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Background: This study investigates the prevalence of lower urinary tract symptoms (LUTS) in school-age children with Attention-Deficit/Hyperactivity Disorder (ADHD) based on hospital-based and population-based cohorts. Methods: The hospital-based sample comprised 42 children with ADHD and 65 without ADHD aged 6–12 years. Voiding dysfunction was assessed by the Dysfunctional Voiding Scoring System (DVSS) questionnaire. We compared the baseline data, DVSS score, and uroflowmetry between the two groups. For the population-based cohort in the national insurance database, we included 6526 children aged 6–12 years, whose claims record included the diagnosis of ADHD, and another 6526 control subjects matched by gender and age. We compared the presence of LUTS diagnosis codes between the two groups. Results: Our results showed that, for the hospital-based cohort, the mean total DVSS score and the proportion of significant LUTS in children in the ADHD group were significantly higher than in subjects in the non-ADHD group. The DVSS subscales showed that the item “I cannot wait when I have to pee” item was significantly higher in the ADHD group (1.62 ± 1.17 vs. 0.90 ± 1.09, p = 0.002). For the population-based cohort, children with ADHD had a significantly higher likelihood of storage symptoms (5.53% vs. 2.91%, p < 0.001) and enuresis (3.28% vs. 1.95%, p < 0.001) compared with those of the no ADHD group. Conclusions: Children with ADHD have a higher prevalence of significant LUTS, especially storage symptoms and enuresis, than children without ADHD. The observed correlations between ADHD and LUTS provided the supporting evidence to evaluate the concomitant voiding dysfunction in children with ADHD.

Background/purpose This study investigates the safety and feasibility to perform laparoscopic nephroureterectomy (LNU) for upper tract urothelial carcinoma (UTUC) without routine nasogastric tube (NGT) decompression. Methods The hospital-based samples comprised of 100 consecutive UTUC patients receiving elective LNU performed by two experienced surgeons. The nationwide data was based on LHID2005 composed of one million beneficiaries randomly selected from the Taiwan National Health Insurance Research Database to identify patients with the diagnoses of UTUCs receiving LNUs. We then compared baseline characteristics, peri-operative data, convalescence parameters and complications between two groups stratified by use of NGT tube. Results The hospital-based samples composed of 50 subjects with NGT and 50 without. There were no significant differences in baseline characteristics between two groups. Peri-operative and convalescence parameters were similar when comparing no NGT versus NGT: blood loss of 206 vs. 165 mL; operative time of 180.5 vs.181.1 min; days to intake was 2.1 vs.1.7 days; and hospital stay of 7.8 vs. 7.5 days (all p > 0.05). The nationwide study samples comprised 140 subjects, of which 72 were with NGT and 68 were with no NGT. The baseline data, complications and length of hospital stay were similar between two groups. Conclusions Surgery-naive patients with localized UTUC received LNU without peri-operative NGT is safe and feasible.

Background To investigate the role of lncRNA LSAT1 in the hypoxia-induced invasion and metastasis of non-small cell lung cancer (NSCLC). Methods High-throughput microarrays were used to compare the lncRNA expression profile difference between normoxia-induced and hypoxia-induced NSCLC cell lines including A549, NCI-H1650 and NCI-H1299 in order to preliminarily screen key molecules related to hypoxia-induced invasion and metastasis of NSCLC. The different expression of lncRNA LSAT1 was measured in hypoxia-induced NSCLC cells (compared to normoxia-induced NSCLC cells) and 20 pairs of NSCLC tissues (compared to adjacent tissues) with RT-PCR. The expression of lncRNA LSAT1 in NSCLC cells A549 and NCI-H1299 was down-regulated by lentiviral transfection. Transwell migration and invasion assays and tail vein injection metastasis assay were employed for investigating the effect of lncRNA LSAT1 knockdown on the hypoxia-induced invasion and metastasis of NSCLC cells. Results RT-PCR showed that lncRNA LSAT1 was significantly increased in hypoxia-induced NSCLC cells A549, NCI-H1650 and NCI-H1299 and compared with adjacent tissues. The expression of lncRNA LSAT1 was also upregulated in NSCLC tissues. Transwell migration and invasion assays demonstrated that hypoxia could enhance the abilities of migration and invasion of NSCLC cells A549 and NCI-H1299. However, these two abilities were significantly inhibited after lncRNA LSAT1 knockdown. In addition, nude mice tail vein injection metastasis assay also verified that lncRNA LSAT1 knockdown inhibited liver metastasis and lung metastasis of NSCLC cell A549 in vivo. Conclusions We found a series of hypoxia-related lncRNAs in NSCLC by means of high-throughput screening microarrays. Clinical specimen analysis and functional loss test confirmed that lncRNA LSAT1 is a key lncRNA for hypoxia-induced invasion and metastasis of NSCLC. In addition, STAT3 may be one of the target genes for lncRNA LSAT1 to play a regulatory role.

Background Thrombospondin-related adhesive protein (TRAP) is a transmembrane protein that plays a crucial role during the invasion of Plasmodium falciparum into liver cells. As a potential malaria vaccine candidate, the genetic diversity and natural selection of PfTRAP was assessed and the global PfTRAP polymorphism pattern was described. Methods 153 blood spot samples from Bioko malaria patients were collected during 2016–2018 and the target TRAP gene was amplified. Together with the sequences from database, nucleotide diversity and natural selection analysis, and the structural prediction were preformed using bioinformatical tools. Results A total of 119 Bioko PfTRAP sequences were amplified successfully. On Bioko Island, PfTRAP shows its high degree of genetic diversity and heterogeneity, with π value for 0.01046 and Hd for 0.99. The value of dN–dS (6.2231, p PfTRAP on Bioko Island. Globally, the African PfTRAPs showed more diverse than the Asian ones, and significant genetic differentiation was discovered by the fixation index between African and Asian countries (Fst > 0.15, p 1) indicated a destabilization of protein structure. Conclusions Evidences in the present investigation supported that PfTRAP gene from Bioko Island and other malaria endemic countries is highly polymorphic (especially at T cell epitopes), which provided the genetic information background for developing an PfTRAP-based universal effective vaccine. Moreover, some mutations have been shown to be detrimental to the protein structure or function and deserve further study and continuous monitoring.

