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儿科日间手术中超重（或肥胖症）与胃液特性的关系：在禁食指南和误吸风险评估方面的意义

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麻醉与镇痛 2010年第6期6卷 38-49页

作者： scott D. Cook-sather Paul R. Gallagher Lydia E. Kruge Jonathan M. Beus Brian P. Ciampa Kevin Conor Welch sina shah-Hosseini Jieun s. Choi Reshma Pachikara Kim Minger Ronald s. Litman Mark s. schreiner 周洁(译) 李士通(校) Departments of Anesthesiology and Critical Care medicine Departments of Biostatistics and Epidemiology Nursing The Children's Hospital of Philadelphia The University of Pennsylvania School of Medicine Philadelphia Pennsylvania 不详

背景超重或肥胖的日间手术儿科患者手术前2小时禁水的安全性尚未得到证实。健康的儿童和肥胖的成人在手术前禁水2小时后残留胃液量（GFVs）并不多，因此认为误吸风险并不高。因此我们将测算日间手术患者中超重症或肥胖症的患病率，并假... 详细信息

背景超重或肥胖的日间手术儿科患者手术前2小时禁水的安全性尚未得到证实。健康的儿童和肥胖的成人在手术前禁水2小时后残留胃液量（GFVs）并不多，因此认为误吸风险并不高。因此我们将测算日间手术患者中超重症或肥胖症的患病率，并假设不管是体重指数还是禁食时间均不会对GFV或胃液pH值产生显著的影响。所有受试儿童均于手术前禁清水2小时，并假设超重或肥胖患儿的GFV不会多于偏瘦或正常体重患儿，而呕吐或误吸的风险也很低。方法本研究中连续纳入了1000例2－12岁行日间手术的患儿，记录人口统计学资料、病史、身高和体重。另外纳入1000例需全麻插管的日间手术患儿（2。12岁）进行研究。气管插管后，经口插入一根14—18F的胃管，抽空胃内容物。用药情况、禁食时间、GFV、pH值和呕吐事件均被详细记录。采用疾病预防及控制中心的生长图表（2000）评定理想体重（IBW=第50个百分位数），并对患儿进行分层：偏瘦或正常体重（BMI在第25—75个百分位数）、超重（第95个百分位数〈BMI≥第85个百分位数）、肥胖（BMI≥第95个百分位数）。结果在所有的日间手术患儿中有14％属于超重，13．3％属于肥胖。肥胖儿按公斤体重算出的GFV较低（P〈0．001）。当我们用IBW进行校正后，所有BMI组中GFV（mw校正后）的容量都相等（均值为0．96ml／kg，sD为0．71；中位数为0．86ml／kg，IQR为0．96）。手术前使用对乙酰氨基酚和咪达唑仑均导致GFV（1BW校正后）增加（P=0．025和P=0．001）。而AsA11I级（P=0．024）、男性（P=0．012）、胃食管反流性疾病（P=0．049）和使用质子泵抑制剂（P=0．018）患儿的GFV（mw校正后）较低。GFV（IBw校正后）与禁食时间和年龄无关。胃液酸度较低与年龄较小（P=0．005）、BMI较高（P=0．036）和美国非洲裔（P=0．033）患儿等因素相关。有8例患儿在全麻诱导时发生了呕吐（其中50％有肥胖症，P=0．052，75％患有阻塞性睡眠呼吸暂停症，P=0．061）。呕吐与AsA分级较高有关，但却与禁食时间的长短无关。研究中没有出现误吸事件。结论27％的儿科日闻手术患儿属超重或肥胖儿童。无论进食时间长短或BMI如何，GFV（IBw校正后）均为1ml／kg，因此这些患儿均可以在手术前2小时饮清水。在此研究群体中，罕见的呕吐事件与禁食时间的缩短并无相关性。

关键词：禁食时间儿科患者风险评估肥胖症超重症胃液量误吸阻塞性睡眠呼吸暂停症

Cytokine- and chemokine-induced inflammatory colorectal tumor microenvironment: Emerging avenue for targeted therapy

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Cancer Communications 2022年第8期42卷 689-715页

