Minor hepatectomy combined with cholangioplasty and cholangiojejunostomy for Bismuth II hilar cholangiocarcinoma: A propensity score matching analysis.

BACKGROUND: The optimal surgical approach for Bismuth II hilar cholangiocarcinoma (HCCA) remains controversial. This study compared perioperative and oncological outcomes between minor and major hepatectomy. MATERIALS AND METHODS: One hundred and seventeen patients with Bismuth II HCCA who underwent hepatectomy and cholangiojejunostomy between January 2018 and December 2022 were retrospectively investigated. Propensity score matching created a cohort of 62 patients who underwent minor (n = 31) or major (n = 31) hepatectomy. Perioperative outcomes, complications, quality of life, and survival outcomes were compared between the groups. Continuous data are expressed as the mean ± standard deviation, categorical variables are presented as n (%). RESULTS: Minor hepatectomy had a significantly shorter operation time (245.42 ± 54.31 vs. 282.16 ± 66.65 min; P = 0.023), less intraoperative blood loss (194.19 ± 149.17 vs. 315.81 ± 256.80 mL; P = 0.022), a lower transfusion rate (4 vs. 11 patients; P = 0.038), more rapid bowel recovery (17.77 ± 10.00 vs. 24.94 ± 9.82 h; P = 0.005), and a lower incidence of liver failure (1 vs. 6 patients; P = 0.045). There were no significant between-group differences in wound infection, bile leak, bleeding, pulmonary infection, intra-abdominal fluid collection, and complication rates. Postoperative laboratory values, length of hospital stay, quality of life scores, 3-year overall survival (25.8 % vs. 22.6 %; P = 0.648), and 3-year disease-free survival (12.9 % vs. 16.1 %; P = 0.989) were comparable between the groups. CONCLUSION: In this propensity score-matched analysis, overall survival and disease-free survival were comparable between minor and major hepatectomy in selected patients with Bismuth II HCCA. Minor hepatectomy was associated with a shorter operation time, less intraoperative blood loss, less need for transfusion, more rapid bowel recovery, and a lower incidence of liver failure. Besides, this findings need confirmation in a large-scale, multicenter, prospective randomized controlled trial with longer-term follow-up.

Structure-Activity Relationship (SAR) Studies of Novel Monovalent AR/AR-V7 Dual Degraders with Potent Efficacy against Advanced Prostate Cancer.

Androgen receptor (AR) has been extensively established as a potential therapeutic target for nearly all stages of prostate cancer (PCa). However, acquired resistance to AR-targeted drugs inevitably develops and severely limits their clinical efficacy. Particularly, there currently exists no efficient treatment for patients expressing the constitutively active AR splice variants, such as AR-V7. Herein, we report the structure-activity relationship studies of 55 N-heterocycle-substituted hydantoins, which identified the structural motifs required for AR/AR-V7 degradation. Among them, the most potent compound 27c exhibited selective AR/AR-V7 degradation over other hormone receptors and excellent antiproliferative activities in LNCaP and 22RV1 cells. RNA sequence analysis confirmed that 27c effectively suppressed transcriptional activity of the AR signaling pathway. Importantly, 27c demonstrated potent antitumor efficacy in an enzalutamide-resistant 22RV1 xenograft model. These results highlight the potential of 27c as a promising dual AR/AR-V7 degrader for overcoming drug resistance in advanced PCa expressing AR splice variants.

A comprehensive quality evaluation strategy of Shensong Yangxin capsules based on qualitative, fingerprint and quantitative analyses.

