Background and Objectives: Anticoagulation clinics are widely used for anticoagulation management in many countries, but have only recently began to gain acceptance in Taiwan. Our service model is a physician-managed outpatient clinic collaborating with clinical pharmacist and nurse. This study aimed to evaluate the adequacy of anticoagulation and rates of warfarin-related complications before and after referral to our collaborative anticoagulation clinic (CAC). Methods: Stroke patients taking warfarin from the neurology department were identifi ed and referred to the CAC during the 12-month period from February 2009 to January 2010. Quality markers include percentage of international normalized ratio (INR) values in the therapeutic range, frequency of INR monitoring, and frequency of follow-up visits and the mean interval of next INR monitoring after non-therapeutic INRs were compared one year before and after management in the CAC. Using studied patients as self-control, they were included in the analysis if patients had at least 3 months follow-up or 3 INR values both before and after referral. Results: A total of 44 stroke patients were included: mean age of 75.0 ± 9.7 years, with a CHADS2 score of 3.71 ± 0.69. The adequacy of anticoagulation was signifi cantly greater during CAC care compared with the period before referral; the percentage of INR within expanded therapeutic range was 60.9% versus 53.7%, respectively (p=0.049). Reduction in sub-therapeutic INR values from 31.8% to 24.2% (p=0.023) contributed mostly to the improved quality of care. The time interval of next INR monitoring after non-therapeutic INRs ( 4.0 or 1.5) was also signifi cantly shorter. However, there was no signifi cant difference in the rates of thromboembolic and hemorrhagic events which may be attributed to a small sample size. Conclusion: Based on results of our study, a CAC may be the optimal structure for anticoagulation management service in the future.

Glucose-6-phosphate dehydrogenase is main regulatory enzyme for pentose phosphate pathway. To amplify the core sequence of G6PDH gene from Chimonanthus praecox, the primers were synthesized, based on the conserved nucleotide sequence of other reported plant G6PDH genes. The specific primers were designed according to the major fragment. The full length cDNA of the G6PDH1 gene was isolated by the 3' and 5' rapid amplification of cDNA ends approach. Transcript levels of G6PDH1 isoform was measured by real-time quantitative RT-PCR in different tissues and in responds to cold treatment. The G6PDH1 subcellular localization, transmembrane domain, three-dimensional structure, and phylogenetic analysis were predicted by different software to analysis the bioinformatics of G6PDH1 protein. The G6PDH1 cDNA sequence was 2 011 bp in length and consisted of 1 551 bp Open Reading Frame (ORF) , encoding a protein of 516 amino acids. Expression analysis results in different tissues showed that G6PDH1 was primarily observed in flowers and roots, as opposed to the leaves and stems. Cold treatment experiments indicated that cold treatment caused a rapid increase in G6PDH1 expression in flowers within 12 h. The full-length cDNA of G6PDH1 and its expression analysis will play an important role for further study on cold stress responses in Ch. praecox.
Calycanthaceae ; chemistry ; classification ; enzymology ; genetics ; Cloning, Molecular ; Enzyme Stability ; Glucosephosphate Dehydrogenase ; chemistry ; genetics ; metabolism ; Models, Molecular ; Open Reading Frames ; Phylogeny ; Plant Proteins ; chemistry ; genetics ; metabolism

