This paper summarizes the progress on anti -tumor effect and its mechanism of Noni over the past decade.Plenty of tests indicated that noni juice , juice extracts, leaf and root extracts have anti -tumor effects.It can inhibit tumor growth through inducing tumor cell apoptosis ,activating host immune system ,inhibi-tion of angiogenesis and cyclooxygenase ,anti -oxidation and blocking carcinogen -DNA adduct formation.This paper provides a reference for the adjuvant therapy of anticancer drugs and food form Noni .

Objective To explore a fast and precise registration algorithm for megavolt (MV) portal images(PIs) used for radiotherapy positioning verification, and find auto analysis method of set-up error using the computed image processing and mutual information comparison technology, which provide a basis for the development of automatic image guidance software. Methods MV PIs of patients undergoing radiotherapy were tested, pre-processed with noise reduction technique based on improved filtering algorithm and contrasted by gray-scale transforming using partial derivative threshold. The bone structures were then highlighted but soft tissues and the cavities were restrained simultaneously. Improved particle swarm optimization and powell hybrid algorithm were used to optimize and transform the mutual information based on wavelet multiresolution analysis when registering the Pls with digital reconstructed radiographs (DRRs) of treatment planning or X-ray simulation-film images(SIs). Application of the designed registration algorithm was verified and evaluated through simulated set-up shifts of head and neck phantom. Results The improved noise reduction algorithm satisfactorily met the requirements for contrast of bony structures in the MV PIs. The established mutual information registration method well behaved in both accuracy and speed of registration calculation. The processing of automatic registration took only 31.4 seconds averagely for the PIs and X-ray Sis of head-neck phantom. Mean errors of automatic registration of PIs and X-ray Sis in horizontal, vertical and rotational reduced by 62. 74% ,67. 32% and 66. 61% respectively compared with manual registration in the testing of 20-cases head and neck phantom. Conclusions A precise image registration algorithm and set-up error analysis method based on MV portal images is established, and it can meet the clinical application in registration accuracy and speed.

South Korea and Taiwan have had similar experiences of economic development in the post-war era. The two societies have also successfully overcome the threat of liver cancer by using mass hepatitis B vaccinations. However, to reach their current states, they followed different directions, and experienced differing effects on their national health governance systems. In South Korea, vaccine production occurred prior to effectively introducing immunization programs. In contrast, Taiwan established an effective immunization program first. However, industrialization of vaccines against hepatitis B has failed. Taiwan has to import vaccines for domestic use. This article provides a contextual overview on the different methods South Korea and Taiwan have used to arrive at their modern status of hepatitis B immunization.
Economic Development ; Hepatitis ; Hepatitis B ; Hepatitis B Vaccines ; Immunization ; Immunization Programs ; Liver Neoplasms ; Republic of Korea ; Taiwan ; Vaccination ; Vaccines ; Industrial Development

Background: The aim of this study was to investigate whether there is a relationship between Parkinson’s disease and pancreatic cancer in Taiwan. Methods: This was a case-control study using claim data of the Taiwan National Health Insurance Program. There were 13,861 subjects aged 20- 84 with newly diagnosed pancreatic cancer as cases and 55,444 randomly selected subjects without pancreatic cancer as controls from 1998 to 2011. Cases and controls were matched by sex, age and index year of diagnosing pancreatic cancer. The association of pancreatic cancer with Parkinson’s disease was evaluated by the multivariable logistic regression model to estimate the adjusted odds ratio (OR) and 95% confidence interval (95% CI). Results: After adjusting for confounding factors including acute pancreatitis, chronic pancreatitis, diabetes mellitus, biliary stone, alcoholism, hepatitis B and hepatitis C, the multivariable logistic regression analysis showed the adjusted OR of pancreatic cancer was 0.82 for subjects with Parkinson’s disease (95% CI 0.55, 1.21), as compared with subjects without Parkinson’s disease. Conclusion: No association is detected between Parkinson’s disease and pancreatic cancer.
Parkinson Disease ; Pancreatic Neoplasms

