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Wen-Lin Hsu,1,* Hung-Yi Chen,2,* Fung-Wei Chang,3–5 Ren-Jun Hsu6,71Department of Radiation Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; 2Divisions of Urology, Department of Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan; 3Department of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; 4Tri-Service General Hospital Penghu Branch, National Defense Medical Center, Penghu Branch, Taipei, Taiwan; 5Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan; 6Cancer Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; 7College of Medicine, Tzu Chi University, Hualien, TaiwanCorrespondence: Ren-Jun HsuCancer Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung-Yang Road, Hualien 970, TaiwanTel +886 3 856 1825Fax +886 3 856 1825#15620Email hsurnai@gmail.comFung-Wei ChangDepartment of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanEmail doc30666@gmail.com*These authors contributed equally to this workPurpose: Chronic obstructive pulmonary disease (COPD) is a major pulmonary disease. However, few studies have investigated the relationship between COPD and prostate cancer (PCa). This study aimed to investigate the association between COPD severity and PCa risk.Patients and methods: We conducted a nationwide population-based cohort study utilizing data from 2001 to 2013 from the National Health Insurance Research Database of Taiwan. Cox proportional hazards models with 1:1 propensity score-matched analysis were used to investigate the association between COPD and PCa risk. We further divided the COPD group according to severe complications (including acute respiratory failure, cardiopulmonary arrest, pneumonia, and acute exacerbation) to test for the relationship between COPD severity and PCa risk.Results: This study included 47,634 patients (23,817 COPD patients and 23,817 matched non-COPD controls). Among them, 756 (1.59%) were diagnosed with PCa during a mean follow-up period of 7.05±4.13 years; 387 (1.62%) were from the COPD group and 369 (1.55%) were from the control group. Compared with the patients without COPD, the adjusted hazard ratio (HR) for PCa in the COPD patients was 1.10 (95% confidence interval [CI] 0.95–1.27), while that in the COPD patients with complications was 2.46 (95% CI 1.96–3.61).Conclusions: An increased risk for PCa was found among the COPD patients with complications. COPD complications included acute respiratory failure, cardiopulmonary arrest, pneumonia, and acute exacerbation. These findings may help physicians in treating COPD with complications and in remaining alert to the potential development of PCa.Keywords: National Health Insurance Research Database, prostate cancer, chronic obstructive pulmonary disease

Jui-Ming Liu,1–3,* Ren-Jun Hsu,3–5,* Fung-Wei Chang,6 Feng-Hsiang Chiu,7,8 Chia-Lun Yeh,1 Chun-Fa Huang,9,10 Shu-Ting Chang,11 Hung-Chang Lee,12 Hsin Chi,12,13 Chien-Yu Lin14,15 1Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 2Department of Medicine, National Yang-Ming University, 3Graduate Institute of Life Sciences, 4Department of Pathology and Graduate Institute of Pathology and Parasitology, the Tri-Service General Hospital, National Defense Medical Center, 5Biobank Management Center of the Tri-Service General Hospital, 6Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 7Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; 8Superintendent office, Lihuili Eastern Hospital, Ningbo, Zhejiang province, People’s Republic of China; 9School of Chinese Medicine, College of Chinese Medicine, China Medical University, 10Department of Nursing, College of Medical and Health Science, Asia University, Taichung City, 11Department of Gastroenterology, BinKun Women’s and Children’s Hospital, Taoyuan City, 12Department of Infectious Disease, MacKay Children’s Hospital, Taipei, 13Department of Medicine, MacKay Medical College, New Taipei city, 14Department of Pediatrics and Infectious Disease, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan; 15Division of Infection and Pathway Medicine, College of Medicine and Veterinary Medicine, The University of Edinburgh, Scotland, UK *These authors contributed equally to this work Objectives: Scabies is a common and annoying disorder. Pernicious anemia (PA) is a serious disease which, when untreated, leads to death. Mounting evidence suggests that immune-mediated inflammatory processes play a role in the pathophysiology of both diseases. The relationship between these two diseases has not been investigated. We conducted this study to explore the potential relationship between scabies and PA.Materials and methods: This nationwide, population-based study was conducted using the National Health Insurance Research Database of Taiwan. In total, 5,407 patients with scabies were identified as a study group and 20,089 matched patients were randomly selected as a control group. We tracked patients in both groups for a 7-year period to identify the incidence of PA. The demographic characteristics and comorbidities of the patients were analyzed, and Cox proportional hazards regression was used to calculate the hazard ratios for PA.Results: Of the 25,496 patients in this study, 183 (0.7%) patients with newly diagnosed PA were identified during the 7-year follow-up period; 71 of 5,407 (1.3%) from the scabies group and 112 of 20,089 (0.6%) from the control group. Patients with scabies had a higher risk of subsequent PA, with a crude hazard ratio of 2.368. After adjusting for covariates, the adjusted hazard ratio was 1.51 (95% confidence interval: 1.09–2.08).Conclusion: This study demonstrated an increased risk of PA (adjusted hazard ratio 1.51) among patients with scabies. Immune-mediated inflammatory processes may contribute to this association. Further studies are warranted to investigate the entire pathological mechanisms between these two diseases. Physicians should pay attention to patients with history of scabies presented with anemia. Further confirmative tests of PA may contribute to correct diagnosis and initiation of vitamin B12 supplement. Keywords: scabies, pernicious anemia, National Health Insurance Research Database, autoimmune gastritis, vitamin B12 deficiency, cobalamin

Jung-Yueh Chen,1,* Jui-Ming Liu,2,* Fung-Wei Chang,3 Hung Chang,4,5 Kuan-Chen Cheng,6,7 Chia-Lun Yeh,2 Yu-Feng Wei,1 Ren-Jun Hsu8–10 1Division of Chest Medicine, Department of Internal Medicine, E-DA Hospital, I-Shou University, Kaohsiung, 2Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, 3Department of Obstetrics & Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 4Division of Thoracic Surgery, Department of Surgery, Taichung Armed Forces General Hospital, Taichung, 5Department of Physiology, National Defense Medical Center, 6Graduate Institute of Food Science and Technology, National Taiwan University, 7Institute of Biotechnology, National Taiwan University, 8Graduate Institute of Life Sciences, National Defense Medical Center, 9Department of Pathology, Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center, 10Biobank Management Center, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan *These authors contributed equally to this work Background: Scabies is a common parasitic infectious disease, and COPD is a major pulmonary disease. However, there have been no previous studies that have investigated the relationship between scabies and COPD. Materials and methods: This nationwide population-based study included a total of 3,568 patients with scabies as the study group and 14,255 patients as a control group. We followed up patients in both groups for a 5-year period to identify any new diagnoses of COPD. We then followed them up for an additional 2-year period to determine the severity of any newly diagnosed cases of COPD as indicated by acute respiratory events. Cox proportional hazard regression analyses were performed to calculate the hazard ratio (HR) of COPD during the 5-year follow-up period and COPD complication during the additional 2-year follow-up period. Results: Of the 17,823 patients in the study, 2,765 (15.5%) were newly diagnosed with COPD during the 5-year follow-up period; 904 (32.7%) were from the scabies group; and 1,861 (67.3%) were from the control group. Compared to the patients without scabies, the adjusted HR (aHR) for COPD for the subjects with scabies was 1.72 (95% CI: 1.59–1.87) during the 5-year follow-up period. For those newly diagnosed with COPD, the aHR for COPD with acute exacerbation was 1.85 (95% CI: 1.67–2.06), the aHR for COPD with pneumonia was 3.29 (95% CI: 2.77–3.92), the aHR for COPD with acute respiratory failure was 4.00 (95% CI: 3.08–5.19), and the aHR for COPD with cardiopulmonary arrest was 3.95 (95% CI: 2.25–6.95) during the additional 2-year follow-up period. Conclusion: The results of this study indicate a 72% increased risk for COPD among patients with scabies. The results also reveal an increased risk of severe COPD complications such as acute respiratory failure, cardiopulmonary arrest, pneumonia, and acute exacerbation among patients with scabies. This useful information may help physicians in treating scabies and remaining alert to the potential development of COPD and its severe complications. Keywords: scabies, chronic obstructive pulmonary disease, National Health Insurance Research Database

