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Decreased Expression of TRPM3 and mAChRM3 in the Small Intestine in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

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International Journal of Clinical Medicine 2018年第5期9卷 467-480页

作者： Sonya Marshall-Gradisnik Marshall Fretel Natalie Eaton Helene Cabanas Cassandra Balinas Vinod Gopalan Daniel Petersen Rachel Passmore Kevin Tang Mazhar Haque alfred Lam Donald Staines School of Medical Science Griffith University Brisbane Australia The National Centre for Neuroimmunology and Emerging Diseases Menzies Health Institute Queensland Griffith University Brisbane Australia Gold Coast University hospital Parklands Australia Mater Hill Gastroenterology South Brisbane Australia

Introduction: Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is often associated with gastrointestinal disturbance and inflammatory markers;however, there have been no histological studies performed in the small intestine from CFS/ME patients. The aim of this investigation was to assess the expression of certain inflammatory markers and inflammatory receptors, namely transient receptor potential melastin 3 (TRPM3) ion channels and muscarinic acetylcholine M3 (mAChRM3) receptors, in small intestinal tissues in a case controlled study comprising a CFS/ME patient and a healthy non-fatigued control. Method: Immunohistochemistry was performed on a small intestinal biopsy from a CFS/ME patient (age = 50;female) with self-reported symptoms of gastrointestinal disturbance and a non-fatigued control (NFC), (age = 28;female). Semi-quantitative analysis of expression was undertaken for interferon-gamma (IFNy), interleukin-1 alpha (IL-1α), tumour necrosis factor-alpha (TNFα), TRPM3 ion channels and mAChRM3 acetylcholine receptors. Results: There was significantly decreased expression of TRPM3 in the CFS/ME patient (35% ±9%) and a significant decrease in mAChRM3 in the CFS/ME patient (54% ±9%). There was no difference in IL-1α between CFS/ME patient and NFC, however;there was an increase in IFNy (13% ±6%) in the CFS/ME patient compared to NFC. There was a difference observed in TNFα in CFS/ME compared to NFC. Conclusion: Differences were noted in the expression of specific TRP ion channels and cholinergic receptors in CFS/ME compared with NFC, with CFS/ME demonstrating decreased TRPM3 and mAChRM3. Further, IFNy was increased, and TNFα decreased, in the small intestine of the CFS/ME patient with reported gastrointestinal disturbance.

关键词： Chronic Fatigue Syndrome/Myalgic Encephalomyelitis Irritable Bowel TRPM3 mAChRM3 Small Intestine Inflammation

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ICU碳青霉烯耐药肺炎克雷伯菌的毒力基因分布及分子流行病学特征

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中南大学学报（医学版） 2024年第5期49卷 730-736页

作者：黄雅轩蔡依含何婉霞张莉滟赵越南方医科大学附属广东省人民医院/广东省医学科学院检验科广州510080 南加州大学alfred E.Mann药学与制药科学学院美国洛杉矶90089 中山市小榄人民医院/中山市第五人民医院检验科广东中山528415 广州南方学院云康医学与健康学院广州510970

目的:碳青霉烯耐药肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)携带的耐药基因会限制临床用药选择,其毒力基因也会严重影响患者预后。本研究旨在探讨重症监护室(intensive care unit,ICU)CRKP的毒力基因分布、荚膜... 详细信息

目的:碳青霉烯耐药肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)携带的耐药基因会限制临床用药选择,其毒力基因也会严重影响患者预后。本研究旨在探讨重症监护室(intensive care unit,ICU)CRKP的毒力基因分布、荚膜血清型及分子流行病学特征,了解ICU中CRKP的感染特点,为ICU有效监测和防控CRKP感染提供科学依据。方法:收集2021年1月至2022年12月广东省人民医院ICU所分离并已确定为CRKP的非重复菌株共40株。采用全基因组测序方法,分析待测菌株耐药基因、毒力基因、荚膜血清型的分布,同时将CRKP基因组7个管家基因序列上传至肺炎克雷伯菌(Klebsiella pneumoniae,KPN)多位点序列分型(multilocus sequence typing,MLST)数据库进行分析,以明确菌株的序列型(sequence typing,ST)。结果:40例ICU CRKP感染患者年龄为(69.03±17.82)岁,且伴有多种基础疾病,临床结局好转和死亡各20例。所分离菌株主要来源于中段尿、肺泡灌洗液等标本。全基因组测序结果显示其主要携带blaKPC-1(29株,72.5%)和blaNDM-1(6株,15.0%),另有5株同时携带blaKPC-1和blaNDM-1。所携带的毒力基因有多种,其中entA、entB、entE、entS、fepA、fepC、fepG、yag/ecp、ompA等基因的携带率达100%,entD、fimB、iroB、iroD、fes、pla等基因携带率较低。ICU所分离的CRKP以ST11型(27例,67.5%)为主,荚膜血清型以KL64型(29例,72.5%)为主。共检出23例ST11-KL64型CRKP,占57.5%。结论:ICU CRKP主要为ST11-KL64型,并携带多种毒力基因,其中以铁吸收类毒力基因为主;且blaKPC已由blaKPC-2转为blaKPC-1。因此,需密切监测CRKP的分子流行病学变化,同时制订严格的防控措施,有效遏制CRKP感染的发生。