Shensong Yangxin capsule (SSYXC), an effective Chinese patent medicine, has been recorded in the Chinese Pharmacopeia, mainly for the treatment of coronary heart disease and ventricular premature beat. To further complete the quality evaluation of SSYXC, a comprehensive analysis strategy was established. Firstly, the components of SSYXC were qualitatively analysed using ultra-high- performance liquid chromatography-Fourier transform ion cyclotron resonance mass spectrometry. A total of 134 compounds were identified or tentatively characterized. Additionally, the fingerprint of SSYXC was established by HPLC, and the similarity of 10 batches of SSYXC was elucidated by similarity analysis. The result indicated that the consistency of chemical composition is good. Finally, to enhance the quality control of SSYXC, according to the results of the fingerprint analysis, the contents of the seven active components was determined, comprising morroniside, loganin, paeoniflorin, salvianolic acid B, palmatine hydrochloride, berberine hydrochloride and tanshinone IIA. In conclusion, the established method, comprising identification of components, fingerprint analysis and quantification of multicomponents, can be sensitively and comprehensively applied to the quality evaluation of SSYXC, which can provide chemical ingredients bases for quality control and the pharmacodynamic mechanism of SSYXC, which could serve as a benchmark for controlling the quality of other Chinese patent medicines.

Polysaccharides from Phellinus linteus attenuate type 2 diabetes mellitus in rats via modulation of gut microbiota and bile acid metabolism.

Type 2 diabetes mellitus (T2DM) is the most prevalent metabolic disorder. Polysaccharides from Phellinus linteus (PLP) have been found to have anti-diabetes effects, but the mechanism has not been elucidated. The purpose of this study was to investigate the mechanism of PLP on T2DM through the gut microbiota and bile acids metabolism. The T2DM rat model was induced by a high-fat high-carbohydrate (HFHC) diet and streptozocin (30 mg/kg). We found that PLP ameliorated diabetes symptoms. Besides, PLP intervention increased the abundance of g_Bacteroides, g_Parabacteroides, and g_Alistioes, which are associated with the biosynthesis of short-chain fatty acids (SCFAs) and bile acids (BAs) metabolism. Meanwhile, untargeted and targeted metabolomics indicated that PLP could regulate the composition of BAs and increase the levels of SCFAs. Real-time quantitative PCR (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA) were performed to analyze the expression levels of BAs metabolism enzymes in the liver. Finally, the results of correlation analysis and Glucagon-like peptide-1 (GLP-1) showed that PLP stimulated the release of GLP-1 by regulating SCFAs and BAs. In conclusion, this study demonstrated that PLP can regulate gut microbiota and BAs metabolism to promote GLP-1 secretion, thereby increasing insulin release, decreasing blood glucose and attenuating T2DM.

A comprehensive strategy for quality evaluation of Changan powder by fingerprinting combined with rapid qualitative and quantitative multi-ingredients profiling.

INTRODUCTION: Changan powder (CAP) is mainly used to treat various intestinal diseases. Few studies on CAP have been reported; therefore, it is necessary to clarify the material basis of CAP to lay the foundation for further elucidating its functional mechanism and support the rational use of drugs. OBJECTIVES: In the present study, we aimed to propose a methodology for the quality control of CAP based on qualitative and quantitative analysis of its components. METHODS: An ultra-performance liquid chromatography coupled with Fourier transform ion cyclotron resonance mass spectrometry (UPLC-FT-ICR-MS) method was developed to identify chemical components in CAP. In addition, fingerprints of 10 different batches of CAP were established, and quantitative analysis based on UPLC was performed to analyze the quality of CAP. RESULTS: A total of 58 compounds were preliminarily characterized. The similarity of 10 batches of CAP was greater than 0.995, and 23 common peaks were calibrated. Investigation of the quantitative analytical methodology showed that the four components had good linear relationships within their respective concentration ranges (r2 ≥ 0.9992), and the relative standard deviation (RSD) of precision and stability was less than 2%. The RSD of sample recovery ranged from 0.78% to 1.52%. CONCLUSION: The established method can quickly and effectively identify the chemical components of CAP and accurately quantify the known components in CAP. The established fingerprinting and content determination method is stable, reliable, and easy to operate and can be applied in quality control and in vivo research on CAP.

