[The mechanism of berberine on Methicillin resistant Staphylococcus aureus in vitro].

Objective: To explore the impact of traditional Chinese medicine berberine (BBR) on membrane integrity and permeability of Methicillin-resistant Staphylococcus aureus (MRSA) and the change of bacterial cell wall structure, laying a foundation for the clinical application of berberine in antibacterial. Methods: This study used a non-randomized concurrent controlled trial. The 3 MRSA strains were isolated and cultured from lower respiratory tract samples of geriatric patients from Shanghai Eighth People's Hospital between 2019 and 2020.The Meirier VETEK MS fully automated rapid microbial mass spectrometry detection system and VETEK 2 Compact fully automated microbial identification instrument were used to identify bacterial drug sensitivity experiments to detect bacterial species and drug sensitivity. The minimal inhibitory concentration (MIC) of BBR on MRSA strains was determined by broth microdilution. This study used conductivity tests to assess the changes in membrane permeability in response to different concentration of BBR on MRSA, while also investigating the changes in MRSA morphology by transmission electron microscopy. GraphPad Prism5 was used to analyze the differences in the electrical conductivity experimental results. Results: The MIC of BBR on MRSA was 64 µg/ml. After co-culturing MRSA with BBR for 4 h at 8 µg/ml, 16 µg/ml, 32 µg/ml, 64 µg/ml and 128 µg/ml, respectively, the electrical conductivity increased, compared with the control group, by 24.49%,34.59%,208.92%,196.40% and 208.68%, respectively. By transmission electron microscopy, This study found that low concentration of BBR (8 µg/ml,1/8 MIC) caused no significant damage to MRSA, and the bacterial structure of MRSA remained intact. The cell wall of MRSA became thinner after treatment with berberine at medium concentration (64 µg/ml,1 MIC), while high concentration of BBR (512 µg/ml,8 MIC) induced the destruction and dissolution of MRSA cell wall structure and the leakage of bacterial contents, leading to bacterial lysis. Conclusion: Berberine can kill bacteria by altering the permeability of MRSA cell membrane and destroying and dissolving the structure of the cell wall.

[Mechanisms mediating the inhibitory effects of quercetin against phthalates-induced testicular oxidative damage in rats].

OBJECTIVE: To explore the mechanism underlying the inhibitory effect of quercetin against testicular oxidative damage induced by a mixture of 3 commonly used phthalates (MPEs) in rats. METHODS: Forty male Sprague-Dawley rats were randomly divided into control group, MPEs exposure group, and MPEs with low-, median- and high-dose quercetin treatment groups. For MPEs exposure, the rats were subjected to intragastric administration of MPEs at the daily dose of 900 mg/kg for 30 consecutive days; Quercetin treatments were administered in the same manner at the daily dose of 10, 30, and 90 mg/kg. After the treatments, serum levels of testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), and testicular malondialdeyhde (MDA), catalase (CAT) and superoxide dismutase (SOD) were detected, and testicular pathologies of the rats were observed with HE staining. The expressions of nuclear factor-E2-related factor 2 (Nrf2), Kelch-like ECH2 associated protein 1 (Keap1) and heme oxygenase 1 (HO-1) in the testis were detected using immunofluorescence assay and Western blotting. RESULTS: Compared with the control group, the rats with MPEs exposure showed significant reductions of the anogenital distance, weight of the testis and epididymis, and the coefficients of the testis and epididymis with lowered serum testosterone, LH and FSH levels (P < 0.05). Testicular histological examination revealed atrophy of the seminiferous tubules, spermatogenic arrest, and hyperplasia of the Leydig cells in MPEs-exposed rats. MPEs exposure also caused significant increments of testicular Nrf2, MDA, SOD, CAT and HO-1 expressions and lowered testicular Keap1 expression (P < 0.05). Treatment with quercetin at the median and high doses significantly ameliorated the pathological changes induced by MPEs exposure (P < 0.05). CONCLUSION: Quercetin treatment inhibits MPEs-induced oxidative testicular damage in rats possibly by direct scavenging of free radicals to lower testicular oxidative stress and restore the regulation of the Nrf2 signaling pathway.

