[Efficacy and outcomes of shunt surgery for secondary hydrocephalus].

Records of secondary hydrocephalus patients undergoing shunt surgery in the Department of Neurosurgery of Peking Union Medical College Hospital from September 2012 to April 2022 and their clinical characteristics and outcomes were retrospectively reviewed and analyzed. Among 121 patients who received first time shunt placement, the most common causes of secondary hydrocephalus were brain hemorrhage (55, 45.5%) and trauma (35, 28.9%). Cognition decline (106, 87.6%), abnormal gait (50, 41.3%) and incontinence (40, 33.1%) were the most prevalent manifestations. Postoperative central nervous system infection (4, 3.3%), shunt obstruction (3, 2.5%) and subdural hematoma/effusion (4, 3.3%) were the most frequent neurological complications. Overall incidence of postoperative complications was 9% (11 cases) in the current cohort. And 50.5% (54/107) of the patients receiving shunting achieved a Glasgow outcome scale (GOS) score of at least 4. Shunt surgery is preferred for secondary hydrocephalus, especially for secondary normal pressure hydrocephalus. Moreover, it is recommended to complete cranioplasty in staged operation or one-stage operation for the patients with decompressive craniectomy.

[The surgical treatment in adults with idiopathic normal pressure hydrocephalus].

Objective: To investigate the effect of Ventriculoperitoneal shunt (VPS)in adult patients with idiopathic normal pressure hydrocephalus (iNPH). Methods: The patients with idiopathic normal pressure hydrocephalus were reviewed, who were admitted into the Peking union medical college hospital from October 2010 to October 2016.The patients treated via VPS were retrospectively analyzed by collecting the data including clinic features, iNPH score and imaging data. Results: 33 patients were included in the group.3 months after operation, the iNPH scores were significantly decreased (3.0±1.0 vs 6.0±2.5, P<0.01), and there were no difference among 3 month, 6 month and 12 month post operation.The Evans index and the width of the three ventricles were also significantly decreased.1 patient suffered from subdural hematoma and no other complications such as infection, obstruction or death occurred. Conclusions: VPS is an effective treatment approach of iNPH and multidisciplinary team is the key in diagnosis.

[The diagnosis and treatment of systemic lupus erythematosus complicated with hydrocephalus].

Objective: To investigate the pathogenesis and management of the hydrocephalus in patients with systemic lupus erythematosus (SLE). Methods: Eight cases of hospitalized lupus patients with hydrocephalus in Peking Union Medical College Hospital from Jan 1990 to Mar 2017 were analyzed retrospectively.We collected the patients' medical records including medical history, CT and/or MRI images and analysis of cerebrospinal fluid via lumbar puncture in order to investigate the pathogenesis of the hydrocephalus in patients with SLE and summarize treatment experience. Results: All the 8 patients with SLE complicated with hydrocephalus were treated with steroids or immunosuppressive agents, and 5 cases were diagnosed with the central nervous system infection. Three cases received ventriculoperitoneal shunt, 5 cases received treatment of medicine.They all were followed up for 2-12 months, of which 3 cases were markedly effective, 1 case effective and 4 cases dead. Conclusion: The pathogenesis of lupus combined with hydrocephalus may have a certain relationship with the central infection, should take effective anti-infection treatment.We recommend cerebrospinal fluid shunt surgery intervention.

The Role of Uric Acid for Predicting Future Metabolic Syndrome and Type 2 Diabetes in Older People.

