Objective To compare the differences of five diagnostic criteria used for metabolic syndrome (MS),issued by International Diabetes Federation (IDF),the National Cholesterol Education Program (ATPIII),America-Heart-Associatien (AHA),Chinese Medical Association Diabetes Branch (CDS) and The Taiwan Health Bureau (TAIWAN),during a physical check-up program among population aged 35-74 years,in Taiwan.Methods A total number of 28 408 people who had received physical checkup program first time at the MJ centers,were recruited from 2005 to 2007.The prevalence of MS and the degree of agreement were both calculated according to the five definitions and the results of MS components.Distributions and risk factor aggregation of the results were also analyzed.Results According to the five definitions (1)The range of age-adjusted prevalence of MS appeared to be 10.6%(CDS)23.6%(AHA),and were 13.4%(CDS)-27.6%(AliA)and 8.0%(CDS)-20.5%(IDF) for men and women respectively.(2) The range of five MS components were 22.5%(low-HDL-C)-39.7%(high FPG),with 22.3%of the total subjects presented at least 3 risk factors.In addition,0%(AHA),6.7%(TAIWAN),6.9%(ATP III),8.9%(IDF) and 14.9%(CDS) of the subjects diagnosed as MS-free,by the five criterions,also appeared of having≥3 risk factors.(3) Among all the MS subjects,the proportions of clinical symptom complex,having 5,4 and 3 MS components were 8.0%,29.5%and 62.5%respectively.The most common clinical symptoms complex of MS were obesity,hypertension and high FPG.(4) The MS diagnostic criteria of ATPIII,AHA and TAIWAN were in good accordance with Kappa index,showing 0.81-0.98 for the three criteria.CDS and IDF were in relatively weak agreementwhen comparing with other definitions with Kappa index showed as 0.35 and 0.62.Conclusion Our findings revealed big differences in the prevalence and aggregation of risk components on MS,when using the five definitions.We suggested that prospective cohort studies be planned to investigate the impact on cardiovascular disease morbidity and mortality so as to verify whies criterion might be suitable to the population in Taiwan,considering the possible bias.

OBJECTIVETo observe the effect of traditional Chinese medicine (TCM) treatment according to syndrome differentiation on acute radio-reaction (ARR) in nasopharyngeal carcinoma (NPC) patients.

METHODSOne hundred and ninety-five NPC patients who received radiotherapy (RT) for the first time were randomly assigned to two groups: the control group (89 cases) was treated by RT alone for 7 weeks and the treatment group (106 cases) was treated by RT combined with oral taking TCM from starting of RT till 5 weeks after RT. The overall changes in total ARR score and ARR in different locations were observed weekly and compared.

RESULTSThe total ARR score in the treatment group was significantly lower than that in the control group (P<0.05). And the ARR scores of different organs, including skin, oropharyngeal mucosa, salivary glands, larynx, car, upper digestive tract, and central nervous system, in the treatment group were all lower than those of the corresponding organs in the control group. In addition, the ARR scores in both groups showed an ascending trend in the first 7 weeks and a descending trend from the 8th to the 10th week after beginning RT.

CONCLUSIONTCM treatment could relieve the ARR in the NPC patients without any affection on the efficacy of RT.

Adult ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; Combined Modality Therapy ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; Phytotherapy ; Radiation Injuries ; diagnosis ; prevention & control ; Syndrome ; Treatment Outcome

Actins ; metabolism ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Bile Duct Neoplasms ; metabolism ; pathology ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; metabolism ; pathology ; surgery ; Female ; Giant Cells ; metabolism ; pathology ; Humans ; Keratins ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; surgery ; Osteoclasts ; metabolism ; pathology ; Vimentin ; metabolism

OBJECTIVETo assess the antihypertensive effect and safety on medicine named 'Beijing Hypertensive No. 0' in a three-year treatment of primary hypertension.

METHODSA community-based intervention study was conducted. The antihypertensive effects and adverse events were observed.

RESULTS4000 patients with primary hypertension were randomly divided into two groups with 1529 patients treated with 'Beijing Hypertensive No. 0' and 976 patients treated with other antihypertensive drugs, among which 946 and 853 patients in the two groups completed the three-year study. After treatment, the systolic blood pressure decreased 13 mm Hg and 7 mm Hg while diastolic blood pressure decreased 8 mm Hg and 4 mm Hg in the 'No. 0' group and controlled group respectively. After three years of treatment, 90.0% and 79.5% in the 'No.0' group and in the control group had reached the BP 'fulfillment criteria', which were much higher than the baseline data. Side effects occurred in 33/1274 (2.6%) cases during three years' treatment with most commonly seen as dizziness, headache, palpitation and weakness. No serious adverse reactions occurred. There were some positive effects after treated by 'No. 0', including 0.13 mmol/L decrease of TC, 0.70 mmol/L decrease of LDL-C and an average 0.12 mmol/L increase of HDL-C. All of these changes were statistically significant. There were also opposite effects as 0.13 mmol/L increase of TG, 0.24 mmol/L increase of K+, and 0.88 mmol/L increase of Na+ on average, which were also statistically significant.

