The feasibility of using a problem-dependent method to solve systems of second order ODEs is corroborated by an eigen-based theory and a methodology to develop such a numerical method is constructed.The key steps of t...The feasibility of using a problem-dependent method to solve systems of second order ODEs is corroborated by an eigen-based theory and a methodology to develop such a numerical method is constructed.The key steps of this methodology are to decouple a system of ODEs of second order into a set of uncoupled ODEs of second order;next,an eigen-dependent method is proposed to approximate the solution of each uncoupled ODE of second order.It is vital to transform all eigen-dependent methods to a problem-dependent method to bypass an Eigen analysis.The development of an eigen-dependent method plays a key role in this methodology so that slow eigenmodes can be accurately integrated while there is no instability or excessive amplitude growth in fast eigenmodes.This can explain why a problem-dependent method can simultaneously combine the explicitness of each step and A-stability.Consequently,huge computational efforts can be saved for solving nonlinear stiff problems.A new family of problem-dependent methods is developed in this work so that the feasibility of the proposed methodology can be affirmed.It has almost the same performance as that of the HHT-αmethod.However,it can save more than 99.5%of CPU demand in approximating a solution for a system of 1000 nonlinear second order ODEs.展开更多
Chronic hepatitis B is a global health problem. The clinical outcomes of chronic hepatitis B infection include asymptomatic carrier state, chronic hepatitis(CH), liver cirrhosis(LC), and hepatocellular carcinoma(HCC)....Chronic hepatitis B is a global health problem. The clinical outcomes of chronic hepatitis B infection include asymptomatic carrier state, chronic hepatitis(CH), liver cirrhosis(LC), and hepatocellular carcinoma(HCC). Because of the spontaneous error rate inherent to viral reverse transcriptase, the hepatitis B virus(HBV) genome evolves during the course of infection under the antiviral pressure of host immunity. The clinical significance of pre-S/S variants has become increasingly recognized in patients with chronic HBV infection. Pre-S/S variants are often identified in hepatitis B carriers with CH, LC, and HCC, which suggests that these naturally occurring pre-S/S variants may contribute to the development of progressive liver damage and hepatocarcinogenesis. This paper reviews the function of the pre-S/S region along with recent findings related to the role of pre-S/S variants in liver diseases. According to the mutation type, five pre-S/S variants have been identified: pre-S deletion, pre-S point mutation, pre-S1 splice variant, C-terminus S point mutation, and pre-S/S nonsense mutation. Their associations with HBV genotype and the possible pathogenesis of pre-S/S variants are discussed. Different pre-S/S variants cause liver diseases through different mechanisms. Most cause the intracellular retention of HBV envelope proteins and induction of endoplasmic reticulum stress, which results in liver diseases. Pre-S/S variants should be routinely determined in HBV carriers to help identify individuals who may be at a high risk of less favorable liver disease progression. Additional investigations are required to explore the molecular mechanisms of the pre-S/S variants involved in the pathogenesis of each stage of liver disease.展开更多
A statin is a cholesterol-lowering agent,which inhibits HMG-CoA(3-hydroxy-3-methylglutaryl-coenzyme A)reductase and subsequently reduces the cholesterol precursor,and was first used commercially in 1987.The concept of...A statin is a cholesterol-lowering agent,which inhibits HMG-CoA(3-hydroxy-3-methylglutaryl-coenzyme A)reductase and subsequently reduces the cholesterol precursor,and was first used commercially in 1987.The concept of cholesterol restriction leading to cancer cell dysfunction was proposed in 1992.The interruption of different signaling pathways has been proved in preclinical experiments to elucidate the anti-tumor mechanism of statins in pancreatic adenocarcinoma.Observational studies have shown that the clinical use of statins is beneficial in patients with pancreatic adenocarcinoma,including a chemoprevention effect,post-surgical resection follow-up and therapeutic prognosis of advanced cancer stage.Arrest of the cancer cell cycle by the combined use of gemcitabine and statin was observed in a cell line study.The effect of microbiota on the tumor microenvironment of pancreatic adenocarcinoma is a new therapeutic approach as statins can modulate the gut microbiota.Hence,further randomized trials of statins in pancreatic adenocarcinoma treatment will be warranted with application of precision medicine from microbiota-derived,cell cycle-based and signaling pathway-targeted research.展开更多
The knowledge of gallstone disease(GSD) is crucial to manage this condition when organizing screening and preventive strategies and identifying the appropriated clinical therapies. Although cholecystectomy still be th...The knowledge of gallstone disease(GSD) is crucial to manage this condition when organizing screening and preventive strategies and identifying the appropriated clinical therapies. Although cholecystectomy still be the gold standard treatment for patients with symptomatic GSD, expectant management could be viewed as a valid therapeutic method for this disorder. If early treatment of GSD decreases the morbidity or avoids further cholecystectomy, it may save clinical care costs in later disease periods sufficiently to offset the screening and early treatment costs. In addition, whether routine screening for GSD is worthwhile depends on whether patients are willing to pay the ultrasonography screening cost that would reduce the risk of cholecystectomy. In this review we discuss the epidemiology, management, and economic evaluation of screening of GSD among type 2 diabetics.展开更多