作者： Ajaz A.Bhat sabah Nisar Mayank singh Bazella Ashraf Tariq Masoodi Chandra P.Prasad Atul sharma selma Maacha Thasni Karedath sheema Hashem syed Besina Yasin Puneet Bagga Ravinder Reddy Michael P.Frennaux shahab Uddin Punita Dhawan Mohammad Haris Muzafar A.Macha Laboratory of Molecular and Metabolic Imaging Cancer Research DepartmentSidra MedicineDoha 26999Qatar Department of Medical Oncology Dr.B.R.Ambedkar Institute Rotary Cancer HospitalAll India Institute of Medical Sciences(AIIMS)New Delhi 110029India Department of Biotechnology School of Life SciencesCentral University of KashmirGanderbalJammu&Kashmir 191201India Division of Translational medicine Research BranchSidra MedicineDoha 26999Qatar Genomics Core Facility QBRIQatar FoundationDoha 34110Qatar Department of Pathology Sher-I-Kashmir Institute of Medical SciencesSrinagarJammu&Kashmir 190011India Department of Diagnostic Imaging St.Jude Children’s Research HospitalMemphisTN 38105USA Center for Advanced Metabolic Imaging in Precision medicine Department of RadiologyPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaPA 19104USA Academic Health system Hamad Medical CorporationDoha 3050Qatar Translational Research Institute Hamad Medical CorporationDoha 3050Qatar Department of Biochemistry and Molecular Biology University of Nebraska Medical CenterOmahaNE 68198USA Laboratory Animal Research Center Qatar UniversityDoha 2713Qatar Watson-Crick Centre for Molecular medicine Islamic University of Science and TechnologyAwantiporaJammu&Kashmir 192122India

Colorectal cancer(CRC)is a predominant life-threatening cancer,with liver and peritoneal metastases as the primary causes of *** inflammation,a known CRC risk factor,nurtures a local inflammatory environment enriched with tumor cells,endothelial cells,immune cells,cancer-associated fibroblasts,immunosuppressive cells,and secretory growth *** complex interactions of aberrantly expressed cytokines,chemokines,growth factors,and matrix-remodeling enzymes promote CRC pathogenesis and evoke systemic responses that affect disease *** evidence suggests that these cytokines and chemokines play a role in the progression of CRC through immunosuppression and modulation of the tumor microenvironment,which is partly achieved by the recruitment of immunosuppressive *** cells impart features such as cancer stem cell-like properties,drug resistance,invasion,and formation of the premetastatic niche in distant organs,promoting metastasis and aggressive CRC growth.A deeper understanding of the cytokineand chemokine-mediated signaling networks that link tumor progression and metastasis will provide insights into the mechanistic details of disease aggressiveness and facilitate the development of novel therapeutics for ***,we summarized the current knowledge of cytokine-and chemokine-mediated crosstalk in the inflammatory tumor microenvironment,which drives immunosuppression,resistance to therapeutics,and metastasis during CRC *** also outlined the potential of this crosstalk as a novel therapeutic target for *** major cytokine/chemokine pathways involved in cancer immunotherapy are also discussed in this review.

关键词： chemokine colorectal cancer cytokine drug resistance epithelial-mesenchymal transition immunosuppression immunotherapy inflammation metastasis tumor microenvironment

单基因遗传性高血压:一类可“治愈”的高血压（英文）

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science Bulletin 2023年第7期 657-660页

作者：卢伊婷范鹏 Hakon Hakonarson 胡爱华刘亚欣周宪梁 Department of Cardiology Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Center for Applied Genomics Children's Hospital of Philadelphia and the Division of Human Genetics Department of Pediatrics Perelman School of Medicine University of Pennsylvania Department of Non-Communicable Disease Management Beijing Children's Hospital Capital Medical UniversityNational Center for Children's Health Emergency and Critical Care Center Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Hypertension is a global problem that affects more than 1 billion people worldwide with the increased prevalence year by year[1,2]. It contributes to major impacts on health including morbidity and all-cause mortality...

