1.Bile acid induced gut hormones and hepatic glucose metabolism
Chinese Journal of Diabetes 2015;(12):1134-1137
[Summary] Bile acid is a main component of bile ,which plays a key role in keeping cholesterol metabolism balance in vivo and promoting lipids digestion in intestine. Recently ,more and more researches focus on bile acid for its regulating effect on glucose ,lipid and energy metabolism as a signal molecule. The reabsorbed bile acid stimulates the secretion of fibroblast growth factor 19 (FGF19) and glucagon-like peptide-1(GLP-1) in the intestine by activating a nuclear receptor farnesoid X-activated receptor (FXR) and a membrane receptor TGR5. FGF19 and GLP-1 regulate hepatic glucose metabolism through different pathways. Here ,we briefly summarize the research progress and relationship between bile acid induced gut hormones and hepatic glucose metabolism.
2.inical and radiological features of the late-onset methylmalonic aciduria: a review of three cases
Zhaoxia NG ; Wei ZHANG ; Yanling YANG ; Yun YUAN
Chinese Journal of Neurology 2000;0(04):-
jective To study the clinical and radiological features of the patients with late-onset methylmalonic aciduria ( MMA). Methods Two men and one woman with MMA were screened and confirmed by urinary organic acid analysis with gas chromatograph/mass spectrometer (GC/MS) at their 26, 18 and 34 years old, respectively. Their clinical features, laboratory findings, radiological manifestations, treatment and outcome were reviewed. Results The clinical features of 3 patients were varied with neurological abnormalities. Case 1 had periodic enuresis for 16 months, progressive dementia and movement disorder for 3 months. Physical examination showed an apparent cognitive decline with psychiatric symptoms. Dysarthria, bilateral weakness and pyramidal signs, rigidity and mild tremor of limbs were observed. Case 2 had a progressive memory deterioration, learning difficulty, walking unstably and decreased vision when he was 13 years old, and a general seizure at an age of 16 years. Diffused abnormalities of EEG and rnild renal defects were found in the above two patients. General white matter hyperintensity and cerebral atrophy on T2-weighted MR images were evident. Additionally, these two patients had hyperhomocystinemia and carnitine deficiency. Case 3 had complained about walking unstably and fatigue over 2 months. Reduced facial movements, deep sensation loss and muscle weakness in lower extremities, marked rigidity and diminished tendon reflexes were detected. Megaloblastic anemia and cobalamin deficiency were found. MRJ performed revealed bilateral symmetric areas having high density involving the globi pallidi, posterior limbs of internal capsule and the cerebral peduncles. Remarkable elevations of urinary methylmalonic and methylcitric acid were confirmed in all 3 patients. After vitamin B12 supplementation, significant improvement was observed. Conclusion Three cases with vitamin BI2 responsive type of late-onset MMA were reported. Two patients were combined with hyperhomocystinemia and the other had only isolated MMA. There might remain prominent differences among MMA subgroups in clinical presentations and neuroradiologic findings. VitaminB12 might be very effective to improve the prognosis of the patients. MMA should be considered as a differential diagnosis for the etiological investigation of adult cerebral metabolic or degenerative diseases.
3.Antipsychotics And Electrocardiographic Monitoring In Patients With Schizophrenia
Pamela Mei Yuan Ng ; Suet Bin Chai ; Ker-Chiah Wei
ASEAN Journal of Psychiatry 2016;17(2):151-159
Objectives: Patients with schizophrenia are more likely to die prematurely than
the general population. They have a higher risk of cardiovascular related
morbidity and mortality. Antipsychotic medications are also known to be
associated with the prolongation of the rate-corrected QT (QTc) interval, which
is linked to dangerous arrhythmias. The primary objective of our study is to
investigate the practice of electrocardiogram (ECG) monitoring for patients with
schizophrenia who were hospitalised. The secondary objective is to evaluate the
prevalence of QTc prolongation in this group of patients. Methods: We included
patients with schizophrenia who were discharged from the acute general adult
psychiatric wards of the Institute of Mental Health in Singapore from 1 July
2014 to 21 July 2014. A retrospective analysis of the medical records was carried
out to assess if they had received ECG during their hospitalisation. We also
analysed their risk of developing QTc prolongation. Results: We had a sample
size of 107 patients. There were 31 patients (29·0%) who received ECG during
their hospitalisation. Of the 95 patients who had moderate-to-high risk of
developing QTc prolongation, 29 of them received ECG. Of the 31 patients who
received ECG, 10 of them (32·3%) had QTc prolongation. Conclusion: The ECG
monitoring in the study patients was inadequate, and as a result, we were unable
to evaluate the prevalence of prolonged QTc interval with confidence. We
recommend performing baseline ECGs for these patients and conducting ECG
teachings for clinicians who work in the psychiatric service settings. ASEAN
Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.