Lysine decarboxylase is a key enzyme involved in the upstream biosynthesis of lycopodium alkaloids (LAs) such as huperzine A, contributing to the decarboxylation of lysine to 1,5-pentanediamine (cadaverine). Three lysine decarboxylase genes (HsLDC-L1, HsLDC-L2, HsLDC-L3) were successfully cloned from Huperzia serrata using transcriptomic sequence data mining strategy combined with reverse transcription PCR. The physicochemical properties, secondary and tertiary structures, amino acid identities, and evolutionary relationship of the three LDCs were analyzed by online bioinformatics analysis platforms and DNAMAN, MEGA 7.0 software, revealing that all of these proteins had the conserved PLP binding domain and active site residues were completely conserved in LDCs. Phylogenetic analysis showed that these LDCs were located in the same branch as other known LDCs from LA-producing plants. Accordingly, the ORFs of these three HsLDCs were inserted into different expression plasmids for further expression in E. coli. However, only HsLDC-L1 was successfully expressed in E. coli BL21 (DE3) by inserting into a pCold TF vector. The recombinant protein was purified by Ni²⁺ affinity chromatography purification. HsLDC-L1 contains 469 amino acid residues, with a calculated molecular weight of 50.50 kDa. HsLDC-L1 expectedly catalyzed the decarboxylation of lysine to produce cadaverine. In addition, HsLDC-L1 can also catalyze the generation of putrescine from ornithine. However, it cannot catalyze the decarboxylation of tyrosine, phenylalanine, tryptophan and histidine. The results not only provide insight into the biosynthesis of LAs including huperzine A, but also provide a critical genetic element for the overproduction of Δ¹-piperideine and pelletierine, the essential biosynthetic precursors of LAs, using synthetic biology strategies.

OBJECTIVEThe experiment was conducted to study the dynamic growth rhythm of Achyranthes bidentata under different densities.

METHODThe plant samples were collected to measure the growth rate of each organ.

RESULTUnder different densities, the growing dynamic rhythm of A. bidentata were similar. The growth of main root exhibited a trend of "slow-fast-slow" by stages. The increase of dry root weight was fastest during the period of 30-40 days before harvest. The dry-matter increasing rate of whole plant was fastest in the later period of branching stage. The differences of root yields among the plants growing under different densities were significant.

CONCLUSIONFor high yield and good quality, the density of planting of A. bidentata should be considered.

Achyranthes ; anatomy & histology ; chemistry ; growth & development ; Biomass ; Drugs, Chinese Herbal ; analysis ; Organ Size ; Plant Leaves ; anatomy & histology ; chemistry ; Plant Roots ; anatomy & histology ; chemistry ; growth & development ; Plant Stems ; anatomy & histology ; chemistry ; Plants, Medicinal ; anatomy & histology ; chemistry ; growth & development ; Quality Control

Photosynthetic and growth characteristics of Angelica dahurica were studied in order to clarity the relations of photosynthesis, growth and root dry weight, and provide a theoretical basis for its cultivation. Photosynthesis and growth indexes were meas- ured every 25 days. The contents of chlorophyll a, b, a + b, soluble protein and the activities of Hill reaction, Ca(2+)-ATPase, Mg(2+)-ATPase had an increasing trend; They had the highest value in leaf high-speed growth period. Then, they were decreased in root high- speed growth period. The root dry weight showed negative corelation with photosynthetic characteristics indexes except stomatal con- ductance, however, the negative corelation only from net photosynthetic rate and Ca(2+)-ATPase were significant. The vegetative growth period of spring sowing A. dahuricia was divided into three phases: seedling period, leaf high-speed growth period and root high-speed growth period. The root dry weight showed a significantly positive corelation with the root diameter, leaf dry weight, shoot dry weight, aboveground dry weight. There was the competitive relation between aboveground and underground, so underground growth could be es- timated from leaf area and shoot dimeter.
Adenosine Triphosphatases ; metabolism ; Angelica ; enzymology ; growth & development ; metabolism ; Chlorophyll ; metabolism ; Photosynthesis ; Plant Proteins ; metabolism ; Plant Roots ; growth & development ; Seasons

OBJECTIVEThe experiments were conducted to study specialty of seed germinating, plant growing and developing and cultural practices of A. edgeworthii.

METHODThe germinating and sowing test, growth habitants, photosensitive reaction of seedling from subterraneous seeds and above ground seeds on A. edgeworthii were studied in this experiment.

RESULT AND CONCLUSIONThe results indicated that (1) The water could not be absorbed by seed from plant above ground; (2) The underground and above ground seeds could normally germinate, grow, blossom and bear fruits, A. edgeworthii sowed in early May, blossomed in early September and matured in the last ten days of October; (3) The seed leaf of seedling grew underground; (4) The underground seed was produced from subterraneous branch stem which developed from node of seed leaf; (5) A. edgeworthii was shade demanding, high-temperature sensible short-day light plant. The flowering could be greatly advantaged by short-day light treatment (12, 10, 8, 6 h). Cultural practices were studied also in this experiment.

