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Biliopleural fistula: A rare complication of percutaneous transhepatic gallbladder drainage

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World Journal of Gastroenterology 2007年第23期13卷 3268-3270页

作者： Ming-Tsung lee Sheng-Chuan hsi Philip Hu Kuang-Yi Liu Division of General Surgery Department of Surgery Armed Forces Taoyuan General Hospital

A 79-year-old previously healthy man presented with acute acalculous cholecystitis with obstruction of the biliary tract. He was successfully treated with antibiotics and percutaneous transhepatic gallbladder drainage, but returned to the hospital two days after discharge with a rare complication of this technique, biliopleural fistula. A thoracostomy tube was inserted to drain the pleural effusion, and the patient’s previous antibiotics reinstated. After two weeks of drainage and antibiotics, the fistula healed spontaneously without the need for further intervention.

关键词： Biliopleural fistula Percutaneous transhepatic gallbladder drainage Cholecystitis Complications Biliary drainage

A three-year longitudinal study of the relation between left atrial diameter remodeling and atrial fibrillation ablation outcome

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Journal of Geriatric Cardiology 2018年第7期15卷 496-501页

作者： Hui-Ling lee Yi-Ting Hwang Po-Cheng Chang Ming-Shien wen Chung-Chuan Chou Department of Anesthesia Chang Gung Memorial Hospital Taipei Taiwan China Department of Statistics National Taipei University Taipei Taiwan China Division of Cardiology Department of Internal Medicine Chang Gung Memorial Hospital Taipei Taiwan China Chang Gung University College of Medicine Taoyuan Taiwan China

Background The long-term prognostic influence of left atrial diameter （LAD） remodeling on the status of post-radiofrequency catheter ablation （RI CA） atrial fibrillation （AF） is unclear. This study employed a two-stage model from 3-year echocardiographic data to ascertain whether the two-stage model predicts RFCA outcome more favorably than models using the baseline LAD. Methods Data were retrospectively collected from 263 consecutive patients with drug-refractory AF undergoing RFCA. Regular echocardiographic measurements of LAD were performed at baseline, 1, 3, 6, and 12 months and then every 6 months after RFCA. Sex, age, type of AF, number of RFCA, and AF status were recorded. We obtain the actual （predicted） 3-year LAD using a longitudinal linear mixed model （1st stage）. Logistic regression models based on the baseline LAD （Model 1）, actual （predicted） 3-year LAD （Model 2）（2nd stage）, and observed 3-year LAD （Model 3） were constructed to predict RFCA outcome. The area under the receiver operating characteristic curve （AUC） were used to assess the performance of models. Results The lowess smoothed curve indicated that the LAD declined over the first three months and remained stable up to 36 months after RFCA. The degree of LAD reduction was significantly influenced by the baseline LAD. Non-paroxysmal AF, large LAD and female gender were significant predictors of AF recurrence. Model 2 had the largest AUC among the three models. Conclusions This longitudinal study-based two-stage model outperforms the original logistic model using the baseline LAD. Non-paroxysmal AF, larger LAD and female gender are significant predictors of RFCA failure.

关键词： Atrial fibrillation Left atrial diameter Longitudinal data Radiofrequency catheter ablation Two-stage model

Fructose promotes pyoluteorin biosynthesis via the CbrAB-CrcZ-Hfq/Crc pathway in the biocontrol strain Pseudomonas PA1201

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Synthetic and Systems Biotechnology 2023年第4期8卷 618-628页

作者： Ying Cui Kai Song Zi-Jing Jin Learn-Han lee Chitti Thawai Ya-wen He State Key Laboratory of Microbial Metabolism Joint International Research Laboratory of Metabolic and Developmental SciencesSchool of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghai200240China Novel Bacteria and Drug Discovery Research Group(NBDD) Microbiome and Bioresource Research Strength(MBRS)Jeffrey Cheah School of Medicine and Health SciencesMonash University MalaysiaBandar SunwaySelangor Darul Ehsan47500Malaysia Department of Biology Faculty of ScienceKing Mongkut’s Institute of Technology LadkrabangBangkok10520Thailand

Biocontrol strain Pseudomonas PA1201 produces pyoluteorin(Plt),which is an antimicrobial secondary *** represents a promising candidate pesticide due to its broad-spectrum antifungal and antibacterial *** PA1201 contains a complete genetic cluster for Plt biosynthesis,it fails to produce detectable level of Plt when grown in media typically used for Pseudomonas *** this study,minimum medium(MM)was found to favor Plt *** the medium M,which contains all the salts of MM medium except for mannitol,as a basal medium,we compared 10 carbon sources for their ability to promote Plt ***,mannitol,and glycerol promoted Plt biosynthesis,with fructose being the most effective carbon *** or succinic acid had no significant effect on Plt biosynthesis,but effectively antagonized fructose-dependent synthesis of ***-lacZ fusion reporter strains demonstrated that fructose acted through activation of the pltLABCDEFG(pltL)operon but had no effect on other genes of plt gene cluster;glucose or succinic acid antagonized fructose-dependent pltL ***,fructose-mediated Plt synthesis involved carbon catabolism *** two-component system CbrA/CbrB and small RNA catabolite repression control Z(crcZ)were essential for fructose-induced Plt *** small RNA binding protein Hfq and Crc negatively regulated fructose-induced *** together,this study provides a new model of fructose-dependent Plt production in PA1201 that can help improve Plt yield by biosynthetic approaches.

