Self-Assembling Sulfated Lactobacillus Exopolysaccharide Nanoparticles as Adjuvants for SARS-CoV-2 Subunit Vaccine Elicit Potent Humoral and Cellular Immune Responses.

Coronavirus disease 2019 (COVID-19) has caused a global pandemic since its onset in 2019, and the development of effective vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to induce potent and long-lasting immunity remains a priority. Herein, we prepared two Lactobacillus exopolysaccharide (EPS) nanoparticle adjuvants (NPs 7-4 and NPs 8-2) that were constructed by using sulfation-modified EPS and quaternization-modified chitosan. These two NPs displayed a spherical morphology with sizes of 39 and 47 nm. Furthermore, the zeta potentials of NPs 7-4 and NPs 8-2 were 50.40 and 44.40 mV, respectively. In vitro assays demonstrated that NPs could effectively adsorb antigenic proteins and exhibited a sustained release effect. Mouse immunization tests showed that the NPs induced the expression of cytokines and chemokines at the injection site and promoted the uptake of antigenic proteins by macrophages. Mechanically, the NPs upregulated the expression of pattern recognition receptors (toll-like receptors and nod-like receptors) and activated the immune response of T cells and the production of neutralizing antibodies. In addition, the NP adjuvants had favorable immune-enhancing effects in cats, which are of great significance for controlling the trans-host transmission and re-endemicity of SARS-CoV-2. Overall, we demonstrated that NP-adjuvanted SARS-CoV-2 receptor binding domain proteins could induce robust specific humoral and cellular immunity.

Glycolysis-non-canonical glutamine dual-metabolism regulation nanodrug enhanced the phototherapy effect for pancreatic ductal adenocarcinoma treatment.

Clinical pancreatic ductal adenocarcinoma (PDAC) treatment is severely limited by lack of effective KRAS suppression strategies. To address this dilemma, a reactive oxygen species (ROS)-responsive and PDAC-targeted nanodrug named Z/B-PLS was constructed to confront KRAS through dual-blockade of its downstream PI3K/AKT/mTOR and RAF/MEK/ERK for enhanced PDAC treatment. Specifically, photosensitizer zinc phthalocyanine (ZnPc) and PI3K/mTOR inhibitor BEZ235 (BEZ) were co-loaded into PLS which was constructed by click chemistry conjugating MEK inhibitor selumetinib (SEL) to low molecular weight heparin with ROS-responsive oxalate bond. The BEZ and SEL blocked PI3K/AKT/mTOR and RAF/MEK/ERK respectively to remodel glycolysis and non-canonical glutamine metabolism. ZnPc mediated photodynamic therapy (PDT) could enhance drug release through ROS generation, further facilitating KRAS downstream dual-blockade to create treatment-promoting drug delivery-therapeutic positive feedback. Benefiting from this broad metabolic modulation cascade, the metabolic symbiosis between normoxic and hypoxic tumor cells was also cut off simultaneously and effective tumor vascular normalization effects could be achieved. As a result, PDT was dramatically promoted through glycolysis-non-canonical glutamine dual-metabolism regulation, achieving complete elimination of tumors in vivo. Above all, this study achieved effective multidimensional metabolic modulation based on integrated smart nanodrug delivery, helping overcome the therapeutic challenges posed by KRAS mutations of PDAC.

G protein-coupled estrogen receptor activation by bisphenol-A disrupts lipid metabolism and induces ferroptosis in the liver.

