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Wu YH, Huang BP, Feng JY, Huang LY, Zhao XM, Wang J, Guan JY, Li XQ, Zhang YH, Zhang J. [Prognostic performance of pulmonary effective arterial elastance in patients with heart failure]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:397-404. [PMID: 38644255 DOI: 10.3760/cma.j.cn112148-20231120-00449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Objective: To explore the predictive value of pulmonary effective arterial elastance (Ea) in patients with heart failure (HF). Methods: This is a retrospective cohort study, which retrospectively included 284 patients with HF who underwent right heart catheterization at Heart Failure Center in Fuwai Hospital between September 2013 and February 2022. Data regarding baseline clinical characteristics, hemodynamic profiles, and prognosis were collected. Ea was calculated as mean pulmonary arterial pressure/stroke volume. Patients were divided into Ea<0.555 group and Ea≥0.555 group according to the median value of Ea (0.555 mmHg/ml, 1 mmHg=0.133 kPa). The primary outcome was the primary clinical event, set as the first occurrence of a series of composite events, including all-cause death, heart transplantation, left ventricular assist device implantation, and HF rehospitalization. Event-free survival was defined as the absence of primary clinical events. Spearman correlation analysis was used to calculate the correlation coefficient between Ea and parameters reflective of right heart function. The Kaplan-Meier analysis was used to compare the different groups for the estimation of outcomes with the log-rank test. We used Cox proportional-hazards regression models to estimate hazard ratios (HR) for primary clinical event. Subgroup analysis was performed based on the age, gender, New York Heart Association (NYHA) functional class, left ventricular ejection fraction, presence of pulmonary hypertension, and serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) values. We used receiver operating characteristic (ROC) curve to calculate the area under the curve (AUC) of Ea for predicting event-free survival in patients with HF. Results: The median age was 51 years, and 206 (72.5%) patients were male. Ea and pulmonary vascular resistance (PVR) were significantly correlated (r=0.698, P<0.001). The correlation between Ea and pulmonary arterial elastance (PAC) were even more significant (r=-0.888, P<0.001). Compared with Ea<0.555 group, Ea≥0.555 group presented with higher serum NT-proBNP values (4 443 (1 792, 8 554) ng/L vs. 1 721 (480, 4 528)ng/L,P<0.001), higher PVR (3.4 (2.5, 4.7) Wood vs. 1.4 (0.9, 2.2) Wood, P<0.001), lower cardiac output (3.0 (2.3, 3.9) L/min vs. 4.3 (3.8, 4.9) L/min, P<0.001), and lower PAC (1.6 (1.3, 2.0) ml/mmHg vs. 4.0 (3.0, 6.0) ml/mmHg, P<0.001). The median follow-up time was 392 (166, 811) days. The Kaplan-Meier survival curve demonstrated a lower event-free survival rate in the Ea≥0.555 group compared to the Ea<0.555 group (Plog-rank<0.001). After multivariate adjustment, Ea (HR=1.734, P<0.001) remained significantly associated with the primary outcome. Subgroup analysis indicated that Ea was associated with the primary outcome across all subgroups. The AUC was 0.724 (P<0.001) for Ea to predict event-free survival calculated from ROC analysis. Conclusions: Ea is closely related to parameters reflective of right ventricular afterload. Increased Ea is an independent predictor of adverse outcomes in patients with HF.
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Affiliation(s)
- Y H Wu
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - B P Huang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J Y Feng
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - L Y Huang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - X M Zhao
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J Wang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J Y Guan
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - X Q Li
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Y H Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Huang YT, Lin SC, Huang LY, Rujikajorn K, Chen PYJ, Chen JJY, Wu MY, Lin HJ, Wan L. Incidence, Risk Factors and Management of Postoperative Complications in Horizontal Strabismus Surgery. Semin Ophthalmol 2024; 39:143-149. [PMID: 37921332 DOI: 10.1080/08820538.2023.2275620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/19/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To report the incidence, risk factors and management of postoperative complications after horizontal strabismus surgery. DESIGN Retrospective Cohort study. PARTICIPANTS The study assessed 1,273 patients with 1,035 cases of exotropia and 238 cases of esotropia, with a minimum 18-month follow-up. METHODS Retrospective review of strabismus operation patients' medical records included baseline demographics, age at surgery, pre/postoperative visual acuity, and deviation. Complications were categorized as surgical site (infection, scarring, cyst, granuloma, ischemia) and strabismus-related (recurrence, diplopia), with analysis of incidence, risk factors, and management. RESULTS Among surgical site complications, the incidence of infection, pyogenic granuloma, and anterior segment ischemia were similar between the exotropia (0.3%, 0.3%, 0.2%) and esotropia (0.8%, 0%, 0.4%) groups (p = .221, 0.406, 0.515). In contrast, the esotropia group presented a higher risk of conjunctival inclusion cyst and conjunctival scar than the exotropia group, with incidences of 5.0% vs 2.2% and 6.3% vs 1.3%, respectively (p = .004, <0.001). Regarding strabismus complications, the incidence of early recurrence was not significant between the two groups, with 10.0% in the exotropia group and 10.5% in the esotropia group (p = .553). Older age and poor initial visual acuity were associated with early recurrence (p < .001). The esotropia group had a higher risk of persistent diplopia than the exotropia group, with incidences of 4.2% vs 2.0%, respectively (p = .003). CONCLUSION Esotropia carries a higher risk of conjunctival inclusion cysts, conjunctival scarring, and persistent diplopia compared to the exotropia group, while both groups exhibit similar rates of early recurrence and other surgical site complications.
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Affiliation(s)
- Yu-Te Huang
- Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Sheng-Chun Lin
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Li-Ying Huang
- Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Kewalee Rujikajorn
- Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Po-Yu Jay Chen
- Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Jamie Jiin-Yi Chen
- Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Ming-Yen Wu
- Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Hui-Ju Lin
- Department of Ophthalmology, Eye Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Lei Wan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, China Medical University, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
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Liu CH, Peng CH, Huang LY, Chen FY, Kuo CH, Wu CZ, Cheng YF. Comparison of multiple linear regression and machine learning methods in predicting cognitive function in older Chinese type 2 diabetes patients. BMC Neurol 2024; 24:11. [PMID: 38166825 PMCID: PMC10759520 DOI: 10.1186/s12883-023-03507-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION The prevalence of type 2 diabetes (T2D) has increased dramatically in recent decades, and there are increasing indications that dementia is related to T2D. Previous attempts to analyze such relationships principally relied on traditional multiple linear regression (MLR). However, recently developed machine learning methods (Mach-L) outperform MLR in capturing non-linear relationships. The present study applied four different Mach-L methods to analyze the relationships between risk factors and cognitive function in older T2D patients, seeking to compare the accuracy between MLR and Mach-L in predicting cognitive function and to rank the importance of risks factors for impaired cognitive function in T2D. METHODS We recruited older T2D between 60-95 years old without other major comorbidities. Demographic factors and biochemistry data were used as independent variables and cognitive function assessment (CFA) was conducted using the Montreal Cognitive Assessment as an independent variable. In addition to traditional MLR, we applied random forest (RF), stochastic gradient boosting (SGB), Naïve Byer's classifier (NB) and eXtreme gradient boosting (XGBoost). RESULTS Totally, the test cohort consisted of 197 T2D (98 men and 99 women). Results showed that all ML methods outperformed MLR, with symmetric mean absolute percentage errors for MLR, RF, SGB, NB and XGBoost respectively of 0.61, 0.599, 0.606, 0.599 and 0.2139. Education level, age, frailty score, fasting plasma glucose and body mass index were identified as key factors in descending order of importance. CONCLUSION In conclusion, our study demonstrated that RF, SGB, NB and XGBoost are more accurate than MLR for predicting CFA score, and identify education level, age, frailty score, fasting plasma glucose, body fat and body mass index as important risk factors in an older Chinese T2D cohort.
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Affiliation(s)
- Chi-Hao Liu
- Department of Medicine, Division of Nephrology, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, R.O.C
| | - Chung-Hsin Peng
- Department of Urology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan, R.O.C
| | - Li-Ying Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Department of Medical Education, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C
| | - Fang-Yu Chen
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Fu Jen Catholic University Hospital, New Taipei City, Taiwan, R.O.C
| | - Chun-Heng Kuo
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C
| | - Chung-Ze Wu
- Department of Internal Medicine, Division of Endocrinology, Shuang Ho Hospital, New Taipei City, 23561, R.O.C
- Division of Endocrinology and Metabolism, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan, R.O.C
| | - Yu-Fang Cheng
- Department of Endocrinology and Metabolism, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua City, 50006, Taiwan, R.O.C..
- Department of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C..
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Chen CH, Lin WY, Lee KY, Sun WJ, Huang LY, Guo YLL. Adaptation behaviors modify the effects of body fat on heat-related symptoms among Taiwanese elderly. Int J Hyg Environ Health 2024; 255:114296. [PMID: 37979230 DOI: 10.1016/j.ijheh.2023.114296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND The aging process increases body fat and susceptibility to heat-related illnesses. The relationship between body composition and symptoms associated with exposure to extreme heat among the elderly is unclear. Additionally, the influence of individual adaptive behaviors in mitigating these risks has not been adequately explored. OBJECTIVES This study aimed to evaluate the association between body composition and heat-related symptoms as well as the potential modifying effects of heat adaptation behavior. METHODS The body composition of elderly individuals was measured using bioelectrical impedance analysis. Face-to-face interviews were conducted a year later to determine the heat-related symptoms and adaptive behaviors practiced for the extremely hot days of the previous year. The association between body composition indices and the presence of more than two symptoms was assessed using logistic regression analysis, while stratified analysis and interaction term in models were used to evaluate the effect modifications of adaptive behaviors. RESULTS Of the 859 participants, 16% reported more than two heat-related symptoms. Increased body fat mass index (fat mass in kg/squared height in meters) was associated with an elevated risk of more heat-related symptoms (odds ratio 1.11, 95% confidence interval 1.02-1.20). Each combination of staying indoors, using an umbrella and hat, and using air conditioning at noon reduced the risk association between body fat and symptoms. For females, a combination of reducing physical activity and staying indoors provided similar protective effect. Surprisingly, bathing more frequently in hot weather with heated instead of non-heated water augmented the risk correlation. Neither fan usage nor window opening displayed protective effects. CONCLUSIONS Elevated body fat levels, indicative of obesity, corresponded with an increased risk of heat-related symptoms. Integrating multiple adaptive behaviors can diminish the negative health impact of body fat on heat-induced symptoms. However, certain commonly adopted practices might not confer expected benefits.
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Affiliation(s)
- Chi-Hsien Chen
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan
| | - Wen-Yi Lin
- Department of Occupational Medicine, Health Management Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Jung Sun
- Department of Community Medicine, Center of R/D in Community Based Palliative Care, Holistic Mental Health Center, Taipei City Hospital, Taipei, Taiwan; Family Medicine Division, Taipei City Hospital Zhongxing Branch, Taipei, Taiwan
| | - Li-Ying Huang
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, and Department of Medical Education, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Yue-Liang Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan; National Institute of Environmental Sciences, National Health Research Institutes, Miaoli County, Taiwan; Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei, 100, Taiwan.
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Yang CC, Peng CH, Huang LY, Chen FY, Kuo CH, Wu CZ, Hsia TL, Lin CY. Comparison between multiple logistic regression and machine learning methods in prediction of abnormal thallium scans in type 2 diabetes. World J Clin Cases 2023; 11:7951-7964. [DOI: 10.12998/wjcc.v11.i33.7951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/23/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes (T2D) has been increasing dramatically in recent decades, and 47.5% of T2D patients will die of cardiovascular disease. Thallium-201 myocardial perfusion scan (MPS) is a precise and non-invasive method to detect coronary artery disease (CAD). Most previous studies used traditional logistic regression (LGR) to evaluate the risks for abnormal CAD. Rapidly developing machine learning (Mach-L) techniques could potentially outperform LGR in capturing non-linear relationships.
AIM To aims were: (1) Compare the accuracy of Mach-L methods and LGR; and (2) Found the most important factors for abnormal TMPS.
METHODS 556 T2D were enrolled in the study (287 men and 269 women). Demographic and biochemistry data were used as independent variables and the sum of stressed score derived from MPS scan was the dependent variable. Subjects with a MPS score ≥ 9 were defined as abnormal. In addition to traditional LGR, classification and regression tree (CART), random forest, Naïve Bayes, and eXtreme gradient boosting were also applied. Sensitivity, specificity, accuracy and area under the receiver operation curve were used to evaluate the respective accuracy of LGR and Mach-L methods.
RESULTS Except for CART, the other Mach-L methods outperformed LGR, with gender, body mass index, age, low-density lipoprotein cholesterol, glycated hemoglobin and smoking emerging as the most important factors to predict abnormal MPS.
CONCLUSION Four Mach-L methods are found to outperform LGR in predicting abnormal TMPS in Chinese T2D, with the most important risk factors being gender, body mass index, age, low-density lipoprotein cholesterol, glycated hemoglobin and smoking.