CONCLUSIONCompared with the conventional treatment, this treatment of 'Beijing Hypertensive No.0' was more convenient, safe and effective in treating mild to moderate primary hypertension in the community.

Aged ; Antihypertensive Agents ; adverse effects ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Hypertension ; drug therapy ; Male ; Safety

Objective To compare the cost-effectiveness of two anti-hypertensive therapy regimens,Compound anti-hypertensive tablets and other common anti-hypertensive agents,in the treatment program of Primary Hypertension.Methods We conducted a cost-effectiveness analysis based on a community trial.Two communities'primary hypertensive patients were enrolled to receive different therapy drugs:Compound anti-hypertensive tablets(Group A)or other common anti-hypertensive agents(Group B).Blood pressure,medicine used,and adverse drug reactions were observed and recorded for one year,and then costeffectiveness ratio of the two groups and incremental ratio were calculated.We considered a 30%drug price fluctuating load to make the sensitivity analysis.Results 2505 cases were enrolled with 1529 cases in group A and 976 cases in group B.The cost-effectiveness ratios were 418.1 and 1057.7 for Group A and B respectively while the incremental cost-effectiveness of Group B vs.Group A was 19 202.2.The results were insensitive to variation in the costs of drugs over clinically reasonable ranges.Conclusion Compound anti-hypertensive tablets appeared to be relatively cost-effective when compared to common drugs for the treatment of primary hypertension.

Induced pluripotent stem (iPS) cells were originally generated from mouse fibroblasts by enforced expression of Yamanaka factors (Oct3/4, Sox2, Klf4, and c-Myc). The technique was quickly reproduced with human fibroblasts or mesenchymal stem cells. Although having been showed therapeutic potential in animal models of sickle cell anemia and Parkinson's disease, iPS cells generated by viral methods do not suit all the clinical applications. Various non-viral methods have appeared in recent years for application of iPS cells in cell transplantation therapy. These methods mainly include DNA vector-based approaches, transfection of mRNA, and transduction of reprogramming proteins. This review summarized these non-viral methods and compare the advantages, disadvantages, efficiency, and safety of these methods.
Animals ; Cellular Reprogramming ; Humans ; Induced Pluripotent Stem Cells ; physiology ; Transduction, Genetic ; Transfection ; Transgenes

OBJECTIVETo study the chemical constituents of Costus speciosus and C. tonkinensis (Zingiberaceae) distributed in Yunnan province.

METHODChromatography and spectral analyses were used to isolate the constituents and elucidate their structure.

RESULTSix compounds were isolated from the rhizome of C. speciosus and elucidated as diosgenin(1), prosapogenin B of dioscin(2), diosgenone(3), cycloartanol(4), 25-en-cycloartenol(5) and octacosanoic acid(6). Four compounds were isolated from the rhizome of Costus tonkinensis and elucidated as tetracosanoic acid(7), succinic acid(8), beta-sitosterol(9) and daucosterin(10).

CONCLUSIONCompounds of 3-6 were obtained from C. speciosus for the first time and compounds of 7-10 were obtained from C. tonkinensis for the first time too.

Costus ; chemistry ; classification ; Fatty Acids ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Spiro Compounds ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification

This study investigated the effects of concentration, intestinal section, pH and P-gp on the absorption of daphnetin. The absorptions of three concentrations (10, 20, 40 microg x mL(-1)) of daphnetin in different intestinal segments were studied with phenol red as the marker by in situ rats single pass perfusion model. The results showed that daphnetin was stable under pH 6.0 condition and little affected by metabolism enzyme. There was upgrade tendency between the Peff of duodenum, jejunum, ileum and colon in different concentration of daphnetin, and it has obvious difference between the high concentration and low concentration in jejunum and colon, which indicated that the absorption of daphnetin was passive diffusion and no difference in different segments of rat intestine. However, compared with colon, the absorption of small intestine was better significantly (P < 0.05). Daphnetin may be not a substrate of P-gp as verapamil had not significantly affected the absorption of daphnetin in different intestinal segments of rats.
ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Animals ; Female ; Hydrogen-Ion Concentration ; Intestinal Absorption ; drug effects ; Male ; Perfusion ; Permeability ; Rats ; Rats, Sprague-Dawley ; Umbelliferones ; pharmacokinetics

OBJECTIVETo evaluate the effect of combined chemoradiotherapy followed by surgery for patients with esophageal carcinoma.