As a metabolic disruptor, bisphenol A (BPA) has been widely reported to disrupt lipid balance. Moreover, BPA has gained significant attention due to its estrogenic activity. While both ferroptosis and the G-protein-coupled estrogen receptor (GPER) have been implicated in lipid metabolism, their link to BPA-induced lipid accumulation remains unclear. In this study, chickens were randomly assigned to three groups and housed them for 4 weeks: a control group (0 µg/L BPA), a low dose group (50 µg/L BPA) and a high dose group (5000 µg/L BPA) to investigate the underlying mechanism of BPA-induced hepatotoxicity. Our results showed that BPA exposure significantly increased the contents of TG, TC, and LDL-C while decreasing HDL-C levels. We also found that BPA treatment altered the levels of genes involved in fatty acid ß-oxidation (ampkα, cpt-1, and ppaα), synthesis (acc, fas, scd-1, and srebp-1) and absorption (lpl and cd36). Moreover, the results showed that the BPA group had higher levels of IL-1ß, IL-18 and TNF-α. These results indicated that BPA exposure disrupted lipid metabolism and induced inflammation in the liver. We also demonstrated that BPA caused hepatic ferroptosis by raising iron content and the expression of genes related to lipid peroxidation (lpcat3, acsl4 and alox15), while reducing the expression of antioxidant system-associated genes (gpx4, slc7a11 and slc3a2). Importantly, BPA remarkably activated GPER expression in the liver. Interestingly, inhibition of GPER remarkably ameliorated BPA-induced lipid metabolism disorder, inflammatory response, and ferroptosis, indicating the crucial role of GPER in BPA-induced liver abnormalities. These findings highlight the link between GPER and ferroptosis in BPA-induced hepatotoxicity, providing new insights into the potential hazard of BPA.

The effects of rhein on D-GalN/LPS-induced acute liver injury in mice: Results from gut microbiome-metabolomics and host transcriptome analysis.

Background: Rhubarb is an important traditional Chinese medicine, and rhein is one of its most important active ingredients. Studies have found that rhein can improve ulcerative colitis by regulating gut microbes, but there are few reports on its effects on liver diseases. Therefore, this study aims to investigate these effects and underlying mechanisms. Methods: Mice were given rhein (100 mg/kg), with both a normal control group and a model group receiving the same amount of normal saline for one week. Acute liver injury was induced in mice by intraperitoneal injection of D-GalN (800 mg/kg)/LPS (10 ug/kg). Samples (blood, liver, and stool) were then collected and assessed for histological lesions and used for 16S rRNA gene sequencing, high-performance liquid chromatography-mass spectrometry (LC-MS) and RNA-seq analysis. Results: The levels of ALT and AST in the Model group were abnormal higher compared to the normal control group, and the levels of ALT and AST were significantly relieved in the rhein group. Hepatic HE staining showed that the degree of liver injury in the rhein group was lighter than that in the model group, and microbiological results showed that norank_o:Clostridia_UCG-014, Lachnoclostridium, and Roseburia were more abundant in the model group compared to the normal control group. Notably, the rhein treatment group showed reshaped disturbance of intestinal microbial community by D-GalN/LPS and these mice also had higher levels of Verrucomicrobia, Akkermansiaceae and Bacteroidetes. Additionally, There were multiple metabolites that were significantly different between the normal control group and the model group, such as L-α-amino acid, ofloxacin-N-oxide, 1-hydroxy-1,3-diphenylpropan-2-one,and L-4-hydroxyglutamate semialdehyde, but that returned to normal levels after rhein treatment. The gene expression level in the model group also changed significantly, various genes such as Cxcl2, S100a9, Tnf, Ereg, and IL-10 were up-regulated, while Mfsd2a and Bhlhe41 were down-regulated, which were recovered after rhein treatment. Conclusion: Overall, our results show that rhein alleviated D-GalN/LPS-induced acute liver injury in mice. It may help modulate gut microbiota in mice, thereby changing metabolism in the intestine. Meanwhile, rhein also may help regulate genes expression level to alleviate D-GalN/LPS-induced acute liver injury.

The Qingchangligan Formula Alleviates Acute Liver Failure by Regulating Galactose Metabolism and Gut Microbiota.

