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Zhong JC, Wang LW. [Primary antibody deficiencies and respiratory manifestations in adults]. Zhonghua Jie He He Hu Xi Za Zhi 2024; 47:388-392. [PMID: 38599818 DOI: 10.3760/cma.j.cn112147-20230803-00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Primary antibody deficiencies (PAD) are a group of congenital disorders caused by genetic defects that affect the development and function of the body's immune defence mechanisms. Patients with PAD may present with recurrent infections, lymphoproliferation, autoimmune diseases, autoinflammation, or malignancies. Respiratory system manifestations may include bronchiectasis, bronchial asthma, and interstitial lung disease, among others. A comprehensive understanding of PADs will help to distinguish these covert cases from more common respiratory diseases.
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Affiliation(s)
- J C Zhong
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases in Shenzhen People's Hospital, Shenzhen 518020, China
| | - L W Wang
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases in Shenzhen People's Hospital, Shenzhen 518020, China
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Huang YC, Lin HC, Chang YT, Tsai ML, Chang YC, Wang LW. Preterm birth increases cerebral palsy hazards in children of mothers with chronic hypertension in pregnancy. Pediatr Neonatol 2024:S1875-9572(24)00040-8. [PMID: 38531715 DOI: 10.1016/j.pedneo.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/19/2023] [Accepted: 10/02/2023] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Children of mothers with chronic-hypertension in pregnancy have high rates of preterm-birth (<37 weeks of gestation) and small-for-gestational-age (SGA), both of which are risk factors of cerebral palsy (CP). This study investigated the cumulative risks of CP in children exposed to maternal chronic-hypertension vs. other types of hypertensive-disorders-of-pregnancy (HDP), and whether preterm-birth and SGA potentiate the antenatal impact of chronic-hypertension to increase CP hazards. METHODS This population-based cohort study enrolled 1,417,373 mother-child pairs with singleton live births between 2004 and 2011 from the Taiwan Maternal and Child Health Database. A total of 19,457 pairs with HDP were identified and propensity-score-matched with 97,285 normotensive controls. Children were followed up for CP outcome until age 6-13 years. HDP were classified into chronic-hypertension, gestational-hypertension, preeclampsia, and preeclampsia-with-chronic-hypertension. Using the normotensive group as the reference, the associations between chronic-hypertension and CP hazard were assessed with adjusted hazard ratios (HR) and 95% confidence intervals (CI) in Cox proportional hazards regression models, and the effects of preterm-birth and SGA on the associations were examined. RESULTS The HDP group had higher rates of CP (0.8%) than the normotensive group (0.5%), particularly the subgroup of preeclampsia-with-chronic-hypertension (1.0%), followed by preeclampsia (0.9%), chronic-hypertension (0.7%) and gestational-hypertension (0.6%). Preterm-birth, but not SGA, exerted moderating effects to increase CP risks in children exposed to maternal chronic-hypertension. Before adjustments, chronic-hypertension alone had no substantial contribution to CP hazard (HR 1.35, 95% CI 1.00-1.83), while preeclampsia alone (1.64, 1.28-2.11) or with superimposed-chronic-hypertension (1.83, 1.16-2.89) had significant effects. After including preterm-birth in the multivariable model, the CP hazard for chronic-hypertension alone rather than other types of HDP was raised and became significant (1.56, 1.15-2.12), and the significance remained after stepwise adjustments in the final model (1.74, 1.16-2.60). CONCLUSIONS Preterm-birth might potentiate CP hazards in children of mothers with chronic-hypertension in pregnancy.
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Affiliation(s)
- Yi-Chien Huang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Hung-Chih Lin
- Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan; Department of Pediatric, Asia University Hospital, Asia University, Taichung, Taiwan
| | - Yu-Tzu Chang
- Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan; School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Ming-Luen Tsai
- Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan
| | - Yu-Chia Chang
- Department of Long-Term Care, College of Health and Nursing, National Quemoy University, Kinmen County, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
| | - Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
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Wang FY, Liang ZY, Yang YQ, Wang LW, Chen RC. [Annual review of progress in research on chronic obstructive pulmonary disease(2022-2023)]. Zhonghua Jie He He Hu Xi Za Zhi 2024; 47:54-59. [PMID: 38062696 DOI: 10.3760/cma.j.cn112147-20231019-00248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is the most common chronic airway disease, with a high prevalence and high disease burden. Clinical questions have driven advances in clinical research that continue to deepen our understanding of COPD. At the same time, new perspectives, evidence, and strategies have emerged. Studies since 2022 have increased knowledge of the impact of risk factors, such as low-to-moderate income and ambient ozone, on the prevalence of COPD. The effect of preterm birth on obstructive lung function deficits and COPD in the sixth decade of life was investigated for the first time. Screening studies for COPD in developed and low- and middle-income countries suggest the importance of tailoring screening strategies to local conditions. Developments in artificial intelligence provide a general framework for using machine-learning-based methods and medical record-based labels to improve disease prediction. New perspectives on endotypes/phenotypes and prognostic assessment of COPD were provided by lifetime spirometry patterns of obstruction and limitation, sensitisation to recombinant Aspergillus fumigatus allergens, airway-occluding mucus plugs and exacerbation history in COPD group A and B patients. Clinical trials focusing on inflammatory mediators, comorbidity treatment, non-pharmacological treatments, and environmental interventions shed light on some crucial and long-debated issues. Further research is needed for individualised diagnosis and treatment of COPD.
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Affiliation(s)
- F Y Wang
- National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Z Y Liang
- National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Y Q Yang
- National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - L W Wang
- Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital, Shenzhen 518020, China
| | - R C Chen
- National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital, Shenzhen 518020, China
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Wang LW, Chio CC, Chao CM, Chao PY, Lin MT, Chang CP, Lin HJ. Mesenchymal stem cells reduce long-term cognitive deficits and attenuate myelin disintegration and microglia activation following repetitive traumatic brain injury. Sci Prog 2024; 107:368504241231154. [PMID: 38425276 PMCID: PMC10908245 DOI: 10.1177/00368504241231154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
The underlying mechanisms for the beneficial effects exerted by bone marrow-mesenchymal stem cells (BM-MSCs) in treating repetitive traumatic brain injury (rTBI)-induced long-term sensorimotor/cognitive impairments are not fully elucidated. Herein, we aimed to explore whether BM-MSCs therapy protects against rTBI-induced long-term neurobehavioral disorders in rats via normalizing white matter integrity and gray matter microglial response. Rats were subjected to repeated mild lateral fluid percussion on day 0 and day 3. On the fourth day post-surgery, MSCs groups received MSCs (4 × 106 cells/ml/kg, intravenously) and were assessed by the radial maze, Y maze, passive avoidance tests, and modified neurological severity scores. Hematoxylin & eosin, and Luxol fast blue stainings were used to examine the histopathology and white matter thickness. At the same time, immunofluorescence staining was used to investigate the numbers of tumor necrosis factor-alpha (TNF-α)-containing microglia in gray matter. Three to nine months after neurotrauma, rats displayed sensorimotor and cognitive impairments, reduced thickness in white matter, and over-accumulation of TNF-α-containing microglia and cellular damage in gray matter. Therapy with BM-MSCs significantly attenuated the rTBI-induced sensorimotor and cognitive impairments and all their complications. Mesenchymal stem cell therapy might accelerate the recovery of sensorimotor and cognitive impairments in rats with rTBI via normalizing myelin integrity and microglia response.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan 710, Taiwan
- Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan
| | - Chung-Ching Chio
- Division of Neurosurgery, Department of Surgery, Chi Mei Medical Center, Tainan 710, Taiwan
| | - Chien-Ming Chao
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, 73657, Taiwan
- Department of Dental Laboratory Technology, Min-Hwei College of Health Care Management, Tainan, 73657, Taiwan
| | - Pi-Yu Chao
- Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan
| | - Mao-Tsun Lin
- Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan
| | - Ching-Ping Chang
- Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan
| | - Hung-Jung Lin
- Department of Emergency Medicine, Chi Mei Medical Center, Tainan 710, Taiwan
- School of Medicine, Taipei Medical University, Taipei 110, Taiwan
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Ren ZG, Xu Y, Hua ZZ, Mo ZY, Wang LW, Shi GB, Liu WL, Sun W, Zheng BQ, Wang CM, Jin YJ, Chen Y. [Efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma]. Zhonghua Zhong Liu Za Zhi 2023; 45:973-980. [PMID: 37968084 DOI: 10.3760/cma.j.cn112152-20230331-00140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Objective: To explore the efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma. Methods: A total of 296 patients who underwent radical surgery for stage Ⅱ-Ⅲ cutaneous orlimb melanoma at Fudan University Shanghai Cancer Center and Shanghai Electric Power Hospital between 2017 and 2021 and received adjuvant PD-1 monoclonal antibody immunotherapy, low-dose interferon (IFN), or observational follow-up were enrolled in this study. Patients were divided into the PD-1 monoclonal antibody group (164 cases) and the IFN or observation group (IFN/OBS group, 132 cases) based on postoperative adjuvant treatment methods. Patients' disease recurrence and survival were observed. Results: Among the 296 patients, 77 had cutaneous melanoma and 219 had limb melanoma; 110 were stage Ⅱ and 186 were stage Ⅲ. Among stage Ⅱ patients, the median recurrence-free survival (RFS) in the PD-1 monoclonal antibody group (46 cases) did not reach, while the median RFS in the IFN/OBS group (64 cases) was 36 months. The 1-year RFS rates were 85.3% and 92.1% and the 2-year RFS rates were 71.9% and 63.7% in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with no statistically significant difference (P=0.394). Among stage Ⅲ patients, the median RFS rates in the PD-1 monoclonal antibody group (118 cases) and the IFN/OBS group (68 cases) were 23 and 13 months, respectively. The 1-year RFS rates were 70.0% and 51.8% and the 2-year RFS rates were 51.8% and 35.1%in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with a statistically significant difference (P=0.010). Stratified analysis showed that the advantage of PD-1 monoclonal antibody adjuvant therapy in improving RFS persisted in the subgroups of primary ulceration (HR=0.558, 95% CI: 0.348-0.893), lymph node macroscopic metastasis (HR=0.486, 95% CI: 0.285-0.828), stage ⅢC (HR=0.389, 95% CI: 0.24-0.63), and the subgroup without BRAF/c-Kit/NRAS gene mutations (HR=0.347, 95% CI: 0.171-0.706). In terms of recurrence patterns, in stage Ⅱ patients, the recurrence and metastasis rate was 15.2% (7/46) in the PD-1 monoclonal antibody group, significantly lower than the IFN/OBS group [43.8% (28/64), P=0.002]. In stage Ⅲ melanoma patients, the recurrence and metastasis rate was 42.4% (50/118) in the PD-1 monoclonal antibody group, also lower than the IFN/OBS group [63.2% (43/68), P=0.006]. Conclusions: In real-world settings, compared with patients receiving low-dose IFN adjuvant therapy or observational follow-up, PD-1 monoclonal antibody immunotherapy can reduce the recurrence and metastasis rate of cutaneous and limb melanoma, and prolong the postoperative RFS of stage Ⅲ cutaneous and limb melanoma patients. Patients with a heavier tumor burden benefit more from immunotherapy.
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Affiliation(s)
- Z G Ren
- Department of Orthopedics, Shanghai Electric Power Hospital, Shanghai 200050, China
| | - Y Xu
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Z Z Hua
- Department of Orthopedics, Shanghai Electric Power Hospital, Shanghai 200050, China
| | - Z Y Mo
- Department of Orthopedics, Shanghai Electric Power Hospital, Shanghai 200050, China
| | - L W Wang
- Department of Orthopedics, Shanghai Electric Power Hospital, Shanghai 200050, China
| | - G B Shi
- Department of Orthopedics, Shanghai Electric Power Hospital, Shanghai 200050, China
| | - W L Liu
- Department of Orthopedics, Shanghai Electric Power Hospital, Shanghai 200050, China
| | - W Sun
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - B Q Zheng
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - C M Wang
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Y J Jin
- Department of Orthopedics, Shanghai Electric Power Hospital, Shanghai 200050, China
| | - Y Chen
- Department of Musculoskeletal Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
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Han YY, Zhang QH, Chen WS, Li ZL, Xie D, Zhang SL, Lu H, Wang LW, Xu ZH, Zhang LZ. Fermented rape pollen powder can alleviate benign prostatic hyperplasia in rats by reducing hormone content and changing gut microbiota. Benef Microbes 2023; 14:503-524. [PMID: 38656098 DOI: 10.1163/18762891-20230039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/22/2023] [Indexed: 04/26/2024]
Abstract
Benign prostatic hyperplasia (BPH) can cause urethral compression, bladder stone formation, and renal function damage, which may endanger the life of patients. Therefore, we aimed to develop plant-based preparations for BPH treatment with no side effects. In this study, the Lactiplantibacillus plantarum 322Hp, Lactobacillus acidophilus 322Ha, and Limosilactobacillus reuteri 322Hr were used to ferment rape pollen. The fermented rape pollen was subsequently converted into fermented rape pollen powder (FRPP) through vacuum freeze-drying technology. After fermenting and drying, the bioactive substances and antioxidant capacity of FRPP were significantly higher than those of unfermented rapeseed pollen, and FRPP had a longer storage duration, which can be stored for over one year. To investigate the therapeutic effect of FRPP on BPH, a BPH rat model was established by hypodermic injection of testosterone propionate. The BPH rats were treated differently, with the model group receiving normal saline, the positive control group receiving finasteride, and the low, medium, and high dose FRPP group receiving FRPP at doses of 0.14 g/kg/d, 0.28 g/kg/d, and 0.56 g/kg/d, respectively. The results indicate that medium dose FRPP reduced the levels of hormone such as testosterone, dihydrotestosterone, and oestradiol in rats with BPH by about 32%, thus bringing the prostate tissue of BPH rats closer to normal. More importantly, medium dose FRPP treatment had a significant effect on the composition of gut microbiota in rats with BPH, increasing the levels of beneficial genera (such as Coprococcus and Jeotgalicoccus), and decreasing the levels of harmful pathogens (such as Turicibacter and Clostridiaceae_Clostridium) in the gut. This study showed that medium dose FRPP reduced the hormone level and regulated the unbalanced gut microbiota in BPH rats, thereby alleviating BPH.
