Use of Facebook by Academic Medical Centers in Taiwan During the COVID-19 Pandemic: Observational Study.

BACKGROUND: The battle against COVID-19 remains ongoing, and social media has played an important role during the crisis for both communication and health promotion, particularly for health care organizations. Taiwan's success during the COVID-19 outbreak is well known and the use of social media is one of the key contributing factors to that success. OBJECTIVE: This nationwide observational study in Taiwan aimed to explore the use of Facebook by academic medical centers during the COVID-19 pandemic. METHODS: We conducted a nationwide observational study of all Facebook fan page posts culled from the official accounts of all medical centers in Taiwan from December 2019 to April 2020. All Facebook posts were categorized into either COVID-19-related posts or non-COVID-19-related posts. COVID-19-related posts were split into 4 categories: policy of Taiwan's Center for Disease Control (TCDC), gratitude notes, news and regulations from hospitals, and education. Data from each post was also recorded as follows: date of post, headline, number of "likes," number of messages left, number of shares, video or non-video post, and date of search. RESULTS: The Facebook fan pages of 13 academic medical centers, with a total of 1816 posts, were analyzed. From January 2020, the percentage of COVID-19 posts increased rapidly, from 21% (January 2020) to 56.3% (April 2020). The trends of cumulative COVID-19 posts and reported confirmed cases were significantly related (Pearson correlation coefficient=0.93, P<.001). Pages from private hospitals had more COVID-19 posts (362 versus 289), as well as more video posts (72 posts, 19.9% versus 36 posts, 12.5%, P=.011), when compared to public hospitals. However, Facebook pages from public hospitals had significantly more "likes," comments, and shares per post (314, 5, 14, respectively, P<.001). Additionally, medical centers from different regions displayed different strategies for using video posts on Facebook. CONCLUSIONS: Social media has been a useful tool for communication during the COVID-19 pandemic. This nationwide observational study has helped demonstrate the value of Facebook for academic medical centers in Taiwan, along with its engagement efficacy. We believe that the experience of Taiwan and the knowledge it can share will be helpful to health care organizations worldwide during our global battle against COVID-19.

A Strategic Imperative for Promoting Hospital Branding: Analysis of Outcome Indicators.

BACKGROUND: Optimizing the use of social media to promote hospital branding is important in the present digital era. In Taiwan, only 51.1% of hospitals have official Facebook fan pages. The numbers of likes for these hospitals are also relatively low. OBJECTIVE: Our objective was to establish a special branding team for social media operation, led by top administrators of our hospital. Here we present our strategic imperative for promoting hospital branding as well as an analysis of its effectiveness. METHODS: Led by top administrators, the branding team was formed by 11 divisions to create branding strategies. From 2016 to 2018, the team implemented action plans. All information unique to the hospital was posted on Facebook, as well as on the hospital's official website. To determine the plans' efficiencies, we obtained reference data from Google Analytics, and we compared Facebook Insights reports for 2016 with those for 2017 and 2018. RESULTS: One of the branding team's main missions was to establish branding strategies and to integrate segmental branding messages. In each quarter we regularly monitored a total of 52 action plan indicators, including those for process and outcome, and discussed the results at team meetings. We selected 4 main performance outcome indicators to reflect the effectiveness of the branding efforts. Compared with 2016, the numbers of likes posted on the Facebook fan page increased by 61.2% in 2017 and 116.2% in 2018. Similarly, visits to the hospital website increased by 4.8% in 2017 and 33.1% in 2018. Most Facebook fan page and website viewers were in 2 age groups: 25 to 34 years, and 35 to 44 years. Women constituted 60.42% (14,160/23,436) of Facebook fans and 59.39% (778,992/1,311,605) of website viewers. According to the Facebook Insights reports, the number of likes and post sharing both increased in 2017 and 2018, relative to 2016. Comment messages also increased from 2016 to 2018 (P=.02 for the trend). The most common theme of posts varied over time, from media reports in 2016, to innovative services in both 2017 and 2018. Likes for innovative services posts increased from 2016 through 2018 (P=.045 for the trend). By the end of 2018, we recorded 23,436 cumulative likes for posts, the highest number among medical centers in Taiwan. CONCLUSIONS: We achieved the largest number of Facebook fans among all medical centers in Taiwan. We would like to share our experience with other hospitals that might be interested in engaging in social media for future communications and interactions with their patients.

