Search

Objectives: To determine whether pars plana vitrectomy (PPV) or cataract surgery should be performed first in concurrent epiretinal membrane (ERM) and cataract treatment with respect to visual outcome and pseudophakic cystoid macular oedema (PCMO) incidence. Methods: Patients who underwent PPV and cataract surgery sequentially at a tertiary medical centre were retrospectively recruited. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) measured from optical coherence tomography (OCT) images collected before and after each surgery were documented. OCT-defined PCMO incidence and its influence on visual outcomes were analysed. Results: In total, 259 and 159 eyes received PPV (ERM-CATA) before and after cataract surgery (CATA-ERM), respectively. The ERM-CATA group had better final BCVA (logMAR: 0.274 vs. 0.558, p< 0.001) and greater BCVA gain (logMAR VA change: −0.379 vs. −0.220, p= 0.001) than did the CATA-ERM group. Baseline BCVA was positively correlated with final BCVA (p< 0.001), whereas baseline CMT, final CMT, and postoperative CMT changes were not. PCMO incidence did not differ significantly between the two groups (15.4% vs. 19.5%, p= 0.287), and final BCVA changes did not significantly differ between eyes with and without PCMO. PCMO incidence was much higher (29.40% vs. 16.30%, p= 0.008) in eyes with baseline CMT ≥ 500 μm. Conclusions: When managing ERM and cataract, PPV should be performed before cataract surgery to yield better visual outcomes. Both surgical sequences yield similar PCMO rates. Greater baseline CMT is a risk factor for PCMO after cataract surgery.

Patients with glaucoma are at risk of having unfavorable visual outcomes after epiretinal membrane surgery, especially those with advanced, fixation-threatening visual field defects and temporally located inner nuclear layer microcysts. Visual field testing is imperative for surgical planning and outcome prediction in patients comorbid with idiopathic epiretinal membrane and glaucoma.

Irinotecan, a topoisomerase inhibitor, is a common cytotoxic agent prescribed for metastatic colorectal cancer (mCRC) patients. Diarrhea is the most common adverse event (AE). The underlying mechanism of irinotecan-induced diarrhea is intestinal mucosal damage caused by SN-38 (active metabolite of irinotecan) hydrolyzed from SN-38G (inactive metabolite) by bacterial -glucuronidase (G). According to an animal study, silymarin reduces the activity of bacterial G without impairing antitumor efficacy. We conducted a prospective open-label pilot study to evaluate the effect of silymarin as supplementation in reducing toxicities of mCRC patients undergoing irinotecan-based chemotherapy. We enrolled and randomized 70 mCRC patients receiving first-line FOLFIRI (5-fluorouracil/leucovorin/irinotecan) plus bevacizumab. In each treatment cycle, the study group was administered silymarin capsules (150 mg) three times daily for 7 days. The study group experienced less AEs in diarrhea (5.7% vs. 14.6%, p=0.002) and nausea (27.0% vs. 40.2%, p=0.005) in comparison with the control group, but no significant differences in hepatic toxicities were observed. In conclusion, simultaneous administration of silymarin is a potential effective supplementation for reducing toxicities in mCRC patients undergoing first-line FOLFIRI plus bevacizumab, especially in diarrhea and nausea.

Colorectal cancer (CRC) is the third leading cause of cancer death in Taiwan. A recent study suggested a link between exposure to endocrine-disrupting chemicals (EDCs) and increased susceptibility to pathology. Exposure to di-(2-ethylhexyl) phthalate (DEHP), an EDC and plasticizer widely used in consumer products, has been reported to be significantly positively correlated with increased risks of various cancers. We explored this connection of DEHP exposure with the development of CRC through the detection of urinary monoethylhexyl phthalate (MEHP), a potent metabolite of DEHP. Participants comprised 221 individuals recruited between October 2016 and November 2019 from a single institution. Overall, urinary MEHP concentrations were significantly higher in patients with CRC than in the patients with adenoma or healthy participants (both P< 0.001). Higher exposure to DEHP may contribute to the occurrence of CRC. Urinary MEHP detection may serve as a beneficial noninvasive indicator of increased CRC risk.