Estrogen receptor‑associated receptor α (ERRα) is an orphan nuclear receptor that lacks corresponding ligands. ERRα recruits co‑regulators to regulate gene transcription and plays an important role in human physiological functions. Peroxisome proliferator‑activated receptor γ (PPARγ) is also a nuclear receptor that regulates the expression of target genes via a ligand‑dependent mechanism, thereby participating in a series of physiological processes. Both ERRα and PPARγ are involved in the process of energy metabolism and tumorigenesis. In the present review, a concise overview of the important roles governed by ERRα and PPARγ in metabolism and their association with various disease are provided.

BackgroundWe aim to examine the trend in the use of antimuscarinics and off-label alpha-adrenergic blockers for treatment of lower urinary tract symptoms (LUTS) in a Taiwanese Women Cohort between 2007 and 2012.MethodsThis population-based National Health Insurance Research Database (NHIRD) was used to examine the trends in the use of antimuscarinics or off-label alpha-adrenergic blockers in Taiwan. A sample of 1,000,000 individuals randomly drawn from the whole population of 23 million individuals who were registered in the NHI in 2005. From 2007 through 2012, women aged over 18 years whose claim record contained prescriptions of either of the two drugs for treatment of any of the LUTS-related diagnoses were identified and analyzed. The annual usage of the two drug classes were calculated by defined daily dose (DDD).ResultsFrom 2007-2012, there was a 0.80 fold (69676.8 to 125104.3) increase in DDD of antimuscarinics in our cohort. The overall healthcare seeking prevalence of LUTS was 7.33% in 2007 and 12.38% in 2012, in a rising trend. The prevalence of antimuscarinics-treated LUTS in our cohort increased from 2.53 in 2007 to 3.41 per 1000 women in 2012. The prevalence of LUTS treated by antimuscarinics increased especially for those older than 60 years during the study period.ConclusionsThis 6-year observational study provided the epidemiologic information of clinically significant LUTS of Asian female population. Moreover, there was a rising trend in the use of antimuscarinics and off-label alpha-adrenergic blockers in the population-based cohort.

AIM: To evaluate the neuroprotective effect of nerve growth factor(NGF)on acute angle-closure glaucoma patients after trabeculetomy. METHODS: Patients with viral keratitis who underwent trabeculectomy in treatment of acute angle-closure glaucoma in Xiamen Eye Center of Xiamen University from December 2011 to October 2013 were selected and completed the treatment, 61 eyes of 45 cases were followed up. The treatment group of 23 cases(32 eyes)with acute angle-closure glaucoma patients were treated by NGF gel for 3mo after trabeculetomy, while in the control group 22 cases(29 eyes)were treated by normal saline replaced NGF. All patients were followed up for at least 12mo, visual acuity, perimetry, retinal nerve fiber layer(RNFL)thickness and cup/disc ratio of the patients were followed up during the treatment. The safety of topical use of NGF gel was also evaluated. RESULTS:In all patients, the intraocular pressure(IOP)was successfully controlled under 21mmHg and the visual acuity was markedly increased in the affected eye after trabeculectomy. Compared with control group, the postoperative IOP and visual acuity had no significant differences in treatment group(P>0.05). The average light sensitivity of perimetry and mean defect were better than that in control group postoperative 6 and 12mo; The results of optical coherent tomography(OCT)and Heiderburg Retina Tomography(HRT)-Ⅲ showed that RNFL thickness was significantly greater than that in control group, while cup/disc ratio significantly less than that in control group postoperative 6 and 12mo. Ocular surface damage, corneal endothelium to reduce and other eye complication were no observed in treatment group. CONCLUSION:Acute angle-closure glaucoma treated by NGF gel after operation is effective and safe.

To investigate the trends of newly diagnosed incidence, medical utilization, and medical costs for pediatric urolithiasis in Taiwan.The present study uses the National Health Insurance Research Database, which contains the data of all medical benefit claims from the individuals enrolled in the national and single-payer insurance program in Taiwan. The National Health Insurance covered 22,717,053 enrollees, nearly 99% of Taiwan's population. Our analysis includes all subjects aged18 years with a primary diagnosis of urolithiasis. We analyzed the temporal trend for annual newly diagnosed incidence, medical care visits, and medical costs for pediatric urolithiasis from 1998 to 2007.A total of 1474 patients aged18 years with newly diagnosed urolithiasis were identified, including 719 (48.8%) boys and 755 (51.2%) girls. The overall newly diagnosed rate of urolithiasis in pediatric population was 0.038% in 2007. The peak age stratum of urolithiasis occurrence in 2007 was 15-18 years. The trend of annual newly diagnosed incidences for boys, girls, and all children declined from 1998 to 2007. Furthermore, there were declining trends both in medical costs and annual medical care visits during the study period.This is the first nationwide population-based study to indicate the declining trends in newly diagnosed rate, medical care visits, and medical costs for pediatric urolithiasis. These findings help to quantify and establish the burden of pediatric urolithiasis. These findings help to quantify and establish the burden of medical care for pediatric urolithiasis and to further refine the medical policy.