Bile acids metabolism involved in the beneficial effects of Danggui Shaoyao San via gut microbiota in the treatment of CCl4 induced hepatic fibrosis.

ETHNOPHARMACOLOGICAL RELEVANCE: Danggui Shaoyao San (DSS) is a traditional Chinese medicine (TCM) first recorded in the Synopsis of the Golden Chamber. DSS has proven efficacy in treating hepatic fibrosis (HF). However, the effects and mechanisms of DSS on HF are not clear. AIM OF THE STUDY: To investigate the effect of DSS on HF via gut microbiota and its metabolites (SCFAs, BAs). MATERIALS AND METHODS: HF rats were induced with CCl4 and treated with DSS. Firstly, the therapeutic efficacy of DSS in HF rats and the protection of gut barrier were assessed. Then, 16S rRNA gene sequencing and untargeted fecal metabolomics preliminarily explored the mechanism of DSS in treating HF, and identified different microbiota and metabolic pathways. Finally, targeted metabolomics and RT-qPCR were used to further validate the mechanism of DSS for HF based on the metabolism of SCFAs and BAs. RESULTS: After 8 weeks of administration, DSS significantly reduced the degree of HF. In addition, DSS alleviated inflammation in the ileum and reduced the levels of LPS and D-lactate. Furthermore, DSS altered the structure of gut microbiota, especially Veillonella, Romboutsia, Monoglobus, Parabacteroides, norank_f_Coriobacteriales_Incertae_Sedis. These bacteria have been linked to the production of SCFAs and the metabolism of BAs. Untargeted metabolomics suggested that DSS may play a role via BAs metabolism. Subsequently, targeted metabolomics and RT-qPCR further confirmed the key role of DSS in increasing SCFAs levels and regulating BAs metabolism. CONCLUSIONS: DSS can alleviate CCl4-induced HF and protect the gut barrier. DSS may exert its beneficial effects on HF by affecting the gut microbiota and its metabolites (SCFAs, BAs).

Prediction of Diabetic Macular Edema Using Knowledge Graph.

Diabetic macular edema (DME) is a significant complication of diabetes that impacts the eye and is a primary contributor to vision loss in individuals with diabetes. Early control of the related risk factors is crucial to reduce the incidence of DME. Artificial intelligence (AI) clinical decision-making tools can construct disease prediction models to aid in the clinical screening of the high-risk population for early disease intervention. However, conventional machine learning and data mining techniques have limitations in predicting diseases when dealing with missing feature values. To solve this problem, a knowledge graph displays the connection relationships of multi-source and multi-domain data in the form of a semantic network to enable cross-domain modeling and queries. This approach can facilitate the personalized prediction of diseases using any number of known feature data. In this study, we proposed an improved correlation enhancement algorithm based on knowledge graph reasoning to comprehensively evaluate the factors that influence DME to achieve disease prediction. We constructed a knowledge graph based on Neo4j by preprocessing the collected clinical data and analyzing the statistical rules. Based on reasoning using the statistical rules of the knowledge graph, we used the correlation enhancement coefficient and generalized closeness degree method to enhance the model. Meanwhile, we analyzed and verified these models' results using link prediction evaluation indicators. The disease prediction model proposed in this study achieved a precision rate of 86.21%, which is more accurate and efficient in predicting DME. Furthermore, the clinical decision support system developed using this model can facilitate personalized disease risk prediction, making it convenient for the clinical screening of a high-risk population and early disease intervention.

A preliminary nomogram model for predicting relapse of patients with primary membranous nephropathy.