[Effects of different planting density, leaf position and leaf age on growth and quality of Artemisia argyi var. argyi 'Qiai'].

In order to guide the standardized planting and scientific harvesting of Artemisia argyi var. argyi 'Qiai', effects of diffe-rent planting density, leaf position and leaf age on the growth and quality of A. argyi var. argyi 'Qiai' were studied in this paper. The results showed that appropriate sparse planting could increase stem diameter, compact leaf spacing, increase the leaf size, reduce the rate of withered leaves and increase the number of effective leaves. Dense planting can significantly increase the yield of A. argyi var. argyi 'Qiai' per Mu(1 Mu≈667 m~2) and the output rate of moxa, but reduce the yield per plant and the number of effective leaves. With the decrease of leaf position and the increase of leaf age, the leaf size and the weight of one hundred leaves increased at first and then decreased, the density of non-glandular hair field of the lower epidermis and the output rate of moxa decreased. With the increase of planting density, the contents of eucalyptus oleoresin, camphor, α-platyclone, and cyanidin decreased gradually, the contents of chlorogenic acid, isochlorogenic acid B, isochlorogenic acid A and isochlorogenic acid C in the leaves of A. argyi var. argyi 'Qiai' increased gradually, while the contents of borneol, bornyl acetate and isozelanin increased at first and then decreased significantly. With the decrease of leaf position and the increase of leaf age, the contents of volatile oil, phenolic acid and flavonoid in A. argyi var. argyi 'Qiai' decreased gradually. PCA analysis can divide the leaf quality characteristics of A. argyi var. argyi 'Qiai' into two parts: the middle and upper 10-30 days leaf age, the middle and lower 40-50 days above leaf age. Based on the above factors, the planting density of 28 000 plants/Mu(row spacing of 10 cm×20 cm) can be selected for cultivation of A. argyi var. argyi 'Qiai' rhizome, and the effective plants in the field are about 142 800 plants/Mu. In terms of harvesting, it is suggested that the A. argyi var. argyi 'Qiai' should be harvested on "March 3 rd" and "May 5 th" of the lunar calendar. If it is the traditionally harvested at one time in May, the A. argyi var. argyi 'Qiai' should be divided into two parts: the middle and upper leaves, the middle and lower leaves, so as to achieve high quality and high price of A. argyi var. argyi 'Qiai' leaves and improve the economic benefits of A. argyi var. argyi 'Qiai' planting.

[Effect of planting period and ridge pattern on yield and quality of Artemisia argyi var.argyi 'Qiai'].

To solve the problems of the unclear planting period and the traditional flat planting of Artemisia argyi var.argyi 'Qiai', such as the serious dead leaves in the middle and lower parts of the plant and the low yield and low quality in the field, the effects of different planting period and ridge pattern on yield and quality of A. argyi var.argyi 'Qiai' were studied. The results showed that the growth and development of A. argyi var.argyi 'Qiai' was better when planted in autumn and winter, and the ridge directions had little effect on the growth and yield of A. argyi var.argyi 'Qiai', while the ridge width had a significant effect. Compared the traditional wide ridge planting mode(the width of the ridge is 160 cm) with the ridge width of 80 cm, 60 cm and 40 cm, the results showed that the density per unit area, the number of effective plants, and the rate of dead leaves were decreased, while the number of productive leaves per plant, the number of lateral branches, and the total yield per plant were increased, the total yield was decreased. The output rates of moxa in the leaves of A. argyi var.argyi 'Qiai' decreased with the planting time postponed and the width of planting ridge increased. The contents of volatile oil, 1,8-oxido-p-menthane, camphor and borneol in A. argyi var.argyi 'Qiai' reach to the highest when planted in autumn and winter and the ridge width was 80 cm. In addition, the contents of total flavonoids, kaempferol, jeceosidin and eupatilin flavonoids in the leaves of A. argyi var.argyi 'Qiai' gradually decreased as the planting period postponed and the ridge width increased. The results show that the A. argyi var.argyi 'Qiai' should be planted in autumn and winter, and the double row ridge planting mode with width of 60-80 cm is more suitable for the cultivation and production of A. argyi var.argyi 'Qiai' in Qichun County of Hubei Province. This study will provide a theoretical basis and guidance for higher yield and quality in cultivation of A. argyi var.argyi 'Qiai' in Qichun county.