The Qingchangligan formula (QCLGF) is a traditional Chinese medicine that has significant clinical potential for patients with acute liver failure (ALF). However, the experimental evidence of the effect of QCLGF on ALF and the associated mechanisms remain elusive. We aimed to evaluate the function of QCLGF in ALF and the underlying mechanism. ALF was induced in rats by intraperitoneal injection of D-GalN (1100 mg/kg). The Qingchangligan formula was administered to the rats (6.725 g/kg · d) for 5 days, and the model group and the control group were given the same amount of physiological saline. Then 16S rRNA gene sequencing, high performance gas chromatography-mass spectrometry (GC-MS), and RNA-seq analysis were performed on the samples. The levels of ALT and AST in the ALF rats were abnormal (5322.08 ± 566.27 U/L and 7655.95 ± 1238.08 U/L, respectively) compared with the normal control (98.98 ± 6.90 U/L and 99.63 ± 10.94 U/L, respectively). The levels of ALT and AST in the QCLGF rats (2997.67 ± 469.24 U/L and 4158.40 ± 596.07 U/L, respectively) were closer the normal control group. Liver HE staining showed that the degree of liver damage in the QCLGF rats was lighter than that in the ALF rats. The overall structure of the gut microbiota after ALF was significantly altered, including Proteobacteria, Blautia, Romboutsia, Parabacteroides, UCG-008, Parasutterella, Ruminococcus, norank_f:Lachnospiraceae, the Eubacterium_xylanophilum_group, Oscillibacter, and Eisenbergiella. QCLGF balanced the structure and abundance of intestinal flora. The levels of D(+)galactose, isopropyl beta-D-1-thiogalactopyranoside and D-mannitol were lighter in the plasma of the ALF rats than in the normal control rats, but there were significantly elevated levels of those metabolites in the QCLGF rats. The gene expression changed significantly in the ALF rats. QCLGF regulated the expression of THBS1 and the KEGG pathways of carbohydrate metabolism, lipid metabolism, signal transduction, the immune system, and infectious disease: bacterial. QCLGF may alleviating intestinal flora disorder, regulating galactose metabolism and downregulating the expression of THBS1 to alleviate D-GalN induced acute liver failure.

Soy isoflavones ameliorate experimental colitis by targeting ERα/NLRP3 inflammasome pathways.

Soy isoflavones (SIFs) are selective estrogen receptor modulators (SERMs) that have anti-inflammatory activities. Our previous study found that estrogen receptor α (ERα) directly regulates the NLRP3 transcription and NLRP3 inflammasome assembly. Therefore, we hypothesized that SIFs alleviate colitis via an ERα-dependent mechanism by targeting the NLRP3 inflammasome. The influence of SIFs on colitis and the potential mechanisms were thoroughly determined in this study. The results suggested that SIFs ameliorated dextran sodium sulfate (DSS)-induced body weight loss, reduced disease activity index and promoted the recovery of colon pathological damage in mice. Moreover, expression of the NLRP3 inflammasome was significantly inhibited, and the release of IL-1ß and IL-18 was suppressed by SIFs. Furthermore, ERα blockade ameliorated DSS-induced inflammatory responses in the intestine, and SIFs markedly suppressed the expression of ERα in a dose-dependent manner. Our study demonstrated that the protective therapeutic action of SIFs on DSS-induced colitis depended on inhibition of ERα and subsequent NLRP3 inflammasome activation, and SIFs are promising therapeutic agents for the treatment of colitis.

Virtue Existential Career Model: A Dialectic and Integrative Approach Echoing Eastern Philosophy.

Our Virtue Existential Career (VEC) model aims at complementing western modernism and postmodernism career theories with eastern philosophy. With dialectical philosophy and virtue-practice derived from the Classic of Changes, the VEC theoretical foundation incorporates merits from Holland typology, Minnesota Theory of Work Adjustment, Social Cognitive Career Theory, Meaning Therapy, Narrative Approach Career Counseling, and Happenstance Learning Theory. While modernism considers a matched job as an ideal career vision and prefers rational strategies (controlling and realizing) to achieve job security; postmodernism prefers appreciating and adapting strategies toward openness and appreciates multiple possible selves and occupations, our model pursues a blending of security and openness via controlling-and-realizing and appreciating-and-adapting interwoven with each other in a dialectical and harmonious way. Our VEC counseling prototype aims at a secular goal of living on the earth with ways and harmony () and an ultimate end to spiral up to the wisdom of living up to the way of heaven () with mind and virtue (). A VEC counseling process of five major career strategies, metaphorical stories of qian and kun, and experiential activities are developed to deliver VEC concepts. The VEC model and prototype presented in this research is the product of an action research following Lewin's (1946) top-to-down model. Situated structure analyses were conducted to further investigate the adequacy of this version of VEC model and prototype. Data from two groups (one for stranded college graduates and the other for growing college students) revealed empirical supports. Yang type of career praxes tends to induce actualization, which resulting in realistic goals and concrete action plans; yin type of career praxes tends to increase self-efficacy, which resulting in positive attitude toward current situatedness and future development. Acceptance and dialectic thinking often result from yin-yang-blending career praxes. Growing developers benefit from a strategy sequence of yang-yin-synthesized; stranded developers from a strategy sequence of yin-yang-synthesized. Our contributions and limitations are discussed in the context of developing indigenous career theories and practices for a globalized and ever-changing world.

