Quantifying the effects of anomalies of temperature, precipitation, and surface water storage on diarrhea risk in Taiwan.

OBJECTIVES: Diarrheal disease continues to be a significant cause of morbidity and mortality. We investigated how anomalies in monthly average temperature, precipitation, and surface water storage (SWS) impacted bacterial, and viral diarrhea morbidity in Taiwan between 2004 and 2015. METHODS: A multivariate analysis using negative binomial generalized estimating equations was employed to quantify age-specific and cause-specific cases of diarrhea associated with anomalies in temperature, precipitation, and SWS. RESULTS: Temperature anomalies were associated with an elevated rate of all-cause infectious diarrhea at a lag of 2 months, with the highest risk observed in the under-5 age group (incidence rate ratio [IRR], 1.03, 95% confidence interval [CI], 1.01 to 1.07). Anomalies in SWS were associated with increased viral diarrhea rates, with the highest risk observed in the under-5 age group at a 2-month lag (IRR, 1.27; 95% CI, 1.14 to 1.42) and a lesser effect at a 1-month lag (IRR, 1.18; 95% CI, 1.06 to 1.31). Furthermore, cause-specific diarrheal diseases were significantly affected by extreme weather events in Taiwan. Both extremely cold and hot conditions were associated with an increased risk of all-cause infectious diarrhea regardless of age, with IRRs ranging from 1.03 (95% CI, 1.02 to 1.12) to 1.18 (95% CI, 1.16 to 1.40). CONCLUSIONS: The risk of all-cause infectious diarrhea was significantly associated with average temperature anomalies in the population aged under 5 years. Viral diarrhea was significantly associated with anomalies in SWS. Therefore, we recommend strategic planning and early warning systems as major solutions to improve resilience against climate change.

The impact of temperature and precipitation on all-infectious-, bacterial-, and viral-diarrheal disease in Taiwan.

BACKGROUND: The ongoing climate change will elevate the incidence of diarrheal in 2030-2050 in Asia, including Taiwan. This study investigated associations between meteorological factors (temperature, precipitation) and burden of age-cause-specific diarrheal diseases in six regions of Taiwan using 13 years of (2004-2016) population-based data. METHODS: Weekly cause-specific diarrheal and meteorological data were obtained from 2004 to 2016. We used distributed lag non-linear model to assess age (under five, all age) and cause-specific (viral, bacterial) diarrheal disease burden associated with extreme high (99th percentile) and low (5th percentile) of climate variables up to lag 8 weeks in six regions of Taiwan. Random-effects meta-analysis was used to pool these region-specific estimates. RESULTS: Extreme low temperature (15.30 °C) was associated with risks of all-infectious and viral diarrhea, with the highest risk for all-infectious diarrheal found at lag 8 weeks among all age [Relative Risk (RR): 1.44; 95 % Confidence Interval (95 % CI): 1.24-1.67]. The highest risk of viral diarrheal infection was observed at lag 2 weeks regardless the age. Extreme high temperature (30.18 °C) was associated with risk of bacterial diarrheal among all age (RR: 1.07; 95 % CI: 1.02-1.13) at lag 8 weeks. Likewise, extreme high precipitation (290 mm) was associated with all infectious diarrheal, with the highest risk observed for bacterial diarrheal among population under five years (RR: 2.77; 95 % CI: 1.60-4.79) at lag 8 weeks. Extreme low precipitation (0 mm) was associated with viral diarrheal in all age at lag 1 week (RR: 1.08; 95 % CI: 1.01-1.15)]. CONCLUSION: In Taiwan, extreme low temperature is associated with an increased burden of viral diarrheal, while extreme high temperature and precipitation elevated burden of bacterial diarrheal. This distinction in cause-specific and climate-hazard specific diarrheal disease burden underscore the importance of incorporating differences in public health preparedness measures designed to enhance community resilience against climate change.

Cordycepin augments the chemosensitivity of osteosarcoma to cisplatin by activating AMPK and suppressing the AKT signaling pathway.