关键词： Pseudomonas Biocontrol Pyoluteorin Fructose Carbon catabolism repression

Local inhibition of matrix metalloproteinases reduced M2 macrophage activity and impeded recovery in spinal cord transected rats after treatment with fibroblast growth factor-1 and nerve grafts

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Neural Regeneration Research 2018年第8期13卷 1447-1454页

作者： Chuan-wen Chiu wen-Hung Huang Huai-Sheng Kuo May-Jywan Tsai Ching-Jung Chen Meng-Jen lee Henrich Cheng Department and Institute of Pharmacology National Yang-Ming University Taipei Taiwan China Neural Regeneration Laboratory Department of Neurosurgery Neurological Institute Taipei Veterans General Hospital Taipei Taiwan China Department of Applied Chemistry Chaoyang University of Technology Taichung Taiwan China Center for Neural Regeneration Department of Neurosurgery Neurological Institute Taipei Veterans General Hospital Taipei Taiwan China

Alternatively activated macrophages （M2 macrophages） promote central nervous system regeneration. Our previous study demonstrated that treatment with peripheral nerve grafts and fibroblast growth factor-1 recruited more M2 macrophages and improved partial functional recovery in spinal cord transected rats. The migration of macrophages is matrix metalloproteinase （MMP） dependent. We used a general inhibitor of MMPs to influence macrophage migration, and we examined the migration of macrophage populations and changes in spinal function. Rat spinal cords were completely transected at Ts, and 5 mm of spinal cord was removed （group T）. In group R, spinal cord-transected rats received treatment with fibroblast grow th factor- 1 and peripheral nerve grafts. In group RG, rats received the same treatment as group R with the addition of 200 μM GM6001 （an MMP inhibitor） to the fibrin mix. We found that MMP-9, but not MMP- 2, was upregulated in the graft area of rats in group R. Local application of the MMP inhibitor resulted in a reduction in the ratio of arginase-1 （M2 macrophage subset）/inducible nitric oxide synthase-postive cells. When the MMP inhibitor was applied at 8 weeks postoperation, the partial functional recovery observed in group R was lost. This effect was accompanied by a decrease in brain-derived neurotrophic factor levels in the nerve graft. These results suggested that the arginase-1 positive population in spinal cord transected rats is a migratory cell population rather than the phenotypic conversion of early iNOS^＋ cells and that the migration of the arginase-1^＋ population could be regulated locally. Simultaneous application of MMP in- hibitors or promotion of MMP activity for spinal cord injury needs to be considered if the coadministered treatment involves M2 recruitment.

关键词： spinal cord injury fibroblast growth factor-1 matrix metalloproteinase GM6001 macrophage

Assessment of post-harvest fish losses Croaker Pseudotolithus elongatus,(Bowdich,1825),Catfish Arius heudeloti,(Valenciennes,1840)and Shrimp Nematopalaemon hastatus(Aurivillius,1898)in Ondo State,Nigeria

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Aquaculture and Fisheries 2018年第5期3卷 209-216页

作者： Olusumbo Adeolu Adelaja Roslina Binti Kamaruddin lee wen Chiat School of Economics Finance and BankingCollege of BusinessUniversiti Utara MalaysiaMalaysia

The study assess post-harvest fish losses among three(3)dominant marine fish species along coastal areas of Ondo State,*** random sampling was used to select 100 fishermen from 5 viable fishing communities along coastal areas of Ondo State while questionnaire was used for data *** statistics shows that small-scale fishing is dominated by males with mean age of 39 *** fishermen incurred average post-harvest fish losses of 8.15%for croaker,7.76%for catfish and 7.57%for shrimp *** of post-harvest fish losses in the study area includes lengthy duration of fishing cycle,poor handling practices,lack of covering facilities,failure to use ice,lack of storage facilities and lack of good means of *** model revealed a statistical significant relationship(P<0.05)with age,educational level,fishing experience,duration of fishing cycle,storage and transportation facilities against percentage fish losses(Croaker:Pseudotolithus elongatus,Catfish:Arius heudeloti and Shrimp:Nematopalaemon hastatus).In order to ensure food security,post-harvest fish losses needs to be reduced to the barest *** should provide adequate infrastructural facilities to the small-scale fisheries sector in order to improve their standard of living and increase their income level.