Introduction: Post-operative pain control remains unsatisfactory in patients after laparotomy. This study aimed to evaluate the efficacy, safety, and quality of life with a single dose of extended-release dinalbuphine sebacate (ERDS) pre-operatively to intravenous patient-controlled analgesia (PCA) with fentanyl in patients undergoing laparotomy. Methods: This was a prospective, open-label, randomized controlled study. Of 110 randomized patients, 107 completed all assessments. The area under the curve (AUC) of visual analogue scale (VAS) from baseline to 48 h after surgery, VAS throughout 7 days after surgery, post-operative analgesics use, quality of life, satisfaction, and safety were evaluated. Results: The AUC of VAS from baseline to 48 h after surgery were 118.6 [97.5% confidence interval (CI) 95.6–141.6] in ERDS group and 176.13 (97.5% CI 150.8–201.4) in PCA group, which showed the non-inferiority because the upper limit of the 97.5% CIs of ERDS group was lower than the lower limit of PCA group (P &lt; 0.001), but also had superiority in favor of ERDS group (P &lt; 0.001). ERDS group reported a significant reduction in VAS pain intensity at 4, 24, 32, 72, 120, and 144 h after surgery, and better quality of life (P&lt; 0.05). The safety profile was comparable between ERDS and PCA groups. Conclusions: In patients undergoing laparotomy, a single dose of dinalbuphine sebacate was superior to intravenous PCA with fentanyl on lower pain intensity and better quality of life. Trial Registration: NCT03296488.

Serine incorporator protein 5 (SERINC5) is the host antiretroviral factor that reduces HIV-1 infectivity by incorporating into virions and inhibiting the envelope glycoprotein (Env) mediated virus fusion with target cells. We and others have shown that SERINC5 incorporation into virions alters the Env structure and sensitizes the virus to broadly neutralizing antibodies targeting cryptic Env epitopes. We have also found that SERINC5 accelerates the loss of Env function over time compared to control viruses. However, the exact mechanism by which SERINC5 inhibits HIV-1 fusion is not understood. Here, we utilized 2D and 3D super-resolution microscopy to examine the effect of SERINC5 on the distribution of Env glycoproteins on single HIV-1 particles. We find that, in agreement with a previous report, Env glycoproteins form clusters on the surface of mature virions. Importantly, incorporation of SERINC5, but not SERINC2, which lacks antiviral activity, disrupted Env clusters without affecting the overall Env content. We also show that SERINC5 and SERINC2 also form clusters on single virions. Unexpectedly, Env and SERINC molecules exhibited poor codistribution on virions, as evidenced by much greater Env–SERINC pairwise distances compared to Env–Env distances. This observation is inconsistent with the previously reported interaction between Env and SERINC5 and suggests an indirect effect of SERINC5 on Env cluster formation. Collectively, our results reveal a multifaceted mechanism of SERINC5-mediated restriction of HIV-1 fusion that, aside from the effects on individual Env trimers, involves disruption of Env clusters, which likely serve as sites of viral fusion with target cells.

To elucidate whether robotic assisted laparoscopic myomectomy (RALM) with barbed sutures is superior to traditional laparoscopic myomectomy (TLM) with barbed sutures.

Objective The UGT1A1*28polymorphism reduces UGT1A1enzymatic activity, which may increase the risk of severe toxicity in patients who receive standard-dose irinotecan, such as severe neutropenia and diarrhea. This real-world study assessed the optimal irinotecan dose in terms of efficacy and toxicity in metastatic colorectal cancer (mCRC) patients homozygous for the UGT1A1*28polymorphism and receiving FOLFIRI plus bevacizumab or cetuximab as first-line therapy.Methods We analyzed toxicity and treatment outcomes in seven mCRC patients who were homozygous for UGT1A1*28and received FOLFIRI plus bevacizumab or cetuximab, with an initial irinotecan dose of 120 mg/m2.Results Six of the seven patients tolerated 120 mg/m2irinotecan without requiring dose reductions in subsequent cycles. The overall response and disease control rates were 43.0% (3/7) and 71.4% (5/7), respectively. The median progression-free survival and overall survival were 11.0 and 33.0 months, respectively. Only one severe adverse event, grade III neutropenia (2.5%), was observed.Conclusions mCRC patients homozygous for the UGT1A1*28allele can tolerate irinotecan at an initial dose of 120 mg/m2with favorable oncological outcomes and toxicity profiles. Further prospective studies are warranted to optimize irinotecan-based chemotherapy in these patients.

This study proposes a novel sol-gel method of fabricating the two-dimensional flakes polycrystalline zinc oxide (ZnO). Apply zinc acetate dehydrate in glycerol and hydrolyzed to get the precursor zinc alkoxide particles at 160°C, and self-assemble into flakes ZnO nanostructures, and then got higer crystallinity polycrystalline ZnO after calcination for one hour at 500°C. Field-emission scanning electron microscopy (FE-SEM) was used to observe the morphology of the flakes. Its size got to a few μm2. Analyze the crystal structure and crystallinity by X-ray powder diffraction (XRD). After calcination for one hour at 500°C, we can determine it is the hexagonal wurtzite structure of ZnO. And TGA/DSC to observe the loss and phase change of the solution. The Study has successfully synthesized ZnO polycrystalline flakes by sol-gel method.