Three surveys were carried out to study the phytoplankton role in influencing the Hg distribution in a poorly eutrophic estuary by measuring the total Hg (THg) and methylHg (MeHg) concentrations in waters and four-size fractions of phytoplankton. The THg and MeHg concentrations in waters and phytoplankton varied markedly temporal during the three surveys. The total concentrations of THg and MeHg in the four-size fractions of phytoplankton ranged between 0.62 and 28.15 mg/kg and 0.022-4.411 mg/kg, respectively. The dominance of THg and MeHg phytoplankton concentrations differed from different size fractions and varied with the various surveys. The huge uptake of Hg by abundant phytoplankton decreased both Hg concentrations in waters and phytoplankton, which was attributed to the biomass dilution effect during the July survey. The Hg partition between water and phytoplankton provided substantial evidence to illustrate the huge uptake of Hg by the abundant phytoplankton., Competing Interests: Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Gonadotropin-Releasing Hormone Agonist (GnRH-a) and levonorgestrel releasing intrauterine system (LNG-IUS) are conventional conservative treatments for adenomyosis, and high-intensity focused ultrasound (HIFU) is a novel ablation technique. This study aimed to investigate the effectiveness of HIFU combined with GnRH-a or LNG-IUS for adenomyosis patients. In this systematic review and meta-analysis, Pubmed, Embase, Cochrane Library and Scopus databases were searched up to December 2021. Published studies comparing HIFU plus GnRH-a with HIFU plus LNG-IUS in adenomyosis patients were assessed for eligibility by two independent authors. Risk of bias tool was utilized for risk evaluation. We selected treatment effective rate of dysmenorrhea (pain during menstruation) as the primary outcome; effective rate of menorrhagia severity and reduction rate of adenomyotic lesion as the secondary outcomes. Adverse effects were assessed. Four studies with a total 729 patients were enrolled in the meta-analysis. HIFU plus LNG-IUS showed lower dysmenorrhea [within 6 months: risk ratio (RR) 0.88, 95% confidence interval (CI) 0.83-0.93, p < 0.00001; over 1 year: RR 0.73, 95% CI 0.65-0.82, p < 0.00001] and less menorrhagia severity (RR 0.63, 95% CI 0.60-0.66, p < 0.00001) than HIFU plus GnRH-a. Both groups demonstrated equal efficacy in adenomyotic lesion reduction rate (RR 1.03, 95% CI 0.97-1.09, p = 0.30). Adverse effects happened equally in both groups. Combination therapy of HIFU and LNG-IUS revealed better effectiveness in treating dysmenorrhea and menorrhagia than that of HIFU and GnRH-a. However, interpreting the conclusion should be approached with caution as a result of significant heterogeneity., Competing Interests: Declaration of competing interest All authors have declared no conflicts of interest., (Copyright © 2024. Published by Elsevier B.V.)

Mesenchymal stem cell (MSC)-derived extracellular vesicles (exosomes) possess regeneration, cell proliferation, wound healing, and anti-senescence capabilities. The functions of exosomes can be modified by preconditioning MSCs through treatment with bio-pulsed reagents ( Polygonum multiflorum Thunb extract). However, the beneficial effects of bio-pulsed small extracellular vesicles (sEVs) on the skin or hair remain unknown. This study investigated the in vitro mechanistic basis through which bio-pulsed sEVs enhance the bioactivity of the skin fibroblasts and hair follicle cells. Avian-derived MSCs (AMSCs) were isolated, characterized, and bio-pulsed to produce AMSC-sEVs, which were isolated, lyophilized, characterized, and analyzed. The effects of bio-pulsed AMSC-sEVs on cell proliferation, wound healing, and gene expression associated with skin and hair bioactivity were examined using human skin fibroblasts (HSFs) and follicle dermal papilla cells (HFDPCs). Bio-pulsed treatment significantly enhanced sEVs production by possibly upregulating RAB27A expression in AMSCs. Bio-pulsed AMSC-sEVs contained more exosomal proteins and RNAs than the control. Bio-pulsed AMSC-sEVs significantly augmented cell proliferation, wound healing, and gene expression in HSFs and HFDPCs. The present study investigated the role of bio-pulsed AMSC-sEVs in the bioactivity of the skin fibroblasts and hair follicle cells as mediators to offer potential health benefits for skin and hair.

The trace metals species in surface sediments of the Taiwanese river estuarine mouths and the Taiwan Strait were examined by sequential extraction method. Based on the metal species present in sediments, trace metals can be divided into three groups: (1) Co, Cr, Fe, Ni and Zn; (2) Cu and Hg; and (3) Mn and Pb. The total concentrations of trace metals in the first two groups are dominated by the residual fraction. While, Cu and Hg their organic species also contributes a significant percentage and reduces the residual fraction portion. Lead and Mn are dominated by the labile fraction. The total metal concentrations in the analyzed sediments seem to be influenced by Fe oxides, TOC and grain size. The metals contamination status assessed by three environmental indices suggests that the analyzed sediments are minor contaminated by trace metals, with a few exceptions of Cu and Hg at some stations., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

During certain clinical situations, some parturients require instruments for operative vaginal delivery, and various designs of vacuum extractors may affect the fetal head. To investigate the biomechanical effects of divergent sizes of silicone rubber vacuum extractors, we employed finite element analysis in this study. First, we constructed computer models for different vacuum extractor sizes (diameters: 40 mm, 50 mm, 60 mm, and 70 mm), flat surface, hemispherical ball, and fetal head shape. A hemispherical ball was the main design for the vacuum extractor model, and the material used for the vacuum extractor was silicone rubber. Next, the settings of 1 mm vacuum extractor displacement and vacuum cap pressure of 60 cmHg were applied. The main observation markers of this study were the respective von Mises stresses on the vacuum extractor and skull by the reaction force on the fixed end. The concluded results revealed that vacuum extractors with larger diameters lead to greater reaction force, stress, and strain on fetal heads. Therefore, this study's biomechanical analytic consequences suggest that clinicians avoid selecting larger vacuum extractors during operative instrumental delivery so that fetal heads will experience less external force, deformation, and resultant complications. It could also provide a practical reference for obstetricians for instrumental vaginal delivery with the vacuum extractor made of silicone rubber.

Telomeres cap the ends of eukaryotic chromosomes and are indispensable chromatin structures for genome protection and replication. Telomere length maintenance has been attributed to several functional modulators, including telomerase, the shelterin complex, and the CST complex, synergizing with DNA replication, repair, and the RNA metabolism pathway components. As dysfunctional telomere maintenance and telomerase activation are associated with several human diseases, including cancer, the molecular mechanisms behind telomere length regulation and protection need particular emphasis. Cancer cells exhibit telomerase activation, enabling replicative immortality. Telomerase reverse transcriptase (TERT) activation is involved in cancer development through diverse activities other than mediating telomere elongation. This review describes the telomere functions, the role of functional modulators, the implications in cancer development, and the future therapeutic opportunities.

Whether meconium-stained amniotic fluid (MSAF) serves as an indicator of fetal distress is under debate; however, the presence of MSAF concerns both obstetricians and pediatricians because meconium aspiration is a major contributor to neonatal morbidity and mortality, even with appropriate treatment. The present study suggested that thick meconium in infants might be associated with poor outcomes compared with thin meconium based on chart reviews. In addition, cell survival assays following the incubation of various meconium concentrations with monolayers of human epithelial and embryonic lung fibroblast cell lines were consistent with the results obtained from chart reviews. Exposure to meconium resulted in the significant release of nitrite from A549 and HEL299 cells. Medicinal agents, including dexamethasone, L-Nω-nitro-arginine methylester (L-NAME), and NS-398 significantly reduced the meconium-induced release of nitrite. These results support the hypothesis that thick meconium is a risk factor for neonates who require resuscitation, and inflammation appears to serve as the primary mechanism for meconium-associated lung injury. A better understanding of the relationship between nitrite and inflammation could result in the development of promising treatments for meconium aspiration syndrome (MAS).

