir Humza Sohail Saqr Alsakarneh Umar Hayat Sheza Malik Yash R Shah Bhanu Siva Mohan Pinnam Sahib Singh Islam Mohamed Adishwar Rao Saurabh Chandan Mohammad Al-Haddad Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityMO 66160United States Department of Internal Medicine Chandka Medical CollegeSindh 77280Pakistan Department of Gastroenterology and Hepatology University of Arkansas For Medical SciencesLittle RockAR 72205United States Division of Gastroenterology Hepatology and NutritionEast Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64108United States Department of Internal Medicine Geisinger Wyoming Valley Medical CenterWilkes BarrePA 18711United States Department of Internal Medicine Rochester General HospitalRochesterNY 14621United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine Sinai hospitalBaltimoreMD 21215United States Department of Hepatology University of MissouriColumbiaMO 65211United States Department of Internal Medicine Guthrie Robert Packer HospitalSayrePA 18840United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

Worldwide,a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient ***,benzodiazepines and opioids continue to be widely ***,in recent years,Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal(gi)*** is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural *** has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase,volume of distribution,total body clearance,and negligible drug-drug *** also has satisfactory efficacy and has achieved high rates of successful sedation in gi ***,studies have demonstrated that the efficacy of Remimazolam is non-inferior to Propofol,which is currently a gold standard for procedural sedation in most parts of the ***,the use of Propofol is associated with hemodynamic instability and respiratory *** contrast,Remimazolam has lower incidence of these adverse effects intra-procedurally and hence,may provide a safer alternative to Propofol in procedural *** this comprehensive narrative review,highlight the pharmacologic characteristics,efficacy,and safety of Remimazolam for procedural *** also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.

关键词： Remimazolam Endoscopy Sedation Outcomes Efficacy Safety Pharmacokinetics

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Ultrastructure of mouse teratozoospermia induced by parathion

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Asian Journal of Andrology 1999年第1期1卷 79-80页

作者： EduardoBustos-Obegón OctavioDíaz Biology of Reproduction Unit Program of Morphology ICBM Faculty of Medicine University of Chile PO Bax 70061 Santiago 7 Chile.Biology of Reproduction Unit Program of Morphology ICBM Faculty of Medicine University of Chile PO Bax 70061 Santiago 7 Chile.

Male fertility has been correlated to sperm counts,motility and morphology. Wyrobek et al (1983),evaluating changes in sperm morphology caused bychemicals (including some pesticides) found that analysisof teratozoospermia is a useful tool to asses testiculartoxicants. In view of their wide agricultural use and scarcereproductive information available regarding organo-

关键词： spermatozoa organophosphorous compounds parathion pesticides

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Stimulating effects of quercetin on sperm quality and reproductive organs in adult male rats

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Asian Journal of Andrology 2008年第2期10卷 249-258页

作者： Ladachart Taepongsorat Prakong Tangpraprutgul Noppadon Kitana Suchinda Malaivijitnond Interdepartment of Physiology program Graduate School Chulalongkorn University Bangkok 10330 Thailand Primate Research Unit Department of Biology Faculty of Science Chulalongkorn University Bangkok 10330 Thailand

Aim： To investigate effects of quercetin on weight and histology of testis and accessory sex organs and on sperm quality in adult male rats. Methods： Male Sprague-Dawley rats were injected s.c. with quercetin at the dose of 0, 30, 90, or 270 mg/kg body weight/day （hereafter abbreviated Q0, Q30, Q90 and Q270, respectively）, and each dose was administered for treatment durations of 3, 7 and 14 days. Results： From our study, it was found that the effects of quercetin on reproductive organs and sperm quality depended on the dose and duration of treatment. After Q270 treatment for 14 days, the weights of testes, epididymis and vas deferens were significantly increased, whereas the weights of seminal vesicle and prostate gland were significantly decreased, compared with those of Q0. The histological alteration of those organs was observed after Q270 treatment for 7 days as well as 14 days. The sperm motility, viability and concentration were significantly increased after Q90 and Q270 injections after both of 7 and 14 days. Changes in sperm quality were earlier and greater than those in sex organ histology and weight, respectively. Conclusion： Overall results indicate that quercetin might indirectly affect sperm quality through the stimulation of the sex organs, both at the cellular and organ levels, depending on the dose and the duration of treatment. Therefore, the use of quercetin as an alternative drug for treatment of male infertility should be considered. （Asian J Androl 2008 Mar. 10： 249-258）