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Affiliation(s)
- Chung-Chi Yang
- Division of Cardiovascular Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City 32551, Taiwan
- Division of Cardiovascular, Tri-service General Hospital, Taipei City 114202, Taiwan
| | - Chung-Hsin Peng
- Department of Urology, Cardinal Tien Hospital, New Taipei City 23148, Taiwan
- School of Medicine, Fu-Jen Catholic University, New Taipei City 242062, Taiwan
| | - Li-Ying Huang
- Department of Internal Medicine, Department of Medical Education, School of Medicine, Fu Jen Catholic University Hospital, New Taipei City 243, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 243, Taiwan
| | - Fang Yu Chen
- Department of Endocrinology, Fu Jen Catholic University Hospital, New Taipei City 243, Taiwan
| | - Chun-Heng Kuo
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 243, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei City 243, Taiwan
| | - Chung-Ze Wu
- Division of Endocrinology, Shuang Ho Hospital, New Taipei City 23561, Taiwan
- School of Medicine, Taipei Medical University, Taipei City 11031, Taiwan
| | - Te-Lin Hsia
- Department of Internal Medicine, Cardinal Tien Hospital, New Taipei City 23148, Taiwan
| | - Chung-Yu Lin
- Department of Cardiology, Fu Jen Catholic University Hospital, New Taipei City 24352, Taiwan
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242062, Taiwan
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Wu ZH, Yang XD, Huang LY, Li SL, Xia FY, Qiu YZ, Yi XZ, Jia P, Liao B, Liang JL, Shu WS, Li JT. In situ enrichment of sulphate-reducing microbial communities with different carbon sources stimulating the acid mine drainage sediments. Sci Total Environ 2023; 898:165584. [PMID: 37467988 DOI: 10.1016/j.scitotenv.2023.165584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/21/2023]
Abstract
The applications of sulphate-reducing microorganisms (SRMs) in acid mine drainage (AMD) treatment systems have received extensive attention due to their ability to reduce sulphate and stabilize metal(loid)s. Despite great phylogenetic diversity of SRMs, only a few have been used in AMD treatment bioreactors. In situ enrichment could be an efficient approach to select new effective SRMs for AMD treatment. Here, we performed in situ enrichment of SRMs in highly stratified AMD sediment cores using different kinds of carbon source mixture. The dsrAB (dissimilatory sulfite reductase) genes affiliated with nine phyla (two archaeal and seven bacterial phyla) and 26 genera were enriched. Remarkably, those genes affiliated with Aciduliprofundum and Vulcanisaeta were enriched in situ in AMD-related environments for the first time, and their relative abundances were negatively correlated with pH. Furthermore, 107 dsrAB-containing metagenome-assembled genomes (MAGs) were recovered from metagenomic datasets, with 14 phyla (two archaeal and 12 bacterial phyla) and 15 genera. The relative abundances of MAGs were positively correlated with total carbon and sulphate contents. Our findings expanded the diversity of SRMs that can be enriched in AMD sediment, and revealed the physiochemical properties that might affect the growth of SRMs, which provided guidance for AMD treatment bioreators.
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Affiliation(s)
- Zhuo-Hui Wu
- Institute of Ecological Science, Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring, Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Xiao-Dan Yang
- Institute of Ecological Science, Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring, Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Li-Ying Huang
- School of Life Sciences, Sun Yat-sen University, Guangzhou 510275, PR China
| | - Shi-Lin Li
- Institute of Ecological Science, Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring, Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Fei-Yun Xia
- Institute of Ecological Science, Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring, Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Yong-Zhi Qiu
- Institute of Ecological Science, Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring, Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Xin-Zhu Yi
- Institute of Ecological Science, Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring, Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Pu Jia
- Institute of Ecological Science, Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring, Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Bin Liao
- School of Life Sciences, Sun Yat-sen University, Guangzhou 510275, PR China
| | - Jie-Liang Liang
- Institute of Ecological Science, Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring, Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou 510631, PR China.
| | - Wen-Sheng Shu
- Institute of Ecological Science, Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring, Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Jin-Tian Li
- Institute of Ecological Science, Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring, Guangdong Provincial Key Laboratory of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
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Tzou SJ, Peng CH, Huang LY, Chen FY, Kuo CH, Wu CZ, Chu TW. Comparison between linear regression and four different machine learning methods in selecting risk factors for osteoporosis in a Chinese female aged cohort. J Chin Med Assoc 2023; 86:1028-1036. [PMID: 37729604 DOI: 10.1097/jcma.0000000000000999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Population aging is emerging as an increasingly acute challenge for countries around the world. One particular manifestation of this phenomenon is the impact of osteoporosis on individuals and national health systems. Previous studies of risk factors for osteoporosis were conducted using traditional statistical methods, but more recent efforts have turned to machine learning approaches. Most such efforts, however, treat the target variable (bone mineral density [BMD] or fracture rate) as a categorical one, which provides no quantitative information. The present study uses five different machine learning methods to analyze the risk factors for T-score of BMD, seeking to (1) compare the prediction accuracy between different machine learning methods and traditional multiple linear regression (MLR) and (2) rank the importance of 25 different risk factors. METHODS The study sample includes 24 412 women older than 55 years with 25 related variables, applying traditional MLR and five different machine learning methods: classification and regression tree, Naïve Bayes, random forest, stochastic gradient boosting, and eXtreme gradient boosting. The metrics used for model performance comparisons are the symmetric mean absolute percentage error, relative absolute error, root relative squared error, and root mean squared error. RESULTS Machine learning approaches outperformed MLR for all four prediction errors. The average importance ranking of each factor generated by the machine learning methods indicates that age is the most important factor determining T-score, followed by estimated glomerular filtration rate (eGFR), body mass index (BMI), uric acid (UA), and education level. CONCLUSION In a group of women older than 55 years, we demonstrated that machine learning methods provide superior performance in estimating T-Score, with age being the most important impact factor, followed by eGFR, BMI, UA, and education level.
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Affiliation(s)
- Shiow-Jyu Tzou
- Teaching and Researching Center, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan, ROC
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan, ROC
| | - Chung-Hsin Peng
- Department of Urology, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC
| | - Li-Ying Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei, Taiwan
| | - Fang-Yu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei, Taiwan
| | - Chun-Heng Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei, Taiwan
| | - Chung-Ze Wu
- Department of Internal Medicine, Shuang Ho Hospital, New Taipei City, Division of Endocrinology and Metabolism, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Ta-Wei Chu
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
- MJ Health Research Foundation, Taipei, Taiwan, ROC
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Holtorf AP, Danyliv A, Krause A, Hanna A, Venable Y, Mattingly TJ, Huang LY, Pierre M, Silveira Silva A, Walsh D. Ethical and legal considerations in social media research for health technology assessment: conclusions from a scoping review. Int J Technol Assess Health Care 2023; 39:e62. [PMID: 37842838 DOI: 10.1017/s0266462323000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
OBJECTIVES The objective was to identify and describe the published guidance and current academic discourse of ethical issues and standards related to the use of Social Media Research for generating patient insights for the use by health technology assessment (HTA) or health policy decisions. METHODS A scoping review of the literature was conducted in PubMed and Embase and identified 935 potential references published between January 2017 and June 2021. After title and abstract screening by three reviewers, 40 publications were included, the relevant information was extracted and data were collected in a mind map, which was then used to structure the output of the review. RESULTS Social Media Research may reveal new insights of relevance to HTA or health policies into patient needs, patient experiences, or patient behaviors. However, the research approaches, methods, data use, interpretation, and communication may expose those who post the data in social media channels to risks and potential harms relating to privacy, anonymity/confidentiality, authenticity, context, and rapidly changing technologies. CONCLUSIONS An actively engaged approach to ensuring ethical innocuousness is recommended that carefully follows best practices throughout planning, conduct, and communication of the research. Throughout the process and as a follow-up, there should be a discourse with the ethical experts to maximally protect the current and future users of social media, to support their trust in the research, and to advance the knowledge in parallel to the advancement of the media themselves, the technologies, and the research tools.
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Affiliation(s)
- Anke-Peggy Holtorf
- PCIG Project Coordinator, Health Outcomes Strategies GmbH, Basel, Switzerland
| | | | | | - Alissa Hanna
- Patient Engagement, Edwards Lifesciences, Irvine, CA, USA
| | | | | | - Li-Ying Huang
- Division of Health Technology Assessment, Center for Drug Evaluation, Taipeh, Taiwan
| | - Miranda Pierre
- Scottish Medicines Consortium, Healthcare Improvement Scotland, Glasgow, Scotland
| | | | - Donna Walsh
- European Federation of Neurological Associations, Brussels, Belgium
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Wang CY, Wu CZ, Chen FY, Pei D, Huang LY. Changes in insulin resistance, glucose effectiveness, and first and second phases of insulin secretion in women aged 45-60 years old in Taiwan. J Chin Med Assoc 2023; 86:897-901. [PMID: 37559215 DOI: 10.1097/jcma.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND In women after menopause, the incidence of diabetes mellitus increases. Increased insulin resistance (IR), decreased glucose effectiveness (GE), and the first and second phases of insulin secretion (FPIS and SPIS), are the four most important factors that trigger glucose intolerance and diabetes (diabetogenic factor [DF]). In the cross-sectional study, we enrolled nondiabetic women between the ages of 45 and 60 years to observe the changes in DFs during the perimenopausal period and to elucidate the underlying mechanisms of diabetes in menopausal women. METHODS We randomly enrolled 4194 women who underwent health checkups. Using demographic and biochemical data, IR, FPIS, SPIS, and GE were calculated using previously published equations. The relationship between the DFs and age was evaluated using a simple correlation. RESULTS Body mass index, blood pressure, fasting plasma glucose, low-density lipoprotein cholesterol, triglyceride, and SPIS were higher, and GE was lower in older women (≥52 years old). A significant decrease in GE and increased SPIS were observed with age. However, no changes were observed in IR or FPIS. CONCLUSION The IR and FPIS did not change during perimenopause. Increased SPIS may compensate for the decrease in GE, which is probably one of the reasons for the higher incidence of diabetes in menopausal women.
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Affiliation(s)
- Chen-Yu Wang
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chung-Ze Wu
- Division of Endocrinology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, ROC
- Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Fang-Yu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC
| | - Dee Pei
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC
| | - Li-Ying Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, ROC
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Holtorf AP, Danyliv A, Huang LY, Venable Y, Hanna A, Krause A, Pierre M, Walsh D, Silveira Silva A, Lee SH, Mattingly TJ. Using social media research in health technology assessment: stakeholder perspectives and scoping review. Int J Technol Assess Health Care 2023; 39:e63. [PMID: 37732455 DOI: 10.1017/s0266462323002593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVES The aim of this initiative was to examine collaboratively, in a multi-stakeholder team (health technology assessment (HTA) practitioners with patient involvement expertise, health technology industry, patient advocates, health policy experts, patient engagement experts), whether evidence generated through social media research (SMR) fills current information gaps relating to insights on specific aspects of patient experiences, preferences, or patient needs and delivers additional value to HTA. METHODS The framing of the project was done in a co-creative, deliberative multi-stakeholder process. Challenge and refinement happened through discussions with 25 independent stakeholders from HTA bodies, industry, academia, and patient advocacy. For critical themes identified during the framing phase, scoping literature reviews were performed including the state of methods and examples for the use of SMR in HTA. RESULTS The framing and stakeholder discussions specified a set of expectations and requirements, and the scoping reviews revealed the current state of methods and usage of SMR in health-policy decision making. CONCLUSIONS The project concluded that SMR can contribute new, relevant evidence to HTA. It is however recommended to evolve the science through defining best practices when planning, conducting, and using SMR and to conduct multi-stakeholder pilot SMR projects to address questions relevant to current HTAs and to validate and improve the proposed practices.
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Affiliation(s)
- Anke-Peggy Holtorf
- PCIG at HTAi, Project Coordinator, Basel, Switzerland
- College of Pharmacy, University of Utah, Salt Lake City, USA
| | | | - Li-Ying Huang
- Division of Health Technology Assessment, Center for Drug Evaluation, Taiwan
| | | | | | | | - Miranda Pierre
- Scottish Medicines Consortium, Healthcare Improvement Scotland, Glasgow, Scotland
| | - Donna Walsh
- European Federation of Neurological Associations, Ireland
| | - Aline Silveira Silva
- Patient Voices Network, Brazil/Canada
- University of British Columbia, Vancouver, Canada
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Huang LY, Li ST, Lin SC, Kao CH, Hong CH, Lee CH, Yang LT. Gasdermin A Is Required for Epidermal Cornification during Skin Barrier Regeneration and in an Atopic Dermatitis-Like Model. J Invest Dermatol 2023; 143:1735-1745.e11. [PMID: 36965577 DOI: 10.1016/j.jid.2023.03.1657] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/27/2023]
Abstract
Atopic dermatitis is featured with impaired skin barrier. The stratum corneum and the intercellular tight junctions constitute the permeability barrier, which is essential to protect water loss in the host and prevent pathogen entry. The epidermal barrier is constantly renewed by differentiating keratinocytes through cornification, during which autophagy contributes to elimination of organelles and nucleus. The human GSDMA and its mouse homologs Gsdma1-3 are expressed in the suprabasal epidermis. Although a pyroptotic role of GSDMA/Gsdma1 in host defense against Streptococcus pyogenes has been reported, the physiological function of Gsdma1/a2/a3 in epidermal homeostasis remains elusive. Here, through repeated epidermal barrier disruption, we found that tight junction formation and stratum corneum maturation were defective in the Gsdma1/a3-deficient epidermis. Using comparative gene profiling analysis, mitochondrial respiration measurement, and in vivo tracing of mitophagy, our data indicate that Gsdma1/a3 activation leads to mitochondrial dysfunction and subsequently facilitates mitochondrial turnover and epidermal cornification. In calcipotriol (MC903)-induced atopic dermatitis-like animal model, we showed that Gsdma1/a3-deficiency selectively enhanced the T helper type 2 response. Remarkably, the GSDMA expression is reduced in the epidermis of patients with atopic dermatitis compared with that of normal individuals. Gsdma1/a3-deficiency might be involved in atopic dermatitis pathogenesis, likely through GSDMA-mediated epidermal differentiation and cornification.
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Affiliation(s)
- Li-Ying Huang
- Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Taiwan
| | - Shao-Ting Li
- Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Taiwan
| | - Shiang-Chi Lin
- Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Taiwan
| | - Cheng-Heng Kao
- Center of General Education, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Hui Hong
- Department of Dermatology, School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taiwan; Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chih-Hung Lee
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Liang-Tung Yang
- Institute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.