Postpartum depression (PPD) is associated with negative physical and mental health outcomes for the mother and infant. Women often experience elevated symptoms of PPD, and the incidence of PPD has increased in recent years. There were lack of studies to investigate the effects of medications during pregnancy. Herein, we focused on the most common obstetric medical therapies used in labor and determined whether the medical therapies cause mental stress in pregnant women. This 14-year retrospective population-based nationwide study was based on the National Health Insurance Research Database. Univariate and multivariate logistic regression analyses were used to evaluate unadjusted and adjusted odds ratios and 95% confidence intervals for each tocolytic and uterotonic treatments during pregnancy and common medical illnesses. In comparing the effects of tocolytic and uterotonic medications on maternal PPD, tocolysis with the injection form of ritodrine resulted in a significantly higher risk of PPD based on multivariate analysis. This study supports existing research demonstrating an association between tocolysis with ritodrine and PPD. Ritodrine treatment for preterm labor was a significant risk factor for PPD, especially the injection form. This information provides obstetricians and health policy providers to pay attention to maternal mental health outcomes among high-risk pregnant women.

Antrodia cinnamomea is a Taiwanese medicinal mushroom with multiple pharmacological activities. Antrodia cinnamomea solid-state cultivated mycelium (LAC) exerts health-related effects in animal and cell models, but clinical data is limited. This study aimed to determine the safety and effects of LAC on human physiological functions. In an open-label, single-arm study, 32 healthy men and women ingested LAC capsules for three months. The subjects were monitored during the study and one month after the study end-point. LAC consumption did not significantly change fasting blood glucose, blood pressure, and triglyceride levels or liver and renal function indices. No adverse events occurred during the trial. Moreover, a significant change from baseline in total cholesterol levels was observed; men and women had decreases of 5.7% and 5.3%, respectively. Based on these, the ingestion of LAC-capsule has a considerable degree of safety and has the potential to reduce total cholesterol in healthy adults., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2020 Wan-Jing Chen and Fung-Wei Chang.)

Background: Congenital TORCH (toxoplasmosis, other viruses [varicella-zoster virus, VZV, etc.], rubella, cytomegalovirus [CMV], Herpes simplex virus [HSV]) infections are major causes of prenatal, perinatal, and postnatal morbidity and mortality. Although treatment or prevention strategies are available for these pathogens, all drugs may not be safe during the pregnancy. The aim of this study is to measure the antibodies (Abs) concentration in the intravenous immunoglobulin (IVIG) preparation to evaluate the therapeutic potential for TORCH infection., Methods: We tested the only one commercial IVIG preparation from Taiwanese for the presence of Abs against Toxoplasma gondii, VZV, Epstein-Barr virus (EBV), measles, mumps, rubella, CMV, HSV type 1 (HSV-1), and HSV type 2 (HSV-2) by using enzyme-linked immunosorbent assay or chemiluminescent microparticle immunoassay., Results: In our study, the median level (range) of anti-CMV immunoglobulin G (IgG) is > 250 (All > 250) (arbitrary unit, AU)/mL, anti-EBV > 200 (All > 200) (relative unit, RU)/mL, anti-HSV > 200 (152.75 to >200) RU/mL, anti-VZV > 5000 (All > 5000) IU/L, anti-measles > 5000 (All > 5000) IU/L, anti-mumps > 200 (156.5 to > 200) RU/mL, anti-rubella 209.8 IU/mL (192.7 to 238.5), and anti-Toxoplasma is 14.05 (12.3 to 16) IU/mL. There was not any immunoglobulin M (IgM) against HSV, VZV, mumps, measles, rubella, CMV, EBV, and Toxoplasma in the "Taiwan Blood Services Foundation" IVIG preparations., Conclusion: There was high activity against T. gondii, VZV, EBV, measles, mumps, rubella, CMV, HSV-1, and HSV-2 in all IVIG batches. Further investigation is warranted to confirm the efficacy of IVIG from Taiwanese for congenital TORCH infections.

Objective: Air pollution has been widely recognized to pose a threat to health. Urban outdoor air pollution was listed as the 14th biggest risk factor for global deaths in 2004 in the Global Health Risks report published by the World Health Organization in 2009. Many past studies have indicated that exposure to environmental contaminants promotes changes in the internal mechanisms of diseases, including the infection of various systems in the body, hormonal changes, and vascular proliferation. These changes may be related to the severity of endometrial hyperplasia. Therefore, this study used the air quality monitoring data of the Environmental Protection Administration (EPA) to examine the effects of air pollutant concentration on patients with endometrial hyperplasia., Materials and Methods: This population-based nationwide study used data for 2002-2013 from the National Health Insurance Research Database of Taiwan. Patients who developed endometrial hyperplasia before 2002 were excluded. In total, 14,883 patients with endometrial hyperplasia were tracked. The exposure levels and air quality index (AQI) values in this study were based on the taiwan air quality monitoring network data collected by the EPA from 2000 to 2013. The data were further divided into the good air quality group (AQI ≤ 50) and poor air quality group (AQI > 50). The study used linear regression model to estimate the correlation linking air pollutant concentration with endometrial hyperplasia., Results: The results indicated that, in comparison to endometrial hyperplasia patients who were exposed to air with good quality, those exposed to air with poor quality had a higher average age (p < 0.001) and higher proportion of living in southern Taiwan (p < 0.001), as well as higher rates of diabetes (p < 0.001), hyperlipidemia (p < 0.001), hypertension, cerebrovascular diseases (p = 0.024), cerebral vascular accidents (p = 0.024), and chronic kidney disease (p < 0.001)., Conclusion: The patients with endometrial hyperplasia in poor AQI area had severe comorbidity. Thus, attention must be paid to the improvement of air quality and the implementation of preventive measures against contaminants., (Copyright © 2019. Published by Elsevier B.V.)

Objective: Emergency air medical services (EAMS) share a common helicopter system for prehospital care and transfer in several countries. In Penghu, two systems are involved in EAMS: the helicopter and C130 systems. Given their features and limitations, patients using the two systems have significantly different characteristics., Materials and Methods: To clearly understand the disease patterns and dynamic changes in transferred patients, we studied 1228 patients transported from Penghu to Taiwan between January 2009 and December 2017., Results: Our findings show that the helicopter group had more acute diseases, while the C130 system group had more chronic diseases. Cardiovascular disease was the most common diagnosis (328 patients, 26.71%), followed by cerebrovascular disease (263 patients, 21.41%) and gastrointestinal disease (221 patients, 17.99%). Following interventions to support local medicine by Tri-Service General Hospital and the establishment of a cardiac catheterization laboratory, the annual number of transported patients decreased, especially those with cardiovascular diseases. The disease pattern also shifted from acute to chronic disease., Conclusion: Current data indicate that the local medical system is developing the ability to manage chronic diseases and care problems. This article analyzes dynamic changes in the disease patterns of transferred patients in both EAMS groups, providing a strong foundation for developing local medical systems., Competing Interests: There is no conflict of interest., (Copyright: © 2019 Tzu Chi Medical Journal.)

The pigment melanin is produced by melanocytes, is primarily responsible for skin color, and protects it against ultraviolet rays that can cause the destruction of genetic material within the keratinocytes. To elucidate the mechanisms of many diseases associated with melanocytes, such as melanoma and albinism, or burns with uneven pigment distribution, the disease model needs to be established first. In this study, we aimed to construct the melanocyte model from patients in a short period.Sandai virus vector containing 4 stemness genes (Oct4, Sox2, Klf4, c-Myc) was transfected into human adipose-derived stem cells to produce induced pluripotent stem cells (iPSCs). Immunofluorescence staining was used to confirm the expression of specific proteins for iPSCs, including Tra-1-60, Tra-1-81, Oct-4, Sox-2, and Nango. polymerase chain reaction results also showed that specific genes of iPSCs with the ability to cause the differentiation of cells into the 3 germ layers were expressed. In our in vivo experiments, iPSCs were subcutaneously injected into nude mice to induce teratoma formation for 2 months. The morphology of the 3 germ layers was confirmed by hematoxylin and eosin staining. Furthermore, melanocytes were purified by serial induction medium, and their presence was confirmed by flow cytometry and the expression of different markers for melanocytes.

