Journal of the Chinese Medical Association最新文献

{"title":"Is the relation between three comorbidities and carotid atherosclerosis dependent on the sum or not?","authors":"Yiu-Tai Li, Wen-Hsun Chang","doi":"10.1097/JCMA.0000000000000890","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000000890","url":null,"abstract":"","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 6","pages":"614"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9879580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes associated with hypertension exacerbated oxidative stress-mediated inflammation, apoptosis and autophagy leading to erectile dysfunction in rats: Erratum.","authors":"","doi":"10.1097/JCMA.0000000000000926","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000000926","url":null,"abstract":"","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 6","pages":"619"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9956613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive surgery for hepatocellular carcinoma.","authors":"Yiu-Tai Li, Szu-Ting Yang, Peng-Hui Wang","doi":"10.1097/JCMA.0000000000000915","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000000915","url":null,"abstract":"","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 5","pages":"457-458"},"PeriodicalIF":3.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10238467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on oxidative stress and inflammatory/antioxidant substance levels in autism spectrum disorder.","authors":"Masahito Morimoto,&nbsp;Toshiaki Hashimoto,&nbsp;Yoshimi Tsuda,&nbsp;Midori Suenaga,&nbsp;Toshimi Nakamura,&nbsp;Shinsuke Katoh","doi":"10.1097/JCMA.0000000000000917","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000000917","url":null,"abstract":"<p><strong>Background: </strong>The etiology of autism spectrum disorder (ASD) includes oxidative stress and brain inflammation. We investigated the relationship among oxidative stress markers, in vivo inflammatory substances, and antioxidants that can be easily measured in the clinic and compared them between children with ASD and those with typical development (TD).</p><p><strong>Methods: </strong>Sixty-one children with TD and 199 with untreated ASD were investigated. They were Japanese children aged 2-15 years and were divided into those aged <7 and ≥7 years. Serum levels of reactive oxygen metabolites (ROMs), high-sensitivity C-reactive protein (hsCRP), prolactin (PRL), albumin (Alb), total bilirubin (T-Bil), and uric acid (UA) were measured. These measurements were compared between TD and ASD, and the relationship between oxidative stress and relevant laboratory parameters was analyzed.</p><p><strong>Results: </strong>The hsCRP and PRL levels were significantly higher in patients with ASD than in those with TD. Among those aged <7 years, hsCRP and PRL were significantly higher in those with ASD than in those with TD. Among those aged ≥7 years, ROMs, hsCRP, and PRL were significantly higher in those with ASD than in those with TD. In ASD, ROMs were significantly correlated with hsCRP, Alb, T-Bil, and PRL. In contrast, no significant correlations were found in the TD group except for the relationship between ROMs and hsCRP in those aged <7 years.</p><p><strong>Conclusion: </strong>The results suggest that serum levels of in vivo inflammatory substances, stress-related substances, and antioxidants are altered in ASD under oxidative stress.</p>","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 5","pages":"489-493"},"PeriodicalIF":3.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9880102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of the hemodynamic and clinical effects of using or not tourniquet in total knee arthroplasty.","authors":"Shih-Hsin Hung,&nbsp;Fang-Yao Chiu,&nbsp;Ming-Fai Cheng","doi":"10.1097/JCMA.0000000000000914","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000000914","url":null,"abstract":"<p><strong>Background: </strong>Pneumatic tourniquet is widely used in lower limb surgery to provide a bloodless operating field. Previous studies on total knee arthroplasty (TKA) in which tourniquets have been applied during surgery have reported some vascular and soft-tissue complications. Nevertheless, it is still not well known exactly how use of tourniquets contributes to hemodynamics of the lower limb and its clinical relevance following TKA. In this prospective study, we wished to determine whether tourniquet affects the hemodynamics and postoperative healing of the lower limb in the first few weeks and its clinical relevancies following TKA.