OBJECTIVE: To explore the predictive factors and establish a nomogram model for predicting relapse risk in primary membranous nephropathy (PMN). METHODS: The clinical, laboratory, pathological and follow-up data of patients with biopsy-proven membranous nephropathy were collected in the Affiliated Hospital of Qingdao University. A total of 400 PMN patients who achieved remission were assigned to the development group (n = 280) and validation group (n = 120) randomly. Cox regression analysis was performed in the development cohort to determine the predictive factors of relapse in PMN patients, a nomogram model was established based on the multivariate Cox regression analysis and validated in the validation group. C-index and calibration plots were used to evaluate the discrimination and calibration performance of the model respectively. RESULT: Hyperuricemia (HR = 2.938, 95% CI 1.875-4.605, p < 0.001), high C-reactive protein (CRP) (HR = 1.147, 95% CI 1.086-1.211, p < 0.001), and treatment with calcineurin inhibitors with or without glucocorticoids (HR = 2.845, 95%CI 1.361-5.946, p = 0.005) were independent risk factors, while complete remission (HR = 0.420, 95%CI 0.270-0.655, p < 0.001) was a protective factor for relapse of PMN according to multivariate Cox regression analysis, then a nomogram model for predicting relapse of PMN was established combining the above indicators. The C-indices of this model were 0.777 (95%CI 0.729-0.825) and 0.778 (95%CI 0.704-0.853) in the development group and validation group respectively. The calibration plots showed that the predicted relapse probabilities of the model were consistent with the actual probabilities at 1, 2 and 3 years, which indicated favorable performance of this model in predicting the relapse probability of PMN. CONCLUSIONS: Hyperuricemia, remission status, CRP and therapeutic regimen were predictive factors for relapse of PMN. A novel nomogram model with good discrimination and calibration was constructed to predict relapse risk in patients with PMN early.

Anti-neutrophil cytoplasmic antibody patterns can predict clinical relapse in ANCA-associated vasculitis: overall population and subgroups.

OBJECTIVES: In anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), relapses are cause of concern as they are unpredictable and predictors of poor prognosis. We aimed to assess the characteristic and predictors of clinical relapse in AAV. METHODS: This retrospective study included 132 cases of AAV newly diagnosed from January 2016 through November 2021 in the Affiliated Hospital of Qingdao University. We reviewed clinical data of patients and analysed the risk factors for clinical relapse of overall population and subgroups by univariate and multivariate regression models and the K-M survival curve was plotted. RESULTS: The rate of relapse was highest in the positive conversion group than the others significantly (p<0.001). In overall population, ANCA patterns (p<0.001; persistent positive pattern: HR=3.352, 95%CI 1.463~7.678, p=0.004; positive conversion pattern: HR=4.760, 95%CI 2.094~10.820, p<0.001) and infections (HR =4.684, 95%CI 1.980~11.079, p<0.001) were significantly associated with clinical relapse. In myeloperoxidase (MPO)-AAV patients, ANCA patterns (p=0.001; persistent positive pattern: HR=4.495, 95%CI 1.508~13.396, p=0.007; positive conversion pattern: HR=7.404, 95%CI 2.652~20.671, p<0.001) and infections (HR=3.594, 95%CI 1.511~8.547, p=0.004) were significantly associated with clinical relapse. In renal involvement patients, ANCA patterns (p=0.004; persistent positive pattern: HR=3.618, 95%CI 1.364~9.592, p=0.01; positive conversion pattern: HR=4.492, 95%CI 1.778~11.352, p<0.001) and infections (HR=7.791, 95%CI 2.511~24.174, p<0.001) were significantly associated with clinical relapse, but were not in patients without renal involvement. CONCLUSIONS: Persistently positive and re-positive ANCA and infections predict clinical relapse in AAV, especially in patients with MPO-AAV and renal involvement. Regular ANCA monitoring should be carried out in high-risk populations.

Real-Time In Situ Volatile Organic Compound Sensing by a Dual-Emissive Polynuclear Ln-MOF with Pronounced LnIII Luminescence Response.

