Objective:To explore value of pulsed wave (PW) and tissue synchronization imaging (TSI) evaluate cardi-ac systolic synchronization in patients with ischemic cardiomyopathy (ICM) .Methods:A total of 50 ICM patients were enrolled as ICM group and 35 healthy volunteers without organic heart disease were regarded as healthy control group ,PW was used to measure mitral diastolic blood flow duration/RR interval (LVFT/RR) to evaluate synchroni-zation of left atrial and left ventricular synchronization ;interventricular mechanical delay (IVMD) was measured to evaluate left and right ventricular synchronization ;TSI software was used to measure mitral annular mean systolic peak velocity (LV-Sm) ,systolic time to peak (Ts) and Ts standard deviation (Ts-SD) of all segments in order to e-valuate left ventricular systolic synchronization .Results:Compared with healthy control group ,there were signifi-cant reductions in LVFT/RR [ (44.74 ± 1.58)% vs .(41.08 ± 4.65)% ] and LV-Sm [ (9.72 ± 0.53) ms vs .(4.09 ± 1.06) ms] ,and significant rise in IVMD [ (15.51 ± 5.52) ms vs .(41.96 ± 4.20) ms] and Ts-SD [ (16.47 ± 4.16) ms vs .(34.13 ± 11.68) ms] in ICM group , P<0.01 all;Ts of anterior wall ,inferior wall et .6 positions were significantly longer ,and its synchronization significantly reduced , P<0. 05 all ,percentages of the most de-layed systolic part of left ventricle were no significant differences between two groups (P> 0.05) .Conclusion:Compared with healthy control group ,left ventricular total systolic function ,left atrial&ventricular ,left&right ventricular synchronization and systolic synchronization within left ventricular significantly reduce in ICM patients .

OBJECTIVE: To investigate the feasibility of applying multiple displacement amplification (MDA) to DNA typing in forensic pathological section. METHODS: Ninety-eight pieces of pathological sections were prepared in terms of 3 factors as the period of preservation, tissue types and death ages, and randomized into groups by Latin square by double 7-order design. Silicon bead method was used to extract the DNA template. Compared with the PCR amplification performed directly by AmpFlSTR Identifiler kit in the control group, MDA was performed before amplification in the experimental group. Based on the samples from fresh autopsies as the standard genotypes, the number of detection and the detection rate were analyzed and compared between the experimental group and the control group. RESULTS: Between the control group and the experimental group, there was significantly statistical difference regarding the rate of DNA typing in each period of the tissue sections preserved (P<0.01). The detection rate of the 16 loci in the experimental group was more than 95% when the period of the tissue sections were preserved within 360d. There was significant difference in different tissue types (P<0.01). But there was no significant difference in different death ages (P>0.01). CONCLUSION MDA is efficacious in DNA typing of forensic pathological sections, for it can improve the DNA template quantification through abating the inhibiting factor's concentration of PCR and reducing the rate of allele drop out (ADO). However, the period of the sections preserved and tissue types would affect the results of genotyping by MDA.
Adolescent ; Adult ; Age Factors ; Brain Chemistry ; Cadaver ; Child ; Child, Preschool ; DNA/genetics* ; DNA Fingerprinting/methods* ; Feasibility Studies ; Forensic Pathology/methods* ; Frozen Sections ; Genetic Loci ; Genotype ; Humans ; Infant ; Kidney ; Liver ; Loss of Heterozygosity/genetics* ; Middle Aged ; Nucleic Acid Amplification Techniques/methods* ; Polymerase Chain Reaction/methods* ; Preservation, Biological/methods* ; Time Factors ; Young Adult

OBJECTIVETo compare balance ability between elderly individuals who practiced Tai-Chi-Chuan (TCC) for average 9.64 years and elderly individuals who did not practice TCC and its relationship with lower extremity muscle strength and ankle proprioception.

METHODSTwenty-five elderly volunteers were divided into two groups according to their TCC practcing experience. Sixteen were TCC group and the other nine were control population. Subjects completed a static balance test and ankle proprioception test using a custom-designed evaluation system, and concentric and eccentric knee extensor and flexor muscle strength tests. Subjects stood on the plate form to measure the proprioception in functional standing position which was differed from the previous studies. Multiple linear regressions were also used to predict the important factor affecting balance.