OBJECTIVE: Although it is known that high uric acid (UA) level is associated with type 2 diabetes (T2DM) and metabolic syndrome (MetS), most of the previous studies were focused on adults. Since aging becomes a major problem for many societies, in this longitudinal study, we investigated the role of UA in future T2DM and MetS in a large cohort of people who were older than 65 years. DESIGN: A cross-sectional and longitudinal study. SETTING/PARTICIPANTS: 18,907 elderly (9,732 men, 9,175 women) aged above 65 years, enrolled from health check-up centers, were classified into three subgroups by 10-year intervals (young old 65-74 years, YO; old old 75-84 years, OO; and oldest old 85-94 years, ODO), with the average follow-up period of 4.3 years. MEASUREMENTS: The optimal cut-off values (CoVs) of baseline UA to predict future MetS and T2DM were determined by receiving operating characteristic (ROC) curve analysis. Using these CoVs of UA, the participants were divided into normal- and high-level groups of UA. Cox proportional hazard analysis was used to calculate hazard ratios (HRs) for the subjects with a high level of UA for the risk of future MetS and T2DM. In addition, Kaplan-Meier plots and log rank test were used to evaluate the time effect on the incidence of developing MetS and T2DM between the two groups. RESULTS: In ROC curve analysis, the optimal CoVs of baseline UA were 6.0, 6.3 and 6.7 mg/dl in YO, OO, and ODO men, respectively; 5.5 and 4.9 mg/dl in YO and OO women, respectively (all p < 0.05). However, the CoVs of UA in ODO women (6.1 mg/dl) failed to show its discriminant power (p = 0.13). The Cox regression analysis showed the YO subjects with a higher baseline level of UA had a higher risk of developing MetS (HRs 1.56 and 1.58 for men and women, respectively, both p < 0.001); as for T2DM the HRs were 1.39 and 1.57. In OO men, the HRs was 1.89 for developing future MetS. However, no significant findings could be noted in the ODO group. Kaplan-Meier plots and log rank test also showed the same findings. CONCLUSION: Our study showed that old subjects with high levels of UA will have a higher chance to have MetS and T2DM, particularly in the YO group (6.0 mg/dl for men and 5.5 mg/dl for women, respectively). Using UA as one of the metabolic biomarkers may help clinicians to early detect and prevent MetS and diabetes.

Normal fasting plasma glucose predicts type 2 diabetes and cardiovascular disease in elderly population in Taiwan.

BACKGROUND: Hyperglycemia increases prevalence of metabolic syndrome (MetS), type 2 diabetes (T2D) and cardiovascular disease (CVD). But the role of normoglycemia on the development of T2D and CVD in elderly population remains unclear. AIM: To determine an optimal cut-off for fasting plasma glucose (FPG) to predict MetS and subsequent risk of T2D and CVD in an elderly Taiwanese population with normal FPG levels. DESIGN: Two stages included cross-sectional (Stage 1) and prospective (Stage 2) cohort study. METHODS: In Stage 1 18 287 subjects aged ≥60 years were enrolled; of these, 5039 without T2D and CVD advanced to Stage 2 and a mean follow-up of 3.8 years. MetS components were analysed, and in Stage 1, FPG cut-offs for MetS risk were calculated using receiver operating characteristic (ROC) curve analyses. In Stage 2, subjects without T2D and CVD in Stage 1 were classified into high-FPG and low-FPG groups based on cut-offs, and sex specific differences in incidence for T2D and CVD were calculated. RESULTS: ROC curve analysis gave an optimal FPG cut-off for MetS of 93 mg/dl and 92 mg/dl for males and females, respectively. The high-FPG group had a 1.599- and 1.353-fold higher chance of developing T2D compared with the low-FPG group for males and females, respectively (95% CI: 1.606-2.721 and 1.000-1.831, P = 0.015 and 0.05). The high-FPG group had a 1.24-fold higher chance of developing CVD for females (95% CI: 1.015-1.515, P = 0.035); however, there was no difference for males. CONCLUSIONS: Our results suggest that FPG within the normal range was associated with MetS, and elderly subjects with high normal levels have a higher incidence of developing T2D for both sexes, and CVD for females, over the short-term.

Associations between genetic variants and the severity of metabolic syndrome in subjects with type 2 diabetes.

