41 results on '"Cheng, Pin‐Nan"'
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2. Real-World Efficacy and Safety of Universal 8-Week Glecaprevir/Pibrentasvir for Treatment-Naïve Patients from a Nationwide HCV Registry in Taiwan
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Yang, Chun-Chi, Huang, Chung-Feng, Chang, Te-Sheng, Lo, Ching-Chu, Hung, Chao-Hung, Huang, Chien-Wei, Chong, Lee-Won, Cheng, Pin-Nan, Yeh, Ming-Lun, Peng, Cheng-Yuan, Cheng, Chien-Yu, Huang, Jee-Fu, Bair, Ming-Jong, Lin, Chih-Lang, Yang, Chi-Chieh, Wang, Szu-Jen, Hsieh, Tsai-Yuan, Lee, Tzong-Hsi, Lee, Pei-Lun, Wu, Wen-Chih, Lin, Chih-Lin, Su, Wei-Wen, Yang, Sheng-Shun, Wang, Chia-Chi, Hu, Jui-Ting, Mo, Lein-Ray, Chen, Chun-Ting, Huang, Yi-Hsiang, Chang, Chun-Chao, Huang, Chia-Sheng, Chen, Guei-Ying, Kao, Chien-Neng, Tai, Chi-Ming, Liu, Chun-Jen, Lee, Mei-Hsuan, Kuo, Hsing-Tao, Tsai, Pei-Chien, Dai, Chia-Yen, Kao, Jia-Horng, Lin, Han-Chieh, Chuang, Wang-Long, Tseng, Kuo-Chih, Chen, Chi-Yi, and Yu, Ming-Lung
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Introduction: Eight-week glecaprevir/pibrentasvir (GLE/PIB) is indicated for treatment-naïve (TN) patients with chronic hepatitis C (CHC), with or without compensated cirrhosis. Given that the Taiwanese government is committed to eliminating hepatitis C virus (HCV) by 2025, this study aimed to measure real-world evidence for TN patients using 8-week GLE/PIB in the Taiwan HCV Registry (TACR). Methods: The data of patients with CHC treated with 8-week GLE/PIB were retrieved from TACR, a nationwide registry program organized by the Taiwan Association for the Study of the Liver (TASL). Treatment efficacy, defined as a sustained virologic response at posttreatment week 12 (SVR12), was assessed in the modified intention-to-treat (mITT) population, which excluded patients who were lost to follow-up or lacked SVR12 data. The safety profile of the ITT population was assessed. Results: A total of 7246 (6897 without cirrhosis; 349 with cirrhosis) patients received at least one dose of GLE/PIB (ITT), 7204 of whom had SVR12 data available (mITT). The overall SVR12 rate was 98.9% (7122/7204) among all patients, 98.9% (6780/6856) and 98.3% (342/348) among patients without and with cirrhosis, respectively. For the selected subgroups, which included patients with genotype 3 infection, diabetes, chronic kidney disease, people who injected drugs, and those with human immunodeficiency virus coinfection, the SVR12 rates were 95.1% (272/286), 98.9% (1084/1096), 99.0% (1171/1183), 97.4% (566/581), and 96.1% (248/258), respectively. Overall, 14.1% (1021/7246) of the patients experienced adverse events (AEs). Twenty-two patients (0.3%) experienced serious AEs, and 15 events (0.2%) resulted in permanent drug discontinuation. Only one event was considered treatment drug related. Conclusion: Eight-week GLE/PIB therapy was effective and well tolerated in all TN patients, regardless of cirrhosis status.
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- 2024
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3. TASL, TADE, and DAROC consensus for the screening and management of hepatitis C in patients with diabetes.
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Yu, Ming-Lung, Wang, Chih-Yuan, Lee, Mei-Hsuan, Ou, Horng-Yih, Cheng, Pin-Nan, Tu, Shih-Te, Huang, Jee-Fu, Chen, Jung-Fu, Hu, Tsung-Hui, Hsu, Chih-Cheng, Kao, Jia-Horng, Chen, Chien-Jen, Lin, Han-Chieh, and Huang, Chien-Ning
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MEDICAL screening ,PEOPLE with diabetes ,HEPATITIS C virus ,MEDICAL societies ,ANTIVIRAL agents ,HEPATOLOGY - Abstract
Diabetes mellitus (DM) and hepatitis C virus (HCV) infection are prevalent diseases globally and emerging evidence demonstrates the bidirectional association between the two diseases. Direct-acting antivirals (DAAs) for HCV have a high treatment success rate and can significantly reduce the risks of short and long-term complications of HCV infection. However, despite the evidence of the association between diabetes and HCV and the benefits of anti-HCV treatment, previously published guidelines did not focus on the universal HCV screening for patients with diabetes and their subsequent management once confirmed as having HCV viremia. Nonetheless, screening for HCV among patients with diabetes will contribute to the eradication of HCV infection. Thus, the three major Taiwan medical associations of diabetes and liver diseases endorsed a total of 14 experts in the fields of gastroenterology, hepatology, diabetology, and epidemiology to convene and formulate a consensus statement on HCV screening and management among patients with diabetes. Based on recent studies and guidelines as well as from real-world clinical experiences, the Taiwan experts reached a consensus that provides a straightforward approach to HCV screening, treatment, and monitoring of patients with diabetes. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Entecavir Prevents HBV Reactivation During Direct Acting Antivirals for HCV/HBV Dual Infection: A Randomized Trial.
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Cheng, Pin-Nan, Liu, Chun-Jen, Chen, Chi-Yi, Tseng, Kuo-Chih, Lo, Ching-Chu, Peng, Cheng-Yuan, Lin, Chih-Lin, Chiu, Hung-Chih, Chiu, Yen-Cheng, and Chen, Pei-Jer
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A strategy to prevent hepatitis B virus (HBV) virologic reactivation (HBVr) and clinical reactivation (CR) during direct acting antiviral (DAA) treatment of hepatitis C virus (HCV)/HBV dual infection remains an unresolved issue. Noncirrhotic patients with dual HCV/HBV infection were enrolled and allocated randomly to 1 of 3 groups as follows: 12 weeks of DAA alone (group 1), 12 weeks of DAA plus 12 weeks of entecavir (group 2), or 12 weeks of DAA plus 24 weeks of entecavir (group 3). The entire study duration was 72 weeks. The primary end point was the occurrence of HBVr (defined by an increase of HBV DNA level >10-fold with quantifiable HBV DNA at baseline or the presence of HBV DNA with prior unquantifiable HBV DNA) and CR (defined by serum alanine aminotransferase level >2-fold the upper limit of normal in addition to HBVr). Fifty-six patients were allocated randomly as follows: 20 patients in group 1, 16 patients in group 2, and 20 patients in group 3. In group 1, HBV DNA levels increased significantly as early as 4 weeks after initiation of DAA and persisted until the end of the study. During DAA treatment, HBVr occurred in 50% in group 1 vs 0% in group 2 and 0% in group 3 (P <.001), whereas the majority of HBVr in groups 2 and 3 occurred 12 weeks after cessation of entecavir (cumulative incidence, 93.8% in group 2 and 94.7% in group 3). Three patients (5.4%; 1 in each group) showed CR at week 48 and did not receive entecavir treatment. Twelve weeks of entecavir is suggested to be co-administered with DAA for HCV/HBV dually infected patients. ClinicalTrials.gov no: NCT04405011. [ABSTRACT FROM AUTHOR]
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- 2022
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5. Real-world effectiveness and safety of sofosbuvir/velpatasvir and glecaprevir/pibrentasvir for genotype 6 chronic hepatitis C.