Lanthanide metal-organic frameworks (Ln-MOFs) are promising for luminescence detection of volatile organic compound (VOC) vapors, but usually suffer from the silent or quenched Ln3+ emission. Herein, we report a new dual-emissive Eu-MOF composed of the coordinatively unsaturated Eu9 clusters that afford abundant open metal sites to form a confined "binding pocket" to facilitate the preconcentration and recognition of VOCs. Single-crystal structural analyses reveal that specific analytes can replace the OH oscillators in the first coordination sphere of Eu3+ and form a unique hydrogen-bonding second-sphere adduct tying adjacent Eu9 clusters together to minimize their nonradiative vibrational decay. With the promoted Eu3+ luminescence, the MOF realizes real-time in situ visual sensing of THF vapor (<1 s) and shows a quantitative ratiometric response to the vapor pressure with a limit of detection down to 17.33 Pa. Also, it represents a top-performing ratiometric luminescent thermometer.

Robotic versus open extended cholecystectomy for T1a-T3 gallbladder cancer: A matched comparison.

Background: The feasibility and safety of robotic extended cholecystectomy (REC) are still uncertain. This study was performed to compare the short- and long-term outcomes of REC with those of open extended cholecystectomy (OEC) for T1a-T3 gallbladder cancer. Methods: From January 2015 to April 2022, 28 patients underwent REC in our center. To minimize any confounding factors, a 1:2 propensity score-matching analysis was conducted based on the patients' demographics, liver function indicators, T stage, and symptoms. The data regarding demographics, perioperative outcomes, and long-term oncologic outcomes were reviewed. Results: The visual analogue scale score was significantly lower in the REC than OEC group immediately postoperatively (3.68 ± 2.09 vs. 4.73 ± 1.85, P = 0.008), on postoperative day 1 (2.96 ± 1.75 vs. 3.69 ± 1.41, P = 0.023), and on postoperative day 2 (2.36 ± 1.55 vs. 2.92 ± 1.21, P = 0.031). In addition, the REC group exhibited a shorter time to first ambulation (P = 0.043), a shorter time to drainage tube removal (P = 0.038), and a shorter postoperative stay (P = 0.037), but hospital costs were significantly higher in the REC group (P < 0.001). However, no statistically significant difference was found in the operation time (P = 0.134), intraoperative blood loss (P = 0.467), or incidence of postoperative morbidity (P = 0.227) or mortality (P = 0.289) between the REC and OEC groups. In regard to long-term outcomes, the 3-year disease-free survival rate was comparable between the OEC and REC groups (43.1% vs. 57.2%, P = 0.684), as was the 3-year overall survival rate (62.8% vs. 75.0%, P = 0.619). Conclusion: REC can be an effective and safe alternative to OEC for selected patients with T1a-T3 gallbladder cancer with respect to short- and long-term outcomes.

Modulation of Hierarchical Pores in Metal-Organic Frameworks for Improved Dye Adsorption and Electrocatalytic Performance.

The hierarchical porous metal-organic framework (HP-MOF) has emerged as a hot topic in porous materials in consideration of their advantages in storage capacity and catalysis performance. Herein, we report the construction and property investigation of a series of HP-MOFs. A series of isoreticular microporous MOFs featuring the pacs topology network based on 2,4,6-tris(4-pyridyl)-1,3,5-triazine and different carboxylic acid ligands are found to be potential precursors to construct HP-MOFs. Through the decarboxylation of carboxylate ligands at high temperatures, a hierarchical porous structure could be obtained with the reservation of a crystalline framework. The formation of hierarchical pores is highly dependent on the structural and component nature (carboxylate ligands and metal centers) of the pristine MOF and the pyrolysis conditions (temperature and treatment time), indicating the highly tunable hierarchical pore characteristic of the HP-MOFs. By taking advantage of the increased pore volume and more exposed activation sites, the HP-MOFs reveal enhanced anionic dye adsorption capacity (800 mg·g-1 for Congo red and 140 mg·g-1 for methyl blue) and catalytic activity toward electrocatalytic oxygen reduction reaction (overpotential of 0.302 V at a current density of 10 mA·cm-2, 51 mV lower than that of the pristine MOF).