Metabolic syndrome (MetS) includes obesity, dyslipidemia, elevated blood pressure, and dysglycemia. Subjects with type 2 diabetes (T2D) exhibit features of MetS. The etiology of MetS is complex, involving both environmental and genetic factors. In this study, we examined the role of specific candidate genetic variants on the severity of MetS in T2D subjects. A total of 240 T2D subjects aged 35-64 years were recruited. Waist circumstance, plasma triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, and blood pressure were measured to define MetS. Subjects were divided into 4 groups according to MetS components. Target genes involved in fibrotic and inflammatory processes, insulin and diabetes, cell growth and proliferation, and hypertension were genotyped. A total of 13 genes and 103 single-nucleotide polymorphisms (SNPs) were analyzed to evaluate their genetic association with MetS severity in T2D subjects. Univariate ordinal logistic regression using a dominant model (homozygous for the major allele vs carriers of the minor allele) revealed 6 SNP markers within 4 genes with genotypes associated with MetS risk. For the SNP genotypes of rs362551 (SNAP25), rs3818569 (RXRG), rs1479355, rs1570070 (IGF2R), and rs916829 (ABCC8), heterozygotes showed a lower risk of MetS compared with the reference group. In addition, the CC genotype was comparable to the TT genotype for rs3777411. There was no gender-specific effect. In conclusion, our results suggest that among the Han Chinese population, several SNPs increase the risk of severe MetS in T2D subjects. Further study in a large population should be conducted.

Higher normal range of fasting plasma glucose still has a higher risk for metabolic syndrome: a combined cross-sectional and longitudinal study in elderly.

INTRODUCTION: It is well known that higher fasting plasma glucose (FPG) is associated with metabolic syndrome (MetS). This relationship still exists even the FPG is within the normal range. However, most of these studies did not exclude subjects who were on medications which would affect the results of the studies. At the same time, there is no longitudinal study done to validate this correlation, especially in elderly. In this study, the relationships between normal FPG and MetS were evaluated. METHOD: We randomly selected 57,517 subjects who were ≥ 60-years old from health screening centre. In the first part of study, subjects were enrolled in the cross-sectional study to find out the optimal cut-off value of FPG with higher chances to have MetS. In the second part of current study, subjects with MetS at baseline were excluded from the same study group, and performed a median 5.3-year longitudinal study. RESULTS: There were 18,287 subjects enrolled in this study. In the first part of study, the cross-sectional study, optimal cut-off values of FPG were determined by the ROC curve and the sensitivity for these cut-off values were 56.6% in men and 60.9% in women, respectively. The result showed that lower FPG is healthier than the higher (log-rank test, p < 0.001). During the follow-up period, 5039 subjects showed hazard ratios of 2.09 for men and 1.884 for women developing future MetS. CONCLUSION: Our study is the first longitudinal design in elderly and showed that older subjects with higher FPG proved to have higher risk of Mets even the FPG is still within its normal range.

Treatment of acute paraquat intoxication using recommended megadose of vitamin C: a reappraisal.

Megadose of vitamin C (MVC) has been proposed for an emergent treatment of acute paraquat (PQ) poisoning. However, the safety issue of this treatment protocol has not been evaluated. Here, we present the first evidence that vitamin C can promote aggravated production of hydroxyl radical (OH(•)) via interacting with preexisting PQ(+•)/H2O2 system in a nonmetal-catalyzed manner. This enhanced oxidative stress would therefore expect to cause more deleterious effect during acute PQ intoxication. To lend support to this possibility, we set out to attest the effects of MVC on a simulated, PQ-intoxicated, Madin-Darby canine kidney (MDCK) cell model. First, PQ alone could trigger oxidative-nitrosative stress (ONS) through robust generation of reactive oxygen species and nitric oxide (NO) that could induce apoptotic killing via promoting effective release of mitochondrial cytochrome c, an apoptogenic factor. The percentage of apoptosis for MDCK cells treated with 1.0 mM PQ for 24 h was 16.3 ± 13.0%. However, when MDCK cells were treated with a combination of PQ (1.0 mM) and MVC (20 mM) for 24 h, the severity of apoptotic killing was further exacerbated as reflected by a nearly 7-fold increase in the release of mitochondrial cytochrome c and the percentage of apoptotic cell population rose sharply to 90.7 ± 5.1%. These data indicate that MVC apparently exacerbates further killing rather than cytoprotection on this simulated, PQ-intoxicated MDCK cell model and suggest that the treatment of PQ poisoning using MVC protocol should be cautious.