Controlling Indoor Air Pollution from Moxibustion.

Indoor air quality (IAQ) control of hospitals plays a critical role in protecting both hospital staffs and patients, particularly those who are highly susceptible to the adverse effects of indoor noxious hazards. However, moxibustion in outpatient departments (OPDs) of traditional Chinese medicine (TCM) may be a source of indoor air pollution in hospitals. Some studies have investigated indoor air pollution during moxibustion in Chinese medicine clinics (CMCs) and moxibustion rooms, demonstrating elevated air pollutants that pose a threat to the health of medical staff and patients. Our study investigated the indoor air pollutants of indoor carbon dioxide (CO2), carbon monoxide (CO), formaldehyde (HCHO), total volatile organic compounds (TVOCs), airborne particulate matter with a diameter of ≤10 µm (PM10) and ≤2.5 µm (PM2.5) during moxibustion in an acupuncture and moxibustion room of the OPD in a hospital in Taipei. To evaluate the different control strategies for indoor air pollution from moxibution, a comparison of air pollutants during moxibution among the methods of using alternative old moxa wools, local exhaust ventilation and an air cleaner was conducted. In this study, burning alternative old moxa wools for moxibustion obviously reduced all gaseous pollutants except for aerosols comparing burning fresh moxa wools. Using local exhaust ventilation reduced most of the aerosols after burning moxa. We also found that using an air cleaner was inefficient for controlling indoor air pollutants, particularly gaseous pollutants. Therefore, combining replacing alternative old moxa wools and local exhaust ventilation could be a suitable design for controlling indoor air pollution during moxibustion therapy.

Determination of total phthalates in edible oils by high-performance liquid chromatography coupled with photodiode array detection.

The previously reported procedure for the determination of the total phthalate in fatty food involved the extraction of phthalates using chloroform/methanol followed by the removal of the solvents before alkaline hydrolysis requiring 20 h and derivatization of phthalic acid. In this study, a phase-transfer catalyst (tetrabutylammonium chloride) was used in the liquid-liquid heterogeneous hydrolysis of phthalates in oil matrix shortening the reaction time to within 25 min. The resulting phthalic acid in the hydrolysate was extracted by a novel molecular complex based dispersive liquid-liquid microextraction method coupled with back-extraction before high-performance liquid chromatography coupled with photodiode array detection. Under the optimal experimental conditions, the linearity of the method was in the range of 0.5-12 nmol/g with the correlation coefficients (r) >0.997. The detection limit (S/N = 3) was 0.11 nmol/g. Intraday and interday repeatability values expressed as relative standard deviation were 3.9 and 7.1%, respectively. The recovery rates ranged from 82.4 to 99.0%. The developed method was successfully applied for the analysis of total phthalate in seven edible oils.

Rapid screening of edible oils for phthalates using phase-transfer catalyst-assisted hydrolysis and liquid phase microextraction coupled to high performance liquid chromatography-tandem mass spectrometry.

Edible oil is easily contaminated with phthalic acid esters (PAEs). Conventional procedures to analyze individual PAEs require very rigorous experimental conditions that are extremely labor-intensive due to significant procedural contaminations generated by the ubiquitous presence of PAEs in the laboratory environment. In this study, a rapid screening method for PAEs in edible oil was successfully developed. Using a phase-transfer catalyst (terabutylammonium bromide) during oil/water biphasic base hydrolysis of PAEs, the hydrolysis time was decreased from a previously reported time of 20 h to 10 min (80 °C). The resulting phthalic acid in the acidified hydrolysate was extracted with 600 µL of tributyl phosphate and then analyzed by high performance liquid chromatography-tandem mass spectrometry in 6 min. Parameters affecting the hydrolysis of PAEs and the extraction of phthalic acid were optimized, and the analytical method was validated. No obvious matrix effect existed in the edible oils whether an external or internal standard method was used. The detection limit was 1.0 µmol kg(-1), and the quantification limit was 1.3 µmol kg(-1). The recovery rates varied from 86 to 107% with relative standard deviations equal to or lower than 9.9% in all of the tested conditions. Twenty-six samples were analyzed, and the background corrected total PAE content was found to be in the range of

Determination of phthalate esters in edible oils by use of QuEChERS coupled with ionic-liquid-based dispersive liquid-liquid microextraction before high-performance liquid chromatography.

