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Background This study was to perform an economic evaluation to understand clinical outcomes and health resource use between hip fracture patients receiving hospital-based postfracture fracture liaison service (FLS) care and those receiving usual care (UC) in Taiwan. Methods This cohort study included hospital-based data of 174 hip fracture patients who received FLS care (FLS group) from National Taiwan University Hospital, and 1697 propensity score-matched patients who received UC (UC group) of National Health Insurance claim-based data. Two groups had similar baseline characteristics but differed in hip fracture care after propensity score matching. Clinical outcomes included refracture-free survival (RFS), hip-refracture-free survival (HRFS), and overall survival (OS). Health resource use included inpatient, outpatient, and pharmacy costs within 2 years follow-up after the index of hip fracture. The economic evaluation of the FLS model was analyzed using the net monetary benefit regression framework based on the National Health Insurance perspective. Results The FLS group had longer RFS than the UC group, with an adjusted difference of 44.3 days (95% confidence interval: 7.2–81.4 days). Two groups did not differ in inpatient and outpatient costs during follow-up, but the FLS group had a higher expenditure than the UC group on osteoporosis-related medication. The probability of FLS being cost-effective was >80% and of increasing RFS, HRFS, and OS was 95%, 81%, and 80%, respectively, when the willingness-to-pay threshold was >USD 65/gross domestic product per day. Conclusion FLS care was cost-effective in reducing refracture occurrence days for patients initially diagnosed with hip fractures.

Background: Perineural injection therapy with 5% dextrose water (D5W) is a potential and innovative treatment with long-term efficacy for carpal tunnel syndrome (CTS). However, the prognostic factors of this management are lacking; hence, the aim of this retrospective study was to identify the prognostic factors of D5W perineural injection therapy for mild-to-moderate CTS. Methods: A total of 52 patients (52 wrists) diagnosed with mild-to-moderate CTS and treated with a single ultrasound-guided 5cc D5W perineural injection were retrospectively reviewed. Patient-reported injection outcomes (visual analog scale, VAS) at 6 months post-injection were categorized into two groups; (1) Good outcome, when symptom relief ≥50% compared to pre-injection and (2) Poor outcome, when symptom relief < 50% compared to pre-injection. Significant variables between groups were entered into a binary logistic regression with forward stepwise regression to determine the prognostic factors for these outcomes. Results: The treatment outcome was significantly related to body height and sensory nerve conduction velocity (SNCV) (159.1 ± 1.0 vs. 155.0 ± 1.8, p=0.04; 33.6 ± 0.8 vs. 28.3 ± 1.2, p=0.001, good vs. poor outcomes). However, only SNCV remained significantly correlated with the outcomes after conducting stepwise logistic regression (ORs: 1.201; 95% CI 1.05-1.38; p=0.01). Conclusions: SNCV was found to be a significant prognostic factor of treatment outcome for patients with mild-to-moderate CTS 6 months after a D5W perineural injection.

Kobresia species are common in meadows on the Qinghai–Tibet Plateau. They are important food resources for local livestock, and serve a critical foundation for ecosystem integration. Genetic resources of Kobresia species are scarce. Here, we generated a chromosome-level genome assembly for K. myosuroides (Cyperaceae), using PacBio long-reads, Illumina short-reads, and Hi–C technology. The final assembly had a total size of 399.9 Mb with a contig N50 value of 11.9 Mb. The Hi–C result supported a 29 pseudomolecules model which was in consistent with cytological results. A total of 185.5 Mb (44.89% of the genome) transposable elements were detected, and 26,748 protein-coding genes were predicted. Comparative analysis revealed that Kobresia plants have experienced recent diversification events during the late Miocene to Pliocene. Karyotypes analysis indicated that the fission and fusion of chromosomes have been a major driver of speciation, which complied with the lack of whole-genome duplication (WGD) in K. myosuroides genome. Generally, this high-quality reference genome provides insights into the evolution of alpine sedges, and may be helpful to endemic forage improvement and alpine ecosystem preservation.