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Evaluation of an interactive virtual surgical rotation during the COVID-19 pandemic

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World Journal of Otorhinolaryngology-Head and Neck surgery 2022年第4期8卷 302-307页

作者： Yasmeen M.Byrnes Neil N.Luu Ariel s.Frost Tiffany N.Chao Robert M.Brody steven B.Cannady Karthik Rajasekaran Rabie M.shanti Jason G.Newman perelman school of medicine at the University of Pennsylvania Jordan Medical Education Center3400 Civic Center BlvdPhiladelphia19104PAUSA Department of Otorhinolaryngology-Head& Neck SurgeryHospital of the University of Pennsylvania3400 Spruce StreetPhiladelphia19104PAUSA

Objective:To evaluate medical student and attending surgeon experiences with a novel interactive virtual Otolaryngology-Head and Neck surgery(OHNs)medical student elective during the COVID-19 *** Design:A virtual OHNs elective was created,with three components:(1)interactive virtual operating room(OR)experience using live-stream video-conferencing,(2)telehealth clinic,(3)virtual ***:OHNs Department at the University of Pennsylvania(May 2020 to June 2020).Methods:six medical students from the University of Pennsylvania;five attending *** surveys were designed and distributed to participating medical students and attending *** included 5-point Likert scale items,with 1 indicating"not at all"and 5 indicating"very much so".Results:Response rate was 100%for both *** on average rated the educational value of the telehealth experience as 4.2±1.2,and the virtual OR experience as 4.0±*** students(n=5,83%)indicated that they had enough exposure to faculty they met on this rotation to ask for a letter of recommendation(LOR)for residency if needed,while attending surgeons had an average response of 3.0±1.0 when asked how comfortable they would feel writing a LOR for a student they met through the rotation.A majority of students(n=4,67%)felt they connected enough with faculty during the rotation to ask for *** the students(n=5,50%)indicated that the rotation allowed them to evaluate the department's culture either"extremely well"or"somewhat well".Conclusions:Overall,participating students described this innovative virtual surgical rotation as an educationally and professionally valuable *** the continued suspension of visiting student rotations due to the COVID-19 pandemic,this virtual model may have continued relevance to medical education.

关键词： Virtual surgical education Otolaryngology Undergraduate medical education Covid-19 Telemedicine surgical video capture

Effectiveness of BNT162b2 Vaccine against Critical Covid-19 in Adolescents

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四川生理科学杂志 2021年第11期43卷 1723-1723页

作者： samantha M Olson From the Covid-19 Response Team Centers for Disease Control and Prevention (S.M.O. A.M.P. L.D.Z. A.P.C. M.M.P.) and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics Emory University School of Medicine (S.K.) - both in Atlanta the Department of Anesthesiology Critical Care and Pain Medicine Boston Children's Hospital (M.M.N. A.G.R.) and the Departments of Anaesthesia and Pediatrics Harvard Medical School (A.G.R.) - both in Boston the Division of Pediatric Infectious Diseases Department of Pediatrics Vanderbilt University Medical Center Nashville (N.B.H.) the Department of Pediatrics Baylor College of Medicine Immunization Project Texas Children's Hospital Houston (J.A.B. L.C.S.) and the Department of Pediatrics Division of Critical Care Medicine University of Texas Southwestern Children's Medical Center Dallas Dallas (M.M.) the Division of Infectious Diseases Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology University of Southern California Los Angeles (P.S.P.) the Division of Pediatric Hospital Medicine UC San Diego-Rady Children's Hospital San Diego (M.A.C.) the Division of Critical Care Medicine UCSF Benioff Children's Hospital Oakland (N.Z.C.) and the Department of Pediatrics Divisions of Critical Care Medicine and Allergy Immunology and Bone Marrow Transplant University of California San Francisco San Francisco (M.S.Z.) - all in California section of Pediatric Critical Care Department of Pediatrics Arkansas Children's Hospital Little Rock (K.I.) the Department of Pediatrics University of North Carolina at Chapel Hill Children's Hospital Chapel Hill (T.C.W. S.P.S.) the Department of Pediatrics Section of Critical Care Medicine University of Colorado School of Medicine and Children's Hospital Colorado Aurora (A.B.M.) the Division of Pediatric Critical Care medicine Medical University of South Carolina Charleston (E.H.M.) the Department of