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Affiliation(s)
- Y Y Han
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - Q H Zhang
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - W S Chen
- Nanjing Jiufengtang Bee Products Co., Ltd, Nanjing, 210000, China P.R
| | - Z L Li
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - D Xie
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - S L Zhang
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - H Lu
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - L W Wang
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - Z H Xu
- College of Bioscience and Bioengineering, Jiangxi Agricultural University, Nanchang, 330045, China P.R
| | - L Z Zhang
- College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang, 330045, China P.R
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Wang LW, Chu CH, Lin YC, Huang CC. Trends in Gestational Age-Related Intelligence Outcomes of School-Age Children Born Very Preterm from 2001 to 2015 in Taiwan. J Pediatr 2023; 261:113584. [PMID: 37354990 DOI: 10.1016/j.jpeds.2023.113584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/21/2023] [Accepted: 06/16/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE To investigate whether gestational age (GA)-related intelligence outcomes of children born very preterm improved over time. STUDY DESIGN A multicenter cohort study recruited 4717 infants born at GA <31 weeks and admitted to neonatal intensive care units between 2001 and 2015 in Taiwan. Intelligence outcomes at age 5.5 years were classified by intelligent quotient (IQ) into no cognitive impairment (IQ > -1 SD), mild cognitive impairment (IQ = -1∼-2 SD), and moderate/severe cognitive impairment (IQ < -2 SD). Trends were assessed for neonatal morbidities, mortality, and intelligence outcomes by birth epoch (2001-2003, 2004-2006, 2007-2009, 2010-2012, 2013-2015) and GA (23-24, 25-26, 27-28, 29-30 weeks). RESULTS Maternal education levels increased and rates of brain injury and mortality decreased over time. Among the 2606 children who received IQ tests, the rates of no, mild, and moderate/severe cognitive impairment were 54.5%, 30.5%, and 15.0%, respectively. There were significant trends in the increasing rates of no cognitive impairment and declining rates of mild and moderate/severe cognitive impairment in all GA groups across the 5 birth epochs. Relative to the occurrence in 2001-2003, the odds were significantly reduced for moderate/severe cognitive impairment from 2007-2009 (aOR 0.49, 95% CI 0.30-0.81) to 2013-2015 (0.35, 0.21-0.56) and for mild cognitive impairment from 2010-2012 (0.54, 0.36-0.79) to 2013-2015 (0.36, 0.24-0.53). CONCLUSIONS For children born very preterm between 2001 and 2015 in Taiwan, the improvement of maternal education levels and improvements in neonatal brain injury and mortality were temporally associated with trends of decreasing intellectual impairment at school age across all GA groups.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Chi-Hsiang Chu
- Department of Statistics, Tunghai University, Taichung, Taiwan
| | - Yung-Chieh Lin
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Ching Huang
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Wang LW, Lin HC, Tsai ML, Chang YT, Chang YC. Maternal hypertensive pregnancy disorders increase childhood intellectual disability hazards independently from preterm birth and small for gestational age. Early Hum Dev 2023; 185:105856. [PMID: 37688888 DOI: 10.1016/j.earlhumdev.2023.105856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/09/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Children of mothers with hypertensive-disorders-of-pregnancy (HDP) have high rates of preterm-birth (<37 weeks' gestation) and small-for-gestational-age (SGA), both of which are risk factors of intellectual disability (ID). AIMS To test the multiple-hit hypothesis that preterm-birth and SGA in the neonatal period might potentiate the antenatal impact of HDP to increase childhood ID hazards, and HDP might not have independent effects. METHODS This population-based cohort study enrolled 1,417,373 mother-child pairs between 2004 and 2011. A total of 19,457 pairs with HDP were identified and propensity-score-matched with 97,285 normotensive controls. Children were followed up for ID outcome until 6-13 years of age. HDP were classified into chronic-hypertension, gestational-hypertension, preeclampsia, and preeclampsia-with-chronic-hypertension. Using the normotensive group as the reference, the associations between HDP subgroups and ID hazards were assessed with adjusted hazard ratios (aHR) and 95 % confidence intervals (CI), and the effects of preterm-birth and SGA on the associations were examined. RESULTS The HDP group had higher cumulative rates of ID (1.6 %) than the normotensive group (0.9 %), particularly the subgroup of preeclampsia-with-chronic-hypertension (2.4 %), followed by preeclampsia (1.7 %), chronic-hypertension (1.5 %) and gestational hypertension (1.0 %). Preterm-birth and SGA exerted aggravating effects on ID hazards in children exposed to any HDP. After adjustments, maternal chronic-hypertension (aHR 1.59, 95 % CI 1.28-1.97), preeclampsia (1.52, 1.26-1.83), and preeclampsia-with-chronic-hypertension (1.86, 1.38-2.51) independently contributed to ID outcome. CONCLUSIONS Maternal HDP other than gestational hypertension increased offspring's ID hazards independently from the potentiating hits of preterm-birth and SGA, implicating long-lasting influence of in-utero HDP exposure on children's cognitive development.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
| | - Hung-Chih Lin
- Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan; Department of Pediatrics, Asia University Hospital, Asia University, Taichung, Taiwan
| | - Ming-Luen Tsai
- Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan
| | - Yu-Tzu Chang
- Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan; School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chia Chang
- Department of Long-Term Care, College of Health and Nursing, National Quemoy University, Kinmen County, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Chou Y, Wang LW, Lin CJ, Wang LY, Tsai WH, Ko MJ. Evaluation of feeding difficulties using videofluoroscopic swallow study and swallowing therapy in infants and children. Pediatr Neonatol 2023; 64:547-553. [PMID: 36849324 DOI: 10.1016/j.pedneo.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Infants and children with feeding difficulties have swallowing dysfunction and high risk of aspiration, which could be silent without choking, resulting in recurrent pneumonia and long-term respiratory morbidity. Videofluoroscopic swallow study (VFSS) is a useful tool for real-time visualization of the swallowing process and airway aspiration. This study reported a single-institutional 10-year experience of VFSS in pediatric patients with feeding difficulties and the efficacy of swallowing therapy. METHODS From 2011 to 2020, 30 infants and children with feeding difficulties received VFSS examinations in a medical center at a median age of 19 months (range 7 days-8 years). The images of the swallowing process (oral phase, triggering of pharyngeal swallowing, and pharyngeal phase) under videofluoroscopy were analyzed by a radiologist and a speech-language pathologist. Aspiration severity was assessed from VFSS observations and rated by an eight-point Penetration-Aspiration-Scale (PAS), with higher scores indicating increased severity. Swallowing therapy was performed by experienced speech-language therapists, and follow-up of oral feeding tolerance and risk of aspiration pneumonia was done. RESULTS Of the 30 patients, 24 (80%) had neurological deficits. High PAS scores (6-8) were observed in 25 (83.4%) patients, and 22 had a PAS score of 8, indicating silent aspiration. Of the 25 patients with high PAS scores, 19 (76%) had neurological deficits, and 18 (72%) depended on tube feeding at a median age of 20 months. Swallowing problems occurred most frequently during the pharyngeal phase in the patients with high PAS scores. VFSS-based swallowing therapy improved oral feeding ability and reduced aspiration episodes. CONCLUSION Infants and children with swallowing dysfunction and neurological deficits had high risk of severe aspiration. Swallowing problems in the pharyngeal phase were the most common VFSS findings in patients with severe aspiration. VFSS may help guide problem-oriented swallowing therapy to reduce the risk of recurrent aspiration.
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Affiliation(s)
- Yun Chou
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Chien-Jen Lin
- Department of Medical Imaging, Chi Mei Medical Center, Tainan, Taiwan
| | - Lin-Yu Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Center for General Education, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Wen-Hui Tsai
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan
| | - Mei-Ju Ko
- Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan.
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Li KZ, Huang QY, Tong KJ, Wang LW, Gou WB. [Imaging analysis of primary hepatic adenosquamous cell carcinoma: a case report]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:643-645. [PMID: 37400391 DOI: 10.3760/cma.j.cn501113-20220531-00291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Affiliation(s)
- K Z Li
- Department of Imaging, People's Hospital of Wanning City, Hainan Province, Wanning 571500, China
| | - Q Y Huang
- Chongqing Medical University Medical Imaging Specialty, Chongqing 400000, China
| | - K J Tong
- Department of Imaging, People's Hospital of Wanning City, Hainan Province, Wanning 571500, China
| | - L W Wang
- Department of Imaging, People's Hospital of Wanning City, Hainan Province, Wanning 571500, China
| | - W B Gou
- Department of Imaging, People's Hospital of Wanning City, Hainan Province, Wanning 571500, China
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11
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Wang LW, Lin HC, Tsai ML, Chang YT, Chang YC. Preterm birth and small for gestational age potentiate the association between maternal hypertensive pregnancy and childhood autism spectrum disorder. Sci Rep 2023; 13:9606. [PMID: 37311942 DOI: 10.1038/s41598-023-36787-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/09/2023] [Indexed: 06/15/2023] Open
Abstract
Children of mothers with hypertensive disorders of pregnancy (HDP) have high rates of preterm-birth (gestational age < 37 weeks) and small-for-gestational-age (SGA), both of which are risk factors of autism spectrum disorder (ASD). This study tested the multiple-hit hypothesis that preterm-birth and SGA in the neonatal period might potentiate the antenatal impact of HDP to increase childhood ASD hazards, and HDP might not be a major contributor. The propensity-score-matched cohort enrolled 18,131 mother-child pairs with HDP and 90,655 normotensive controls between 2004 and 2011. Children with siblings born to the same mothers were excluded for analysis to reduce the potential familial-genetic influence. HDP were classified into chronic-hypertension, gestational-hypertension, preeclampsia, and preeclampsia-with-chronic-hypertension. Using the normotensive group as the reference, the associations between HDP subgroups and the cumulative ASD risks were assessed with hazard ratios, and the effects of preterm-birth and SGA on the associations were examined. The HDP group had a higher cumulative rate of ASD (1.5%) than the normotensive group (1.2%). Preterm-birth and SGA exerted moderating effects to aggravate ASD hazards in children exposed to chronic-hypertension or gestational-hypertension. None of HDP types significantly contributed to ASD after adjustments. In conclusion, antenatal HDP exposure might predispose to ASD outcome through susceptibility to the impact of preterm-birth and SGA.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, #901, Chung Hwa Rd., Yung Kang District, Tainan, 710402, Taiwan.
- Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
| | - Hung-Chih Lin
- Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan
- Department of Pediatrics, Asia University Hospital, Asia University, Taichung, Taiwan
| | - Ming-Luen Tsai
- Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan
| | - Yu-Tzu Chang
- Department of Pediatrics, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chia Chang
- Department of Long-Term Care, College of Health and Nursing, National Quemoy University, #1, University Rd., Jinning Township, Kinmen County, 892009, Kinmen, Taiwan.
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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12
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Wang LW, Lin HJ, Chao CM, Lin MT, Wang LY, Chein LH, Chang CP, Chio CC. The interrelationships between neuronal viability, synaptic integrity, microglial responses, and amyloid-beta formation in an in vitro neurotrauma model. Sci Rep 2022; 12:22028. [PMID: 36539544 PMCID: PMC9768168 DOI: 10.1038/s41598-022-26463-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
The interrelationships between neuronal viability, synaptic integrity, and microglial responses remain in infancy. In dealing with the question, we induced a stretch injury to evaluate the mechanical effects of trauma on rat primary cortical neurons and BV2 microglial cells in a transwell culture system. The viability of primary neurons and BV2 cells was determined by MTT. Synaptic integrity was evaluated by determining the expression of beta-secretase 1 (BACE1), amyloid-beta (Aβ), microtubule-associated protein 2 (MAP2), and synaptophysin (vehicle protein). Both CD16/32-positive (CD16/32+) and CD206-positive (CD206+) microglia cells were detected by immunofluorescence staining. The phagocytic ability of the BV2 cells was determined using pHrodo E. coli BioParticles conjugates and flow cytometry. We found that stretch injury BV2 cells caused reduced viability and synaptic abnormalities characterized by Aβ accumulation and reductions of BACE1, MAP2, and synaptophysin in primary neurons. Intact BV2 cells exhibited normal phagocytic ability and were predominantly CD206+ microglia cells, whereas the injured BV2 cells exhibited reduced phagocytic ability and were predominantly CD16/32+ microglial cells. Like a stretch injury, the injured BV2 cells can cause both reduced viability and synaptic abnormalities in primary neurons; intact BV2 cells, when cocultured with primary neurons, can protect against the stretch-injured-induced reduced viability and synaptic abnormalities in primary neurons. We conclude that CD206+ and CD16/32+ BV-2 cells can produce neuroprotective and cytotoxic effects on primary cortical neurons.