Objective: Vitrification prevents ice formation within the high concentration of cryoprotectant agents and allows the cells and extracellular milieu to solidify into a glass-like state. This study aimed to provide objective information on the available data regarding singleton births comparing embryo vitrification with fresh embryo transfers. Methods: PubMed and Cochrane databases were searched for studies conducted up to 2017. Low birth weight (LBW), very low birth weight (VLBW), preterm birth (PTB), very PTB, small for gestational age (SGA), large for gestational age, perinatal mortality, cesarean section, and preeclampsia were measured. Results: The search returned 220 articles, and 13 of these met the inclusion criteria. A significantly lower risk of SGA birth was observed in the vitrified embryo transfer group than in the fresh transfer group. Conversely, a higher risk of very PTB, VLBW, large size for gestational age, and perinatal mortality was observed more frequently in the vitrified embryo transfer group. Conclusions: Vitrified embryo transfer was associated with the improved outcome of neonates regarding the SGA rate compared with fresh embryo transfer, but included a higher risk of very PTB, VLBW, large size for gestational age, and perinatal mortality. Caution should be exercised in interpreting these findings given the low level of evidence of the studies.

Treatment persistence was higher among the patients who initially received an anti-osteoporosis medication (AOM) with a long-dose-interval.With long-dose-interval anti-osteoporosis medications (AOMs) available for osteoporosis management, it is important to evaluate persistence of any AOM as long as it is continuously used. The purpose of this study was to investigate the treatment pattern and persistence of AOMs, allowing for medication switch.This study was an observational retrospective cohort study using Taiwan's National Health Insurance claims data. We selected patients who first initiated an AOM between January 1, 2013, and June 30, 2016. AOM therapy included alendronate, raloxifene, teriparatide, denosumab, zoledronate, and ibandronate; the latter three were categorized as long-dose-interval medications. Persistence was defined as continual prescription of any AOM at a given time point with a grace period of 45 days within which to obtain prescription refill. The competing risk model was used to examine the factors affecting patients switching their initial AOM.During the study period, 126,539 patients with mean age of 75 years met the inclusion criteria; 85% were female. For initial AOM, 43.3%, 25.6%, 14.6%, 9.3%, 5.3%, and 1.9% of the patients received alendronate, denosumab, raloxifene, zoledronate, ibandronate, and teriparatide, respectively. During a mean 36-month follow-up, 29.6% of the patients who received at least two AOM pharmacy claims throughout the study period have ever switched their initial medication. Long-dose-interval medications, mainly denosumab and zoledronate, were the preferred choice for medication switch. Treatment persistence was higher in patients who initiated with long-dose-interval AOMs.The real-world data reveal long-dose-interval therapy as an initial treatment or at the first switch stage may improve management of persistent AOM treatment.

Deer family is one of the most abundant mammalian families in the world. Deer species are distributed in wide geographic ranges including the North Pole, tropical regions and high-altitude mountains. Of these deer species, China accounts for more than 40% of them and is the main site for deer evolution. Besides the common phenotypical attributes for ruminants, deer family is evolved to possess the unique head gears with periodic regeneration, i.e. antlers. It is currently well accepted that deer is a very valuable model for the studies of ecology, behavior, evolution and biology, especially for the study of mammalian organ regeneration. Reference deer genome is the basis for systematically illustrating deer evolution, deciphering unique biological attributes of deer species, and is significant in protection and utilization of deer genetic resources. In this review, we summarize the recent progress in the field of deer genome research, including data of deer genetic variation, molecular basis of adaptive evolution, and key genes and functional genomics involved in deer antler origin and evolution. The overall aim of the paper is to provide the reference neccessary for in depth investigation of deer species.鹿科动物是世界上最丰富的大型哺乳动物之一,在极北地区、热带地区和高海拔地区都有分布。中国占世界鹿科动物40%以上,是鹿科动物进化的主战场。鹿科动物除了具有反刍动物常见的独特表型特征外,更是进化出周期性再生新器官——鹿茸角。鹿科动物是研究生态学、行为学和进化生物学非常有价值的动物模型,特别是在研究哺乳动物器官再生方面具有重要科学价值。鹿基因组是系统阐述鹿的进化和演变,解析鹿科动物独特生物学性状的依据,对遗传资源保护和利用具有重要意义。目前,随着鹿科动物参考基因组的不断完善,在鹿基础科学研究上取得了诸多重要成果。本文详细综述了鹿科动物基因组学研究进展,主要包括鹿遗传变异数据、适应性进化分子基础、独特性状鹿茸角的起源进化关键基因和功能基因组学,以期为鹿科动物的深入研究奠定理论基础。.