Background and Aims: MicroRNA-21 (miR-21) is reported to be overexpressed and to contribute to proliferation, apoptosis and gemcitabine resistance in pancreatic ductal adenocarcinomas (PDACs). The aims of this study were to explore regulation of miR-21 expression by epigenetic change and its impact on chemoresistance and malignant properties of of pancreatic cancer. Materials and methods: We retrospectively collected 41 cases of advanced pancreatic cancer patients who were sensitive or resistant to gemcitabine and assessed levels of serum circulating miR-21 for correlation with cytotoxic activity. Histone acetylation in the miR-21 promoter was also studied in gemcitabine-sensitive and gemcitabine-resistant PDAC cells. Gemcitabine-resistant HPAC and PANC-1 cells were transfected with pre-miR-21 precursors (pre-miR-21) and antisense oligonucleotides (anti-miR-21), and were treated with TSA. Finally, invasion and metastasis assays were performed and alteration in mir-21, PTEN, AKT and pAKT level was evaluated in these cells. Results: Serum miR-21 levels were increased in gemcitabineresistant PDAC patients compared with gemcitabine-sensitive subjects. The miR-21 levels were increased in 6 PDAC cells treated with gemcitabine significantly, associated with 50% inhibitory concentrations (IC 50 s). Histone acetylation levels at miR-21 promoter were increased in PDAC cells after treatment with gemcitabine. Enhanced invasion and metastasis, increased miR-21 expression, decreased PTEN, elevated pAKT level were demonstrated in gemcitabine-resistant HPAC and PANC-1 cells. Pre-miR-21 transfection or TSA treatment further increased invasion and metastasis ability, decreased PTEN, and elevated pAKT levels in these two lines. In contrast, anti-miR-21 transfection could reverse invasion and metastasis, and PTEN and pAKT expressions induced by gemcitabine. Conclusions: MiR-21 upregulation induced by histone acetylation in the promoter zone is associated with chemoresistance to gemcitabine and enhanced malignant potential in pancreatic cancer cells.

We investigated the epidemiology of upper urinary tract stone disease in Taiwan using a nationwide, population based database.This study was based on the National Health Insurance Research Database of Taiwan, which contains data on all medical beneficiary claims from 22.72 million enrollees, accounting for almost 99% of the Taiwanese population. The Longitudinal Health Insurance Database 2005, a subset of the National Health Insurance Research Database, contains data on all medical benefit claims from 1997 through 2010 for a subset of 1 million beneficiaries randomly sampled from the 2005 enrollment file. For epidemiological analysis we selected subjects whose claims records included the diagnosis of upper urinary tract urolithiasis.The age adjusted rate of medical care visits for upper urinary tract urolithiasis decreased by 6.5% from 1,367/100,000 subjects in 1998 to 1,278/100,000 in 2010. There was a significantly decreasing trend during the 13-year period in visits from female and all subjects (r(2) = 0.86, p = 0.001 and r(2) = 0.52, p = 0.005, respectively). In contrast, an increasing trend was noted for male subjects (r(2) = 0.45, p = 0.012). The age adjusted prevalence in 2010 was 9.01%, 5.79% and 7.38% in male, female and all subjects, respectively. The overall recurrence rate at 1 and 5 years was 6.12% and 34.71%, respectively. Male subjects had a higher recurrence rate than female subjects.Our study provides important information on the epidemiology of upper urinary tract stone disease in Taiwan, helping to quantify the burden of urolithiasis and establish strategies to decrease the risk of urolithiasis.

Background/Purpose Current guidelines recommend that hypospadias repair should be performed before age 18 months. This study aims to investigate the trends of surgical timing and to determine what factors are associated with age at surgery. Methods The present study utilized a subset of the National Health Insurance Research Database, known as Longitudinal Health Insurance Database 2005, which contains the data of all paid medical benefit claims over the period from 1997 to 2007 for a subset of one million beneficiaries randomly drawn from the population of 22.72 million individuals in NHI program during any part of calendar year 2005. We analyzed claims data for all subjects with the diagnoses of hypospadias. Results Among 52,705 live male newborns, 218 were diagnosed with hypospadias and thus were included as subjects in our study. Among them, 89 received repair surgery. Approximately 60.6% of the study subjects received repair after the age of 18 months. Multivariate analysis showed that several factors were significantly associated with age at hypospadias surgery: specialty of clinics where first diagnosis was made; specialty of physician making the first diagnosis, age of physician making the first diagnosis; specialty of surgeon performing the surgery; number of years since surgeon's board certification; urbanization level of subject's residence; modality of surgery; concomitant cryptorchidism; concomitant prematurity and low birth weight; age at diagnosis; and number of well-baby clinic visits. Conclusion This study addresses an important issue of delayed hypospadias surgery in Taiwan, which provides a potential opportunity for improvement in quality of care.

Large-scale streptococcal outbreaks occurred continuously in tilapia farms of China from 2009 to 2011. The objective of this study was to characterize the prevalent strains of tilapia streptococci from the main cultured areas of China through species specific PCR and pulse field gel electrophoresis (PFGE). A total of 105 prevalent strains were isolated from Guangdong, Guangxi, Hainan and Fujian provinces between 2006 and 2011, 85 of which were identified as Streptococcus agalactiae while the rest were all identified as Streptococcus iniae. The prevalent stains in 2006 and 2007 were S. iniae (94.7%, 18/19), with S. agalactiae account for only 5.3% (1/19); The prevalent strains in 2009 and 2011 however changed to S. agalactiae (97.7%, 84/86), with only 2.3% (2/86) was S. iniae. Of these 105 strains, a total of 13 PFGE types (A-M) were characterized, among which D, F, G and K genotypes were predominant, accounting for 81.90% (86/105). The cluster analysis of PFGE electropherograms separated S. iniae and S. agalactiae to two distinctive branches, 20 strains of S. iniae exhibiting 3 types of PFGE band patterns with a similarity of 94.8-100%, and the 85 strains of S. agalactiae producing 10 types of PFGE band patterns with a similarity between 48.4% and 100%. Data suggested that the prevalent strains of tilapia streptococci in China have shifted from the former (before 2008) dominant strains of S. iniae to the current (2009-2011) dominant strains of S. agalactiae. Moreover, PFGE genotypes of the prevalent strains demonstrated geographic differences and temporal changes.