A path to ultranarrow patterns using self-assembled lithography.

The templated self-assembly of block copolymer (BCP) thin films can generate regular arrays of 10-50 nm scale features with good positional and orientational accuracy, but the ordering, registration and pattern transfer of sub-10-nm feature sizes is not well established. Here, we report solvent-annealing and templating methods that enable the formation of highly ordered grating patterns with a line width of 8 nm and period 17 nm from a self-assembled poly(styrene-b-dimethylsiloxane) (PS-PDMS) diblock copolymer. The BCP patterns can be registered hierarchically on a larger-period BCP pattern, which can potentially diversify the available pattern geometries and enables precise pattern registration at small feature sizes. Sub-10-nm-wide tungsten nanowires with excellent order and uniformity were fabricated from the self-assembled patterns using a reactive ion etching process.

Synthesis and biological activity of Wuweizisu C and analogs.

Lignans are widely distributed in nature. The earliest recorded medicinal use of lignans dated back to over 1000 years ago. Lignan-rich plant products were also active ingredients in Chinese and Japanese folk medicines for the treatment of various diseases. The dried root and stem of this plant are listed in the Chinese pharmacopoeia for the treatment of rheumatoid arthritis, gastric, duodenal ulcers and many other diseases. This review highlights synthetic strategies for the Wuweizisu C analogs and the important pharmacological activities as well as therapeutic findings related to the treatment of HBV and other diseases. Notably a significant and ongoing project on Wuweizisu C and its analogs has led to the discovery and development of two potent derivatives alpha-DDB and BICYCLOL which are currently in clinical trials against HBV, especially in lowering elevated SGPT levels. Further design, synthesis, and evaluation of Wuweizisu C analogs are discussed.

ApoE epsilon4 allele is associated with incidental hallucinations and delusions in patients with AD.

Of 135 patients with Alzheimer disease (AD), 56 without psychiatric symptoms at the first visit were followed for a mean period of 51.9 +/- 10.3 months to identify incident psychiatric symptoms. The hazard ratios of ApoE epsilon4 allele in developing psychiatric symptoms were calculated by Cox regression hazard analyses. The presence of the ApoE epsilon4 allele carried a 19.0-fold risk for developing hallucinations and a 3.4-fold risk for delusions.

The effect of surgical stress on insulin sensitivity, glucose effectiveness and acute insulin response to glucose load.

Hyperglycemia after stress is a very common clinical phenomenon. It is generally hypothesized that the underlying cause is a neuroendocrine-mediated deterioration in glucose metabolism. However, the detailed roles of insulin sensitivity, glucose effectiveness and acute insulin response to glucose load in response to stress have not been well established. Hernioplasty was used as a minor stress model for studying stress-induced hyperglycemia. Eleven healthy young men were enrolled voluntarily in this study. Their mean age was 22.0 +/- 0.9 yr and BMI 23.3 +/- 0.6 kg/m2. Frequently sampled i.v. glucose tolerance tests were performed one day before and one day after the surgery. Insulin sensitivity (SI), glucose effectiveness (EG) and area under acute insulin response (AIR) were calculated from "minimal model" algorithms. We also measured fasting concentrations of human GH, ACTH and F on the days of the test. Compared to the pre-operation data, levels of ACTH and F did not change significantly after the surgery. Only GH levels were marginally significant. On the other hand, the SI (0.75 +/- 0.1, 0.52 +/- 0.9 x 10(-5) min(-1)/pmol, p = 0.04), EG (0.023 +/- 0.03, 0.016 +/- 0.003 min(-1), p = 0.01) and AIR (6738.5 +/- 1111.6, 5130.0 +/- 1047.2 pmol, p = 0.005) were all significantly decreased after surgery. The percentages of decrease were 16.3 +/- 15.5, 32.1 +/- 10.3 and 17.8 +/- 10.3%, respectively. Finally, only the changes of EG positively correlate with the changes of ACTH before and after surgery. No significant changes were noted among other stress hormones and the changes of SI, EG and AIR. In conclusion, hernioplasty results in reduced SI, EG and AIR. Among them, although not statistically significant, the EG showed the most distinct decrease after the surgery, which has not been found in previous literature.