Existence and stability of traveling wavefronts for discrete three species competitive-cooperative systems.

The purpose of this work is to investigate the existence and stability of traveling wavefronts for competitive-cooperative systems with three species. The existence result can be derived by using the technique of monotone method with the help of a pair of explicit supersolution and subsolution. Moreover, some su cient conditions ensure the linear determinacy for the minimal speed is given. Then, applying the weighted energy method, we prove that the traveling wavefronts are asymptotically stable in the weighted Banach spaces provided that the initial perturbations of the traveling wavefronts also belong to the same spaces.

[Spatial Distribution, Sources and Bioavailability of Heavy Metals in the Surface Sediments of Longjiang River, Southern China].

In order to evaluate the pollution status, possible sources, and bioavailability of heavy metals (As, Cd, Pb, Sb, Zn, and Tl), 33 surface sediments were collected from Longjiang River, Southern China. The total concentrations and potential bioavailable concentrations of the heavy metals were analyzed using ICP-MS. Enrichment factors (EFs), Pearson correlation analysis, and principal component analysis (PCA) were used to further assess their pollution degree and potential sources. Results showed that the surface sediments of Longjiang River have been suffering heavy metal (As, Cd, Pb, Sb, and Zn) pollution to different degrees. The maximum concentrations of As, Cd, Pb, Sb, and Zn were 67.0, 7.42, 227, 229, and 807 mg·kg-1, respectively, while the Tl concentration were very low, with little variation. Moreover, the polluted sites were mostly located in the mid-lower of the main stem and in tributaries (Dongxioajiang and downstream of Dahuanjiang), and the pollution degree of the heavy metals, in a descending order, were Cd > Sb > Zn > Pb > As > Tl. Pearson correlation analysis and PCA indicated that As, Cd, Pb, Sb, and Zn predominantly originated from anthropogenic inputs, including nonferrous metal mining and smelting, municipal sewage, and agricultural activities, and Tl mostly derived from natural rock weathering. The bioavailability of heavy metals in the sediments tended to be controlled by their sources. The percentages of bioavailable heavy metals (As, Cd, Pb, Sb, and Zn) in the highly anthropogenic impacted areas (the mid-lower of the main stem and downstream of Dongxiaojiang tributary) were also high, with the average percentages of bioavailable As, Cd, Pb, Sb, and Zn of 26%, 51%, 49%, 38%, and 47%, respectively. High EF values and high bioavailable percentages of heavy metals easily and greatly cause high ecological risk of Longjiang River.

A nomogram predicting re-operation due to secondary hemorrhage after monopolar transurethral resection of prostate.

We aim to develop a nomogram to predict re-operation due to secondary hemorrhage after Monopolar transurethral resection of the prostate (M-TURP). We identified patients undergoing M-TURP at Peking University First Hospital from 2000 to 2013. Univariate and multivariate logistic regression models were developed to predict the occurrence re-operation due to secondary hemorrhage. The discriminatory ability of the nomogram was tested using the area under the receiver operating characteristic curve (ROC), and internal validation was performed via bootstrap resampling. Of the 1901 patients who underwent M-TURP during the study period, 9.1% (173 patients) experienced hemorrhage after M-TURP, and they had a 22.0% re-operation rate (38 patients). Benign prostatic hyperplasia (BPH)-related complications (odds ratio, 0.386; 95% CI, 0.177-0.841), percent of resected prostate (OR, 0.156; 95% CI, 0.023-1.060) and suprapubic cystostomy (OR, 0.298; 95% CI, 0.101-0.881) were independently associated with re-operation. The nomogram accurately predicted re-operation (area under the ROC curve 0.718). The negative predictive value was 88.0%, while the positive predictive value was 47.9%. Re-operation due to secondary hemorrhage after M-TURP was associated with no BPH-related complications, lower percent of resected prostate and no suprapubic cystostomy and was accurately predicted with using the nomogram.

Suprapubic cystostomy versus nonsuprapubic cystostomy during monopolar transurethral resection of prostate: a propensity score-matched analysis.