关键词： epididymis prostate quercetin seminal vesicle sperm quality

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Research highlights from ACACR members

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Genes & Diseases 2018年第4期5卷 301-301页

作者： Zhenghe John Wang Department of Genetics and Genome Sciences Case Western Reserve University School of MedicineGI Cancer Genetics ProgramCase Comprehensive Cancer Center10900 Euclid AvenueClevelandOH 44106-7285USA Association of Chinese Americans in Cancer Research(ACACR)BaltimoreMDUSA

*** He at The University of Chicago and his collaborator at the ShanghaiTech University found that N6-methyladenosine(m6A)facilitates hippocampus-dependent learning and memory through YTHDF1,a m6A binding protein that... 详细信息

关键词： Chicago stimulus synthesis

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Dextrose in the banked blood products does not seem to affect the blood glucose levels in patients undergoing liver transplantation

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World Journal of Gastroenterology 2005年第18期11卷 2789-2791页

作者： Kwok-Wai Cheng Chia-Chih Tseng Chih-Hsien Wang Yaw-Sen Chen Chih-Chi Wang Tung-Liang Huang Hock-Liew Eng King-Wah Chiu Shih-Hor Wang Chih-Che Lin Tsan-Shiun Lin Yueh-Wei Liu Bruno Jawan Department of Anesthesiology and Liver Transplantation program Chang Gung Memorial Hospital Kaohsiung Medical Center Taiwan China Chang Gung University Ta-pei Taiwan China

AIM: Hyperglycemia commonly seen in liver transplantation (LT) has often been attributed to the dextrose in the storage solution of blood transfusion products. The purpose of the study is to compare the changes of the blood glucose levels in transfused and non-transfused patients during LT. METHODS: A retrospective study on 60 biliary pediatric patients and 16 adult patients undergoing LT was carried out. Transfused pediatric patients were included in Group Ⅰ (GⅠ), those not transfused in Group Ⅱ (GⅡ). Twelve adult patients were not given transfusion and assigned to Group Ⅲ(GⅢ); whereas, four adult patients who received massive transfusion were assigned to Group Ⅳ (GⅣ). The blood glucose levels, volume of blood transfused, and the volume of crystalloid infused were recorded, compared and analyzed. RESULTS: Results showed that the changes in blood glucose levels during LT for both non-transfused and minimally transfused pediatric groups and non-transfused and massively-transfused adult groups were almost the same. CONCLUSION: We conclude that blood transfusion does not cause significant changes in the blood glucose levels in this study.

关键词： Organ Liver surgery Transplantation Anesthesia General monitoring Blood glucose transfusion Bank blood component Infusion 5% dextrose in 1/4 saline

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Nucleotide excision repair pathway gene polymorphisms are associated with risk and prognosis of colorectal cancer

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World Journal of Gastroenterology 2020年第3期26卷 307-323页

作者： Yan-Ke Li Qian Xu Li-Ping Sun Yue-Hua Gong Jing-Jing Jing Cheng-Zhong Xing Yuan Yuan Tumor Etiology and Screening Department of Cancer Institute and General Surgery Key Laboratory of Cancer Etiology and Prevention of Liaoning Education DepartmentKey Laboratory of GI Cancer Etiology and Prevention of Liaoning Provincethe First Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina Department of Anorectal Surgery the First Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina

BACKGROUND Single nucleotide polymorphisms(SNPs)are universally present in nucleotide excision repair(NER)pathway genes,which could make impacts on colorectal carcinogenesis and *** To explore the association of all tagSNPs in NER pathway genes with colorectal cancer(CRC)risk and prognosis in a northern Chinese population by a two-stage case-control design composed of a discovery and validation *** Genotyping for NER SNPs was performed using kompetitive allele specific *** the discovery stage,39 tagSNPs in eight genes were genotyped in 368 subjects,including 184 CRC cases and 184 individual-matched *** the validation stage,13 SNPs in six genes were analyzed in a total of 1712 subjects,including 854 CRC cases and 858 CRC-free *** Two SNPs(XPA rs10817938 and XPC rs2607775)were associated with an increased CRC risk in overall and stratification *** cumulative and interaction effects were also demonstrated in the studied SNPs on CRC *** two SNPs(ERCC2 rs1052555 and ERCC5 rs2228959)were newly found to be associated with a poor overall survival of CRC *** Our findings suggest novel SNPs in NER pathway genes that can be predictive for CRC risk and prognosis in a large-scale Chinese *** present study has referential values for the identification of all-round NER-based genetic biomarkers in predicting the susceptibility and clinical outcome of CRC.