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Affiliation(s)
- Lan-Wan Wang
- grid.413876.f0000 0004 0572 9255Department of Pediatrics, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, 710 Taiwan ,grid.412717.60000 0004 0532 2914Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, 710 Taiwan
| | - Hung-Jung Lin
- grid.413876.f0000 0004 0572 9255Department of Emergency Medicine, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, 710 Taiwan ,grid.412896.00000 0000 9337 0481School of Medicine, Taipei Medical University, Taipei, 110 Taiwan
| | - Chien-Ming Chao
- grid.413876.f0000 0004 0572 9255Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, No.201, Taikang Taikang Vil., Liouying Dist., Tainan, 73657 Taiwan ,grid.452538.d0000 0004 0639 3335Department of Dental Laboratory Technology, Min-Hwei College of Health Care Management, Tainan, 73657 Taiwan
| | - Mao-Tsun Lin
- grid.413876.f0000 0004 0572 9255Department of Medical Research, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, 710 Taiwan
| | - Lin-Yu Wang
- grid.413876.f0000 0004 0572 9255Department of Pediatrics, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, 710 Taiwan ,grid.412717.60000 0004 0532 2914Center for General Education, Southern Taiwan University of Science and Technology, Tainan, 71005 Taiwan
| | - Lan-Hsiang Chein
- grid.413876.f0000 0004 0572 9255Department of Medical Research, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, 710 Taiwan
| | - Ching-Ping Chang
- grid.413876.f0000 0004 0572 9255Department of Medical Research, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, 710 Taiwan
| | - Chung-Ching Chio
- grid.413876.f0000 0004 0572 9255Division of Neurosurgery, Department of Surgery, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang District, Tainan, 710 Taiwan
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13
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Wang LW, Wang R, Fang JG, Zhong LZ, Hou HZ, Ma L, Feng SZ, He CS, Wang L, Zhang L. [Analysis of the diagnosis and treatment of patients with SMARCB1 (INI-1)-deficient sinonasal carcinoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:848-853. [PMID: 35866278 DOI: 10.3760/cma.j.cn115330-20211028-00690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To summarize the clinical features, treatments and outcomes of patients with SMARCB1(INI-1)-deficient sinonasal carcinoma (SDSC). Methods: Fifteen patients who were diagnosed as SDSC in Beijing Tongren Hospital from October 2016 to June 2021 were retrieved, including nine males and six females, ranged from 25 to 78 years old. For TNM stage, one case was in stage T2, one case was in stage T3, 13 cases were in stage T4; 13 cases were in stage N0, two cases were in stage N2; 14 cases were in stage M0, one case was in stage M1. The most common paranasal sinus affected by tumor was the ethmoid sinus. Five patients were treated by radical surgical resection combined with postoperative adjuvant therapy, four patients treated by neoadjuvant therapy with surgical resection, three patients treated by surgical resection only, one patient treated by neoadjuvant therapy with concurrent chemoradiotherapy, one patient treated by preoperative radiotherapy with surgery, and one patient received palliative chemotherapy. Immunohistochemical analysis was performed in all cases. The Kaplan-Meier method was used to draw the survival curve, and the Log-rank test was used to compare the difference to 20 undifferentiated carcinoma patients with positive INI-1 expression in the same period. Results: Immunohistochemical analysis showed the complete absence of INI-1 expression in the tumor nuclei in all 15 cases. The follow-up information was available with a median follow-up time of 21 months (3-56 months). The 3-year overall survival rate, disease specific survival rate, disease-free survival rate and metastasis-free survival rate were 58.9%, 58.9%, 36.4% and 31.2%, respectively. Disease-free survival in SDSC patients was significantly lower compared with undifferentiated carcinoma patients with positive INI-1 expression (HR=2.87,95%CI:0.92~8.91,P=0.043). Cox regression analysis showed that patients with comprehensive treatment based on surgery had a better prognosis than others (HR=8.61,95%CI:1.38~53.73,P=0.021). Conclusion: SDSC is a highly aggressive malignant tumor with the characteristics of easy recurrence, early metastasis and poor prognosis. INI-1 immunohistochemical analysis is recommended in the pathologically poorly differentiated sinonasal carcinoma. Comprehensive treatment based on radical resection may be the first choice for SDSC patients.
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Affiliation(s)
- L W Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - R Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - J G Fang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - L Z Zhong
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - H Z Hou
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - L Ma
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - S Z Feng
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - C S He
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - L Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China Beijing Institute of Otolaryngology, Beijing 100730, China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China Beijing Institute of Otolaryngology, Beijing 100730, China
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Qiu MZ, Zhang H, Wu D, Chen RC, Chen SZ, Wang LW. [Hyper-IgE syndrome in adults characterized by disseminated mixed infection: a case report and literature review]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:546-551. [PMID: 35658378 DOI: 10.3760/cma.j.cn112147-20211102-00763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To improve the awareness of hyper-IgE syndrome (HIES) characterized by disseminated infection. Methods: We retrospectively analyzed a patient with HIES characterized by Talaromyces marneffei and Staphylococcus aureus mixed disseminated infection in Shenzhen People's Hospital. The clinical manifestations, results of laboratory tests/genetic examinations, therapeutic strategies and prognosis were summarized. The keywords "hyper-lgE syndrome" were used to search and review the literature in Wanfang databases and Pubmed database. Results: In February 2021, an 18-year-old male patient was admitted to our hospital with backache for over 3 weeks and fever for 4 days. Physical examination revealed deciduous teeth in the oral cavity, bilateral renal pain on percussion, and interphalangeal joint hyperextension. Laboratory studies demonstrated increased blood eosinophils and serum level of total IgE. Bacterial culture from bronchoscopic secretions, bronchial mucosa, and necrotic tissue from the left upper arm showed Talaromyces marneffei. Bacterial culture from alveolar lavage fluid, left upper arm necrotic tissue, puncture fluid of right retroauricular abscess and renal drainage fluid suggested methicillin-sensitive Staphylococcus aureus. The chest and abdominal CT revealed diffuse patchy and nodular lesions in bilateral lungs, cavitary lesions in the upper lobe of the left lung, multiple enlarged lymph nodes in the mediastinum, and infectious lesions within both kidneys and perirenal space. Furthermore, the patients was identified with STAT3 mutations by whole exome sequencing, which confirmed the diagnosis of HIES. Nineteen literature articles were retrieved, involving 27 adult patients with a median age of diagnosis of 23 years. The most common manifestations included: skin infection (16/27), eczema (15/27), elevated IgE (26/27) and eosinophils (17/27), as well as positive STAT3 mutation (11/27). Conclusion: Clinicians should be alert to the possibility of hyper-IgE syndrome in patients with severe or disseminated intracellular bacterial infections.
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Affiliation(s)
- M Z Qiu
- Health Management Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020,China
| | - H Zhang
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases in Shenzhen People's Hospital, Shenzhen 518020,China
| | - D Wu
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases in Shenzhen People's Hospital, Shenzhen 518020,China
| | - R C Chen
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases in Shenzhen People's Hospital, Shenzhen 518020,China
| | - S Z Chen
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases in Shenzhen People's Hospital, Shenzhen 518020,China
| | - L W Wang
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases in Shenzhen People's Hospital, Shenzhen 518020,China
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15
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Chen F, Wang LW, Bu JQ. [Clinical analysis of 61 cases of salivary duct carcinoma]. Zhonghua Yi Xue Za Zhi 2022; 102:1394-1397. [PMID: 35545586 DOI: 10.3760/cma.j.cn112137-20211111-02515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The clinical data of 61 patients of salivary duct carcinoma admitted to the First Medical Centre of Chinese PLA General Hospital from January 2010 to December 2020 were retrospectively reviewed. A total of 55 patients (90.2%) were male and 6 (9.8%) were female. There were 51 patients (83.6%) aged≥50 years. The primary tumor of 45 patients (73.8%) were from the parotid gland. There were 35 patients (57.4%) who had cervical lymph node metastasis and 25 patients (41.0%) had distant metastasis. All patients underwent surgery and 50 of them (82.0%) received adjuvant radiotherapy. The 3-year and 5-year survival rates were 58.0% and 43.3%, respectively. Compared with the patients who had undergone surgery only, the survival rates of those who had postoperative adjuvant radiotherapy and chemoradiotherapy were higher. It can be seen that radical surgical treatment is necessary, and postoperative radiotherapy can reduce the recurrence rate and increase the survival rate to a certain extent.
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Affiliation(s)
- F Chen
- Department of Stomatology,the First Medical Centre of Chinese PLA General Hospital, Beijing 100853, China
| | - L W Wang
- Department of Stomatology,the First Medical Centre of Chinese PLA General Hospital, Beijing 100853, China
| | - J Q Bu
- Department of Stomatology,the First Medical Centre of Chinese PLA General Hospital, Beijing 100853, China
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16
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Zhan DT, Chen RC, Wang LW. [Two families with Birt-Hogg-Dubé syndrome:case report and literature review]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:59-63. [PMID: 35000307 DOI: 10.3760/cma.j.cn112147-20210607-00402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To improve the awareness of Birt-Hogg-Dubé syndrome. Methods: We performed a retrospective analysis with two families of Birt-Hogg-Dubé syndrome (BHD syndrome) diagnosed in Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital from 2020 to 2021. Clinical manifestations, imaging features, diagnosis and gene detection results were summarized. Relative literatures were reviewed in Wanfang Database and PubMed from 2015 to 2021 by using the search terms of "BHD syndrome" "Birt-Hogg-Dubé" "Birt-Hogg-Dubé syndrome", respectively. Results: The probands of both families were female, aged 37 and 34 years respectively. The onset manifestation was pulmonary bullae combined with pneumothorax. Chest computed tomography (CT) imaging showed multiple pulmonary cysts in both lobes, and no skin lesions or renal tumors were found in either case. History of pneumothorax was present in Family 1 while absent in Family 2. The FLCN gene of the two probands and their relatives showed the same mutation site. Totally 12 Chinese literatures and 394 English literatures were retrieved, among which 96 reported lung involvement only. A total of 10 literatures about Chinese population were screened out from the English literatures, and 115 patients, 31 males and 84 females, were included. The incidence of spontaneous pneumothorax was 66.95% (77/115), while a family history of pneumothorax was 88.31%(68/77). The onset age of spontaneous pneumothorax was between 30 and 44 years. The most common mutation site of FLCN was c.1285dup. Conclusions: BHD syndrome in Asian population may only have lung involvement. Patients with pneumothorax and pulmonary cystic lesions should be inquired of the family history. We speculate that there are many underdiagnosed cases in clinical practice.
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Affiliation(s)
- D T Zhan
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases in Shenzhen People's Hospital,Shenzhen 518020,China
| | - R C Chen
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases in Shenzhen People's Hospital,Shenzhen 518020,China
| | - L W Wang
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases in Shenzhen People's Hospital,Shenzhen 518020,China
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Wang LW, Lin YK, Lin YC, Huang CC. Early Mental Trajectories Predict Different Cognitive Levels at School Age in Very Preterm Children. Neonatology 2022; 119:222-229. [PMID: 35124677 DOI: 10.1159/000521634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/08/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Early identification of preterm children at high risk of intellectual disability (intelligence quotient [IQ] <70) or borderline intelligence (IQ = 70-84) is critical for different early intervention. We investigated whether early-life mental trajectories predict intellectual disability and borderline intelligence, respectively, among school-age preterm children. METHODS A multicenter study recruited preterm infants born at <32 weeks' gestation between 2001 and 2014 in Taiwan who underwent mental assessments (Bayley Scales of Infant Development) at corrected ages 6, 12, and 24 months and IQs at age 5.5 years. Mental trajectories from ages 6 to 24 months determined using group-based trajectory modeling were employed to predict intellectual disability and borderline intelligence, respectively. Model fit was assessed using the area under the receiver operating characteristic curve (AUROC) and Akaike information criterion (AIC). RESULTS Among the 1,680 children enrolled, three mental trajectories were identified: high-stable (59.7%), high-declining (35.3%), and low-declining (5.0%), in which the borderline-intelligence/intellectual-disability rate was 14.1%/1.5%, 36.1%/13.7%, and 10.7%/82.1%, respectively. Compared with children with normal intelligence, the low-declining trajectory had 37.7-fold higher odds (95% confidence interval [CI], 26.3-48.1) for intellectual disability, and the high-declining trajectory had 4.4-fold higher odds (95% CI, 3.1-6.1) for borderline intelligence. Compared to the models with risk factors alone (AIC 1,791.2), the models that included both risk factors and trajectory groups had better overall performance (AIC 1,419.8) and increased prediction power for intelligence outcomes: low-declining trajectory for intellectual disability (AUROC increased from 0.81 to 0.92) and high-declining trajectory for borderline intelligence (AUROC increased from 0.68 to 0.75). CONCLUSIONS Early-life mental trajectories help identify preterm children at risk of intellectual disability and borderline intelligence, respectively, at school age for timely intervention.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan.,Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.,Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Yung-Chieh Lin
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Ching Huang
- Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Sim JY, Wang LW, Chow JC, Hsu WY, Chen YC, Chang YH, Chou Y, Chen WY, Tang HJ, Chang TH. Streptococcus gallolyticus - A potentially neglected pathogen causing neonatal sepsis not covered by routine group B streptococcus screening. J Microbiol Immunol Infect 2021; 54:1190-1192. [PMID: 34052145 DOI: 10.1016/j.jmii.2021.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 06/12/2023]
Abstract
We report 4 cases of neonatal sepsis caused by Streptococcus gallolyticus. The clinical course was quite similar to early-and late-onset group B streptococcus disease. None of the mothers had group B streptococcus (GBS) colonization on prenatal screening nor received intrapartum antibiotics. We proposed the sporadic distribution of S. gallolyticus sepsis among neonates was partly due to relatively low colonization rate in adults compared with GBS. Species determination of S. gallolyticus may not be available using conventional microbiological methods and may contribute to underestimation or misclassification. In our series, we highlighted the importance of S. gallolyticus as an important pathogen in neonatal sepsis deserving further surveillance.