关键词： Post-harvest fish losses Small-scale fishermen Food security Livelihood Fish species

Factors influencing communication of traditional Chinese medicine use between patients and doctors:A multisite cross-sectional study

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Journal of Integrative Medicine 2019年第6期17卷 396-403页

作者： wen Qiang lee Jeremy Teoh Pei Zheng Kenneth lee Zhi Xiong Gerard Low Xueling Sim Foong Fong Mary Chong Norbert Ludwig Wagner Yong Loo Lin School of Medicine National University of Singapore117597Singapore Saw Swee Hock School of Public Health National University of Singapore117549Singapore

Objective: In Singapore, the use of traditional Chinese medicine(TCM) alongside Western medicine(WM)is common. There are risks of adverse herb-drug interactions when taken concurrently. Current literature suggests that TCM use is not regularly reported to WM doctors in Singapore, but the underlying reasons are not ***: A cross-sectional study was conducted across Singapore by administering questionnaires to TCM-using patients and WM-practising general practitioners(GPs). The questionnaire examined the following themes:(1) demographics and TCM use pattern;(2) respondents'(patients and GPs) knowledge and beliefs about TCM and the factors influencing the discussion of TCM during the WM consultation;and(3) respondents' qualitative suggestions to increase disclosure ***: A total of 484 patients and 334 GPs were surveyed. Factors associated with patients' initiation of TCM discussion include length of consultation(odds ratio [OR]: 2.1;P < 0.001), comfort level in discussing TCM(OR: 1.6;P < 0.001) and belief in importance of discussion(OR: 1.4;P = 0.017). Doctor's initiation of discussion(74%) was the top patient-ranked factor influencing their discussion of TCM. For doctors,knowledge of TCM indications(OR: 2.2;P < 0.001), belief in importance of discussion(OR: 2.1;P < 0.001) and comfort level in discussing TCM(OR: 1.9;P = 0.001) were associated with their initiation of TCM use discussion. Possible WM-TCM interactions(58%) was the top doctor-ranked factor influencing their discussion of ***: The discussion of TCM in a WM setting is multifactorial. Interventions include doctors' active screening for TCM use in patients and equipping doctors with TCM knowledge. Improving communication between patients and doctors is key to avoiding harmful herb-drug interactions.

关键词： Traditional Chinese medicine Western medicine Patient-provider communication Primary care General practice Public health

Effect of platinum on the photocatalytic degradation of chlorinated organic compound

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Journal of Environmental Sciences 2011年第4期23卷 687-692页

作者： Chih Ming Ma Ya wen lee Gui Bing Hong Te Li Su Je Lueng Shie Chang Tang Chang Department of Cosmetic Application and Management St. Mary's Medicine Nursing and Management College Yilan County 266 Taiwan China. Department of Environmental Engineering I-Lan University Yilan City 260 Taiwan China

TiO 2 nanoparticles, doped with different Pt contents, were prepared by a modified photodeposition method using Degussa P-25 TiO 2 , H 2 PtCl 6 ·6H 2 O and methanol as the solvents. The physicochemical properties of Pt/TiO 2 were investigated by the nitrogen adsorption and desorption isotherm measurement technique, X-ray diffraction analysis and photoluminescence spectra, respectively. Reaction rates from photocatalytic removal of dichloromethane over Degussa P-25 TiO 2 and Pt/TiO 2 were evaluated. The average diameter and BET surface area of the TiO 2 catalyst particles were 300 nm and 50 m 2 /g, respectively. The degradation efficiency was 99.0%, 82.7%, 55.2%, and 57.9% with TiO 2 at inlet concentrations of 50, 100, 200, and 300 ppm, respectively. And the degradation efficiency was 99.3%, 79.7%, 76.5%, and 73.4% with a 0.005 wt.% Pt/TiO 2 at inlet concentrations of 50, 100, 200, and 300 ppm, respectively. In addition, we found that the photoluminescence emission peak intensities decreased with increases in the doping amount of Pt, which indicates that the irradiative recombination was weakened. Furthermore, the results showed that the UV/0.005 wt.% Pt/TiO 2 process was capable of efficiently decomposing gaseous DCM in air.

