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Serum insulin, insulin resistance, p-cell dysfunction, and gallstone disease among type 2 diabetics in Chinese population: A community-based study in Kinmen, Taiwan

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World Journal of Gastroenterology 2005年第45期11卷 7159-7164页

作者： Chi-Ming Liu Tao-Hsin Tung Shih-Tzer Tsai Jorn-Hon Liu Yeh-Kuang Tsai Victor Tze-Kai Chen Tseng-Nip Tam Hsu-Feng Lu Kuang-Kuo Wang Chung-Te Hsu Hui-Chuan Shih De-Chuan Chan pesus chou Community Medicine Research Center and Institute of Public Health National Yang-MingUniversity Cheng Hsin General Hospital Taipei Taiwan China Department of medicine Veterans GeneralHospital Taipei Taiwan China Cheng Hsin General Hospital Faculty ofMedicine School of Medicine National Yang-Ming UniversityTaipei Taiwan China University of California San Francisco SanFrancisco CA United States Cardinal Tien Hospital College ofMedicine Fu-Jen Catholic University National Defence MedicineCenter Taipei Taiwan China Cheng Hsin General Hospital Taipei Taiwan China Department of Nursing Kaohsiung MilitaryGeneral Hospital Kaohsing Taipei Taiwan China Division of General Surgery Tri-ServiceGeneral Hospital National Defence Medical Center TaipeiTaiwan China Community Medicine Research Center and Instituteof Public Health National Yang-Ming University Taipei TaiwanChina

AIM: To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease (GSD) in type 2 diabetics. METHODS: We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance (HOMA IR) and β-cell dysfunction (HOMA β-cell). RESULTS: We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% (26/187) among males and 14.7% (36/245) among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4th vs 1st quartile odds ratios (OR) = 4.46 (95%CI: 1.71-11.66)] and HOMA IR [4th vs 1st quartile OR = 4.46 (95%CI: 1.71-11.66)]. Better HOMA β-cell function was significantly related to decreased risk of GSD [4th vs 1st quartile OR = 0.16 (95%CI: 0.03-1.70)]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA β-cell was observed among males. CONCLUSION: Serum insulin, insulin resistance, and β-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.

关键词： Type 2 diabetes Gallstone disease Insulinresistance β-cell dysfunction Community-based study

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Long-term efficacy and safety of very-low-dose amiodarone treatment for the maintenance of sinus rhythm in patients with chronic atrial fibrillation after successful direct-current cardioversion

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Chinese Medical Journal 2006年第24期119卷 2030-2035页

作者： JONG Gwo-ping, CHANG Mu-hsin, CHANG Ting-chuan, chou pesus, FU Chong-yau, TIEN Li-yun,CHEN Chung-yin and MA Tso-chiang JONG Gwo-ping CHANG Mu-hsin CHANG Ting-chuan chou pesus FU Chong-yau TIEN Li-yun CHEN Chung-yin MA Tso-chiang Community Medical Research Center Institute of Public HealthNational Yang-Ming University and Division of CardiologyArmed Forces Taichung General Hospital Taipei China Community Medical Research Center and Institute of Public Health National Yang-Ming University Taipei China Institute of Public Health National Yang-Ming University TaipeiChina Division of Cardiology Kuang-Tien General Hospital TaichungChina Department of Health Service Management China Medical University Taichung China

Background Long-term maintenance of sinus rhythm after successful conversion of chronic atrial fibrillation （CAF）, often ameliorates patients＇ symptoms, reduces the risk of ischemic stroke and improves cardiovascular hemodynamics. This prospective study aims to evaluate the long-term efficacy and safety of very low-dose amiodarone （100 mg daily） for the maintenance of sinus rhythm after successful direct-current （DC） cardioversion in patients with CAF and rheumatic heart disease （RHD） post intervention. Methods This study was a randomized prospective trial. One day after successful DC cardioversion （remained normal sinus rhythm） in patients with CAF and RHD post intervention for more than six months and adequate anticoagulation, all were randomly administered either amiodarone 200 mg daily in group A or amiodarone 100 mg dally in group B. Results A total of 76 patients （40 men and 36 women） were examined from February 1998 to December 1999. The mean age of the patients was （664- 10） years, and the mean follow-up was （674-8） months （range 61 to 84 months）. Actuarial rates of the maintenance of sinus rhythm were similar in the two groups after 5 years of follow-up. Four patients （11%） in group A but none in group B experienced significant adverse effects that necessitated withdrawal of amiodarone. No death occurred during the study period. Conclusion A very low dose of amiodarone results in adequate long-term efficacy and is safe for maintaining sinus rhythm in patients with CAF and RHD post intervention after successful DC cardioversion.