关键词： Nucleotide excision repair Polymorphism Colorectal cancer Susceptibility Prognosis

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Divergent trajectories of lean vs obese non-alcoholic steatohepatitis patients from listing to post-transplant:A retrospective cohort study

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World Journal of Gastroenterology 2022年第26期28卷 3218-3231页

作者： Fakhar Ali Qazi-Arisar Raj Uchila Catherine Chen Cathy Yang Shi-Yi Chen Ravikiran Sindhuvalada Karnam Amirhossein Azhie Wei Xu Zita Galvin Nazia Selzner Leslie Lilly Mamatha Bhat Ajmera Transplant program Toronto General HospitalUniversity Health NetworkToronto M5G 2N2OntarioCanada Division of Gastroenterology and Hepatology Department of MedicineUniversity of TorontoToronto M5G 2N2OntarioCanada National Institute of Liver and gi Diseases Dow University of Health SciencesKarachi 75330Pakistan Department of Biostatistics Princess Margaret Cancer CenterUniversity Health NetworkToronto M5G 2C1OntarioCanada Division of Biostatistics Dalla Lana School of Public HealthUniversity of TorontoToronto M5G 2C1OntarioCanada

BACKGROUND Non-alcoholic steatohepatitis(NASH)cirrhosis is the second most common indication for liver transplantation(LT).The role of body mass index(BMI)on outcomes of NASH cirrhosis has been *** To compare the longitudinal trajectories of patients with lean vs obese NASH cirrhosis,from listing up to post-transplant,having adjusted their BMI for *** We retrospectively reviewed all adult NASH patients listed for LT in our program from 2012 to ***-Gray Competing Risk analyses and Cox Proportional-Hazard Models were performed to examine the cumulative incidence of transplant and survival outcomes *** Out of 265 NASH cirrhosis listed patients,176 were *** age was 61.0 years;46%were females.111 patients underwent *** robust patients had better waitlist survival[hazard ratio(HR):0.12;95%CI:0.05–0.29,P<0.0001]with higher instantaneous rate of transplant(HR:5.71;95%CI:1.26–25.9,P=0.02).Lean NASH patients had a substantially higher risk of graft loss within 90 d post-LT(1.2%vs 13.8%,P=0.032)and death post-LT(2.4%vs 17.2%,P=0.029).1-3-and 5-year graft survival was poor for lean NASH(78.6%,77.3%and 41.7%vs 98.6%,96%and 85%respectively).Overall patient survival post-LT was significantly worse in lean NASH(HR:0.17;95%CI:0.03–0.86,P=0.0142)with 83%lower instantaneous rate of death in obese *** Although lean NASH is considered to be more benign than obese NASH,our study suggests a paradoxical correlation of lean NASH with waitlist outcomes,and graft and patient survival post-LT.

关键词： Outcomes Frailty Waitlist Liver transplant Survival

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The ubiquitin ligase Siah2 is revealed as an accomplice of the androgen receptor in castration resistant prostate cancer

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Asian Journal of Andrology 2013年第4期15卷 447-448页

作者： Michael R Freeman Research Division of Cancer Biology and Therapeutics Departments of Surgery Medicine and BiomedicalSciences Cancer Biology Program Samuel OschinComprehensive Cancer Institute Los Angeles CA90048 USA

The androgen receptor （AR） remains the primary molecular target forprostate cancer （PCa） treatment and for development of novel therapies. Profiling and other analyses of human prostate adenocarcinoma have shown that the AR is still functional during latestage disease in the absence of circulating hormone fol lowing castration therapy. The molecular mechanisms that operate during this ＇cas tration resistant＇ phase are still not well understood. Qi et al. have now implicated the ubiquitin ligase Siah2 as an important mediator of AR action in castration resis tant prostate cancer （CRPC）. Siah2 was found to target repressed AR chromatin complexes for degradation, resulting in activation of ARregulated genes involved in tumor cell proliferation, cell motility and lipid metabolism. The authors show a requirement for Siah2 activity for PCa cell growth under conditions of low androgen, and also that targeting Siah2 results in tumor growth suppression under castrate conditions. These findings identify a new mechanism of AR regulation in progressing disease as well as a novel enzymatic target for therapeutic intervention. The AR is a wellstudied hormone receptor that belongs to the large nuclear receptor gene superfamily. AR is activated by androgen binding （principally 5：~dihydrotestosterone, 5DHT）, which elicits changes in AR resident cytosolic complexes, translocation of the receptor to cell nuclei, formation of multiprotein transcriptional complexes onchromatin, and activation or repression of gene expression. Experiments with in vivo model systems have provided evidence that virtually all physiologic processes affected by androgens require the AR as a mediator of molecular effects at the gene level.1 AR is widely expressed beyond the reproductive systems and is believed to play important roles in several nonreproductive tissues, including muscle and brain. The fact that PCa growth is initially dependent on the pre sence of androgens in the circulation, and that prostat