关键词： dichloromethane photodeposition method platinum TiO 2 light intensity

Incidence trends and predictors for cost and average lengths of stay in colorectal cancer surgery

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World Journal of Gastroenterology 2014年第2期20卷 532-538页

作者： Daw-Shyong Perng I-Cheng Lu Hon-Yi Shi Chih-wen Lin Kuang-wen Liu Ya-Fen Su King-Teh lee Department of Medicine E-Da Hospital I-Show University Graduate Institute of Healthcare Administration Kaohsiung Medical University Division of Colorectal Surgery Department of SurgeryE-Da Hospital

AIM:To evaluate the changing trends and outcomes of colorectal cancer(CRC)surgery performed at a large single institution in ***:This study retrospectively analyzed 778patients who received colorectal cancer surgery at E-Da Hospital in Taiwan from 2004 to *** patients were from health examination,inpatient or emergency *** following attributes were analyzed in patients who had undergone CRC surgical procedures:gender,age,source,surgical type,tumor number,tumor size,number of lymph node metastasis,pathologic differentiation,chemotherapy,distant metastases,tumor site,tumor stage,average hospitalization cost and average lengths of stay(ALOS).The odds ratio and95%confidence intervals were calculated to assess the relative rate of *** models were employed to predict average hospitalization cost and ***:The study sample included 458(58.87%)males and 320(41.13%)females with a mean age of64.53 years(standard deviation,12.33 years;range,28-86 years).The principal patient source came from inpatient and emergency room(96.02%).The principal tumor sites were noted at the sigmoid colon(35.73%)and rectum(30.46%).Most patients exhibited a tumor stage of 2(37.28%)or 3(34.19%).The number of new CRC surgeries performed per 100000 persons was12.21 in 2004 and gradually increased to 17.89 in 2009,representing a change of 46.52%.During the same period,the average hospitalization cost and ALOS decreased from$5303 to$4062 and from 19.7 to 14.4 d,*** following factors were associated with considerably decreased hospital resource utilization:age,source,surgical type,tumor size,tumor site,and tumor ***:These results can be generalized to patient populations elsewhere in Taiwan and to other countries with similar patient profiles.

关键词： Colorectal cancer Average hospitalization cost Average lengths of stay Incidence trend Colorectal cancer surgery

Routine defunctioning stoma after chemoradiation and total mesorectal excision:A single-surgeon experience

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World Journal of Gastroenterology 2013年第11期19卷 1797-1804页

作者： Shao-Chieh Lin Po-Chuan Chen Chung-Ta lee Hong-Ming Tsai Peng-Chan Lin Helen HW Chen Yuan-Hwa Wu Bo-wen Lin wen-Pin Su Jenq-Chang lee Division of Colorectal Surgery Department of SurgeryNational Cheng Kung University HospitalCollege of Medicine National Cheng Kung University Tainan 704Taiwan Department of Pathology National Cheng Kung University HospitalCollege of Medicine Department of Radiology National Cheng Kung University HospitalCollege of Medicine Department of Oncology National Cheng Kung University HospitalCollege of Medicine Department of Radiation Oncology National Cheng Kung University HospitalCollege of Medicine

AIM:To investigate the 10-year results of treating low rectal cancer by a single surgeon in one ***:From Oct 1998 to Feb 2009,we prospectively followed a total of 62 patients with cT2-4 low rectal cancer with lower tumor margins measuring at 3 to 6 cm above the anal *** patients received neoadjuvant chemoradiation(CRT) for 6 *** them,85% of the patients received 225 mg/m2/d 5-fluorouracil using a portable infusion *** whole pelvis received a total dose of 45 Gy of irradiation in 25 fractions over 5 *** interval from CRT completion to surgical intervention was planned to be approximately 6-8 *** mesorectal excision(TME) and routine defunctioning stoma construction were performed by one *** distal resection margin,circumferential resection margin,tumor regression grade(TRG) and other parameters were *** used TRG to evaluate the tumor response after neoadjuvant *** evaluated anal function outcomes using the Memorial Sloan-Kettering Cancer Center anal function scores after closure of the defunctioning ***:The median distance from the lower margin of rectal cancer to the anal verge was 5 cm:6 cm in 9 patients,5 cm in 32 patients,4 cm in 10 patients,and 3 cm in 11 *** receiving neoadjuvant CRT,45 patients(72.6%) had a cT3-4 tumor,and 21(33.9%) patients had a cN1-2 lymph node *** CRT,30 patients(48.4%) had a greater than 50% clinical reduction in tumor *** final pathology reports revealed that 33 patients(53.2%) had a ypT3-4 tumor and 12(19.4%) patients had ypN1-2 lymph node *** patients completed the entire course of neoadjuvant *** patients developed only Grade 1-2 toxicities during *** patients(21%) achieved a pathologic complete *** post-operative complications *** 90% of the defunctioning stomas were closed within 6 *** local recurrence rate was 3.2%.Pathologic lymph node involvement was the only prognostic factor predicting

关键词： Rectal cancer Neoadjuvant chemoradiation Total mesorectal excision Pathologic complete response Defunctioning stoma