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Chen, Jyh-Jou, Chiu, Yen-Cheng, Lee, Pei-Lun, Tung, Hung-Da, Chiu, Hung-Chih, Chien, Shih-Chieh, and Cheng, Pin-Nan
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HEPATITIS C ,CHRONIC hepatitis C ,HEPATITIS C virus ,GENOTYPES ,GLOMERULAR filtration rate ,SOFOSBUVIR - Abstract
Background: Hepatitis C virus (HCV) genotype 6 mainly distributes in Southeast Asia and South China. Because of the low prevalence in developed countries, optimal treatment for HCV genotype 6 in real-world setting remains to be determined. We aimed to evaluate the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) and glecaprevir/pibrentasvir (GLE/PIB) for patients with HCV genotype 6 infection in Taiwan.Methods: A total of 286 patients with chronic hepatitis C (CHC) genotype 6, 161 receiving 12-week SOF/VEL and 125 receiving 8-week GLE/PIB, were enrolled. All patients were followed up for 12 weeks after treatment completion. Demographic information, HCV viral load (VL), profiles of lipid and sugar, and adverse events were recorded and reviewed.Results: Sustained virological response (SVR) rates of SOF/VEL and GLE/PIB evaluated by intention-to-treat analysis were 99.38% and 100%, respectively. SVR achieved 100%, regardless of cirrhosis or viral load (cutoff: 6 MIU/mL), of both regimens by per-protocol analysis. Skin itching was the most common adverse event, with an overall incidence of 6.64% which was more prevalent in GLE/PIB (12.0%) than SOF/VEL (2.48%). A significant decrease in the estimated glomerular filtration rate was observed in patients receiving SOF/VEL but not in those receiving GLE/PIB at the time of SVR. No patient discontinued treatment due to adverse event.Conclusion: The high SVR and excellent safety of SOF/VEL and GLE/PIB in real-world setting reveals that the two DAA regimens are favorable options for treatment of HCV genotype 6 in Taiwan and Asia. [ABSTRACT FROM AUTHOR]- Published
- 2022
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6. Clinical prognosis of surgical resection versus transarterial chemoembolization for single large hepatocellular carcinoma (≥5 cm): A propensity score matching analysis
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Hsieh, Pei‐Min, Hsiao, Pojen, Chen, Yaw‐Sen, Yeh, Jen‐Hao, Hung, Chao‐Ming, Lin, Hung‐Yu, Ma, Ching‐Hou, Tang, TaoQian, Huang, Yu Wei, Cheng, Pin‐Nan, Hsieh, Kun‐Chou, Hu, Kuang‐Chun, Bair, Ming‐Jong, and Lin, Chih‐Wen
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Favorable prognostic factors and therapeutic strategies are important for patients with single large hepatocellular carcinoma (HCC). This retrospective study aimed to investigate the prognostic factors in patients with single large (≥5 cm) HCC with Child‐Pugh (CP) class A patients and to recommend therapeutic strategies. Overall, 298 HCC patients with single and large (≥5 cm) tumors with CP class A, but without distant metastasis and macrovascular invasion were included, and their clinicopathological data, overall survival (OS), and progression‐free survival (PFS) were recorded. OS and PFS was analyzed by the Kaplan–Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed. The 298 HCC patients were 79.2% male and median age of 64 years. For the initial treatment, surgical resection (SR) and transarterial chemoembolization (TACE) was 50.8% and 49.2%, respectively. The OS and PFS were significantly higher in patients receiving SR than those receiving TACE before and after PSM. Furthermore, in multivariate analysis, cirrhosis (Hazard ratio [HR]: 2.04; 95% confidence interval [CI]: 1.35–3.03, p< 0.001, CP class A5/6 [HR: 4.01; 95% CI: 2.43–6.66, p< 0.001], and initial treatment [SR vs. TACE HR = 3.23; 95% CI: 2.13–5.01, p< 0.001]) remained significantly associated with mortality. Moreover, in multivariate analysis, CP class A5/6 (HR: 3.23; 95% CI: 1.89–5.88, p< 0.001), and initial treatment (Resection vs. TACE; HR = 4.17; 95% CI: 1.64–8.33, p= 0.039) remained significantly associated with recurrence. In conclusion, SR was associated with significantly higher OS and PFS rates than TACE before and after PSM for single large HCC patients.
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- 2023
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7. Interdependence of glycemic and lipid modulation in cured chronic hepatitis C patients by direct-acting antiviral agents
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Cheng, Pin-Nan, Sun, Hung-Yu, Feng, I-Che, Chiu, Yen-Cheng, Wang, Sin-Tian, Tan, Dyoness Charmaine, Chiu, Hung-Chih, Chien, Shih-Chih, and Young, Kung-Chia
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Chronic hepatitis C virus (HCV) infection causes various liver diseases and metabolic disorders. With direct-acting antiviral agents (DAAs), which effectively eradicate pan-genotypic HCV, hepatic and concomitant metabolic restorations are achieved. The study aims to evaluate the posttherapeutic benefits of lipid and glycemic homeostasis.
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- 2023
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8. Ledipasvir/sofosbuvir for HCV genotype 1, 2, 4-6 infection: Real-world evidence from a nationwide registry in Taiwan.
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Lo, Ching-Chu, Huang, Chung-Feng, Cheng, Pin-Nan, Tseng, Kuo-Chih, Chen, Chi-Yi, Kuo, Hsing-Tao, Huang, Yi-Hsiang, Tai, Chi-Ming, Peng, Cheng-Yuan, Bair, Ming-Jong, Chen, Chien-Hung, Yeh, Ming-Lun, Lin, Chih-Lang, Lin, Chun-Yen, Lee, Pei-Lun, Chong, Lee-Won, Hung, Chao-Hung, Chang, Te Sheng, Huang, Jee-Fu, and Yang, Chi-Chieh
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CHRONIC hepatitis C ,CHRONIC kidney failure ,SOFOSBUVIR ,GENOTYPES ,CIRRHOSIS of the liver ,HEPATORENAL syndrome ,COMBINATION drug therapy ,HETEROCYCLIC compounds ,ACQUISITION of data ,HEPATITIS viruses ,ANTIVIRAL agents ,HYDROCARBONS ,NUCLEOTIDES ,RIBAVIRIN ,DISEASE complications - Abstract
Background/purpose: The Taiwan Association for the Study of the Liver (TASL) HCV Registry (TACR) is a nationwide registry of chronic hepatitis C patients in Taiwan. This study evaluated antiviral effectiveness of ledipasvir (LDV)/sofosbuvir (SOF) in patients in the TACR.Methods: Patients enrolled in TACR from 2017-2020 treated with LDV/SOF were eligible. The primary outcome was the proportion of patients with sustained virologic response 12 weeks after end of treatment (SVR12).Results: 5644 LDV/SOF ± ribavirin-treated patients were included (mean age: 61.4 years; 54.4% female). Dominant viral genotypes were GT1 (50.8%) and GT2 (39.3%). 1529 (27.1%) patients had liver cirrhosis, including 201 (3.6%) with liver decompensation; 686 (12.2%) had chronic kidney disease. SVR12 was achieved in 98.6% of the overall population and in 98.2% and 98.7% of patients with and without cirrhosis, respectively. SVR12 rates in patients with compensated cirrhosis treated with LDV/SOF without RBV were >98%, regardless of prior treatment experience. SVR12 was 98.6%, 98.4%, 100%, 100%, and 98.7% among those with GT1, GT2, GT4, GT5, and GT6 infections, respectively. Although patient numbers were relatively small, SVR12 rates of 100% were reported in patients infected with HCV GT2, GT5, and GT6 with decompensated cirrhosis and 98% in patients with severely compromised renal function. LDV/SOF adherence ≤60% (P < 0.001) was the most important factor associated with treatment failure. Incidence of adverse events was 15.8%, with fatigue being the most common.Conclusion: LDV/SOF is effective and well tolerated in routine clinical practice in Taiwan. Cure rates were high across patient populations. [ABSTRACT FROM AUTHOR]- Published
- 2022
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9. Serum cytokine/chemokine profiles predict hepatitis B reactivation in HBV/HCV co-infected subjects receiving direct-acting antiviral agents.