A selective and low organic-solvent-consuming method of sample preparation combined with high-performance liquid chromatography with diode-array detection is introduced for analysis of phthalic acid esters in edible oils. Sample treatment involves initial liquid-liquid partitioning with acetonitrile, then QuEChERS cleanup by dispersive solid-phase extraction with primary secondary amine as sorbent. Preconcentration of the analytes is performed by ionic-liquid-based dispersive liquid-liquid microextraction, with the cleaned-up extract as disperser solvent and 1-hexyl-3-methylimidazolium hexafluorophosphate as extraction solvent. Under the optimized conditions, correlation coefficients (r) were 0.998-0.999 and standard errors (S y/x ) were 2.67-3.37 × 10(3) for calibration curves in the range 50-1000 ng g(-1). Detection limits, at a signal-to-noise ratio of 3, ranged from 6 to 9 ng g(-1). Intra-day and inter-day repeatability, expressed as relative standard deviation, were in the ranges 1.0-6.9 % and 2.4-9.4 %, respectively. Recovery varied between 84 % and 106 %. The developed method was successfully used for analysis of the analytes in 28 edible oils. The dibutyl phthalate content of four of the 28 samples (14 %) exceeded the specific migration limit established by domestic and international regulations.

Development and comparison of two dispersive liquid-liquid microextraction techniques coupled to high performance liquid chromatography for the rapid analysis of bisphenol A in edible oils.

In this study, two novel sample extraction methods for the analysis of bisphenol A (BPA) in edible oils were developed by using liquid-liquid extraction followed by a dispersive liquid-liquid microextraction (LLE-DLLME) and reversed-phase dispersive liquid-liquid microextraction (RP-DLLME). RP-DLLME showed a superior characteristic over LLE-DLLME and other previously reported procedures because of its easy operation, short extraction time, high sensitivity, low organic solvent consumption and waste generation. The optimized extraction conditions of RP-DLLME for 1.0 g of edible oil diluted in 4 mL of n-hexane were: extractant, 100 µL 0.2 M sodium hydroxide solution (80% methanol, v/v); extraction time, 1 min; centrifugation, 3 min. The determination of BPA was carried out by high performance liquid chromatography coupled with a DAD detector. The method offered excellent linearity over a range of 0.010-0.5 µg g(-1) with a correlation coefficient of r>0.997. Intra-day and inter-day repeatability values expressed as relative standard deviation were 1.9% and 5.9%, respectively. The quantitation limit and detection limit were 6.3 and 2.5 ng g(-1). The target analyte was detected in 5 out of 16 edible oil samples. The recovery rates in real samples ranged from 89.5 to 99.7%.

Rapid determination of α-tocopherol in cereal grains using dispersive liquid-liquid microextraction followed by HPLC.

The traditional for the determination of α-tocopherol in cereal grains includes saponification of a sample followed by liquid-liquid extraction, and it is time- and solvent consuming. In this study, a dispersive liquid-liquid microextraction (DLLME) method was developed to extract α-tocopherol in situ from the saponified grain sample solution. The DLLME experimental parameters including the type and volume of extractants, the volume of dispersers, the addition of salt and the extraction/centrifuging time were examined and optimized. The recommended analytical procedure showed excellent precision (relative SDs of the α-tocopherol amount of 3.1% over intraday and 7.2% over interday), high sensitivity (the detection limit of 1.9 ng/mL), and strong recovery values (88.9-102.5%). In addition, statistical analyses showed no significant difference between the detected amounts of α-tocopherol found by the standardized method and this new procedure. The method was successfully applied to determining the amounts and distribution of α-tocopherol in 14 cereal grain samples.

High rate of qacA- and qacB-positive methicillin-resistant Staphylococcus aureus isolates from chlorhexidine-impregnated catheter-related bloodstream infections.