Plasma C-reactive protein concentrations in relation to 5-year body weight change among children: the Taipei Children Heart Study.

OBJECTIVE: C-reactive protein (CRP), a nonspecific inflammatory marker, may be associated with the development of cardiovascular disease (CVD) among adults. The purpose of this study is to evaluate the relation between plasma CRP levels and 5-y body weight and body mass index (BMI) change among school children in Taiwan. METHOD: In 1995, we conducted an epidemiological survey to evaluate the anthropometric characteristics and CVD risk factors among 1500, aged 12-15 y, school children in Taipei. We measured plasma high sensitivity CRP levels using nephelometric method. In 2000, we followed these children to evaluate their changes in body height, weight and BMI during 5 y. RESULTS: In general, boys were taller, heavier and had higher BMI than girls at the baseline (1995) and at the 5-y follow-up (2000). Baseline plasma CRP levels were positively correlated with body weight and BMI in both 1995 and 2000. However, plasma CRP levels were negatively correlated with 5-y BMI change in both genders. We further divided the children into three subgroups based on their baseline CRP levels (nondetected, 0.188-1.00 and >1.0 mg/dl). Children in the higher plasma CRP levels (>1.0 mg/dl) were heavier and had higher BMI (both in 1995 and 2000) than those children with nondetected CRP levels. However, children with higher CRP subgroup had a lower 5-y increasing of BMI and there was even a decrease of BMI levels among the higher CRP girls. CONCLUSION: From this prospective study, we found that baseline plasma CRP levels were positively correlated with the baseline and the 5-y follow-up body weight and BMI in both genders. However, plasma CRP levels may not be a good predictor of 5-y body weight and BMI changes among children in Taiwan.

Determinants and distributions of plasma total homocysteine concentrations among school children in Taiwan.

BACKGROUND: Plasma total homocysteine (tHcy) level is an independent risk factor for cardiovascular disease (CVD) even among children. The purpose of this study is to evaluate the determinants and distributions of plasma tHcy levels and the relationship between plasma tHcy, folate and vitamin B12 levels among school children in Taipei. METHODS: After multi-stage sampling, we randomly selected 1234 school children (609 boys and 625 girls) with the mean age of 13 years (from 12 to 15 years) in this study. Fasting plasma tHcy levels were measured using an ABBOTT IMx analyzer (Axis Biochemicals ASA, Oslo, Norway). Plasma folate and vitamin B12 levels were measured by ACS:180 automated chemiluminescence analyzer (Bayer, Tarrytown, NY, USA). RESULTS: The distribution of plasma tHcy levels were skewed to the right with the mean values of 10.50 and 8.95 micromol/l and medians of 9.67 and 8.474 micromol/l for boys and girls, respectively. Plasma tHcy concentrations were lower in younger children and progressively increased with increasing age. Boys had significantly higher plasma tHcy levels than girls (10.50 +/- 4.134 vs. 8.95 +/- 2.61 micromol/l, p < 0.01) and lower plasma folate levels (6.05 +/- 2.85 vs. 6.39 +/- 2.58 nmol/l, p < 0.01), and vitamin B12 levels (444.8 +/- 158.4 vs. 495.0 +/- 181.5 pmol/l, p < 0.001). Plasma tHcy levels were significantly positively associated with anthropometric measures in boys; but these characteristics attenuated and became insignificant after adjusting for other potential confounders in girls. Plasma tHcy levels were negatively associated with plasma folate and vitamin B12 levels even after adjusting for BMI and other potential confounders in both genders. CONCLUSIONS: From this study, the distributions of tHcy levels were skewed to the right and the boys had higher plasma tHcy levels than girls. Plasma tHcy levels were significantly positively associated with BMI among boys. Further studies are needed to evaluate the relationship between tHcy and CVD risk factors among children for the better prevention of heart disease in early life.