The immunogenicity identification of epidemic strain is important for the development and application of vaccine. In this study, 85 Streptococcus agalactiae prevalent strains from the tilapia main cultured areas of China were distributed among 10 distinct PFGE genotypes (A–J). For each genotype, one representative strain (S.a A –S.a J ) was selected to develop an inactivated whole-cell bacterial vaccine (V A –V J ), which then underwent a protective immunity test. V A –V J showed similar relative percent survival (RPS) to the homologous or heterologous strains with the identical genotype, while the average RPS among V A –V J protecting against itself genotype strains showed large differences (44.71–98.81%). The RPS of V A –V J vaccinated fish against infections by the mixture of S.a A –S.a J at 15 days post vaccination (dpv) was ranged from 13.33% to 60.00%, and V B , V D , V F , and V G showed the highest RPS of 60.00%, 46.67%, 53.33% and 60.00% respectively. V B , V D and V G have their own specific protection scope, V B showed strong protective immunity to infections caused by A–D, F, G and J (53.57–100%), and V G showed strong protective immunity to C–H and J (50.00–100%), whereas V D showed weak protective immunity to all non-self genotype strains (14.81–36.67%). The results of the combined vaccination showed that V G + V B group had wider protection scope and higher RPS value than V G + V D group. Our results demonstrated that the protective immunity of S. agalactiae from tilapia was not only associated with their serotypes, but also related to their PFGE genotypes. It is difficult to acquire a single vaccine candidate strain that can protect against all genotype strains from the same serotype.

This study provides the valuation of mortgage insurance (MI) considering upward and downward jumps in housing prices, which display separate distributions and probabilities of occurrence, and the mortgage insurer’s default risk. The empirical results indicate that the asymmetric double exponential jump diffusion performs better than the log-normally distributed jump diffusion and the Black-Scholes model, generally used in previous literature, to fit the single-family mortgage national average of all home prices in the US. Finally, the sensitivity analysis shows that the MI premium is an increasing function of the normal volatility, the mean down-jump magnitudes, the shock frequency of the abnormal bad events, and the asset-liability structure of the mortgage insurer. In particular, the shock frequency of the abnormal bad events has the largest effect of all parameters on the MI premium. The asset-liability structure of the mortgage insurer and shock frequency of the abnormal bad events have a larger effect of all parameters on the default risk premium.

In this study, we used Andersen's Behavioral Model with the family as a unit of analysis to examine the patterns of awareness and utilization of social services by families with at least one adult with intellectual disabilities. Face-to-face interview questionnaires were conducted with primary family caregivers in Hsinchu City, Taiwan in 2004. Data were collected on adults' and caregivers' predisposing, enabling, and need variables as well as awareness and utilization of formal social services. A total of 792 interviews were completed, making a response rate of 94.2%. Multivariate logistic regression analysis was used to identify potential predictors of social service awareness and utilization. We found awareness and utilization to be mostly associated with predisposing and enabling variables including caregiver's socioeconomic status, family connection with social networks, and family participation in related groups or associations. Younger caregivers were more likely to access formal assistance, while adults whose families were more connected into social networks were more likely to be aware of in-kind and voucher services, e.g., in-home services including respite and home care, and vocational services such as sheltered workshops, and bus voucher services.

To develop a duplex PCR method for identifying Metagonimus yokogawai and Haplorchis taichui.ITS1 sequences of M. yokogawai and H. taichui, as well as those of their homologous species were obtained from GenBank, and two sets of specific primer pairs for M. yokogawai and H. taichui were designed accordingly using Primer Premier 5.0 software. PCR reaction system and conditions were optimized. The established duplex PCR method was applied in a pool of M. yokogawai, H. taichui, and 17 related species to examine its specificity. Sensitivity was evaluated through serial dilutions of plasmids containing their specific sequences. Finally, the duplex PCR was applied to identify M. yokogawai and H. taichui among trematodes collected from the viscera of 47 cats and 40 dogs to test its practicality.The duplex PCR method amplified target sequences of M. yokogawai and H. taichui, generating 648 bp and 279 bp products, respectively. No cross reaction was found with the following 17 related species: Haplorchis pumilio, Clonorchis sinensis, Pharyngostomum cordatum, the metacercaria of Metorchis sp. and Exorchis sp., Echinochasmus liliputanus, Echinochasmus perfoliatus, Echinostoma friedi, Hypoderaeum conoideum, Holostephanus sp., Diplodiscus sp., Anisakis sp., Metorchis orientais, Paragonimus westermani, Watsonius watsoni, Notocotylus sp. and Hysterothylacium sp, indicating a high specificity of this method. The detection limits for DNAs of M. yokogawai and H. taichui were 1.49 x 10(-1) pg and 1.14 x 10(-1) pg, suggesting a good sensitivity for this method. Further, the duplex PCR successfully identified M. yokogawai and H. taichui from cat and dog viscera, with no cross amplification of other trematodes.The duplex PCR is effective in identifying Metagonimus yokogawai and Haplorchis taichui.

To observe the ultrastructure of adult Gnathostoma doloresi worms isolated from wild boar by using scanning electron microscope (SEM), and analyze its phylogenetic relationships based on ITS2 and COXI gene sequences.Two adult G. doloresi worms were fixed by glutaraldehyde and osmium peroxide. Ultrastructural characters of those samples were observed under SEM. Amplification and sequencing of the ITS2 and COXI genes were performed following the extraction of total genomic DNA. Sequence analysis was performed based on multiple alignments and phylogenetic analysis was made by Neighbor-Joining method using MEGA 6.0.The bottle-shaped adult worm covered with numerous small spines. The cervical groove connected head bulb and body without spines. There was obvious distinction in body spines which surround cervical papillae and swollen area in the middle part of the body. The fragments of ITS2 (418 bp) and COXI (381 bp) gene were obtained by PCR combined with sequencing, and were registered to the GenBank database with the accession No. of JN408329 and JN408299, respectively. The BLAST results showed that, two sequences had 99% and 98% consistency with G. doloresi ITS2 (GenBank accession No. AB181156) and COX1 (No. AB180100) gene sequences, respectively. The phylogenetic tree indicated that the two G. doloresi worms were at the same clade with a bootstrap value at 100% and 85% based on the ITS2 and COXI sequences, respectively. G. doloresi and G. hispidum were also clustered together.The results provide adequate information for the SEM morphological data of adult G. doloresi worms, and its phylogenetic relationship.