Prediction of chronic kidney disease after orthotopic liver transplantation: development and validation of a nomogram model.

BACKGROUND: We aimed to develop and validate a nomogram model for predicting CKD after orthotopic liver transplantation (OLT). METHODS: The retrospective data of 399 patients who underwent transplantation and were followed in our centre were collected. They were randomly assigned to the training set (n = 293) and validation set (n = 106). Multivariable Cox regression analysis was performed in the training set to identify predictors of CKD. According to the Cox regression analysis results, a nomogram model was developed and validated. The renal function of recipients was monitored, and the long-term survival prognosis was assessed. RESULTS: The incidence of CKD at 5 years after OLT was 25.6%. Cox regression analysis identified several predictors of post-OLT CKD, including recipient age at surgery (HR 1.036, 95% CI 1.006-1.068; p = 0.018), female sex (HR 2.867, 95% CI 1.709-4.810; p < 0.001), preoperative hypertension (HR 1.670, 95% CI 0.962-2.898; p = 0.068), preoperative eGFR (HR 0.996, 95% CI 0.991-1.001; p = 0.143), uric acid at 3 months (HR 1.002, 95% CI 1.001-1.004; p = 0.028), haemoglobin at 3 months (HR 0.970, 95% CI 0.956-0.983; p < 0.001), and average concentration of cyclosporine A at 3 months (HR 1.002, 95% CI 1.001-1.003; p < 0.001). According to these parameters, a nomogram model for predicting CKD after OLT was constructed and validated. The C-indices were 0.75 and 0.80 in the training and validation sets. The calibration curve of the nomogram showed that the CKD probabilities predicted by the nomogram agreed with the observed probabilities at 1, 3, and 5 years after OLT (p > 0.05). Renal function declined slowly year by year, and there were significant differences between patients divided by these predictors. Kaplan-Meier survival analysis showed that the survival prognosis of recipients decreased significantly with the progression of renal function. CONCLUSIONS: With excellent predictive abilities, the nomogram may be a simple and reliable tool to identify patients at high risk for CKD and poor long-term prognosis after OLT.

Efficient Regulation of Energy Transfer in a Multicomponent Dye-Loaded MOF for White-Light Emission Tuning.

Owing to their rich porosity and structural diversity, metal-organic frameworks (MOFs) offer substantial advantages over other emission sources for the precise design and color regulation of white-light phosphors. However, achieving efficient white-light emission remains a considerable challenge. Herein, we report a strategy to achieve tunable and efficient white-light emission by regulating energy transfer in a multicomponent dye-loaded MOF. An anionic MOF NKU-114 featuring appropriate confined spaces is designed as a host to deliberately encapsulate three red-, green-, and blue-emissive dyes with adaptive spectral overlap, DSM, AF, and 9-AA, respectively, yielding the NKU-114@dyes composites. Integrating the suitable spectral overlap and efficient energy transfer between the dyes and the framework produced a white-light emission material containing the multicomponent dyes NKU-114@DSM/AF/9-AA. The obtained material has a broadband white emission with a high quantum yield (up to 42.07%) and nearly identical CIE coordinates of (0.34, 0.32), and the moderate correlated color temperature and color-rendering index value can reach up to 5101 K and 81, respectively, suggesting the potential of the multicomponent dye-loaded MOF for white-light-emitting phosphors with good color quality.

Silibinin Promotes Cell Proliferation Through Facilitating G1/S Transitions by Activating Drp1-Mediated Mitochondrial Fission in Cells.