关键词： ligase revealed accomplice

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CDX2 protein expression compared to alcian blue staining in the evaluation of esophageal intestinal metaplasia

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World Journal of Gastroenterology 2015年第9期21卷 2770-2776页

作者： Dennis R Johnson Maisoun Abdelbaqui Maryam Tahmasbi Zoltan Mayer Hung-Wei Lee Mokenge P Malafa Domenico Coppola Department of Anatomic Pathology Moffitt Cancer Center and Research InstituteTampaFL 33612United States Florida Digestive Health Specialists Lakewood RanchFL 34202United States Department of Oncological Sciences University of South FloridaTampaFL 33612United States gi Tumor program Moffitt Cancer Center and Research InstituteTampaFL 33612United States Tumor Biology program Moffitt Cancer Center and Research InstituteTampaFL 33612United States

AIM:To compare the sensitivity and specificity of CDX2 and alcian blue(AB) p H 2.5 staining in identifying esophageal intestinal ***:One hundred and ninty-nine biopsies from 186 patients were retrospectively reviewed and categorized as Barrett's esophagus(BE)(n =108); non-Barrett's esophagus(NBE)(n =48); columnar blue cells(CB) and esophageal glands(EG)(n =43).The biopsies were stained with AB and immunostained for CDX2 using a mouse monoclonal antibody from Biogenex(clone CDX2-88) and the Ventana Discovery X automated *** positive and negative predictive value of each group was used to determine the predictive power of CDX2 and AB in diagnosing intestinal ***:All of the 108 BE biopsies(100%) were positive for AB and 102 of them(94.4%) were positive for *** six BE patients(5.6%) who failed to stain with CDX2 were found to have lost the focus of intestinal metaplasia upon deeper sectioning for *** AB and CDX2 were negative in 43 out of 48(89.6%) NBE *** NBE patients(10.4%) were falsely positive for AB due to the presence of EG and CB in these *** cases were all CDX2 *** addition,5 AB negative NBE were found to be CDX2 *** on these results the CDX2 immunostain had similar sensitivity but higher specificity(100% vs about 91%) than AB in detecting intestinal type metaplasia in these *** data shows that CDX2 has a better PPV in detecting intestinal metaplasia as compared to AB(95.6% vs 71.5%,respectively).CONCLUSION:CDX2 has a better positive predictive value than AB in detecting intestinal ***2may be useful when challenged by gastro-esophageal biopsies containing mimikers of BE.

关键词： Barrett’s esophagus Alcian blue pH 2.5 CDX2 Intest

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Injury severity analysis： comparison of multilevel logistic regression models and effects of collision data aggregation

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Journal of Modern Transportation 2016年第1期24卷 73-87页

作者： Taimur Usman Liping Fu Luis F.Miranda-Moreno Department of Civil & Environmental Engineering University of Waterloo Waterloo ON N2L 3GI Canada School of Transportation and Logistics Southwest Jiaotong University Chengdu 610031 China Department of Civil Engineering & Applied Mechanics McGill University Montreal QC H3A 2K6 Canada

This paper describes an empirical study aiming at identifying the main differences between different logistic regression models and collision data aggregation methods that are commonly applied in road safety literature for modeling collision severity. In particular, the research compares three popular multilevel logistic models （i.e., sequential binary logit models, ordered logit models, and multinomial logit models） as well as three data aggregation methods （i.e., occupant based, vehicle based, and collision based）. Six years of collision data （2001-2006） from 31 highway routes from across the province of Ontario, Canada were used for this analysis. It was found that a multilevel multinomial logit model has the best fit to the data than the other two models while the results obtained from occupant-based data are more reliable than those from vehicle- and collision-based data. More importantly, while generally consistent in terms of factors that were found to be significant between different models and data aggregation methods, the effect size of each factor differ sub- stantially, which could have significant implications forevaluating the effects of different safety-related policies and countermeasures.

关键词： Injury severity - Multilevel logistic regressionmodels Collision data aggregation

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