'Nausicaa' compression suture: a simple and effective alternative to hysterectomy in placenta accreta spectrum and other causes of severe postpartum haemorrhage.

Postpartum haemorrhage (PPH), especially resulting from placenta accreta spectrum (PAS), has become a worldwide concern in maternity care. We describe a novel method of uterine compression sutures (the 'Nausicaa' technique) as an alternative to hysterectomy for patients who have suffered from major PPH. We applied this technique in 68 patients with major PPH during caesarean section (including 43 patients with PAS, 20 patients with placenta praevia totalis, and five patients with uterine atony), and none of these patients required further hysterectomy. We conclude that our Nausicaa suture is a simple and feasible alternative to hysterectomy in patients suffering from major PPH.

Expression and characterization of a codon-optimized blood coagulation factor VIII.

Essentials Recombinant factor VIII (FVIII) is known to be expressed at a low level in cell culture. To increase expression, we used codon-optimization of a B-domain deleted FVIII (BDD-FVIII). This resulted in 7-fold increase of the expression level in cell culture. The biochemical properties of codon-optimized BDD-FVIII were similar to the wild-type protein. SUMMARY: Background Production of recombinant factor VIII (FVIII) is challenging because of its low expression. It was previously shown that codon-optimization of a B-domain-deleted FVIII (BDD-FVIII) cDNA resulted in increased protein expression. However, it is well recognized that synonymous mutations may affect the protein structure and function. Objectives To compare biochemical properties of a BDD-FVIII variants expressed from codon-optimized and wild-type cDNAs (CO and WT, respectively). Methods Each variant of the BDD-FVIII was expressed in several independent Chinese hamster ovary (CHO) cell lines, generated using a lentiviral platform. The proteins were purified by two-step affinity chromatography and analyzed in parallel by PAGE-western blot, mass spectrometry, circular dichroism, surface plasmon resonance, and chromogenic, clotting and thrombin generation assays. Results and conclusion The average yield of the CO was 7-fold higher than WT, whereas both proteins were identical in the amino acid sequences (99% coverage) and very similar in patterns of the molecular fragments (before and after thrombin cleavage), glycosylation and tyrosine sulfation, secondary structures and binding to von Willebrand factor and to a fragment of the low-density lipoprotein receptor-related protein 1. The CO preparations had on average 1.5-fold higher FVIII specific activity (activity normalized to protein mass) than WT preparations, which was attributed to better preservation of the CO structure as a result of considerably higher protein concentrations during the production. We concluded that the codon-optimization of the BDD-FVIII resulted in significant increase of its expression and did not affect the structure-function properties.

[Burning mouth syndrome in the views of modern stomatology and traditional Chinese medicine].

Burning mouth syndrome (BMS) is a common clinical disorder characterized by burning of the mouth or other discomfort, which significantly affects the quality of life of patients. The present article introduces and makes comparison of the mechanisms and clinical treatments of BMS in modern stomatology and traditional Chinese medicine. Modern stomatology studies have shown that BMS is related to the factors of neuropathy, psychology, endocrine or metabolic disorders, drug effects and local adverse stimuli. Traditional Chinese medicine suggests that BMS is mainly caused by diet, fatigue, bad emotion, poor health, oldness, etc. Individualized therapy is advocated in the treatment of BMS. Modern stomatology pays attention to comprehensive treatment for psychological disorder, systematic and oral local diseases. The thoughts of dialectical therapy and health keeping in traditional Chinese medicine also have clinical value.

Differential effects of grape juice on gastric emptying and renal function from cisplatin-induced acute adverse toxicity.