关键词：重症监护室碳青霉烯耐药肺炎克雷伯菌全基因组测序毒力基因荚膜血清型多位点序列分型分子流行病学

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REWRITE YOUR STORY Changing the Perception of Depression in the Modern World

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城市漫步（GBA版） 2019年第12期 63-63页

作者： alfred Chambers Mental Health Services at Guangzhou United Family hospital

'Depression'is just a ***,it has come to have a very negative connotation in our modern *** has become a catchall word,so to speak,for people to describe themselves or others when life is not going as planned and they're not happy about *** course,life rarely ever goes according to plan,so does that mean we are living in a constant state of depression?*** perhaps we can look at this whole idea in a different light.

关键词： language. World speak

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Uses of a dedicated 3D reconstruction software with augmented and mixed reality in planning and performing advanced liver surgery and living donor liver transplantation(with videos)

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Hepatobiliary & Pancreatic Diseases International 2022年第5期21卷 455-461页

作者： Deniz Balci Elvan Onur Kirimker Dimitri Aristotle Raptis Yujia Gao alfred Wei Chieh Kow Department of Surgery Medical Park Goztepe Hastanesi Organ Nakli Merkezi Nisan SokBahce se hir UniversityNo.23 Merdivenkoy KadıkoyIstanbulTurkiye Department of Surgery Ankara UniversityAnkaraTurkiye Clinical Service of HPB Surgery and Liver Transplantation NHS Foundation TrustRoyal Free London HospitalLondonUK Division of Surgery&Interventional Science University College LondonLondonUK Division of Hepatobiliary&Pancreatic Surgery Department of SurgeryNational University of SingaporeSingapore Liver Transplant Program National University Center for Organ Transplantation(NUCOT)National University Health SystemSingapore

The development of digital intelligent diagnostic and treatment technology has opened countless new opportunities for liver surgery from the era of digital anatomy to a new era of digital diagnostics,virtual surgery simulation and using the created scenarios in real-time surgery using mixed *** this article,we described our experience on developing a dedicated 3 dimensional visualization and reconstruction software for surgeons to be used in advanced liver surgery and living donor liver ***,we shared the recent developments in the field by explaining the outreach of the software from virtual reality to augmented reality and mixed reality.

关键词： Living donor liver transplantation 3D reconstruction software 3D volumetry Precision medicine Augmented reality Mixed reality

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Environmental and landscape influences on the spatial and temporal distribution of a cattle herd in a South Texas rangeland

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Ecological Processes 2020年第1期9卷 443-460页

作者： Christopher Cheleuitte-Nieves Humberto L.Perotto-Baldivieso XBen Wu Susan M.Cooper Department of Ecosystem Science and Management Texas A&M University2120 TAMU320 WFES BuildingCollege StationTX 77843-2138USA Present address:Center of Comparative Medicine and Pathology Memorial Sloan Kettering Cancer CenterWeill Cornell Medicineand Hospital for Special Surgery408 East 69th StreetZ-913New YorkNY 10021USA Caesar Kleberg Wildlife Research Institute Texas A&M University-Kingsville700 University Blvd.MSC 218KingsvilleTX 78363USA Texas A&M AgriLife Research 1619 Garner Field RoadUvaldeTX 78801USA