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12
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Liang L, An T, Zhao XM, Huang LY, Tian PC, Guan JY, Zou CH, Zhang J, Zhang YH. [Clinical characteristics of patients referred to cardio-oncology clinic]. Zhonghua Yi Xue Za Zhi 2023; 103:2183-2186. [PMID: 37482731 DOI: 10.3760/cma.j.cn112137-20221108-02348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
To explore characteristics of outpatients in a single cardio-oncology clinic, patients visiting cardio-oncology clinic of Fuwai Hospital CAMS&PUMC (Beijing, China) from January 2020 to December 2021 were analyzed retrospectively. In total, 330 patients were included, the median age (Q1, Q3) was 58(46, 66) years, and there were 192 females (58.2%). The purposes for visit included an evaluation and treatment of cardiovascular adverse reactions (n=247, 74.8%), pre-antitumor therapy assessment (n=51, 15.5%), and management of primary or metastatic cardiac tumors (n=32, 9.7%). For patients with cardiovascular adverse reactions, the most common tumor type was breast cancer (n=88, 29.5%), followed by gastrointestinal cancer (n=70, 23.5%), and hematological cancers (n=62, 20.8%). Among them, 236 cases (95.5%) had received antitumor drugs in the past; 38 cases (15.4%) had a history of chest radiotherapy; some cases were complicated with hypertension (n=69, 23.2%) and/or hyperlipidemia (n=69, 23.2%); 42 cases (14.1%) had a history of coronary heart disease; and 16 cases (5.4%) were complicated with atrial fibrillation or flutter. Among 32 patients with cardiac tumors, 11 cases (34.4%) had primary malignant tumors; 6 cases (18.8%) had benign tumors; 2 cases (6.3%) had metastatic tumors; and 13 (40.6%) had unknown pathological types. This study explores the epidemiology of cardio-oncology in China and provides clinical insights for the future development of cardio-oncology. In the future, it is still necessary to study the benefits of cardio-oncology clinics and develop standardized indicators to evaluate their benefits.
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Affiliation(s)
- L Liang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - T An
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - X M Zhao
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - L Y Huang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - P C Tian
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J Y Guan
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - C H Zou
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Y H Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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13
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Huang LY, Liu CH, Chen FY, Kuo CH, Pitrone P, Liu JS. Aging Affects Insulin Resistance, Insulin Secretion, and Glucose Effectiveness in Subjects with Normal Blood Glucose and Body Weight. Diagnostics (Basel) 2023; 13:2158. [PMID: 37443552 DOI: 10.3390/diagnostics13132158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/18/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
AIM Several studies have demonstrated that factors including diabetes, including insulin resistance (IR), glucose effectiveness (GE), and the first and second phase of insulin secretion (FPIS, SPIS) could easily be calculated using basic characteristics and biochemistry profiles. Aging is accompanied by deteriorations of insulin resistance (IR) and insulin secretion. However, little is known about the roles of aging in the different phases of insulin secretion (ISEC), i.e., the first and second phase of insulin secretion (FPIS, SPIS), and glucose effectiveness (GE). METHODS In total, 169 individuals (43 men and 126 women) recruited from the data bank of the Meei-Jaw (MJ) Health Screening Center and Cardinal Tien Hospital Data Access Center between 1999 and 2008, with a similar fasting plasma glucose (FPG: 90 mg/dL) and BMI (men: 23 kg/m2, women 22 kg/m2) were enrolled. The IR, FPIS, SPIS, and GE were estimated using our previously developed equations shown below. Pearson correlation analysis was conducted to assess the correlations between age and four diabetes factors (DFs: IR, FPIS, SPIS, and GE). The equations that are used to calculate the DF in the present study were built and published by our group. RESULTS The age of the participants ranged from 18 to 78 years. Men had higher FPIS but lower HDL-C levels than women (2.067 ± 0.159, 1.950 ± 0.186 μU/min and 1.130 ± 0.306, 1.348 ± 0.357 mmol/dl, accordingly). The results of the Pearson correlation revealed that age was negatively related to the IR and GE in both genders (IR: r = -0.39, p < 0.001 for men, r = -0.24, p < 0.003 for women; GE: r = 0.66, p < 0.001 for men, r = 0.78, p < 0.001 for women). At the same time, the FPIS was also only found to be negatively correlated with age in females (r = -0.238, p = 0.003), but there was no difference in the SPIS and age among both genders. CONCLUSIONS We have found that in Chinese subjects with a normal FPG level (90 mg/dL) and body mass index (men: 23 kg/m2, women: 22: kg/m2), age is negatively related to the IR and GE among both genders. Only the FPIS was found to be negatively related to age in women. The tightness of their relationships, from the highest to the lowest, are GE, FPIS, and IR. These results should be interpreted with caution because of the small sample size.
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Affiliation(s)
- Li-Ying Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei 24352, Taiwan
| | - Chi-Hao Liu
- Division of Nephrology, Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung 80284, Taiwan
| | - Fang-Yu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei 24352, Taiwan
| | - Chun-Heng Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei 24352, Taiwan
| | - Pietro Pitrone
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98158 Messina, Italy
| | - Jhih-Syuan Liu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Zhou P, Huang LY, Zhai M, Huang Y, Zhuang XF, Liu HH, Zhang YH, Zhang J. [The prognostic value of free triiodothyronine/free thyroxine ratio in patients hospitalized with heart failure]. Zhonghua Yi Xue Za Zhi 2023; 103:1679-1684. [PMID: 37302858 DOI: 10.3760/cma.j.cn112137-20230220-00239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To investigate the effect of free triiodothyronine/free thyroxine (FT3/FT4) ratio on the prognosis of patients with heart failure (HF). Methods: A total of 3 527 patients hospitalized in the Heart Failure Center of Fuwai Hospital from March 2009 to June 2018 were analyzed in our study. Patients were divided into two groups according to median of FT3/FT4 ratio: low FT3/FT4 group (n=1 764, FT3/FT4<2.15) and high FT3/FT4 group (n=1 763, FT3/FT4≥2.15). The primary endpoint was defined as a composite endpoint of all-cause death or heart transplantation or implantation of a left ventricular assist device. The baseline characteristics of patients with different FT3/FT4 ratio groups were compared, and a multivariate Cox proportional hazard regression model was used to analyze the relationship between FT3/FT4 ratio and the prognosis of hospitalized patients with HF. Results: The age of the total population was (56.8±16.0) years, and 2 544 cases (72.1%) were males. The median follow-up time was 2.79 (1.00, 5.03) years, and a total of 1 542 end-point events were recorded at the final follow-up. The mean ages of patients in the low FT3/FT4 group and high FT3/FT4 group were (58.8±16.5) and (54.8±15.2) years (P<0.001), respectively; and the cumulative survival rates were 38.4% and 61.9%, respectively (P<0.001). FT3 (HR=0.72, 95%CI: 0.63-0.84, P<0.001), FT3/FT4 (HR=0.76, 95%CI: 0.65-0.87, P<0.001) was associated with all-cause death, heart transplantation, or LVAD implantation in patients with heart failure. HR values (95%CI) of FT3/FT4 ratio predicting the risk of composite endpoint in the subgroup of left ventricular ejection fraction (LVEF)<40%, 40% to 49%, and≥50% were 0.91 (0.77-1.08), 0.83 (0.50-1.39), and 0.65 (0.50-0.85), respectively (P interaction=0.045). Conclusions: Low FT3 and low FT3/FT4 are important correlative factors for poor prognosis in hospitalized HF patients, especially in patients with LVEF≥50%.
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Affiliation(s)
- P Zhou
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - L Y Huang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - M Zhai
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Y Huang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - X F Zhuang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - H H Liu
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Y H Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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15
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Wu CZ, Huang LY, Chen FY, Kuo CH, Yeih DF. Using Machine Learning to Predict Abnormal Carotid Intima-Media Thickness in Type 2 Diabetes. Diagnostics (Basel) 2023; 13:diagnostics13111834. [PMID: 37296685 DOI: 10.3390/diagnostics13111834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023] Open
Abstract
Carotid intima-media thickness (c-IMT) is a reliable risk factor for cardiovascular disease risk in type 2 diabetes (T2D) patients. The present study aimed to compare the effectiveness of different machine learning methods and traditional multiple logistic regression in predicting c-IMT using baseline features and to establish the most significant risk factors in a T2D cohort. We followed up with 924 patients with T2D for four years, with 75% of the participants used for model development. Machine learning methods, including classification and regression tree, random forest, eXtreme gradient boosting, and Naïve Bayes classifier, were used to predict c-IMT. The results showed that all machine learning methods, except for classification and regression tree, were not inferior to multiple logistic regression in predicting c-IMT in terms of higher area under receiver operation curve. The most significant risk factors for c-IMT were age, sex, creatinine, body mass index, diastolic blood pressure, and duration of diabetes, sequentially. Conclusively, machine learning methods could improve the prediction of c-IMT in T2D patients compared to conventional logistic regression models. This could have crucial implications for the early identification and management of cardiovascular disease in T2D patients.
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Affiliation(s)
- Chung-Ze Wu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 11031, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Li-Ying Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Department of Medical Education, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan
| | - Fang-Yu Chen
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
| | - Chun-Heng Kuo
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
| | - Dong-Feng Yeih
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan
- Division of Cardiology, Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan
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Zhou P, Huang LY, Zhai M, Huang Y, Zhuang XF, Liu HH, Zhang YH, Zhang J. [Clinical features and prognosis of patients hospitalized with heart failure and low T 3 syndrome]. Zhonghua Nei Ke Za Zhi 2023; 62:526-531. [PMID: 37096279 DOI: 10.3760/cma.j.cn112138-20230210-00078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Objective: To investigate the association between triiodothyronine (T3) and inflammatory factors, and its potential effect on long-term outcomes in hospitalized patients with heart failure (HF). Methods: A total of 2 475 patients with HF admitted in Heart Failure Care Unit were consecutively enrolled in this retrospective cohort study from December 2006 to June 2018. Patients were divided into low T3 syndrome group (n=610, 24.6%) and normal thyroid function group (n=1 865, 75.4%). The median follow-up time was 2.9 (1.0, 5.0) years. A total of 1 048 all-cause deaths were recorded at the final follow-up. The effects of free T3 (FT3) and high-sensitivity C-reactive protein (hsCRP) on the risk of all-cause death were evaluated by Cox regression analysis and Kaplan-Meier analysis. Results: The age of the total population was 19-95 (57±16) years, 1 823 cases (73.7%) were male. Compared to those with normal thyroid function, albumin [(36.5±5.4) vs. (40.7±4.7) g/L], hemoglobin [(129.4±25.1) vs. (140.6±20.6) g/L], total cholesterol [3.6 (3.0, 4.4) vs. 4.2 (3.5, 4.9) mmol/L] (all P<0.001) were lower, Whereas age [(60.5±16.0) vs. (55.2±15.4) years], creatinine [105.0 (83.6, 137.0) vs. 87.8 (75.6, 106.3) mmol/L], log N-terminal B-type natriuretic peptide [(8.2±1.3) vs. (7.2±1.4) ng/L] were higher in LT3S patients (all P<0.001). In Kaplan-Meier survival analysis, patients with lower FT3 and higher hsCRP had significantly lower cumulative survival (P<0.001), lower FT3 combined with higher hsCRP subgroup had the highest risk of all-cause death (Ptrend<0.001). In multivariate Cox regression analysis, LT3S was an independent predictor of all-cause mortality (HR=1.40, 95%CI 1.16-1.69, P<0.001). Conclusion: LT3S is an independent predictor of poor prognosis in patients with heart failure. FT3 combined with hsCRP improve the predictive value of all-cause death in hospitalized patients with heart failure.
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Affiliation(s)
- P Zhou
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - L Y Huang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - M Zhai
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Y Huang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - X F Zhuang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - H H Liu
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Y H Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - J Zhang
- Heart Failure Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China
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17
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Liu M, Deng W, Lu YY, He YZ, Huang LY, Du H. Surgical treatment of tethered cord syndrome showed promising outcome in young children with short duration. Eur Rev Med Pharmacol Sci 2023; 27:1831-1836. [PMID: 36930477 DOI: 10.26355/eurrev_202303_31545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Aside from the severity, surgical interventions for the treatment of neurological dysfunctions remain controversial. This study aimed to find factors predicting the benefits of tethered cord syndrome (TCS) surgery. PATIENTS AND METHODS 80 children with TCS were included and followed up for pre- and post-operative factors along with neurophysiological analysis. Outcomes were assessed by univariate and multivariate analysis. RESULTS Surgical treatment not only improved preoperative signs and symptoms in 79% of TCS patients but it showed to be an efficient procedure for the occurrence of future neurological defects. Univariate analysis also revealed that surgical intervention in TCS children (age <1 year) can modulate filar lipoma location and cutaneous abnormalities three months after surgery. Neurophysiological assessment revealed only 5.0% of surgical complications in TCS patients. Two patients had cerebrospinal fluid leakage, and two cases of CNS infection were detected. CONCLUSIONS Surgical intervention is highly recommended for the prevention of neurological deficits in children with TCS. Electrophysiological monitoring revealed rare complications following the surgery.
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Affiliation(s)
- M Liu
- Department of Nerve Electrophysiology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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18
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Wang ZC, Wang Y, Huang LY, Liao XJ, Jiang ZH, Xu SH, Zhao BX. Two new halogenated metabolites from the red alga Laurencia sp. J Asian Nat Prod Res 2023; 25:61-67. [PMID: 35352584 DOI: 10.1080/10286020.2022.2056029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
Two new halogenated metabolites, laurenhalogens A (1) and B (2), along with four known ones (3-6), were isolated from the red alga Laurencia sp. The structures of 1 and 2 were determined by the means of UV, IR, MS, NMR and X-ray diffraction analysis. In addition, the antibacterial activities of 1-6 were also evaluated.