Grape skin and seeds contain large amounts of phytochemicals such as polyphenols, resveratrol, and proanthocyanidins, which possess antioxidant activities. Cisplatin is widely used in the treatment of cancer. High doses of cisplatin have also been known to produce acute adverse effects. The aim of this study was to investigate the protective effects of antioxidant properties of whole grape juice (with skin and seeds) on cisplatin-induced acute gastrointestinal tract disorders and nephrotoxicity in Wistar rats. Gastric emptying is significantly increased in whole grape juice-pretreated rats when compared to cisplatin treatment alone. The expression of ghrelin mRNA of stomach is increased in rats with whole grape juice. However, pretreatment with whole grape juice did not reduce renal function markers in acute renal toxicity. No significant changes were recorded in the oxidative stress/antioxidant status parameters of any study group. In contrast, pretreatment with whole grape juice slightly improved tubular cell vacuolization, tubular dilatation, and cast formation in renal tubules. These results show that consumption of whole grape juice induces somewhat beneficial effects in preventing cisplatin-mediated dyspepsia but does not offer protection against cisplatin-induced acute renal toxicity.

Effects of dietary garlic scape meal on the growth and meat characteristics of geese.

This study evaluated the growth performance and meat characteristics of grower geese whose diets included garlic scape meal (GSM), a by-product of garlic production. Scape is the leaf-less flower stem of garlic. Garlic scape (GS) extracts contained 84.7 ± 3.8 µg/g dry weight (DW), 81.4 ± 8.2 µg/g DW, 0.78 ± 0.05 mg gallic acid equivalent/g DW and 31.67 ± 2.25 µg/g DW of allicin, alliin, total phenolics and flavonoid contents, respectively. In total, 120 White Roman geese aged 5 weeks were randomly distributed among 12 pens and fed on a grower diet ad libitum during the growth period. Employing a completely random design, 5 males and 5 females were placed in each pen. Each treatment was applied to three pens (in total 30 birds) and the treatments comprised the following: 1) control (maize-soybean meal), 2) 5% of maize replaced with 5% of GSM (5% GSM), 3) 10% of maize replaced with 10% of GSM (10% GSM) and 4) 15% of maize replaced with 15% of GSM (15% GSM). Each group of 30 birds was treated for 8 weeks. The results revealed that the 15% GSM group was characterised by a lower feed conversion ratio than the control group; however, these groups did not differ significantly in their body weights (BWs). In addition, the 10% GSM group did not differ in both the feed conversion ratio and consumption. The flavour intensity score of meats in the 10% GSM group was significantly lower than those of meats in the 5% GSM and control groups. The general acceptability scores of meats in the 5% GSM and control groups were higher than those of meat in the 10% GSM group. The study concluded that 5% dietary GSM in the feed did not adversely affect the growth performance, meat characteristics or sensory evaluation of grower geese. Hence, the environment can be protected by including agricultural waste in goose diets.

5α-Reductase inhibitors increase acute coronary syndrome risk in patients with benign prostate hyperplasia.

BACKGROUND: This study explored the possible association between the use of two typical 5ARIs (finasteride and dutasteride) and the risk of acute coronary syndrome (ACS) in patients with benign prostate hyperplasia (BPH). METHODS: From the claims data of the Taiwan National Health Insurance (NHI) Taiwan, we identified 1843 ACS cases among BPH patients and randomly selected 7330 controls without ACS, with a similar mean age of 73 years. Multivariate logistic regression analysis estimated the odds ratio (OR) and 95 % confidence interval (CI) for the relationship between the 5ARIs medications and ACS risk. RESULTS: We found that BPH patients who had received treatment with both finasteride and dutasteride were at a higher risk of ACS with an OR of 3.47 (95 % CI 1.05-11.5), compared to patients without 5ARIs treatment. Furthermore, the dosage analysis showed that there were no significant associations between ACS risk and uses of a single drug medication regardless the dosages. The ORs for those who took only dutasteride were 1.07 (95 % CI 0.39-2.99) with low dose and 0.73 (95 % CI 0.38-1.44) with high dose. The ORs for those who took only finasteride were 1.30 (95 % CI 0.89-1.92) with low dose and 0.98 (95 % CI 0.19-5.13) with high dose. CONCLUSION: This population-based nested case-control study suggests that 5ARI use may increase ACS risk among patients with BPH when patients were exposed to both finasteride and dutasteride.