The multiple spatial and temporal parameters affecting cattle herd distribution and activity dynamics can significantly affect resource utilization but are not fully *** aim of this study was to determine whether current animal tracking technology and spatio-temporal analysis tools can be used to integrate multi-scale information on herd distribution patterns as a function of seasonal forage production,periods of the day,animal activity,and landscape *** and activity information of 11 free-ranging cows within a 31-member herd was obtained at 5-min intervals by using GPS collars for 1 year within a 457-ha ranch in the semi-arid rangelands of South *** biomass was calculated with satellite *** analysis of cattle distribution and landscape features was conducted with *** spread was greatest during the growing *** the year,during midday,the herd showed smaller spread and greater use of shade patches than any other time of *** also aggregated under trees in winter,particularly during the *** was no statistically significant overall pattern of seasonal changes in the use of water and supplemental feeding areas,but a trend toward highest use during the ***,significantly different diurnal patterns in the use of supplemental feed and water were observed within each *** study found a strong influence of shade patches relative to the influence of water and supplemental feeding areas on the diurnal and seasonal movement patterns of cattle in shrub-dominated *** this study used only 11 tracked cows in a 31-member herd,the results indicated that techniques such as seasonal and diurnal GPS tracking,GIS,and remote sensing data enable evaluation of multiple spatial and temporal dynamics of cattle distribution and activity *** smaller spread during the dry winter season associated with the observed aggregation of individuals in water and supplemental feeding ar

关键词： Cattle behavior Cross-scale interactions GPS collars Group dispersion Normalized difference vegetation index(NDVI) Thermoregulation Ungulate grazing patterns

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ICU假丝酵母血流感染患者临床特征及预后危险因素

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中华医院感染学杂志 2024年第17期34卷 2589-2593页

作者：郭婧黄雅轩张莉滟赵越广西壮族自治区妇幼保健院检验科广西南宁530003 南加州大学alfred E.Mann药学与制药科学学院洛杉矶90089 南方医科大学附属广东省人民医院/广东省医学科学院检验科广东广州510080

目的探讨医院重症监护室(ICU)假丝酵母血流感染患者的临床特征及预后危险因素,为其诊治及预后改善提供理论依据。方法回顾性分析2018年1月-2023年3月广东省人民医院ICU假丝酵母血流感染患者的临床资料及预后情况,并对生存和死亡患者间... 详细信息

目的探讨医院重症监护室(ICU)假丝酵母血流感染患者的临床特征及预后危险因素,为其诊治及预后改善提供理论依据。方法回顾性分析2018年1月-2023年3月广东省人民医院ICU假丝酵母血流感染患者的临床资料及预后情况,并对生存和死亡患者间的相关危险因素进行比较分析。结果134例ICU假丝酵母血流感染患者中,白假丝酵母分离率最高(49株,36.57%),其次为近平滑假丝酵母(28株,20.89%)、光滑假丝酵母(23株,17.16%)和热带假丝酵母(20株,14.93%)等,药敏结果显示光滑假丝酵母和热带假丝酵母对唑类抗真菌药物的耐药率较高;134例患者中死亡42例,病死率为31.34%,死亡组患者平均年龄高于生存组(t=2.255,P=0.026);单因素分析显示:患者伴有恶性肿瘤、使用糖皮质激素、碳青霉烯类药物以及>3种抗菌药物联用与预后相关,多因素Logistic回归分析显示:患者伴有恶性肿瘤和使用糖皮质激素是影响其预后的危险因素。结论ICU假丝酵母血流感染患者病死率高,同时临床需尽早完善患者血培养送检,并加强药物管理及临床护理工作,以降低假丝酵母血流感染风险,改善患者预后。

关键词：假丝酵母血流感染重症监护室临床特征预后

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Physicians’Perspectives of Informed Consent for Medical Procedures:A Qualitative Interview Study

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Journal of Health Science 2020年第1期8卷 9-26页

作者： alfred P.Minei Rachelyn Ann S.Arana Sam O.Kaipu Jerry M.Minei School of Law University of Papua New GuineaWaiganiPO Box 126National Capital DistrictPapua New Guinea Institute of Statistics College of Arts and SciencesUniversity of the Philippines Los BañosLaguna 4031Philippines Townsville hospital TownsvillePO Box 670Townsville Queensland 4810Australia