关键词： chronic atrial fibrillation rheumatic heart disease cardioversion very low-dose amiodarone

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Reduced bile duct contractile function in rats with chronic hyperglycemia

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Health 2010年第9期2卷 1072-1077页

作者： Chi-Ming Liu Hui-Chen Su Yen-Ting Wang Tao-Hsin Tung pesus chou Yiing-Jeng chou Jorn-Hon Liu Jan-Kan Chen 不详

The incidence of gallstone is higher in patients with diabetes mellitus than in general popula- tion. It is generally attributed to hypomotility and lowered emptying function of the gallblad- der. In this study, we investigate if chronic hy- perglycemia is correlated with reduced contrac- tile function of the bile ducts in rat. Hypergly- cemic rats were induced by streptozotocin-nic-otinamide treatment. Hyperglycemic rats were sacrificed eight months after induction and bile ducts were removed for the subsequent studies. The bile duct contractility of the normal rats is consistently higher than that of the hypergly- cemic rats. The contractities were measured to be 5.5 ± 0.2 mg vs. 4.2 ± 0.1 mg without CCK stimulation, and 5.5 ± 0.3 mg vs. 7.9 ± 0.4 mg with CCK stimulation, respectively for hypergly-cemic and normal rats. There was no significant difference in plasma CCK concentration in hy- perglycemic rats and normal rats. The expres- sion of CCK-A receptor protein in the bile duct tissue was decreased in hyperglycemic rats compared with that of the normal rats, and it may, at least in part, responsible for a reduced contractility. A reduced bile duct motility may cause bile retention, and may be one of the factors predispose to gallstone formation in type 2 diabetes patients, which is characterized with chronic hyperglycemia.

关键词： Hyperglycemia Bile Duct Contractile

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A population-based follow-up study on gallstone disease among type 2 diabetics in Kinmen,Taiwan

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World Journal of Gastroenterology 2006年第28期12卷 4536-4540页

作者： Tao-Hsin Tung Hsiao-Man Ho Hui-Chuan Shih pesus chou Jorn-Hon Liu Victor TK Chen De-Chuan Chan Chi-Ming Liu Cheng Hsin Rehabilitation Medical Center TaipeiTaiwan National Taipei College of Nursing TaipeiTaiwanChina Department of Mathematics and Science Education National Taipei Teachers CollegeTaipeiTaiwanChina Department of Nursing Kaohsiung Military General HospitalKaohsiungTaiwan I-Shou University KaohsiungTaiwanChina Community Medicine Research Center & Institute of Public Health National Yang-Ming UniversityTaipeiTaiwanChina Cheng Hsin Rehabilitation Medical Center Faculty of Medicine School of MedicineNational Yang-Ming UniversityTaipeiTaiwanChina Cardinal Tien Hospital College of Medicine Fu-Jen Catholic University National Defence Medicine Center TaipeiTaiwanChina Division of General Surgery Tri-Service General HospitalNational Defense Medical CenterTaipeiTaiwanChina Community Medicine Research Center and Institute of Public Health National Yang-Ming UniversityTaipeiTaiwanChina

AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time abdominal ultrasound to examine the abdominal region after patients had fasted for at least eight hours. Screening, which was conducted in 2001, involved 848 patients diagnosed with type 2 diabetes. After exclusion of 63 subjects with prevalent GSD, 377 participants without GSD were invited in 2002 for a second round of screening. A total of 281 （74.5%） subjects were re-examined. RESULTS： Among the 281 type 2 diabetics who had no GSD at the first screening, 10 had developed GSD by 2002. The incidence was 3.56% per year （95%CI： 1.78% per year-6.24% per year）. Using a Cox regression model, age （RR = 1.07, 95% CI： 1.00-1.14）, waist circumference （RR = 1.12, 95% CI： 1.01-1.29）, and ALT （RR = 1.13, 95%CI： 1.01-1.26） appeared to be significantly correlated with development of GSD. CONCLUSION： Older age is a known risk factor for the development of GSD. Our study shows that greater waist circumference and elevated ALT levels are also associated with the development of GSD among type 2 diabetics in Kinmen.

关键词： Type 2 diabetes Gallstone disease Incidence density Population-based study

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Clinical correlation of gallstone disease in a Chinese population in Taiwan:Experience at Cheng Hsin General Hospital

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World Journal of Gastroenterology 2006年第8期12卷 1281-1286页

作者： Chi-Ming Liu Tao-Hsin Tung pesus chou Victor Tze-Kai Chen Chung-Te Hsu Wu-Shyong Chien Yeu-Tyng Lin Hsu-Feng Lu Hui-Chuan Shih Jorn-Hon Liu Community Medicine Research Center & Institute of Public Health National Yang-Ming University Cheng Hsin General Hospital Taipei Taiwan China Community Medicine Research Center & Institute of Public Health National Yang-Ming University Taipei TaiwanChina Cardinal Tien Hospital College of Medicine Fu-Jen Catholic University National Defence Medicine Center Taipei Taiwan China Department of Nursing Kaohsiung Military General Hospital Kaohsiung Taiwan China Faculty of Medicine School of Medicine National Yang-Ming University Cheng Hsin General Hospital TaipeiTaiwan China

AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.

关键词： Cross-sectional study Gallstone disease Prevalence Risk factors

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Cost-benefit analysis of screening for diabetic retinopathy among Chinese type 2 diabetes: decision from different perspectives of a population-based study

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Health 2009年第4期1卷 304-312页

作者： Ching-Ching Peng pesus chou Tao-Hsin Tung Wu-Hsiung Chien Fenq-Lih Lee Shih-Jen Chen Shih-Tzer Tsai Chi-Ming Liu Jorn-Hon Liu 不详

The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the popula-tion-based study in Kinmen, Taiwan. A total of 971 community dwelling adults previously di-agnosed with type 2 diabetes in 1991-1993 un-derwent DR screening in 1999-2002 by a panel of ophthalmologists using on-site indirect oph-thalmoscopy and 45-degree color fundus retinal photographs. The cost-benefit analysis is used to evaluate the DR screening. In terms of bene-fit-cost ratio, the different screening programs for DR could save New Taiwan Dollars (NTD) from 14.38 to 36.83 in discounted costs for each dollar incurred in different screening years from the societal viewpoint for Taiwan and save NTD from 0.81 to 1.80 in different screening years from health care payer’s perspective. The av-erage estimate of willingness-to-pay to translate into benefit yields NTD from 937.8 to 4,689 be- nefits per case due to DR screening in different screening years during 10-year follow-up. The net present value of the DR screening were NTD from -167,318 to -307,251.2 in different screening years. In conclusion, it is worthwhile to initial a routine DR screening of Chinese type 2 diabetes for blindness prevention from the societal per-spective but not from consumer decision based on the willingness-to-pay perspective.