BACKGROUND:Jumonji domain-containing histone demethylase (JMJD) can promote osteoblast differentiation, and estrogen-related receptor alpha (ERRα) can promote osteoblast differentiation and increase bone formation. However, little is reported on the association between postmenopausal osteoporosis andJMJD and ERRα. OBJECTIVE: To study the changes in the JMJD2 family expression in patients with postmenopausal osteoporosis. METHODS: Postmenopausal patients with osteoarthritis of the hip scheduled for total hip arthroplasty, aged 50-70 years, were enroled, including 10 postmenopausal osteoporosis patients (experimental group) and 10 patients with no postmenopausal osteoporosis (control group). During the arthroplasty, the cancelous bone specimens from the femoral head were colected. Then, immunohistochemistry and western blot assay were used to detect expression of histone demethylase (JMJD2A, JMJD2B), histone methylation (H3K9me3, H3K36me3) and ERRα. RESULTS AND CONCLUSION:In the experimental group, the expressions of JMJD2A, JMJD2B and ERRαwere from weakly positive to positive; these expressions were significantly lower in the experimental group than the control group (P < 0.05). The expressions of H3K9me3 and H3K36me3 were significantly higher in the experimental group than the control group (P < 0.05). These findings indicate that the expression of JMJD2A and JMJD2B is consistent with the expression of ERRα in the patients with postmenopausal osteoporosis, and JMJD is likely to serve as an antagonistic enzyme of osteoporosis.

Background It has found that ischemic postconditioning (IPO) might decrease pulmonary ischemia/reperfusion (I/ R) injury,which is one of the main reasons of lung injury caused by cardiopulmonary bypass (CPB).It was found that aquaporins (AQPs) play a role in the maintenance of fluid homeostasis.But it is still unclear whether IPO influences the expression of aquaporin-1 (AQP1).This study was designed to investigate whether IPO can reduce CPB-related lung injury and affect the expression of AQP1 of lungs.Methods Twelve healthy dogs were divided into control group (C group) and ischemia postconditioning group (IPO group).CPB procedures were implemented.Ten minutes later,the left pulmonary artery was separated and blocked.Postconditioning consisted of two cycles of 5-minute pulmonary artery reperfusion/5-minute reocclusion starting at the beginning of reperfusion.The 2×4 cm tissues of both sides of pulmonary apex,superior,middle and inferior lobe were taken before CPB (T1),before occlusion and reopening of left pulmonary artery (T2,T3),and 2 hours after CPB (T4).Samples were used to evaluate lung injury degrees and to detect the expression of AQP1.At T1 and T4,blood was collected from femoral artery to calculate pulmonary function.Results At T4,each pulmonary function showed significant deterioration compared with T1.Lung injury could be found at the onset of CPB.However,the expression of AQP1 decreased and wet to dry weight ratio (W/D) increased after T2.In the left lung of C group,the worst pulmonary function and structures were detected.The slightest changes were discovered in the right lung of C group.A close relationship between W/D and lung injury score was found.The lung injury score was negatively related with the expression of AQP1.It was found that the expression of AQP1 was negatively connected with W/D.Conclusions In dog CPB models,lung injury induced by CPB was related with down regulated expression of AQP1.AQP1 is believed to be involved in the mechanisms of lung ischemia/reperfusion (I/R) injury caused by CPB.IPO increases the expression of AQP1,provides a protective effect on lung suffering from CPB,and alleviates CPB-related lung injury.

OBJECTIVES: The global burden of non-alcoholic fatty liver disease (NAFLD) is rising. An alternative term, metabolic dysfunction-associated fatty liver disease (MAFLD), instead highlights the associated metabolic risks. This cohort study examined patient classifications under NAFLD and MAFLD criteria and their associations with all-cause mortality. METHODS: Participants who attended a paid health check-up (2012-2015) were included. Hepatic steatosis (HS) was diagnosed ultrasonographically. NAFLD was defined as HS without secondary causes, while MAFLD involved HS with overweight/obesity, type 2 diabetes mellitus, or ≥2 metabolic dysfunctions. Mortality was tracked via the Taiwan Death Registry until November 30, 2022. RESULTS: Of 118,915 participants, 36.9% had NAFLD, 40.2% had MAFLD, and 32.9% met both definitions. Participants with NAFLD alone had lower mortality, and those with MAFLD alone had higher mortality, than individuals with both conditions. After adjustment for potential confounders, the hazard ratios (HRs) for all-cause mortality were 1.08 (95% confidence interval [CI], 0.78 to 1.48) for NAFLD alone and 1.26 (95% CI, 1.09 to 1.47) for MAFLD alone, relative to both conditions. Advanced fibrosis conferred greater mortality risk, with HRs of 1.93 (95% CI, 1.44 to 2.58) and 2.08 (95% CI, 1.61 to 2.70) for advanced fibrotic NAFLD and MAFLD, respectively. Key mortality risk factors for NAFLD and MAFLD included older age, unmarried status, higher body mass index, smoking, diabetes mellitus, chronic kidney disease, and advanced fibrosis. CONCLUSIONS All-cause mortality in NAFLD and/or MAFLD was linked to cardiometabolic covariates, with risk attenuated after multivariable adjustment. A high fibrosis-4 index score, indicating fibrosis, could identify fatty liver disease cases involving elevated mortality risk.