Chlorhexidine has been widely used for infection control. Although the use of chlorhexidine-impregnated catheters has reduced catheter-related infections, chlorhexidine-resistant Staphylococcus aureus has emerged. The correlation between the existence of the chlorhexidine-resistant genes qacA and qacB (qacA/B) in methicillin-resistant Staphylococcus aureus (MRSA) isolates and the effectiveness of chlorhexidine-impregnated catheters in the prevention of MRSA infections is unknown. Sixty methicillin-sensitive Staphylococcus aureus (MSSA) and 96 MRSA isolates from the blood cultures of different patients were collected, and a case-control study was conducted to determine whether more clinical S. aureus isolates from chlorhexidine-impregnated catheter-related bloodstream infections (CRBSI) have the biocide-resistant genes (qacA/B or smr) than those from other infections. The chlorhexidine MIC(50)s of MSSA and MRSA isolates were 1 µg/ml and 2 µg/ml, respectively. Results of PCR analyses showed that 3.3% (n = 2) of MSSA and 43.8% (n = 42) of MRSA isolates harbored qacA/B and 5% (n = 3) of MSSA and 25% (n = 24) of MRSA isolates contained smr. With multivariate logistic regression analyses, the significant risk factors for definite CRBSI with chlorhexidine-impregnated catheters were determined to be S. aureus isolates with qacA/B and a chlorhexidine MIC of ≥2 µg/ml (odds ratios [OR], 9.264 and 8.137, respectively, in all 156 S. aureus isolates and 6.097 and 4.373, respectively, in the 96 MRSA isolates). Further prospective studies are needed to investigate the transmission of these biocide-resistant genes.

Subcritical water extraction of alkaloids in Sophora flavescens Ait. and determination by capillary electrophoresis with field-amplified sample stacking.

The extraction and determination of cytisine, sophocarpine, matrine, sophoridine and oxymatrine in Sophora flavescens Ait. were performed using subcritical water extraction and capillary electrophoresis with field-amplified sample stacking. The effects of extraction temperature, pressure, time and cycle number on the extraction yields were investigated systematically for accelerated solvent extraction with ethanol (ASE) and accelerated solvent extraction with water (subcritical water extraction, SWE). The extraction yields obtained using SWE, ASE, water ultrasonic extraction and chloroform soaking extraction methods were compared. The electrophoresis separation buffer was monosodium phosphate (pH 3.0; 110 mM)-isopropanol (85:15, v/v). The effect of phosphoric acid added to the sample matrix on the reproducibility of the peak heights of the analytes was also examined. Cytisine, sophoridine and oxymatrine showed good linearity (R(2)>0.999) within 0.125-4.0 µg/mL, and sophocarpine and matrine exhibited good linearity (R(2)>0.998) within 0.0625-2.0 µg/mL, with the detection limits in the range of 0.004-0.0013 µg/mL. The five alkaloid contents in medicinal plants from different sources and Sophora instant granule were determined and compared.

Mortality and cancer incidence among physicians of traditional Chinese medicine: a 20-year national follow-up study.

OBJECTIVE: To study the risks of mortality and cancer incidence in physicians of traditional Chinese medicine (TCM) who had frequent exposure to herbal medicine. METHODS: A population-based cohort design was conducted in which a total of 7675 certified physicians of TCM who ever practised between 1985 and 2005 were compared with the age-, sex- and calendar year-specific mortalities and cancer incidence rates of the general population of Taiwan. The age-, sex- and calendar year-standardised mortality ratio (SMR) and standardised cancer incidence ratio (SIR) were calculated to estimate the relative risks of all causes and site-specific mortality and cancer incidence. RESULTS: Over an up to 20-year observational period, 796 (10.4%) physicians of TCM died, and 279 (3.6%) developed cancer. The study cohort showed a significantly reduced SMR for all-causes mortality (68, 95% CI 63 to 73), and for deaths from infectious (SMR=64), circulatory (SMR=68), respiratory (SMR=64) and digestive (SMR=56) disease. The study cohort also had a significantly reduced SIR (80, 95% CI 71 to 90) for all cancers, and for neoplasm of rectum, rectosigmoid junction, and anus (SIR=45), female breast (SIR=30) and cervix uteri (SIR=10). On the other hand, we noted that physicians of TCM suffered from a significantly increased SIR for neoplasm of liver and intrahepatic bile ducts (SIR=151, 95% CI 116 to 192) and of bladder cancer (SIR=259, 95% CI 167 to 382). CONCLUSION: Like other healthcare workers, we noted that physicians of TCM had significantly reduced risks of all-causes mortality and cancer incidence. Nonetheless, reasons truly responsible for significantly increased risks of liver and bladder neoplasm among physicians of TCM warrant further investigations.