Background Tumor microenvironment plays important roles in the development of cancer. The aim of our study was to examine the expression of genes in colorectal cancer and also to evaluate the association value between expression level of these genes and clinical features. Methods We combined The Cancer Genome Atlas (TCGA) datasets to identify differentially expressed genes in colon cancer. Using these differentially expressed genes, we constructed protein-protein interaction network and conducted functional enrichment analysis. Genes with degree beyond 10 in the PPI network were regarded as hub genes. Then, we verified of the expression of molecules in Oncomine datasets and conducted Kaplan-Meier curve and log-rank test and functional enrichment analysis on these hub genes. Finally, we analyzed the relationship clinicopathological features analysis with the key gene. Results There were 719 differentially expressed genes identified to be associated with colon cancer microenvironment. We screened out 10 hub genes by construction of PPI network. The functions of these hub genes were enriched in cytokine-cytokine receptor interaction, alcoholism and systemic lupus erythematosus, which provided further insight into the roles of these genes in the tumor microenvironment. GNG4, with the highest degrees in the PPI network, were highly exprepressed in metastasis(P = 9.5-05) ,N1(P = 0.0025) and N2(,0.037).It was a relationship with stage. It was significantly different between with stage I and IV, II and III, II and IV,III and IV (P = 0.0015,0.029,3.9-05,0.00074,0.01,respectively) Conclusions We identified GNG4 can be regarded as a prognostic biomarker in colon cancer.

Objectives: Transfer of cryopreserved-warmed blastocysts is common in the practice of in vitro fertilization. The purpose of the study is to examine the available evidence and determine whether cryopreservation of blastocysts and subsequent frozen blastocyst transfer (BT) result in better outcomes than fresh BT. Material and methods: Related studies comparing outcomes of in vitro fertilization (IVF) cycles between fresh and frozen BTs were retrieved from Medline, Cochrane Central Register of Clinical Trials, EMBASE, DARE, and CINAHL through March 2020. The outcomes of interest were preterm birth, extremely preterm birth, small for gestational age, large for gestational age, low birth weight, extremely low birth weight, caesarean section, perinatal mortality and preeclampsia. The analysis was performed using Rev Man 5.1 software. Risk ratios (RRs) and risk differences were calculated with 95% confidence intervals, to evaluate the results of each outcome. The quality of the referenced studies was assessed using the Newcastle-Ottawa scale (NOS) checklists. Results: Nine studies with 42,342 women incorporated in this meta-analysis. The incidence of preterm birth (RR = 0.89, 95% CI: 0.82, 0.97) and small for gestational age (RR = 0.55, 95% CI 0.41–0.74) was low in frozen BT group. There was no significant difference in the risk of low birth weight (RR = 0.89, 95% CI: 0.67, 1.19) and perinatal mortality (RR = 1.47, 95% CI: 0.85, 2.55) between frozen-thawed and fresh BT. Singleton pregnancy after frozen BT was associated with higher large for gestational age (RR = 1.47, 95% CI: 1.37, 1.57), caesarean section rates (RR = 1.24, 95% CI: 1.13, 1.36) and preeclampsia compared with fresh BT (RR = 1.85, 95% CI: 1.22, 2.82). Conclusions: The frozen BT results in better perinatal outcomes compared with that of fresh BT. Furthermore, comprehensive randomized clinical trials comparing freeze-all with fresh BT cycles are needed to draw sound conclusions.