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Affiliation(s)
- Zhao-Cong Wang
- Department of Chemistry, College of Chemistry and Materials Science, Jinan University, Guangzhou 511400, China
| | - Yan Wang
- Department of Pharmacy, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, China
- School of pharmaceutical sciences, Southern Medical University, Guangzhou 510515, China
| | - Li-Ying Huang
- Department of Chemistry, College of Chemistry and Materials Science, Jinan University, Guangzhou 511400, China
| | - Xiao-Jian Liao
- Department of Chemistry, College of Chemistry and Materials Science, Jinan University, Guangzhou 511400, China
| | - Zhi-Hui Jiang
- Department of Pharmacy, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, China
| | - Shi-Hai Xu
- Department of Chemistry, College of Chemistry and Materials Science, Jinan University, Guangzhou 511400, China
| | - Bing-Xin Zhao
- Department of Chemistry, College of Chemistry and Materials Science, Jinan University, Guangzhou 511400, China
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Huang LY, Chiang CC, Li YL, Lai HY, Hsieh YC, Wu YH, Tsai YY. Corneal Complications after COVID-19 Vaccination: A Systemic Review. J Clin Med 2022; 11:jcm11226828. [PMID: 36431307 PMCID: PMC9698276 DOI: 10.3390/jcm11226828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Multiple vaccines are now being used across the world, and several studies have described cases of corneal graft rejection following the administration of the COVID-19 vaccine. The purpose of this article is to review the corneal adverse event that occurred following COVID-19 vaccine administration. The literature search was conducted in March 2022 using MEDLINE, PubMed, and the Cochrane Database of Systematic Reviews. A total of 27 articles, including 37 cases, have documented corneal adverse events that occurred following COVID-19 vaccination. The mean age was 60 ± 14.9 years (range, 27-83 years). The most common events were acute corneal graft rejection (n = 21, 56.8%), followed by herpes zoster ophthalmicus (n = 11, 29.7%) and herpes simplex keratitis (n = 2, 5.4%). The mean time from vaccination to the event was 10 ± 8.5 days (range, 1-42 days) after the first or second dose of vaccine. All patients with corneal graft rejection, immune-mediated keratolysis, and peripheral ulcerative keratitis (PUK) (n = 24, 64.9%) were managed topically with or without oral corticosteroids. Patients with herpes zoster ophthalmicus and herpes simplex keratitis were managed with oral antiviral agents. Two patients received penetrating keratoplasty due to keratolysis after invalid topical treatment. Disease resolution was noted in 29 patients (78.3%), whereas 3 (8.1%) had persistent corneal edema after graft rejection, 1 (2.7%) had corneal infiltration after HZO, and 4 (10.8%) were not mentioned in the articles. Corneal adverse events could occur after COVID-19 vaccination. After timely treatment with steroids or antiviral agents, most of the events were mild and had a good visual outcome. Administrating or increasing steroids before vaccination may be useful for the prevention of corneal graft rejection. However, the prophylactic use of antiviral treatments in patients with a herpes viral infection history is not recommend.
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Affiliation(s)
- Li-Ying Huang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Chun-Chi Chiang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 406040, Taiwan
- Department of Optometry, Asia University, Taichung 413305, Taiwan
| | - You-Ling Li
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Hung-Yin Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Yi-Ching Hsieh
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Ying-Hsuen Wu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 406040, Taiwan
- Department of Optometry, Asia University, Taichung 413305, Taiwan
- Correspondence: ; Tel.: +886-4-22052121 (ext. 1141); Fax: +886-4-22059265
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20
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Juang RS, Wang KS, Cheng YW, Wu WE, Lin YH, Jeng RJ, Huang LY, Yang MC, Liu SH, Liu TY. Intelligent and thermo-responsive Au-pluronic® F127 nanocapsules for Raman-enhancing detection of biomolecules. Spectrochim Acta A Mol Biomol Spectrosc 2022; 279:121475. [PMID: 35696969 DOI: 10.1016/j.saa.2022.121475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/23/2022] [Accepted: 06/03/2022] [Indexed: 06/15/2023]
Abstract
Thermo-responsive Raman-enhanced nanocapsules were successfully fabricated by Pluronic® F127 (F127) decorated with gold nanoparticles (AuNPs) for surface-enhanced Raman scattering (SERS) detection of biomolecules. F127 nanocapsules changes from hydrophilicity (swelling) to hydrophobicity (de-swelling) when the temperature increases from 15 °C to 37 °C, owing to the lower critical solution temperature (LCST) of F127 is about 26.5 °C. The size of nanocapsules would be enormous shrinking from 160 nm to 20 nm, resulting in a significant decrease in the distance between AuNPs to enhance hot spot effect, which increases the sensitivity of SERS detection. Based on the thermo-sensitive behavior, the ratio of AuNPs and F127 would be manipulated to find the optimal SERS enhancement effect. SERS nanocapsules can rapidly detect biomolecules (adenine and R6G) with limit of detection (LOD) lower than 10-6 M. In addition, the relatively difficult to detect clinical samples, carboxyl-terminal parathyroid hormone fragments (C-PTH), can also be measured by the thermo-responsive SERS nanocapsules developed in this work. It is expected the biomolecules can be adsorbed at low temperature (15 °C), as well as collected and concentrated at high temperature (37 °C) for SERS detection, to increase the sensitivity and stability of SERS detection.
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Affiliation(s)
- Ruey-Shin Juang
- Department of Chemical and Materials Engineering, Chang Gung University, Guishan, Taoyuan 33302, Taiwan; Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Safety, Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City 243303, Taiwan
| | - Kuan-Syun Wang
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei 10617, Taiwan
| | - Yu-Wei Cheng
- Department of Chemical Engineering, Ming Chi University of Technology, New Taipei City 243303, Taiwan
| | - Wei-En Wu
- Department of Materials Engineering, Ming Chi University of Technology, New Taipei City 243303, Taiwan
| | - Yu-Hsuan Lin
- Department of Materials Engineering, Ming Chi University of Technology, New Taipei City 243303, Taiwan
| | - Ru-Jong Jeng
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei 10617, Taiwan
| | - Li-Ying Huang
- Department of Materials Science and Engineering, National Taiwan University of Science and Technology, Taipei 10607, Taiwan
| | - Ming-Chien Yang
- Department of Materials Science and Engineering, National Taiwan University of Science and Technology, Taipei 10607, Taiwan.
| | - Shou-Hsuan Liu
- Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Ting-Yu Liu
- Department of Materials Engineering, Ming Chi University of Technology, New Taipei City 243303, Taiwan.
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21
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Lin A, Huang LY, Chen YS. Accident influence to the thermal conditions of the main buildings of the Kuosheng plant during the decommissioning process. Nuclear Engineering and Design 2022. [DOI: 10.1016/j.nucengdes.2022.111889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Huang LY, Chen FY, Jhou MJ, Kuo CH, Wu CZ, Lu CH, Chen YL, Pei D, Cheng YF, Lu CJ. Comparing Multiple Linear Regression and Machine Learning in Predicting Diabetic Urine Albumin–Creatinine Ratio in a 4-Year Follow-Up Study. J Clin Med 2022; 11:jcm11133661. [PMID: 35806944 PMCID: PMC9267784 DOI: 10.3390/jcm11133661] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 02/07/2023] Open
Abstract
The urine albumin–creatinine ratio (uACR) is a warning for the deterioration of renal function in type 2 diabetes (T2D). The early detection of ACR has become an important issue. Multiple linear regression (MLR) has traditionally been used to explore the relationships between risk factors and endpoints. Recently, machine learning (ML) methods have been widely applied in medicine. In the present study, four ML methods were used to predict the uACR in a T2D cohort. We hypothesized that (1) ML outperforms traditional MLR and (2) different ranks of the importance of the risk factors will be obtained. A total of 1147 patients with T2D were followed up for four years. MLR, classification and regression tree, random forest, stochastic gradient boosting, and eXtreme gradient boosting methods were used. Our findings show that the prediction errors of the ML methods are smaller than those of MLR, which indicates that ML is more accurate. The first six most important factors were baseline creatinine level, systolic and diastolic blood pressure, glycated hemoglobin, and fasting plasma glucose. In conclusion, ML might be more accurate in predicting uACR in a T2D cohort than the traditional MLR, and the baseline creatinine level is the most important predictor, which is followed by systolic and diastolic blood pressure, glycated hemoglobin, and fasting plasma glucose in Chinese patients with T2D.
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Affiliation(s)
- Li-Ying Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Department of Medical Education, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan; (L.-Y.H.); (F.-Y.C.); (C.-H.K.); (D.P.)
| | - Fang-Yu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Department of Medical Education, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan; (L.-Y.H.); (F.-Y.C.); (C.-H.K.); (D.P.)
| | - Mao-Jhen Jhou
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
| | - Chun-Heng Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Department of Medical Education, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan; (L.-Y.H.); (F.-Y.C.); (C.-H.K.); (D.P.)
| | - Chung-Ze Wu
- Division of Endocrinology, Department of Internal Medicine, Shuang Ho Hospital, New Taipei City 23561, Taiwan;
- Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Chieh-Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Yen-Lin Chen
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Dee Pei
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Department of Medical Education, Fu Jen Catholic University Hospital, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24352, Taiwan; (L.-Y.H.); (F.-Y.C.); (C.-H.K.); (D.P.)
| | - Yu-Fang Cheng
- Department of Endocrinology and Metabolism, Changhua Christian Hospital, Changhua 50051, Taiwan;
| | - Chi-Jie Lu
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
- Artificial Intelligence Development Center, Fu Jen Catholic University, New Taipei City 242062, Taiwan
- Department of Information Management, Fu Jen Catholic University, New Taipei City 242062, Taiwan
- Correspondence: ; Tel.: +886-2-2905-2973
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Tsai HY, Huang YW, Chang SY, Huang LY, Lin CJ, Lee PC. The reimbursement coverage decisions and pricing rules for medical devices in Taiwan. GMS Health Innov Technol 2022; 16:Doc02. [PMID: 35360087 PMCID: PMC8953662 DOI: 10.3205/hta000134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Medical technology is undergoing rapid transformations, and the classifications of medical devices have also expanded greatly; therefore, it is necessary to develop appropriate reimbursement policies and pricing mechanisms in a timely manner. This paper aims to introduce the reimbursement coverage and pricing rules for medical devices in Taiwan. In addition, this paper identifies and evaluates available health technology assessments (HTA) and literature on published websites concerning medical device decision-making processes and pricing systems in South Korea and Japan, which are near Taiwan and have similar reimbursement coverage processes. Reimbursement policy and pricing mechanisms are constantly being revised in Taiwan, Japan, and South Korea. Recently, all three countries attempted to establish new reimbursement coverage decision-making and pricing rules, adopting a differentiated approach based on the level of evidence required for the appropriated reimbursement in terms of a feasible evaluation mechanism for providing patients with more effective medical devices. This article is expected to contribute to providing references to new reimbursement coverage decision-making and pricing rules.
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Affiliation(s)
- Hsin-Yi Tsai
- Division of Health Technology Assessment, Center for Drug Evaluation, Taipei, Taiwan
| | - Yu-Wen Huang
- National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Shu-Ya Chang
- National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Li-Ying Huang
- Division of Health Technology Assessment, Center for Drug Evaluation, Taipei, Taiwan,*To whom correspondence should be addressed: Po-Chang Lee, , E-mail:
| | - Chii Jeng Lin
- College of Medicine, National Cheng Kung University, Tainan, Taiwan,Medical Devices Reimbursement Committee of Taiwan, Tainan, Taiwan,*To whom correspondence should be addressed: Po-Chang Lee, , E-mail:
| | - Po-Chang Lee
- National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan,Departement of Surgery, College of Medicine, National Cheng Kung University, Tainain, Taiwan,*To whom correspondence should be addressed: Po-Chang Lee, , E-mail:
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24
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Lin CJ, Huang LY, Lai CT, Hsia NY, Bair H, Tien PT, Chen WL, Lin JM, Chiang CC, Tsai YY. Temporal and double inverted internal limiting membrane flap for bilateral choroidal ruptures complicated by bilateral macular holes. Taiwan J Ophthalmol 2022. [PMID: 37484614 PMCID: PMC10361440 DOI: 10.4103/tjo.tjo_20_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Choroidal ruptures occur in 5% to 10% closed-globe injuries with wide variation in visual prognosis, which depending on the visual acuity at presentation, the location of the rupture, and other associated ocular injuries. We reported a case of bilateral traumatic choroidal rupture with a large macular hole. We performed surgery in the right eye of microincisional vitrectomy, temporally inverted internal limiting membrane (ILM) flap, and C3F8 tamponade; then microincisional vitrectomy, fibrotic scar removal, double inverted ILM flap, and C3F8 tamponade in the left eye. After surgery, she achieved both good anatomical and visual acuity improvement in the right eye, but limited visual acuity improvement in the left eye due to subfoveal choroidal scar formation.
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25
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Huang LY, Hsia NY, Lai CT, Tien PT, Lin CJ, Lin JM, Tsai YY, Chen WL. Significant improvement of ocular clinical pictures of iris metastasis from small-cell lung cancer after systemic chemotherapy. Taiwan J Ophthalmol 2021; 11:402-404. [PMID: 35070672 PMCID: PMC8757523 DOI: 10.4103/tjo.tjo_59_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/07/2020] [Indexed: 11/06/2022] Open
Abstract
The uveal tract is the most common ophthalmic site of ocular metastasis from systemic tumors due to the luxurious blood flow within the choroidal tissue. However, iris metastasis from systemic cancer is uncommon, accounting for only 8% of cases of uveal metastasis. There are several methods for the treatment of iris tumor. Here, we reported a case of iris metastasis from small-cell lung cancer. The tumor shrunk after systemic treatment for lung cancer and showed no recurrence after a 4-month follow-up.