We aim to reassess the safety of the monopolar transurethral resection of the prostate (M-TURP) without suprapubic cystostomy at our institution over the past decade. This retrospective study was conducted in patients who underwent M-TURP at Peking University First Hospital between 2003 and 2013. A total of 1680 patients who had undergone M-TURP were identified, including 539 patients in the noncystostomy group and 1141 patients in the cystostomy group. After propensity score matching, the number of patients in each group was 456. Smaller reductions in hemoglobin and hematocrit (10.9 g vs 17.6 g and 3.6% vs 4.7%, respectively) were found in the noncystostomy group. In addition, patients undergoing surgery without cystostomy had their catheters removed earlier (4.6 days vs 5.2 days), required shorter postoperative stays in the hospital (5.1 days vs 6.0 days), and were at lower risk of operative complications (5.7% vs 9.2%), especially bleeding requiring blood transfusion (2.9% vs 6.1%). Similar findings were observed in cohorts of prostates of 30-80 ml and prostates >80 ml. Furthermore, among patients with a resection weight >42.5 g or surgical time >90 min, or even propensity-matched patients based on surgical time, those with cystostomy seemed to be at a higher risk of operative complications. These results suggest that M-TURP without suprapubic cystostomy is a safe and effective method, even among patients with larger prostates, heavier estimated resection weights, and longer surgical times.

Correlation of benign prostatic obstruction-related complications with clinical outcomes in patients after transurethral resection of the prostate.

We aim to investigate the correlation of benign prostatic obstruction (BPO)-related complications with clinical outcomes in patients after transurethral resection of the prostate in China. We reviewed the medical history of all patients who underwent surgery from 1992 to 2013. We assessed the preoperative clinical profile, clinical management, and operative complications. Overall, 2271 patients were enrolled in the study. Of these patients, 1193 (52.5%) had no BPO-related complications and 1078 (46.3%) had BPO-related complications. Compared with patients without BPO-related complications, those with BPO-related complications were older (p = 0.001) and usually had other urologic comorbidities (p = 0.003). Additionally, they tended to have more tissue resected (p < 0.001), a higher American Society of Anesthesiologists grade (p = 0.002), and larger prostates (p < 0.001). Nonetheless, there was no obvious difference in surgical complications between both groups (p > 0.05). Among patients with BPO-related complications, compared with the bladder stone group, only the bladder stone+ group tended to have a greater urinary infection risk after transurethral resection of the prostate. Compared with patients with one or two BPO-related complications, those with three BPO-related complications tended to have a higher risk of pulmonary embolism and acute coronary syndrome (p < 0.05). Despite the widespread use of medication, patients with BPO-related complications were older and had larger prostates; however, transurethral resection of the prostate is still considered a safe and recommended surgical treatment. Nevertheless, those with three or more complications were at a higher risk of severe complication after surgery, and active surgical intervention is needed once BPO-related complications develop.

Anthropogenic Cycles of Arsenic in Mainland China: 1990-2010.

Arsenic (As) is a trace element in the global environment with toxicity to both humans and ecosystem. This study characterizes China's historical anthropogenic arsenic cycles (AACs) from 1990 to 2010. Key findings include the following: (1) the scale of China's AACs grew significantly during the studied period, making China the biggest miner, producer, and user of arsenic today; (2) the majority of arsenic flows into China's anthroposphere are the impurity of domestically mined nonferrous metal ores, which far exceeds domestic intentional demands; (3) China has been a net exporter of arsenic trioxide and arsenic metalloid, thus suffering from the environmental burdens of producing arsenic products for other economies; (4) the growth of arsenic use in China is driven by simultaneous increases in many applications including glass making, wood preservatives, batteries, semiconductors, and alloys, implying the challenge for regulating arsenic uses in multiple applications/industries at the same time; (5) the dissipative arsenic emissions resulting from intentional applications are at the same order of magnitude as atmospheric emissions from coal combustion, and their threats to human and ecosystem health can spread widely and last years to decades. Our results demonstrate that the characterization of AACs is indispensable for developing a complete arsenic emission inventory.

[Spatial Distribution Characteristics and Potential Ecological Risk of Antimony and Selected Heavy Metals in Sediments of Duliujiang River].