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Huang, Shang-Chin, Cheng, Pin-Nan, Liu, Chen-Hua, Yang, Hung-Chih, Su, Tung-Hung, Tseng, Tai-Chung, Chen, Pei-Jer, Kao, Jia-Horng, and Liu, Chun-Jen
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HEPATITIS B ,ANTIVIRAL agents ,HEPATITIS B virus ,DISEASE risk factors ,CYTOKINES - Abstract
Background/purpose: Direct-acting antiviral agents (DAAs) have revolutionized the paradigm for HCV treatment. However, patients with HBV and HCV co-infection receiving DAAs are at significant risk of HBV reactivation, with limited literature addressing the roles of serum chemokines/chemokines. We aimed to explore the profiles and predictive value of serum cytokines/chemokines regarding HBV reactivation in this clinical setting.Methods: From 2017 to 2019, 25 patients with HBV and HCV co-infection scheduled for DAA therapy were prospectively enrolled. At enrolment and after DAA treatment, serial serum cytokine/chemokine levels were examined. The baseline and dynamic levels were compared between those with versus without HBV virologic (defined by an increase of serum HBV DNA to >10 times) and clinical reactivation (defined by > 1.5-fold elevated ALT level than nadir and >100 U/L; or > 2-fold increase from nadir and greater than the upper normal limit, in addition to virologic reactivation).Results: There were 20 patients (80%) experiencing HBV virologic reactivation and 6 patients (24%) experiencing clinical reactivation. Patients with clinical reactivation had higher pre-treatment TNF-alpha (27.93 versus 18.85 pg/mL, P = 0.015), lower week-4 IFN-gamma (1.07 versus 8.74 pg/mL, P = 0.020) levels and significant declines of CCL2 and TNF-alpha (P < 0.05). Single or combination of these cytokines helped predict clinical reactivation (all P < 0.05).Conclusion: Higher serum TNF-alpha at baseline and lower IFN-gamma at week 4 were associated with mild clinical reactivation of HBV in patients with HBV/HCV co-infection receiving DAAs. Combination of these cytokines reliably predicted HBV reactivation early. [ABSTRACT FROM AUTHOR]- Published
- 2022
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10. Licogliflozin for nonalcoholic steatohepatitis: a randomized, double-blind, placebo-controlled, phase 2a study
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Harrison, Stephen A., Manghi, Federico Perez, Smith, William B., Alpenidze, Diana, Aizenberg, Diego, Klarenbeek, Naomi, Chen, Chi-Yi, Zuckerman, Eli, Ravussin, Eric, Charatcharoenwitthaya, Phunchai, Cheng, Pin-Nan, Katchman, Helena, Klein, Samuel, Ben-Ari, Ziv, Mendonza, Anisha E., Zhang, Yiming, Martic, Miljen, Ma, Shenglin, Kao, Sheena, Tanner, Sandra, Pachori, Alok, Badman, Michael K., He, YanLing, Ukomadu, Chinweike, and Sicard, Eric
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Nonalcoholic steatohepatitis (NASH) is a common chronic liver disease that may advance to fibrosis and lead to mortality; however, no pharmacotherapy is currently available. We tested the hypothesis that inhibition of both the sodium–glucose cotransporters 1 and 2 with licogliflozin would lead to improvement in NASH. A total of 107 patients with phenotypic or histologic NASH were randomized (1:2:2) to receive oral administration of either placebo (n= 21), licogliflozin 30 mg (n= 43) or 150 mg (n= 43) once daily for 12 weeks. Licogliflozin 150 mg showed a significant 32% (80% confidence interval (CI): 21–43%; P= 0.002) placebo-adjusted reduction in serum alanine aminotransferase after 12 weeks of treatment, the primary endpoint of the study. However, the 30 mg dose of licogliflozin did not meet the primary endpoint (placebo-adjusted reduction 21% (80% CI: 7–32%; P= 0.061)). Diarrhea occurred in 77% (33 of 43), 49% (21 of 43) and 43% (9 of 21) of patients treated with licogliflozin 150 mg, 30 mg and placebo, respectively, which was mostly mild in severity. No other major safety concerns were identified. Treatment with 150 mg licogliflozin led to reductions in serum alanine aminotransferase in patients with NASH. Studies of longer duration and in combination with drugs that have different mechanisms of action are needed to validate these findings and to define a role of licogliflozin as a therapeutic option for NASH. ClinicalTrials.gov identifier: NCT03205150.
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- 2022
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11. Sofosbuvir/Velpatasvir for Hepatitis C Virus Infection: Real-World Effectiveness and Safety from a Nationwide Registry in Taiwan.
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Cheng, Pin-Nan, Mo, Lein-Ray, Chen, Chun-Ting, Chen, Chi-Yi, Huang, Chung-Feng, Kuo, Hsing-Tao, Lo, Ching-Chu, Tseng, Kuo-Chih, Huang, Yi-Hsiang, Tai, Chi-Ming, Peng, Cheng-Yuan, Bair, Ming-Jong, Chen, Chien-Hung, Yeh, Ming-Lun, Lin, Chih-Lang, Lin, Chun-Yen, Lee, Pei-Lun, Chong, Lee-Won, Hung, Chao-Hung, and Chang, Te Sheng
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- 2022
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12. Sofosbuvir/Velpatasvir for Hepatitis C Virus Infection: Real-World Effectiveness and Safety from a Nationwide Registry in Taiwan
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Cheng, Pin-Nan, Mo, Lein-Ray, Chen, Chun-Ting, Chen, Chi-Yi, Huang, Chung-Feng, Kuo, Hsing-Tao, Lo, Ching-Chu, Tseng, Kuo-Chih, Huang, Yi-Hsiang, Tai, Chi-Ming, Peng, Cheng-Yuan, Bair, Ming-Jong, Chen, Chien-Hung, Yeh, Ming-Lun, Lin, Chih-Lang, Lin, Chun-Yen, Lee, Pei-Lun, Chong, Lee-Won, Hung, Chao-Hung, Chang, Te Sheng, Huang, Jee-Fu, Yang, Chi-Chieh, Hu, Jui-Ting, Lin, Chih-Wen, Wang, Chia-Chi, Su, Wei-Wen, Hsieh, Tsai-Yuan, Lin, Chih-Lin, Tsai, Wei-Lun, Lee, Tzong-Hsi, Chen, Guei-Ying, Wang, Szu-Jen, Chang, Chun-Chao, Yang, Sheng-Shun, Wu, Wen-Chih, Huang, Chia-Sheng, Chou, Kwok-Hsiung, Kao, Chien-Neng, Tsai, Pei-Chien, Liu, Chen-Hua, Lee, Mei-Hsuan, Cheng, Chien-Yu, Tsai, Ming-Chang, Liu, Chun-Jen, Dai, Chia-Yen, Lin, Han-Chieh, Kao, Jia-Horng, Chuang, Wan-Long, and Yu, Ming-Lung
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Introduction: Pangenotypic direct-acting antivirals are expected to cure hepatitis C virus (HCV) in more than 95% of treated patients. However, data on the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) in Taiwan are limited. This study aims to characterize the patient population in the nationwide Taiwan Association for the Study of the Liver (TASL) HCV Registry and evaluate treatment outcome in Taiwanese patients receiving SOF/VEL. Methods: This study was a retrospective-prospective, observational, multicenter, real-world analysis. Adults with chronic hepatitis C were treated with SOF/VEL 400/100 mg ± ribavirin for 12 weeks. The primary outcome was sustained virologic response 12 weeks after end of therapy (SVR12). Factors associated with not achieving SVR12 were evaluated using logistic regression and covariate analysis. Safety was also assessed. Results: In total, 3480 patients were included: 86.8% genotype 1/2, 2.8% genotype 3, 0.1% genotype 4/5, 9.6% genotype 6; unclassified, 0.8%; 12.2% compensated cirrhosis; 3.3% decompensated cirrhosis; and 15.8% chronic kidney disease. Overall SVR12 rate was 99.4% (genotype 1, 99.5%; genotype 2, 99.4%; genotype 3, 96.9%; genotype 4, 100%; genotype 6, 99.7%). SVR12 rates among patients with compensated cirrhosis, decompensated cirrhosis, and chronic kidney disease stages 4–5 were 99.5%, 100%, and 100%, respectively. There were 21 patients (0.6%) who did not achieve SVR12. Factors associated with failure were treatment adherence below 60%, high viral load, and genotype 3 (p< 0.001, p= 0.028, and p= 0.001, respectively). Adverse events occurred in 10% of patients; 0.6% were serious and one was related to treatment. Treatment discontinuation occurred in 0.3% of patients; none were treatment related. The estimated glomerular filtration rate remained stable throughout treatment and follow-up, regardless of baseline values and cirrhosis status. Conclusion: SOF/VEL was highly effective and well tolerated in Taiwanese patients, irrespective of viral genotype, liver disease severity, and comorbidities.
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- 2022
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13. Effectiveness and safety of ledipasvir/sofosbuvir for genotype 2 chronic hepatitis C infection: Real-world experience from Taiwan.