Background:The increasing incidence of pediatric hospitalizations associated with coronavirus disease 2019(Covid-19)caused by the B.1.617.2(delta)variant of severe acute respiratory syndrome coronavirus 2(sARs-CoV-2)in the United states has offered an opportunity to assess the real-world effectiveness of the BNT162b2 messenger RNA vaccine in adolescents between 12 and 18 years of ***:We used a case-control,test-negative design to assess vaccine effectiveness against Covid-19 resulting in hospitalization,admission to an intensive care unit(ICU),the use of life-supporting interventions(mechanical ventilation,vasopressors,and extracorporeal membrane oxygenation),or *** July 1 and October 25,2021,we screened admission logs for eligible case patients with laboratory-confirmed Covid-19 at 31 hospitals in 23 *** estimated vaccine effectiveness by comparing the odds of antecedent full vaccination(two doses of BNT162b2)in case patients as compared with two hospitalbased control groups:patients who had Covid-19-like symptoms but negative results on testing for sARs-CoV-2(test-negative)and patients who did not have Covid-19-like symptoms(syndrome-negative).

关键词： vaccine doses acute

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酒精、先天免疫和HIV/HCV

酒精、先天免疫和HIV/HCV

Impact of antibiotics on smell dysfunction

第十届全国药物依赖性学术会议暨首届中美药物滥用和HIV/HCV共病专题研讨会

作者： Wenzhe Ho Division of Allergy & Immunology the Children’s Hospital of PhiladelphiaUniversity of Pennsylvania School of MedicinePhiladelphiaPA19104

Alcohol is one of the most commonly used and abused drugs. Chronic and acute alcohol admin- istration is associated with alterations of host immunity and high morbidity and mortality from infec- tious diseases,such as HIV and hepatitis C virus (HCV).since HIV and HCV share the same par- enteral route of transmission and risk factors for infection,coinfections with HIV and HCV are very

关键词： alcohol HIV/HCV innate immunity

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World Journal of Otorhinolaryngology-Head and Neck surgery 2018年第1期4卷 33-38页

作者： Jing-Jie Wang Jonathan Chen Richard L. Doty Institute of medicine Chung Shan Medical UniversityTaichungTaiwanChina Department of Otolaryngology Taichung Veterans General HospitalTaichungTaiwanChina smell and Taste Center Department of Otorhinolaryngology - Head and Neck SurgeryPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA

Objective: Viral or bacterial respiratory infections can cause long-lasting olfactory dysfunction. Antibiotic therapy is indicated in severe cases; however, it is unclear whether antibiotic use produces a positive, negative, or null effect on olfactory function. This retro-spective study sought to determine whether antibiotic use has an influence on odor identifica-tion and detection threshold test scores of patients with smell dysfunction secondary to upper respiratory infections (URIs), lower respiratory infections (LRIs), or rhinosinusitis. Methods: Data from a total of 288 patients presenting to the University of Pennsylvania smell and Taste Center were evaluated. Results: Patients with a URI etiology who had taken bactericidal antibiotics had lower detec-tion thresholds than did patients who had not taken antibiotics (P sis of covari-ance with age and time since infection onset as covariates). Moreover, thresholds were lower for bactericidal antibiotic users than for bacteriostatic antibiotic users with either URI (P = 0.023) or rhinosinusitis (P = 0.028) etiologies. No meaningful influences of antibiotics on the odor identification test scores were evident. Conclusions: These findings, which need to be confirmed in prospective double-blind studies, suggest that bactericidal antibiotic therapy may be beneficial in mitigating, at least to some degree, chronic decrements in smell sensitivity due to URIs and rhinosinusitis.