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Affiliation(s)
- Li-Ying Huang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
| | - Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
| | - Chun-Ting Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
| | - Peng-Tai Tien
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan.,Department of Optometry, Asia University, Taichung City, Taiwan
| | - Jane-Ming Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
| | - Wen-Lu Chen
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
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26
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Zhai M, Huang LY, Zou CH, Wang YH, Zhou Q, Huang Y, Zhao XM, Tian PC, Zhang YH, Zhang J. [Clinical characteristics of hypertrophic cardiomyopathy and restricted cardiomyopathy patients complicating with intracardiac thrombosis]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:809-812. [PMID: 34404191 DOI: 10.3760/cma.j.cn112148-20210317-00239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical characteristics of patients with hypertrophic cardiomyopathy (HCM) and restrictive cardiomyopathy (RCM) complicating with intracardiac thrombosis. Methods: This is a retrospective observational study. Consecutive patients diagnosed with HCM or RCM and complicated with intracardiac thrombosis (including left and right atrium or ventricular thrombosis), who were admitted to the Heart Failure Care Unit of Fuwai Hospital, Chinese Academy of Medical Sciences, from September 2008 to September 2018, were enrolled in this study. Patients with myocardial infarction were excluded. The general clinical data of the enrolled patients, including demographic data, major complications, laboratory indicators, echocardiographic indicators, drug application and distribution of intracardiac thrombosis, were collected from electronic medical record system and analyzed. Results: A total of 98 patients were enrolled in this study, including 52 patients (53.1%) with HCM and 46 patients (46.9%) with RCM. The most common comorbidity was atrial fibrillation/flutter: 40 patients (76.9%) in HCM group and 36 patients (78.3%) in RCM group. Majority of patients received oral anticoagulants treatment: 43 patients (82.7%) in HCM group and 35 patients (76.1%) in RCM group. Intracardiac thrombosis was mainly located in the left atrium in both HCM group (39 cases (75.0%)) and RCM group (32 cases (69.6%)). Thrombosis was found in ≥ 2 chambers in 7 patients (7.1%). Rate of left atrial thrombosis was the highest (81.6% (62/76)) in HCM and RCM patients complicating with atrial fibrillation/flutter. Intra-aneurysmal thrombosis occurred in 4 out of 5 patients complicated with apical left ventricular aneurysm. The rate of left ventricular thrombosis in patients with left ventricular ejection fraction≥50% was 7.4% (4/54), which was significantly lower than that in patients with left ventricular ejection fraction<50% (34.5%(10/29)) (P<0.01). Conclusion: There are certain distribution characteristics of HCM and RCM patients with intracardiac thrombosis, and the left atrium is the most common site of thrombosis, more attention should be paid in HCM and RCM patients on the diagnosis and treatment of intracardiac thrombosis.
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Affiliation(s)
- M Zhai
- Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Disease, Beijing 100037, China
| | - L Y Huang
- Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Disease, Beijing 100037, China
| | - C H Zou
- Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Disease, Beijing 100037, China
| | - Y H Wang
- Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Disease, Beijing 100037, China
| | - Q Zhou
- Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Disease, Beijing 100037, China
| | - Y Huang
- Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Disease, Beijing 100037, China
| | - X M Zhao
- Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Disease, Beijing 100037, China
| | - P C Tian
- Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Disease, Beijing 100037, China
| | - Y H Zhang
- Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Disease, Beijing 100037, China
| | - J Zhang
- Heart Failure Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Disease, Beijing 100037, China
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Abstract
BACKGROUND Static progressive orthosis is used for the treatment of severe joint contracture after trauma and/or surgery. However, a custom-fabricated static progressive splint would be expensive and labor intensive. Especially, owing to very limited payment under the current Taiwanese National Health Insurance, the incentives to fabricate a patient-specific splint are insufficient for a therapist. To ease splint construction, we introduced three-dimensional (3D)-printed "shark fin"-shaped device works as a static progressive orthosis for the hand rehabilitation. The aim of this study was to describe and demonstrate the newly designed device. METHODS This study included a 46-year male suffered from a left distal radius fracture and underwent open reduction internal fixation and a 23-year male with the right thumb flexor pollicis longus rupture, requiring tendon repair. Both subjects used this "shark fin"-shaped device to stretch for increasing range of motion (ROM) of wrist extension and the thumb. RESULTS The patient receiving ulnar shortening surgery used this device to stretch for increasing ROM of wrist extension. The active ROM of wrist extension improved from 30° to 50°. The other patient with the right thumb flexor pollicis longus rupture suffered from thumb contracture; the ROMs of the metacarpophalangeal (MCP) joint and interphalangeal (IP) joint were 40°-55° and 20°-25°, respectively. After tenolysis surgery, his ROMs of the MCP and IP joints were improved to 10°-35° and 40°-65°, respectively. Following physical therapy by applying the device, his ROMs of the MCP and IP joints were further increased to 0°-40° and 25°-70°, respectively. CONCLUSION Incorporating the "shark fin"-shaped orthosis into hand rehabilitation increased the ROM of wrist extension for a patient with distal radius fracture and improved the ROM of the MCP and IP joints in another patient after tenolysis surgery.
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Affiliation(s)
- Li-Ying Huang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Tien-Hsiang Wang
- Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei Taiwan, ROC
- Department of Mechanical Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Bao-Chi Chang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Biomedical Engineering, Chung-Yuag Christian University, Taoyuan, Taiwan, ROC
| | - Chia-I Huang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Li-Wei Chou
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shyh-Jen Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Experimental Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Wei-Ming Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei Taiwan, ROC
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Huang XM, Liu XH, Huang LY, Cai ZR, Chen YF, Wu XJ. [Risk factors of peritoneal metastasis in primary appendiceal tumor]. Zhonghua Zhong Liu Za Zhi 2021; 43:806-809. [PMID: 34289577 DOI: 10.3760/cma.j.cn112152-20200901-00784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the risk factors of peritoneal metastasis in primary appendiceal tumor. Methods: The clinic data of 71 patients with primary appendiceal tumor admitted in the Sixth Affiliated Hospital of Sun Yat-sen University between Dec 2012 and Jan 2019 were enrolled retrospectively. Multivariate logistic regression analysis were carried out to evaluate the risk factors of appendiceal tumor with peritoneal metastasis. Results: Of the 71 patients, 33 were peritoneal metastasis (peritoneal metastasis group) and 38 were non-peritoneal metastasis (no peritoneal metastasis group). Twenty-one patients in the peritoneal metastasis group had increased preoperative cancer embryo antigen (CEA), while 3 cases in the non-peritoneal metastasis group, with statistically significant difference (P<0.001). Sixteen cases in peritoneal metastasis group had increased preoperative carbohydrate antigen 199, while only 2 cases in the non-peritoneal metastasis group, the difference was statistically significant (P<0.001). The pathological type of 30 cases in the peritoneal metastasis group was adenocarcinoma (including mucus adenocarcinoma and colon adenocarcinoma), while 12 cases of adenocarcinoma in the non-peritoneal metastasis group, with statistically significant difference (P<0.001). Twelve cases in the peritoneal metastasis group had lymph node metastasis, while 3 cases in the non-peritoneal metastasis group, the difference is statistically significant (P=0.003). Preoperative CEA elevation and pathological type is adenocarinoma were independent risk factors for peritoneal metastasis of appendiceal cancer (P<0.05). Conclusions: The propensity of peritoneal metastasis in primary appendiceal tumor is high and the outcome is poor. Patients with increased preoperative CEA, adenocarcinoma histopathology are more inclined to have peritoneal metastasis.
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Affiliation(s)
- X M Huang
- Department of Coloretcal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
| | - X H Liu
- Department of Coloretcal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
| | - L Y Huang
- Department of Coloretcal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
| | - Z R Cai
- Department of Coloretcal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
| | - Y F Chen
- Department of Coloretcal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
| | - X J Wu
- Department of Coloretcal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
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Huang LY, Zhang DL, Fu RF, Liu W, Chen YF, Xue F, Liu XF, Bi TT, Yang RC, Zhang L. [Analysis of gene mutation spectrum and pharmacokinetics of fibrinogen infusion in 146 cases of congenital fibrinogen disorders]. Zhonghua Xue Ye Xue Za Zhi 2021; 42:555-562. [PMID: 34455742 PMCID: PMC8408493 DOI: 10.3760/cma.j.issn.0253-2727.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical type and gene mutations, clinical manifestations, laboratory tests, diagnosis, and fibrinogen replacement therapy of congenital fibrinogen disorders. Methods: Clinical data of 146 patients with congenital fibrinogen disorders diagnosed from April 2000 to November 2020 were retrospectively analyzed. Results: Among the 146 patients, 61 (41.8%) men and 85 (58.2%) women had a median age of 33.5 years at the time of consultation. 34 patients (34.7%) were found to suffer from the disease due to bleeding symptoms, 33 patients (33.7%) due to preoperative examination. 55 patients (56.1%) had at least one bleeding symptom, and 42 patients (42.9%) had no bleeding symptoms. There is a negative correlation between fibrinogen activity concentration and bleeding ISTH-BAT score (rs=-0.412, P=0.001) . A total of 34 gene mutations were detected in 56 patients, of which 84.1% were missense mutations, and 16 new mutations were found. FGA Exon2 and FGG Exon8 mutations accounted for 71.4% of all mutation sites. Patients with afibrinogenemia were younger, with a median age of 2 (1-12) years, an ISTH-BAT score of 4, and patients with dysfibrinogenemia had significantly longer thrombin time (TT) , with a median of 28.5 (19.2-36.6) s. The 1 hour in vivo recovery (IVR) after fibrinogen infusion was (127.19±44.03) %, and the 24 hour IVR was (101.78±43.98) %. In addition to the obvious increase in the concentration of fibrinogen activity, the TT and the prothrombin time (PT) both decreased significantly, and the TT decreased more significantly, with an average decrease of 15.2% compared to the baseline after 24 hours of infusion. Conclusion: Most patients with congenital fibrinogen disorders have mild or no bleeding symptoms. Patients with afibrinogenemia have more severe symptoms. There is a negative correlation between the fibrinogen and the degree of bleeding. Genetic testing is helpful for the diagnosis of disease classification. FIB∶C/FIB∶Ag<0.7 can be used as a basis for clinical diagnosis. The TT can be used as the basis for the diagnosis of dysfibrinogenemia and the effectiveness of fibrinogen infusion.
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Affiliation(s)
- L Y Huang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - D L Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - R F Fu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - W Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y F Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - F Xue
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - X F Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - T T Bi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - R C Yang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - L Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Tianjin Laboratory of Blood Disease Gene Therapy, CAMS Key Laboratory of Gene Therapy for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
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Chen TT, Hsueh YSA, Liaw CK, Shih LN, Huang LY. Does public report card matter? A 10-year interrupted time series analysis on total knee replacement. Eur J Public Health 2021; 30:4-9. [PMID: 31177269 DOI: 10.1093/eurpub/ckz112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND There is a lack of evidence that shows whether a report card can improve health outcomes in terms of infection rates or unscheduled readmission by using rigorous methods to evaluate its impact. METHODS We used the National Health Insurance Administration's claims database from 1 January 2004 to 30 December 2013 and a time series analysis to evaluate the impact of the quality report card initiative on three negative outcomes of total knee replacement for each quarter of the year, including the rates of superficial infection of a knee replacement, deep infection of knee arthroplasty and unplanned readmissions for surgical site infection. RESULTS These negative outcomes (original scale) do not show significant decreases in terms of superficial infection (-0.05‰, -0.63 to 0.53‰, P = 0.87), deep infection (-0.003‰, -0.19 to 0.18‰, P = 0.97) and unscheduled readmission (0.02‰, -0.21 to 0.25‰, P = 0.88). CONCLUSION The total knee replacement public report card initiative did not improve the rate of infection and unscheduled readmission for surgical site infection. This report card in Taiwan should involve physicians' participation in the design and be tailored to be suitable for reading by patients in order to further enhance the chance of improvement in these negative outcomes.
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Affiliation(s)
- Tsung-Tai Chen
- Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ya-Seng Arthur Hsueh
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Chen-Kun Liaw
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.,Division of Orthopedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Orthopedics, National Taiwan University Hospital, Taipei, Taiwan
| | - Ling-Na Shih
- Lo-Sheng Sanatorium Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.,Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Li-Ying Huang
- Division of Health Technology Assessment, Center for Drug Evaluation, Taipei, Taiwan
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Hu R, Zhong Q, Xu ZG, Huang LY, Cheng Y, Wang YR, He YD, Cheng Y. [Application of deep convolutional neural networks in the diagnosis of laryngeal squamous cell carcinoma based on narrow band imaging endoscopy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:454-458. [PMID: 34010998 DOI: 10.3760/cma.j.cn115330-20200927-00773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the possibility of using artificial intelligence (AI) technology based on convolutional neural network (CNN) to assist the clinical diagnosis of laryngeal squamous cell carcinoma (LSCC) through deep learning algorithm. Methods: A deep CNN was developed and applied in narrow band imaging (NBI) endoscopy of 4 799 patients with laryngeal lesions, including 3 168 males and 1 631 females, aged from 21 to 87 years, from 2015 to 2017 in Beijing Tongren Hospital, Capital Medical University. A simple randomization method was used to select the laryngeal NBI images of 2 427 patients (1 388 benign lesions and 1 039 LSCC lesions) for the training and correction the CNN model. The remaining laryngeal NBI images of 2 372 patients (including 1 276 benign lesions and 1 096 LSCC lesions) were used as validation data set to compare performance between CNN and otolaryngologists. SPSS 21.0 software was used for Chi-square test to calculate the accuracy, sensitivity and specificity of AI and otolaryngologists. The area under the curve (AUC) of receiver operating curve (ROC) was used to evaluate the diagnostic ability of the algorithm for NBI images. Results: The accuracy, sensitivity and specificity for NBI predictions were respectively 90.91% (AUC=0.96), 90.12% and 91.53%, which were equivalent to those for otolaryngologists' predictions (accuracy, sensitivity and specificity were (91.93±3.20)%, (91.33±3.25)% and (93.02±2.59)%, t values were 0.64, 0.75 and 1.17, and P values were 0.32, 0.28 and 0.21, respectively). The diagnostic efficiency of CNN was significantly higher than that of otolaryngologists (0.01 vs. 5.50, t =9.15, P<0.001). Conclusion: AI based on deep CNN is effective for using in the laryngeal NBI image diagnosis, showing a good application prospect in the diagnosis of LSCC.