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Affiliation(s)
- Jun Yi Sim
- Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan
| | - Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Julie Chi Chow
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Wei-Yun Hsu
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu-Chin Chen
- Department of Pediatrics, Chi Mei Medical Center, Chiali, Tainan, Taiwan
| | - Yi-Hsin Chang
- Department of Pediatrics, Chi Mei Medical Center, Chiali, Tainan, Taiwan
| | - Yun Chou
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Wei-Yu Chen
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Hung-Jen Tang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Tu-Hsuan Chang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan.
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Chen YC, Tsai WH, Ho CH, Wang HW, Wang LW, Wang LY, Wang HH, Hwang YS. Atypical Sensory Processing and Its Correlation with Behavioral Problems in Late Preterm Children at Age Two. Int J Environ Res Public Health 2021; 18:6438. [PMID: 34198645 PMCID: PMC8296277 DOI: 10.3390/ijerph18126438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/10/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to compare the prevalence rate of atypical sensory processing in late preterm (LP) and term children at two years of age and to further investigate the co-occurrence of atypical sensory processing and behavioral problems (internalizing/externalizing) in both groups of children. A total of 104 children (52 LP and 52 sex- and birth order-matched term children) were included. The primary caregivers were asked to complete the Infant/Toddler Sensory Profile-Chinese version and the Child Behavior Checklist 1.5-5Y-Chinese version (CBCL-C/1.5-5). We found that the LP group had a similar prevalence rate of atypical sensory processing to the term group. However, neonatal intensive care unit experience (r = -0.356, p = 0.013, with visual processing) and days of ventilation and supplementary oxygen (r = -0.392, p = 0.004, with low registration) after birth were significantly correlated with the atypical sensory processing of LP children. Both LP and term children with behavioral problems seemed to have a higher prevalence rate of atypical sensory processing than their peers without behavioral problems. However, when Bonferroni correction was used to control for the statistical errors of multiple comparisons, only in the LP group did the co-occurrence of atypical sensory processing (auditory and oral sensory processing and sensation avoiding) and behavioral problems reach significance. In conclusion, the influence of late preterm birth on sensory processing may become subtle at age two, with the exception of those LP children experiencing complicated medical management after birth. A high level of co-occurrence of atypical sensory processing and behavioral problems suggests that the administration of a sensory processing assessment may be helpful to clarify the cause of problematic behavior and to recommend an appropriate intervention for LP children with behavioral problems.
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Affiliation(s)
- Yu-Chin Chen
- Department of Pediatrics, Chi Mei Medical Center, Chiali, Tainan 72263, Taiwan;
- Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan; (W.-H.T.); (L.-W.W.); (L.-Y.W.); (H.-H.W.)
| | - Wen-Hui Tsai
- Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan; (W.-H.T.); (L.-W.W.); (L.-Y.W.); (H.-H.W.)
- Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan 711301, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan;
| | - Hsuan-Wen Wang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei 11080, Taiwan;
| | - Lan-Wan Wang
- Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan; (W.-H.T.); (L.-W.W.); (L.-Y.W.); (H.-H.W.)
- Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan 71073, Taiwan
| | - Lin-Yu Wang
- Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan; (W.-H.T.); (L.-W.W.); (L.-Y.W.); (H.-H.W.)
- Center for General Education, Southern Taiwan University of Science and Technology, Tainan 71073, Taiwan
| | - Hsin-Hua Wang
- Division of Neonatology, Department of Pediatrics, Chi Mei Medical Center, Tainan 71004, Taiwan; (W.-H.T.); (L.-W.W.); (L.-Y.W.); (H.-H.W.)
- Department of Pediatrics, Chi Mei Hospital, Liouying, Tainan 73657, Taiwan
| | - Yea-Shwu Hwang
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
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Wu WM, Chen J, Bai CM, Chi Y, Du YQ, Feng ST, Huo L, Jiang YX, Li JN, Lou WH, Luo J, Shao CH, Shen L, Wang F, Wang LW, Wang O, Wang Y, Wu HW, Xing XP, Xu JM, Xue HD, Xue L, Yang Y, Yu XJ, Yuan CH, Zhao H, Zhu XZ, Zhao YP. [The Chinese guidelines for the diagnosis and treatment of pancreatic neuroendocrine neoplasms (2020)]. Zhonghua Wai Ke Za Zhi 2021; 59:401-421. [PMID: 34102722 DOI: 10.3760/cma.j.cn112139-20210319-00135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.
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Affiliation(s)
- W M Wu
- Department of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730,China
| | - J Chen
- Department of Gastroenterology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080,China
| | - C M Bai
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730,China
| | - Yihebali Chi
- Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100021,China
| | - Y Q Du
- Department of Gastroenterology, Changhai Hospital Affiliated to Navy Medical University, Shanghai 200433,China
| | - S T Feng
- Department of Radiology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080,China
| | - L Huo
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730,China
| | - Y X Jiang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730,China
| | - J N Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730,China
| | - W H Lou
- Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032,China
| | - J Luo
- Department of Pathology, China-Japan Friendship Hospital, Beijing 100029,China
| | - C H Shao
- Department of Pancreatic-biliary Surgery, Changzheng Hospital, Navy Medical University, Shanghai 200003,China
| | - L Shen
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing 100142,China
| | - F Wang
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210029,China
| | - L W Wang
- Department of Oncology, Renji Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200127,China
| | - O Wang
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730,China
| | - Y Wang
- Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080,China
| | - H W Wu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730,China
| | - X P Xing
- Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730,China
| | - J M Xu
- Department of Gastrointestinal Oncology, the Fifth Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100071,China
| | - H D Xue
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730,China
| | - L Xue
- Department of Pathology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080,China
| | - Y Yang
- Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630,China
| | - X J Yu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032,China
| | - C H Yuan
- Department of General Surgery, Peking University Third Hospital, Beijing 100191,China
| | - H Zhao
- Department of Hepatobiliary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021,China
| | - X Z Zhu
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032,China
| | - Y P Zhao
- Department of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730,China
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Wang LW, Lin YC, Wang ST, Huang CC. Trends in survival, neonatal morbidity and neurodevelopmental outcome of very preterm infants in Tainan, Southern Taiwan, 1995-2016. J Formos Med Assoc 2021; 120:1314-1323. [PMID: 33478783 DOI: 10.1016/j.jfma.2020.12.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/04/2020] [Accepted: 12/24/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Using regression modeling analysis to investigate the breakpoints of the trends in survival-without-major-neonatal-morbidities (MNM) or -without-neurodevelopmental- impairment (NDI) by year and gestational age (GA) in preterm infants. METHODS We enrolled 2237 preterm infants (GA < 32 weeks) in Tainan, Taiwan. The trends in survival-without-MNM or -without-NDI by year (1995-2016) and GA (23-31 weeks), and the epochs and GA ranges with distinct changes were examined. Adjusted rate ratios (aRR) (95% confidence interval [CI]) were calculated using the rates in infants born at 23 weeks in 1995 as the reference. RESULTS For yearly trend, there were three epochs (1995-2000, 2001-2006, 2007-2016) with distinct changes in the rates of survival-without-MNM (aRR [95% CI] 1.07 [1.02-1.12], 1.04 [1.02-1.07], 1.02 [1.01-1.04]) and -without-NDI (1.03 [1.02-1.07], 1.02 [1.01-1.04], 1.01 [0.98-1.04]). For GA trend, the three GA ranges with different increases in the rates of survival-without-MNM were 23+0-26+6 (1.60 [1.31-1.94]), 27+0-28+6 (1.24 [1.14-1.34]) and 29+0-31+6 weeks (1.17 [1.02-1.34]), while those in the rates of survival-without-NDI were 23+0-25+6 (1.14 [1.03-1.25]), 26+0-28+6 (1.06 [1.02-1.12]) and 29+0-31+6 weeks (1.04 [1.02-1.07]). The trends in survival-without-MNM and -without-NDI increased over years in infants with GA 25-31 but not < 25 weeks. CONCLUSION The yearly trends in survival-without-MNM and -without-NDI had steady increases from 1995 to 2016 with distinct changes in three epochs, and the GA trends also increased with different rates per week in three GA ranges. Infants with GA < 25 weeks did not improve on the rates of survival-without-MNM or -without-NDI per year from 1995 to 2016.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, Taiwan; Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yung-Chieh Lin
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shan-Tair Wang
- Research Division, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Chao-Ching Huang
- Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
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22
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Chen LW, Wang ST, Wang LW, Kao YC, Chu CL, Wu CC, Chiang CH, Huang CC. Early Neurodevelopmental Trajectories for Autism Spectrum Disorder in Children Born Very Preterm. Pediatrics 2020; 146:peds.2020-0297. [PMID: 32900877 DOI: 10.1542/peds.2020-0297] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Children born preterm are at high risk for autism spectrum disorder (ASD). However, there is still a lack of appropriate developmental markers. In this study, we aim to examine whether early mental performance trajectory is related to ASD outcome in the preterm population. METHODS The population-based cohort included 414 very preterm survivors born between 2008 and 2014. After excluding children with severe neurosensory impairment, 319 children with available records of developmental quotients before age 2 years were enrolled. The trajectory of mental performance evaluated by using the Bayley Scales of Infant Development across 6, 12, and 24 months of age was analyzed with group-based trajectory modeling. At 5 years of age, the ASD diagnosis was established by using the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised. RESULTS There were 29 children with ASD and 290 children without ASD. The mental performances from age 6 to 24 months could be classified into 3 trajectory patterns: low declining, high declining, and high stable, which corresponded to ASD prevalence at age 5 years of 35%, 9%, and 3%, respectively. ASD odds was 15 times higher in the low-declining group than in the high-stable group (odds ratio 15; 95% confidence interval 3.8-59; P < .001). Through the analysis of multinomial logistic regression, we found that male infants with longer exposure to oxygen therapy whose mothers had lower maternal education levels tended to follow the low-declining trajectory. CONCLUSIONS The early-life mental trajectory patterns, by using the Bayley Scales of Infant Development, may lead to identification of vulnerable children born preterm for early ASD diagnosis and targeted intervention.
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Affiliation(s)
- Li-Wen Chen
- Graduate Institutes of Clinical Medicine and .,Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shan-Tair Wang
- Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Division of Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan.,Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Yu-Chia Kao
- Graduate Institutes of Clinical Medicine and.,Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan
| | - Ching-Lin Chu
- Department of Educational Psychology and Counseling, National Pingtung University, Pingtung, Taiwan
| | - Chin-Chin Wu
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan; and
| | - Chung-Hsin Chiang
- Research Center for Mind, Brain, and Learning and Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Chao-Ching Huang
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; .,Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Yang LJ, Li LJ, Liu T, Zhang YZ, Wang LW, Shen P. [Ultrastructural study of ampulla of mouse inner ear]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 55:501-505. [PMID: 32842366 DOI: 10.3760/cma.j.cn115330-20190807-00498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Objective: To observe the ultrastructure of the ampulla, and analyze its physiological and pathological significance. Methods: In this study, 20 Kunming mice were used, and scanning electron microscopy was used to observe the ultrastructure of the ampulla of inner ear. Results: Otoconia was found among the cilia bundles of different haircell(intercilla otoconia of ampulla). The cupula was attached to the lateral wall of the ampulla, and easily to be separated; after separated, a kind of slender crystal(surface otoconia of ampulla) could be seen between the cupula and lateral wall of the ampulla, both sides of ampullary crest were covered with slender crystals too. On the canal side of the ampulla wall, there was more particulate matter attached to the wall near the bottom of ampullary crest, partially embedded in the wall, and less on the utricle side of the ampulla wall. Conclusions: The observation of the ultrastructure of the ampulla is helpful for better understanding the physiological functions of the semicircular canals and the ampulla, and better understanding the pathogenesis and solution of some vertigo diseases.