Hepatitis C virus(HCV) infection is a major global health issue.Infection by the HCV can cause acute and chronic liver diseases and may lead to cirrhosis,hepatocellular carcinoma or liver failure.The World Health Orga...Hepatitis C virus(HCV) infection is a major global health issue.Infection by the HCV can cause acute and chronic liver diseases and may lead to cirrhosis,hepatocellular carcinoma or liver failure.The World Health Organization estimates that approximately 3% of the world population have been infected with HCVand the worldwide prevalence is between 1% and 8% in pregnant women and between 0.05% and 5% in children.Following the introduction of blood product screening,vertical transmission becomes the leading cause of childhood HCV infection.The prevalence of pediatric HCV infection varies from 0.05% to 0.36% in developed countries and between 1.8% and 5% in the developing world.All children born to women with antiHCV antibodies should be checked for HCV infection.Though universal screening is controversial,selective antenatal HCV screening on high-risk populations is highly recommended and should be tested probably.Multiple risk factors were shown to increase the possibility of HCV vertical transmission,including coinfections with human immunodeficiency virus,intravenous drug use and elevated maternal HCV viral load,while breastfeeding and HCV genotypes have been studied to have little impact.At present,no clinical intervention has been clearly studied and proved to reduce the HCV vertical transmission risk.Cesarean section should not be recommended as a procedure to prevent vertical transmission,however,breastfeeding is generally not forbidden.The high prevalence of global HCV infection necessitates renewed efforts in primary prevention,including vaccine development,as well as new approaches to reduce the burden of chronic liver disease.Future researches should focus on the interruption of vertical transmission,developments of HCV vaccine and directacting antivirals in infancy and early childhood.展开更多
BACKGROUND It is evident that current clinical criteria are suboptimal to accurately estimate patient prognosis.Studies have identified epigenetic aberrant changes as novel prognostic factors for colorectal cancer(CRC...BACKGROUND It is evident that current clinical criteria are suboptimal to accurately estimate patient prognosis.Studies have identified epigenetic aberrant changes as novel prognostic factors for colorectal cancer(CRC).AIM To estimate whether a methylation gene panel in different clinical stages can reflect a different prognosis.METHODS We enrolled 120 CRC patients from Tri-Service General Hospital in Taiwan and used the candidate gene approach to select six genes involved in carcinogenesis pathways.Patients were divided into two groups based on the methylation status of the six evaluated genes,namely,the<3 aberrancy group and≥3 aberrancy group.Various tumor stages were divided into two subgroups(local and advanced stages)on the basis of the pathological type of the following tissues:Tumor and adjacent normal tissues(matched normal).We assessed DNA methylation in tumors and adjacent normal tissues from CRC patients and analyzed the association between DNA methylation with different cancer stages and the prognostic outcome including time to progression(TTP)and overall survival.RESULTS We observed a significantly increasing trend of hazard ratio as the number of hypermethylated genes increased both in normal tissue and tumor tissue.The 5-year TTP survival curves showed a significant difference between the≥3 aberrancy group and the<3 aberrancy group.Compared with the<3 aberrancy group,a significantly shorter TTP was observed in the≥3 aberrancy group.We further analyzed the interaction between CRC prognosis and different cancer stages(local and advanced)according to the methylation status of the selected genes in both types of tissues.There was a significantly shorter 5-year TTP for tumors at advanced stages with the promoter methylation status of selected genes than for those with local stages.We found an interaction between cancer stages and the promoter methylation status of selected genes in both types of tissues.CONCLUSION Our data provide a significant association between the methylation markers in normal tissues with advanced stage and prognosis of CRC.We recommend using these novel markers to assist in clinical decision-making.展开更多
BACKGROUND Patients with colorectal cancer(CRC)undergo surgery,as well as perioperative chemoradiation or adjuvant chemotherapy primarily based on the tumor–node–metastasis(TNM)cancer staging system.However,treatmen...BACKGROUND Patients with colorectal cancer(CRC)undergo surgery,as well as perioperative chemoradiation or adjuvant chemotherapy primarily based on the tumor–node–metastasis(TNM)cancer staging system.However,treatment responses and prognostic outcomes of patients within the same stage vary markedly.The potential use of novel biomarkers can improve prognostication and shared decision making before implementation into certain therapies.AIM To investigate whether SUMF2,ADAMTS5,and PXDN methylation status could be associated with CRC prognosis.METHODS We conducted a Taiwan region cohort study involving 208 patients with CRC recruited from TriService General Hospital and applied the candidate gene approach to identify three genes involved in oncogenesis pathways.A methylation-specific polymerase chain reaction(MS-PCR)and Epi TYPER DNA methylation analysis were employed to detect methylation status and to quantify the methylation level of candidate genes in tumor tissue and adjacent normal tissue from participants.We evaluated SUMF2,ADAMTS5,and PXDN methylation as predictors of prognosis,including recurrence-free survival(RFS),progression-free survival(PFS),and overall survival(OS),using a Cox regression model and Kaplan–Meier analysis.RESULTS We revealed various outcomes related to methylation and prognosis.Significantly shorter PFS and OS were associated with the CpG_3+CpG_7 hypermethylation of SUMF2 from tumor tissue compared with CpG_3+CpG_7 hypomethylation[hazard ratio(HR)=2.24,95%confidence interval(CI)=1.03-4.85 for PFS,HR=2.56 and 95%CI=1.08-6.04 for OS].By contrast,a significantly longer RFS was associated with CpG_2 and CpG_13 hypermethylation of ADAMTS5 from normal tissue compared with CpG_2 and CpG_13 hypomethylation[HR(95%CI)=0.15(0.03-0.71)for CpG_2 and 0.20(0.04-0.97)for CpG_13].The relationship between the methylation status of PXDN and the prognosis of CRC did not reach statistical significance.CONCLUSION Our study found that CpG_3+CpG_7 hypermethylation of SUMF2 from tumor tissue was associated with significantly shorter PFS and OS compared with CpG_3+CpG_7 hypomethylation.CpG_2 and CpG_13 hypermethylation of ADAMTS5 from normal tissue was associated with a significantly longer RFS compared with CpG_2 and CpG_13 hypomethylation.These methylationrelated biomarkers which have implications for CRC prognosis prediction may aid physicians in clinical decision-making.展开更多
AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily ad...AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.展开更多