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Affiliation(s)
- R Hu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China
| | - Q Zhong
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China
| | - Z G Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China
| | - L Y Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China
| | - Y Cheng
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China
| | - Y R Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China
| | - Y D He
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China
| | - Yingduan Cheng
- Department of Urology, the First Affiliated Hospital of Southern University of Science and Technology, the Second Clinical Medical College of Jinan University, Shenzhen People's Hospital,Shenzhen 518000, China
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Wang KS, Yu G, Xu C, Meng XH, Zhou J, Zheng C, Deng Z, Shang L, Liu R, Su S, Zhou X, Li Q, Li J, Wang J, Ma K, Qi J, Hu Z, Tang P, Deng J, Qiu X, Li BY, Shen WD, Quan RP, Yang JT, Huang LY, Xiao Y, Yang ZC, Li Z, Wang SC, Ren H, Liang C, Guo W, Li Y, Xiao H, Gu Y, Yun JP, Huang D, Song Z, Fan X, Chen L, Yan X, Li Z, Huang ZC, Huang J, Luttrell J, Zhang CY, Zhou W, Zhang K, Yi C, Wu C, Shen H, Wang YP, Xiao HM, Deng HW. Accurate diagnosis of colorectal cancer based on histopathology images using artificial intelligence. BMC Med 2021; 19:76. [PMID: 33752648 PMCID: PMC7986569 DOI: 10.1186/s12916-021-01942-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Accurate and robust pathological image analysis for colorectal cancer (CRC) diagnosis is time-consuming and knowledge-intensive, but is essential for CRC patients' treatment. The current heavy workload of pathologists in clinics/hospitals may easily lead to unconscious misdiagnosis of CRC based on daily image analyses. METHODS Based on a state-of-the-art transfer-learned deep convolutional neural network in artificial intelligence (AI), we proposed a novel patch aggregation strategy for clinic CRC diagnosis using weakly labeled pathological whole-slide image (WSI) patches. This approach was trained and validated using an unprecedented and enormously large number of 170,099 patches, > 14,680 WSIs, from > 9631 subjects that covered diverse and representative clinical cases from multi-independent-sources across China, the USA, and Germany. RESULTS Our innovative AI tool consistently and nearly perfectly agreed with (average Kappa statistic 0.896) and even often better than most of the experienced expert pathologists when tested in diagnosing CRC WSIs from multicenters. The average area under the receiver operating characteristics curve (AUC) of AI was greater than that of the pathologists (0.988 vs 0.970) and achieved the best performance among the application of other AI methods to CRC diagnosis. Our AI-generated heatmap highlights the image regions of cancer tissue/cells. CONCLUSIONS This first-ever generalizable AI system can handle large amounts of WSIs consistently and robustly without potential bias due to fatigue commonly experienced by clinical pathologists. It will drastically alleviate the heavy clinical burden of daily pathology diagnosis and improve the treatment for CRC patients. This tool is generalizable to other cancer diagnosis based on image recognition.
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Affiliation(s)
- K S Wang
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - G Yu
- Department of Biomedical Engineering, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - C Xu
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - X H Meng
- Laboratory of Molecular and Statistical Genetics, College of Life Sciences, Hunan Normal University, Changsha, 410081, Hunan, China
| | - J Zhou
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - C Zheng
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - Z Deng
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - L Shang
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
| | - R Liu
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
| | - S Su
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
| | - X Zhou
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
| | - Q Li
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
| | - J Li
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
| | - J Wang
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410078, Hunan, China
| | - K Ma
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - J Qi
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - Z Hu
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - P Tang
- Department of Pathology, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - J Deng
- Department of Deming Department of Medicine, Tulane Center of Biomedical Informatics and Genomics, Tulane University School of Medicine, 1440 Canal Street, Suite 1610, New Orleans, LA, 70112, USA
| | - X Qiu
- Centers of System Biology, Data Information and Reproductive Health, School of Basic Medical Science, School of Basic Medical Science, Central South University, Changsha, 410008, Hunan, China
| | - B Y Li
- Centers of System Biology, Data Information and Reproductive Health, School of Basic Medical Science, School of Basic Medical Science, Central South University, Changsha, 410008, Hunan, China
| | - W D Shen
- Centers of System Biology, Data Information and Reproductive Health, School of Basic Medical Science, School of Basic Medical Science, Central South University, Changsha, 410008, Hunan, China
| | - R P Quan
- Centers of System Biology, Data Information and Reproductive Health, School of Basic Medical Science, School of Basic Medical Science, Central South University, Changsha, 410008, Hunan, China
| | - J T Yang
- Centers of System Biology, Data Information and Reproductive Health, School of Basic Medical Science, School of Basic Medical Science, Central South University, Changsha, 410008, Hunan, China
| | - L Y Huang
- Centers of System Biology, Data Information and Reproductive Health, School of Basic Medical Science, School of Basic Medical Science, Central South University, Changsha, 410008, Hunan, China
| | - Y Xiao
- Centers of System Biology, Data Information and Reproductive Health, School of Basic Medical Science, School of Basic Medical Science, Central South University, Changsha, 410008, Hunan, China
| | - Z C Yang
- Department of Pharmacology, Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, 410078, Hunan, China
| | - Z Li
- School of Life Sciences, Central South University, Changsha, 410013, Hunan, China
| | - S C Wang
- College of Information Science and Engineering, Hunan Normal University, Changsha, 410081, Hunan, China
| | - H Ren
- Department of Pathology, Gongli Hospital, Second Military Medical University, Shanghai, 200135, China
- Department of Pathology, the Peace Hospital Affiliated to Changzhi Medical College, Changzhi, 046000, China
| | - C Liang
- Pathological Laboratory of Adicon Medical Laboratory Co., Ltd, Hangzhou, 310023, Zhejiang, China
| | - W Guo
- Department of Pathology, First Affiliated Hospital of Hunan Normal University, The People's Hospital of Hunan Province, Changsha, 410005, Hunan, China
| | - Y Li
- Department of Pathology, First Affiliated Hospital of Hunan Normal University, The People's Hospital of Hunan Province, Changsha, 410005, Hunan, China
| | - H Xiao
- Department of Pathology, the Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - Y Gu
- Department of Pathology, the Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - J P Yun
- Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - D Huang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Z Song
- Department of Pathology, Chinese PLA General Hospital, Beijing, 100853, China
| | - X Fan
- Department of Pathology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - L Chen
- Department of Pathology, The first affiliated hospital, Air Force Medical University, Xi'an, 710032, China
| | - X Yan
- Institute of Pathology and southwest cancer center, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
| | - Z Li
- Department of Pathology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Z C Huang
- Department of Biomedical Engineering, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - J Huang
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, 410013, Hunan, China
| | - J Luttrell
- School of Computing Sciences and Computer Engineering, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - C Y Zhang
- School of Computing Sciences and Computer Engineering, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - W Zhou
- College of Computing, Michigan Technological University, Houghton, MI, 49931, USA
| | - K Zhang
- Department of Computer Science, Bioinformatics Facility of Xavier NIH RCMI Cancer Research Center, Xavier University of Louisiana, New Orleans, LA, 70125, USA
| | - C Yi
- Department of Pathology, Ochsner Medical Center, New Orleans, LA, 70121, USA
| | - C Wu
- Department of Statistics, Florida State University, Tallahassee, FL, 32306, USA
| | - H Shen
- Department of Deming Department of Medicine, Tulane Center of Biomedical Informatics and Genomics, Tulane University School of Medicine, 1440 Canal Street, Suite 1610, New Orleans, LA, 70112, USA
- Division of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA, 70112, USA
| | - Y P Wang
- Department of Deming Department of Medicine, Tulane Center of Biomedical Informatics and Genomics, Tulane University School of Medicine, 1440 Canal Street, Suite 1610, New Orleans, LA, 70112, USA
- Department of Biomedical Engineering, Tulane University, New Orleans, LA, 70118, USA
| | - H M Xiao
- Centers of System Biology, Data Information and Reproductive Health, School of Basic Medical Science, School of Basic Medical Science, Central South University, Changsha, 410008, Hunan, China.
| | - H W Deng
- Department of Deming Department of Medicine, Tulane Center of Biomedical Informatics and Genomics, Tulane University School of Medicine, 1440 Canal Street, Suite 1610, New Orleans, LA, 70112, USA.
- Centers of System Biology, Data Information and Reproductive Health, School of Basic Medical Science, School of Basic Medical Science, Central South University, Changsha, 410008, Hunan, China.
- Division of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA, 70112, USA.
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Abstract
BACKGROUND To surgically remove osteoma and to keep an optimal cosmetic profile would be very challenging. To solve the difficulty, we utilized the three-dimensional (3D) printing technologies in generating a patient-specific instrument guide (PSIG) for the safe removal of a skull bone tumor. METHODS The preoperational brain computed tomography (CT) provided the digital imaging with thin slices, and then images were reconstructed into a 3D skull model. Based on the model, we designed a PSIG to make landmarks on the osteoma to avoid excessive removal of the skull bone. During the operation, the surgeons could remove the osteoma piece by piece by using the landmark as a reference point. RESULTS The PSIG was successfully applied to remove an osteoma that measured 60 × 48 × 40 mm over the left frontoparietal skull of a female patient. The 3D CT reconstruction taken both before and 4 months after surgery showed a significant change in the appearance of the osteoma. CONCLUSION The PSIG was able to guide the surgeon in the safe removal of the skull osteoma, as well as in maintaining the cosmetic skull profile.
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Affiliation(s)
- Tien-Hsiang Wang
- Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Mechanical Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Hsu Ma
- Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Li-Ying Huang
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yu-Cheng Hung
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Te-Han Wang
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Wen-Chan Yu
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Fang-Yau Chiu
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Shyh-Jen Wang
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Experimental Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan, ROC
- Address correspondence. Dr. Shyh-Jen Wang, Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: (S.-J. Wang)
| | - Wei-Ming Chen
- Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Address correspondence. Dr. Shyh-Jen Wang, Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: (S.-J. Wang)
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Gu YQ, Xia Y, Zhang SM, Bao X, Wu HM, Bian SS, Huang LY, Meng G, Niu KJ. [Method of dietary nutritional status assessment and its application in cohort study of nutritional epidemiology]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:1145-1150. [PMID: 32741185 DOI: 10.3760/cma.j.cn112338-20200110-00027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Minimizing the burden on study subjects and assessing the general dietary nutritional status as accurately as possible are the basis of a nutritional epidemiological cohort study in the general population. While introducing the main dietary nutrition assessment methods, this paper manly describes the basic contents and principles for the development of food frequency questionnaire, and briefly illustrates the problems and solutions for the development of area specific food frequency questionnaires by taking the example of Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study. Finally, discusses preliminarily the necessity and possibility of developing a national food frequency questionnaire.
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Affiliation(s)
- Y Q Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China; Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Y Xia
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - S M Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - X Bao
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - H M Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - S S Bian
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - L Y Huang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - G Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - K J Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
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Liu H, Zhang XR, Xu HC, Ma Y, Huang LY, Zhai LY, Zhao Y. Effects of VEGF Inhibitor Conbercept on Corneal Neovascularization Following Penetrating Keratoplasty in Rabbit Model. Clin Ophthalmol 2020; 14:2185-2193. [PMID: 32801629 PMCID: PMC7410491 DOI: 10.2147/opth.s260302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/09/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose To evaluate the effects of the vascular endothelial growth factor inhibitor conbercept (KH902) on corneal neovascularization and wound healing following penetrating keratoplasty in rabbits. Methods Conbercept was administered to New Zealand white rabbits through topical and subconjunctival routes. Corneal neovascularization and wound healing were examined by slit-lamp photography and histological analyses. The expressions of vascular endothelial growth factor inhibitor, α-smooth muscle actin, and keratocan in the corneal grafts were measured by real-time quantitative polymerase chain reaction (RT-qPCR). Results The anterior segment photographs demonstrated that corneal neovascularization started in the 2nd week. In the 4th week, histologically, the superficial corneal stroma layer showed disordered arrangement, and there were large numbers of dense inflammatory cells and blood vessels in the stroma layer. Vascular endothelial growth factor in the experimental groups was significantly decreased at all time points compared with the control group (both P = 0.001). Expression of α-smooth muscle actin in corneal grafts demonstrated an increase in time even it was lower in experimental groups, but the difference was not statistically significant (P equaled to 0.507 and 0.723, respectively). There were no significant differences with the expression of keratocan in all groups except that it significantly declined at the 4th week as to the second week in all groups and P values were 0.022, 0.020 and 0.014 in control (C), topical (E1), and subconjunctival (E2) group, respectively. Conclusion The study found that conbercept inhibited the formation of corneal neovascularization without affecting keratocan-mediated corneal wound healing and there were no significant differences between topical administration of different doses of conbercept on the rabbit corneal neovascularization after penetrating keratoplasty in this study.
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Affiliation(s)
- Huan Liu
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,Hebei OPO Eye Bank, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Xiao-Rong Zhang
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,Hebei OPO Eye Bank, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Hong-Chang Xu
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Yue Ma
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Li-Ying Huang
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Li-Ying Zhai
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
| | - Ying Zhao
- Hebei OPO Eye Bank, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China
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Lai YJ, Chen YY, Ko MC, Chou YS, Huang LY, Chen YT, Hung KC, Lin YK, Wang CC, Chen CC, Chuang PH, Yen YF. Low Socioeconomic Status Associated With Lower Utilization of Hospice Care Services During End-of-Life Treatment in Patients With Cancer: A Population-Based Cohort Study. J Pain Symptom Manage 2020; 60:309-315.e1. [PMID: 32240750 DOI: 10.1016/j.jpainsymman.2020.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 03/14/2020] [Accepted: 03/19/2020] [Indexed: 01/22/2023]
Abstract
CONTEXT Socioeconomic status (SES) is an important determinant of disparities in health services and may affect the utilization of hospice care services during end-of-life (EOL) treatment in patients with cancer. However, previous studies evaluating the association between SES and utilization of hospice care services among patients with cancer revealed inconsistent findings. OBJECTIVES This study aimed to determine the association between SES and utilization of hospice care services during the last year of life in patients with cancer. METHODS From January 1, 2006 to December 31, 2016, we identified adults with cancer diagnoses from the Registry for Catastrophic Illness in Taiwan. The cancer diagnoses in study subjects were proved by the pathohistological reports. The utilization of hospice care services during the last year of life in patients with cancer included hospice inpatient care, hospice-shared care, and hospice home care. RESULTS In the follow-up period, 28.6% of 516,409 patients with cancer used hospice care services during the last year of life. After adjusting for other covariates, low SES significantly reduced the utilization of hospice care services by 18% during the last year of life in patients with cancer. Moreover, a positive trend between decreasing levels of SES and lower utilization of hospice care during EOL treatment was noted (P < 0.001). CONCLUSION Low SES was associated with lower utilization of hospice care services during EOL care in patients with cancer. Our data support the need to target low SES patients with cancer in efforts to optimally increase hospice care services during EOL care.