Effects of dietary supplementation with creatine monohydrate during the finishing period on growth performance, carcass traits, meat quality and muscle glycolytic potential of broilers subjected to transport stress.

A total of 320 male Arbor Acres broiler chickens (28 days old) were randomly allotted to one of the three experimental diets supplemented with 0 (160 birds), 600 (80 birds) or 1200 mg/kg (80 birds) creatine monohydrate (CMH) for 14 days. On the morning of 42 day, after an 8-h fast, the birds of CMH-free group were divided into two equal groups, and all birds of these four groups were transported according to the follow protocol: 0.75-h transport without CMH supplementation (as a lower stress control group), 3-h transport without CMH supplementation, 3-h transport with 600 or 1200 mg/kg CMH supplementation. Each treatment group was composed of 8 replicates with 10 birds each. The results showed that supplementation of CMH for 14 days before slaughter did not affect the overall growth performance and carcass traits of stressed broilers (P>0.05). A 3-h transport decreased plasma glucose concentration, elevated plasma corticosterone concentration, increased bird live weight loss, breakdown of muscle glycogen, as well as the accumulation of muscle lactate (P<0.05), which induced some detrimental changes to breast meat quality (lower ultimate pH and higher drip loss, P<0.05). Nevertheless, supplementation of 1200 mg/kg CMH reduced chicken weight loss, decreased the contents of lactate and glycolytic potential in pectoralis major of 3-h transported broilers (P<0.05), which is beneficial to maintain breast meat quality by reducing the drip loss (P<0.05). These findings suggest that the reduction of muscle glycolysis is probably the reason for maintainance of meat quality by supplementation of CMH in transported broilers.

Micronutrients-incorporated calcium phosphate particles with protective effect on osteoporotic bone tissue.

BACKGROUND: Supplementation of individual micronutrient is inadequate for maintaining bone function because single micronutrient can not contribute significantly a positive remodeling balance. OBJECTIVE: We developed the highly integrated, stably dietary multi-micronutrients with good bioavailability and low adverse effect on the improvement of bone consolidation in osteoporosis. METHODS: The trace element-codoped calcium phosphate (teCaP) particles were prepared in the modified body fluid and carefully evaluated. Rats, aged 3 months, were ovariectomized and when 6 month intervened with the conditioned, low, moderate, and high teCaP diets. RESULTS: The teCaP particles showed highly dissolvable in stomach juice-mimicing acidic solutions. Three months after intervention, the body weight increase showed remarkable differences among the low teCaP diet (~52 g), moderate teCaP diet (~34 g) and high teCaP diet (~23 g) group. In particular, the intake of moderate teCaP greatly improved the retention of trace elements in femural bone for better protection against the skeletal weakening, and resulted in a significant increase of bone mineral density (104.06%) in comparison with the conventional high calcium plus vitamin D3 diet (Control group). CONCLUSIONS: These investigations improve our understanding of micronutrient retention on bone consolidation in osteoporotic bone tissue, and also provide new mild wet-chemical approach to prepare potent nutritionally effective edible complements to synergistically relieve bone degeneration and prevent osteoporosis.

Carnitine and carnitine orotate affect the expression of the prolactin-releasing peptide gene.