Testosterone replacement therapy has benefits for aging men and those with hypogonadism. However, the effects of exogenous testosterone on Leydig cells are still unclear and need to be clarified. In this report, we de...Testosterone replacement therapy has benefits for aging men and those with hypogonadism. However, the effects of exogenous testosterone on Leydig cells are still unclear and need to be clarified. In this report, we demonstrate that testosterone supplementation can reduce oxidative damage in Leydig cells. The TM3 Leydig cell line was used as an in vitrocell model in this study. Cytoprotective effects were identified with 100-nmol l-1 testosterone treatment, but cytotoxic effects were found with ≥ 500-nmol l-1 testosterone supplementation. Significantly reduced reactive oxygen species （ROS） generation, lipid peroxide contents and hypoxia induction factor （HIF）-lα stabilization and activation were found with lO0-nmol 1-1 testosterone treatment. There was a 1.72-fold increase in ROS generation in the 500-nmol l-1 compared to the lO0-nmol l-1 testosterone treatment. A 1.58-fold increase in steroidogenic acute regulatory protein （STAR） expression was found in 50-nmol l-1 testosterone-treated cells （P〈0.01）. Chemically induced hypoxia was attenuated by testosterone supplementation. Leydig cells treated with low-dose testosterone supplementation showed cytoprotection by decreasing ROS and lipid peroxides, increasing StAR expression and relieving hypoxia stress as demonstrated by HIF-1α stabilization. Increased oxidative damage was found with ≥ 500-nmol l-1 testosterone manipulation. The mechanism governing the differential dose effects of testosterone on Leydig cells needs further investigation in order to shed light on testosterone replacement therapy.展开更多
Diabetic retinopathy (DR) is a well-characterized chronic ocular disorder that developed in nearly all diabetic patients in the long run. The knowledge of DR is crucial to manage this disorder when planning screening ...Diabetic retinopathy (DR) is a well-characterized chronic ocular disorder that developed in nearly all diabetic patients in the long run. The knowledge of DR is crucial to manage this disorder when planning screening and preventive programs and identifying the appropriated therapeutic strategies among. Expectant management may represent a valid therapeutic approach depending upon the clinical manifestations of the disease and, in particular, on the changes over time. If early treatment of DR reduces the probability of severe stage or slows the progression of blindness, it might sufficiently reduce treatment costs in later years to offset the costs of screening and early treatment. In addition, whether screening for DR is worthwhile is contingent on whether subjects are willing to pay the eye screening program that would decrease the risk of photocoagulation. In this review we discuss epidemiology, management, and economic evaluation of screening of DR among type 2 diabetes.展开更多
This study aimed to investigate differences in healthcare service utilization between patients with and those without benign prostatic hyperplasia （BPH） using Taiwan＇s National Health Insurance population-based dat...This study aimed to investigate differences in healthcare service utilization between patients with and those without benign prostatic hyperplasia （BPH） using Taiwan＇s National Health Insurance population-based database. A total of 7413 patients with BPH and 7413 age-matched patients without BPH were included. The outcome variable was 1-year utilization of healthcare services Jncluding the number of outpatient visits, inpatient days, and the costs of outpatient and inpatient treatments. In addition, we separated healthcare services into urology services and nonurology services for analysis. We found that as to the utilization of outpatient urological services, patients with BPH had more outpatient services （7.84 vs 0.52, P 〈 0.001）, higher outpatient costs （US$372 vs US$34, P 〈 0.001）, a longer length of inpatient stay （0.55 vs 0.11, P 〈 0.001）, higher in-patients costs （US$149 vs US$32, P 〈 0.001）, and higher total costs （US$521 vs US$67, P 〈 0.001） than the comparison group. As for nonurological services, patients with BPH also had more outpatient services （49.11 vs 24.79, P〈 0.001）, higher outpatient costs （US$1794 vs US$1014, P〈 0.001）, a longer length of in-patient stay （3.72 vs 2.04, P〈 0.001）, higher inpatient costs （US$874 vs US$486, P〈 0.001）, and higher total costs （US$2668 vs US$1500, P 〈 0.001） compared to comparison patients. We also found that the average total cost was about 2-fold greater for patients with BPH than comparison patients. We concluded that patients with BPH had higher healthcare utilization than comparison patients without BPH.展开更多
Objective: This study evaluated the effectiveness of a 10-week exercise intervention in reducing depression and fatigue in women with postpartum depression. Design: A one-group pretest/ posttest quasi-experiment was c...Objective: This study evaluated the effectiveness of a 10-week exercise intervention in reducing depression and fatigue in women with postpartum depression. Design: A one-group pretest/ posttest quasi-experiment was conducted. Setting: A postpartum ward in a medical center in Taipei city was used. Participants: Nineteen women at 7 - 12 weeks postpartum with an Edinburgh Postnatal Depression Scale score ≥ 9 were recruited. Methods: The women participated in a postpartum exercise support program 1 hour per week for 10 weeks. The program was led by a professional coach;it integrated yoga, Pilates, elastic band exercise, low-intensity aerobics, and motherhood role experience sharing. Results: After the postpartum exercise support program intervention, depression scores decreased from 10.4 ± 3.29 to 7.80 ± 2.73 (t = 3.632, P = 0.003);fatigue scores decreased from 8.73 ± 5.02 to 5.40 ± 3.89 (t = 2.988, P = 0.010). Conclusion: PESP administered to women with postpartum depression appeared to benefit their psychological wellbeing.展开更多
AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time a...AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time abdominal ultrasound to examine the abdominal region after patients had fasted for at least eight hours. Screening, which was conducted in 2001, involved 848 patients diagnosed with type 2 diabetes. After exclusion of 63 subjects with prevalent GSD, 377 participants without GSD were invited in 2002 for a second round of screening. A total of 281 （74.5%） subjects were re-examined. RESULTS： Among the 281 type 2 diabetics who had no GSD at the first screening, 10 had developed GSD by 2002. The incidence was 3.56% per year （95%CI： 1.78% per year-6.24% per year）. Using a Cox regression model, age （RR = 1.07, 95% CI： 1.00-1.14）, waist circumference （RR = 1.12, 95% CI： 1.01-1.29）, and ALT （RR = 1.13, 95%CI： 1.01-1.26） appeared to be significantly correlated with development of GSD. CONCLUSION： Older age is a known risk factor for the development of GSD. Our study shows that greater waist circumference and elevated ALT levels are also associated with the development of GSD among type 2 diabetics in Kinmen.展开更多