</p><p><strong>Methods: </strong>We prospectively collected consecutive 110 patients with advanced osteoarthritis of the knee. All the subjects were randomly assigned to one of two TKA procedures: TKA with (Group T) or without (Group O) tourniquets. The hemodynamics of each operated leg was assessed by Doppler, first before the operation, then postoperatively on days 2, 6, 14, and 28. The operative and postoperative managements were done the same as those described in the papers done by the author. Parameters during the operative and postoperative course, including, demography, pre- or postoperative knee score, tourniquet time, operation time, estimated blood loss, perioperative blood transfusion, hospital course, and complications will all be recorded and compared in detail. All patients were measured for all response variables, which included demographic variables, results of Doppler, and important surgical outcomes. Fisher's exact test was used to compare differences between the two groups for each discrete variable, and a Mann-Whitney Rank Sum Test was used to analyze each continuous variable. The p value was set for each test at 0.05 before analysis took place. In accordance with the repeated measures, the venous hemodynamic parameters were checked. If any significant differences appeared in the overall test, values were then compared in pairs using two sample t-tests for all statistical tests. The level of significance was set at p < 0.05.</p><p><strong>Results: </strong>In our 110 patients (55 with tourniquet, 55 without), all checked clinical parameter were without significant difference except postoperative quadriceps muscle recovery. This implied tourniquet use influenced postoperative rehabilitation program. Blood loss amount were similar in both groups. There was only one DVT found.</p><p><strong>Conclusion: </strong>Tourniquet use in TKA must be managed very carefully. Not only because of immediate complication resulted from tourniquet but also influence on post-operational functional recovery, especially in quadriceps muscle function. According to this study, TKA without tourniquet use preserves better quadriceps muscle function to provide faster recovery and less transfusion need. It avoids complications from tourniquets as well.</p>","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 5","pages":"529-533"},"PeriodicalIF":3.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9880089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The statistical significance may be misinterpreted.","authors":"Yiu-Tai Li,&nbsp;Wen-Hsun Chang","doi":"10.1097/JCMA.0000000000000874","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000000874","url":null,"abstract":"","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 5","pages":"534"},"PeriodicalIF":3.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9879572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of erythropoietin in neonates with hypoxic-ischemic encephalopathy receiving therapeutic hypothermia.","authors":"Tzu-Hua Lin,&nbsp;Chia-Huei Chen,&nbsp;Mary Hsin-Ju Ko,&nbsp;Jeng-Daw Tsai,&nbsp;Mei-Jy Jeng","doi":"10.1097/JCMA.0000000000000898","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000000898","url":null,"abstract":"<p><strong>Background: </strong>Minimizing multiple organ dysfunction-related mortality and morbidity is a critical issue for patients with hypoxic-ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH). Although erythropoietin (EPO) has demonstrated protective effects on various hypoxic-ischemic organs in animal studies and clinical trials in adults, its effects on neonates with HIE require further investigation.</p><p><strong>Methods: </strong>This study retrospectively analyzed the medical records of neonates with HIE who received TH with or without EPO (TH+EPO vs TH groups) administration in a tertiary referral hospital from January 2016 to January 2021. Data regarding patient characteristics, medical treatment, and clinical (neurological, cardiac, respiratory, gastrointestinal, hepatic, and renal) function assessments were collected. To control for confounding factors and selection bias between the two groups, a 1:1 propensity matching method was applied.</p><p><strong>Results: </strong>A total of 45 neonates with HIE received TH during the study period, with 24 patients (53%) in the TH+EPO group. After matching, each group enrolled 13 cases. No significant difference in mortality or hospital stay between the two groups was noted. During the first 3 days, the patients in the TH+EPO group showed significantly higher blood pressure (BP) than those in the TH group ( p < 0.05 on day 1). The TH+EPO group showed trends of higher blood hemoglobin ( p > 0.05) and creatinine ( p > 0.05) levels and lower estimated glomerular filtration rate ( p > 0.05) and urine output ( p > 0.05) during the first 2 weeks than TH group.</p><p><strong>Conclusion: </strong>The use of EPO in addition to TH is safe for neonates with HIE. The neonates with moderate or severe HIE who received EPO may have a lesser risk of hypotension than those who received TH alone. Further clinical studies on renal and cardiac functions and long-term neurological effects of EPO are required.</p>","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 5","pages":"515-522"},"PeriodicalIF":3.