关键词： Type 2 Diabetes Diabetic Retinopathy Cost-Benefit Analysis Population-Based Study

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Reduced bile duct contractile function in rats with chronic hyperglycemia

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Health（健康） 2010年第9期

作者： Chi-Ming Liu Hui-Chen Su Yen-Ting Wang Tao-Hsin Tung pesus chou Yiing-Jeng chou Jorn-Hon Liu Jan-Kan Chen

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基于心肌灌注显像评估心肌基质特征与心脏再同步治疗后心肌逆向重塑表现的关系

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中华核医学与分子影像杂志 2017年第5期37卷 320-320页

作者： Kuo-Feng Chiang Chien-Ming Cheng Shih-Chuan Tsai Wan-Yu Lin Yu-Cheng Chang Jin-Long Huang Guang-Uei Hung Chia-Hung Kao Shih-Ann Chen pesus chou Ji Chen Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan Department of Biomedical Imaging and Radiological Sciences, China Medical University, Taichung, Taiwan Department of Biomedical Imaging and Radiological Sciences China Medical UniversityTaichungTaiwan Department of Nuclear Medicine Chang Bing Show Chwan Memorial Hospital 华中科技大学同济医学院附属协和医院核医学科

目的心脏再同步治疗(CRT)能产生心肌逆向重塑(RR), 其中可能包括机械逆向重塑(MRR)和(或)电逆向重塑(ERR)。然而, MRR和ERR却未必相伴相生, 且其机制尚不清楚。该研究旨在评价基于心肌灌注显像(MPI)评估的心肌基质特征与心脏再同步治疗... 详细信息

目的心脏再同步治疗(CRT)能产生心肌逆向重塑(RR), 其中可能包括机械逆向重塑(MRR)和(或)电逆向重塑(ERR)。然而, MRR和ERR却未必相伴相生, 且其机制尚不清楚。该研究旨在评价基于心肌灌注显像(MPI)评估的心肌基质特征与心脏再同步治疗后心肌RR表现的关系。方法 41例患有心力衰竭的患者, 男26例, 女15例, 平均年龄(66±10)岁, 接受为期至少12个月的CRT。依据其心肌RR的表现分为3组:组Ⅰ, MRR和ERR[左室收缩末期容积(ESV)降低≥15%和固有QRS持续时间减少≥10 ms);组Ⅱ, 仅有MRR(ESV降低≥15%);组Ⅲ, 无应答者(其他)。所有患者还需在CRT短暂停止后进行MPI, 以评价心肌固有基质, 包括心肌瘢痕面积、左室体积和功能、收缩的不同步性以及激活顺序。此外, 还记录了随访期间由CRT装置所检测到的室性心动过速(VT)和心室纤维性颤动(VF)。结果 MPI定量分析显示, 组Ⅰ(n=15), 组Ⅱ(n=16)和组Ⅲ(n=10)的瘢痕负荷分别为(15.9±9.5)%、(26.8±16.1)%和(45.6±15.1)%, P<0.001;左室舒张末期容积分别为(136.6±64.9)、(221.6±123.9)和(351.8±216.3) ml, P=0.002;ESV分别为(82.6±59.8)、(172.3±117.2)和(293.3±209.6) ml, P=0.001;左室射血分数分别为(44.9±15.0)%、(25.6±10.9)%和(21.5±11.7)%, P<0.001;收缩期相位SD分别为(23.4±10.3)°、(36.0±16.2)°和(57.0±22.2)°, P<0.001;带宽分别为(72.5±31.1)°、(113.4±56.4)°和(199.1±90.1)°, P<0.001;所有参数差异均有统计学意义。心肌瘢痕干扰机械活动的正常传导, 并导致异相激活顺序。与组Ⅱ(仅有MRR)相比, 组Ⅰ(ERR和MRR)具有显著较少的初始活化片段(1.9±1.0和2.6±0.7, P<0.05)和较短的最大收缩延迟[(46.9±12.9)°和(58.8±18.5)°, P<0.05]。随访期间, 21例次发生了VT或VF, 包括组Ⅰ中仅1例(6.7%)患者(室性心动过速), 组Ⅱ有8例(50%)患者(7例VT和1例VF), 和组Ⅲ中的9例(90%)患者(7例VT和5例VF)。结论通过MPI评估心肌基质特征在CRT后不同的心脏RR表现之间存在显著差异。心肌瘢痕在ERR的发展中起重要作用。不同的心脏RR水平是导致室性心律失常发病率不同的主要原因, ERR和MRR的组合提供了最强的抗心律失常作用。

关键词：心脏再同步化逆向重塑心肌基质心肌灌注显像室性心律失常

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