The Ming dynasty （1368 - 1644） inherited the lens-standing culture in China, of course including the textile technology. Besides a large amount of sinsle color damask silk, many pattern woven silk including dragon r...The Ming dynasty （1368 - 1644） inherited the lens-standing culture in China, of course including the textile technology. Besides a large amount of sinsle color damask silk, many pattern woven silk including dragon robes, patterned costumes and luxurious silk textiles are found in complicated and colorful pattern woven brocade called zhuang hua. It was prevailed in Ming dynasty when compared with the frequency of the name chuang hua recorded in related historical documents. These pattern silk and brcrade were produced by the advanced pattern weavin8 technology, which was well developed in Ming dynasty. From historical documents of＂Tian gong kai wu＂, Exploitation of the works of nature, there is the detailed description of the draw loom （hua Io ji） which can weave normal patterned textiles. It also indicated that to produce dragon robes needed much more high technique, similar to the hua Io ）i but more complicated and difficult. A big draw loom is found to weave Nanjing Yen brocade today inherits the technolosy to weave zhuang hua brocade. After sorting the historical documents, it is found that some records are coincident with the existed materials, both the silk textiles and weaving technology. With these evidences research and exploration, this dissertatien tries to unravel the pattern weaving technolosy in the Ming dynasty.展开更多
AIM:To investigate whether screening for gallstone disease was economically feasible and clinically effective.METHODS:This clinical study was initially conducted in2002 in Taipei,Taiwan.The study cohort total included...AIM:To investigate whether screening for gallstone disease was economically feasible and clinically effective.METHODS:This clinical study was initially conducted in2002 in Taipei,Taiwan.The study cohort total included2386 healthy adults who were voluntarily admitted to a regional teaching hospital for a physical check-up.Annual follow-up screening with ultrasound sonography for gallstone disease continued until December 31,2007.A decision analysis using the Markov Decision Model was constructed to compare different screening regimes for gallstone disease.The economic evaluation included estimates of both the cost-effectiveness and cost-utility of screening for gallstone disease.RESULTS:Direct costs included the cost of screening,regular clinical fees,laparoscopic cholecystectomy,and hospitalization.Indirect costs represent the loss of productivity attributable to the patient’s disease state,and were estimated using the gross domestic product for 2011 in Taiwan.Longer time intervals in screening for gallstone disease were associated with the reduced efficacy and utility of screening and with increased cost.The cost per life-year gained(average cost-effectiveness ratio)for annual screening,biennial screening,3-year screening,4-year screening,5-year screening,and no-screening was new Taiwan dollars(NTD)39076,NTD 58059,NTD 72168,NTD 104488,NTD 126941,and NTD 197473,respectively(P<0.05).The cost per quality-adjusted life-year gained by annual screening was NTD 40725;biennial screening,NTD64868;3-year screening,NTD 84532;4-year screening,NTD 110962;5-year screening,NTD 142053;and for the control group,NTD 202979(P<0.05).The threshold values indicated that the ultrasound sonography screening programs were highly sensitive to screening costs in a plausible range.CONCLUSION:Routine screening regime for gallstone disease is both medically and economically valuable.Annual screening for gallstone disease should be recommended.展开更多
AIM: To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease (GSD) in type 2 diabetics. METHODS: We used a community-based study conducted between 1991 and 1993 ...AIM: To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease (GSD) in type 2 diabetics. METHODS: We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance (HOMA IR) and β-cell dysfunction (HOMA β-cell). RESULTS: We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% (26/187) among males and 14.7% (36/245) among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4th vs 1st quartile odds ratios (OR) = 4.46 (95%CI: 1.71-11.66)] and HOMA IR [4th vs 1st quartile OR = 4.46 (95%CI: 1.71-11.66)]. Better HOMA β-cell function was significantly related to decreased risk of GSD [4th vs 1st quartile OR = 0.16 (95%CI: 0.03-1.70)]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA β-cell was observed among males. CONCLUSION: Serum insulin, insulin resistance, and β-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.展开更多
BACKGROUND Identifying novel colorectal cancer(CRC)prognostic biomarkers is crucial to helping clinicians make appropriate therapy decisions.Melatonin plays a major role in managing the circadian rhythm and exerts onc...BACKGROUND Identifying novel colorectal cancer(CRC)prognostic biomarkers is crucial to helping clinicians make appropriate therapy decisions.Melatonin plays a major role in managing the circadian rhythm and exerts oncostatic effects on different kinds of tumours.AIM To explore the relationship between MTNR1B single-nucleotide polymorphism(SNPs)combined with gene hypermethylation and CRC prognosis.METHODS A total of 94 CRC tumour tissues were investigated.Genotyping for the four MTNR1B SNPs(rs1387153,rs2166706,rs10830963,and rs1447352)was performed using multiplex polymerase chain reaction.The relationships between the MTNR1B SNPs and CRC 5-year overall survival(OS)was assessed by calculating hazard ratios with 95%CIs.RESULTS All SNPs(rs1387153,rs2166706,rs10830963,and rs1447352)were correlated with decreased 5-year OS.In stratified analysis,rs1387153,rs10830963,and rs1447352 risk genotype combined with CDKN2A and MGMT methylation status were associated with 5-year OS.A strong cumulative effect of the four polymorphisms on CRC prognosis was observed.Four haplotypes of MTNR1B SNPs were also associated with the 5-year OS.MTNR1B SNPs combined with CDKN2A and MGMT gene methylation status could be used to predict shorter CRC survival.CONCLUSION The novel genetic biomarkers combined with epigenetic biomarkers may be predictive tool for CRC prognosis and thus could be used to individualise treatment for patients with CRC.展开更多