Carnitine is involved in fatty acid metabolism in mammals and is widely used as a nutritional supplement; carnitine orotate is a more absorbable form of carnitine. We investigated the effects of carnitine and carnitine orotate on mouse prolactin-releasing peptide (PrRP) mRNA expression. Twenty-four female mice were randomly divided into four groups of six; control mice were orally drenched with physiological saline solution (250 mg/kg body weight) and treatment mice were orally drenched with carnitine (250 mg/kg) or carnitine orotate (250 or 750 mg/kg), once a day, for 20 days from parturition. The carnitine or carnitine orotate was dissolved in saline solution before administration. The hypothalamus, pituitary and ovary were sampled on day 21 after parturition, and PrRP mRNA levels in these tissues were measured by semi-quantitative PCR, with glyceraldehyde 3-phosphate dehydrogenase as a control. Expression of PrRP in mice treated with carnitine and carnitine orotate was significantly increased in the ovary and significantly reduced in the pituitary gland. Compared with the control, hypothalamus PrRP mRNA increased significantly in the carnitine and low-dose carnitine orotate groups and decreased significantly in the high-dose carnitine orotate group. We conclude that carnitine and carnitine orotate regulate expression of PrRP in the pituitary gland and ovaries.

Early-onset growth hormone deficiency results in diastolic dysfunction in adult-life and is prevented by growth hormone supplementation.

OBJECTIVE: The primary goal of growth hormone (GH) replacement is to promote linear growth in children with growth hormone deficiency (GHD). GH and insulin-like growth factor-1 (IGF-1) are also known to have roles in cardiac development and as modulators of myocardial structure and function in the adult heart. However, little is known about cardiac diastolic function in young adults with childhood onset GH deficiency in which GH treatment was discontinued following puberty. The aim of the study was to evaluate the effects of long standing GHD and peri-pubertal or continuous GH replacement therapy on diastolic function in the adult dwarf rat. DESIGN: The dwarf rat, which possesses a mutation in a transcription factor necessary for development of the somatotroph, does not exhibit the normal peri-pubertal rise in GH around day 28 and was used to model childhood or early-onset GHD (EOGHD). In another group of male dwarfs, GH replacement therapy was initiated at 4 weeks of age when GH pulsatility normally begins. Ten weeks after initiation of injections, GH-treated dwarf rats were divided into 2 groups; continued treatment with GH for 12 weeks (GH-replete) or treatment with saline for 12 weeks. This latter group models GH supplementation during adolescence with GHD beginning in adulthood (adult-onset GHD; AOGHD). Saline-treated heterozygous (HZ) rats were used as age-matched controls. At 26 weeks of age, cardiac function was assessed using invasive or noninvasive (conventional and tissue Doppler) indices of myocardial contractility and lusitropy. RESULTS: Systolic function, as determined by echocardiography, was similar among groups. Compared with HZ rats and GH-replete dwarfs, the EOGHD group exhibited significant reductions in myocardial relaxation and increases in left ventricular filling pressure, indicative of moderate diastolic dysfunction. This was further associated with a decrease in the cardiac content of sarcoplasmic reticulum Ca(2+) ATPase (SERCA2), one of the important cardiac calcium regulatory proteins. Dwarfs supplemented with GH during the peri-adolescence stage, but not beyond (AOGHD), exhibited a subtle prolongation in the deceleration time to early filling. In contrast, continual GH replacement preserved diastolic function such that the cardiac phenotype of the GH-replete dwarfs resembled that of their age-matched HZ counterpart. DISCUSSION: Our data indicate that GHD during adolescence leads to overt diastolic dysfunction in early adulthood and this is prevented by continual GH replacement therapy. Since discontinuation of GH replacement following adolescence only mitigated the lusitropic deficits that were observed in untreated dwarfs, GH treatment into adulthood could be beneficial.

Propofol inhibits lipopolysaccharide-induced lung epithelial cell injury by reducing hypoxia-inducible factor-1alpha expression.

