The association between serum fetuin A and diabetic nephropathy (DN) in patients with type 2 diabetes mellitus(T2DM) was investigated.Serum levels of fetuin-A and adiponectin were measured by ELISA and the clinical data were collected in 101 T2DM patients with normal albuminuria (NA group),87 patients with microalbuminuria (MA group),44 patients with overt albuminuria (OA group),and 130 normal control subjects (NC group).Fetuin-A levels increased progressively from NC,NA,MA,to OA groups,and there were significant differences among groups(P＜0.05 or P＜0.01).Fetuin-A level in patients was positively associated with duration of illness,urinary albumin to creatinine ratio (ACR),fasting blood glucose,2-hour postprandial blood glucose,and C-reactive protein(CRP,P＜0.05 or P＜0.01),but was negatively associated with age and adiponectin (all P＜ 0.01).Multiple stepwise regression analysis indicated that duration of diabetes,fetuin-A,CRP,and adiponectin were independent determinants for ACR (all P ＜ 0.01).Fetuin-A may be involved in the development and pathogenesis of DN by proinflammatory effects and repressing adiponectin production.

Objective To investigate serum alpha2-Heremans-Schmid glycoprotein ( AHSG ) level and its relationship with associated clinical parameters in subjects with simple overweight and obesity. Methods Forty-nine subjects with obesity ( OB group) , 176 subjects with overweight ( OW group) , and 327 individuals with normal weight ( NW group) were randomly enrolled. The clinical data were collected and serum levels of AHSG and adiponectin ( APN) were determined by ELISA. The associations of serum AHSG level with other clinical parameters were assessed by Pearson correlation analysis and multiple linear regressive model. Results Serum AHSG levels were higher in OW and OB groups than that in NW group[(276. 30 and 302. 10 vs 241. 60)μg/ml], being especially higher in OB group (P<0. 05 or P<0. 01). Serum AHSG level in NW group was positively associated with fasting plasma glucose, homoeostasis model assessment of insulin resistance index, C-reactive protein (CRP), triglycerides, and free fatty acids ( FFA ) , but negatively associated with age and APN. In OW and OB groups, AHSG was also positively associated with body mass index, waist hip ratio(WHR), and low density lipoprotein cholesterol(P<0. 05 or P<0. 01) except the aforementioned clinical parameters. In multiple linear regression model, AHSG was positively associated with WHR, CRP, and FFA, and was negatively associated with APN ( P<0. 05 or P<0. 01). Conclusion The raised AHSG level in overweight and obese subjects may be a risk factor for obesity-related diseases.

The progressive attrition of teeth is a normal process by aging. However, excessive tooth wear with decreased vertical dimension of occlusion and collapse of occlusal plane may cause pathologic pulpal condition, occlusal disharmony, functional disorders and esthetic problems. The change of vertical dimension is required in case that there is no sufficient clearance for restoration or in case that the occlusal relationship is modified. For gaining the vertical dimension, a careful diagnosis is essential prior to starting the restoration treatment. After evaluating adaptation of neuromuscular system of patient during provisional phase, the final restorations can be fabricated. In this case, a 78 year old male with severely worn down dentition was treated. To improve the esthetic appearance and to achieve the ideal occlusal relationship, the full mouth rehabilitation with minimal increase of vertical dimension is planned and diagnostic wax-up was performed at the increased vertical dimension. After evaluation of provisional restorations for 12 weeks, final restorations were fabricated and routine clinical assessments were made. After 1 year, the restorations with newly established occlusal scheme are well maintained without significant complications and esthetically and functionally satisfactory results were obtained.
Aging ; Dental Occlusion ; Dentition* ; Diagnosis ; Humans ; Male ; Mouth Rehabilitation* ; Mouth* ; Tooth ; Tooth Wear ; Vertical Dimension*

No abstract available.
Hepatitis*

To address the limitations of animal testing, scientific research is increasingly focused on developing alternative testing methods. These alternative tests utilize cells or tissues derived from animals or humans for in vitro testing, as well as artificial tissues and organoids. In western countries, animal testing for cosmetics has been banned, leading to the adoption of artificial skin for toxicity evaluation, such as skin corrosion and irritation assessments. Standard guidelines for skin organoid technology becomes necessary to ensure consistent data and evaluation in replacing animal testing with in vitro methods. These guidelines encompass aspects such as cell sourcing, culture techniques, quality requirements and assessment, storage and preservation, and organoid-based assays.

PURPOSE: The purpose of this study was to examine the effects of simulation-based learning on the knowledge about and performance confidence in the nursing care of children with asthma. METHODS: A one-group pre- and post- study design was used. A total of 70 nursing students participated in the study. In groups of five, the participants experienced simulation-based learning during their child health nursing practicum. The given scenario was about nursing care for children with asthma. The simulation learning was provided for 3 hours, and included a group discussion before the simulation and a debriefing. RESULTS: After the simulation, knowledge about and performance confidence in the nursing care of children with asthma significantly increased. The nursing students reported a high level of satisfaction with the simulation-based learning. There was a significant positive correlation between knowledge and performance confidence. CONCLUSION: Simulation-based learning was effective for nursing students in the nursing care of children with asthma. Our results suggest utilizing this new way of learning to strengthen the clinical experience of child health nursing in nursing students.
Asthma* ; Child Health ; Child* ; Education, Nursing ; Humans ; Learning* ; Nursing Care* ; Nursing* ; Patient Simulation ; Students, Nursing