Objective: To assess the effectiveness of interventions on patient trust Methods: A system review was conducted through searching 11 relevant databases, such as Cochrane Library, EMBASE, PsycINFO, CINAHL, PubMed, Web of Science, SinoMed, CNKI, WANFANG. The randomized controlled trials (RCTs) were screened from 1539 original studies according to inclusion and exclusion criteria Meta-analysis was used to evaluate and interpret the interventions. Results: Ten RCTs were included in the review. It was concluded from meta-analysis that no significant difference could be found between controlled and intervention groups by increasing doctors'abilities(SMD = -0.05, 95％ CI: -0.22 -0.12); while the other two interventions, doctor's information disclosure as well as patient education and nursing intervention, significantly enhanced patient trust (SMD = 0.13, 95％ CI: 0.06 - 0.21; SMD = 0.60, 95％ CI: 0.29 - 0.90). Conclusion: Doctor's information disclosure, patient education and nursing intervention are effective in increasing patients'trust, while intervention of doctor's ability promotion seems not so remarkable.

BACKGROUNDThe increased incidence of pyogenic liver abscess caused by Klebsiella pneumoniae (K.pneumoniae) was reported in the recent literature. This study was conducted retrospectively to investigate the clinical characteristics and outcomes of these patients.

METHODSMicrobiological and medical databases of a medical center were searched from January 2000 to June 2003. Eighty-four patients with liver abscess caused by K.pneumoniae were analyzed.

RESULTSIn the 84 patients, 52 men and 32 women aged (58.2 +/- 13.3) years on average, 64.4% had concomitant diabetes mellitus and 23.8% had biliary disease. The most common clinical symptoms were fever (98.8%), chills (69.0%) and abdominal pain (58.3%). 85.7% of the 84 patients received catheter drainage for the abscess. The length of hospital stay was (17.4 +/- 8.7) days. The mortality rate was 7.1%. Older age and presence of biliary disease were associated with mortality.

CONCLUSIONSThe low mortality of our patients was probably related to the high proportion of patients who received catheter drainage. Older age and presence of biliary disease were associated with the mortality.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Klebsiella Infections ; complications ; Klebsiella pneumoniae ; Liver Abscess, Pyogenic ; etiology ; Male ; Middle Aged ; Retrospective Studies

Background/Aims: Hypopharyngeal multichannel intraluminal impedance-pH (HMII-pH) technology incorporating 2 trans-upper esophageal sphincter impedance channels has been developed to detect pharyngeal reflux. We used the HMII-pH technique to validate the candidate pharyngeal acid reflux (PAR) episodes based on the dual-pH tracings and determined the interobserver reproducibility. Methods: We conducted a cross-sectional study in tertiary centers in Taiwan. Ninety patients with suspected laryngopharyngeal reflux and 28 healthy volunteers underwent HMII-pH test when off acid suppressants. Candidate PAR episodes were characterized by pharyngeal pH drops of at least 2 units and reaching a nadir pH of 5 within 30 seconds during esophageal acidification. Two experts manually independently identified candidate PAR episodes based on the dual-pH tracings. By reviewing the HMII-pH tracings, HMII-pH-proven PAR episodes were subsequently confirmed. The consensus reviews of HMII-pH-proven PAR episodes were considered to be the reference standard diagnosis. The interobserver reproducibility was assessed. Results: A total of 105 candidate PAR episodes were identified. Among them 84 (80.0%; 95% CI, 71.0-87.0%) were HMII-pH-proven PAR episodes (82 in 16 patients and 2 in 1 healthy subject). Patients tended to have more HMII-pH-proven PAR episodes than healthy controls (median and percentile values [25th, 75th, and 95th percentiles]: 0 [0, 0, 3] vs 0 [0, 0, 0], P = 0.067). The concordance rate in diagnosing HMII-pH-proven PAR episodes between 2 independent observers was 92.2%. Conclusion Our preliminary data showed that 80.0% (71.0-87.0%) of the proposed candidate PAR episodes were HMII-pH-proven PAR episodes, among which the interobserver reproducibility was good.