This study evaluated the self-perceived importance and competence with regard to foodservice quality of hospitality students in Taiwan. The study used a 6-dimension food quality scale to gather self-assessed data from...This study evaluated the self-perceived importance and competence with regard to foodservice quality of hospitality students in Taiwan. The study used a 6-dimension food quality scale to gather self-assessed data from student participants. A total of 400 questionnaires were sent out, with 355 （88.75%） returned, validated, and used in research. In the dimension of perceived importance, participants placed the highest importance on ＂food safety＂ and the lowest importance on ＂food characteristics＂. In the dimension of competence, participants placed the highest competence on ＂service quality＂, while the competence concerning ＂culinary skill＂ was lower. An importance-performance analysis （IPA） identified ＂food safety＂ as showing the greatest be improved among the six dimensions. The courses and internship experience predicted 26.4% of the variability in perceived competence of foodservice quality. Both the two variables showed a statistical significance. The culinary courses had a greater impact on food quality-related perceptions than did either hospitality professional or general management courses. Finally, this study identified that the school courses had a positive contribution to the competence of foodservice quality and with hospitality students who completed school courses having better quality perception competence than those who had not.展开更多
文摘The feasibility of using a problem-dependent method to solve systems of second order ODEs is corroborated by an eigen-based theory and a methodology to develop such a numerical method is constructed.The key steps of this methodology are to decouple a system of ODEs of second order into a set of uncoupled ODEs of second order;next,an eigen-dependent method is proposed to approximate the solution of each uncoupled ODE of second order.It is vital to transform all eigen-dependent methods to a problem-dependent method to bypass an Eigen analysis.The development of an eigen-dependent method plays a key role in this methodology so that slow eigenmodes can be accurately integrated while there is no instability or excessive amplitude growth in fast eigenmodes.This can explain why a problem-dependent method can simultaneously combine the explicitness of each step and A-stability.Consequently,huge computational efforts can be saved for solving nonlinear stiff problems.A new family of problem-dependent methods is developed in this work so that the feasibility of the proposed methodology can be affirmed.It has almost the same performance as that of the HHT-αmethod.However,it can save more than 99.5%of CPU demand in approximating a solution for a system of 1000 nonlinear second order ODEs.
基金Supported by the grant from the National Science Council(NSC 96-2320-B-030-004-MY3),Executive Yuan,Taiwan
文摘Chronic hepatitis B is a global health problem. The clinical outcomes of chronic hepatitis B infection include asymptomatic carrier state, chronic hepatitis(CH), liver cirrhosis(LC), and hepatocellular carcinoma(HCC). Because of the spontaneous error rate inherent to viral reverse transcriptase, the hepatitis B virus(HBV) genome evolves during the course of infection under the antiviral pressure of host immunity. The clinical significance of pre-S/S variants has become increasingly recognized in patients with chronic HBV infection. Pre-S/S variants are often identified in hepatitis B carriers with CH, LC, and HCC, which suggests that these naturally occurring pre-S/S variants may contribute to the development of progressive liver damage and hepatocarcinogenesis. This paper reviews the function of the pre-S/S region along with recent findings related to the role of pre-S/S variants in liver diseases. According to the mutation type, five pre-S/S variants have been identified: pre-S deletion, pre-S point mutation, pre-S1 splice variant, C-terminus S point mutation, and pre-S/S nonsense mutation. Their associations with HBV genotype and the possible pathogenesis of pre-S/S variants are discussed. Different pre-S/S variants cause liver diseases through different mechanisms. Most cause the intracellular retention of HBV envelope proteins and induction of endoplasmic reticulum stress, which results in liver diseases. Pre-S/S variants should be routinely determined in HBV carriers to help identify individuals who may be at a high risk of less favorable liver disease progression. Additional investigations are required to explore the molecular mechanisms of the pre-S/S variants involved in the pathogenesis of each stage of liver disease.
文摘A statin is a cholesterol-lowering agent,which inhibits HMG-CoA(3-hydroxy-3-methylglutaryl-coenzyme A)reductase and subsequently reduces the cholesterol precursor,and was first used commercially in 1987.The concept of cholesterol restriction leading to cancer cell dysfunction was proposed in 1992.The interruption of different signaling pathways has been proved in preclinical experiments to elucidate the anti-tumor mechanism of statins in pancreatic adenocarcinoma.Observational studies have shown that the clinical use of statins is beneficial in patients with pancreatic adenocarcinoma,including a chemoprevention effect,post-surgical resection follow-up and therapeutic prognosis of advanced cancer stage.Arrest of the cancer cell cycle by the combined use of gemcitabine and statin was observed in a cell line study.The effect of microbiota on the tumor microenvironment of pancreatic adenocarcinoma is a new therapeutic approach as statins can modulate the gut microbiota.Hence,further randomized trials of statins in pancreatic adenocarcinoma treatment will be warranted with application of precision medicine from microbiota-derived,cell cycle-based and signaling pathway-targeted research.
文摘The knowledge of gallstone disease(GSD) is crucial to manage this condition when organizing screening and preventive strategies and identifying the appropriated clinical therapies. Although cholecystectomy still be the gold standard treatment for patients with symptomatic GSD, expectant management could be viewed as a valid therapeutic method for this disorder. If early treatment of GSD decreases the morbidity or avoids further cholecystectomy, it may save clinical care costs in later disease periods sufficiently to offset the screening and early treatment costs. In addition, whether routine screening for GSD is worthwhile depends on whether patients are willing to pay the ultrasonography screening cost that would reduce the risk of cholecystectomy. In this review we discuss the epidemiology, management, and economic evaluation of screening of GSD among type 2 diabetics.
