Objective To explore prognosis and remission-related factors in lupus nephritis (LN) patients.Methods Patients diagnosed as LN by renal biopsy in Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology between Jan 1,2011 and July 31,2016 were enrolled.All related baseline clinical data was recorded and regular follow-up was performed.Kaplan-Meier curves was used to analyze partial remission and complete remission rates.Log-rank test was performed to compare remission rates of patients with nephrotic-range proteinuria (24-hour proteinuria≥3.5 g) and without nephrotic-range proteinuria (24-hour proteinuria＜3.5 g).Univariate and muhivariate Cox regression analyses were performed to evaluate the remission-related factors in different periods.Results A total of 115 patients,with 88.7％ female and (31.5±9.5)years mean age,were followed up for up to 5 years.During follow-up period 2 patients died and 1 dialyzed.The 6-,12-,24-and 36-and 48-month renal partial remission and complete remission rates were 33.3％,58.2％,71.5％,84.0％,89.6％,and 18.9％,40.5％,67.3％,79.4％,87.0％,respectively.Patients without nephrotic-range proteinuria had higher complete remission than patients with nephrotic -range proteinuria (HR=2.01,95％CI 1.15-3.34,P=0.014),but there was no difference in their partial remission (HR=1.33,95％ CI 0.74-2.43,P=0.341).Multivariate Cox regression model indicated that every 1 g/L increase in baseline level of serum albumin was associated with increased 8％ and 9％ risk,respectively,in partial remission (HR=1.08,95％CI 1.01-1.15,P=0.024) and complete remission (HR=1.09,95％CI 1.01-1.07,P=0.038).Conclusions Around half of LN patients reach remission during 1 year.Patients without nephrotic-range proteinuria have higher complete remission,and serum albumin is a remission-related factors.

Autophagy, an evolutionarily conserved lysosomal degradation process, has drawn an increasing amount of attention in recent years for its role in a variety of human diseases, such as cancer. Notably, autophagy plays an important role in regulating several survival and death signaling pathways that determine cell fate in cancer. To date, substantial evidence has demonstrated that some key autophagic mediators, such as autophagy-related genes (ATGs), PI3K, mTOR, p53, and Beclin-1, may play crucial roles in modulating autophagic activity in cancer initiation and progression. Because autophagy-modulating agents such as rapamycin and chloroquine have already been used clinically to treat cancer, it is conceivable that targeting autophagic pathways may provide a new opportunity for discovery and development of more novel cancer therapeutics. With a deeper understanding of the regulatory mechanisms governing autophagy, we will have a better opportunity to facilitate the exploitation of autophagy as a target for therapeutic intervention in cancer. This review discusses the current status of targeting autophagic pathways as a potential cancer therapy.
Antibiotics, Antineoplastic ; therapeutic use ; Apoptosis Regulatory Proteins ; metabolism ; Autophagy ; drug effects ; genetics ; Beclin-1 ; Chloroquine ; therapeutic use ; Drug Discovery ; Humans ; Membrane Proteins ; metabolism ; Molecular Targeted Therapy ; Neoplasms ; metabolism ; pathology ; therapy ; Phosphatidylinositol 3-Kinases ; antagonists & inhibitors ; metabolism ; Signal Transduction ; Sirolimus ; therapeutic use ; TOR Serine-Threonine Kinases ; metabolism ; Tumor Suppressor Protein p53 ; metabolism