In order to investigate the spatial distribution characteristics of Sb and selected heavy metals, and to discriminate their sources and potential ecological risks in surface sediments of the Duliujiang river,a total of 62 surface sediment samples were collected in this study. Total contents of Sb, As, Cd, Co, Cr, Cu, Mo, Ni, Pb, Tl, Zn and Fe in these samples were measured by inductively coupled plasma mass spectrometry(ICP-MS) and the inductive plasma optical emission spectrometry(ICP-OES). Principal component analysis(PCA) and Pearson correlation analysis were used to deduce the potential sources of these elements. Geo-accumulation index(Igeo), enrichment factor(EF) and Hakanson's potential ecological risk index(Eri and RI) were calculated to evaluate the pollution degree of heavy metals in sediments. The results indicated that the contents of heavy metals in sediments were impacted by human activities to different extents, and the Duliujiang River was significantly contaminated by Sb. The contents of Sb in sediments reached up to 7080 mg·kg-1, and gradually decreased from upstream to downstream, while the contents of As, Cd, Co, Cr, Cu, Mo, Ni, Pb, Tl and Zn varied indistinctively. The PCA results showed that the cumulative proportion of the first two components accounted for 77.67% of the total variables, suggesting that two major sources of Sb and other heavy metals were mining/smelting industry and natural sources. The calculated Igeo and EFs also showed that the surface sediments of the Duliujiang River were majorly polluted by Sb, followed by As and Co, lightly contaminated with Co, Cu, Mo, Ni, Pb and Tl, and uncontaminated with Cr. The ecological hazards(Eri) for each metals in a descending order were Sb > Cd > As > Co > Ni > Pb > Cu > Zn > Cr. The comprehensive index of potential ecological risks(RI) for heavy metals indicated that 58.1% of the 62 sediments samples had more than moderate ecological risks, and the sites with high RIs were generally located around Sb mining area and the downstream of the Baluo River. In addition, the Eri of Sb was a predominant component of RI, indicating that the Duliujiang River is an area with extremely high potential ecological risk of Sb.

PDZ1 inhibitor peptide protects neurons against ischemia via inhibiting GluK2-PSD-95-module-mediated Fas signaling pathway.

Respecting the selective inhibition of peptides on protein-protein interactions, they might become potent methods in ischemic stroke therapy. In this study, we investigated the effect of PDZ1 inhibitor peptide on ischemic neuron apoptosis and the relative mechanism. Results showed that PDZ1 inhibitor peptide, which significantly disrupted GluK2-PSD-95 interaction, efficiently protected neuron from ischemia/reperfusion-induced apoptosis. Further, PDZ1 inhibited FasL expression, DISC assembly and activation of Caspase 8, Bid, Caspase 9 and Caspase 3 after global brain ischemia. Based on our previous report that GluK2-PSD-95 pathway increased FasL expression after global brain ischemia, the neuron protection effect of PDZ1 inhibitor peptide was considered to be achieved by disrupting GluK2-PSD-95 interaction and subsequently inhibiting FasL expression and Fas apoptosis pathway.

[Effects of Compound Aconitum Polysaccharide on Glycosylation of Tumor Cells].

Objective To observe inducing or inhibiting effects of Chinese medicine (CM) poly- saccharides on glycoprotein chain synthetized different glycosyltransferases, thus disclosing targets of CM polysaccharides and its mechanisms. Methods In vivo anti-tumor effects of CM polysaccharides were observed using the inhibiting rate of tumor growth by dividing different Aconitum containing groups. Effects of CM polysaccharides on liver cancer cell SK-HEP-1 glycosyltransferase and tumor related gene expressions were observed. Meanwhile, changes of polylactosamine expression were detected using flow cytometry (FCM) with polylactosamine specific biotin labeling lectin. Results Compared with the model group, the average tumor weight was significantly lower in each medication group (P <0. 01). Compared with the adriamycin group, no significant difference in average tumor weight of the three compound groups (P>0. 05). The expression level of polylactosamine was reduced after adding Aconitum polysac- charide; and CM compound polysaccharides respectively. Conclusions Polysaccharide compound showed similar anti-tumor effect as that of adriamycin. Besides, polylactosamine expression level was reduced in the three compound groups along with increased prepared Aconitum polysaccharide, with more obvious anti-tumor effects shown.

Impact of preoperative urodynamic testing for urinary incontinence and pelvic organ prolapse on clinical management in Chinese women.