Flow cytometry assays using aldehyde dehydrogenase (ALDH) activity or CD133 positivity to isolate cancer stem cells (CSCs) are widely applied but have limitations. Thus, characterization of CSC makers for a specific cancer is potentially important. We have previously shown that miR-21 regulates cancer cell growth via FoxO1 in pancreatic ductal adenocarcinoma (PDAC). Here, we areported evidence of FoxO1-negative PDAC cells as CSCs in PDAC. Both ALDH-high and CD133-high cell fractions isolated from PDAC of the patients expressed high levels of miR-21 and null FoxO1. Cultured PDAC cells were virally transduced with GFP under FoxO1 promoter. GFP (FoxO1)-null PDAC cells expressed high levels of miR-21 and grew more quickly than FoxO1-positive PDAC cells. Moreover, the fold increases in growth of FoxO1-negative vs FoxO1-positive cells were greater than CD133-high vs CD133-low cells, or ALDH-high vs ALDH-low cells. Further, FoxO1-negative cells formed tumor spheres in culture and developed tumors after serial adoptive transplantation into NOD/SCID mice, while the FoxO1-positive cells did not. Finally, selective elimination of FoxO1-negative cells completely inhibited the growth of PDAC cells. Together, these data suggest that FoxO1-negative cells as CSCs in PDAC and targeting FoxO1-negative cells in PDAC may provide better therapeutic outcome.

Summary Background/Objective To analyze the preoperative factors associated with the need for secondary surgery following primary urethroplasty. Methods This study utilized a subset of the National Health Insurance Research Database, which includes the data on all paid medical benefit claims from 1997 to 2007, for 1 million beneficiaries in 2005. We analyzed the claims data for all patients with hypospadias who had undergone primary urethroplasty. The characteristics of the patients, surgeons, and hospitals associated with surgical outcomes were analyzed to investigate possible associations with the need for secondary surgery. Results Among 52,705 live male newborn babies, 218 were diagnosed with hypospadias, of whom 89 received repair surgery. A total of 75 (84.3%) male newborn babies received single hypospadias surgery, and 14 (15.7%) underwent more than two surgical procedures. Univariate analysis demonstrated that the type of hypospadias and the surgeon caseload volume were significantly associated with the need for additional hypospadias surgery ( p = 0.02 and p = 0.03, respectively). In multivariate analysis, the type of hypospadias (distal vs. proximal, odds ratio, 0.25; p = 0.03) and the surgeon caseload volume (high vs. low, odds ratio, 0.04; p = 0.05) were significantly correlated with secondary operation. Conclusion The type of hypospadias and the surgeon caseload volume were significantly associated with the need for secondary hypospadias surgery. The findings of this study provide important information on the outcomes of hypospadias repair for parents and specialists.

Three new cyclopeptides, including halolitoralin A (a cyclic hexapeptide), halolitoralin B and C (two cyclic tetrapeptides), together with three known cyclic dipeptides, cyclo(Pro-Val), cyclo(Pro-Leu) and cyclo(Ile-Val) were isolated from the ferment broth of a marine sediment-derived Halobacillus litoralis YS3106. The cyclopeptides show surprisingly simple architectures with highly repeated residue units, which showed moderate antifungal and weak antitumor activities in vitro.

To inspect the third stage larvae of Gnathostoma in imported Monopterus albus, and identify its species.Ten batches of M. albus imported to Shanghai were detected for nematode Gnathostoma from January 2010 to March 2011. Fifty-two M. albus imported from the Philippines (25), Indonesia (24) and Bangladesh (3) were sampled (3-10/batch), which were dissected, minced, and digested. The suspension was filtered with 10 mesh screen to take the deposit. The complete parasites were picked out under stereoscope followed by morphological identification. The rate and intensity of infection were calculated. Genomic DNA of Gnathostoma was extracted to amplify internal transcribed spacer region 2 (ITS-2) and cytochrome C oxidase subunit 1 (cox1) by PCR, the product of which was analyzed by electrophoresis and sequencing. The sequences were aligned with corresponding sequences in GenBank.The third stage larvae of Gnathostoma were detected in M. albus from Indonesia and Philippines with infection rate of 36.0% (9/25) and 50.0% (12/24) and average infectiosity of 7.8 (70/9) and 2.8 (34/12), respectively. No Gnathostoma was found in M. albus imported from Bangladesh. Under microscope, the larvae showed one cephalic bulb with 4 rings of hooklets on it, cross striations and small spines on the body surface. The front body spines were bigger and denser, while the rear spines were smaller and sparser. It had 1 cervical papilla and 4 cervical capsules. Morphological characteristics were similar to the third stage larvae of G. spinigerum. PCR results showed that the length of the ITS-2 and cox1 PCR products was 647 bp and 441 bp, respectively. Sequence alignment analysis showed that the two PCR products had 99%-100% consistency with G. spinigerum ITS-2 (GenBank Accession No. AB181155 and Z97175) and cox1 (GenBank Accession No. AY501388, AB180099, and AB551552).All the larvae detected in M. albus imported from the Philippines and Indonesia have been identified as G. spinigerum.