Original missions: Aquatic therapy in Cheng Hsin General Hospital was founded specifically for patients with poliomyelitis in 1960s. At that time, Taiwan was shrouded in darkness due to the outbreak of polio. Many children were paralyzed overnight and thousands of families broke down. Desperate as they were, they had caught a glimmer of hope when the First Lady, Madam Chiang, decided to run a national shelter for children with polio. Cheng Hsin Children’s Home was built and involved in educational and medical systems to provide full time care for free. Aquatic therapy was also included at that time. Following Missions: After poliomyelitis being eradicated in Taiwan in 1983, our team was dedicated in aquatic rehabilitation for people with all kinds of disabilities. Since Taiwan National Health Insurance System being established in 1995, the population receiving rehabilitation kept on rising. As a pioneer in the field of aquatic therapy, we delivered our experience to assist in construction of aquatic rehabilitation nationwide. Learning from the numerous cases, we have accumulated much experience, especially neurological deficits. Thus, physical therapists in Cheng Hsin General Hospital have designed some treatment guidelines for neurological patients. These guidelines, though not standardized, provide therapists various aspects to evaluate clinical problems and to design programs (See Table). Further missions: From the polio to all kinds of special needs, aquatic therapy in Cheng Hsin General Hospital has prosperously developed. In order to broaden our horizon, our team is eager to joining international society of medical hydrology and adopting professional advices and collaboration.

OBJECTIVEClinical observation of electrophysiological study and implantable cardioverter defibrillator (ICD) therapy in patients with Brugada syndrome.

METHODSTen patients (all male) with Brugada wave (spontaneous or propafenone test positive in ECG) underwent electrophysiological study (EPS). The mean age was (41 +/- 10) years. They had no structural heart disease with echocardiogram and the angiogram work-up. The ICD implanted in the patients with EPS-induced ventricular fibrillation in those who were available.

RESULTSThree patients had the history of familial sudden cardiac death (SCD). Four patients had repeated syncope episodes, two of them had documented ventricular fibrillation during syncope episodes. The AH and HV intervals were 50 - 124 (86 +/- 21) ms and 41 - 84 (58 +/- 15) ms. The ventricular fibrillation was induced in four patients with syncope and atrioventricular reentry tachycardia in one patient with palpitation. Three patients had spontaneous or inducible atrial fibrillation. The ICD implanted in three patients with inducible ventricular fibrillation. Due to economic issue, one patient without ICD implantation had got SCD during follow-up. The patient with atrioventricular reentry tachycardia underwent a successful left atrioventricular accessory pathway ablation.

CONCLUSIONThe Brugada patients with syncope and high rate of inducible ventricular fibrillation in EPS are the high risk population for SCD, in whom ICD should implant promptly to prevent SCD.

Adult ; Brugada Syndrome ; physiopathology ; therapy ; Death, Sudden, Cardiac ; prevention & control ; Defibrillators, Implantable ; Electrophysiology ; Humans ; Male ; Middle Aged ; Ventricular Fibrillation ; therapy

OBJECTIVETo study the characterization of time distribution of ventricular arrhythmias in patients with Brugada syndrome (BrS) using Holter monitoring and ICD follow-up.

METHODSPatients with BrS [all male, mean age (41.07 +/- 11.49) years], were divided into ventricular fibrillation (VF) group (n = 7) and no ventricular fibrillation (N-VF) group (n = 7). Premature ventricular capture (PVC) and VF episodes were detected by Holter monitoring and ICD recording.

RESULTSThe 24 hours total number of PVCs ranged from 0 to 74 (mean 9.61 +/- 17.23) in most of the patients and were similar between VF group and N-VF group. The percentage of PVC episodes in VF group was significantly higher than that in N-VF group from nocturnal time to early morning (22:00 to 7:00, 98.67% vs. 44.14%, P < 0.01). There were total 75 VF episodes during (23.18 +/- 17.96) months' follow-up in 5 patients with BrS, 93.3% of which occurred from nocturnal time to early morning (22:00 to 7:00).

CONCLUSIONSThe episodes of PVC were enriched from nocturnal time to early morning in BrS patients, this time distribution could be a new noninvasive risk stratification factor for BrS. The episodes of VF in BrS patients were also enriched from nocturnal time to early morning and this time characteristic of episodes of VF could be used to guide drug therapy.