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Chiu, Hung-Chih, Chiu, Yen-Cheng, Yang, Er-Hsiang, Chang, Ting-Tsung, Chien, Shih-Chieh, Wu, I-Chin, Wu, Chun-Hsien, and Cheng, Pin-Nan
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CHRONIC hepatitis C ,HEPATITIS C virus ,GENOTYPES ,GLOMERULAR filtration rate ,CHRONIC kidney failure ,COMBINATION drug therapy ,HETEROCYCLIC compounds ,HEPATITIS viruses ,ANTIVIRAL agents ,RIBAVIRIN ,HYDROCARBONS ,TREATMENT effectiveness - Abstract
Background/purpose: Genotype 2 (GT2) hepatitis C virus infection is the second common genotype in Taiwan. Real-world experience of ledipasvir/sofosbuvir (LDV/SOF) for GT2 infection is limited. The aim of this study is to evaluate the effectiveness and safety of LDV/SOF in patients with GT2 chronic hepatitis C (CHC) infection.Methods: CHC patients with GT2 infection receiving 12 weeks LDV/SOF from three hospitals were enrolled. HCV RNA was checked at baseline, end-of-treatment and 12 weeks after completing treatment. Demographic data, adverse events, renal function and metabolic profiles were recorded.Results: Among 392 enrolled patients, 33 patients (8.4%) were cirrhotic. Sustained virological response (SVR) rate was 96.7% (379/392) by intention-to-treat analysis and 97.2% (379/390) by per-protocol analysis. The SVR rate was lower in cirrhotic patients than in non-cirrhotic patients (90.6% vs 97.8%, p = 0.053). Two cirrhotic patients who took LDV/SOF plus ribavirin both achieved SVR. Neither drug-related severe adverse events nor discontinuation due to drug-related adverse event were reported. The estimated glomerular filtration rate (eGFR) remained stable in patients with chronic kidney disease 3a/3b.Conclusion: Twelve weeks of LDV/SOF treatment provided an excellent and safe regimen for GT2 CHC infection, particularly in non-cirrhotic patients. [ABSTRACT FROM AUTHOR]- Published
- 2021
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14. Elbasvir/grazoprevir is effective and tolerable for the treatment of HCV GT1-infected patients: A real world multicenter observatory study in Taiwan
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Cheng, Pin-Nan, Chen, Chi-Yi, Yu, Ming-Lung, Lin, Chun-Che, Lin, Chun-Yen, Peng, Cheng-Yuan, Tseng, Kuo-Chih, Lo, Ching-Chu, Tseng, I-Hao, and Liu, Chun-Jen
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Treatment of hepatitis C virus (HCV) by elbasvir/grazoprevir (EBR/GZR) was found to be efficacious and well tolerated in clinical trials. This study aimed to evaluate the effectiveness and tolerability of EBR/GZR in the treatment of HCV genotype 1-infected Taiwanese patients.
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- 2021
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15. Limited drug-drug interaction of elbasvir/grazoprevir for chronic hepatitis C.
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Liu, Chun-Jen, Tseng, Kuo-Chih, Lo, Ching-Chu, Tseng, I-Hao, and Cheng, Pin-Nan
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CHRONIC hepatitis C ,DRUG interactions ,GASTROINTESTINAL diseases ,HETEROCYCLIC compounds ,ANTIVIRAL agents ,HEPATITIS viruses ,HYDROCARBONS ,IMIDAZOLES ,ACYCLIC acids ,SULFONAMIDES ,AMIDES - Abstract
Background/purpose: The assessment of drug-drug interaction (DDI) is important not only for safety but also for maintaining the efficacy of direct acting antivirals in chronic hepatitis C (CHC). This study aims to evaluate DDI before and during elbasvir/grazoprevir (EBR/GZR) treatment.Methods: CHC patients who treated with EBR/GZR in five hospitals were enrolled. The patients' demographic data, comorbidities, concomitant medications taken before and during EBR/GZR were recorded. DDI was evaluated using a tool from the HEP Drug Interactions (www.hep-druginteractions.org) website. In addition to the evaluation of DDI for EBR/GZR, the virtual DDI of ledipasvir/sofosbuvir (LDV/SOF), sofosbuvir/velpatasvir (SOF/VEL) and glecaprevir/pibrentasvir (GLE/PIB) were evaluated. Degrees of DDI were classified as "do not co-administer", "potential interaction", and "potentially weak interaction".Results: A total of 460 patients were enrolled. At baseline, 80.1% of patients had one or more comorbidities and 72.8% took one or more medications. Cardiovascular diseases (43.9%), gastrointestinal diseases (37.4%), and metabolic diseases (36.7%) were the three most common comorbidities. The prevalence of DDI before EBR/GZR treatment was 12.8% (59 patients). Among the same population, the prevalence of virtual DDI of SOF/VEL, GLE/PIB, and LDV/SOF were 38.5% (179 patients), 48.8% (220 patients), and 57.0% (262 patients), respectively. During EBR/GZR treatment, 167 patients (36.3%) took newly prescribed medications. One patient (0.2%) and seven patients (1/5%) exhibited do-not-co-administer and potential interaction with EBR/GZR, respectively.Conclusion: DDI was limited in treatment with EBR/GZR. DDI can occur upon the administering of a new medication during antiviral treatment and attention should be paid to it.Trial Registration Number: NCT03706222. [ABSTRACT FROM AUTHOR]- Published
- 2020
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16. Real-world anti-viral treatment decisions among chronic hepatitis C patients in Taiwan: The INITIATE study.
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Liu, Chen-Hua, Yu, Ming-Lung, Peng, Cheng-Yuan, Hsieh, Tsai-Yuan, Huang, Yi-Hsiang, Su, Wei-Wen, Cheng, Pin-Nan, Lin, Chih-Lin, Lo, Ching-Chu, Chen, Chi-Yi, Chen, Jyh-Jou, Ma, Qian, Brooks-Rooney, Craig, and Kao, Jia-Horng
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CHRONIC hepatitis C ,RIBAVIRIN ,ANTIVIRAL agents ,PATIENT decision making ,DRUG therapy ,HEPATITIS C virus ,DRUG side effects ,INTERFERONS - Abstract
Background/purpose: While direct-acting antiviral regimens have been approved for chronic hepatitis C (CHC) patients in Taiwan, reimbursement is limited to certain populations. Thus, pegylated interferon plus ribavirin (PEG-IFN/RBV) remains the standard of care for many patients. The aim of this study was to investigate the percentage of CHC patients who were recommended and willing to receive PEG-IFN/RBV, and to identify reasons why patients were not recommended or unwilling to receive treatment.Methods: 822 Taiwanese CHC patients were enrolled from May-August 2016 in this cross-sectional study. PEG-IFN/RBV recommendation and patient willingness to receive treatment were evaluated through surveys. Patient characteristics associated with treatment recommendation and willingness were assessed.Results: 311 (37.8%) patients were recommended PEG-IFN/RBV while 102 (12.4%) were willing to follow treatment recommendation. Rates of recommendation and willingness were lower in treatment-experienced, hepatitis C virus genotype 1 (GT1) and cirrhotic patients, and those treated in Northern Taiwan. Multivariate analyses found factors such as prior treatment experience, GT1, cirrhosis and low hemoglobin levels to be associated with lower recommendation rates while advanced age, GT1 and low baseline viral loads were associated with lower willingness rates. Physicians' top reasons for not recommending PEG-IFN/RBV included the wish to wait for better treatment options (60.3%), prior treatment failure (21.3%) and patients' advanced age (20.9%). Patients were unwilling to receive treatment mainly due to concerns about side effects (91.4%), the wish to wait for better treatment options (71.3%) and inconvenience (25.4%).Conclusion: A minority of Taiwanese CHC patients were recommended PEG-IFN/RBV, of which few were willing to receive treatment. [ABSTRACT FROM AUTHOR]- Published
- 2019
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17. Real-world effectiveness and safety of sofosbuvir plus daclatasvir with or without ribavirin for genotype 2 chronic hepatitis C in Taiwan.
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Cheng, Pin-Nan, Chiu, Yen-Cheng, Chien, Shih-Chieh, and Chiu, Hung-Chih
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CHRONIC hepatitis C ,GENOTYPES ,HEPATITIS C virus ,RIBAVIRIN - Abstract
Background and Purpose: Sofosbuvir (SOF) and daclatasvir (DCV) treatment achieves excellent efficacy and safety in treating chronic hepatitis C (CHC) with various genotypes. Real world experience of SOF/DCV regimen to treat genotype 2 CHC was scanty in Asia. This study aimed to evaluate the effectiveness and safety of SOF/DCV with or without ribavirin to treat genotype 2 CHC patients in real world practice in Taiwan.Methods: Patients with genotype 2 CHC treated with 12-week of SOF/DCV or SOF/DCV/ribavirin were enrolled prospectively. Effectiveness was evaluated by sustained virological response (SVR) which was defined as undetectable hepatitis C virus (HCV) RNA at post-treatment week 12. Adverse events were recorded for safety analysis.Results: In total of 32 patients were enrolled from October 2016 to June 2017. All were infected with genotype 2 HCV. Sixteen patients (50%) exhibited cirrhosis including 6 patients with decompensation. Regimens of SOF/DCV and SOF/DCV/ribavirin were used to treat 14 and 18 patients, respectively. SVR was achieved in all 31 patients (100%) who completed follow-up. Significantly higher levels of cholesterol (p = 0.013) and higher low density lipoprotein-cholesterol (p = 0.015) were exhibited after successful viral clearance. SOF/DCV/ribavirin regimen resulted in more adverse events, significantly higher bilirubin levels, and decline of hemoglobin during treatment than SOF/DCV regimen. Four patients with chronic kidney disease maintained renal function during treatment. Overall, SOF/DCV or SOF/DCV/ribavirin treatment was well tolerated.Conclusion: SOF/DCV with or without ribavirin is highly effective and safe for patients with genotype 2 HCV infection in real-world experience in Taiwan. [ABSTRACT FROM AUTHOR]- Published
- 2019
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18. Efficacy and safety of 12 weeks of daclatasvir, asunaprevir plus ribavirin for HCV genotype-1b infection without NS5A resistance-associated substitutions.