To investigate the factors associated with outcomes and medical costs for percutaneous nephrolithotomy (PCNL).The present study uses a subset of the National Health Insurance Research Database (NHIRD), known as the Longitudinal Health Insurance Database 2005 (LHID 2005), which contains the data of all medical benefit claims from 1997 to 2010 for a subset of 1 million enrollees randomly drawn from the population of 22.72 million persons who were enrolled in 2005. The claims data for all subjects with a diagnosis of urolithiasis who underwent PCNL were analyzed. Hospital and surgeon case volume were classified by quartile. The correlations of all patient, surgeon, and hospital variables with the outcomes and medical costs of PCNL were analyzed by generalized estimating equations.A total of 995 subjects received PCNL. In univariate analysis, PCNL performed by high-volume surgeons (≥12) cost 26% less ($2684 vs $1986) and resulted in a 34.3% shorter hospital stay (6.5 vs 9.9 days) compared with low-volume surgeons (≤3). In multivariate analysis, surgeon volume was a significant predictor for medical cost, length of stay, and intensive care unit transfer but not complications and mortality.Surgeon volume was associated with lower medical costs and shorter length of stay after PCNL. Surgeon volume, however, was not an independent predictor of complications and mortality. Our findings have important implications for urologists and policymakers with regard to the cost and effectiveness of PCNL.

Burn patients often suffer from different degrees of dysfunction, such as residual burn wounds, formation of hyperplastic scar, scar itching, cardiopulmonary dysfunction, limitation of motion, and psychological disorders, which exert severe impact on their daily life. This article reviews various rehabilitation treatments for dysfunction after burn injury to promote rehabilitation of burn patients.

MicroRNAs have been demonstrated to regulate proliferation and apoptosis in many types of cancers, but biological functions in osteosarcomas remain relatively unknown. Here, we found expression of miR-802 to be up-regulated in osteosarcoma tissues in comparison with adjacent normal tissues. Enforced expression of miR-802 was able to promote cell proliferation in U2OS and MG63 cells, while miR-802 antisense oligonucleotides (antisense miR-802) inhibited cell proliferation. At the molecular level, our results further revealed that expression of p27, a negative cell-cycle regulator, was negatively regulated by miR-802. Therefore, the data reported here indicate that miR-802 is an important regulator in osteosarcoma, our findings contributing to a better understanding of important mis-regulated miRNAs in this tumour type.

To explore the effect of curcumin (CMN) on contrast-induced nephropathy (CIN) in rats and explore the potential mechanisms focusing on heme oxygenase-1 (HO-1) expression.Male SD rats (n = 24) were randomly divided into four groups (n = 6 each): control group (group A), diatrizoate group (DTZ, group B), DTZ + CMN group (group C), DTZ + CMN + zinc protoporphyrin IX group (group D). All rats were fed with normal chow for 1 week, right kidney was excised under anesthesia and rats were fed with normal chow for another 4 weeks. Afterwards, rats in group A was fed with normal chow, and rats in group B to D were fed with low-salt diet. All rats were injected furosemide 2 mg×kg(-1)×d(-1) for 7 days intramuscularly. At the beginning of the 7(th) day, rats in group C were injected intramuscularly with CMN 20 mg/kg, rats in group D were injected with CMN (20 mg/kg) + zinc protoporphyrin IX (7.5 mg/kg) while rats in group A and B were injected with equal volume of physiological saline. At the end of the 7(th) day, indometacin (10 mg/kg) was injected into tail vein of all rats. One hour later, 60% DTZ (8 ml/kg) was injected to rats in the group B, C and D while equal volume saline was injected to rats in group A through common carotid artery. After 48 hours, blood was drawn from the hearts of deeply anesthetized rats and kidney tissue was obtained for histology, HO-1, Bax, Bcl-2 expression and the apoptotic index measurements.The serum creatinine of group B, C and D [(83.67 ± 4.50) µmol/L, (63.67 ± 4.76) µmol/L, (104.17 ± 4.58) µmol/L] was significantly higher than that of group A [(41.50 ± 5.58) µmol/L, all P0.05], the serum creatinine was significantly higher in group B than in group C and lower than in group D (all P0.05). HO-1 expression of group B, C and D was significantly higher than that of group A (all P0.05), significantly higher in group C than in group B and D (all P0.05). HO-1 activity of group A, B and C was significantly higher than that of group D(all P0.05), HO-1 activity was significantly higher in group B than in group A and significantly lower in group B than in group C (all P0.05). Bax, Bcl-2 expression and apoptosis index of group B, C and D were significantly higher than that of group A (all P0.05), while Bcl-2/Bax of group B, C and D were significantly lower than that of group A (all P0.05). Bcl-2 and Bcl-2/Bax were significantly higher while apoptosis index was significantly lower in group C than in group B (all P0.05). Bax and apoptosis index were significantly higher and Bcl-2, Bcl-2/Bax were significantly lower in group D than in group B (all P0.05).CMN could protect against contrast-induced nephropathy through reducing renal cell apoptosis via upregulating HO-1 expression and activating HO-1 activity in rats.

The gene encoding the Nin one binding (NOB1) protein which plays an essential role in protein degradation has been investigated for possible tumor promoting functions. The present study was focused on NOB1 as a possible therapeutic target for breast cancer treatment. Lentivirus mediated NOB1 siRNA transfection was used to silence the NOB1 gene in two established breast cancer cell lines, MCF-7 and MDA-MB-231, successful transfection being confirmed by fluorescence imaging. NOB1 deletion caused significant decline in cell proliferation was observed in both cell lines as investigated by MTT assay. Furthermore the number and size of the colonies formed were also significantly reduced in the absence of NOB1. Moreover NOB1 gene knockdown arrested the cell cycle and inhibited cell cycle related protein expression. Collectively these results indicate that NOB1 plays an essential role in breast cancer cell proliferation and its gene expression could be a therapeutic target.