关键词： Antibiotics Rhinosinusitis Viruses Bacteria Olfaction

武汉市美沙酮门诊治疗者丙型肝炎病毒基因分型

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中华流行病学杂志 2007年第12期28卷 1207-1210页

作者：彭劲松周敦金裴德恩周玉刘满清唐力许骏吴雄文霍文哲周旺华中科技大学同济医学院武汉430030 武汉市疾病预防控制中心 Division of Allergy & Immunology Joseph StokesJr.Research Institute at The Children's Hospital of PhiladelphiaDepartment of PediatricsUniversity of Pennsylvania School of MedicinePhiladelphiaUSA

目的探讨武汉市美沙酮门诊治疗者丙型肝炎病毒(HCV)及不同基因型感染状况。方法用酶标记免疫(ELIsA)法检测抗-HCV抗体,在86份抗-HCV抗体阳性的血清标本中,分别提取HCV RNA,通过逆转录巢式聚合酶链反应(RT-nested PCR)扩增C基因的羧基至E... 详细信息

目的探讨武汉市美沙酮门诊治疗者丙型肝炎病毒(HCV)及不同基因型感染状况。方法用酶标记免疫(ELIsA)法检测抗-HCV抗体,在86份抗-HCV抗体阳性的血清标本中,分别提取HCV RNA,通过逆转录巢式聚合酶链反应(RT-nested PCR)扩增C基因的羧基至E1基因的氨基端长度为474 bp的片段,测定其核苷酸序列,与GenBank中已知的HCV序列进行系谱分析,确定HCV基因型。结果武汉市美沙酮门诊332名治疗者中抗-HCV IgG阳性率为94.3%;其中86份血清的HCV序列通过系谱显示6a型71例,占82.5%;3b 7例,占8.2%;1a 5例,占5.8%;1b 3例,占3.5%。结论武汉市美沙酮门诊入组的吸毒者HCV感染以6a型为优势株,其次为3b,吸毒者中HCV感染率较高,且基因亚型呈现多样性。

关键词：丙型肝炎病毒基因分型美沙酮门诊

CRIsPR-Cas9 Gene Editing for sickle Cell Disease and β-Thalassemia

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四川生理科学杂志 2020年第4期42卷 506-506页

作者： Haydar Frangoul From the sarah Cannon Center for Blood Cancer at the children’s hospital at Tristar Centennial Nashville (H.F. J.D.) and St. Jude Children’s Research Hospital Memphis (A.S.) — both in Tennessee Vertex Pharmaceuticals (D.A. B.K.E. J.L.-H. A.Y.) and Boston University School of Medicine (M.H.S.) Boston and CRISPR Therapeutics Cambridge (Y.-S.C. T.W.H. A. Kernytsky S. Soni) — both in Massachusetts the University of Milan Milan (M.D.C.) and Ospedale Pediatrico Bambino Gesù Rome Sapienza University of Rome Rome (F.L.) the University of Regensburg Regensburg (J. Foell S.C.) and Children’s University Hospital University of Tübingen Tübingen (R.H.) — both in Germany Imperial College Healthcare NHs Trust St. Mary’s Hospital London (J. de la Fuente) children’s hospital of philadelphia Perelman School of Medicine at the University of Pennsylvania Philadelphia (S.G.) the University of Athens Athens (A. Kattamis) BC children’s hospital University of British Columbia Vancouver (A.M.L.) and the Hospital for Sick Children–University of Toronto Toronto (D.W.) — both in Canada Columbia University (M.Y.M.) and the Joan and sanford I. Weill Medical College of Cornell University (s. sheth) New York Necker–Enfants Malades hospital Assistance Publique–Hôpitaux de Paris University of Paris Paris (M.M.) and the University of Illinois at Chicago Chicago (D.R.).

Transfusion-dependent β-thalassemia(TDT)and sickle cell disease(sCD)are severe monogenic diseases with severe and potentially life-threatening ***11A is a transcription factor that represses γ-globin expression and fetal hemoglobin in erythroid *** performed electroporation of CD34+hematopoietic stem and progenitor cells obtained from healthy donors,with CRIsPR-Cas9 targeting the BCL11A erythroid-specific *** 80% of the alleles at this locus were modified,with no evidence of off-target *** undergoing myeloablation,two patients-one with TDT and the other with sCD-received autologous CD34+cells edited with CRIsPR-Cas9 targeting the same BCL11A *** than a year later,both patients had high levels of allelic editing in bone marrow and blood,increases in fetal hemoglobin that were distributed pancellularly,transfusion independence,and(in the patient with sCD)elimination of vaso-occlusive episodes.

关键词： fetal transfusion patients