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Yu, Ming-Lung, Hung, Chao-Hung, Huang, Yi-Hsiang, Peng, Cheng-Yuan, Lin, Chun-Yen, Cheng, Pin-Nan, Chien, Rong-Nan, Hsu, Shih-Jer, Liu, Chen-Hua, Huang, Chung-Feng, Su, Chien-Wei, Huang, Jee-Fu, Liu, Chun-Jen, Kao, Jia-Horng, Chuang, Wan-Long, Chen, Pei-Jer, and Chen, Ding-Shinn
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RIBAVIRIN ,HEPATITIS C virus ,HEPATITIS C ,ANTIVIRAL agents ,COMBINATION drug therapy ,CLINICAL trials ,DRUG resistance in microorganisms ,HEPATITIS viruses ,IMIDAZOLES ,ISOQUINOLINE ,LONGITUDINAL method ,MEDICAL cooperation ,PROTEINS ,RESEARCH ,RNA ,SULFONAMIDES ,CHRONIC hepatitis C ,THERAPEUTICS - Abstract
Background/purpose: Treatment with daclatasvir plus asunaprevir (DCV + ASV) for 24 weeks provided a sustained virologic response (SVR) rate of over 90% in hepatitis C virus genotype 1b (HCV-1b) infected patients without non-structural 5A (NS5A) resistance-associated substitutions (RASs) at the L31 and Y93 sites. In this study, we investigated whether adding ribavirin to the DCV + ASV combination could shorten the original treatment regimen to 12 weeks without compromising the treatment efficacy for HCV-1b patients without NS5A RASs.Methods: In the prospective, open-label, single-arm, nationwide multi-center phase III study, a total of 70 interferon-naïve or interferon-experienced HCV-1b patients without baseline L31/Y93 RASs received daclatasvir (60 mg/day) and asunaprevir (100 mg twice daily) plus weight-based ribavirin (1000-1200 mg/day) for 12 weeks, with a 12-week post-treatment follow-up. The primary end-point was the rate of undetectable HCV RNA 12 weeks post-treatment (SVR12).Results: The SVR12 rate was 97.1% (68/70) and 100% (68/68) in the full-analysis-set and the per-protocol population, respectively. None of the 68 patients who completed the 12-week treatment experienced relapse during post-treatment follow-up. Two patients withdrew from the study at treatment days 21 and 34 due to anorexia and fatigue, which were considered ribavirin-related and resolved post medication cessation. A total of 4 serious adverse events were reported and considered treatment-unrelated. No deaths or grade 4 adverse events requiring hospitalization was observed throughout the study.Conclusion: Truncated regimen of DCV + ASV plus ribavirin for 12 weeks was highly effective and safe in HCV-1b patients without NS5A L31/Y93 RAS. [ABSTRACT FROM AUTHOR]- Published
- 2019
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19. Structural Polymorphs Suggest Competing Pathways for the Formation of Amyloid Fibrils That Diverge from a Common Intermediate Species.
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Buchanan, Lauren E., Maj, Michał, Dunkelberger, Emily B., Cheng, Pin-Nan, Nowick, James S., and Zanni, Martin T.
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- 2018
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20. Combined Transarterial Embolization/Chemoembolization-Based Locoregional Treatment with Sorafenib Prolongs the Survival in Patients with Advanced Hepatocellular Carcinoma and Preserved Liver Function: A Propensity Score Matching Study
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Chien, Shih-Chieh, Chen, Chiung-Yu, Cheng, Pin-Nan, Liu, Yi-Shan, Cheng, Hsiu-Chi, Chuang, Chiao-Hsiung, Chang, Ting-Tsung, Chiu, Hong-Chi, Lin, Yih-Jyh, and Chiu, Yen-Cheng
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Background: Sorafenib is the standard treatment for patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC). However, the treatment outcome is not satisfactory. We retrospectively analyzed whether adding transarterial embolization/chemoembolization (TA(C)E)-based locoregional therapy to sorafenib can further improve treatment efficacy. Patients and Methods: We included 147 BCLC stage C HCC patients with Child-Turcotte-Pugh class A liver function and treated with sorafenib for analysis. Through propensity score matching, we divided patients into the combined treatment group (n = 63; patients received TA(C)E-based locoregional treatment and sorafenib) and the sorafenib monotherapy group (n = 63). We analyzed the effects of patients’ clinical and tumor-related factors on their overall survival (OS) and time to tumor progression. Results: The OS was better in the combined treatment group than in the sorafenib monotherapy group (419 vs. 223 days, p = 0.028). In the Cox regression model, combined treatment, a lower baseline α-fetoprotein (AFP) level < 400 ng/mL, tumors without main portal venous tumorous thrombosis, and age ≥60 years were identified as independent factors for OS. Subgroup analysis demonstrated that patients with a higher baseline AFP level > 400 ng/mL, age < 60 years, tumors with branched portal venous tumorous thrombosis only or without extrahepatic metastasis benefited the most from combined treatment. Conclusion: Combining TA(C)E-based locoregional treatment with sorafenib resulted in better OS in patients with BCLC stage C HCC compared with sorafenib alone. TA(C)E-based locoregional treatment can be an adjunctive treatment to sorafenib for patients with advanced HCC and a satisfactory liver functional reserve.
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- 2019
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21. Structural Polymorphs Suggest Competing Pathways for the Formation of Amyloid Fibrils That Diverge from a Common Intermediate Species
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Buchanan, Lauren E., Maj, Michał, Dunkelberger, Emily B., Cheng, Pin-Nan, Nowick, James S., and Zanni, Martin T.
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It is now recognized that many amyloid-forming proteins can associate into multiple fibril structures. Here, we use two-dimensional infrared spectroscopy to study two fibril polymorphs formed by human islet amyloid polypeptide (hIAPP or amylin), which is associated with type 2 diabetes. The polymorphs exhibit different degrees of structural organization near the loop region of hIAPP fibrils. The relative populations of these polymorphs are systematically altered by the presence of macrocyclic peptides which template β-sheet formation at specific sections of the hIAPP sequence. These experiments are consistent with polymorphs that result from competing pathways for fibril formation and that the macrocycles bias hIAPP aggregation toward one pathway or the other. Another macrocyclic peptide that matches the loop region but extends the lag time leaves the relative populations of the polymorphs unaltered, suggesting that the branching point for structural divergence occurs after the lag phase, when the oligomers convert into seeds that template fibril formation. Thus, we conclude that the structures of the polymorphs stem from restricting oligomers along diverging folding pathways, which has implications for drug inhibition, cytotoxicity, and the free energy landscape of hIAPP aggregation.
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- 2018
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22. Performance of Noninvasive Tests of Fibrosis Among Asians, Hispanic, and non-Hispanic Whites in the STELLAR Trials.