Aim: To determine the incidence rate and characteristics in patients with testicular torsion in Taiwan using a nationwide insurance database. Methods: This study utilizes a subset of national health insurance research database, which contains the data of all paid medical benefit claims over the period 1997–2010 for in 1 000 000 beneficiaries in 2005. We analysed claims data for all male subjects younger than 25 years with the diagnosis of testicular torsion. Results: A total of 86 subjects younger than 25 years with the diagnosis of testicular torsion were included. Among them, 22 (25.6%) underwent orchiectomies and 64 (74.4%) underwent orchiopexies. The estimated incidence of testicular torsion was 3.5 per 100 000 person-years. There are two peaks in the age-specific incidence rates: the first in boys aged 10–14 years (at 7.7 per 100 000 person-years) and the second in male infants aged

Objective To investigate the frequency and characteristics of newly diagnosed vesicoureteral reflux (VUR) in children younger than 18 years based on a nationwide database in Taiwan. Methods The present study utilizes a subset of the Taiwan's National Health Insurance Research Database, known as the Longitudinal Health Insurance Database 2005, which contains the data of all paid medical benefit claims over 1997–2007 for a subset of 1,000,000 beneficiaries randomly drawn from the population of 22.72 million individuals during any part of the 2005 calendar year. Our analysis includes the data of all pediatric patients with the diagnosis of VUR. Results A total of 738 subjects with VUR diagnosis were identified, including 412 (55.8%) boys and 326 (44.2%) girls. The peak age of VUR occurrence was the first year for males and 1–4 years for females. Approximately 49.7% of all subjects presented with urinary tract infection (UTI); moreover, there were significant differences between genders concerning the presence of UTI (RR = 0.8; p = 0.002). The occurrence rate of VUR in the pediatric population ranged from 2.63 in 1998 to 3.94 in 2003 per 10,000 children during 1998–2005. The frequency of newly-diagnosed VUR in the pediatric population was significantly correlated with urbanization levels of residence. Conclusion The nationwide, population-based study of pediatric VUR shows there were gender differences in age distribution and presence of UTI. Further studies are warranted to clarify the correlations between urbanization level of residence and occurrence of VUR.

To observe the ultrastructure of nymphal Armillifer sp. isolated from Macaca fascicularis by using scanning electron microscope (SEM), and analyze the phylogenetic relationships based on 18S rRNA gene sequences.The parasite samples stored in 70% alcohol were fixed by glutaraldehyde and osmium peroxide. Ultrastructural characters of those samples were observed under SEM. Amplification and sequencing of the 18S rRNA gene were performed following the extraction of total genome DNA. Sequence analysis was performed based on multiple alignment using ClustalX1.83, while phylogenetic analysis was made by Neighbor-Joining method using MEGA4.0.The nymphs were in cylindrical shape, the body slightly claviform tapering to posterior end. Abdominal annuli were gradually widened from anterior to posterior parts, the 12th-13th abdominal annuli of which were similar in width. The annuli ranged closer in the front half body, whereas in the latter part there were certain gaps between them. The circular-shaped mouth located in the middle of head ventrally. Folds were seen in inner margin of the mouth with a pair of curved hooks on both sides above it which practically disposed in a straight line. Two pairs of large sensory papillae were observed symmetrically over the last thoracic annulus of cephalothoraxs lying below the outer hook, and the first abdominal annulus was near the median ventral line. The number of abdominal annuli was 29, not including 2 incomplete terminal annuli. Rounded sensory papillae were fully distributed on the body surface, except the dorsal side of head and the ventral part of the terminal annulus. Agglomerate-like anus opening was observed at the end of ventral abdominal annuli and distinctly sub-terminal. These morphological features demonstrated that the nymphs were highly similar with that of Armillifer moniliformis Diesing, 1835. A fragment of 18SrRNA gene (1 836 bp) sequences was obtained by PCR combined with sequencing, and was registered to the GeneBank database with an accession number HM048870. The phylogenetic tree indicated that A. moniliformis, A.agkistrodon and A.armillatus were at the same clade with a bootstrap value at 95%, and A. moniliformis and A. agkistrodon were solo at a clade with a bootstrap value of 75%.The nymphs isolated from Macaca fascicularis are identified as A. moniliformis temporarily.

Aspergillus flavus is second only to A. fumigatus in causing invasive aspergillosis and it is the major agent responsible for fungal sinusitis, keratitis and endophthalmitis in many countries in the Middle East, Africa and Southeast Asia. Despite the growing challenge due to A. flavus, data on the molecular epidemiology of this fungus remain scarce. The objective of the present study was to develop a new typing method based on the detection of VNTR (Variable number tandem repeat) markers. Eight VNTR markers located on 6 different chromosomes (1, 2, 3, 5, 7 and 8) of A. flavus were selected, combined by pairs for multiplex amplifications and tested on 30 unrelated isolates and six reference strains. The Simpson index for individual markers ranged from 0.398 to 0.818. A combined loci index calculated with all the markers yielded an index of 0.998. The MLVA (Multiple Locus VNTR Analysis) technique proved to be specific and reproducible. In a second time, a total of 55 isolates from Chinese avian farms and from a Tunisian hospital have been evaluated. One major cluster of genotypes could be defined by using the graphing algorithm termed Minimum Spanning Tree. This cluster comprised most of the isolates collected in an avian farm in southern China. The MLVA technique should be considered as an excellent and cost-effective typing method that could be used in many laboratories without the need for sophisticated equipment.