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Affiliation(s)
- L J Yang
- Department of Otorhinolaryngology, Beijing Chuiyangliu Hospital, Beijing 100022, China
| | - L J Li
- Department of Otorhinolaryngology, Beijing Chuiyangliu Hospital, Beijing 100022, China
| | - T Liu
- Department of Otorhinolaryngology, Beijing Chuiyangliu Hospital, Beijing 100022, China
| | - Y Z Zhang
- Department of Otorhinolaryngology, Beijing Chuiyangliu Hospital, Beijing 100022, China
| | - L W Wang
- Department of Otorhinolaryngology, Beijing Chuiyangliu Hospital, Beijing 100022, China
| | - P Shen
- Department of Otorhinolaryngology, Beijing Chuiyangliu Hospital, Beijing 100022, China
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24
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Affiliation(s)
- L W Wang
- Shenzhen People's Hospital, Shenzhen Institute of Respiratory Diseases, Shenzhen Branch-Network Collaboration Group of National Clinical Research Center for Respiratory Disease, Shenzhen Municipal Health Commission, Medical Prevention and Respiratory Medicine Project Team, Shenzhen 518020, China
| | - R C Chen
- Shenzhen People's Hospital, Shenzhen Institute of Respiratory Diseases, Shenzhen Branch-Network Collaboration Group of National Clinical Research Center for Respiratory Disease, Shenzhen Municipal Health Commission, Medical Prevention and Respiratory Medicine Project Team, Shenzhen 518020, China
| | - N S Zhong
- The First Affiliated Hospital of Guangzhou Medical University Guangzhou Institute of Respiratory Health, National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China
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Wang FY, Wang LW, Yang YQ, Liang ZY, Chen RC, Qiu C. [Annual reveiew of progress in research on chronic obstructice pulmonary disease]. Zhonghua Jie He He Hu Xi Za Zhi 2019; 42:858-861. [PMID: 31694097 DOI: 10.3760/cma.j.issn.1001-0939.2019.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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26
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Chen LW, Wang ST, Wang LW, Kao YC, Chu CL, Wu CC, Hsieh YT, Chiang CH, Huang CC. Behavioral characteristics of autism spectrum disorder in very preterm birth children. Mol Autism 2019; 10:32. [PMID: 31367295 PMCID: PMC6647137 DOI: 10.1186/s13229-019-0282-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/10/2019] [Indexed: 12/27/2022] Open
Abstract
Background Lower gestational age may increase autism spectrum disorder (ASD) vulnerability; however, the incidence of ASD diagnosis through a direct assessment on every very preterm birth child on the population base remains unclear. Moreover, the behavioral characteristics of preterm birth ASD are unknown. Methods Every very preterm birth child (gestational age < 32 weeks; birth weight < 1500 g) who was discharged from neonatal intensive care units in Southern Taiwan and prospectively followed to 5 years of age was evaluated using the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R). The term birth (gestational age > 37 weeks) ASD children characterized by ADOS and ADI-R were group matched to the preterm birth ASD by age at examination for comparison. ADOS severity scores were calculated by the Mann-Whitney U test and ADI-R by multivariate analysis of variance and canonical discriminant analysis. Results Two hundred forty-six (87%) of the 283 very preterm survivors were followed prospectively to 5 years of age. Nineteen (7.7%) of the 246 children fulfilled the diagnostic criteria of ASD. After excluding 1 patient with cerebral palsy and profound mental disability, 18 preterm ASD children were compared with 44 term birth ASD children. The two ASD groups were comparable for age at examination, gender, and intelligence quotient. The two groups showed comparable ADOS severity scores in social affect deficits, restricted repetitive behaviors, and total score, but had differences in qualitative abnormalities in reciprocal social interaction (Wilks lambda F value = 6.2, P < 0.001) of ADI-R. Compared to term birth ASD children, preterm birth ASD children exhibited worse nonverbal behaviors that regulate social interaction (OR 2.59, 95% CI 1.41-4.73, P = 0.002) but more favorable peer relationships (OR 0.58, 95% CI 0.38-0.90, P = 0.01) and socioemotional reciprocity (OR 0.55, 95% CI 0.33-0.92, P = 0.02). In contrast to the heterogeneous severity of social reciprocity in the term ASD group, the behavioral characteristics of the preterm ASD group showed a homogeneous reciprocal social interaction pattern. Conclusions The 5-year incidence rate of ASD was high in very preterm birth children. Preterm birth ASD exhibited a specific behavioral phenotype of reciprocal social interaction.
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Affiliation(s)
- Li-Wen Chen
- 1Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70403 Taiwan.,2Graduate Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shan-Tair Wang
- 3Graduate Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Lan-Wan Wang
- 4Department of Pediatrics, Chi-Mei Medical Center, Tainan, Taiwan.,5Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan.,6Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Yu-Chia Kao
- 2Graduate Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,7Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan
| | - Ching-Lin Chu
- 8Department of Educational Psychology and Counseling, National Pingtung University, Pingtung, Taiwan
| | - Chin-Chin Wu
- 9Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Ting Hsieh
- 10Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Hsin Chiang
- 11Department of Psychology, National Chengchi University, Taipei, Taiwan.,12Research Center for Mind, Brain and Learning, National Chengchi University, Taipei, Taiwan
| | - Chao-Ching Huang
- 1Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70403 Taiwan.,5Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Abstract
Liver failure is a familiar severe disease, with no good clinical early diagnostic indicators and treatment methods. Studies have shown that non-encoding RNA (ncRNA) characterized by microRNA (miRNA) and long non-coding RNA (lncRNA) can be used not only as an early diagnostic indicator of liver failure, but also play a key regulatory role in an inflammatory response to liver failure, hepatocyte death and hepatocyte regeneration. Simultaneously, the epigenetic regulation of ncRNA also participates in the initiation and progression of liver failure. This article reviews the relationship between miRNA, lncRNA, and liver failure to find new targets for the diagnosis and treatment of liver failure.
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Affiliation(s)
- Y Wang
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan 430060, China
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Jiao FZ, Zhang HY, Yang F, Wang LW, Gong ZJ. [Protective effect of the histone deacetylase inhibitor ACY1215 against brain edema in mice with acute liver failure]. Zhonghua Gan Zang Bing Za Zhi 2019; 25:695-700. [PMID: 29108192 DOI: 10.3760/cma.j.issn.1007-3418.2017.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the protective effect of ACY1215 (Rocilinostat), a histone deacetylase inhibitor, against brain edema in mice with acute liver failure. Methods: Lipopolysaccharide combined with D-galactosamine was used to establish a mouse model of acute liver failure, and ACY1215 was used for intervention. The effect of ACY1215 on histopathological changes of the liver was observed after 24 hours, as well as the changes in alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood ammonia, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), brain water content, blood-brain barrier structure, NF-κB-p65, histone, acetylated histone, and TNF-α mRNA in brain tissue. Results: The mice with acute liver failure had marked pathological damage in liver tissue, as well as significant increases in the levels of ALT, AST, blood ammonia, TNF-α, and IFN-γ (t≥5.367, all P < 0.05). ACY1215 significantly improved the pathological damage in liver tissue and reduced the serum levels of ALT, AST, blood ammonia, TNF-α, and IFN-γ (t≤-3.515, all P < 0.05). ACY1215 also significantly reduced the expression of NF-κB-p65 (t = -5.871, P = 0.004) and the mRNA expression of TNF-α (t = -11.913, P < 0.01) in brain tissue and brain water content (t = -2.355, P < 0.01). According to the results of electron microscopy, the model group had an abnormal blood-brain barrier structure, and the ACY1215 group had slighter damage than the model group. Compared with the normal group, the model group had significant increases in the acetylation level of histone H3 and H4 in brain tissue (t≥3.009, both P < 0.05), while ACY1215 further upregulated the acetylation levels of histone H3 and H4 (t≥6.682, both P < 0.05). Conclusion: ACY1215 exerts a protective effect against brain edema in mice with acute liver failure, possibly by regulating histone acetylation and inhibiting inflammation.
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Affiliation(s)
- F Z Jiao
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan 430060, China
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Wu ZZ, Xu Q, Chen Q, Wang LW, Gu JP. [The diagnostic value of low dose of dual-source CT venography for deep venous thrombosis]. Zhonghua Yi Xue Za Zhi 2018; 98:3158-3161. [PMID: 30392274 DOI: 10.3760/cma.j.issn.0376-2491.2018.39.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: To investigate the diagnostic value of low dose of dual-source CT venography examination for DVT (deep venous thrombosis). Methods: A total of 60 patients from Nanjing First Hospital with suspected DVT underwent indirect low dose CTV examination and treatment of DSA from January to December, 2017, and recording the radiation dose for CTV.DSA as the gold standard, calculate the sensitivity, specificity of CTV, kappa consistency test was used to exam the results of CTV and DSA.McNemar test was used to check statistical difference between two examinations. Results: A total of 60 patients, 780 blood vessels took CTV examinations, 326 were positive; 420 blood vessels took DSA examinations, 332 were positive.DSA as the gold standard, the sensitivity, specificity, of DVT detection by CTV were 96.2% and 92.6%, kappa=0.860, P<0.05, and the result of McNemar test was P=0.263. Conclusion: Low dose of dual-source indirect CTV examination for DVT can not only reduce radiation dose for the patients, but also has a high clinical value in the diagnosis of DVT.
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Wang LW, Lin YC, Wang ST, Huang CC. Identifying Risk Factors Shared by Bronchopulmonary Dysplasia, Severe Retinopathy, and Cystic Periventricular Leukomalacia in Very Preterm Infants for Targeted Intervention. Neonatology 2018; 114:17-24. [PMID: 29621770 DOI: 10.1159/000487505] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 02/08/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Bronchopulmonary dysplasia (BPD), severe retinopathy of prematurity (sROP), and cystic periventricular leukomalacia (cPVL) are 3 major morbidities with long-term neurodevelopmental impairments in preterm infants. OBJECTIVE To investigate the strength of associations and identify key risk factors shared by BPD, sROP, and cPVL for targeted intervention. METHODS We studied the Taiwanese very-preterm-infant registry data on 3,507 infants admitted to neonatal intensive care units and discharged at postmenstrual age ≥36 weeks between 2008 and 2013. RESULTS Of 3,507 infants, 1,497 presented with at least 1 morbidity (26 [1.7%], 386 [25.8%], and 1,085 [72.5%] exhibited 3, 2, and 1 morbidities, respectively). BPD was strongly associated with sROP (odds ratio 5.93; 95% confidence interval 5.02-7.03), followed by cPVL (2.08; 1.63-2.64), but sROP and cPVL were weakly associated (1.59; 1.17-2.13). Most risk factors contributed to BPD, which shared risk factors with sROP and cPVL. A birth weight of < 1,000 g, male sex, and prolonged mechanical ventilation (MV) were shared by BPD and sROP, and chorioamnionitis, severe respiratory distress syndrome, and prolonged MV specifically contributed to BPD and cPVL. Prolonged MV was the single risk factor common to BPD, sROP, and cPVL. Avoiding prolonged MV reduced the risk of having at least 1 of the 3 morbidities by 37%. CONCLUSIONS BPD and sROP were most strongly associated. Most risk factors contributed to BPD, with differentially shared effects on sROP and cPVL. Prolonged MV was the only risk factor shared by all 3 morbidities, and avoiding it potentially reduced the risk of having at least 1 of them.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan.,Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.,Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yung-Chieh Lin
- Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan
| | - Shan-Tair Wang
- Institute of Gerontology, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan
| | - Chao-Ching Huang
- Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Pediatrics, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan
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Shen LM, Hou HF, Yao CY, Wang LW. Insignificant influence of the matrix on the melting of incoherently embedded tin and zinc nanoparticles. J Phys Condens Matter 2017; 29:035004. [PMID: 27869636 DOI: 10.1088/1361-648x/29/3/035004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
For studying the melting point depression of metals, isolated metallic nanoparticles embedded in a matrix are usually prepared by mechanical milling. Al is the main available matrix material. In this work, to explore possible alternative matrices for further investigation of melting, mechanically milled metal-nonmetal systems are developed, namely Sn-LiF, Zn-LiF and Zn-Al2O3. The outcome indicates that different matrices do not have a significantly different influence on the melting of Sn and Zn. Theoretical analyses of both the thermodynamics and kinetics of surface-induced melting may support this experimental finding.