BACKGROUND/AIMS: Chronic cough may be the only manifestation of asthma. This study prospectively evaluated the validation of a modified European Community Respiratory Health Survey (ECRHS) questionnaire (including postnasal drip and GERD) in patients with chronic cough. METHODS: We recruited patients with a chronic cough exceeding 8 weeks from Oct. 2004 to March 2008. The patients had undergone an assessment using the modified ECRHS questionnaire, methacholine challenge test, chest PA, and PNS series, as well as the MAST and skin prick test in some patients. RESULTS: A total of 1518 patients were recruited. A total of 511 patients (33.6%) were physician diagnosed with asthma. Wheezing (53%, odds ratio [OR]: 2.989), nocturnal cough or dyspnea (57.3%,OR: 1.751), resting dyspnea (43.8%, OR: 2.216), post-exercise dyspnea (63.4%,OR: 2.297), esophageal reflux symptoms (34.1%, OR: 1.107) and postnasal drip (13.1%, OR: 1.116) are symptoms that have been reported. As the number of asthmatic symptoms included in the questionnaire increased, the number of patients diagnosed with asthma by a physician increased. The correlation between bronchial hyperresoponsiveness (BHR) and physician diagnosed asthma was evaluated by the area under the receiver operator characteristic (ROC) curve. The questionnaire was more correlated with BHR than with physician diagnosed asthma (area: 0.852 vs. 0.631). CONCLUSIONS: The Modified ECRHS questionnaire is an available method to assist in the diagnosis of asthma and to evaluate BHR in patients with chronic cough.
Asthma ; Cough ; Dyspnea ; European Union ; Gastroesophageal Reflux ; Health Surveys ; Humans ; Methacholine Chloride ; Odds Ratio ; Prospective Studies ; Respiratory Sounds ; Skin ; Thorax ; Surveys and Questionnaires

BACKGROUND/AIMS: Chronic cough may be the only manifestation of asthma. This study prospectively evaluated the validation of a modified European Community Respiratory Health Survey (ECRHS) questionnaire (including postnasal drip and GERD) in patients with chronic cough. METHODS: We recruited patients with a chronic cough exceeding 8 weeks from Oct. 2004 to March 2008. The patients had undergone an assessment using the modified ECRHS questionnaire, methacholine challenge test, chest PA, and PNS series, as well as the MAST and skin prick test in some patients. RESULTS: A total of 1518 patients were recruited. A total of 511 patients (33.6%) were physician diagnosed with asthma. Wheezing (53%, odds ratio [OR]: 2.989), nocturnal cough or dyspnea (57.3%,OR: 1.751), resting dyspnea (43.8%, OR: 2.216), post-exercise dyspnea (63.4%,OR: 2.297), esophageal reflux symptoms (34.1%, OR: 1.107) and postnasal drip (13.1%, OR: 1.116) are symptoms that have been reported. As the number of asthmatic symptoms included in the questionnaire increased, the number of patients diagnosed with asthma by a physician increased. The correlation between bronchial hyperresoponsiveness (BHR) and physician diagnosed asthma was evaluated by the area under the receiver operator characteristic (ROC) curve. The questionnaire was more correlated with BHR than with physician diagnosed asthma (area: 0.852 vs. 0.631). CONCLUSIONS: The Modified ECRHS questionnaire is an available method to assist in the diagnosis of asthma and to evaluate BHR in patients with chronic cough.
Asthma ; Cough ; Dyspnea ; European Union ; Gastroesophageal Reflux ; Health Surveys ; Humans ; Methacholine Chloride ; Odds Ratio ; Prospective Studies ; Respiratory Sounds ; Skin ; Thorax ; Surveys and Questionnaires

OBJECTIVES: To develop dedicated markup language for clinical contents models (CCM) to facilitate the active use of CCM in electronic health record systems. METHODS: Based on analysis of the structure and characteristics of CCM in the clinical domain, we designed extensible markup language (XML) based CCM markup language (CCML) schema manually. RESULTS: CCML faithfully reflects CCM in both the syntactic and semantic aspects. As this language is based on XML, it can be expressed and processed in computer systems and can be used in a technology-neutral way. CONCLUSIONS: CCML has the following strengths: it is machine-readable and highly human-readable, it does not require a dedicated parser, and it can be applied for existing electronic health record systems.
Computer Systems ; Electronic Health Records ; Electronics ; Electrons ; Semantics

BACKGROUND: The aims of this study were to evaluate the abilities of direct sequencing (DS), peptide nucleic acid (PNA) clamping, and pyrosequencing methods to detect epidermal growth factor receptor (EGFR) mutations in formalin-fixed paraffin-embedded (FFPE) non-small cell lung carcinoma (NSCLC) samples and to correlate EGFR mutational status as determined by each method with the clinical response to EGFR tyrosine kinase inhibitors (TKIs). METHODS: Sixty-one NSCLC patients treated with EGFR TKIs were identified to investigate somatic mutations in the EGFR gene (exons 18-21). RESULTS: Mutations in the EGFR gene were detected in 38 of the 61 patients (62%) by DS, 35 (57%) by PNA clamping and 37 (61%) by pyrosequencing. A total of 44 mutations (72%) were found by at least one of the three methods, and the concordances among the results were relatively high (82-85%; kappa coefficient, 0.713 to 0.736). There were 15 discordant cases (25%) among the three different methods. CONCLUSIONS: All three EGFR mutation tests had good concordance rates (over 82%) for FFPE samples. These results suggest that if the DNA quality and enrichment of tumor cells are assured, then DS, PNA clamping, and pyrosequencing are appropriate methods for the detection of EGFR mutations.
Constriction ; DNA ; Genes, erbB-1 ; Humans ; Lung ; Lung Neoplasms ; Peptide Nucleic Acids ; Polymerase Chain Reaction ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Tyrosine