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10256210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced prognostic value of combined circulating tumor cells and serum carcinoembryonic antigen in patients with colorectal cancer.","authors":"Chih-Yung Yang,&nbsp;Chun-Chi Lin,&nbsp;Sheng-Chieh Huang,&nbsp;Ruey-Hwa Lu,&nbsp;Liang-Chuan Lo,&nbsp;Ju-Yu Tseng,&nbsp;Chien-Yi Tung,&nbsp;Chi-Hung Lin,&nbsp;Jeng-Kai Jiang","doi":"10.1097/JCMA.0000000000000906","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000000906","url":null,"abstract":"<p><strong>Background: </strong>Circulating tumor cells (CTCs) have been investigated as a potential biomarker for predicting prognosis and monitoring therapeutic responses in colorectal cancer (CRC). However, the sensitivity of CTCs detection is low, thus limiting the clinical utility of CTCs. We aim to examine the clinicopathological parameters that improve prognosis prediction for CRC using CTCs as a biomarker.</p><p><strong>Methods: </strong>We enumerated CTCs in 186 CRC patients and associated the number of CTCs with the clinicopathological features and overall survival (OS) using a univariate and multivariate Cox regression model and Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>The presence of CTCs from 186 CRC patients was significantly associated with stage, preoperational carcinoembryonic antigen (CEA), and CA19-9 levels. Using Kaplan-Meier survival and Cox regression analysis, patients with five or more CTCs exhibited significantly worse OS compared to patients with fewer than five CTCs. The combination of CTCs with tumor marker CEA has a better OS prediction than individual CTCs or CEA and serves as a more effective prediction model in patients with CRC.</p><p><strong>Conclusion: </strong>We identified that patients with more than five CTCs exhibited significantly worse OS. Additionally, patients with the normal level of CEA, but who also had more than five CTCs trended towards a worse OS.</p>","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 5","pages":"465-471"},"PeriodicalIF":3.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9879615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of N-terminal-pro-brain natriuretic peptide with postoperative outcomes of older patients undergoing transcatheter aortic valve replacement.","authors":"Ying-Ching Huang,&nbsp;Hsiao-Huang Chang,&nbsp;Po-Lin Chen,&nbsp;Chi-Ming Chu,&nbsp;Jen-Chen Tsai,&nbsp;Kwua-Yun Wang","doi":"10.1097/JCMA.0000000000000916","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000000916","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing transcatheter aortic valve replacement surgery (TAVR) are typically older adults with multiple chronic diseases and therefore have a high surgical risk. The N-terminal of brain natriuretic peptide (BNP) and pro-BNP, referred to as NT-pro-BNP, is an easily measurable biomarker of heart failure. Studies on correlation between higher NT-pro-BNP levels and adverse prognoses after TAVR have yielded inconsistent results. Here, we investigated whether preoperative NT-pro-BNP levels are correlated with outcomes among older adults undergoing TAVR.</p><p><strong>Methods: </strong>This retrospective study included older adults with severe aortic stenosis (AS) who received TAVR from a medical center between January 2013 and June 2017. The patients' demographics, preoperative laboratory data, postoperative complications, and 1-year mortality were recorded. They were divided into two groups based on their preoperative NT-pro-BNP levels. The post-TAVR outcomes in the two groups were analyzed using a multivariate logistic regression analysis of the binary results.</p><p><strong>Results: </strong>Of the 132 patients included (mean age: 81.5 ± 8.1 years; 47% men), 96 (72.7%) had preoperative NT-pro-BNP levels ≤ 4853 ng/L, and 36 (27.3%) had preoperative NT-pro-BNP levels > 4853 ng/L. The postoperative outcomes were significantly better in the NT-pro-BNP≤4853 group than in the NT-pro-BNP>4853 group: postoperative extracorporeal membrane oxygenation fittings (4.2% vs 16.7%, p = 0.025), number of days in hospital (17.5 ± 21.0 vs 27 ± 17.0, p = 0.009), in-hospital mortality (4.2% vs 16.7%, p = 0.025), and 1-year mortality (11.5% vs 38.9%, p = 0.001); the significant differences persisted after controlling for other variables.</p><p><strong>Conclusion: </strong>For older patients undergoing TAVR with NT-pro-BNP levels > 4853 ng/L, their postoperative outcomes and 1-year mortality were correlated. Thus, NT-pro-BNP is useful for the risk assessment of patients undergoing TAVR and should be regarded as a biomarker in future risk assessments.</p>","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 5","pages":"479-484"},"PeriodicalIF":3.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9880103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it possible that advanced-stage gastric cancer patients can be cured by surgery alone?: Erratum.","authors":"","doi":"10.1097/JCMA.0000000000000920","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000000920","url":null,"abstract":"","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 5","pages":"538"},"PeriodicalIF":3.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9781891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}