Objectives: This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition.The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach. Methods: A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and anti resorptive agents in sequential therapy approaches. Results: The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to anti resorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for in dividuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment. Conclusions This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.

Cardio-oncology is an emerging multi-disciplinary field, which aims to reduce morbidity and mortality of cancer patients by preventing and managing cancer treatment-related cardiovascular toxicities. With the exponential growth in cancer and cardiovascular diseases in Asia, there is an emerging need for cardio-oncology awareness among physicians and country-specific cardio-oncology initiatives. In this state-of-the-art review, we sought to describe the burden of cancer and cardiovascular disease in Asia, a region with rich cultural and socio-economic diversity. From describing the uniqueness and challenges (such as socio-economic disparity, ethnical and racial diversity, and limited training opportunities) in establishing cardio-oncology in Asia, and outlining ways to overcome any barriers, this article aims to help advance the field of cardio-oncology in Asia.

Objective To isolate α-mangostin (AMG) from the peels of mangosteen (Garcinia mangostana L.), grown in Vietnam, and to investigate antibiofilm activity of this compound against three Staphylococcus aureus (S. aureus) strains, one of which was methicillin-resistant S. aureus (MRSA) and the other two strains were methicillin-sensitive S. aureus (MSSA). Methods AMG in n-hexane fraction was isolated on a silica gel column and chemically analyzed by HPLC and NMR. The antibiofilm activity of this compound was investigated by using a 96-well plate model for the formation of biofilms. Biofilm biomass was quantified using crystal violet. The viability of cells was observed under confocal microscopy using LIVE/DEAD BacLight stains. Biofilm composition was determined using specific chemical and enzyme tests for polysaccharide, protein and DNA. Membrane-damaging activity was assayed by measuring the hemolysis of human red blood cells in presence of AMG. Results The results indicated that the isolated AMG, with a purity that exceeded 98%, had minimal inhibitory concentrations in the range of 4.6–9.2 μmol/L for the three strains tested. Interestingly, the MSSA strains were more sensitive to AMG than the MRSA strain. Minimal bactericidal concentrations were 2-fold higher than the minimal inhibitory concentration values for the three strains, indicating that AMG was a bactericidal compound. AMG also prevented biofilm formation effectively, albeit that again the MRSA strain was the most resistant. Interestingly, biofilms of the MRSA strain contained protein as a main component of the extracellular matrix, whereas this was polysaccharide in the MSSA strains. This might relate to the resistance of the MRSA 252 strain to AMG. Assays using human red blood cells indicated that AMG caused significant membrane damage with 50% of cell lysis occurred at concentration of about 36 μmol/L. Conclusions Our results provide evidence that the isolated AMG has inhibitory activity against biofilm formation by S. aureus, including MRSA. Thus, isolated AMG proposes a high potential to develop a novel phytopharmaceutical for the treatment of MRSA.

Matrix metalloproteinase-9 (MMP-9) secreted from macrophages plays an important role in tissue destruction and inflammation through degradation of matrix proteins and proteolytic activation of cytokines/chemokines. Whereas the MEK-ERK and PI3K-Akt pathways up-regulate MMP-9 expression, regulation of MMP-9 by JNK remains controversial. Presently, we aimed to determine the role of JNK in MMP-9 regulation in Raw 264.7 cells. Inhibition of JNK by the JNK inhibitor SP600125 induced MMP-9 in the absence of serum and suppressed the expression of TNF-alpha, IL-6 and cyclooxygenase-2 in LPS-treated Raw 264.7 cells. In a knockdown experiment with small interfering RNA, suppression of JNK1 induced MMP-9 expression. Interestingly, mouse serum suppressed SP600125-mediated MMP-9 induction, similar to IFN-gamma. However, the inhibitory activity of mouse serum was not affected by pyridone 6, which inhibits Janus kinase downstream to IFN-gamma. In addition to mouse serum, conditioned media of Raw 264.7 cells contained the inhibitory factor(s) larger than 10 kDa, which suppressed SP600125- or LPS-induced MMP-9 expression. Taken together, these data suggest that JNK1 suppresses MMP-9 expression in the absence of serum. In addition, the inhibitory factor(s) present in serum or secreted from macrophages may negatively control MMP-9 expression.
Animals ; Anthracenes/metabolism ; Cell Line ; Culture Media, Conditioned/*chemistry ; Enzyme Activation ; Enzyme Induction ; Enzyme Inhibitors/metabolism ; Extracellular Signal-Regulated MAP Kinases/genetics/metabolism ; *Gene Expression Regulation, Enzymologic ; MAP Kinase Signaling System/physiology ; Macrophages/cytology/*metabolism ; Matrix Metalloproteinase 9/genetics/*metabolism ; Mice ; Mitogen-Activated Protein Kinase 8/genetics/*metabolism ; NF-kappa B/genetics/metabolism ; Proto-Oncogene Proteins c-akt/genetics/metabolism ; Tumor Necrosis Factor-alpha/metabolism ; p38 Mitogen-Activated Protein Kinases/genetics/metabolism