Objective To investigate the prevalence, incidence, associated risk factors, and treatment of pediatric urolithiasis in Taiwan. Methods The present study used a subset of the National Health Insurance Research Database, known as the Longitudinal Health Insurance Database 2005, which contains the data for all paid medical benefit claims from 1997 to 2006 for a subset of 1 million beneficiaries randomly drawn from the population of 22.72 million individuals during any part of the calendar year 2005. Our analysis included the data of all newly diagnosed pediatric patients with an "International Classification of Disease, 9th revision," diagnosis of urolithiasis from 1997 through 2006. Results A total of 1679 pediatric subjects who had newly diagnosed urolithiasis without a previous attack were identified from 1997 to 2006 as the study sample. Of the 1679 patients, 808 were boys (48.1%) and 871 were girls (51.9%). The incidence rate of urolithiasis in 2005 was 0.047%. The peak age of pediatric stone occurrence in the study sample was 15-18 years (49.6%). The most common associated disease was urinary tract infection (34.1% of all subjects). The occurrence rate of pediatric urolithiasis correlated significantly with the urbanization level of the residence and geographic area. Conclusion Using a nationwide, population-based study provides important clinical and epidemiologic information regarding pediatric urolithiasis. Additional studies are warranted to determine the effect of geographic area and urbanization level on the occurrence of pediatric stone disease.

We investigated the rate of diagnosis and treatment trends of hypospadias in Taiwan within the first 3 years of life.We used a subset of the Taiwan National Health Insurance Research Database, which contains data on all inpatient and outpatient medical benefit claims, for the period 1997 through 2008 for a sample of 1 million individuals randomly drawn from the population of 25.68 million who held membership in the National Health Insurance program during any part of the calendar year 2005. We analyzed claims data for all subjects who were diagnosed with hypospadias through age 3 years.Among 52,705 newborns (individuals whose claims included live birth) 178 were diagnosed with hypospadias within 3 years of birth. Thus, mean incidence was 33.8 per 10,000 live male births. The hypospadias repair rate was 14.3 per 10,000 live male births. There was no significant tendency toward increase or decrease in rates of diagnoses or repairs, or proportion of severe hypospadias. There were significant associations between rates of hypospadias diagnoses and urbanization level of the community where the diagnosis was made. Approximately 54% of patients who underwent surgical repair did so after age 18 months.The nationwide incidence of hypospadias in children younger than 3 years in Taiwan is similar to that reported in previous studies. Delayed diagnosis and treatment of hypospadias are important clinical concerns that warrant further investigation.

Three new cyclopeptides, including halolitoralin A (a cyclic hexapeptide), halolitoralin B and C (two cyclic tetrapeptides), together with three known cyclic dipeptides, cyclo(Pro-Val), cyclo(Pro-Leu) and cyclo(Ile-Val) were isolated from the ferment broth of a marine sediment-derived Halobacillus litoralis YS3106. The cyclopeptides show surprisingly simple architectures with highly repeated residue units, which showed moderate antifungal and weak antitumor activities in vitro.

Purpose: Pancreatic cancer is a highly aggressive malignant tumour with poor prognosis. The median survival is only 6 months. This study investigated the prognostic value of nuclear export protein chromosomal region maintenance/exportin 1/Xpo1 (CRM1) expression in pancreas cancer. Methods: CRM1 expression was detected, by Western blot, in pancreatic tissue from 69 cancer patients and 10 normal subjects. Results: CRM1 showed increased expression in pancreatic cancer tissue (P = 0.007). The high expression of CRM1 was associated with increased serum levels of CEA (P = 0.002) and CA19-9 (P = 0.005). There was an association between CRM1 expression and tumour size (P = 0.01), lymphadenopathy (P = 0.004) and liver metastasis (P = 0.003). High CRM1 expression was not correlated with the other clinicopathological parameters. High CRM1 expression was a prognostic indicator for progression-free survival (PFS) (P = 0.006) as well as overall survival (OS) (P = 0.001). Expression of CRM1 was an independent prognostic parameter for poorer PFS and OS (95% CI, 1.27–5.39). Conclusions: CRM1 expression demonstrated prognostic value in pancreatic cancer. Prospective studies are required to determine the prognostic role of high expression of CRM1 in pancreatic cancer.

Many parasites of domestic animals in China are of major socioeconomic and medical importance. Hence, veterinary parasitology is one of the core subjects for undergraduate and postgraduate students of veterinary science. Here, we review the teaching of veterinary parasitology in Chinese universities, including a description of the veterinary science curricula and measures to improve the quality of veterinary parasitology teaching in China.

P-dissolving Penicillium oxalicum P8 was isolated previously in this lab which has a considerable ability to dissolve many kinds of inorganic phosphorus and improve crop growth. In order to study rhizosphere colonization of plants by Penicillium oxalicum P8, protoplasts were transformed with a double-marker expression vector of green fluorescent protein and hygromycin B resistance. Some transformants were selected which expressed both the GFP and hygromycin B phosphotransferase and did not show significant morphological or physiological differences as compared to wild-type strain. Southern blot analysis confirmed the heterogeneous genomic integration of the vector DNA into the transformants.

OBJECTIVE To observe the characteristics of biology and pathogenicity of the third stage Anisakis simplex larvae (L3).The survival time of the L3 in various conditions was observed and the pathological change after experimental infection in rats was examined.The results showed that the L3 frozen at -20 degrees C for 10 - 12 h can be killed. In the temperature range of 4 - 10 degrees C, the L3, can survive for over 8 months. The L3 was very active at 37 degrees C, and was killed at the high temperature over 40 degrees C in a very short time. The ingredients for sashimi cannot kill the L3. The experiment of rats infected by the L3 showed that about 15% -25% of the L3 penetrated into the gastrointestinal wall or migrated into the peritoneal cavity in 2 days. After 3d the L4 was not infectious, and died automatically in 7 - 10 days and could not develop into adults. The animals can be easily infected when the stomach was empty. The pathological study showed that the primary infection was a kind of reaction to foreign body, while that of the re - infection was allergic.The L3 has a strong resistance to low temperature and to ingredients, it can be killed by freezing at -20 degrees C in 24 hours. The L3 can not mature in the body of terrestrial mammals but causes pathological change in the stomach and allergy.