Skin substitutes with existing vascularization are in great demand for the repair of full-thickness skin defects. In the present study, we hypothesized that a pre-vascularized skin substitute can potentially promote wound healing. Novel three-dimensional (3D) skin substitutes were prepared by seeding a mixture of human endothelial progenitor cells (EPCs) and fibroblasts into a human plasma/calcium chloride formed gel scaffold, and seeding keratinocytes onto the surface of the plasma gel. The capacity of the EPCs to differentiate into a vascular-like tubular structure was evaluated using immunohistochemistry analysis and WST-8 assay. Experimental studies in mouse full-thickness skin wound models showed that the pre-vascularized gel scaffold significantly accelerated wound healing 7 days after surgery, and resembled normal skin structures after 14 days post-surgery. Histological analysis revealed that pre-vascularized gel scaffolds were well integrated in the host skin, resulting in the vascularization of both the epidermis and dermis in the wound area. Moreover, mechanical strength analysis demonstrated that the healed wound following the implantation of the pre-vascularized gel scaffolds exhibited good tensile strength. Taken together, this novel pre-vascularized human plasma gel scaffold has great potential in skin tissue engineering.

Postpartum depression (PPD) is one of the most common examples of postnatal morbidity, but the subsequent risks of autoimmune diseases in patients with PPD have yet to be fully investigated. This nationwide population-based study utilized data of the National Health Insurance Research Database of Taiwan for the period from 1996 to 2013. In total, 45,451 women with primiparity were identified. Among them, 542 patients with PPD were enrolled as a study group while 2165 matched patients without PPD were enrolled as a control group. The demographic characteristics and comorbidities of the patients were analyzed, and Cox regression analysis was applied to calculate the hazard ratios for the risk of autoimmune diseases. Of the 2707 women enrolled in this study, 469 (17.3%) patients with newly diagnosed autoimmune diseases were identified, including 123 (22.7%) in the PPD group and 346 (16%) in the non-PPD group. After adjusting for confounding factors, it was determined that the patients with PPD had a significantly higher risk of subsequent autoimmune diseases (adjusted hazard ratio (aHR): 1.61, 95% confidence interval (CI): 1.30⁻1.99; p < 0.001). Specifically, increased risks of pernicious anemia (aHR: 3.85, 95% CI: 2.06⁻7.22), rheumatoid arthritis (aHR: 2.62, 95% CI: 1.28⁻5.39), and Graves' disease (aHR: 1.57, 95% CI: 1.05⁻2.33) were observed in the PPD group. This study demonstrated that patients with PPD have higher risks of subsequent autoimmune diseases, especially pernicious anemia, rheumatoid arthritis, and Graves' disease. This useful information provides physicians with clues regarding the associations between autoimmune diseases and PPD.

Objective: Defects in L-selectin ligand (LSL) expression have been reported to cause implantation failure, but little is known about LSL expression in adenomyosis. This study evaluates LSL expression throughout the menstrual cycle in women with adenomyosis., Materials and Methods: Endometrial samples were obtained from reproductive-aged women with adenomyosis who underwent hysterectomy. A total of 42 endometrial biopsies were included. There were 12 women in proliferative phase, 10 in early-secretory phase, 9 in mid-secretory phase, and 11 in late-secretory phase. Immunohistochemistry, western blotting, and RT-PCR were performed to evaluate LSL expression. A non-parametric Kruskal-Wallis one-way analysis of variance with multiple comparisons was performed to examine differences among menstrual phases., Results: Immunohistochemistry analysis with MECA-79 shows that LSL is expressed with weak intensity in the endometrium in all phases. In the luminal epithelium, MECA-79 reactivity increased from the proliferative to the late-secretory phase but decreased in the mid-secretory phase. There were significant differences in the mean histological scores (HSCOREs) among the proliferative, early-secretory, and late-secretory phases (p < 0.05). Five LSL genes were detected in the adenomyotic endometria: PODXL, EMCN, CD300LG, GLYCAM1, and CD34. The mRNA expression of LSL genes occurred differentially among phases. Moreover, PODXL differed significantly among phases (p < 0.05)., Conclusions: LSL expressions were downregulated in the luminal epithelium of adenomyotic endometria in the mid-secretory phase. The mRNA expressions of LSL genes also had differential expression patterns throughout the menstrual cycle, especially for PODXL. Our study showed that adenomyosis may cause abnormalities of LSL production in the mid-secretory phase, which may contribute to impaired endometrial receptivity and implantation failure., (Copyright © 2018. Published by Elsevier B.V.)

Background: Urinary tract infections (UTIs) are among the most common bacterial infections in pregnant women due to anatomic and physiologic changes in the female urinary tract during pregnancy, and antepartum UTIs can cause adverse pregnancy outcomes that may induce mental stress. There have only been a few studies, however, investigating antepartum UTIs and mental stress. As such, the present study was conducted in order to investigate the association between antepartum UTIs and postpartum depression (PPD)., Methods: We used data from the 2000-2013 National Health Insurance Research Database (NHIRD) of Taiwan. Data regarding a total of 55,087 singleton pregnancies was utilized, including data regarding 406 women who were newly diagnosed with PPD in the first 6 months postpartum. The associations between PPD and antepartum UTIs or other risk factors were examined by multiple logistic regression analysis., Results: The logistic regression analysis results indicated that PPD was associated with antepartum UTIs (adjusted odds ratio [aOR] 1.27; 95% confidence interval [CI] (1.07-1.65). Furthermore, the risk of PPD was higher in women with an upper antepartum UTI (aOR 2.97 (1.31, 6.77) than in those with a lower antepartum UTI (aOR 1.21 (1.02, 1.58))., Conclusions: Antepartum UTIs, particularly upper antepartum UTIs, are significantly associated with PPD. This information may encourage physicians to pay greater attention to the mental health of women who have suffered upper UTIs during their pregnancies.

Both scabies and psoriasis are pruritic inflammatory skin diseases. The clinical manifestations are similar and provocation of psoriasis by mite bite was reported. The association between scabies and psoriasis was not investigated before. We conducted this nationwide population-based matched-cohort study to describe if patients with a diagnosis of scabies have a different risk of developing new psoriasis. From the National Health Insurance Research Database of Taiwan, patients with scabies (n = 5137) were identified and matched for age and sex with non-scabies controls (n = 19 142). We tracked them for a 7-year period to identify the incidence of psoriasis. One hundred and ninety (0.8%) patients with newly diagnosed psoriasis were identified; 91 (1.8%) from the scabies group and 99 (0.5%) from the control group. Patients with scabies had a higher risk of subsequent psoriasis, with a crude hazard ratio of 3.45 and an adjusted hazard ratio (aHR) of 3.03 (95% confidence interval, 2.24-4.11). An increased risk for psoriasis among patients with scabies was observed (aHR, 3.03). Immunopathology involving the T-helper 17 cell-mediated inflammatory pathway may contribute to this association. Physicians may consider implementing assessments of psoriatic symptoms in patients with scabies., (© 2018 Japanese Dermatological Association.)

This study investigates peptide components of L-selectin ligand (LSL) and their gene expressions in human endometrium during the natural menstrual cycle. We recruited 41 endometrial samples from reproductive-aged women with leiomyoma and undergoing hysterectomy and 11 endometrial samples from menopausal women as controls. Immunohistochemistry revealed strong MECA-79 expression from the early through the mid-secretory phase and low expression in menopausal endometrium. Five peptide components of LSL were detected in reproductive and menopausal endometrium by one-step quantitative RT-PCR: podocalyxin, endomucin, nepmucin, GlyCAM-1, and CD34. Endomucin differed significantly between the proliferative and early-secretory phases. CHST2 and CHST4 genes (which are involved in the generation of LSL epitopes) were expressed without significant differences among phases. The gene expression of progesterone receptor decreased from the proliferative to the late-secretory phase, and the difference was significant. However, estrogen receptor α expression showed stability among phases. The significant expression of endomucin between the proliferative and early-secretory phases might play a vital role in endometrial receptivity. Further studies are needed to investigate the factors that regulate the expression of endomucin and other LSL peptide components in different phases of the menstrual cycle.