RESULTSTCC group performed better than the control group in balance, proprioception, and muscle strength of lower extremity. The proprioception was the most important factor related to balance ability and it can be accounted for explaining 44% of variance in medial-lateral sway direction, and 53% of variance in antero-posterior sway direction. The proprioception may be a more important factor which affecting the balance ability.

CONCLUSIONTCC training is recommended to the elders; as it can improve balance ability through better proprioception.

Aged ; Ankle Joint ; physiology ; Female ; Humans ; Kinesthesis ; Linear Models ; Male ; Middle Aged ; Muscle Strength ; physiology ; Postural Balance ; physiology ; Posture ; physiology ; Proprioception ; physiology ; Tai Ji

INTRODUCTIONThe exposed section of a traditional nasogastric (NG) tube can interfere with patients' social activities and thereby result in distress. This study was conducted to evaluate the feasibility and safety of a novel two-piece NG tube for patients with dysphagia.

METHODSTen patients with dysphagia were recruited between November 2011 and May 2012. Patients who were unconscious or in critical condition, had a traditional NG tube < 50 cm or > 60 cm in fixed length, or were unable to follow instructions or sign consent forms were excluded. The two-piece NG tube, which was placed in the patients for one week, comprised a removable external tube that can be joined to an internal tube via a T-connector, which was placed close to the naris. Events related to safety (e.g. nasal pressure sores, number of unplanned extubation, displacement and spontaneous migration of the NG tube, other unpredictable injuries) and effectiveness (e.g. liquid food spills, tube obstruction, perfusion rate, other adverse circumstances) were assessed daily.

RESULTSAll patients received feeding without complication using the two-piece NG tube and none experienced premature removal of the tube. No serious NG tube complications or malfunctions were observed.

CONCLUSIONThe results of this study indicate that the two-piece NG feeding tube is a feasible option for patients with dysphagia. Future improvements to the connector may help enhance its performance. A rigorous randomised controlled trial to examine the effects of the two-piece NG tube on patients' quality of life and quality of medical care is being planned.

Aged ; Aged, 80 and over ; Deglutition Disorders ; therapy ; Enteral Nutrition ; instrumentation ; methods ; Equipment Design ; Female ; Humans ; Intubation, Gastrointestinal ; adverse effects ; methods ; Male ; Middle Aged

OBJECTIVETo identify the risk factors associated with anastomotic leakage following an anterior resection for rectal cancer.

METHODSBetween June, 1999 and June, 2009, 628 patients underwent anterior resection for rectal cancer. A retrospective study of the cases was performed to identify the risk factors for anastomotic leakage following the resection.

RESULTSThe overall incidence rate of anatomic leak was 8.6% (54/628) in these patients. A low albumin level (less than 35 g/L), diabetes, absence of a protective stoma, a distance less than 7 cm from the tumor to the anal edge, and a tumor diameter over 5 cm were identified as the risk factors for anastomotic leakage after anterior resection.

CONCLUSIONFor patients at a high risk for anastomotic leakage, a protective stoma can significantly decrease the rate of clinical leaks and subsequent reoperation after low anterior resection for rectal cancer.

Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical ; adverse effects ; Anastomotic Leak ; etiology ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Risk Factors ; Young Adult

OBJECTIVETo evaluate the therapeutic effect of Roux-en-Y anastomosis following subtotal gastrectomy on type 2 diabetes mellitus (T2DM) in non-obese patients.

METHODSWe performed a retrospective analysis of 16 non-obese patients with T2DM undergoing Roux-en-Y anastomosis following subtotal gastrectomy for stomach cancer and upper gastrointestinal tract ulcer.

RESULTSAll the patients were followed up for 6 months after the surgery. Roux-en-Y gastrojejunostomy significantly lowered the levels of fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG), and glycated hemoglobin (HbA1c)(P<0.05). Of these patients, 8 (50%) achieved adequate glycemic control without antidiabetic medication and 5 (31.25%) showed obvious improvement. The total effectiveness rate of the surgery was 81.25%.