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Wong, Vincent Wai-Sun, Tak, Won Young, Goh, George Boon Bee, Cheng, Pin-Nan, Lawitz, Eric J., Younossi, Zobair M., Vuppalanchi, Raj, Younes, Ziad, Alkhouri, Naim, Wang, Lulu, Liu, Jialuo, Kersey, Kathryn, Myers, Robert P., Harrison, Stephen A., Goodman, Zachary, Trauner, Michael, Romero-Gomez, Manuel, Anstee, Quentin M., Nguyen, Mindie H., and Okanoue, Takeshi
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The effect of race on routinely available noninvasive tests of fibrosis is incompletely understood. This study evaluated the performance of noninvasive tests among white and Asian patients in the STELLAR trials (NCT03053050 and NCT03053063), which evaluated selonsertib in patients with advanced (F3-F4) fibrosis due to nonalcoholic steatohepatitis (NASH). Baseline liver biopsies were centrally read using the NASH Clinical Research Network system, and 4 noninvasive tests (Nonalcoholic fatty liver disease fibrosis score [NFS], Fibrosis-4 index [FIB-4], Enhanced Liver Fibrosis test [ELF], and liver stiffness by vibration-controlled transient elastography) were measured. The performance of these tests to discriminate advanced fibrosis was evaluated using areas under the receiver operating characteristics curves with 5-fold cross-validation repeated 100 times. Among 3207 patients screened with evaluable liver histology, 2281 were whites and 762 were Asians. Seventy-two percent of whites and 67% of Asians had advanced fibrosis. The areas under the receiver operating characteristics curves of the noninvasive tests for advanced fibrosis were similar in whites and Asians: 0.73 and 0.75 for NFS, 0.78 and 0.80 for FIB-4, 0.79 and 0.81 for ELF, and 0.80 and 0.83 for liver stiffness, respectively. At the published cutoffs, the tests had similar sensitivities and specificities in the 2 groups. However, the sensitivities of NFS, FIB-4, and ELF were low in both white and Asian patients younger than 40 years. In the global phase III STELLAR trials, the diagnostic performance of routinely available noninvasive tests for the detection of advanced fibrosis due to NASH was acceptable and similar between white and Asian patients. [ABSTRACT FROM AUTHOR]
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- 2023
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23. Favouring modulation of circulating lipoproteins and lipid loading capacity by direct antiviral agents grazoprevir/elbasvir or ledipasvir/sofosbuvir treatment against chronic HCV infection
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Sun, Hung-Yu, Cheng, Pin-Nan, Tseng, Chiung-Ying, Tsai, Wei-Jen, Chiu, Yen-Cheng, and Young, Kung-Chia
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ObjectiveLipid homoeostasis is disturbed in patients with HCV infection. Direct-acting antiviral agent (DAA) treatment eradicates chronic HCV viraemia, but the dynamics of lipid components remain elusive. This study investigates the clinical manifestation and mechanistic relevance of plasma triglyceride (TG), cholesterol (Chol), lipoproteins and apolipoproteins (apos) after DAA treatment.DesignTwenty-four patients with chronic genotype 1 (GT1) HCV treated with elbasvir/grazoprevir or ledipasvir/sofosbuvir for 12 weeks, and followed-up thereafter, were recruited. Their TG, Chol, apoAI and apoB levels were quantified in plasma samples and individually fractionated lipoprotein of various classes. Liver fibrosis was evaluated using the FIB-4 Score. The TG and Chol loading capacities were calculated with normalisation to apoB, which represents per very low density lipoprotein (VLDL) and LDL particle unitResultsDAA treatment achieved a sustained virological response rate of 91.7% and reduced the FIB-4 Score. Relative to the baseline, the plasma TG level was reduced but the Chol level increased gradually. Plasma apoB levels and apoB/apoAI ratio were transiently downregulated as early as the first 4 weeks of treatment. The TG and Chol loading capacities in VLDL were elevated by ~20% during the period of DAA treatment and had steadily increased by 100% at follow-up. Furthermore, the TG-to-Chol ratio in VLDL was increased, while the ratio in LDL was reduced, indicating an efficient catabolism.ConclusionThe DAA treatment of patients with chronic hepatitis C might lead to efficient HCV eradication and hepatic improvement concomitantly evolving with favouring lipoprotein/apo metabolisms.
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- 2018
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24. Reversibility of some oxidative stress markers in chronic hepatitis C patients after receiving direct-acting antiviral agents
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Cheng, Pin-Nan, Sun, Hung-Yu, Feng, I-Che, Wang, Sin-Tian, Chiu, Yen-Cheng, Chiu, Hung-Chih, Chien, Shih-Chieh, and Young, Kung-Chia
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Hepatitis C (HCV) is associated with extra-hepatic involvment, morbidity as well as metabolic changes. Whether these might be reversible if sustained virologic response (SVR) is achieved by direct-acting antiviral (DAA) therapy remains unknown.
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- 2023
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25. Impact of Sofosbuvir-Based Direct-Acting Antivirals on Renal Function in Chronic Hepatitis C Patients With Impaired Renal Function: A Large Cohort Study From the Nationwide HCV Registry Program (TACR).
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Huang, Chung-Feng, Tseng, Kuo-Chih, Cheng, Pin-Nan, Hung, Chao-Hung, Lo, Ching-Chu, Peng, Cheng-Yuan, Bair, Ming-Jong, Yeh, Ming-Lun, Chen, Chien-Hung, Lee, Pei-Lun, Lin, Chun-Yen, Kuo, Hsing-Tao, Chen, Chun-Ting, Yang, Chi-Chieh, Huang, Jee-Fu, Tai, Chi-Ming, Hu, Jui-Ting, Lin, Chih-Lang, Su, Wei-Wen, and Tsai, Wei-Lun
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Sofosbuvir is approved for chronic hepatitis C (CHC) patients with severe chronic kidney disease (CKD). The impact of sofosbuvir-based therapy on renal function augmentation on a real-world nationwide basis is elusive. The 12,995 CHC patients treated with sofosbuvir-based (n = 6802) or non–sofosbuvir-based (n = 6193) regimens were retrieved from the Taiwan nationwide real-world HCV Registry Program. Serial estimated glomerular filtration rate (eGFR) levels were measured at baseline, end of treatment (EOT), and end of follow-up (EOF) (3 months after EOT). The eGFR decreased from baseline (91.4 mL/min/1.73 m
2 ) to EOT (88.4 mL/min/1.73 m2 ; P <.001) and substantially recovered at EOF (88.8 mL/min/1.73 m2 ) but did not return to pretreatment levels (P <.001). Notably, a significant decrease in eGFR was observed only in patients with baseline eGFR ≥90 mL/min/1.73 m2 (from 112.9 to 106.4 mL/min/1.73 m2 ; P <.001). In contrast, eGFR increased progressively in patients whose baseline eGFR was <90 mL/min/1.73 m2 (from 70.0 to 71.5 mL/min/1.73 m2 ; P <.001), and this increase was generalized across different stages of CKD. The trend of eGFR amelioration was consistent irrespective of sofosbuvir usage. Multivariate adjusted analysis demonstrated that baseline eGFR >90 mL/min/1.73 m2 was the only factor independently associated with significant slope coefficient differences of eGFR (–1.98 mL/min/1.73 m2 ; 95% confidence interval, –2.24 to –1.72; P <.001). The use of sofosbuvir was not an independent factor associated with eGFR change. Both sofosbuvir and non–sofosbuvir-based regimens restored renal function in CHC patients with CKD, especially in those with significant renal function impairment. [ABSTRACT FROM AUTHOR]- Published
- 2022
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26. Qualification and Verification of Serological Biomarker Candidates for Lung Adenocarcinoma by Targeted Mass Spectrometry
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Wu, Hsin-Yi, Goan, Yih-Gang, Chang, Ying-Hua, Yang, Yi-Fang, Chang, Hsiao-Jen, Cheng, Pin-Nan, Wu, Chih-Chieh, Zgoda, Victor G., Chen, Yu-Ju, and Liao, Pao-Chi
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Lung cancer is the leading cause of cancer mortality worldwide. Although many biomarkers have been identified for lung cancer, their low specificity and sensitivity present an urgent need for the identification of more candidate biomarkers. In this study, we conducted MRM-based targeted analysis to evaluate the potential utility of a list of candidate proteins for lung cancer diagnosis. A total of 1249 transitions of 420 peptides representing 102 candidate proteins from our previous study and the literature were first screened by MRM analysis in pooled plasma samples, resulting in 78 proteins remaining in the list. Relative quantification of these 78 proteins was further performed in 60 individual plasma samples from lung adenocarcinoma patients in stages I–III and matched healthy control subjects. Ultimately, nine proteins were found to be able to distinguish patients from controls. Further combinations of five, three, and two candidate marker proteins improved the sensitivity to discriminate patients from controls and resulted in a merged AUC value of nearly 1.00 in stages I–III patients versus controls. Our results highlighted several possible markers for lung adenocarcinoma, and the proposed protein panels require further validation in a larger cohort to evaluate their potential use in clinical applications or development of therapeutics.
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- 2015
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27. Different schedules of bowel preparation with sodium phosphate lead to different bowel cleansing effects and adenoma detection rates at colonoscopy
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Kang, Jui‐Wen, Chuang, Chiao‐Hsiung, Chen, Chiung‐Yu, Cheng, Hsiu‐Chi, Chang, Wei‐Lun, Chen, Wei‐Ying, Cheng, Pin‐Nan, and Sheu, Bor‐Shyang
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Adequate bowel preparation is an important quality indicator of colonoscopy. This study validated whether the bowel cleansing quality and adenoma detection rate (ADR) could be different between two bowel preparation schedules in individuals receiving health examinations. We enrolled individuals who had received a colonoscopy as part of the regimen for their health checkup program with split‐dose phosphosoda for bowel preparation. Prior to December 31, 2012, the second dose of phosphosoda was administered at 10:00 pmbefore the day of the colonoscopy and the individuals were defined as the 10‐pmgroup. After January 1, 2013, the schedule was changed to 4:00 amthe same day as the colonoscopy and was defined as the 4‐amgroup. The bowel cleansing quality was assessed using the Aronchick scale. A total of 431 individuals were included, 259 in the 10‐pmgroup and 172 in the 4‐amgroup. The 4‐amgroup individuals had a higher rate of excellent or good bowel cleansing quality as compared with the 10‐PM group (77.3% vs. 22%, respectively; p< 0.001). The ADR was also higher in the 4‐amgroup than in the 10‐pmgroup (36% vs. 25.5%, respectively; p= 0.019). Modifying the time schedule of bowel preparation could improve bowel cleansing quality and increase the colonic ADR in a health management center.