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Affiliation(s)
- Yun-Ju Lai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan; Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan
| | - Yu-Yen Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Chung Ko
- Department of Urology, Taipei City Hospital, Taipei, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yi-Sheng Chou
- Department of Hematology and Oncology, Taipei City Hospital, Renai Branch, Taipei, Taiwan
| | - Li-Ying Huang
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei City, Taiwan; Department of Medical Education, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Yi-Tui Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu-Kai Lin
- Department of Health and Welfare, College of City Management, University of Taipei, Taipei, Taiwan
| | - Chun-Chieh Wang
- Division of Chest Medicine, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Taichung, Taiwan; Central Taiwan University of Science and Technology Department of Eldercare, Taichung, Taiwan
| | - Chu-Chieh Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Pei-Hung Chuang
- Taipei Association of Health and Welfare Data Science, Taipei, Taiwan
| | - Yung-Feng Yen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Section of Infectious Diseases, Taipei City Hospital, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
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Abstract
Purpose: To provide a detailed review on the therapeutic efficacy of conbercept for the management of ocular vasculopathies. Methods: A comprehensive literature search of various electronic databases was performed. Results: Ocular vasculopathy is one of the major causes of visual impairment and blindness which includes a range of disorders. Vascular endothelial growth factor (VEGF) regulates angiogenesis, enhances vascular permeability, and drives the formation of neovascularization. Anti-VEGF therapy has been shown to prevent vision loss or potentially improve vision in patients with exudative or neovascular retinal disease. The most recent anti-VEGF drug in China is conbercept. In the USA and Europe, bevacizumab is the most recently approved anti-VEGF agent. Conclusions: Conbercept serves as another anti-VEGF option for patients with neovascular AMD and other retinal vascular disorders. There have not been many clinical trials that study conbercept as compared with other currently available anti-VEGF drugs. There is a need for large-scale, well-designed, randomized clinical trials to ensure its long-term safety and efficacy and to determine if it has any advantages over other anti-VEGF agents.
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Affiliation(s)
- Huan Liu
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University , Shijiazhuang, Hebei, China.,Hebei OPO Eye Bank, The Third Affiliated Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Yue Ma
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Hong-Chang Xu
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Li-Ying Huang
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
| | - Li-Ying Zhai
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University , Shijiazhuang, Hebei, China.,Department of Ophthalmology, Cangzhou Central Hospital , Cangzhou, Hebei, China
| | - Xiao-Rong Zhang
- Division of Ocular Injuries, Department of Ophthalmology, The Third Affiliated Hospital of Hebei Medical University , Shijiazhuang, Hebei, China.,Hebei OPO Eye Bank, The Third Affiliated Hospital of Hebei Medical University , Shijiazhuang, Hebei, China
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Chen YY, Chou P, Huang YF, Chien HJ, Wu YC, Lee CC, Huang LY, Chen HH. Repeated intravitreal injections of antivascular endothelial growth factor in patients with neovascular age-related macular degeneration may increase the risk of ischemic optic neuropathy. BMC Ophthalmol 2019; 19:268. [PMID: 31888553 PMCID: PMC6937927 DOI: 10.1186/s12886-019-1284-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 12/23/2019] [Indexed: 12/12/2022] Open
Abstract
Background Previous case reports have demonstrated the occurrence of ischemic optic neuropathy (ION) following intravitreal injections of antivascular endothelial growth factor (anti-VEGF). However, no previous studies have investigated the impact of injection numbers on the risk of ION. The aim of our study was to investigate whether repeated intravitreal injections of anti-VEGF would increase the risk of subsequent ION in patients with neovascular age-related macular degeneration (AMD). Methods A population-based, retrospective cohort study using the Taiwan National Health Insurance Research Database was conducted from 2007 to 2013. Neovascular AMD patients receiving intravitreal injections of anti-VEGF during the study period were enrolled in the study cohort. Enrollees were divided into three groups according to the categorized levels of injection number (first level: < 10 times, second level: 10–15 times, and third level: > 15 times). Kaplan-Meier curves were generated to compare the cumulative hazard of subsequent ION among the three groups. Cox regression analyses were used to estimate crude and adjusted hazard ratios (HRs) for ION development with respect to the different levels of injection numbers. The confounders included for adjustment were age, sex, and comorbidities (diabetes, hypertension, hyperlipidemia, ischemic heart disease, and glaucoma). Results In total, the study cohort included 77,210 patients. Of these, 26,520, 38,010, and 12,680 were in the first-, second-, and third-level groups, respectively. The Kaplan-Meier method revealed that the cumulative hazards of ION were significantly higher in those who had a higher injection number. After adjusting for confounders, the adjusted HRs for ION in the second- and third-level groups were 1.91 (95% confidence interval [CI], 1.32–2.76) and 2.20 (95% CI, 1.42–3.43), respectively, compared with those in the first-level group. Conclusions Among patients with neovascular AMD, those who receive a higher number of anti-VEGF injections have a significantly higher risk of developing ION compared with individuals who receive a lower number of injections.
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Affiliation(s)
- Yu-Yen Chen
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan. .,School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
| | - Pesus Chou
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Fang Huang
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan
| | - Hung-Jen Chien
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan
| | - Yu-Chieh Wu
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan
| | - Chia-Chi Lee
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan
| | - Li-Ying Huang
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei, Taiwan.,Department of Medical Education, Fu Jen Catholic University Hospital, New Taipei, Taiwan
| | - Hsin-Hua Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.,Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Institute of Biomedical Science and Rong-Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan
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Wang LM, Dong LJ, Liu X, Huang LY, Liu W, Lyu YJ, Li XR, Liu AH. [Proteomic analysis of aqueous humor in acute primary angle-closure glaucoma]. Zhonghua Yan Ke Za Zhi 2019; 55:687-694. [PMID: 31495154 DOI: 10.3760/cma.j.issn.0412-4081.2019.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the difference among expression of aqueous humor proteins in acute primary angle-closure glaucoma (APACG). Methods: Case-control study. The patients with APACG combined cataract (APACG with cataract group) and patients with cataract (cataract group), who had undertaken surgical treatment at the Tianjin Medical University Eye Hospital from October 2016 to June2017 were collected. Upon receipt of patient's consent, 50 μl of aqueous humor were collected with 1 ml syringe and No.1 needle through the surgical access during the surgery, and then injected into a sterile collection tube to be stored at -80 ℃. Those proteins extracted from aqueous humor were analyzed by quantitative proteomic mass spectrometry. The differential significance test was performed by Maxquant significances A approach. The differential proteins of the two groups were screened and determined with the conditions of P<0.05 and difference multiple>2. The functions and signal pathway of differential proteins in aqueous humor were annotated in biological big data, on the basis gene ontology (GO) and the Kyoto gene and genomic encyclopedia (KEGG) analyses. Results: There were 3 males and 7 females with an average age of (68±6) years in the APACG group. The cataract group included 2 males and 8 females with an average age of (71±8) years. There were no statistical differences in gender ratio and age between the two groups (both P>0.05). A total of 91 differential proteins were detected in this experiment, including 50 up-regulated proteins (annexinA1, vimentin, S100 calcium binding protein A8, interleukin 6, C reactive protein, laminin β2, etc.) and 41 down-regulated (keratin 85, γ-crystallin D, syntaxin-binding protein 5, semaphoring 4B, matrilin 2, cathepsin O, cadherin 4, semaphoring 3B, platelet-derived growth factor D, transforming growth factor β, etc.). On one hand, the functions of differential proteins involved in many aspects. AnnexinA1, CD163, S100 calcium-binding protein A8, C reactive protein, interleukin 6 are involved in the inflammatory reaction, cadherin 4 and laminin β2 regulate cell adhesion, matrilin 2, vimentin and laminin β2 participate in tissue fibrosis; on the other hand, KEGG analysis showed that the differential proteins participate diverse signaling pathways such as phosphatidylinositol-3-kinase-protein kinase B signaling pathway, transformation growth factor β signaling pathway, mitogen activated protein kinase signaling pathway, Toll-like receptor signaling pathway, the nuclear factor κ-light chain enhancer of the activated B cells signaling pathway, focal adhension and extracellular matrix receptor interaction pathway and so on. Conclusions: The expression of annexin A1 is significantly up-regulated in the aqueous humor in APACG, while some other factors such as transformation growth factor β, cadherin-4, and matrilin 2 are down-regulated. The change of proteins in aqueous humor is related with the outbreak of APACG. (Chin J Ophthalmol, 2019, 55: 687-694).
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Affiliation(s)
- L M Wang
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin 300384, China
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Chen K, Feng CJ, Ma H, Hsiao FY, Tseng LM, Tsai YF, Lin YS, Huang LY, Yu WC, Perng CK. Preoperative breast volume evaluation of one-stage immediate breast reconstruction using three-dimensional surface imaging and a printed mold. J Chin Med Assoc 2019; 82:732-739. [PMID: 31335631 DOI: 10.1097/jcma.0000000000000155] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Accurate assessment of breast volume is an essential component of preoperative planning in one-stage immediate breast reconstruction (IBR) for achieving breast symmetry and a satisfactory cosmetic outcome. In this study, we compared breast volume estimation using three-dimensional (3D) surface imaging with magnetic resonance imaging (MRI) to determine the accuracy of breast volume measurements. Further, a 3D printing mold for facilitating autologous breast reconstruction intraoperatively is described. METHODS Patients scheduled to therapeutic or prophylactic mastectomy with one-stage IBR, either by autologous tissue transfer or direct implant, from 2016 to 2019, were enrolled in this study. 3D surface image and MRI were performed to evaluate breast volume and shape. The results were validated by the water displacement volume of the mastectomy specimen. Finally, a 3D printing mold was designed for breast reconstruction with autologous tissue. RESULTS Nineteen women who were scheduled to have 20 mastectomies (18 unilateral and one bilateral) were included. There was a strong linear association between breast volume measured using the two different methods and water displacement of mastectomy specimens when a Pearson correlation was used (3D surface image: r = 0.925, p < 0.001; MRI: r = 0.915, p < 0.001). Bland-Altman plots demonstrated no proportional bias between the assessment methods. The coefficient of variation was 52.7% for 3D surface imaging and 59.9% for MRI. The volume of six breasts was evaluated by both measurements and the intraclass correlation coefficient was 0.689 for 3D surface image (p = 0.043) and 0.743 for MRI (p = 0.028). CONCLUSION Using 3D surface image to evaluate breast shape and volume is a quick, effective, and convenient method. The accuracy, reproducibility, and reliability of 3D surface imaging were comparable with MRI in our study. In addition, 3D-printed molds can achieve better symmetry and aesthetic outcomes in immediate autologous breast reconstructions.
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Affiliation(s)
- Keng Chen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chin-Jung Feng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Comprehensive Breast Health Center and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Hsu Ma
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Surgery, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Fu-Yin Hsiao
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Comprehensive Breast Health Center and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Doctoral Degree Program of Translational Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ling-Ming Tseng
- Comprehensive Breast Health Center and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine and Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yi-Fang Tsai
- Comprehensive Breast Health Center and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine and Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yen-Shu Lin
- Comprehensive Breast Health Center and Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Li-Ying Huang
- 3D Printing Technology and Resource Integration Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Wen-Chan Yu
- 3D Printing Technology and Resource Integration Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Cherng-Kang Perng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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Tan S, Liu J, Fang Y, Hedlund BP, Lian ZH, Huang LY, Li JT, Huang LN, Li WJ, Jiang HC, Dong HL, Shu WS. Insights into ecological role of a new deltaproteobacterial order Candidatus Acidulodesulfobacterales by metagenomics and metatranscriptomics. ISME J 2019; 13:2044-2057. [PMID: 30962514 PMCID: PMC6776010 DOI: 10.1038/s41396-019-0415-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/15/2019] [Accepted: 03/24/2019] [Indexed: 12/21/2022]
Abstract
Several abundant but yet uncultivated bacterial groups exist in extreme iron- and sulfur-rich environments, and the physiology, biodiversity, and ecological roles of these bacteria remain a mystery. Here we retrieved four metagenome-assembled genomes (MAGs) from an artificial acid mine drainage (AMD) system, and propose they belong to a new deltaproteobacterial order, Candidatus Acidulodesulfobacterales. The distribution pattern of Ca. Acidulodesulfobacterales in AMDs across Southeast China correlated strongly with ferrous iron. Reconstructed metabolic pathways and gene expression profiles showed that they were likely facultatively anaerobic autotrophs capable of nitrogen fixation. In addition to dissimilatory sulfate reduction, encoded by dsrAB, dsrD, dsrL, and dsrEFH genes, these microorganisms might also oxidize sulfide, depending on oxygen concentration and/or oxidation reduction potential. Several genes with homology to those involved in iron metabolism were also identified, suggesting their potential role in iron cycling. In addition, the expression of abundant resistance genes revealed the mechanisms of adaptation and response to the extreme environmental stresses endured by these organisms in the AMD environment. These findings shed light on the distribution, diversity, and potential ecological role of the new order Ca. Acidulodesulfobacterales in nature.