Spread of 60Co contaminated steel and its legal consequences in Taiwan.

Since 1992, over 200 civilian residential and school buildings in Taiwan have been identified to have contained 60Co contaminated steel rebar emitting excessive gamma-radioactivity in living environments. These buildings were mostly constructed in early 1983 and 1984 by employing steels from one steel mill, which had recycled unknown 60Co orphan sources in northern Taiwan. In 1994, a group of residents who once stayed for a protracted period up to 10 y in the contaminated Ming-Sheng Villa filed a civil action against Taiwan's nuclear regulatory office, the Atomic Energy Council, for state tort compensation of 3.4 M U.S. dollars in equivalent. After three years of court processes, the Taipei District Court handed down a decision in partial favor of the exposed residents. Both parties soon appealed against this judgment to the Taiwan Appellate Court. This article analyzes the main legal issues involved, including government's obligations to prevent and eliminate contamination, to take preventive measures, and to take necessary remedial measures; and plaintiffs' assertion on any legal right against governmental offices. Moreover, discussion issues contain the scope of damage and compensation, causation analysis, absence of effective and efficient regulation over radioactive contamination, limit of tort compensation law and compensation amount, weight of medical evidence as well as role of expert witnesses, and related comparative legal studies.

Infrainguinal revascularizations in octogenarians and septuagenarians.

OBJECTIVE: Severe atherosclerosis is a major contributor for death in octogenarians and a cause of multiple vascular-related ailments, including claudication and limb loss. Advanced age and health may limit the success of limb-salvaging procedures. Mortality, morbidity, and outcome of infrainguinal grafts have been examined in octogenarians and septuagenarians. METHODS: After 128 femoropopliteal and 99 femorotibial bypass grafts in 209 octogenarians and 242 femoropopliteal and 166 femorotibial bypass grafts in 383 septuagenarians, survival, primary patency, limb salvage, myocardial infarction and stroke rates were determined. The survival, myocardial infarction, and stroke rates of controls, 1514 octogenarians and 2011 septuagenarians, were compared. RESULTS: After a bypass graft, 5-year survival of octogenarians (54%) and septuagenarians (64%) was similar (P >.2) and was 89% and 89% for controls. The 5-year primary patency rates were 74% for octogenarians and 68% for septuagenarians (P >.2). Five-year limb salvage rates were 86% for octogenarians and 86% for septuagenarians. After a bypass graft, the respective rates of myocardial infarction were 4.1% and 3.9% per year and of a stroke 3.2% and 3.2% per year for octogenarians and septuagenarians, which occurred more frequently (P <.05) than in controls. CONCLUSIONS: Death and cardiovascular events are higher after revascularization in octogenarians and septuagenarians, compared with controls, and are related to the severity of atherosclerosis and not age. Patency rates are excellent and similar. Limb salvage procedures should be considered for most octogenarians.

Lipoprotein profiles, not anthropometric measures, correlate with serum lipoprotein(a) values in children: the Taipei children heart study.