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- 2015
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28. Different schedules of bowel preparation with sodium phosphate lead to different bowel cleansing effects and adenoma detection rates at colonoscopy
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Kang, Jui-Wen, Chuang, Chiao-Hsiung, Chen, Chiung-Yu, Cheng, Hsiu-Chi, Chang, Wei-Lun, Chen, Wei-Ying, Cheng, Pin-Nan, and Sheu, Bor-Shyang
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Adequate bowel preparation is an important quality indicator of colonoscopy. This study validated whether the bowel cleansing quality and adenoma detection rate (ADR) could be different between two bowel preparation schedules in individuals receiving health examinations.
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- 2015
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29. Efficacy of Entecavir in Chronic Hepatitis B Patients with Persistently Normal Alanine Aminotransferase: Randomized, Double-Blind, Placebo-Controlled Study
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Tseng, Kuo-Chih, Chen, Chi-Yi, Tsai, Hung-Wen, Chang, Ting-Tsung, Chuang, Wan-Long, Hsu, Ping-I, Liu, Wen-Chun, and Cheng, Pin-Nan
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Background It is still inconclusive whether chronic hepatitis B (CHB) patients with persistently normal alanine aminotransferase (PNALT) should receive nucleoside/nucleotide analogues. This study is to evaluate the efficacy of entecavir in improving liver histology in CHB patients with PNALT.Methods In this prospective randomized, double-blind, placebo-controlled study, 380 CHB patients with PNALT were screened, 82 patients received biopsy and 43 patients met the HBV DNA and histology criteria and were randomly assigned to either an entecavir or placebo group for 52 weeks, with 22 and 21 in each group, respectively. The primary objective was to evaluate histological improvement. The secondary objective is to evaluate virological efficacy.Results A total of eight (38.1%) patients in the entecavir group and eight (44.4%) in the placebo group (P=0.752) showed histological improvement. The decrease in total Knodell scores (±sd) was 1.3 ±1.9 in the entecavir group and 1.5 ±2.2 in the placebo group (P=0.803). The subjects with undetectable HBV DNA at week 52 were 16/21 (76.2%) in the entecavir group and 0/18 (0%) in the placebo group (P<0.001). The mean HBV DNA reduction from baseline to week 52 was 4.73 ±0.83 in the entecavir and 0.25 ±0.81 in the placebo group (P<0.001).Conclusions CHB patients with PNALT receiving entecavir therapy for one year achieved virological efficacy, but not histological benefit. ClinicalTrials.gov number NCT01833611.
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- 2014
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30. The needs of surveillance of metabolic associated fatty liver disease in Taiwan
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Cheng, Pin‐Nan
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- 2021
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31. Aeromonas spontaneous bacterial peritonitis: a highly fatal infectious disease in patients with advanced liver cirrhosis.
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Wu, Chi-Jung, Lee, Hsin-Chun, Chang, Ting-Tsung, Chen, Chiung-Yu, Lee, Nan-Yao, Chang, Chia-Ming, Sheu, Bor-Shyang, Cheng, Pin-Nan, Shih, Hsin-I, and Ko, Wen-Chien
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AEROMONAS ,PERITONITIS ,CIRRHOSIS of the liver ,BODY fluids ,COMPARATIVE studies ,DIFFERENTIAL diagnosis ,GRAM-negative bacteria ,GRAM-negative bacterial diseases ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,EVALUATION research ,RETROSPECTIVE studies ,DISEASE complications ,DIAGNOSIS - Abstract
Background/purpose: Aeromonas infections, rarely reported in Western countries, are not uncommon infectious diseases in Taiwan. The clinical manifestations and prognostic factors of Aeromonas spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis were investigated.Methods: We reviewed the medical charts and microbiological records of liver cirrhosis patients with Aeromonas SBP between January 1990 and December 2005, in a medical center in southern Taiwan.Results: Thirty-one liver cirrhosis patients developed Aeromonas SBP within a 16-year period. The majority (26, 84%) had concurrent Aeromonas bacteremia. A. sobria (55%) and A. hydrophila (45%) were the causative species. The predominant clinical manifestations included fever (84%), abdominal pain (74%), hypotension on admission (48%), altered mental status (45%), and acute renal failure (42%). Gram-negative bacilli were found in Gram staining of ascitic fluids in 27% of 26 patients, while aeromonads were isolated from ascitic fluids in 55% of 31 patients. The yield rate of ascitic fluid cultures decreased greatly, if paracentesis was performed at > 3 hours after the administration of antimicrobial therapy. All but one patient received in-vitro-active antimicrobial agents within 48 hours, but the all-cause mortality rate was 56%. Initial high Pitt's bacteremia score was independently associated with a fatal outcome in multivariate analysis.Conclusion: Aeromonas SBP is a fatal disease, and must be included in the differential diagnosis of SBP in patients with advanced liver cirrhosis in endemic areas. [ABSTRACT FROM AUTHOR]- Published
- 2009
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32. [3]Pseudorotaxane-Like Complexes Formed between Bipyridinium Dications and Bis-p-xylyl[26]crown-6
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Cheng, Pin-Nan, Lin, Chi-Feng, Liu, Yi-Huang, Lai, Chien-Chen, Peng, Shie-Ming, and Chiu, Sheng-Hsien
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The crown ether BPX26C6 forms a [3]pseudorotaxane-like complex with the N,N‘-dimethyl-4,4‘-bipyridinium dication both in solution and in the solid state. The facile one-pot synthesis of a [2]rotaxane from neutral precursors−BPX26C6, 4,4‘-dipyridyl, and 3,5-di-tert-butylbenzyl bromide−suggests that BPX26C6 may bind to (mono)pyridinium cations in a [2]pseudorotaxane-like manner.
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- 2006
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33. A Macrocycle/Molecular‐Clip Complex that Functions as a Quadruply Controllable Molecular Switch
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Chiang, Pinn‐Tsong, Cheng, Pin‐Nan, Lin, Chi‐Feng, Liu, Yi‐Hung, Lai, Chien‐Chen, Peng, Shie‐Ming, and Chiu, Sheng‐Hsien
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Herein, we report the synthesis of a molecular clip with TTF side‐walls and its binding behavior towards electron‐deficient guests, namely the formation of macrocycle/molecular‐clip supramolecular complexes in solution. Four different sets of external stimuli—the K+/[2.2.2]cryptand, NH4+/Et3N and (p‐BrPh)3NSbCl6/Zn pairs, and heating/cooling cycles—control the movement of this molecular switch between its threaded and unthreaded states and provide color changes that are observable by the naked eye. This macrocycle/molecular‐clip complex system can be considered not only as a quadruple‐use molecular switch, but can also be operated by three of these stimuli as a three‐input molecular NOR‐functioning logic gate that may be monitored by UV‐visible spectroscopy.
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- 2006
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34. Hepatotoxicity Associated with Acarbose Therapy
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Hsiao, Shu-Hwa, Liao, Li-Hsiang, Cheng, Pin-Nan, and Wu, Ta-Jen
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Objective: To report a case of acarbose-induced hepatotoxicity and compare other reported cases from the literature.Case Summary: A 57-year-old woman with type 2 diabetes mellitus for about 10 years had been treated with insulin glargine 20 units/day since December 19, 2002. Acarbose 100 mg 3-times-daily add-on therapy for inadequate glycemic control was started on June 5, 2003. Six months later, the woman complained of gastrointestinal discomfort; the acarbose dose was decreased to 50 mg 3 times daily thereafter. Laboratory examination later revealed alanine aminotransferase (ALT) 640 U/L (upper reference value 55). To elucidate the possibilities of adverse reactions caused by concurrent use of nutritional supplements and medication, we discontinued propolis extract, Ginkgo biloba, placeta extract, and estrogen. Although no remarkable symptoms were noted thereafter, the abnormal ALT values persisted, and no definite viral or autoimmune etiologies were identified. Acarbose was discontinued in August 2004; aspartate aminotransferase and ALT values returned to normal in October 2004.Discussion: In addition to ruling out other possible etiologic factors, we assessed the probability of acarbose-induced hepatotoxicity by observing the close time relationship between drug administration and the development of signs and symptoms, as well as the close time relationship between drug withdrawal and the normalization of abnormal liver function test values. An objective causality assessment revealed that an adverse drug reaction was probable as determined by both the Naranjo probability scale and the Roussel Uclaf Causality Assessment Method score.Conclusions: Although acarbose-induced hepatotoxicity appears to be uncommon, diabetic patients receiving long-term acarbose therapy should be closely monitored for this adverse effect.