Fabaceae ; growth & development ; Plants, Medicinal ; growth & development ; Seedlings ; growth & development ; Seeds ; growth & development ; Sunlight

Objective To determine the prevalence and distribution of type 2 diabetes mellitus (T2DM) and the relationship between maximum body mass index (MAXBMI) and T2DM. Methods From June to August, 2005, a stratified cluster sampling of 1071 permanent residents in communities, over 20 years old, from 4 districts and 1 county of Mudanjiang was chosen. The prevalence of T2DM, and the association between T2DM and different levels of the MAXBMI, current BMI were studied. Results The prevalence in the communities was 7.09% and in those with past maximum BMI≥28 kg/m~2, it was 12.10%. With the increase of past MAXBMI levels, the risk of T2DM patients also increased significantly(trend X~2=17.387 23, P<0.0001). Data from multifactor analysis showed that MAXBMI in the past was positively related to T2DM (OR=3.06, P=0.0013). In T2DM patients, the group with MAXBMI≥27.4 kg/m~2 had higher 2-hour postprandial blood glucose than those with lower MAXBMI (P=0.0408). When compared with low maximum BMI group in normal blood glucose population, the group with higher MAXBMI (≥ 25.4 kg/m~2) had higher blood glucose and greater change of BMI. Conclusion In both groups that patients with T2DM and with normal glucose, in order to control blood glucose better, researchers should not only concern about the influence of the MAXBMI in the past, but also pay attention to constantly keep BMI at the normal range.

Objective:To assess the effectiveness of percutaneous acetabuloplasty (PA) in combination with radiotherapy for the treatment of acetabular metastases.Methods:A retrospective analysis of medical records from 43 patients with acetabular metastases admitted between May 2017 and May 2022 were performed, with 24 cases meeting inclusion criteria. The study cohort consisted of 9 males and 15 females, with an average age of 56.0 years (range: 40-85 years). There were 12 cases on the left side and 12 cases on the right side. The primary cancer types were breast cancer (8 cases, 33%), lung cancer (7 cases, 29%), prostate cancer (4 cases, 17%), bowel cancer (2 cases, 8%), cervical cancer (1 case, 4%), kidney cancer (1 case, 4%), and liver cancer (1 case, 4%). All patients had multiple bone metastases, with 16 cases (67%) also presenting with metastases in other organs. Among the bone metastases, 19 cases (79%) were osteolytic lesions, and 5 cases (21%) were mixed lesions. Lesion distribution included 11 cases in the acetabulum, 2 cases in the acetabulum and anterior column, 8 cases in the acetabulum and posterior column, and 3 cases in the acetabulum, anterior column, and posterior column. Lesion sizes ranged from 2.0 cm×1.5 cm×2.0 cm to 4.5 cm×4.0 cm×11.0 cm. Cortical defects were observed in 11 cases (46%), and soft tissue masses were present around the acetabular metastasis in 8 cases (33%). PA was performed under local or general anesthesia, followed by local radiotherapy within 1 week after surgery (external radiotherapy, 30 Gy, 10 d). Various clinical parameters, including primary lesion location, time of tumor diagnosis, time of bone metastasis diagnosis, number and nature of bone metastases, distribution area, lesion size, presence of cortical defects and soft tissue masses, presence of other organ metastases, surgical site, operation duration, filling effect, complications, visual analog scale (VAS) scores, walking scores, Eastern Cooperative Oncology Group (ECOG) scores, and long-term complications, were recorded and compared before surgery, after surgery, after radiotherapy, at 1, 3, and 6 months post-surgery, and during the last follow-up. The median follow-up period was 18 months.Results:Among the 24 patients, the procedure was successfully completed in 23 cases and failed in 1 case due to puncture needle-related complications. At the last follow-up, 92% (22/24) of patients showed no local symptom progression. VAS score, walking score, and ECOG score improved from 7.2±1.1, 1.4±1.4, 2.5±0.7 before surgery to 2.6±1.9, 2.5±1.4, 2.0±0.8 at 48 hours post-operation. There were no significant differences in scores between 48 hours post-surgery and 48 hours post-radiotherapy.Conclusion:PA can rapidly restore acetabular stability, alleviate pain, and enhance the quality of life for patients. In cases of poor response to PA, radiotherapy may not be effective, but it can effectively control local symptom progression. The combination of these two interventions can yield satisfactory clinical outcomes for patients with acetabular metastases.