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Wang LW, Lin YC, Tu YF, Wang ST, Huang CC. Isolated Cystic Periventricular Leukomalacia Differs from Cystic Periventricular Leukomalacia with Intraventricular Hemorrhage in Prevalence, Risk Factors and Outcomes in Preterm Infants. Neonatology 2017; 111:86-92. [PMID: 27643988 DOI: 10.1159/000448615] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/19/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cystic periventricular leukomalacia (cPVL) is the most severe white matter injury and is often associated with intraventricular hemorrhage (IVH) in preterm infants. OBJECTIVE The aim of this study was to investigate the prevalence, risk factors and neurodevelopmental outcomes of isolated cPVL and cPVL with low-grade and high-grade IVH in premature infants. METHODS From 2001 to 2012, 9,964 infants with <31 weeks' gestational age (GA) admitted to Taiwan hospitals were enrolled. cPVL was classified into three groups: isolated cPVL, cPVL with low-grade (I/II) IVH, and cPVL with high-grade (III) IVH. RESULTS Of 7,805 infants with complete ultrasound data, 286 (3.7%) had cPVL. Among the cPVL infants, 93 (32.5%) were isolated, 118 (41.3%) had low-grade IVH and 75 (26.2%) had high-grade IVH. The risk of cPVL with IVH was significantly higher among infants with <27 weeks' GA than those with ≥27 weeks' GA, in contrast to that of isolated cPVL. Using infants without cPVL and IVH as the reference group, the most significant predictor of isolated cPVL was neonatal sepsis (odds ratio 2.39; 95% confidence interval 1.52-3.77), while 5-min Apgar score <5 (2.50; 1.48-4.21) and prolonged mechanical ventilation (2.19; 1.42-3.42) were associated with cPVL with low-grade IVH, and GA <27 weeks (2.63; 1.56-4.42), pneumothorax (3.04; 1.40-6.65) and prolonged mechanical ventilation (3.36; 1.88-6.01) contributed to cPVL with high-grade IVH. cPVL infants with low-grade and high-grade IVH had a higher risk of abnormal neurodevelopmental outcomes than infants with isolated cPVL at the age of 24 months. CONCLUSIONS Isolated cPVL, cPVL with low-grade IVH and cPVL with high-grade IVH had different risk factors and neurodevelopmental outcomes, suggestive of different causal pathways.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Southern Taiwan University of Science and Technology, Tainan, Taiwan, ROC
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Lu TH, Huang TD, Wang JG, Wang LW, Alfano RR. Generation of flower high-order Poincaré sphere laser beams from a spatial light modulator. Sci Rep 2016; 6:39657. [PMID: 28000779 PMCID: PMC5175162 DOI: 10.1038/srep39657] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/24/2016] [Indexed: 11/09/2022] Open
Abstract
We propose and experimentally demonstrate a new complex laser beam with inhomogeneous polarization distributions mapping onto high-order Poincaré spheres (HOPSs). The complex laser mode is achieved by superposition of Laguerre-Gaussian modes and manifests exotic flower-like localization on intensity and phase profiles. A simple optical system is used to generate a polarization-variant distribution on the complex laser mode by superposition of orthogonal circular polarizations with opposite topological charges. Numerical analyses of the polarization distribution are consistent with the experimental results. The novel flower HOPS beams can act as a new light source for photonic applications.
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Affiliation(s)
- T H Lu
- Department of Physics, National Taiwan Normal University, 88 Tingchou Road, Sec. 4, Taipei 11677, Taiwan
| | - T D Huang
- Department of Physics, National Taiwan Normal University, 88 Tingchou Road, Sec. 4, Taipei 11677, Taiwan
| | - J G Wang
- Department of Physics, National Taiwan Normal University, 88 Tingchou Road, Sec. 4, Taipei 11677, Taiwan
| | - L W Wang
- Department of Physics, National Taiwan Normal University, 88 Tingchou Road, Sec. 4, Taipei 11677, Taiwan
| | - R R Alfano
- Institute for Ultrafast Spectroscopy and Lasers, Physics Department, The City College of New York of the City University of New York, New York, NY 10031, USA
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Wang LW, Meng XL, Guo XY, Zhao W, Wang ZY. [Influence of sevoflurane concentration and stimulation voltage on motor evoked potentials in intraspinal tumor surgery]. Beijing Da Xue Xue Bao Yi Xue Ban 2016; 48:297-303. [PMID: 27080285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the effects of increasing end-tidal concentrations of sevoflurane and increasing stimulation voltage on motor evoked potentials, so as to provide evidence in making anesthesia plan for intraspinal tumor surgery. METHODS In the study, 48 patients scheduled to undergo intraspinal tumor surgery [American Society of Anesthesiology,(ASA) I-II, 18-65 years old] were enrolled. After general anesthesia induction, the patients were assigned to receive sevoflurane anesthesia of increasing end-tidal concentration in the sequence of 0.0%, 0.5%, 1.0% and 1.5% respectively, under a background of propofol and remifentanil. All the observations were done before the important steps of surgery. Remifentanil infusion rate was 0.2 μg /(kg×min), while the propofol infusion rate was adjusted to maintain the bispectral index values within the range of 30-50. At each concentration, 4 stimulation voltages of 300 V, 400 V, 500 V and 600 V were employed to elicit motor evoked potentials (MEPs). The amplitude and latency of each MEP were compared. The success ratio was also recorded. RESULTS The concentration of sevoflurane and the stimulation voltage had impacts on the amplitude and latency of MEPs. Under each stimulation voltage, the MEPs amplitude decreased following increasing end-tidal sevoflurane concentrations, and significant differences were found in comparing 1.5% sevoflurane (left 20.50 μV, 70.71 μV, 135.97 μV, 190.00 μV , right 14.29 μV, 50.71 μV, 73.10 μV, 77.50 μV) with 0.0% sevoflurane (left 143.00 μV, 388.10 μV, 484.53 μV, 500.00 μV, right 176.00 μV, 407.60 μV, 384.35 μV, 451.00 μV) and 0.5% sevoflurane (left 100.00 μV, 362.57 μV, 444.05 μV, 435.00 μV, right 115.00 μV, 207.15 μV, 258.34 μV, 358.50 μV), left χ(2)= 27.46,P<0.01, right χ(2)= 60.49,P<0.01; left χ(2)= 20.73,P<0.01, right χ(2)= 55.05,P<0.01;left χ(2)= 34.25,P<0.01,right χ(2)=33.58,P<0.01;left χ(2)= 28.61,P<0.01 ,right χ(2)= 49.04,P<0.01; while there were no statistical differences in the latency changes (P=0.26). Under each end-tidal sevoflurane concentration, the MEPs amplitude increased following increasing stimulation voltages, and significant differences were found in comparing 300 V (left 143.00 μV, 100.00 μV, 61.50 μV, 20.50 μV , right 176.00 μV, 115.00 μV, 41.07 μV, 14.29 μV) with 400 V (left 388.10 μV, 362.57 μV, 198.81 μV, 70.71 μV, right 407.60 μV, 207.15 μV, 89.00 μV, 50.71 μV) and 500 V (left 484.53 μ V, 444.05 μV, 216.24 μV, 135.97 μV, right 384.35 μV, 258.34 μV, 187.50 μV, 73.10 μV) and 600 V (left 500.00 μV, 435.00 μV, 344.00 μV, 190.00 μV, right 451.00 μV, 385.50 μV, 156.00 μV, 77.50 μV), left χ(2)= 45.55,P<0.01, right χ(2)= 25.73,P<0.01; left χ(2)= 46.67,P<0.01, right χ(2)= 55.30,P<0.01;left χ(2)= 47.36,P<0.01,right χ(2)= 47.82,P<0.01; left χ(2)= 38.67,P<0.01, right χ(2)= 45.87,P<0.01; while the latencies were decreased, and significant differences were found in comparing 300 V with 400 V and 500 V and 600V(left F=7.50,P=0.01 , right F=13.33,P<0.01), but the differences had little clinical significance. The success ratio decreased by increasing end-tidal sevoflurane concentration, and significant differences were found in comparing 1.5% sevoflurane (left 43.8%,70.8%, 77.1%,81.3%, right 37.5%,60.4%,75.0%,66.7%) with 0.0% sevoflurane (left 79.2%,87.5%,95.8%,93.8%, right 75.0%,95.8%,95.8%, 95.8%) and 0.5% sevoflurane (left 72.9%,89.6%,95.8%,95.8%, right 66.7%,89.6%,95.8%, 97.9%); the success ratio increased by increasing stimulation voltage, and significant differences were found in comparing 300 V(left 79.2%,72.9%,62.5%,43.8%, right 75.0%,66.7%,60.4%, 37.5%)with 400 V(left 87.5% ,89.6%,77.1%,70.8% , right 95.8%,89.6%,79.2%,60.4%)and 500 V(left 95.8%,95.8%,91.7%,77.1%, right 95.8%,95.8%,81.3%,75.0%)and 600 V (left 93.8%, 95.8%,89.6%,81.3%, right 95.8%,97.9%,89.6%,66.7%), but there were no statistical differences in the success ratio of MEPs between the group with stimulation voltage of 600 V , end tidal sevoflurane concentration of 1.5% and the group with stimulation voltage of 300 V, end tidal sevoflurane concentration of 0.0% (P=0.22). CONCLUSION Sevoflurane inhibited MEPs in a dose-dependent manner. It can decrease the amplitudes and prolong the latencies. But increasing stimulation voltage will facilitate MEPs monitoring and increase the success ratio. Sevoflurane can be used in larger parts of MEPs monitoring surgery by increasing the stimulation voltage.
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Affiliation(s)
- L W Wang
- Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China
| | - X L Meng
- Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China
| | - X Y Guo
- Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China
| | - W Zhao
- Department of Neurosurgery, Peking University Third Hospital, Beijing 100191, China
| | - Z Y Wang
- Department of Neurosurgery, Peking University Third Hospital, Beijing 100191, China
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Tu YF, Wang LW, Wang ST, Yeh TF, Huang CC. Postnatal Steroids and Febrile Seizure Susceptibility in Preterm Children. Pediatrics 2016; 137:peds.2015-3404. [PMID: 27012746 DOI: 10.1542/peds.2015-3404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate risk factors, seizure characteristics, and outcomes of febrile seizure (FS) in children born very preterm. METHODS This study used a prospective registry data set of 844 preterm infants (birth weight <1500 g and gestational age <32 weeks) admitted to NICUs from 2001 to 2009 in southern Taiwan. We investigated the prevalence, risks, seizure patterns, and outcomes of FS in children aged 5 years. RESULTS Among 575 children (follow-up rate, 85.8%) followed up for 5 years, 35 (6.1%) developed FS. The FS and non-FS groups were comparable regarding their mean gestational age, birth weight, 5-minute Apgar score <6, and prenatal and postnatal complications. No difference was observed in the use of prenatal corticosteroids between the 2 groups. The FS group had a significantly higher rate of postnatal corticosteroid treatment than the non-FS group, even after adjusting for confounding factors (odds ratio, 5.4 [95% confidence interval, 1.9-15.8]; P = .006). No differences were observed in IQs or subsequent epilepsy rates between the 2 groups. Although no difference was observed in the age of FS onset or neurodevelopmental outcomes between the 2 groups, children with FS who received postnatal corticosteroid treatment had a significantly lower mean body temperature during the first FS attack compared with those who did not receive postnatal corticosteroid treatment (38.6 ± 0.4°C vs 39.2 ± 0.6°C; P = .034). CONCLUSIONS Children born very preterm have a higher rate of FS, and postnatal corticosteroid treatment was associated with FS susceptibility in these children.
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Affiliation(s)
- Yi-Fang Tu
- Department of Pediatrics, National Cheng Kung University Hospital, Institute of Clinical Medicine, and
| | - Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; and Departments of Pediatrics, College of Medicine, and
| | - Shan-Tair Wang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsu-Fu Yeh
- Departments of Pediatrics, College of Medicine, and
| | - Chao-Ching Huang
- Department of Pediatrics, National Cheng Kung University Hospital, Departments of Pediatrics, College of Medicine, and Department of Pediatrics, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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Wang LW, Jabbour A, Hayward CS, Furlong TJ, Girgis L, Macdonald PS, Keogh AM. Potential role of coenzyme Q10 in facilitating recovery from statin-induced rhabdomyolysis. Intern Med J 2016; 45:451-3. [PMID: 25827512 DOI: 10.1111/imj.12712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 02/01/2015] [Indexed: 11/30/2022]
Abstract
Rhabdomyolysis is a rare, but serious complication of statin therapy, and represents the most severe end of the spectrum of statin-induced myotoxicity. We report a case where coenzyme Q10 facilitated recovery from statin-induced rhabdomyolysis and acute renal failure, which had initially persisted despite statin cessation and haemodialysis. This observation is biologically plausible due to the recognised importance of coenzyme Q10 in mitochondrial bioenergetics within myocytes, and the fact that statins inhibit farnesyl pyrophosphate production, a biochemical step crucial for coenzyme Q10 synthesis. Coenzyme Q10 is generally well tolerated, and may potentially benefit patients with statin-induced rhabdomyolysis.
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Affiliation(s)
- L W Wang
- Department of Cardiology, St Vincent's Hospital, Darlinghurst, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia
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Howe TH, Sheu CF, Hsu YW, Wang TN, Wang LW. Predicting neurodevelopmental outcomes at preschool age for children with very low birth weight. Res Dev Disabil 2016; 48:231-241. [PMID: 26630614 DOI: 10.1016/j.ridd.2015.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 10/28/2015] [Accepted: 11/07/2015] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to examine predictors of neurodevelopmental outcome in very low birth weight children without major impairment at 5 years of age, as well as to identify the contribution of early neurodevelopmental assessment to preterm children's later developmental outcomes. The participants in this study included 126 children who were prematurely born with very low birth weight. Outcomes of the childrens' later development were measured in tests that factored cognitive function, motor performance, and adaptive behavior. The results indicated that more than 50% of full-scale intelligence and 30% of both motor performance and adaptive behavior at the age of 5 can be explained by four predictors. The four predictors include preterm children's medical complications at birth, maternal education, early motor assessments, and cognitive assessments. Adding each test score obtained in early ages provides additional information to predict children's cognitive, motor, and adaptive behavior at 5 years of age. Manifold assessments conducted in multiple time periods strengthen the predictive values of later developmental outcomes. In addition, the findings of this study indicate that very low birth weight children tend to have lower adaptive behavior at 5 years old. With regard to our findings, we believe that having adaptive function is a reflection of a child's overall integrated abilities. Further study is warranted to increase understanding of this topic, as well as to be able to predict adaptive strengths and weakness and pinpoint limiting factors that may be useful for targeting behaviors in intervention.