This work is based on an on-going research on medical informed consent in Papua New Guinea(PNG)with 19 doctors from hospitals,health care centers and private medical establishments in the National Capital District and Central Province who voluntarily participated in the *** authors conducted an examination of doctors’understanding of informed consent for medical procedures through a qualitative interview study and we describe our *** saw a need to involved patients in decision-making about their care,ethical imperative and concerns about litigation and their complaints highlighted the issue of informed *** order for the patients to make an informed decision about medical procedure,the doctors involved in the proposed treatment should conduct the informed consent *** discussion should include the treatment,the risks and benefits of treatment,and alternative therapies with associated risks and *** studied doctors’perspectives of gaining informed consent for routine medical *** used qualitative study methods using structured interviews selected by purposive *** data collected were entered into a data base and were analyzed *** discussion is based on review of legal decisions,commentaries and our personal experience in studying medical malpractice *** have utilized case reports and several informative writings that have appeared in the world literature,as well as selections from vast amounts of material available in USA,UK,Australia,India and *** current informed consent processes do not appear to be ideal for many doctors in *** particular,there are inhibiting factors that affect patients from making medical informed decisions,doctors find time not enough to run discussions on informed consent,Department of Health does not have a standard informed consent form,patients complain about no consent form,and they have not signed consent *** are but some issues that affect patients wh

关键词： Health care professionals qualitative study consent form medical procedure litigation

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Estimation of Endotracheal Tube Cuff Pressure in a Large Teaching hospital in Ghana

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Open Journal of Anesthesiology 2015年第12期5卷 233-241页

作者： Ebenezer Owusu Darkwa Frank Boni Eugenia Lamptey Yaw Adu-Gyamfi Christian Owoo Robert Djagbletey alfred Edwin Yawson Edmund Ayesu Daniel Akwanfo Yaw Sottie Department of Anaesthesia School of Medicine and Dentistry College of Health Sciences University of Ghana Accra Ghana Department of Community Health School of Public Health College of Health Sciences University of Ghana Accra Ghana Department of Statistics Kumasi Polytechnic Kumasi Ghana Department of Anaesthesia Korle-Bu Teaching Hospital Accra Ghana

Background: Maintenance of optimal Endotracheal Tube cuff Pressure (ETTcP) in anaesthetic practice reduces cuff pressure complications. Aneroid manometers for measurement of ETTcP are not widely available in Ghana, hence anaesthesia providers estimate ETTcP according to their experience. The study assessed ETTcP obtained from estimation techniques between anaesthesia providers at Korle-Bu Teaching hospital (KBTH). It also evaluated the Volume of Air Required (VAR) to obtain an acceptable cuff inflation pressure for sizes 7.0 and 8.0 mm adult endotracheal tubes used at the hospital, and the effect of patient’s age, weight and height on this volume. Methods: Eighty-one patients who underwent general anaesthesia were recruited. ETTcP was measured using an aneroid manometer via a three-way tap. After full cuff deflation, the cuff was refilled with air until an ETTcP of 20 cm H2O was obtained. Independent t-test was used to measure the statistical variations in the ETTcP using estimation techniques in relation to recommended levels as well as the significant difference of mean VAR to obtain a cuff pressure of 20 cm H2O. Grouped t-test was used to determine significant differences in ETTcP between anaesthesia providers using estimation techniques. Results: Mean ETTcP obtained from estimation techniques was (61.87, 73.79) cm H2O. The mean ETTcP measured for Physician and Nurse Anaesthetists were 65.36 cm H20 and 69.52 cm H2O respectively. The mean VAR to achieve an ETTcP of 20 cm H2O for endotracheal tube sizes 7.0 mm and 8.0 mm were 3.90 ± 1.13 mls and 4.55 ± 0.95 mls respectively. Age and weight significantly influenced the VAR to achieve a cuff pressure of 20 cm H2O, however, height did not. Conclusions: This study demonstrated that cuff pressures obtained by estimation techniques were generally higher than the recommended average with no significant difference between anaesthesia providers. However, in the absence of an aneroid manometer, ETTcP of tube sizes 7.0 mm and

关键词： Endotracheal Tube Cuff Pressure Physician Anaesthetist Nurse Anaesthetist Korle-Bu Teaching hospital

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Supporting smoking cessation in healthcare: obstacles in scientific understanding and tobacco addiction management

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Health 2010年第11期2卷 1272-1279页

