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Risk factors and metabolic abnormality of patients with non-alcoholic fatty liver disease: Either non-obese or obese Chinese population

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Hepatobiliary & Pancreatic Diseases International 2018年第1期17卷 45-48页

作者： Shou-Wu Lee Teng-Yu Lee Sheng-Shun Yang Chun-Fang Tung hong-zen yeh Chi-Sen Chang Division of Gastroenterology Department of Internal Medicine Taichung Veterans General Hospital

Background: Non-alcoholic fatty liver disease(NAFLD) occurs not only in obese individuals but also in non-obese ones. The aim of this study was to focus on the association between NAFLD and metabolic events in a non-obese or obese Chinese ***: Data collected from subjects registered at Taichung Veterans General Hospital from January to December 2009 were analyzed. The exclusion criteria were alcoholics, chronic hepatitis B or C. Patients included in analyses were assigned to four groups according to sonography of their liver(normal or NAFLD), and body mass index(BMI) levels(non-obese if BMI < 25 kg/m~2 or obese if BMI ≥ 25 kg/m~2).Results: There were 745, 208, 770 and 285 patients enrolled in four groups labeled non-obese normal liver(group A), non-obese NAFLD(group B), obese normal liver(group C) and obese NAFLD(group D),respectively. The highest ratio of metabolic syndrome existed in the group B(26.9%), followed by group A(11.7%), group D(10.9%) and finally the group C(5.2%). The positive association with NAFLD in non-obese individuals was significant in triglyceride(OR = 1.01; 95% CI: 1.01–1.02) and glucose(OR = 1.02; 95% CI:1.01–1.03), while the positive association with NAFLD in obese subjects was only significant in triglyceride(OR = 1.01; 95% CI: 1.01–1.02). The positive association was most significant in all cases(adjusted OR = 2.41; 95% CI: 1.78–3.24), especially in non-obese individuals(OR = 2.81; 95% CI: 1.92–4.12).Conclusions: Non-obese NAFLD subjects displayed a higher proportion of metabolic abnormality. Hyperlipidemia and hyperglycemia had the most positive strength association with NAFLD.

关键词： Fatty liver Non-alcoholic fatty liver disease Obese Chinese population

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The association of non-alcoholic fatty liver disease and metabolic syndrome in a Chinese population

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Hepatobiliary & Pancreatic Diseases International 2017年第2期16卷 176-180页

作者： Shou-Wu Lee Teng-Yu Lee Sheng-Shun Yang Yen-Chun Peng hong-zen yeh Chi-Sen Chang Division of Gastroenterology Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan China

BACKGROUND： Non-alcoholic fatty liver disease（NAFLD） is associated with features of metabolic syndrome. The aim of this study was to investigate the association between NAFLD and metabolic syndrome in a Chinese population. METHODS： Data from subjects were retrospectively collected from 2006 to 2009. The exclusion criteria included significant consumption of alcohol and chronic hepatitis B and C. The patients were assigned to two groups according to ultrasound findings： normal group and fatty liver group. The liver function of patients was determined by assessing serum alanine aminotransferase（ALT）. Metabolic syndrome was diagnosed based on the 2005 International Diabetes Federation criteria. RESULTS： A total of 7568 subjects were enrolled and 5736（75.8%） and 1832（24.2%） patients were assigned to the normal and fatty liver groups, respectively. The fatty liver group had significant male predominance（69.7% vs 56.0%）, higher body mass index（mean, 26.67 vs 23.55 kg/m^2） compared with the normal group. There were 441（7.7%） and 377（20.6%） cases with metabolic syndrome in the normal and fatty liver groups, respectively, with significant difference（P=0.001）, and the subgroup of 385 cases with fatty liver and elevated ALT had higher prevalence（28.8%） of metabolic syndrome. The strongest association of an individual component of metabolic syndrome with NAFLD was hyperlipidemia（adjusted OR=2.55, 95% CI： 2.22-2.94）.CONCLUSION： The individuals with NAFLD had a higher ratio of metabolic syndrome. Hyperlipidemia had the strongest positive association with NAFLD.

