Adiponectin is a kind of adipocyte-specific protein which is only inversely related with obesity by now. It is involved in enhancing insulin sensitivity,anti-atherogenic and antiinflammatory activities.Recent studies have reported that adiponectin is closely correlated with the genesis and development of a variety of obesity related malignant tumors,especially postmenopausal breast cancer.Obesity is an independent risk factor for the development of breast cancer.Recently researches about the correlation between adiponectin and breast cancer relations and the action mechanisms,signaling pathways have made a progress.

Objective To study the significance of radiotherapy of mediastinal metastasis after radical surgery for thoracic esophageal carcinoma. Methods Seventy six patients with esophageal carcinoma who developed mediastinal metastasis 3～18 months after radical surgery were retrospectively analyzed. The size of mediastinal metastasis was 3?cm in 32. Nine of these patients had metastasis in neck lymph nodes and 3 had distant metastasis as well. Radiotherapy was given with a Cobalt 60 unit. The radiation dose ranged from 10.8?Gy to 75.0?Gy by conventional fractionation. Results Nine patients did not finish radiotherapy and all of them died within one year of (after) treatment. The mean of survival time was 4.9 months. Sixty seven patients received radiation of 50～70?Gy. The corresponding overall survivals at 1, 2, and 3 years were 75.0% (57/76), 27.6% (21/76) and 9.2% (7/76), respectively. Conclusion Radical radiotherapy may improve the prognosis with an appropriate tumor dose of 65～75?Gy.

Objective To evaluate the effect of 3-dimmentional conformal radiotherapy (3-DCRT) for mediastinal metastasis from esophageal carcinoma after surgery.Methods Sixty-three such patients were treated by 3-DCRT. Tumor diameter was: cm 20 patients. Positive supraclavicular lymph node was found in 9 patients. The number of tumor at the upper right, upper left and upper median mediastinum was 27, 27 and 20. All patients received 3-DCRT to the dose of 40?Gy (2?Gy/f, 5f/w), after resetting of portals, the dose was boost to 64～70?Gy by 3?Gy/f, 5f/w. Dose of the patients who had been irradiated was boosted to 50?Gy without further positioning. Results Complete response rate and partial response rate were 43% and 48% one month after the treatment was concluded,with no progression of disease. The 1-, 2- and 3-year survival rates were 75%, 43% and 15%. Conclusions Three-dimmentional conformal radiotherapy, with little side-effects, can markedly improve the local control rate and suvival rate of patients with mediastinal metastasis from esophageal carcinoma after surgery.

Purpose:To study the efficiency and safety on vinorelbine combined with capecitabine in the treatment of metastatic breast cancer. Methods:Twenty-eight patients with measurable lesions of metestetic breast cancer received vinorelbine 6 mg/m 2 d 1-5 civ,cycles were repeated every 21 days. Patients received capecitabine for 2-4 cycles at the same time. All patients received more than one course of chemotherapy regimens and 19 patients had adriamycin and (or) paclitaxel treatment. Results:Thirteen patients received two cycles treatment and fifteen patients received four cycles of treatment. Complete response in one patient,partial response in six patients,minor response in seven patients,stable response in seven patients and progressive disease in seven patients were observed. Overall responsed rate was 50%.The common side effects were neutronpenia,hand-foot syndrome,skin pigmentation,fatigue. Conclusions:The combination of vinorelbine and capecitabine in the treatment of metastatic breast cancer was effective and the toxicities were tolerable. It is possible that this regimen is an ideal second line chemotherapy for metastatic breast cancer.

Adult ; COVID-19/prevention & control* ; Cross Infection/prevention & control* ; Female ; Health Personnel/statistics & numerical data* ; Humans ; Male ; Middle Aged ; Respiratory Tract Diseases/virology* ; SARS-CoV-2 ; Taiwan/epidemiology*

Objective To study the molecular genetic mechanism of a patient with 17? hydroxylase (CYP17) deficiency. Methods Genomic DNA were abstracted from the blood of the patient, her parents and healthy control. The 8 exons of CYP17 gene were amplified, using 5 pairs of designed primers, with polymerase chain reaction (PCR), and the 8 exons were sequenced by the dideoxy terminator method to determined the mutation sites. The corresponding exons of the parents of the patients were also amplified and sequenced to determine the zygosity of the patient and the source of the gene variances. Results The analysis revealed that the patient (46, XY) was a compound heterozygote carrying two different inherited mutations on CYP17 gene, one from mother containing a point mutation Arg 96 (C G G)→ Gln(C A G) and the other from father containing a nine base deletion (CACTCTTTC) at amino acid position 487～489 (Asp Ser Phe) near the carboxyl terminus of P450c17. Conclusion The CYP17 gene of the patient with 17? hydroxylase deficiency is a compound heterozygous mutation. The mutation changes the amino acid sequence of P450c17 enzyme, which in turn affected the enzymatic activity. Arg 96 is essential in P450c17 enzyme activity. Deletion of Asp 487 Ser 488 Phe 489 in exon 8 may be a prevalent mutation causing P450c17 deficiency in Southeast Asia.