Adult ; Brugada Syndrome ; complications ; physiopathology ; Electrocardiography ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Risk Factors ; Time ; Ventricular Fibrillation ; etiology

OBJECTIVETo investigate the changes of open probability (Po) of large conductance Ca(2+)-activated K(+) channel (BK channel) in diabetic coronary smooth muscle cells and elucidate the underlying cellular electrophysiology mechanisms of coronary dysfunction.

METHODSRat coronary smooth muscle cells were isolated from control group and diabetic group. BK single channel currents were recorded by patch clamp technique in inside-out configuration. Open probabilities were calculated and compared between two groups. After exposure to DHS-1, a specific BK channel activator, Po at 0.2 and 1 µmol/L free Ca(2+) were compared between control and diabetic groups.

RESULTSIn the presence of 0.2 µmol/L free Ca(2+), the Po at baseline was significantly lower in diabetic rats than in control rats (0.0032 ± 0.0012 vs. 0.095 ± 0.036, P < 0.05). Cytoplasmic application of DSH-1 significantly increased the Po to 0.335 ± 0.096 (P < 0.05 vs. baseline) in control rats, whereas DSH-1 had no effect in diabetic rats (Po = 0.022 ± 0.018, P > 0.05 vs. baseline). In the presence of 1 µmol/L free Ca(2+), the Po at baseline was also significantly lower in diabetic rats than in control rats (0.210 ± 0.055 vs. 0.458 ± 0.077, P < 0.05). Cytoplasmic application of DHS-1 further robustly enhanced Po to 0.823 ± 0.019 (P < 0.05 vs. baseline) in control rats and to 0.446 ± 0.098 in diabetic rats (P < 0.05 vs. baseline of diabetic rats; P < 0.05 vs. control rats with DHS-1).

CONCLUSIONThe decrease of Po of BK single channel in coronary smooth muscle cells may be a potential cause for coronary dysfunction in diabetic rats.

Animals ; Coronary Vessels ; metabolism ; physiopathology ; Diabetes Mellitus, Experimental ; metabolism ; physiopathology ; Large-Conductance Calcium-Activated Potassium Channels ; metabolism ; Male ; Muscle, Smooth, Vascular ; cytology ; physiopathology ; Myocytes, Smooth Muscle ; metabolism ; Patch-Clamp Techniques ; Rats ; Rats, Sprague-Dawley

  Hydrotherapy refers to therapy conducted in water. The most advanced aquatic therapy of all is the therapeutic swimming. Therapeutic swimming is to use swimming, with adjusted strokes and changed moves, as a fashion of treatment based on patients’ diagnosis. Almost everyone is indicated.   It’s much easier to those who already know how to swim. Making local adjustment of the strokes for special needs is all therapist has to do. For instance, a scoliosis case, having C curve at thoracic region with concave to left, can use modified breaststroke. By extending elbow during power phase, the muscles on upper back and shoulder can be recruited. These muscles are protectors of the thoracic spine. Freestyle stroke can be in use, too. The left hand enters the water when the arm reaches out to the farthest; in addition, the head rotates to the opposite side of the reaching hand. These movements can stretch and elongate the shortened side. As for the lengthened side, the right side, strengthening should be emphasized more. Hence, patients put their right hand on their sacrum. This is not only effective for upper back and shoulder strengthening, but also good for chest expansion.   However, the therapy won’t jump to therapeutic swimming for beginners. New patients usually start with basic exercise, for example, walking, marching, stretching, and strengthening. Therapeutic swimming is saved to the last. “Be friend with water” is the primary mission. The therapy cannot work until the patients feel at home in water. There are seven characteristics of water, which are buoyancy, hydrostatic pressure, resistance, visual feedback, audio feedback, and balance and coordination. All exercise programs are derived from the seven characteristics. Through thousands of times of practice, patients ought to be adapted to water, to like it, to know the benefits that they can gain from water. Most importantly, patients need to understand how safe they are in the water. The mean density of human is smaller than the density of water, which means patients can always float. Once they realize this fact, they should be able to embrace water and relax. It’s easy to move by pushing water toward the opposite direction they are heading to. After they learned the skills, staying in water becomes a joy instead of fear. Do remember, therapeutic swimming is never a pageant. Speed and stunts are not our emphasis.   Once they catch up the skills, therapeutic swimming is more than a rehabilitation program. It is a part of their life. It is something they are enjoy doing. Some patients are extraordinarily talented, and they will further perfect their performance. Moreover, they can seek for professional advice of contest rules, and the speeding skills from swimming coach. At this point, they might have the chance to attend Paralympics! Therapeutic swimming was initially a rehabilitation approach. Then, people with special needs find delight from it. It becomes their recreation. Finally, this advanced exercise will likely bring them to an international stage. Therapeutic swimming realizes their dreams to outshine!