文摘Hepatitis C virus(HCV) infection is a major global health issue.Infection by the HCV can cause acute and chronic liver diseases and may lead to cirrhosis,hepatocellular carcinoma or liver failure.The World Health Organization estimates that approximately 3% of the world population have been infected with HCVand the worldwide prevalence is between 1% and 8% in pregnant women and between 0.05% and 5% in children.Following the introduction of blood product screening,vertical transmission becomes the leading cause of childhood HCV infection.The prevalence of pediatric HCV infection varies from 0.05% to 0.36% in developed countries and between 1.8% and 5% in the developing world.All children born to women with antiHCV antibodies should be checked for HCV infection.Though universal screening is controversial,selective antenatal HCV screening on high-risk populations is highly recommended and should be tested probably.Multiple risk factors were shown to increase the possibility of HCV vertical transmission,including coinfections with human immunodeficiency virus,intravenous drug use and elevated maternal HCV viral load,while breastfeeding and HCV genotypes have been studied to have little impact.At present,no clinical intervention has been clearly studied and proved to reduce the HCV vertical transmission risk.Cesarean section should not be recommended as a procedure to prevent vertical transmission,however,breastfeeding is generally not forbidden.The high prevalence of global HCV infection necessitates renewed efforts in primary prevention,including vaccine development,as well as new approaches to reduce the burden of chronic liver disease.Future researches should focus on the interruption of vertical transmission,developments of HCV vaccine and directacting antivirals in infancy and early childhood.
基金Supported by the Ministry of Science and Technology,Taiwan,No.MOST 104-2314-B-016-010-MY2 and No.MOST 106-2320-B-016-018the Ministry of National Defense,Taiwan,No.MAB-107-075,No.MAB-108-057and No.MAB-109-061
文摘BACKGROUND It is evident that current clinical criteria are suboptimal to accurately estimate patient prognosis.Studies have identified epigenetic aberrant changes as novel prognostic factors for colorectal cancer(CRC).AIM To estimate whether a methylation gene panel in different clinical stages can reflect a different prognosis.METHODS We enrolled 120 CRC patients from Tri-Service General Hospital in Taiwan and used the candidate gene approach to select six genes involved in carcinogenesis pathways.Patients were divided into two groups based on the methylation status of the six evaluated genes,namely,the<3 aberrancy group and≥3 aberrancy group.Various tumor stages were divided into two subgroups(local and advanced stages)on the basis of the pathological type of the following tissues:Tumor and adjacent normal tissues(matched normal).We assessed DNA methylation in tumors and adjacent normal tissues from CRC patients and analyzed the association between DNA methylation with different cancer stages and the prognostic outcome including time to progression(TTP)and overall survival.RESULTS We observed a significantly increasing trend of hazard ratio as the number of hypermethylated genes increased both in normal tissue and tumor tissue.The 5-year TTP survival curves showed a significant difference between the≥3 aberrancy group and the<3 aberrancy group.Compared with the<3 aberrancy group,a significantly shorter TTP was observed in the≥3 aberrancy group.We further analyzed the interaction between CRC prognosis and different cancer stages(local and advanced)according to the methylation status of the selected genes in both types of tissues.There was a significantly shorter 5-year TTP for tumors at advanced stages with the promoter methylation status of selected genes than for those with local stages.We found an interaction between cancer stages and the promoter methylation status of selected genes in both types of tissues.CONCLUSION Our data provide a significant association between the methylation markers in normal tissues with advanced stage and prognosis of CRC.We recommend using these novel markers to assist in clinical decision-making.
基金Supported by Ministry of National Defense-Medical Affairs Bureau,Taiwan,No.MND-MAB-110-109,No.MND-MAB-D-111059Cheng-Hsin General Hospital,Taiwan,No.CHNDMC-111-4。
文摘BACKGROUND Patients with colorectal cancer(CRC)undergo surgery,as well as perioperative chemoradiation or adjuvant chemotherapy primarily based on the tumor–node–metastasis(TNM)cancer staging system.However,treatment responses and prognostic outcomes of patients within the same stage vary markedly.The potential use of novel biomarkers can improve prognostication and shared decision making before implementation into certain therapies.AIM To investigate whether SUMF2,ADAMTS5,and PXDN methylation status could be associated with CRC prognosis.METHODS We conducted a Taiwan region cohort study involving 208 patients with CRC recruited from TriService General Hospital and applied the candidate gene approach to identify three genes involved in oncogenesis pathways.A methylation-specific polymerase chain reaction(MS-PCR)and Epi TYPER DNA methylation analysis were employed to detect methylation status and to quantify the methylation level of candidate genes in tumor tissue and adjacent normal tissue from participants.We evaluated SUMF2,ADAMTS5,and PXDN methylation as predictors of prognosis,including recurrence-free survival(RFS),progression-free survival(PFS),and overall survival(OS),using a Cox regression model and Kaplan–Meier analysis.RESULTS We revealed various outcomes related to methylation and prognosis.Significantly shorter PFS and OS were associated with the CpG_3+CpG_7 hypermethylation of SUMF2 from tumor tissue compared with CpG_3+CpG_7 hypomethylation[hazard ratio(HR)=2.24,95%confidence interval(CI)=1.03-4.85 for PFS,HR=2.56 and 95%CI=1.08-6.04 for OS].By contrast,a significantly longer RFS was associated with CpG_2 and CpG_13 hypermethylation of ADAMTS5 from normal tissue compared with CpG_2 and CpG_13 hypomethylation[HR(95%CI)=0.15(0.03-0.71)for CpG_2 and 0.20(0.04-0.97)for CpG_13].The relationship between the methylation status of PXDN and the prognosis of CRC did not reach statistical significance.CONCLUSION Our study found that CpG_3+CpG_7 hypermethylation of SUMF2 from tumor tissue was associated with significantly shorter PFS and OS compared with CpG_3+CpG_7 hypomethylation.CpG_2 and CpG_13 hypermethylation of ADAMTS5 from normal tissue was associated with a significantly longer RFS compared with CpG_2 and CpG_13 hypomethylation.These methylationrelated biomarkers which have implications for CRC prognosis prediction may aid physicians in clinical decision-making.
文摘AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.