关键词： fatty liver hyperlipidemia metabolic syndrome

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Relationship between use of selective serotonin reuptake inhibitors and irritable bowel syndrome: A populationbased cohort study

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World Journal of Gastroenterology 2017年第19期23卷 3513-3521页

作者： Wan-Tzu Lin Yi-Jun Liao Yen-Chun Peng Chung-Hsin Chang Ching-Heng Lin hong-zen yeh Chi-Sen Chang Division of Gastroenterology and Hepatology Department of Internal MedicineTaichung Veterans General Hospital Division of Gastroenterology and Hepatology Department of Internal MedicinePuli Branch of Taichung Veterans General Hospital Faculty of Medicine College of MedicineNational Yang-Ming University Taichung Veteran General Hospital

AIM To investigate the relationship between selective serotonin reuptake inhibitor(SSRI)use and the subsequent development of irritable bowel syndrome(IBS).METHODS This retrospective,observational,population-based cohort study collected data from Taiwan’s National Health Insurance Research Database.A total of 19653patients newly using SSRIs and 78612 patients not using SSRIs,matched by age and sex at a ratio of 1:4, were enrolled in the study from January 1,2000 to December 31,*** patients were followed until IBS diagnosis,withdrawal from the National Health Insurance system,or the end of *** analyzed the effects of SSRIs on the risk of subsequent IBS using Cox proportional hazards regression *** A total of 236 patients in the SSRI cohort(incidence,2.17/1000 person-years)and 478 patients in the comparison cohort(incidence,1.04/1000 person-years)received a new diagnosis of *** mean follow-up period from SSRI exposure to IBS diagnosis was *** incidence of IBS increased with advancing *** with anxiety disorders had a significantly increased adjusted hazard ratio(a HR)of IBS(a HR=1.33,95%CI:1.11-1.59,P=0.002).After adjusting for sex,age,urbanization,family income,area of residence,occupation,the use of anti-psychotics and other comorbidities,the overall a HR in the SSRI cohort compared with that in the comparison cohort was1.74(95%CI:1.44-2.10;P<0.001).The cumulative incidence of IBS was higher in the SSRI cohort than in the non-SSRI cohort(log-rank test,P<0.001).CONCLUSION SSRI users show an increased risk of subsequent diagnosis of IBS in Taiwan.

关键词： Brain-gut axis Irritable bowel syndrome Selective serotonin reuptake inhibitor

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Risk factors and therapeutic response in Chinese patients with peptic ulcer disease

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World Journal of Gastroenterology 2010年第16期16卷 2017-2022页

作者： Shou-Wu Lee Teng-Yu Lee hong-zen yeh Chun-Fang Tung Yen-Chun Peng Division of Gastroenterology and Hepatology Department of Internal MedicineTaichung Veterans General Hospital

AIM:To assess the risk factors and the eff icacy of medications of patients with gastric and duodenal ulcers among Chinese patients in ***:Patients with peptic ulcers,diagnosed by upper endoscopy,were retrospectively collected between January 2008 and December *** differences were ***:Among all 448 cases,254(56.6%) and 194(43.4%) patients had gastric ulcers and duodenal ulcers *** with gastric ulcers were younger than those with duodenal *** more men existed,there was a female predominance in middle-aged *** with duodenal ulcers had a higher rate of Helicobacter pylori(***) infection(62.4% vs 43.3%,P = 0.001),and those with gastric ulcers owned a significantly higher amount of aspirin and nonsteroidal anti-inflammatory drug(NSAID) use(7.5% vs 1.5%,6.7% vs 2.1%,P = 0.001).Tobacco smoking and alcohol drinking had no different impact between these two ***-pump inhibitors and H2-receptor antagonists(H2RA) were effective,but significantly less so in cases with duodenal ulcers receiving H2RAs,or in those with *** infection and a history of NSAID ***:Patients with gastric ulcers had lower *** infection but more aspirin or NSAID *** therapy was ineffective in gastric ulcers underwent H2RA treatment,and cases combined *** infection and NSAID use.