OBJECTIVE: Hypermethylation of human papillomavirus (HPV) and host genes has been reported in cervical cancer. However, the degree of methylation of different HPV types relative to the severity of the cervical lesions remains controversial. Studies of the degree of methylation associated with the host gene and the HPV genome to the severity of cervical lesions are rare. We examined the association of methylation status between host genes and late gene 1 (L1) regions of HPV16, 18, 52, and 58 in cervical brushings. METHODS: Cervical brushings from 147 HPV-infected patients were obtained. The samples comprised normal (n=28), cervical intraepithelial neoplasia (CIN) 1 (n=45), CIN2 (n=13), and CIN3/carcinoma in situ (n=61). The methylation status of HPV and host genes was measured using bisulfite pyrosequencing and quantitative methylation-specific polymerase chain reaction (PCR). RESULTS: The degree of methylation of L1 in HPV16, 18, and 52 was associated with the severity of the cervical lesion. In HPV52, C-phosphate-G (CpG) sites 6368m, 6405m, and 6443m showed significantly higher methylation in lesions ≥CIN3 (p=0.005, 0.003, and 0.026, respectively). Methylation of most HPV types except HPV52 (r<−0.1) was positively correlated with the degree of methylation of host genes including PAX1 and SOX1 (0.4≤r≤0.7). Combining HPV methylation with PAX1 methylation improved the clustering for ≥CIN2. CONCLUSION: Our study showed that the degree of L1 methylation of HPV16, 18, and 52 but not 58 is associated with the severity of cervical lesions. The association between HPV methylation and host gene methylation suggests different responses of host cellular epigenetic machinery to different HPV genotypes.
Cervical Intraepithelial Neoplasia* ; DNA Methylation ; Epigenomics ; Genome ; Genotype ; Human papillomavirus 16 ; Humans ; Methylation* ; Papillomaviridae ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

BACKGROUNDFractional flow reserve (FFR) is currently considered as the gold standard for evaluating the functional significance of coronary stenosis. However, its potential benefits in real-world practice remain unknown in China. This study aimed to test the hypothesis that the use of FFR is associated with improved outcome and reduced cost in Chinese real-world clinical practice.

METHODSA retrospective cohort study was carried out using the database of Second Affiliated Hospital of Zhejiang University, a tertiary and high-volume center in China. Clinical events were compared using the Cox proportional hazards model during a median follow-up of 13 months.

RESULTSThe study cohort consisted of 366 consecutive patients referred for coronary revascularization with adjunct FFR and 366 matched controls, from 2010 to 2014. Major adverse cardiac events (MACEs) (death, myocardial infarction, repeated revascularization, or hospitalization for angina) at 4 years were found in 12.0% of angiography-guided patients and 4.9% in the FFR-guided group (P < 0.001). The mean number of implanted stents was significantly lower in FFR treated subjects (0.52 ± 0.82 stents) compared with the angiography-guided group (0.93 ± 0.96 stents) (P < 0.001). No difference in overall costs at initial hospitalization was observed between angiography-guided percutaneous coronary intervention (PCI) compared with FFR-guided PCI (RMB 33,000 Yuan, range: RMB 7393-44,700 Yuan) versus RMB 21,200 Yuan (RMB 19,100-47,100 Yuan) (P = 0.54). However, costs for MACEs during follow-up were significantly reduced in the FFR-guided arm (P < 0.001).

CONCLUSIONSIn the contemporary clinical practice, FFR-guided PCI is associated with decreased use of stents, improved clinical outcome, and reduced costs, compared with angiography-guided PCI.

Aged ; China ; Costs and Cost Analysis ; Female ; Fractional Flow Reserve, Myocardial ; physiology ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; economics ; methods ; Retrospective Studies