BACKGROUND: Osteosarcoma is the most common primary bone tumor in children and adolescents. However, some patients with osteosarcoma develop resistance to chemotherapy, leading to a poor clinical prognosis. Hence, effective therapeutic agents that can improve the response to chemotherapy drugs to improve the prognosis of patients with osteosarcoma are urgently needed. Cordycepin has recently emerged as a promising antitumor drug candidate. This study aims to explore the effect of cordycepin in suppressing osteosarcoma in vivo and in vitro and the synergistic effect of cordycepin combined with cisplatin and to demonstrate the underlying molecular mechanism. METHODS: CCK-8 assay was performed to investigate the inhibition effect of cordycepin combined with cisplatin in osteosarcoma cell lines. The colony formation and invasion abilities were measured by colony formation assay and Transwell assay. Osteosarcoma cells apoptosis was detected by flow cytometry. Western blot analysis were used to detect the expression of cell apoptosis-related proteins and AMPK and AKT/mTOR signaling pathway-related proteins. Finally, we performed the in vivo animal model to further explore whether cordycepin and cisplatin exert synergistic antitumor effects. RESULTS: Notably, we found that treatment with cordycepin inhibited cell proliferation, invasion, and induced apoptosis in osteosarcoma cells in vitro and in vivo. Moreover, the combination of cordycepin and cisplatin led to marked inhibition of osteosarcoma cell proliferation and invasion and promoted osteosarcoma cell apoptosis in vitro and in vivo. Mechanistically, we demonstrated that cordycepin enhanced the sensitivity of osteosarcoma cells to cisplatin by activating AMPK and inhibiting the AKT/mTOR signaling pathway. CONCLUSIONS: In brief, this study provides comprehensive evidence that cordycepin inhibits osteosarcoma cell growth and invasion and induces osteosarcoma cell apoptosis by activating AMPK and inhibiting the AKT/mTOR signaling pathway and enhances the sensitivity of osteosarcoma cells to cisplatin, suggesting that cordycepin is a promising treatment for osteosarcoma.

Mortality and morbidity of asthma and chronic obstructive pulmonary disease associated with ambient environment in metropolitans in Taiwan.

BACKGROUND: This study investigated risks of mortality from and morbidity (emergency room visits (ERVs) and outpatient visits) of asthma and chronic obstructive pulmonary disease (COPD) associated with extreme temperatures, fine particulate matter (PM2.5), and ozone (O3) by sex, and age, from 2005 to 2016 in 6 metropolitan cities in Taiwan. METHODS: The distributed lag non-linear model was employed to assess age (0-18, 19-39, 40-64, and 65 years and above), sex-cause-specific deaths, ERVs, and outpatient visits associated with extreme high (99th percentile) and low (5th percentile) temperatures and PM2.5 and O3 concentrations at 90th percentile. Random-effects meta-analysis was adopted to investigate cause-specific pooled relative risk (RR) and 95% confidence intervals (CI) for the whole studied areas. RESULTS: Only the mortality risk of COPD in the elderly men was significantly associated with the extreme low temperatures. Exposure to the 90th percentile PM2.5 was associated with outpatient visits for asthma in 0-18 years old boys [RR = 1.15 (95% CI: 1.09-1.22)]. Meanwhile, significant elevation of ERVs of asthma for females aged 40-64 years was associated with exposure to ozone, with the highest RR of 1.21 (95% CI: 1.05-1.39). CONCLUSIONS: This study identified vulnerable subpopulations who were at risk to extreme events associated with ambient environments deserving further evaluation for adaptation.

[Clinical and genetic features of 45,X maleness: A case report and review of the literature].

OBJECTIVE: To explore the relationship between the clinical and genetic features of a short-statured azoospermia male with the karyotype of 45,X. METHODS: Using GTG-banded chromosome analysis, we performed karyotyping for a 150 cm-high infertile male with azoospermia and investigated the presence and location of the genes on the Y chromosome by FISH and PCR. RESULTS: GTG-banded chromosome analysis showed the karyotype of the patient to be 45,X,add(14)(p11). The results of PCR manifested the deletion of AZFa, AZFb, AZFc, and AZFd in the SRY gene. FISH revealed the translocation of the short arm of the Y chromosome to that of chromosome 14 and deletion of most proportions of its long arm, with the disruption site close to the centromere region. The karyotype of the patient was 45,X,der(Y)t(Y;14)(q11;q11.2), 14.ish (SRY+, CEP Y+ , DYZ1－). CONCLUSIONS: The karyotype of the patient was unbalanced Y/14 translocation. The SRY gene is the key to maleness. The deletion of AZFa－ d induces spermatogenic disturbance, and the deletion of the q arm of the Y chromosome may be related with short stature.

Sexual dysfunctions and psychological disorders associated with type IIIa chronic prostatitis: a clinical survey in China.