METHODSNinety-seven patients with stage II or III esophageal carcinoma without contraindication against operation and chemoradiotherapy, were randomly divided into two groups: combined group (Group A) 48 and control group (Group B) 49. Patients in group A were given neoadjuvant treatment consisted of chemotherapy with 5-fluorouracil and cisplatin for 2 cycles and radiotherapy of DT36 Gy/12 f/17 d. Three weeks later, operation was performed. Patients in group B were given operation alone. Survival rate was calculated with Kaplan-Meier method. Chi and Log-rank test was used to assess the difference between the two groups.

RESULTSThe radical resectability of group A and group B were 85.4% and 65.3% (P = 0.018 1). The lymph node metastasis rate of the two groups were 21.7% and 45.7% (P = 0.019 4). The T stage of group A was significantly lowered (P = 0.003 6). The local and regional recurrence rate of two groups were 34.8% and 58.7% (P = 0.023 6), while there was no significant difference in operative complications between the two groups. Significant improvement in the long-term survival rate was observed in group A, especially in patients who achieved partial and complete response with high 5-year survival rate of 56.5%.

CONCLUSIONPreoperative neoadjuvant chemoradiotherapy is able to reduce the tumor and tumor stage, lower the lymph node metastasis rate and local or regional recurrence rate, also it can improve radical resectability and long-term survival without increasing the operative complications.

Adenocarcinoma ; drug therapy ; radiotherapy ; surgery ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; surgery ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Esophageal Neoplasms ; drug therapy ; radiotherapy ; surgery ; Esophagectomy ; Female ; Fluorouracil ; administration & dosage ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Particle Accelerators ; Prospective Studies ; Radiotherapy, Adjuvant ; Survival Rate

OBJECTIVETo compare the differences of two recommended diagnostic criteria for metabolic syndrome (MS) in a health check-up population aged 12-19 years in Taiwan province.

METHODThe study data were supplied by the MJ Health Screening Center, which is a private membership chain clinic with 4 health screening centers around the Taiwan Island and provides periodic health examination to its members. The database included a self-administered questionnaire for health history, asking about demographic, socioeconomic, medical, and lifestyle information, and clinical and laboratory measures for every member. A total of 1629 members (873 boys and 756 girls, respectively) received a health check-up first time at MJ centers were recruited from 2005 to 2006. MS detection rate and agreement rate was calculated according to two definitions, respectively. The distributions of MS components and the aggregation of risk factors were further analyzed.

RESULT(1) The range of age-adjusted detection rate of MS for two definitions were 4.05% (5.84% for boys, 1.98% for girls) and 8.35% (10.42% for boys, 5.95% for girls), respectively. It was 0.94% , 14.20% and 36.59% for criterion I among adolescents who were overweight (BMI over 95th percentile), at risk of overweight (BMI between 85th and 95th percentile) and normal weight (BMI below the 85th percentile), respectively; while 3.61%, 25.93% and 53.66% for criterion II. (2) The range of five MS components were 9.09% (low-HDL-C)-16.39% (high blood pressure) for definition I, while 0.98% (high FBG)-27.13% (high WC) for definition II. (3) Of the total subjects, 2.76%, 1.04% and 0.25% were presented with three, four and five MS risk factors for definition I; while 6.69%, 1.60% and 0.34% for definition II, separately. (4) The most common clinical symptom complex of MS was "obesity, hypertension and low-HDL-C" for criterion I, "high TG, obesity and low-HDL-C" for criterion II. (5) The MS diagnostic criterions of I and II were in moderate accordance with agreement rate of 94.35%, Kappa index was 0.518.

CONCLUSIONOur findings reveal that there were relatively large differences in detection and aggregation of risk components on MS when using two recommended definitions, the detection rate of MS in adolescents depends strongly on the parameters chosen and their respective cut-off points. In order to avoid possible relevant under- or over-estimation of the prevalence, it seems advisable that the use of unversally specific cut-off values seems to be more appropriate to give more reliable results.

Adolescent ; Adult ; Child ; Cross-Sectional Studies ; Diagnostic Techniques and Procedures ; standards ; Female ; Humans ; Male ; Metabolic Syndrome ; diagnosis ; Reference Standards ; Taiwan