Heart, liver, and kidney, which are known as the essential organs for metabolism, possess the unique ability to regulate the proliferation function of the body against injury. Silibinin (SB), a natural polyphenolic flavonoid extracted from traditional herb Silybum marianum L., has been used to protect hepatocytes. Whether SB can regulate mitochondrial fission in normal cells and the underlying mechanisms remain unclear. Here, we showed that SB markedly promoted cell proliferation by facilitating G1/S transition via activating dynamin-related protein 1 (Drp1), which in turn mediated mitochondrial fission in these normal cells. SB dose-dependently increased the mitochondrial mass, mtDNA copy number, cellular adenosine triphosphate production, mitochondrial membrane potential, and reactive oxygen species in normal cells. Furthermore, SB dose-dependently increased the expression of Drp1. Blocking Drp1 abolished SB-induced mitochondrial fission. In conclusion, we demonstrate that SB promotes cell proliferation through facilitating G1/S transition by activating Drp1-mediated mitochondrial fission. This study suggests that SB is a potentially useful herbal derivative for the daily prevention of various diseases caused by impaired mitochondrial fission.

Collision of Aptamer/Pt Nanoparticles Enables Label-Free Amperometric Detection of Protein in Rat Brain.

Single particle collision is emerging as a powerful and sensitive technique for analyzing small molecules, however, its application in biomacromolecules detection, for example, protein, in complex biological environments is still challenging. Here, we present the first demonstration on the single particle collision that can be developed for the detection of platelet-derived growth factor (PDGF), an important protein involved in the central nervous system in living rat brain. The system features Pt nanoparticles (PtNPs) conjugated with the PDGF recognition aptamer, suppressing the electrocatalytic collision of PtNPs toward the oxidation of hydrazine. In the presence of PDGF, the stronger binding between targeted protein and the aptamer disrupts the aptamer/PtNPs conjugates, recovering the electrocatalytic performance of PtNPs, and allowing quantitative, selective, and highly sensitive detection of PDGF in cerebrospinal fluid of rat brain.

The Association Between Different Patterns of Traditional Chinese Medicine Treatment and All-Cause Mortality Among Cancer Patients.

BACKGROUND: Cancer patients receiving Western medical treatment, frequently seek Traditional Chinese Medicine (TCM) to alleviate adverse effects and prolong survival. OBJECTIVE: This study evaluated the association between the use of TCM and cancer survival rate. Research into the effect of TCM on patient survival is limited, this analysis focused on 3 patterns of TCM use. METHODS: Three retrospective cohorts with different patterns of TCM use were selected from the National Health Insurance Research Database of Taiwan and analyzed. Patients with newly diagnosed cancer between 1997 and 2012 were classified into groups of prediagnosis, postdiagnosis, and continuous TCM use associated with awareness of cancer diagnosis. All demographic and clinical data were analyzed. RESULTS: After propensity score matching, longevity of the postdiagnosis and continuous TCM user was significantly longer than the non-TCM user. The adjusted hazard ratios of death in postdiagnosis and continuous TCM use groups (0.59 and 0.61, respectively) were lower than the non-TCM use group. CONCLUSION: The analysis suggests that cancer patients using TCM in conjunction with Western medical treatment exhibited a higher survival rate than patients not using TCM treatment.

Application of a smartphone nurse call system for nursing care.

BACKGROUND: Traditionally, a patient presses the nurse call button and alerts the central nursing station. This system cannot reach the primary care nurse directly. The aim of this study was to apply a new smartphone system through the cloud system and information technology that linked a smartphone and a mobile nursing station for nursing care service. MATERIALS AND METHODS: A smartphone and mobile nursing station were integrated into a smartphone nurse call system through the cloud and information technology for better nursing care. RESULTS: Waiting time for a patient to contact the most responsible nurse was reduced from 3.8 min to 6 s. The average time for pharmacists to locate the nurse for medication problem was reduced from 4.2 min to 1.8 min by the new system. CONCLUSIONS: After implementation of the smartphone nurse call system, patients received a more rapid response. This improved patients' satisfaction and reduced the number of complaints about longer waiting time due to the shortage of nurses.