4.Fluorescence-Guided versus Conventional Surgical Resection of High Grade Glioma: A Single-Centre, 7-Year, Comparative Effectiveness Study
Wei Ping Ng ; Boon Seng Liew ; Azmin Kass Rosman
Malaysian Journal of Medical Sciences 2017;24(2):78-86
Background: High grade gliomas (HGGs) are locally invasive brain tumours that carry a
dismal prognosis. Although complete resection increases median survival, the difficulty in reliably
demonstrating the tumour border intraoperatively is a norm. The Department of Neurosurgery,
Hospital Sungai Buloh is the first public hospital in Malaysia to overcome this problem by
adopting fluorescence-guided (FG) surgery using 5-aminolevulinic acid (5-ALA).
Methods: A total of 74 patients with histologically proven HGGs treated between January
2008 and December 2014, who fulfilled the inclusion criteria, were enrolled. Kaplan-Meier
survival estimates and Cox proportional hazard regression were used.
Results: Significant longer survival time (months) was observed in the FG group
compared with the conventional group (12 months versus 8 months, P < 0.020). Even without
adjuvant therapy, HGG patients from FG group survived longer than those from the conventional
group (8 months versus 3 months, P = 0.006). No significant differences were seen in postoperative
Karnofsky performance scale (KPS) between the groups at 6 weeks and 6 months after
surgery compared to pre-operative KPS. Cox proportional hazard regression identified four
independent predictors of survival: KPS > 80 (P = 0.010), histology (P < 0.001), surgical method
(P < 0.001) and adjuvant therapy (P < 0.001).
Conclusion: This study showed a significant clinical benefit for HGG patients in terms
of overall survival using FG surgery as it did not result in worsening of post-operative function
outcome when compared with the conventional surgical method. We advocate a further multicentered,
randomised controlled trial to support these findings before FG surgery can be
implemented as a standard surgical adjunct in local practice for the benefit of HGG patients.
5.Factors deterring registered nurses from pursuing post graduate nursing degree in a private hospital in Penang, Malaysia
Mei Foong Ng ; Bee Yean Ooi ; Wei Fern Siew
International e-Journal of Science, Medicine and Education 2015;9(3):38-46
Background: In Malaysia the percentage of diploma
registered nurses outnumber the percentage of degree
registered nurses. Internationally, most registered nurses
earn associate degrees or bachelor’s degrees in nursing.
Malaysia is in the pipeline of ensuring that its registered
nurses are professionally qualified with nursing degree by
year 2020. Registered nurses with diploma qualification
are feeling the pressure to upgrade their qualification to
degree. There are concerns as to why these nurses are
not pursuing their post registration nursing degree.
Objective: To determine factors that are deterring the
registered nurses of a private hospital in Penang from
pursuing the post registered nursing degree.
Methods: This descriptive study utilised a convenient
sample of 150 registered nurses from Lam Wah Ee
Hospital in Penang. The instrument of this study was
developed based on literature search and the conceptual
framework of Force Fields Analysis developed by Kurt
Lewin in 1952.
Results: The deterring factors for registered nurses
not pursuing post registration nursing degree from this
hospital were determined through negative mean score,
which was valued at less than 2.5. The top 3 deterring
factors identified were: high educational cost, with a
score of 1.92; financial commitment, with a score of 2.22
and time constraints and high workload, with a score of
2.27.
Conclusions: High educational cost, financial
commitment, time constraint and high workload were
the main factors deterring the registered nurses from
this hospital from pursuing their post registration
nursing degree. Thus it is timely for the organisational
management to consider workable measures to assist
and motivate their nurses to upgrade themselves with
nursing degree in line with Malaysia’s vision to meet the
increasing challenges and complex needs in the care of
clients in health services.
Education, Nursing
6.Association of vascular calcification and gremlin expression in radial arteries of patients with stage 5 of chronic kidney disease
Li-feng GONG ; Jing-kui LU ; Wei-gang TANG ; Wei NG JIA ; Gui-xiang MA
Chinese Journal of Nephrology 2011;27(11):807-810
Objective To study the association of the expression of bone morphogenetic protein (BMP) antagonist gremlin and vascular calcification in radial arteries of patients with stage 5 of chronic kidney disease (CKD).Methods Radial arteries of 40 patients with stage 5 of CKD were collected as specimens of the study group,which were trimmed off during arterial venous fistula operations.Splenic trabecular arteries were collected as specimens of the control group,which were removed from 38 patients with simple traumatic splenic rupture.All the arteries were examined histologically for calcification with yon Kossa stain.Expressions of gremlin and BMP-2,-7were detected by immunohistochemistry and their serum concentrations were detected by ELISA.Images of histological sections were semi-quantitatively analyzed by Image-Pro Plus 6.0.SPSS 19.0software was used to perform statistical analysis.Results Significantly positive von Kossa stain was found in radial arteries from 12 of 40 patients (30%) in study group,which located in the layer of medial smooth muscle cells.However,there was no obvious positive stain in control group.Additionally,in study group,significant expressions of gremlin and BMP-2 were detected in those radial arteries of positive yon Kossa stain,which also located in the layer of medial smooth muscle cells.Positive correlations were found among gremlin expression level,BMP-2 expression level and yon Kossa stain intensity.However,the BMP-7 expression intensity in arteries of study group was much weaker as compared to control group.Conclusions Both gremlin and BMP-2 may be involved in the process that the smooth muscle cells of radial arteries in patients with stage 5 of CKD phenotypically transform into osteoblast-like cells.However,BMP-7 possibly prevents this process.