Background: Heparan-sufate interacting protetin (HIP) has been known to be up-regulated and expressed in various human cancer cell lines at both transcript and protein levels. HIP\u2019s expression was related to the differentiation status and cancer development. Objective: Using a semi-quantitative PCR method to determine HIP transcript levels in benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia (PIN) and prostate cancer tissues. Subjects and methods: 30 samples of BPH, 12 samples of high-grade PIN, and 40 samples of prostate cancer were collected from patients at Viet Duc Hospital and Friendship Hospital. Total RNA was extracted from BPH, PIN and prostate cancer tissues; cDNA synthesis by reverse transcript - polymerase chain reaction (RT - PCR); HIP transcript determination using semi-quantitative PCR. Results: There was significant difference in HIP transcript levels. HIP transcript was very highly up-regulated in the prostate cancer tissues. The up-regulation of HIP transcript was lower in PIN, and lowest in BPH. HIP transcript levels in benign samples were 1/2 and 2/3 compared with cancer and PIN samples, respectively (P< 0.05). These indicated that up-regulation of HIP transcript may be an early event in tumorigenesis. Conclusions: Levels of HIP transcript were different between tissues of prostate cancer, PIN, and BPH. HIP may be a marker for pre-cancer of the prostate.
HIP/L29 ; prostate cancer ; Transcript

Background: Production of semi-functional dystrophin protein from the dystrophin gene encoded with a premature stop codon has been shown to modify the severe phenotype of Duchenne Muscular Dystrophy (DMD). The mutation of the dystrophin gene affects the process of complete mRNA and is important in gene therapy. Objective: To analyze the mutation of dystrophin gene in DMD cases. Subjects and methods: A patient with diagnosed with DMD when he was 2 years old, and at age 9, he was completely disabled and had to use a wheelchair. DNA and total RNA were extracted from fresh peripheral blood; cDNA was synthesized by transcript polymerase chain reaction (RT - PCR). PCR, nested PCR or sequence methods were used to determine the mutation of the dystrophin gene. Results: A nonsensical mutation (E638) due to a single nucleotide change in exon 17 of the dystrophin gene (GAA2047TAA) was identified. This mutation affects mRNA splicing process and induces complete exon 17 skipping. Conclusion: Patients, who had E638X mutation with exon 17 deletion in the dystrophin gene, had clinical symptoms of Becker Muscular Dystrophy (BMD). This discovery as a potential target for therapeutic strategies for DMD, to change the severe phenotype of DMD to a milder phenotype (BMD), in order to improve clinical conditions for the patients.
Duchenne muscular dystrophy ; dystrophin gene

Background: In Vascular Dementia (VaD) patients, the causes of blood vessels were common, and preventable and treatable, so that it is very important to detect and diagnose in the early stages of the disease. Diagnosis of dementia is based on clinical symptoms, and neuropsychological tests are useful tools. Objectives: (1) To evaluate the severity of VaD and Vascular Cognitive Impairment (VCI) after the 1st ischemic stroke in patients over 60 years old. (2) To make observations on the clinical features of post stroke dementia in these patient groups using neuropsychological battery. Subjects: 94 patients with 1st acute ischemic stroke, who were over 60 years old, conscious and literate, and cooperated well with physicians. A standard evaluation protocol was conducted at one month after an ischemic stroke for all the patients. Method: Prospective study. Data was analyzed by using SPSS software version 13.0. Results and conclusions: The rates of VCI and VaD after the first ischemic stroke were 21.3% and 25.5%, respectively. Clinical determinants of dementia were: visuoconstruction (65% patients), visual motor speed (50%), memory disorders (more than 40%, in which visual memory 45.8% and verbal memory 41.6%), executive function (37.5%), and language skill (37.5%). The attention and language functions were less affected (only 25% of the patients). Mini mental state examination score can be used to evaluate and classify clearly 3 groups: VaD, VCI patients and normal people.
Ischemic stroke ; Dementia ; Neuropsychological test