BACKGROUND: Lipopolysaccharide (LPS) may activate hypoxia-inducible factor (HIF)-1α, which up-regulates cytokine expression and the lethality of LPS-induced shock. We investigated the effect of propofol on HIF-1α expression and acute lung injury in LPS-treated mice. METHODS: A series of both positive and negative control experiments were performed. We injected BALB/C mice with propofol or vehicle i.p. immediately and 12 h after an LPS challenge. After 24 h, we examined the lung wet/dry weight ratio, neutrophil infiltration, and HIF-1α mRNA expression and inflammatory cytokines in the lung tissue. Survival was determined for 48 h after LPS injection. In vitro, we determined the responses of A549 cells, with and without HIF-1α silenced, to treatment with LPS alone and LPS plus propofol. RESULTS: Propofol prolonged survival and attenuated acute lung injury and decreased the expression of HIF-1α, interleukin (IL)-6, keratinocyte-derived chemokine, and tumour necrosis factor-alpha (TNF-α) in the lungs of endotoxaemic mice. In HIF-1α knockdown-A549 cells, LPS-induced TNF-α, IL-6, and the pro-apoptotic gene, BNIP3 expression and apoptosis were reduced. Propofol, but not an inhibitor of nuclear factor κB, reduced HIF-1α expression in LPS-stimulated A549 cells. Propofol also down-regulated, in A549 cells, the expression of IL-6, IL-8, and TNF-α, Bcl-2/adenovirus E1B 19 kDa interacting protein 3 (BNIP3), and apoptosis. CONCLUSIONS: Propofol reduces apoptosis in LPS-stimulated lung epithelial cells by decreasing HIF-1α, BNIP3, and cytokine production. Using propofol to inhibit HIF-1α expression may protect against the acute lung injury caused by LPS-induced sepsis.

Establishing a 'Physician's Spiritual Well-being Scale' and testing its reliability and validity.

The purpose of this study was to develop a Physician's Spiritual Well-Being Scale (PSpWBS). The significance of a physician's spiritual well-being was explored through in-depth interviews with and qualitative data collection from focus groups. Based on the results of qualitative analysis and related literature, the PSpWBS consisting of 25 questions was established. Reliability and validity tests were performed on 177 subjects. Four domains of the PSpWBS were devised: physician's characteristics; medical practice challenges; response to changes; and overall well-being. The explainable total variance was 65.65%. Cronbach α was 0.864 when the internal consistency of the whole scale was calculated. Factor analysis showed that the internal consistency Cronbach α value for each factor was between 0.625 and 0.794 and the split-half reliability was 0.865. The scale has satisfactory reliability and validity and could serve as the basis for assessment of the spiritual well-being of a physician.

Changes in extratemporal integrity and cognition in temporal lobe epilepsy: a diffusion tensor imaging study.

BACKGROUND: Diffusion tensor imaging (DTI) is a sensitive technique for studying cerebral white matter. Only a few studies have examined the association between changes in extratemporal integrity and cognition in temporal lobe epilepsy (TLE), especially in Chinese patients. AIM: We used DTI to characterize microstructural changes and investigate their associations with cognition in patients with temporal lobe epilepsy. PATIENTS AND METHODS: We studied 27 adult patients with TLE and 21 healthy controls. A standardized neuropsychological evaluation and diffusion tensor imaging examination were conducted on each subject. Eight patients were excluded because T2-weighted magnetic resonance imaging (MRI) results showed visible lesions. Furthermore, we determined mean diffusivity (MD) and fractional anisotropy (FA) values in the different regions of interest - normal-appearing white matter (NAWM) in the frontal lobe white matter, the occipital lobe white matter, the corpus callosum, the internal capsules, the external capsules; and normal-appearing gray matter (NAGM) in the caudate nucleus head, the putamens and the thalami. These diffusion measurements were compared between the two groups, and we examined the correlations between DTI values and clinical characteristics. In addition, multiple linear regression analysis was used to study the association of DTI values with cognitive function. RESULTS: Compared with normal controls, TLE patients demonstrated decreased FA in NAGM of both thalami and NAWM of the posterior limb of the left internal capsule (P<.01). In patients with temporal lobe epilepsy, right thalamus FA showed a tendency to correlate with age at seizure onset (ß=0.47, P=.045), and left thalamus MD showed a tendency to correlate with the duration of epilepsy (ß=0.54 P=.038). Patients with temporal lobe epilepsy showed significantly poorer performance on nearly all tasks concerning category fluency and other executive functions (P<.01). In patients with TLE, there was a positive correlation between category fluency scores and FA in the white matter of the left frontal lobe (ß=0.429, P=.041) and the right occipital lobe (ß=0.613, P=.001). CONCLUSIONS: Our results suggested that the thalamus might be a potentially important extratemporal structure involved in temporal lobe epilepsy. Moreover, a longer duration of epilepsy or an earlier age at onset may result in more abnormalities in the thalamus. Patients with temporal lobe epilepsy showed significantly poorer performance on nearly all tasks concerning category fluency and other executive functions. Our results showed that frontal lobe white matter contributed to category fluency impairment in patients with TLE, but other areas might also contribute to these impairments.