AIM: To assess the impact of preoperative urodynamic testing on the clinical management of urinary incontinence and pelvic organ prolapse. METHODS: Urodynamic testing was performed prior to surgery in 307 patients with pelvic organ prolapse or urinary incontinence. The resulting changes to planned treatment were recorded and retrospectively assessed. RESULTS: Results of urodynamic testing prompted changes to the treatment plan in 136 cases (44.2%), including 86 cases of no or slight-stress urinary incontinence, 28 cases of bladder outlet obstruction, 12 cases of occult stress urinary incontinence and 10 cases of detrusor overactivity and urge urinary incontinence. Urodynamic testing excluded disadvantageous factors in 69 cases (22.4%), including 46 cases of overactive bladder and 23 cases of voiding dysfunction. The information provided to patients when seeking informed consent was augmented by the results of urodynamic testing in 63 cases (20.5%). Urodynamic testing was of no value in 39 cases (12.7%). CONCLUSIONS: Preoperative urodynamic testing for urinary incontinence and pelvic organ prolapse can result in changes to treatment plans, exclusion of disadvantageous factors, and augmentation of information provided to patients when seeking informed consent.

Inhibition by imatinib of expression of O-glycan-related glycosyltransferases and tumor-associated carbohydrate antigens in the K562 human leukemia cell line.

OBJECTIVE: To study changes of tumor associated carbohydrate antigen (TACAs) expression and mRNA levels for tumor associated glycosyltransferases, and assess subcellular localizations of N-acetyl galactosyltransferases (GalNAc-Ts) in the K562 leukemia cell line after imatinib treatment. METHODS: RT-PCR was performed to analyze the expression of glycosyltransferases which synthesize O-glycan in tumor-associated carbohydrate antigens (TCTAs). The expression of Tn antigen, T antigen and sialyl T antigen on K562 cell membranes was measured by flow cytometry after treatment with different concentrations of imatinib. Co-localization of GalNAc-Ts and ER (endoplasmic reticulum) was determined by confocal laser scanning microcopy. RESULTS: Transcript expression levels of several glycosyltransferases related to TCTAs were decreased after imatinib (0-0.3µM) treatment. Expression of Tn antigen and T antigen was increased while that of sialyl T antigen was decreased. Co-localization of GalNAc-Ts and ER was reduced by 0.2µM of imatinib. CONCLUSION: Imatinib inhibited the expression of O-glycan related TACAs and several related glycosyltransferases, while decreasing the co-localization of GalNAc-Ts and ER and normalizing O-glycosylation in the K562 human leukemia cell.

[Effects of diabetic hyperlipidemia on bladder function and its possible mechanisms in a male rabbit model].

OBJECTIVE: To evaluate the effects of chronic hyperlipidemia on bladder function and its possible mechanisms and examine the functional and histological changes of bladder in a diabetic hyperlipidemic model. METHODS: A total of 30 male New Zealand white rabbits (2.5 to 3.0 kg) were numbered sequentially and randomly divided into 2 groups (hyperlipidemic group and control group). Then urodynamic test and detrusor strip contraction study were performed to assess bladder function.Histological studies of bladder and internal iliac arteries were performed with hematoxylin and eosin staining. The ultrastructure of bladder detrusor tissue was examined by transmission electron microscopy. Also the bladder tissue M2, 3-muscarinic receptor protein levels were examined by immunohistochemistry. RESULTS: After 12 weeks, the urodynamic test of the test group showed significantly increased non-voiding contractions (10/14 vs 1/13, P < 0.05) and decreased compliance ((2.16 ± 0.17) vs (4.18 ± 0.21) ml/cm H2O, P < 0.01) versus the control group. The functional experiments showed that carbachol-induced contractions significantly decreased in hyperlipidemic rabbits than those in controls. As to the relaxant actions of selective muscarinic receptor M3 antagonist solifenacin, the bladder strips of hyperlipidemic rabbits were significantly more sensitive than those of the controls.Histological examination showed thickened intima of internal iliac arteries, urothelial disruption and mild fibrosis in the hyperlipidemic rabbits. Transmission electron microscopy of hyperlipidemic bladder muscle tissues showed swollen mitochondrial damage. As to the immunohistochemical results, compared with the control group, the hyperlipidemic group showed significantly increased M3 receptor expression both in bladder urothelium (146 ± 14 vs 108 ± 9, P < 0.01) and smooth muscle layer (131 ± 17 vs 116 ± 15, P < 0.05) . And the expression was more obvious in urothelium layer. CONCLUSIONS: Involuntary detrusor overactivity with decreased bladder compliance and decreased contractions of detrusor are present in hyperlipidemic rabbits. And chronic bladder ischemia and increased M3 receptor expression may contribute to bladder dysfunction.

ß3GnT8 regulates laryngeal carcinoma cell proliferation via targeting MMPs/TIMPs and TGF-ß1.