Background: Heparansulfate Interacting Protein (HIP) is a protein that belongs to a novel class of heparin and heparansulfate binding protein. It plays an important role in extracellular matrix structure and function, cell-cell and cell-extracellular matrix adhesion, growth and differentiation. HIP was shown to be expressed in normal epithelia and epithelial cell lines at both mRNA and protein levels. Especially, HIP was found to be up-regulated in some cancer cell lines and related to different status and metastasis.\r\n', u'Objectives: To determinate HIP transcript level of mRNA in breast cancer tissues in comparison with normal tissues; to compare HIP transcript level at different cancer stages and cancer cell types. \r\n', u'Subjects and method: Total RNA was isolated from 62 tissue samples (47 breast cancer and 15 normal tissues); cDNA synthesis by reverse transcript \u2013polymerase chain reaction (RT \u2013 PCR); determination of HIP transcript using semi-quantitative RT \u2013 PCR. \r\n', u'Results: HIP transcript was particularly up \u2013 regulated in breast cancer tissues compared to normal tissues, especially this up-regulated in cancer tissues at different stages of development and cancer cell types. \r\n', u'Conclusion: These results show that the HIP transcript level was different between breast cancer and normal tissues and its expression was related to different status and metastasis in human cancer cell lines. HIP may be used as a prognostic marker for breast cancer.\r\n', u'
Heparansulfate Interacting Protein (HIP) ; breast cancer

Background: Dementia is a common pathological condition that affects older people. Most causes of dementia are Alzheimer\u2019s disease and vascular dementia. Diagnosing these conditions mostly relied on clinical patterns, but some biomarkers have been mentioned as the indicators of this condition. Objectives: 1) To evaluate the alteration of some biomarkers in cerebrospinal fluid (CSF) samples from Alzheimer\u2019s patients. 2) To compare the concentration of biomarkers in CSF samples from patients with vascular dementia and Alzheimer\u2019s disease. Subjects and method: Case group involved 41 patients who were diagnosed as AD and vascular dementia based on DSM-IV criteria. 31 matched healthy people were included in control group. All subjects were given neuro-psychological tests and thorough clinical examination. Brain CT scan and MRI were done for both groups. CSF samples were taken from patients in the study group to measure levels of some biomarkers. Results. The levels of total taurine (T-tau) and phosphorylated taurine (P-tau) 181 proteins are higher in the dementia group. The concentration of Abeta-42 is significantly different between case and control groups, but similar between vascular dementia and Alzheimer\u2019s disease patients. Conclusion: Changes in biomarkers are valuable in different diagnosis of Alzheimer\u2019s disease and other types of dementia. However, findings of CSF studies have to be considered with findings from imaging studies and clinical examination.
Biomarker ; Dementia ; Alzheimer\u2019s disease

Background: Heparansulfate Interacting Protein (HIP) is up-regulated in various human cancer cell lines at both transcript and protein levels. HIP expression is related to the differentiation status and cancer development. Objectives: To determine HIP in benign prostatic hyperplasia, prostatic intraepithelial neoplasia and prostate cancer tissues. Materials and method: Western blot method was used to determine HIP expression in 3 different types of prostate tissue, including 11 prostate cancer samples, 2 benign prostatic hyperplasia samples and 11 prostatic intraepithelial neoplasia samples. Results. HIP was particularly up-regulated in prostate cancer and prostatic intraepithelial neoplasia, indicating that up-regulation of HIP expression may be an early event in tumorgenesis. Conclusion: The expression of HIP was different between cancer, prostatic intraepithelial neoplasia tissue and benign prostatic hyperplasia. HIP may serve as a prognostic marker for prostate carcinoma.
HIP expression ; Prostate cancer ; Prostatic hyperplasia.