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Affiliation(s)
- Tsu-Hsin Howe
- Department of Occupational Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, United States
| | - Ching-Fan Sheu
- Institute of Education, National Cheng Kung University, Tainan City, Taiwan
| | - Yung-Wen Hsu
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Tien-Ni Wang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan.
| | - Lan-Wan Wang
- Department of Pediatrics, Chi-Mei Medical Center, Tainan City, Taiwan
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Wei R, Liu LS, Wang LW, Li YB, Zhang T, Liu J, Zuo SW, Jia SH, Song YX, Wu ZY, Duan C, Ge YY, Li HB, Xiong J, Jia X, Wang X, Kong W, Xu XP, Guo W, Huo Y. Association of Resting Heart Rate with Infrarenal Aortic Diameter: A Cross Sectional Study in Chinese Hypertensive Adults. Eur J Vasc Endovasc Surg 2015; 50:714-21. [PMID: 26474738 DOI: 10.1016/j.ejvs.2015.05.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/27/2015] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Elevated resting heart rate (RHR) has been shown to be a risk marker for cardiovascular disease. Results from studies on the effects of RHR in large arteries are limited to the functional changes of those arteries, while the association between RHR and aortic diameter remains largely understudied. METHODS This was a cross sectional study of hypertensive Chinese adults from rural areas. The maximum infrarenal aortic diameter (maxIAD) from renal arteries to the iliac bifurcation was obtained by ultrasound. MaxIADs in different RHR groups were compared in males and females separately because of the significant differences between sexes. Multiple regression analysis was used to determinate the correlation between RHR and maxIAD. Further interactions between three factors (BMI, smoking, and anti-hypertensive regimens) and RHR for maxIAD were examined using subgroup analysis. RESULTS 19,200 subjects were enrolled in the study, with an average age of 64.8±7.4 years and 61.6% females. Only 22 cases (0.11%) were detected with AAA, with males (n = 17) presenting a higher AAA incidence than females (n = 5). In subjects ≥65 years, there were 18 (0.19%) AAA, and 15 (83.3%) had a history of smoking. In the total subjects, the mean maxIAD ranged from 15.7±2.1 mm to 15.2±2.2 mm as RHR changed from the lowest quartile to the highest (≥84 bpm) in males, with a similar tendency observed in females. The correlation coefficient of RHR on maxIAD was -0.17 in males and -0.12 in females. Further subgroup analysis revealed that smoking exaggerated the correlation between RHR and maxIAD, but only in females. CONCLUSIONS A low AAA incidence was observed in this hypertensive Chinese population. There was a negative association between RHR and maxIAD, potentially exaggerated by smoking, especially in females.
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Affiliation(s)
- R Wei
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China; School of Medicine, Nankai University, Tianjin, People's Republic of China
| | - L S Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, People's Republic of China
| | - L W Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, People's Republic of China
| | - Y B Li
- National Clinical Research Center for Kidney Diseases, Southern Medical University, Guangzhou, People's Republic of China
| | - T Zhang
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China
| | - J Liu
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China
| | - S W Zuo
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China
| | - S H Jia
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China
| | - Y X Song
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China
| | - Z Y Wu
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China
| | - C Duan
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China; School of Medicine, Nankai University, Tianjin, People's Republic of China
| | - Y Y Ge
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China
| | - H B Li
- Institute of Biomedicine, Anhui Medical University, Hefei, People's Republic of China
| | - J Xiong
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China
| | - X Jia
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China
| | - X Wang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, People's Republic of China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, People's Republic of China
| | - W Kong
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing, People's Republic of China; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, People's Republic of China
| | - X P Xu
- Institute of Biomedicine, Anhui Medical University, Hefei, People's Republic of China
| | - W Guo
- Department of Vascular and Endovascular Surgery, General Hospital of People's Liberation Army, Beijing, People's Republic of China.
| | - Y Huo
- Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.
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Chen LW, Chen JS, Tu YF, Wang ST, Wang LW, Tsai YS, Huang CC. Age-dependent vulnerability of cyclosporine-associated encephalopathy in children. Eur J Paediatr Neurol 2015; 19:464-71. [PMID: 25769225 DOI: 10.1016/j.ejpn.2015.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 02/06/2015] [Accepted: 02/20/2015] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Cyclosporine (CsA) is an immunosuppressant known for its neurotoxicity, which presents with acute encephalopathy and seizures in the most severe form. However, whether there is age-related neurological susceptibility in pediatric population is poorly defined. The study aims to examine the vulnerability of CsA neurotoxicity among different age groups of pediatric patients in terms of occurrence rate, acute presentations, long-term outcomes, and neuroimaging findings. METHODS Pediatric patients (age <18 years) who received CsA in a tertiary referral center between July 1, 1988 and August 31, 2011 were retrospectively reviewed for CsA-related encephalopathy. The clinical presentations, demographic data, and laboratory examinations were analyzed through t-test for numerical and Fisher's exact test for categorical variables. Exact logistic regression was used to examine the effect of each variables. RESULTS Twelve (8%) of the enrolled 146 patients developed CsA-induced encephalopathy. Compared to the non-neurotoxicity group, the neurotoxicity group was significantly younger upon starting CsA (p = 0.008) and had higher percentages of hypertension after CsA treatment (p = 0.01). Regression analysis showed that age <6 years (OR 7.6, 95% CI 1.6-51.5; p = 0.007) and hypertension after CsA (OR 6.3, 95% CI 1.4-35.4; p = 0.016) were significantly associated with CsA encephalopathy. Younger children were prone to have more severe seizures in the acute stage and more epilepsy and neuropsychiatric disorders in the future. Follow-up neuroimaging showed parietal cerebral atrophy in all examined children <6 years of age. CONCLUSIONS Age-dependent susceptibility of CsA neurotoxicity occurs in children, with severe acute presentations and long-term sequelae in children below 6 years old.
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Affiliation(s)
- Li-Wen Chen
- Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan
| | - Jiann-Shiuh Chen
- Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan
| | - Yi-Fang Tu
- Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan
| | - Shan-Tair Wang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan; Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Shan Tsai
- Department of Diagnostic Radiology, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan
| | - Chao-Ching Huang
- Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan; Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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Wang LW, Kwan BCH, Glanville AR. Regional differences in ventilation-perfusion ratio may help explain the differential diagnosis in interstitial lung disease. Intern Med J 2015; 45:365-7. [PMID: 25735587 DOI: 10.1111/imj.12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 09/04/2014] [Indexed: 11/26/2022]
Affiliation(s)
- L W Wang
- St Vincent's Hospital, Sydney, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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Wang LW, Chang YC, Chen SJ, Tseng CH, Tu YF, Liao NS, Huang CC, Ho CJ. TNFR1-JNK signaling is the shared pathway of neuroinflammation and neurovascular damage after LPS-sensitized hypoxic-ischemic injury in the immature brain. J Neuroinflammation 2014; 11:215. [PMID: 25540015 PMCID: PMC4300587 DOI: 10.1186/s12974-014-0215-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 12/04/2014] [Indexed: 01/13/2023] Open
Abstract
Background Hypoxic-ischemia (HI) and inflammation are the two major pathogenic mechanisms of brain injury in very preterm infants. The neurovascular unit is the major target of HI injury in the immature brain. Systemic inflammation may worsen HI by up-regulating neuroinflammation and disrupting the blood–brain barrier (BBB). Since neurons and oligodendrocytes, microvascular endothelial cells, and microglia may closely interact with each other, there may be a common signaling pathway leading to neuroinflammation and neurovascular damage after injury in the immature brain. TNF-α is a key pro-inflammatory cytokine that acts through the TNF receptor (TNFR), and c-Jun N-terminal kinases (JNK) are important stress-responsive kinases. Objective To determine if TNFR1-JNK signaling is a shared pathway underlying neuroinflammation and neurovascular injury after lipopolysaccharide (LPS)-sensitized HI in the immature brain. Methods Postpartum (P) day-5 mice received LPS or normal saline (NS) injection before HI. Immunohistochemistry, immunoblotting and TNFR1- and TNFR2-knockout mouse pups were used to determine neuroinflammation, BBB damage, TNF-α expression, JNK activation, and cell apoptosis. The cellular distribution of p-JNK, TNFR1/TNFR2 and cleaved caspase-3 were examined using immunofluorescent staining. Results The LPS + HI group had significantly greater up-regulation of activated microglia, TNF-α and TNFR1 expression, and increases of BBB disruption and cleaved caspase-3 levels at 24 hours post-insult, and showed more cortical and white matter injury on P17 than the control and NS + HI groups. Cleaved caspase-3 was highly expressed in microvascular endothelial cells, neurons, and oligodendroglial precursor cells. LPS-sensitized HI also induced JNK activation and up-regulation of TNFR1 but not TNFR2 expression in the microglia, endothelial cells, neurons, and oligodendrocyte progenitors, and most of the TNFR1-positive cells co-expressed p-JNK. Etanercept (a TNF-α inhibitor) and AS601245 (a JNK inhibitor) protected against LPS-sensitized HI brain injury. The TNFR1-knockout but not TNFR2-knockout pups had significant reduction in JNK activation, attenuation of microglial activation, BBB breakdown and cleaved caspase-3 expression, and showed markedly less cortical and white matter injury than the wild-type pups after LPS-sensitized HI. Conclusion TNFR1-JNK signaling is the shared pathway leading to neuroinflammation and neurovascular damage after LPS-sensitized HI in the immature brain. Electronic supplementary material The online version of this article (doi:10.1186/s12974-014-0215-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, 710, Taiwan. .,Department of Pediatrics, College of Medicine, Taipei Medical University, #250, Wu-Hsing Street, Taipei, 11031, Taiwan. .,Department of Pediatrics, School of Medicine, Chung Shan Medical University, Taichung, 402, Taiwan.
| | - Ying-Chao Chang
- Department of Pediatrics, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan.
| | - Shyi-Jou Chen
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, 114, Taiwan.
| | - Chien-Hang Tseng
- Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 704, Taiwan.
| | - Yi-Fang Tu
- Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 704, Taiwan.
| | - Nan-Shih Liao
- Institute of Molecular Biology, Academia Sinica, Taipei, 115, Taiwan.
| | - Chao-Ching Huang
- Department of Pediatrics, College of Medicine, Taipei Medical University, #250, Wu-Hsing Street, Taipei, 11031, Taiwan. .,Department of Pediatrics, Wan-Fang Hospital, Taipei Medical University, Taipei, 110, Taiwan. .,Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 704, Taiwan.
| | - Chien-Jung Ho
- Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 704, Taiwan.
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Wang LW, Lin YC, Wang ST, Yeh TF, Huang CC. Hypoxic/ischemic and infectious events have cumulative effects on the risk of cerebral palsy in very-low-birth-weight preterm infants. Neonatology 2014; 106:209-15. [PMID: 25012626 DOI: 10.1159/000362782] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 04/10/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Hypoxia/ischemia and inflammation are two major mechanisms for cerebral palsy (CP) in preterm infants. OBJECTIVE To investigate whether hypoxia/ischemia- and infection-related events in the perinatal and neonatal periods had cumulative effects on CP risk in very-low-birth-weight (VLBW) premature infants. METHODS From 1995 to 2005, 5,807 VLBW preterm infants admitted to Taiwan hospitals were enrolled. The cumulative effects of hypoxic/ischemic and infectious events during the perinatal and neonatal periods on CP risk at corrected age 24 months were analyzed. RESULTS Of the 4,355 infants with 24-month follow-up, 457 (10.5%) had CP. The CP group had significantly higher incidences of hypoxia/ischemia-related events in the perinatal and neonatal periods, and sepsis in the neonatal period than the normal group. Three hypoxic/ischemic events, including birth cardiopulmonary resuscitation (OR 2.25; 95% CI 1.81-2.82), patent ductus arteriosus (PDA) ligation (2.94; 1.35-5.75) and chronic lung disease (3.14; 2.61-3.85) had the most significant contribution to CP. Relative to CP risk for infants with neither the three hypoxic/ischemic events nor sepsis, the CP odds increased 1.98-, 2.26- and 2.15-fold for infants with birth cardiopulmonary resuscitation, PDA ligation and chronic lung disease, respectively; while the combination with sepsis further increased the odds to 3.18-, 3.83- and 3.25-fold, respectively. Using the three hypoxic/ischemic events plus sepsis, CP rates were 10.0, 16.7, 26.7, 40.0 and 54.7% for infants with none, one, two, three and four events, respectively. CONCLUSIONS Hypoxic/ischemic and infectious events across the perinatal and neonatal periods exerted cumulative effects on CP risk in VLBW premature infants.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan, ROC
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Wu CC, Chen YC, Chang YC, Wang LW, Lin YC, Chiang YL, Ho CJ, Huang CC. Human umbilical vein endothelial cells protect against hypoxic-ischemic damage in neonatal brain via stromal cell-derived factor 1/C-X-C chemokine receptor type 4. Stroke 2013; 44:1402-9. [PMID: 23449265 DOI: 10.1161/strokeaha.111.000719] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Agents that protect against neurovascular damage provide a powerful neuroprotective strategy. Human umbilical vein endothelial cells (HUVECs) may be used to treat neonates with hypoxic-ischemia (HI) because of its autologous capability. We hypothesized that peripherally injected HUVECs entered the brain after HI, protected against neurovascular damage, and provided protection via stromal cell-derived factor 1/C-X-C chemokine receptor type 4 pathway in neonatal brain. METHODS Postpartum day 7 rat pups received intraperitoneal injections of low-passage HUVEC-P4, high-passage HUVEC-P8, or conditioned medium before and immediately after HI. HUVECs were transfected with adenovirus-green fluorescent protein for cell tracing. Oxygen-glucose deprivation was established by coculturing HUVEC-P4 with mouse neuroblastoma neuronal cells (Neuro-2a) and with mouse immortalized cerebral vascular endothelial cells (b.End3). RESULTS HUVEC-P4-treated group had more blood levels of green fluorescent protein-positive cells than HUVEC-P8-treated group 3 hours postinjection. Intraperitoneally injected HUVEC-P4, but not HUVEC-P8, entered the cortex after HI and positioned closed to the neurons and microvessels. Compared with the condition medium-treated group, the HUVEC-P4-treated but not the HUVEC-P8-treated group showed significantly less neuronal apoptosis and blood-brain barrier damage and more preservation of microvessels in the cortex 24 hours after HI. On postpartum day 14, the HUVEC-P4-treated group showed significant neuroprotection compared with the condition medium-treated group. Stromal cell-derived factor 1 was upregulated in the ipsilateral cortex 3 hours after HI, and inhibiting the stromal cell-derived factor 1/C-X-C chemokine receptor type 4 reduced the protective effect of HUVEC-P4. In vitro transwell coculturing of HUVEC-P4 also significantly protected against oxygen-glucose deprivation cell death in neurons and endothelial cells. CONCLUSIONS Cell therapy using HUVECs may provide a powerful therapeutic strategy in treating neonates with HI.