CONCLUSIONRoux-en-Y gastrectomy can effectively ameliorate the diabetic symptoms and might serve as a new treatment option for T2DM in non-obese patients.

Adult ; Anastomosis, Roux-en-Y ; Diabetes Mellitus, Type 2 ; surgery ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Obesity ; Postoperative Period ; Retrospective Studies ; Treatment Outcome

Objective　To explore the characteristics of the changes of several metabolic and biochemical indices in dogs with both hindlimbs injured by kinetic weapon. Methods　12 animals were divided into 4 groups (Group Ⅰ, injured by regular weapon; Group Ⅱ,Ⅲ,Ⅳ injured by imitative kinetic weapons with different energy respectively). Levels of plasma Na+,Ca2+,K+ glucose, AMY, LDH, CK and serum T3,insulin,TSH were determined before and after injured. Results　①Local wounding conditions and distant organs' injuries in group Ⅱ,Ⅲ, and Ⅳ were more serious than those in group Ⅰ. ②Levels of plasma glucose in group Ⅱ,Ⅲ and Ⅳ were inereased significantly after injury than before(P<0.05), but not in group Ⅰ. Levels of Na+,Ca2+,K+,AMY,LDH in 4 groups had similar changes after injury while levels of CK in group Ⅱ,Ⅲ and Ⅳ were inereased significantly than that in group Ⅰ (P<0.05). ③After injury, levels of T3 in serum of all animals showed a decreased tendency and that of insulin decreased more significantly (P<0.05). There was no difference between every two groups. Levels of TSH in group Ⅱ,Ⅲ and Ⅳ were increased significantly after injured than before (P<0.05), but not in group Ⅰ. Conclusion　Not only local severe injury but also more serious injury in distant organs and more obvious changes of metabolic and biochemical indices can be induced by kinetic weapons than regular weapons.

OBJECTIVETo evaluate and compare the efficacy and safety of Nedaplatin (NDP)-based regimen and cisplatin (DDP)-based regimen for head and neck squamous cell carcinoma (HNSCC), non-small cell lung cancer (NSCLC), esophageal cancer and ovary epithelial cell carcinoma.

METHODSSingle agent group: NDP was administered at a dose of 100 mg/m(2) on D1, every 3 weeks for at least 2 cycles. Combination chemotherapy group: combined with 5-Fu, NVB, VDS + 5-Fu, PTX or CTX respectively, NDP 80 mg/m(2) on D1 or DDP 30 mg/m(2) on D1-3, every 3 weeks for at least 2 cycles was given.

RESULTSOf 237 patients in this trial, 37 were treated by single Nedaplatin, 139 by NDP-based regimen, 61 by DDP-based regimen in the control group. The response rate of single Nedaplatin chemotherapy for advanced NSCLC was 10.5% (2/19), for ovary carcinoma (1/3) and HNSCC (1/1). For NSCLC and ovary carcinoma patients who had failed in the previous DDP-based chemotherapy, the response rates by single NDP chemotherapy were still 9.1% and 33.3%. The response rate of NDP-based combination regimen for NSCLC, ovary carcinoma, HNSCC and esophageal cancer was 33.9% (21/62), 44.8% (13/29), 20.0% (3/15) and 18.2% (4/22), respectively, which was not statistically different from the rate of controlled group treated by DDP-based regimen. For chemonaive NSCLC, the effect of NDP-based combination regimen (35.7%) was significantly superior to the effect of DDP-based regimen (17.1%) (P = 0.045). The most common adverse events of nedaplatin were myelosuppression (leukopenia, thrombocytopenia, anemia), nausea and vomiting. The myelosuppression and renal toxicity of NDP-based regimen were similar to that of DDP-based regimen, but vomiting was milder than that of DDP-based regimen (54% vs. 75.4%), and grade I/II liver toxicity was more common in the NDP-based regimen than in DDP-based regimen (10.8% vs. 0).