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- 2006
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35. Clinical assessment of the bacterial load of Helicobacter pylori on gastric mucosa by a new multi‐scaled rapid urease test
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CHOU, CHANG‐HUA, SHEU, BOR‐SHYANG, YANG, HSIAO‐BAI, CHENG, PIN‐NAN, SHIN, JENG‐SHIANN, CHEN, CHIUNG‐YU, and LIN, XI‐ZHANG
- Abstract
The present study tests the efficacy of the multi‐scaled urease test (MUT) in detecting Helicobacter pyloriinfection and determines whether the MUT can predict the bacterial density on histology. A total of 111 sets of gastric specimens were obtained from patients with dyspepsia but without recent bleeding. Two biopsies were taken as closely as possible in each set. One sample was used for the MUT (Hp fast; GI Supply, Camp Hill, PA, USA), while the other was used to determine the histological density of H. pyloriby modified Giemsa stain (grade 0–5). The results of MUT were interpreted as negative if the colour was yellow or bright green (reaction score 0) and positive if the colour was green, light blue, or blue (reaction score 1, 2 and 3, respectively). The reaction scores of MUT were recorded sequentially at 15 and 30 min and 1, 4 and 24 h. On the basis of histological confirmation, MUT had a sensitivity of 89.6%, a specificity of 88.2%, a positive predictive value of 94.5% and a negative predictive value of 78.9%. Focusing on specimens with the presence of bacteria under histology, 77 specimens were divided into five subgroups by grades of density of H. pylori(HPD1–5). The reaction scores had become sequentially elevated from 30 min through to 24 h in each subgroup. For subgroups HPD4 and 5, the positive rates of MUT were 70.6 and 66.6%, respectively, as early as 30 min and progressed to 100% within 4 h. In contrast, the positive rate for the HPD1 subgroup was 16.6% at 4 h and increased to only 62.5% at 24 h. In subgroups HPD 2 and 3, the positive rates were less than 30% at 30 min, but became more than 66.6% at 4 h and were 100% at 24 h. The early (i.e. mean value of reaction scores before 4 h) and late (24 h) mean reaction scores disclosed two elevated trends as the density of H. pyloriincreased (early: 0.2, 0.7, 0.8, 1.5, 1.2; late: 1.4, 2.3, 2.6, 3.0, 3.0; P< 0.05). In conclusion, MUT is a reliable method for the diagnosis of H. pyloriinfection. It can also indirectly predict the density of H. pylorion histology.
- Published
- 1997
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36. A switchable macrocycle–clip complex that functions as a NOR logic gateElectronic supplementary information (ESI) available: Experimental procedures for the preparation of 1·2PF6, 2, and 3·2PF6and their characterization data. See http://www.rsc.org/suppdata/cc/b4/b417823h/
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Cheng, Pin-Nan, Chiang, Pinn-Tsong, and Chiu, Sheng-Hsien
- Abstract
We have synthesized a new molecular switch—based on a macrocycle–clip complex—whose switching behavior not only can be controlled through the use of either K–2,2,2cryptand or NH4–Et3N systems but also provides color changes that are visible to the naked eye; consequently, this system operates as a two-input NOR functioning molecular logic gate.
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- 2005
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37. Range of Normal Liver Stiffness and Factors Associated With Increased Stiffness Measurements in Apparently Healthy Individuals.
- Author
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Bazerbachi, Fateh, Haffar, Samir, Wang, Zhen, Cabezas, Joaquín, Arias-Loste, Maria Teresa, Crespo, Javier, Darwish-Murad, Sarwa, Ikram, M. Arfan, Olynyk, John K., Gan, Eng, Petta, Salvatore, Berzuini, Alessandra, Prati, Daniele, de Lédinghen, Victor, Wong, Vincent W., Del Poggio, Paolo, Chávez-Tapia, Norberto C., Chen, Yong-Peng, Cheng, Pin-Nan, and Yuen, Man-Fung
- Abstract
Background & Aims Transient elastography (TE) is a noninvasive technique used to measure liver stiffness to estimate the severity of fibrosis. The range of liver stiffness measurements (LSMs) in healthy individuals is unclear. We performed a systematic review to determine the range of LSMs, examined by TE, in healthy individuals and individuals who are susceptible to fibrosis. Methods We collected data from 16,082 individuals, in 26 cohorts, identified from systematic searches of Embase, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews for studies of liver stiffness measurements. Studies analyzed included apparently healthy adults (normal levels of liver enzymes, low-risk alcohol use patterns, and negative for markers of viral hepatitis). The presence of diabetes, hypertension, dyslipidemia, or steatosis, based on ultrasound examination, was known for most participants. We performed a meta-analysis of data from individual participants. The cohort was divided into 4 groups; participants with a body mass index <30 kg/m
2 were examined with the medium probe and those with a body mass index ≥30 kg/m2 were examined with the extra-large probe. Linear regression models were conducted after adjusting for potential confounding factors of LSMs. We performed several sensitivity analyses. Results We established LSM ranges for healthy individuals measured with both probes—these did not change significantly in sensitivity analyses of individuals with platelets ≥150,000/mm3 and levels of alanine aminotransferase ≤33 IU/L in men or ≤25 IU/L in women. In multivariate analysis, factors that modified LSMs with statistical significance included diabetes, dyslipidemia, waist circumference, level of aspartate aminotransferase, and systolic blood pressure at examination time. Significant increases in LSMs were associated with the metabolic syndrome in individuals examined by either probe. Diabetes in obese individuals increased the risk of LSMs in the range associated with advanced fibrosis. Conclusions In a systematic review and meta-analysis of data from individual participants, we established a comprehensive set of LSM ranges, measured by TE in large cohorts of healthy individuals and persons susceptible to hepatic fibrosis. Regression analyses identified factors associated with increased LSMs obtained by TE with the medium and extra-large probes. [ABSTRACT FROM AUTHOR]- Published
- 2019
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38. Existence of Hepatitis C Virus in Culex quinquefasciatusafter Ingestion of Infected Blood: Experimental Approach to Evaluating Transmission by Mosquitoes
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Chang, Ting-Tsung, Chang, Tsuey-Yu, Chen, Cheng-Chen, Young, Kung-Chia, Roan, Jun-Neng, Lee, Yen-Chien, Cheng, Pin-Nan, and Wu, Hua-Lin
- Abstract
ABSTRACTWe used PCR to detect hepatitis C virus (HCV) RNA among supernatants of ground Culex quinquefasciatusmosquitoes that (i) had been fed HCV-positive blood, (ii) had been intrathoracically inoculated with HCV-positive blood, or (iii) were from homes of hepatitis C patients. HCV RNA was detectable under all three conditions, but it did not replicate in mosquitoes and was not detectably transmitted during feeding.
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- 2001
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39. Sa1557 - Normal Values of Liver Stiffness as Measured by Transient Elastography: Pooled Individual Participant Data Meta-Analysis from 26 Studies and 14,883 Participants.
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Bazerbachi, Fateh, Haffar, Samir, Wang, Zhen, Cabezas, Joaquin, Arias-Loste, Maria Teresa, Crespo, Javier, Murad, Sarwa Darwish, Arfan Ikram, M., Petta, Salvatore, Berzuini, Alessandra, Prati, Daniele, de Ledinghen, Victor, Wong, Vincent, Del Poggio, Paolo, Chávez-Tapia, Norberto C., Chen, Yong-Peng, Cheng, Pin-Nan, Yuen, Man-Fung, Das, Kausik, and Chowdhury, Abhijit
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- 2017
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40. The Application of Liver Stiffness Measurement in Residents Without Overt Liver Diseases Through a Community-Based Screening Program
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Cheng, Pin-Nan, Chiu, Yen-Cheng, Chiu, Hung-Chih, Chien, Shih-Chieh, and Tarantino., Giovanni
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- 2016
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41. Splenic infarction after histoacryl injection for bleeding gastric varices
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Cheng, Pin-Nan, Sheu, Bor-Shyang, Chen, Chiung-Yu, Chang, Ting-Tsung, and Lin, Xi-Zhang
- Published
- 1998
- Full Text
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