Background and objective Metformin is a first-line treatment for patients with diabetes. Recent animal studies indicated that metformin can reduce airway inflammation. However, it remains unclear whether the use of metformin can help patients maintain asthma control. The purpose of this study was to evaluate the association between the use of metformin and asthma-related outcomes, which include asthma-related hospitalization, asthma-related emergency room visits and asthma exacerbation, among patients with concurrent asthma and diabetes. Methods We conducted an 11-year (2001–2011) retrospective cohort study using the Taiwan National Health Insurance Research Database. Patients with concurrent asthma and diabetes were included. The date of the first observed prescription of metformin was defined as the index date. For each metformin user, two matched metformin non-users of the same age and gender were randomly selected. Patients were followed for 3 years to measure the occurrence of asthma-related outcomes. Multivariable logistic regression models were used to assess the association between metformin use and asthma-related outcomes. Results Of 1332 patients with concurrent asthma and diabetes, 444 (33.3%) were metformin users. Compared with non-users, metformin users had a lower risk of asthma-related hospitalization (OR = 0.21, 95% CI: 0.07–0.63) and asthma exacerbation (OR = 0.39, 95% CI: 0.19–0.79). Conclusion The risk of asthma-related outcomes was lower for metformin users than non-users. Health-care providers should consider metformin as a treatment strategy for patients with concurrent asthma and diabetes.

Si δ-doped AlGaAs/InGaAs/AlGaAs quantum well (QW) structure is commonly adopted as one of the core elements in modern electric and optoelectronic devices. Here, the time dependent photoconductivity spectra along the active InGaAs QW channel in a dual and symmetric Si δ-doped AlGaAs/InGaAs/AlGaAs QW structure are systematically studied under various temperatures (T = 80–300 K) and various incident photon energies (E in = 1.10–1.88 eV) and intensities. In addition to positive photoconductivity, negative photoconductivity (NPC) was observed and attributed to two origins. For T = 180–240 K with E in = 1.51–1.61 eV, the trapping of the photo-excited electrons by the interface states located inside the conduction band of InGaAs QW layer is one of the origins for NPC curves. For T = 80–120 K with E in = 1.10–1.63 eV, the photoexcitation of the excess ‘supersaturated’ electrons within the active InGaAs QW caused by the short cooling process is another origin.

Cervi Cornu Pantotrichum, as a traditional Chinese medicine, has great potential for development. However, the identification and quality control system is not perfect, leading to the market chaos and chronic slow growth in deep processing of Cervi Cornu Pantotrichum. This paper gives an overview of present situation in identification and quality control system of the Cervi Cornu Pantotrichum, and analyzes present problems. Based on these results, the feasibility study scheme in identification and quality control system for Cervi Cornu Pantotrichum would be then put forward, providing ideas to establish its comprehensive evaluation system.

A new amdoparvovirus, named raccoon dog and fox amdoparvovirus (RFAV), was identified in farmed sick raccoon dogs and arctic foxes. Phylogenetic analyses showed that RFAV belongs to a new species within the genus Amdoparvovirus of the family Parvoviridae. An RFAV strain was isolated in Crandell feline kidney cell culture.

This study investigated the feasibility of dietary supplemental mixed probiotics and bromelain fermented soybean meal (FS) and the strength of fermented soybean meal (SFS) (adjusted amino acids and protein) to replace expensive fish meal for broilers, in order to reduce feeding cost. Trial 1 investigated the effects of adding different levels of mixed probiotics fermented solution and bromelain (a kind of protease extracted from pineapple) on the quality of fermented soybean meal. Trial 2 included (1) 4% fish meal (FM) as the control, (2) 6% wet fermented soybean meal (WFS), (3) 5% soybean meal (SBM), (4) 5% wet strengthened fermented soybean meal (WSFS) and (5) 4.5% dry strengthened fermented soybean meal (DSFS) groups. The best outcome of Trial 1 resulted from inoculation with a 34% fermented solution and 0.05% bromelain, and incubation at 34±0.5 °C for a week. Results from Trial 2 showed that the growth performance in the FM group had a significantly better average body weight gain (BWG) and feed intake ( P P

The conventional histogram-based reversible data-hiding scheme is one-dimensional (1D). In this article, a novel framework that can be used to design 2D reversible data-hiding schemes is presented. Through the flexibility of selecting peaks for each channel, this 2D technique offers higher embedding performance than the conventional 1D techniques. For illustration, the framework is applied to develop two new schemes, C-2D and S-2D. Compared with the 1D schemes that use the predictions individually, the experimental results show that C-2D and S-2D have apparent performance advantages. This framework can be applied to any architecture. Furthermore, it can be easily extended into a multi-dimensional framework. By combining appropriate prediction methods, more reversible data-hiding schemes can be derived.