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Affiliation(s)
- Chia-Ching Wu
- Department of Cell Biology and Anatomy, National Cheng Kung University Hospital, No. 138 Sheng-Li Rd, Tainan City 704, Taiwan
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Wang LW, Tu YF, Huang CC, Ho CJ. JNK signaling is the shared pathway linking neuroinflammation, blood-brain barrier disruption, and oligodendroglial apoptosis in the white matter injury of the immature brain. J Neuroinflammation 2012; 9:175. [PMID: 22805152 PMCID: PMC3414763 DOI: 10.1186/1742-2094-9-175] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 07/17/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND White matter injury is the major form of brain damage in very preterm infants. Selective white matter injury in the immature brain can be induced by lipopolysaccharide (LPS)-sensitized hypoxic-ischemia (HI) in the postpartum (P) day 2 rat pups whose brain maturation status is equivalent to that in preterm infants less than 30 weeks of gestation. Neuroinflammation, blood-brain barrier (BBB) damage and oligodendrocyte progenitor apoptosis may affect the susceptibility of LPS-sensitized HI in white matter injury. c-Jun N-terminal kinases (JNK) are important stress-responsive kinases in various forms of insults. We hypothesized that LPS-sensitized HI causes white matter injury through JNK activation-mediated neuroinflammation, BBB leakage and oligodendroglial apoptosis in the white matter of P2 rat pups. METHODS P2 pups received LPS (0.05 mg/kg) or normal saline injection followed by 90-min HI. Immunohistochemistry and immunoblotting were used to determine microglia activation, TNF-α, BBB damage, cleaved caspase-3, JNK and phospho-JNK (p-JNK), myelin basic protein (MBP), and glial fibrillary acidic protein (GFAP) expression. Immunofluorescence was performed to determine the cellular distribution of p-JNK. Pharmacological and genetic approaches were used to inhibit JNK activity. RESULTS P2 pups had selective white matter injury associated with upregulation of activated microglia, TNF-α, IgG extravasation and oligodendroglial progenitor apoptosis after LPS-sensitized HI. Immunohistochemical analyses showed early and sustained JNK activation in the white matter at 6 and 24 h post-insult. Immunofluorescence demonstrated upregulation of p-JNK in activated microglia, vascular endothelial cells and oligodendrocyte progenitors, and also showed perivascular aggregation of p-JNK-positive cells around the vessels 24 h post-insult. JNK inhibition by AS601245 or by antisense oligodeoxynucleotides (ODN) significantly reduced microglial activation, TNF-α immunoreactivity, IgG extravasation, and cleaved caspase-3 in the endothelial cells and oligodendrocyte progenitors, and also attenuated perivascular aggregation of p-JNK-positive cells 24 h post-insult. The AS601245 or JNK antisense ODN group had significantly increased MBP and decreased GFAP expression in the white matter on P11 than the vehicle or scrambled ODN group. CONCLUSIONS LPS-sensitized HI causes white matter injury through JNK activation-mediated upregulation of neuroinflammation, BBB leakage and oligodendrocyte progenitor apoptosis in the immature brain.
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Affiliation(s)
- Lan-Wan Wang
- Institute of Clinical Medicine, National Cheng Kung University College of Medicine, 35 Hsiao-Tung Road, North District, 704, Tainan, Taiwan
- Department of Pediatrics, Chi Mei Medical Center, 901 Chung-Hua Road, Yung-Kang Disctrict, 710, Tainan, Taiwan
| | - Yi-Fang Tu
- Departments of Emergency Medicine, National Cheng Kung University College of Medicine and Hospital, 138 Sheng-Li Road, 704, Tainan, Taiwan
| | - Chao-Ching Huang
- Institute of Clinical Medicine, National Cheng Kung University College of Medicine, 35 Hsiao-Tung Road, North District, 704, Tainan, Taiwan
- Departments of Pediatrics, National Cheng Kung, University College of Medicine and Hospital, 138 Sheng-Li Road, 704, Tainan, Taiwan
| | - Chien-Jung Ho
- Departments of Pediatrics, National Cheng Kung, University College of Medicine and Hospital, 138 Sheng-Li Road, 704, Tainan, Taiwan
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Zhao JH, Zhang YL, Wang LW, Wang JY, Zhang CL. Bioactive secondary metabolites from Nigrospora sp. LLGLM003, an endophytic fungus of the medicinal plant Moringa oleifera Lam. World J Microbiol Biotechnol 2012; 28:2107-12. [PMID: 22806033 DOI: 10.1007/s11274-012-1015-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 01/30/2012] [Indexed: 11/28/2022]
Affiliation(s)
- J H Zhao
- College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou 310014, People's Republic of China
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Tu YF, Tsai YS, Wang LW, Wu HC, Huang CC, Ho CJ. Overweight worsens apoptosis, neuroinflammation and blood-brain barrier damage after hypoxic ischemia in neonatal brain through JNK hyperactivation. J Neuroinflammation 2011; 8:40. [PMID: 21518436 PMCID: PMC3090337 DOI: 10.1186/1742-2094-8-40] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 04/25/2011] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Apoptosis, neuroinflammation and blood-brain barrier (BBB) damage affect the susceptibility of the developing brain to hypoxic-ischemic (HI) insults. c-Jun N-terminal kinase (JNK) is an important mediator of insulin resistance in obesity. We hypothesized that neonatal overweight aggravates HI brain damage through JNK hyperactivation-mediated upregulation of neuronal apoptosis, neuroinflammation and BBB leakage in rat pups. METHODS Overweight (OF) pups were established by reducing the litter size to 6, and control (NF) pups by keeping the litter size at 12 from postnatal (P) day 1 before HI on P7. Immunohistochemistry and immunoblotting were used to determine the TUNEL-(+) cells and BBB damage, cleaved caspase-3 and poly (ADP-ribose) polymerase (PARP), and phospho-JNK and phospho-BimEL levels. Immunofluorescence was performed to determine the cellular distribution of phospho-JNK. RESULTS Compared with NF pups, OF pups had a significantly heavier body-weight and greater fat deposition on P7. Compared with the NF-HI group, the OF-HI group showed significant increases of TUNEL-(+) cells, cleaved levels of caspase-3 and PARP, and ED1-(+) activated microglia and BBB damage in the cortex 24 hours post-HI. Immunofluorescence of the OF-HI pups showed that activated-caspase 3 expression was found mainly in NeuN-(+) neurons and RECA1-(+) vascular endothelial cells 24 hours post-HI. The OF-HI group also had prolonged escape latency in the Morris water maze test and greater brain-volume loss compared with the NF-HI group when assessed at adulthood. Phospho-JNK and phospho-BimEL levels were higher in OF-HI pups than in NF-HI pups immediately post-HI. JNK activation in OF-HI pups was mainly expressed in neurons, microglia and vascular endothelial cells. Inhibiting JNK activity by AS601245 caused more attenuation of cleaved caspase-3 and PARP, a greater reduction of microglial activation and BBB damage post-HI, and significantly reduced brain damage in OF-HI than in NF-HI pups. CONCLUSIONS Neonatal overweight increased HI-induced neuronal apoptosis, microglial activation and BBB damage, and aggravated HI brain damage in rat pups through JNK hyperactivation.
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Affiliation(s)
- Yi-Fang Tu
- Institute of Clinical Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan
- Department of Emergency Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Yau-Sheng Tsai
- Institute of Clinical Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan
| | - Lan-Wan Wang
- Institute of Clinical Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Hsin-Chieh Wu
- Department of Pediatrics, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Chao-Ching Huang
- Institute of Clinical Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan
- Department of Pediatrics, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Chien-Jung Ho
- Department of Pediatrics, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
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Dubey R, Wang LW, Figueira EC, Amjadi S, Brown TM, Younan NM, Wilcsek G, Francis IC. Management of marginal chalazia: a surgical approach. Br J Ophthalmol 2009; 95:590,596-7. [PMID: 19661071 DOI: 10.1136/bjo.2008.146704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- R Dubey
- Department of Ophthalmology, Prince of WalesHospital, Randwick, New South Wales, Australia
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Wang LW, Lee KJY, Masselos K, Brown TM, Figueira EC, Francis IC. Management of angle-closure glaucoma in East Asian eyes: a response to argon laser iridotomy-induced bullous keratopathy, a growing problem in Japan. Br J Ophthalmol 2008; 92:1300; author reply 1300-1. [PMID: 18723753 DOI: 10.1136/bjo.2008.138628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
AIM To determine the developmental trajectories of very-low-birthweight (VLBW) infants during the first 2 years of life, and investigate the most contributory predictors of diverse trajectories. METHODS This prospective cohort study enrolled 887 VLBW infants from January 1999 to December 2002 with regular follow-up at corrected age of 6, 12, 18 and 24 months. Sociodemographic and medical data were collected, and the outcome measures consisted of neurological assessment and the Bayley Scales of Infant Development-II. RESULTS Five trajectories of cognitive development based on the mental developmental indices from the age of 6 to 24 months were determined, including average-stable (group A, 20.1%), average-decline to borderline delay (group B, 34%), borderline delay-catch-up to average (group C, 20.2%), borderline delay-decline to significant delay (group D, 17.2%) and significant delay-stable (group E, 8.5%). Using group A as the reference category, we determined 6-month neurological status and maternal education as the most significant predictors for various trajectories (p < 0.01). Infants with transient or definite neurological abnormality and/or low maternal education had higher odds of displaying the disadvantageous trajectories (group B, D and E; odds ratios, 1.79-46.4). CONCLUSION VLBW infants with neurological abnormalities and/or low maternal education had high risk of developmental decline and might benefit from early intervention.
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Affiliation(s)
- Lan-Wan Wang
- Department of Pediatrics, Chi Mei Medical Center; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Chen LX, Zhu LY, Jacob TJC, Wang LW. Roles of volume-activated Cl- currents and regulatory volume decrease in the cell cycle and proliferation in nasopharyngeal carcinoma cells. Cell Prolif 2007; 40:253-67. [PMID: 17472731 PMCID: PMC6496325 DOI: 10.1111/j.1365-2184.2007.00432.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Previously it has been shown, that the volume-activated plasma membrane chloride channel is associated with regulatory volume decrease (RVD) of cells and may play an important role in control of cell proliferation. We have demonstrated that both expression of the channel and RVD capacity are actively regulated in the cell cycle. In this study, we aimed to further study the role of the volume-activated chloride current and RVD in cell cycle progression and overall in cell proliferation. MATERIALS AND METHODS Whole-cell currents, RVD, cell cycle distribution, cell proliferation and cell viability were measured or detected with the patch-clamp technique, the cell image analysis technique, flow cytometry, the MTT assay and the trypan blue assay respectively, in nasopharyngeal carcinoma cells (CNE-2Z cells). RESULTS The Cl- channel blockers, 5-nitro-2-(3-phenylpropylamino) benzoic acid (NPPB) and tamoxifen, inhibit the volume-activated chloride current, RVD and proliferation of CNE-2Z cells in a dose-dependent manner. Analysis of relationships between the current, RVD and cell proliferation showed that both the current and RVD were positively correlated with cell proliferation. NPPB (100 microM) and tamoxifen (20 microM) did not significantly induce cell death, but inhibited cell proliferation, implying that the blockers may inhibit cell proliferation by affecting cell cycle progression. This was verified by the observation that tamoxifen (20 microM) and NPPB (100 microM) inhibited cell cycle progress and arrested cells at the G0/G1 phase boundary. CONCLUSIONS Activity of the volume-activated chloride channel is one of the important factors that regulate the passage of cells through the G1 restriction point and that the Cl- current associated with RVD plays an important role in cell proliferation.
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Affiliation(s)
- L X Chen
- Medical College, Jinan University, Guangzhou, China
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