Previous evidence showed ß1, 3-N-acetylglucosaminyltransferase 8 (ß3GnT8), which can extend polylactosamine on N-glycans, to be highly expressed in some cancer cell lines and tissues, indicating roles in tumorigenesis. However, so far, the function of ß3GnT8 in laryngeal carcinoma has not been characterized. To test any contribution, Hep-2 cells were stably transfected with sense or interference vectors to establish cell lines that overexpressed or were deficient in ß3GnT8. Here we showed that cell proliferation was increased in ß3GnT8 overexpressed cells but decreased in ß3GnT8 knockdown cells using MTT. Furthermore, we demonstrated that change in ß3GnT8 expression had significant effects on tumor growth in nude mice.We further provided data suggesting that overexpression of ß3GnT8 enhanced the expression of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) at both the mRNA and protein levels, associated with shedding of tissue inhibitors of metalloproteinase TIMP-2. In addition, it caused increased production of transforming growth factor beta 1 (TGF-ß1), whereas ß3GnT8 gene knockdown caused the reverse effect. The results may indicate a novel mechanism by which effects of ß3GnT8 in regulating cellular proliferation are mediated, at least in partvia targeting MMPs/TIMPs and TGF-ß1 in laryngeal carcinoma Hep-2 cells. The finding may lay a foundation for further investigations into the ß3GnT8 as a potential target for therapy of laryngeal carcinoma.

The effects of low dose X-irradiation on osteoblastic MC3T3-E1 cells in vitro.

BACKGROUND: It has been indicated that moderate or high dose of X-irradiation could delay fracture union and cause osteoradionecrosis, in part, mediated by its effect on proliferation and differentiation of osteoblasts. However, whether low dose irradiation (LDI) has similar roles on osteoblasts is still unknown. In this study, we investigated whether and to what extent LDI could affect the proliferation, differentiation and mineralization of osteoblasts in vitro. METHODS: The MC3T3-E1 cells were exposed to single dose of X-irradiation with 0, 0.1, 0.5, 1.0 Gy respectively. Cell proliferation, apoptosis, alkaline phosphatase (ALP) activity, and mineralization was evaluated by methylthiazoletetrazolium (MTT) and bromodeoxyuridine (BrdU) assay, flow cytometry, ALP viability kit and von Kossa staining, respectively. Osteocalcin (OCN) and core-binding factor α1 (Cbfα1) expressions were measured by real time-PCR and western blot, respectively. RESULTS: The proliferation of the cells exposed to 2.0 Gy was significantly lower than those exposed to ≤1.0 Gy (p < 0.05) from Day 4 to Day 8, measured by MTT assay and BrdU incorporation. For cells exposed to ≤1.0 Gy, increasing dosages of X-irradiation had no significant effect on cell proliferation and apoptosis. Importantly, LDI of 0.5 and 1 Gy increased ALP activities and mineralized nodules of MC3T3-E1 cells. In addition, mRNA and protein expressions of OCN and Cbfα1 were also markedly increased after treatment with LDI at 0.5 and 1 Gy. CONCLUSIONS: LDI have different effects on proliferation and differentiation of osteoblasts from those of high dose of X-irradiation, which might suggest that LDI could lead to promotion of fracture healing through enhancing the differentiation and mineralization of osteoblasts.

[Distribution characteristics of cancerous foci in the prostate among patients undergoing single positive core biopsy].

OBJECTIVE: To determine the distribution characteristics of cancerous foci in the prostate by retrospective analysis on the radical prostatectomy (RP) samples from patients with prostate cancer diagnosed by single positive core biopsy and treated by RP. METHODS: Thirty-seven patients with prostate cancer diagnosed by ultrasound-guided biopsy and single positive core biopsy underwent RP. We reviewed the pre- and post-operative data of the patients, compared the results of biopsies and pathological examination of the RP samples, and analyzed the factors that led to the underestimation of the overall prostate cancer risks. RESULTS: Post-operative pathological results showed multifocal distribution of the tumors in 70% of the patients (26/37) and obviously increased Gleason score (7-9) in 56% (21/37). The clinical stages of the tumors had been significantly underestimated preoperatively. The underestimation of their clinical stages might be due to a larger proportion of cancer tissues in a single positive core biopsy, and that of the overall cancer risks attributed to PSAD > 0.2 microg/L. Larger prostate volume (> or = 40 ml) increased the possibility of multifocal distribution. CONCLUSION: The risk of prostate cancer diagnosed by single positive core biopsy might be underestimated, and the cancerous foci were characterized by multifocal distribution in the prostate.