The purpose of this study was to discuss the effects of different solvent systems for aluminum doped zinc oxide (AZO) thin film deposition by using the sol-gel method. In the conventional sol-gel method of producing AZO thin films, the solution selected as the precursor solvent was used ethylene glycol monomethylether (EGME), which in this study propylene glycol mono-methyl ether (PGME) was used. The precursor solution was observed by TGA/DSC to understand the variations while heating. The two prepared precursor solutions were then respectively spin coated onto substrates of boron silicate glass. XRD analysis indicated both showed significant c-axis preferred orientation. The surface morphology of the films was observed by FESEM, which showed that the thin film surface by PGME solvent was smoother and dense. A four-point probe was used to measure the electrical resistance of the thin films, which the measured results indicated that the thin film produced by PGME had lower resistivity than those produced by EGME. Resulting with a thin film electric resistance reaching as low as 3.474×10-3(W×cm). The visible light transparency was determined via UV-vis analysis. Results showed that the average transparency of thin films produced by the EGME solvent reached 95% and above, where the average transparency from PGME solvent still reached 90% and above. Experimental results demonstrated that PGME is a good option to synthesize AZO thin films.

Background:The diagnostic power of the transferrin receptor–ferritin (TfR-F) index for identification of iron responsiveness in long-term hemodialysis (HD) patients compared with the routine markers recommended by the current US and European guidelines was appraised. Methods:Initially, 121 long-term HD patients with a serum ferritin level less than 800 µg/L and on recombinant erythropoietin (rHuEPO) therapy for longer than 6 months were enrolled for intravenous iron (IVFE) supplementation (100 mg of iron polymaltose 3 times/wk for 4 weeks, then 100 mg every 2 weeks for 5 months). Routine iron tests (ie, serum ferritin and transferrin saturation [TSAT]), TfR-F index calculated by the ratio of soluble TfR to log ferritin level, hematocrit, hemoglobin, red blood cell count, and serum high-sensitive C-reactive protein were examined at baseline. Hematocrit and hemoglobin were followed up every 2 weeks during the study period. Results:One hundred patients (52 men, 48 women; mean age, 59 years) completed this study. Fifty-two patients were IVFE responders, defined as an increase in hematocrit greater than 3% and/or a decrease in rHuEPO dose greater than 30% of baseline values at the end of the study, and 48 nonresponders did not fulfill these criteria. Of 52 responders, only 14 patients (27%) could be recognized for iron deficiency by means of routine iron tests (ferritin < 100 µg/L and/or TSAT < 20%). Thirty-three responders (63%) could be further identified for iron deficiency by using TfR-F index (0.6), but 5 (10%) still could not by either method. Analyses by using receiver operating characteristic (ROC) curves showed that a cutoff value greater than 0.6 for TfR-F index had greater sensitivity (90%) for the detection of iron deficiency than ferritin level less than 100 µg/L (29%) and TSAT less than 20% (6%). TfR-F index showed a greater area under the ROC curve than ferritin level (P< 0.05) and TSAT (P< 0.001). Conclusion:TfR-F index is superior to routine tests for predicting response to IVFE supplementation in long-term HD patients. Our study indicates that TfR-F index is a new and surrogate marker to estimate body iron stores and guide IVFE therapy for long-term HD patients.

A 38-year-old woman presented with muscle cramping of 4 extremities and paralysis for months. Laboratory results showed an elevated antinuclear antibody titer; antibodies to the ribonucleoprotein antigen Ro; hypokalemia; hypomagnesemia with hyperreninemia, but abnormally high urine potassium and magnesium levels and low urine calcium levels; and a blunted diuretic effect to thiazide, but not furosemide, which met the criteria for Gitelman's syndrome (GS) and led to the diagnosis of primary Sjögren's syndrome (pSS). She received medical treatment, including a potassium supplement and aldosterone antagonist. GS as a presentation of pSS has never been reported in the literature. The features of renal diseases related to SS are reviewed. SS is the underlying cause of GS, which may precede the onset of the well-known sicca complex.

Research has been undertaken to study numerically and experimentally the effects of large vehicle parameters on dynamic wheel pavement loads. Here, a two–axle truck having constant speed and travelling along a straight road was used and only the tyre normal loads on pavements are considered. To identify the required accuracy of vehicle parameter measurements, a simulation model sensitivity analysis was conducted. Forty–two vehicle parameters were considered along with three values of road roughness and four vehicle speeds. The Phase 4 simulation program, as developed by the University of Michigan, was used and prediction of normal pavement loads was shown to be predominantly sensitive to accuracies in measurement of wheelbase, base vehicle curb weight, payload weight, suspension stiffness, unsprung weight, tyre stiffness and coulomb friction. Additional observations were made regarding the effects of vehicle parameter measurements, road roughness and vehicle speed on mean tyre/pavement loads, maximum tyre/pavement loads and on the Dynamic Load Coefficient.

To investigate the age and gender differences among chronic dialysis patients who developed genitourinary cancers in Taiwan.