To further refine the classification and phylogeny of sika deer subspecies, the well-annotated sequences of the complete mitochondrial DNA (mtDNA) control region of 13 sika deer subspecies from GenBank were downloaded, aligned and analyzed in this study. By reconstructing the phylogenetic tree with an extended sample set, the results revealed a split between Northern and Southern Mainland Asia/Taiwan lineages, and moreover, two subspecies, C.n.mantchuricus and C.n.hortulorum, were existed in Northern Mainland Asia. Unexpectedly, Dybowskii's sika deer that was thought to originate from Northern Mainland Asia joins the Southern Mainland Asia/Taiwan lineage. The genetic divergences were ranged from 2.1% to 4.7% between Dybowskii's sika deer and all the other established subspecies at the mtDNA sequence level, which suggests that the maternal lineage of uncertain sika subspecies in Europe had been maintained until today. This study also provides a better understanding for the classification, phylogeny and phylogeographic history of sika deer subspecies.

The feasibility of using the eco-friendly biodegradable surfactant saponin (a plant-based surfactant) from soapberry and surfactin from Bacillus subtilis (BBK006) for the removal of heavy metals from contaminated industrial soil (6511 mg kg −1 copper, 4955 mg kg −1 lead, and 15 090 mg kg −1 zinc) by foam fractionation and a soil flushing process was evaluated under variation of fundamental factors (surfactant concentration, pH, temperature and time). The results of latter process showed that 1–2% Pb, 16–17% Cu and 21–24% Zn was removed by surfactin after 48 h, whereas the removal of Pb, Cu and Zn was increased from 40% to 47%, 30% to 36% and 16% to 18% in presence of saponin with an increase from 24 to 72 h at room temperature by the soil washing process at pH 4. In the foam fractionation process, the metal removal efficiencies were increased with increases in the saponin concentration (0.075–0.15 g L −1 ) and time (24–72 h), whereas the efficiency was decreased with increasing pH (4–10) and temperature (>40 °C). The removal efficiencies of Pb, Cu and Zn were increased significantly from 57% to 98%, 85% to 95% and 55% to 56% with an increase in the flow rate from 0.2 to 1.0 L min −1 at 0.15 g L −1 saponin (pH 4 and 30 °C). The present investigation indicated that the foam fractionation process is more efficient for the removal of heavy metal from contaminated industrial soil in comparison to the soil washing process. The plant-based eco-friendly biodegradable biosurfactant saponin can be used for environmental cleanup and pollution management.

Coker gas oil (CGO) is difficult to be cracked in the conventional FCC process, due to their high nitrogen content, especially the basic nitrogen compounds. To enhance the conversion of CGO, the high reaction temperature and catalyst to oil ratio processing scheme was performed in a pilot-scale riser FCC apparatus. To study the impact of (basic) nitrogen content, two kinds of CGO were tested. The results show that increasing the reaction temperature and CTO is an effective method for enhancing the conversion of CGO. The (basic) nitrogen content significantly influences the cracking behavior of CGO and the choose of optimal reaction conditions.

The use of a biodegradable natural plant-based surfactant extracted from soapberry is proposed for the remediation of Ni, Cr and Mn from industrial soil site in Hai-Pu, Taiwan. Batch experiments were performed under variation of fundamental factors (saponin concentration, pH, and incubation time) for metal remediation. Removal of Ni and Mn were increased with increasing saponin concentration (0.015-0.150 g/L), whereas the removal of Cr was increased upto 0.075 g/L saponin. The Ni, Cr and Mn were removed significantly (p < or = 0.05) at near to the neutral and slightly acidic (pH 5 to 8) conditions. Removal efficiency of Ni (99%) from the soil was found to be greater than that of Cr (73%) or Mn (25%) in the presence of saponin at a concentration of 0.150 g/L at pH 5. The removal percentage increased with incubation time where the removal of Ni was faster than that of Cr and Mn. The result indicates the feasibility of eco-friendly removal of heavy metal (Ni, Cr and Mn) from industrial soil by soil washing process in presence of plant derived saponin.