Lifetime costs of the top five cancers in Taiwan.

The purpose of this study was to determine cancer-related medical care costs for long-term cancer care costs of breast, cervical, liver, lung, and colorectal cancer. Data were sourced from Taipei Veterans General Hospital cancer registry and claim data during 1999-2002. Besides, claimed data from National Health Insurance were used to match the comparison group. To estimate lifetime cost (10 years), the whole disease process was divided into initial, continuing, and terminal three phases. The expected lifetime cost of a specific cancer patient was estimated by incorporating the average phase-specific costs with the survival rate and mortality rate. The undiscounted average lifetime costs (10 years) for lung cancer, colorectal cancer, liver cancer, cervical cancer, and breast cancer were NT$448,371 (1USD≒NTD 33), NT$584,985, NT$351,222, NT$511,563, and NT$674,282 (in 2002 NTD), respectively. The aggregate lifetime cost of cancer is useful for health policymaking and clinical decision-making.

[Diagnosis realization of knee joint synovial chondromatosis:clinical data of 28 cases].

OBJECTIVE: To investigate diagnosis and therapeutic effects of knee joint synovial chondromatosis with arthroscopic. METHODS: From March 1995 to July 2011, 28 patients with knee joint synovial chondromatosis were treated. Among them, 18 males and 10 females ranging age from 25 to 81 (mean 55.2) years,the course of disease ranged from 0.5 to 15 (mean 5.6) years. Clinical manifestation mainly included pain, swell and functional limitation of knee joint. Knee open surgery (17 cases) and laparoscopic surgery (10 cases) were respectively used. Clinical symptom,image data,pathological manifestation and effects under arthroscopy were observed, Lysholm scoring was used to evaluate effects. RESULTS: All patients were followed up except one lost, the duration ranging from 6 to 24 months. Lysholm score in knee open surgery was increased from (41.89 +/- 6.81) preoperatively to (67.73 +/- 7.62) postoperatively;while in laparoscopic surgery it was increased from (40.78 +/- 7.54) preoperatively to (77.46 +/- 8.43) postoperatively. CONCLUSION: Arthroscopic surgery, which has no risk of rupture of incision, nonunion, earlier to exercise, is a good method to diagnosis and treat knee joint synovial chondromatosis.

Expression of ß1,3-N-acetylglucosaminyltransferases during differentiation of human acute myeloid leukemia cells.

The expressions of ß1,3-N-acetylglucosamonyltransferase-2 and -8 (ß3GnT-2, ß3GnT-8),-the two main glycosyltransferases responsible for the synthesis of poly-N-acetyllactosamine (polyLacNAc) in glycans, and ß3GnT-5 participating in the syntheses of sphingoglycolipids were studied in leukemia cell lines during differentiation using RT-PCR method. ß3GnT-2 and ß3GnT-8 distribute widely in six myeloid and monocytoid leukemia cell lines with different abundances, while ß3GnT-4 was only present in NB4 cells. ATRA (all-trans retinoic acid) and dimethylsulfoxide (DMSO), which induce the differentiation of HL-60 and NB4 (two human acute myeloid leukemia cell lines) to myelocytic lineage, up-regulated these two enzymes with various degrees at 2 and 72 h of treatment. In HL-60 cells treated with ATRA, the increase of ß3GnT-8 was more than ß3GnT-2, while in NB4 cells treated with DMSO, the increase of ß3GnT-2 was more than ß3GnT-8. However, when HL-60 and NB4 were differentiated to monocytic lineage induced by phorbol 12-myristate 13-acetate the expressions of ß3GnT-2 and ß3GnT-8 showed no alterations or the increase of expressions was far less than those in myelocytic differentiation. By means of FITC-labeled tomato lectin affinity staining and flow-cytometry, it was found that the product of ß3GnT-2 and -8, polyLacNAc was also increased on the cell surface of HL-60 and NB4 treated with ATRA or DMSO, but unchanged when treated with PMA. These results were in accordance with the up-regulation of the mRNAs of ß3GnT-2 and -8. The expression of ß3GnT-5, however, was not changed both in myelocytic and monocytic differentiations. The difference in the up-regulation of ß3GnT-2 and -8, especially their products may become a useful index to discriminate the myelocytic and monocytic differentiation of leukemia cells.