Both scabies and bipolar disorder (BD) are common and troublesome disorders. There are several similarities in both diseases: pruritus, a higher prevalence in crowded environments, and cytokine-mediated inflammatory processes in the pathophysiology. We conducted this nationwide population-based study to investigate the possible relationship between scabies and BD. Based on the National Health Insurance Research Database (NHIRD) of Taiwan, a total of 7096 patients with scabies were identified as a study group and 28,375 matched patients as a control. We tracked the patients in both groups for a 7-year period to identify those newly diagnosed with BD. The demographic characteristics and comorbidities of the patients were analyzed, and Cox proportional hazard regressions were performed to calculate the hazard ratio (HR) of BD. Of the 35,471 patients in this study, 183 (0.5%) patients with newly diagnosed BD were identified, with 58 (0.8%) from the scabies group and 125 (0.4%) from the control group. The patients with scabies had a higher risk of subsequent BD, with a crude hazard ratio of 1.86 and an adjusted hazard ratio of 1.55 (95% confidence interval: 1.12-2.09, P < 0.05). This study shows there is an increased risk for BD among patients with scabies. Immunopathology may contribute to this association., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Scabies is an infectious inflammatory pruritic skin disease. Cytokine-mediated inflammatory processes contribute to the pathologic mechanism in scabies. Myasthenia gravis (MG) is also an autoimmune disease that is mediated by cytokines. The study aimed to investigate the association between scabies and myasthenia gravis. We conducted a nationwide population-based cohort study utilized data from the National Health Insurance Research Database (NHIRD) of Taiwan. Patients with scabies (n=5429) and control subjects without scabies (n=20,176) were enrolled. We tracked the subjects in both groups for a 7-year period to identify new onset MG. Cox regression analysis was performed to calculate the hazard ratio (HR) for MG. A total of 25,605 patients were enrolled in the study, including 5429 patients in the scabies group and 20,176 in the control group. There were 40 (0.7%) patients from the scabies group and 84 (0.4%) subjects from the control group who were newly diagnosed with MG during the 7-year follow-up period. The scabies patients had a significantly increased risk of MG, with an adjusted HR of 1.27 (95% confidence interval [CI] 1.01-1.89). As such, prompt diagnosis and treatment of scabies may decrease the risk of subsequent MG., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: There was no national data on group B streptococcus (GBS) infections in Taiwan. Until 2012, when prenatal GBS screening was introduced to obstetric practices as a national health policy aimed at reducing neonatal GBS infections. The purpose of this study was to examine the impact of this national health policy on the incidence of maternal GBS colonization and neonatal GBS infection rate. Relatedly, the clinical characteristics of neonatal GBS infection were investigated to determine the correlations between the incidence of maternal GBS colonization and the neonatal GBS infection rate., Materials and Methods: This population-based nationwide study used data for 2012-2013 from the National Health Insurance Research Database of Taiwan. A total of 789 newly diagnosed pregnant women with genital GBS infection were recruited., Results: The maternal GBS screening rate was 93.2%. The maternal colonization rate of GBS was around 8.2%, and the incidence of neonatal GBS infection was 22.6%. The data indicate that no sepsis was developed in any of the cases, while fever was found in 3 cases (3/179, 1.7%) and UTI was found in 1 case (1/179, 0.6%)., Conclusions: We conclude that a policy calling for universal maternal rectovaginal cultures for GBS with intrapartum antibiotic prophylaxis is a good national policy for reducing morbidity due to GBS infections in neonates in Taiwan., (Copyright © 2017. Published by Elsevier B.V.)

Objective: Urinary tract infection (UTI) is the main reason of community-acquired infection which causes large losses in social economy. The individual as well as climate factors make changes on the incidence. Acute pyelonephritis (APN) is one of the most serious UTI in female. The object of our study is to analyze whether climate factors will have effect on the incidence of female APN in Taiwan., Materials and Methods: This study consisted of 14,568 female patients with APN from 2001 to 2013 in Taiwan and patients with repeated APN were excluded. The monthly climate data was collected from the Central Weather Bureau. The available monthly climate data included highest, lowest, and average level of temperatures, humidity, rainfall, total rain days, and sunshine hours., Results: The total incidence of female APN was 23.44 each 10,000 populations. The incidence of APN was positively correlated with temperature (r = 0.66), sunshine hours (r = 0.45), rainfall (r = 0.42), rain days (r = 0.29), and humidity (r = 0.23) per month. There is the strongest correlation between the average monthly temperature and the incidence of APN (β = 0.54). The correlation with the incidence of APN was also followed by rain days (β = 0.28) and humidity (β = 0.27)., Conclusion: There is a significant expression on the incidence of female APN affected by seasonality and climate parameters. The monthly average temperature has the strongest correlation with female APN. The results of this research may facilitate the potential preventive strategies on female APN., (Copyright © 2017. Published by Elsevier B.V.)

Scabies is a commonly occurring infectious immune-mediated inflammatory skin disease. Immune-mediated inflammatory processes are also observed in autoimmune diseases. There have been very few previous studies; however, that have investigated the possible association between scabies and autoimmune diseases. To address this research gap, we conducted a nationwide population-based cohort study that included a total of 4481 scabies patients and 16,559 control subjects matched by gender, age, insured region, urbanization and income. We tracked both cohorts for a 7-year period to identify the incidence of autoimmune diseases in both groups during that follow-up period. Relatedly, a Cox regression analysis was performed to calculate and compare the hazard ratio (HR) for autoimmune diseases of both groups. An overall increased risk for 19 autoimmune diseases was observed in the scabies patients, with an adjusted HR (aHR) of 1.14 (95% CI 1.04-1.25). Compared with the control group, the scabies patients exhibited increased risks of hypersensitivity vasculitis (aHR 5.44, 95% CI 1.64-18.07), dermatomyositis (aHR 4.91, 95% CI 1.80-13.38), polyarteritis nodosa (aHR 2.89, 95% CI 1.46-5.73), systemic lupus erythematosus (aHR 2.73, 95% CI 1.33-5.64), psoriasis (aHR 2.31, 95% CI 1.85-2.88), myasthenia gravis (aHR 2.01, 95% CI 1.31-3.12), type 1 diabetes mellitus (aHR 1.93, 95% CI 1.53-2.44), pernicious anemia (aHR 1.92, 95% CI 1.42-2.61), and rheumatoid arthritis (aHR 1.43, 95% CI 1.12-1.83). In conclusion, the associations between scabies and a variety of autoimmune diseases may exist. Further studies are needed to clarify the shared etiologies and relationships between scabies and autoimmune diseases.

Scabies is a common and distressing disease caused by the mite Sarcoptes scabiei var. hominis. Psychiatric disorder in childhood is an important disease and easily neglected. There are several similarities in scabies and psychiatric disorders in childhood (PDC). Both of them may present with pruritus. They are relatively common in patients with lower socioeconomic status and crowded environment. Furthermore, immune-mediated inflammatory processes play a role in the pathophysiology in both diseases. An association between scabies and psychiatric disorders may exist. This nationwide population-based cohort study utilized data from the National Health Insurance Research Database to investigate the relationship between scabies and PDC. A total of 2137 children with scabies were identified as the study group and 8548 age- and sex-matched children were selected as the control group. A total of 607 (5.68%) children developed PDC during the 7-year follow-up period. The overall incidences of PDC are similar but patients with scabies had a higher risk of developing intellectual disability (ID) (scabies group vs control group: 1.3% vs 0.6%, adjusted hazard ratio: 2.04 and 95% confidence interval: 1.25-3.32). The immune-mediated inflammatory processes of both diseases were reviewed and may contribute to the 104% increased risk of interleukin in patients with scabies. We suggest a more comprehensive management in treating patients with scabies or ID. Early and comprehensive treatment of scabies and other risk factors may decrease the risk of subsequent ID. When we approach patients with ID, concurrent evaluation of scabies and other risk factors may contribute to successful management.