In this study, pressure drop across a novel CFB riser integrated with an enlarged bottom section was investigated under various operating conditions. Experimental results indicated that total pressure drop was much higher across the riser with larger diameter-enlarged section dimensions, consequently, resulting in lower solids circulation rate realizable in the riser. Based on the measured pressure drop across this novel riser, apparent solids concentrations of the diameter-enlarged section and the conveying section were obtained. Furthermore, empirical correlations for estimating overall average solids concentration in these two sections were established, respectively. And a satisfactory agreement between predictions and experimental results was observed.

Partial update (PU) methods play a critical part in least-mean square (LMS) algorithms with an aim to reducing computational complexity. This paper presented a novel variable step-size PU procedure for LMS algorithms via the performance metric, called error difference indicator. With the aid of such an indicator, the PU procedure can determine the proper step size and works efficiently with a low-cost hardware implementation. Simulation results revealed that the proposed PU method speeds up the convergence rate of LMS algorithms as compared to the existing methods.

In this study, a plasma surface modification with printing process was developed to fabricate printed flexible conductor patterns or devices directly on polydimethylsiloxane (PDMS) surface. An atmospheric plasma treatment was first used to oxidize the PDMS surface and create a hydrophilic silica surface layer, which was confirmed with photoelectron spectra. The plasma operating parameters, such as gas types and plasma powers, were optimized to obtain surface silica layers with the longest lifetime. Conductive paste with epoxy resin was screen-printed on the plasma-treated PDMS surface to fabricate flexible conductive tracks. As a result of the strong binding forces between epoxy resin and the silica surface layer, the printed patterns showed great adhesion on PDMS and were undamaged after several stringent adhesion tests. The printed conductive tracks showed strong mechanical stability and exhibited great electric conductivity under bending, twisting, and stretching conditions. Finally, a printed pressure sensor with good sensitivity and a fast response time was fabricated to demonstrate the capability of this method for the realization of printed electronic devices.

According to field measurement datum in disturbed overburden stratum of five drillings, disturbed overburden stratum movement characteristics were analyzed. Negative exponent function model of measurement points movement law was also constructed. Moreover, variation law of stratum subsidence speed and relation between overburden stratum subsidence factor and surface subsidence factor were deeply researched. The results show that starting-distance of panel is nearly 70m, bedrock and alluvium subside synchronically and key-stratum isn’t exist in overburden stratum. Also, displacement curve of measurement points in stratum submits negative exponent function model and mutagenesis of surveying points subsidence speed is the key position where face passed drilling 100m. Furthermore, subsidence factor of overburden stratum and surface submits exponent function model.

Oligomerization of ethylene in fluidized catalytic cracking (FCC) dry gas to propylene was investigated as a feasible approach to use FCC dry gas. The thermodynamic calculation indicated that the equilibrium conversion of ethylene decreased with an increasing temperature, while the experimental conversion achieved peak value at nearly 500°C due to kinetic limit. The catalytic performances of HZSM-5 catalysts with FCC dry gas as feedstock were studied in fixed-bed reactor. It was confirmed that oligomerization carried out at a higher temperature using dilute feed or a less active catalyst such as steam treated catalyst favored propylene yield. With ethylene conversion of approximately 50%, the propylene yield was over14% at 0.3MPa, 550°C with dilute ratio of 1:1 over steam treated catalyst. An apparent reaction order of 2.5 with respect to ethylene was obtained.

In order to research the possibility of digital close-range photogrammetric surveying in small scale physical simulation experiment, physical model coinciding with engineering practice was constructed based on similar theory. The datum processing method and surveying precision of digital close-range photogrammetric were analyzed. And the function relationship between overburden subsidence factor qr and the ratio z/H of stratum horizon z and mining depth H was researched. The results show that surveying points position mean error along horizontal direction is ±0.131 mm and vertical direction is ±0.192 mm. Therefore, multi-taking station cross direction digital close-range photogrammetric can completely satisfy the precision need of physical simulation experiment. And the empirical formula can be utilized to represent evolution law of stratum subsidence factor.