关键词： Epidemiology Peptic ulcer disease Therapy

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Etiologies of Dyspepsia among a Chinese Population: One Hospital-Based Study

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Open Journal of Gastroenterology 2014年第6期4卷 249-254页

作者： Shou-Wu Lee Han-Chung Lien Teng-Yu Lee Sheng-Shun Yang hong-zen yeh Chi-Sen Chang Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei

Background and Methods: Dyspepsia refers to a collection of upper gastrointestinal symptoms, and the causes may be either organic or functional. The aim of this study was to investigate the etiologies of dyspepsia among a Chinese population in Taiwan. Patients who underwent upper endoscopy for symptoms of dyspepsia were retrospectively analyzed between January and December 2008. Exclusion criteria included cirrhosis with varices, heart-burn sensation as the main symptom, gastrointestinal bleeding, hepatobiliary abnormalities, prior gastric surgery, and use of anti-acid medication for more than 2 months. Patients were classified according to the findings of upper endoscopy. Results: Data from the medical records of 2062 patients were collected and retrospectively analyzed. Normal endoscopic findings, gastritis, gastric ulcers, duodenal ulcers, reflux esophagitis and esophageal or gastric malignancy accounted for 1174 (56.9%), 215 (10.4%), 254 (12.3%), 194 (9.4%), 182 (8.8%) and 43 (2.1%) cases, respectively. The overall ratio of H. pylori infection was 28.4%. The ratio was the highest in duodenal ulcers and the lowest in reflux esophagitis. A significantly higher ratio of patients with gastric ulcers had a history of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) usage. Conclusion: Patients with organic dyspepsia, compared to those with functional dyspepsia, were older, male, and had a higher H. pylori infection ratio, a positive relationship with aspirin or NSAIDs usage, and more risk factors. These findings demonstrate that upper endoscopy has a high diagnostic yield in patients in this group.

关键词： Duodenal Ulcer Dyspepsia Gastric Ulcer Gastritis Malignancy

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The impact of intravenous cefazolin to the outcomes of cirrhotic patients with esophageal varices bleeding

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Open Journal of Gastroenterology 2013年第3期3卷 190-195页

作者： Shou-Wu Lee Teng-Yu Lee Sheng-Shun Yang Chung-Wang Ko hong-zen yeh Chi-Sen Chang Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei Department of Internal Medicine Chung Shan Medical University Taichung Chinese Taipei Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei Department of Internal Medicine Chung Shan Medical University Taichung Chinese Taipei Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei Department of Internal Medicine Yang-Ming University School of Medicine Taipei Chinese Taipei

Background and Method: Prophylatic antibiotics in cirrhotic patients with acute esophageal varices (EV) bleeding has been shown to increase survival and decrease the rate of bacterial infections and recurrent bleeding. This study aimed to compare the outcome of intravenous cefazolin, a first-generation cephalosporin, in the cirrhotic patients with EV bleeding. 92 consecutive cirrhotic patients with EV bleeding but without evidence of infection were retrospectively analyzed from December 2006 to February 2009, and 50 with cefazolin prophylaxis and 42 without antibiotic prophylaxis were enrolled in the antibiotic prophylaxis group and control group respectively. The outcomes were compared between both groups. Results: The incidence of infection was significantly lesser in the antibiotic prophylaxis group than that of the control group (6% vs. 33.3%, P prophylaxis group when compared with control group (6.6 vs. 7.8 days). Conclusion: Intravenous cefazolin can effectively reduce the rate of infection in cirrhotic patients with acute EV bleeding, but cannot significant benefit for preventing recurrent EV bleeding and mortality within 10 days after initial bleeding.

关键词： Cirrhosis Esophageal Variceal Hemorrhage Mortality Rebleeding

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Transarterial embolization of metastatic mediastinal hepatocellular carcinoma

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World Journal of Gastroenterology 2013年第22期19卷 3512-3516页

作者： Chia-Chang Chen hong-zen yeh Chi-Sen Chang ChungWang Ko Han-Chung Lien Chun-Ying Wu Siu-Wan Hung Department of Gastroenterology and Hepatology Taichung Veterans General Hospital Department of Radiology Taichung Veterans General Hospital