Selective production of hydrogen by partial oxidation of methanol (POM), using gold supported on composite metal oxides, Fe2O3–MO x (M: Al, Zr, Zn) was investigated. The catalysts were characterized by TGA, XRD, TEM and XPS analyses. TGA and DTGA analysis indicates that minimum decomposition temperature required to obtain α-Fe2O3 in Fe2O3–ZrO2 composite support is 570 K. The catalytic activity and stability of Au/Fe2O3 catalyst is improved by using Al2O3 as an additional support, but there is no improved activity was observed with ZrO2. The uncalcined catalysts shows high activity for selective formation of hydrogen. The presence of Al2O3 in Au/Fe2O3–Al2O3 stabilize the gold particles against sintering during calcination as evidenced from TEM analysis. XPS analysis revealed that in the uncalcined catalysts gold is present as Au2O3 and Auº. The amount of metallic gold (Auº) in the catalyst increases with increase in calcination temperature. The catalytic behavior is related to the presence of highly dispersed Au of partially oxidized state in the catalyst. Under the optimized condition, the most active catalyst Au/Fe2O3–Al2O3 shows 100% conversion and 48% H2 selectivity at 523 K. The catalytic activity of Au/Fe2O3–Al2O3 catalysts in the temperature range 423–548 K showed that methanol conversion increased with rise in temperature and attains 100% at 448 K; Hydrogen selectivity increased with rise in temperature up to 523 K and then decreased at high temperatures. The overall reactions involved are methanol combustion, partial oxidation, steam reforming and decomposition. CO produced by methanol decomposition and/or by reverse water gas shift is subsequently transformed into CO2 and H2 by the water gas shift and/or CO oxidation thereby reduce the CO selectivity. The low hydrogen selectivity at high temperature is due to reverse water gas shift and/or hydrogen combustion.

Aim: To examine genomic medicine (GM) practice and associated factors (i.e., attitudes, intention, self-efficacy, previous training in genomics, and demographic characteristics) among Taiwanese physicians., Methods: A survey was distributed to physicians attending an internal training workshop at a large medical center in Taiwan. Data were analyzed using structural equation modeling., Results: A total of 137 physicians comprised our final sample; less than a third of them had practiced GM. Yet, participants overall had positive intention, favorable attitudes, and high self-efficacy in GM practice. Moreover, intention, attitudes, self-efficacy, educational level, and continuing education in GM were positively and significantly associated with participants' GM practice., Conclusion: Offering continuing education for Taiwanese physicians is needed to enhance their practice in GM.

Background: Multidrug resistance is a major obstacle in the successful therapy of breast cancer. Studies have proved that this kind of drug resistance happens in both human cancers and cultured cancer cell lines. Understanding the molecular mechanisms of drug resistance is important for the reasonable design and use of new treatment strategies to effectively confront cancers., Results: In our study, ATP-binding cassette sub-family G member 2 (ABCG2), adenosine triphosphate (ATP) synthase and cytochrome c oxidase subunit VIc (COX6C) were over-expressed more in the MCF-7/MX cell line than in the normal MCF7 cell line. Therefore, we believe that these three genes increase the tolerance of MCF7 to mitoxantrone (MX). The data showed that the high expression of COX6C made MCF-7/MX have more stable on mitochondrial membrane potential (MMP) and reactive oxygen species (ROS) expression than normal MCF7 cells under hypoxic conditions. The accumulation of MX was greater in the ATP-depleted treatment MCF7/MX cells than in normal MCF7/MX cells. Furthermore, E2 increased the tolerance of MCF7 cells to MX through inducing the expression of ABCG2. However, E2 could not increase the expression of ABCG2 after the inhibition of estrogen receptor α (ERα) in MCF7 cells. According to the above data, under the E2 treatment, MDA-MB231, which lacks ER, had a higher sensitivity to MX than MCF7 cells., Conclusions: E2 induced the expression of ABCG2 through ERα and the over-expressed ABCG2 made MCF7 more tolerant to MX. Moreover, the over-expressed ATP synthase and COX6c affected mitochondrial genes and function causing the over-expressed ABCG2 cells pumped out MX in a concentration gradient from the cell matrix. Finally lead to chemoresistance., Competing Interests: The authors declare no conflict of interest.

Background . Epididymo-orchitis is a common infectious disease among men, especially men aged 20 to 39 years. The aim of this study was to analyze possible associations of various meteorological indicators on the incidence of epididymo-orchitis in Taiwan. Methods and Materials . This nationwide population-based study collected data on cases of epididymo-orchitis that were newly diagnosed from 2001 to 2013 in Taiwan. Monthly meteorological indicators, including average temperatures, humidity, rainfall, total rain days, and sunshine hours, were collected from the Central Weather Bureau of Taiwan. Data for a total of 7,233 patients with epididymo-orchitis were collected for this study. Results . The monthly incidence of epididymo-orchitis was positively correlated with temperature, rainfall, and sunshine hours. The average monthly temperature had a linear correlation with the incidence of epididymo-orchitis (ß = 0.11). The monthly average temperature is significantly related, with a positive linear correlation, to the incidence of epididymo-orchitis in Taiwan. Conclusion . This finding may constitute useful information in terms of helping physicians to distinguish between patients with epididymo-orchitis and testicular torsion in hot or cold weather., Competing Interests: The authors declare that they have no conflict of interests.

We investigated the role of oxidative stress-responsive kinase-1 (OSR1) and STE20 (sterile 20)/SPS1-related proline/alanine-rich kinase (SPAK), upstream regulators of the Na + -K + -2Cl - cotransporter (NKCC1)-essential for spermatogenesis-in mouse models of male fertility. Global OSR1 +/- gene mutations, but not global SPAK -/- or Sertoli cell (SC)-specific OSR1 gene knockout (SC-OSR1 -/- ), cause subfertility with impaired sperm function and are associated with reduced abundance of phosphorylated (p)-NKCC1 but increased p-SPAK expression in testicular tissue and spermatozoa. To dissect further in a SC-specific manner the compensatory effect of OSR1 and SPAK in male fertility, we generated SC-OSR1 -/- and SPAK -/- double knockout (DKO) male mice. These are infertile with defective spermatogenesis, presenting a SC-only-like syndrome. Disrupted meiotic progression and increased germ cell apoptosis occurred in the first wave of spermatogenesis. The abundance of total and p-NKCC1 was significantly decreased in the testicular tissues of DKO mice. These results indicate that OSR1 and SPAK cooperatively regulate NKCC1-dependent spermatogenesis in a SC-restricted manner.