OBJECTIVE: Plasma lipoprotein(a) [Lp(a)] is a risk factor for cardiovascular disease. The purpose of this study is to evaluate the correlation of anthropometric measures, lipids and lipoprotein profiles and serum Lp(a) values among children in Taiwan. We will attempt to find parameters that will be able to predict Lp(a) levels in children. DESIGN AND METHODS: After a probability-proportional-to size, multi-stages sampling procedure, we randomly sampled 1500 schoolchildren from 10 schools in Taipei city. Anthropometric measures including body weight, body height, waist and hip circumference and skinfolds were measured. We used standard methods to measure serum total cholesterol (CHOL), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), apolipoprotein A1 and B (ApoA1 and ApoB) and Lp(a) levels. We also calculated low density lipoprotein-cholesterol (LDL-C) and CHOL HDL-C ratio (TCHR) by formula. RESULTS: We sampled 1283 children (635 boys and 648 girls) with a mean age of 13.3 years (from 12 to 16 years) in this study. The mean and medium serum Lp(a) levels were 16.8 and 8.8 mg/dl among boys and 20.8 and 11.9 mg/dl among girls. Children in the highest quintile of Lp(a) (mean = 49.6 and 58.6 mg/dl for boys and girls, respectively) had higher CHOL, LDL-C, ApoB levels and TCHR than children in the lowest quintile (mean = 3.1 and 3.7 mg/dl for boys and girls, respectively). Lipids and lipoprotein profiles, such as CHOL, LDL-C, Apo-B and TCHR were positively correlated with Lp(a) levels in both genders. Furthermore, the children with Lp(a) levels greater than or equal to 30 mg/dl had higher CHOL, LDL-C and Apo-B levels when compared to children with Lp(a) levels less than 30 mg/dl. After adjusting for age, cigarette smoking, alcohol drinking, puberty development and heart rates, LDL-C and ApoB levels were significantly positively associated with Lp(a) levels while ApoA1 was negatively associated among boys. Among girls, only Apo-B was significantly positively associated with Lp(a) and TG was negatively associated with Lp(a) levels. Most importantly, none of the anthropometric measures were significantly correlated with Lp(a) levels. CONCLUSIONS: From this study, we found that lipids and lipoproteins profiles, rather than degree of adiposity as reflected by anthropometric measures, are significantly associated with serum Lp(a) levels among school children.

Relationship between single voided urine protein/creatinine ratio and 24-hour urine protein excretion rate among children and adolescents in Taiwan.

BACKGROUND: As there have been few studies conducted on children or adolescents, the purpose of this study was evaluate the relationship between single voided urine protein/creatinine (Up/Ucr) ratio and 24-hour urine protein excretion rate (PER), especially among children and adolescents in Taiwan. METHODS: After multistage random sampling, we collected 1,072 fasting single voided urine samples and 125 24-hour urine samples from seven- to 18-year-old students in Taiwan. We calculated the Up/Ucr of single voided urine samples and the 24-hour PER in urine. RESULTS: The mean value and the 95th percentile of the fasting single voided urine Up/Ucr ratio were 0.118 and 0.235, respectively. The mean value and the 95th percentile of the 24-hour PER were 3.61 and 5.66 mg/h/m2, respectively. There was no significant difference in Up/Ucr ratio between boys and girls. Up/Ucr ratio decreased significantly as age increased. The fasting single voided Up/Ucr ratio was highly correlated with 24-hour PER, with r2 = 0.95 (p < 0.001). CONCLUSIONS: Fasting single voided Up/Ucr ratio is a good marker of 24-hour PER. It is also a simple, easy, convenient and speedy method to measure Up excretion. The single voided Up/Ucr ratio may also serve as a reference for the clinical diagnosis of Up excretion among normal subjects.

[Direct optical resolution of acidic biphenyl drugs by high performance liquid chromatography on tris(3,5-dimethylphenylcarbamate) of cellulose].

A chiral stationary phase was prepared by coating cellulose-tris(3, 5-dimethylphenylcarbamate) onto aminopropylated silica gel. A series of enantiomeric acidic biphenyl drugs were directly resolved on the chiral stationary phase (CSP) by normal-phase high performance liquid chromatography (HPLC). A hexane-2-propanol eluting system containing 1% of trifluoroacetic acid was used as mobile phase. Efficient optical resolution of the acidic biphenyl drugs has been attained. The factors that influence chiral discrimination such as structural characeristic of the samples and mobile phase were investigated. An interaction model between the stationary phase and the samples was discussed. The results showed that efficient optical resolution of racemic carboxylic acids could be attained by normal-phase HPLC on CSP using a hexane-2-propanol eluting system containing 1% of trifluoroacetic acid.