Lower morbidity and disease risk among the Chinese medicine physicians in Taiwan.

Healthy physicians are critical to the quality of care for patients. There is a common trend in Chinese societies seeking for medical treatments from Chinese medicine physicians. However, there are limited studies that investigated the health status for the Chinese medicine physicians. In this report, we used National Health Insurance Research database of Taiwan between 1998 and 2002 to compare the morbidities between Chinese medicine physicians and general population. The number of Chinese medicine physicians in this study is 6,143 (5,036 males with the mean age of 40.47 years and 1,107 females with the mean age of 36.24 years), and the number of the referent subjects is 24,576, randomly selected from the database matching by sex and age. We found that the Chinese medicine physicians have lower all-causes morbidity (86% vs. 95%, p < 0.001), except that female Chinese medicine physicians had significantly higher rates of complications of pregnancy, childbirth, and puerperium than female population. Such an exception might reflect a consequence of maternal age effect. The odds ratio between all causes and two comparison groups was 0.36 (95% CI: 0.33, 0.40), indicating that the Chinese medicine physicians have much lower disease risk. Higher education, better socioeconomic status, and good knowledge in medicine (possible self-treatment) may explain the observed differences. Among the Chinese medicine physicians, the morbidity rate of male subjects is lower than the female subjects (85.9% vs. 91.4%, p < 0.001). This study will provide the helpful information in guiding future investigations about health hazards to the practice of Chinese medicine.

Lower mortality in male physicians of Chinese medicine than male population in Taiwan.

Studies on the physicians' health have paid less attention on the Chinese medicine than on the western medicine professionals. Like western medicine professionals, Chinese medicine physicians' health condition is critical to the quality of care and patients' safety. They also cared a large number of patients in many Asia societies. However, no data have been reported regarding the health problems associated with Chinese medicine physicians. The aim of this study was to examine the mortality patterns of a cohort consisting of 6109 male physicians of Chinese medicine who were followed from 1991 through 2003 in Taiwan. The analyses of female subjects were not included due to small sample size. We calculated the overall and cause-specific standardized mortality ratios (SMRs) and life expectancy of the study cohort using the death rates of some 11 millions of Taiwanese male population as reference. We found out that physicians of Chinese medicine experienced significantly lower death rate of mortality from all causes (SMR = 0.63, 95% > CI: 0.57, 0.69), from malignant neoplasms (SMR = 0.69, 95% CI: 0.57, 0.82) and from cerebrovascular disease (SMR = 0.53, 95% CI: 0.38, 0.72). Additionally, they have longer life expectancy (ranged from 3 years to approximately 15 years). Our study is crucial to evaluate potential health risks associated with Chinese medicine physicians. Although this study did not reveal elevated death rate among Chinese medicine physicians, researchers and policy makers should not overlook other heath problems that Chinese medicine physicians might have experienced.

Field-amplified sample stacking in capillary electrophoresis for on-column concentration of alkaloids in Sophora flavescens Ait.

A simple and rapid capillary zone electrophoresis method was developed for the separation of the main alkaloids from Sophora flavescens Ait. with the optimum buffer solution containing 110 mM NaH(2)PO(4) and 15% 2-propanol (pH 3.0). The field-amplified sample stacking (FASS) technique was applied to the on-line concentration of the alkaloids. The data presented in this work demonstrate that the use of a short water plug at the column inlet is essential for improving the reproducibility of FASS with electro-injection, and that the water plug injection time affected the sensitivity significantly. The sample concentration was further increased by about 2-3-fold by the introduction of a relatively longer water plug. With this stacking measure, the concentration sensitivity was about 3-4 orders of magnitude higher than in hydrodynamic injection.