文摘Testosterone replacement therapy has benefits for aging men and those with hypogonadism. However, the effects of exogenous testosterone on Leydig cells are still unclear and need to be clarified. In this report, we demonstrate that testosterone supplementation can reduce oxidative damage in Leydig cells. The TM3 Leydig cell line was used as an in vitrocell model in this study. Cytoprotective effects were identified with 100-nmol l-1 testosterone treatment, but cytotoxic effects were found with ≥ 500-nmol l-1 testosterone supplementation. Significantly reduced reactive oxygen species （ROS） generation, lipid peroxide contents and hypoxia induction factor （HIF）-lα stabilization and activation were found with lO0-nmol 1-1 testosterone treatment. There was a 1.72-fold increase in ROS generation in the 500-nmol l-1 compared to the lO0-nmol l-1 testosterone treatment. A 1.58-fold increase in steroidogenic acute regulatory protein （STAR） expression was found in 50-nmol l-1 testosterone-treated cells （P〈0.01）. Chemically induced hypoxia was attenuated by testosterone supplementation. Leydig cells treated with low-dose testosterone supplementation showed cytoprotection by decreasing ROS and lipid peroxides, increasing StAR expression and relieving hypoxia stress as demonstrated by HIF-1α stabilization. Increased oxidative damage was found with ≥ 500-nmol l-1 testosterone manipulation. The mechanism governing the differential dose effects of testosterone on Leydig cells needs further investigation in order to shed light on testosterone replacement therapy.
文摘Diabetic retinopathy (DR) is a well-characterized chronic ocular disorder that developed in nearly all diabetic patients in the long run. The knowledge of DR is crucial to manage this disorder when planning screening and preventive programs and identifying the appropriated therapeutic strategies among. Expectant management may represent a valid therapeutic approach depending upon the clinical manifestations of the disease and, in particular, on the changes over time. If early treatment of DR reduces the probability of severe stage or slows the progression of blindness, it might sufficiently reduce treatment costs in later years to offset the costs of screening and early treatment. In addition, whether screening for DR is worthwhile is contingent on whether subjects are willing to pay the eye screening program that would decrease the risk of photocoagulation. In this review we discuss epidemiology, management, and economic evaluation of screening of DR among type 2 diabetes.
文摘This study aimed to investigate differences in healthcare service utilization between patients with and those without benign prostatic hyperplasia （BPH） using Taiwan＇s National Health Insurance population-based database. A total of 7413 patients with BPH and 7413 age-matched patients without BPH were included. The outcome variable was 1-year utilization of healthcare services Jncluding the number of outpatient visits, inpatient days, and the costs of outpatient and inpatient treatments. In addition, we separated healthcare services into urology services and nonurology services for analysis. We found that as to the utilization of outpatient urological services, patients with BPH had more outpatient services （7.84 vs 0.52, P 〈 0.001）, higher outpatient costs （US$372 vs US$34, P 〈 0.001）, a longer length of inpatient stay （0.55 vs 0.11, P 〈 0.001）, higher in-patients costs （US$149 vs US$32, P 〈 0.001）, and higher total costs （US$521 vs US$67, P 〈 0.001） than the comparison group. As for nonurological services, patients with BPH also had more outpatient services （49.11 vs 24.79, P〈 0.001）, higher outpatient costs （US$1794 vs US$1014, P〈 0.001）, a longer length of in-patient stay （3.72 vs 2.04, P〈 0.001）, higher inpatient costs （US$874 vs US$486, P〈 0.001）, and higher total costs （US$2668 vs US$1500, P 〈 0.001） compared to comparison patients. We also found that the average total cost was about 2-fold greater for patients with BPH than comparison patients. We concluded that patients with BPH had higher healthcare utilization than comparison patients without BPH.
文摘Objective: This study evaluated the effectiveness of a 10-week exercise intervention in reducing depression and fatigue in women with postpartum depression. Design: A one-group pretest/ posttest quasi-experiment was conducted. Setting: A postpartum ward in a medical center in Taipei city was used. Participants: Nineteen women at 7 - 12 weeks postpartum with an Edinburgh Postnatal Depression Scale score ≥ 9 were recruited. Methods: The women participated in a postpartum exercise support program 1 hour per week for 10 weeks. The program was led by a professional coach;it integrated yoga, Pilates, elastic band exercise, low-intensity aerobics, and motherhood role experience sharing. Results: After the postpartum exercise support program intervention, depression scores decreased from 10.4 ± 3.29 to 7.80 ± 2.73 (t = 3.632, P = 0.003);fatigue scores decreased from 8.73 ± 5.02 to 5.40 ± 3.89 (t = 2.988, P = 0.010). Conclusion: PESP administered to women with postpartum depression appeared to benefit their psychological wellbeing.
基金Supported by the grants from the Cheng Hsin Rehabilitation Medical Center, No. 93-25
文摘AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time abdominal ultrasound to examine the abdominal region after patients had fasted for at least eight hours. Screening, which was conducted in 2001, involved 848 patients diagnosed with type 2 diabetes. After exclusion of 63 subjects with prevalent GSD, 377 participants without GSD were invited in 2002 for a second round of screening. A total of 281 （74.5%） subjects were re-examined. RESULTS： Among the 281 type 2 diabetics who had no GSD at the first screening, 10 had developed GSD by 2002. The incidence was 3.56% per year （95%CI： 1.78% per year-6.24% per year）. Using a Cox regression model, age （RR = 1.07, 95% CI： 1.00-1.14）, waist circumference （RR = 1.12, 95% CI： 1.01-1.29）, and ALT （RR = 1.13, 95%CI： 1.01-1.26） appeared to be significantly correlated with development of GSD. CONCLUSION： Older age is a known risk factor for the development of GSD. Our study shows that greater waist circumference and elevated ALT levels are also associated with the development of GSD among type 2 diabetics in Kinmen.