Background: Understanding mothers' economic conditions and postpartum depression (PPD) is important for determining how they will take care of themselves and their infants during the postnatal period, especially for low-income families. This study examined the relationship between economic conditions and PPD to elucidate the effect of economic contraction on PPD., Methods: Our population-based nationwide study used 2000-2013 the National Health Insurance Research Database of Taiwan. A total of 1240 newly diagnosed PPD patients were recruited. We used the database of the Directorate General of Budget, Accounting, and Statistics of Executive Yuan of Taiwan for national economic indicators. The correlation between economic indicators and PPD was examined., Results: The PPD incidence was positively correlated with yearly unemployment rate, consumer price index, and gross domestic product. During the great recession of 2008-2009, PPD was positively correlated with inflation rate. Consumer price index had a positive correlation with PPD incidence per month when comparing PPD in 2010 with the economic indicators during the great recession., Limitations: As this retrospective study evaluated macroeconomic indicators, it is unclear whether the macroeconomic indicators' effect on PPD totally reflects the effect of true personal economic status on PPD., Conclusions: There was a significant association between PPD and economic conditions. This study shows that mothers' familial environment plays an important role in the development of PPD. The impact of the worldwide economic downturn of the great recession on women is persistent. This useful finding may give health policy planners a hint of early discovering and dealing with PPD when worldwide economic downturn., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Estrogen induces ERα-positive breast cancer aggressiveness via the promotion of cell proliferation and survival, the epithelial-mesenchymal transition, and stem-like properties. Integrin β4 signaling has been implicated in estrogen/ERα-induced tumorigenicity and anti-apoptosis; however, this signaling cascade poorly understood. ΔNp63, an N-terminally truncated isoform of the p63 transcription factor, functions as a transcription factor of integrinβ4 and therefore regulates cellular adhesion and survival. Therefore, the aim of the present study was to investigate the estrogen-induced interaction between ERα, ΔNp63 and integrin β4 in breast cancer cells. In ERα-positive MCF-7 cells, estrogen activated ERα transcription, which induced ΔNp63 expression. And ΔNp63 subsequently induced integrin β4 expression, which resulted in AKT phosphorylation and enhanced cell viability and motility. Conversely, there was no inductive effect of estrogen on ΔNp63-integrinβ4-AKT signaling or on cell viability and motility in ERα-negative MDA-MB-231 cells. ΔNp63 knockdown abolishes these estrogen-induced effects and reduces cell viability and motility in MCF-7 cells. Nevertheless, ΔNp63 knockdown also inhibited cell migration in MDA-MB-231 cells through reducing integrin β4 expression and AKT phosphorylation. In conclusion, estrogen enhances ERα-positive breast cancer cell viability and motility through activating the ERα-ΔNp63-integrin β4 signaling pathway to induce AKT phosphorylated activation. Those findings should be useful to elucidate the crosstalk between estrogen/ER signaling and ΔNp63 signaling and provide novel insights into the effects of estrogen on breast cancer progression.

Scabies is a common infectious disease and can cause severe outbreaks if not controlled quickly. Besides personal contact history, environmental factors are also important. This study analyzed the effects of environmental climate factors on the incidence of scabies in Taiwan. We conducted a 14-year nationwide population-based study: a total of 14,883 patients with scabies infestation were enrolled. Monthly climate data were collected from Taiwan's Central Weather Bureau, including data on temperature, relative humidity, total rainfall, total rain days, and total sunshine hours. The linear relationships between these climate factors and scabies infestations or other risk factors were examined by Pearson's correlation analysis. Overall, the incidence of scabies was negatively correlated with temperature (γ = -0.152, p < 0.001), while being positively correlated with humidity (γ = 0.192, p < 0.001). This useful information may provide evidence for lowering humidity at nursing facilities, hospitals, and military camps with scabies infestations, which may help to reduce its spread and prevent outbreaks., (© J.-M. Liu et al., published by EDP Sciences, 2016.)

Objective: The heterogeneous nature of mesenchymal stem cells (MSCs) and the absence of known MSC-specific biomarkers make it challenging to define MSC phenotypes and characteristics. In this study, we compared the phenotypic and functional features of human placenta-derived MSCs with those of human dermal fibroblasts in vitro in order to identify a biomarker that can be used to increase the purity of MSCs in a primary culture of placenta-derived cells., Materials and Methods: Liquid chromatography-tandem mass spectrometry analysis was used to analyze and compare the proteome of human placenta-derived MSCs with that of fibroblasts. Quantitative real-time polymerase chain reaction, immunofluorescence, and flow cytometry were used to determine expression levels of EphA2 in placenta-derived MSCs. EphA2-positive cells were enriched by magnetic-activated cell sorting or with a cell sorter. An shRNA-mediated EphA2 knockdown was used to assess the role of EphA2 in MSC response to Tumor necrosis factor (TNF)-α stimulation., Results: Analysis of proteomics data from MSCs and fibroblasts resulted in the identification of the EphA2 surface protein biomarker, which could reliably distinguish MSCs from fibroblasts. EphA2 was significantly upregulated in placenta-derived MSCs when compared to fibroblasts. EphA2 played an important role in MSC migration in response to inflammatory stimuli, such as TNF-α. EphA2-enriched MSCs were also more responsive to inflammatory stimuli in vitro when compared to unsorted MSCs, indicating a role for EphA2 in the immunomodulatory functionality of MSCs., Conclusion: EphA2 can be used to distinguish and isolate MSCs from a primary culture of placenta-derived cells. EphA2-sorted MSCs exhibited superior responsiveness to TNF-α signaling in an inflammatory environment compared with unsorted MSCs or MSC-like cells., (Copyright © 2015. Published by Elsevier B.V.)

Background: Breast cancer-related mortality increases annually. The efficacy of current breast cancer treatments is limited, and they have numerous side effects and permit high recurrence. Patients with estrogen receptor (ER)-negative or triple-negative breast cancer are particularly difficult to treat. Treatment for this type of cancer is lacking, and its prognosis is poor, necessitating the search for alternative treatments., Methods: This study screened Chinese herb Hibiscus syriacus extracts and identified a novel anti-cancer drug for patients with ER-negative breast cancer. The inhibitory effects on cell viability and migration were evaluated for each compound, and the molecular regulatory effects were evaluated on both mRNA and protein levels., Result: We found several triterpenoids including betulin (K02) and its derivatives (K03, K04, and K06) from H. syriacus inhibited human triple-negative breast cancer cell viability and migration but revealed smaller cytotoxic effects on normal mammalian epithelial cells. Betulin and its derivatives induced apoptosis by activating apoptosis-related genes. In addition, they activated p21 expression, which induced cell cycle arrest in breast cancer cells. Betulin (K02) and betulinic acid (K06) had stronger inhibitory effects on cell viability and migration than K03 and K04., Conclusions: H. syriacus extracts might inhibit breast cancer cell viability and induce apoptosis by activating p53 family regulated pathways and inhibiting AKT activation. H. syriacus extracts may provide important insight into the development of novel alternative therapies for breast cancer.

Partial oxidation of methanol (POM) to produce hydrogen was investigated over Au/Fe2O3 catalysts. The catalysts were prepared by inverse co-precipitation method. The influence of catalyst synthesis parameters such as precipitant, gold loading, calcination temperature and reaction parameter such as reaction temperature on POM reaction to produce hydrogen were investigated. The catalysts have been characterized by means of TGA, BET, XRD, TEM, SEM-EDS and XPS analyses. TGA and DTGA profiles clearly indicate that minimum decomposition temperature required to obtain Fe2O3 in Au/Fe2O3 catalysts is 660 K. SEM-EDS analysis confirms that Au and Fe in Au/Fe2O3 are homogeneously distributed over the agglomerate. A detailed microstuctural characterization of Au/Fe2O3 sample by XRD, TEM and XPS analyses has shown that nanometer sized gold particles with oxidized gold species is in predominant amount in the uncalcined catalysts sample. The mean particle size and metallic state of gold particles increase with increasing calcination temperature. A highly active Au/Fe2O3 catalyst is obtained by using Na2CO3 as precipitant with lower gold loading and calcination at 673 K. The catalytic behavior of the Au/Fe2O3 catalyst is related not only to the gold but also to the chemical state of the support. The effect of reaction temperature on the catalytic performance of the Au/Fe2O3 catalysts was studied in the temperature range of 423 to 523 K. Oxygen conversion was complete through out the examined temperature range. Methanol conversion increased with rise in temperature and attains 100% at 503 K; Hydrogen selectivity increased with rise in reaction temperature up to 523 K and then dropped off. The overall reactions involved are methanol combustion, partial oxidation, steam reforming and decomposition. CO produced by methanol decomposition and/or by reverse water gas shift is subsequently transformed into CO2 and H2 by the water gas shift and/or CO oxidation.