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Affiliation(s)
- Sha Tan
- State Key Laboratory of Biocontrol, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, 510275, Guangzhou, China
| | - Jun Liu
- State Key Laboratory of Biocontrol, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, 510275, Guangzhou, China
- Department of Geology and Environmental Earth Science, Miami University, Oxford, OH, 45056, USA
| | - Yun Fang
- State Key Laboratory of Biogeology and Environmental Geology, China University of Geosciences, 430074, Wuhan, China
| | - Brian P Hedlund
- School of Life Sciences, University of Nevada Las Vegas, Las Vegas, NV, 89154, USA
- Nevada Institute of Personalized Medicine, University of Nevada Las Vegas, Las Vegas, NV, 89154, USA
| | - Zheng-Han Lian
- State Key Laboratory of Biocontrol, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, 510275, Guangzhou, China
- Guangdong Magigene Biotechnology Co. Ltd., 510000, Guangzhou, China
| | - Li-Ying Huang
- State Key Laboratory of Biocontrol, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, 510275, Guangzhou, China
| | - Jin-Tian Li
- School of Life Sciences, South China Normal University, 510631, Guangzhou, China
| | - Li-Nan Huang
- State Key Laboratory of Biocontrol, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, 510275, Guangzhou, China
| | - Wen-Jun Li
- State Key Laboratory of Biocontrol, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-Sen University, 510275, Guangzhou, China
| | - Hong-Chen Jiang
- State Key Laboratory of Biogeology and Environmental Geology, China University of Geosciences, 430074, Wuhan, China
| | - Hai-Liang Dong
- Department of Geology and Environmental Earth Science, Miami University, Oxford, OH, 45056, USA.
- State Key Laboratory of Biogeology and Environmental Geology, China University of Geosciences, 100083, Beijing, China.
| | - Wen-Sheng Shu
- School of Life Sciences, South China Normal University, 510631, Guangzhou, China.
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Teng H, Huang LY, Tian F, Dong LJ, Zhang H. [Effects of SMP-30 overexpression on apoptosis of human lens epithelial cells induced by ultraviolet B irradiation]. Zhonghua Yan Ke Za Zhi 2019; 53:835-841. [PMID: 29141388 DOI: 10.3760/cma.j.issn.0412-4081.2017.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: This study was to observe the effect of SMP-30 on ultraviolet B (UVB)-induced apoptosis of human lens epithelial cells(HLE-B3) in vitro. Methods: Experimental study. The SMP-30 cDNA was amplified by PCR and inserted into the pRFP-N1 expressing vector which had been double digested by XhoI/HindIII. HLE-B3 cells were cultured and divided into three groups: normal group, pRFP-N1 vector plasmid group and pRFP-N1-SMP-30 plasmid group (SMP-30). Then cells were exposed to UVB and the survival rate of cells was detected by MTT assay. The effects of SMP-30 on UVB-induced HLE-B3 apoptosis were measured by the Cell Death Detection ELISA kit. Meanwhile, the influence of SMP-30 on UVB-induced apoptosis-relative protein expression in HLE-B3 cells was tested by Western blots. Moreover, 2', 7'-Dichlorofluorescin diacetate staining was performed to monitor the protective effects of SMP-30 on UVB-induced HLE-B3 reactive oxygen species(ROS). One-way analysis of variance combined with Dunnett's statistical method were performed to analyze the data. Results: The full length of PSF cDNA fragment was correctly inserted into the pRFP-N1 vector, which was confirmed by DNA sequencing. The SMP-30 fragment was inserted to the plasmid pRFP-N1 correctly, which was also confirmed by DNA sequencing. The PRFP-N1-SMP-30 plasmid was transfected into HLE-B3 successfully. SMP-30 expression was up-regulated in the transfection group, compared with the control group. Data showed that the survival rate of HLE-B3 after the pRFP-N1-SMP-30 plasmid transfection was 0.90±0.14, while the apoptosis rate was 0.43±0.06 and the ROS production was 0.52±0.02, showing significant difference in comparison with the vector plasmid group and the normal group(t=5.830, 9.934, 12.19, P<0.05). In the meantime, SMP-30 overexpression down-regulated the levels of Bax and cleav-caspase-3, but up-regulated the Bcl-2 and Pro-caspase-3 expression levels under UVB irradiation. Conclusion: SMP-30 overexpression plays a protective role in UVB-induced apoptosis via regulating the expression of apoptosis-related proteins and inhibiting the production of ROS in HLE-B3 cells. (Chin J Ophthalmol, 2017, 53: 835-841).
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Affiliation(s)
- H Teng
- Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, College of Optometry and Ophthalmology, Tianjin 300384, China
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Huang TY, Pan LLH, Yang WW, Huang LY, Sun PC, Chen CS. Biomechanical Evaluation of Three-Dimensional Printed Dynamic Hand Device for Patients With Chronic Stroke. IEEE Trans Neural Syst Rehabil Eng 2019; 27:1246-1252. [DOI: 10.1109/tnsre.2019.2915260] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Huang LY, Yang MC, Tsou HM, Liu TY. Hemocompatibility and anti-fouling behavior of multilayer biopolymers immobilized on gold-thiolized drug-eluting cardiovascular stents. Colloids Surf B Biointerfaces 2018; 173:470-477. [PMID: 30326363 DOI: 10.1016/j.colsurfb.2018.10.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/10/2018] [Accepted: 10/06/2018] [Indexed: 10/28/2022]
Abstract
To solve the thrombosis and restenosis problem in cardiovascular stent implantation for cardiovascular artery disease, chondroitin 6-sulfate (ChS) with heparin (HEP) have been used as drug carrier layers and alternatively covalently bonded on gold (Au)-dimercaptosuccinic acid (DMSA)-thiolized cardiovascular metallic (SUS316 L stainless steel, SS) stents. Sirolimus, a model drug, was encapsulated in the ChS-HEP alternative layers. The behavior of the drug in releasing and suppressing the growth of smooth-muscle cells (SMCs) was evaluated with 5-layer CHS-HEP coating on the SS stents. Moreover, hemocompatibility of blood clotting time and platelet adhesion was performed. The results showed that the 5-layer ChS-HEP-modified SS stents displayed the greatest hemocompatibility, showing prolonged blood clotting time of the activated partial thrombin time (> 500 s) and less platelet adhesion to reduce thrombosis. Furthermore, sirolimus can be released continuously for more than 40 days with the 5-layer ChS-HEP coating and is beneficial for inhibiting the growth of SMCs; however, it does not affect the proliferation of endothelial cells, which can avoid restenosis formation. Therefore, the multilayers of ChS-HEP grafted onto the Au-DMSA-cardiovascular SS stents provide high potential for use as drug eluting stents.
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Affiliation(s)
- Li-Ying Huang
- Department of Materials Science and Engineering, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan
| | - Ming-Chien Yang
- Department of Materials Science and Engineering, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan.
| | - Hui-Ming Tsou
- Department of Materials Engineering, Ming Chi University of Technology, New Taipei City, 24301, Taiwan
| | - Ting-Yu Liu
- Department of Materials Engineering, Ming Chi University of Technology, New Taipei City, 24301, Taiwan.
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Wu PK, Shih YC, Chen CM, Chen G, Chen WM, Huang LY, Hung YC, Wang TH, Yu WC, Chang CK, Chang BC, Lin PH, Wang SJ. Printing a 3-dimensional, Patient-speci c Splint for Wound Immobilization: A Case Demonstration. OWM 2018. [DOI: 10.25270/0wm/2018.7.817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Wu HM, Liu C, Liu XH, Yao J, Liao JQ, Chen Y, Mei P, Huang LY, Liu YH. [Clinicopathologic features of myxoid adrenocortical adenomas]. Zhonghua Bing Li Xue Za Zhi 2018; 47:527-530. [PMID: 29996318 DOI: 10.3760/cma.j.issn.0529-5807.2018.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the clinicopathologic characteristics, immunophenotype, pathologic diagnosis and differential diagnosis of myxoid adrenocortical adenomas. Methods: The clinical data, histological features and immunohistochemical results of 4 cases of myxoid adrenocortical adenomas were analyzed, which were collected from January 2014 to December 2016 at Guangdong General Hospital, with review of literature. Results: Four cases of myxoid adrenocortical adenomas were presented. The patients ages ranged from 26 to 45 years (mean =35 years). Microscopically, it showed a typical morphology, characterized by small-sized tumor cell cords or pseudo-glands embedded in an abundant extracellular myxoid matrix. Immunohistochemical staining showed tumor cells were strongly positive for Melan A, vimentin and focally for α-inhibin, one case showed strong and diffuse positivity for CAM5.2, and two cases showed diffuse positivity for synaptophysin, while negative for CgA, S-100 protein, epithelial antigen, CK7, CK20 and CKpan. Conclusions: Myxoid adrenocortical adenomas are extremely rare, which may cause confusion with metastatic well-differentiated neuroendocrine tumours, sex cord-stromal tumoursor metanephric adenoma. Recognition of this entity would be beneficial for pathologists to avoid misdiagnosis, and unnecessary treatment.
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Affiliation(s)
- H M Wu
- Department of Pathology, Guangdong General Hospital; Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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Chu D, Yen YF, Hu HY, Lai YJ, Sun WJ, Ko MC, Huang LY, Chen CC, Curtis JR, Lee YL, Huang SJ. Factors associated with advance directives completion among patients with advance care planning communication in Taipei, Taiwan. PLoS One 2018; 13:e0197552. [PMID: 29979678 PMCID: PMC6034783 DOI: 10.1371/journal.pone.0197552] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 05/06/2018] [Indexed: 12/19/2022] Open
Abstract
Background Although advance directives (AD) have been implemented for years in western countries, the concept of AD is not promoted extensively in eastern countries. In this study we evaluate a program to systematically conduct advance care planning (ACP) communication for hospitalized patients in Taiwan and identify the factors associated with AD completion. Methods In this retrospective evaluation of a clinical ACP program, we identified adult patients with chronic life-limiting illness admitted to Taipei City Hospital between April 2015 and January 2016. Trained healthcare providers held an ACP meeting to discuss patients’ preference regarding end-of-life care and AD completion. A multiple logistic regression was performed to determine the factors associated with the AD completion. Results A total of 2878 patients were determined to be eligible for ACP during the study, among which 1798 (62.5%) completed ACP and data was available for 1411 patients (49.1%). Of the 1411 patients who received ACP communication with complete data, the rate of AD completion was 82.6%. The overall mean (SD) age was 78.2 (14.4) years. Adjusting for other variables, AD completion was associated with patients aged ≥ 85 years [adjusted odds ratio (AOR) = 1.80, 95% CI 1.21–2.67], critical illness (AOR = 1.17, 95% CI 1.06–1.30), and social workers participating in ACP meetings (AOR = 1.74, 95% CI 1.24–2.45). Conclusion The majority of inpatients with chronic life-limiting illness had ACP communication as part of this ACP program and over 80% completed an AD. Our study demonstrates the feasibility of implementing ACP discussion in East Asia and suggests that social workers may be an important component of ACP communication with patients.
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Affiliation(s)
- Dachen Chu
- Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- * E-mail:
| | - Yung-Feng Yen
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Section of Infectious Diseases, Taipei City Hospital, Taipei, Taiwan
| | - Hsiao-Yun Hu
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Yun-Ju Lai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan
| | - Wen-Jung Sun
- Community Medicine Department & Family Medicine Division, Taipei City Hospital Zhongxing Branch, Taipei, Taiwan
| | - Ming-Chung Ko
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Department of Urology, Taipei City Hospital, Taipei, Taiwan
| | - Li-Ying Huang
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Chu-Chieh Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - J. Randall Curtis
- Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Seattle, Washington
| | - Ya-Ling Lee
- Department of Dentistry, Taipei City Hospital, Taipei, Taiwan
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Sheng-Jean Huang
- Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan
- Department of Surgery, Medical College, National Taiwan University Hospital, Taipei, Taiwan
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Wu PK, Shih YC, Chen CM, Chen G, Chen WM, Huang LY, Hung YC, Wang TH, Yu WC, Chang CK, Chang BC, Lin PH, Wang SJ. Printing a 3-dimensional, Patient-specific Splint for Wound Immobilization: A Case Demonstration. Ostomy Wound Manage 2018; 64:28-33. [PMID: 30059337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Three-dimensional (3D) printing technology can generate objects in almost any shape and geometry. This technique also has clinical applications, such as the fabrication of specific devices based on a patient's anatomy. A demonstration study is presented of a 54-year-old man who needed a thermoplastic splint to limit arm movement while a dehisced left shoulder wound healed. The patient's upper extremity was scanned using the appropriate noncontact scanner and 3D technology software, and the polylactic acid splint was printed over the course of 66 hours. This patient-specific splint was worn during the day, and after 2 weeks the wound was healed sufficiently to permit hospital discharge. Creation of an individualized splint is one of many potential medical uses of 3D technology. Although the lengthy printing time imposes limitations, the implications for practice are positive.
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Affiliation(s)
- Po-Kuei Wu
- Therapeutical and Research Center, Musculoskeletal Tumor, Department of Orthopedic Surgery and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chung Shih
- Division of Plastic and Reconstructive Surgery, Taipei Veterans General Hospital; Department of Surgery, School of Medicine, National Yang-Ming University
| | - Chao-Ming Chen
- Department of Orthopedic Surgery and Traumatology, Taipei Veterans General Hospital; and Institute of Clinical Medicine, National Yang-Ming University
| | - Geng Chen
- Division of Plastic and Reconstructive Surgery, Taipei Veterans General Hospital; and Department of Surgery, National Yang-Ming University
| | - Wei-Ming Chen
- Taipei Veterans General Hospital; and Institute of Clinical Medicine, School of Medicine, National Yang-Ming University
| | - Li-Ying Huang
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital
| | - Yu-Cheng Hung
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital
| | - Te-Han Wang
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital
| | - Wen-Chan Yu
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital
| | - Chin-Kang Chang
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital
| | - Bao-Chi Chang
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital; and Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan City, Taiwan
| | - Pei-Hsin Lin
- Rehabilitation and Technical Aids Center, Taipei Veterans General Hospital
| | - Shyh-Jen Wang
- Rehabilitation and Technical Aids Center and Division of Experimental Surgery; and Institute of Hospital and Health Care Administration, National Yang-Ming University
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Huang LY, Liu JX, Huang AL, Yang F. [Tubal metastasis of cervical adenocarcinoma: report of two cases]. Zhonghua Bing Li Xue Za Zhi 2018; 47:300-301. [PMID: 29690674 DOI: 10.3760/cma.j.issn.0529-5807.2018.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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