Objective: To examine the effect of early comprehensive interventions on the physical growth and nerve development among premature infants, so as to provide insights into the follow-up management of premature infants after discharge from hospital. Methods: A total of 130 premature infants delivered in Shaoxing Municipal Maternal and Child Health Care Hospital from 2019 to 2021 were selected and divided into high- and low-risk groups according to gestational age and birth weight, while 306 full-term normal infants in the same hospital during the study period served as controls. All premature infants were given early comprehensive interventions until age of 12 months, including nutritional support and parental guidance of children's feeding and development, and all normal infants received periodical health checkup according to the basic public health service program. All infants received periodical measurements of height, weight and head circumference, and the 12-month intellectual and motor development ability was measured using the Bayley Scales of Infant Development revised in Chinese cities was used to assess. Infants' physical growth, mental development index (MDI) and motor development index (PDI) were compared among groups. Results: There were 130 premature infants with gestational ages of 28 to 36 weeks and birth weight of 1 200 to 3 440 g, including 79 male infants, and there were 80 infants in the low-risk group and 50 infants in the high-risk group. The full-term infants had a gestational age of 37 to 42 weeks, and birth weights of 2 500 to 4 000 g, including 162 male infants. There were significant differences in height (Wald χ2=28.664, P<0.001) and head circumference growth (Wald χ2=19.312, P=0.013) among the three groups as revealed by the generalized estimating equation; however, no significant differences were seen in the 12-month weight (F=0.639, P=0.528), height (F=1.051, P=0.350) or head circumference (F=0.318, P=0.728) among the three groups. The percentages of abnormal MDI were 2.00%, 0 and 1.31% among the high-risk premature infants, low-risk premature infants and full-term infants at ages of 12 months (χ2=1.319, P=0.517), while the percentages of abnormal PDI were 20.00%, 7.50% and 5.56% among the three groups at ages of 12 months (χ2=12.818, P=0.002). Conclusions Following implementation of early comprehensive interventions, the premature infants have favorable physical growth and comparable MDI with full-term infants; however, a high percentage of abnormal PDI is seen in high-risk premature infants. An improvement in the motor development among high-risk premature infants is recommended to be emphasized during the management of premature infants.

In Taiwan, high-risk patients have been identified and tested for preventing community spread of COVID-19. Most sample collection was performed in emergency departments (EDs). Traditional sample collection requires substantial personal protective equipment (PPE), healthcare professionals, sanitation workers, and isolation space. To solve this problem, we established a multifunctional sample collection station (MSCS) for COVID-19 testing in front of our ED. The station is composed of a thick and clear acrylic board (2 cm), which completely separates the patient and medical personnel. Three pairs of gloves (length, 45 cm) are attached and fixed on the outside wall of the MSCS. The gloves are used to conduct sampling of throat/nasal swabs, sputum, and blood from patients. The gap between the board and the building is only 0.2 cm (sealed with silicone sealant). ED personnel communicate with patients using a small two-way broadcast system. Medical waste is put in specific trashcans installed in the table outside the MSCS. With full physical protection, the personnel conducting the sampling procedure need to wear only their N95 mask and gloves. After we activated the station, our PPE, sampling time, and sanitization resources were considerably conserved during the 4-week observation period. The MSCS obviously saved time and PPE. It elevated the efficiency and capacity of the ED for handling potential community infections of COVID-19.
Betacoronavirus ; Clinical Laboratory Techniques ; Coronavirus Infections ; diagnosis ; epidemiology ; Emergency Service, Hospital ; organization & administration ; Humans ; Mass Screening ; methods ; Pandemics ; Personal Protective Equipment ; supply & distribution ; Pneumonia, Viral ; diagnosis ; epidemiology ; Taiwan ; epidemiology

We reported two patients with nasopharyngeal adenocarcinoma resected by using the exclusively endoscopic approach. Case reports and a review of the world literature concerning nasopharyngeal adenocarcinoma. The tumors were resected successfully via the exclusively endoscopic approach and no conversions to the conventional approach were necessary. The two patients were followed up for 26 and 18 months respectively, and no recurrence was noted without postoperative chemotherapy or radiotherapy. To the best of our knowledge, this is the first report of endoscopic resection of nasopharyngeal adenocarcinoma. Our experience revealed that not only for the early recurrent nasopharyngeal carcinoma, the exclusively endoscopic nasopharyngectomy can be expanded for the resection of selected nasopharyngeal adenocarcinoma.
Adenocarcinoma* ; Drug Therapy ; Endoscopes ; Humans ; Nasopharyngeal Neoplasms ; Radiotherapy ; Recurrence

Although agomelatine may be associated with an increased risk of hepatotoxicity, the incidence rate of acute hepatitis seemed divergent between clinical trials and daily practice. Whether aging or gender is a risk factor in developing hepatotoxicity due to agomelatine is not clear. We present 3 older female cases with acute hepatitis occurring due to highly probable idiosyncratic drug-induced liver injury caused by agomelatine. From these cases, regular surveillance on liver function in the older women taking antidepressants would be of benefits.