Renal cell carcinoma (RCC) originates in the lining of the proximal convoluted tubule and accounts for approximately 3% of adult malignancies. The RCC incidence rate increases annually and is twofold higher in males than in females. Female hormones such as estrogen may play important roles during RCC carcinogenesis and result in significantly different incidence rates between males and females. In this study, we found that estrogen receptor β (ERβ) was more highly expressed in RCC cell lines (A498, RCC-1, 786-O, ACHN, and Caki-1) than in breast cancer cell lines (MCF-7 and HBL-100); however, no androgen receptor (AR) or estrogen receptor α (ERα) could be detected by western blot. In addition, proliferation of RCC cell lines was significantly decreased after estrogen (17-β-estradiol, E2) treatment. Since ERβ had been documented to be a potential tumor suppressor gene, we hypothesized that estrogen activates ERβ tumor suppressive function, which leads to different RCC incidence rates between males and females. We found that estrogen treatment inhibited cell proliferation, migration, invasion, and increased apoptosis of 786-O (high endogenous ERβ), and ERβ siRNA-induced silencing attenuated the estrogen-induced effects. Otherwise, ectopic ERβ expression in A498 (low endogenous ERβ) increased estrogen sensitivity and thus inhibited cell proliferation, migration, invasion, and increased apoptosis. Analysis of the molecular mechanisms revealed that estrogen-activated ERβ not only remarkably reduced growth hormone downstream signaling activation of the AKT, ERK, and JAK signaling pathways but also increased apoptotic cascade activation. In conclusion, this study found that estrogen-activated ERβ acts as a tumor suppressor. It may explain the different RCC incidence rates between males and females. Furthermore, it implies that ERβ may be a useful prognostic marker for RCC progression and a novel developmental direction for RCC treatment improvement.

Anti-inflammatory and anti-angiogenic effects of flavonoids isolated from Lycium barbarum fruits, a traditional Chinese medicine, on human umbilical vein endothelial cells (HUVECs) were investigated. Initially, flavonoids were extracted with 80% ethanol and separated using a Cosmosil 140 C18-OPN column, with the acidic fraction eluted with deionized water being composed of chlorogenic acid, caffeoyl quinic acid, caffeic acid and p-coumaric acid and the neutral fraction eluted with methanol composed of quercetin-diglycoside, rutin and kaempferol-O-rutinoside. Flavonoid extract was effective in inhibiting expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule (VCAM-1) induced by TNF-α in HUVECs. The RT-PCR analysis indicated that ICAM-1 mRNA induced by TNF-α was inhibited by flavonoid extract. The flavonoid extract attenuated TNF-α-induced IκB phosphorylation as well as NF-κB, p65 and p50 translocation from cytosol to nucleus, through inhibition on TNF-α- and H(2)O(2)-induced intracellular reactive oxygen species (ROS) production. For the anti-angiogenic study, the flavonoid extract inhibited vascular endothelial growth factor (VEGF)-induced cell proliferation and migration in HUVECs, as well as angiogenesis. However, the flavonoid extract did not inhibit VEGF signaling. Surprisingly, HUVECs adhesion to the extracellular matrix was compromised and adhesion-induced signaling was retarded by the flavonoid extract.

Varicocele-associated apoptosis has been recognised as a cause of male infertility. Thus, we assessed the expression of somatic apoptosis-related proteins (the typical protein-dependent apoptosis markers) in ejaculated sperm plasma from both patients with varicocele and normal donors. We evaluated the relationships between certain apoptosis-related proteins and normal semen quality. Semen samples were obtained from 25 patients with varicocele and from 10 normal fertile controls. These samples were compared using computer-assisted semen analysis for motion parameters and manual analysis for morphology, and were also assayed for apoptosis-related protein activation including caspase-3, poly-ACP-ribose polymerase (PARP), the Bcl-2 family (Bcl-2, Bak) and p53 by means of immunoblot analysis. PARP, Bak and p53 were expressed substantially more in the sperm cells of the varicocele group when compared with the normal group (P < 0.05). The expression of caspase-3 and Bcl-2 did not appear to differ between these two study groups. An increased expression of PARP, Bak and p53 for varicocele-afflicted individuals indicated an increased participation by these agents in the regulating of apoptosis in the ejaculated semen from patients with varicocele, suggesting that certain protein-development apoptotic mechanisms might originate in the cytoplasmic droplet or within mitochondria of spermatocytes and then might function within the nucleus of the cell.

Objective: To report two cases of recurrent uterine sarcoma that developed ifosfamide-induced encephalopathy (IIE) with successful management., Case Reports: The patient in the first case developed grade 4 toxicity and had a partial response after the fourth dose of intravenous methylene blue was administered. Full recovery occurred 4 days after the development of IIE. The patient in the second case, who had grade 3 toxicity, had completely recovered 32 hours after the first dose of thiamine., Conclusion: Careful evaluation of patients with recurrent gynecologic cancers and vigilance during infusion of chemotherapeutic regimens are important in reducing the risk and timely management of IIE. Both methylene blue and thiamine appear to be effective treatments for IIE.

Objective: To determine the integrity of the sperm plasma membrane, mitochondria, and DNA, which are essential for accurate transmission of genetic material to offspring, and to quantify possible apoptosis and investigate any relationship between these parameters in ejaculated sperm from men with or without varicoceles., Design: Retrospective study., Setting: University teaching hospital., Patient(s): Twenty-five patients with varicocele and 10 normal, fertile controls., Intervention(s): Apoptosis-related phenotype activations including the plasma membrane translocation of phosphatidylserine, mitochondrial dysfunction, and nuclear DNA damage, were assessed by using the annexin-V/propidium iodide double staining assay, 3,3'-dihexloxacarbocyanine iodide staining assay, and single-cell gel electrophoresis assay (comet assay)., Main Outcome Measure(s): Apoptosis-related phenotype., Result(s): Patients with varicocele had statistically significantly more annexin V live sperm cells and nuclear DNA fragmentation than did the control men. In contrast, their numbers of 3,3'-dihexloxacarbocyanine iodide live cells were statistically significantly less than those in control men., Conclusion(s): The increased externalization of phosphatidylserine, mitochondrial dysfunction, and nuclear DNA damage occurred in the sperm of men with varicoceles, suggesting that certain apoptotic mechanisms may relate to the condition of varicocele, originating in the mitochondria of spermatocytes and then functioning within the nucleus of the cell.

Objective: To evaluate the effect of soy isoflavones on menopausal symptoms in women who do and who do not produce equol, a daidzein metabolite., Method: A randomized, double-blind, placebo-controlled clinical trial was conducted over 6 months with 96 healthy menopausal women. After taking take 135 mg of isoflavones daily for 1 week, the women in the study group were assigned to the equol-producing (EP) or the non-EP group according to the presence or absence of equol in their urine. Menopausal symptoms were evaluated using a modified Kupperman Index., Result: Compared with the placebo group, the scores for hot flashes and excessive sweating were significantly reduced after 3 months, and the scores for weakness, palpitations, limb paresthesia, and total symptoms after 6 months, in the EP group only., Conclusions: Isoflavone supplementation improves menopausal symptoms only in women with the ability to produce equol.

Objective: To report a case of a woman with a large uterine myoma who underwent laparoscopy-assisted robotic myomectomy using the da Vinci system., Case Report: A 38-year-old, gravida 2, para 2, female patient presented to our office with a chief complaint of lower abdominal pressure and pain. A pelvic sonogram disclosed a subserosal myoma with a broad base, measuring approximately 9 x 8 x 7 cm, which was located at the anterior uterine wall. The patient insisted on preserving her uterus and was concerned with the cosmetic results after the surgery. She showed willingness to undergo myomectomy using the newly developed laparoscopy-assisted robotic system (da Vinci) and signed the consent form. The operation time was about 3 hours, with an estimated blood loss of 150 mL. The patient passed flatus and resumed oral intake on the following day., Conclusion: Minimally invasive surgery is the trend of the future. Robot-assisted laparoscopic surgery is a new technique for myomectomy. This robotic system provides a three-dimensional operative field and an easy-to-use control panel, which may be of great help when applying the suturing techniques and may shorten the learning curve. More experience with and long-term follow-up of robotic surgery may be warranted to further validate the role the robot-assisted approach in gynecologic surgery.