7.The perioperative myocardial protection of high-dose atorvastatin to acute coronary syndrome patients during percutaneous coronary artery interventional therapy
Wei ZHANG ; Ming ZHAO ; Xiao-hong LI ; Xiao-feng WANG ; Hong-bin NG ZHA ; Ping SUN ; Jian-guo NG YA
Chinese Journal of Postgraduates of Medicine 2011;34(19):29-31
Objective To observe the perioperative myocardial protection of high-dose atorvastatin to acute coronary syndrome(ACS) patients during percutaneous coronary artery interventional therapy(PCI).Methods One hundred and twenty patients with ACS undergoing elective PCI were divided into group A and group B with different oral dose of atorvastatin ( 80 mg/d and 20 mg/d ) for 3 days before operation by random digits table. Troponin I (cTnI), creatine kinase isozyme MB (CK-MB), high sensitive C-reactive protein (hs-CRP), interleukin (IL)-6 levels were measured before operation, 6 hours, 12 hours after operation and total cholesterol (TC), triglyeride (TG), low desity lipeprotein cholesterol (LDL-C), high density lipeprotein cholesterol (HDL-C) levels were measured before operation and 3 days after operation.Results cTnI,CK-MB,hs-CRP and IL-6 levels in the two groups were increased significandy 6 hours and 12 hours after operation (P <0.05). Six hours after operation, cTnI and CK-MB levels in group A were significantly lower than those in group B [(0.35±0. 18 ) μg/L vs. (0.48±0. 16 ) μg/L, ( 3.78±0.45 )μg/Lvs. (4.56±0.55 )μg/L] (P < 0.05 ). Twelve hours after operation , hs-CRP and IL-6 levels in group A were significantly lower than those in group B [(4.53±0.98 ) mg/L vs. (7.03±0.88 ) mg/L, ( 30.6±11.2) ng/L vs.(43.8±12.1) ng/L] (P <0.05). TC, TG, LDL-C, HDL-C levels in the two groups did not change significantly before and after operation (P >0.05). Conclusions Myocardial protective effects of ACS patients treated with atorvastatin 80 mg/d for 3 days are better than those treated with oral atorvastatin 20 mg/d. High-dose atorvastatin can produce more beneficial effects.
10.The effect of blocking the janus kinase signal transducers and activators of transcription signal pathway on the activity of Caspase-3 in the synovial tissue of rheumatoid arthritis rats
Wei GAO ; Rong ZHANG ; Li-juan ZHAO ; Jing LU ; Pin-ting NG YA
Chinese Journal of Rheumatology 2011;15(10):703-706
ObjectiveTo explore the effect of blocking the JAK/STAT signal pathway on the activity of Caspase-3 in the synovial tissue of rheumatoid arthritis rats.MethodsFifty rat models of collageninduced arthritis,which had arthritis index more than 2 were divided into the model group,the low dosage of AG490 group,the medium dosage of AG490 group and high dosage of AG490 group.Inaddition,6 rats were treated as normal control group.Normal saline,AG490 1,5,10 mg·kg-1 ·d-1 were given by intraperitoneal injection.Then the volume claws and pathologic scores of the rat models were recorded and the activity of Caspase-3 in the synovial tissue were compared.The results were analyzed by one-way ANOVA and LSD-t or Tamhane's T2 test.ResultsThe arthritis of the CIA models progressed fast,the volume of the claws and the pathological score of them were significantly higher than those of the control group.At the same time,no Caspase-3 positive express could be detected in the control group,whilethe model group had slightly increased expression.After different dosages of AG490 were applied,the swollen of joints was significantly improved compared with the model group.The histopathological score of the medium AG490 dosage of group and high dosage group(2.7±0.8,1.8+0.9) were remarkably decreased than those of the model group(4.3+1.2),the differences were statistically significant (P<0.01).In addition,the Caspase-3 expression in the low,medium and high AG490 dosage group ( 1.90±0.15,3.13±0.33,3.56+0.34) was significantly higher than that of the model group(1.48±0.18)(P<0.05 or P<0.01 ).ConclusionBlocking JAK/STAT signal pathway can increase the activity of Caspase-3,reduce the excessive proliferation of synovial tissue,and improve arthritis symptoms.