CONCLUSIONNedaplatin is effective in the treatment for HNSCC, NSCLC and ovary carcinoma. Compared with the control group treated by DDP-based regimen, nedaplatin-based combination chemotherapy has similar effect on HNSCC, NSCLC, ovary carcinoma and esophageal cancer. Gastrointestinal reaction of nedaplatin is milder than that of cisplatin but the liver function during chemotherapy must be monitored closely.

Adolescent ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cisplatin ; administration & dosage ; Esophageal Neoplasms ; drug therapy ; Female ; Fluorouracil ; administration & dosage ; Head and Neck Neoplasms ; drug therapy ; Humans ; Leukopenia ; chemically induced ; Lung Neoplasms ; drug therapy ; Lymphatic Metastasis ; Male ; Middle Aged ; Nausea ; chemically induced ; Organoplatinum Compounds ; administration & dosage ; therapeutic use ; Ovarian Neoplasms ; drug therapy ; Vinblastine ; administration & dosage ; analogs & derivatives

Background/Aims: Chronic hepatitis C (CHC) patients who failed antiviral therapy are at increased risk for hepatocellular carcinoma (HCC). This study assessed the potential role of metformin and statins, medications for diabetes mellitus (DM) and hyperlipidemia (HLP), in reducing HCC risk among these patients. Methods: We included CHC patients from the T-COACH study who failed antiviral therapy. We tracked the onset of HCC 1.5 years post-therapy by linking to Taiwan’s cancer registry data from 2003 to 2019. We accounted for death and liver transplantation as competing risks and employed Gray’s cumulative incidence and Cox subdistribution hazards models to analyze HCC development. Results: Out of 2,779 patients, 480 (17.3%) developed HCC post-therapy. DM patients not using metformin had a 51% increased risk of HCC compared to non-DM patients, while HLP patients on statins had a 50% reduced risk compared to those without HLP. The 5-year HCC incidence was significantly higher for metformin non-users (16.5%) versus non-DM patients (11.3%; adjusted sub-distribution hazard ratio [aSHR]=1.51; P=0.007) and metformin users (3.1%; aSHR=1.59; P=0.022). Statin use in HLP patients correlated with a lower HCC risk (3.8%) compared to non-HLP patients (12.5%; aSHR=0.50; P<0.001). Notably, the increased HCC risk associated with non-use of metformin was primarily seen in non-cirrhotic patients, whereas statins decreased HCC risk in both cirrhotic and non-cirrhotic patients. Conclusions Metformin and statins may have a chemopreventive effect against HCC in CHC patients who failed antiviral therapy. These results support the need for personalized preventive strategies in managing HCC risk.

Background/Aims: Despite the high efficacy of direct-acting antivirals (DAAs), approximately 1–3% of hepatitis C virus (HCV) patients fail to achieve a sustained virological response. We conducted a nationwide study to investigate risk factors associated with DAA treatment failure. Machine-learning algorithms have been applied to discriminate subjects who may fail to respond to DAA therapy. Methods: We analyzed the Taiwan HCV Registry Program database to explore predictors of DAA failure in HCV patients. Fifty-five host and virological features were assessed using multivariate logistic regression, decision tree, random forest, eXtreme Gradient Boosting (XGBoost), and artificial neural network. The primary outcome was undetectable HCV RNA at 12 weeks after the end of treatment. Results: The training (n=23,955) and validation (n=10,346) datasets had similar baseline demographics, with an overall DAA failure rate of 1.6% (n=538). Multivariate logistic regression analysis revealed that liver cirrhosis, hepatocellular carcinoma, poor DAA adherence, and higher hemoglobin A1c were significantly associated with virological failure. XGBoost outperformed the other algorithms and logistic regression models, with an area under the receiver operating characteristic curve of 1.000 in the training dataset and 0.803 in the validation dataset. The top five predictors of treatment failure were HCV RNA, body mass index, α-fetoprotein, platelets, and FIB-4 index. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the XGBoost model (cutoff value=0.5) were 99.5%, 69.7%, 99.9%, 97.4%, and 99.5%, respectively, for the entire dataset. Conclusions Machine learning algorithms effectively provide risk stratification for DAA failure and additional information on the factors associated with DAA failure.