This study was purposed to investigate the mechanism of thrombocytopenia in patients with systemic lupus erythematosus (SLE) through detecting anti-megakaryocyte antibodies in SLE patients. The serum anti-megakaryocyte antibodies in 36 SLE cases with thrombocytopenia were detected by using indirect immunofluorescence, the detected results were compared with detected results of 30 SLE cases without thrombocytopenia and 30 healthy persons. The results showed that the positive incidences of anti-megakaryocyte antibody in serum of 36 SLE cases with thrombocytopenia, 30 SLE cases without thrombocytopenia and 30 healthy persons were 19.4% (7/36), 6.7% (2/30) and 3.3% (1/30) respectively. As compared with SLE patients without thrombocytopenia and healthy persons, SLE patients with thrombocytopenia had higher incidence of anti-megakaryocyte antibodies, moreover there was significant difference between SLE patients with thrombocytopenia and healthy persons (p < 0.05), while there was no significant difference between SLE patients with or without thrombocytopenia (p > 0.05). It is concluded that autoantibodies against megakaryocytes exist in SLE patients and may partially contribute to the incidence of thrombocytopenia in SLE patients. The detection of anti-megakaryocyte antibodies with a enough case number is needed to make a final conclusion on thrombocytopenia pathogenesis in SLE.
Adult ; Autoantibodies ; blood ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Lupus Erythematosus, Systemic ; blood ; immunology ; Male ; Megakaryocytes ; immunology ; Middle Aged

Adult ; Apolipoproteins E ; genetics ; Asian Continental Ancestry Group ; Exons ; genetics ; Female ; Humans ; Kidney Diseases ; genetics ; Mutation ; genetics ; Young Adult

Objective To evaluate the detection accuracy of the biomarkers dickkopf-1, DCP and AFP as a serum biomarker panel by comparing the sensitivity of the panel with those of the individual biomarkers. Methods The study was composed of three groups, one with HCC patients, one with non-HCC liver diseases and one with healthy controls. Serum AFP was measured using a chemiluminescence assay and serum dickkopf-1 and DCP were measured with ELISA. The sensitivity and specificity of the biomarkers were analyzed as single parameters and as a serum panel. Results The HCC group showed higher levels of dickkopf-1, DCP and AFP than the other two groups (P < 0.05). Dickkopf-1 showed better sensitivity (73.26% vs. 58.13%, P < 0.05) and better specificity (44.0% vs. 29.0%, P < 0.05) than AFP. DCP also had better sensitivity (74.42% vs. 58.13%, P < 0.05) than AFP, but their specificity was similar (30.00% vs. 29.00%, P > 0.05). The combination of the biomarkers as a serum panel produced much better sensitivity (93.02%) and specificity (78.00%) than each of the markers individually (P < 0.05). Conclusion The combination of AFP, DCP and dickkopf-1 as a biomarker panel can significantly improve the detection power with much higher sensitivity and specificity for HCC than any of the biomarkers alone. The tests are convenient and inexpensive, and may serve as a valuable addition to current options for the diagnosis of HCC.