文摘The Ming dynasty （1368 - 1644） inherited the lens-standing culture in China, of course including the textile technology. Besides a large amount of sinsle color damask silk, many pattern woven silk including dragon robes, patterned costumes and luxurious silk textiles are found in complicated and colorful pattern woven brocade called zhuang hua. It was prevailed in Ming dynasty when compared with the frequency of the name chuang hua recorded in related historical documents. These pattern silk and brcrade were produced by the advanced pattern weavin8 technology, which was well developed in Ming dynasty. From historical documents of＂Tian gong kai wu＂, Exploitation of the works of nature, there is the detailed description of the draw loom （hua Io ji） which can weave normal patterned textiles. It also indicated that to produce dragon robes needed much more high technique, similar to the hua Io ）i but more complicated and difficult. A big draw loom is found to weave Nanjing Yen brocade today inherits the technolosy to weave zhuang hua brocade. After sorting the historical documents, it is found that some records are coincident with the existed materials, both the silk textiles and weaving technology. With these evidences research and exploration, this dissertatien tries to unravel the pattern weaving technolosy in the Ming dynasty.
基金Supported by Grant from the National Science Council,No.NSC-98-2314-B-350-002-MY3(in part)
文摘AIM:To investigate whether screening for gallstone disease was economically feasible and clinically effective.METHODS:This clinical study was initially conducted in2002 in Taipei,Taiwan.The study cohort total included2386 healthy adults who were voluntarily admitted to a regional teaching hospital for a physical check-up.Annual follow-up screening with ultrasound sonography for gallstone disease continued until December 31,2007.A decision analysis using the Markov Decision Model was constructed to compare different screening regimes for gallstone disease.The economic evaluation included estimates of both the cost-effectiveness and cost-utility of screening for gallstone disease.RESULTS:Direct costs included the cost of screening,regular clinical fees,laparoscopic cholecystectomy,and hospitalization.Indirect costs represent the loss of productivity attributable to the patient’s disease state,and were estimated using the gross domestic product for 2011 in Taiwan.Longer time intervals in screening for gallstone disease were associated with the reduced efficacy and utility of screening and with increased cost.The cost per life-year gained(average cost-effectiveness ratio)for annual screening,biennial screening,3-year screening,4-year screening,5-year screening,and no-screening was new Taiwan dollars(NTD)39076,NTD 58059,NTD 72168,NTD 104488,NTD 126941,and NTD 197473,respectively(P<0.05).The cost per quality-adjusted life-year gained by annual screening was NTD 40725;biennial screening,NTD64868;3-year screening,NTD 84532;4-year screening,NTD 110962;5-year screening,NTD 142053;and for the control group,NTD 202979(P<0.05).The threshold values indicated that the ultrasound sonography screening programs were highly sensitive to screening costs in a plausible range.CONCLUSION:Routine screening regime for gallstone disease is both medically and economically valuable.Annual screening for gallstone disease should be recommended.
基金Supported by the grants from the National Science Council, Nos.NSC-91-2320-B-010-102 and NSC-92-2320-B-010-102
文摘AIM: To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease (GSD) in type 2 diabetics. METHODS: We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance (HOMA IR) and β-cell dysfunction (HOMA β-cell). RESULTS: We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% (26/187) among males and 14.7% (36/245) among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4th vs 1st quartile odds ratios (OR) = 4.46 (95%CI: 1.71-11.66)] and HOMA IR [4th vs 1st quartile OR = 4.46 (95%CI: 1.71-11.66)]. Better HOMA β-cell function was significantly related to decreased risk of GSD [4th vs 1st quartile OR = 0.16 (95%CI: 0.03-1.70)]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA β-cell was observed among males. CONCLUSION: Serum insulin, insulin resistance, and β-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.
基金the grant from the Ministry of National Defense-Medical Affairs Bureau,Taiwan,No.MND-MAB-110-109 and No.MND-MAB-D-111059.
文摘BACKGROUND Identifying novel colorectal cancer(CRC)prognostic biomarkers is crucial to helping clinicians make appropriate therapy decisions.Melatonin plays a major role in managing the circadian rhythm and exerts oncostatic effects on different kinds of tumours.AIM To explore the relationship between MTNR1B single-nucleotide polymorphism(SNPs)combined with gene hypermethylation and CRC prognosis.METHODS A total of 94 CRC tumour tissues were investigated.Genotyping for the four MTNR1B SNPs(rs1387153,rs2166706,rs10830963,and rs1447352)was performed using multiplex polymerase chain reaction.The relationships between the MTNR1B SNPs and CRC 5-year overall survival(OS)was assessed by calculating hazard ratios with 95%CIs.RESULTS All SNPs(rs1387153,rs2166706,rs10830963,and rs1447352)were correlated with decreased 5-year OS.In stratified analysis,rs1387153,rs10830963,and rs1447352 risk genotype combined with CDKN2A and MGMT methylation status were associated with 5-year OS.A strong cumulative effect of the four polymorphisms on CRC prognosis was observed.Four haplotypes of MTNR1B SNPs were also associated with the 5-year OS.MTNR1B SNPs combined with CDKN2A and MGMT gene methylation status could be used to predict shorter CRC survival.CONCLUSION The novel genetic biomarkers combined with epigenetic biomarkers may be predictive tool for CRC prognosis and thus could be used to individualise treatment for patients with CRC.
文摘This study evaluated the self-perceived importance and competence with regard to foodservice quality of hospitality students in Taiwan. The study used a 6-dimension food quality scale to gather self-assessed data from student participants. A total of 400 questionnaires were sent out, with 355 （88.75%） returned, validated, and used in research. In the dimension of perceived importance, participants placed the highest importance on ＂food safety＂ and the lowest importance on ＂food characteristics＂. In the dimension of competence, participants placed the highest competence on ＂service quality＂, while the competence concerning ＂culinary skill＂ was lower. An importance-performance analysis （IPA） identified ＂food safety＂ as showing the greatest be improved among the six dimensions. The courses and internship experience predicted 26.4% of the variability in perceived competence of foodservice quality. Both the two variables showed a statistical significance. The culinary courses had a greater impact on food quality-related perceptions than did either hospitality professional or general management courses. Finally, this study identified that the school courses had a positive contribution to the competence of foodservice quality and with hospitality students who completed school courses having better quality perception competence than those who had not.