Water extract of Zizyphus Jujube attenuates ischemia/reperfusion-induced liver injury in rats (PP106).

AIMS: Ischemia and reperfusion (I/R) injuries in the liver remain important clinical problems. Free oxygen radicals and nitrosative stress have been shown to be involved in the pathogenesis I/R-related liver injury. The purpose of this study was to characterize the effects of an extract of Zizyphus Jujube (ZJ), which has strong antioxidant effects, on I/R-induced liver injury. MATERIALS AND METHODS: Ischemia (I) was induced in rat livers by clamping the common hepatic artery and portal vein for 40 minutes, after which flow was restored, and the liver was reperfused for 90 minutes. Blood samples were collected prior to I and after reperfusion to assay blood levels of alanine transaminase (ALT), lactic dehydrogenase (LDH), oxygen radical (OH), and nitric oxide (NO). In the pharmacologic intervention group a water extract of the fruit of ZJ was administered orally to rats (100 mg/mL for 7 days) that were subsequently exposed to the I/R liver injury. RESULTS: The data showed that reperfusion (R) of the liver produced increases in blood concentrations of ALT (41.9+/-8.2 vs 338.0+/-89.6; P<.01; N=7) and LDH (317+/-129 vs 4073+/-950; P<.001; N=7). Oxygen radicals (55.1+/-14.3 vs 262.4+/-60.3; P<.001; N=7) and NO (69.3+/-14.9 vs 121.6+/-27.1; P<.01; N=7) also increased significantly in this R group. In the ZJ intervention group the liver injury, oxidative stress, and nitrosative stress were all significantly attenuated. CONCLUSION: These results suggested that I/R-induced liver injury with white blood cell activation, oxidative stress, and nitrosative stress. Pretreatment with an extract of ZJ, which shows high antioxidant effects, significantly attenuated the I/R-induced liver injury.

Improved treatment results for childhood acute myeloid leukemia in Taiwan.

To improve treatment results for children with de novo acute myeloid leukemia (AML), we introduced a novel protocol, Taiwan Pediatric Oncology Group-AML-97A, for AML other than acute promyelocytic leukemia (APL), for which modified conventional protocols were used. From January 1, 1997, to December 31, 2002, 141 children younger than 17 years old with de novo AML were enrolled. In total, 117 patients with non-APL AML were treated with induction therapy of idarubicin and cytarabine (Ara-C), postremission therapy with high-dose Ara-C - containing regimens for four monthly courses, and moderate-dose therapy with idarubicin and Ara-C for four monthly courses. The first 19 patients with APL were treated with all-trans retinoic acid, idarubicin and Ara-C, with the remaining five patients receiving all-trans retinoic acid and idarubicin, followed by maintenance therapy for 2 years. Stem cell transplantation was performed in 29 patients in first remission with a similar outcome as chemotherapy alone. The remission rate in the AML-97A study was 90%, the 5-year survival 51 +/- 5.3% (s.e.) and the 5-year event-free survival 50 +/- 4.8%; for APL, these were 100%, 86 +/- 7.0, and 75 +/- 9.8%. For the whole group, the 5-year survival was 57 +/- 4.7% and the 5-year event-free survival 54 +/- 4.4%. The AML-97A regimen was well tolerated.