This paper introduces an innovative treatment for extrahepatic metastasis of hepatocellular carcinoma. A 71-yearold patient had a stable liver condition following treatment for hepatocellular carcinoma, but later developed symptomatic mediastinal metastasis. This rapidly growing mediastinal mass induced symptoms including cough and hoarseness. Serial sessions of transarterial embolization (TAE) successfully controlled this mediastinal mass with limited side effects. The patient's survival time since the initial diagnosis of the mediastinal hepatocellular carcinoma was 32 mo, significantly longer than the 12 mo mean survival period of patients with similar diagnoses: metastatic hepatocellular carcinoma and a liver condition with a Child-Pugh class A score. Currently, oral sorafenib is the treatment of choice for metastatic hepatocellular carcinoma. Recentstudies indicate that locoregional treatment of extrahepatic metastasis of hepatocellular carcinomas might also significantly improve the prognosis in patients with their primary hepatic lesions under control. Many effective locoregional therapies for extrahepatic metastasis, including radiation and surgical resection, may provide palliative effects for hepatocellular carcinoma-associated mediastinal metastasis. This case report demonstrates that TAE of metastatic mediastinal hepatocellular carcinoma provided this patient with tumor control and increased survival time. This finding is important as it can potentially provide an alternative treatment option for patients with similar symptoms and diagnoses.

关键词： Embolization Hepatocellular carcinoma Lymphatic metastasis Endosonography Mediastinal neoplasm

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Adjuvant heparanase inhibitor PI-88 therapy for hepatocellular carcinoma recurrence

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World Journal of Gastroenterology 2014年第32期20卷 11384-11393页

作者： Chun-Jen Liu Juliana Chang Po-Huang Lee Deng-Yn Lin Cheng-Chung Wu Long-Bin Jeng Yih-Jyh Lin King-Tong Mok Wei-Chen Lee hong-zen yeh Ming-Chih Ho Sheng-Shun Yang Mei-Due Yang Ming-Chin Yu Rey-Heng Hu Cheng-Yuan Peng Kuan-Lang Lai Stanley Shi-Chung Chang Pei-Jer Chen Graduate Institute of Clinical Medicine Hepatitis Research Center and Department of Internal Medicine National Taiwan University College of Medicine and National Taiwan University Hospital Chang Gung Memorial Hospital-Linkou Medical Center and Chang Gung University Taichung Veterans General Hospital China Medical University Hospital National Cheng Kung University Hospital Kaohsiung Veterans General Hospital Medigen Biotechnology Corporation

AIM: To demonstrate that administering heparanase inhibitor PI-88 at 160 mg/d is safe and promising in reducing hepatocellular carcinoma (HCC) recurrence for up to 3 year following curative resection.

关键词： Antiangiogenesis Antimetastasis Adjuvant therapy Disease-free survival Heparanase inhibitor Hepatocellular carcinoma PI-88 Tumor recurrence

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Lipocoacervate,a tunable vesicle for protein delivery

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Nano Research 2024年第10期17卷 9135-9140页

作者： Chia-Wei yeh Nathaniel Wright Chelsea Loh Nabeen Chu Yadong Wang Nancy E.and Peter C.Meinig School of Biomedical Engineering Cornell UniversityKimball Hall 290Ithaca 14853USA Human Biology Healthand Society.College of Human EcologyCornell UniversityIthaca 14853USA

Controlled delivery of proteins and other biologics is a growing medium of therapy for diseases previously *** we report a self-assembling,tunable vesicle for the controlled delivery of growth factors and *** made of heparin and a biocompatible polycation,PEAD,forms the core of the vesicle;lipids form the membrane of the *** call this vesicle lipocoacervate(LipCo),which has a high affinity for growth factors and cytokines due to *** is a tunable protein delivery *** vesicle size is controlled through polymer and salt *** functionalization enables potential for targeting capabilities with long-term storage through ***,the controlled delivery of therapeutics also avoids high toxicity to treated cells in *** we report on these key principles of LipCo assembly and design.

关键词： complex coacervate drug delivery protein delivery heparin lipid particle

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Geophysical fluid dynamics in the hypergravity field

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Acta Mechanica Sinica 2024年第6期40卷 3-10页

作者： Harry yeh School of Civil&Construction Engineering Oregon State UniversityCorvallisOR97331USA

Hypergravity can be realized by creating a field imposed by centripetal acceleration in a centrifuge *** an apparatus is often used to test soil response in geotechnical engineering *** we present the potential usage of a centrifuge apparatus to study various topics in *** scaling law associated with hydrodynamics is first reviewed,and the advantage of controlling the body force is *** of the perceived disadvantages in such experiments is the unwanted presence of the Coriolis effect in the ***,we propose exploiting this effect to our advantage to study geophysical fluid-dynamic problems that occur particularly in the equatorial region.

关键词： Hypergravity Scaling Geophysical fluid dynamics Centrifuge

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