作者： Dianne de Korte Onno C.Pvan Schayck Paul van Spiegel Ad A.Kaptein alfred Sachs Maureen Rutten-van Molken Niels Chavannes Trudi Tromp-Beelen Rik Bes Remi Allard Gerard Peeters Leo Kliphuis Jan Willem Schouten Lies van Gennip Renevan Ommen Javier Asin Department of General Practice Maastricht University Medical CentreSchool CAPHRIMaastrichtthe Netherlands 2.MIRO Innovation in Smoking CessationCore Teamthe Netherlands Slotervaart hospital Amsterdamthe Netherlands Leiden University Medical Center Leidenthe Netherlands Julius Center for Health Sciences and Primary Care Utrechtthe Netherlands Erasmus University Rotterdam Rotterdamthe Netherlands Jellinek Clinic Amsterdamthe Netherlands Centre for Motivation and Change Hilversumthe Netherlands VU University Medical Center Amsterdamthe Netherlands St.Elisabeth hospital Tilburgthe Netherlands Netherlands Association of Organized Primary Healthcare Utrechtthe Netherlands STIVORO Den Haagthe Netherlands Pfizer BV Capelle aan den IJsselthe Netherlands ACSION Zeistthe Netherlands

Despite ongoing efforts to reduce tobacco smoking, the smoking prevalence in many countries has remained stable for years. This may be a consequence of either lack of knowledge about effective ways to reduce smoking, or failing treatment of tobacco addiction in healthcare. This study explored gaps in the current understanding of smoking cessation and the challenges facing tobacco addiction management in order to formulate recommendations for future research and healthcare practice. A narrative review was written to determine areas in which more research is needed as well as areas in which sufficient knowledge is already available. Recommendations for future research were prioritised using a Delphi-procedure. Recommendations for healthcare practice were confirmed by expert’s assessment. Smoking is not widely acknowledged as an addiction and a relatively small number of smokers ask help from a healthcare professional when trying to stop smoking. Most healthcare professionals recognise the importance of advising patients to stop smoking, but experience certain barriers to actually do this. Overall, healthcare professionals need to be convinced that tobacco smoking is an addiction and should be treated likewise. If all healthcare professionals systematically advise their patients to give up smoking, eventually more smokers will successfully stop smoking.

关键词： Tobacco Addiction Smoking Cessation Smoking Cessation Interventions Healthcare Practice Tobacco Control

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两种单纯疱疹病毒载体在大鼠脑内所致炎性反应的比较

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华西医科大学学报 2002年第3期33卷 381-383,400页

作者：章为 alfred Geller 四川大学华西基础医学与法医学院组织胚胎学与神经生物学教研室成都610041 Division of Endocrinology of Children's hospital Harvard Medical SchoolUSA

目的　在比较质粒型 HSV- 1载体包装系统 (p HSVlac/helper)和无辅助病毒的载体包装系统(p HSVlac/helper virus- free)导致的特异性免疫应答的基础上 ,进一步选择 L CA、Mac- 1和 GFAP等标记抗原 ,探讨载体引入后引起的非特异性炎性反... 详细信息

目的　在比较质粒型 HSV- 1载体包装系统 (p HSVlac/helper)和无辅助病毒的载体包装系统(p HSVlac/helper virus- free)导致的特异性免疫应答的基础上 ,进一步选择 L CA、Mac- 1和 GFAP等标记抗原 ,探讨载体引入后引起的非特异性炎性反应。方法　采用免疫组化技术结合细胞计数 ,观察载体引入后引起的非特异性炎性反应以及星形胶质细胞的反应。结果　免疫组化结果显示 ,L CA的反应高峰出现在基因转移后第 4天 ,p HSVlac/helper引起的反应强度显然大于 p HSVlac/helper virus- free组 (P<0 .0 0 1)。与 L CA不同 ,Mac- 1对p HSVlac/helper virus- free的反应在第 4天达到峰值 ,并高于 p HSVlac/helper引起的反应。两种载体系统及 PBS均使注射侧纹状体内 GFAP阳性细胞增多、增大 ,突起变粗 ,反应增强 ,而非注射侧半球内 GFAP阳性细胞数量少 ,突起细长。结论　无辅助病毒载体包装系统仅引起较弱的炎性反应。

关键词：单纯疱疹病毒载体基因转移炎性反应

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