INTRODUCTION: Chronic prostatitis (CP) is a frequent prostate-related complaint, impacts negatively on quality of life and is mostly of unclear etiology. Increasing attention has been paid to the prevalence of sexual dysfunctions in CP patients; however, the impact of specific types of CP and the correlation of sexual dysfunctions with psychological disorders associated with CP are not well understood. Type IIIa CP is characterized by chronic pelvic pain, urination symptoms and white blood cells in expressed prostatic secretion, but free of bacterial infection. METHODS: A population of 600 type IIIa CP patients were randomly selected and 40 normal man were included as the control group. Queries were conducted by urologists. The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function (IIEF-5) and the Symptom Checklist 90-R were used to evaluate the symptoms and severity of prostatitis, erectile dysfunctions and psychological problems, respectively. Scores of ejaculatory pain and premature ejaculation were also collected. RESULTS: Our study revealed that sexual dysfunctions are frequently associated with this specific type of CP. The prevalence of erectile dysfunction, premature ejaculation and ejaculatory pain was 19, 30 and 30 %, respectively. A variety of psychological problems exist among type IIIa CP patients, including depression, anxiety, somatization, obsessive-compulsive and interpersonal sensitivity. In particular, the severity of erectile dysfunctions, but not premature ejaculation and ejaculatory pain, correlated significantly with depression and anxiety. CONCLUSION: Our data indicate that a moderate level of sexual dysfunctions exists among the type IIIa CP patients, and highlight the association of depression and anxiety with erectile dysfunction in CP patients, suggestting that special attention should be paid to these psychological issues in clinical treatments of the prostatitis symptoms and the associated erectile dysfunctions.

[Efficacy of transurethral resection of ejaculatory duct for treatment of ejaculatory duct obstruction: report of 60 cases].

OBJECTIVE: To evaluate the effect of transurethral resection of ejaculatory duct (TURED) for treatment of ejaculatory duct obstruction (EDO). METHODS: The clinical data of 60 cases of EDO from Oct. 2004 to Oct. 2010 were analyzed. The diagnostic criteria included semen analyses, fructose in seminal plasma, transrectal ultrasonography (TRUS), and vasography if necessary. All the patients were treated by TURED. Post-operative semen assay, postoperative patency rate and postoperative impregnation rate were followed. RESULTS: Semen analyses in the majority of cases showed the typical characteristics of EDO, azoospermia, low semen volume (average 1.10 ± 0.76 mL), low pH (average 6.5 ± 1.4), absent or low semen fructose (average 5.86 ± 2.19 µmol/one ejaculation). TRUS showed pure dilation of both ejaculatory ducts in 15 cases, prostatic cyst in 6, pure dilated seminal vesicles on both sides in 10, unilateral dilated seminal vesicle in 4, dilation of both ejaculatory duct and seminal vesicles in 10, dilated seminal vesicles with prostatic cyst in 5, unilateral dilated seminal vesicle and contralateral aplasia of seminal vesicle in 2, dilated seminal vesicles with dilation and calcifications of both ejaculatory ducts in 3. The remaining 5 had unilateral dilated ejaculatory duct and seminal vesicle with contralateral aplasia of seminal vesicle. In all the cases followed up more than 6 to 78 months after TURED, 51 patients (85.0%) had improved semen parameters and 16 patients' wives (26.7%) had pregnancies. CONCLUSION: TURED may be the simple, minimally invasive and effective method for the treatment of EDO.

[Surgical treatment of obstructive azoospermia: a report of 56 cases].

OBJECTIVE: To evaluate the diagnosis and surgical treatment of obstructive azoospermia. METHODS: We analyzed the clinical data of 56 cases of obstructive azoospermia, 43 of them with ejaculatory duct obstruction (EDO), and the other 13 suspected of epididymal obstruction. The diagnostic methods included semen analyses, measurement of fructose and neutral alpha-glucosidase in the seminal plasma, transrectal ultrasonography (TRUS), and vasography when necessary. The 43 patients with EDO were treated by transurethral resection of the ejaculatory duct (TURED), and 11 of the 13 cases of suspected epididymal obstruction were confirmed by scrotal exploration and underwent either bilateral or unilateral vasoepididymostomy. The patients were followed up for 3 -51 months for postoperative semen quality and impregnation. RESULTS: Of the 43 azoospermia patients with EDO treated by TURED, 36 (83.7%) showed improved semen parameters and 11 (25.6%) achieved pregnancies. Among the 11 cases of azoospermia with confirmed epididymal obstruction treated by vasoepididymostomy, 6 (54.5%) had sperm in the semen assay and 3 (27.3%) achieved pregnancies. CONCLUSION: Semen analyses, measurement of fructose and neutral alpha-glucosidase in the seminal plasma, TRUS and vasography are important diagnostic methods for obstructive azoospermia. TURED is effective for azoospermia with EDO, while vasoepididymostomy is preferable for the treatment of azoospermia with epididymal obstruction.