A primary cDNA expression library with a titer of 5.0 × 10 5 PFU mL −1 was constructed from mRNA extracted from larval Haemaphysalis qinghaiensis ticks in order to identify certain genes, which would then be used as candidate molecules for development of effective vaccines to control this parasite. Totally 11 positive clones, which designated as HqL01-11, were obtained by immunoscreening of the library using a polyclonal antibody generated in rabbit with larval tick protein extract. Results of sequence analysis from BLASTN searching revealed that 6 of them had no significant homology with the adult H. qinghaiensis ticks' known genes, 4 of them had no significant homology with all genes deposited in GenBank database. HqL07, HqL08, HqL09, and HqL11 were deposited to GenBank database, and accession numbers were EF605263 , EF605264 , EF605265 , and EF605266 , respectively. Subsequently, HqL07 and HqL09 were expressed in vitro and the molecular weights of the corresponding expressed products were 60 and 70 kDa, respectively. Western blot analyses showed that HqL07 and HqL09 had immunogenicity. This study laid the foundation for future production of genetically engineered vaccines for the immunological control of H. qinghaiensis .

Establishment of integrated course system in human development and genetics is an important part of course reformation, and the improvement of this system is achieved by integrating the content of course, stabilizing teaching force, building teaching materials and applying problem-based learning. Integrity-PBL teaching model is founded and proved to be feasible and effective by teaching practice. Therefore, it maybe play an important role in improving teaching effect and cultivating ability of students to analyse and solve problems.

Background Hairy cell leukemia (HCL) is a rare B-cell lymphoid malignancy that is characterized by the presence of hairy cells in the peripheral blood and bone marrow, pancytopenia and various degrees of splenomegaly. Very few reports have explored the clinicopathologic features and treatment outcome of HCL in Taiwan. Methods Of 33 patients with malignant lymphoma who underwent splenectomy over a 10-year period (1996–2005), 5 cases of HCL were retrospectively studied. Results All cases presented with various degrees of splenomegaly. Pancytopenia was noted in 3 cases, and lymphadenopathy in 1. Typical hairy cells with positive tartrate-resistant acid phosphatase stain were noted in 2 cases. Only 3 cases could be diagnosed with HCL based solely on bone marrow findings. In contrast, all spleen specimens had characteristic pathologic features. All patients underwent splenectomy uneventfully, and cladribine was given at a median time of 2 months after splenectomy without significant side effects. Complete remission with durable response was documented in 4 patients (80%) with a median follow-up of 29 months (range, 4–96 months). The last patient experienced partial remission but was only followed up for 4 months. Conclusion For the HCL patients in this study, splenectomy had a role not only in improving cytopenia but in aiding diagnosis. Cladribine is safe and highly effective for Taiwanese patients and should be considered as first-line treatment for HCL.

Metformin is a first-line treatment for patients with diabetes. Recent animal studies indicated that metformin can reduce airway inflammation. However, it remains unclear whether the use of metformin can help patients maintain asthma control. The purpose of this study was to evaluate the association between the use of metformin and asthma-related outcomes, which include asthma-related hospitalization, asthma-related emergency room visits and asthma exacerbation, among patients with concurrent asthma and diabetes.We conducted an 11-year (2001-2011) retrospective cohort study using the Taiwan National Health Insurance Research Database. Patients with concurrent asthma and diabetes were included. The date of the first observed prescription of metformin was defined as the index date. For each metformin user, two matched metformin non-users of the same age and gender were randomly selected. Patients were followed for 3 years to measure the occurrence of asthma-related outcomes. Multivariable logistic regression models were used to assess the association between metformin use and asthma-related outcomes.Of 1332 patients with concurrent asthma and diabetes, 444 (33.3%) were metformin users. Compared with non-users, metformin users had a lower risk of asthma-related hospitalization (OR = 0.21, 95% CI: 0.07-0.63) and asthma exacerbation (OR = 0.39, 95% CI: 0.19-0.79).The risk of asthma-related outcomes was lower for metformin users than non-users. Health-care providers should consider metformin as a treatment strategy for patients with concurrent asthma and diabetes.